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2.
Front Public Health ; 8: 582699, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33313038

RESUMO

Background: From the beginning of March 2020, lockdown regimens prevented patients with obesity from receiving bariatric surgery. Surgical emergencies and oncological procedures were the only operations allowed in public hospitals. Consequently, patients with morbid obesity were put in a standby situation. With the aim at exploring the viewpoint of our future bariatric surgery patients, we built a questionnaire concerning obesity and COVID-19. Method: A total of 116 bariatric surgery candidates were approached using a telephonic interview during the Italian lockdown. Results: Of the total sample, 73.8% were favorable to regular bariatric surgery execution. Forty percent were concerned about their own health status due to the COVID-19 emergency, and 61.1% were troubled by the temporary closure of the bariatric unit. The majority of the sample were eating more. Forty-five percent and the 27.5% of patients reported a worsening of the emotional state and physical health, respectively. Most of the patients (52.2%) considered themselves more vulnerable to COVID-19, especially individuals with class III obesity. Patients who reported an increased consumption of food were younger (43.44 ± 12.16 vs. 49.18 ± 12.66; F = 4.28, p = 0.042). No gender difference emerged. Conclusion: The lockdown had a negative result on Italian patients' psychological well-being and eating habits. The majority of patients would have proceeded with the surgery even during the COVID-19 emergency. Effective management and bariatric surgery should be restarted as soon as possible.


Assuntos
Cirurgia Bariátrica/estatística & dados numéricos , Comportamento Alimentar/psicologia , Saúde Mental , Obesidade Mórbida/cirurgia , Listas de Espera , Adulto , Cirurgia Bariátrica/psicologia , Feminino , Humanos , Entrevistas como Assunto , Itália , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/psicologia , Pacientes/estatística & dados numéricos , Inquéritos e Questionários
3.
BMC Public Health ; 20(1): 1527, 2020 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-33032559

RESUMO

BACKGROUND: Spontaneous reporting (SR) of adverse drug reactions (ADRs) from patients can be considered as a valuable activity providing both objective and subjective data. However, improving the rate of under-reporting has been a major challenge to ensure successful operation of the SR system. This study aimed to assess knowledge, attitude, and intent to report ADRs and explore the factors contributing to consumers' reporting intent in South Korea. METHODS: Self-administered questionnaire was collected from a sex-, age-, and regionally stratified nationwide convenience sample of consumers using a commercial panel in December 2018. Univariate and multivariate logistic regression analyses were used to explore the factors contributing to the intent to report ADRs by consumers. RESULTS: A total of 1000 respondents were enrolled in the survey; 50.9% were males and the mean age was 44.4 (standard deviation, 13.3) years. While less than 15% of the respondents were aware of the SR system and even fewer (3.4%) had actual experience of SR, however, 59.2% expressed their intent to report ADRs. The positive attitude (adjusted odds ratio [aOR] 3.972, p < 0.001), awareness of the SR system (aOR 2.102, p < 0.01), self-efficacy for SR (aOR 1.956, p < 0.001), and experiences related to ADR counselling with healthcare professionals (OR 2.318, p < 0.001) are the significant factors contributing to reporting intent. CONCLUSIONS: Findings of this study highlight the need for increasing the awareness of the SR system among consumers and empowering them to report ADRs by themselves, which would ultimately improve the drug-safety environment.


Assuntos
Sistemas de Notificação de Reações Adversas a Medicamentos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Intenção , Pacientes/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes/estatística & dados numéricos , República da Coreia , Inquéritos e Questionários
4.
J Prim Care Community Health ; 11: 2150132720954687, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32865152

RESUMO

BACKGROUND: COVID-19 is a highly infectious disease which usually presents with respiratory symptoms. This virus is disseminated through respiratory droplets, and, therefore, individuals residing in close quarters are at a higher risk for the acquisition of infection. The prison population is at a significantly increased risk for infection. METHODS: Prisoners from the Montford Correctional facility in Lubbock, Texas, hospitalized in the medical intensive care unit at University Medical Center between March 1, 2020 and May 15, 2020 were compared to community-based patients hospitalized in the same medical intensive care unit. Clinical information, laboratory results, radiographic results, management requirements, and outcomes were compared. RESULTS: A total of 15 community-based patients with a mean age of 67.4 ± 15.5 years were compared to 5 prisoners with a mean age of 56.0 ± 9.0 years. All prisoners were men; 10 community-based patients were men. Prisoners presented with fever, dyspnea, and GI symptoms. The mean number of comorbidities in prisoners was 2.4 compared to 1.8 in community-based patients. Prisoners had significantly lower heart rates and respiratory rates at presentation than community-based patients. The mean length of stay in prisoners was 12.6 ± 8.9 days; the mean length of stay in community-based patients was 8.6 ± 6.5. The case fatality rate was 60% in both groups. CONCLUSIONS: Prisoners were younger than community-based patients but required longer lengths of stay and had the same mortality rate. This study provides a basis for comparisons with future studies which could involve new treatment options currently under study.


