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1.
Rev Bras Enferm ; 74(3): e20200253, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34133679

RESUMO

OBJECTIVE: to understand professional care for maternal grief in the puerperium of stillbirth. METHODS: a clinical-qualitative study with all the women who had stillbirths living in Maringá (Brazil) and participating in the Center d'Études et de Recherche in Family Intervention at the University of Quebec in Outaouais in Gatineau (Canada). Semi-structured interviews were carried out and the relevant aspects were categorized into themes. RESULTS: the identified categories were: Assistance received in the puerperium with a focus on grief: hospital and outpatient environment, and Professional support in coping with maternal grief after fetal loss: with contact and memories, without contact and without memories and impossibilities of contact with the baby. FINAL: considerations: the need for a multidisciplinary support and monitoring network for women who experienced fetal loss was evident. From this study, a routine of care for grief can be implemented in Brazil based on experiences in Canada.


Assuntos
Mães , Natimorto , Brasil , Canadá , Feminino , Pesar , Humanos , Lactente , Gravidez , Prática Profissional
2.
Front Public Health ; 9: 678545, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33996734

RESUMO

In addition to the importance of fostering and developing measures for better health-system resilience globally from the effects of climate change, there have been increasing calls for health professionals, as well as public health and medical education systems, to become partners in climate change mitigation efforts. Direct clinical practice considerations, however, have not been adequately fostered equitably across all regions with an often-confusing array of practice areas within planetary health and sustainable healthcare. This article calls for a more coordinated effort within clinical practice spaces given the urgency of global environmental change, while also taking lessons from Indigenous traditional knowledge systems-a viewpoint that is rarely heard from or prioritized in public health or medicine. Simpler and more coordinated messaging in efforts to improve patient and planetary health are needed. The creation of unifying terminology within planetary health-rooted clinical and public health practice has been proposed with the potential to bring forth dialogue between and within disciplinary offshoots and public health advocacy efforts, and within clinical and health-system policy spaces.


Assuntos
Mudança Climática , Política de Saúde , Humanos , Prática Profissional , Saúde Pública
3.
Rech Soins Infirm ; N° 144(1): 105-115, 2021 Apr 26.
Artigo em Francês | MEDLINE | ID: mdl-34002586

RESUMO

Introduction : Historically, it is accepted that women caregivers have always had care-giving roles. Care is expressed in various ways in professional acts.Background : A context where nursing activity is more centered on technical and cure-related acts raises questions about the role of care-related professional knowledge in nursing.Objective : To present the results of a study looking at the identification of care-related professional acts in the activity of nurses in care-providing situations and their links to nursing knowledge.Method : The study was conducted in the context of clinical activity using simple self-confrontation and lookalike instruction methods. Data were collected from independent nurses through recordings and note-taking and then analyzed to categorize them using the frames of reference of lexical analysis, enunciative topics and the typology of nursing knowledge.Results : Four types of care-related professional acts were identified : acts of atmosphere, acts of solicitude, acts of evaluation, and acts of regulation. The results made it possible to design a tool for analyzing these care-related professional acts.Discussion : Care-related professional acts exist and can be identified. Analysis of the results confirms that experience transforms knowledge of various kinds into practical knowledge.Conclusion : The confrontation between professional practice and the various types of knowledge acquired enables the construction of professional knowledge.


Assuntos
Gestos , Conhecimento , Feminino , Humanos , Prática Profissional
4.
Online braz. j. nurs. (Online) ; 20: e20216418, 05 maio 2021. tab
Artigo em Inglês, Espanhol, Português | LILACS, BDENF - Enfermagem | ID: biblio-1222613

RESUMO

OBJETIVO: Conhecer as crenças e atitudes dos profissionais da Estratégia Saúde da Família de Santa Cruz Cabrália/Bahia. sobre a problemática do suicídio. MÉTODO: Estudo transversal, quantitativo, realizado com 37 profissionais. Foi aplicado aos profissionais um questionário de atitudes em relação ao comportamento suicida (QUACS) dos usuários atendidos pela Estratégia Saúde da Família no município e um formulário de formação profissional. Os dados foram analisados pelo Statistical Package for the Social Science ­ SPSS, verificando-se a média e desvio padrão dos fatores. RESULTADOS: Evidencia-se um despreparo dos profissionais no atendimento a usuários em risco de suicídio, com sentimentos de incapacidade e atitudes moralistas. DISCUSSÃO: Os profissionais da Atenção Primária à Saúde são fundamentais na detecção e intervenção precoce do suicídio. CONCLUSÃO: É necessário melhor preparo dos profissionais para o acompanhamento desses usuários na Estratégia Saúde da Família. Compete aos gestores, assegurar que esses usuários sejam acompanhados de maneira integral nos serviços de saúde.


