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1.
BMC Public Health ; 24(1): 1292, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38741128

RESUMO

BACKGROUND: A birth companion is a powerful mechanism for preventing mistreatment during childbirth and is a key component of respectful maternity care (RMC). Despite a growing body of evidence supporting the benefits of birth companions in enhancing the quality of care and birth experience, the successful implementation of this practice continues to be a challenge, particularly in developing countries. Our aim was to investigate the acceptability, adoption, appropriateness, feasibility, and fidelity of implementation strategies for birth companions to mitigate the mistreatment of women during childbirth in Tehran. METHODS: This exploratory descriptive qualitative study was conducted between April and August 2023 at Valiasr Hospital in Tehran, Iran. Fifty-two face-to-face in-depth interviews were conducted with a purposive sample of women, birth companions, and maternity healthcare providers. Interviews were audio-recorded, transcribed verbatim, and analyzed using content analysis, with a deductive approach based on the Implementation Outcomes Framework in the MAXQDA 18. RESULTS: Participants found the implemented program to be acceptable and beneficial, however the implementation team noticed that some healthcare providers were initially reluctant to support it and perceived it as an additional burden. However, its adoption has increased over time. Healthcare providers felt that the program was appropriate and feasible, and it improved satisfaction with care and the birth experience. Participants, however, highlighted several issues that need to be addressed. These include the need for training birth companions prior to entering the maternity hospital, informing women about the role of birth companions, assigning a dedicated midwife to provide training, and addressing any physical infrastructure concerns. CONCLUSION: Despite some issues raised by the participants, the acceptability, adoption, appropriateness, feasibility, and fidelity of the implementation strategies for birth companions to mitigate the mistreatment of women during childbirth were well received. Future research should explore the sustainability of this program. The findings of this study can be used to support the implementation of birth companions in countries with comparable circumstances.


Assuntos
Parto , Pesquisa Qualitativa , Humanos , Feminino , Irã (Geográfico) , Adulto , Gravidez , Parto/psicologia , Estudos de Viabilidade , Serviços de Saúde Materna , Amigos/psicologia , Entrevistas como Assunto , Adulto Jovem , Respeito
2.
BMC Pregnancy Childbirth ; 24(1): 359, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38745117

RESUMO

BACKGROUND: Respectful Maternal and Neonatal Care (RMNC) maintains and respects a pregnant person's dignity, privacy, informed choice, and confidentiality free from harm and mistreatment. It strives for a positive pregnancy and post-pregnancy care experiences for pregnant people and their families, avoiding any form of obstetric violence. Though RMNC is now widely accepted as a priority in obstetric care, there is a gap in resources and support tools for healthcare wproviders to clearly understand the issue and change long-established practices such as non-humanized caesarean sections. MSI Reproductive Choices (MSI) manages 31 maternities across 7 countries with a zero-tolerance approach towards disrespectful maternity care and obstetric violence. MSI developed and implemented a hybrid training package, which includes an online module and 1-day in-person workshop that allows healthcare providers to explore their beliefs and attitudes towards RMNC. It leverages methodologies used in Values-Clarification-Attitudes-Transformation (VCAT) workshops and behaviour change approaches. METHODS: The impact of this training intervention was measured from the healthcare providers' and patients' perspectives. Patient experience of (dis)respectful care was collected from a cross-sectional survey of antenatal and postnatal patients attending MSI maternities in Kenya and Tanzania before and following the RMNC training intervention. Healthcare providers completed pre- and post-workshop surveys at day 1, 90 and 180 to measure any changes in their knowledge, attitudes and perception of intended behaviours regarding RMNC. RESULTS: The results demonstrate that healthcare provider knowledge, attitudes and perceived RMNC practices can be improved with this training interventions. Patients also reported a more positive experience of their maternity care following the training. CONCLUSION: RMNC is a patient-centred care priority in all MSI maternities. The training bridges the gap in resources currently available to support changes in healthcare wproviders' attitudes and behaviours towards provision of RMNC. Ensuring health system infrastructure supports compassionate obstetric care represents only the first step towards ensuring RMNC. The results from the evaluation of this RMNC provider training intervention demonstrates how healthcare provider knowledge and attitudes may represent a bottleneck to ensuring RMNC that can be overcome using VCAT and behaviour change approaches.


