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1.
Multimedia | Recursos Multimídia | ID: multimedia-13200

RESUMO

Estamos fortaleciendo el Centro de Información y Derivación de Pacientes (CIDP) para mejorar la coordinación en la atención médica durante emergencias y situaciones de plétora de los servicios.


Assuntos
Centros de Informação , Pacientes
2.
Health Informatics J ; 30(2): 14604582241259343, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38900576

RESUMO

Serious games are increasingly being applied within healthcare, but their integration in psychotherapeutic settings is less documented. OBJECTIVES: The present study sought to identify the attitudes of psychotherapists and patients towards the hypothetical use of serious games in psychotherapy in the South African context. METHODS: Online surveys assessed acceptance, experience, and requirements for the utilisation of serious games in therapeutic contexts. Clients utilising mental health services (n = 209) and psychotherapists delivering mental health services (n = 156) in South Africa completed the online survey. RESULTS: Knowledge about serious games is limited with only 15% of clients and 16% of therapists reporting knowledge of the existence and application of serious games. Use of serious games is even more infrequent with only 1% of therapists and 6% of clients currently using serious games as an intervention. Despite this, our findings highlight an apparent demand for their use, with 71% of therapists indicating that serious games would be a suitable adjunct treatment modality for their patients. Our results show a general openness toward the use of serious games in psychotherapy. CONCLUSION: The use of serious games as an e-mental health treatment modality is conceivable for both patients and therapists, particularly as a complementary strategy to traditional face-to-face psychotherapy.


Assuntos
Atitude do Pessoal de Saúde , Psicoterapia , Humanos , Psicoterapia/métodos , Psicoterapia/estatística & dados numéricos , Masculino , África do Sul , Feminino , Adulto , Inquéritos e Questionários , Pessoa de Meia-Idade , Jogos de Vídeo/psicologia , Pacientes/psicologia , Pacientes/estatística & dados numéricos
3.
Health Expect ; 27(3): e14107, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38896003

RESUMO

INTRODUCTION: Assisted dying (AD) has been legalised in a small but growing number of jurisdictions globally, including Canada and Australia. Early research in both countries demonstrates that, in response to access barriers, patients and caregivers take action to influence their individual experience of AD, as well as AD systems more widely. This study analyses how patients and caregivers suggest other decision-makers in AD systems should address identified issues. METHODS: We conducted semistructured, qualitative interviews with patients and caregivers seeking AD in Victoria (Australia) and three Canadian provinces (British Columbia, Ontario and Nova Scotia). Data were analysed using reflexive thematic analysis and codebook template analysis. RESULTS: Sixty interviews were conducted with 67 participants (65 caregivers, 2 patients). In Victoria, this involved 28 interviews with 33 participants (32 caregivers, 1 patient) about 28 patient experiences. In Canada, this involved 32 interviews with 34 participants (33 caregivers, 1 patient) about 33 patient experiences. We generated six themes, corresponding to six overarching suggestions by patients and caregivers to address identified system issues: (1) improved content and dissemination of information about AD; (2) proactively develop policies and procedures about AD provision; (3) address institutional objection via top-down action; (4) proactively develop grief resources and peer support mechanisms; (5) amend laws to address legal barriers; and (6) engage with and act on patient and caregiver feedback about experiences. CONCLUSION: AD systems should monitor and respond to suggestions from patients and caregivers with firsthand experience of AD systems, who are uniquely placed to identify issues and suggestions for improvement. To date, Canada has responded comparatively well to address identified issues, whereas the Victorian government has signalled there are no plans to amend laws to address identified access barriers. This may result in patients and caregivers continuing to take on the burdens of acting to address identified issues. PATIENT OR PUBLIC CONTRIBUTION: Patients and caregivers are central to this research. We interviewed patients and caregivers about their experiences of AD, and the article focuses on their suggestions for addressing identified barriers within AD systems. Patient interest groups in Australia and Canada also supported our recruitment process.


Assuntos
Cuidadores , Entrevistas como Assunto , Pesquisa Qualitativa , Suicídio Assistido , Humanos , Cuidadores/psicologia , Suicídio Assistido/legislação & jurisprudência , Suicídio Assistido/psicologia , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Canadá , Austrália , Adulto , Idoso de 80 Anos ou mais , Pacientes/psicologia
4.
BMC Palliat Care ; 23(1): 156, 2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-38902635

