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1.
Disaster Med Public Health Prep ; 14(3): 406-412, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32576316

RESUMO

OBJECTIVES: Previous research has identified a lack of clarification regarding paramedic professional obligation to work. Understanding community expectations of paramedics will provide some clarity around this issue. The objective of this research was to explore the expectations of a sample of Australian community members regarding the professional obligation of paramedics to respond during pandemics. METHODS: The authors used qualitative methods to gather Australian community member perspectives immediately before the onset of the coronavirus disease 2019 (COVID-19) pandemic. Focus groups were used for data collection, and a thematic analysis was conducted. RESULTS: The findings revealed 9 key themes: context of obligation (normal operations versus crisis situation), hierarchy of obligation (individual versus organizational obligation), risk acceptability, acceptable occupational risk (it's part of the job), access to personal protective equipment, legal and ethical guidelines, education and training, safety, and acceptable limitations to obligation. The factors identified as being acceptable limitations to professional obligation are presented as further sub-themes: physical health, mental health, and competing personal obligations. CONCLUSIONS: The issue of professional obligation must be addressed by ambulance services as a matter of urgency, especially in light of the COVID-19 coronavirus pandemic. Further research is recommended to understand how community member expectations evolve during and after the COVID-19 coronavirus pandemic.


Assuntos
Pessoal Técnico de Saúde/ética , Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Responsabilidade Social , Pessoal Técnico de Saúde/psicologia , Pessoal Técnico de Saúde/estatística & dados numéricos , Grupos Focais/métodos , Humanos , Motivação , Pandemias/ética , Pandemias/estatística & dados numéricos , Papel Profissional , Pesquisa Qualitativa
2.
Aust J Gen Pract ; 49(5): 280-287, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32416655

RESUMO

BACKGROUND AND OBJECTIVES: Currently when undergoing Australian general practice training, a registrar must determine when clinical supervision is needed. The aim of this study was to identify situations in early Australian general practice training requiring closer supervision and consider how this can be achieved. METHOD: The study used a qualitative approach involving 75 registrars, supervisors and medical educators from seven focus groups in Victoria and Tasmania. RESULTS: Eighty circumstances in which a registrar should call their general practice supervisor were identified. Participants indicated the 'call for help' list should be modified early in the term after considering the registrar's prior experience, and through the term as supervision and teaching identifies readiness for independent practice. DISCUSSION: The size of the list developed by the focus groups reflects the breadth of general practice. It is a 'call for help' list rather than a safety checklist as it is not exclusively concerned with high-risk scenarios and includes broad triggers to call for help. The 'call for help' list is an aid to patient safety and the supervisor-registrar alliance.


Assuntos
Medicina Geral/educação , Corpo Clínico Hospitalar/educação , Adulto , Feminino , Grupos Focais/métodos , Medicina Geral/tendências , Humanos , Masculino , Corpo Clínico Hospitalar/tendências , Pesquisa Qualitativa , Tasmânia , Vitória
3.
J Med Internet Res ; 22(5): e15976, 2020 05 27.
Artigo em Inglês | MEDLINE | ID: mdl-32459181

RESUMO

BACKGROUND: In remote areas, connected health (CH) is needed, but as local resources are often scarce and the purchasing power of residents is usually poor, it is a challenge to apply CH in these settings. In this study, CH is defended as a technological solution for reshaping the direction of health care to be more proactive, preventive, and precisely targeted-and thus, more effective. OBJECTIVE: The objective of this study was to explore the identity of CH stakeholders in remote areas of Taiwan and their interests and power in order to determine ideal strategies for applying CH. We aimed to explore the respective unknowns and discover insights for those facing similar issues. METHODS: Qualitative research was conducted to investigate and interpret the phenomena of the aging population in a remote setting. An exploratory approach was employed involving semistructured interviews with 22 participants from 8 remote allied case studies. The interviews explored perspectives on stakeholder arrangements, including the power and interests of stakeholders and the needs of all the parties in the ecosystem. RESULTS: Results were obtained from in-depth interviews and focus groups that included identifying the stakeholders of remote health and determining how they influence its practice, as well as how associated agreements bring competitive advantages. Stakeholders included people in government sectors, industrial players, academic researchers, end users, and their associates who described their perspectives on their power and interests in remote health service delivery. Specific facilitators of and barriers to effective delivery were identified. A number of themes, such as government interests and power of decision making, were corroborated across rural and remote services. These themes were broadly grouped into the disclosure of conflicts of interest, asymmetry in decision making, and data development for risk assessment. CONCLUSIONS: This study contributes to current knowledge by exploring the features of CH in remote areas and investigating its implementation from the perspectives of stakeholder management. It offers insights into managing remote health through a CH platform, which can be used for preliminary quantitative research. Consequently, these findings could help to more effectively facilitate diverse stakeholder engagement for health information sharing and social interaction.


