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1.
Stud Health Technol Inform ; 263: 109-121, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31411157

RESUMO

The accumulation of medical knowledge, technology and expertise has provided people with more and more options to improve their health and increase longevity. However, healthcare options typically come with benefits as well as harms and often involve important and complex, high-stakes trade-offs. The ideal of Shared Decision Making (SDM), where a healthcare provider and a patient exchange information, bring in their respective professional and existential expertise and consider the options in light of what matters most from the patient's perspective, is a paradigm that is increasingly viewed as a gold standard for high quality care nowadays. eHealth provides ample opportunities to foster personal health choices and SDM through digital information exchange and personal values clarification support. The boosting framework attempts to describe how to foster people's competences to make choices. Its vision is to equip individuals with competences, for instance improved risk literacy, to empower them to make well-informed choices when facing a difficult choice, such as decisions about health issues. Application of the boosting framework to personal health choices and the SDM process unveils new and promising horizons for future research and could inform the design and evaluation of health informatics interventions such as decision support systems.


Assuntos
Técnicas de Apoio para a Decisão , Informática Médica , Participação do Paciente , Tomada de Decisões , Pessoal de Saúde , Humanos
2.
West Afr J Med ; 36(2): 116-121, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385596

RESUMO

BACKGROUND: Hand hygiene (HH) practices are emphasized as the single most important way of reducing HealthCare-Associated Infection (HCAIs). This study was done to assess the compliance with hand hygiene and knowledge about standard HH practices by health care workers as well as to assess the availability of HH materials in the largest tertiary Hospital in Nigeria. METHODS: A cross-sectional, observational study involving consecutive observations during routine patient care in various units of the University College Hospital (UCH), Ibadan; using a checklist and compliance forms adapted from the WHO guidelines was done. HH knowledge scores were categorized as < 4 = poor, 4-6=fair and >7 = good. RESULTS: A total of 559 HH opportunities were identified and overall compliance was 30.4% (170/ 559). Compliance differed by units: Neonatology SCBU (68.2%), Intensive Care Unit (41.8%), Obstetrics & Gynaecology (39.4%), Adult emergency (26.7%), Children emergency (24.6%), Medicine (22.4%), Surgery (14.9%) and Paediatrics (12.8%). Nurses were more likely to practice hand hygiene (33.2%) compared to doctors (29.0%) [c2 = 33.270, CI= 95%, P<0.001]. Female HCWs had higher hand hygiene compliance (30.6% vs. 25.4%) [c2= 2.129, CI= 95%, P= 0.345]. Soap and water were employed more (95.5%) compared to alcohol-based hand rub (4.5%). Only 12.1% had good HH knowledge scores (>7). CONCLUSION: Poor HH compliance is observed at the facility and is attributable to inadequate education, poor knowledge of standard HH practices and unavailability of HH materials in most of the units. A multidimensional approach is advocated to tackle these issues.


Assuntos
Infecção Hospitalar , Fidelidade a Diretrizes , Higiene das Mãos , Adulto , Criança , Estudos Transversais , Feminino , Pessoal de Saúde , Humanos , Nigéria , Centros de Atenção Terciária/normas
5.
Stud Health Technol Inform ; 264: 1101-1105, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438095

RESUMO

In 2018, the Saudi Commission for Health Specialties (SCFHS) created a national working group composed of key health informatics (HI) professionals, researchers and educators tasked with the development of a draft competency framework for Saudi HI professionals. Over an eight-month period, the research group collected data obtained from literature sources (both academic and grey), international competency standards, participant surveys, focus groups, and expert panel reviews. Through multiple rounds of discussions and graphic visualisation of the information collected using Microsoft PowerPoint and flip charts, the data were summarised and a visual representation of the proposed SHICF was developed. The result of this effort was the development of the first Saudi Health Informatics Competency Framework (SHICF). This paper provides a comparative assessment between the Saudi HI competency framework development and that of other internationally recognised HI competency development frameworks. Challenges related to the development of the SHICF are also discussed.


