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1.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1359570

RESUMO

Objetivo: descrever as percepções dos profissionais da saúde sobre a presença do acompanhante no processo do nascimento. Método: estudo descritivo, qualitativo, realizado em um hospital escola, com 29 profissionais da saúde. A coleta de dados foi realizada por meio de entrevistas, entre maio a julho de 2018, sendo analisadas com abordagem baseada no Discurso do Sujeito Coletivo. Resultados: após análise emergiram quatro Ideias Centrais: experiências positivas e a participação do acompanhante, o ambiente desconhecido gera sentimento de insegurança no acompanhante, a presença do acompanhante causa desconforto na equipe de saúde e o profissional barra o acompanhante pela presunção de que ele irá atrapalhar. Conclusão: as percepções dos profissionais se mostraram conflitantes, sendo que alguns percebem a importância e os benefícios do acompanhante no nascimento, e outros apontaram que ele atrapalha a equipe de saúde, pela ansiedade e estresse, prejudicando a equipe de saúde e interferindo de maneira negativa


Objective: to describe the perceptions of health professionals about the presence of a companion in the birth process. Method: a descriptive, qualitative study, carried out in a teaching hospital, with 29 health professionals. Data collection was carried out through interviews, between May and July 2018, being analyzed using an approach based on the Collective Subject Discourse. Results:after analysis, four Central Ideas emerged: positive experiences and the companion's participation, the unknown environment generates feelings of insecurity in the companion, the presence of the companion causes discomfort in the health team and the professional stops the companion due to the presumption that it will hinder. Conclusion: the perceptions of the professionals were conflicting, with some perceiving the importance and benefits of the companion at birth, and others pointed out that it disturbs the health team, due to anxiety and stress, harming the health team and interfering in a negative way


Objetivo: describir las percepciones de los profesionales de la salud sobre la presencia de un acompañante en el proceso del parto. Método: estudio descriptivo, cualitativo, realizado en un hospital universitario, con 29 profesionales de la salud. La recolección de datos se realizó a través de entrevistas, entre mayo y julio de 2018, siendo analizadas con un enfoque basado en el Discurso Colectivo del Sujeto. Resultados: luego del análisis surgieron cuatro Ideas Centrales: experiencias positivas y la participación del acompañante, el entorno desconocido genera sentimientos de inseguridad en el acompañante, la presencia del acompañante provoca malestar en el equipo de salud y el profesional detiene al acompañante por presunción de que dificultará. Conclusión: las percepciones de los profesionales fueron conflictivas, algunos percibieron la importancia y los beneficios del acompañante al nacer, y otros señalaron que perturba al equipo de salud, por ansiedad y estrés, perjudicando al equipo de salud e interfiriendo de manera negativa


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente/tendências , Parto Humanizado , Acompanhantes Formais em Exames Físicos/tendências , Relações Hospital-Paciente , Pesquisa Qualitativa , Hospitais de Ensino
2.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1395377

RESUMO

Objetivo: Descrever a avaliação de pessoas privadas de liberdade sobre a assistência de enfermagem recebida no ambiente hospitalar. Métodos: Pesquisa qualitativa realizada em unidades de clínica médica e cirúrgica de três hospitais públicos, de capitais da região Nordeste do Brasil, referência em atendimento de urgência e emergência. A partir da aplicação técnica de exaustão, a amostra foi composta por 17 custodiados, do sexo masculino, em internação hospitalar. Para a coleta de dados, utilizou-se entrevistas semiestruturadas. Submeteu-se os dados à metodologia da análise de conteúdo proposta por Bardin. Resultados: Emergiram três categorias de análise: Percepção sobre o cuidado, Protocolo de segurança e Direitos das pessoas privadas de liberdade. Os sujeitos relataram insatisfação na garantia dos seus direitos, especificamente quando se referem à autorização de visitas; descrevem a realização de cuidados com distinção e preconceitos evidentes e reconhecem que o uso da algema e a presença do policial penal geram uma atmosfera de medo entre os profissionais e os demais pacientes na ala hospitalar. Conclusão: A avaliação sobre a prática assistencial hospitalar é positiva embora seja evidente a necessidade de refletir sobre a (re)organização do processo de trabalho, afinal a qualidade da assistência de enfermagem não se refere exclusivamente a habilidades técnicas. (AU)


Objective: To describe the assessment of people deprived of liberty on the nursing care received in the hospital environment. Methods: Qualitative research carried out in medical and surgical clinic units of three public hospitals, in capitals of the Northeast region of Brazil, reference in urgent and emergency care. From the technical application of exhaustion, the sample consisted of 17 male custodians in hospital. For data collection, semi-structured interviews were used. Data were submitted to the content analysis methodology proposed by Bardin. Results: Three categories of analysis emerged: Perception of care, Safety protocol and people deprived of liberty rights. The subjects reported dissatisfaction with the guarantee of their rights, specifically when referring to authorization for visits; describe the performance of care with distinction and evident prejudices and recognize that the use of handcuffs and the presence of the criminal policeman generate an atmosphere of fear among professionals and other patients in the hospital wing. Conclusion: The assessment of hospital care practice is positive, although the need to reflect on the (re)organization of the work process is evident, after all, the quality of nursing care does not refer exclusively to technical skills. (AU)