Assuntos
Infecções por Coronavirus/terapia , Cuidados Críticos/estatística & dados numéricos , Pandemias , Pacientes/estatística & dados numéricos , Pneumonia Viral/terapia , Prisioneiros/estatística & dados numéricos , Centros Médicos Acadêmicos , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Feminino , Hospitalização , Humanos , Unidades de Terapia Intensiva , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Estudos Retrospectivos , Texas/epidemiologia , Resultado do Tratamento
5.
PLoS One ; 15(9): e0239679, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32970741

RESUMO

BACKGROUND: Undergo a health check for cardiovascular disease (CVD) is an important strategy to improve cardiovascular (CV) health. Men are reported to be less likely to undergo cardiovascular disease (CVD) health check than women. Gender difference could be one of the factors influencing health seeking behaviour of men and women. We aimed to identify gender differences in factors influencing the intention to undergo CVD health checks. METHODS: This was a cross-sectional survey using mall intercept interviews. Malaysians aged ≥30 years without known CVD were recruited. They were asked for their intention to undergo CVD health checks and associated factors. The factors included seven internal factors that were related to individuals' attitude, perception and preparedness for CVD health checks and two external factors that were related to external resources. Hierarchical ordinal regression analysis was used to evaluate the importance of the factors on intention to undergo CVD health checks, for men and women separately. RESULTS: 397 participants were recruited, 60% were women. For men, internal factors explained 31.6% of the variances in likeliness and 9.6% of the timeline to undergo CVD health checks, with 1.2% and 1.8% added respectively when external factors were sequentially included. For women, internal factors explained 18.9% and 22.1% of the variances, with 3.1% and 4.2% added with inclusion of the external factors. In men, perceived drawbacks of health checks was a significant negative factor associated with likeliness to undergo CVD health checks (coefficient = -1.093; 95%CI:-1.592 to -0.594), and timeline for checks (coefficient = -0.533; 95%CI:-0.975 to -0.091). In women, readiness to handle outcomes following health checks was significantly associated with likeliness to undergo the checks (coefficient = 0.575; 95%CI: 0.063 to 1.087), and timeline for checks (coefficient = 0.645; 95%CI: 0.162 to 1.128). Both external factors 1) influence by significant others (coefficient = 0.406; 95%CI: 0.013 to 0.800) and 2) external barriers (coefficient = -0.440; 95%CI:-0.869 to -0.011) were also significantly associated with likeliness to undergo CVD health checks in women. CONCLUSIONS: Both men and women were influenced by internal factors in their intention to undergo CVD health checks, and women were also influenced by external factors. Interventions to encourage CVD health checks need to focus on internal factors and be gender sensitive.


Assuntos
Doenças Cardiovasculares/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes/estatística & dados numéricos , Fatores Sexuais
6.
PLoS One ; 15(9): e0239656, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32970770

RESUMO

It is necessary to understand the learning needs of heart failure (HF) patients to provide adequate patient education. It is necessary to identify what HF patients want to know and how this differs from the educational needs of healthcare providers. The aim of this descriptive and exploratory study was to evaluate and compare the learning needs priorities between HF patients and their healthcare providers. One hundred patients with HF and 20 healthcare providers were recruited from cardiovascular outpatient clinics at 2 large tertiary medical centers in South Korea. Learning needs were measured using a self-administered questionnaire with the Heart Failure Patients' Learning Needs Inventory. Data were analyzed using SPSS 23.0 program. Overall rank orders for 48 items were similar in both groups (Spearman rank order correlation 0.605, p < .001). The educational topics of medications and worsening signs and symptoms ranked highest in both groups. However, healthcare providers were more concerned with diet management than were the patients (mean score 4.18 vs. 3.62; p = .001). The study showed both similarities and differences between the assessments of the patients and healthcare providers of detailed educational learning needs. It is important to develop patient-centered educational materials considering HF patients' actual learning needs, and also to provide comprehensive and practical patient education based on a supportive understanding of healthcare provider needs.


Assuntos
Pessoal de Saúde/educação , Insuficiência Cardíaca/epidemiologia , Aprendizagem , Determinação de Necessidades de Cuidados de Saúde , Educação de Pacientes como Assunto/estatística & dados numéricos , Adulto , Feminino , Pessoal de Saúde/estatística & dados numéricos , Prioridades em Saúde , Insuficiência Cardíaca/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes/estatística & dados numéricos
7.
Environ Health Prev Med ; 25(1): 36, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32738883

RESUMO

BACKGROUND: Few studies have specifically addressed quality of life issues for elderly hospice patients. The purpose of this study is to explore various factors and service patterns of the quality of life of end-of-life care for the elderly. METHODS: We collect the data and make small-scale exploratory study via semi-structured individual interviews. Data were collected from the family of 2 elderly cancer patients receiving hospice services, and the data were analyzed qualitatively. RESULTS: After investigation, we found that elderly people in hospice care, regardless of age, are suffering from physical and psychological pain and do not want to spend the rest of their lives in the hospital, but want to die in their own homes. CONCLUSIONS: Both hospitalization and in-home care can improve resource utilization, and the key is to find various factors affecting the quality of life. Improving the quality of life is what patients and their families need most.


