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1.
Worldviews Evid Based Nurs ; 18(4): 251-260, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34355844

RESUMO

BACKGROUND: During the COVID-19 pandemic, providing care for critically ill patients has been challenging due to the limited number of skilled nurses, rapid transmission of the virus, and increased patient acuity in relation to the virus. These factors have led to the implementation of team nursing as a model of nursing care out of necessity for resource allocation. Nurses can use prior evidence to inform the model of nursing care and reimagine patient care responsibilities during a crisis. PURPOSE: To review the evidence for team nursing as a model of patient care and delegation and determine how it affects patient, nurse, and organizational outcomes. METHODS: We conducted an integrative review of team nursing and delegation using Whittemore and Knafl's (2005) methodology. RESULTS: We identified 22 team nursing articles, 21 delegation articles, and two papers about U.S. nursing laws and scopes of practice for delegation. Overall, team nursing had varied effects on patient, nursing, and organizational outcomes compared with other nursing care models. Education regarding delegation is critical for team nursing, and evidence indicates that it improves nurses' delegation knowledge, decision-making, and competency. LINKING EVIDENCE TO ACTION: Team nursing had both positive and negative outcomes for patients, nurses, and the organization. Delegation education improved team nursing care.


Assuntos
COVID-19/enfermagem , Delegação Vertical de Responsabilidades Profissionais/métodos , Equipe de Enfermagem/normas , Admissão e Escalonamento de Pessoal/normas , COVID-19/transmissão , Delegação Vertical de Responsabilidades Profissionais/normas , Mão de Obra em Saúde , Humanos , Equipe de Enfermagem/métodos
2.
Cancer Radiother ; 25(6-7): 638-641, 2021 Oct.
Artigo em Francês | MEDLINE | ID: mdl-34284967

RESUMO

For several years, the profession of radiographer has been unattractive and is in search of professional recognition. Increasingly complex therapeutic and diagnostic evolutions forces professionals to develop their skills to ensure quality and safe care for all patients. The primary role of the radiographer is to support patients and to accompany them during their examination or treatment, combining caregiver and technician's roles. Transversal missions and delegation of tasks are inherent to the profession but are not widely recognized. Cooperation between radiotherapy professionals is a response to offer the therapeutic radiographer/radiation therapist (RTT) opportunities in terms of attractiveness, career prospects, and increased skills. In radiotherapy, advanced practice activities already exist in some departments but require regulatory adjustments, in particular regarding the redistribution of the roles of RTT but also the status of these professionals. The formalization of these practices can be largely inspired by the many feedbacks around the world. This article aims to reflect the evolution's perspectives in the career of an RTT and on the valorisation of this profession in the current context.


Assuntos
Pessoal Técnico de Saúde/normas , Competência Profissional/normas , Tecnologia Radiológica/normas , Pessoal Técnico de Saúde/tendências , Escolha da Profissão , Mobilidade Ocupacional , Delegação Vertical de Responsabilidades Profissionais/normas , Humanos , Relações Interprofissionais , Determinação de Necessidades de Cuidados de Saúde , Relações Profissional-Paciente , Radioterapia (Especialidade) , Radiografia , Radioterapia , Tecnologia Radiológica/tendências
3.
Dermatol Surg ; 47(5): 645-648, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33905393

RESUMO

BACKGROUND: There is limited knowledge on the extent physicians delegate cosmetic procedures to midlevel providers. OBJECTIVE: To assess dermatology and plastic surgery practice patterns for the injections of neurotoxins and dermal fillers. MATERIALS AND METHODS: Four hundred ninety-two dermatology and plastic surgery practices were identified from 10 major US metropolitan areas. These practices were contacted, and staff were asked a series of questions to best characterize the practice patterns in regard to who performs the injectables in the office. RESULTS: Although most dermatology and plastic surgery practices had physicians as the only provider who gives injectables, 18.35% of dermatology and 25.4% of plastic surgery practices had nurse practioners and physician assistants giving injectables both with and without oversight of the supervising physician onsite. CONCLUSION: In a large majority of both plastic surgery and dermatology practices, physicians exclusively perform injections of neurotoxins and fillers. For practices that allow midlevel providers to perform injectables, the level of physician supervision is variable. In a small percentage of plastic surgery practices, surveyed midlevel providers exclusively performed injectables.


