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1.
Health Expect ; 27(2): e14008, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38481384

RESUMEN

BACKGROUND: Long Covid is an emerging long-term condition, with those affected raising concerns about lack of healthcare support. OBJECTIVE: We conducted a qualitative study to identify facilitators and barriers to healthcare access for people with Long Covid, aiming to enhance our understanding of the specific nature of these barriers and how patient experiences may vary. SETTING AND PARTICIPANTS: In the context of the Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways (STIMULATE-ICP) Delphi study, a nationally distributed online survey was conducted. Eight patients and eight healthcare practitioners (HCP) were interviewed via telephone or video call. Framework analysis, sensitised by the candidacy theory, was used to identify barriers and facilitators over four levels of access to care. RESULTS: Three themes were identified: (i) patients' efforts to navigate emerging pathways for Long Covid, (ii) the patient-HCP interaction and (iii) service resources and structural constraints. Barriers to specialist care included long waiting times, communication gaps across services and a lack of continuity in care. Facilitators included collaborative, patient-centred approaches, patients' active role in their healthcare and blended approaches for appointments. The perspectives of both patients and HCPs largely aligned. DISCUSSION: The candidacy framework was valuable in understanding the experiences of people with Long Covid seeking access to healthcare. Individuals perceived themselves as eligible for care, but they often encountered obstacles in obtaining the expected level of care or, in some cases, did not receive it at all. Our findings are discussed in the context of the candidacy model through multiple processes of identification, negotiation, permeability and appearances at health services. These themes seem to be especially important for the emerging new pathway model and are relevant to both primary and secondary care. CONCLUSIONS: This study highlights that despite these interviews being conducted two years after the start of the COVID-19 pandemic, people with Long Covid still struggle to access healthcare, emphasising the ongoing need to provide equitable timely healthcare access for people with Long Covid. PATIENT OR PUBLIC CONTRIBUTION: People with Long Covid advised on all stages of this research.


Asunto(s)
COVID-19 , Síndrome Post Agudo de COVID-19 , Humanos , COVID-19/epidemiología , COVID-19/terapia , Pandemias , Servicios de Salud , Accesibilidad a los Servicios de Salud , Investigación Cualitativa
2.
Healthc Q ; 26(4): 17-23, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38482644

RESUMEN

The future of quality is personal. Health Quality 5.0 moves people-centred, integrated health and social care systems to the forefront of our post-COVID-19 agenda - and that cannot happen without addressing our global workforce crisis. Building back a stronger, healthier workforce is the first of the five big challenges we address in our special series. Starting with the global health workforce crisis is fitting, given it is the most fundamental and formidable barrier to health and quality today. As we put the pieces of the Health Quality 5.0 puzzle together, a picture of a more resilient health system will emerge and a new leadership agenda to get there will take shape.


Asunto(s)
COVID-19 , Fuerza Laboral en Salud , Humanos , Recursos Humanos , Programas de Gobierno , COVID-19/epidemiología , Liderazgo
3.
PLoS One ; 19(3): e0298799, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38457452

RESUMEN

BACKGROUND: Contact tracing is a key component in controlling the spread of COVID-19, however little research has focused on learning from the experiences of contact tracing staff. Harnessing learning from those in this role can provide valuable insights into the process of contact tracing and how best to support staff in this crucial role. METHODS: Thematic analysis was used to analyse 47 semi-structured interviews conducted with contact tracing staff via telephone or Zoom at three time points in 2021: March, May and September-October. RESULTS: Six themes related to the contact tracing role were identified, including training, workforce culture, systems issues, motivation and support. While initially nervous in the role, participants were motivated to contribute to the pandemic response and believed the role provided them with valuable transferable skills. Participants described the training as having improved over time while desiring more proactive training. Sources of frustration included a perceived lack of opportunity for feedback and involvement in process changes, feelings of low autonomy, and a perception of high staff turnover. Participants expressed a need for improved communication of formal emotional supports. Increased managerial support and provision of opportunities for career advancement may contribute to increased motivation among staff. CONCLUSIONS: These findings identify the experiences of contact tracing staff working during the COVID-19 pandemic, and have important implications for the improvement of the contact tracing system. Recommendations based on learning from participants offer suggestions as to how best to support the needs of contact tracing staff during a pandemic response.


Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Trazado de Contacto , Pandemias , Irlanda/epidemiología , Comunicación
4.
Health Expect ; 27(2): e14013, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38493303

RESUMEN

BACKGROUND: Digital contact tracing (DCT) was a central component of the global response to containing COVID-19. Research has raised concerns that DCT could exacerbate inequities, yet the experiences of diverse communities at greater risk from COVID-19 are typically underrepresented. METHODS: The present study aimed to understand the perceived barriers to the adoption of the app amongst Maori, Pasifika, and disabled people. Focus groups and interviews were undertaken with Maori, Pasifika, and disability sector stakeholders and community participants. RESULTS: Participants (n = 34) generally expressed willingness to utilise DCT and support its adoption within the communities. Simultaneously, participants revealed how the app could marginalise community members who struggled with the usability and those distrusting of the government's COVID-19 interventions. CONCLUSIONS: The findings highlight how addressing communication inequality can assist in the development of contact-tracing responses that are both effective and equitable. The study provides insights about the role of information and communication technologies as health resources. PATIENT OR PUBLIC CONTRIBUTION: Consulting with members of the target communities was central throughout the present study, including recommendations for potential participants, participation in interviews and sharing early findings for feedback. This study reports on focus groups and interviews with individuals from Maori and disability sectors.


Asunto(s)
COVID-19 , Humanos , Nueva Zelanda , Trazado de Contacto , Pueblo Maorí , Comunicación
5.
Palliat Med ; 38(3): 379-388, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38439152

RESUMEN

BACKGROUND: Children and young people with life-limiting and life-threatening conditions have multidimensional needs and heterogenous cognitive and communicative abilities. There is limited evidence to support clinicians to tailor their communication to each individual child. AIM: To explore the language children and young people use to describe their own condition, to inform strategies for discussing needs and priorities. DESIGN: Positioned within a social constructivist paradigm, a secondary discourse analysis of semi-structured interview data was conducted incorporating the discourse dynamics approach for figurative language. SETTING/PARTICIPANTS: A total of 26 children and young people aged 5-17 years with life-limiting or life-threatening conditions (6 cancer; 20 non-cancer) were recruited from nine clinical services (six hospitals and three hospices) across two UK nations. RESULTS: The language children and young people use positions them as 'experts in their condition'. They combine medical terminology with their preferred terms for their body to describe symptoms and treatments, and use comparatives and superlatives to communicate their health status. Their language depicts their condition as a 'series of (functional and social) losses', which single them out from their peers as 'the sick one'. Older children and young people also incorporate figurative language to expand their descriptions. CONCLUSION/DISCUSSION: Children and young people can provide rich descriptions of their condition. Paying attention to their lexical choices, and converging one's language towards theirs, may enable more child-centred discussions. Expanding discussions about 'what matters most' with consideration of the losses and differences they have experienced may facilitate a fuller assessment of their concerns, preferences and priorities.


Asunto(s)
Cuidados Paliativos al Final de la Vida , Cuidados Paliativos , Humanos , Niño , Adolescente , Investigación Cualitativa , Cuidados Paliativos/psicología , Lenguaje , Comunicación
6.
BMJ Open ; 14(3): e077060, 2024 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-38521525

RESUMEN

INTRODUCTION: Health development army is a network of women volunteers organised to promote health and prevent disease through community empowerment and participation. OBJECTIVE: To assess the level of motivation and associated factors of the health development army in the implementation of health extension packages in Northwest Ethiopia. DESIGN: Data were from a community-based cross-sectional study. SETTING: This study was conducted in Mecha district, Northwest Ethiopia. The district is located around 30 km from Bahir Dar, the capital city of Amhara National Regional State, Ethiopia. PARTICIPANTS: A total of 624 health development army members were interviewed using a structured questionnaire from 20 April 2020 to 20 May 2020. OUTCOME MEASURES: Motivation was assessed using a five-item Likert scale statement ranging from 1 to 5. Data were collected using a structured questionnaire and analysed using a binary logistic regression model. RESULTS: The proportion of health development army members, who had motivation in the implementation of the health extension package, was 47.8% (95% CI (43.90 to 51.80)). The odds of having motivation were higher among health development army members who lived in urban areas ((adjusted OR, AOR 2.47; 95% CI (1.21 to 5.03)), were less than 30 years ((AOR 2.42; 95% CI (1.22 to 4.78)), had more than 4 years work experience ((AOR 4.72; 95% CI (2.54 to 8.76)), had high intrinsic job satisfaction ((AOR 2.31; 95% CI (1.51 to 3.55)), had good community support ((AOR 2.46; 95% CI (1.34 to 4.51)), received supportive supervision ((AOR 1.85; 95% CI (1.24 to 2.77)) and were recognised for their efforts ((AOR 1.52; 95% CI (1.01 to 2.30)). CONCLUSION: The proportion of motivation among health development army members was low. To increase the motivation of health development army members in the implementation of the health extension package, measures or strategies may consider targeting members who live in rural areas, are older than 30 years, have less than 4 years of work experience, report low job satisfaction, have low community support, do not have supportive supervision and are not recognised.


