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Revista Brasileira de Enfermagem 2020to evaluate the attributes of primary health care, care coordination and longitudinality, from the perception of the professional and patients in the state of Amazonas,...
OBJECTIVES
to evaluate the attributes of primary health care, care coordination and longitudinality, from the perception of the professional and patients in the state of Amazonas, Brazil.
METHODS
quantitative evaluative study, in which was used an external evaluation instrument with 469 professionals and 1,888 patients from 367 primary health care facilities that adhered to the Program for Improving Access and Quality of primary health care (Portuguese acronym: PMAQ) standardized by the Ministry of Health. Data were grouped by multivariate cluster analysis in order to find a classification of primary health care from the perspective of professionals and patients.
RESULTS
the attributes of coordination and longitudinality are still expressed in a weak and undeveloped way in the Brazilian Amazon scenario.
CONCLUSIONS
it is necessary to recognize the organizational barriers and what could promote conditions for the performance of health care teams in the perspective of a continuous, integral and coordinated care.
Topics: Brazil; Continuity of Patient Care; Health Personnel; Humans; Organization and Administration; Patients; Perception; Primary Health Care
PubMed: 32321132
DOI: 10.1590/0034-7167-2018-0841 -
Bulletin of the World Health... Nov 2013To assess the effectiveness of care provided by mid-level health workers. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To assess the effectiveness of care provided by mid-level health workers.
METHODS
Experimental and observational studies comparing mid-level health workers and higher level health workers were identified by a systematic review of the scientific literature. The quality of the evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation criteria and data were analysed using Review Manager.
FINDINGS
Fifty-three studies, mostly from high-income countries and conducted at tertiary care facilities, were identified. In general, there was no difference between the effectiveness of care provided by mid-level health workers in the areas of maternal and child health and communicable and noncommunicable diseases and that provided by higher level health workers. However, the rates of episiotomy and analgesia use were significantly lower in women giving birth who received care from midwives alone than in those who received care from doctors working in teams with midwives, and women were significantly more satisfied with care from midwives. Overall, the quality of the evidence was low or very low. The search also identified six observational studies, all from Africa, that compared care from clinical officers, surgical technicians or non-physician clinicians with care from doctors. Outcomes were generally similar.
CONCLUSION
No difference between the effectiveness of care provided by mid-level health workers and that provided by higher level health workers was found. However, the quality of the evidence was low. There is a need for studies with a high methodological quality, particularly in Africa - the region with the greatest shortage of health workers.
Topics: Delivery, Obstetric; Global Health; Health Personnel; Humans; Maternal Health Services; Midwifery; Patient Care Team; Physicians; Quality Indicators, Health Care; Quality of Health Care; Tertiary Care Centers; World Health Organization
PubMed: 24347706
DOI: 10.2471/BLT.13.118786 -
Annali Dell'Istituto Superiore Di Sanita 2020In Italy, minor migrants represent 21.8% of the non-EU citizens. The care of minor migrants might be challenging as this population is characterized by higher...
INTRODUCTION
In Italy, minor migrants represent 21.8% of the non-EU citizens. The care of minor migrants might be challenging as this population is characterized by higher vulnerability and special needs. The study aim was to describe the perceptions on the provision of care, the bio-psycho-social needs of migrant children and the professional training needs.
METHODS
The study is qualitative descriptive. In May 2019 three focus group, involving health and social professionals, cultural mediators and NGOs operators, were organized.
RESULTS
The study explored different areas of the provision of care to minor migrants including bio-psycho-social needs, care provision, barriers to care and professionals' training needs.
DISCUSSION AND CONCLUSIONS
The provision of care should consider the specific migration journey and narrative. In some cases healthcare is fragmented, generating obstacles to access especially in minors with lower levels of health literacy. Training plays a key role in the development of cultural competence.
Topics: Attitude to Health; Child; Health Personnel; Humans; Italy; Needs Assessment; Qualitative Research; Self Report; Social Workers; Transients and Migrants
PubMed: 33346173
DOI: 10.4415/ANN_20_04_09 -
Annals of Internal Medicine Aug 2022Monkeypox virus is reemerging, with cases reported on every inhabited continent at a time when clinical and public health resources have been stretched to the limit by...
Monkeypox virus is reemerging, with cases reported on every inhabited continent at a time when clinical and public health resources have been stretched to the limit by COVID-19. As the monkeypox outbreak grows, health care workers must understand the threat and be prepared to address an infectious disease risk that may herald yet another unprecedented epidemic.
