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1.
N Engl J Med ; 384(10): 891-893, 2021 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-33705618
2.
Nurs Adm Q ; 45(2): 94-101, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33651727

RESUMO

Novel coronavirus disease-2019 (COVID-19) is a new respiratory disease that has spread widely throughout the world. On February 20, 2020, the first Italian case of COVID-19 was reported. The infection rapidly spread across the country, and by August 11, 2020, a total of 250 566 official cases with 32 205 deaths (12.8%) were reported in Italy, counting a total of 96 884 positive cases and 16 833 deaths (17.3%) in the Lombardy region only. A huge demand to handle the COVID-19 outbreak challenged both the health care providers and the ordinary work in the hospital. From the beginning of the crisis, San Raffaele Scientific Institute, a 1318-bed tertiary care university hospital located in Lombardy, Northern Italy, has played a major role in supporting the national health care system for the treatment of COVID-19 cases, and a significant reorganization of the hospital was immediately required. The reorganization was carried out both structurally and with regard to the distribution of medical and nonmedical staff. This article aims to highlight the management strategies for the health care staff subsequent to the pandemic intense workload in San Raffaele Scientific Institute.


Assuntos
/enfermagem , Hospitais Universitários/organização & administração , Recursos Humanos de Enfermagem no Hospital/organização & administração , Equipamento de Proteção Individual/provisão & distribução , /epidemiologia , Humanos , Itália/epidemiologia , Pandemias , Relações Profissional-Família
3.
5.
J Hand Surg Asian Pac Vol ; 26(1): 24-30, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33559574

RESUMO

Background: Congenital hand differences (CHD) exhibit enormous diversity and heterogeneity. Surgeons and parents often have different concepts of severity, making things difficult during parental consultation. This study aims to align surgeon/parental views on the severity of the child's CHD using a novel severity classification. Methods: Parents of affected children were asked to score the severity of their child's abnormality pre- and post-consultation using a subjective scale (1-4) without any explanation. Furthermore, parents were asked to rate their concerns about the future function and appearance of their child's hand condition using a similar scale of 1-4. They were then asked to rate the severity of the CHD post-consultation and three months post-operatively following explanation of the 4-point scale, as follows: 1 = treatment possible to normal; 2 = treatment possible to near normal; 3 = treatment possible but always some hand differences; 4 = treatment not possible. The surgeon also independently scored all children using his perception of the scale. Results: Forty-three children with a range of CHD were recruited into the sample. Linear weighted kappa analyses comparing inter-rater agreement showed no agreement between surgeon and parents during the initial scoring without any explanations. However, with explanations added, agreement rose significantly (kappa = 0.437 post-consultation and kappa = 0.706 three months post-op). No correlation was found between severity with both appearance and function (r = 0.277 and r = -0.184, respectively). Conclusions: This study demonstrated that the use of a simple scoring system was able to improve parental understanding of the severity and prognosis of CHD. The system demonstrated a good correlation between surgeon and parents. Such a scoring system can be easily utilised in the outpatient department to manage expectations and reduce anxiety.


Assuntos
Deformidades Congênitas da Mão/classificação , Pais , Índice de Gravidade de Doença , Criança , Pré-Escolar , Comunicação , Feminino , Deformidades Congênitas da Mão/cirurgia , Humanos , Lactente , Estudos Longitudinais , Masculino , Pais/psicologia , Relações Profissional-Família , Prognóstico , Estudos Prospectivos , Encaminhamento e Consulta
6.
Rev Infirm ; 70(268): 28-29, 2021 Feb.
Artigo em Francês | MEDLINE | ID: mdl-33608092

RESUMO

The patient being cared for at home should be considered with his entourage. In the case of dialysis, the relative is involved and his relationship with the patient becomes more complex, because the patient is in a situation of increased dependency. Hence, the relative is a fully-fledged partner in home haemodialysis, particularly in the decision-making process. Support from professionals helps to rebalance this relationship, if necessary.