Assuntos
Informática Médica , Pessoal de Saúde , Humanos , Arábia Saudita , Inquéritos e Questionários
6.
Stud Health Technol Inform ; 264: 1169-1173, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438109

RESUMO

A learning management system (LMS) used for the initial training of health professionals has been rejected by students. Our study aimed to explain the reason of this rejection. We performed this evaluation on a sample of health students in 2012 and 2017 (n = 144). We used scales from the literature (Technology Acceptance Model, General Self-Efficacy Scale, LMS-Self-Efficacy Scale), and studied the social representation of the LMS. The system seemed accessible and useful, but unfortunately with similarities to the system used in a traumatic student environment. Health students using the system did not have a lower self-efficacy. Although the LMS seemed relevant to students, its initial rejection might have been due to a confounding context that created confusion in the acceptability of the tool. To conclude, there is a need to create new dematerialized course formats but with strong tutorship to improve the usage of the technologies by students.


Assuntos
Instrução por Computador , Autoeficácia , Pessoal de Saúde , Humanos , Aprendizagem , Estudantes
7.
Stud Health Technol Inform ; 264: 1174-1178, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438110

RESUMO

Due to technological advancement of medicine, patients have been maintained through mechanical ventilation and vasoactive drugs despite complete and irreversible brain injuries. Accurate diagnosis of brain death (BD) reduces costs, shortens family's suffering, and increases availability of intensive care beds and organs for transplantation. Guidelines were created to standardize BD diagnostic parameters, but knowledge of medical students and medical professionals has been demonstrated to be insufficient. To assist health professionals' in BD determination, a digital training tool that contained images, videos and interactive content was developed for desktops and mobile devices. Software to create and animate 3D models (MakeHuman™ and Blender™) and a game development platform (Unity) were used. Versions for all the major operating systems (iOS™, Android™, macOS™, Windows™ and Linux™) are being made available through online repositories and mobile application stores.


Assuntos
Morte Encefálica/diagnóstico , Aplicativos Móveis , Estudantes de Medicina , Pessoal de Saúde , Humanos , Gravação de Videoteipe
8.
Stud Health Technol Inform ; 264: 1819-1820, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438360

RESUMO

To prevent worsening of diabetes mellitus, we conducted a developmental research of personal health record (PHR), whereby affected individuals, medical staff and an insurer cooperate and manage effective treatment. Medical expenses can be suppressed by preventing the onset of lifestyle-related diseases. Companies can benefit from improved employee productivity by promoting healthy and efficient working styles. We conducted a health and medical consciousness survey to examine PHR models that are attractive for both employers and employees.


Assuntos
Registros de Saúde Pessoal , Pessoal de Saúde , Mão de Obra em Saúde , Humanos , Assistência Individualizada de Saúde , Inquéritos e Questionários
9.
Pan Afr Med J ; 33(Suppl 2): 9, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31402967

RESUMO

Introduction: The 2014-2016 Ebola virus disease (EVD) outbreak in Liberia highlighted the importance of robust preparedness measures for a well-coordinated response; the initially delayed response contributed to the steep incidence of cases, infections among health care workers, and a collapse of the health care system. To strengthen local capacity and combat disease transmission, various healthcare worker (HCW) trainings, including the Ebola treatment unit (ETU) training, safe & quality services (SQS) training and rapid response team (RRT), were developed and implemented between 2014 and 2017. Methods: Data from the ETU, SQS and RRT trainings were analyzed to determine knowledge and confidence gained. Results: The ETU, SQS and RRT training were completed by a total of 21,248 participants. There were improvements in knowledge and confidence, an associated reduction in HCWs infection and reduced response time to subsequent public health events. Conclusion: No infections were reported by healthcare workers in Liberia since the completion of these training programs. HCW training programmes initiated during and post disease outbreak can boost public trust in the health system while providing an entry point for establishing an Epidemic Preparedness and Response (EPR) framework in resource-limited settings.


Assuntos
Surtos de Doenças/prevenção & controle , Pessoal de Saúde/organização & administração , Mão de Obra em Saúde/organização & administração , Doença pelo Vírus Ebola/prevenção & controle , Fortalecimento Institucional , Assistência à Saúde/organização & administração , Epidemias/prevenção & controle , Doença pelo Vírus Ebola/epidemiologia , Humanos , Libéria/epidemiologia , Saúde Pública
10.
Stud Health Technol Inform ; 264: 1253-1257, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438126

RESUMO

The training and competence of healthcare professionals are key factors in adopting new eHealth services. The scope of eHealth is broadening from information systems to eHealth services such as patient portals supporting self-management, which create a need for new competencies. In this study, we evaluated clinical leaders' eHealth competencies and training needs in two public healthcare organizations in Finland. The target organizations' goal was to increase the number of patients' eHealth services and clinical leaders were seen as critical in this change. Data were collected through an online survey of 98 clinical leaders working in two healthcare organizations. The results imply that managing change and planning implementation are challenging to clinical leaders. They need more information about eHealth services, their possibilities, and benefits in order to support their subordinates and patients. The clinical leaders seem to be in a critical role in supporting healthcare professionals and avoiding resistance to change.


