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3.
Br J Community Nurs ; 25(10): 480-488, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33030369

RESUMO

People with chronic pain faced potential treatment disruption during the COVID-19 pandemic in Singapore, as the focus of healthcare shifted. A model of rapid integration of a pain centre with community healthcare teams was implemented to care for vulnerable older patients with chronic pain and multiple comorbidities. Telemedicine and home visits by community nurses were used, with risk-mitigation measures, ensuring comprehensive assessment and treatment compliance. Medications from pain physicians were delivered at home through a hospital pharmacy. A secure national electronic health records system used by all teams ensured seamless access and documentation. Potential emergency department visits, admissions and delayed discharges were thus avoided. Integration of community teams with chronic pain management services can be recommended to ensure pandemic preparedness.


Assuntos
Dor Crônica/terapia , Enfermagem em Saúde Comunitária , Infecções por Coronavirus , Visita Domiciliar , Clínicas de Dor , Manejo da Dor , Pandemias , Pneumonia Viral , Telemedicina , Betacoronavirus , Comportamento Cooperativo , Assistência à Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Encaminhamento e Consulta , Singapura , Fluxo de Trabalho
4.
Rev Alerg Mex ; 67(2): 199-201, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32892535
5.
Indian J Dent Res ; 31(3): 494-499, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32769289

RESUMO

Context: Home visit is a modality of health care that is expanding in Brazil and in the world. Public and private services have invested in the implementation of this type of assistance. It happens due to its potential to transform the model of care, highlighting the work quality of the primary health care teams. Aims: To analyze house call rates in primary care in the Brazilian public healthcare system according to professional categories and health macro-regions in the state of Minas Gerais, southeast region of Brazil. Settings and Design: An ecological study that used as the information source the production data from the Primary Care Information System (2010 to 2015). Methods and Materials: House call rates (per 3000 inhabitants) by primary care professionals constituted the response variable. The independent variables were professional categories and the 13 health macro-regions of the state. Statistical Analysis Used: The data were analyzed using the Mann-Whitney test. Results: A total of 26,932,463 house calls were performed in the period, but the number of visits in 2015 was significantly lower compared to 2010. Significantly higher house call rates were found for some professional categories (mid-level professionals and nurses) and significant differences were found among the macro-regions (P < 0.05). Conclusions: The profile of house calls by primary care professionals revealed the constant presence of this care modality, but the distribution of these visits is uneven among the different professional categories and macro-regions of the state.


Assuntos
Visita Domiciliar , Atenção Primária à Saúde , Brasil , Humanos
6.
PLoS One ; 15(8): e0237629, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32790804

RESUMO

BACKGROUND: During the COVID-19 pandemic, general practitioners worldwide re-organise care in very different ways because of the lack of evidence-based protocols. OBJECTIVE: This paper describes the organisation and the characteristics of consultations in Belgian out-of-hours primary care during five weekends at the peak of a COVID-19 outbreak and compares it to a similar period in 2019. METHODS: Real-time observational study using pseudonymised routine clinical data extracted out of reports from home visits, telephone- and physical consultations (iCAREdata). Nine general practice cooperatives (GPCs) participated covering a population of 1 513 523. RESULTS: All GPCs rapidly re-organised care in order to handle the outbreak and provide a safe working environment. The average consultation rate was 222 per 100 000 citizens per weekend. These consultations were handled by telephone alone in 40% (N = 6293). A diagnosis at risk of COVID-19 was registered in 6692 (43%) consultations,. Out of 5311 physical consultations, 1460 were at risk of COVID-19 of which 443 (30%) did not receive prior telephone consultation to estimate this risk. Compared to 2019, the workload initially increased due to telephone consultations but afterwards declined drastically. The physical consultation rate declined by 45% with a marked decline in diagnoses unrelated to COVID-19. CONCLUSIONS: General practitioners can rapidly re-organise out-of-hours care to handle patient flows during a COVID-19 outbreak. Forty percent of the out-of-hours primary care contacts are handled by telephone consultations alone. We recommend to give a telephone consultation to all patients and not to rely on call takers to differentiate between infectious and regular care. The demand for physical consultations declined drastically provoking questions about patient's safety for care unrelated to COVID-19.