Assuntos
Cuidadores , Hemodiálise no Domicílio , Relações Profissional-Família , Cuidadores/psicologia , Hemodiálise no Domicílio/enfermagem , Humanos
8.
J Am Board Fam Med ; 34(Suppl): S37-S39, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33622816

RESUMO

BACKGROUND: In 2016, we launched our first Patient and Family Advisory Council (PFAC) as a means of collaborating with our patients and families to improve care. Using an Internet-based remote meeting technology, we transitioned to a virtual platform in April. METHODS: We have conducted 12 PFAC meetings across 4 sites to date. Virtual PFAC meeting topics over the past few months include communication about the coronavirus, community resources needed by patients during the pandemic, telehealth visit troubleshooting, current office policy, and changing work flow. A convenience sample of advisors generated qualitative responses on the transition from in-person meetings to a virtual platform. RESULTS: Attendance increased as we transitioned to a virtual platform from 13.2 advisors to 14.7 advisors. Advisors affirm the value of a PFAC and importance of patient engagement, especially during this pandemic. Patient advisors confirm the role of patient voice in pandemic-induced practice changes. DISCUSSION: The transition of our PFACs to a virtual platform continues to generate critically important partnerships between patients and providers. In this time of health care uncertainty and stress for patients, providers, and staff, this partnership remains our most valuable asset. CONCLUSION: Patient voice provides reliable and relevant information for practices through virtual PFAC meetings.


Assuntos
Participação do Paciente , Telemedicina/métodos , /epidemiologia , Humanos , Pandemias , Relações Profissional-Família
9.
BMC Palliat Care ; 20(1): 15, 2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33435936

RESUMO

BACKGROUND: Effective communication in support of clinical decision-making is central to the pediatric cancer care experience for families. A new laboratory derived pharmacogenetic test (LDT) that can diagnose difficult-to-treat brain cancers has been developed to stratify children based on their ability to respond to available treatment; however, the potential implementation of the LDT may make effective communication challenging since it can potentially remove the option for curative treatment in those children identified as non-responders, i.e. those with a catastrophic diagnosis. OBJECTIVE: We solicited the perspectives of parents of children with difficult-to-treat brain cancer on communication preferences surrounding the potential implementation of the LDT in standard care using deliberative stakeholder consultations. METHODS: Eight bereaved parents of children who succumbed to difficult-to-treat brain cancer, and four parents of children currently undergoing treatment for similar cancers attended separate small-group deliberative consultations - a stakeholder engagement method that enables the co-creation of recommendations following the consideration of competing arguments and diverse opinions of parents with different experiences. In the small-group consultations (Phase I), parents discussed four questions about potential communication issues that may arise with the LDT in practice. In Phase II, a total of five parents from both stakeholder groups (4 bereaved and 1 in current treatment) attended a consultation, known as the 'mixed' consultation, with the purpose of co-developing concrete recommendations for implementation of the LDT. RESULTS: Explaining the risks, benefits, and accuracy of the LDT were considered essential to parents. Once an LDT-based diagnosis/prognosis can be made, parents valued honesty, empathy, and clarity in communication. Parents also requested that all results and treatment options be presented to them in measured doses, and in an unbiased manner over the course of several meetings. This communication strategy allowed sufficient time to understand and accept the diagnosis/prognosis, particularly if it was catastrophic. Continuous access to the appropriate psychological and social support or counselling at and post-diagnosis was also strongly recommended. CONCLUSIONS: Deliberants co-created family-centered recommendations surrounding communication issues of the LDT, providing guidance to pediatric oncologists that could implement the test in practice.


Assuntos
Neoplasias Encefálicas/terapia , Comunicação , Oncologia , Cuidados Paliativos , Pais , Testes Farmacogenômicos , Relações Profissional-Família , Revelação da Verdade , Luto , Neoplasias Encefálicas/genética , Empatia , Humanos , Pediatria , Participação dos Interessados
10.
Healthc Q ; 23(4): 60-64, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33475494

RESUMO

BACKGROUND: Patient and family experience are integral to the care that we provide. In the pediatric hospital setting, multiple family members are directly involved in patient care. We identified the need for greater caregiver name recognition at The Hospital for Sick Children, Toronto, ON. OBJECTIVE: We aimed to improve communication between healthcare providers and families via the optimization of caregiver identification badges. METHODS: We used a qualitative, narrative study design to explore perceptions surrounding caregiver identification badges via unstructured interviews. RESULTS: We identified key hospital and family stakeholders. Unstructured interviews supported the theory that badge optimization could improve communication and patient care. Our initiative, however, was abruptly interrupted by the emergence of the COVID-19 pandemic. CONCLUSION: Communication with patients and families is crucial across medical disciplines. The optimization of caregiver identification badges to facilitate the use of preferred names and pronouns will ultimately lead to the more effective and safer delivery of high-quality care.