Assuntos
Portais do Paciente , Autogestão , Telemedicina , Finlândia , Pessoal de Saúde , Humanos
11.
Stud Health Technol Inform ; 264: 1278-1282, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438131

RESUMO

With the adoption of Personal Health Records (PHRs) integrated with Electronic Health Records (EHRs) and the increase of accessibility to data, institutions have the possibility of exchanging medical information with their patients. Involving the patient reported data has the potential to improve the quality of care and safety and create a feedback loop between patients and health professionals. The objective of this study is to describe a user-centered design of a module for medication list with reconciliation functionalities managed by the patients themselves, and connected to their EHR for supervision and medical validation. We conducted 42 interviews (31 patients and 11 general practitioners). From the interviews, we performed qualitative analysis and extracted the main findings from comments in both groups. Correctitude rate was 57 to 100%, and satisfaction of use (SUS) maximum was 96% and 92%. These findings may be relevant to patients, health care providers, and policymakers.


Assuntos
Registros de Saúde Pessoal , Reconciliação de Medicamentos , Registros Eletrônicos de Saúde , Pessoal de Saúde , Humanos
12.
Stud Health Technol Inform ; 264: 1308-1312, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438137

RESUMO

Improving visualizations in clinical quality reports and dashboards may improve the visualization influence on clinical practice. Tailored displays could accommodate individual and situational differences, but these diplays introduce complex requirements across healthcare professionals and teams. We applied user stories, a method for managing complex software requirements, to a user-centered design process for tailored visual displays about postpartum contraception care. We mapped user stories to tailored displays to identify the quantity of displays that were supported by each user story. We developed 9 tailored displays and 11 user stories. Displays varied in their mappings to user stories (mean 5, max 9, min 0), revealing differences in healthcare professionals and teams preferences and information needs. User stories and user-centered design may be useful for healthcare organizations to manage complex requirements of tailored displays in clinical practice feedback.


Assuntos
Assistência à Saúde , Software , Retroalimentação , Feminino , Pessoal de Saúde , Humanos
13.
Stud Health Technol Inform ; 264: 1323-1326, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438140

RESUMO

Telehealth is available world-wide and in addition to clinical uses, it can also be used to provide education for health professionals, supporting e-Networking. However, within New Zealand the uptake and widespread use of telehealth remains low, and why telehealth is not used more is not understood. This study describes nurse educators use of telehealth for education and identifies barriers and facilitators to increase the uptake of telehealth amongst nurse educators. An on-line survey administered using Survey Monkey had a response rate of 57% (n = 19). Equipment that was not user friendly and a lack of initial training were recognised as barriers to their uptake of telehealth. Telehealth training and support, and local champions were identified facilitators to increase the uptake of telehealth. Recommendations include the need for early adopting nurse educators to be recognised and encouraged, to role model good practice in telehealth, and mentor and support others.


Assuntos
Telemedicina , Docentes de Enfermagem , Pessoal de Saúde , Humanos , Nova Zelândia , Inquéritos e Questionários
14.
Medicine (Baltimore) ; 98(33): e16697, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415361

RESUMO

BACKGROUND: Patient-centered care should be the focus of health services, where improvements in the communication skills of health professionals promote excellent health and quality care. Thus, this study is a protocol for a systematic review and meta-analysis to evaluate the effectiveness of training programs in communication skills to promote self-efficacy in the communication of health personnel. METHODS: This systematic review protocol is conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) statement guidelines and the Cochrane Handbook of Systematic Reviews of Interventions. The review should include studies carried out with health professionals who have undergone training in communication skills aimed at promoting their self-efficacy. Clinical trials (randomized, non-randomized), community trials, and quasi-experimental studies should be included. Therefore, the comprehensive search strategy will be conducted in the following databases: PubMed/Medline, Scopus, Web of Science, EMBASE, Science Direct, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL). Two independent reviewers will conduct all study selection procedures, data extraction, and methodological evaluation, and disagreements will be referred to a third reviewer. RevMan 5.3 software will be used to gather data and perform the meta-analysis if possible. RESULTS: This systematic review will provide evidence on more effective programs for communication skills training and will consider information such as duration, educational strategies, assessment measures, and outcomes that promote health worker self-efficacy. DISCUSSION: This systematic review should provide evidence for effective communication skills training for health professionals in order to guide new strategies for quality care. DISSEMINATION AND ETHICS: The findings of this scoping review will be disseminated in print, at conferences, or via peer-reviewed journals. Ethical approval is not necessary as this paper does not involve patient data. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019129384.


