Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 26.239
Filtrar
1.
Med Sci (Paris) ; 36(11): 1034-1037, 2020 Nov.
Artigo em Francês | MEDLINE | ID: mdl-33151866

RESUMO

Coronavirus disease (COVID)-19 is an emerging pandemic infection whose significant ability to spread in a naïve population is well established. The first response of states to the COVID-19 outbreak was to impose lock-down and social barrier measures, such as wearing a surgical mask or social distancing. One of the consequences of this pandemic in terms of public health was the suspension or slowdown of infant vaccination campaigns, in almost all countries. The indirect effects of COVID-19 may therefore weigh on mortality from measles and polio in developing countries. In this pandemic chaos, the only hope lies in the rapid development of an effective vaccine against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). However, acceptance of this vaccine has not yet been won, as beyond the many unknowns that will inevitably weigh around such rapid development, skepticism among vaccine hesitants is growing.


Assuntos
Infecções por Coronavirus/epidemiologia , Programas de Imunização/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Saúde Pública/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Betacoronavirus/fisiologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças/prevenção & controle , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Programas de Imunização/organização & administração , Programas de Imunização/normas , Programas de Imunização/tendências , Sarampo/epidemiologia , Sarampo/prevenção & controle , Pandemias/prevenção & controle , Participação do Paciente/estatística & dados numéricos , Participação do Paciente/tendências , Pneumonia Viral/imunologia , Pneumonia Viral/prevenção & controle , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Saúde Pública/normas , Saúde Pública/tendências , Cobertura Vacinal/organização & administração , Cobertura Vacinal/estatística & dados numéricos , Vacinas Virais/uso terapêutico
2.
Prim Dent J ; 9(4): 31-36, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33225852

RESUMO

Engaging patients in shared decision making (SDM) is a professional requirement since the Montgomery ruling in 2015. Endodontic treatments present a specific challenge to achieving SDM, both for the clinician and the patient. The treatments are often perceived as more challenging to complete by the clinician, and the assessment of risk and likely outcome requires a deep understanding of the (limited) evidence base. For the patient, decisions can be required at a time of acute symptoms and prolonged treatments. There are health literacy demands in comparison to some less complex dental treatments. Treatment decisions may be based more on inherent biases and prior experiences than objective probabilities. This article discusses options and supports effective shared decision making in endodontic treatment.


Assuntos
Tomada de Decisão Compartilhada , Endodontia , Tomada de Decisões , Assistência Odontológica , Humanos , Participação do Paciente
3.
Methodist Debakey Cardiovasc J ; 16(3): 220-224, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33133358

RESUMO

Improving patient experience is a fundamental component of patient-centered care and one of the key strategies for improving health care quality, delivery, and outcomes. Several studies have described the association between improved patient experience and better health outcomes among individuals with cardiovascular disease. These findings are important given that cardiovascular disease is a leading cause of morbidity and mortality in the United States and globally. This review summarizes the findings on patient-reported health care experiences and discusses how optimizing these experiences may be a tool to improve health outcomes among individuals with cardiovascular disease.


Assuntos
Doenças Cardiovasculares/terapia , Participação do Paciente , Medidas de Resultados Relatados pelo Paciente , Satisfação do Paciente , Assistência Centrada no Paciente , Doenças Cardiovasculares/diagnóstico , Tomada de Decisão Compartilhada , Humanos , Assistência Centrada no Paciente/normas , Relações Médico-Paciente , Melhoria de Qualidade , Indicadores de Qualidade em Assistência à Saúde
4.
Stud Health Technol Inform ; 275: 47-51, 2020 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-33227738

RESUMO

The belief that following rigorous inclusive methods will eliminate bias from 'quality' measures ignores the preferences necessarily embedded in any formative instrument. These preferences almost always reflect the interests of its developers when one uses the wide definition of 'interest' appropriate in healthcare research and provision. We focus on the International Patient Decision Aid Standards instrument, a popular normative measure of decision aid quality. Drawing on its application to a set of 23 breast cancer screening decision aids, we show the effects of modifications that reflect our own different interest-conflicted preferences. It is emphasised that the only objection is to the implication that any formative instrument should be promoted or treated as the 'the gold standard', without a conflict of interests disclaimer, and to the implication that other instruments cannot provide equally valid, high-quality measures.