Asunto(s)
Promoción de la Salud , Motivación , Humanos , Femenino , Estudios Transversales , Etiopía , Encuestas y Cuestionarios
7.
BMC Public Health ; 24(1): 871, 2024 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-38515081

RESUMEN

BACKGROUND: The COVID-19 pandemic was characterized by an abundance of information, some of it reliable and some of it misinformation. Evidence-based data on the impact of misinformation on attitudes and behaviours remains limited. Studies indicate that older adults are more likely to embrace and disseminate misinformation than other population groups, making them vulnerable to misinformation. The purpose of this article is to explore the effects of misinformation and information overload on older adults, and to present the management strategies put in place to deal with such effects, in the context of COVID-19. METHODS: A qualitative exploratory approach was adopted to conduct this research. A total of 36 semi-structured interviews were conducted with older adults living in Quebec, Canada. The interviews were fully transcribed and subjected to a thematic content analysis. RESULTS: Participants said they could easily spot misinformation online. Despite this, misinformation and its treatment by the media could generate fear, stress and anxiety. Moreover, the polarization induced by misinformation resulted in tensions and even friendship breakdowns. Participants also denounced the information overload produced largely by the media. To this end, the participants set up information routines targeting the sources of information and the times at which they consulted the information. CONCLUSIONS: This article questions the concept of vulnerability to misinformation by highlighting older adults' agency in managing misinformation and information overload. Furthermore, this study invites us to rethink communication strategies by distinguishing between information overload and misinformation.


Asunto(s)
COVID-19 , Pandemias , Humanos , Anciano , Comunicación , Investigación Cualitativa , Ansiedad , Trastornos de Ansiedad
8.
Rev Esc Enferm USP ; 58: 20230303, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38466907

RESUMEN

OBJECTIVE: This study aims to examine the risk perceptions of midwifery and nursing senior students regarding COVID-19 and compliance with vaccination and protective measures. METHOD: This cross-sectional study was conducted in two academic years on senior midwifery and nursing students (n = 358). In the present study, the descriptive characteristics of the students and the COVID-19 risk perception scale were used. RESULTS: The students' COVID-19 Risk Perception Scale scores were at a moderate level and a similar level in both years of this study. More than 80% of the students were fully vaccinated, and the family history of COVID-19 was positive in approximately half of them. In the second year of the pandemic, they paid less attention to social distance and avoidance of being indoors. CONCLUSION: Although the COVID-19 risk perceptions of future health professional students remained at a similar level during the examined period, it was found that in the second year of the pandemic, they started to get used to the process and paid less attention to social protective measures.


Asunto(s)
COVID-19 , Bachillerato en Enfermería , Partería , Estudiantes de Enfermería , Humanos , Embarazo , Femenino , Partería/educación , Estudios Transversales , Encuestas y Cuestionarios , COVID-19/prevención & control
9.
BMC Pregnancy Childbirth ; 24(1): 112, 2024 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-38321392

