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1.
Rev. enferm. UERJ ; 28: e35224, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1096015

RESUMO

Objetivo: investigar a atuação dos enfermeiros frente à amamentação cruzada e correlacionar com a atual questão da precarização do trabalho. Método: estudo qualitativo do tipo descritivo com base metodológica de análise do discurso, realizado com seis enfermeiras da Estratégia de Saúde da Família (ESF) por meio de um grupo focal. Resultados: o tema amamentação cruzada é apresentado como um indicador de conflitos ético-profissionais no processo de trabalho, expressando-se nos seguintes aspectos: conhecimento das prescrições de contraindicação, sensação de dificuldade em intervir e transferência à nutriz por qualquer dano à saúde da criança. Considerações finais: no cotejo entre esses resultados e uma organização de trabalho com normas e rotinas institucionalizadas, discutem-se como efeitos da não utilização de técnicas de aconselhamento, a fragilização da autonomia da nutriz, de forma imperceptível, reproduzidas por enfermeiros na assistência.


Objective: to investigate nurses' role related to cross-breastfeeding and to correlate with the current issue of precarious work.Method: descriptive andqualitative study based on methodological discourse analysis, carried out with six nurses from Estratégia de Saúde da Família (ESF) Program through a focus group. Results: cross-breastfeeding topic is presented as an indicator of ethical-professional conflicts in the work process, expressing itself in the following aspects: knowledge of prescriptions of contraindication, feeling of difficulty in intervening and transference to the nursing mother for any harm to the child's health. Final considerations: in the comparison between these results and a work organization with institutionalized norms and routines, we discuss the effects of not using counseling techniques, the fragility of nurses' autonomy, imperceptibly reproduced by nurses in care.


Objetivo: investigar el papel de las enfermeras relacionadas con la lactancia cruzada y su correlación con el tema actual del trabajo precario. Método: estudio descriptivo y cualitativo basado en el análisis metodológico del discurso, realizado con seis enfermeras del Programa Estratégia de Saúse da Familia (ESF) através de un grupo focal. Resultados: el tema de la lactancia cruzada se presenta como un indicador de conflictos ético-profesionales en el proceso de trabajo, expresándose en los siguientes aspectos: conocimiento de prescripciones de contraindicación, sensación de dificultad para intervenir y transferencia a la madre lactante por cualquier daño a la salud del niño Consideraciones finales: en la comparación entre estos resultados y una organización de trabajo con normas y rutinas institucionalizadas, discutimos los efectos de no utilizar técnicas de asesoramiento, la fragilidad de la autonomía de las enfermeras, reproducida imperceptiblemente por las enfermeras bajo cuidado.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde/ética , Condições de Trabalho , Aleitamento Materno , Papel do Profissional de Enfermagem , Estratégia Saúde da Família , Contraindicações , Relações Trabalhistas , Brasil , Competência Clínica , Grupos Focais , Pesquisa Qualitativa
2.
Rev. enferm. UERJ ; 28: e42793, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1118060

RESUMO

Objetivo: descrever a elaboração de protocolo para a identificação do paciente com transtorno mental agudo. Método: estudo exploratório e qualitativo, realizado de maio 2018 a janeiro 2019, por meio das etapas: revisão integrativa da literatura, questionário online respondido por 17 profissionais de saúde vinculados à Sociedade Brasileira para a Qualidade do Cuidado e Segurança do Paciente, e grupo focal com 04 especialistas em Saúde Mental. Para tratamento dos dados, utilizou-se a análise descritiva e comparativa. Resultados: na revisão não se encontraram artigos sobre identificação do paciente com transtorno mental agudo. Na consulta aos especialistas da segurança do paciente identificou-se que 82,3% não possuíam em suas instituições protocolo específico. No grupo focal evidenciou-se dificuldade na identificação deste paciente. Conclusão: acreditase que o protocolo com a inserção da pulseira fotográfica apresenta-se como uma ferramenta inovadora na redução de riscos associados à identificação deste paciente.


Objective: to describe the development of a protocol for identification of patients with acute mental disorders. Method: this qualitative exploratory study was carried out from May 2018 to January 2019 through an integrative literature review, an online questionnaire answered by 17 health personnel belonging to the Brazilian Society for Quality of Care and Patient Safety, and a focus group of four mental health experts. Results: no articles specifically on identification for patients with acute mental disorders were found in the review. The consultation of patient safety experts found that 82.3% had no specific protocol in their institutions. The focal group highlighted difficulties communicating with these patients. Conclusion: the protocol including the photographic bracelet is believed to constitute an innovative tool for reducing risks associated with identification of these patients.


