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1.
Ann Agric Environ Med ; 26(4): 636-643, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31885239

RESUMO

OBJECTIVE: The aim of the study is to compare the hope of rural and urban inhabitants in the terminal stage of a neoplastic disease covered by stationary hospice care. MATERIAL AND METHODS: The study was carried out among patients in the terminal phase of a neoplastic disease. They were patients of both 24-hour and daily palliative and hospice care units throughout the country. The study group consisted of 246 patients, average age - 59.5, the youngest respondent was 18 and the oldest - 90. The B. L. Block (NCN-36) test, prepared for people struggling with serious life-threatening diseases, was used. Comparison of the results with regard to the place of residence was based on the test Friedman ANOVA and Kendall compatibility factor. The general comparison of hope in individual dimensions and globally with the division into the degree of urbanization, was based on the Kruskal-Wallis test. RESULTS: On the basis of factor analysis, 4 scales constructed from 8 items branch were distinguished. The following scales are used to study hope in the situational dimension - health, the telek-temporal dimension - goals, the spiritual dimension - religious beliefs and in the emotional-affective (affective) dimension - motivations. CONCLUSIONS: The strength of hope in people in the terminal phase of cancer, residing in villages, settlements, small, medium and large cities, was similar and depended on its magnitude. Of all the manifestations of hope, the greatest variation in results occurred in the subjects when they encountered serious problems and difficulties. The inhabitants of medium-sized cities were characterized by a higher hope at that time.


Assuntos
Neoplasias/psicologia , Adolescente , Adulto , Idoso , Feminino , Esperança , Habitação , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes/psicologia , Adulto Jovem
2.
Rev Infirm ; 68(256): 43-44, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31870481

RESUMO

ICU services are a source of anxiety and stress. There are many barriers to well-being for the patients who are admitted. From this observation was born the surgical intensive care project of the Pellegrin Hospital in Bordeaux, which aims to create a wellness trolley. Its objective is to improve hospital conditions and the patient's experience.


Assuntos
Ansiedade , Cuidados Críticos , Unidades de Terapia Intensiva , Humanos , Pacientes/psicologia
4.
BMC Complement Altern Med ; 19(1): 305, 2019 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-31711478

RESUMO

BACKGROUND: Patient-centered culturally sensitive health care (PC-CSHC) has emerged as a primary approach to health care. This care focuses on the cultural diversity of the patients rather than the views of the health care professionals. PC-CSHC enables the patient to feel comfortable, respected, and trusted in the health care delivery process. As users of traditional and complementary medicine (T&CM) rarely inform their conventional health care providers of such use, the providers need to identify the users of T&CM themselves to avoid negative interaction with conventional medicine and to be able to provide them with PC-CSHC. Since the patterns of traditional medicine (TM) use are different to those of complementary medicine (CM), the aim of this study was to investigate the prevalence, and the health- and sociodemographic associations for visits to TM- and CM providers in an urban population. METHOD: The data were collected through two self-administrated questionnaires from the seventh survey of the Tromsø Study, a population-based cohort study conducted in 2015-2016. All inhabitants of Tromsø aged 40 or above were invited (n = 32,591) and n = 21,083 accepted the invitation (response rate 65%). Pearson chi-square tests and one-way ANOVA tests were used to describe differences between the groups whereas binary logistic regressions were used for adjusted values. RESULTS: The results revealed that 2.5% of the participants had seen a TM provider, 8.5% had seen a CM provider whereas 1% had visited both a TM and a CM provider during a 12-month period. TM users tended to be older, claim that religion was more important to them, have poorer economy and health, and have lower education compared to CM users. We found that more than 90% of the participants visiting T&CM providers also used conventional medicine. CONCLUSION: A considerable number of the participants in this study employed parallel health care modalities including visits to conventional, traditional, and complementary medicine providers. To offer patient-centered culturally sensitive health care that is tailored to the patients' treatment philosophy and spiritual needs, conventional health care providers need knowledge about, and respect for their patients' use of parallel health care systems.