Assuntos
Plantão Médico/organização & administração , Betacoronavirus , Infecções por Coronavirus/terapia , Medicina Geral/organização & administração , Pneumonia Viral/terapia , Atenção Primária à Saúde/organização & administração , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bélgica/epidemiologia , Criança , Infecções por Coronavirus/virologia , Feminino , Clínicos Gerais , Visita Domiciliar , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Segurança do Paciente , Pneumonia Viral/virologia , Consulta Remota/métodos , Carga de Trabalho , Adulto Jovem
7.
BMC Public Health ; 20(1): 1047, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32615942

RESUMO

BACKGROUND: Household contract tracing (HHCT) is an important strategy for active tuberculosis case finding and offers an opportunity for testing of other diseases such as HIV. However, there is limited data on the patient-centered approach to HHCT. Our study aimed to describe experiences and preferences of household contacts (HHCs) for HHCT. METHODS: We conducted a qualitative study in Rustenburg, South Africa from September 2013 to March 2015. Twenty-four HHCs (≥18 years) had audio-recorded in-depth interviews. We used an inductive thematic analysis approach to develop themes. We made an a priori assumption that we would reach saturation with at least 20 interviews. RESULTS: There were 16 (66.7%) females (median age = 36 years) and eight (33.3%) males (median age = 34 years). Two themes developed: (i) Positive attitude of HHCs towards TB services provided at home and (ii) HHCs relationship to and acceptance of people living with TB (PLTB). The first main theme emphasized that HHCs appreciated the home visits. Participants preferred home visits because they had negative experiences at the clinic such as delayed waiting times and long queues. HHCs supported the screening of children for TB at home. Participants suggested that the research staff could expand their services by screening for diabetes and hypertension alongside TB screening. In the second main theme, there was a sense of responsibility from the HHCs towards accepting the diagnosis of PLTB and caring for them. A sub-theme that emerged was that as their knowledge on TB disease improved, they accepted the TB status of the PLTB empowering them to take care of the PLTB. CONCLUSIONS: HHCs are supportive of HHCT and felt empowered by receiving TB education that ultimately allowed them to better understand and care for PLTB. HHCs were supportive of screening children for TB at home. Future HHCT activities should consider raising community awareness on the benefits of TB contact tracing at households.


Assuntos
Atitude Frente a Saúde , Busca de Comunicante/estatística & dados numéricos , Visita Domiciliar/estatística & dados numéricos , Tuberculose/epidemiologia , Adolescente , Adulto , Instituições de Assistência Ambulatorial , Criança , Características da Família , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Fatores de Risco , África do Sul , Tuberculose/psicologia
8.
Matern Child Health J ; 24(10): 1224-1230, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32691359

RESUMO

PURPOSE: This evaluation describes efforts taken by MIECHV administrators and staff during the pandemic using data collected from 60 MIECHV staff surveys and nine statewide weekly focus groups. DESCRIPTION: The Florida Maternal, Infant and Early Childhood Home Visiting (MIECHV) Initiative funds perinatal home visiting for pregnant women and families with infants throughout the state. Florida MIECHV has shown resilience to disasters and times of crises in the past, while generating a culture of adaptation and continuous quality improvement among local implementing agencies. Florida MIECHV responded to the COVID-19 pandemic crisis within the first few days of the first reported case in Florida by providing guidance on virtual home visits and working remotely. ASSESSMENT: Findings highlight the role of administrative leadership and communication, staff willingness/morale, logistical considerations, and the needs of enrolled families who face hardships during the pandemic such as job loss, limited supplies, food insecurity, technology limitations, and stress. Home visitors support enrolled families by connecting them with resources, providing public health education and delivering evidence-based home visiting curricula virtually. They also recognized the emotional burden surrounding COVID-19 impacts and uncertainties along with achieving work-life balance by caring for their own children. CONCLUSION: This evaluation helped in understanding the impact of the pandemic on this maternal and child health program and fundamentals of transition to virtual home visiting services. Virtual home visiting appears to be feasible and provides an essential connection to supports for families who may not otherwise have the means or knowledge to access them.


