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1.
Arq. ciências saúde UNIPAR ; 25(2): 145-153, maio-ago. 2021.
Artigo em Português | LILACS | ID: biblio-1252386

RESUMO

A adolescência é considerada um rito de passagem da fase infantil para a adulta. Nessa fase muitos hábitos e atitudes sofrerão variações na idade adulta, tornando-se mais difíceis de serem contornados. Para transformar essa realidade, faz-se necessário implementar estratégias educativas que por meio da supervisão de profissionais que facilitem os adolescentes a expressarem sentimentos, trocarem experiências, proporcionando atitudes de respeito e reflexão sobre os temas abordados. O artigo trata de um relato de experiência cujo objetivo é analisar as atividades de educação e promoção da saúde planejadas e implementadas por um grupo de residentes participantes da Residência Multiprofissional em Saúde da Família da UNEB em parceria com um GT de adolescentes na USF Professor Humberto Castro Lima, localizado no bairro de Pernambués, Salvador-Ba, no ano de 2018. As ações realizadas no grupo tiveram como objetivo, incentivar o autoconhecimento, protagonismo, desenvolvimento pessoal, social, coletivo e reflexão do processo saúde/doença. Como resultados destaca-se a contribuição do grupo para a promoção da saúde dos jovens, a construção do vínculo entre os adolescentes com a unidade, a contribuição para o protagonismo no processo ensino-aprendizagem e a sensibilização dos adolescentes para a adoção de práticas preventivas. Conclui-se que a implementação de práticas educativas de caráter participativo, reflexivo, dialógico, dinâmico e problematizador se tornou cada vez mais necessária. Pôde-se perceber a potencialidade dessa estratégia que transcende o modelo biomédico, visando à atenção integral do sujeito, bem como o atendimento às demandas e necessidades dos usuários através da escuta, da construção conjunta do conhecimento, de modo que esses possam ser participativos no processo de mudança de atitudes diante do cuidado com a saúde.(AU)


Adolescence is considered a rite of passage from childhood to adulthood. In this phase, many habits and attitudes will suffer variations as going into adulthood, becoming more difficult to be circumvented. In order to transform this reality, educational strategies should be implemented so that, through the supervision of professionals, can help adolescents to express their feelings, exchange experiences, providing attitudes of respect and reflection on the topics addressed. This article is a report on an experiment which had the objective of analyzing the education and health promotion activities planned and implemented by a group of residents participating in the Multi-professional Residency in Family Health at UNEB in partnership with a Working Group of adolescents at USF Professor Humberto Castro Lima, located in the neighborhood of Pernambués, in the city of Salvador, state of Bahia, in 2018. . The actions carried out in the group aimed at fostering self-knowledge, leadership, personal, social, collective development, and reflections on the health/disease process. As a result, the authors highlight the contribution of the group to the promotion of young people's health, the construction of the bond between adolescents and the health unit, the contribution to becoming protagonists in the teaching-learning process, and the raising of the adolescents' awareness on the adoption of preventive practices. It can be concluded that the implementation of educational practices of a participatory, reflective, dialogical, dynamic, and problem-solving character is increasingly necessary. It was possible to perceive the potential of this strategy that transcends the biomedical model, aiming at the integral care of the subject, as well as meeting the demands and needs of users through listening, and the joint construction of knowledge so that they can participate in the process of changing attitudes towards health care.(AU)


Assuntos
Humanos , Educação em Saúde/métodos , Estratégia Saúde da Família , Promoção da Saúde/métodos , Epidemiologia Descritiva , Adolescente , Pesquisa Qualitativa
2.
Occup Ther Int ; 2021: 6693141, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34121957

RESUMO

The Namibian government ratified the UNCRPD and its optional protocol in 2007 raising expectations that such a convention would fundamentally improve the lives of persons with disabilities. However, persons with disabilities continue to experience inequalities and violation of dignity. This study explores the impact of the UNCRPD as reflected on the lives of persons with disabilities in Namibia. An exploratory qualitative study with the use of photovoice and in-depth interviews was conducted in Omusati and Khomas regions, Namibia. Persons with disabilities (n = 31) were recruited via purposive sampling, of which n = 25 participants were engaged in three focus group discussions. Participants employed in the disability sector (n = 6) were engaged in in-depth interviews. Data were thematically analysed. The study findings revealed the inadequacy of disability rights information dissemination and continued barriers to inclusivity of persons with disabilities. Stigma, discrimination, limited financial opportunities, weak political support, and limited accessibility to physical infrastructure caused barriers to inclusivity. However, opportunities to advance the UNCRPD were also identified. There is a need for the disability sector to build on identified institutional facilitators to advance disability rights through mobilisation of local resources, communities, and government to redress the challenges identified in Namibia.