Assuntos
Terapias Complementares/psicologia , Medicina Tradicional/psicologia , Pacientes/psicologia , Adulto , Idoso , Assistência Ambulatorial/psicologia , Assistência Ambulatorial/estatística & dados numéricos , Estudos de Coortes , Terapias Complementares/estatística & dados numéricos , Demografia , Feminino , Pessoal de Saúde/psicologia , Humanos , Masculino , Medicina Tradicional/estatística & dados numéricos , Pessoa de Meia-Idade , Noruega , Pacientes/estatística & dados numéricos , Prevalência , Religião , Confiança
5.
BMC Complement Altern Med ; 19(1): 301, 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31694617

RESUMO

BACKGROUND: Complementary and alternative medicine (CAM) use among infertile women is popular in many countries, including Korea. Previous research has repeatedly found more than half of infertile women surveyed use CAM therapies for fertility enhancement and overall well-being. However, there is currently little evidence to support this practice, and this raises the question of infertile women's experiences in the uptake of those modalities and sociodemographic and psychological factors associated with CAM use. Thus, this study aims to explore the perceptions and experiences of infertile women with regard to their use of CAM in Korea. METHODS: A cross-sectional study was conducted using data from 263 infertile women attending infertility specialty clinics in Seoul, Korea, in June 2012. The survey instrument included 47 questions on the use of CAM, demographic characteristics, health status, and infertility related factors such as duration and type of infertility, experience and satisfaction of conventional treatment, and self-perceived severity of infertility condition. Chi-square test and logistic regression were used for data analysis. RESULTS: Among 286 respondents (response rate, 95.3%), a total of 263 women were included in the final analysis. 63.5% of respondents used one or more types of CAM modalities during infertility treatment. The utilization of CAM was associated with employment status, duration of infertility treatment, and self-perceived severity of the disease. The most commonly used CAM modalities were multivitamin and herbal medicine, and differences in types of CAM modalities used were found between the group with a higher rating of self-perceived disease severity and the lower perceived severity group. CONCLUSIONS: High prevalence of CAM use among infertile women was observed in Korea. Our findings support that infertile women's own understanding of their illness and physical condition influences self-care behavior such as CAM use. This calls for an urgent need for further in-depth study of the clinical effects of popular CAM modalities among infertile women when used in conjunction with conventional treatment.


Assuntos
Terapias Complementares/psicologia , Infertilidade Feminina/terapia , Adulto , Estudos Transversais , Feminino , Humanos , Infertilidade Feminina/psicologia , Pacientes/psicologia , Percepção , República da Coreia , Índice de Gravidade de Doença
6.
Vasc Health Risk Manag ; 15: 301-308, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31616150

RESUMO

Objective: We aimed to characterize patients after an acute cardiac event regarding their negative expectations around returning to work and the impact on work capacity upon discharge from cardiac rehabilitation (CR). Methods: We analyzed routine data of 884 patients (52±7 years, 76% men) who attended 3 weeks of inpatient CR after an acute coronary syndrome (ACS) or cardiac surgery between October 2013 and March 2015. The primary outcome was their status determining their capacity to work (fit vs unfit) at discharge from CR. Further, sociodemographic data (eg, age, sex, and education level), diagnoses, functional data (eg, exercise stress test and 6-min walking test [6MWT]), the Hospital Anxiety and Depression Scale (HADS) and self-assessment of the occupational prognosis (negative expectations and/or unemployment, Würzburger screening) at admission to CR were considered. Results: A negative occupational prognosis was detected in 384 patients (43%). Out of these, 368 (96%) expected not to return to work after CR and/or were unemployed before CR at 29% (n=113). Affected patients showed a reduced exercise capacity (bicycle stress test: 100 W vs 118 W, P<0.01; 6MWT: 380 m vs 421 m, P<0.01) and were more likely to receive a depression diagnosis (12% vs 3%, P<0.01), as well as higher levels on the HADS. At discharge from CR, 21% of this group (n=81) were fit for work (vs 35% of patients with a normal occupational prognosis (n=175, P<0.01)). Sick leave before the cardiac event (OR 0.4, 95% CI 0.2-0.6, P<0.01), negative occupational expectations (OR 0.4, 95% CI 0.3-0.7, P<0.01) and depression (OR 0.3, 95% CI 0.1-0.8, P=0.01) reduced the likelihood of achieving work capacity upon discharge. In contrast, higher exercise capacity was positively associated. Conclusion: Patients with a negative occupational prognosis often revealed a reduced physical performance and suffered from a high psychosocial burden. In addition, patients' occupational expectations were a predictor of work capacity at discharge from CR. Affected patients should be identified at admission to allow for targeted psychosocial care.