Objetivo: describir el desarrollo de un protocolo para la identificación de pacientes con trastornos mentales agudos. Método: este estudio exploratorio cualitativo se realizó de mayo de 2018 a enero de 2019 a través de una revisión integradora de la literatura, un cuestionario en línea respondido por 17 miembros del personal de salud pertenecientes a la Sociedad Brasileña de Calidad de Atención y Seguridad del Paciente, y un grupo focal de cuatro personas de salud mental expertos. Resultados: en la revisión no se encontraron artículos específicos sobre identificación de pacientes con trastornos mentales agudos. La consulta de expertos en seguridad del paciente encontró que el 82,3% no tenía un protocolo específico en sus instituciones. El grupo focal destacó las dificultades para comunicarse con estos pacientes. Conclusión: se cree que el protocolo que incluye la pulsera fotográfica constituye una herramienta innovadora para reducir los riesgos asociados a la identificación de estos pacientes.


Assuntos
Humanos , Sistemas de Identificação de Pacientes , Qualidade da Assistência à Saúde , Medidas de Segurança , Pessoas Mentalmente Doentes , Segurança do Paciente , Brasil , Inquéritos e Questionários , Grupos Focais , Pesquisa Qualitativa , Inovação
3.
Aust J Gen Pract ; 49(10): 625-629, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33015676

RESUMO

BACKGROUND: The availability of a COVID-19 vaccine is being heralded as the solution to control the current COVID-19 pandemic, reduce the number of infections and deaths and facilitate resumption of our previous way of life. OBJECTIVE: The aim of this article is to provide a framework for primary care of what will be needed to optimise COVID-19 vaccine confidence and uptake in Australia once the vaccine prioritisation schedule and key target groups are known. DISCUSSION: While a number of vaccines are currently under development, with at least seven undergoing phase III trials (28 August 2020), it is hoped that an effective COVID-19 vaccine will become available to the public in 2021. Ensuring public confidence in vaccine safety and effectiveness will be crucial to facilitate uptake. General practitioners are at the forefront of public health, and one of the most trusted sources for patients. In this article, the authors discuss the expedited vaccine development process for COVID-19 vaccines; the likely vaccine prioritisation schedule and anticipated key target groups; the behavioural and social drivers of vaccination acceptance, including the work required to facilitate this; and the implications for general practice.


Assuntos
Infecções por Coronavirus , Clínicos Gerais/psicologia , Programas de Imunização/organização & administração , Pandemias , Pneumonia Viral , Saúde Pública/métodos , Vacinação , Vacinas Virais/farmacologia , Austrália , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Grupos Focais , Acesso aos Serviços de Saúde/organização & administração , Humanos , Pandemias/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Atenção Primária à Saúde/métodos , Autoimagem , Vacinação/métodos , Vacinação/psicologia
4.
Arch. prev. riesgos labor. (Ed. impr.) ; 23(3): 330-342, jul.-sept. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194119

RESUMO

ANTECEDENTES: En abril de 2018 se detectó un número inusualmente elevado de síntomas irritativos de ojos, garganta y nariz, síntomas inespecíficos digestivos y mareos en trabajadores de los laboratorios de microbiología (LAM) y análisis clínicos (LAC) de un hospital de tercer nivel de Mallorca, asociados a olores también inhabituales. OBJETIVO: Confirmar la existencia del brote, identificar sus causas, y contribuir a su control y prevención. MÉTODOS: Estudio epidemiológico del brote con componentes cualitativo y cuantitativo. El primero se basó en la técnica de Grupos Focales. El estudio cuantitativo permitió elaborar las curvas epidémicas, en base a las visitas de los trabajadores por molestias al Servicio de Salud Laboral (SSL) y los episodios de incapacidad temporal (IT). Finalmente, se revisaron los informes higiénicos disponibles, valorando las posibles relaciones con la distribución de los casos. RESULTADOS: Mediante los grupos focales se establecieron dos definiciones operativas de caso, junto a la identificación de las posibles explicaciones del brote según las percepciones de los trabajadores. El estudio cuantitativo confirmó la existencia de un brote en el LAM, descartándolo en el LAC. Los episodios de IT en el LAM entre las semanas 16 y 39 excedieron en cuatro veces el número de casos esperados. El número de visitas al SSL también mostró un exceso de casos en las mismas semanas. CONCLUSIONES: El estudio cuantitativo confirma la existencia de un brote epidémico que ha finalizado, si bien el estudio cualitativo pone de manifiesto la continuación de los malos olores y molestias. La mejora de los sistemas de vigilancia epidemiológica facilitará la monitorización y control de otros posibles brotes en el futuro