Assuntos
Cuidadores , Comunicação , Relações Profissional-Família , Cuidadores/psicologia , Hospitais , Humanos , Entrevistas como Assunto , Participação dos Interessados
11.
J Am Geriatr Soc ; 69(3): 587-592, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33320956

RESUMO

BACKGROUND/OBJECTIVE: The COVID-19 pandemic has resulted in rapid changes to end-of-life care for hospitalized older adults and their families, including visitation restrictions. We examined bereaved families' perceptions of the quality of end-of-life communication among Veterans, families and staff in Veterans Affairs (VA) medical centers during the COVID-19 pandemic. DESIGN: Qualitative descriptive study using data from a survey of bereaved family members of Veterans administered from March-June 2020. Data were analyzed using qualitative content analysis. SETTING: VA medical centers with the highest numbers of COVID-19 cases during the study period. PARTICIPANTS: Next-of-kin of 328 Veterans who died in one of 37 VA medical centers' acute care, intensive care, nursing home, or hospice units. MEASUREMENTS: Open-ended survey questions (response rate = 37%) about family member's perceptions of: (1) communication with the healthcare team about the patient, (2) communication with the patient, and (3) use of remote communication technologies. RESULTS: Bereaved family members identified contextual factors perceived to impact communication quality including: allowing family at the bedside when death is imminent, fears that the patient died alone, and overall perceptions of VA care. Characteristics of perceived high-quality communication included staff availability for remote communication and being kept informed of the patient's condition and plan of care. Low-quality communication with staff was perceived to result from limited access to staff, insufficient updates regarding the patient's condition, and when the family member was not consulted about care decision-making. Communication quality with the patient was facilitated or impeded by the availability and use of video-enabled remote technologies. CONCLUSION: Communication between patients, families, and healthcare teams at the end of life remains critically important during times of limited in-person visitation. Families report that low-quality communication causes profound distress that can affect the quality of dying and bereavement. Innovative strategies are needed to ensure that high-quality communication occurs despite pandemic-related visitation restrictions.


Assuntos
Luto , Família/psicologia , Relações Profissional-Família , Assistência Terminal/psicologia , Idoso , Idoso de 80 Anos ou mais , Comunicação , Feminino , Hospitais de Veteranos , Humanos , Masculino , Percepção , Pesquisa Qualitativa , Qualidade da Assistência à Saúde , Estados Unidos , United States Department of Veterans Affairs , Veteranos/psicologia
13.
Enferm. intensiva (Ed. impr.) ; 31(4): 192-202, oct.-dic. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-197687

RESUMO

INTRODUCCIÓN: El cuidado en la unidad de cuidados intensivos implica contemplar, entre otras dimensiones del paciente, a la familia. Para esto es necesario que la enfermera establezca relaciones con los familiares del paciente. OBJETIVO: Identificar la forma en que se establece la relación enfermera-familia en la UCI de adultos, al igual que las condiciones, elementos y factores que la favorecen o la dificultan. MÉTODO: Revisión narrativa integrativa de la literatura científica. Las bases de datos consultadas fueron: Ovid, PubMed, Science Direct, Scopus, Clinical Key, Google Académico y Scielo. Se buscaron artículos en inglés y español publicados entre el 2014 y el 2018. Los descriptores y fórmulas utilizadas se seleccionaron de acuerdo con el acrónimo Population and their problems, Exposure and Outcomes or themes (PEO). La población correspondió a las enfermeras de UCI y los familiares de pacientes en estado crítico; la exposición o contexto, a la unidad de cuidados intensivos adultos y los resultados esperados, a la forma como estos se relacionan. Para la evaluación metodológica se utilizaron la guía STROBE para artículos observacionales, PRISMA para artículos de revisión, COREQ para artículos cualitativos y CASPe para artículos derivados de proyectos. RESULTADOS: Se identificaron 214 artículos, de los cuales se seleccionaron 63 para incluir en la revisión. Las temáticas centrales identificadas fueron: el entorno de la UCI y sus efectos sobre el familiar, la empatía como indicador de la relación, la interacción como medio para relacionarse, la comunicación como centro de las relaciones y las barreras para el establecimiento de relaciones. CONCLUSIONES: La relación enfermera-familia en la unidad de cuidados intensivos se da a partir de la interacción y la comunicación en medio de barreras humanas, físicas, normativas y administrativas. Mejorar la relación enfermera-familia contribuye a la humanización de las unidades de cuidados intensivos de adultos