Assuntos
Conflito de Interesses , Técnicas de Apoio para a Decisão , Viés , Tomada de Decisões , Detecção Precoce de Câncer , Humanos , Participação do Paciente
5.
Stud Health Technol Inform ; 275: 52-56, 2020 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-33227739

RESUMO

Empirical measures of 'decision aid quality', like normative ones, are of a formative construct and therefore embody interest-conflicted preferences in their criteria selection and weighting. The preferences of the International Patient Decision Aid Standards consortium distinguish the quality of the decision-making process and the quality of the choice that is made '(i.e., decision quality)'. The Decision Conflict Scale features heavily in their profile measure of the former and Decision Quality Instruments (DQIs), have been developed by members of the consortium to measure the latter. We confirm that both of these, and other components, like the higher-level measures, are preference-sensitive and interest-conflicted. Non-financial interest-conflicted preferences are endemic in healthcare research, policy-making, and practice. That they are inevitable means the main problem lies in the denial of this and attitude to and behaviour towards alternatives, equally interest-conflicted.


Assuntos
Técnicas de Apoio para a Decisão , Participação do Paciente , Conflito de Interesses , Tomada de Decisões , Pesquisa sobre Serviços de Saúde , Humanos
6.
J Psychosoc Nurs Ment Health Serv ; 58(11): 9-12, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33119116

RESUMO

The COVID-19 pandemic has changed psychopharmacological prescribing and management of patients around the world. Social distancing requirements led to a transition from face-to-face patient visits to telepsychiatry. Relaxed federal reimbursement policies during the COVID-19 pandemic expanded patient awareness and access to virtual care. For many psychiatric advanced practice RNs (APRNs), the transition to telepsychiatry was intended as a temporary solution until it is possible to return to in-person patient care. Instead, virtual care has become an expectation of patients and agencies. The current article presents a case study example of an adolescent psychiatric patient, exploring the challenges of therapeutic alliance, patient engagement, psychiatric evaluation, laboratory orders, deprescribing, and psychopharmacological adherence. The case study discusses considerations for APRNs who use telemental health in child and adolescent psychiatry and resources for clinical practice. [Journal of Psychosocial Nursing and Mental Health Services, 58(11), 9-12.].


Assuntos
Transtornos Mentais/terapia , Participação do Paciente/métodos , Participação do Paciente/psicologia , Enfermagem Psiquiátrica/métodos , Psiquiatria/métodos , Telemedicina/métodos , Adolescente , Humanos , Masculino , Transtornos Mentais/psicologia
7.
PLoS One ; 15(10): e0241473, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33120402

RESUMO

BACKGROUND: Until a vaccine is developed, a test, trace and isolate strategy is the most effective method of controlling the COVID-19 outbreak. Contact tracing and case isolation are common methods for controlling infectious disease outbreaks. However, the effectiveness of any contact tracing system rests on public engagement. Numerous factors may influence an individual's willingness to engage with a contact tracing system. Understanding these factors has become urgent during the COVID-19 pandemic. OBJECTIVE: To identify facilitators and barriers to uptake of, and engagement with, contact tracing during infectious disease outbreaks. METHOD: A rapid systematic review was conducted to identify papers based on primary research, written in English, and that assessed facilitators, barriers, and other factors associated with the uptake of, and engagement with, a contact tracing system. PRINCIPAL FINDINGS: Four themes were identified as facilitators to the uptake of, and engagement with, contact tracing: collective responsibility; personal benefit; co-production of contact tracing systems; and the perception of the system as efficient, rigorous and reliable. Five themes were identified as barriers to the uptake of, and engagement with, contact tracing: privacy concerns; mistrust and/or apprehension; unmet need for more information and support; fear of stigmatization; and mode-specific challenges. CONCLUSIONS: By focusing on the factors that have been identified, contact tracing services are more likely to get people to engage with them, identify more potentially ill contacts, and reduce transmission.