BACKGROUND: In April 2018, an unusually high number of eye, throat and nose irritative symptoms, nonspecific gastrointestinal symptoms and dizziness were identified in workers in the microbiology (LAM) and clinical analysis (LCA) laboratories of a tertiary public hospital in Mallorca; these symptoms were also associated with perception of unusual odors. OBJECTIVE: To confirm the presence of an outbreak, identify its causes, and contribute to its prevention and control. METHODS: Epidemiological study of the outbreak involving qualitative and quantitative methods. The qualitative component was based on conducting focus groups The quantitative study allowed us to develop epidemic curves, based on employee visits to the hospital's occupational health service (OHS) due to either symptoms or episodes of sickness absence (SA). Lastly, available industrial hygiene reports were reviewed to examine possible relationships with the distribution of cases. RESULTS:Two operational case definitions were established through the focus groups, along with identification of possible explanations for the outbreak based on employee perception. The quantitative study confirmed the outbreak in the LAM, but not in the LCA. The SA episodes in the LAM between weeks 16 and 39 exceeded the number of expected cases four-fold. We also detected an excess of visits to the OHS during the same time period. CONCLUSIONS: The quantitative study confirmed an epidemic outbreak that has since ended, although the qualitative study indicated the persistence of bad smell and discomfort. The improvement of epidemiological surveillance systems as a result of the study will facilitate the monitoring and control of future possible outbreaks


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Surtos de Doenças/prevenção & controle , Doenças Profissionais/epidemiologia , Pessoal de Laboratório/estatística & dados numéricos , Surtos de Doenças/estatística & dados numéricos , Fatores Sexuais , Grupos Focais , Incidência
5.
Rech Soins Infirm ; (141): 49-59, 2020 06.
Artigo em Francês | MEDLINE | ID: mdl-32988189

RESUMO

A team of multi-specialized professionals meet annually on World Stroke Day, working to prevent and raise awareness of this condition. These professionals contribute to health education despite their lack of official training. Does the process used in the organization and implementation of the day enable the professionals involved to develop their educational skills ?The objectives of this research were to identify and categorize the educational skills developed during the process of organizing and implementing World Stroke Day, as well as to identify the elements of the process contributing to the development of these skills.In this descriptive qualitative study, the data were collected through a focus group with professionals involved in the day, and then subjected to a content analysis. This day enables professionals to develop their educational skills and gives them the opportunity to share what they have learned with others. The organization set up as part of this day is an opportunity to improve professionals' relationship to knowledge and their feeling of belonging. Interprofessionality and the learning context enable an educational attitude to be developed. Further research would help us to understand the transferability conditions of the process.


Assuntos
Educação em Saúde , Pessoal de Saúde/educação , Acidente Vascular Cerebral , Aniversários e Eventos Especiais , Grupos Focais , Pessoal de Saúde/psicologia , Humanos , Aprendizagem
6.
PLoS One ; 15(9): e0239234, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32931509

RESUMO

Effective and culturally appropriate hand-hygiene education is essential to promote health-related practices to control and prevent diseases such as Diarrhoea, Ebola and COVID-19. In this paper we outline and evaluate the Co-Creation processes underpinning a handwashing intervention for young children (A Germ's Journey) developed and delivered in India, Sierra Leone and the UK, and consider the implications surrounding Imperialist/Colonial discourse and the White Saviour Complex. The paper focuses both on the ways Co-Creation was conceptualised by our collaborators in all three countries and the catalysts and challenges encountered. Qualitative data have been drawn from in-depth interviews with five key stakeholders, focus group data from 37 teachers in Sierra Leone and responses to open-ended questionnaires completed by teachers in India (N = 66) and UK (N = 63). Data were analysed using thematic analysis and three themes, each with three constituent subthemes are presented. In the theme 'Representations of and Unique Approaches to Co-Creation' we explore the ways in which Co-Creation was constructed in relation to teamwork, innovative practice and more continuous models of evaluation. In 'Advantages of Co-Creation' we consider issues around shared ownership, improved outcomes and more meaningful insights alongside the mitigation of risks and short-circuiting of problems. In 'Challenges of Co-Creation' we discuss issues around timing and organisation, attracting and working with appropriate partners and understanding the importance of local context with inherent social, economic and structural barriers, especially in low-and-middle-income countries. We consider how theoretical elements of Co-Creation can inform effective international public health interventions; crucial during a global pandemic in which handwashing is the most effective method to control the transmission of COVID-19. Finally we reflect on some of the methodological challenges of our own work and in managing the potentially conflicting goals of the ethical and participatory values of Co-Creation with pragmatic considerations about ensuring an effective final 'product'.