RESUMO

BACKGROUND: Patients who have benefited from specialist intervention during periods of acute/complex palliative care needs often transition from specialist-to-primary care once such needs have been controlled. Effective communication between services is central to co-ordination of care to avoid the potential consequences of unmet needs, fragmented care, and poor patient and family experience. Discharge communications are a key component of care transitions. However, little is known about the experiences of those primarily receiving these communications, to include patients', carers' and primary care healthcare professionals. This study aims to have a better understanding of how the discharge communications from specialist palliative care services to primary care are experienced by patients, carers, and healthcare professionals, and how these communications might be improved to support effective patient-centred care. METHODS: This is a 15-month qualitative study. We will interview 30 adult patients and carers and 15 healthcare professionals (n = 45). We will seek a range of experiences of discharge communication by using a maximum variation approach to sampling, including purposively recruiting people from a range of demographic backgrounds from 4-6 specialist palliative care services (hospitals and hospices) as well as 5-7 general practices. Interview data will be analysed using a reflexive thematic approach and will involve input from the research and advisory team. Working with clinicians, commissioners, and PPI representatives we will co-produce a list of recommendations for discharge communication from specialist palliative care. DISCUSSION: Data collection may be limited by the need to be sensitive to participants' wellbeing needs. Study findings will be shared through academic publications and presentations. We will draft principles for how specialist palliative care clinicians can best communicate discharge with patients, carers, and primary care clinicians. These will be shared with clinicians, policy makers, commissioners, and PPI representatives and key stakeholders and organisations (e.g. Hospice UK) and on social media. Key outputs will be recommendations for a specialist palliative care discharge proforma. TRIAL REGISTRATION: Registered in ISRCTN Registry on 29.12.2023 ref: ISRCTN18098027.


Assuntos
Cuidadores , Comunicação , Cuidados Paliativos , Alta do Paciente , Pesquisa Qualitativa , Humanos , Cuidados Paliativos/métodos , Cuidados Paliativos/normas , Alta do Paciente/normas , Cuidadores/psicologia , Pessoal de Saúde/psicologia , Atenção Primária à Saúde/normas , Masculino , Feminino , Adulto , Entrevistas como Assunto/métodos , Pacientes/psicologia , Continuidade da Assistência ao Paciente/normas
6.
West J Emerg Med ; 25(2): 230-236, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38596924

RESUMO

Introduction: Older adults often have multiple comorbidities; therefore, they are at high risk for adverse events after discharge. The 4Ms framework-what matters, medications, mentation, mobility-has been used in acute and ambulatory care settings to identify risk factors for adverse events in older adults, although it has not been used in the emergency department (ED). We aimed to determine whether 1) use of the 4Ms worksheet would help emergency clinicians understand older adult patients' goals of care and 2) use of the worksheet was feasible in the ED. Methods: We conducted a qualitative, descriptive study among patients aged ≥60 years and emergency clinicians from January-June 2022. Patients were asked to fill out a 4Ms worksheet; following this, semi-structured interviews were conducted with patients and clinicians separately. We analysed data to create codes, which were divided into categories and sub-categories. Results: A total of 20 older patients and 19 emergency clinicians were interviewed. We identified two categories based on our aims: understanding patient goals of care (sub-categories: clinician/ patient concordance; understanding underlying goals of care; underlying goals of care discrepancy) and use of 4Ms Worksheet (sub-categories: worksheet to discussion discrepancy; challenges using worksheet; challenge completing worksheet before discharge). Rates of concordance between patient and clinician on main concern/goal of care and underlying goals of care were 82.4% and 15.4%, respectively. Conclusion: We found that most patients and emergency clinicians agreed on the main goal of care, although clinicians often failed to elicit patients' underlying goal(s) of care. Additionally, many patients preferred to have the interviewer fill out the worksheet for them. There was often discrepancy between what was written and what was discussed with the interviewer. More research is needed to determine the best way to integrate the 4Ms framework within emergency care.


Assuntos
Alta do Paciente , Pacientes , Humanos , Idoso , Fatores de Risco , Assistência Ambulatorial , Serviço Hospitalar de Emergência , Pesquisa Qualitativa
8.
Clin Psychol Psychother ; 31(2): e2977, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38600845

RESUMO

BACKGROUND: Informed consent is an ethical prerequisite for psychotherapy. There are no routinely used standardized strategies for obtaining informed consent. A new optimized informed consent consultation (OIC) strengthened treatment-relevant aspects. It remains unclear which factors influence the OIC efficacy regarding clinical and decision-related outcomes. METHODS: N = 122 adults were included in a randomized controlled online trial. Participants received an information brochure on psychotherapy (TAU; n = 61) or OIC + TAU (n = 61). The main and interaction effects of group allocation, therapeutic alliance, prior knowledge about psychotherapy and treatment motivation on treatment expectations, decisional conflict and capacity to consent were tested. Floodlight analyses were conducted for significant interactions. RESULTS: Large interaction effects were shown between treatment motivation and group allocation on treatment expectations (ß = -0.53) and between prior knowledge and group assignment on capacity to consent (ß = 0.68). The interaction between treatment motivation and group allocation was significant up to a motivation score of 5.54 (range: 1-7). The interaction between prior knowledge and group assignment was significant up to a knowledge score of 14.38 (range: 5-20). CONCLUSION: Moderator analyses indicated varying efficacy degrees for the OIC regarding decisional outcomes and expectation. Especially patients with little treatment motivation or low prior knowledge benefited from optimized information about the efficacy and possible side effects of psychotherapy. TRIAL REGISTRATION: PsychArchives (https://doi.org/10.23668/psycharchives.4929): 17.06.2021.