Assuntos
Envelhecimento/ética , Grupos Focais/métodos , Humanos , Pesquisa Qualitativa , Participação dos Interessados
4.
Global Health ; 16(1): 33, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32295611

RESUMO

BACKGROUND: Sustainable Development Goal (SDG) 17 focuses on North/South partnerships for sustainable development. Literature on research partnerships and capacity -building often neglects how these processes are carried out in practice, their social impacts and participants' subjective experiences. Recognizing the increasingly global dimensions of Higher Education Institutions, the University Development and Innovation - Africa project (UDI-A) was designed to train lecturers and administrative staff of Angolan and Mozambican Universities through collaborations with European institutions, aiming at strengthening African academic and social landscapes through knowledge translation and dissemination. This paper examines potential outcomes of UDI-A on participants' academic pathways, investigating the conflict between different imaginaries of capacity-building and partnerships, focusing on how Angolan and Mozambican health sciences researchers experience international collaborations. METHODS: Semi-structured interviews were conducted with seven health academics, as well as a focus group discussion involving all participants. These were recorded, fully transcribed, anonymized and coded to identify common themes. A consent form was signed by all participants. RESULTS AND DISCUSSION: UDI-A was considered innovative, fostering the improvement of pedagogical skills and increasing social entrepreneurship activities. Participants arrived with a specific institutional mandate and believed that the training received should be incorporated into institutional practices to "modernize" these specific Portuguese speaking African Universities and the health sector. The institutional mechanisms put in place to attain this goal, Centres for Academic Development and Innovation ("CADIs"), were considered potential research and development hubs and drivers of academic and societal transformation. Nevertheless, participants shared a sense of asymmetry (infrastructural, financial, in terms of access to information) between them and European trainers. Although this asymmetry was the underlying basis of this capacity-building project, they argued that UDI-A did not fully acknowledge their local contexts, compromising the prospective development of partnerships in the health field. CONCLUSIONS: More attention should be devoted to understanding how participants experience capacity building processes, integrating the diversity of their aspirations and perceptions into subsequent phases of the project, requiring the development of methodological innovations to increase the impact of these programs.


Assuntos
Parcerias Público-Privadas/tendências , Pesquisadores/psicologia , Angola , Fortalecimento Institucional/métodos , Grupos Focais/métodos , Humanos , Entrevistas como Assunto/métodos , Medicina/estatística & dados numéricos , Moçambique , Pesquisa Qualitativa , Pesquisadores/estatística & dados numéricos
5.
Australas Emerg Care ; 23(1): 1-5, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32113919

RESUMO

BACKGROUND: The creation of the safety culture coordinator role within an Australian Local Health District followed a critical incident in one of its emergency departments. As part of the role, it was important to have an understanding of how nurses viewed the term safety culture in order to support them in implementing any changes that would influence their everyday practice. METHODS: A descriptive qualitative design was chosen for the study. Focus groups allowed the perspectives of nurses to be heard and represented. RESULTS: Five themes emerged from the data: defining safety culture, influences of team culture, differences in environmental impact, the reality of reporting incidents and commitment to best practice and patient care. These highlighted the influencing factors that promoted and inhibited a safety culture. CONCLUSION: This study provides a greater understanding of what supports a positive safety culture and the challenges that nurses face. Across the three emergency departments, nurses had similar beliefs about safety culture, with a consensus that safety was everyone's responsibility. This has enabled the safety culture coordinator position to have greater consideration of what initiatives are valued and important in working with nurses to design strategies that influence their safety culture.