Assuntos
Controle de Doenças Transmissíveis/métodos , Higiene das Mãos , Betacoronavirus , Criança , Doenças Transmissíveis/patologia , Doenças Transmissíveis/transmissão , Doenças Transmissíveis/virologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Grupos Focais , Humanos , Índia , Entrevistas como Assunto , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Professores Escolares/psicologia , Serra Leoa , Inquéritos e Questionários , Reino Unido
7.
Soc Work Public Health ; 35(7): 511-522, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32970546

RESUMO

Covid-19 is a virus that has created tension and devastation around the globe. This study is designed to specifically find out the effect of Covid-19 on the socioeconomic well-being of Nigerians, the health sector preparedness to handle the pandemic, and the role of Nigerian social workers in the fight against Covid-19 in Nigeria. The study employed a phenomenological and exploratory research design in its inquiry. Sixteen respondents made up the sample size for the study. A Focus Group Discussion Guide and an In-Depth Interview Guide were the instruments for data collection. The result of the study shows that the Covid-19 pandemic has had a devastating impact on the socioeconomic well-being of Nigerians. Second, the Nigerian health system is ill equipped and underprepared to handle the Covid-19 pandemic. Third, Nigerian social workers, most especially medical social workers, have played a significant role in passing out information on Covid-19 preventive measures to the general public. The study recommends that the Nigerian government should wake up and fix the health sector and make it proactive to handle epidemics/pandemics in the future. Social work practice in Nigeria should be promoted by the government through institutionalization of the profession.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/economia , Infecções por Coronavirus/prevenção & controle , Pandemias/economia , Pandemias/prevenção & controle , Pneumonia Viral/economia , Pneumonia Viral/prevenção & controle , Papel Profissional , Assistentes Sociais , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Grupos Focais , Humanos , Nigéria/epidemiologia , Pneumonia Viral/epidemiologia , Fatores Socioeconômicos
8.
BMC Med Educ ; 20(1): 328, 2020 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-32967669

RESUMO

BACKGROUND: The current COVID-19 pandemic has demonstrated that personal protective equipment (PPE) is essential, to prevent the acquisition and transmission of infectious diseases, yet its use is often sub-optimal in the clinical setting. Training and education are important to ensure and sustain the safe and effective use of PPE by medical interns, but current methods are often inadequate in providing the relevant knowledge and skills. The purpose of this study was to explore medical graduates' experiences of the use of PPE and identify opportunities for improvement in education and training programmes, to improve occupational and patient safety. METHODS: This study was undertaken in 2018 in a large tertiary-care teaching hospital in Sydney, Australia, to explore medical interns' self-reported experiences of PPE use, at the beginning of their internship. Reflexive groups were conducted immediately after theoretical and practical PPE training, during hospital orientation. Transcripts of recorded discussions were analysed, using a thematic approach that drew on the COM-B (capability, opportunity, motivation - behaviour) framework for behaviour. RESULTS: 80% of 90 eligible graduates participated. Many interns had not previously received formal training in the specific skills required for optimal PPE use and had developed potentially unsafe habits. Their experiences as medical students in clinical areas contrasted sharply with recommended practice taught at hospital orientation and impacted on their ability to cultivate correct PPE use. CONCLUSIONS: Undergraduate teaching should be consistent with best practice PPE use, and include practical training that embeds correct and safe practices.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/instrumentação , Internato e Residência , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Austrália , Competência Clínica , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Currículo , Grupos Focais , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Autoavaliação
9.
BMC Public Health ; 20(1): 1385, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32912177

RESUMO

BACKGROUND: In El Salvador, Aedes aegypti mosquitoes transmitting Zika and other arboviruses use water storage containers as important oviposition sites. Promotion of water storage container cleaning is a key element of prevention programs. We explored community perceptions surrounding cleaning practices among pregnant women, male partners of pregnant women, and women likely to become pregnant. METHODS: Researchers conducted 11 focus groups and 12 in-depth interviews which included individual elicitations of Zika prevention measures practiced in the community. Focus group participants rated 18 images depicting Zika-related behaviors according to effectiveness and feasibility in the community context, discussed influencing determinants, voted on community intentions to perform prevention behaviors, and performed washbasin cleaning simulations. In-depth interviews with male partners of pregnant women used projective techniques with images to explore their perceptions on a subset of Zika prevention behaviors. RESULTS: General cleaning of the home, to ensure a healthy environment, was a strong community norm. In this context, participants gave water storage container cleaning a high rating, for both its effectiveness and feasibility. Participants were convinced that they cleaned their water storage containers effectively against Zika, but their actual skills were inadequate to destroy Aedes aegypti eggs. A further constraint was the schedule of water availability. Even during pregnancy, male partners rarely cleaned water storage containers because water became available in homes when they were at work. Furthermore, prevailing gender norms did not foster male participation in domestic cleaning activities. Despite these factors, many men were willing to provide substantial support with cleaning when their partners were pregnant, in order to protect their family. CONCLUSIONS: Behavior change programs for the prevention of Zika and other arboviruses need to improve community members' mosquito egg destruction skills rather than perpetuate the promotion of non-specific cleaning in and around the home as effective. Egg elimination must be clearly identified as the objective of water storage container maintenance and programs should highlight the effective techniques to achieve this goal. In addition, programs must build the skills of family members who support pregnant women to maintain the frequency of effective egg destruction in all water storage containers of the home.


