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1.
BMC Public Health ; 22(1): 791, 2022 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-35439984

RESUMO

BACKGROUND: Mineworkers in Southern Africa have the highest rates of tuberculosis (TB) among working populations in the world (The World Bank, Benefits and costs associated with reducing tuberculosis among Southern Africa's mineworkers, 2014), making mineworkers a key population for TB program efforts. The current evaluation aimed to characterize mineworkers and former (ex-) mineworkers, and assess knowledge, attitudes and practices related to TB and HIV care among mineworkers and healthcare workers (HCWs) in Zambia. METHODS: A mixed-methods evaluation of current and former (ex-) mineworkers and HCWs was conducted in the Copperbelt and North-Western provinces, Zambia. Knowledge, attitudes and practices (KAPs) related to TB care and policies were assessed using a structured survey. Focus Group Discussions (FGDs) were conducted with current and ex-mineworkers to understand perceptions, practices, and barriers related to accessing healthcare for TB. RESULTS: Overall, 2,792 mineworkers and 94 HCWs completed the KAP survey, and 206 (171 current, 71 ex-) mineworkers participated in FGDs. Mineworkers and ex-mineworkers were knowledgeable about TB symptoms (cough; 94%), transmission (81.7%) and treatment (99.2%). Yet, barriers to seeking care were evident with 30% of mineworkers experiencing cough, and 19% reporting 2 or more TB symptoms at the time of the survey. The majority of mineworkers (70.9%) were aware of policies barring persons from working after a diagnosis of TB, and themes from FGDs and HCW comments (n = 32/62; 51.6%) recognized fear of job loss as a critical barrier to providing timely screening and appropriate care for TB among mineworkers. The majority (76.9%) of mineworkers indicated they would not disclose their TB status to their supervisor, but would be willing to share their diagnosis with their spouse (73.8%). CONCLUSION: Fear of job loss, driven by governmental policy and mistrust in mining companies, is a major barrier to healthcare access for TB among mineworkers in Zambia. As a result of these findings, the government policy prohibiting persons from working in the mines following TB disease is being repealed. However, major reforms are urgently needed to mitigate TB among mineworkers, including ensuring the rights of mineworkers and their communities to healthy living and working environments, improved social responsibility of mining companies, and facilitating choice and access to affordable, timely, and high-quality healthcare services.


Assuntos
Infecções por HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Acesso aos Serviços de Saúde/estatística & dados numéricos , Mineração , Tuberculose/epidemiologia , Tosse , Infecções por HIV/diagnóstico , Pessoal de Saúde/psicologia , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/tendências , Humanos , Mineração/organização & administração , Políticas , Determinantes Sociais da Saúde/economia , Determinantes Sociais da Saúde/tendências , Tuberculose/diagnóstico , Tuberculose/prevenção & controle , Zâmbia/epidemiologia
3.
J Healthc Eng ; 2022: 9969604, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35463662

RESUMO

The imbalance between supply and demand for organs has been a global crisis, despite the efforts of transplant coordinators from healthcare institutions to promote donor registration. Because the patient's family has legal rights over the patient's remains, they can easily undermine any efforts spent on organ procurement by simply refusing the patient's consent before death in practice. Most related studies seldom mention the decision-making on organ donation from patients' families. The objectives of this study are to find what are the priorities of those factors acting as the pillars of organ donation by patients' families. This study applied the analytic network process (ANP) to the prioritization factors contributing toward the willingness of families to donate organs of intensive care unit patients. The purposive sampling method used structured questionnaires and ANP questionnaires to enroll 180 patients' families from five intensive care units who met the criteria in the regional teaching hospital of southern Taiwan. Through the ANP analysis, it was found that when family members made organ donation decisions, the weights of the four domains are as follows: psychology-47.6%, externality-20.3%, spirituality-19.7%, and physiology-12.3%. The main decision-making factors that influenced the weighting factors were "attitude" (31.5%), "physician's experience" (0.88%), "religion" (19.3%), and "organ selection" (31.9%). These results could assist organ donation teams to take the best strategies for persuading people to agree with organ donation and formulating an individual organ donation plan.


