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Ferreira Siano G, Fonseca de Oliveira CS, de Sousa FG, Beier SL, da Costa-Val AP. Knowledge and perception about the welfare and mistreatment of dogs in Brazil. PLoS One 2024; 19:e0302317. [PMID: 38640135 PMCID: PMC11029625 DOI: 10.1371/journal.pone.0302317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/01/2024] [Indexed: 04/21/2024] Open
Abstract
Animal welfare encompasses the overall well-being of an animal, spanning both its physical and mental health, assessable through potential measurements. It stands in contrast to mistreatment, which involves actions, direct or indirect, that endanger an animal's well-being. This study sought to appraise the factors influencing the Brazilian population's understanding of dog welfare and mistreatment. The survey questions were adapted from the Animal Welfare Examination Protocol, utilized by veterinarians to evaluate suspected passive abuse cases in dogs. Out of 1377 responses, 1353 were valid and analyzed. Among the 19 assessed indicators, 15 demonstrated an adequate response rate surpassing 90% of all 1353 responses. However, for three questions related to comfort, a smaller yet notable percentage of responses were only minimally adequate. Moreover, in one question within the comfort assessment, 186 participants (13.74%) provided inadequate responses. This implies that these people could potentially subject animals to a state of low Animal Welfare. Lack of knowledge emerged as a potential root of passive abuse, specifically negligence. In the assessment of nutritional indicators, water supply and quality received unanimous adequate responses. In evaluating comfort perceptions, significant associations were noted between gender, dog ownership, family income, and responses regarding resting surface. Regarding health indicators, the majority responded appropriately. Female gender and dog ownership correlated with providing the appropriate response, while not owning a dog was associated with minimally adequate responses. In the context of comfort indicators, "Hitting the Dog" also demonstrated an association with gender, with females tending towards appropriate responses. Given the lack of significant correlation between educational levels and the most suitable responses, it underscores the urgency of implementing environmental education programs in schools with a focus on animal protection.
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Affiliation(s)
- Gabriela Ferreira Siano
- Department of Veterinary Clinics and Surgery, Veterinary School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Felipe Gaia de Sousa
- Department of Veterinary Clinics and Surgery, Veterinary School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Suzane Lilian Beier
- Department of Veterinary Clinics and Surgery, Veterinary School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Adriane Pimenta da Costa-Val
- Department of Veterinary Clinics and Surgery, Veterinary School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Guimarães-Fernandes F, Benoit L, de Oliveira LM, Neto PC, Feniman DC, Correia AV, de Oliveira Bosoni N, Macaya DM, Miguel EC, Ceron-Litvoc D, Castellana GB. Facing the Unknown: An Inductive Analysis of the Lived Experience of Medical Residents during the COVID-19 Pandemic. Psychopathology 2024; 57:169-181. [PMID: 38467115 DOI: 10.1159/000536135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 01/02/2024] [Indexed: 03/13/2024]
Abstract
INTRODUCTION The COVID-19 pandemic had significant repercussions for the everyday life and public health of society. Healthcare professionals were particularly vulnerable. Here, we interviewed medical residents about their lived experiences during the pandemic to offer a phenomenological analysis. To this end, we discuss their pandemic experiences considering Jaspers' "limit situation" concept - that is, a radical shift from their everyday experiences, to one causing them to question the basis of their very existence. METHODS We interviewed 33 medical residents from psychiatry and other specialties from the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP) who either (a) worked directly with COVID-19 patients or (b) provided psychiatric care to other healthcare professionals. Semi-structured interviews were developed using the Inductive Process to Analyze the Structure of lived Experience (IPSE). RESULTS The descriptions of the lived experiences of medical residents during the pandemic were organized into four content themes: (a) existential defense, (b) limit situations during the COVID-19 pandemic, (c) changes in lived experience, and (d) new world meanings through lived experience. CONCLUSION During the COVID-19 pandemic, medical residents experienced what can be thought of as a "limit situation," as they encountered the healthcare delivery challenges coupled with the social isolation imposed by the COVID-19 pandemic. These challenges included fear of infection and potential death, uncertainty about the future, and the emotional overload caused by the sharp increase in patient deaths. That said, after facing such a limit situation, residents reported feeling strengthened by this experience. This is consistent with the notion that when confronted with limit situations, we draw on our resources to overcome adversity and, in turn, reap existential gains. Health care providers might use these experiences to energize their own professional approach.