INTRODUCTION: Care in the Intensive Care Unit involves contemplating, among other dimensions of the patient, the family. For this, it is necessary for the nurse to establish relationships with the patient's relatives. OBJECTIVE: To identify the way in which the nurse-family relationship is established in the adult ICU, as well as the conditions, elements and factors that favour or hinder it. METHOD: Integrative narrative review of the scientific literature. The databases consulted were Ovid, PubMed, Science Direct, Scopus, Clinical Key, Google Scholar and Scielo. Articles in English and Spanish published between 2014 and 2018 were searched. The descriptors and formulas used were selected according to the acronym Population and their problems, Exposure and Outcomes or themes- PEO. The population comprised ICU nurses and the relatives of patients in critical condition; Adult Intensive Care Unit exposure or context; the expected results, and how they are related. For the methodological evaluation, the STROBE guide was used for observational articles, PRISMA for review articles, COREQ for qualitative articles and CASPe for articles derived from projects. RESULTS: We identified 214 articles, of which 63 were selected to be included in the review. The central themes identified were: the ICU environment and its effects on the family, empathy as an indicator of relationship, interaction as a means of relating, communication as the centre of relationships and barriers to the establishment of relationships. CONCLUSIONS: The nurse-family relationship in the Intensive Care Unit is based on interaction and communication amidst human, physical, regulatory and administrative barriers. Improving the nurse-family relationship contributes to the humanization of Adult Intensive Care Units


Assuntos
Humanos , Relações Profissional-Família , Relações Enfermeiro-Paciente , Unidades de Terapia Intensiva , Cuidados Críticos/métodos , Relações Familiares , Empatia , Comunicação
14.
Siglo cero (Madr.) ; 51(4): 69-92, oct.-dic. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-198066

RESUMO

El propósito de la Atención Temprana es ofrecer un servicio de calidad para el máximo desarrollo y autonomía de los niños y abogar por la calidad de vida y el bienestar familiar. El modelo actual de intervención se identifica con las prácticas centradas en la familia, basadas en la construcción de capacidades familiares, donde los profesionales deben actuar como colaboradores para dar respuesta a las necesidades de los progenitores. Este artículo pretende realizar una revisión sistematizada de la literatura, para analizar las investigaciones empíricas en el campo de la Atención Temprana desde el año 2000 e identificar aspectos que inducen a nuevas investigaciones. Se hallaron y analizaron un total de 33 artículos. Los resultados muestran que, a pesar de que se lleve a cabo el modelo centrado en la familia, hay obstáculos para desempeñar prácticas participativas, ya que implican la modificación de los apoyos profesionales y, al mismo tiempo, cambios en el protagonismo de la familia durante la intervención. La formación, la actitud del profesional o la toma de decisiones conjunta entre el profesional y la familia son aspectos que requieren ser mejorados de acuerdo con los principios del modelo centrado en la familia. Además, se precisa mayor investigación en la relación profesional-familia, el bienestar familiar, el desarrollo de nuevos programas y la actitud de los profesionales para consagrar la calidad de los servicios de Atención Temprana


The purpose of Early Childhood Intervention is to provide a quality service for the maximum development and autonomy of children and to advocate quality of life and family well-being. The current model of intervention is focused on family-centred practices. These are based on building family capacity, where professionals must act as partners to respond to parents' needs. This article aims to conduct a systematized review of the literature, to analyze empirical research in the field of Early Intervention since 2000 and to identify aspects that lead to new research. A total of 33 articles were analysed and percived. The results show that despite family-centred practices, there are obstacles to participatory. These involve the modification of professional supports and, at the same time, the role of the family during the intervention. The training, the attitude of the professional or the joint decision making between the professional and the family are aspects that require improvement according to the principles of the family-centred model. In addition, more research is needed on the professional-family relationship, family welfare, the development of new programs and the attitude of professionals to establish the quality of Early Intervention services