Assuntos
Formação de Conceito , Enfermeiras e Enfermeiros/psicologia , Gestão da Segurança , Enfermagem em Emergência/métodos , Enfermagem em Emergência/normas , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Grupos Focais/métodos , Humanos , New South Wales , Enfermeiras e Enfermeiros/estatística & dados numéricos
6.
Global Health ; 16(1): 25, 2020 03 20.
Artigo em Inglês | MEDLINE | ID: mdl-32197660

RESUMO

BACKGROUND: While great strides have been achieved in fighting malaria through the Roll Back Malaria (RBM) strategy, the recent world malaria report shows an increase in malaria-related deaths compared to previous years. Malaria control tools are efficacious and effective in preventing the disease; however, the human behaviour aspect of the intervention strategies is weak due to heavy reliance on positive human health behaviour. The challenge lies in adoption of control interventions by the target population which, to an extent, may include access to prevention and treatment tools. We present a qualitative assessment of the use of the Health Animator (HA) model for Information, Education and Communication (IEC) to improve adoption and use of malaria control by promoting positive health behaviours. RESULTS: We conducted 3 Focus Group Discussions (FGDs) and 23 individual in-depth interviews (IDIs) with HAs. Each FGD consisted of 8 participants. Data was analysed using QSR International NVivo 10 software. There are four main themes emerging regarding HA experiences. The perceptions include; collaborative work experience, personal motivation and growth, community participation with health animation and challenges with implementation. Results suggest that HAs were pleased with the training as they gained new information regarding malaria, which affected their use of malaria control interventions within their families. Knowledge was well assimilated from the trainings and influenced personal growth in becoming a community leader. Support from the leadership within the village and the health system was important in legitimising the main messages. The community responded positively to the workshops valued the information imparted. The voluntary nature of the work in a poverty-stricken community affected sustainability. CONCLUSIONS: There is need to empower communities with strategies within their reach. Functioning traditional social support structures are a crucial element in sustainability. Voluntarism is also key for sustainability, especially for rural and remote communities with limited sources of income.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Malária/terapia , Saúde Pública/métodos , População Rural/estatística & dados numéricos , Gerenciamento Clínico , Feminino , Grupos Focais/métodos , Humanos , Malária/psicologia , Malaui , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
8.
Rev Bras Enferm ; 73(1): e20180188, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32049234

RESUMO

OBJECTIVE: To understand what factors motivate people to reduce or stop tobacco use and what difficulties they face in this process. METHOD: Qualitative, empirical and interpretative research that used a focal group technique for data collection and Discourse Analysis as a theoretical reference for analysis. RESULTS: The responses centered on the following aspects: motivation for reduction or cessation of smoking, family and community support received during treatment, benefits from cessation of tobacco, difficulties encountered and strategies for overcoming triggers. FINAL CONSIDERATIONS: The results showed that the users expressed their desire for cessation of tobacco use and that to achieve this goal, family and group support, professional help and changing habits are key factors for this process.


Assuntos
Motivação , Abandono do Hábito de Fumar/psicologia , Idoso , Feminino , Grupos Focais/métodos , Comportamentos Relacionados com a Saúde , Humanos , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Grupos de Autoajuda , Abandono do Hábito de Fumar/métodos
9.
Rev Bras Enferm ; 73(1): e20180201, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32049239

RESUMO

OBJECTIVE: To characterize the mental health care provided in Primary Care from the perception of health professionals in the cities to the 5th Regional Health Center of the state of Paraná. METHOD: An exploratory qualitative research. Participants were 121 health professionals working in primary care in the 20 cities of 5th Regional Health Center of the state of Parana. Twenty-two focus groups were recorded, transcribed and analyzed by content analysis. RESULTS: Five thematic categories emerged, of which two were analyzed in this study: actions that professionals consider to be mental health actions; mental health actions developed by Primary Care professionals. FINAL CONSIDERATIONS: Despite of the indications of inclusion of mental health actions in Primary Care, this relationship is still occasional and unplanned. Policies that foster this interaction from a psychosocial perspective are needed.