RESUMEN

BACKGROUND: In many countries, abortions at 20 weeks and over for indications other than fetal or maternal medicine are difficult to access due to legal restrictions and limited availability of services. The Abortion and Contraception Service at the Royal Women's Hospital in Victoria, Australia is the only service in the state that provides this service. The views and experiences of these abortion providers can give insight into the experiences of staff and women and the abortion system accessibility. The aim of this study was to examine health providers' perceptions and experiences of providing abortion care at 20 weeks and over for indications other than fetal or maternal medicine, as well as enablers and barriers to this care and how quality of care could be improved in one hospital in Victoria, Australia. METHODS: A qualitative study was conducted at the Abortion and Contraception Service at the Royal Women's Hospital. Participants were recruited by convenience and purposive sampling. Semi-structured interviews were conducted one-on-one with participants either online or in-person. A reflexive thematic analysis was performed. RESULTS: In total, 17 healthcare providers from medicine, nursing, midwifery, social work and Aboriginal clinical health backgrounds participated in the study. Ultimately, three themes were identified: 'Being committed to quality care: taking a holistic approach', 'Surmounting challenges: being an abortion provider is difficult', and 'Meeting external roadblocks: deficiencies in the wider healthcare system'. Participants felt well-supported by their team to provide person-centred and holistic care, while facing the emotional and ethical challenges of their role. The limited abortion workforce capacity in the wider healthcare system was perceived to compromise equitable access to care. CONCLUSIONS: Providers of abortion at 20 weeks and over for non-medicalised indications encounter systemic enablers and barriers to delivering care at personal, service delivery and healthcare levels. There is an urgent need for supportive policies and frameworks to strengthen and support the abortion provider workforce and expand provision of affordable, acceptable and accessible abortions at 20 weeks and over in Victoria and in Australia more broadly.


Asunto(s)
Aborto Inducido , Actitud del Personal de Salud , Embarazo , Femenino , Humanos , Victoria , Aborto Inducido/psicología , Anticoncepción , Personal de Salud/psicología , Investigación Cualitativa , Accesibilidad a los Servicios de Salud
10.
Proc Natl Acad Sci U S A ; 121(10): e2315195121, 2024 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-38412133

RESUMEN

A great deal of empirical research has examined who falls for misinformation and why. Here, we introduce a formal game-theoretic model of engagement with news stories that captures the strategic interplay between (mis)information consumers and producers. A key insight from the model is that observed patterns of engagement do not necessarily reflect the preferences of consumers. This is because producers seeking to promote misinformation can use strategies that lead moderately inattentive readers to engage more with false stories than true ones-even when readers prefer more accurate over less accurate information. We then empirically test people's preferences for accuracy in the news. In three studies, we find that people strongly prefer to click and share news they perceive as more accurate-both in a general population sample, and in a sample of users recruited through Twitter who had actually shared links to misinformation sites online. Despite this preference for accurate news-and consistent with the predictions of our model-we find markedly different engagement patterns for articles from misinformation versus mainstream news sites. Using 1,000 headlines from 20 misinformation and 20 mainstream news sites, we compare Facebook engagement data with 20,000 accuracy ratings collected in a survey experiment. Engagement with a headline is negatively correlated with perceived accuracy for misinformation sites, but positively correlated with perceived accuracy for mainstream sites. Taken together, these theoretical and empirical results suggest that consumer preferences cannot be straightforwardly inferred from empirical patterns of engagement.


Asunto(s)
Comportamiento del Consumidor , Medios de Comunicación Sociales , Humanos , Comunicación , Encuestas y Cuestionarios , Cognición , Investigación Empírica
11.
BMJ Open ; 14(2): e075682, 2024 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-38382950

RESUMEN

INTRODUCTION: The healthcare systems in Europe are changing rapidly due to the increased complexity of healthcare needs, specifically for the ageing population with chronic diseases. Nurses play a key role in providing care for patients with chronic diseases, encouraging patients to take care of their own health improving their Health Literacy (HL) too. Previous works have highlighted the paucity of HL content in nursing curricula, and the need to prioritise the development of HL skills in academic teaching and assessment methods. The aim of this study is to analyse HL skills nursing literature to further develop scientific knowledge in this area of research. METHODS AND ANALYSIS: This scoping review will be conducted following Arksey and O'Malley's framework. This study is based on the Joanna Briggs Institute manual. A systematic search will be performed by four researchers using the electronic databases of MEDLINE (via PubMed), the Education Resources Information Centre, the Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science and Google Scholar. We will include any paper that focuses on HL skills and undergraduate nursing students. We will select every primary study (quantitative, qualitative and mixed method design) published in peer-reviewed journals up until February 2023, in both Italian and English language, without any time limit. ETHICS AND DISSEMINATION: This scoping review is part of a large project of the University of Catania which aims at developing higher educational standards for nursing student. This project will not involve patients/public and does not require ethical committee approval. This scoping review will be submitted to international peer-reviewed journals. REGISTRATION DETAILS: The protocol was registered with the Open Science Framework on 20 April 2023 (https://osf.io/cn8d7).