Assuntos
Humanos , Criança , Intervenção Médica Precoce/normas , Relações Profissional-Família , Modelos de Assistência à Saúde/normas , Família , Intervenção Médica Precoce/tendências , Desenvolvimento Infantil , Modelos de Assistência à Saúde/tendências , Garantia da Qualidade dos Cuidados de Saúde
15.
Texto & contexto enferm ; 29: e20190025, Jan.-Dec. 2020.
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1094547

RESUMO

ABSTRACT Objective: to analyze the perceptions of the family members of users of a children's psychosocial care center, regarding the facilitating factors and the difficulties in the communication with the health professionals. Method: a qualitative and descriptive study conducted with 25 family members of users of a children's psychosocial care center in a city of Minas Gerais (Brazil). Data collection took place between April and July 2017 using focus groups and a semi-structured script for the implementation of group sessions. Data was analyzed according to content analysis, thematic category. Results: two categories emerged from the analysis: Professional-Family relationship and Suggestions to enhance communication, which included practicalities and difficulties in communication. The data showed that the professional-family relationship refers to the professionals' positive actions, which facilitate communication, and to their negative actions, which means offering a distant and dehumanized care and failing to provide guidance. The suggestions to enhance communication were directed to the interventions focused on the family and on the dynamics and management of the service. Conclusion: there is a need for collaboration among management, staff and family members, which can contribute to a better health care and to building more solidary and dialogical relationships.


RESUMEN Objetivo: analizar las percepciones de los familiares de los usuarios de un centro de atención psicosocial infanto-juvenil, en relación con los factores facilitadores y las dificultades de la comunicación con los profesionales de la salud. Método: estudio cualitativo y descriptivo realizado con 25 familiares de usuarios de un centro de atención psicosocial infanto-juvenil en un municipio de Minas Gerais (Brasil). Los datos se recolectaron entre los meses de abril y junio de 2017 por medio de grupos focalizados, con la aplicación de un guión semiestructurado para desarrollar las sesiones grupales. Los datos se analizaron conforme al análisis de contenido, con la modalidad temática. Resultados: a partir del análisis surgieron dos categorías: Relación profesional-familia y Sugerencias para potenciar la comunicación; ambas abarcaron facilidades y dificultades en la comunicación. Los datos evidenciaron que la relación profesional-familia se refiere tanto a las acciones positivas de los profesionales, que facilitan la comunicación, como a sus acciones negativas, que significan ofrecer una atención distante y poco humanizada con escasa orientación. Las sugerencias para potenciar la comunicación estuvieron dirigidas a las intervenciones enfocadas en la familia y en la dinámica y organización del servicio. Conclusión: se hace evidente que es necesaria una aproximación entre la administración, el equipo de profesionales y los familiares, lo que puede ayudar a mejorar los cuidados en salud y hacer posible que se establezcan relaciones más solidarias y con más diálogo.


RESUMO Objetivo: analisar as percepções dos familiares de usuários de um centro de atenção psicossocial infantojuvenil, em relação aos fatores facilitadores e dificultadores da comunicação com os profissionais de saúde. Método: estudo qualitativo, descritivo, realizado com 25 familiares de usuários de um centro de atenção psicossocial infantojuvenil, em um município de Minas Gerais (Brasil). A coleta de dados ocorreu entre os meses de abril a julho de 2017, por meio de grupos focais, aplicando-se roteiro semiestruturado para desenvolvimento das sessões grupais. Os dados foram analisados segundo a análise de conteúdo, modalidade temática. Resultados: da análise emergiram duas categorias: Relação profissional-família e Sugestões para potencializar a comunicação, as quais abrangeram facilidades e dificuldades na comunicação. Os dados evidenciaram que a relação profissional-família diz respeito às ações positivas dos profissionais que facilitam a comunicação, e às ações negativas atuação distante, pouco humanizado, com escassez de orientação. As sugestões para potencializar a comunicação foram direcionadas às intervenções focadas na família e na dinâmica e organização do serviço. Conclusão: evidencia-se a necessidade de aproximação entre gerência, equipe de profissionais e familiares; o que pode contribuir para melhoria do cuidado em saúde e para a construção de relações mais solidárias e dialógicas.