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Affiliation(s)
| | - Laelia Benoit
- Yale School of Medicine, Yale University, New Haven, Connecticut, USA
- CESP, Team DevPsy, Inserm 1178, Maison de Solenn, Hôpital Cochin AP-HP, Université Paris-Saclay, UVSQ, Paris, France
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Zhang W, Qi X, Yang L, Meng X, Xu G, Luo S, Wu K, Tang J, Wang B, Fu L, Han B, He J, Zhang Y, Wang F, Lin Y, Cao W, Liu S, He L, Gao Y, Lv F, Lu H, Qian J, Zou H. Mpox patients' experience from infection to treatment and implications for prevention and control: A multicenter qualitative study in China. J Med Virol 2024; 96:e29338. [PMID: 38163280 DOI: 10.1002/jmv.29338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/13/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024]
Abstract
Monkeypox (mpox), a viral zoonotic disease, is spreading worldwide. However, evidence that informs prevention and control strategies in the Asia Pacific Region is very limited. Our study aims to investigate the experiences of mpox patients from infection to treatment to provide scientific basis for the prevention and control. A multicenter qualitative design was used. A total of 15 mpox patients were recruited between July 6 and July 25, 2023, from six cities in China. Semistructured interviews were conducted by telephone and analyzed using the thematic analysis. The interview was divided into two sections: patients' experiences (prediagnosis experience, treatment-seeking experience, and quarantine experience) and advice. Prediagnosis experience was summarized into three themes: symptoms, possible routes of infection, and knowledge of mpox. Treatment-seeking experience was summarized into three themes: time of visit to hospital, diagnostic difficulties, and attitude toward diagnosis. Quarantine experience was summarized into three themes: body and mind reactions, reluctance to self-disclose infection status, and factors facilitating recovery. Themes identified from patients' advice were as follows: (1) Increase in testing channels and methods, (2) Development and introduction of vaccines, (3) Adjustment of quarantine program, (4) Improvement of treatment measures, and (5) Improvement of publicity and education. To effectively curb the mpox epidemic, structured measures are urgently needed to address the mpox-related stigma and discrimination. Targeted health education should be provided to MSM, focusing on the prevention, detection, and treatment services. Hospitals should enhance the training of clinicians in key departments including infectious disease and dermatology, to improve diagnostic capability and sensitivity. Furthermore, given the absence of specific antiviral medications, supervised home quarantine may be a good option.