Asunto(s)
Bachillerato en Enfermería , Alfabetización en Salud , Estudiantes de Enfermería , Humanos , Academias e Institutos , Enfermedad Crónica , Proyectos de Investigación , Literatura de Revisión como Asunto
12.
Appl Ergon ; 117: 104188, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38301320

RESUMEN

Despite robot-assisted surgery (RAS) becoming increasingly common, little is known about the impact of the underlying work organization on the stress levels of members of the operating room (OR) team. To this end, assessing whether RAS may impact work-related stress, identifying associated stress factors and surveying relevant measurement methods seems critical. Using three databases (Scopus, Medline, Google Scholar), a systematic review was conducted leading to the analysis of 20 articles. Results regarding OR team stress levels and measurement methods were heterogeneous, which could be explained by differing research conditions (i.e., lab. vs. real-life). Relevant stressors such as (in)experience with RAS and quality of team communication were identified. Development of a common, more reliable methodology of stress assessment is required. Research should focus on real-life conditions in order to develop valid and actionable knowledge. Surgical teams would greatly benefit from discussing RAS-related stressors and developing team-specific strategies to handle them.


Asunto(s)
Procedimientos Quirúrgicos Robotizados , Humanos , Comunicación , Encuestas y Cuestionarios
13.
Can Fam Physician ; 70(2): 109-116, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38383018

RESUMEN

OBJECTIVE: To determine the scale and scope of use of point-of-care ultrasound (POCUS) in rural British Columbia (BC). DESIGN: Online survey. SETTING: Rural BC. PARTICIPANTS: Physicians practising in rural BC communities. MAIN OUTCOME MEASURES: Practitioner demographic and practice characteristics, locations and frequency of POCUS use, POCUS education and training, and practitioner attitudes about and barriers to POCUS use. RESULTS: Two hundred twenty-seven surveys were completed in fall 2021, corresponding to a response rate of 11.9% of all rural practitioners in BC. A total of 52.1% of respondents worked in communities with less than 10,000 people, while 24.9% had practices with relatively large proportions of Indigenous patients (more than 20% of the practice population). Respondents reported ease of access to local POCUS devices, with use highest in emergency departments (87.2%) followed by ambulatory care clinic (54.7%) and inpatient (50.3%) settings. Use of POCUS influenced clinical decision making in half the occasions in which it was employed, including a range of diagnostic and procedural applications. Barriers to use included lack of training, limited time to perform POCUS scans, and absence of image review or consultative support. Needed support for POCUS identified by respondents included real-time image acquisition advice and funding for both device acquisition and training. Recommendations for including POCUS training in undergraduate and residency education were strongly supported. CONCLUSION: Use of POCUS in BC is expanding in frequency, scope, and scale in practices serving rural areas and in rural communities with large Indigenous populations, with practitioners reporting important improvements in clinical care as a result. Future research could help improve systemic support for POCUS use, guide needed curriculum changes in medical school and postgraduate training, and be used to inform continuing professional development needs.


Asunto(s)
Sistemas de Atención de Punto , Población Rural , Humanos , Colombia Británica , Curriculum , Encuestas y Cuestionarios , Ultrasonografía/métodos
14.
Ann Glob Health ; 90(1): 15, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38370864

RESUMEN

Background: Health National Adaptation Plans were developed to increase the capacity of low- and middle-income countries (LMICs) to adapt to the impacts of climate change on the health sector. Climate and its health impacts vary locally, yet frameworks for evaluating the adaptive capacity of health systems on the subnational scale are lacking. In Kenya, counties prepare county integrated development plans (CIDPs), which contain information that might support evaluations of the extent to which counties are planning climate change adaptation for health. Objectives: To develop and apply a framework for evaluating CIDPs to assess the extent to which Kenya's counties are addressing the health sector's adaptive capacity to climate change. Methods: CIDPs were analyzed based on the extent to which they addressed climate change in their description of county health status, whether health is noted in their descriptions of climate change, and whether they mention plans for developing climate and health programs. Based on these and other data points, composite climate and health adaptation (CHA) scores were calculated. Associations between CHA scores and poverty rates were analyzed. Findings: CHA scores varied widely and were not associated with county-level poverty. Nearly all CIDPs noted climate change, approximately half mentioned health in the context of climate change and only 16 (34%) noted one or more specific climate-sensitive health conditions. Twelve (25%) had plans for a sub-program in both adaptive capacity and environmental health. Among the 24 counties with plans to develop climate-related programs in health programs, all specified capacity building, and 20% specified integrating health into disaster risk reduction. Conclusion: Analyses of county planning documents provide insights into the extent to which the impacts of climate change on health are being addressed at the subnational level in Kenya. This approach may support governments elsewhere in evaluating climate change adaptation for health by subnational governments.