Assuntos
Busca de Comunicante/métodos , Surtos de Doenças/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/transmissão , Humanos , Pandemias , Participação do Paciente , Pneumonia Viral/transmissão , Privacidade , Responsabilidade Social , Estereotipagem , Confiança
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5785-5788, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019289

RESUMO

Most individuals with advanced dementia lose the ability to communicate with the outside world through speech. This limits their ability to participate in social activities crucial to their well-being and quality of life. However, there is mounting evidence that individuals with advanced dementia can still communicate non-verbally and benefit greatly from these interactions. A major problem in facilitating the advancement of this research is of a practical and methodical nature: assessing the success of treatment is currently done by humans, prone to subjective bias and inconsistency, and it involves laborious and time consuming effort. The present work is the first attempt at exploring if automatic (artificial intelligence based) quantification of the degree of patient engagement in Adaptive Interaction sessions, a highly promising intervention developed to improve the quality of life of nonverbal individuals with advanced dementia. Hence we describe a framework which uses computer vision and machine learning as a potential first step towards answering this question. Using a real-world data set of videos of therapeutic sessions, not acquired specifically for the purposes of the present work, we demonstrate highly promising results.


Assuntos
Demência , Participação do Paciente , Inteligência Artificial , Demência/terapia , Humanos , Aprendizado de Máquina , Qualidade de Vida
9.
IEEE Pulse ; 11(5): 28-31, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33064642

RESUMO

An at-home test for coronavirus disease 2019 (COVID-19) could be released commercially as early as August, according to Scanwell Health of Los Angeles. A combination of a finger-prick blood sample and a smart-phone app, the test is designed to detect the presence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19. The company hopes to receive Emergency Use Authorization from the U.S. Food and Drug Administration (FDA) by the end of summer, and make its first commercially available tests soon after.


Assuntos
Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Técnicas de Laboratório Clínico/instrumentação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Humanos , Aplicativos Móveis , Pandemias , Participação do Paciente/métodos , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Estados Unidos/epidemiologia
10.
Z Evid Fortbild Qual Gesundhwes ; 156-157: 89-99, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33055014

RESUMO

BACKGROUND AND OBJECTIVES: In recent years, the reporting on patient and public involvement (PPI) in health-related research has gained significantly in importance. However, little attention is being paid to the selection of target groups or participating citizens and patients. Individual contributions already point out that the selection is often described in a complex but ambiguous way; for example, individual groups are often not sufficiently differentiated from each other. The aim of our study is to provide an overview of the main topics, questions and challenges that are specific to the selection of participants in PPI by means of an explorative sample of different PPI documents (studies with PPI, studies on PPI, PPI guidelines, PPI websites, PPI journals). Based on this overview, we will make recommendations to help authors of studies and other relevant stakeholders in the planning, implementation and reporting of participant selection. METHODS: First, the explorative sample of the above-mentioned PPI documents was identified by conducting a systematic database and online search. A total of 46 documents were taken into account, including 11 studies with PPI, 12 studies on PPI, 12 guidelines, 6 websites and 5 journals. Relevant text passages were extracted from each of them and evaluated using deductively and inductively developed topic-specific categories. RESULTS: Overall, the selected PPI documents significantly vary a) in the use of terms, b) in the detailing of the individual aspects of participant selection, and c) in the description of the planning and implementation of participant selection. For the latter, there is usually a lack of systematic, comprehensive explanations, e. g., on how to weigh up a relevant number of participants, on objectives and methods in the selection process and on how to prepare participants. DISCUSSION: The various documents about and contributions to the topic of PPI should, in future, report more transparently and systematically on the selection of participants, especially to create practical added value for authors of studies. This includes, in particular, the description of the selection (studies with PPI), a complete overview of all relevant steps of the selection process (PPI guidelines), recommendations on how to deal with representativeness (studies on PPI), notes on reporting PPI (journals) as well as overviews of individual steps of the implementation process (PPI websites).


Assuntos
Pesquisa Biomédica , Pesquisa sobre Serviços de Saúde , Participação do Paciente , Alemanha , Humanos , Seleção de Pacientes
11.
Artigo em Inglês | MEDLINE | ID: mdl-33063479

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic prevented a group-based partial hospitalization program (PHP) from running in-person care due to social distancing guidelines. However, the crisis also simultaneously increased stress on families while decreasing their desire to hospitalize youth for a nonmedical issue. Hence, the need for a PHP remained high. Health care organizations worked diligently to create a secure telehealth platform (tele-PHP) to be delivered to patients in their home environments. This article describes the development and implementation of child and adolescent tele-PHPs in response to the COVID-19 pandemic. These new programs were started in mid-March 2020, and changes were implemented over the next 3 to 4 weeks. Overall, patients and families have been receptive to behavioral health services delivered through telemedicine. While tele-PHPs are the most plausible solution to continue behavioral health care for these patients, some challenges were observed during this process. Besides procedural and technological challenges associated with creating a virtual setup, other difficulties include variable patient engagement, specific treatment-related challenges, and system-related changes. These challenges are addressed through psychoeducation, provision of online measures to assess treatment outcomes, and efforts to optimize parent engagement prior to treatment initiation for better treatment adherence. Initial experiences during a time of crisis suggest that tele-PHP services can be a viable long-term treatment option in the future during both a disaster and routine times to improve access for those who otherwise cannot take advantage of such services. Long-term effectiveness of these interventions still needs to be explored.