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos/administração & dosagem , Neurotoxinas/administração & dosagem , Profissionais de Enfermagem/estatística & dados numéricos , Assistentes Médicos/estatística & dados numéricos , Adulto , Competência Clínica , Delegação Vertical de Responsabilidades Profissionais , Dermatologia , Feminino , Humanos , Injeções , Masculino , Cirurgia Plástica , Inquéritos e Questionários , Estados Unidos
4.
Am J Surg ; 222(3): 536-540, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33485620

RESUMO

OBJECTIVE: We aimed to identify potential variables predictive of a resident achieving faculty future entrustment as a way to enhance attending surgeons' planning of teaching in the operating room leading to improved resident operative autonomy in practice. METHODS: We reviewed 273 resident performance evaluations from 91 surgical cases that were collected from 11 general surgery chief residents and 16 attending surgeons between April 2018 and June 2019 using a validated evaluation instrument. The primary outcome measure was prospective resident entrustment estimated by the rater for future similar cases. We used descriptive statistics and the boosted tree analysis model to find potential predictors for the outcome measure and examine test-retest reliability by procedure. RESULTS: Step-specific guidance (r = 0.77, p < 0.0001) was the variable most highly associated with prospective resident entrustment in bivariate linear analysis. The boosted tree analysis demonstrated step-specific guidance was the strongest predictor for prospective resident entrustment in the OR, and its predictive importance was much higher than the overall guidance (0.64 > 0.18). Test-retest reliability was from 0.93 to 0.98 across procedures, indicating the likelihood that attending surgeons granted future autonomy complied with their evaluation of prospective resident entrustment was high. CONCLUSIONS: By assessing step-specific guidance, attending surgeons can reliably judge residents' future entrustment and potentially better plan for operative teaching/supervision that may lead to granting a surgical resident operative autonomy on similar cases in the future. Our findings provide insight into prospective faculty development of surgical teaching aimed at improving resident readiness for independent practice.


Assuntos
Competência Clínica , Cirurgia Geral/educação , Internato e Residência , Autonomia Profissional , Procedimentos Cirúrgicos Operatórios/educação , Delegação Vertical de Responsabilidades Profissionais , Docentes de Medicina , Feminino , Humanos , Masculino , Salas Cirúrgicas , Avaliação de Resultados em Cuidados de Saúde , Reprodutibilidade dos Testes , Cirurgiões/educação
5.
Rev Esp Anestesiol Reanim (Engl Ed) ; 67(9): 487-495, 2020 Nov.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33036762

RESUMO

INTRODUCTION: The current SARS-CoV-2 pandemic has been the world's largest socio-health crisis experienced in the last century. Each healthcare center has been compelled to adapt the treatment guidelines established by the different scientific societies. OBJECTIVES: Analyze the impact of the methodology based on simulation as a tool to improve our clinical practice: work dynamics, effectiveness and safety of all the physicians involved in the management of labor in COVID pregnant women and its usefulness to facilitate the adaptation of protocols to a specific clinical context. METHOD: Descriptive observational study that includes the C-sections and deliveries of COVID pregnant women performed in our hospital. The actions carried out in each procedure were analyzed using the simulation multidisciplinary briefing and debriefing tools, before and after each case. RESULTS: A total of 5 clinical cases were analyzed. Difficulties were found in the execution of the protocols established for the care of the COVID pregnant. Organizational, structural, material resources and human factors obstacles were the most common. CONCLUSIONS: Our results showed that the analysis example using simulation methodology was a tool of great value in three aspects: teamwork improvement, actions consent and improvement proposals for the adaptation and implementation of protocols.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Parto Obstétrico/métodos , Equipe de Assistência ao Paciente/organização & administração , Pneumonia Viral/terapia , Complicações Infecciosas na Gravidez/terapia , Treinamento por Simulação/métodos , Adulto , COVID-19 , Teste para COVID-19 , Cesárea , Tomada de Decisão Clínica , Técnicas de Laboratório Clínico/métodos , Protocolos Clínicos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Delegação Vertical de Responsabilidades Profissionais , Emergências , Feminino , Humanos , Comunicação Interdisciplinar , Pandemias , Admissão e Escalonamento de Pessoal , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , SARS-CoV-2 , Adulto Jovem
6.
BMC Health Serv Res ; 20(1): 491, 2020 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-32493386