Assuntos
Visita Domiciliar/tendências , Pandemias/prevenção & controle , Cuidado Pós-Natal/métodos , Telemedicina , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Feminino , Florida , Humanos , Pneumonia Viral/epidemiologia , Gravidez , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde
9.
Yakugaku Zasshi ; 140(7): 859-867, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32612047

RESUMO

Our pharmacy is a support center for home-care dispensing with a sterile dispensary, actively participating in a regional collaboration among medical treatment, nursing, and social care. We have supported hundreds of home-care patients, most of whom were elderly people living at home but a dozen or so were pediatric patients. Although the primary diseases of the children varied, what they had in common was a high degree of medical dependence and it was difficult to move them. At the same time, a caregiver had to be in constant attendance because medical care was intermittent. At the pharmacy, they faced long waiting times and received so many medications that they needed platform carts to carry them. By providing pharmacist-led home guidance on medications, we supported the pharmacotherapy of children with extreme symptoms who remained under the supervision of a physician from an advanced medical institution even after returning home. Through my experience of visiting both elderly people and children, it is clear that the home medical care system for the elderly, which assumes that the patients' physicians will visit their homes, is badly suited to pediatric patients who must visit advanced medical institutions for examinations.


Assuntos
Serviços Comunitários de Farmácia , Serviços de Assistência Domiciliar , Farmacêuticos , Papel Profissional , Cuidadores , Criança , Pré-Escolar , Feminino , Visita Domiciliar , Humanos , Lactente , Japão , Masculino
11.
Rev Lat Am Enfermagem ; 28: e3308, 2020.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-32609266

RESUMO

OBJECTIVE: to analyze opportunities for orientations to promote the care of premature infants during home visits and telephone support. METHOD: a qualitative study from the perspective of philosophical hermeneutics conducted with 18 mothers of premature infants discharged from hospital. Hospital contact and interviews were carried out, 15 and 45 days after discharge and at the infants' six months of life, with data analysis by interpretation of meanings from 25 home visits and 56 telephone support contacts. RESULTS: the following two thematic units emerged: Needs for contact and guidance: the place for home visits and opportunities for resolving doubts by telephone support, indicating aspects that suggest weakening child health, discontinuity in follow-up and vulnerability in specialized follow-ups. Home visits and telephone support favored the concern of health needs, doubts about basic care and problem solving, as ways to prevent damage and promote child health. CONCLUSION: home visits and telephone support emerge as collaborative practices of care and detection of latent conditions, which can be reduced or interrupted with prompt return of guidance, suggesting opportune strategies to increase follow-up, linkage and access to the health services.


Assuntos
Visita Domiciliar , Recém-Nascido Prematuro , Telefone , Criança , Feminino , Humanos , Lactente , Recém-Nascido , Mães , Alta do Paciente , Gravidez
12.
Soins Psychiatr ; 41(327): 35-38, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32718461

RESUMO

Patients with psychosis are known to dislike change or being hurried. Their relationship with time must therefore be taken into account, all the more so given that today's society leads us to believe that immediate satisfaction takes priority. Constant switching and addiction upset the stability which supports these patients with difficulty. The case of a patient visited at home shows that the team's decision to adapt to that one time will favour her subjectivation and the consolidation of her equilibrium.


Assuntos
Visita Domiciliar , Relações Profissional-Paciente , Transtornos Psicóticos/terapia , Feminino , Humanos , Transtornos Psicóticos/psicologia , Fatores de Tempo
13.
Br J Gen Pract ; 70(697): e540-e547, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32661009