Objetivo: Describir la valoración de las personas privadas de libertad sobre los cuidados de enfermería recibidos en el ámbito hospitalario. Métodos: Investigación cualitativa realizada en unidades clínicas médico-quirúrgicas de tres hospitales públicos, en capitales de la región Nordeste de Brasil, referencia en atención urgente y de emergencia. A partir de la aplicación técnica del agotamiento, la muestra estuvo compuesta por 17 custodios masculinos en el hospital. Para la recolección de datos se utilizaron entrevistas semiestructuradas. Los datos fueron sometidos a la metodología de análisis de contenido propuesta por Bardin. Resultados: Surgieron tres categorías de análisis: Percepción del cuidado, Protocolo de seguridad y Derechos de las personas privadas de libertad. Los sujetos informaron descontento con la garantía de sus derechos, específicamente al referirse a la autorización de visitas; describir el desempeño de la atención con distinción y prejuicios evidentes y reconocer que el uso de esposas y la presencia del policía criminal generan un ambiente de miedo entre los profesionales y otros pacientes en el ala del hospital. Conclusion: La valoración de la práctica asistencial hospitalaria es positiva, si bien es evidente la necesidad de reflexionar sobre la (re) organización del proceso de trabajo, al fin y al cabo, la calidad de la atención de enfermería no se refiere exclusivamente a las habilidades técnicas. (AU)


Assuntos
Prisioneiros , Relações Hospital-Paciente , Cuidados de Enfermagem
3.
Enferm. glob ; 20(61): 361-376, ene. 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-201467

RESUMO

OBJETIVO: Determinar el nivel de comunicación terapéutica del profesional de enfermería desde la perspectiva de las personas hospitalizadas en el servicio de medicina del Hospital General Jaén, Perú. MATERIAL Y MÉTODO: Estudio cuantitativo, nivel descriptivo; observacional, prospectivo, transversal, análisis estadístico univariado, muestra constituida por 122 personas hospitalizadas, se utilizó como instrumento el "Cuestionario de la comunicación terapéutica" elaborado por Lourdes Guevara Chuquillanqui, con validez por juicio de expertos fue VC = 2.2 > VT = 1.6449 y una confiabilidad de 0.92. RESULTADOS: El 100% (122) de las personas hospitalizadas; 71.3% (87) percibió una comunicación terapéutica de nivel bajo y el 28.7% (35) nivel medio. Según las dimensiones: en empatía el 70.5% (86) percibió una comunicación terapéutica de nivel bajo, el 27% (33) nivel medio y 2.5% (3) nivel alto, en la dimensión respeto el 54.9% (67) percibió una comunicación terapéutica un nivel bajo, el 42.6% (52) un nivel medio y el 2.5% (3) nivel alto, en la dimensión escucha receptiva el 54.9% (67) percibió una comunicación terapéutica de nivel bajo y el 45.1% (55) nivel medio, en la dimensión emociones del paciente el 57.4% (70) percibió una comunicación terapéutica de nivel bajo, el 34.4% (42) nivel medio y el 8.2% (10) nivel alto, en la dimensión acompañamiento en su reflexión el 68% (83) percibió una comunicación terapéutica de nivel bajo, el 68% (83) nivel bajo, el 25.4% (31) nivel medio y 6.6% (8) nivel alto. CONCLUSIONES: La percepción de comunicación terapéutica de las personas hospitalizadas fue de nivel bajo a medio


OBJECTIVE: Determine the level of therapeutic communication professional nursing from the perspective of people hospitalized in the Internal Medicine Service of the General Hospital Jaén, Peru. MATERIAL AND METHOD: Research quantitative, descriptive level; an observational, prospective and cross-sectional study, univariate statistical analysis. The sample was composed of 122 people hospitalized, It was used as an instrument of the "therapeutic communication Questionnaire" developed by Lourdes Guevara Chuquillanqui, which was validated by expert judgement as VC = 2.2 > VT = 1.6449 and a reliability of 0.92. RESULTS: 100% (122) of persons hospitalized; 71.3% (87) perceived a therapeutic communication of low level and the 28.7% (35) medium level. According to the dimensions: In empathy 86 (70.5%) perceived a therapeutic communication of low level, the 27% (33) Medium level and 2.5% (3) high level, in the respect dimension 67 (54.9%) perceived a therapeutic communication a low level, the 42.6% (52) a medium level and 2.5% (3) high level, in the dimension receptive listening 67 (54.9%) perceived a therapeutic communication of low level and the 45.1% (55) medium level, in the emotions of the patient 70 (57.4%) perceived a therapeutic communication of low level, the 34.4% (42) Medium level and 8.2% (10) high level, in the dimension accompanying upon their reflection the 68%. (83) earned a therapeutic communication of low level, the 68% (83) low level, 25.4% (31) Medium level and 6.6% (8) high level. CONCLUSIONS: In conclusion the perception of therapeutic communication of persons hospitalized was of low to medium level


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Comunicação em Saúde/classificação , Informação de Saúde ao Consumidor/classificação , Relações Enfermeiro-Paciente , Cuidados de Enfermagem/classificação , Peru/epidemiologia , Pacientes Internados/estatística & dados numéricos , Estudos Prospectivos , Satisfação do Paciente/estatística & dados numéricos , Relações Hospital-Paciente
4.
Rev. chil. fonoaudiol. (En línea) ; 19: 1-9, nov. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1148401

RESUMO

La enfermedad COVID-19 fue declarada pandemia por la Organización Mundial de la Salud. Su presentación más severa genera una condición que requiere tratamiento en unidades de cuidados intensivos, condición que al prolongarse en el tiempo requiere la implementación de una traqueostomía para facilitar la entrega de soporte ventilatorio invasivo. Si bien este dispositivo posee importantes ventajas que favorecen la recuperación y rehabilitación, también es cierto que genera diversas complicaciones en la comunicación de las personas, condición que se suma a los efectos propios del COVID-19 y la frecuente historia de intubación endotraqueal previa. El objetivo de este artículo es proveer orientaciones y herramientas clínicas para el tratamiento de la fonación para la comunicación en personas con traqueostomía y COVID-19. Se considera para ello las recomendaciones de la literatura existentes a la fecha, bajo un análisis pragmático y basado en nuestra experiencia de atender a más de 561 personas con esta condición. Se exponen las características de la comunicación en esta población, su tratamiento, consideraciones para el uso de técnicas específicas y orientaciones para la mejora de la calidad de vida. Siempre con un enfoque orientado al cuidado y protección de las/os usuarias/os y el equipo de salud, en particular fonoaudiólogas y fonoaudiólogos del país.