Assuntos
Atitude do Pessoal de Saúde , Pessoal de Saúde , Respeito , Humanos , Quênia , Tanzânia , Feminino , Gravidez , Adulto , Estudos Transversais , Pessoal de Saúde/educação , Pessoal de Saúde/psicologia , Serviços de Saúde Materna/normas , Recém-Nascido , Relações Profissional-Paciente , Adulto Jovem
3.
BMC Pregnancy Childbirth ; 24(1): 370, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38750412

RESUMO

OBJECTIVE: To ascertain and explore the views of women and their partners, giving birth in the Czech Republic, of the level of respectful or disrespectful care provided during pregnancy and early labour. DESIGN: Ethical approval was granted for a descriptive, online anonymous survey of 65 questions, with quantitative and qualitative responses. SETTING: The Czech Republic.The survey was completed by 8,767 women and 69 partners in 2018. MEASUREMENTS AND FINDINGS: Descriptive statistics and thematic analysis were used to present results. The majority of women were aged 26-35 years. Most had birthed in one of 93 hospitals, with 1.5% home births. Almost 40% never had an abdominal examination.in pregnancy. Quantitative data analysis revealed that less than half were given information on place of birth, or how to keep labour normal or non-interventionist. Almost 60% did not get information on positions for birth. Most (68%) commenced labour naturally, 25% had labour induced, 40% of them before term, and 7% had an elective caesarean section; 55% stated they had not been given any choice in the decision. Over half of those who had a membrane sweep said permission had not been sought. Half (54%) only had 'checking' visits from the midwife in labour. KEY CONCLUSIONS: Findings reveal a lack of information-giving, discussion and shared decision-making from healthcare professionals during pregnancy and early labour. Some practices were non-evidenced-based, and interventions were sometimes made without consent. IMPLICATIONS FOR PRACTICE: The examples of disrespectful care described in this study caused women distress during childbirth, which may result in an increased fear of childbirth or an increase in free-birthing.


Assuntos
Respeito , Humanos , Feminino , Gravidez , Adulto , República Tcheca , Inquéritos e Questionários , Trabalho de Parto/psicologia , Adulto Jovem , Relações Profissional-Paciente , Gestantes/psicologia , Parto Obstétrico/psicologia , Atitude do Pessoal de Saúde
5.
BMC Med Ethics ; 25(1): 62, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38773588

RESUMO

BACKGROUND: Respect for human rights and bioethical principles in prisons is a crucial aspect of society and is proportional to the well-being of the general population. To date, these ethical principles have been lacking in prisons and prisoners are victims of abuse with strong repercussions on their physical and mental health. METHODS: A systematic review was performed, through a MESH of the following words (bioethics) AND (prison), (ethics) AND (prison), (bioethics) AND (jail), (ethics) AND (jail), (bioethics) AND (penitentiary), (ethics) AND (penitentiary), (prison) AND (human rights). Inclusion and exclusion criteria were defined and after PRISMA, 17 articles were included in the systematic review. RESULTS: Of the 17 articles, most were prevalence studies (n.5) or surveys (n.4), followed by cross-sectional studies (n.3), qualitative studies (n.1), retrospective (n.1) and an explanatory sequential mixed-methods study design (n.1). In most cases, the studies associated bioethics with prisoners' access to treatment for various pathologies such as vaccinations, tuberculosis, hepatitis, HIV, it was also found that bioethics in prisons was related to the mental health of prisoners, disability, ageing, the condition of women, the risk of suicide or with the request for end-of-life by prisoners. The results showed shortcomings in the system of maintaining bioethical principles and respect for human rights. CONCLUSIONS: Prisoners, in fact, find it difficult to access care, and have an increased risk of suicide and disability. Furthermore, they are often used as improper organ donors and have constrained autonomy that also compromises their willingness to have end-of-life treatments. In conclusion, prison staff (doctors, nurses, warders, managers) must undergo continuous refresher courses to ensure compliance with ethical principles and human rights in prisons.