Assuntos
Síndrome Coronariana Aguda/reabilitação , Reabilitação Cardíaca , Motivação , Alta do Paciente , Pacientes/psicologia , Retorno ao Trabalho , Avaliação da Capacidade de Trabalho , Síndrome Coronariana Aguda/diagnóstico , Síndrome Coronariana Aguda/fisiopatologia , Síndrome Coronariana Aguda/psicologia , Adulto , Comorbidade , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
7.
Rev Med Suisse ; 15(669): 1982-1986, 2019 Oct 30.
Artigo em Francês | MEDLINE | ID: mdl-31663698

RESUMO

Economists traditionally describe individuals as well-informed and rational decision-makers. Recent developments in behavioural economics, which lies at the intersection between psychology and economics, challenge these assumptions and describe the common cognitive biases that affect us all. The resulting decision errors are particularly frequent in health and health care given the predominance of uncertainty and the complexity of choices. Interventions aiming at correcting, or exploiting, these biases to improve decisions of citizens, patients, and health professionals have recently emerged. We present here a critical synthesis of findings and discuss potential applications in our health system.


Assuntos
Tomada de Decisões , Economia Comportamental , Educação em Saúde , Pessoal de Saúde/psicologia , Medicina/métodos , Pacientes/psicologia , Assistência à Saúde , Humanos
8.
Niger Postgrad Med J ; 26(4): 211-215, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31621660

RESUMO

Introduction: Recent evidence suggests that rates of drug use and abuse in Nigeria exceed the global average. There is a strong treatment demand for psychoactive drug use disorders in Nigeria; however, it is not known whether available treatment facilities are attending to the array of treatment needs. This audit compares the pattern of presentations at a tertiary facility with a community-based survey. Methods: A review of cases (n = 212) seen at a regional drug treatment facility over a 4-year period, using local data retrieved from the Nigerian Epidemiological Network of Drug Use (NENDU) and comparison with data from the recently published national drug use survey. Results: Nine out of ten clients seen were male (93.4%). About half (49.5%) of the clients used psychoactive substances for the first time between ages 10 and 19 years. Cannabis was the primary drug of use overall and also among males, while females were more likely to present with opiate abuse. Over half had a co-occurring physical or mental disorder, and a minority had received testing for hepatitis C in the past 12 months. Conclusion: Although patterns of drug abuse presentations were consistent with findings from a national community-based survey, there was an under-representation of females in treatment. Implications for policy development and practice are discussed.


Assuntos
/efeitos adversos , Transtornos Mentais/epidemiologia , Pacientes/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/terapia , Adolescente , Adulto , Distribuição por Idade , Alcoolismo/epidemiologia , Alcoolismo/reabilitação , Criança , Comorbidade/tendências , Estudos Transversais , Feminino , Hospitais Psiquiátricos , Humanos , Tempo de Internação/estatística & dados numéricos , Tempo de Internação/tendências , Masculino , Abuso de Maconha/epidemiologia , Transtornos Mentais/reabilitação , Pessoa de Meia-Idade , Nigéria/epidemiologia , Pacientes/psicologia , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Adulto Jovem
9.
Int J Equity Health ; 18(1): 150, 2019 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-31604437

RESUMO

BACKGROUND: Type 1 diabetes is a complex chronic condition which requires lifelong treatment with insulin. Health outcomes are dependent on ability to self-manage the condition. Socioeconomic inequalities have been demonstrated in access to treatment and health outcomes for adults with type 1 diabetes; however, there is a paucity of research exploring how these disparities occur. This study explores the influence of socioeconomic factors in gaining access to intensive insulin regimens for adults with type 1 diabetes. METHODS: We undertook a qualitative descriptive study informed by a phenomenological perspective. In-depth face-to-face interviews were conducted with 28 patients and 6 healthcare professionals involved in their care. The interviews were analysed using a thematic approach. The Candidacy theory for access to healthcare for vulnerable groups framed the analysis. RESULTS: Access to intensive insulin regimens was through hospital-based specialist services in this sample. Patients from lower socioeconomic groups had difficulty accessing hospital-based services if they were in low paid work and because they lacked the ability to navigate the healthcare system. Once these patients were in the specialist system, access to intensive insulin regimens was limited by non-alignment with healthcare professional goals, poor health literacy, psychosocial problems and poor quality communication. These factors could also affect access to structured diabetes education which itself improved access to intensive insulin regimens. Contact with diabetes specialist nurses and attendance at structured diabetes education courses could ameliorate these barriers. CONCLUSIONS: Access to intensive insulin regimens was hindered for people in lower socioeconomic groups by a complex mix of factors relating to the permeability of specialist services, ability to navigate the healthcare system and patient interactions with healthcare providers. Improving access to diabetes specialist nurses and structured diabetes education for vulnerable patients could lessen socioeconomic disparities in both access to services and health outcomes.