The COVID-19 disease was declared a pandemic by the World Health Organization. When most severe, it generates a condition that requires treatment in intensive care units, which, when extended in time, requires implementing of a tracheostomy to facilitate invasive ventilatory support. Although ventilatory support has important advantages that favor recovery and rehabilitation, it generates various complications for patients' communication, a condition that adds to the effects of COVID-19 and the frequent history of previous endotracheal intubation. The aim of this article is to provide guidance and clinical tools for the treatment of phonation to facilitate communication in people with tracheostomy and COVID-19. For this, the recommendations of the existing available literature are considered, under a pragmatic analysis and based on our experience of treating more than 561 infected patients. The characteristics of communication in this population, its treatment, considerations for the use of specific techniques and guidelines to improve quality of life are exposed. Always with an approach oriented to the care and protection of users and the health team, in particular speech-language pathologists in the country.


Assuntos
Humanos , Pneumonia Viral/cirurgia , Traqueostomia/efeitos adversos , Distúrbios da Voz/etiologia , Infecções por Coronavirus/cirurgia , Transtornos da Comunicação/etiologia , Fonoaudiologia/normas , Fonação , Pneumonia Viral/complicações , Pneumonia Viral/reabilitação , Qualidade de Vida , Relações Hospital-Paciente , Distúrbios da Voz/reabilitação , Infecções por Coronavirus/complicações , Infecções por Coronavirus/reabilitação , Comunicação , Transtornos da Comunicação/reabilitação , Cuidados Críticos , Fonoaudiologia/métodos , Pandemias , Betacoronavirus , Intubação Intratraqueal
7.
PLoS One ; 14(12): e0224899, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31805061

RESUMO

PURPOSE: To understand how different methodologies of qualitative research are able to capture patient experience of the hospital journey. METHODS: A qualitative study of orthopaedic patients admitted for hip and knee replacement surgery in a 250-bed university hospital was performed. Eight patients were shadowed from the time they entered the hospital to the time of transfer to rehabilitation. Four patients and sixteen professionals, including orthopaedists, head nurses, nurses and administrative staff, were interviewed. RESULTS: Through analysis of the data collected four main themes emerged: the information gap; the covering patient-professionals relationship; the effectiveness of family closeness; and the micro-integration of hospital services. The three different standpoints (patient shadowing, health professionals' interviews and patients' interviews) allowed different issues to be captured in the various phases of the journey. CONCLUSIONS: Hospitals can significantly improve the quality of the service provided by exploring and understanding the individual patient journey. When dealing with a key cross-functional business process, the time-space dynamics of the activities performed have to be considered. Further research in the academic field can explore practical, methodological and ethical challenges more deeply in capturing the whole patient journey experience by using multiple methods and integrated tools.


Assuntos
Relações Hospital-Paciente , Hospitalização , Pacientes/psicologia , Idoso , Atitude Frente a Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Assistência ao Paciente , Qualidade da Assistência à Saúde
8.
BMJ Open ; 9(7): e022212, 2019 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-31320339

RESUMO

OBJECTIVES: To report on women's and families' expectations and experiences of hospital postnatal care, and also to reflect on women's satisfaction with hospital postnatal care and to relate their expectations to their actual care experiences. DESIGN: Systematic review. SETTING: UK. PARTICIPANTS: Postnatal women. PRIMARY AND SECONDARY OUTCOMES: Women's and families' expectations, experiences and satisfaction with hospital postnatal care. METHODS: Embase, MEDLINE, PsycINFO, Applied Social Sciences Index and Abstracts, Cumulative Index to Nursing and Allied Health (CINAHL Plus), Science Citation Index, and Social Sciences Citation Index were searched to identify relevant studies published since 1970. We incorporated findings from qualitative, quantitative and mixed-methods studies. Eligible studies were independently screened and quality-assessed using a modified version of the National Institutes of Health Quality Assessment Tool for quantitative studies and the Critical Appraisal Skills Programme for qualitative studies. Data were extracted on participants' characteristics, study period, setting, study objective and study specified outcomes, in addition to the summary of results. RESULTS: Data were included from 53 studies, of which 28 were quantitative, 19 were qualitative and 6 were mixed-methods studies. The methodological quality of the included studies was mixed, and only three were completely free from bias. Women were generally satisfied with their hospital postnatal care but were critical of staff interaction, the ward environment and infant feeding support. Ethnic minority women were more critical of hospital postnatal care than white women. Although duration of postnatal stay has declined over time, women were generally happy with this aspect of their care. There was limited evidence regarding women's expectations of postnatal care, families' experience and social disadvantage. CONCLUSION: Women were generally positive about their experiences of hospital postnatal care, but improvements could still be made. Individualised, flexible models of postnatal care should be evaluated and implemented. PROSPERO REGISTRATION NUMBER: CRD42017057913.


Assuntos
Satisfação do Paciente , Cuidado Pós-Natal/psicologia , Qualidade da Assistência à Saúde , Feminino , Ambiente de Instituições de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Relações Hospital-Paciente , Humanos , Unidade Hospitalar de Ginecologia e Obstetrícia , Gravidez , Pesquisa Qualitativa , Reino Unido
9.
Artigo em Inglês | MEDLINE | ID: mdl-30923263

RESUMO

Digitally engaging patients in their care processes was for many years limited to sharing care related documents (e.g. laboratory or radiology findings, discharge letters) with them through personal electronic health records. Newer concepts have led to the establishment of patient portals as patient frontends to a hospitals electronic health record. Rarely however have complete patient pathways with pre-hospitalization, inpatient stay and post-hospitalization been evaluated to identify chains of communication processes involving clinical care scenarios, as well as subsequent home monitoring scenarios. Neither have such approaches been integrated with digital communication processes related to a patients engagement in medical research projects. In order to enhance hospital-patient relationships in a holistic manner, we hypothesize that an integrated environment (e.g. patient portal) supporting shared decision making and communication in a patient´s care situation and in the same time providing communication processes for patient research engagement will optimize the patient-hospital relationship and be supportive in binding a patient to this care providing institution.