Assuntos
Aedes/virologia , Conhecimentos, Atitudes e Prática em Saúde , Controle de Mosquitos/métodos , Abastecimento de Água , Água , Infecção por Zika virus/prevenção & controle , Zika virus , Adolescente , Adulto , Animais , El Salvador , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Pesquisa Qualitativa , Características de Residência , Adulto Jovem , Zika virus/crescimento & desenvolvimento , Infecção por Zika virus/transmissão , Infecção por Zika virus/virologia
10.
PLoS Negl Trop Dis ; 14(9): e0008499, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32936792

RESUMO

Since the prioritization of Lymphatic Filariasis (LF) elimination in 1997, progress has been made in reducing disease transmission and burden. Validation of elimination through Transmission Assessment Surveys (TAS) in implementation units (IUs) that have received at least 5 rounds of mass drug administration (MDA) and achieved minimum threshold of 65% treatment coverage is required. There are IUs that do not qualify for TAS due to achievement of low treatment coverage. This study sought to identify barriers of community participation and access to MDA, develop and test strategies to be recommended for improved uptake. Two wards in Kaloleni sub-county, Kilifi county with an average treatment coverage of 56% in 2015, 50.5% in 2016 were purposively sampled and a quasi-experimental study conducted. Through systematic random sampling, 350 (pre-intervention) and 338 (post-intervention) household heads were selected and interviewed for quantitative data. For qualitative data, 16 Focus Group Discussions (FGDs) with purposively selected community groups were conducted. Participatory meetings were held with county stakeholders to agree on strategies for improved community participation in MDA. The quantitative data were analyzed using STATA version 14.1, statistical significance assessed by chi square test and qualitative data by QSR NVIVO version 10. The identified strategies were tested in experimental sites during the 2018 MDA and the usual MDA strategies applied in control sites. The results showed an increase in community participation and access to MDA in both sites 80.6% (pre-intervention), 82.9% (post-intervention). The proportion of participants who considered the treatment as necessary significantly (p = 0.001) increased to 96.2% from 88.3% and significantly dropped for those with drug swallowing problems associated with: size (p<0.001), number (p<0.027) and taste (p = 0.001). The implemented strategies may have contributed to increased participation and access to MDA and should be applied for improved treatment uptake. Health education on disease aetiology and importance of drug uptake in all rounds is key to program's success.


Assuntos
Participação da Comunidade/métodos , Filariose Linfática/tratamento farmacológico , Educação em Saúde , Administração Massiva de Medicamentos/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos de Deglutição , Filariose Linfática/prevenção & controle , Características da Família , Feminino , Filaricidas/uso terapêutico , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Quênia , Masculino , Pessoa de Meia-Idade
11.
Sante Publique ; 32(2): 229-237, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32985839

RESUMO

OBJECTIVE: The HIV self-test has been on sale in France since September 2015. What is the point of view of pharmacists and key populations with regard to accessing self-tests in community pharmacies ? METHOD: One year after the HIV self-test came onto the market, the points of view of pharmacists and key populations with regard to HIV were collected during six focus groups: the pharmacists themselves; people who had already used HIV self-tests; potential users from two key populations with regard to HIV: migrants from sub-Saharan Africa and men who have sex with men; potential users from populations with active sex lives but not particularly vulnerable with regard to HIV: young adults (<25 years of age), multi-partner heterosexual adults. RESULTS: The HIV self-test in community pharmacies is perceived by all participants as a significant step forward for accessing screening for HIV. However, issues around discretion and anonymity were seen to create significant tensions with regard to accessing the test itself, but also the information necessary to use it correctly both at a technical level and above all concerning how to interpret test results. CONCLUSION: Although the present study underlines the role of the pharmacist as a significant public health actor in the dispensation of the self-test, the sales price and questions of anonymity are seen as major obstacles. Priority actions include renewing communication campaigns concerning the existence and the use of the product for the upcoming generations of young people but also specific campaigns targeting more vulnerable populations.


Assuntos
Atitude do Pessoal de Saúde , Infecções por HIV/diagnóstico , Programas de Rastreamento/métodos , Farmacêuticos/psicologia , Adulto , Feminino , Grupos Focais , França , Humanos , Masculino , Farmácias , Autocuidado , Adulto Jovem
12.
JMIR Mhealth Uhealth ; 8(8): e19433, 2020 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-32795985