Assuntos
Humanos , Criança , Adolescente , Adulto , Relações Profissional-Família , Saúde Mental , Cuidadores , Comunicação , Serviços de Saúde Mental
16.
Rev. enferm. UERJ ; 28: e47321, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1116094

RESUMO

Objetivo: analisar a produção científica nacional e internacional, buscando as interfaces existentes entre os princípios bioéticos e os cuidados em saúde prestados ao fim da vida às pessoas idosas. Método: revisão integrativa, cuja busca ocorreu entre outubro e novembro de 2019 nas bases de dados Medline via Pubmed, Lilacs e Scopus com os descritores: "Palliative Care", "Aged" e "Bioethics" de 2014-2019. Resultados: a partir dos artigos selecionados, emergiram as seguintes categorias: condutas terapêuticas frente aos cuidados ao fim da vida; tomada de decisão nos cuidados ao fim da vida; e desafios nos cuidados ao fim da vida. Conclusão: destaca-se a relevância dos profissionais manterem o compromisso com a pessoa idosa e sua família de forma a considerar suas subjetividades e preferências e os instrumentalizar para que os cuidados sejam pautados em princípios bioéticos, para assim proporcionar um processo de morte e de morrer com dignidade.


Objective: to examine the Brazilian and international scientific production for connections between bioethical principles and the health care provided to older adults at the end of their lives. Method: between October and November 2019 this integrative review searched the Medline (Pubmed), Lilacs, and Scopus databases using the descriptors: "Palliative Care", "Aged", and "Bioethics" for the period 2014-2019. Results: the following categories emerged from the selected articles: therapeutic conducted with regard to end-of-life care; decision making on end-of-life care; and challenges in end-of-life care. Conclusion: of particular importance is for health professionals to uphold their commitment to older adults and their families, consider their subjectivities and preferences, and empower and equip them so that care is guided by bioethical principles in order to assure a dignified process of dying and death.


Objetivo: examinar la producción científica brasileña e internacional en busca de conexiones entre los principios bioéticos y la atención médica brindada a los adultos mayores al final de sus vidas. Método: entre octubre y noviembre de 2019, esta revisión integradora buscó en las bases de datos Medline (Pubmed), Lilacs y Scopus utilizando los descriptores: "Cuidados paliativos", "Envejecido" y "Bioética" para el período 2014-2019. Resultados: las siguientes categorías surgieron de los artículos seleccionados: terapéutico realizado con respecto a la atención al final de la vida; toma de decisiones sobre la atención al final de la vida; y desafíos en la atención al final de la vida. Conclusión: es de particular importancia que los profesionales de la salud mantengan su compromiso con los adultos mayores y sus familias, consideren sus subjetividades y preferencias, y los empoderen y equipen para que la atención se guíe por principios bioéticos para asegurar un proceso digno de muerte y muerte.


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Cuidados Paliativos na Terminalidade da Vida/ética , Temas Bioéticos , Pessoalidade , Morte , Relações Profissional-Família/ética , Relações Profissional-Paciente/ética , Atitude Frente a Morte , Valor da Vida
17.
Texto & contexto enferm ; 29: e20190025, Jan.-Dec. 2020.
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1059133

RESUMO

ABSTRACT Objective: to analyze the perceptions of the family members of users of a children's psychosocial care center, regarding the facilitating factors and the difficulties in the communication with the health professionals. Method: a qualitative and descriptive study conducted with 25 family members of users of a children's psychosocial care center in a city of Minas Gerais (Brazil). Data collection took place between April and July 2017 using focus groups and a semi-structured script for the implementation of group sessions. Data was analyzed according to content analysis, thematic category. Results: two categories emerged from the analysis: Professional-Family relationship and Suggestions to enhance communication, which included practicalities and difficulties in communication. The data showed that the professional-family relationship refers to the professionals' positive actions, which facilitate communication, and to their negative actions, which means offering a distant and dehumanized care and failing to provide guidance. The suggestions to enhance communication were directed to the interventions focused on the family and on the dynamics and management of the service. Conclusion: there is a need for collaboration among management, staff and family members, which can contribute to a better health care and to building more solidary and dialogical relationships.