Assuntos
Registros Eletrônicos de Saúde , Relações Hospital-Paciente , Pacientes Internados , Alta do Paciente , Portais do Paciente , Comunicação , Humanos
10.
Eur Radiol ; 29(10): 5395-5402, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30903338

RESUMO

OBJECTIVE: To determine the frequency, nature (using standardized coding taxonomy), and temporal trends of patient complaints about the radiological service provided in a European tertiary care center. METHODS: This retrospective study included all written patient complaints received by the department of radiology of a European tertiary care center within a 9-year period. RESULTS: A total of 94 written patient complaints were included. Overall complaint frequency was 14.4 per 100,000 radiological procedures. Complaint frequencies per 100,000 procedures were 103.7 for interventional radiology, 13.9 for MRI, 6.9 for ultrasonography, 6.5 for CT, 4.5 for fluoroscopy, and 1.2 for conventional radiography. Interventional radiology received significantly more complaints than all other radiological procedures (p < 0.001), and cross-sectional imaging (CT, MRI, and ultrasonography) received significantly more complaints than conventional radiography (p < 0.001). Fifty-three (56.4%) complaints belonged to the clinical domain, 22 (23.4%) to the relationships domain, and 19 (20.2%) to the management domain. Quality (34.0%), safety (22.3%), timing and access (18.1%), and communication (18.1%) constituted almost all complaint categories. Patient journey (19.1%), delays (18.1%), communication breakdown (16.0%), errors in diagnosis (11.7%), quality of care (9.6%), treatment (6.4%), and staff attitudes (2.1%) constituted almost all complaint subcategories. Annual frequency of complaints decreased over time (Mann-Kendall tau = - 0.429), although not significantly (p = 0.174). CONCLUSION: Written patient complaints directed to a department of radiology at a European tertiary care center are relatively few in number and have not shown a temporal increase. Knowledge of sources of patient dissatisfaction may help to reduce the number of patient complaints and improve patient care. KEY POINTS: • Approximately 14.4 written patient complaints per 100,000 radiological procedures are filed in a European tertiary care center, and they have not increased over a 9-year period. • Written patient complaints most frequently involve interventional radiology, and the main complaint categories are quality (34.0%), safety (22.3%), timing and access (18.1%), and communication (18.1%). • Knowledge of the nature of and circumstances under which patient complaints arise may reduce their number and improve patient care.


Assuntos
Satisfação do Paciente/estatística & dados numéricos , Radiologia/normas , Centros de Atenção Terciária/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Comunicação , Feminino , Relações Hospital-Paciente , Humanos , Lactente , Imageamento por Ressonância Magnética/normas , Imageamento por Ressonância Magnética/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Países Baixos , Assistência Centrada no Paciente/normas , Assistência Centrada no Paciente/estatística & dados numéricos , Radiologia/estatística & dados numéricos , Serviço Hospitalar de Radiologia/normas , Serviço Hospitalar de Radiologia/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Tempo , Tomografia Computadorizada por Raios X/normas , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Ultrassonografia/normas , Ultrassonografia/estatística & dados numéricos , Adulto Jovem
11.
BMJ Open ; 8(11): e023792, 2019 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-30798293

RESUMO

OBJECTIVE: Engaging bereaved parents in the review process that examines their care before and after a perinatal death might help parents deal with their grief more effectively and drive improvements in patient safety. The objective of this study is to explore whether healthcare professionals would accept or support parent engagement in the perinatal mortality review process. DESIGN: Qualitative focus group interviews. Transcripts were analysed with an inductive thematic approach. SETTING: Two geographically distinct tertiary maternity hospitals in the UK. PARTICIPANTS: Five focus groups were conducted with clinical staff including midwives, obstetricians, neonatologists, nursing staff and chaplaincy services. RESULTS: Twenty-seven healthcare professionals unanimously agreed that parents' involvement in the perinatal mortality review process is useful and necessary. Six key themes emerged including: parental engagement; need for formal follow-up; critical structure of perinatal mortality review meeting; coordination and streamlining of care; advocacy for parents including role of the bereavement care lead; and requirement for training and support for staff to enable parental engagement. CONCLUSIONS: Healthcare professionals strongly advocated engaging bereaved parents in the perinatal mortality review: empowering parents to ask questions, providing feedback on care, helping generate lessons and providing them with the opportunity to discuss a summary of the review conclusions with their primary healthcare professional contact. The participants agreed it is time to move on from 'a group of doctors reviewing notes' to active learning and improvement together with parents, to enable better care and prevention of perinatal death.