OBJECTIVE: To know the beliefs and attitudes of the professionals working in the Family Health Strategy of Santa Cruz Cabrália/Bahia on the issue of suicide. METHOD: A cross-sectional and quantitative study, carried out with 37 professionals. The professionals had to answer a questionnaire on attitudes in relation to suicidal behavior (QUACS) of the users assisted by the Family Health Strategy in the municipality, as well as a professional training form. The data were analyzed by means of the Statistical Package for the Social Science ­ SPSS, verifying the mean and standard deviation of the factors. RESULTS: Lack of preparation of the professionals is evidenced in the care for users at risk of suicide, with feelings of incapacity and moralistic attitudes. DISCUSSION: The professionals working in Primary Health Care are fundamental in the early detection and intervention of suicide. CONCLUSION: Better preparation of the professionals is necessary to monitor these users in the Family Health Strategy. It is the managers' responsibility to ensure that these users are comprehensively monitored in the health services.


OBJETIVO: Conocer las creencias y actitudes de los profesionales de la Estrategia Salud de la Familia de Santa Cruz Cabrália/Bahía sobre la problemática del suicidio. MÉTODO: Estudio transversal, cuantitativo, realizado con 37 profesionales. Se les solicitó a los profesionales que respondieran un cuestionario sobre actitudes hacia la conducta suicida (CUACS) de los usuarios atendidos por la Estrategia Salud de la Familia en el municipio y un formulario de formación profesional. Los datos fueron analizados por el Statistical Package for the Social Science ­ SPSS, para verificar la media y la desviación estándar de los factores. RESULTADOS: Es evidente que los profesionales no están preparados para atender a los usuarios con riesgo de suicidio, tienen sentimientos de incapacidad y actitudes moralistas. DISCUSIÓN: Los profesionales de la atención primaria de la salud son fundamentales en la detección e intervención precoces del suicidio. CONCLUSIÓN: Es necesario preparar mejor a los profesionales para el seguimiento de estos usuarios en la Estrategia de Salud de la Familia. Es responsabilidad de los gestores asegurarse de que se realice un seguimiento integral a los usuarios en los servicios de salud.


Assuntos
Humanos , Suicídio , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Estratégia Saúde da Família , Atenção Primária à Saúde , Prática Profissional , Estudos Transversais
5.
Online braz. j. nurs. (Online) ; 20: e20216473, 05 maio 2021. ilus, graf
Artigo em Inglês, Espanhol, Português | LILACS, BDENF - Enfermagem | ID: biblio-1223171

RESUMO

OBJETIVO: Identificar e mapear a produção literária latino-americana acerca do ambiente da prática profissional de enfermagem no cenário hospitalar com base nos instrumentos Nursing Working Index-Revised e Practice Environment Scale. MÉTODO: Scoping review em cinco bases de dados e outras fontes sobre o tema. A amostra contabilizou 20 artigos, nove Teses e cinco Dissertações publicados na última década. RESULTADO: O Brasil apresentou o maior número de publicações em periódicos, na amostra. Os ambientes mostraram-se favoráveis com a aplicação do Nursing Working Index-Revised e desfavoráveis com a Practice Environment Scale. Entre os domínios destacam-se, com os piores escores, o controle do ambiente e adequação da equipe e de recursos. CONCLUSÃO: A produção literária adquire destaque apenas na última década e aponta para a associação entre ambientes da prática favoráveis e melhores resultados assistenciais.


OBJECTIVE: To identify and map the Latin American literary production about the nursing work environment in the hospital setting based on the Nursing Working Index-Revised and on the Practice Environment Scale. METHOD: A scoping review in five databases and other sources on the topic. The sample included 20 articles, nine Theses and five Dissertations published in the last decade. RESULT: In the sample, Brazil presented the largest number of publications in journals. The environments were favorable with the application of the Nursing Working Index-Revised and unfavorable with the Practice Environment Scale. Among the domains with the worst scores, control over the environment and adequacy of the team and resources stand out. CONCLUSION: The literary production has gained prominence only in the last decade and points to the association between favorable practice environments and better care results.