RESUMO

BACKGROUND: Allied health assistants (AHAs) are support staff who complete clinical and non-clinical tasks under the supervision and delegation of an allied health professional. The effect of allied health professional delegation of clinical tasks to AHAs on patient and healthcare organisational outcomes is unknown. The purpose of this systematic review was to investigate the effect of allied health professional delegation of therapy to AHAs on patient and organisational outcomes. METHODS: A systematic review and meta-analysis was conducted. Databases MEDLINE (Ovid), Embase (Ovid), Informit (all databases), Emcare (Ovid), PsycINFO (Ovid), Cumulative Index to Nursing and Allied Health Literature [CINAHL] (EbscoHost) and the Cochrane Database of Systematic Reviews were searched from earliest date available. Additional studies were identified by searching reference lists and citation tracking. Two reviewers independently applied inclusion and exclusion criteria. The quality of the study was rated using internal validity items from the Downs and Black checklist. Risk ratios (RR) and mean differences (MD) were calculated for patient and organisational outcomes. Meta-analyses were conducted using the inverse variance method and random-effects model. RESULTS: Twenty-two studies met the inclusion criteria. Results of meta-analysis provided low quality evidence that AHA supervised exercise in addition to usual care improved the likelihood of patients discharging home (RR 1.28, 95%CI 1.03 to 1.59, I2 = 60%) and reduced length of stay (MD 0.28 days, 95%CI 0.03 to 0.54, I2 = 0%) in an acute hospital setting. There was preliminary evidence from one high quality randomised controlled trial that AHA provision of nutritional supplements and assistance with feeding reduced the risk of patient mortality after hip fracture (RR 0.41, 95%CI 0.16 to 1.00). In a small number of studies (n = 6) there was no significant difference in patient and organisational outcomes when AHA therapy was substituted for therapy delivered by an allied health professional. CONCLUSION: We found preliminary evidence to suggest that the use of AHAs to provide additional therapy may be effective for improving some patient and organisational outcomes. REVIEW REGISTRATION: CRD42019127449.


Assuntos
Pessoal Técnico de Saúde , Delegação Vertical de Responsabilidades Profissionais , Atenção à Saúde/organização & administração , Avaliação de Resultados da Assistência ao Paciente , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
9.
BMC Health Serv Res ; 20(1): 65, 2020 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-31996195

RESUMO

BACKGROUND: The burden of hypertension in many low-and middle-income countries is alarming and requires effective evidence-based preventative strategies that is carefully appraised and accepted by key stakeholders to ensure successful implementation and sustainability. We assessed nurses' perceptions of a recently completed Task Shifting Strategy for Hypertension control (TASSH) trial in Ghana, and facilitators and challenges to TASSH implementation. METHODS: Focus group sessions and in-depth interviews were conducted with 27 community health nurses from participating health centers and district hospitals involved in the TASSH trial implemented in the Ashanti Region, Ghana, West Africa from 2012 to 2017. TASSH evaluated the comparative effectiveness of the WHO-PEN program versus provision of health insurance for blood pressure reduction in hypertensive adults. Qualitative data were analyzed using open and axial coding techniques with emerging themes mapped onto the Consolidated Framework for Implementation Research (CFIR). RESULTS: Three themes emerged following deductive analysis using CFIR, including: (1) Patient health goal setting- relative priority and positive feedback from nurses, which motivated patients to make healthy behavior changes as a result of their health being a priority; (2) Leadership engagement (i.e., medical directors) which influenced the extent to which nurses were able to successfully implement TASSH in their various facilities, with most directors being very supportive; and (3) Availability of resources making it possible to implement the TASSH protocol, with limited space and personnel time to carry out TASSH duties, limited blood pressure (BP) monitoring equipment, and transportation, listed as barriers to effective implementation. CONCLUSION: Assessing stakeholders' perception of the TASSH implementation process guided by CFIR is crucial as it provides a platform for the nurses to thoroughly evaluate the task shifting program, while considering the local context in which the program is implemented. The feedback from the nurses informed barriers and facilitators to implementation of TASSH within the current healthcare system, and suggested system level changes needed prior to scale-up of TASSH to other regions in Ghana with potential for long-term sustainment of the task shifting intervention. TRIAL REGISTRATION: Trial registration for parent TASSH study: NCT01802372. Registered February 27, 2013.