Assuntos
Atitude do Pessoal de Saúde , Luto , Pais , Participação do Paciente , Morte Perinatal/prevenção & controle , Mortalidade Perinatal , Adulto , Comunicação , Feminino , Grupos Focais , Pessoal de Saúde/educação , Cuidados Paliativos na Terminalidade da Vida , Relações Hospital-Paciente , Maternidades , Humanos , Recém-Nascido , Entrevistas como Assunto , Masculino , Satisfação do Paciente , Relações Médico-Paciente , Gravidez , Pesquisa Qualitativa , Inquéritos e Questionários , Reino Unido
12.
Support Care Cancer ; 27(1): 199-208, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29931489

RESUMO

PURPOSE: Regular exercise is recommended to mitigate the adverse effects of androgen deprivation therapy in men with prostate cancer. The purpose of this study was to explore the experience of transition to unsupervised, community-based exercise among men who had participated in a hospital-based supervised exercise programme in order to propose components that supported transition to unsupervised exercise. METHODS: Participants were selected by means of purposive, criteria-based sampling. Men undergoing androgen deprivation therapy who had completed a 12-week hospital-based, supervised, group exercise intervention were invited to participate. The programme involved aerobic and resistance training using machines and included a structured transition to a community-based fitness centre. Data were collected by means of semi-structured focus group interviews and analysed using thematic analysis. RESULTS: Five focus group interviews were conducted with a total of 29 men, of whom 25 reported to have continued to exercise at community-based facilities. Three thematic categories emerged: Development and practice of new skills; Establishing social relationships; and Familiarising with bodily well-being. These were combined into an overarching theme: From learning to doing. Components suggested to support transition were as follows: a structured transition involving supervised exercise sessions at a community-based facility; strategies to facilitate peer support; transferable tools including an individual exercise chart; and access to 'check-ups' by qualified exercise specialists. CONCLUSIONS: Hospital-based, supervised exercise provides a safe learning environment. Transferring to community-based exercise can be experienced as a confrontation with the real world and can be eased through securing a structured transition, having transferable tools, sustained peer support and monitoring.


Assuntos
Terapia por Exercício/organização & administração , Relações Hospital-Paciente , Cooperação do Paciente/estatística & dados numéricos , Transferência de Pacientes , Neoplasias da Próstata/terapia , Autocuidado , Idoso , Antagonistas de Androgênios/uso terapêutico , Atitude Frente a Saúde , Terapia Combinada , Dinamarca/epidemiologia , Terapia por Exercício/métodos , Terapia por Exercício/psicologia , Grupos Focais , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente/psicologia , Transferência de Pacientes/métodos , Transferência de Pacientes/organização & administração , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/psicologia , Qualidade de Vida , Treinamento de Força , Autocuidado/métodos , Autocuidado/psicologia
13.
Rev. chil. salud pública ; 23(1): 49-59, 2019.
Artigo em Espanhol | LILACS | ID: biblio-1371859

RESUMO

La violencia en los centros de salud, que históricamente afectaba a algunos puestos de trabajo, actualmente es generalizada. La alta exposición de los trabajadores a agresiones repercute negativamente en su seguridad y salud. OBJETIVO: Describir la violencia percibida por los trabajadores de la salud de parte de los usuarios del Servicio de Salud Talcahuano en Lirquén, Chile. MÉTODOS: Se realizó en 2017 un estudio descriptivo transversal, en lo cual participaron 155 trabajadores de dos centros de salud pertenecientes al Servicio de Salud Talcahuano. Los participantes, quienes dieron su consentimiento informado, contestaron un instrumento validado, de autoaplicación, anónimo y confidencial. El análisis se presenta con tablas de distribución, promedios y datos de dispersión. RESULTADOS: Se encontró que el 70,3% de los trabajadores reporta haber sufrido violencia por parte de los usuarios, tratándose en el 85,3% de violencia verbal. Los más afectados son médicos, odontólogos y enfermeros. Los actos de violencia ocurrieron preferentemente en la mañana, durante la espera de su hora o en medio de una atención sanitaria. Las principales causas identificadas fueron el tiempo de espera y la salud mental del usuario. El perfil del agresor corresponde a un paciente adulto sin distinción de sexo. Finalmente, sólo el 9,2% de las agresiones se notificó formalmente; un 30% de los trabajadores considera que el registro es inútil, y un 72,5% considera que la frecuencia de la violencia se mantiene igual o va en aumento. CONCLUSIONES: La violencia de los usuarios afecta a la mayoría de los trabajadores de la salud. Existe mínima notificación formal y escaso registro de las agresiones. Es necesario capacitar a los trabajadores para prevenir y manejar las agresiones.


INTRODUCTION: Violence in health centers, which historically affected only a few occupations, is now widespread. The prevalent exposure of workers to aggressions has a negative impact on their safety and health. OBJECTIVE: To describe user violence perceived by health workers of the Talcahuano Health Service in Lirquén, Chile. METHODS. A cross-sectional descriptive study was conducted, with 155 participants who were workers in two health centers, belonging to the Talcahuano Health Service, in 2017. After going through an informed consent process, participants answered a validated, self-applied, anonymous, and confidential instrument. Analysis is presented with distribution tables, averages, and dispersion data. RESULTS: It was found that 70.3% of workers reported having suffered violence by users, and that 85.3% of that violence was verbal. The most affected workers were doctors, dentists, and nurses. The acts of violence occurred tended to occur in the morning, while users waited to be seen or during their appointment; the main causes were wait time and the users' mental health. The aggressors were adult users, of both sexes. Finally, only 9.2% of the attacks were formally reported; 30% of the workers believe that registering the violence is useless; and 72.5% consider that the amount of violence remains the same or is increasing. CONCLUSIONS: User violence affects the majority of health workers. There is minimal formal notification and scarce registration of the aggressions. Workers should be trained to prevent and address these aggressions.