Assuntos
Pessoal de Saúde/psicologia , Serviços de Saúde Mental/normas , Percepção , Adulto , Atitude do Pessoal de Saúde , Brasil , Feminino , Grupos Focais/métodos , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Serviços de Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/normas , Pesquisa Qualitativa , Qualidade da Assistência à Saúde/normas , Qualidade da Assistência à Saúde/estatística & dados numéricos
10.
Midwifery ; 83: 102657, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32035341

RESUMO

OBJECTIVE: Rates of maternal and neonatal death remain high in the Global South, especially in Sub-Saharan Africa. In addition, indicators vary significantly by geography. This study aimed to understand what communities in northern Ghana with frequent maternal and newborn deaths or near deaths (near-misses) perceive to be the causes. As part of a larger study, four communities in Ghana's Northern Region were identified as areas with high concentrations of deaths and near-misses of mothers and babies. DESIGN: Stakeholders were interviewed using in-depth interviews (IDIs) and focus-group discussions (FGDs). Field workers conducted 12 FGDs and 12 IDIs across a total of 126 participants. SETTING: This exploratory descriptive study was conducted in the East Mamprusi District in the Northern Region of Ghana, in the communities of Jawani, Nagboo, Gbangu and Wundua. PARTICIPANTS: FGDs were led by trained field workers and attended by traditional chiefs and their elders, members of women's groups, and traditional birth attendants in each of the four study communities. IDIs, or one-on-one interviews, were conducted with traditional healers who manage maternal and neonatal cases, community health nurses, and midwives. MEASUREMENTS AND FINDINGS: Qualitative data were audio-recorded, transcribed, and thematically analyzed using the Attride-Sterling analytical framework. Discussions focused on where blame should be attributed for the negative outcomes of mothers and babies - with blame either being directed at the actions or inactions of the mothers (behavioral), or at the larger factors associated with poverty (situational) that necessitate mothers' behavior. For example, some respondents blamed women for their poor diets, while others blamed the lack of money or household support to buy nutritious foods. Blame was rarely attributed to the fathers despite local gender norms of males being the household decision-makers with regard to spending and care-seeking. KEY CONCLUSIONS: These findings contribute to a small but growing body of literature on the blaming of mothers for their own deaths and those of their newborns - a phenomenon also described in high-income countries - and is supported by blame attribution theories that explain the self-protective nature of victim-blaming. IMPLICATIONS FOR PRACTICE: These results carry important implications for education and intervention design related to maternal and neonatal mortality, including more focused efforts at incorporating men and the larger community. More research is warranted on blame attribution for these adverse outcomes and its effects on the victims.


Assuntos
Mortalidade Fetal/tendências , Mortalidade Materna/tendências , Opinião Pública , Adulto , Idoso , Feminino , Grupos Focais/métodos , Gana , Humanos , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Tocologia/normas , Tocologia/estatística & dados numéricos , Gravidez , Pesquisa Qualitativa , População Rural/estatística & dados numéricos
11.
Gac. sanit. (Barc., Ed. impr.) ; 34(1): 10-14, ene.-feb. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-195409

RESUMO

OBJECTIVES: Each year tobacco is responsible for 650,000 deaths in Europe and 55,000 in Spain. With tobacco advertising and promotion banned in Spain and most of Europe, the last bastion of marketing is the packaging. Plain tobacco packaging -which involves packs having a standardised appearance- has been proposed to counter this. The objective of this study is to research perceptions arising from the plain packaging of tobacco products. METHODS: We employed a qualitative research methodology -focus groups- with smokers and non-smokers in in two medium-sized Andalusian towns (Spain). RESULTS: Results show the importance of plain cigarette packaging as a form of promotion, particularly among women and young people, how pack colour influences product perceptions, and how removing full branding increases the salience of the warnings. CONCLUSIONS: Plain packaging, combined with pictorial health warnings, may reduce the capacity of packaging to be distinctive and a badge product. Altering pack design in such a way would make it more difficult for tobacco companies to create a favourable image of their brands and may help to reinforce the ability of the population to protect themselves from the dangers of smoking