Assuntos
Pessoal de Saúde/psicologia , Cuidados Paliativos na Terminalidade da Vida/estatística & dados numéricos , Neoplasias/terapia , Pacientes/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Serviço Social , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Pessoal de Saúde/estatística & dados numéricos , Cuidados Paliativos na Terminalidade da Vida/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes/psicologia
8.
Am J Disaster Med ; 15(2): 99-111, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804390

RESUMO

OBJECTIVE: Identify operational lessons to support hospital and health system preparedness and response for sea-sonal and pandemic influenza based on firsthand experiences from the 2017-2018 influenza season. DESIGN: We conducted semistructured, retrospective interviews with New York City Health+Hospitals (NYCH+H) personnel to gather firsthand experiences from the 2017-2018 influenza season and evaluated stress data across four operational domains reported by NYCH+H hospitals during the 2017-2018 influenza season. SETTING: Frontline hospitals in the NYCH+H health system during and after the 2017-2018 influenza season. PARTICIPANTS: Interviews conducted with personnel from 5 NYCH+H frontline hospitals. Operational stress data re-ported by 11 NYCH+H hospitals during the 2017-2018 influenza season. MAIN OUTCOME MEASURES: Operational challenges and lessons from frontline hospitals responding to severe sea-sonal influenza. RESULTS: Operational stresses during the 2017-2018 influenza season varied over the influenza season, between facilities, and across operational domains. Patient surge and staff absenteeism pushed some facilities to their limits, and supply shortages highlighted shortcomings in existing procurement systems. Resources tied to pandemic influ-enza were unavailable without a pandemic declaration. CONCLUSION: Seasonal influenza poses dynamic operational stresses across health systems and cities, potentially causing major impacts outside of declared pandemics. Lessons from NYCH+H can help other hospitals and health systems anticipate operational challenges, but novel solutions are needed to mitigate effects of patient surge and per-sonnel and supply shortages during severe influenza seasons and pandemics. Improved data collection can help health systems better understand operational stresses and challenges across their facilities.


Assuntos
Assistência à Saúde/organização & administração , Pessoal de Saúde/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Influenza Humana , Pacientes/estatística & dados numéricos , Absenteísmo , Pessoal de Saúde/psicologia , Planejamento em Saúde/organização & administração , Administração Hospitalar , Humanos , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Entrevistas como Assunto , Cidade de Nova Iorque/epidemiologia , Pandemias , Estudos Retrospectivos , Estações do Ano
9.
JAMA ; 324(3): 270-278, 2020 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-32692387

RESUMO

Importance: Philanthropy is an increasingly important source of support for health care institutions. There is little empirical evidence to inform ethical guidelines. Objective: To assess public attitudes regarding specific practices used by health care institutions to encourage philanthropic donations from grateful patients. Design, Setting, and Participants: Using the Ipsos KnowledgePanel, a probability-based sample representative of the US population, a survey solicited opinions from a primary cohort representing the general population and 3 supplemental cohorts (with high income, cancer, and with heart disease, respectively). Exposures: Web-based questionnaire. Main Outcomes and Measures: Descriptive analyses (with percentages weighted to make the sample demographically representative of the US population) evaluated respondents' attitudes regarding the acceptability of strategies hospitals may use to identify, solicit, and thank donors; perceptions of the effect of physicians discussing donations with their patients; and opinions regarding gift use and stewardship. Results: Of 831 individuals targeted for the general population sample, 513 (62%) completed surveys, of whom 246 (48.0%) were women and 345 (67.3%) non-Hispanic white. In the weighted sample, 47.0% (95% CI, 42.3%-51.7%) responded that physicians giving patient names to hospital fundraising staff after asking patients' permission was definitely or probably acceptable; 8.5% (95% CI, 5.7%-11.2%) endorsed referring without asking permission. Of the participants, 79.5% (95% CI, 75.6%-83.4%) reported it acceptable for physicians to talk to patients about donating if patients have brought it up; 14.2% (95% CI, 10.9%-17.6%) reported it acceptable when patients have not brought it up; 9.9% (95% CI, 7.1%-12.8%) accepted hospital development staff performing wealth screening using publicly available data to identify patients capable of large donations. Of the participants, 83.2% (95% CI, 79.5%-86.9%) agreed that physicians talking with their patients about donating may interfere with the patient-physician relationship. For a hypothetical patient who donated $1 million, 50.1% (95% CI, 45.4%-54.7%) indicated it would be acceptable for the hospital to show thanks by providing nicer hospital rooms, 26.0% (95% CI, 21.9%-30.1%) by providing expedited appointments, and 19.8% (95% CI, 16.1%-23.5%) by providing physicians' cell phone numbers. Conclusions and Relevance: In this survey study of participants drawn from the general US population, a substantial proportion did not endorse legally allowable approaches for identifying, engaging, and thanking patient-donors.