Assuntos
Tomada de Decisões , Doadores de Tecidos , Obtenção de Tecidos e Órgãos , Família/psicologia , Humanos , Unidades de Terapia Intensiva , Doadores de Tecidos/psicologia , Obtenção de Tecidos e Órgãos/organização & administração
4.
Trials ; 23(1): 357, 2022 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-35477835

RESUMO

Clinical trial managers play a vital role in the design and conduct of clinical trials in the UK. There is a current recruitment and retention crisis for this specialist role due to a complex set of factors, most likely to have come to a head due to the COVID-19 pandemic. Academic clinical trial units and departments are struggling to recruit trial managers to vacant positions, and multiple influences are affecting the retention of this highly skilled workforce. Without tackling this issue, we face major challenges in the delivery on the Department of Health and Social Care's Future of UK Clinical Research Delivery implementation plan. This article, led by a leading network of and for UK Trial Managers, presents some of the issues and ways in which national stakeholders may be able to address this.


Assuntos
Ensaios Clínicos como Assunto , Recursos Humanos , COVID-19 , Ensaios Clínicos como Assunto/organização & administração , Humanos , Pandemias , Projetos de Pesquisa
6.
Front Public Health ; 10: 811858, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35359775

RESUMO

Public health emergencies such as disease outbreaks and bioterrorism attacks require immediate response to ensure the safety and well-being of the affected community and prevent the further spread of infection. The standard method to increase the efficiency of mass dispensing during health emergencies is to create emergency points called points of dispensing (PODs). PODs are sites for distributing medical services such as vaccines or drugs to the affected population within a specific time constraint. These PODs need to be sited in optimal locations and have people (demand points) assigned to them simultaneously; this is known as the location-allocation problem. PODs may need to be selected to serve the entire population (full allocation) or different priority or needs groups (partial allocation). Several previous studies have focused on location problems in different application domains, including healthcare. However, some of these studies focused on healthcare facility location problems without specifying location-allocation problems or the exact domain. This study presents a survey of the PODs location-allocation problem during public health emergencies. This survey aims to review and analyse the existing models for PODs location-allocation during public health emergencies based on full and partial demand points allocation. Moreover, it compares existing models based on their key features, strengths, and limitations. The challenges and future research directions for PODs location-allocation models are also discussed. The results of this survey demonstrated a necessity to develop a variety of techniques to analyse, define and meet the demand of particular groups. It also proved essential that models be developed for different countries, including accounting for variations in population size and density. Moreover, the model constraints, such as those relating to time or prioritizing certain groups, need to be considered in the solution. Finally, additional comparative studies are required to clarify which methods or models are adequate based on predefined criteria.


Assuntos
Emergências , Serviços Médicos de Emergência , Saúde Pública , Surtos de Doenças/prevenção & controle , Serviços Médicos de Emergência/organização & administração , Humanos , Inquéritos e Questionários
7.
Comput Math Methods Med ; 2022: 8169963, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35295197