RESUMEN Objetivo: analizar las percepciones de los familiares de los usuarios de un centro de atención psicosocial infanto-juvenil, en relación con los factores facilitadores y las dificultades de la comunicación con los profesionales de la salud. Método: estudio cualitativo y descriptivo realizado con 25 familiares de usuarios de un centro de atención psicosocial infanto-juvenil en un municipio de Minas Gerais (Brasil). Los datos se recolectaron entre los meses de abril y junio de 2017 por medio de grupos focalizados, con la aplicación de un guión semiestructurado para desarrollar las sesiones grupales. Los datos se analizaron conforme al análisis de contenido, con la modalidad temática. Resultados: a partir del análisis surgieron dos categorías: Relación profesional-familia y Sugerencias para potenciar la comunicación; ambas abarcaron facilidades y dificultades en la comunicación. Los datos evidenciaron que la relación profesional-familia se refiere tanto a las acciones positivas de los profesionales, que facilitan la comunicación, como a sus acciones negativas, que significan ofrecer una atención distante y poco humanizada con escasa orientación. Las sugerencias para potenciar la comunicación estuvieron dirigidas a las intervenciones enfocadas en la familia y en la dinámica y organización del servicio. Conclusión: se hace evidente que es necesaria una aproximación entre la administración, el equipo de profesionales y los familiares, lo que puede ayudar a mejorar los cuidados en salud y hacer posible que se establezcan relaciones más solidarias y con más diálogo.


RESUMO Objetivo: analisar as percepções dos familiares de usuários de um centro de atenção psicossocial infantojuvenil, em relação aos fatores facilitadores e dificultadores da comunicação com os profissionais de saúde. Método: estudo qualitativo, descritivo, realizado com 25 familiares de usuários de um centro de atenção psicossocial infantojuvenil, em um município de Minas Gerais (Brasil). A coleta de dados ocorreu entre os meses de abril a julho de 2017, por meio de grupos focais, aplicando-se roteiro semiestruturado para desenvolvimento das sessões grupais. Os dados foram analisados segundo a análise de conteúdo, modalidade temática. Resultados: da análise emergiram duas categorias: Relação profissional-família e Sugestões para potencializar a comunicação, as quais abrangeram facilidades e dificuldades na comunicação. Os dados evidenciaram que a relação profissional-família diz respeito às ações positivas dos profissionais que facilitam a comunicação, e às ações negativas atuação distante, pouco humanizado, com escassez de orientação. As sugestões para potencializar a comunicação foram direcionadas às intervenções focadas na família e na dinâmica e organização do serviço. Conclusão: evidencia-se a necessidade de aproximação entre gerência, equipe de profissionais e familiares; o que pode contribuir para melhoria do cuidado em saúde e para a construção de relações mais solidárias e dialógicas.


Assuntos
Saúde Mental , Cuidadores , Comunicação , Serviços de Saúde Mental , Relações Profissional-Família , Assistência à Saúde , Relações Familiares
18.
Rev. enferm. UERJ ; 28: e45871, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1128440

RESUMO

Objetivo: analisar, sob a ótica dos profissionais que atuam em unidade de terapia intensiva neonatal e dos pais das crianças internadas, o entendimento do cuidado centrado na família. Método: estudo quantitativo de abordagem descritiva, realizado em 2018 com 19 profissionais de enfermagem de um hospital de ensino na região noroeste do Paraná e nove familiares. Utilizaram-se dois questionários autoaplicáveis acerca do tema e os sujeitos foram abordados durante seu período de permanência na unidade. Os dados foram analisados por estatística descritiva. Pesquisa aprovada pelo comitê de ética em pesquisa da instituição. Resultados: a equipe demonstra acolhimento pela família, os pais sentem esse vínculo, porém nos momentos de tomada de decisão, esta ainda é centralizada no profissional de saúde. Conclusão: a percepção dos profissionais e dos familiares converge para o cuidado centrado na família, porém, de forma incipiente, desconhecendo seus demais desdobramentos e maneiras de colocá-lo em prática.


Objective: to examine family-centered care as seen by health personnel working in a neonatal intensive care unit and the parents of children hospitalized there. Method: this quantitative, descriptive study was conducted in 2018 with 19 nursing personnel at a teaching hospital in northwest Paraná State and nine family members. Two self-administered questionnaires on the topic were used, and study subjects were approached during their time at the unit. Data were analyzed using descriptive statistics. The study was approved by the institution's research ethics committee. Results: the team demonstrated acceptance by the family, and the parents felt that bond, although decision making still centered on the health professional. Conclusion: the health personnel's and patient relatives' perceptions converge to family-centered care, although in an incipient manner, and they are unaware of how it can be further developed and put into practice.