Assuntos
Comunicação , Educação/métodos , Pessoal de Saúde/educação , Pessoal de Saúde/psicologia , Autoeficácia , Adulto , Feminino , Humanos , Masculino , Metanálise como Assunto , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa , Revisão Sistemática como Assunto
15.
Rev. Ciênc. Plur ; 5(1): 52-70, jun. 2019. ilus, tab
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1007343

RESUMO

Introdução:Os serviços de emergência médica exigem do profissional da saúde uma pronta resposta às demandas de cada paciente. Nesse contexto, o estresse laboral pode ser extremamente destrutivo não só para o trabalhador, mas também para o serviço de saúde prestado.Objetivo:Assim, este estudo tem como objetivo analisar os fatores desencadeantes do estresse laboral em profissionais de saúde que trabalham em serviços de emergência médica.Metodologia:Para isso, foi realizada uma revisão integrativa de literatura, tendo como fonte as basesde dados Lilacs, MedLinee Scielo. Foram incluídos estudos transversais ou longitudinais em inglês, português ou espanhol sem restrição de período de publicação que tinham como objetivo avaliar os níveis de estresse em profissionais de saúde que trabalham em serviços de emergência médica. Logo, nove artigos transversais e dois longitudinais foram incluídos, totalizando onze artigos.Resultados:Como resultado, observou-se que uma série de fatores ambientais (más condições de trabalho, atividades de administração) e pessoais(união estável, menor tempo de serviço) são associados ao estresse laboral. Todavia, principalmente os fatores relacionados ao ambiente são passíveis de intervenção.Conclusões:Dessa forma, surge a necessidade de políticas de melhoria do ambiente de trabalho e de empoderamento do profissional de saúde que trabalha em serviços de emergência médica (AU).


Introduction:The emergency medical services require the health professional to respond promptly to the demands of each patient. In this context, work stress can be extremely destructive not only for the worker, but also for the health service provided. Objective:Thus, this study aims to analyze the factors that trigger work stress in health professionals working in emergency medical services.Methods:For this, a integrative review of the literature was performed, based on the Lilacs, MedLineand Scielodatabases. We included cross-sectional or longitudinal studies in English, Portuguese or Spanish without restriction of publication period that aimed to evaluate stress levels in health professionals working in emergency medical services. Therefore, nine transverse and two longitudinal articles were included, totaling eleven articles.Results:As a result, it was observed that a series of environmental factors (poor working conditions, administration activities) and personal factors (stable union, shorter working time) are associated with work stress. However, mainly environmental factors are amenable to intervention.Conclusions:Thus, there is a need for policies to improve the work environment and the empowerment of the health professional working in emergency medical services (AU).


Assuntos
Pessoal de Saúde , Pessoal de Saúde/psicologia , Serviços Médicos de Emergência/métodos , Estresse Ocupacional/psicologia , Brasil , Saúde Pública , Revisão
16.
J Glob Health ; 9(1): 011101, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31275570