OBJETIVOS: El tabaco es causa de aproximadamente 650.000 muertes en Europa, y de ellas, unas 55.000 en España. Debido a las prohibiciones de realizar actividades de publicidad y promoción, el envase está considerado como el último bastión de comunicación para la industria tabacalera. El envase neutro -un aspecto uniforme del envase para toda marca comercializada- ha sido propuesto como forma de combatirlo. El objetivo de este trabajo se centra en estudiar las percepciones que suscita el diseño neutro del envase. MÉTODOS: Se ha realizado una investigación cualitativa, a través de grupos focales en dos ciudades de tamaño medio con personas fumadoras y no fumadoras en dos ciudades de tamaño medio de Andalucía (España). RESULTADOS: Los resultados señalan la importancia que tendría el envase de tabaco neutro como estrategia de desnormalización del tabaco, en especial en las mujeres y las personas jóvenes, como el color del envase neutro influye en las percepciones que el consumidor tiene del producto, y como incrementa la visibilidad de las esquelas sanitarias insertadas en el envase. CONCLUSIONES: El envase neutro, unido a las advertencias sanitarias combinadas, podrían reducir la capacidad distintiva del envase. La desaparición de los rasgos estéticos del envase, de esta manera, añadiría una dificultad más a las compañías para presentar sus marcas de forma favorable, y ayudaría a proteger a la población de los peligros del tabaco


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Fumar Cigarros/psicologia , Abandono do Hábito de Fumar/métodos , Rotulagem de Produtos Derivados do Tabaco , Publicidade de Produtos Derivados do Tabaco , Prevenção do Hábito de Fumar/métodos , Grupos Focais/métodos , Pesquisa Qualitativa
12.
Emerg Med J ; 37(4): 200-205, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31919232

RESUMO

BACKGROUND: Policies aimed at diverting care from EDs to alternative services have not been successful in reducing ED attendances and have contributed to confusion for service users when making care-seeking decisions. It is important that service users are at the heart of decision making to ensure new services meet the needs of those who will be accessing them. In this study, service users were encouraged to think freely about the desirable qualities of an ideal urgent and emergency care (UEC) system. METHODS: From September to February 2019, an open inductive methodology was used to conduct focus groups with service users who had used UK UEC services within the previous year. Service users that had contact with NHS111, ambulance service, General Practice out-of-hours, minor injuries unit, walk-in centre or ED were purposively sampled and stratified into the following groups: (1) 18-45 years; (2)≥75 years; (3) adults with young children; (4) adults with long-term conditions. Focus groups were structured around experiences of accessing UEC services and perspectives of an 'ideal' UEC system. RESULTS: 30 service users took part in the study, across four focus groups. The ideal UEC system centred around three themes: a simplified UEC system (easier to understand and a single-point of access); more 'joined-up' UEC services and better communication between health staff and patients. CONCLUSION: Desirable qualities of an ideal UEC system from a service user perspective related to simplifying access for example, through a single point of access system where health professionals decide the appropriate service required and improving continuity of care through better integration of UEC services. Service users value reassurance and communication from health professionals about care pathways and care choices, and this helps service users feel more in control of their healthcare journey.


Assuntos
Assistência à Saúde/normas , Serviços Médicos de Emergência/normas , Satisfação do Paciente/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Assistência Ambulatorial/métodos , Assistência Ambulatorial/normas , Assistência Ambulatorial/estatística & dados numéricos , Assistência à Saúde/estatística & dados numéricos , Serviços Médicos de Emergência/métodos , Serviços Médicos de Emergência/estatística & dados numéricos , Feminino , Grupos Focais/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Medicina Estatal/estatística & dados numéricos
13.
BMC Palliat Care ; 19(1): 8, 2020 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-31937289

RESUMO

BACKGROUND: There is little information about how healthcare professionals feel about providing palliative care for patients with a substance use disorder (SUD). Therefore, this study aims to explore: 1) the problems and needs experienced by healthcare professionals, volunteers and experts-by-experience (HCP/VE) during their work with patients with SUD in a palliative care trajectory and; 2) to make suggestions for improvements using the quality of care model by Donabedian (Structure, Process, Outcome). METHODS: A qualitative study was conducted, consisting of six focus group interviews which consisted of HCP/VE working with patients with SUD in a palliative care phase. At the end of the focus group interviews, participants structured and summarized their experiences within a Strengths, Weaknesses, Opportunities and Threats (SWOT) framework. Interview transcripts (other than the SWOT) were analysed by the researchers following procedures from the Grounded Theory Approach ('Grounded Theory Lite'). SWOT-findings were not subjected to in-depth analysis. RESULTS: HCP/VE stated that within the Structure of care, care networks are fragmented and HCP/VE often lack knowledge about patients' multiplicity of problems and the time to unravel these. Communication with this patient group appears limited. The actual care-giving Process requires HCP/VE a lot of creativity and time spent seeking for cooperation with other caregivers and appropriate care settings. The latter is often hindered by stigma. Since no formalized knowledge is available, care-delivery is often exclusively experience-based. Pain-medication is often ineffective due to active substance use. Finally, several Outcomes were brought forward: Firstly, a palliative care phase is often identified only at a late stage. Secondly, education and a (mobile) team of expertise are desired. Thirdly, care for the caregivers themselves is often de-prioritized. CONCLUSIONS: Better integration and collaboration between the different professionals with extensive experience in addiction, palliative and general curative care is imperative to assure good palliative care for patients with SUD. Currently, the resources for this care appear to be insufficient. Development of an educational program and social mapping may be the first steps in improving palliative care for patients with severe SUD.