Assuntos
Atitude do Pessoal de Saúde , Delegação Vertical de Responsabilidades Profissionais , Hipertensão/prevenção & controle , Enfermeiros de Saúde Comunitária/psicologia , Adulto , Centros Comunitários de Saúde/organização & administração , Feminino , Grupos Focais , Gana , Hospitais de Distrito/organização & administração , Humanos , Hipertensão/enfermagem , Masculino , Enfermeiros de Saúde Comunitária/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa
10.
Behav Res Ther ; 130: 103466, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31733813

RESUMO

The study's objective was to determine the effectiveness of a task-sharing psychological treatment for perinatal depression using non-specialist community health workers. A double-blind individual randomised controlled trial was conducted in two antenatal clinics in the peri-urban settlement of Khayelitsha, Cape Town. Adult pregnant women who scored 13 or above on the Edinburgh Postnatal Depression rating Scale (EPDS) were randomised into the intervention arm (structured six-session psychological treatment) or the control arm (routine antenatal health care and three monthly phone calls). The primary outcome was response on the Hamilton Depression Rating Scale (HDRS) at three months postpartum (minimum 40% score reduction from baseline) among participants who did not experience pregnancy or infant loss (modified intention-to-treat population) (registered on Clinical Trials: NCT01977326). Of 2187 eligible women approached, 425 (19.4%) screened positive on the EPDS and were randomised; 384 were included in the modified intention-to-treat analysis (control: n = 200; intervention: n = 184). There were no significant differences in response on the HDRS at three months postpartum between the intervention and control arm. A task-sharing psychological treatment was not effective in treating depression among women living in Khayelitsha, South Africa. The findings give cause for reflection on the strategy of task-sharing in low-resource settings.


Assuntos
Agentes Comunitários de Saúde , Aconselhamento/métodos , Depressão Pós-Parto/terapia , Transtorno Depressivo/terapia , Complicações na Gravidez/terapia , Intervenção Psicossocial/métodos , Adulto , Delegação Vertical de Responsabilidades Profissionais , Atenção à Saúde , Método Duplo-Cego , Feminino , Humanos , Gravidez , África do Sul , Resultado do Tratamento , Adulto Jovem
12.
Afr J Reprod Health ; 23(3): 149-160, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31782639

RESUMO

Task shifting of Caesarean-sections to non-physician clinicians (NPCs) has raised concerns over NPCs' competences and rationale of using them in facilities where medical doctors (MDs) are scarce to provide mentorship. We conducted a scoping review to provide an update on NPCs' contribution to C-sections including barriers and enablers to task shifting. Using the PRISMA Flow Diagram, we identified 15 eligible articles from Google Scholar, PubMed and Africa Index Medicus using specific search terms and a pre-established inclusion criterion. All 15 studies characterised NPCs: their names, training, challenges and enablers to task shifting. NPCs performed 50%-94% C-sections. Outcomes of such C-sections were comparable to those performed by MDs. Enablers included supportive policies, pre-existing human resources for health shortage, well- resourced health facilities and supervision of NPCs. Weak health systems were major barriers. While NPCs make a significant contribution to accessing C-sections services, there is need to address challenges to fully realize benefits.


Assuntos
Cesárea , Delegação Vertical de Responsabilidades Profissionais , Mão de Obra em Saúde , Serviços de Saúde Materna , Feminino , Acesso aos Serviços de Saúde , Humanos , Gravidez
13.
Sociol Health Illn ; 41(8): 1667-1684, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31407367

RESUMO

Adopting a critical realist perspective, this article examines the emergence of a relatively new non-professional healthcare role, the assistant practitioner (AP). The role is presented as a malleable construct cascading through and sensitive to structure-agency interaction at different levels of NHS England: the sector, organisation and department. At the core of the analysis is the permissiveness of structures established at the respective levels of the NHS, facilitating or restricting agency as the role progresses through the healthcare system. A permissive regulatory framework at the sector level is reflected in the different choices made by two case study NHS acute hospital trusts, in their engagement with the AP role. These different choices have consequences for how the AP impacts at the departmental level.