Assuntos
Motivação , Aliança Terapêutica , Adulto , Humanos , Consentimento Livre e Esclarecido , Psicoterapia , Pacientes
9.
J Robot Surg ; 18(1): 170, 2024 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-38598030

RESUMO

Currently, there is no specific perioperative nursing standard for RARC based on the ERAS concept. This retrospective study investigates to analyze the effect of RARC-ERAS nursing program on VTE and other clinical outcomes in patients undergoing RARC surgery. This retrospective study included 216 patients undergoing RARC surgery From January 1, 2022 to December 30, 2023, and propensity score adjustment analysis was applied. The study compares a control group receiving traditional nursing and an observation group receiving RARC-ERAS nursing program. Perioperative variables and other postoperative complications were retrieved from the hospital medical records. After propensity score matching, there were no significant differences in the demographic and clinical characteristics between the two groups (p > 0.05). The ERAS group exhibited aa significantly higher rate of postoperative unobstructed venous blood flow in the lower extremities by color Doppler ultrasound as compared to the control group (94.6% VS 80.4%, p = 0.042). Before anesthesia induction, lower preoperative anxiety and surgical information needs scores were observed in the ERAS group than in the control group (p < 0.05). Compared to the control group, the ERAS group demonstrated a shorter surgical duration, a lower incidence of perioperative hypothermia, less time needed for getting out of bed, anal exhaust, and for defecation after returning to the ward (p < 0.05). RARC-ERAS nursing program significantly increased the rate of postoperative unobstructed venous blood flow in the lower extremities by color doppler ultrasound, lower preoperative anxiety and intraoperative hypothermia in patients undergoing RARC. This nursing approach presents a valuable strategy for enhancing patient outcomes and merits further exploration in clinical practice.Trial registration:ChiCTR2400081118; http://www.chictr.org.cn , Principal investigator: Mang-mang He, Date of registration: Feb 22, 2024.


Assuntos
Hipotermia , Procedimentos Cirúrgicos Robóticos , Humanos , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/métodos , Hospitais , Pacientes
10.
BMC Health Serv Res ; 24(1): 439, 2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-38589922

RESUMO

BACKGROUND: Electronic health records (EHR) are becoming an integral part of the health system in many developed countries, though implementations and settings vary across countries. Some countries have adopted an opt-out policy, in which patients are enrolled in the EHR system following a default nudge, while others have applied an opt-in policy, where patients have to take action to opt into the system. While opt-in systems may exhibit lower levels of active user requests for access, this contrasts with opt-out systems where a notable percentage of users may passively retain access. Thus, our research endeavor aims to explore facilitators and barriers that contribute to explaining EHR usage (i.e., actively accessing the EHR system) in two countries with either an opt-in or opt-out setting, exemplified by France and Austria. METHODS: A qualitative exploratory approach using a semi-structured interview guideline was undertaken in both countries: 1) In Austria, with four homogenously composed group discussions, and 2) in France, with 19 single patient interviews. The data were collected from October 2020 to January 2021. RESULTS: Influencing factors were categorized into twelve subcategories. Patients have similar experiences in both countries with regard to all facilitating categories, for instance, the role of health providers, awareness of EHR and social norms. However, we highlighted important differences between the two systems regarding hurdles impeding EHR usage, namely, a lack of communication as well as transparency or information security about EHR. CONCLUSION: Implementing additional safeguards to enhance privacy protection and supporting patients to improve their digital ability may help to diminish the perception of EHR-induced barriers and improve patients' health and commitment in the long term. PRACTICAL IMPLICATIONS: Understanding the differences and similarities will help to develop practical implications to tackle the problem of low EHR usage rates in the long run. This problem is prevalent in countries with both types of EHR default settings.


Assuntos
Comunicação , Registros Eletrônicos de Saúde , Humanos , Áustria , Privacidade , Pacientes
13.
Georgian Med News ; (347): 113-116, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38609125

RESUMO

Children born with structural or functional defects were reported as congenital anomalies. The rate of these deficits has increasingly been reported globally with upregulated trends for unknown specific reasons. Congenital anomalies are reported as a clinical challenge for clinical settings due to handling, transportation, daycare, and staff requirements. The present study aimed to characterize such types of congenital anomalies in Tikrit governorate (Iraq). A total of 180 file records of newborn babies were allocated for those babies who have been admitted to the hospital after birth due to their requirement for help as a consequence of their diagnosis of congenital anomalies. These anomalies were counted and placed together for potential comparisons and determination of the highest percentage of them. The most common area for anomalies was the central nervous system (40%) followed by the musculoskeletal (22%), gastrointestinal system (16%), and heart (11%). The lowest proportion of congenital anomalies were those of the eye, face, ear (7%), and Skin (7%). Characterization of the frequency of anomalies and allocation of their causative factors are important to take further steps forward for the specification of the diseases and required treatments.