Assuntos
Pessoas com Deficiência , Terapia Ocupacional , Humanos , Namíbia , Pesquisa Qualitativa , Nações Unidas
3.
BMC Fam Pract ; 22(1): 108, 2021 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-34078281

RESUMO

BACKGROUND: Attempts to manage the COVID-19 pandemic have led to radical reorganisations of health care systems worldwide. General practitioners (GPs) provide the vast majority of patient care, and knowledge of their experiences with providing care for regular health issues during a pandemic is scarce. Hence, in a Danish context we explored how GPs experienced reorganising their work in an attempt to uphold sufficient patient care while contributing to minimizing the spread of COVID-19. Further, in relation to this, we examined what guided GPs' choices between telephone, video and face-to-face consultations. METHODS: This study consisted of qualitative interviews with 13 GPs. They were interviewed twice, approximately three months apart in the initial phase of the pandemic, and they took daily notes for 20 days. All interviews were audio recorded, transcribed, and inductively analysed. RESULTS: The GPs re-organised their clinical work profoundly. Most consultations were converted to video or telephone, postponed or cancelled. The use of video first rose, but soon declined, once again replaced by an increased use of face-to-face consultations. When choosing between consultation forms, the GPs took into account the need to minimise the risk of COVID-19, the central guidelines, and their own preference for face-to-face consultations. There were variations over time and between the GPs regarding which health issues were dealt with by using video and/or the telephone. For some health issues, the GPs generally deemed it acceptable to use video or telephone, postpone or cancel appointments for a short term, and in a crisis situation. They experienced relational and technical limitations with video consultation, while diagnostic uncertainty was not regarded as a prominent issue CONCLUSION: This study demonstrates how the GPs experienced telephone and video consultations as being useful in a pandemic situation when face-to-face consultations had to be severely restricted. The GPs did, however, identify several limitations similar to those known in non-pandemic times. The weighing of pros and cons and their willingness to use these alternatives shifted and generally diminished when face-to-face consultations were once again deemed viable. In case of future pandemics, such alternatives seem valuable, at least for a short term.


Assuntos
Atitude do Pessoal de Saúde , COVID-19/prevenção & controle , Medicina Geral/tendências , Padrões de Prática Médica/tendências , Consulta Remota/tendências , COVID-19/epidemiologia , Tomada de Decisão Clínica/métodos , Dinamarca/epidemiologia , Medicina Geral/métodos , Medicina Geral/organização & administração , Humanos , Entrevistas como Assunto , Pandemias , Relações Médico-Paciente , Padrões de Prática Médica/organização & administração , Pesquisa Qualitativa , Consulta Remota/métodos , Consulta Remota/organização & administração , Telefone , Comunicação por Videoconferência
4.
BMC Health Serv Res ; 21(1): 567, 2021 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-34107941

RESUMO

BACKGROUND: Healthcare practitioners (HCPs) play a crucial role in recognising, responding to, and supporting female patients experiencing intimate partner abuse (IPA). However, research consistently identifies barriers they perceive prevent them from doing this work effectively. These barriers can be system-based (e.g. lack of time or training) or personal/individual. This review of qualitative evidence aims to synthesise the personal barriers that impact HCPs' responses to IPA. METHODS: Five databases were searched in March 2020. Studies needed to utilise qualitative methods for both data collection and analysis and be published between 2010 and 2020 in order to qualify for inclusion; however, we considered any type of healthcare setting in any country. Article screening, data extraction and methodological appraisal using a modified version of the Critical Appraisal Skills Program checklist for qualitative studies were undertaken by at least two independent reviewers. Data analysis drew on Thomas and Harden's thematic synthesis approach. RESULTS: Twenty-nine studies conducted in 20 countries informed the final review. A variety of HCPs and settings were represented. Three themes were developed that describe the personal barriers experienced by HCPs: I can't interfere (which describes the belief that IPA is a "private matter" and HCPs' fears of causing harm by intervening); I don't have control (highlighting HCPs' frustration when women do not follow their advice); and I won't take responsibility (which illuminates beliefs that addressing IPA should be someone else's job). CONCLUSION: This review highlights the need for training to address personal issues in addition to structural or organisational barriers. Education and training for HCPs needs to: encourage reflection on their own values to reinforce their commitment to addressing IPA; teach HCPs to relinquish the need to control outcomes so that they can adopt an advocacy approach; and support HCPs' trust in the critical role they can play in responding. Future research should explore effective ways to do this within the context of complex healthcare organisations.