Assuntos
Delegação Vertical de Responsabilidades Profissionais/organização & administração , Atenção à Saúde/organização & administração , Assistentes de Enfermagem/organização & administração , Medicina Estatal/organização & administração , Inglaterra , Humanos , Papel do Profissional de Enfermagem , Inquéritos e Questionários
14.
Trials ; 20(1): 416, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291974

RESUMO

'Assumptions are made and most assumptions are wrong' (Albert Einstein) Clinical trial conduct must be consistent with trial design, yet conducting the trial according to plan remains a major challenge.We discuss the importance of optimal co-applicant team formation in trial leadership, appropriate delegation of tasks and staff supervision arrangements. Finally, we discuss five standard documents which we believe require particular attention. With appropriate engagement by or with co-applicants during the preparation of these five standard documents, we believe many of the pitfalls trials commonly experience can be avoided. The risks inherent in failing to identify and address mistaken assumptions during the preparation of these documents are discussed and recommendations for best practice suggested.


Assuntos
Ensaios Clínicos como Assunto/normas , Delegação Vertical de Responsabilidades Profissionais/normas , Liderança , Projetos de Pesquisa/normas , Pesquisadores/normas , Protocolos de Ensaio Clínico como Assunto , Comitês de Monitoramento de Dados de Ensaios Clínicos/normas , Ensaios Clínicos como Assunto/métodos , Ensaios Clínicos como Assunto/estatística & dados numéricos , Comportamento Cooperativo , Interpretação Estatística de Dados , Controle de Formulários e Registros/normas , Formulários como Assunto , Humanos , Comunicação Interdisciplinar , Participação dos Interessados
15.
Hum Resour Health ; 17(1): 60, 2019 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331348

RESUMO

BACKGROUND: The global shortage of surgeons disproportionately impacts low- and middle-income countries. To mitigate this, Zambia introduced a 'task-shifting' solution and started to train non-physician clinicians (NPCs) called medical licentiates (ML) to perform surgery. The aim of this randomised controlled trial was to assess their contribution to the delivery of surgical care in rural hospitals in Zambia. METHODS: Sixteen hospitals were randomly assigned to intervention and control arms of the study. Nine MLs were deployed to eight intervention sites. Crude numbers of selected major surgical procedures between intervention and control sites were compared before and after the intervention. Volume and outcomes of surgery were compared within intervention hospitals, between NPCs and surgically active medical doctors (MDs). RESULTS: There was a significant increase in the numbers of caesarean sections (CS) in the intervention hospitals (+ 15.2%) and a drop by almost half in the control group (- 47%) (P = 0.015), between the two time periods. There were marginal shifts in the numbers of index procedures: a small drop in the intervention group (- 4.9%) and slight increase in the control arm (+ 4.8%) (P = 0.505). In all pairs, MLs had higher mean number of CS and other major surgical cases done in the intervention period compared with MDs. There was no significant difference in postoperative wound infection rates for CS (P = 0.884) and other major surgical cases (P = 0.33) at intervention hospitals between MLs and MDs. CONCLUSION: This study provided evidence that the ML training programme in Zambia is an effective and safe way to bridge the gap in rural hospitals between the demand and the limited availability of surgically trained workforce in the country. Such evidence is greatly needed as more developing countries are developing national surgical plans. TRIAL REGISTRATION: ISRCTN66099597 Registered: 07/01/2014.


Assuntos
Pessoal Técnico de Saúde/provisão & distribuição , Delegação Vertical de Responsabilidades Profissionais/estatística & dados numéricos , Mão de Obra em Saúde/estatística & dados numéricos , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Competência Clínica , Países em Desenvolvimento , Humanos , População Rural , Zâmbia
17.
Am J Community Psychol ; 63(3-4): 355-365, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30834554

RESUMO

In the United States, the demand for child mental health services is increasing, while the supply is limited by workforce shortages. These shortages are unlikely to be corrected without significant structural changes in how mental health services are provided. One strategy for bridging this gap is task-shifting, defined as a process by which services that are typically delivered by professionals are moved to individuals with less extensive qualifications or training. Although task-shifting can increase the size of the workforce, there are challenges related to training new workers. In this paper, we propose Just-In-Time Training (JITT) as one strategy for improving task-shifting efforts. We define JITT as on-demand training experiences that only include what is necessary, when it is necessary, to promote competent service delivery. We offer a proof of concept from our own work shifting counseling and academic support tasks from school mental health professionals to pre-baccalaureate mentors, citing lessons learned during our iterative process of JITT development. We conclude with a series of key considerations for scaling up the pairing of task-shifting and JITT, including expanding the science of JITT and anticipating how task-shifting and JITT would work within the context of dynamic mental health service systems.