Assuntos
Feto , Hospitais de Ensino , Lactente , Criança , Recém-Nascido , Feminino , Gravidez , Humanos , Prevalência , Cuidado Pré-Natal , Pacientes
15.
Soins ; 69(884): 18-21, 2024 Apr.
Artigo em Francês | MEDLINE | ID: mdl-38614513

RESUMO

The maintenance and optimization of functional capacities before, during, and after treatment are major challenges for frailty persons as cancer's patients. It is now known that physical activity in prehabilitation plays a crucial role in limiting, among other things, post-operative complications. The benefits have already been demonstrated in various studies, including a decrease in hospitalization duration, an increase in cardiorespiratory endurance, improvement in quality of life, and better fatigue management. It is observed that patients who undergo prehabilitation are those who recover their preoperative capacities the fastest. However, it is estimated that only one-third of patients with access to prehabilitation improve their physical capacities.


Assuntos
Exercício Pré-Operatório , Qualidade de Vida , Humanos , Exercício Físico , Hospitalização , Pacientes
16.
Soins ; 69(884): 22-25, 2024 Apr.
Artigo em Francês | MEDLINE | ID: mdl-38614514

RESUMO

Improved recovery after surgery leads to a significant reduction in postoperative morbidity, but this is concentrated in the intra- and postoperative periods. Prehabilitation complements this, by taking charge of the pre-operative phase. Its aim is to improve pre-operative functional capacity and physical, nutritional and psychosocial status. Interdisciplinary collaboration is a key element of this integrated approach.


Assuntos
Recuperação Pós-Cirúrgica Melhorada , Exercício Pré-Operatório , Humanos , Pacientes
17.
Soins ; 69(884): 38-41, 2024 Apr.
Artigo em Francês | MEDLINE | ID: mdl-38614518

RESUMO

Undernutrition (UD) increases perioperative morbidity and mortality. Its prevention and treatment are therefore essential in surgical prehabilitation and rehabilitation programs. Nutritional treatment is individualized according to the patient's nutritional status, ingesta and protein-energy requirements. Oral nutrition is optimized to increase intakes through personalized dietary advice and oral nutritional supplements. Artificial nutrition support is indicated in cases of UD or high risk of UD before major surgery. Enteral nutrition is preferred to parenteral nutrition when the digestive tract is functional.


Assuntos
Desnutrição , Exercício Pré-Operatório , Humanos , Pacientes , Educação em Saúde , Desnutrição/prevenção & controle
18.
J Nepal Health Res Counc ; 21(3): 486-490, 2024 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-38615222

RESUMO

BACKGROUND: Facial growth and development is necessary for proper orthodontic diagnosis and treatment planning. Growth of cranial base is linked to the overall growth of facial bones, especially the maxilla and mandible. Any change in the amount and direction of growth of the cranial base can have direct or indirect effects on the developing maxilla and mandible. Thus the aim of this study was to determine the linear and angular cranial base measurements in different skeletal malocclusion in Nepalese population. METHODS: Pretreatment lateral cephalograms of 225 patients aged between 17-30 years were collected. Linear measurements Sella-Nasion (S-N), Sella-Articulare (S-Ar), Articulare-Gonion (Ar-Go), Gonion-Gnathion (Go-Gn) and angular measurements Saddle angle (N-S-Ar), Articular angle (S-Ar-Go) and Gonial angle (Ar-Go-Gn) were measured. RESULTS: In angular measurements statistically significant differences were found in the saddle and gonial angles between class I, II, and III skeletal pattern. In linear measurements, anterior and posterior cranial base lengths were not significantly different among groups however, ramal height and mandibular body length were significantly different among groups with a P value < 0.05. CONCLUSIONS: Skeletal class III has a larger gonial angle, ramal height and mandibular length. Males have larger linear measurements and females have larger angular measurements.


Assuntos
Má Oclusão , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Má Oclusão/diagnóstico por imagem , Nepal , Pacientes , Base do Crânio/diagnóstico por imagem , População do Sul da Ásia
20.
JAMA Netw Open ; 7(4): e247021, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38630479

RESUMO

This cohort study compares measures of referral vs receipt in evaluating social resource platform outcomes among patients with health-related social needs.


Assuntos
Pacientes , Serviço Social , Humanos , Encaminhamento e Consulta
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