Assuntos
Infecções por Coronavirus , Hospital Dia/métodos , Pandemias , Participação do Paciente , Pneumonia Viral , Telemedicina/métodos , Adolescente , Psiquiatria do Adolescente , Betacoronavirus , Criança , Psiquiatria Infantil , Humanos , Pais
12.
PLoS One ; 15(10): e0239607, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33017442

RESUMO

BACKGROUND: HIV self-testing (HIVST) is an additional approach to increasing uptake of HIV testing services. The practicability and accuracy of and the preference for the capillary blood self-test (Exacto Test HIV) versus the oral fluid self-test (OraQuick HIV self-test) were compared among untrained individuals in the Democratic Republic of the Congo (DRC). METHODS: This multicenter cross-sectional study (2019) used face-to-face, tablet-based, structured questionnaires in a facility-based HIVST approach. Volunteers from the general public who were at high risk of HIV infection, who were between 18 and 49 years of age, and who had signed an informed consent form were eligible for the study. The successful performance and correct interpretation of the self-test results were the main outcomes of the practicability evaluation. The successful performance of the HIV self-test was conditioned by the presence of the control band. The sensitivity and specificity of the participant-interpreted results compared to the laboratory results were estimated for accuracy. Preference for either type of self-test was assessed. Logistic regression models were used to examine factors associated with participants' preference. RESULTS: A total of 528 participants were included in this survey. The rate of successful performance of the HIV self-tests was high, with the blood test (99.6%) and the oral-fluid test (99.4%) yielding an absolute difference of 0.2% (95% CI: -1.8 to 1.1; P = 0.568). The rate of correct interpretation of the HIV self-test results was 84.4% with the blood test versus 83.8% with the oral-fluid test (difference = 0.6; 95% CI: -0.2 to 1.7; P = 0.425). Misinterpretation (25.4% for the blood test and 25.6% for the oral-fluid test) and inability to interpret (20.4% for the blood test and 21.1% for the oral-fluid test) test results were significantly more prevalent with invalid tests. The Exacto Test HIV self-test and the OraQuick HIV self-test showed 100% and 99.2% sensitivity, and 98.9% and 98.1% specificity, respectively. Preference for oral-fluid-based HIVST was greater than that for blood-based HIVST (85.6% versus 78.6%; P = 0.008). Preference for the blood test was greater among participants with a university education (86.1%; aOR = 2.4 [95% CI: 1.1 to 4.9]; P = 0.016), a higher risk of HIV infection (88.1%; aOR = 2.3 [95% CI: 1.0 to 5.3]; P = 0.047), and knowledge about the existence of HIVST (89.3%; aOR = 2.2 [95% CI: 1.0 to 5.0]; P = 0.05). CONCLUSION: Our field observations demonstrate that blood-based and oral-fluid-based HIVST are both practicable approaches with a high and comparable rate of accuracy in the study setting. Although preference for the oral-fluid test was generally greater, preference for the blood test was greater among participants with a university education, a high risk of HIV infection, and knowledge about the existence of HIVST. Both approaches seem complementary in the sense that users can choose the type of self-test that best suits them for a similar result. Taken together, our observations support the use of the two HIV self-test kits in the DRC.