RESUMO

BACKGROUND: Dental visits are unpleasant; sometimes, patients only seek treatment when they are in intolerable pain. Recently, the novel coronavirus (COVID-19) pandemic has highlighted the need for remote communication when patients and dentists cannot meet in person. Gingivitis is very common and characterized by red, swollen, bleeding gums. Gingivitis heals within 10 days of professional care and with daily, thorough oral hygiene practices. If left untreated, however, its progress may lead to teeth becoming mobile or lost. Of the many medical apps currently available, none monitor gingivitis. OBJECTIVE: This study aimed to present a characterization and development model of a mobile health (mHealth) app called iGAM, which focuses on periodontal health and improves the information flow between dentists and patients. METHODS: A focus group discussed the potential of an app to monitor gingivitis, and 3 semistructured in-depth interviews were conducted on the use of apps for monitoring gum infections. We used a qualitative design process based on the Agile approach, which incorporated the following 5 steps: (1) user story, (2) use cases, (3) functional requirements, (4) nonfunctional requirements, and (5) Agile software development cycles. In a pilot study with 18 participants aged 18-45 years and with different levels of health literacy, participants were given a toothbrush, toothpaste, mouthwash, toothpicks, and dental floss. After installing iGAM, they were asked to photograph their gums weekly for 4 weeks. RESULTS: All participants in the focus group believed in the potential of a mobile app to monitor gingivitis and reduce its severity. Concerns about security and privacy issues were discussed. From the interviews, 2 themes were derived: (1) "what's in it for me?" and (2) the need for a take-home message. The 5 cycles of development highlighted the importance of communication between dentists, app developers, and the pilot group. Qualitative analysis of the data from the pilot study showed difficulty with: (1) the camera, which was alleviated with the provision of mouth openers, and (2) the operation of the phone, which was alleviated by changing the app to be fully automated, with a weekly reminder and an instructions document. Final interviews showed satisfaction. CONCLUSIONS: iGAM is the first mHealth app for monitoring gingivitis using self-photography. iGAM facilitates the information flow between dentists and patients between checkups and may be useful when face-to-face consultations are not possible (such as during the COVID-19 pandemic).


Assuntos
Assistência Odontológica/métodos , Gengivite/prevenção & controle , Aplicativos Móveis , Fotografação , Telemedicina , Adolescente , Adulto , Infecções por Coronavirus/epidemiologia , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Satisfação do Paciente/estatística & dados numéricos , Projetos Piloto , Pneumonia Viral/epidemiologia , Pesquisa Qualitativa , Interface Usuário-Computador , Adulto Jovem
13.
BMC Med Educ ; 20(1): 285, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32859188

RESUMO

BACKGROUND: The closure of educational activities in the Kingdom of Saudi Arabia due to the ongoing COVID-19 pandemic resulted in an unplanned shift from traditional learning to a setup that exclusively involves digital teaching and learning. Within this context, the present study aimed to explore undergraduate medical students' perceptions regarding the effectiveness of synchronized online learning at Unaizah College of Medicine and Medical Sciences, Qassim University, Saudi Arabia. METHODS: A qualitative study was conducted using virtual focus group discussions synchronously with the help of a discussion guide consisting of seven open-ended questions. Overall, 60 medical students were recruited using a maximum variation sampling technique; these students then participated in eight focus group discussions. All interviews were recorded, transcribed verbatim, and analyzed for thematic contents using the standard (Mayring, Kiger. M. E. and Braun.V) content analysis framework. RESULTS: A thematic content analysis yielded four core themes: (1) educational impact, (2) time management, (3) challenges encountered, and (4) preferences for the future. The online modality was well-received, and all participants agreed that online sessions were time saving and that their performance was improved due to enhanced utility of time; however, they indicated that they encountered some challenges, including methodological, content perception, technical, and behavioral challenges during sessions and online exams. Most of the preclinical students preferred online learning for the upcoming academic years. CONCLUSION: Synchronized online classes were well-accepted by the medical students. This represents significant and promising potential for the future of medical education. The principles of the online learning model and learning outcomes should be rigorously and regularly evaluated to monitor its effectiveness.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Educação a Distância/organização & administração , Educação de Graduação em Medicina/organização & administração , Pneumonia Viral/epidemiologia , Estudantes de Medicina/psicologia , Adulto , Infecções por Coronavirus/prevenção & controle , Feminino , Grupos Focais , Humanos , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pesquisa Qualitativa , Arábia Saudita , Adulto Jovem
14.
PLoS One ; 15(8): e0236831, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32857781

RESUMO

AIM: The aim of this study was to explore the current and potential use of information and communication technology (ICT) to enhance coherent person-centred rehabilitation after stroke, from the perspectives of physiotherapists and occupational therapists. METHOD: Five occupational therapists and four physiotherapists from different phases of the Danish stroke rehabilitation process were included and two focus group interviews were carried out. A grounded theory approach was used throughout the study and a constant comparative method was used in the analysis. RESULTS: Three subcategories were identified from the analysis of interviews with participants: 1) ICT and apps as meaningful and supportive in the rehabilitation process, 2) ICT as a tool in communication and documentation and 3) Barriers to the integration of ICT and apps in the rehabilitation process. From these categories one core category emerged: The potential of a personalized app solution to facilitate coherent person-centred rehabilitation. CONCLUSION: ICT was perceived as important to integrate in stroke rehabilitation both for assessment, training and to compensate for remaining deficits. The development of a personalized app solution could accommodate stroke survivors' and significant others' need for insight into and overview over the rehabilitation process as well as access to relevant information, which would thereby empower them. Furthermore, a personalized app solution could also facilitate follow-up after discharge and was perceived to ease the communication and documentation within and between sectors, as well as communication with both stroke survivors and significant others.