Asunto(s)
Cambio Climático , Desastres , Humanos , Kenia , Promoción de la Salud , Planificación Social
15.
Support Care Cancer ; 32(3): 164, 2024 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-38367086

RESUMEN

PURPOSE: Advance care planning (ACP) discussions can help adolescents and young adults (AYAs) communicate their preferences to their caregivers and clinical team, yet little is known about willingness to hold conversations, content, and evolution of care preferences. We aimed to assess change in care preferences and reasons for such changes over time and examine the reasons for engaging or not engaging in ACP discussions and content of these discussions among AYAs and their caregivers. METHODS: We conducted a pilot randomized controlled trial of a novel video-based ACP tool among AYA patients aged 18-39 with advanced cancer and their caregivers. Participants were asked their care preferences at baseline, after viewing the video or hearing verbal description (post questionnaire), and again 3 months later. Three-month phone calls also queried if any ACP conversations occurred since the initial study visit. Study team notes from these phone calls were evaluated using content analysis. RESULTS: Forty-five AYAs and 40 caregivers completed the 3-month follow-up. Nearly half of AYAs and caregivers changed their care preference from post questionnaire to 3-month follow-up. Increased reflection and learning on the topic (n = 45) prompted preference change, with participants often noting the nuanced and context-specific nature of these decisions (n = 20). Most AYAs (60%) and caregivers (65%) engaged in ACP conversation(s), often with a family member. Disease-related factors (n = 8), study participation (n = 8), and a desire for shared understanding (n = 6) were common reasons for initiating discussions. Barriers included disease status (n = 14) and timing (n = 12). ACP discussions focused on both specific wishes for treatment (n = 26) and general conversations about goals and values (n = 18). CONCLUSION: AYAs and caregivers acknowledged the complexity of ACP decisions, identifying obstacles and aids for these discussions. Clinicians should support a personalized approach to ACP that captures these nuances, promoting ACP as an iterative, longitudinal, and collaborative process. TRIAL REGISTRATION: This trial was registered 10/31/2019 with ClinicalTrials.gov (Identifier: NCT0414907).


Asunto(s)
Planificación Anticipada de Atención , Neoplasias , Humanos , Adolescente , Adulto Joven , Neoplasias/terapia , Comunicación , Familia
16.
Support Care Cancer ; 32(3): 180, 2024 Feb 22.
Artículo en Inglés | MEDLINE | ID: mdl-38386075

RESUMEN

PURPOSE: The objective of this study is to identify the beliefs, values, perceptions, and experiences of medical oncology, radiation oncology, and clinical haematology professionals about the advance care planning process. METHODS: Qualitative exploratory study. There were four focus groups with 14 nurses and 12 physicians (eight medical oncology, one radiation oncology, three haematology). A reflexive thematic analysis of the data obtained was performed. RESULTS: We identified 20 thematic categories, which we grouped into four themes: lack of knowledge about advance care planning; perception of the advance care planning process: knowledge acquired from practice; barriers and facilitators for the implementation of advance care planning; and communication as a key aspect of advance care planning. CONCLUSIONS: The participants valued advance care planning as an early intervention tool that promotes autonomy. They perceived difficulties in approaching planning due to lack of knowledge, training, and time. They identified the therapeutic relationship with the person, the participation of the person's loved ones, teamwork, and communication skills as essential to ensuring the quality of the process. Finally, they recognised that palliative care professionals provide added value in supporting planning processes.


Asunto(s)
Planificación Anticipada de Atención , Hematología , Humanos , Investigación Cualitativa , Grupos Focales , Comunicación
17.
N Z Med J ; 137(1590): 57-76, 2024 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-38386856

RESUMEN

AIMS: Cervical cancer remains a burden within Aotearoa New Zealand, with 2022 screening rates sitting 12.7% below target. The National Cervical Screening Programme has changed to primary human papillomavirus (HPV) testing for all screen-eligible people, with the aim for home self-testing. Little is known about the readiness of primary care for the change to self-testing and its associated challenges. A pilot HPV cervical cancer screening programme is being conducted in 17 practice centres. The aim of this study is to explore smear-taker knowledge at these centres about the use of primary HPV testing for cervical cancer screening. METHODS: This is an ethically approved questionnaire study, with data from a structured web-based questionnaire sent to all smear-takers at the pilot centres. RESULTS: We achieved a total completion rate of 57.8%. The average score for "Knowledge of HPV" was 56.5% (range=20-100%). The challenges to patient home HPV self-testing were felt to be overall "not at all" to "mildly challenging". Up to 73.3% of participants identified ongoing needs for further education. CONCLUSIONS: The findings indicate knowledge deficits regarding HPV testing for cervical cancer screening and a desire for the provision of further education. Overall, respondents felt that no major barriers to implementing HPV self-testing would occur.