Assuntos
Sorodiagnóstico da AIDS/métodos , Infecções por HIV/diagnóstico , Sorodiagnóstico da AIDS/estatística & dados numéricos , Adolescente , Adulto , Líquidos Corporais/imunologia , Estudos Transversais , República Democrática do Congo , Feminino , Anticorpos Anti-HIV/análise , Anticorpos Anti-HIV/sangue , Infecções por HIV/sangue , Infecções por HIV/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Boca/imunologia , Participação do Paciente , Autocuidado , Inquéritos e Questionários , Adulto Jovem
13.
PLoS One ; 15(10): e0239000, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027284

RESUMO

We analyzed 4,352 participant- and staff-collected respiratory specimens from 2,796 subjects in the Oregon Child Absenteeism due to Respiratory Disease Study. Trained staff collected oropharyngeal specimens from school-aged children with acute respiratory illness while household participants of all ages collected their own midturbinate nasal specimens in year one and anterior nasal specimens in year two. Human ribonuclease P levels were measured using RT-PCR for all staff- and participant-collected specimens to determine adequacy, defined as Cycle threshold less than 38. Overall, staff- and participant-collected specimens were 99.9% and 96.4% adequate, respectively. Participant-collected midturbinate specimens were 95.2% adequate in year one, increasing to 97.2% in year two with anterior nasal collection. The mean human ribonuclease P Cycle threshold for participant-collected specimens was 31.18 in year one and 28.48 in year two. The results from this study suggest that community-based participant collection of respiratory specimens is comparable to staff-collected oropharyngeal specimens, is feasible, and may be optimal with anterior nasal collection.


Assuntos
Cavidade Nasal/enzimologia , Orofaringe/enzimologia , Ribonuclease P/genética , Ribonuclease P/isolamento & purificação , Manejo de Espécimes/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Serviços de Saúde Comunitária , Feminino , Humanos , Influenza Humana/diagnóstico , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Cavidade Nasal/virologia , Orofaringe/virologia , Participação do Paciente/métodos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Manejo de Espécimes/instrumentação , Wisconsin , Adulto Jovem
14.
J Med Life ; 13(3): 293-299, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33072199

RESUMO

Diabetes is a significant public health problem and one of the causes of death and disability globally. One of the main problems with diabetes control is the lack of adherence to therapeutic regimens in people with diabetes. This study investigates the experiences and views of the Iranian people with diabetes to identify the challenges of the process of adherence to treatment. A grounded theory research design was used, incorporating in-depth interviews to collect the data. Using purposeful sampling, 28 people with type 2 diabetes (9 men, 19 women) from different places were included in the study. Constant comparative analysis was undertaken to identify key categories. The main challenge in this process is losing the golden time of preventing the complications of the disease that occurs for the following reasons: cultural habits and values, religious beliefs (believing diabetes was God's will), resistance to change due to age, job conditions, lack of harmony in the family, and non-shared decision-making in the health system. People with diabetes go through trial and error in order to achieve awareness and insight, and consequently, adherence to treatment. Therefore, they need help and support to achieve insight and adherence to treatment faster and without complications. In fact, if the care plan is designed to encourage active patient participation by the treatment team in the shortest possible time, the time to achieve compliance will be shorter and will have the least side effects for these people.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Adesão à Medicação , Pesquisa Qualitativa , Adulto , Fatores Etários , Idoso , Cultura , Tomada de Decisões , Assistência à Saúde , Emprego , Família , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Participação do Paciente , Religião
15.
Yakugaku Zasshi ; 140(10): 1275-1284, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32999206

RESUMO

In April 2018, as part of their fifth-year pre-clinical education curriculum, pharmacy students at Setsunan University attended a lecture presented by hepatitis B patients and their lawyer entitled "Lecture by Hepatitis B Patients". This lecture was intended to help the students to understand the circumstances and difficulties encountered by hepatitis B patients on a daily basis. For this study, we conducted questionnaire surveys of the pharmacy students before and after the lecture. The survey items pertained to students' knowledge about hepatitis B (e.g., its spread and infection possibility in daily life). Students' responses before and after the lecture varied depending on the survey topic. Hepatitis B knowledge acquired by the students in their junior year increased after the lecture; moreover, attitudes to hepatitis B patients and understanding of the difficulties and prejudice that they experienced showed a significant change. For example, responses to the items, "Feel sympathy for patients suffering from discrimination and prejudice" and "Hard to work…" were much more sympathetic after the lecture; additionally, students were less likely to "Fear infection when near patients" and more likely "… to associate with patients". Thus, the "Lecture by Hepatitis B Patients" had a significant impact on the pharmacy students' perceptions of these patients, allowing them to cultivate greater empathy. From an educational standpoint, it is of the utmost importance for pharmacy/medical students to develop their humanity as members of healthcare teams. Educational real-world experiences, such as the "Lecture by Hepatitis B Patients", provide opportunities for this development.