RESUMO

Background: Measures of quality of care in low- and middle-income countries (LMICs) rarely include experience of care. This gap in service quality metrics may be driven by a lack of understanding of client and provider perspectives. Understanding these perspectives is a critical first step in not only improving metrics, but also in improving service delivery. This study identifies the items antenatal care (ANC) clients and health care providers in Tanzania associate with a quality ANC service and explores the experience of care domain from both client and provider perspectives. Methods: We conducted semi-structured interviews with15 providers and 35 clients in Tanzania that included a free-listing activity to elicit items clients and providers associate with quality ANC services. We analyzed the free-listing for rank order and frequency to identify the most salient items, which were included in the second phase of data collection. We then conducted semi-structured interviews with a pile sort activity with the same 15 providers and 32 new clients to understand the importance of the items identified in the free-listing. We used a thematic analysis driven by the framework approach to analyze interview data. Results: Both clients and providers perceived quality of ANC as being comprised of items related to experience of care, provision of care, and cross-cutting essential physical and human resources. The free-listing findings illuminated that the experience of care was equally important to clients and providers as the availability of physical and human resources and the content of the care delivered. In addition, clients and providers perceived that a positive patient care experience - marked by good communication, active listening, keeping confidentiality, and being spoken to politely - increased utilization of health services and improved health outcomes. Conclusions: The experience of care in LMICs is an overlooked, yet critically important topic. Understanding the experience of care from those who receive and deliver services is key to measuring and improving the quality of ANC. Our research highlights the importance of incorporating experience of care into future quality improvement activities and quality measures. By doing so, we identify barriers and facilitating factors of practical use to policy-makers and governments in LMICs.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Pessoal de Saúde/psicologia , Cuidado Pré-Natal , Qualidade da Assistência à Saúde , Adolescente , Adulto , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Pesquisa Qualitativa , Tanzânia , Adulto Jovem
17.
Stud Health Technol Inform ; 262: 101-104, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349276

RESUMO

Tuberculosis (TB) represents a global challenge in terms of prevention, care and control. Decision support systems (DSS) can supply the necessary knowledge basis to underpin investigators, policy makers and health personnel actions and to provide crucial elements that can help reducing TB burden. Thus, the objectives of this work are to present the protocol to be followed for carrying out a scoping review to identify topics where DSSs are used, to define appropriate categories and to clarify main outcomes and research gaps. As part of the protocol, five electronic bibliographic databases will be searched for articles from 2006 to 2019 and two investigators will independently screen each work using the study inclusion criteria. Data extraction will be performed, and findings will be reported. The results will be used to provide a broad understanding of how DSSs for TB are being used.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Tuberculose , Assistência à Saúde , Pessoal de Saúde , Humanos , Projetos de Pesquisa , Pesquisadores , Literatura de Revisão como Assunto , Tuberculose/terapia
18.
Stud Health Technol Inform ; 262: 130-133, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349283

RESUMO

Over time there has been an increase of the number of people affected by chronic obstructive respiratory diseases, burdening healthcare providers. Following the growth of information technologies, it has been sought the development of innovative solutions that help monitoring and treating patients. In this work is proposed the architecture for a coaching module to be integrated in the system developed by the PHE project. With the goal to improve patients' health condition by providing innovative and intelligent measuring and monitoring tools for preventive healthcare and allow affordable solutions with increased patient involvement. With this work, we define the architecture for a module that can generate recommendations adapted to each patient. By doing so, we believe to be possible to motivate the adoption of behaviors that benefit the health condition of the patient and decrease the risk of complications associated to the disease.


Assuntos
Tutoria , Doença Pulmonar Obstrutiva Crônica , Assistência à Saúde , Pessoal de Saúde , Humanos , Autoimagem
19.
Stud Health Technol Inform ; 262: 150-153, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349288

RESUMO

Healthcare professionals play a key role in supporting self-care among patients and clients. Their attitudes and behaviors may influence a patient's capacity to use electronic services (e-services) and may increase patients' trust toward a technical solution. The technology acceptance model explains information systems use and the important variables that play a role in an individual's acceptance of e-services. This survey was designed to capture the expectations of healthcare personnel. Participants (n = 91) suggested that patients would benefit from this e-service. The e-services enabled participants to find patient health records more easily than before, and they perceived that the care relationship improved as a result.


Assuntos
Atitude , Pessoal de Saúde , Portais do Paciente , Humanos , Inquéritos e Questionários , Confiança
20.
Stud Health Technol Inform ; 262: 300-303, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349327

RESUMO

Information quality has an important role in health care as digital services provide patients and healthcare professionals more opportunities for searching and utilising information. Information quality is one of the key factors affecting user satisfaction, perception of digital service usability and intention to use the service. The conceptual framework for this study was the updated Information Systems Success Model of DeLone and McLean. The study was conducted in the context of Health Village, a digital interactive and secured portal providing health services to patients and citizens. The purpose of the study was to survey health professionals' perception (n = 91) of information quality and its effect on user satisfaction. Concerns were raised about the interoperability of the portal with other health information systems and the ease of finding information. Generally, in the Health Village portal, information quality was considered relatively high.


Assuntos
Confiabilidade dos Dados , Pessoal de Saúde , Intenção , Serviços de Saúde , Humanos , Portais do Paciente , Inquéritos e Questionários
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