Assuntos
Atitude Frente a Saúde , Obtenção de Fundos/métodos , Doações , Hospitais , Pacientes/psicologia , Papel do Médico/psicologia , Adulto , Distribuição por Idade , Idoso , Estudos de Coortes , Economia Hospitalar , Feminino , Obtenção de Fundos/ética , Doações/ética , Cardiopatias , Hospitais/ética , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Neoplasias , Pacientes/estatística & dados numéricos , Probabilidade , Distribuição por Sexo , Fatores Socioeconômicos , Inquéritos e Questionários/estatística & dados numéricos , Estados Unidos , Adulto Jovem
10.
PLoS One ; 15(7): e0235539, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32615581

RESUMO

The scope of practice of the osteopathic profession in Italy is underreported. The first part of the present study investigated the Italian osteopaths' profile, focusing on the socio-demographic information and geographical distribution together with the main characteristics of their education. The OPERA-IT study highlighted that the majority of respondents declared to work as sole practitioners (58.4%), while the remaining declared to work as part of a team. Since teamwork and networking are recognized as fundamental aspects of healthcare, the present study aims to compare the osteopathic practice, diagnostic and treatment modalities of osteopaths who work as a sole practitioner and osteopaths who work as part of a team to highlight possible differences. Moreover, patients' characteristics will be presented. The OPERA-IT study population was chosen to provide a representative sample. A web campaign was set up to inform the Italian osteopaths before the beginning of the study. The OPERA IT study used a previously tested questionnaire. The questionnaire was translated into Italian following the World Health Organization recommendation. The questionnaire was composed of 57 items grouped in five sections, namely: socio-demographics, osteopathic education and training, working profile, organization, and management of the clinical practice and patient profile. The survey was delivered online through a dedicated platform. The survey was completed by 4,816 individuals. Osteopaths who work as sole practitioners represented the majority of the sample (n = 2814; 58.4%). Osteopaths who work as part of a team declared to collaborate mostly with physiotherapists (n = 1121; 23.3%), physicians with speciality (n = 1040; 21.6%), and other osteopaths (n = 943; 19.6%). The two groups showed heterogeneous characteristics. Significative differences were observed in all the factors, namely: geographical distribution, age, gender, training, working contract and working place, daily consultations and time for each consultation, fees, and the average waiting period to book an appointment. The principal component analysis supported a ten-component model and explained 80.5% of the total variance. The analysis showed that osteopaths working as sole practitioners have an increased probability (OR = 0.91; CI 95%: 0.88-0.94; p<0.01) of using systemic diagnostic and treatment techniques and have distinct clinical features with higher probability (OR = 0.92; 0.88-0.96; p<0.01) of spending less time with patients, being paid less but treating a higher number of patients per week. The most represented patients' age groups were 41-64 years old (n = 4452; 92.4%) and 21-40 years old (n = 4291; 89.1%). Similarly, the most reported new patients' age groups were 41-64 years old (n = 4221; 87.7%) and 21-40 years old (n = 3364; 69.9%). The most common presenting complaints were back pain, neck pain, cervical radiculopathy, sciatica, shoulder pain, and headaches. Osteopathic practice in Italy seems to be characterised by interprofessional collaboration, mostly with physiotherapists. Our results highlighted two different profiles in terms of sociodemographic characteristics and work modalities between osteopaths who work as sole practitioners and those who work as part of a team. Although according to the respondents, people of all ages consult Italian osteopaths, the majority of patients are adults. Most of them have been referred to osteopathy by other patients or acquaintances. Patients seek osteopathic care mostly for musculoskeletal related complaints.


Assuntos
Médicos Osteopáticos/psicologia , Adulto , Bases de Dados Factuais , Feminino , Humanos , Itália , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/diagnóstico , Doenças Musculoesqueléticas/terapia , Pacientes/estatística & dados numéricos , Análise de Componente Principal , Encaminhamento e Consulta/economia , Inquéritos e Questionários , Adulto Jovem
11.
BMC Psychiatry ; 20(1): 276, 2020 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-32493263

RESUMO

BACKGROUND: The underestimation of depression among men may result from atypical depression symptoms and male help-seeking behaviour. However, higher suicide rates among men than among women indicate a need for gender-specific services for men with depression. In order to develop gender-specific services, it is essential to examine professionals' attitudes towards men's depressive symptoms and treatment needs as well as barriers to and facilitators of treatment. This study examined gender-specific treatment needs in male patients and treatment approaches to male patients from a professional perspective. METHODS: Semi-structured face-to-face interviews were conducted with 33 mental health professionals (MHPs) from five German psychiatric institutions. The study assessed the characteristics and attributes of male patients with depression risk factors for the development of depression among men, their condition at the beginning of treatment, male patients' depressive symptoms, the needs and expectations of male patients, the importance of social networks in a mental health context, and MHPs' treatment aims and treatment methods. Transcripts were analysed using qualitative content analysis. RESULTS: The professionals' reference group of male patients were men who were characterised in accordance with traditional masculinity. Attributes reported as in line with this type of men were late initiations of inpatient treatment after crisis, suicidal ideation or attempted suicide, and high expectations towards treatment duration, success rate in recovery and therapeutic sessions. In contrast, male patients who deviate from these patterns were partially described with reference to female stereotypes. Professionals referred to psychosocial models in their explanations of the causes of depression and provided sociological explanations for the development of masculine ideals among men. The consequences of these for treatment were discussed against the background of normative expectations regarding the male gender. From the professionals' point of view, psychoeducation and the acceptance of depression (as a widespread mental illness) were the most important goals in mental health treatment. CONCLUSIONS: In order to improve mental health among men, gender-specific services should be offered. Awareness of the role of gender and its implications on mental health treatment should be an integral part of MHPs' education and their daily implementation of mental health treatment practices.