Assuntos
Pessoal de Saúde , Violência por Parceiro Íntimo , Atenção à Saúde , Feminino , Instalações de Saúde , Humanos , Violência por Parceiro Íntimo/prevenção & controle , Pesquisa Qualitativa
5.
Reprod Health ; 18(1): 113, 2021 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-34092236

RESUMO

BACKGROUND: Adolescent Syrian refugee girls in Lebanon are thought to experience a disproportionate risk of poor sexual and reproductive health, related in part to conflict and displacement. The purpose of this qualitative study was to explore healthcare provider and educator perceptions of the sexual and reproductive health determinants and care-seeking behaviors of this vulnerable population. The findings of the study will inform a health intervention that aims to reduce early marriage and improve access to sexual and reproductive health information and services. METHODS: In-depth interviews and focus group discussions were conducted with stakeholders who work with adolescent Syrian refugee girls in an under-resourced area of eastern Lebanon bordering Syria. Data analysis followed principles of Clarke and Braun's thematic analysis. RESULTS: Study participants perceived adolescent pregnancy, reproductive tract infections, and sexual- and gender-based violence as major population health needs. The study also identified a number of influencing structural and sociocultural determinants of health, including early marriage, adolescent disempowerment, and men's disengagement from care. A conceptual framework based upon the Gelberg-Andersen Behavioral Model for Vulnerable Populations was developed to relate these determinants and guide pathways for potential interventions. CONCLUSIONS: Adolescent sexual and reproductive health interventions among Syrian refugees in Lebanon should adopt a multi-pronged, community-based approach to address underlying health determinants and engage with men and parents of adolescents. Special attention should be given to provider biases in healthcare settings accessible to adolescents, as these may reflect underlying tensions between host and refugee populations and discourage adolescents from seeking care.


Assuntos
Violência de Gênero/etnologia , Pessoal de Saúde/psicologia , Refugiados , Delitos Sexuais/etnologia , Adolescente , Saúde do Adolescente , Feminino , Humanos , Entrevistas como Assunto , Líbano/epidemiologia , Masculino , Gravidez , Pesquisa Qualitativa , Saúde Reprodutiva , Síria/etnologia
6.
BMC Health Serv Res ; 21(1): 571, 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34112151

RESUMO

BACKGROUND: Effective implementation processes play a central role in health care organizations and affect the care of patients. Managers are pivotal in facilitating the use of new practices, but their experience and how it affects the implementation outcome are still largely unknown. In the field of disability health care in particular, managers experiences have scarcely been investigated. Therefore, the aim of this study is to explore managers' experiences of the implementation process when transferring new practices into disability health care settings. METHODS: Semi-structured individual telephone interviews were conducted with managers at disability health care organizations in four administrative regions in central Sweden. A total of 23 managers with formal managerial responsibility from both public and private health care were strategically selected to be interviewed. The interviews were analysed using reflexive thematic analysis with an inductive approach. RESULTS: The analysis resulted in two themes about factors influencing the implementation process: firstly, Contextual factors set the agenda for what can be achieved, which highlighted aspects that hinder or enable the implementation process, such as internal and external conditions, the workplace culture, the employees and managers' attitudes and openness to change: secondly, Leadership in the winds of change, which described the challenges of balancing managerial tasks with leading the change, and the importance of a leadership that involves the participation of the employees. CONCLUSIONS: This study explored how and to what extent managers address and manage the implementation process and the many associated challenges. The findings highlight the importance of leadership support and organizational structure in order to transfer new practices into the work setting, and to encourage an organizational culture for leading change that promotes positive outcomes. We suggest that identifying strategies by focusing on contextual factors and on aspects of leadership will facilitate implementation processes. TRIAL REGISTRATION: The SWAN (Structured Water Dance Intervention) study was retrospectively registered on April 9, 2019 and is available online at ClinicalTrials.gov (ID: NCT03908801).


Assuntos
Atenção à Saúde , Liderança , Humanos , Pesquisa Qualitativa , Suécia , Local de Trabalho
7.
Health Qual Life Outcomes ; 19(1): 158, 2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34059081