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has resulted in a rapid change in workload across healthcare systems. Factors related to this adaptation in UK primary care have not yet been examined. AIM: To assess the responsiveness and prioritisation of primary care consultation type for older adults during the COVID-19 pandemic. DESIGN AND SETTING: A cross-sectional database study examining consultations between 17 February and 10 May 2020 for patients aged ≥65 years, drawn from primary care practices within the Oxford Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) sentinel network, UK. METHOD: The authors reported the proportion of consultation type across five categories: clinical administration, electronic/video, face-to-face, telephone, and home visits. Temporal trends in telephone and face-to-face consultations were analysed by polypharmacy, frailty status, and socioeconomic group using incidence rate ratios (IRR). RESULTS: Across 3 851 304 consultations, the population median age was 75 years (interquartile range [IQR] 70-82); and 46% (n = 82 926) of the cohort (N = 180 420) were male. The rate of telephone and electronic/video consultations more than doubled across the study period (106.0% and 102.8%, respectively). Face-to-face consultations fell by 64.6% and home visits by 62.6%. This predominantly occurred across week 11 (week commencing 9 March 2020), coinciding with national policy change. Polypharmacy and frailty were associated with a relative increase in consultations. The greatest relative increase was among people taking ≥10 medications compared with those taking none (face-to-face IRR 9.90, 95% CI = 9.55 to 10.26; telephone IRR 17.64, 95% CI = 16.89 to 18.41). CONCLUSION: Primary care has undergone an unprecedented in-pandemic reorganisation while retaining focus on patients with increased complexity.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Visita Domiciliar/estatística & dados numéricos , Pneumonia Viral/terapia , Atenção Primária à Saúde/organização & administração , Idoso , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Clínicos Gerais/organização & administração , Humanos , Masculino , Pandemias , Pneumonia Viral/epidemiologia , Reino Unido/epidemiologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-32545730

RESUMO

Visiting nurses are commonly exposed to workplace violence, but there is a lack of research on violence against these nurses. The purpose of this study was to identify visiting nurses' workplace violence experiences during home visits. This study used a mixed method design. Survey data of 357 home visiting nurses from public health centers were collected for the quantitative data, and a focus group interview was conducted with six visiting nurses for the qualitative data. The quantitative data were analyzed using logistic regression, and the qualitative data were analyzed using content analysis. Younger, temporary visiting nurses and those who had previously been exposed to violent clients had a higher risk of workplace violence. The violence visiting nurses faced included not only violence during the visits but also unpredicted danger and harassment after the visit. After experiencing a violent event, visiting nurses' attitudes and emotions changed toward nursing services. Visiting nurses were likely to deal with violence at the individual level given the insufficient organizational support system. An organizational-level safety management system should be established based on the characteristics of workplace violence risks and the nurses' experiences in this study.


Assuntos
Enfermeiros de Saúde Comunitária , Violência no Trabalho , Local de Trabalho , Estudos Transversais , Feminino , Visita Domiciliar , Humanos , Masculino , Saúde Pública , República da Coreia , Inquéritos e Questionários , Violência no Trabalho/prevenção & controle
20.
BMC Public Health ; 20(1): 688, 2020 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-32410651

RESUMO

BACKGROUND: The ageing population is increasing worldwide, and this trend is bringing challenges both for the older person and for society. In order to meet the challenges a comprehensive approach is needed involving both health promotion and risk prevention. The preventive home visit is a public health intervention used around the world with the purpose of promoting health and preventing risk among older persons. However, most preventive home visits are focused on questions asking about risks. In order to strengthen the health promotion perspective during the preventive home visits, factors associated with good health need to be identified. The aim of this study was therefore to determine which factors were associated with good self-rated health among older persons who received preventive home visit. METHODS: This was a register study with a cross-sectional design, including older persons (≥75 years old), living in their own homes, and that had received preventive home visit. Data were collected during a period of 9 months, in two municipalities in the south of Sweden. A questionnaire covered mental, physical and lifestyle factors were used at home visit. Binary logistic regression was used to analyse the data. RESULTS: In total, 619 older persons were included in the study; 55.4% were women, and the mean age was 80.6 years (standard deviation 2.2 years). The following items were significantly associated with good health (after adjustment for age and gender): being able to do things that make one feel valuable, having no physical problems affecting participation in social activities, not feeling sad, not having reduced energy, and not having impaired endurance. CONCLUSIONS: The main conclusion of this study is that questions focusing on risks could be seen from a health promotion perspective and could thus be turned into assets with a positive impact on older persons' health. Furthermore, the mental and physical factors identified in the results as associated with good health have implications for the person's ability to feel valuable and participate in social activities. The results suggest that issues regarding both health promotion as well as risk prevention must be brought up during the preventive home visit.


Assuntos
Envelhecimento , Promoção da Saúde , Nível de Saúde , Visita Domiciliar , Estilo de Vida , Serviços Preventivos de Saúde , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/psicologia , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Saúde Mental , Desempenho Físico Funcional , Inquéritos e Questionários , Suécia
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