Assuntos
Atitude do Pessoal de Saúde , Depressão/psicologia , Depressão/terapia , Homens/psicologia , Saúde Mental/estatística & dados numéricos , Pesquisa Qualitativa , Adulto , Assistência à Saúde/estatística & dados numéricos , Depressão/epidemiologia , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Masculinidade , Saúde do Homem/estatística & dados numéricos , Pessoa de Meia-Idade , Pacientes/psicologia , Pacientes/estatística & dados numéricos , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Adulto Jovem
12.
PLoS One ; 15(6): e0235001, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32559245

RESUMO

Effective adoption of genetics in clinical practice requires the support of and interaction between the different partners of healthcare system; healthcare professionals (HCPs) and patients. The study aimed to assess and compare the knowledge, factors affecting the knowledge, and concerns of HCPs and patients regarding genetic-related issues such as lack of knowledge about genetics and genetic conditions, awareness of the importance of genetics in clinical practice and genetic services and resources deficits. A cross sectional study was conducted in different areas of Jordan using a convenient sampling approach. An English questionnaire was self-administered to HCPs. Face-to-face interviews were conducted with patients in Arabic by trained researcher. A total of 1000 HCPs and 1448 patients were recruited. There was a significant difference (p<0.001) in the knowledge between HCPs and patients. Among HCPs, physicians (OR = 2.278, 95%CI = 1.410-3.680, p = 0.001) and pharmacists (OR = 2.163, 95%CI = 1.362-3.436, p = 0.001) were more knowledgeable than nurses. In addition, females were more knowledgeable than males (OR = 1.717, 95%CI = 1.203-2.451, p = 0.003). Among patients, participants who had a bachelor degree (OR = 1.579, 95%CI = 1.231-2.025, p<0.001) were more knowledgeable compared to those who only had school education. HCPs appeared to have more concerns than patients (p<0.001) regarding all genetic-related issues. These findings suggested a positive association between education and genetic knowledge as well as concerns; as HCPs were more knowledgeable and concerned than patients. Appropriate integration and expansion of basic genetic knowledge courses and clinical genetic training in the curriculum should be adopted to prepare HCPs to enhance the integration of genetic information in clinical settings.


Assuntos
Serviços em Genética , Genética Médica , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Pacientes/psicologia , Adulto , Feminino , Letramento em Saúde/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Humanos , Jordânia , Masculino , Pessoa de Meia-Idade , Pacientes/estatística & dados numéricos
13.
Online braz. j. nurs. (Online) ; 19(2)jun. 2020. tab, graf
Artigo em Inglês, Espanhol, Português | LILACS, BDENF - Enfermagem | ID: biblio-1120707

RESUMO

OBJETIVOS: Descrever as características sociodemográficas e clínicas dos pacientes oncológicos atendidos em unidades de pronto-socorro; identificar os sintomas presentes nas últimas 24 horas; avaliar a correlação entre os dados sociodemográficos e clínicos com os sintomas apresentados. MÉTODO: descritivo, transversal, quantitativo, realizado na unidade de pronto-socorro de um hospital público geral do munícipio de São Paulo. RESULTADOS: amostra não probabilística, com 44 pacientes. Os cânceres mais prevalentes foram os geniturinários (15,9%) e hematológicos (15,9%). Os sinais e sintomas mais incidentes foram: dor com uma média de 6,6 (0-10; DP= 3,9) e alteração do apetite 6,6 (0-10; DP= 3,8). Quanto à intensidade dos sintomas, a prevalência foi do item "preocupação" com média de 7,1 (0-10; DP= 3,6). Quanto à capacidade do sintoma de interferir na vida, o item de maior prevalência foi "atividades em geral" com uma média de 9,1 (0-10; DP= 2,2). CONCLUSÃO: as características sociodemográficas e econômicas correlacionaram-se com as características clínicas.


OBJETIVOS: Describir las características sociodemográficas y clínicas de pacientes con cáncer tratados en unidades de emergencia; identificar los síntomas presentes en las últimas 24 horas; Evaluar la correlación entre los datos sociodemográficos y clínicos con los síntomas presentados. MÉTODO descriptivo, transversal, cuantitativo, realizado en el servicio de urgencias de un hospital público general del municipio de São Paulo. RESULTADOS: muestra no probabilística, con 44 pacientes. Los cánceres más prevalentes fueron genitourinarios (15.9%) y hematológicos (15.9%). Los signos y síntomas más incidentes fueron: dolor con un promedio de 6.6 (0-10; DP = 3.9) y alteración del apetito 6.6 (0-10; DP = 3.8). En cuanto a la intensidad de los síntomas, la prevalencia fue del ítem "preocupación" con una media de 7.1 (0-10; DP = 3.6). En cuanto a la capacidad del síntoma de interferir con la vida, el ítem más frecuente fue "actividades en general" con un promedio de 9.1 (0-10;DP=2.2). CONCLUSIÓN características sociodemográficas y económicas correlacionadas con características clínicas.


