Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.257
Filtrar
Más filtros

Intervalo de año de publicación
1.
Int J Group Psychother ; 74(2): 177-216, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38621114

RESUMEN

This feasibility study reports on the development and initial evaluation of a novel online intervention for helping professionals (HPs; i.e. mental health professionals, chaplains, clergy) designed to (a) address occupational hazards, such as burnout and vicarious traumatization, and (b) promote well-being and flourishing at work. In contrast with competency and self-care focused models, the CHRYSALIS (Catalyzing Helping Professionals' Resilience, VitalitY, Spirituality, Authentic Living, and Inner Strength) intervention centers the self of the provider, explores cultural and spiritual contexts, and attends to systemic challenges. As part of a larger randomized controlled trial evaluating two program formats, the group format entails eight online sessions exploring strengths that can promote well-being, including processing, relational, vitalizing, orienting, and agentic capacities. To pilot test this framework and establish proof of concept, this study analyzed data from 41 HPs who had been randomly assigned to the group condition and completed surveys at four time points. Quantitative results indicated significant reductions in vicarious traumatization and burnout as well as increased well-being and meaning in work. Qualitative results suggest the intervention fostered relational support, cultivated new perspectives, and increased engagement with strengths, positively impacting participants' work and navigation of caregiving systems. Feedback about cohesion and group dynamic challenges in an online format informed further program development. This study provides initial support for the feasibility and efficacy of the group format of the CHRYSALIS intervention as a creative means to address HPs' risk for occupational hazards and promote holistic formation in a relational context.


Asunto(s)
Agotamiento Profesional , Clero , Estudios de Factibilidad , Psicoterapia de Grupo , Humanos , Agotamiento Profesional/prevención & control , Adulto , Masculino , Femenino , Psicoterapia de Grupo/métodos , Personal de Salud , Persona de Mediana Edad , Resiliencia Psicológica , Espiritualidad
2.
PLoS One ; 19(4): e0296247, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38625871

RESUMEN

BACKGROUND: The role of Vitamin D in immune function is well reported with a growing evidence base linking low levels to poorer outcomes from infectious disease. Vitamin D deficiency and insufficiency are prevalent worldwide with healthcare workers identified as a known at-risk group. Here we aim to investigate serum Vitamin D levels in a UK population of front line healthcare workers and to promote the occupational risk. METHODS: A cross-sectional study of 639 volunteers was conducted to identify the prevalence of Vitamin D deficiency and insufficiency amongst a population of front-line health care workers in the UK. Participant demographics and co-morbid factors were collected at the time of serum sampling for multivariate analysis. RESULTS: Only 18.8% of the population had a normal vitamin D level greater than or equal to 75nmol/L. This is compared to Public Health England's (PHE) stipulated normal levels of 60% during winter. 81.2% had a level less than 75nmol/L, with 51.2% less than 50nmol/L and 6.6% less than 25nmol/L. For serum levels less than 25nmol/L, Asian ethnicity was more likely to have a vitamin D deficiency than non-asian (OR (95%CI): 3.81 (1.73-8.39), p = 0.001), whereas white ethnicity was less likely to have a vitamin D deficiency compared to non-white (OR (95%CI: 0.43 (0.20-0.83), p = 0.03). Other factors that contributed to a higher likelihood of lower-than-normal levels within this population included male sex, decreased age and not taking supplementation. CONCLUSION: It is concluded that our population of healthcare workers have higher rates of abnormal vitamin D levels in comparison with the general UK population reported prevalence. Furthermore, Asian ethnicity and age 30 years and below are more at risk of vitamin D insufficiency and deficiency. This highlights an occupational risk factor for the healthcare community to consider.


Asunto(s)
Personal de Salud , Deficiencia de Vitamina D , Vitamina D , Humanos , Masculino , Adulto , Vitamina D/sangre , Deficiencia de Vitamina D/tratamiento farmacológico , Deficiencia de Vitamina D/epidemiología , Vitaminas/administración & dosificación , Estudios Transversales , Reino Unido/epidemiología , Prevalencia , Femenino , Persona de Mediana Edad
3.
J Assoc Nurses AIDS Care ; 35(4): 325-338, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38563452

RESUMEN

ABSTRACT: Promoting adherence to HIV care among persons with HIV (PWH) is a key component to addressing the rising HIV epidemic in the Philippines. HIV care adherence is a complex process that may change throughout an individual's life course or "journey" living with HIV. This qualitative study aimed to explore the HIV care adherence journey of PWH. Maximum variation sampling was used to select 12 PWH and 3 health care providers for in-depth online interviews, which were analyzed using thematic analysis. The four themes that emerged to describe the HIV care adherence journey are integration, relation, navigation, and manifestation. Each theme corresponds to a unique set of activities and goals related to PWH's lived experiences as they initiate, practice, and maintain care adherence. This study provides a preliminary framework to characterize the HIV care adherence journey as a dynamic, complex, and multifaceted phenomenon, which can help to inform holistic interventions to support PWH.


Asunto(s)
Infecciones por VIH , Investigación Cualitativa , Humanos , Infecciones por VIH/psicología , Infecciones por VIH/tratamiento farmacológico , Filipinas , Masculino , Femenino , Adulto , Entrevistas como Asunto , Persona de Mediana Edad , Atención Dirigida al Paciente , Cumplimiento de la Medicación/psicología , Personal de Salud/psicología
4.
Br Dent J ; 236(7): 525-527, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38609610

RESUMEN

The World Health Assembly in May 2021 was a watershed moment in oral health, with the landmark resolution that designated oral diseases as non-communicable diseases (NCDs). This was strongly supported by a host of other NCDs in recognition of the common risk factor principle and acknowledgement of the fact that oral diseases do not occur in isolation from other NCDs, but are commonly associated with cardiovascular disease, diabetes/obesity, respiratory diseases, metabolic syndrome, a range of other inflammatory disorders and cancers. Regular monitoring and early detection would potentially intercept these NCDs and this could form a central plank of a revamped holistic 'health'- as opposed to 'disease'-oriented health care system.Consultation with patients and dentists reveals strong support for maintaining regular recall intervals, which maintains trust and optimises motivation and compliance. In-person visits could be minimised by using technology, such as remote consultations and longitudinal monitoring systems, making it adaptable to different health care settings and equitable, affordable, cost-effective and sustainable.A new paradigm with dentists as oral health professionals, and the mainstreaming of oral health and population-level prevention, means the future of health care can be guided by integration and workforce modification producing a surveillance-based, early interceptive, preventive model of care.


Asunto(s)
Enfermedades Cardiovasculares , Medicina Estatal , Humanos , Personal de Salud , Salud Holística , Odontología
5.
J Spec Pediatr Nurs ; 29(2): e12426, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38615233

RESUMEN

PURPOSE: The transition from hospital to home can be challenging for parents of prematurely born infants. The aim of this ethnographic study was to describe a multidisciplinary and cross-sectoral discharge conference for families with premature infants transitioning from a neonatal intensive care unit to municipal healthcare services. DESIGN AND METHODS: An ethnographically/anthropologically inspired qualitative design was adopted. We conducted four participant observations of multidisciplinary and cross-sectoral discharge conferences and 12 semistructured interviews with four neonatologists, four nurses, and four health visitors who had attended one of the conferences. Salient themes were generated by two-part analysis consisting of a thematic analysis followed by Turner's ritual analysis. RESULTS: This study illustrated how multidisciplinary and cross-sectoral discharge conferences improved the quality of care for premature infants and their families in their transition process which was perceived as complex. These conferences contributed to promoting a sense of coherence and continuity of care. The healthcare professionals experienced that this event may be characterized as a ritual, which created structures that promoted cross-sectoral cooperation and communication while increasing interdisciplinary knowledge sharing. Thus, the conferences triggered a sense that the participants were building bridges to unite healthcare sectors, ensuring a holistic and coordinated approach to meet the unique needs of the infants and their families. IMPLICATIONS FOR PRACTICE: This study presented a unique holistic and family-centered approach to constructing multidisciplinary and cross-sectoral discharge conferences that seemed to underpin the quality of interdisciplinary and health-related knowledge sharing and establish a crucial starting point for early interventions, preventive measures, and health-promoting efforts. Hopefully, our findings will encourage others to rethink the discharge conference as a transitional ritual that may potentially bridge the gap between healthcare sectors. Specifically, our findings contribute to the mounting body of knowledge of family-centered care by showing how healthcare professionals may-in a meaningful and tangible manner-operate, develop, and implement this somewhat elusive theoretical foundation in their clinical practice.


Asunto(s)
Sector de Atención de Salud , Unidades de Cuidado Intensivo Neonatal , Lactante , Recién Nacido , Humanos , Recien Nacido Prematuro , Personal de Salud , Hospitales
6.
PLoS One ; 19(4): e0299627, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38626224

RESUMEN

INTRODUCTION: The United States Institute of Medicine defines patient centred care (PCC), a core element of healthcare quality, as care that is holistic and responsive to individual needs. PCC is associated with better patient satisfaction and improved clinical outcomes. Current conceptualizations of PCC are mainly from Europe and North America. This systematic review summarises the perceived dimensions of PCC among patients and healthcare workers within hospitals in sub-Saharan Africa (SSA). METHODS: Without date restrictions, searches were done on databases of the Web of Science, Cochrane Library, PubMed, Embase, Global Health, and grey literature, from their inception up to 11th August 2022. Only qualitative studies exploring dimensions or perceptions of PCC among patients, doctors and/or nurses in hospitals in (SSA) were included. Review articles and editorials were excluded. Two independent reviewers screened titles and abstracts, and conducted full-text reviews with conflicts resolved by a third reviewer. The CASP (critical appraisal skills program) checklist was utilised to assess the quality of included studies. The framework synthesis method was employed for data synthesis. RESULTS: 5507 articles were retrieved. Thirty-eight studies met the inclusion criteria, of which 17 were in the specialty of obstetrics, while the rest were spread across different fields. The perceived dimensions reported in the studies included privacy and confidentiality, communication, shared decision making, dignity and respect, continuity of care, access to care, adequate infrastructure and empowerment. Separate analysis of patients' and providers' perspective revealed a difference in the practical understanding of shared-decision making. These dimensions were summarised into a framework consisting of patient-as-person, access to care, and integrated care. CONCLUSION: The conceptualization of PCC within SSA was largely similar to findings from other parts of the world, although with a stronger emphasis on access to care. In SSA, both relational and structural aspects of care were significant elements of PCC. Healthcare providers mostly perceived structural aspects such as infrastructure as key dimensions of PCC. TRIAL REGISTRATION: PROSPERO Registration number CRD42021238411.


Asunto(s)
Hospitales , Obstetricia , Embarazo , Femenino , Humanos , Personal de Salud , África del Sur del Sahara , Atención Dirigida al Paciente/métodos
7.
Leadersh Health Serv (Bradf Engl) ; 37(5): 99-129, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38619933

RESUMEN

PURPOSE: Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem set. Competent leaders are in demand to ensure effective and well-performing healthcare organisations that deliver balanced results and high-quality services. Researchers have made significant efforts to identify and define determining competencies for healthcare leadership. Broad terms such as competence are, however, inherently at risk of becoming too generic to add analytical value. The purpose of this study is to suggest a holistic framework for understanding healthcare leadership competence, that can be crucial for operationalising important healthcare leadership competencies for researchers, decision-makers as well as practitioners. DESIGN/METHODOLOGY/APPROACH: In the present study, a critical interpretive synthesis (CIS) was conducted to analyse competency descriptions for healthcare leaders. The descriptions were retrieved from peer reviewed empirical studies published between 2010 and 2022 that aimed to identify healthcare services leadership competencies. Grounded theory was utilised to code the data and inductively develop new categories of healthcare leadership competencies. The categorisation was then analysed to suggest a holistic framework for healthcare leadership competence. FINDINGS: Forty-one papers were included in the review. Coding and analysing the competence descriptions resulted in 12 healthcare leadership competence categories: (1) character, (2) interpersonal relations, (3) leadership, (4) professionalism, (5) soft HRM, (6) management, (7) organisational knowledge, (8) technology, (9) knowledge of the healthcare environment, (10) change and innovation, (11) knowledge transformation and (12) boundary spanning. Based on this result, a holistic framework for understanding and analysing healthcare services leadership competencies was suggested. This framework suggests that the 12 categories of healthcare leadership competencies include a range of knowledge, skills and abilities that can be understood across the dimension personal - and technical, and organisational internal and - external competencies. RESEARCH LIMITATIONS/IMPLICATIONS: This literature review was conducted with the results of searching only two electronic databases. Because of this, there is a chance that there exist empirical studies that could have added to the development of the competence categories or could have contradicted some of the descriptions used in this analysis that were assessed as quite harmonised. A CIS also opens for a broader search, including the grey literature, books, policy documents and so on, but this study was limited to peer-reviewed empirical studies. This limitation could also have affected the result, as complex phenomenon such as competence might have been disclosed in greater details in, for example, books. PRACTICAL IMPLICATIONS: The holistic framework for healthcare leadership competences offers a common understanding of a "fuzzy" concept such as competence and can be used to identify specific competency needs in healthcare organisations, to develop strategic competency plans and educational programmes for healthcare leaders. ORIGINALITY/VALUE: This study reveals a lack of consensus regarding the use and understanding of the concept of competence, and that key competencies addressed in the included papers are described vastly different in terms of what knowledge, skills and abilities they entail. This challenges the operationalisation of healthcare services leadership competencies. The proposed framework for healthcare services leadership competencies offers a common understanding of work-related competencies and a possibility to analyse key leadership competencies based on a holistic framework.


Asunto(s)
Personal de Salud , Liderazgo , Humanos , Competencia Profesional , Instituciones de Salud , Atención a la Salud
8.
Vaccine ; 42(12): 3122-3133, 2024 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-38604909

RESUMEN

IMPORTANCE: Healthcare personnel (HCP) are important messengers for promoting vaccines, for both adults and children. Our investigation describes perceptions of fully vaccinated HCP about COVID-19 vaccine for themselves and primary series for their children. OBJECTIVE: To determine associations between sociodemographic, employment characteristics and perceptions of COVID-19 vaccines among HCP overall and the subset of HCP with children, who were all mandated to receive a COVID-19 vaccine, in a large US metropolitan region. DESIGN: Cross-sectional survey of fully vaccinated HCP from a large integrated health system. SETTING: Participants were electronically enrolled within a multi-site NYS healthcare system from December 21, 2021, to January 21, 2022. PARTICIPANTS: Of 78,000 employees, approximately one-third accessed promotional emails; 6,537 employees started surveys and 4165 completed them. Immunocompromised HCP (self-reported) were excluded. EXPOSURE(S) (FOR OBSERVATIONAL STUDIES): We conducted a survey with measures including demographic variables, employment history, booster status, child vaccination status; vaccine recommendation, confidence, and knowledge. MAIN OUTCOME(S) AND MEASURES: The primary outcome was COVID-19 vaccine hesitancy for all dose types - primary series or booster doses - among HCP. RESULTS: Findings from 4,165 completed surveys indicated that almost 17.2 % of all HCP, including administrative and clinical staff, were hesitant or unsure about receiving a COVID-19 vaccine booster, despite the NYS recommendation to do so. Depending on age group, between 20 % and 40 % of HCP were hesitant about having their children vaccinated for COVID-19, regardless of clinical versus non-clinical duties. In multivariable regression analyses, lack of booster dose, unvaccinated children, females, income less than $50,000, and residence in Manhattan remained significantly associated with vaccine hesitancy. CONCLUSIONS AND RELEVANCE: Despite mandated COVID-19 vaccination, a substantial proportion of HCP remained vaccine hesitant towards adult booster doses and pediatric COVID-19 vaccination. While provider recommendation has been the mainstay of combatting COVID-19 vaccine hesitancy, a gap exists between HCP-despite clinical or administrative status-and the ability to communicate the need for vaccination in a healthcare setting. While previous studies describe the HCP vaccine mandate as a positive force to overcome vaccine hesitancy, we have found that despite a mandate, there is still substantial COVID-19 vaccine hesitancy, misinformation, and reluctance to vaccinate children.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Inmunización Secundaria , Adulto , Femenino , Humanos , Niño , COVID-19/epidemiología , COVID-19/prevención & control , Estudios Transversales , Correo Electrónico , Personal de Salud , Vacunación
9.
BMJ Open ; 14(4): e075263, 2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38658007

RESUMEN

OBJECTIVE: The purpose of this exploratory study was to assess healthcare providers' perspectives on maternity care following the introduction of ultrasound services in the area. DESIGN: The qualitative descriptive study. STUDY SETTING: This study was carried out in health centres under Child Health and Mortality Prevention Surveillance (CHAMPS) pregnancy surveillance catchment areas in Kersa, Haramaya and Harar districts in eastern Ethiopia. PARTICIPANTS: The study participants were 14 midwives working in the maternity units and 14 health centre managers in the respective health facilities. Purposive sampling was used to select participants for in-depth interviews using a semistructured interview guide. Data were analysed using thematic analysis. RESULTS: We identified one overarching theme "improved perinatal care" and six subthemes. Based on the accounts of the participants, the introduction of ultrasound services has led to a remarkable transformation in the overall provision of maternity care at health centres. The participants have reported a substantial rise in the utilisation of antenatal, delivery and postnatal care services. The availability of ultrasound has enabled midwives to deliver comprehensive maternity care. CONCLUSION: Ultrasound service utilisation at health centres improves maternity care. The utilisation of ultrasound in healthcare enables providers to closely monitor the growth and development of the fetus, identify potential complications or abnormalities and administer timely interventions. This integration of ultrasound technology translates into enhanced prenatal care, early detection of issues and prompt management, ultimately leading to improved outcomes for both the mother and the baby.


Asunto(s)
Actitud del Personal de Salud , Servicios de Salud Materna , Investigación Cualitativa , Ultrasonografía Prenatal , Humanos , Etiopía , Femenino , Embarazo , Ultrasonografía Prenatal/estadística & datos numéricos , Adulto , Partería , Servicios de Salud Rural , Población Rural , Atención Prenatal , Entrevistas como Asunto , Personal de Salud
10.
BMC Health Serv Res ; 24(1): 519, 2024 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-38658992

RESUMEN

BACKGROUND: Mental disorders are common among people with HIV (PWH) and are associated with poor HIV outcomes. Despite high unmet mental health needs among PWH, use of evidence-based mental health screening and treatment protocols remains limited at HIV treatment facilities across low-resource settings. Integrating mental health services into HIV care can reduce this gap. This study's objective was to explore factors that influence integration of mental health screening and treatment into HIV clinics in Cameroon. METHODS: We analyzed 14 in-depth interviews with clinic staff supporting PWH at three urban HIV treatment clinics in Cameroon. Interviews focused on current processes, barriers and facilitators, and types of support needed to integrate mental health care into HIV care. Interviews were recorded and transcribed. French transcripts were translated into English. We used thematic analysis to identify factors that influence integration of mental health screening and treatment into HIV care in these settings. Ethical review boards in the United States and Cameroon approved this study. RESULTS: Respondents discussed a lack of standardized mental health screening processes in HIV treatment facilities and generally felt ill-equipped to conduct mental health screening. Low community awareness about mental disorders, mental health-related stigma, limited physical space, and high clinic volume affected providers' ability to screen clients for mental disorders. Providers indicated that better coordination and communication were needed to support client referral to mental health care. Despite these barriers, providers were motivated to screen clients for mental disorders and believed that mental health service provision could improve quality of HIV care and treatment outcomes. All providers interviewed said they would feel more confident screening for mental disorders with additional training and resources. Providers recommended community sensitization, training or hiring additional staff, improved coordination to manage referrals, and leadership buy-in at multiple levels of the health system to support sustainable integration of mental health screening and treatment into HIV clinics in Cameroon. CONCLUSIONS: Providers reported enthusiasm to integrate mental health services into HIV care but need more support and training to do so in an effective and sustainable manner.


Asunto(s)
Infecciones por VIH , Tamizaje Masivo , Trastornos Mentales , Servicios de Salud Mental , Investigación Cualitativa , Humanos , Camerún , Infecciones por VIH/terapia , Infecciones por VIH/diagnóstico , Infecciones por VIH/psicología , Masculino , Femenino , Trastornos Mentales/terapia , Trastornos Mentales/diagnóstico , Adulto , Servicios de Salud Mental/organización & administración , Entrevistas como Asunto , Actitud del Personal de Salud , Personal de Salud/psicología , Prestación Integrada de Atención de Salud/organización & administración , Persona de Mediana Edad , Instituciones de Atención Ambulatoria
11.
BMC Med Educ ; 24(1): 396, 2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38600544

RESUMEN

BACKGROUND: Some of the most common complaints addressed by primary care physicians (PCPs) require manual procedures, such as lacerations repair, abscesses drainage, ingrown toenails removal, dry needling for myofascial pain syndrome, and Epley maneuver for treating benign paroxysmal positional vertigo (BPPV). The aim of this study was to describe the procedural skills workshops program for PCPs implemented in Maccabi Healthcare Services and to investigate how many PCPs have participated and used the skills since the program's inception in 2017. METHODS: In this observational study, we followed all participants in courses from 2017 to 2021. We extracted all procedures performed during these years by PCPs who learned the skill in MHS. RESULTS: During the study period, 620 PCPs participated in workshops for dry needling, soft-tissue and joint injections, BPPV treatment, minor surgical procedures, and spirometry. Most procedures performed were dry needling (average annual number 3,537) and minor surgical procedures (average annual number 361). The average annual use per physician was highest for dry needling (annual average use per physician who used the learned skill was 50.9), followed by soft tissue and joint injections (16.8), minor surgical procedures (14.8), and BPPV treatment (7.5). CONCLUSION: procedural skills workshops may expand PCPs' therapeutic arsenal, thus empowering PCPs and providing more comprehensive care for patients. Some manual skills, such as dry needling, soft tissue injections, and the Epley maneuver, were more likely to be used by participants than other skills, such as spirometry and soft tissue injections.


Asunto(s)
Médicos de Atención Primaria , Humanos , Israel , Modalidades de Fisioterapia , Vértigo Posicional Paroxístico Benigno/terapia , Personal de Salud
12.
Midwifery ; 132: 103987, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38599130

RESUMEN

INTRODUCTION: Evidence shows that music can promote the wellbeing of women and infants in the perinatal period. Ireland's National Maternity Strategy (2016-2026) suggests a holistic approach to woman's healthcare needs and music interventions are ideally placed as a non-pharmacological and cost-effective intervention to improve the quality of care offered to women and infants. This cross-sectional survey aimed to explore the healthcare practitioners' personal and professional experiences of using music therapeutically and its impact and barriers in practice. The survey also investigated practitioners' knowledge and attitudes towards the use of music as a therapeutic tool in perinatal care. METHODS: A novel online survey was developed and distributed through healthcare practitioners' electronic mailing lists, social media, Perinatal Mental Health staff App, and posters at the regional maternity hospital during 26th June and 26th October 2020. Survey items included demographics, personal and professional use of music, and perspectives on music intervention in perinatal care. RESULTS: Forty-six healthcare practitioners from across 11 professions were recruited and 42 were included in this study. 98 % of perinatal practitioners used music intentionally to support their wellbeing and 75 % referred to using music in their work. While 90 % found music beneficial in their practice, 15 % reported some negative effect. Around two-thirds of the respondents were familiar with the evidence on music and perinatal wellbeing and 95 % thought there was not enough guidance. 40 % considered music therapy an evidence-based practice and 81 % saw a role for music therapy in standard maternity service in Ireland. The qualitative feedback on how music was used personally and professionally, its' reported benefits, negative effects, and barriers are discussed. DISCUSSION: This study offers insights into how healthcare practitioners viewed and applied music in perinatal practice. The findings indicate high interest and positive experiences in using music as a therapeutic tool in perinatal care which highlights the need for more evidence and guidance.


Asunto(s)
Personal de Salud , Musicoterapia , Atención Perinatal , Humanos , Irlanda , Estudios Transversales , Encuestas y Cuestionarios , Adulto , Atención Perinatal/métodos , Atención Perinatal/normas , Atención Perinatal/estadística & datos numéricos , Femenino , Musicoterapia/métodos , Musicoterapia/normas , Musicoterapia/estadística & datos numéricos , Personal de Salud/psicología , Personal de Salud/estadística & datos numéricos , Embarazo , Persona de Mediana Edad , Masculino , Actitud del Personal de Salud
13.
Orphanet J Rare Dis ; 19(1): 172, 2024 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-38641814

RESUMEN

BACKGROUND: The 'diagnostic odyssey' is a common challenge faced by patients living with rare diseases and poses a significant burden for patients, their families and carers, and the healthcare system. The diagnosis of rare diseases in clinical settings is challenging, with patients typically experiencing a multitude of unnecessary tests and procedures. To improve diagnosis of rare disease, clinicians require evidence-based guidance on when their patient may be presenting with a rare disease. This study aims to identify common experiences amongst patients with rare diseases, to inform a series of 'red flags' that can aid diagnosis of rare diseases in non-specialist settings. A questionnaire was developed by Medics for Rare Diseases, informed by the experiences of clinicians, rare disease patients and patient advocates, and was shared with UK-based rare disease patient groups. Study participants were engaged via social media platforms, blogs and email newsletters of three umbrella rare disease organisations. The questionnaire, comprising 22 questions, was designed to identify typical experiences relating to physical and psychosocial manifestations and presentation of disease, patient interactions with healthcare providers, and family history. RESULTS: Questionnaire responses were received from 79 different rare disease patient groups and the common experiences identified were used to inform seven red flags of rare disease: multi-system involvement (3 or more); genetic inheritance pattern; continued presentation throughout childhood and adulthood; difficulties at school, especially relating to absences, difficulty participating in physical education and experiences of bullying or social isolation; multiple specialist referrals; extended period with unexplained symptoms; and misdiagnosis. In light of the red flags identified, recommendations for primary care and education settings have been proposed, focusing on the need for holistic assessment and awareness of both physical and psychosocial factors. CONCLUSIONS: This study identified key commonalities experienced by patients with rare disease across physical and psychosocial domains, in addition to understanding patients' history and experiences with healthcare providers. These findings could be used to develop a clinical decision­making tool to support non-specialist practitioners to consider when their patient may have an undiagnosed rare condition, which may minimise the challenges of the 'diagnostic odyssey' and improve the patient experience.


Asunto(s)
Atención a la Salud , Enfermedades Raras , Humanos , Niño , Enfermedades Raras/diagnóstico , Cuidadores , Personal de Salud
14.
JMIR Ment Health ; 11: e55552, 2024 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-38663011

RESUMEN

BACKGROUND: Heart rate variability (HRV) biofeedback is often performed with structured education, laboratory-based assessments, and practice sessions. It has been shown to improve psychological and physiological function across populations. However, a means to remotely use and monitor this approach would allow for wider use of this technique. Advancements in wearable and digital technology present an opportunity for the widespread application of this approach. OBJECTIVE: The primary aim of the study was to determine the feasibility of fully remote, self-administered short sessions of HRV-directed biofeedback in a diverse population of health care workers (HCWs). The secondary aim was to determine whether a fully remote, HRV-directed biofeedback intervention significantly alters longitudinal HRV over the intervention period, as monitored by wearable devices. The tertiary aim was to estimate the impact of this intervention on metrics of psychological well-being. METHODS: To determine whether remotely implemented short sessions of HRV biofeedback can improve autonomic metrics and psychological well-being, we enrolled HCWs across 7 hospitals in New York City in the United States. They downloaded our study app, watched brief educational videos about HRV biofeedback, and used a well-studied HRV biofeedback program remotely through their smartphone. HRV biofeedback sessions were used for 5 minutes per day for 5 weeks. HCWs were then followed for 12 weeks after the intervention period. Psychological measures were obtained over the study period, and they wore an Apple Watch for at least 7 weeks to monitor the circadian features of HRV. RESULTS: In total, 127 HCWs were enrolled in the study. Overall, only 21 (16.5%) were at least 50% compliant with the HRV biofeedback intervention, representing a small portion of the total sample. This demonstrates that this study design does not feasibly result in adequate rates of compliance with the intervention. Numerical improvement in psychological metrics was observed over the 17-week study period, although it did not reach statistical significance (all P>.05). Using a mixed effect cosinor model, the mean midline-estimating statistic of rhythm (MESOR) of the circadian pattern of the SD of the interbeat interval of normal sinus beats (SDNN), an HRV metric, was observed to increase over the first 4 weeks of the biofeedback intervention in HCWs who were at least 50% compliant. CONCLUSIONS: In conclusion, we found that using brief remote HRV biofeedback sessions and monitoring its physiological effect using wearable devices, in the manner that the study was conducted, was not feasible. This is considering the low compliance rates with the study intervention. We found that remote short sessions of HRV biofeedback demonstrate potential promise in improving autonomic nervous function and warrant further study. Wearable devices can monitor the physiological effects of psychological interventions.


Asunto(s)
Biorretroalimentación Psicológica , Frecuencia Cardíaca , Dispositivos Electrónicos Vestibles , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Biorretroalimentación Psicológica/métodos , Biorretroalimentación Psicológica/instrumentación , Personal de Salud , Frecuencia Cardíaca/fisiología , Ciudad de Nueva York , Estudios Prospectivos , Telemedicina/métodos , Telemedicina/instrumentación
15.
PLoS One ; 19(4): e0301732, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38635776