Assuntos
Terapeutas Ocupacionais/psicologia , Fisioterapeutas/psicologia , Reabilitação do Acidente Vascular Cerebral , Adulto , Comunicação , Grupos Focais , Teoria Fundamentada , Humanos , Entrevistas como Assunto , Assistência Centrada no Paciente , Acidente Vascular Cerebral/patologia , Acidente Vascular Cerebral/psicologia
15.
PLoS One ; 15(8): e0236248, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760147

RESUMO

Migration has long been used as a strategy for livelihood diversification in rural, subsistence communities. Yet in order for migration to effectively serve as a livelihood diversification strategy, it should meet certain conditions: migration should ease financial burdens, should confer access to economically valuable resources and information, and should broaden social networks. Using qualitative data gathered in 25 interviews with rural migrants to Ouagadougou, Burkina Faso, we examine how mobile phone technology has impacted migration as a livelihood diversification strategy. Our results show that while mobile phones facilitate migration, the advantages conferred may benefit migrants at the expense of the home communities. Mobile phones alleviate financial constraints, enable access to broader networks, and facilitate informational and resource support among migrants. Our results show limited evidence of migrants using mobile phone technology to provide resources or information to the home community. Our results highlight the need to reconsider the ways in which migration can be used as a livelihood diversification strategy in light of changing communication technologies to promote the economic success of both migrants and their home communities.


Assuntos
Telefone Celular , Tomada de Decisões , Comportamento Exploratório , Migração Humana , População Rural , Adulto , Burkina Faso , Países em Desenvolvimento , Feminino , Grupos Focais , Humanos , Masculino , Pesquisa Qualitativa , Adulto Jovem
16.
Afr J AIDS Res ; 19(2): 135-146, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32780677

RESUMO

Since 2012, PMTCT Option B+ has been recommended by the World Health Organization to reduce vertical transmission but numerous adherence challenges remain. We conducted a qualitative study at baseline using six focus group discussions and 14 in-depth interviews to explore knowledge, beliefs, attitudes and challenges towards the Option B+ strategy for PMTCT among HIV-infected pregnant and post-partum women and health workers engaged in Uganda's national Option B+ PMTCT programme. Data were analysed using a thematic approach to capture latent and manifest content with the social ecological model as a theoretic foundation in order to make contextual sense of key stakeholders' needs for an effective Option B+ intervention. Overall, among all study participants, we found multi-level barriers to adhering to Option B+ cutting across all levels of the social ecological model. In line with the model, our study revealed barriers at personal, relational, organizational and societal levels. Some personal beliefs such as that the baby's health is more important that the mother's, organizational (negative attitudes and behaviour of health workers), structural such as poverty, work conflicts, fear and lack of disclosure related to community stigma were all critical obstacles to women adhering to the Option B+ programme. We found that both health workers and participants in the programme have a relatively clear understanding of the benefits of adhering to their treatment; though a more nuanced understanding and thus emphasis in counselling on side effects, is critical to helping patients adhere.


Assuntos
Infecções por HIV/tratamento farmacológico , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/tratamento farmacológico , Cooperação e Adesão ao Tratamento/psicologia , Adulto , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Humanos , Masculino , Mães , Gravidez , Pesquisa Qualitativa , População Rural , Participação dos Interessados , Uganda/epidemiologia , População Urbana
17.
Rev Infirm ; 69(262): 39-41, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32838866

RESUMO

In the current context of the health crisis brought about by the Covid-19 epidemic, the implementation of good practices in terms of preventing contagion and the respect of good hygiene practices is vital. The hospital hygiene teams must be involved in raising awareness of these good practices. They rely notably on hygiene resource paramedical practitioners to share these practices with the nursing teams, notably in the area of the prevention of care-related infections and the spread of emerging highly drug-resistant bacteria. A focus group study conducted in 2019 in a military health facility in Brittany provides interesting insight into their practice.