OBJETIVO: Identificar y mapear la producción literaria latinoamericana sobre el entorno de la práctica profesional de la enfermería en el ámbito hospitalario a partir de los instrumentos Nursing Working Index-Revised y Practice Environment Scale. MÉTODO: Scoping review en cinco bases de datos y otras fuentes sobre el tema. La muestra contó con 20 artículos, nueve Tesis Doctorales y cinco Tesis de Maestría publicadas en la última década. RESULTADO: Brasil tuvo el mayor número de publicaciones en revistas de la muestra. Los entornos fueron favorables con la aplicación del Nursing Working Index-Revised y desfavorables con la Practice Environment Scale. Entre los dominios, con los peores puntajes, se destacan el control del entorno y la adecuación del equipo y los recursos. CONCLUSIÓN: La producción literaria ha ganado notoriedad solo en la última década y apunta a la asociación entre entornos de práctica favorables y mejores resultados de atención.


Assuntos
Humanos , Prática Profissional , Enfermagem , Ambiente de Instituições de Saúde , Hospitais , América Latina , Recursos Humanos de Enfermagem no Hospital
6.
Complement Ther Clin Pract ; 43: 101365, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33819832

RESUMO

BACKGROUND AND PURPOSE: Traumatic psychological events are thought to alter brain physiology, notably regions such as the thalamus and the limbic system, affecting personal choice, autonomy, and behavior. Innovative therapies are needed to address the diverse, mental and physical consequences of these changes. Trauma Center-Trauma Sensitive Yoga (TC-TSY) has shown promising results in clinical trials among individuals experiencing posttraumatic symptomatology. MATERIALS AND METHODS: Using a qualitative, descriptive design, we examined the impact of TC-TSY training on the professional practice of seven practitioners who were certified yoga instructors and/or registered psychologists. RESULTS: The findings suggest TC-TSY training enriched their practices, chiefly through its choice-based, widely applicable approach; invitation- and mindfulness-based language; and building of therapeutic trust and attunement. Some participants questioned the accessibility and suitability of the training, as well as the rigidity of TC-TSY terminology. CONCLUSION: More research is needed to examine potential outcomes of TC-TSY practice related to self-efficacy, coping, quality of life, and stress reduction among traumatized individuals.


Assuntos
Transtornos de Estresse Pós-Traumáticos , Ioga , Humanos , Saúde Mental , Prática Profissional , Qualidade de Vida , Transtornos de Estresse Pós-Traumáticos/terapia , Centros de Traumatologia
7.
Med Sci (Paris) ; 37(4): 315-316, 2021 04.
Artigo em Francês | MEDLINE | ID: mdl-33908844
8.
Medicina (Kaunas) ; 57(4)2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33915713

RESUMO

Background and Objectives: The beginning of the SARS-Cov-2 pandemic period has had a strong impact on patients' life, but also on doctors. The main goal of this research is to identify the difficulties related to the professional activity and personal life of obstetrics and gynecology doctors. Material and Methods: In total, 94 physicians from a single university center answered to an online questionnaire. Socio-demographic, health, family, and job-related data were collected. Data were processed using SPSS (v.25). Results: 7.4% of the doctors were confirmed infected with SARS-Cov-2 during the first 6 months of the pandemic, and 48.94% treated infected patients. Due to the large number of patients, 10.64% of the doctors have had no days-off during the last 6 months, and 22.34% of them have had new medical problems that led them to see a specialist. Seventeen to nineteen percent mentioned an increasing number of working hours and shifts per month due to the pandemic period, more than 10% used pills to cope with work-stress, and 25% of them had sleep disorders along with appetite loss. Extra-protection rules and negative consequences of wearing special equipment were identified: thermal discomfort that caused decreasing resistance and concentration during the surgery (52%), reduced mobility and accuracy of surgical or medical gestures (40%), and intraoperative visibility (47%). Doctors who were working with confirmed pregnant women preferred caesarean section. Conclusions: Working under the stress of an infection with SARS-Cov-2 is causing a lot of pressure and determines changes in personal, familial, social, and professional life. Understanding the challenges that ob-gyn doctors are facing will help institutions to better provide support.