Topics: COVID-19; Conservation of Natural Resources; Delivery of Health Care; Health Personnel; Humans; Mpox (monkeypox)
PubMed: 35696683
DOI: 10.7326/M22-1763 -
Health Care Analysis : HCA : Journal of... Jun 2024In this paper we aim to discuss a theoretical explanation for the positive relationship between patients' knowledge and their trust in healthcare personnel. Our approach...
Patient Knowledge and Trust in Health Care. A Theoretical Discussion on the Relationship Between Patients' Knowledge and Their Trust in Health Care Personnel in High Modernity.
In this paper we aim to discuss a theoretical explanation for the positive relationship between patients' knowledge and their trust in healthcare personnel. Our approach is based on John Dewey's notion of continuity. This notion entails that the individual's experiences are interpreted as interrelated to each other, and that knowledge is related to future experience, not merely a record of the past. Furthermore, we apply Niklas Luhmann's theory on trust as a way of reducing complexity and enabling action. Anthony Giddens' description and analysis of the high modern society provides a frame for discussing the preconditions for patient-healthcare personnel interaction. High modernity is dominated by expert systems and demands trust in these. We conclude that patient knowledge and trust in healthcare personnel is related because both knowledge and trust are future- and action-oriented concepts. The traits of high modernity provides opportunities and challenges as the personnel can and must perform discretion. This discretion must be made in a context where knowledge is considered uncertain and preliminary.
Topics: Humans; Trust; Professional-Patient Relations; Health Knowledge, Attitudes, Practice; Health Personnel
PubMed: 37807014
DOI: 10.1007/s10728-023-00467-7 -
The American Journal of Medicine Jul 2021
Topics: Adaptation, Psychological; Evidence-Based Practice; Health Personnel; Humans
PubMed: 33773971
DOI: 10.1016/j.amjmed.2021.02.010 -
Public Health Reports (Washington, D.C.... 2021The first few months of the coronavirus disease 2019 (COVID-19) pandemic challenged health care facilities worldwide in many ways. Inpatient and intensive care unit...
The first few months of the coronavirus disease 2019 (COVID-19) pandemic challenged health care facilities worldwide in many ways. Inpatient and intensive care unit (ICU) beds were at a premium, and personnel shortages occurred during the initial peak of the pandemic. New York State was the hardest hit of all US states, with a high concentration of cases in New York City and, in particular, Bronx County. The governor of New York and leadership of hospitals in New York City called upon all available personnel to provide support and patient care during this health care crisis. This case study highlights the efforts of Jacobi Medical Center, located in the northeast Bronx, from March 1 through May 31, 2020, and its use of nontraditional health care personnel, including Department of Dentistry/OMFS (Oral and Maxillofacial Surgery) staff members, to provide a wide range of health care services. Dental staff members including ancillary personnel, residents, and attendings were redeployed and functioned throughout the facility. Dental anesthesiology residents provided medical services in support of their colleagues in a step-down COVID-19-dedicated ICU, providing intubation, ventilator management, and critical and palliative care. (Step-down units provide an intermediate level of care between ICUs and the general medical-surgical wards.) Clear communication of an acute need, a well-articulated mission, creative use of personnel, and dedicated staff members were evident during this challenging time. Although not routinely called upon to provide support in the medical and surgical inpatient areas, dental staff members may provide additional health care personnel during times of need.
Topics: Anesthesiologists; COVID-19; Dentists; Hospitals; Humans; Intensive Care Units; New York City; Pandemics; Workforce
PubMed: 33439097
DOI: 10.1177/0033354920976577 -
JAMA Network Open Jul 2019The Implicit Association Test (IAT) is a validated tool used to measure implicit biases, which are mental associations shaped by one's environment that influence...
IMPORTANCE
The Implicit Association Test (IAT) is a validated tool used to measure implicit biases, which are mental associations shaped by one's environment that influence interactions with others. Direct evidence of implicit gender biases about women in medicine has yet not been reported, but existing evidence is suggestive of subtle or hidden biases that affect women in medicine.
OBJECTIVES
To use data from IATs to assess (1) how health care professionals associate men and women with career and family and (2) how surgeons associate men and women with surgery and family medicine.
DESIGN, SETTING, AND PARTICIPANTS
This data review and cross-sectional study collected data from January 1, 2006, through December 31, 2017, from self-identified health care professionals taking the Gender-Career IAT hosted by Project Implicit to explore bias among self-identified health care professionals. A novel Gender-Specialty IAT was also tested at a national surgical meeting in October 2017. All health care professionals who completed the Gender-Career IAT were eligible for the first analysis. Surgeons of any age, gender, title, and country of origin at the meeting were eligible to participate in the second analysis. Data were analyzed from January 1, 2018, through March 31, 2019.