Assuntos
Humanos , Masculino , Feminino , Relações Profissional-Paciente , Pessoal de Saúde/psicologia , Violência no Trabalho/psicologia , Violência no Trabalho/estatística & dados numéricos , Percepção , Violência/psicologia , Violência/estatística & dados numéricos , Visitas a Pacientes , Relações Hospital-Paciente , Chile , Estudos Transversais , Distribuição por Sexo , Agressão/psicologia , Serviços de Saúde
14.
Metas enferm ; 21(8): 67-74, oct. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-172717

RESUMO

OBJETIVO: conocer la opinión de los acompañantes de los pacientes y de profesionales implicados en la atención respecto a las preferencias sobre la visita y acompañamiento en el Servicio de Urgencias Hospitalario. MÉTODO: estudio descriptivo transversal, que se llevó a cabo en el Servicio de Urgencias del Hospital San Eloy, en Barakaldo (Bizkaia). Los sujetos de estudio fueron los acompañantes del paciente que acudía a urgencias del hospital y los profesionales que trabajaban en el servicio. Se diseñó una encuesta para acompañantes con 13 ítems y otra para profesionales con nueve ítems. Se realizó análisis descriptivo. RESULTADOS: participaron 48 profesionales y 150 acompañantes. Acompañantes: mujeres (70,67%), la relación con el paciente fue hija/o (40,67%). Profesionales: médico adjunto (31,25%) y enfermera (27,08%), experiencia en urgencias superior a 10 años (50%). El 42,7% de los sujetos percibió la información como buena, estando un 88,7% muy satisfecho. La opción de presenciar procedimientos de urgencias fue evaluada como buena en un 42,7%. La participación en el cuidado se valoró como buena en el 42% de los casos, eligiéndose la estancia intermitente como mejor opción de visita (77,1%). La mayoría de los profesionales encuestados afirmó que la presencia familiar condicionaba su forma de trabajar. CONCLUSIONES: los acompañantes desean estar con el enfermo el mayor tiempo posible, están dispuestos a colaborar en el cuidado, respetan el trabajo profesional y aceptan abandonar la zona asistencial cuando se les solicita. Están satisfechos con el trato, aunque aprecian déficit de información. En general, apoyan la existencia de normas que regulen las visitas. El profesional valora positivamente dichas normas y la idea de colaboración por parte del acompañante


OBJECTIVE: to understand the opinion by persons accompanying patients and professionals involved in care regarding their preferences on visits and accompanying at the Hospital Emergency Unit. METHOD: a descriptive cross-sectional study, conducted at the Emergency Unit of the Hospital San Eloy, in Barakaldo (Bizkaia). The study subjects were those persons accompanying patients attending the Hospital Emergency Unit, and those professionals working in said unit. A survey with 13 items was designed for accompanying persons, and another survey with 9 items for professionals. A descriptive analysis was conducted. RESULTS: the study included 48 professionals and 150 accompanying persons; of these, 70.67% were women, and patients were their parents (40,67%). In the group of professionals: hospital specialists (31.25%) and nurses (27.08%), with > 10-year experience in the ER (50%). There was a perception of information as Good by 42.7% of the subjects, and 88.7% were Very Satisfied. The option of being present during Emergency procedures was evaluated as Good by 42.7% of participants; involvement in care was considered Good in 42% of cases, and Intermittent Stay was selected as the best option for visits (77.1%). The majority of professionals taking part in the survey stated that the presence of relatives had an impact on the way they worked. CONCLUSIONS: accompanying persons wish to stay with the patient as long as possible, they are willing to collaborate in care, they respect professional work, and accept leaving the care area when requested. They are satisfied with the way they are treated, though they notice there is lack of information. Overall, they support the implementation of rules regulating visits. Professionals have a positive evaluation of rules and of the idea of collaboration by accompanying persons


Assuntos
Humanos , Acompanhantes Formais em Exames Físicos/normas , Serviço Hospitalar de Emergência/normas , Sistemas de Informação Hospitalar/tendências , Relações Profissional-Família , Relações Hospital-Paciente , Cuidadores/normas , Estudos Transversais , Pesquisas sobre Atenção à Saúde/estatística & dados numéricos
15.
Med. paliat ; 25(3): 191-194, jul.-sept. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-180339

RESUMO

ANTECEDENTES Y OBJETIVO: La experiencia de una enfermedad avanzada genera malestar emocional en los pacientes y familiares. El objetivo del trabajo consiste en valorar un procedimiento de evaluación del malestar emocional del binomio paciente-cuidador en una UCP-HA de reciente creación, como un primer paso para reducirlo en la medida de lo posible. Sujetos y MÉTODO: Se realizó un muestreo de conveniencia entre noviembre de 2015 y marzo de 2016. Fueron entrevistados 25 pacientes utilizando el índice de Barthel, el Cuestionario de Evaluación de Síntomas Edmonton y el Cuestionario de Detección del Malestar Emocional. Fueron evaluados 25 cuidadores mediante la Escala Hospitalaria de Ansiedad y Depresión y la Escala Zarit reducida. RESULTADOS: Se pudo evaluar al 37% de los pacientes y cuidadores ingresados en la UCP durante el periodo de estudio. Existe un alto nivel de malestar emocional en el 88% de los pacientes. En los cuidadores evaluados aparecen niveles altos de ansiedad y se observa sobrecarga del cuidador en el 80% según la Escala Zarit reducida. CONCLUSIÓN: A pesar de las dificultades que conlleva evaluar a los pacientes con enfermedad avanzada y sus cuidadores, consideramos que estos procedimientos contribuyen a detectar el sufrimiento y promover su bienestar


BACKGROUND AND OBJECTIVE: The experience of an advanced disease causes emotional distress in patients and relatives. The objective of this paper is to assess a process of evaluation of emotional distress of both patients and caregivers in a recently created Palliative Care Unit of a General Hospital, as a first step towards reducing it as far as possible. Subjects and METHODS: A convenience sampling was used, from November 2015 to 2016 March. A total of 25 patients were interviewed using the Barthel Index, the Edmonton Symptom Assessment System and the questionnaire of Detection of Emotional Distress. Also 25 caregivers were interviewed using the Hospital Anxiety and Depression Score and the reduced Zarit Scale. RESULTS: 37% of patients and caregivers admitted in the Palliative Care Unit during the period of study could be evaluated. A high level of emotional distress was detected among 88% of PATIENTS: Caregivers were observed to have high levels of anxiety and burden was detected in 80% according to the reduced Zarit Scale. CONCLUSIONS: Despite the difficulties involved in evaluating patients with advanced disease and their caregivers, we think these procedures contribute to detecting suffering and to promoting their wellness