Assuntos
COVID-19 , Ginecologia , Obstetrícia , Médicos , Cesárea , Feminino , Nível de Saúde , Humanos , Pandemias , Gravidez , Prática Profissional , Romênia , SARS-CoV-2
10.
Arch. argent. pediatr ; 119(2): e113-e116, abril 2021.
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1151874

RESUMO

En la práctica médica diaria, nos vemos envueltos en situaciones que requieren una visión integral del paciente, no solo dotada de conocimiento científico. Es aquí donde cobra importancia incorporar nociones legales, antropológicas, filosóficas y sociológicas. Todo esto puede resumirse en que tener conocimiento y formación en bioética resulta fundamental para la práctica profesional actual. De esta forma, la atención será de calidad y, además, contribuiremos al cambio de paradigma en las ciencias de la salud. El objetivo de este artículo es recorrer conceptos como persona, dignidad e interés superior del niño, y realizar una reflexión sobre la importancia que les damos en nuestra práctica profesional.


In our daily medical practice, we are constantly facing situations that require a comprehensive view of the patient, based not only on scientific knowledge, but also encompassing relevant legal, anthropological, philosophical, and sociological concepts. This can be summarized by saying that bioethical knowledge and training are critical in current professional practice. This will allow us to provide quality care while contributing to a paradigm change in health sciences. The objective of this article is to review concepts such as person, dignity, and best interests of the child, and reflect on the importance we give to them in our professional practice


Assuntos
Humanos , Masculino , Feminino , Defesa da Criança e do Adolescente , Respeito , Prática Profissional , Assistência ao Paciente , Direitos Humanos
11.
Sr Care Pharm ; 36(5): 267, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33879288

RESUMO

Now may be a good time to get to know the folks who represent you and your professional practice. For the next two years, Congress and the Biden Administration will be controlled by members of the same party, and that generally signals an opportunity for legislation to be passed and signed into law. In this column, we explore the best ways to engage and have your voice heard.


Assuntos
Prática Profissional
12.
J Psychosoc Oncol ; 39(3): 461-468, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33689675

RESUMO

The extent to which oncology social workers (OSWs) are available and adapting to disruptions in service delivery throughout the COVID-19 pandemic is unknown.Objectives: The purpose of this report is to outline the initial impact of COVID-19 on oncology social work practice during the first six months of the pandemic.Methods: As part of a nationwide investigation of workforce conditions for OSWs, three professional organizations surveyed their members to assess the effects of COVID-19 on changes to work hours, employment status, work setting, pay, and mode for patient contact (e.g., telephone or videoconference).Findings: Among 939 OSWs, 20% reported a reduction in work hours, and two-thirds indicated a temporary shift in work to home, with most patient contact occurring primarily via telephone or videoconference.Implications: Results speak to the essential nature of oncology social work and the need for evidence to inform OSW training and advocacy efforts for however long the pandemic continues.


Assuntos
COVID-19 , Pessoal de Saúde/estatística & dados numéricos , Neoplasias/reabilitação , Prática Profissional/estatística & dados numéricos , Serviço Social/estatística & dados numéricos , Assistentes Sociais/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Carga de Trabalho/estatística & dados numéricos , Adulto , Humanos , Psico-Oncologia , Telecomunicações , Telefone
14.
J Prosthet Dent ; 125(5): 816.e1-816.e7, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33745683

RESUMO

STATEMENT OF PROBLEM: Whether recommendations for the use of occlusal devices are made uniformly in terms of indications, designs, and wearing time is unclear. Different recommendations may lead to different clinical outcomes. PURPOSE: The purpose of this survey was to assess the professional practice of dental surgeons in France regarding the use of occlusal devices. MATERIAL AND METHODS: A 26-question cross-sectional survey was sent to a panel of French dentists via the County Councils of the Dental Order. The questionnaire concerned the amount of occlusion-related treatment, the use of an anterior deprogramming device, stabilization splint, and anterior repositioning appliance, and the patient follow-up as well as the drawbacks of using an occlusal device as a therapeutic solution. The statistical tests used in the study were the chi-square test and the Yate correction for continuity. RESULTS: A total of 771 responses were received. Invasive options were still reported as being used as a first-line treatment for temporomandibular disorder, although a statistical difference was found between experienced and recently graduated practitioners, with recent graduates preferring noninvasive options as first-line treatment. Also, the results showed that anterior deprogramming devices were not used or that their application, particularly the length of treatment, was unfamiliar to practitioners. The anterior repositioning appliance seems to be used, but only a few practitioners integrate it into their practice. In general, about one-third of dentists appear to have a good knowledge of occlusion-related treatments, in particular, the use of occlusal devices. CONCLUSIONS: The results indicated that only 20% to 30% of practitioners have good knowledge of contemporary occlusion-related practice. There is a need for the standardization of practice and improved education for practitioners in the use of occlusal devices.