Assuntos
Atividades Cotidianas , Educação em Farmácia/métodos , Empatia , Hepatite B/psicologia , Participação do Paciente/métodos , Pacientes/psicologia , Aprendizagem Baseada em Problemas/métodos , Relações Profissional-Paciente , Estudantes de Farmácia/psicologia , Atitude Frente a Saúde , Currículo , Humanos , Conhecimento , Inquéritos e Questionários
16.
Drugs Today (Barc) ; 56(9): 609-614, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33025954

RESUMO

The Drug Information Association (DIA) Europe 2020 brought together multiple stakeholders from around the world including regulatory agencies, industry, patients and academia, to discuss the most innovative topics in healthcare. Main subjects covered were regulatory science, data and data standards, clinical safety and pharmacovigilance, translational medicines and science, patient engagement in clinical development, value and access, medical affairs and scientific communication, health policy, and public affairs and legal issues. The meeting, which was initially intended to take place in Brussels, was finally held virtually due to the COVID-19 situation. This report covers some of the sessions held on these 5 days of state-of-the-art topic discussions.


Assuntos
Participação do Paciente , Farmacovigilância , Pesquisa Médica Translacional , Congressos como Assunto , Infecções por Coronavirus , Europa (Continente) , Humanos , Pandemias , Segurança do Paciente , Pneumonia Viral
17.
Rehabilitacion (Madr) ; 54(4): 276-283, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32863012

RESUMO

The COVID-19 pandemic poses a challenge to the management of non-COVID pathologies such as lymphatic diseases and lipoedema. The use of telemedicine can prevent the spread of the disease. A system is needed to help determine the clinical priority and selection of face-to-face or telemedicine options for each patient and how to carry them out during the pandemic. The Spanish Lymphology Group has drafted a consensus document with recommendations based on the literature and clinical experience, as clinical practice guidelines for the management of lymphatic abnormalities and lipoedema during the COVID-19 pandemic. These recommendations must be adapted to the characteristics of each patient, the local conditions of the centres, and the decisions of health care professionals. The document contains minimum criteria, subject to modifications according to the evolution of the pandemic, scientific knowledge and instructions from health authorities.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Lipedema/terapia , Doenças Linfáticas/terapia , Pandemias , Pneumonia Viral , Telemedicina , Comorbidade , Bandagens Compressivas , Continuidade da Assistência ao Paciente , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Gerenciamento Clínico , Emergências , Desenho de Equipamento , Necessidades e Demandas de Serviços de Saúde , Humanos , Lipedema/complicações , Lipedema/reabilitação , Doenças Linfáticas/complicações , Doenças Linfáticas/reabilitação , Drenagem Linfática Manual , Visita a Consultório Médico , Pandemias/prevenção & controle , Educação de Pacientes como Assunto , Participação do Paciente , Modalidades de Fisioterapia , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Medicina de Precisão , Telefone , Triagem , Comunicação por Videoconferência
18.
AIDS Patient Care STDS ; 34(9): 399-416, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32931317

RESUMO

HIV disproportionately impacts US racial and ethnic minorities but they participate in treatment and vaccine clinical trials at a lower rate than whites. To summarize barriers and facilitators to this participation we conducted a scoping review of the literature guided by the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Studies published from January 2007 and September 2019 were reviewed. Thirty-one articles were identified from an initial pool of 325 records using three coders. All records were then assessed for barriers and facilitators and summarized. Results indicate that while racial and ethnic minority participation in these trials has increased over the past 10 years, rates still do not proportionately reflect their burden of HIV infection. While many of the barriers mirror those found in other disease clinical trials (e.g., cancer), HIV stigma is a unique and important barrier to participating in HIV clinical trials. Recommendations to improve recruitment and retention of racial and ethnic minorities include training health care providers on the importance of recruiting diverse participants, creating interdisciplinary research teams that better represent who is being recruited, and providing culturally competent trial designs. Despite the knowledge of how to better recruit racial and ethnic minorities, few interventions have been documented using these strategies. Based on the findings of this review, we recommend that future clinical trials engage community stakeholders in all stages of the research process through community-based participatory research approaches and promote culturally and linguistically appropriate recruitment and retention strategies for marginalized populations overly impacted by HIV.