RESUMO

Objective: To survey the application of PDCA (plan, do, check, and action) process management in day operation ward and the influence of nursing quality and safety. Methods: The routine nursing management was carried out in our hospital from March 2019 to March 2020, which was set as the control group (N = 20), and the PDCA process management was implemented from March 2020 to March 2021 as the research group (N = 20). Twenty nurses and patients were selected as subjects in two periods of time. The nursing quality, the score of individual quality control examination in clinical department, the nursing quality of operating room, the incidence of adverse events and nursing errors, the number of problems existing in the quality management of nursing documents, and the score of nursing satisfaction were accessed. Results: In the comparison of nursing quality, the nursing safety, specialty quality, and nursing norms of the study group were higher compared to the control (P < 0.05). In terms of the scores of individual quality control examination in clinical departments, the scores of ward management, rescue, therapeutic articles, drug management, first-level nursing, nursing documents, and head nurses in the study group were greater compared to the control (P < 0.05). In terms of the operating room nursing quality score, the instrument management, instrument preparation, nurses' cooperation skills, disinfection and isolation quality, and the total score of the study group were above the control (P < 0.05). In terms of the incidence of operative adverse events and nursing errors, the incidence of nosocomial infection, iatrogenic injury, information check error, equipment failure, violation of operation regulations, ECG monitoring error, infusion operation error, and medication error in the study group was lower compared to the control (P < 0.05). According to the comparison of the number of problems existing in the quality management of nursing documents, the number of problems in temperature sheet, medical order, evaluation sheet, nursing record, and other nursing documents in the study group was lower than the control (P < 0.05). The scores of nursing communication, professional technology, nursing service attitude, nursing environment, and knowledge education in the study group were higher in contrast to the control (P < 0.05). Conclusion: The application of PDCA management can effectively enhance the nursing quality and safety of the day operation ward, further facilitate the quality of hospital nursing work, and improve patient satisfaction, which exert great potential, and application value in the management of day ward in the future.


Assuntos
Processo de Enfermagem/organização & administração , Recursos Humanos de Enfermagem no Hospital/organização & administração , Adulto , China , Biologia Computacional , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Processo de Enfermagem/normas , Processo de Enfermagem/estatística & dados numéricos , Recursos Humanos de Enfermagem no Hospital/normas , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Qualidade da Assistência à Saúde/organização & administração , Qualidade da Assistência à Saúde/normas , Qualidade da Assistência à Saúde/estatística & dados numéricos , Adulto Jovem
10.
PLoS One ; 17(3): e0264260, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35239680

RESUMO

BACKGROUND: Reports on medium and long-term sequelae of SARS-CoV-2 infections largely lack quantification of incidence and relative risk. We describe the rationale and methods of the Innovative Support for Patients with SARS-CoV-2 Registry (INSPIRE) that combines patient-reported outcomes with data from digital health records to understand predictors and impacts of SARS-CoV-2 infection. METHODS: INSPIRE is a prospective, multicenter, longitudinal study of individuals with symptoms of SARS-CoV-2 infection in eight regions across the US. Adults are eligible for enrollment if they are fluent in English or Spanish, reported symptoms suggestive of acute SARS-CoV-2 infection, and if they are within 42 days of having a SARS-CoV-2 viral test (i.e., nucleic acid amplification test or antigen test), regardless of test results. Recruitment occurs in-person, by phone or email, and through online advertisement. A secure online platform is used to facilitate the collation of consent-related materials, digital health records, and responses to self-administered surveys. Participants are followed for up to 18 months, with patient-reported outcomes collected every three months via survey and linked to concurrent digital health data; follow-up includes no in-person involvement. Our planned enrollment is 4,800 participants, including 2,400 SARS-CoV-2 positive and 2,400 SARS-CoV-2 negative participants (as a concurrent comparison group). These data will allow assessment of longitudinal outcomes from SARS-CoV-2 infection and comparison of the relative risk of outcomes in individuals with and without infection. Patient-reported outcomes include self-reported health function and status, as well as clinical outcomes including health system encounters and new diagnoses. RESULTS: Participating sites obtained institutional review board approval. Enrollment and follow-up are ongoing. CONCLUSIONS: This study will characterize medium and long-term sequelae of SARS-CoV-2 infection among a diverse population, predictors of sequelae, and their relative risk compared to persons with similar symptomatology but without SARS-CoV-2 infection. These data may inform clinical interventions for individuals with sequelae of SARS-CoV-2 infection.