MAIN OUTCOMES AND MEASURES
Measure of implicit bias derived from reaction times on the IATs and a measure of explicit bias asked directly to participants.
RESULTS
Almost 1 million IAT records from Project Implicit were reviewed, and 131 surgeons (64.9% men; mean [SD] age, 42.3 [11.5] years) were recruited to complete the Gender-Specialty IAT. Healthcare professionals (n = 42 991; 82.0% women; mean [SD] age, 32.7 [11.8] years) held implicit (mean [SD] D score, 0.41 [0.36]; Cohen d = 1.14) and explicit (mean [SD], 1.43 [1.85]; Cohen d = 0.77) biases associating men with career and women with family. Similarly, surgeons implicitly (mean [SD] D score, 0.28 [0.37]; Cohen d = 0.76) and explicitly (men: mean [SD], 1.27 [0.39]; Cohen d = 0.93; women: mean [SD], 0.73 [0.35]; Cohen d = 0.53) associated men with surgery and women with family medicine. There was broad evidence of consensus across social groups in implicit and explicit biases with one exception. Women in healthcare (mean [SD], 1.43 [1.86]; Cohen d = 0.77) and surgery (mean [SD], 0.73 [0.35]; Cohen d = 0.53) were less likely than men to explicitly associate men with career (B coefficient, -0.10; 95% CI, -0.15 to -0.04; P < .001) and surgery (B coefficient, -0.67; 95% CI, -1.21 to -0.13; P = .001) and women with family and family medicine.
CONCLUSIONS AND RELEVANCE
The main contribution of this work is an estimate of the extent of implicit gender bias within surgery. On both the Gender-Career IAT and the novel Gender-Specialty IAT, respondents had a tendency to associate men with career and surgery and women with family and family medicine. Awareness of the existence of implicit biases is an important first step toward minimizing their potential effect.
Topics: Adult; Attitude of Health Personnel; Career Choice; Family Practice; Female; General Surgery; Health Personnel; Humans; Male; Physicians, Women; Self-Assessment; Sexism; Social Perception; Task Performance and Analysis
PubMed: 31276177
DOI: 10.1001/jamanetworkopen.2019.6545 -
The Clinical Teacher Feb 2023
Topics: Humans; Interprofessional Education; Health Personnel; Primary Health Care; Delivery of Health Care, Integrated; Interprofessional Relations; Patient Care Team
PubMed: 36385490
DOI: 10.1111/tct.13552 -
MMWR. Morbidity and Mortality Weekly... Apr 2020As of April 9, 2020, the coronavirus disease 2019 (COVID-19) pandemic had resulted in 1,521,252 cases and 92,798 deaths worldwide, including 459,165 cases and 16,570...
As of April 9, 2020, the coronavirus disease 2019 (COVID-19) pandemic had resulted in 1,521,252 cases and 92,798 deaths worldwide, including 459,165 cases and 16,570 deaths in the United States (1,2). Health care personnel (HCP) are essential workers defined as paid and unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials (3). During February 12-April 9, among 315,531 COVID-19 cases reported to CDC using a standardized form, 49,370 (16%) included data on whether the patient was a health care worker in the United States; including 9,282 (19%) who were identified as HCP. Among HCP patients with data available, the median age was 42 years (interquartile range [IQR] = 32-54 years), 6,603 (73%) were female, and 1,779 (38%) reported at least one underlying health condition. Among HCP patients with data on health care, household, and community exposures, 780 (55%) reported contact with a COVID-19 patient only in health care settings. Although 4,336 (92%) HCP patients reported having at least one symptom among fever, cough, or shortness of breath, the remaining 8% did not report any of these symptoms. Most HCP with COVID-19 (6,760, 90%) were not hospitalized; however, severe outcomes, including 27 deaths, occurred across all age groups; deaths most frequently occurred in HCP aged ≥65 years. These preliminary findings highlight that whether HCP acquire infection at work or in the community, it is necessary to protect the health and safety of this essential national workforce.
Topics: Adolescent; Adult; Aged; COVID-19; Coronavirus Infections; Female; Health Personnel; Humans; Male; Middle Aged; Pandemics; Pneumonia, Viral; United States; Young Adult
PubMed: 32298247
DOI: 10.15585/mmwr.mm6915e6