OBJECTIVES: To discover the sociodemographic and clinical characteristics of oncology patients attended in emergency care units; identify the symptoms present in the last 24 hours; evaluate the correlation between the sociodemographic and clinical data with the symptoms presented. METHOD: descriptive, cross-sectional, quantitative, carried out in an emergency care unit of a pubic general hospital in the municipality of São Paulo. RESULTS: nonprobabilistic sample with 44 patients. The most prevalent cancers are geniturinary (15.9%) and hematological (15.9%). The most common signs and symptoms were: pain with an average of 6.6 (0-10; SD = 3.9) and altered appetite 6.6 (0-10; SD = 3.8). As for the intensity of symptoms, the item "concern" was prevalent with a mean of 7.1 (0-10; SD = 3.6). Regarding the symptom's ability to interfere with life, the most prevalent item was "activities in general" with an average of 9.1 (0-10; SD = 2.2). CONCLUSION: sociodemographic and economic characteristics correlated with clinical characteristics.


Assuntos
Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Pacientes/estatística & dados numéricos , Demografia , Serviços Médicos de Emergência , Neoplasias/epidemiologia , Estudos Transversais , Hospitais Públicos , Hospitais Universitários
14.
BMC Health Serv Res ; 20(1): 425, 2020 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-32410681

RESUMO

BACKGROUND: Fingolimod is an oral multiple sclerosis drug that is considered a specialty drug due to its high cost and safety issues. The Fingolimod Patient Support Program (F-PSP) is a specialty pharmacy service developed to ensure the responsible use of fingolimod by promoting patient safety and medication adherence. This study aims to explore the satisfaction, experiences and perceptions regarding the F-PSP among patients currently involved in this program or recently withdrawn. METHODS: A qualitative study was conducted via individual, face-to-face semistructured interviews with patients involved in the F-PSP. The interviews were audio-recorded, transcribed verbatim, coded and analyzed via thematic content analysis. RESULTS: The main themes identified from the interviews (n = 17) were overall perception of the F-PSP, perception of the pharmacist-led consultations, perception of the tools (electronic monitor and drug intake graph), reasons to participate or potentially withdraw, and suggestions for improvements. Participants perceived the F-PSP as a reassuring support that complemented their medical care, providing a more human, personalized and person-centered approach than usual pharmacy care. Pharmacist-led consultations were valued for the medication-related and holistic support they provided. The importance of the pharmacist's attitude was emphasized. The electronic monitor was valued for promoting daily medication adherence and allowing the involvement of relatives, which reassured participants and their relatives. The participants appreciated the drug intake graph because it provided an objective overview of medication adherence, thereby reassuring, rewarding, and motivating them. The main reason to join the program was to be supported, especially with respect to medication adherence. CONCLUSIONS: Participants were satisfied with the F-PSP, each for different reasons. Their feedback enabled the identification of measures for the optimization of the F-PSP and should facilitate its dissemination and transfer to other drugs/diseases/populations. Essential elements of generic pharmacist-led patient support programs considered valuable from the patients' perspective were identified.


Assuntos
Cloridrato de Fingolimode/uso terapêutico , Satisfação do Paciente/estatística & dados numéricos , Pacientes/psicologia , Assistência Farmacêutica/organização & administração , Adulto , Atitude do Pessoal de Saúde , Feminino , Humanos , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Segurança do Paciente , Pacientes/estatística & dados numéricos , Farmacêuticos/psicologia , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Suíça
15.
Nature ; 582(7813): 557-560, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32340022

RESUMO

The ongoing outbreak of coronavirus disease 2019 (COVID-19) has spread rapidly on a global scale. Although it is clear that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted through human respiratory droplets and direct contact, the potential for aerosol transmission is poorly understood1-3. Here we investigated the aerodynamic nature of SARS-CoV-2 by measuring viral RNA in aerosols in different areas of two Wuhan hospitals during the outbreak of COVID-19 in February and March 2020. The concentration of SARS-CoV-2 RNA in aerosols that was detected in isolation wards and ventilated patient rooms was very low, but it was higher in the toilet areas used by the patients. Levels of airborne SARS-CoV-2 RNA in the most public areas was undetectable, except in two areas that were prone to crowding; this increase was possibly due to individuals infected with SARS-CoV-2 in the crowd. We found that some medical staff areas initially had high concentrations of viral RNA with aerosol size distributions that showed peaks in the submicrometre and/or supermicrometre regions; however, these levels were reduced to undetectable levels after implementation of rigorous sanitization procedures. Although we have not established the infectivity of the virus detected in these hospital areas, we propose that SARS-CoV-2 may have the potential to be transmitted through aerosols. Our results indicate that room ventilation, open space, sanitization of protective apparel, and proper use and disinfection of toilet areas can effectively limit the concentration of SARS-CoV-2 RNA in aerosols. Future work should explore the infectivity of aerosolized virus.