RESUMO

BACKGROUND: Patient reported outcome measures (PROMs) are used to understand the impact of lower limb reconstruction surgery on patients' quality of life (QOL). Existing measures have not been developed to specifically capture patient experiences amongst adults with lower limb conditions that require reconstruction surgery. This review aimed to synthesise qualitative evidence to identify what is important to patients requiring, undergoing, or following reconstructive surgery for lower limb conditions. METHODS: MEDLINE, Embase, PsychINFO and Cinahl were searched from inception until November 2020. Studies were included if they employed qualitative research methods, involved patients requiring, undergoing or following lower limb reconstruction and explored patients' experiences of care, treatment, recovery and QOL. Mixed methods studies that did not separately report qualitative findings, mixed population studies that were not separately reported and studies in languages other than English were excluded. Included studies were analysed using thematic synthesis. The Critical Appraisal Skills Programme qualitative studies checklist was used to undertake quality assessment. RESULTS: Nine studies met the inclusion criteria. The thematic synthesis identified two overarching themes: (1) areas of living key to QOL for lower limb reconstruction patients and (2) moving towards a new normal. The way in which lower limb reconstruction affects an individual's QOL and their recovery is complex and is influenced by a range of inter-related factors, which will affect patients to varying degrees depending on their individual circumstances. We identified these factors as: pain, daily functioning and lifestyle, identity, income, emotional wellbeing, support, the ability to adapt and adjust and the ability to move forwards. CONCLUSIONS: The way patients' QOL is affected after a lower limb reconstruction is complex, may change over time and is strongly linked to their recovery. These findings will aid us in developing a conceptual framework which identifies the outcomes important to patients and those that should be included in a PROM. Further research is then required to establish whether the range of factors we identified are captured by existing PROMs. Depending on the outcome of this work, a new PROM for patients following lower limb reconstruction may be required.


Assuntos
Extremidade Inferior/cirurgia , Medidas de Resultados Relatados pelo Paciente , Satisfação do Paciente/estatística & dados numéricos , Qualidade de Vida/psicologia , Procedimentos Cirúrgicos Reconstrutivos/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
8.
Medwave ; 21(4): e8186, 2021 May 24.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-34086666

RESUMO

Introduction: On March 19, 2020, preventive and mandatory social isolation was decreed in Argentina in response to the pandemic caused by the SARS-CoV-2 virus and the disease it causes (COVID-19). This measure aimed to reduce the transmission of the virus and the resulting severe respira-tory condition that frequently besets older adults. However, this measure can also affect the support networks of these isolated people. Objectives: To explore the emerging needs related to the mental health of isolated older adults in this period and to identify the main support networks they have and the emerging coping strategies in the face of the situation. Methodology: We carried out an exploratory qualitative study, summoning participants over 60 years of age. Using snowball sampling, a group of researchers contacted them by phone to collect data. The analysis of the findings was triangulated among researchers with different academic backgrounds (medicine, psychology, and sociology). The concepts emerging from the interviews were linked in conceptual networks using an inductive methodology and were mapped into conceptual frameworks available to researchers. Atlas.ti 8 software was used for coding. Results: Thirty-nine participants belonging to the Buenos Aires Metropolitan Area were interviewed between April and July 2020. For greater clarity, the main themes were described in five cross-sectional axes: network configurations, resources and coping strategies, affective states and emo-tions, perceptions and reflections on the future, and actions emerging from the participatory approach. Participants reported distress, anxiety, anger, uncertainty, exhaustion, and expressed fear of contagion from themselves and their loved ones. We identify greater vulnerability in people living alone, in small and closed environments, with weak linkages and networks, or limited access to technologies. We also found vari-ous coping strategies and technology was a fundamental factor in maintaining the bonds. Conclusions: The findings of this research have implications for decision-making at the individual level, health systems, professional care, and policy devel-opment. Future research may elucidate the regional, temporal, and socioeconomic variations of the phenomena explored in our research.


Assuntos
COVID-19/psicologia , Determinação de Necessidades de Cuidados de Saúde , Distanciamento Físico , Isolamento Social/psicologia , Atividades Cotidianas , Adaptação Psicológica , Idoso , Argentina/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos Transversais , Emoções , Relações Familiares , Medo , Feminino , Regulamentação Governamental , Humanos , Relações Interpessoais , Masculino , Saúde Mental , Pessoa de Meia-Idade , Redes Sociais Online , Grupo Associado , Pesquisa Qualitativa , Quarentena/psicologia , Rede Social , Participação Social , Apoio Social
9.
Medwave ; 21(4): e8192, 2021 May 24.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-34086668

RESUMO

Introduction: On March 19, 2020, a mandatory lockdown was imposed in Argentina due to the global pandemic caused by SARS-CoV-2. Objectives: To explore the elderlys healthcare experiences during the lockdown and the problems that may have arisen regarding accessibility to the healthcare system and emerging adaptations to medical care. Methods: We coded the data using Atlas.ti 8 software and then triangled the analysis among researchers from different backgrounds. Finally, concept maps were developed and themes arising from these were described. Results: Thirty-nine participants were interviewed from the metropolitan area in Buenos Aires from April to July of 2020. The main emerging themes were: 1) access to regularly scheduled consults, 2) access to chronic medication, 3) emergency consultations, and 4) the role of information and communication technologies. Accessibility to the healthcare system was compromised due to reduced outpatient consultations, affecting health checkups, diagnosis, and treatment. However, participants tried to keep their immunizations up to date. Information and communication technologies were used to fill digital prescriptions and online medical consultations. While this was a solution to many, others did not have access to these technologies or had trouble using them. Conclusions: The global pandemic caused a reduction in outpatient medical consultations. Emerging needs originated new ways of carrying out medical consultations, mainly through information and communication technologies, which was a solution for many but led to the exclusion of others because of the preexisting technology gap.