Assuntos
Direitos Humanos , Prisioneiros , Prisões , Humanos , Respeito , Temas Bioéticos , Bioética , Acessibilidade aos Serviços de Saúde/ética
8.
Issues Ment Health Nurs ; 45(4): 365-370, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38564680

RESUMO

Undocumented migrants are often in a position of extreme vulnerability and experience many barriers to accessing mental health care. It is crucial that health professionals understand this and quickly establish trust and respect. If the stressful living conditions that contribute to the distress of undocumented migrants are recognized, compassionate and trauma-informed care is enhanced. In this regard, it is important that health professionals understand the fear of being expelled from a country. This paper discusses problems that arise when health professionals interact with undocumented migrants and the need to quickly convey recognition to establish trust and respect. We argue that insights from Axel Honneth's social philosophical theory of recognition and disrespect can further enhance health professionals strategies to improve their verbal and non-verbal communication and thereby increase access to health care for undocumented migrants. We suggest ideas for codifying this knowledge in health care policies and guidelines.


Assuntos
Migrantes , Humanos , Acessibilidade aos Serviços de Saúde , Respeito , Medo , Política de Saúde
10.
BMC Pregnancy Childbirth ; 24(1): 322, 2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38671343

RESUMO

INTRODUCTION: Over the last decade, there has been an increasing number of studies regarding experiences of mistreatment, disrespect and abuse (D&A) during facility-based childbirth. These negative experiences during labour have been proven to create a barrier for seeking both facility-based childbirth and postnatal health care, as well as increasing severe postpartum depression among the women who experienced them. This constitutes a serious violation of human rights. However, few studies have carried out specifically designed interventions to reduce these practices. The aim of this scoping review is to synthetise available evidence on this subject, and to identify initiatives that have succeeded in reducing the mistreatment, D&A that women suffer during childbirth in health facilities. METHODS: A PubMed search of the published literature was conducted, and all original studies evaluating the efficacy of any type of intervention specifically designed to reduce these negative experiences and promote RMC were selected. RESULTS: Ten articles were included in this review. Eight studies were conducted in Africa, one in Mexico, and the other in the U.S. Five carried out a before-and-after study, three used mixed-methods, one was a comparative study between birth centres, and another was a quasi-experimental study. The most common feature was the inclusion of some sort of RMC training for providers at the intervention centre, which led to the conclusion that this training resulted in an improvement in the care received by the women in childbirth. Other strategies explored by a small number of articles were open maternity days, clinical checklists, wall posters and constant user feedback. DISCUSSION: These results indicate that there are promising interventions to reduce D&A and promote RMC for women during childbirth in health facilities. RMC training for providers stands as the most proven strategy, and the results suggest that it improves the experiences of care received by women in labour. CONCLUSION: The specific types of training and the different initiatives that complement them should be evaluated through further scientific research, and health institutions should implement RMC interventions that apply these strategies to ensure human rights-based maternity care for women giving birth in health facilities around the world.


Assuntos
Parto Obstétrico , Serviços de Saúde Materna , Parto , Relações Profissional-Paciente , Respeito , Humanos , Feminino , Gravidez , Serviços de Saúde Materna/normas , Parto/psicologia , Qualidade da Assistência à Saúde , Atitude do Pessoal de Saúde
12.
JAMA ; 331(18): 1531, 2024 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-38635227

RESUMO

When a resident announced that "the patient has no chance of surviving," a medical student, in this narrative medicine essay, has pondered for years how her mother could have been so reduced and advocates using patients' names when summarizing their conditions.