Assuntos
Pessoal de Saúde/psicologia , Cuidados Paliativos/métodos , Transtornos Relacionados ao Uso de Substâncias/complicações , Medicina do Vício , Adulto , Idoso , Atitude do Pessoal de Saúde , Feminino , Grupos Focais/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos/tendências , Pesquisa Qualitativa , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Voluntários/psicologia
14.
Intensive Crit Care Nurs ; 57: 102796, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31959379

RESUMO

OBJECTIVES: Explore critical care nurses' personal perceptions of expertise, expert performance and transition from novice to expert performer in clinical practice. DESIGN: Following constructivist approach to grounded theory this investigation used qualitative open-ended interviews focused on the social construction of expertise in critical care nursing and the experiences of clinical practice that define that process. SETTING: A multi-site urban area in the southeastern United States. PARTICIPANTS: 10 certified critical care nurses, three males and seven females, with 10-30+ years of critical care experience. FINDINGS: Experience and knowledge are the foundation of expertise and expert performance. The higher the acuity the more frequent the experience the greater the nurses' aptitude and opportunity for learning and professional growth. It was also noted that self-actualisation was a major determinant in the development of expertise in critical care. CONCLUSION: Key findings suggested that clinical experience and personal motivation combined with self-actualisation, the drive to maximise personal potential, determine critical care nurse's trajectory towards professional excellence. Expert performance evolves over time. Knowledge acquisition and experience have an interdependent reciprocal relationship inferring that you cannot have one without the other. Social expectations and experiences have a direct impact on professional aptitude and development if expertise.


Assuntos
Competência Clínica/normas , Enfermeiras e Enfermeiros/normas , Adulto , Atitude do Pessoal de Saúde , Competência Clínica/estatística & dados numéricos , Enfermagem de Cuidados Críticos/métodos , Enfermagem de Cuidados Críticos/normas , Enfermagem de Cuidados Críticos/estatística & dados numéricos , Feminino , Grupos Focais/métodos , Teoria Fundamentada , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Pesquisa Qualitativa
15.
BMC Palliat Care ; 19(1): 10, 2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31948417

RESUMO

BACKGROUND: PaTz (palliative care at home) is a method to improve palliative care in the primary care setting in the Netherlands. PaTz has three basic principles: (1) local GPs and DNs meet at least six times per year to identify and discuss their patients with a life-threatening illness; (2) these meetings are supervised by a specialist palliative care professional; (3) groups use a palliative care register on which all identified patients are listed. Since the start in 2010, the number of PaTz-groups in the Netherlands has been growing consistently. Although the theory of all PaTz-groups is the same, the practical functioning of PaTz-groups may vary substantially, which may complicate further implementation of PaTz as well as interpretation of effect studies. This study aims to describe the variation in practice of PaTz-groups in the Netherlands. METHOD: In this prospective observational study, ten PaTz-groups logged and described the activities in their meetings as well as the registered and discussed patients and topics of discussions in registration forms for a 1 year follow-up period. In addition, non-participatory observations were performed in all participating groups. Meeting and patient characteristics were analysed using descriptive statistics. Conventional content analysis was performed in the analysis of topic discussions. RESULTS: While the basic principles of PaTz are found in almost every PaTz-group, there is considerable variation in the practice and content of the meetings of different PaTz-groups. Most groups spend little time on other topics than their patients, although the number of patients discussed in a single meeting varies considerably, as well as the time spent on an individual patient. Most registered patients were diagnosed with cancer and patient discussions mainly concerned current affairs and rarely concerned future issues. CONCLUSION: The basic principles are the cornerstone of any PaTz-group. At the same time, the observed variation between PaTz-groups indicates that tailoring a PaTz-group to the needs of its participants is important and may enhance its sustainability. The flexibility of PaTz-groups may also provide opportunity to modify the content and tools used, and improve identification of palliative patients and advance care planning.