Assuntos
Placas Oclusais , Transtornos da Articulação Temporomandibular , Estudos Transversais , França , Humanos , Prática Profissional
15.
PLoS One ; 16(3): e0234855, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33725021

RESUMO

This study aimed to investigate the knowledge, practices, and attitudes of medical professionals toward Traditional Chinese Medicine (TCM) for the prevention and treatment of coronavirus disease 2019 (COVID-19). All 401 medical professionals were surveyed using an anonymous with an investigator using the Questionnaire star APP. The participants answered 14 questions; of the 401 participants, 55.2% agreed with the statement "TCM can be used for the prevention and treatment of COVID-19," 40.4% remained neutral, and 4.4% disagreed. Moreover, 75.3% agreed with the statement "There is no specific drug for COVID-19," 67% agreed with the statement "TCM can develop immunity to COVID-19" and 62.1% agreed with "TCM can alleviate the symptoms of patients with COVID-19." Meanwhile, 69.1% were aware that TCM has been recommended for COVID-19 by the National Health Commission of the People's Republic of China. Regarding the selection of sources of knowledge on whether "TCM can be used for the prevention and treatment of COVID-19," There were 277, 123, 82, 369, and 17 participants selected sources from "Hospital training," "Academic journals," "Academic Conferences," "Social media platforms (such as WeChat)" and "Others," respectively. Further, 358 participants will take TCM for the prevention of COVID-19. Multiple logistic regression analysis showed that age, major and received TCM treatment within the last five years were independent factors affecting the participants' attitudes. In the absence of specific drugs for COVID-19, more than half of the participants agreed that TCM could be used for the prevention and treatment of COVID-19 and most participants are willing to take TCM to prevent COVID-19, although unsure about its effectiveness. The main information sources on TCM for the treatment and prevention of COVID-19 were social platforms and hospital training.


Assuntos
Atitude , COVID-19/prevenção & controle , Conhecimento , Medicina Tradicional Chinesa , Prática Profissional , Profissionalismo , Adulto , COVID-19/tratamento farmacológico , COVID-19/patologia , COVID-19/virologia , China , Medicamentos de Ervas Chinesas/uso terapêutico , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2/isolamento & purificação , Mídias Sociais , Inquéritos e Questionários , Adulto Jovem
17.
Ophthalmic Physiol Opt ; 41(3): 603-609, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33609327

RESUMO

The World Health Organization has identified a shortage of trained human resources as one of the greatest challenges to increasing the availability of eye care services and reducing preventable visual impairment around the world. Increased prevalence of myopia and new strategies for myopia management have raised the prospect of various interventions, including contact lenses for therapeutic use as well as for refractive correction. More personnel skilled in contact lens fitting will be needed to address potential worldwide demand for these interventions. This review investigates the current status and future requirements of global contact lens education in light of these developments. The COVD-19 pandemic led educational institutions worldwide to move towards online delivery. An online survey among 546 educators, conducted in May 2020, investigated changes to contact lens education delivery before and after the onset of the pandemic. A total of 214 responses were received from 32 countries. Prior to COVID-19 restrictions, 23% of educators had conducted more than 50% of their total teaching online; however, 69% expected to conduct more than half of their teaching online by the end of 2020 and 12% anticipated 90% or more of their teaching would be online. Some 76% of educators expected to provide more online lectures after the pandemic and 63% anticipated new methods to deliver practical education. Around half were planning to introduce new teaching online platforms (54%) and more online assessment methods (53%). The global need for increasing numbers of skilled personnel points to a crucial role for educators in teaching the contact lens practitioners of the future. Contact lens education delivery was already evolving prior to COVID-19, and changes that are currently occurring may lead to permanent differences in the way contact lenses are taught in future. The International Association of Contact Lens Educators (IACLE) provides educators with a standardised global curriculum, online resources and teaching technology that could also serve as a model for wider ophthalmic education in future.