Assuntos
Atitude do Pessoal de Saúde , Assistência ao Paciente , Relações Médico-Paciente , Humanos , Relações Interpessoais , Respeito , Família , Educação Médica
13.
JAMA ; 331(16): 1357-1358, 2024 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-38568598

RESUMO

This Viewpoint discusses the concept of CARE (compassion, assistance, respect, and empathy) as a way physicians can practice the art of medicine in the current era of care that increasingly incorporates predictive analytics and artificial intelligence.


Assuntos
Atenção à Saúde , Medicina , Assistência Centrada no Paciente , Médicos , Tecnologia , Humanos , Atenção à Saúde/métodos , Educação Médica/métodos , Educação Médica/normas , Empatia , Comportamento de Ajuda , Esforço de Escuta , Medicina/métodos , Assistência Centrada no Paciente/métodos , Relações Médico-Paciente , Médicos/psicologia , Médicos/normas , Respeito
14.
Front Public Health ; 12: 1295291, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38572012

RESUMO

Background: Produce prescription programs have strong potential to improve food security, fruit and vegetable consumption, and health across the life course. Understanding clients' experiences and satisfaction with produce prescription programs is critical for evaluating the person-centeredness and quality of these programs. The objectives of this study were to (1) describe client experiences and satisfaction with produce prescription programs, with an emphasis on the extent to which they felt they were treated with respect and dignity, and (2) identify recommendations for improving client experiences. Methods: We conducted four focus group discussions with clients of produce prescription programs in two Federally Qualified Health Centers in California. We used a modified framework analysis approach and organized participants' experiences with programs into themes. Results: Three themes captured participants' program experiences. First, respectful produce prescription programming encompassed interactions with individuals delivering the programs that felt respectful (e.g., program staff showing they cared about participants' health and offering timely assistance with financial incentives) and disrespectful (e.g., not receiving prompt responses to questions about incentives), as well as aspects of program design perceived to be respectful (e.g., provision of gift cards as financial incentives, which offered privacy when purchasing produce). Second, having autonomy to use gift cards to choose their preferred fresh fruits and vegetables was viewed as a positive experience, though participants desired greater autonomy to shop at stores other than the program designated stores. Third, participants frequently discussed program usability, with some reporting that joining the programs and using the cards was easy, and others describing difficulties activating cards and using them at stores due to cashiers' lack of awareness of the programs. Overall, participants were highly satisfied with the programs. To improve client experiences, they recommended increasing privacy (e.g., by educating cashiers on the programs so that clients do not need to explain in public what the card is for) and autonomy (e.g., allowing cards to be used at other chain or local stores). Discussion: Our findings inform efforts to make produce prescription programs more person-centered and respectful, which in turn may increase program demand, engagement, and impact.


Assuntos
Respeito , Verduras , Humanos , Frutas , California , Satisfação Pessoal
15.
Nurs Philos ; 25(2): e12479, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38627978

RESUMO

Dignity is a central value in care for aged adults, and it must be protected and respected. With demographic changes leading to an aging population, health ministries are increasingly investing in digitalization. However, using unfamiliar digital technology can be challenging and thus impact aged adults' dignity and well-being. The INNOVATEDIGNITY project aims to research new, dignified ways of engaging with aged adults to shape digital developments in care delivery. This qualitative study aimed to explore how innovative digitally-led healthcare have influenced aged adults' well-being and dignity through three studies conducted as part of the INNOVATEDIGNITY project: a scoping review, an empirical study and a policy analysis. The three documents were analysed to uncover meanings relevant to the research problem revealing four main themes: the advantages of new technologies in facilitating aged adults' well-being, the rupture of dignity due to bewilderment in the digital world, aged adults' dignity is affected by their worries about human face of care being replaced by technology and preserving aged adults' dignity in digitally-led healthcare. Digitalization in healthcare impacts aged adults' well-being as providing new opportunities for care, but preserving aged adults' dignity when working with unfamiliar digital innovations is challenging. Aged adults need to be informed about the use of technology in their care and supported to develop the necessary digital skills to better adapt to digitally-led healthcare. The circumstances, conditions and needs of individuals should remain central when implementing new technologies in healthcare settings in a dignified way.