Assuntos
Infecção Hospitalar/prevenção & controle , Higiene , Recursos Humanos em Hospital/psicologia , Infecções por Coronavirus/epidemiologia , Epidemias , Grupos Focais , Humanos , Equipe de Enfermagem , Pandemias , Pneumonia Viral/epidemiologia
18.
Matern Child Health J ; 24(9): 1170-1178, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32754861

RESUMO

INTRODUCTION: Drug use during pregnancy can have negative effects on maternal and child health. However, there is a dearth of data regarding drug use among pregnant women in Kenya, where illicit drug use is on the rise. In this paper, we report factors influencing women's decisions to use drugs during pregnancy. METHODS: In 2015, we conducted in-depth interviews and focus group discussions with 45 women who inject drugs and five key stakeholders involved in provision of services to people who use drugs in coastal Kenya. Inductive thematic analysis was conducted to draw out themes related to key determinants of drug use during pregnancy. RESULTS: Four key themes emerged outlining determinants of drug use during pregnancy: (i) the use of drugs to cope with the stress of unexpected pregnancy, (ii) the continued drug use during pregnancy to manage withdrawal, (iii) the dual effect of pregnancy on drug use either as a facilitator or as a moderator of drug use, and (iv) the role of male intimate partner in influencing women's drug use during pregnancy. CONCLUSION: Our paper reports women's drug use during pregnancy and the factors influencing this phenomenon. To safeguard the health and well-being of pregnant women and their unborn children, there is a need for education and awareness raising, implementing couple-based harm reduction approaches to leverage on positive male influences, improving availability of drug treatment, and provision of family planning interventions for women who use drugs.


Assuntos
Gestantes/psicologia , Parceiros Sexuais/psicologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Adolescente , Adulto , Feminino , Grupos Focais , Redução do Dano , Humanos , Relações Interpessoais , Entrevistas como Assunto , Quênia , Pessoa de Meia-Idade , Gravidez , Gestantes/etnologia , Pesquisa Qualitativa , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
19.
PLoS One ; 15(8): e0235618, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32756563

RESUMO

BACKGROUND: This is a multi-method, in-depth, three part qualitative study exploring the regulation and practice of secondary research with tissue and data in a high-income country. We explore and compare the perspectives of researchers, research ethics committees (RECs) and other relevant professionals (e.g. pathologists and clinicians). We focus on points of contention because they demonstrate misalignment between the expectations, values and assumptions of these stakeholders. METHODS: This is a multi-method study using observational research, focus groups and interviews with 42 participants (conducted 2016-2017) and analyzed using thematic analysis. RESULTS: Results are arranged under the following themes: consent; balancing the social value of the research with consent requirements; and harm. Our findings demonstrate different perspectives on the review process, styles of ethical reasoning and issues of concern. First, researchers and RECs disagreed about whether the cost of re-consenting patients satisfied the criterion of impracticability for consent waivers. Second, most researchers were skeptical that secondary research with already collected tissue and data could harm patients. Researchers often pointed to the harm arising from a failure to use existing material for research. RECs were concerned about the potential for secondary research to stigmatize communities. Third, researchers adopted a more consequentialist approach to decision-making, including some willingness to trade off the benefit of the research against the cost of getting consent; whereas RECs were more deontological and typically considered research benefit only after it had been established that re-consent was impractical. CONCLUSION: This research highlights ways in which RECs and researchers may be talking past each other, resulting in confusion and frustration. These finding provide a platform for realignment of the expectations of RECs and researchers, which could contribute to making research ethics review more effective.


Assuntos
Comitês de Ética em Pesquisa , Consentimento Livre e Esclarecido/ética , Comitês de Ética em Pesquisa/ética , Ética em Pesquisa , Grupos Focais , Humanos , Pesquisa Qualitativa , Projetos de Pesquisa , Pesquisadores/ética , Bancos de Tecidos/ética
20.
Health Psychol ; 39(9): 767-775, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32833478

RESUMO

OBJECTIVE: To describe development of the Positive Affect, Promoting Positive Engagement, and Adherence for Life (APPEAL) program. METHOD: APPEAL is intended to increase HIV medication adherence through promotion of positive affect, and was developed through an iterative process involving 6 focus groups (N = 34) that elicited feedback on intervention content, followed by an individually administered prepilot of the entire intervention (N = 7). RESULTS: Participants provided feedback on important potential moderator variables, including depression, on mode of intervention administration, and on anticipated barriers and benefits to participation. Insights gained were used to finalize study procedures in preparation for a feasibility trial. For the feasibility trial, a total of 80 participants who, in the past 6 months have had at least one plasma HIV RNA >200 copies/mL, will be randomized to receive APPEAL or standard of care (N = 40 per group). Intervention group participants will receive 3 monthly, individually administered sessions, and all participants will have their medication adherence monitored and complete structured interviews at baseline and at 3 and 6 months. CONCLUSION: The APPEAL program is innovative in that it focuses on promoting self-regulation of positive emotions, an understudied approach to promoting chronic disease self-management behaviors such as HIV medication adherence. Findings from the feasibility trial will gauge suitability of the APPEAL intervention and evaluation methods for subsequent testing in a confirmatory trial and will examine changes in positive affect, the primary mechanism of change targeted in the intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Adesão à Medicação/estatística & dados numéricos , Adulto , Estudos de Viabilidade , Feminino , Grupos Focais , Humanos , Masculino , Adulto Jovem
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