Assuntos
COVID-19/complicações , COVID-19/terapia , Cuidados Paliativos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/diagnóstico , COVID-19/epidemiologia , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos/métodos , Cuidados Paliativos/organização & administração , Medidas de Resultados Relatados pelo Paciente , Prognóstico , Sistema de Registros , SARS-CoV-2/fisiologia , Determinantes Sociais da Saúde , Terapias em Estudo/métodos , Fatores de Tempo , Adulto Jovem
11.
BMC Health Serv Res ; 22(1): 333, 2022 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-35279154

RESUMO

BACKGROUND: The Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) project trains non-specialist and primary health care workers in Imo State, Nigeria. This project adapted the World Health Organization's Mental Health Gap Action Programme-Intervention Guide (mhGAP-IG), emphasizing stigma reduction among trainees. This convergent mixed-methods proof-of-concept study evaluates the HAPPINESS pilot project mhGAP-IG training's impact on mental illness stigma among trainees and barriers, facilitators, and opportunities to consider for project improvement. METHODS: Trainees (n = 13) completed a 43-item questionnaire before and after their 5-day training to assess perceptions of mental disorders and attitudes towards people with mental illness. These responses were analyzed using paired-sample t-tests for four subscales of the questionnaire: acceptance of socializing with people with mental illness, normalizing activities and relationships with people with mental illness, supernatural causation of mental illness, and endorsement of a biopsychosocial approach to mental illness. Semi-structured key informant interviews (n = 11) with trainees, trainers, and local health officials who participated in or supported the HAPPINESS project were thematically analyzed to understand their experiences and perspectives of the project's barriers, facilitators, and opportunities. RESULTS: Trainees showed significant improvements on socializing, normalizing, and supernatural causation subscales of the stigma questionnaire (p < 0.05). No significant effect was seen on the biopsychosocial subscale; however, evidence of biopsychosocial beliefs was found in interview responses. Key informant interviews revealed that the HAPPINESS project enhanced trainees' diagnostic and treatment abilities, mental health awareness, and empathy towards patients. Misinformation, stigma, inadequate funding, and lack of road access to clinics were identified as barriers to mental health care integration into general care in Imo State. Respondents also suggested ways that the HAPPINESS project could be improved and expanded in the future. CONCLUSIONS: This study adds to the limited evidence on the implementation of mhGAP-IG in Nigeria. Using mixed methods, it evaluates how mhGAP-IG can impact perceptions and knowledge of stigma among primary care trainees. It also highlights barriers, facilitators, and opportunities to consider for project growth. Future efforts should focus on clinical support, supervision, health outcomes, as well as scaling up and assessing the cost-effectiveness of the HAPPINESS project intervention.


Assuntos
Epilepsia , Saúde Mental , Atenção Primária à Saúde , Epilepsia/psicologia , Epilepsia/terapia , Humanos , Nigéria/epidemiologia , Projetos Piloto , Atenção Primária à Saúde/organização & administração
13.
Artigo em Chinês | MEDLINE | ID: mdl-35307052

RESUMO

The discipline system of critical care medicine consists of the knowledge system and thinking system. The knowledge system includes a series of interrelated knowledge points. Knowledge points are relatively independent and smallest units in knowledge. In the process of development, critical care medicine has formed its own characteristic knowledge points based on the knowledge of medicine. Thinking system refers to the way of thinking which consists of various thinking modes linked inseparably. Thinking system provides an essential driving force for the formation and continuous development of knowledge system. The actual composition of critical care medicine discipline is the professionals who know well the thinking system and knowledge system of critical care medicine.


Assuntos
Cuidados Críticos , Análise de Sistemas , Cuidados Críticos/organização & administração , Humanos , Conhecimento
14.
Prehosp Disaster Med ; 37(2): 179-184, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35322775

RESUMO

INTRODUCTION: Mass gatherings (MGs) often bring together professionals and organizations that collaborate irregularly or have never engaged in joint working. They involve interaction and communication among multiple and diverse services, which can often prove challenging. Planning such an event is of paramount importance for its success, and interorganizational communication ranks among its most important aspects. Nonetheless, there is limited empirical evidence to support interagency communication in MGs. OBJECTIVE: This study used the 2017 Athens Marathon (Athens, Greece) as the empirical setting to examine how interorganizational communication was perceived among the multiple public health and safety professionals during the planning and implementation phase of the event. METHODS: Data comprised 15 semi-structured in-depth interviews with key informants, direct observations of meetings and the event itself, and documentary analysis. Open coding and thematic analysis were used to analyze the data. RESULTS: Findings indicated three key components of interorganizational communication in such an event: (1) shared situational awareness; (2) interorganizational understanding; and (3) implementing liaison officers. CONCLUSION: This study outlined the factors that influenced interorganizational communication before and during a MG. Practical implications arising from this study may inform the way organizers of marathons and other mass sporting events can engage in effective interorganizational communication.