Assuntos
Diabetes Mellitus Tipo 1/tratamento farmacológico , Disparidades em Assistência à Saúde/economia , Insulina/uso terapêutico , Adolescente , Adulto , Idoso , Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Feminino , Pessoal de Saúde/psicologia , Humanos , Insulina/economia , Masculino , Pessoa de Meia-Idade , Pacientes/psicologia , Pacientes/estatística & dados numéricos , Pesquisa Qualitativa , Fatores Socioeconômicos , Adulto Jovem
10.
Ann Agric Environ Med ; 26(3): 469-503, 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31559810

RESUMO

OBJECTIVES: The aim of the study is to determine the scale of interregional migrating patients' hospitalizations in Poland in 2013-2017, as well as their demographic and medical factors, total costs and time changes. MATERIAL AND METHODS: Data from the NHF (National Health Fund) regarding hospitalizations in a given province of patients registered in another province in Poland in 2013-2017 were statistically analyzed. Times series analyses as well as coefficients of correlation, determination and variation were used. RESULTS: The number of patients hospitalized outside their regional registration and the cost of their hospitalization increased from year-to-year during 2013-2017. There was a large variation in provinces in terms of inflow of patients and costs of their hospitalization, while there was only a small variation in terms of outflow of patients and costs of their hospitalization in the analyzed years. Among the patients hospitalized outside the province where they were registered, there were more women then men, while the age group was dominated by 60-year-olds and their share in the subsequent years increased, while the share of other age groups remained unchanged or decreased. The most and increasingly more from year-to-year hospitalizations outside the regional registration were due to neoplasms and diseases of the circulatory system. CONCLUSIONS: The results of the study may significantly contribute to the proper planning of securing the health needs of the inhabitants of particular regions, and to improving the quality and economic efficiency of health services in individual NHF branches.


Assuntos
Hospitalização/economia , Pacientes/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Comportamento de Escolha , Feminino , Custos Hospitalares , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Pacientes/estatística & dados numéricos , Polônia , Fatores de Tempo , Adulto Jovem
13.
Psychiatr Danub ; 31(Suppl 3): 416-417, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488763

RESUMO

OBJECTIVES: We wanted to investigate the patient's expectations on the general practitioner's (GP) responsibilities in screening and follow up of disturbed eating behaviour. Then, we looked for remediation for some of the mentioned shortcomings in family medicine. We also examined if online aid (offered by the non-profit organisation "Eetexpert.be") is already known and used. SUBJECTS AND METHODS: Anonymous patient questionnaires were gathered at 4 treatment centres for eating disorders or were collected with help of the Flemish patients organisation for eating disorders (Vlaamse Vereniging Anorexia Nervosa en Boulimia Nervosa). Later, online enquiries were sent to Flemish GPs. RESULTS: Out of 123 patients responding to the questionnaire, 44 found their GP to have had an important supportive role in their healing process. Active listening and targeted referral were among the most appreciated interventions by those patients. 71 GPs replied the online enquiry. Only 1 out of 5 knew about the free online assistance of "Eetexpert.be". Responders suggested several additional barriers to care. CONCLUSIONS: In Flanders there is a contrast between expectations and needs of patients on one hand compared to the services provided by GPs on the other. Reassuringly, all responding physicians were open to more education and support regarding eating disorder treatment.