Assuntos
Aerossóis/análise , Aerossóis/química , Aparelho Sanitário , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/virologia , Hospitais , Pneumonia Viral/virologia , Local de Trabalho , Betacoronavirus/genética , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Aglomeração , Desinfecção , Humanos , Unidades de Terapia Intensiva , Máscaras , Corpo Clínico , Pandemias/prevenção & controle , Pacientes/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , RNA Viral/análise , Isolamento Social , Ventilação
16.
BMC Health Serv Res ; 20(1): 360, 2020 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-32336267

RESUMO

BACKGROUND: Because the healthcare sector is shifting to a customer-oriented approach, it is important to understand experiences of children as users of healthcare services. So far, studies that measure the influence of medical clowning on patient experiences are scarce. This study aims to measure experiences of children and their parents during day-surgery in hospital setting. METHODS: A case-control study was conducted in a large Finnish children's hospital. Seventy children aged 4-17 years coming for a minor operative procedure including pre-operative cannula insertion prior to surgery were included. Thirty-eight children were exposed to the medical clowning intervention and 32 children (the reference group) did not receive exposure to medical clowning. A novel digital survey tool was used to measure patient experiences before and after the insertion of a venous cannula needed for anaesthesia. The children were asked about their emotions, anxiety levels, the pain from the cannula insertion and the best and worst things about the hospital. The parents were asked about their emotions, expectations and the fluency of the procedure and the hospital day. RESULTS: Before the procedure, 32% or 36% of the children in the intervention group and 44% or 28% of those in the reference group expressed positive or neutral emotions, respectively. After the procedure, 76% or 63% of children in the intervention group or reference group, respectively, expressed positive emotions. The intervention group rated the medical clowns as the best aspect of the hospital day. Both groups reported that the best aspects of the hospital day were related to the nurses and food and the worst were related to waiting and pain. Most commonly the parents felt uncertainty, anxiety or calmness before the procedure and relief afterwards. Their expectations towards the procedure related to its success and the certainty of the diagnosis. CONCLUSIONS: The results show a trend towards more positive emotions in children with exposure to medical clowning. The digital survey tool was suitable for gathering information about the experiences of children and their parents. Information on emotions and expectations of children and parents during a procedure is useful when improving the quality of healthcare services. TRIAL REGISTRATION: Current Controlled Trials NCT04312217, date of registration 17.03.2020. Retrospectively registered.


Assuntos
Hospitais Pediátricos , Terapia do Riso , Pais/psicologia , Pacientes/psicologia , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Finlândia , Humanos , Masculino , Pacientes/estatística & dados numéricos , Inquéritos e Questionários
17.
Intensive Crit Care Nurs ; 59: 102853, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32223920

RESUMO

OBJECTIVES: Intrahospital transports are associated with complications and adverse events in intensive care patients. Yet, little is known about how patients' percive these tranfers. Thus, this study aimed to explore patients' experiences of the intrahospital transport process. RESEARCH DESIGN: An exploratory qualitative study compromising interviews with twelve patients. Data were analysed using thematic analysis. SETTING: Two intensive care units in a university hospital setting. MAIN OUTCOME: An understanding of patients' experiences of the intrahospital transport process. FINDINGS: The main finding was patients' description of "being in safe hands" during the transport. Patients' experience of transports as feasible and safe was reflected in the first main theme, "feeling prepared and safeguarded". The second theme, "being on the move", described patients' perceptions of the transport; although they were aware of movement, the transport was viewed as a minor event during their stay. The third theme, "entrusting myself to others", revealed how patients handed over control and decision making to the staff, confident that they would look after their best interest. CONCLUSIONS: Patients perceived intrahospital transports as an acceptable and safe process. Findings suggest that patients' experience could be improved by being provided with accurate and timely information and preparedness for transport-related events.


Assuntos
Segurança do Paciente/normas , Transferência de Pacientes/normas , Pacientes/estatística & dados numéricos , Adulto , Idoso , Antropologia Cultural/métodos , Cuidados Críticos/métodos , Cuidados Críticos/normas , Cuidados Críticos/estatística & dados numéricos , Feminino , Hospitais Universitários/organização & administração , Hospitais Universitários/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Segurança do Paciente/estatística & dados numéricos , Transferência de Pacientes/métodos , Transferência de Pacientes/estatística & dados numéricos , Pesquisa Qualitativa
18.
Aust J Gen Pract ; 49(4): 208-214, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32233350

RESUMO

BACKGROUND AND OBJECTIVES: Laparoscopic sleeve gastrectomy (LSG) currently accounts for 70.1% of weight-loss surgeries in Australia, according to the Bariatric Surgery Registry. There are limited qualitative studies examining Australian patients' experiences. The aim of this study was to explore patients' perspectives following LSG, providing information for shared decision making. METHOD: Twenty-two patients one, two or three years post-LSG were recruited randomly. Qualitative data were collected through in-depth telephone interviews, and responses were analysed inductively. RESULTS: Three global themes were identified: 1) normality, 2) control and 3) ambivalence, with eight organising sub-themes: 1) weight, 2) physical changes and daily living enhancements, 3) exercise, 4) emotional responses, 5) eating behaviour, 6) societal influences, 7) body image and 8) relationships. DISCUSSION: LSG is generally associated with high levels of patient satisfaction, with physical and psychosocial benefits beyond metabolic improvements. The decision to undergo this elective procedure should be made with an understanding of the significant and permanent effects it has on patients' lives.