Assuntos
Medicina Geral/normas , Cuidados Paliativos/métodos , Avaliação de Programas e Projetos de Saúde/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Grupos Focais/métodos , Medicina Geral/métodos , Medicina Geral/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Cuidados Paliativos/normas , Cuidados Paliativos/tendências , Avaliação de Programas e Projetos de Saúde/métodos , Estudos Prospectivos , Pesquisa Qualitativa
16.
BMC Psychiatry ; 20(1): 29, 2020 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-31996175

RESUMO

BACKGROUND: People with psychosis experience more social isolation than any other diagnostic group and have smaller social networks than the general population. This isolation can have a detrimental effect on quality of life. No direct, standardised interventions have been developed to specifically target this issue. Stakeholders input appears crucial in the process of developing such an intervention. This study aimed to identify the main considerations when developing an intervention aiming to reduce social isolation in people with psychosis. METHODS: Focus groups and individual interviews were conducted with patients, carers and mental health staff. Data was thematically analysed. RESULTS: Thirty four patients with psychosis, 26 carers of people experiencing psychosis and 22 mental health professionals participated in the study. Suggested aspects to be considered in a novel intervention were: i) finding and training the right staff member; ii) discussing negative social attitudes and patients' previous negative experiences, iii) addressing personal ambivalence; iv) establishing how best to provide information about social activities; v) facilitating access to social activities, vi) striking a balance between support and independence. CONCLUSION: The suggestions identified can help to develop more targeted approaches to reduce social isolation within this patient group. A patient-centred approach and generic communication skills appear to be underpinning most of the helpful elements identified, whilst specific techniques and skills can help to overcome negative past experiences and motivational barriers.


Assuntos
Cuidadores/psicologia , Transtornos Psicóticos/psicologia , Transtornos Psicóticos/terapia , Isolamento Social/psicologia , Rede Social , Participação dos Interessados/psicologia , Adulto , Idoso , Feminino , Grupos Focais/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida/psicologia
17.
AORN J ; 111(2): 211-220, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31997315

RESUMO

The purpose of patient positioning is to provide optimal surgical site exposure for surgical team members and prevent negative patient outcomes. This study explores perioperative nurses' experiences when positioning patients for surgery. We collected data using focus group interviews of 17 OR nurses in Norway and used qualitative content analysis to analyze the data. The study findings showed that perioperative nurses emphasized their most important priorities as concepts that can be categorized into three themes: leading and coordinating patient positioning, ensuring patient safety, and promoting efficient use of OR nurses' expertise. The study findings also identify a need to define formal responsibilities in patient positioning and processes for determining positioning outcomes. Perioperative leaders should verify OR nurse competence for patient positioning to help ensure continuity and safety in complex patient pathways.


Assuntos
Prioridades em Saúde/normas , Enfermeiras e Enfermeiros/psicologia , Posicionamento do Paciente/métodos , Enfermagem Perioperatória/normas , Grupos Focais/métodos , Prioridades em Saúde/estatística & dados numéricos , Humanos , Noruega , Enfermeiras e Enfermeiros/estatística & dados numéricos , Posicionamento do Paciente/normas , Posicionamento do Paciente/estatística & dados numéricos , Direitos do Paciente , Enfermagem Perioperatória/métodos , Enfermagem Perioperatória/estatística & dados numéricos , Pesquisa Qualitativa
18.
Australas Emerg Care ; 23(1): 37-46, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31948933