Assuntos
Ensaios Clínicos como Assunto , Grupos Étnicos , Infecções por HIV/tratamento farmacológico , Grupos Minoritários , Participação do Paciente/psicologia , Grupos de Populações Continentais , Infecções por HIV/etnologia , Infecções por HIV/psicologia , Humanos , Grupos Minoritários/estatística & dados numéricos , Seleção de Pacientes/ética , Vacinas/administração & dosagem
19.
PLoS One ; 15(9): e0236861, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32960886

RESUMO

OBJECTIVE: Telephone based health coaching (TBHC) seems to be a promising approach to foster self-management in patients with chronic conditions. The aim of this study was to evaluate the effectiveness of a TBHC on patient-reported outcomes and health behavior for people living with chronic conditions in Germany. METHODS: Patients insured at a statutory health insurance were randomized to an intervention group (IG; TBHC) and a control group (CG; usual care), using a stratified random allocation before giving informed consent (Zelen's single-consent design). The TBHC was based on motivational interviewing, goal setting, and shared decision-making and carried out by trained nurses. All outcomes were assessed yearly for three years. We used mixed effects models utilizing all available data in a modified intention-to-treat sample for the main analysis. Participants and study centers were included as random effects. All models were adjusted for age, education and campaign affiliation. RESULTS: Of the 10,815 invited patients, 4,283 returned their questionnaires at baseline. The mean age was 67.23 years (SD = 9.3); 55.5% were female. According to the model, TBHC was statistically significant superior to CG regarding 6 of 19 outcomes: physical activity in hours per week (p = .030) and in metabolic rate per week (p = .048), BMI (p = .009) (although mainly at baseline), measuring blood pressure (p< .001), patient activation (p< .001), and health literacy (p< .001). Regarding stages of change (p = .005), the IG group also showed statistically different results than the CG group, however the conclusion remains inconclusive. Within-group contrasts indicating changes from baseline to follow-ups and significant between-group comparisons regarding these changes supported the findings. Standardized effect sizes were small. TBHC did not show any effect on mental QoL, health status, alcohol, smoking, adherence, measuring blood sugar, foot monitoring, anxiety, depression and distress. Campaign-specific subgroup effects were detected for 'foot monitoring by a physician' and 'blood sugar measurement'. CONCLUSION: TBHC interventions might have small effects on some patient reported and behavioral outcomes. PRACTICE IMPLICATIONS: Future research should focus on analyzing which intervention components are effective and who profits most from TBHC interventions. REGISTRATION: German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS): DRKS00000584.


Assuntos
Doença Crônica/terapia , Aconselhamento à Distância/métodos , Comportamentos Relacionados com a Saúde , Medidas de Resultados Relatados pelo Paciente , Telemedicina , Idoso , Ansiedade/psicologia , Glicemia/análise , Exercício Físico , Feminino , Alemanha , Letramento em Saúde , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Entrevista Motivacional , Participação do Paciente , Autocuidado
20.
Value Health ; 23(9): 1157-1162, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32940233

RESUMO

OBJECTIVES: Despite wide support for patient involvement in health technology assessments (HTA), determining meaningful engagement is complex. This article explores experiences and perceptions among patient groups participating in the Canadian Agency for Drugs and Technologies in Health (CADTH)'s pan-Canadian Oncology Drug Review (pCODR) process. METHODS: We created a qualitative interview study comprising 22 semi-structured telephone interviews with individuals representing 21 different patient groups registered with the pCODR process. The analysis used a qualitative descriptive approach employing techniques from grounded theory. RESULTS: Patient groups view the ability to make submissions to the pCODR process as a meaningful activity closely aligned with organizational priorities. Concurrently, they face substantial resource challenges to prepare submissions, including high opportunity costs and difficulty accessing needed literature and finding relevant patients. Although patient groups felt that CADTH is committed to transparency, they expressed considerable uncertainty around the direct impact of their submissions and desired additional avenues for engagement. CONCLUSIONS: This study suggests a strong commitment by patient groups to participate in the pCODR process despite uncertainty about how their submissions are used to inform HTA recommendations. Identifying opportunities to provide both financial and nonfinancial resources to patient groups is crucial to encouraging and supporting their meaningful participation in HTA processes.


Assuntos
Antineoplásicos/economia , Oncologia/economia , Participação do Paciente , Avaliação da Tecnologia Biomédica/organização & administração , Canadá , Análise Custo-Benefício , Tomada de Decisões , Humanos , Pesquisa Qualitativa
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA