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BACKGROUND: High participation and performance are necessary conditions for the effectiveness of breast cancer screening programs. Here we describe the process to define and test a planning software application and an audit cycle based on the PRECEDE-PROCEED model applied to improving breast cancer screening. We developed a planning software application following the phases of the PRECEDE-PROCEED model. The application was co-designed by local cancer screening program coordinators. An audit model was also developed. The revised application and the audit model were tested by all the coordinators of 15 breast cancer screening programs in the region of Lombardy in a 3-day workshop. The project plans produced using the application were compared with those produced in the previous year for clarity and completeness. RESULTS: The 9 phases of the PRECEDE-PROCEED model were adapted to screening as follows: 1) identification of program goals (i.e., participation, sensitivity, false positive); 2) epidemiological issues; 3) best practices analysis; 4) evidence-based actions to be implemented in the screening center and the relationships with partners and stakeholders; 5) priority setting and identification of solutions for each issue; 6) definition of indicators; 7) monitoring; 8) evaluation; 9) impact assessment. The application automatically generated reports for each phase. During the audit cycle, the regional health authority negotiated the targets to be reached with local authorities and collected the improvement plans generated by the application. The plans produced after the application was adopted were more standardized and had clearer indicators for monitoring and evaluation compared to those produced in the previous year. CONCLUSIONS: The software application helps standardize criteria for planning interventions to improve screening programs and facilitates the implementation of the audit cycle.
Assuntos
Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer , Auditoria Médica/organização & administração , Idoso , Feminino , Humanos , Itália , Pessoa de Meia-Idade , Modelos Teóricos , Avaliação de Programas e Projetos de SaúdeRESUMO
Increased participation in cancer screening programs is undoubtedly a primary objective in Public Health. The Green and Kreuter model, structured in an Access program, was presented to the Regional Coordinators for cancer screening during specific training events. This survey was carried out to verify their appreciation of the model and whether those who participated in the project intended to use the program.
Assuntos
Detecção Precoce de Câncer , Neoplasias/diagnóstico , Detecção Precoce de Câncer/métodos , Humanos , Itália , SoftwareRESUMO
Since February 2022, 7.8 million people have left Ukraine. In total, 80% are women and children. The present quali-quantitative study is the first in Italy to (i) describe the adaptation challenges and the resources of refugee parents and, indirectly, of their children and (ii) investigate the impact of neuropsychopedagogical training on their wellbeing. The sample includes N = 15 Ukrainian parents (80% mothers, mean age = 34 years) who arrived in Italy in March and April 2022. The parents participated in neuropsychopedagogical training within the program Envisioning the Future (EF): the 10 Keys to Resilience. Before the training, participants completed an ad hoc checklist to detect adjustment difficulties. After the training, they responded to a three-item post-training questionnaire on the course and to a semi-structured interview deepening adaptation problems, personal resources, and the neuropsychopedagogical training effects. Participants report that since they departed from Ukraine, they have experienced sleep, mood, and concentration problems, and specific fears, which they also observed in their children. They report self-efficacy, self-esteem, social support, spirituality, and common humanity as their principal resources. As effects of the training, they report an increased sense of security, quality of sleep, and more frequent positive thoughts. The interviews also reveal a 3-fold positive effect of the training (e.g., behavioral, emotional-relational, and cognitive-narrative).
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The Sphere Model of Consciousness (SMC) delineates a sphere-shaped matrix that aims to describe subjective experiences using geometric coordinates, in accordance with a neurophenomenological perspective. According to the SMC, an experience of overcoming the habitual self and the conditioning of memories could be placed at the center of the matrix, which can then be called the Place of Pre-Existence (PPE). The PPE is causally associated with self-determination. In this context, we suggest that silence could be considered an intentional inner environment enabling self-perception to focus on the "here and now," which in turn improves perception of one's own body in space. To investigate the hypotheses grounded in the model, the current preliminary study examined the Place of Pre-Existence Technique (PPEt), in which practitioners are guided to focus on a self-defined aim, reach a state of detachment from the habitual self, and envision the future. Four-hundred eighty-one volunteer PPEt practitioners completed self-report questionnaires before and after an intensive 3-day meditative training. We analyzed potential relationships between subjective experiences related to physical, emotional, mental, temporal, and spatial components, as well as self-determination and silence, before and after training. The results indicated a transition from a prevailing influence of mental dimension on the other aspects of experience, to a prevailing influence of the spatial dimension. Silence was reported more often following the training and was predominantly related to mental and emotional experiences. The results are discussed in the framework of the SMC, as compared to other models, and in relation to the shift from Narrative to Minimal Self and to increased balance among the considered dimensions.
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AIM: The main aim of this study is to investigate the burden in relatives of psychiatric patients attending long-term psychodynamic multifamily groups (18 months) of some Mental Health Departments of Lazio Region. A further aim is to verify if the decrease of the burden and the group participation are associated with a reduction of psychiatric symptoms in patients. METHODS: The sample consisted of 13 patients (10 men and 3 women) with severe personality disorder with at least one psychotic episode and 42 caregivers (15 men and 27 women). We administered a psychiatric protocol composed of the MCMI-III for the patients and QRS for the caregivers. RESULTS: The results show a reduction of the subjective burden especially in mothers (F=4.231; sig.=.021). Further results show that the reduction of anxiety (F=1.446; p<.001), somatoform (F=3.573; p<.001), dysthymia (F=2.203; p<.001) and thought disorder (F=2.992; p<.001) in the patients is influenced by the relationship between the "time spent in group" and the "lower subjective burden". DISCUSSION AND CONCLUSIONS: These results suggest a burden decrease, particularly in women caregivers, with direct effects on the structural modifications of the severe syndromes in psychiatric patients.