RESUMEN

BACKGROUND: A growing body of evidence has demonstrated that a gender-sensitive approach to healthcare is needed in all areas of medicine. Although medical and nursing guidelines include gender-sensitive care (GSC+) recommendations, the level of implementation in health care practice is unknown. This study aims to examine the current level of implementation and acceptance of GSC+ among physicians and nurses and to identify potential gaps between guidelines and practice and barriers and facilitators of GSC+ implementation, taking the perceptions of all relevant stakeholders into account. The overarching aim is to develop holistic recommended actions to strengthen GSC+. METHODS: This study has a mixed methods triangulation design. The preparation phase consisting of a literature review and a two-part (qualitative and quantitative) data analysis will be conducted in the cardiology department of 9 pilot hospitals in Berlin, North Rhine-Westphalia, Lower Saxony, Rhineland-Palatinate, Germany. 18 focus groups with clinicians and nurses as well as interviews with experts in other relevant fields will be performed. In the national roll-out phase, a questionnaire survey will be conducted with hospital clinicians (n = 382), nurses (n = 386) and patients (n = 388). DISCUSSION: This study will provide comprehensive insights into the implementation and acceptance of GSC+ in cardiology from the perspective of doctors, nurses, patients, stakeholders and experts in relevant fields, such as policy and education. A focus will also be on the extent to which age or gender of health professionals, region and hospital type influence the implementation of GSC+. The identification of GSC+ implementation barriers and facilitators should help to improve the standard of care for cardiology patients of all genders. The outcomes from this study can be used to develop measures and recommended actions for the successful and sustainable implementation of gender-sensitive care. TRIAL REGISTRATION: The study is registered in the German Register of Clinical Studies (DRKS) under study number DRKS00031317.


Asunto(s)
Pacientes Internos , Médicos , Humanos , Masculino , Femenino , Atención a la Salud , Personal de Salud , Grupos Focales , Literatura de Revisión como Asunto
16.
Rev Gaucha Enferm ; 45: e20230100, 2024.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-38655929

RESUMEN

OBJECTIVE: To develop a health promotion action for Street Clinic workers. METHOD: Qualitative research which used the Convergent Care Research methodology. The data collection was conducted through participant observation and convergence groups, from May to October 2021, with 39 workers from six teams of the Street Clinic. Data analysis followed the stages of apprehension, synthesis, theorization, and transfer. RESULTS: Some integrativepractices such as, stretching, group dynamics, dance, music, massage and cinema were suggested as interventions to be implemented. Given the need, Reichian stretching was developed as an intervention which favored body awareness, promoting the well-being of workers. CONCLUSION: The workers presented a conception of health promotion related to access to services and guarantee of rights. Reichian stretching provided a space for care and reflection on caring and respecting limits, favoring the body awareness and promoting relaxation.


Asunto(s)
Promoción de la Salud , Investigación Cualitativa , Humanos , Promoción de la Salud/métodos , Femenino , Adulto , Masculino , Salud Laboral , Persona de Mediana Edad , Personal de Salud/psicología
17.
BMC Health Serv Res ; 24(1): 333, 2024 Mar 13.
Artículo en Inglés | MEDLINE | ID: mdl-38481254

RESUMEN

BACKGROUND: Opioid Maintenance Treatment (OMT) is the gold standard for people with opioid dependence. However, drop-out rates are high, and many patients do not reach desired outcomes. Understanding patients' and healthcare providers' experiences with the treatment can provide valuable information to improve the quality of OMT and to increase acceptability and accessibility of services. The aim of this systematic review is to explore and synthesise the experiences of OMT among persons with opioid dependence and health care providers, to inform policy makers and practitioners on how to improve OMT outcomes. METHODS: We conducted a qualitative evidence synthesis. We systematically searched in electronic databases (CINAHL, Embase, MEDLINE, and nordic databases) and searched for grey literature. As we identified many studies that met our inclusion criteria, we purposively sampled a manageable number of studies to include in this review. Two researchers independently extracted and coded data from the included studies and used the Andersen's healthcare utilization model to organize and develop codes. We assessed the methodological limitations of the studies, and our confidence in the findings using GRADE CERQual. RESULTS: We retrieved 56 relevant studies and purposively sampled 24 qualitative studies of patients' and healthcare providers' experiences with OMT. Our analyses resulted in six main themes: (1) External stigma prevents engagement and retention in treatment, (2) Being identified as in OMT contributed to an increased experience of stigma (3) Inadequate knowledge and expertise among healthcare providers affected patients' treatment experiences, (4) Quality of communication between personnel and patients impacts patients' engagement with treatment and treatment outcomes, (5) Patients wanted help with many aspects of their lives not just medication, and (6) Balancing positive expectations of OMT with treatment stigma. We found that stigma was an overarching theme across these themes. CONCLUSION: Our findings suggest that OMT could be more beneficial for patients if treatment programs prioritize efforts to diminish societal and OMT provider stigma and find strategies to better address patient needs. Initiatives should focus on improving treatment knowledge among providers, encouraging the use of client perspectives, considering the context of family members, and establishing a more holistic and flexible treatment environment.


Asunto(s)
Tratamiento de Sustitución de Opiáceos , Trastornos Relacionados con Opioides , Humanos , Atención a la Salud , Familia , Personal de Salud , Investigación Cualitativa , Trastornos Relacionados con Opioides/tratamiento farmacológico
18.
BMC Palliat Care ; 23(1): 66, 2024 Mar 08.
Artículo en Inglés | MEDLINE | ID: mdl-38454420