Assuntos
Gastrectomia/normas , Satisfação do Paciente , Pacientes/psicologia , Percepção , Adulto , Índice de Massa Corporal , Feminino , Gastrectomia/métodos , Gastrectomia/estatística & dados numéricos , Humanos , Entrevistas como Assunto/métodos , Laparoscopia/métodos , Laparoscopia/normas , Laparoscopia/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pacientes/estatística & dados numéricos , Pesquisa Qualitativa , Inquéritos e Questionários , Resultado do Tratamento
19.
South Med J ; 113(4): 191-197, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32239232

RESUMO

Significant attention has been directed at evaluating reimbursement rates to orthopedic surgeons for various surgical procedures. To evaluate patients' understanding of the surgeon reimbursement process, studies using patient surveys have been conducted to determine patients' perceptions of orthopedic surgeon compensation. To date, there has been no systematic review to consolidate the data of these studies. This study aimed to synthesize the findings of these individual studies across multiple subspecialties of orthopedic surgery to evaluate the potential discrepancy between how much patients believe orthopedic surgeons are reimbursed and the actual reimbursement rate. We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify studies that report findings of patient perceptions of orthopedic surgeon reimbursement for various procedures. Searches were conducted using MEDLINE through PubMed, Embase, and Scopus. Summary estimates of reimbursement discrepancies across subspecialties and overall were reported as unweighted averages of the individual study results within each group. Twelve studies were identified that met inclusion criteria, constituting 4309 surveys. These survey studies measured patients' perceptions of how much orthopedic surgeons are reimbursed for common procedures, including anterior cruciate ligament reconstruction, arthroscopic meniscectomy, carpal tunnel release, rotator cuff repair, multiple spine procedures and total shoulder, hip, and knee arthroplasty. It was found that patients reported reasonable surgeon's fees to be 11.2 times more than actual Medicare reimbursement. Among individual studies, the largest discrepancies were seen in total hip arthroplasty (26 times), whereas the smallest difference was in anterior cruciate ligament reconstruction (1.6 times). On average, patients estimated Medicare reimbursement rates to be 5.9 times higher than the actual surgeon reimbursement. Patients consistently overestimate how much orthopedic surgeons are reimbursed for common orthopedic procedures. The results of this systematic review suggest that patients may value these procedures more than what Medicare reimburses. Such information may help educate the public, direct policy, and increase transparency between orthopedic surgeons and patients.


Assuntos
Cirurgiões Ortopédicos/economia , Pacientes/psicologia , Percepção , Mecanismo de Reembolso/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos/economia , Procedimentos Ortopédicos/normas , Pacientes/estatística & dados numéricos , Mecanismo de Reembolso/estatística & dados numéricos , Inquéritos e Questionários
20.
J Med Internet Res ; 22(4): e13071, 2020 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-32297872

RESUMO

BACKGROUND: Since the turn of this century, the internet has become an invaluable resource for people seeking health information and answers to health-related queries. Health question and answer websites have grown in popularity in recent years as a means for patients to obtain health information from medical professionals. For patients suffering from chronic illnesses, it is vital that health care providers become better acquainted with patients' information needs and learn how they express them in text format. OBJECTIVE: The aims of this study were to: (1) explore whether patients can accurately and adequately express their information needs on health question and answer websites, (2) identify what types of problems are of most concern to those suffering from chronic illnesses, and (3) determine the relationship between question characteristics and the number of answers received. METHODS: Questions were collected from a leading Chinese health question and answer website called "All questions will be answered" in January 2018. We focused on questions relating to diabetes and hepatitis, including those that were free and those that were financially rewarded. Content analysis was completed on a total of 7068 (diabetes) and 6685 (hepatitis) textual questions. Correlations between the characteristics of questions (number of words per question, value of reward) and the number of answers received were evaluated using linear regression analysis. RESULTS: The majority of patients are able to accurately express their problem in text format, while some patients may require minor social support. The questions posted were related to three main topics: (1) prevention and examination, (2) diagnosis, and (3) treatment. Patients with diabetes were most concerned with the treatment received, whereas patients with hepatitis focused on the diagnosis results. The number of words per question and the value of the reward were negatively correlated with the number of answers. The number of words per question and the value of the reward were negatively correlated with the number of answers. CONCLUSIONS: This study provides valuable insights into the ability of patients suffering from chronic illnesses to make an understandable request on health question and answer websites. Health topics relating to diabetes and hepatitis were classified to address the health information needs of chronically ill patients. Furthermore, identification of the factors affecting the number of answers received per question can help users of these websites to better frame their questions to obtain more valuable answers.


Assuntos
Coleta de Dados/métodos , Internet , Pacientes/estatística & dados numéricos , Médicos/normas , China , Humanos , Inquéritos e Questionários
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