Assuntos
Atitude do Pessoal de Saúde , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Clínicos Gerais/psicologia , Preferência do Paciente , Pacientes/psicologia , Inquéritos e Questionários , Bélgica , Clínicos Gerais/educação , Humanos , Encaminhamento e Consulta
14.
Psychiatr Danub ; 31(Suppl 3): 427-433, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488766

RESUMO

BACKGROUND: Our previous research demonstrated that mild depression (MD) is characterized by patterns of atypical language use such as inverted word order, greater repetition, increased use of reflexive/personal (e.g. myself) or negative/ indefinite (e.g. nobody) pronouns, verbs in past tense, and other lexico-grammatical, stylistic and syntactic indicators (how the patient speaks). We now investigate the role of semantic features (what the patient speaks about) in diagnosing (why it is important to listen) affective states. SUBJECTS AND METHODS: 201 written narratives from 124 patients with MD and 77 healthy controls (HC), including 35 cases of normal sadness (NS), were studied using principle component lexis analysis. Statistical data evaluation was performed with SPSS-25 (p<0.05, significant) and included the Cohen's kappa for inter-rater reliability, nonparametric methods to measure between-group differences (Mann-Whitney U-test, Pearson Chi-square test, Kruskal-Wallis, one-way ANOVA), and discriminant analysis for modeling of semantic variables related to affective diagnostic types. RESULTS: Component lexis analysis revealed an exaggerated usage of semantic categories describing existential and family values in the texts of MD patients compared to HC. However, there were fewer cognitive and altruistic categories presented in patients' self-reports. The most substantial between-group difference was the lesser semantics of self-realization in MD patients, as well as their significantly lower ranking of social status' priorities. Communicative and hedonic values in MD speech displaced and predominated in ranking over the values of social status, versus the opposite relationship in HC speech. The discriminant model revealed a set of semantic indicators significantly distinguishing the MD, HC and NS groups (96.3%; Wilks' λ=0.001, p<0.001, r=0.996). CONCLUSIONS: Linguistic structure and content of patients' verbalizations may serve as diagnostic markers of MD. Evaluation of psychosocial themes within the content of narratives should enable a better understanding of MD pathogenesis and emphasize the importance of monitoring social difficulties during treatment.


Assuntos
Depressão/diagnóstico , Depressão/psicologia , Pacientes/psicologia , Semântica , Estudos de Casos e Controles , Audição , Humanos , Relações Profissional-Paciente , Reprodutibilidade dos Testes
15.
Z Psychosom Med Psychother ; 65(3): 239-256, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31476991

RESUMO

Development and validation of a questionnaire for patient competence in coping with cancer (PCQ) Objectives: The aim of the study was the development and evaluation of the psychometric properties of a self-assessment questionnaire for resource-orientated coping with cancer (Patient Competence Questionnaire, PCQ). Methods: In 420 patients and members of cancer support-groups item selection and evaluation of item properties, reliability (Cronbach's Alpha), validity (convergent and divergent) and factorial structure were performed in two studies. Results: The final version of the PCQ (18 items) demonstrated a Cronbach's Alpha between 0.71 and 0.91 for five subscales identified with exploratory factor analysis (religious/spiritual coping, coping competence, healthy lifestyle, information seeking, adaptability) and 0.85 for the total score. The PCQ shows a high convergent validity (r = 0.46) with the Freiburg Questionnaire on Coping with Illness (FKV) and significant correlations with depression (r = -0.23), posttraumatic growth (r = 0.65) and religiosity (r = 0.59). Conclusions: First analyses underline that the PCQ can be regarded as a valid and reliable instrument for assessing patients' resources in dealing with cancer.


Assuntos
Adaptação Psicológica , Neoplasias/psicologia , Pacientes/psicologia , Inquéritos e Questionários/normas , Humanos , Psicometria , Reprodutibilidade dos Testes
16.
BMC Oral Health ; 19(1): 211, 2019 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-31492133

RESUMO

BACKGROUND: The purpose of this study was to assess the salivary cortisol and salivary alpha-amylase levels in children aged between 6 and 9 years, 3 months and 1 year after the successful completion of dental treatment through either pharmacological or non-pharmacological behavior management techniques. METHODS: A total of 1567 patients aged between 6 and 9 years who had completed dental treatment were screened. A total of 703 patients who were caries free at the end of 3 months were classified based on Frankl behavior score and administered the Arabic version of the Children's Fear Survey Schedule- Dental Subscale (CFSS-DS) and accordingly allocated to one of three groups; (Phobic Patients, Anxious Patients, Control Group). A total of 183 patients met the inclusion criteria and were followed up for 1 year. A total of 151 patients completed the study. Patients' heart rate on recall, salivary cortisol and salivary amylase were compared between the groups. RESULTS: The results of the study showed that amylase and cortisol levels had a significant association with the level of dental fear. The phobic patients had the highest levels of salivary amylase and salivary cortisol levels with no significant associations observed with either heart rate or extent of dental treatment. Control and anxious patients had significantly lower amylase levels when compared to phobic patients. There was no significant difference between the salivary cortisol levels of anxious and phobic patients. These findings were replicated on 1-year recall. CONCLUSIONS: Within the limitations of this study we can conclude that salivary amylase is an indicator of of acute stress that can differentiate between anxiety and dental fear; while salivary cortisol appears to be a marker of long-term stress that lacks the sensitivity to differentiate between the two.