Assuntos
Serviços de Saúde da Criança , Delegação Vertical de Responsabilidades Profissionais/métodos , Capacitação em Serviço/métodos , Serviços de Saúde Mental , Criança , Aconselhamento , Humanos , Mentores/educação , Competência Profissional , Papel Profissional , Estudo de Prova de Conceito , Recursos Humanos
18.
BMC Public Health ; 19(1): 185, 2019 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-30760257

RESUMO

BACKGROUND: The Philippines has a high burden of TB and HIV, yet the WHO estimates that only 13% of Filipino TB patients know their HIV status. This is partly attributable to the lack of trained HIV counselors and medical technologists (or laboratory technicians) at the primary healthcare level. In Africa where resources and manpower are also scarce, TB/HIV care is already delegated to community health workers. Evidence is scant however about the acceptability and feasibility of engaging community health workers to provide HIV counseling and testing (HCT) among TB patients in the Philippines. The objective of this paper is to describe and assess the acceptability and feasibility of delegating HCT among TB patients to barangay (community) health workers (BHWs) in the Philippines. METHODS: Mixed methods study that utilized surveys with patients (n = 89), BHWs (n = 81), and ten focus group discussions with key stakeholders (n = 49) in San Jose del Monte, a city with high HIV prevalence. A facility assessment (n = 17) was done using a modified version of WHO-Service Availability and Readiness Assessment questionnaire to assess feasibility (scale of 1 to 4) while acceptability from the perspective of patients and BHWs was determined using surveys. RESULTS: Only 47% of TB patients agreed to receive HIV counseling from BHWs, while 30% agreed to receive HIV testing. Doctors were preferred by patients as HIV counselors, while medical technologists were preferred as HIV test providers. Two out of three BHWs also disagreed to provide HCT but the same number felt that they could provide HCT if additional trainings were given to them. In the group discussions, BHWs preferred to only provide HIV counseling. Stakeholders said that only select BHWs who meet certain criteria should provide HIV counseling. Program managers and stakeholders rated delegation of HCT to BHWs as moderately feasible. CONCLUSIONS: Delegation of both HIV counseling and testing among TB patients to BHWs is feasible, but only delegation of HIV counseling is acceptable. Further studies are needed to guide revision of Philippine HCT policies to accommodate lay HIV counselors, and strengthen the mechanisms for delivering integrated TB and HIV services especially at the primary healthcare level.


Assuntos
Agentes Comunitários de Saúde , Delegação Vertical de Responsabilidades Profissionais/estatística & dados numéricos , Infecções por HIV/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Tuberculose/psicologia , Adulto , Aconselhamento Diretivo/estatística & dados numéricos , Estudos de Viabilidade , Feminino , Grupos Focais/estatística & dados numéricos , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Humanos , Masculino , Programas de Rastreamento/estatística & dados numéricos , Filipinas , Inquéritos e Questionários/estatística & dados numéricos , Tuberculose/complicações
19.
Am J Community Psychol ; 63(3-4): 366-377, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30693961

RESUMO

In order to increase access to child mental health evidence-based interventions (EBIs) for vulnerable and hard-to-engage families involved in the child welfare (CW) system, innovative approaches coupled with input from service providers are needed. One potential solution involves utilizing task-shifting strategies and implementation science theoretical frameworks to implement such EBIs in CW settings. This study examined perceptions among CW staff who were members of a collaborative advisory board involved in the implementation of the 4Rs and 2Ss Strengthening Families Program (4R2S) in CW placement prevention settings, utilizing task-shifting strategies and the Practical, Robust, Implementation, and Sustainability Model. Advisory board members reported difficulties in engaging families, heavy workloads, and conflicting implementation initiatives. While 4R2S was perceived as generally aligned with their organization's mission, modifications to the intervention and to agency procedures were recommended to promote implementation success. Suggested modifications to the existing 4R2S training and supervision are discussed. Findings underscore the importance of understanding the experiences of CW service providers, which can inform future efforts to implement child mental health EBIs in CW services.


Assuntos
Atitude do Pessoal de Saúde , Proteção da Criança , Delegação Vertical de Responsabilidades Profissionais , Serviços de Saúde Mental , Adulto , Comitês Consultivos , Idoso , Terapia Comportamental , Criança , Prática Clínica Baseada em Evidências , Família , Feminino , Humanos , Pessoa de Meia-Idade , Participação do Paciente , Comportamento Problema , Pesquisa Qualitativa , Apoio Social , Carga de Trabalho
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