Assuntos
Comunicação , Relações Interinstitucionais , Corrida de Maratona , Organizações , Conscientização , Grécia , Humanos , Relações Interprofissionais , Organizações/organização & administração , Percepção , Técnicas de Planejamento , Saúde Pública , Gestão de Riscos/organização & administração , Segurança
15.
Comput Math Methods Med ; 2022: 2048294, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35309835

RESUMO

This paper proposes a blend of three techniques to select COVID-19 testing centers. The objective of the paper is to identify a suitable location to establish new COVID-19 testing centers. Establishment of the testing center in the needy locations will be beneficial to both public and government officials. Selection of the wrong location may lead to lose both health and wealth. In this paper, location selection is modelled as a decision-making problem. The paper uses fuzzy analytic hierarchy process (AHP) technique to generate the criteria weights, monkey search algorithm to optimize the weights, and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method to rank the different locations. To illustrate the applicability of the proposed technique, a state named Tamil Nadu, located in India, is taken for a case study. The proposed structured algorithmic steps were applied for the input data obtained from the government of India website, and the results were analyzed and validated using the government of India website. The ranks assigned by the proposed technique to different locations are in aligning with the number of patients and death rate.


Assuntos
Algoritmos , Teste para COVID-19/métodos , COVID-19/diagnóstico , Tomada de Decisões Gerenciais , COVID-19/epidemiologia , Teste para COVID-19/estatística & dados numéricos , Biologia Computacional , Lógica Fuzzy , Humanos , Índia/epidemiologia , /estatística & dados numéricos , Organização e Administração/estatística & dados numéricos , SARS-CoV-2 , Local de Trabalho/organização & administração , Local de Trabalho/estatística & dados numéricos
16.
PLoS Med ; 19(3): e1003930, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35235573

RESUMO

BACKGROUND: Low syphilis testing uptake is a major public health issue among men who have sex with men (MSM) in many low- and middle-income countries. Syphilis self-testing (SST) may complement and extend facility-based testing. We aimed to evaluate the effectiveness and costs of providing SST on increasing syphilis testing uptake among MSM in China. METHODS AND FINDINGS: An open-label, parallel 3-arm randomized controlled trial (RCT) was conducted between January 7, 2020 and July 17, 2020. Men who were at least 18 years of age, had condomless anal sex with men in the past year, reported not testing for syphilis in the last 6 months, and had a stable residence with mailing addresses were recruited from 124 cities in 26 Chinese provinces. Using block randomization with blocks of size 12, enrolled participants were randomly assigned (1:1:1) into 3 arms: standard of care arm, standard SST arm, and lottery incentivized SST arm (1 in 10 chance to win US$15 if they had a syphilis test). The primary outcome was the proportion of participants who tested for syphilis during the trial period and confirmed with photo verification and between arm comparisons were estimated with risk differences (RDs). Analyses were performed on a modified intention-to-treat basis: Participants were included in the complete case analysis if they had initiated at least 1 follow-up survey. The Syphilis/HIV Duo rapid test kit was used. A total of 451 men were enrolled. In total, 136 (90·7%, 136/150) in the standard of care arm, 142 (94·0%, 142/151) in the standard of SST arm, and 137 (91·3%, 137/150) in the lottery incentivized SST arm were included in the final analysis. The proportion of men who had at least 1 syphilis test during the trial period was 63.4% (95% confidence interval [CI]: 55.5% to 71.3%, p = 0.001) in the standard SST arm, 65.7% (95% CI: 57.7% to 73.6%, p = 0.0002) in the lottery incentivized SST arm, and 14.7% (95% CI: 8.8% to 20.7%, p < 0.001) in the standard of care arm. The estimated RD between the standard SST and standard of care arm was 48.7% (95% CI: 37.8% to 58.4%, p < 0.001). The majority (78.5%, 95% CI: 72.7% to 84.4%, p < 0.001) of syphilis self-testers reported never testing for syphilis. The cost per person tested was US$26.55 for standard SST, US$28.09 for the lottery incentivized SST, and US$66.19 for the standard of care. No study-related adverse events were reported during the study duration. Limitation was that the impact of the Coronavirus Disease 2019 (COVID-19) restrictions may have accentuated demand for decentralized testing. CONCLUSIONS: Compared to standard of care, providing SST significantly increased the proportion of MSM testing for syphilis in China and was cheaper (per person tested). TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR1900022409.