RESUMO

BACKGROUND: Little is known about how Australian national safety standards for communicating multidisciplinary care are operationalised during high-risk care transitions. We examined transfer of care for complex patients from the emergency department (ED) to medical wards to explore nurse-to-nurse communication about multidisciplinary care provided in the ED. METHODS: Using naturalistic, mixed-methods design, observation, audit and interview data were collected from a convenience sample of 38 nurses during transfer of care for 19 complex patients from the ED to medical wards at a tertiary hospital. A focus group with 19 clinicians from multiple disciplines explored explanations for findings and recommendations. Quantitative data were analysed using frequencies and descriptive statistics; the Connect, Observe, Listen, Delegate (COLD) framework informed qualitative content analysis. RESULTS: Nurses seldom communicated multidisciplinary care at patient transfer. Most handovers included Connect and Observe (63-95%) and Listen (90%); Delegate (42%) behaviours were infrequent. Behaviours consistent with good practice recommendations (90%) and known to increase communication risk (53%) were observed. Tensions between policies and clinical processes, and information quality negatively impacted transfers. CONCLUSIONS: This study revealed gaps in nurse-to-nurse communication about patients' multidisciplinary care. Complex factors negatively impact nurses' handover communication necessitating workarounds, and highlighting nurses' role as patient safety advocates.


Assuntos
Comunicação Interdisciplinar , Enfermeiras e Enfermeiros/psicologia , Transferência da Responsabilidade pelo Paciente/normas , Adulto , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Grupos Focais/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Transferência da Responsabilidade pelo Paciente/estatística & dados numéricos , Segurança do Paciente/normas , Segurança do Paciente/estatística & dados numéricos , Quartos de Pacientes/organização & administração , Quartos de Pacientes/estatística & dados numéricos , Pesquisa Qualitativa , Vitória
19.
Matern Child Health J ; 24(4): 456-461, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31893386

RESUMO

OBJECTIVE: Parents' concerns about vaccine safety and side effects likely contribute to low rates of human papillomavirus (HPV) vaccination among adolescents. To facilitate parent-provider discussions about the HPV vaccine, we developed and tested the content of a clinical decision support application for implementation in pediatric clinical settings. This study sought to elicit perspectives of parents and providers on the best way to communicate information on vaccine side effects. METHODS: To understand the acceptability of the application's content, we conducted focus groups with parents (n = 11) and providers (n = 9) at three primary care clinics. Focus groups transcriptions were analyzed using iterations of deductive and inductive coding, with independent coding by two trained reviewers to improve inter-rater reliability. RESULTS: Surprisingly, when parents reviewed screen shots of HPV vaccine safety and side effect messages, parents took exception to the expression "no evidence of serious side effects". Parents wanted side effects listed explicitly so they could decide for themselves which side effects were "serious". Parents also felt that the HPV vaccine did have serious side effects, and the wording undermined their trust in the vaccine messaging overall. Providers accepted the phrasing of side effects and did not express concerns that parents would object to the messaging. CONCLUSIONS: Further research is needed to confirm parents' concerns with the phrasing "no serious side effects" for the HPV vaccine and to assess the impact on HPV vaccination deferral or delay.


Assuntos
Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/normas , Pais/psicologia , Adolescente , Adulto , Criança , Estudos de Viabilidade , Feminino , Florida , Grupos Focais/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/tratamento farmacológico , Vacinas contra Papillomavirus/uso terapêutico , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Projetos Piloto , Pesquisa Qualitativa
20.
Nurse Educ Pract ; 42: 102686, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31901489

RESUMO

Developing professionals who are perceptive to the needs of patients and can respond by expressing empathetic behavior is one of the aims of health care education. The aim of this study was to explore the level of empathy in health care students through a mixed method. The quantitative approach included the use of the Jefferson Scale of Empathy and the qualitative a focus group approach to further deepen into the descriptive results. 869 health care students (RR=81%) participated in the study and the level of empathy ranged from 42 to 139 with a mean score of 100.6 (20-140 scale). Significant statistical differences were found between the disciplines (F=8.6, p-value<0.001) and gender (p-value<0.001) with nursing students and women scoring the higher levels. Two focus groups of ten participants each were conducted with 3rd and 4th year nursing students. Four themes were derived from the analysis of these data a) empathy as an imperative component of care b) contact with the clinical reality c) the influence of family and choice of studies d) gender stereotypes. There is a lack of mixed methodologies in the empathy research and this study provided the opportunity of a better understanding of the health care students' views.


Assuntos
Empatia/classificação , Estudantes de Enfermagem/psicologia , Adulto , Análise de Variância , Currículo/tendências , Chipre , Feminino , Grupos Focais/métodos , Humanos , Masculino , Psicometria/instrumentação , Psicometria/métodos , Pesquisa Qualitativa , Estudantes de Enfermagem/estatística & dados numéricos , Inquéritos e Questionários
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