Assuntos
Atenção à Saúde , Respeito , Idoso , Humanos , Pesquisa Qualitativa , Tecnologia
16.
Scand J Caring Sci ; 38(2): 476-486, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38454305

RESUMO

AIM: A key perspective in examining dignity, which is important for older adults, is spirituality. Therefore, this study aimed to identify the components of spirituality in older adults through interviews based on dignity therapy (DT). METHODOLOGICAL DESIGN AND JUSTIFICATION: Colaizzi's descriptive phenomenology was applied to understand experiences rooted in the life world of older adults from their own perspective. ETHICAL ISSUES AND APPROVAL: This study was approved by the ethical review committee of the author's university. All participants provided consent to participate. RESEARCH METHODS: Semi-structured interviews based on DT were conducted with 11 community-dwelling adults aged 65 years or older who were using some form of medical or social services. The interviews were transcribed, and the text was analysed based on Colaizzi's phenomenological method. RESULTS: Four themes were identified as components of spirituality in older adults: trauma, being silent about hard experiences, forming connections and taking on challenges and discovering one's own spirit. The participants felt a sense of helplessness and frustration as they dealt with traumatic events. Feelings of shame, guilt and/or resignation prevented them from talking about the distress they were experiencing, but they were able to move forward after receiving emotional support and having opportunities to share with others. These processes led to the discovery of a new self. STUDY LIMITATIONS: This study assessed the experiences of older adults in Japan and may therefore have been influenced by the social background and culture of Japan. Future research should target older adults from a variety of social backgrounds as well as those with specific health conditions. CONCLUSION: The findings suggest the importance of creating opportunities for healthcare professionals as well as family, friends and community members to help older adults reflect on their lives and talk about their accomplishments and unresolved issues. Doing so should help older adults maintain their dignity while remaining aware of their mortality.


Assuntos
Espiritualidade , Humanos , Idoso , Masculino , Feminino , Idoso de 80 Anos ou mais , Pessoalidade , Respeito , Pesquisa Qualitativa , Terapia da Dignidade
17.
J Exp Psychol Gen ; 153(5): 1189-1212, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38451700

RESUMO

Synthesizing research on wisdom and a real-world practitioner intervention, we develop and test a strategy for presenting political views that fosters cross-partisan respect. This strategy of balanced pragmatism combines two aspects of "wise reasoning": balancing multiple interests and seeking pragmatic solutions. Studies 1-5 (N = 2,846) demonstrate that participants respected outgroup political elites more when they used balanced pragmatism versus other forms of messaging. Studies 6-8 (N = 671) extend the usefulness of balanced pragmatism to everyday political disagreements: cross-partisan comments about divisive issues (i.e., guns and immigration) generated more respect when they used balanced pragmatism versus logical analysis. Strikingly, people were as willing to discuss politics with opponents who used balanced pragmatism as they were with ingroup members. Balanced pragmatism appears to improve cross-partisan respect by making opponents seem more moral and rational. Results highlight connections between political psychology and wisdom research and illustrate the fruitfulness of scientist-practitioner collaborations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Política , Humanos , Adulto , Masculino , Feminino , Respeito , Adulto Jovem
18.
Health Policy ; 143: 105043, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38503173