Assuntos
Infecções por HIV/diagnóstico , Homossexualidade Masculina , Participação do Paciente/métodos , Autoteste , Sífilis/diagnóstico , Adolescente , Adulto , COVID-19/epidemiologia , China/epidemiologia , Seguimentos , Infecções por HIV/prevenção & controle , Acesso aos Serviços de Saúde/organização & administração , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Imunoensaio/métodos , Masculino , Programas de Rastreamento/economia , Programas de Rastreamento/métodos , Programas de Rastreamento/organização & administração , Pessoa de Meia-Idade , Motivação , Pandemias , Kit de Reagentes para Diagnóstico/economia , Kit de Reagentes para Diagnóstico/provisão & distribuição , SARS-CoV-2 , Minorias Sexuais e de Gênero/estatística & dados numéricos , Sífilis/epidemiologia , Sífilis/prevenção & controle , Adulto Jovem
17.
PLoS One ; 17(3): e0264644, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35239726

RESUMO

INTRODUCTION: Patients with high-consequence infectious diseases (HCID) are rare in Western Europe. However, high-level isolation units (HLIU) must always be prepared for patient admission. Case fatality rates of HCID can be reduced by providing optimal intensive care management. We here describe a single centre's preparation, its embedding in the national context and the challenges we faced during the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic. METHODS: Ten team leaders organize monthly whole day trainings for a team of doctors and nurses from the HLIU focusing on intensive care medicine. Impact and relevance of training are assessed by a questionnaire and a perception survey, respectively. Furthermore, yearly exercises with several partner institutions are performed to cover different real-life scenarios. Exercises are evaluated by internal and external observers. Both training sessions and exercises are accompanied by intense feedback. RESULTS: From May 2017 monthly training sessions were held with a two-month and a seven-month break due to the first and second wave of the SARS-CoV-2 pandemic, respectively. Agreement with the statements of the questionnaire was higher after training compared to before training indicating a positive effect of training sessions on competence. Participants rated joint trainings for nurses and doctors at regular intervals as important. Numerous issues with potential for improvement were identified during post processing of exercises. Action plans for their improvement were drafted and as of now mostly implemented. The network of the permanent working group of competence and treatment centres for HCID (Ständiger Arbeitskreis der Kompetenz- und Behandlungszentren für Krankheiten durch hochpathogene Erreger (STAKOB)) at the Robert Koch-Institute (RKI) was strengthened throughout the SARS-CoV-2 pandemic. DISCUSSION: Adequate preparation for the admission of patients with HCID is challenging. We show that joint regular trainings of doctors and nurses are appreciated and that training sessions may improve perceived skills. We also show that real-life scenario exercises may reveal additional deficits, which cannot be easily disclosed in training sessions. Although the SARS-CoV-2 pandemic interfered with our activities the enhanced cooperation among German HLIU during the pandemic ensured constant readiness for the admission of HCID patients to our or to collaborating HLIU. This is a single centre's experience, which may not be generalized to other centres. However, we believe that our work may address aspects that should be considered when preparing a unit for the admission of patients with HCID. These may then be adapted to the local situations.