Asunto(s)
Infecciones por Papillomavirus , Neoplasias del Cuello Uterino , Humanos , Femenino , Detección Precoz del Cáncer , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/prevención & control , Nueva Zelanda , Infecciones por Papillomavirus/diagnóstico , Encuestas y Cuestionarios , Atención Primaria de Salud , Tamizaje Masivo , Papillomaviridae , Frotis Vaginal
18.
J Grad Med Educ ; 16(1): 59-63, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38304599

RESUMEN

Background Internal medicine residents frequently experience distressing clinical events; critical event debriefing is one tool to help mitigate their effects. Objective To evaluate the effectiveness of a 1-hour workshop teaching residents a novel, efficient approach to leading a team debrief after emotionally charged clinical events. Methods An internal needs assessment identified time and confidence as debriefing barriers. In response, we created the STREAM (Structured, Timely, Reflection, tEAM-based) framework, a 15-minute structured approach to leading a debrief. Senior residents participated in a 1-hour workshop on the first day of an inpatient medicine rotation to learn the STREAM framework. To evaluate learning outcomes, participants completed the same survey immediately before and after the session, and at the end of their 4-week rotation. Senior residents at another site who did not complete the workshop also evaluated their comfort leading debriefs. Results Fifty out of 65 senior residents (77%) participated in the workshop. After the workshop, participants felt more prepared to lead debriefs, learned a structured format for debriefing, and felt they had enough time to lead debriefs. Thirty-four of 50 (68%) workshop participants and 20 of 41 (49%) comparison residents completed the end-of-rotation survey. Senior residents who participated in the workshop were more likely than nonparticipants to report feeling prepared to lead debriefs. Conclusions A brief workshop is an effective method for teaching a framework for leading a team debrief.


Asunto(s)
Internado y Residencia , Humanos , Curriculum , Educación de Postgrado en Medicina/métodos , Aprendizaje , Encuestas y Cuestionarios
19.
Aten. prim. (Barc., Ed. impr.) ; 56(2): [102782], Feb. 2024. tab, ilus, graf
Artículo en Español | IBECS | ID: ibc-230388

RESUMEN

Objetivo: El objetivo fue desarrollar un cribado de detección de cardiopatías en atención primaria, para identificar alteraciones electrocardiográficas patológicas y cardiopatías subyacentes en adolescentes. Diseño: Durante un año se realizó el estudio mediante muestreo polietápico. Lugar: Se seleccionaron los centros asistenciales de atención primaria en un área de salud, que dispusieran de equipo de electrocardiograma (ECG) digital (12 centros). Participantes: Inicialmente, se reclutó a 718 (16,6%) adolescentes de 14 años y se excluyeron a los que tenían un diagnóstico de cardiopatía previo. Intervención: El cribado consistió en incluir en la revisión obligatoria de los 14 años un cuestionario de salud y un ECG. Principales medidas: Para el cribado se realizó cuestionario, auscultación cardíaca, ECG y ecocardiografía. Se establecieron criterios de anormalidad para remitir a una segunda valoración por un cardiólogo. Resultados: Finalmente la muestra la componen 698 adolescentes, con una edad media de 13,7± 0,5 años, de los cuales 354 (50,7%) fueron chicos. Fueron seleccionados 149 (21,3%) para la segunda revisión por cardiología: 88 (12,6%) por cuestionario positivo, 11 (2,2%) por auscultación cardíaca anormal y 66 (9,5%) por hallazgos en ECG. Los adolescentes con evidencia de cardiopatía fueron 24 (3,4%). De ellos, 14 (2,0%) tuvieron alteraciones sugestivas y se les recomendó seguimiento, 6 (0,9%) tuvieron diagnóstico definitivo de cardiopatía y 4 (0,6%) tenían otros hallazgos patológicos relacionados con el sistema cardiovascular. Conclusiones: El cribado permitió identificar un 1% de adolescentes con cardiopatía y otro 2% permanecerá en seguimiento. El ECG detectó más casos patológicos que el cuestionario.(AU)