Assuntos
COVID-19/prevenção & controle , Acesso aos Serviços de Saúde , Serviços de Saúde para Idosos , Quarentena , Idoso , Assistência Ambulatorial , Agendamento de Consultas , Argentina/epidemiologia , COVID-19/epidemiologia , COVID-19/psicologia , Prescrição Eletrônica , Serviços Médicos de Emergência , Feminino , Humanos , Tecnologia da Informação , Masculino , Pessoa de Meia-Idade , Preparações Farmacêuticas/provisão & distribuição , Pesquisa Qualitativa , Telemedicina , Vacinação
10.
BMC Health Serv Res ; 21(1): 561, 2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34098973

RESUMO

BACKGROUND: Although risk prediction has become an integral part of clinical practice guidelines for cardiovascular disease (CVD) prevention, multiple studies have shown that patients' risk still plays almost no role in clinical decision-making. Because little is known about why this is so, we sought to understand providers' views on the opportunities, barriers, and facilitators of incorporating risk prediction to guide their use of cardiovascular preventive medicines. METHODS: We conducted semi-structured interviews with primary care providers (n = 33) at VA facilities in the Midwest. Facilities were chosen using a maximum variation approach according to their geography, size, proportion of MD to non-MD providers, and percentage of full-time providers. Providers included MD/DO physicians, physician assistants, nurse practitioners, and clinical pharmacists. Providers were asked about their reaction to a hypothetical situation in which the VA would introduce a risk prediction-based approach to CVD treatment. We conducted matrix and content analysis to identify providers' reactions to risk prediction, reasons for their reaction, and exemplar quotes. RESULTS: Most providers were classified as Enthusiastic (n = 14) or Cautious Adopters (n = 15), with only a few Non-Adopters (n = 4). Providers described four key concerns toward adopting risk prediction. Their primary concern was that risk prediction is not always compatible with a "whole patient" approach to patient care. Other concerns included questions about the validity of the proposed risk prediction model, potential workflow burdens, and whether risk prediction adds value to existing clinical practice. Enthusiastic, Cautious, and Non-Adopters all expressed both doubts about and support for risk prediction categorizable in the above four key areas of concern. CONCLUSIONS: Providers were generally supportive of adopting risk prediction into CVD prevention, but many had misgivings, which included concerns about impact on workflow, validity of predictive models, the value of making this change, and possible negative effects on providers' ability to address the whole patient. These concerns have likely contributed to the slow introduction of risk prediction into clinical practice. These concerns will need to be addressed for risk prediction, and other approaches relying on "big data" including machine learning and artificial intelligence, to have a meaningful role in clinical practice.


Assuntos
Inteligência Artificial , Médicos , Atitude , Atitude do Pessoal de Saúde , Pessoal de Saúde , Humanos , Pesquisa Qualitativa
11.
J Frailty Aging ; 10(3): 259-271, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34105711

RESUMO

The population of older adults over 60 years is growing faster than any other age group and will more than double between 2020 and 2050. This increase has led to clinical, public health, and policy interest in how to age "successfully". Before the Rowe and Kahn's model proposed thirty years ago, aging was seen as a process of losses associated with diseases and disability. However, since the emergence of this model, there has been a shift towards a more positive view, serving for promoting diverse medical or psychosocial models, and personal perspectives. Several technical terms of "success" (e.g. "successful aging", "healthy aging", "active aging", "aging well"…) coexist and compete for the meaning of the concept in the absence of a consensual definition. Our literature review article aims to study discrepancies and similarities between the main technical terms through quantitative or qualitative studies. A literature review using PubMed, SCOPUS, PsycINFO, Psycarticles, Psychology, and Behavioral Sciences Collection, Cochrane database, and clinicaltrials.gov databases was conducted. A total of 1057 articles were found and finally, 43 papers were selected for full extraction. We identified several components in these definitions, which reveal considerable inconsistency. The results particularly suggest that lay personals perspectives could bridge the gap between biomedical and psychosocial models in successful aging. In conclusion, an optimal definition would be a multidimensional one that could combine functional capacities, psychosocial abilities, environmental factors and subjective assessments of one's own criteria to discriminate older adults at potential risk of "unsuccessful" aging to healthy aging trajectories.


Assuntos
Envelhecimento Saudável , Idoso , Envelhecimento , Nível de Saúde , Humanos , Vida Independente , Pesquisa Qualitativa
12.
Curr Oncol ; 28(3): 1867-1878, 2021 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-34068441

RESUMO

Cancer causes substantial emotional and psychosocial distress, which may be exacerbated by delays in treatment. The COVID-19 pandemic has resulted in increased wait times for many patients with cancer. In this study, the psychosocial distress associated with waiting for cancer surgery during the pandemic was investigated. This cross-sectional, convergent mixed-methods study included patients with lower priority disease during the first wave of COVID-19 at an academic, tertiary care hospital in eastern Canada. Participants underwent semi-structured interviews and completed two questionnaires: Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS). Qualitative analysis was completed through a thematic analysis approach, with integration achieved through triangulation. Fourteen participants were recruited, with cancer sites including thyroid, kidney, breast, prostate, and a gynecological disorder. Increased anxiety symptoms were found in 36% of patients and depressive symptoms in 14%. Similarly, 64% of patients experienced moderate or high stress. Six key themes were identified, including uncertainty, life changes, coping strategies, communication, experience, and health services. Participants discussed substantial distress associated with lifestyle changes and uncertain treatment timelines. Participants identified quality communication with their healthcare team and individualized coping strategies as being partially protective against such symptoms. Delays in surgery for patients with cancer during the COVID-19 pandemic resulted in extensive psychosocial distress. Patients may be able to mitigate these symptoms partially through various coping mechanisms and improved communication with their healthcare teams.


Assuntos
Ansiedade/epidemiologia , COVID-19/prevenção & controle , Depressão/epidemiologia , Neoplasias/cirurgia , Tempo para o Tratamento , Adaptação Psicológica , Adulto , Idoso , Ansiedade/diagnóstico , Ansiedade/etiologia , Ansiedade/psicologia , COVID-19/epidemiologia , COVID-19/transmissão , Controle de Doenças Transmissíveis/normas , Estudos Transversais , Depressão/diagnóstico , Depressão/etiologia , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/psicologia , Nova Escócia/epidemiologia , Pandemias/prevenção & controle , Angústia Psicológica , Psicometria/estatística & dados numéricos , Pesquisa Qualitativa , Autorrelato/estatística & dados numéricos , Triagem/normas , Incerteza
13.
Stud Health Technol Inform ; 282: 259-270, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34085974

RESUMO

The purpose of this study was to review the qualitative literature on cognitive accessibility in a digital environment and areas of inquiry for future qualitative research in this context. The focus of this literature review was to identify qualitative research in the cognitive accessibility field and how commonly this term is mentioned in qualitative research articles. In this study, a literature review was conducted on selected qualitative research studies performed globally related to cognitive accessibility. This literature review analysed through meta-synthesis. Based on the results of the literature review, an understanding of existing qualitative research was obtained in the cognitive accessibility field, as well as topics for further qualitative research in the cognitive accessibility field.


Assuntos
Cognição , Pesquisa Qualitativa
14.
Stud Health Technol Inform ; 282: 315-332, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34085978

RESUMO

This paper presents the development of a digital generative design tool for residential building that integrates qualitative data from potential users of buildings. The central aim is to understand and challenge the inherent biases in the design process of architecture for mobility impaired users, whose experiences might be difficult to understand for designers who often move around and use buildings without any difficulty. Although Universal Design promotes designed environments that are more sensitized with the diverse difference of individuals, the most of design generating tools are based on empirically deducted human needs, objectifying the people or seeing them as useful in simply validating design ideas. There is a clear distance in between the real needs and wishes of wheelchair users and what architects imagine when designing. Mixed-methods - expert interview, literature review and data analysis of disability blogs - are used to collect and analyse wheelchair users' experience. Accumulated qualitative data is, then, used as guiding input for the development of an explorative generative model that effectively produces large number of floor plans for residential architecture. The developed generative model effectively selects floor plans that correspond with challenges described by the wheelchair users. The selected floor plans become informed starting points for spatial planning, which can guide architects to produce new and unexpected design solutions that are more sensitised to wheelchair users' experience. The application of generative design tools in early stages of design tasks can help architects to understand users' needs and wishes, and thus challenge biased assumptions about wheelchair users' experiences. And yet, further research needs to be conducted in order to progress the system: additional user data and new design objectives can give rise to new hypothesis and allow the system to be more precise, responding to the complex reality of disabled people in their everyday lives.