Objetivo: analizar la atención centrada en la familia como la ve el personal de salud que trabaja en una unidad de cuidados intensivos neonatales y los padres de los niños hospitalizados allí. Método: este estudio cuantitativo y descriptivo se realizó en 2018 con 19 miembros del personal de enfermería de un hospital universitario del noroeste del estado de Paraná y nueve familiares. Se utilizaron dos cuestionarios autoadministrados sobre el tema y se abordó a los sujetos de estudio durante su tiempo en la unidad. Los datos fueron analizados utilizando estadística descriptiva. El estudio fue aprobado por el comité de ética en investigación de la institución. Resultados: el equipo demostró aceptación por parte de la familia y los padres sintieron ese vínculo, aunque la toma de decisiones aún se centró en el profesional de la salud. Conclusión: las percepciones del personal de salud y familiares del paciente convergen hacia la atención centrada en la familia, aunque de manera incipiente, y desconocen cómo se puede desarrollar y poner en práctica.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Relações Profissional-Família , Unidades de Terapia Intensiva Neonatal/organização & administração , Determinação de Necessidades de Cuidados de Saúde , Equipe de Enfermagem , Pais/psicologia , Percepção , Brasil , Inquéritos e Questionários , Acolhimento , Lacunas da Prática Profissional , Hospitais Universitários
20.
Arch Pediatr ; 27(8): 423-427, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33011025

RESUMO

BACKGROUND: The outbreak of COVID-19 has imposed many challenges on health systems. The purpose of this study was to describe the impact of the COVID-19 pandemic on the clinical activity of pediatricians. METHODS: We conducted a cross-sectional and descriptive online survey among pediatricians practicing in Cameroon. Data were collected through an anonymous pre-tested Google Form®. RESULTS: Among the 118 pediatricians eligible for the survey, 101 responded (85.6%), of whom 61.2% were women. The pediatric outpatient consultations dropped significantly from 60.4% of pediatricians seeing more than 30 patients per week before the pandemic to 9.9% during the pandemic (P<0.000). According to the occupancy rate of hospitalisation beds, 45.5% of pediatricians reported having 76-100% of pediatric hospitalisation beds occupied per week before the pandemic but no pediatrician reported a similar rate during the pandemic (P<0.000). There was a significant increase in the use of telehealth, ranging from no pediatrician using telehealth "very frequently" before the pandemic to 23.8% using it during the pandemic (P<0.000). Most of the pediatricians had at their disposal surgical masks (96%), care gloves (80.2%), hydroalcoholic gel (99.0%), and soap and water (86.1%). For the management of children, 90.1% and 71.3% of pediatricians experienced difficulties accessing COVID-19 PCR and chloroquine, respectively, and 74.3% declared difficulties for proper isolation of patients. More than half (65.3%) of the pediatricians interviewed were "very afraid" or "extremely afraid" of being infected with SARS-Cov-2, respectively 45.5% and 19.8%. The most frequent reasons included fear of infecting their relatives (85.1%) and of developing a severe form of the disease (43.6%). The reluctance to consult health services expressed by the parents was due to: fear of being infected when leaving their home and especially in the health facility (96%), strict compliance with confinement (30.7%), and financial difficulties of families (13.9%). CONCLUSION: This work highlights the impact of the coronavirus pandemic on the clinical activity of Cameroonian pediatricians. Since the beginning of the pandemic, there has been a significant drop in the use of health facilities, which probably has a negative impact on children's overall level of health. Although the preventive measures explain this drop in attendance at health facilities, the parents' fear of being infected when leaving the house was the predominant reason likely to explain this drop in attendance at health facilities. This could constitute an axis for developing messages to parents to encourage a gradual return to child health services.


Assuntos
Atitude do Pessoal de Saúde , Infecções por Coronavirus , Pandemias , Pediatras/psicologia , Pediatria/tendências , Pneumonia Viral , Padrões de Prática Médica/tendências , Adulto , Camarões , Criança , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Infecções por Coronavirus/transmissão , Estudos Transversais , Feminino , Pesquisas sobre Serviços de Saúde , Acesso aos Serviços de Saúde/tendências , Humanos , Controle de Infecções/métodos , Controle de Infecções/estatística & dados numéricos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/diagnóstico , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Pneumonia Viral/transmissão , Relações Profissional-Família , Telemedicina
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