Objective: The objective was to develop a screening for heart disease detection in primary care, to identify pathological electrocardiographic changes and underlying heart disease in adolescents. Design: The study was carried out for one year using multistage sampling. Site: Primary care centers in a health area that had digital ECG equipment (12 centers) were selected. Participants: Initially, 718 (16.6%) 14-year-old adolescents were recruited and those with a previous diagnosis of heart disease were excluded. Interventions: Screening consisted of including a health questionnaire in the mandatory 14-year-old check-up. Main measurements: Screening included a questionnaire, cardiac auscultation, ECG and echocardiography. Abnormality criteria were established to refer for a second evaluation by a cardiologist. Results: Finally, the sample was made up of 698 adolescents, with a mean age of 13.7±0.5 years, and 354 (50.7%) were boys. A total of 149 (21.3%) were selected for a second review by cardiology: 88 (12.6%) due to a positive questionnaire, 11 (2.2%) due to abnormal cardiac auscultation, and 66 (9.5%) due to ECG findings. Adolescents with evidence of heart disease were 24 (3.4%). Of these, 14 (2.0%) had suggestive alterations and follow-up was recommended, 6 (0.9%) had a definitive diagnosis of heart disease, and 4 (0.6%) had other pathological findings related to the cardiovascular system. Conclusions: The screening allowed us to identify 1% of adolescents with heart disease and another 2% will remain in follow-up. The ECG detected more pathological cases than the questionnaire.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Cardiopatías , Atención Primaria de Salud , Electrocardiografía , Tamizaje Masivo , Muerte Súbita Cardíaca , Estudios Prospectivos , España , Encuestas y Cuestionarios
20.
Rev. Fund. Educ. Méd. (Ed. impr.) ; 27(1): 13-19, Feb. 2024. tab
Artículo en Español | IBECS | ID: ibc-231174

RESUMEN

Introducción: El presente trabajo tuvo como propósito conocer el nivel de resiliencia en contexto pandémico en una muestra de estudiantes de pregrado de ciencias de la salud y cómo ésta se comporta en escenarios de telesimulación. Sujetos y métodos: El estudio tuvo un enfoque cuantitativo, con diseño observacional y temporalidad transversal. Se incluyó a 192 estudiantes pertenecientes a cinco carreras de las ciencias de la salud, cuyas edades oscilaron entre los 20 y los 49 años. Para medir la variable de interés se utilizó el cuestionario de resiliencia adaptado a 44 ítems con respuestas en escalamiento de tipo Likert. Resultados: Los resultados muestran niveles altos de resiliencia en carreras con programas de estudio que incluyen la telesimulación y las diferencias entre cada una de estas carreras. Conclusiones: Se sugiere la ampliación de la línea de investigación en otros contextos situacionales e intervención de metodologías de enseñanza-aprendizaje, con el fin de potenciar los procesos de adaptación de los estudiantes de salud y evaluar competencias esperadas del perfil de egreso, directamente relacionadas con su desempeño en su quehacer profesional.(AU)


Introduction: The purpose of this work was to know the level of resilience in a pandemic context in a sample of undergraduate students of health sciences, and how it behaves in tele-simulation scenarios. The study had a quantitative approach, with observational design, cross-sectional temporality and prospective.Subjects and methods: We included 192 students belonging to 5 careers in health sciences, whose ages ranged between 20 and 49 years. To measure the variable of interest, the resilience questionnaire adapted to 44 items with Likert-type scaling responses was used. Results: The results show high levels of resilience in careers with study programs that include tele-simulation and the differences between each of these careers. Conclusions: It is suggested to expand the line of research in other situational contexts and intervention of teachinglearning methodologies, to enhance the adaptation processes of health students and evaluate expected competencies of the graduation profile, directly related to their performance in their professional work.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Adulto , Educación Médica/métodos , Entrenamiento Simulado/métodos , Ciencias de la Salud/educación , Resiliencia Psicológica , /epidemiología , Educación a Distancia , Chile , Educación/métodos , Estudios de Evaluación como Asunto , Estudios Transversales , Estudiantes/psicología , Adaptación Psicológica
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