Assuntos
Pessoas com Deficiência , Cadeiras de Rodas , Humanos , Pesquisa Qualitativa , Projetos de Pesquisa
15.
BMC Health Serv Res ; 21(1): 546, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34088311

RESUMO

BACKGROUND: This study tried to improve the operational efficiency and service quality of the community case management model for the High-Care Elderly in Communities in Taiwan. This study tried to assistant social workers in community care sites to establish individualized treatment planning, to empower them with flexibility to discover and utilize their own unique strengths, to reach the goal of developing community care capacity. METHODS: A case consulting model was employed in this study by providing case by case supervision service. We collected all supervision meeting records and related data as our qualitative research materials, analyzed these materials and tried to define intervention effectiveness of the individualized supervision strategy under the strength perspective applied to the case management model of the high-care elderly in communities. To find out what helps these social workers the most, and how these social workers realize and recognize their process and key to improve their service quality and work efficiency, in the way of qualitative interpretation. RESULTS: A supervision model under the perspective of strength was developed in this study, and was applied to clinical community care sites to help their social workers. The results proved that our supervision model provided an opportunity to empower and re-know themselves, re-establish their professional confidence and meaning of existence for their organization, and eventually produced positive effect to quality of service and service receiver's satisfaction improvement. The key feature that made this supervision model of the strength perspective work was to let social workers have the autonomy to interpret the challenges they face and to think possible alternative solutions creatively. CONCLUSIONS: This study showed that create a supervisee-friendly psycho-socio environment empowered these workers by increasing their resource network and taking advantage of what they still have and what they were good at, this could help these workers upgrade their level on ladders of empowerment, become an active and independent professional worker that have power and confidence to make treatment and intervention.


Assuntos
Administração de Caso , Motivação , Idoso , Humanos , Projetos Piloto , Pesquisa Qualitativa , Taiwan
16.
BMC Health Serv Res ; 21(1): 550, 2021 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-34090421

RESUMO

BACKGROUND: Bleeding during cardiac surgery is a common complication that often requires the transfusion of blood products. The combination of bleeding and blood product transfusion incrementally increases adverse outcomes including infection and mortality. Following bleeding management guideline recommendations could assist with minimising risk but adherence is not high, and the cause for lack of adherence is not well understood. This study aimed to identify barriers and facilitators to practicing and implementing evidenced-based intra-operative, bleeding management in Australian cardiac surgery units. METHODS: We used a qualitative descriptive design to conduct semi-structured interviews with Australian cardiac surgeons, anaesthetists and perfusionists. The Theoretical Domains Framework (TDF) was utilised to guide interviews and thematically analyse the data. Categorised data were then linked with the three key domains of the COM-B model (capability, opportunity, motivation - behaviour) to explore and understand behaviour. RESULTS: Seventeen interviews were completed. Nine of the 14 TDF domains emerged as significant. Analysis revealed key themes to improving capability included, standardisation, monitoring, auditing and feedback of data and cross discipline training. Opportunity for change was improved with interpersonal and interdepartmental collaboration through shared goals, and more efficient and supportive processes allowing clinicians to navigate unfamiliar business and financial models of health care. Results suggest as individuals, clinicians had the motivation to make change and healthcare organisations have an obligation and a responsibility to partner with clinicians to support change and improve goal directed best practice. CONCLUSION: Using a theory-based approach it was possible to identify factors which may be positively or negatively influence clinicians ability to implement best practice bleeding management in Australian cardiac surgical units.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Motivação , Austrália , Humanos , Pesquisa Qualitativa
17.
BMC Med Educ ; 21(1): 320, 2021 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-34090439

RESUMO

BACKGROUND: Self-regulated learning (SRL) is an important contributing element to the academic success of students. Literature suggests that the understanding of SRL among medical students is obscure as there is still some uncertainty about whether high performing medical students use SRL. This study explored the characteristics of high performing medical students from the SRL perspective to gain a better understanding of the application of SRL for effective learning. METHODS: Twenty-one students who scored at the 90th percentile in written knowledge-based assessment consented to participate in this study. Each student wrote a guided reflective journal and subsequently attended a semi-structured interview. Students were prompted to explain the rationales for their answers. The data were then analysed using thematic analysis to identify patterns among these students from the SRL perspective. Two coders analysed the data independently and discussed the codes to reach a consensus. RESULTS: High performing students set goals, made plans, and motivated themselves to achieve the goals. They put consistent efforts into their studies and applied effective learning strategies. They also employed coping mechanisms to deal with challenges. High performing students regularly evaluated their performance and adopted new strategies. CONCLUSIONS: This study reported that high performing students applied SRL and described the rationales of practice. Medical schools could design SRL-driven interventions to enhance the learning experiences of medical students. Recommendations are made for students on how to apply SRL.