Assuntos
Ansiedade ao Tratamento Odontológico , Frequência Cardíaca/fisiologia , Hidrocortisona/análise , Pacientes/psicologia , Saliva/química , alfa-Amilases Salivares/análise , alfa-Amilases/sangue , Fatores Etários , Antecipação Psicológica/fisiologia , Biomarcadores/análise , Estudos de Casos e Controles , Criança , Ansiedade ao Tratamento Odontológico/metabolismo , Feminino , Humanos , Masculino , Arábia Saudita
17.
Public Health ; 175: 60-67, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31401252

RESUMO

OBJECTIVES: The objective of this study is to increase understanding of knowledge, attitudes, and preventative practices regarding ischemic heart disease (IHD) in sub-Saharan Africa in order to develop patient-centered interventions to improve care and outcomes. STUDY DESIGN: This is a prospective observational study. METHODS: Adult patients presenting with chest pain or shortness of breath to an emergency department in northern Tanzania were enrolled. A questionnaire was adapted from existing knowledge attitude and practice surveys regarding cardiovascular disease and the WHO STEPS instrument. Individual five-year risk of cardiovascular event was determined by validated models based on age, sex, systolic blood pressure, body mass index, diabetes, and smoking status. An IHD knowledge score was calculated by giving one point for each correct response to the knowledge-related items, with a maximum score of 10. Associations between IHD knowledge and patient characteristics were assessed by Welch's t-test. RESULTS: A total of 349 patients were enrolled, with median interquartile range (IQR) age 60 (45, 72) years. Of participants, 259 (74.2%) had hypertension, and 228 (65.3%) had greater than 10% five-year risk of cardiovascular event. The mean (SD) knowledge score was 4.8 (3.3). The majority of respondents (224, 64.2%) recognized obesity as a risk factor for heart attack, while a minority (34, 9.7%) knew that a daily aspirin could reduce the risk of cardiovascular event. Greater IHD knowledge was associated with younger age (P = 0.045) and higher levels of education (P < 0.001) but not higher risk of cardiovascular disease (P = 0.123). Most respondents expressed a willingness to diet to improve their health (322, 92.3%) and a preference for treatment from a physician rather than a traditional healer for a heart attack (321, 92.0%). A minority of patients reported exercising regularly (88, 25.2%) or seeing a doctor routinely for checkups (100, 28.7%). CONCLUSIONS: High-risk emergency department patients in northern Tanzania have moderate knowledge regarding IHD but do not consistently engage in healthy preventive practices. Patient-centered interventions are needed to improve IHD knowledge and practices in high-risk populations.


Assuntos
Serviço Hospitalar de Emergência , Conhecimentos, Atitudes e Prática em Saúde , Isquemia Miocárdica/prevenção & controle , Pacientes/psicologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes/estatística & dados numéricos , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários , Tanzânia
18.
BMC Public Health ; 19(1): 1096, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31409317

RESUMO

BACKGROUND: Culturally competent health care service delivery can improve health outcomes, increasing the efficiency of clinical staff, and greater patient satisfaction. We aimed to explore the experience of patients with limited English proficiency and professional interpreters in an acute hospital setting. METHODS: In-depth interviews explored the experiences of four culturally and linguistically diverse communities with regards to their recent hospitalisation and access to interpreters. We also conducted focus group with professional interpreters working. Data were analysed using an inductive thematic approach with constant comparison. RESULTS: Individual interviews were conducted with 12 patients from Greek, Chinese, Dari and Vietnamese backgrounds. Focus groups were conducted with 11 professional interpreters. Key themes emerged highlighting challenges to the delivery of health care due distress and lack of advocacy in patients. Interpreters struggled due to a reliance on family to act as interpreters and hospital staff proficiency in working with them. CONCLUSIONS: In an era of growing ethnic diversity this study confirms the complexity of providing a therapeutic relationships in contemporary health practice. This can be enhanced by training towards the effective use of professional interpreters in a hospital setting. Such efforts should be multidisciplinary and collective in order to ensure patients don't fall through the gaps with regards to the provision of culturally competent care.