RESUMEN

BACKGROUND: Parent-reported experience measures are part of pediatric Quality of Care (QoC) assessments. However, existing measures were not developed for use across multiple healthcare settings or throughout the illness trajectory of seriously ill children. Formative work involving in-depth interviews with parents of children with serious illnesses generated 66 draft items describing key QoC processes. Our present aim is to develop a comprehensive parent-reported experience measure of QoC for children with serious illnesses and evaluate its content validity and feasibility. METHODS: For evaluating content validity, we conducted a three-round Delphi expert panel review with 24 multi-disciplinary experts. Next, we pre-tested the items and instructions with 12 parents via cognitive interviews to refine clarity and understandability. Finally, we pilot-tested the full measure with 30 parents using self-administered online surveys to finalize the structure and content. RESULTS: The Delphi expert panel review reached consensus on 68 items. Pre-testing with parents of seriously ill children led to consolidation of some items. Pilot-testing supported feasibility of the measure, resulting in a comprehensive measure comprising 56 process assessment items, categorized under ten subthemes and four themes: (1) Professional qualities of healthcare workers, (2) Supporting parent-caregivers, (3) Collaborative and holistic care, and (4) Efficient healthcare structures and standards. We named this measure the PaRental Experience with care for Children with serIOUS illnesses (PRECIOUS). CONCLUSIONS: PRECIOUS is the first comprehensive measure and has the potential to standardize assessment of QoC for seriously ill children from parental perspectives. PRECIOUS allows for QoC process evaluation across contexts (such as geographic location or care setting), different healthcare workers, and over the illness trajectory for children suffering from a range of serious illnesses.


Asunto(s)
Padres , Calidad de la Atención de Salud , Niño , Humanos , Padres/psicología , Cuidadores , Personal de Salud , Consenso , Encuestas y Cuestionarios
19.
J Hum Nutr Diet ; 37(3): 706-716, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38462982

RESUMEN

BACKGROUND: Inflammatory bowel disease (IBD) is an incurable illness of the gastrointestinal tract. Its relapsing-remitting nature negatively impacts physical health and quality of life. Food and eating are key concerns for people with this illness. To provide holistic person-centred care, healthcare providers (HCPs) need to meet patients' dietary information needs. However, there is a paucity of literature describing these in any meaningful detail. The present study aimed to explore the perceived dietary information needs of individuals with IBD, the perceptions of HCPs and enablers and barriers to communication. METHODS: Online and face-to-face semi-structured interviews with 13 HCPs and 29 people with IBD were conducted. The framework method aided thematic analysis of de-identified interview recordings. RESULTS: The cyclical nature of IBD contextualised the five themes. Both individuals with IBD and HCPs articulated similar ideas viewed from different perspectives: (1) living with IBD is exasperating and unique to the individual; (2) individuals with IBD desire dietary information; (3) diet manipulation is used to exert control on a disease with unpredictable nature; (4) people with IBD and HCPs have different views on the role of diet; and (5) doctors are perceived as gatekeepers to accessing dietetics care. CONCLUSIONS: A lack of dietary guidance at diagnosis negatively impacts the patient's journey with food and eating. The present study supports a paradigm shift towards holistic person-centred care for consistent access to dietetics services to meet the needs of people with IBD.


Asunto(s)
Dieta , Personal de Salud , Enfermedades Inflamatorias del Intestino , Humanos , Enfermedades Inflamatorias del Intestino/psicología , Enfermedades Inflamatorias del Intestino/dietoterapia , Enfermedades Inflamatorias del Intestino/terapia , Femenino , Masculino , Adulto , Persona de Mediana Edad , Dieta/psicología , Dieta/métodos , Personal de Salud/psicología , Actitud del Personal de Salud , Investigación Cualitativa , Conocimientos, Actitudes y Práctica en Salud , Anciano , Evaluación de Necesidades , Calidad de Vida
20.
J Pediatr Nurs ; 77: 63-73, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38479064

RESUMEN

BACKGROUND: Music therapy is an emerging and useful methodology for improving patient environments within healthcare fields. However, although it has been shown that music therapy interventions with hospitalised children and adolescents have been used for decades with positive effects, there are currently very few studies that specifically describe the perspectives of healthcare professionals regarding the value of music therapy when applied in these patients. OBJECTIVES: To describe the insights of healthcare professionals regarding music therapy, both on a personal level and in terms of its usefulness in the care of hospitalised children and adolescents. DESIGN: This was a qualitative descriptive-exploratory study with focus groups. PARTICIPANTS: Eighteen healthcare professionals. METHODS: In January 2023, two focus groups, containing nine healthcare professionals each, were created to collect data regarding their experiences concerning the effect of music therapy on hospitalised children and adolescents. Before recording their opinions, all these professionals participated in an interactive music therapy session. The thematic analysis in this work was performed using MAXQDA® software. RESULTS: Two main categories emerged: (a) the effects of music therapy on healthcare professionals, and (b) the benefits of music therapy to patients (children and adolescents). CONCLUSIONS: Music therapy was valued positively by healthcare professionals who described the benefits its use has for hospitalised children and adolescents. They also expressed positive viewpoints regarding the use of music therapy to improve their own self-knowledge and self-care. IMPLICATIONS TO PRACTICE: Healthcare professionals may utilise music therapists to improve patient outcomes and reduce the negative effects of hospitalisation.


Asunto(s)
Actitud del Personal de Salud , Niño Hospitalizado , Grupos Focales , Musicoterapia , Investigación Cualitativa , Humanos , Adolescente , Niño , Masculino , Femenino , Niño Hospitalizado/psicología , Personal de Salud/psicología , Adulto
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA