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Moquillaza-Alcantara VH, Palacios-Vivanco DP. Cesarean section prevalence based on prenatal care provider, location, and wealth index: A comparative analysis in peru's healthcare systems. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 38:100924. [PMID: 37988776 DOI: 10.1016/j.srhc.2023.100924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/10/2023] [Accepted: 11/12/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Cesarean section rates are increasing and surpassing WHO guidelines. While sometimes necessary, excessive use poses risks and additional costs to pregnant women and healthcare systems. AIM To evaluate the prevalence of cesarean section according to healthcare professionals, facility location, and the wealth index of pregnant women in each Peruvian healthcare system. METHODS A cross-sectional study analyzed 20,870 records of women aged 12 to 49 from the Demographic and Family Health Survey (ENDES). The evaluated healthcare systems were the Ministry of Health, Social Health Insurance, Armed Forces and National Police, and private institutions. FINDINGS The highest cesarean section prevalence was observed in women receiving prenatal care in private hospitals or clinics (69.13%) and Social Health Insurance hospitals (51.54%). Urban settings, "richest" wealth index, and medical professional involvement increased the probability of cesarean sections. Conversely, the probability of cesarean section was reduced in Ministry of Health facilities when pregnant women belonged to the "poorest" or "poorer" wealth index category and when prenatal care was provided by a midwife in a private facility. CONCLUSION The prevalence of cesarean sections in Peru during 2021 is 33.75%, warranting evaluation of strategies to regulate their indiscriminate use in each system.
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Wang X, Hu Y, Tao J, Hu F, Li P, Shao D, Pan HF, Xu T. Design and Initial Validation of a Humanistic Care Evaluation Tool. J Multidiscip Healthc 2021; 14:2307-2313. [PMID: 34471358 PMCID: PMC8403570 DOI: 10.2147/jmdh.s309104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/19/2021] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed at developing and validating a humanistic care tool in Anhui province that could be used across Chinese public hospitals, and to reflect the humanistic care from patients’ perspective. Participants A cross-sectional survey was conducted in three public hospitals of Anhui Province, China by adopting simple random sampling, which included 312 outpatients and 323 inpatients. Methods The dimensions of the tool were set according to “Further Improve Medical Service Action Plan” in China and Patient-Doctor Relationship Questionnaire. Cronbach’s alpha values were calculated and used to evaluate the reliability of this tool. Construct validity was tested by the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The associations between characteristics and humanistic care were analyzed by binary logistic regression. Results These initial findings showed that about two-thirds of the respondents experienced humanistic care. Both the reliability and construct validity of the humanistic care evaluation tool were suitable Social aspects (location and yearly income), treatment style and having a regular doctor were significantly associated with better humanistic care (all P<0.05). Conclusion The humanistic care tool can directly reflect the humanistic care from patients’ perspective, and can be popularized and applied across Chinese public hospitals. These findings have important implications to further improve medical service in Chinese public hospitals.
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Affiliation(s)
- Xiaohu Wang
- The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Yuqian Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Jie Tao
- Anhui Provincial Hospital, Hefei, People's Republic of China
| | - Fuyong Hu
- School of Public Health, Bengbu Medical College, Bengbu, People's Republic of China
| | - Peng Li
- The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Donghua Shao
- Public Anhui Provincial Health and Family Planning Commission, Hefei, People's Republic of China
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Tao Xu
- School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei, People's Republic of China
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Li X, Meng M, Zhao J, Zhang X, Yang D, Fang J, Wang J, Han L, Hao Y. Shared Decision-Making in Breast Reconstruction for Breast Cancer Patients: A Scoping Review. Patient Prefer Adherence 2021; 15:2763-2781. [PMID: 34916786 PMCID: PMC8670888 DOI: 10.2147/ppa.s335080] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 11/12/2021] [Indexed: 12/14/2022] Open
Abstract
For most breast cancer (BC) patients who have undergone a mastectomy, the decision whether to proceed with breast reconstruction (BR) is complicated and requires deliberation. Shared decision-making (SDM) helps to address those needs and promote informed value-based decisions. However, little is known about the SDM status for BR in BC patients. This scoping review describes: 1) basic characteristics of studies on BR SDM in BC patients; 2) factors influencing BR SDM in BC patients; 3) experience and perception of BR SDM in BC patients; and 4) outcome measures reported. This review was performed in accordance with the Arksey and O'Malley methodology. A total of 5 English and 4 Chinese databases were searched, as well as different sources from grey literature. The data extraction form was developed by referring to the objectives and the Ottawa Decision Support Framework (ODSF). Data was analyzed using thematic analysis, framework analysis and descriptive statistics, with findings presented in the tables and diagrams. A total of 1481 records were retrieved and 42 of these included after screening. In 21 (21/42, 50%) of the studies, patient decision aids (PDAs) were utilized, and in 17 (17/42, 40.48%) of the studies, the factors influencing the implementation of SDM were explored. Of these 17 studies, the factors influencing the implementation of SDM were categorized into the following: the patient level (17/17, 100%), the healthcare level (2/17, 11.76%) and the organizational and system level (7/17, 41.18%). A total of 8 (19.05%) of the 42 studies focused on patients' experiences and perceptions of SDM, and all studies used qualitative research methods. Of these 8 studies, a total of 7 (7/8, 87.50%) focused on patients' experiences of SDM participation, and 4 (4/8, 50.00%) focused on patients' perceptions of SDM. A total of 24 studies (24/42, 57.14%) involved quantitative outcome measures, where 49 items were divided into three classifications according to the outcomes of ODSF: the quality of the decision (17/24, 70.83%), the quality of the decision-making process (20/24, 83.33%), and impact (13/24, 54.17%). Although researchers have paid less attention to other research points in the field of SDM, compared to the design and application of SDM interventional tools, the research team still presents some equally noteworthy points through scoping review. For instance, the various factors influencing BC patients' participation in SDM for BR (especially at the healthcare provider level and at the organizational system level), patients' experiences and perceptions. Systematic reviews (SRs) should be conducted to quantify the impact of these different factors on BR SDM. Implementation of scientific theories and methods can inform the exploration and integration of these factors.
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Affiliation(s)
- Xuejing Li
- School of Nursing, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
- Beijing University of Chinese Medicine Collaborating Center of Joanna Briggs Institute, Beijing, People’s Republic of China
- Beijing University of Chinese Medicine Best Practice Spotlight Organization, Beijing, People’s Republic of China
| | - Meiqi Meng
- School of Nursing, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
- Beijing University of Chinese Medicine Collaborating Center of Joanna Briggs Institute, Beijing, People’s Republic of China
- Beijing University of Chinese Medicine Best Practice Spotlight Organization, Beijing, People’s Republic of China
| | - Junqiang Zhao
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
- Center for Research on Health and Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Xiaoyan Zhang
- School of Nursing, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
- Beijing University of Chinese Medicine Collaborating Center of Joanna Briggs Institute, Beijing, People’s Republic of China
- Beijing University of Chinese Medicine Best Practice Spotlight Organization, Beijing, People’s Republic of China
| | - Dan Yang
- School of Nursing, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
- Beijing University of Chinese Medicine Collaborating Center of Joanna Briggs Institute, Beijing, People’s Republic of China
- Beijing University of Chinese Medicine Best Practice Spotlight Organization, Beijing, People’s Republic of China
| | - Jiaxin Fang
- School of Nursing, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
- Beijing University of Chinese Medicine Collaborating Center of Joanna Briggs Institute, Beijing, People’s Republic of China
- Beijing University of Chinese Medicine Best Practice Spotlight Organization, Beijing, People’s Republic of China
| | - Junxin Wang
- School of Nursing, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
- Beijing University of Chinese Medicine Collaborating Center of Joanna Briggs Institute, Beijing, People’s Republic of China
- Beijing University of Chinese Medicine Best Practice Spotlight Organization, Beijing, People’s Republic of China
| | - Liu Han
- Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, People’s Republic of China
| | - Yufang Hao
- School of Nursing, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
- Beijing University of Chinese Medicine Collaborating Center of Joanna Briggs Institute, Beijing, People’s Republic of China
- Beijing University of Chinese Medicine Best Practice Spotlight Organization, Beijing, People’s Republic of China
- Correspondence: Yufang Hao Liangxiang High Education Park, Fangshan District, Beijing, 102488, People’s Republic of ChinaTel +86-13552850210 Email
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Ruiz EF, Torres-Roman JS, Servan SA, Martinez-Herrera JF, Arce-Huamani MA, Carioli G, La Vecchia C. Trends and geographic pattern of stomach cancer mortality in Peru. Cancer Epidemiol 2018; 58:193-198. [PMID: 30522779 DOI: 10.1016/j.canep.2018.10.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 10/23/2018] [Accepted: 10/28/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Stomach cancer mortality rates in South America are among the highest in the world. In Peru, stomach cancer has the highest absolute number of cancer deaths in both sexes combined. We estimated mortality rates for stomach cancer in Peru by sex and geographical region between 2008 and 2015. METHODS We obtained death data for stomach cancer from the Peruvian Ministry of Health database. We estimated the age-standardized mortality rate (ASMR) per 100,000 persons using the direct method and the world standard population. RESULTS A total of 25,020 deaths from stomach cancer were identified in the study period. At national level, stomach cancer mortality rates (per 100,000 population) for men ranged from 9.8 in 2008 to 8.8 in 2015 with a percent change of -16%, and for women from 8.8 in 2008 to 7.7 in 2015 with a percent change of -16.8%. The highlands had the highest mortality rates overall, mainly in Huancavelica and Huánuco. The rainforest had the lowest rates and the highest decline in stomach cancer ASMRs. The coast displayed intermediate rates overall. CONCLUSIONS Within the study period, mortality rates from stomach cancer in Peru declined by 16%. The highlands had the highest mortality rates as compared to those from the coast or rainforest region. These geographical differences in mortality could reflect a different distribution in stomach cancer risk factors as the prevalence of H. pylori, poor dietary habits, low socioeconomic background of the Andean population and the lack of a decentralized health system.
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Affiliation(s)
- Eloy F Ruiz
- CONEVID, Unidad de Conocimiento y Evidencia, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - J Smith Torres-Roman
- Faculty of Medicine, Universidad Nacional San Luis Gonzaga, Ica, Peru; Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru.
| | - Sebastian A Servan
- Facultad de Medicina "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | | | - Greta Carioli
- Department of Clinical Sciences and Community Health, Universita degli Studi di Milano, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Universita degli Studi di Milano, Milan, Italy
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Torres-Roman JS, Ruiz EF, Martinez-Herrera JF, Mendes Braga SF, Taxa L, Saldaña-Gallo J, Pow-Sang MR, Pow-Sang JM, La Vecchia C. Prostate cancer mortality rates in Peru and its geographical regions. BJU Int 2018; 123:595-601. [PMID: 30281883 DOI: 10.1111/bju.14578] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate the mortality rates for prostate cancer according to geographical areas in Peru between 2005 and 2014. MATERIALS AND METHODS Information was extracted from the Deceased Registry of the Peruvian Ministry of Health. We analysed age-standardised mortality rates (world population) per 100 000 men. Spatial autocorrelation was determined according to the Moran Index. In addition, we used Cluster Map to explore relations between regions. RESULTS Mortality rates increased from 20.9 (2005-2009) to 24.1 (2010-2014) per 100 000 men, an increase of 15.2%. According to regions, during the period 2010-2014, the coast had the highest mortality rate (28.9 per 100 000), whilst the rainforest had the lowest (7.43 per 100 000). In addition, there was an increase in mortality in the coast and a decline in the rainforest over the period 2005-2014. The provinces with the highest mortality were Piura, Lambayeque, La Libertad, Callao, Lima, Ica, and Arequipa. Moreover, these provinces (except Arequipa) showed increasing trends during the years under study. The provinces with the lowest observed prostate cancer mortality rates were Loreto, Ucayali, and Madre de Dios. This study showed positive spatial autocorrelation (Moran's I: 0.30, P = 0.01). CONCLUSION Mortality rates from prostate cancer in Peru continue to increase. These rates are higher in the coastal region compared to those in the highlands or rainforest.
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Affiliation(s)
- Junior Smith Torres-Roman
- Clinica de Urologia Avanzada UROZEN, Lima, Peru.,Facultad de Medicina Humana, Universidad Nacional San Luis Gonzaga, Ica, Peru
| | - Eloy F Ruiz
- CONEVID, Unidad de Conocimiento y Evidencia, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Sonia Faria Mendes Braga
- Department of Social and Preventive Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Luis Taxa
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | | | - Mariela R Pow-Sang
- Department of Urology, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Julio M Pow-Sang
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Universitá degli Studi di Milano, Milan, Italy
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Málaga G, Cuba-Fuentes S, Romero-Albino Z. Implementation of a community-based breast cancer management programme. Lancet Oncol 2018; 19:e3. [DOI: 10.1016/s1470-2045(17)30858-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 10/25/2017] [Indexed: 11/27/2022]
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