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Emoções Manifestas , Cuidados Paliativos/psicologia , Hospitais Gerais/estatística & dados numéricos , Projetos Piloto , Relações Profissional-Paciente , Cuidadores/psicologia , Relações Profissional-Família , Relações Hospital-Paciente , Transtornos de Ansiedade , Escala Fujita-Pearson
16.
Metas enferm ; 21(3): 19-26, abr. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-172673

RESUMO

OBJETIVO: evaluar la calidad de los cuidados realizados en la Unidad de Cuidados Intensivos Pediátrica (UCIP) desde la perspectiva de los familiares de los pacientes. MÉTODO: estudio transversal llevado a cabo en la UCIP del Hospital Clínico Universitario de Santiago de Compostela (A Coruña), entre el 01/01/2016 y el 25/01/2017. Se invitó a participar a los familiares de los niños que fueron dados de alta de la UCIP en ese periodo, solicitando que cumplimentaran el cuestionario EMPATHIC-30, que consta de 30 ítems distribuidos en cinco dimensiones. Se excluyeron los ingresos de menos de 24 horas, los fallecidos, los ingresos previos en los últimos seis meses y los casos de desconocimiento del idioma. Se entregaron un total de 308 encuestas. Se llevó a cabo un análisis descriptivo. Los datos se presentaron con media y desviación estándar (DE). RESULTADOS: se recogieron 181 encuestas (58,8% de los casos posibles). El 63,5% fue cumplimentada por madres, el 26% fue un ingreso superior a siete días, el 32% traslados desde otro hospital y el 30,4% ingresos programados. Sobre una puntuación de 5, la media (DE) de satisfacción de los progenitores fue 4,5 (0,6). Respecto a las distintas dimensiones del cuestionario: organización de la unidad 4,7 (0,5), actitud de los profesionales 4,6 (0,7), cuidados y tratamiento 4,5 (0,7), información 4,4 (0,8) y participación familiar 4,3 (0,8). Los ítems peor valorados fueron el interés del personal por las preocupaciones de los padres 3,9 (1,2) y la participación de los progenitores en la toma de decisiones 3,9 (1,2). CONCLUSIONES: los progenitores de los niños ingresados en la UCIP valoran de forma muy positiva la calidad de los cuidados y la atención llevada a cabo por los profesionales. Sin embargo, se debería mejorar la actitud y empatía de los profesionales, además de fomentar la participación de la familia en los procesos de toma de decisiones


OBJECTIVES: to assess the quality of care offered at the Paediatric Intensive Care Unit (PICU) from the perspective of patient's relatives. METHOD: a transversal study conducted at the PICU of the Hospital Clínico Universitario de Santiago de Compostela (A Coruña), between January, 1st, 2016 and January, 25th, 2017. The relatives of children discharged from the PICU within this period were invited to take part, and they were requested to complete the EMPATHIC-30 questionnaire, which consists in 30 items distributed into five dimensions. The study excluded hospitalizations < 24 hours, deaths, previous admissions in the past six months, and those cases with lack of knowledge of the language. Overall, 308 surveys were handed out. There was a descriptive analysis, and data were presented with mean and standard deviation (SD). RESULTS: there was a collection of 181 surveys (58.8% of all likely cases); of these, 63.5% were completed by mothers, and 26% were for hospitalizations >7 days, 32% were referrals from other hospitals, and 30.4% were scheduled hospitalizations. On a 5 score, the mean (SD) satisfaction of parents was 4.5 (0.6). Regarding the different dimensions in the questionnaire, the scores were: unit organization: 4.7 (0.5), attitude of professionals: 4.6 (0.7), care and treatment: 4.5 (0.7), information: 4.4 (0.8), and family involvement: 4.3 (0.8). The worse rated items were: Interest by the staff for parents' concerns: 3.9 (1.2), and parents' involvement in decision making: 3.9 (1.2). CONCLUSIONS: parents of children admitted in the PICU rate very positively the quality of care conducted by professionals. However, there should be an improvement in the attitude and empathy by professionals, and family involvement should be encouraged in terms of decision making processes


Assuntos
Humanos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Terapia Intensiva Neonatal/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Unidades de Terapia Intensiva Neonatal/organização & administração , Relações Hospital-Paciente , Relações Profissional-Família , Empatia , Tomada de Decisões , Atitude do Pessoal de Saúde , Pesquisas sobre Atenção à Saúde/estatística & dados numéricos , Estudos Transversais
17.
Clin Med (Lond) ; 18(1): 35-40, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29436437

RESUMO

Over a million smokers are admitted to hospitals in the UK each year. The extent to which tobacco dependence is identified and addressed in this population is unclear. Data on 14,750 patients from 146 hospitals collected for the British Thoracic Society smoking cessation audit were analysed to determine smoking prevalence, attempts to ask smokers about quitting, and referrals to smoking cessation services. Associations with hospital organisational factors were assessed by logistic regression. Overall hospital smoking prevalence was 25%. Only 28% of smokers were asked whether they would like to quit, and only one in 13 smokers was referred for treatment of tobacco dependence. There was a higher chance of smokers being asked about quitting in organisations with smoke-free sites, dedicated smoking cessation practitioners, regular staff training, and availability of advanced pharmacotherapy. Treatment of tobacco dependence in smokers attending UK hospitals is poor and could be associated with organisational factors.