Assuntos
Doenças Transmissíveis/terapia , Cuidados Críticos/organização & administração , Unidades de Terapia Intensiva/organização & administração , Isolamento de Pacientes/organização & administração , COVID-19/epidemiologia , Competência Clínica , Doenças Transmissíveis/epidemiologia , Educação Médica Continuada/métodos , Educação Médica Continuada/organização & administração , Educação Continuada em Enfermagem/métodos , Educação Continuada em Enfermagem/organização & administração , Planejamento Ambiental , Alemanha/epidemiologia , História do Século XXI , Humanos , Pandemias , Admissão do Paciente , Equipe de Assistência ao Paciente/organização & administração , Isolamento de Pacientes/métodos , SARS-CoV-2/fisiologia , Treinamento por Simulação/organização & administração , Fluxo de Trabalho
18.
Korean J Med Educ ; 34(1): 17-26, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35255613

RESUMO

PURPOSE: Empathy levels have been observed to often decrease when medical undergraduates move to the clinical years, particularly in the Western countries. However, empathy either remains similar or increases in many Asian medical schools. This study investigated the longitudinal empathy profile of medical students in Singapore. METHODS: Two cohorts of medical students who enrolled in 2013 and 2014 to the National University of Singapore were tracked for 5 years. The Jefferson Scale of Empathy-student version was used. Analyses on the mean of the empathy level and individual factors, year-wise and gender comparison were conducted. RESULTS: Average response rates for cohort 1 and 2 were 68.1% (n=181-263) and 55.4% (n=81-265), respectively. For both cohorts, there was no significant change across year of study in the mean empathy score. Average scores for both cohorts were 113.94 and 115.66. Though not significant, we observed mean empathy to be lowest at the end of year 5 (112.74) and highest in year 2 (114.72) for cohort 1 while for cohort 2, the lowest level of empathy was observed in year 5 (114.20) and highest in year 4 (118.42). Analysis of subcomponents of empathy only showed a significant difference for cohort one factor 1 (perspective taking) and factor 3 (standing in patients' shoes) across the study years. CONCLUSION: No significant change in empathy score was observed during the transition from pre-clinical to clinical years, unlike many Western and Far-Eastern studies. This might be due to the curriculum and influence of the Asian values.


Assuntos
Educação de Graduação em Medicina , Empatia , Estudantes de Medicina , Estudos de Coortes , Currículo , Educação de Graduação em Medicina/organização & administração , Humanos , Singapura , Estudantes de Medicina/psicologia
19.
Korean J Med Educ ; 34(1): 41-48, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35255615

RESUMO

PURPOSE: Active involvement of students in their learning process is a recommended andragogical approach to increase student engagement. Many new teaching-learning strategies based on active learning have been implemented, but their efficacies to achieve the proposed benefits of attaining knowledge, skills, and attitude have not been evaluated, especially in the field of medical education. We substituted passive learning in the conventional tutorial classes with an active-learning strategy of Student-Led Seminar Series (SLSS) in the subject of physiology over 4 months and performed program evaluation for the SLSS. METHODS: Sixty-four first-year medical undergraduate students volunteered to participate, who were divided into groups to present seminars on the allocated topics under the guidance of a mentor. At the end of 4 months, program evaluation was done using Kirkpatrick's model of evaluation-levels 1 and 2, which correspond to reaction and learning, respectively. RESULTS: Statistically significant improvement was observed in students' satisfaction, and the self-perceived increase was observed in knowledge, skills, and attitude. CONCLUSION: Program evaluation of SLSS not only established the significant impact of SLSS as an andragogical approach but also helped us in the improvisation of the program for the next cycle.


Assuntos
Educação de Graduação em Medicina , Fisiologia , Estudantes de Medicina , Educação de Graduação em Medicina/organização & administração , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Fisiologia/educação , Aprendizagem Baseada em Problemas , Avaliação de Programas e Projetos de Saúde , Estudantes de Medicina/psicologia
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