Assuntos
Educação de Graduação em Medicina , Estudantes de Medicina , Competência Clínica , Humanos , Aprendizagem , Pesquisa Qualitativa
18.
BMC Health Serv Res ; 21(1): 553, 2021 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-34090450

RESUMO

BACKGROUND: In health care, the work of keeping the patient safe and reducing the risk of harm is defined as safety work. In our digitised and technology-rich era, safety work usually involves a relationship between people and technologies. Telecare is one of the fastest-growing technology-domains in western health care systems. In the marketing of telecare, the expectation is that safety is implicit simply by the presence of technology in patients' homes. Whilst both researchers and health authorities are concerned with developing cost-benefit analyses and measuring effects, there is a lack of attention to the daily work needed to ensure that technologies contribute to patient safety. This paper aims to describe how patient safety in home care is addressed through and with telecare. We base our exploration on the social alarm, an established technology that care workers are expected to handle as an integrated part of their ordinary work. METHODS: The study has a qualitative explorative design where we draw on empirical data from three case studies, involving five Norwegian municipalities that use social alarm systems in home care services. We analyse observations of practice and interviews with the actors involved, following King's outline of template analysis. RESULTS: We identified three co-existing work processes that contributed to patient safety: "Aligning people and technologies"; "Being alert and staying calm"; and "Coordinating activities based on people and technology". Attention to these work processes exposes safety practices, and how safety is constructed in relational practices involving multiple people and technologies. CONCLUSIONS: We conclude that the three work processes identified are essential if the safety alarm is to function for the end user's safety. The safety of home-dwelling patients is reliant on the person-technology interface. The efforts of care workers and their interface with technology are a central feature of creating safety in a patient's home, and in doing so, they utilise a repertoire of skills and knowledge.


Assuntos
Serviços de Assistência Domiciliar , Telemedicina , Humanos , Noruega , Segurança do Paciente , Pesquisa Qualitativa
19.
J Pak Med Assoc ; 71(5): 1403-1408, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091623

RESUMO

Objective: To explore students' perceptions regarding self-directed learning, their experience of it, and how it may play a role in life-long learning. METHODS: The exploratory study was conducted at the Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia, in January and February 2018, and comprised male undergraduate medical students from academic years 2-6. Data was collected through focus group discussions regarding the students' perception of self-directed learning. The sessions were audiotaped, transcribed, and analysed thematically. Validation was done by member-checking and external audit. RESULTS: There were 29 male students with a mean age of 22.4±1.9 years. A total of 4 focus group discussion sessions were conducted; 2(50%) with students of preclinical years 2 and 3, and 2(50%) with students of clinical years 4-6. Five major themes generated were: understanding of self-directed learning; views about self-directed learning as a strategy; process of the strategy; effects of self-directed learning; self-directed learning and life-long learning. Subthemes which led to developing major themes included self-study, personal efforts, and objectives and goals formed theme1; good strategy, boredom with lectures, and need guidance theme2; time management, outline of planning, and internet browsing theme3; deep learning and curiosity theme4; life-long learning and future progress theme 5. CONCLUSIONS: The students were found to have mixed perceptions regarding self-directed learning. Most students perceived that SDL could affect their learning and future progress positively. However, they needed support to effectively use this strategy. The faculty role was found to be crucial in this regard.


Assuntos
Educação de Graduação em Medicina , Estudantes de Medicina , Adulto , Humanos , Masculino , Percepção , Pesquisa Qualitativa , Arábia Saudita , Adulto Jovem
20.
J Pak Med Assoc ; 71(5): 1476-1478, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091638

RESUMO

This qualitative study aimed to explore medical students' experience of generation gap in their interactions with senior teachers (aged >55) in Japan. Focus group interviews were conducted with 28 medical students (20 to 30 years, mean age 22 ±2 years, classified as millennials, with only one year of studies since starting specialised courses for medicine. The participants were interviewed in groups of four, with each interview lasting 60 minutes. Topics covered included generation gap experienced in daily life and during their studies, and work-life balance issues. The discussions were recorded and transcribed, and content analysis was applied. Four specific influential generation-gap categories were identified - distinctive sociocultural backgrounds, more recent educational media tools and faster information dissemination speed, new-era values, and challenges in communication - that were consistent with findings from previous studies. More senior personnel involved in medical education need to consider these categories to enhance effectiveness of teaching.


Assuntos
Educação Médica , Estudantes de Medicina , Adulto , Grupos Focais , Humanos , Relação entre Gerações , Pesquisa Qualitativa , Adulto Jovem
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