Assuntos
Hospitalização/estatística & dados numéricos , Abandono do Hábito de Fumar , Fumar/epidemiologia , Tabagismo , Adolescente , Adulto , Idoso de 80 Anos ou mais , Feminino , Relações Hospital-Paciente , Humanos , Masculino , Determinação de Necessidades de Cuidados de Saúde , Avaliação de Processos e Resultados em Cuidados de Saúde , Serviço de Farmácia Hospitalar/normas , Serviço de Farmácia Hospitalar/estatística & dados numéricos , Prevalência , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/normas , Serviços Preventivos de Saúde/estatística & dados numéricos , Abandono do Hábito de Fumar/métodos , Abandono do Hábito de Fumar/estatística & dados numéricos , Desenvolvimento de Pessoal , Tabagismo/diagnóstico , Tabagismo/epidemiologia , Tabagismo/terapia , Reino Unido/epidemiologia
18.
BMJ Open ; 8(1): e020164, 2018 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-29326197

RESUMO

BACKGROUND: The perinatal mortality review meeting that takes place within the hospital following a stillbirth or neonatal death enables clinicians to learn vital lessons to improve care for women and their families for the future. Recent evidence suggests that parents are unaware that a formal review following the death of their baby takes place. Many would welcome the opportunity to feedback into the meeting itself. Parental involvement in the perinatal mortality review meeting has the potential to improve patient satisfaction, drive improvements in patient safety and promote an open culture within healthcare. Yet evidence on the feasibility of involving bereaved parents in the review process is lacking. This paper describes the protocol for the Parents' Active Role and Engangement iN the review of their Stillbirth/perinatal death study (PARENTS 2) , whereby healthcare professionals' and stakeholders' perceptions of parental involvement will be investigated, and parental involvement in the perinatal mortality review will be piloted and evaluated at two hospitals. METHODS AND ANALYSIS: We will investigate perceptions of parental involvement in the perinatal mortality review process by conducting four focus groups. A three-round modified Delphi technique will be employed to gain a consensus on principles of parental involvement in the perinatal mortality review process. We will use three sequential rounds, including a national consensus meeting workshop with experts in stillbirth, neonatal death and bereavement care, and a two-stage anonymous online questionnaire. We will pilot a new perinatal mortality review process with parental involvement over a 6-month study period. The impact of the new process will be evaluated by assessing parents' experiences of their care and parents' and staff perceptions of their involvement in the process by conducting further focus groups and using a Parent Generated Index questionnaire. ETHICS AND DISSEMINATION: This study has ethical approval from the UK Health Research Authority. We will disseminate the findings through national and international conferences and international peer-reviewed journals.


Assuntos
Luto , Relações Hospital-Paciente , Pais , Participação do Paciente , Morte Perinatal , Natimorto , Adulto , Atitude do Pessoal de Saúde , Comunicação , Feminino , Grupos Focais , Cuidados Paliativos na Terminalidade da Vida , Hospitais , Humanos , Recém-Nascido , Masculino , Satisfação do Paciente , Relações Médico-Paciente , Projetos Piloto , Gravidez , Pesquisa Qualitativa , Projetos de Pesquisa , Inquéritos e Questionários
19.
Hosp Pract (1995) ; 46(2): 88-96, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29322848

RESUMO

OBJECTIVE: To observe inpatient satisfaction at different public sector hospitals of Karachi, Pakistan. METHODS: A cross sectional study was carried out during 2010-2012 in four major public sector hospitals of Karachi. A total of 710 patients completed the study. Responses were gathered in a self-structured questionnaire that comprised of four dimensions of satisfaction with doctor, staff, administration and treatment. Average Score of each dimension was taken and compared using one way analysis of variance. RESULT: Satisfaction with doctors, staff and administration of provincial and federal hospitals were comparatively similar (P > 0.05). However, satisfaction with treatment significantly differed in all four hospitals (P < 0.0001). Highest satisfaction with treatment was observed among inpatients of hospital running by medical institute (P < 0.0001). Comparison with respect to different departments revealed significant difference for treatment satisfaction of medicine and surgery units. Patients who were admitted from emergency mode acquired lowest satisfaction in all aspects. CONCLUSION: Response of inpatients from public sector hospitals showed satisfaction with healthcare personnel and related administration. However, treatment dimension needs to be improved to get more satisfaction.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Hospitais Públicos , Satisfação do Paciente/estatística & dados numéricos , Relações Médico-Paciente , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Relações Hospital-Paciente , Humanos , Masculino , Paquistão , Qualidade da Assistência à Saúde , Inquéritos e Questionários , População Urbana/estatística & dados numéricos
20.
J Ment Health ; 27(1): 52-58, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28084111

RESUMO

BACKGROUND: Scarce information is available about how users experience treatment at mental health day hospitals, particularly in South America. AIMS: To explore users' perspectives about elements of day hospital treatment that facilitate or hinder the recovery process in a mental health facility in Buenos Aires, Argentina. METHODS: Semi-structured individual interviews (n = 8) and focus groups (n = 4) were carried out with a convenience sample of users of a mental health day hospital program based on a formulation, testing and redevelopment of propositions approach. Results were analyzed through grounded theory techniques. RESULTS: Categories indicating recovery were: starting to do things, being able to see themselves from a new perspective, mood improvement and changes in interpersonal relationships. Aspects facilitating recovery were: activities organized by the facility, the group approach, the care provided by facility workers and the physical environment. Hindering aspects were: heterogeneity of users in terms of age, severity, diagnosis and being underestimated by staff. CONCLUSIONS: Being active again was considered to be the main recovery indicator in this cultural context and participating in activities led by skilled facilitators was the most beneficial factor of the program according to the users.


Assuntos
Hospitais Psiquiátricos/normas , Transtornos Mentais/terapia , Serviços de Saúde Mental/normas , Adulto , Argentina , Feminino , Teoria Fundamentada , Relações Hospital-Paciente , Humanos , Masculino , Pessoas Mentalmente Doentes , Pessoa de Meia-Idade , Avaliação de Resultados da Assistência ao Paciente , Relações Profissional-Paciente , Recuperação de Função Fisiológica , Resultado do Tratamento , Adulto Jovem
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