Assuntos
COVID-19/epidemiologia , Lentes de Contato , Educadores em Saúde/tendências , Optometria/educação , Prática Profissional/tendências , Ajuste de Prótese , SARS-CoV-2 , COVID-19/prevenção & controle , Infecção Hospitalar/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Pesquisas sobre Serviços de Saúde , Humanos , Controle de Infecções/métodos , Miopia/terapia , Optometria/tendências , Telemedicina/métodos
19.
BMC Complement Med Ther ; 21(1): 67, 2021 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-33602181

RESUMO

BACKGROUND: This descriptive study provides the first examination of global naturopathic education, regulation and practice frameworks that have potential to constrain or assist professional formation and integration in global health systems. Despite increasing public use, a significant workforce, and World Health Organization calls for national policy development to support integration of services, existent frameworks as potential barriers to integration have not been examined. METHODS: This cross-sectional survey utilized purposive sampling of 65 naturopathic organisations (educational institutions, professional associations, and regulatory bodies) from 29 countries. Organizational representatives completed an on-line survey, conducted between Nov 2016 - Aug 2019. Frequencies and cross-tabulation statistics were analyzed using SPSSv.25. Qualitative responses were hand-coded and thematically analysed where appropriate. RESULTS: Sixty-five of 228 naturopathic organizations completed the survey (29% response rate) from 29 of 46 countries (63% country response rate). Most education programs (68%) were delivered via a national framework. Higher education qualifications (60%) predominated. Organizations influential in education were professional associations (75.4%), particularly where naturopathy was unregulated, and accreditation bodies (41.5%) and regulatory boards (33.8%) where regulated. Full access to controlled acts, and to health insurance rebates were more commonly reported where regulated. Attitude of decision-makers, opinions of other health professions and existing legislation were perceived to most impact regulation, which was globally heterogeneous. CONCLUSION: Education and regulation of the naturopathic profession has significant heterogeneity, even in the face of global calls for consistent regulation that recognizes naturopathy as a medical system. Standards are highest and consistency more apparent in countries with regulatory frameworks.


Assuntos
Educação Profissionalizante , Saúde Global , Naturopatia , Prática Profissional , Controle Social Formal , Acreditação , Atitude , Estudos Transversais , Atenção à Saúde , Humanos , Medicina Integrativa , Organizações , Inquéritos e Questionários
20.
Khirurgiia (Mosk) ; (1): 93-97, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33395519

RESUMO

It is very difficult to find certain surgical field in which surgeon's decision is absolutely evidence-based. The objective of evidence-based medicine (and surgery) is offering the best treatment for each patient that should encourage conducting the randomized trials (RT) as the highest level of evidence. The results of RTs often contradict the existing clinical experience, and experience per se does not always confirm the significance of the results obtained. One cannot make any conclusions based on RT data. Treatment strategy for a particular patient remains unclear. The authors have analyzed the results of large-scale RTs devoted to laparoscopic cholecystectomy, rectal surgery, lung cancer surgery, postoperative care, treatment of pulmonary emphysema. It was shown that RT data as the highest level of evidence are not always true for surgery. In most clinical situations, the decision is not based on RT results. The desire of surgeons to master a new technique is often more significant than patient care, while clinical experience and the laws of the market are more important than science. There is no doubt that knowledge of RT results are essential in training period, but this means quite a bit for a particular patient. The best decision can be made during discussion and conversation with colleagues, where an experience of each specialist will have the same value as the best evidence.


Assuntos
Medicina Baseada em Evidências/normas , Medicina de Precisão/normas , Prática Profissional/normas , Qualidade da Assistência à Saúde/normas , Ensaios Clínicos Controlados Aleatórios como Assunto , Procedimentos Cirúrgicos Operatórios , Colecistectomia Laparoscópica , Competência Clínica/normas , Tomada de Decisões , Procedimentos Cirúrgicos do Sistema Digestório , Medicina Baseada em Evidências/métodos , Humanos , Relações Interprofissionais , Cuidados Pós-Operatórios/normas , Enfisema Pulmonar/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Procedimentos Cirúrgicos Operatórios/métodos , Procedimentos Cirúrgicos Operatórios/normas
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