Assuntos
Barreiras de Comunicação , Assistência à Saúde Culturalmente Competente , Necessidades e Demandas de Serviços de Saúde , Linguagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Pessoal Técnico de Saúde/psicologia , Pessoal Técnico de Saúde/estatística & dados numéricos , Austrália , Diversidade Cultural , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes/psicologia , Pacientes/estatística & dados numéricos , Pesquisa Qualitativa , Tradução
19.
Psychiatriki ; 30(2): 165-174, 2019.
Artigo em Grego Moderno | MEDLINE | ID: mdl-31425144

RESUMO

The therapeutic relationship is the common place of all medical specialties in therapeutic practice. It is a professional relationship and consists of two components: the work component and the interpersonal component. The focus of the studies aims to show the contribution of the dynamics of the therapist - patient interpersonal relationship as a therapeutic factor in achieving the therapeutic outcome. The issue of doctor-patient relationship has been studied since antiquity, in particular by Socrates and beyond. Hippocrates promotes and systematizes medical philosophy, bioethics and medical ethics, as seen in the well-known "Hippocratic Oath". In the new era, S. Freud continued the work of inductive dialectics of Socrates, while formulating the concept of transference and countertransference. The development of psychotherapies has provided enough evidence for the parameters that interact into a therapeutic relationship, as their techniques were merely dialectical. M. Balint supports the value of counter-transference and transference to the therapeutic relationship. G. Bibring & R. Kahana suggest that psychoanalytic techniques and personality types contribute to the understanding of the physical patient. C. Rogers suggested that the attitudes and the empathic understanding of the therapist, not the techniques, contribute primarily to therapeutic success. G. Engel (1970) promotes the patient's biopsychosocial approach. Since 1980, systematic studies have begun to support the value of the therapeutic relationship, believing that it is itself an autonomous therapeutic factor, confirming the views of M. Balint and C. Rogers. They conclude that the therapeutic effect is a function of the quality of the therapeutic relationship, regardless of any therapeutic technique, and that the therapeutic alliance has a significant effect on the clinical outcome for psychotherapies as well as for pharmacotherapy. Empathy, non-possessive warmth, positive respect and authenticity have a significant effect on the treatment results. The common factor model supports the dynamics of the interpersonal relationship contributing 85% to the therapeutic effect whereas the therapeutic techniques contribute 15%. It therefore seems that the dynamics of the interpersonal relationship, the therapist-patient, is an important therapeutic factor. Studies continue and more questions arise as to whether education is available, the dynamics of interpersonal relationships in the context of therapeutic relationships at undergraduate and postgraduate levels. Also, the development of dialectical techniques, as a response to the empathic therapeutic relationship, which contributes at the clinical level to the patient's approach and information within the general health area and not only to mental health.


Assuntos
Pacientes/psicologia , Relações Profissional-Paciente , Psicoterapia/ética , Empatia , Ética Médica , Humanos , Relações Profissional-Paciente/ética
20.
Res Nurs Health ; 42(5): 369-381, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31368184

RESUMO

People who have a single first-degree relative with type 2 diabetes (T2D) are at increased risk for developing T2D over their lifetime. A positive family history of T2D is also associated with developing risk awareness and engaging in risk-reducing behaviors among the unaffected relatives. Yet, little is known about how people with a positive family history for disease personalize and process their familial risk to form perceptions about their own risk. In this mixed method study, we explored risk personalization among a diverse group of people between the ages of 18 and 60, with a positive family history of T2D, who were themselves unaffected (n = 109). We collected interview and survey data with respect to the familial risk perception personalization model. Using cluster analysis, qualitative and quantitative data were combined to inductively derive three distinct clusters representing three different familial risk perception personalization processes. These results can serve as a basis for tailored interventions aimed at reducing risk for T2D among people with increased risk due to familial history.


Assuntos
Comunicação , Diabetes Mellitus Tipo 2/genética , Família/psicologia , Predisposição Genética para Doença , Pacientes/psicologia , Relações Médico-Paciente , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude Frente a Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários
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