RESUMO

The paper contributes to the literature on the responsiveness of care, patient dignity, and disparities in the provision of health services. It does so by evaluating indicators of patient responsiveness while focusing on aspects of dignified treatment. The data were taken from the Patient Experience Survey of General Public Hospitals conducted by the Israel Ministry of Health in 2018. The analysis focuses on two indicators of responsiveness (i.e., actual) and three indicators of patient satisfaction with responsiveness (i.e., satisfaction). The analysis reveals that variations of these indicators are associated with patients' sociodemographic attributes and the hospitals' characteristics. However, while the likelihood of the actual provision of responsive care tends to be lower for vulnerable patients, the satisfaction of vulnerable populations with responsiveness tends to be higher. The data also reveal that the likelihood of responsive treatment and patient satisfaction with this tends to be lower for patients hospitalized in smaller hospitals and hospitals located in the periphery. The findings and their meaning are discussed in the context of studies on responsiveness of care, health disparities, dignified treatment, and patient satisfaction with the provision of health services.


Assuntos
Pacientes Internados , Respeito , Humanos , Israel , Qualidade da Assistência à Saúde , Satisfação do Paciente , Avaliação de Resultados da Assistência ao Paciente
19.
Transfusion ; 64(4): 585-589, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38501236

RESUMO

BACKGROUND: With a decrease in young and first-time donors, applying gaming elements to blood donation may provide a novel means of encouraging young donors. In August 2023, the online game DiabloIV launched the Blood Harvest in which players were encouraged to donate blood products in the United States to receive virtual in-game rewards. Given the novelty of this independent initiative, our aim was to capture Diablov IV players opinions of the Blood Harvest through thematically analyzing their online discourse related to this blood donation campaign. STUDY DESIGN AND METHODS: We captured publicly available Twitter/X posts (n = 78) and engagement (n = 390) relevant to the Blood Harvest posted during and immediately after the campaign (October 13, 2023-November 27, 2023). RESULTS: Using thematic analysis, we identified 5 themes relating to the Blood Harvest campaign: (1) Positive perceptions and community motivations to donate, (2) Negative perceptions of the initiative and online game, (3) Players' inability to donate and participate in the initiative, (4) Incentives and incentive comparisons, and (5) Benefiting from positive associations focusing on the reputational gain that may be accessed through promoting blood donation. DISCUSSION: Situating a donation campaign in an established video game provides a novel opportunity to engage young donors. Through capturing public data, we provide a unique snapshot of how an online gaming community perceives and reacts to an independently initiated game-integrated blood donation campaign. This highlights key strengths of the approach as well as identifying potential risks for blood collection agencies.


Assuntos
Doação de Sangue , Respeito , Humanos , Opinião Pública , Doadores de Tecidos , Atitude , Doadores de Sangue
20.
Nurs Open ; 11(3): e2142, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38520140

RESUMO

AIM: With the outbreak of COVID-19 and associated challenges such as increased workload for health providers and shortage of equipment, it became more challenging to maintain patients' dignity and satisfaction. This study evaluated the patients' dignity and satisfaction with COVID-19 in Kashan, Iran, in 2021. DESIGN: A cross-sectional descriptive study. METHODS: In total, 385 patients recovered from COVID-19 were selected through sequential sampling method. Data were collected using demographic, patient dignity inventory, and patient satisfaction questionnaires. Data were analysed using descriptive analysis, independent t-test, ANOVA, and Spearman-Brown coefficient. RESULTS: The mean age of patients was 50.57. The mean scores of patients' dignity and satisfaction were 1.622 ± 0.653 and 3.851 ± 0.548 (out of 5), respectively. The dignity rating was associated with age, gender, education, underlying disease, and length of hospital stay (p < 0.05); but patient satisfaction was only associated with education (p = 0.002). The results indicated that dignity and satisfaction have a significant direct correlation (r = -0.23, p < 0.001). PATIENT OR PUBLIC CONTRIBUTION: This study was designed based on the research priorities and needs in the field of clinical research and patients were involved in conducting the study via participating in data collection.


Assuntos
COVID-19 , Respeito , Humanos , Estudos Transversais , Satisfação do Paciente , Pacientes Internados
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