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Affiliation(s)
- Weijie Zhang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xiao Qi
- Beijing Chaoyang District Center for Disease Prevention and Control, Beijing, China
| | - Liuqing Yang
- National Clinical Research Centre for Infectious Diseases, The Third People's Hospital of Shenzhen and The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Xiaojun Meng
- Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Guangyong Xu
- Department of Dermatology, Qingdao Sixth People's Hospital, Qingdao, Shandong, China
| | - Sitong Luo
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Ke Wu
- Beijing Chaoyang District Center for Disease Prevention and Control, Beijing, China
| | - Jiapeng Tang
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Bingyi Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Baihui Han
- Beijing Chaoyang District Center for Disease Prevention and Control, Beijing, China
| | - Jinbo He
- Beijing Chaoyang District Center for Disease Prevention and Control, Beijing, China
| | - Ye Zhang
- Beijing Chaoyang District Center for Disease Prevention and Control, Beijing, China
| | - Fuxiang Wang
- National Clinical Research Centre for Infectious Diseases, The Third People's Hospital of Shenzhen and The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Yuanlong Lin
- National Clinical Research Centre for Infectious Diseases, The Third People's Hospital of Shenzhen and The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Wanxian Cao
- Division of Life Sciences and Medicine, The First Affiliated Hospital of the University of Science and Technology of China, Hefei, Anhui, China
| | - Siyang Liu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Longtao He
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, China
| | - Yong Gao
- Division of Life Sciences and Medicine, The First Affiliated Hospital of the University of Science and Technology of China, Hefei, Anhui, China
| | - Fan Lv
- National Center for AIDS/Sexually Transmitted Disease Control and Prevention, The Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hongzhou Lu
- National Clinical Research Centre for Infectious Diseases, The Third People's Hospital of Shenzhen and The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Jun Qian
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Huachun Zou
- School of Public Health, Fudan University, Shanghai, China
- School of Public Health, Southwest Medical University, Luzhou, China
- Kirby Institute, University of New South Wales, Sydney, Australia
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Beviláqua JC, Dos Reis LC, Alves VH, Penna LHG, da Silva SÉD, Parente AT, de Jesus Dias Sousa F, Vieira BDG, Pereira AV, Fernandes MES, Rodrigues DP. Health professionals' perceptions of planned home birth care within the Brazilian health system. BMC Pregnancy Childbirth 2023; 23:844. [PMID: 38066510 PMCID: PMC10704750 DOI: 10.1186/s12884-023-06161-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/26/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The American College of Obstetricians and Gynecologists, in its opinion of the Committee on Midwifery Practice, points out that planned home birth is a woman's and family's right to experience, but also to choose and be informed about, their baby's place of birth. The aim of this study was to understand obstetric nurses' perceptions of planned home childbirth care within the framework of the Brazilian obstetric model. METHOD A qualitative study, with Snowball Sampling recruitment, totaling 20 obstetric nurses through semi-structured interviews between September 2022 and January 2023, remotely, using the Google Meet application and the recording feature. After the data had been collected, the material was transcribed in full and subjected to content analysis in the thematic modality with the support of ATLAS.ti 8.0 software. RESULTS Obstetric care at home emerged as a counterpoint to hospital care and the biomedical model, providing care at home based on scientific evidence and humanization, bringing qualified information as a facilitator of access and financial costs as an obstacle to effective home birth. CONCLUSION Understanding obstetric nurses' perceptions of planned home birth care in the context of the Brazilian obstetric model shows the need for progress as a public policy and for strategies to ensure quality and regulation.
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Affiliation(s)
| | | | - Valdecyr Herdy Alves
- School of Nursing, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | | | | | | | | | | | - Audrey Vidal Pereira
- School of Nursing, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
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Nosratabadi M, Halvaiepour Z. Identifying Psychological Perceptions of People Ignoring the Novel COVID-19 Warnings: A Qualitative Thematic Analysis in Isfahan, Iran. Integr Psychol Behav Sci 2023; 57:1402-1417. [PMID: 33728525 PMCID: PMC7963463 DOI: 10.1007/s12124-021-09608-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2021] [Indexed: 12/28/2022]
Abstract
Psychological factors are important for the prevention of disease. This study aims to identify the psychological perceptions of people who are ignoring the warnings of novel COVID-19 infection. A qualitative content analysis was carried out from May to July 2020. The interviewees were selected purposefully from Isfahan, Iran. The saturation point was achieved in 20 semi-structured interviews. The thematic analysis approach was used to analyze the transcribed documents using MAXQDA software (version 12).The results revealed 2 themes and 6 sub-themes related to the psychological beliefs of individuals with no attention to corona alerts. Themes and sub-themes included Biased cognitive processing (biased beliefs, attention biases, metacognitive beliefs and Depressogenic schemata), low compassion, and empathy for oneself and others (Negative Emotions towards Oneself, low altruism). To ensure a positive attitude towards precautionary measures in society, the thoughts, perceptions, and behaviors of people who ignore coronavirus alerts need to be changed. This is achieved through the use of mass media and virtual networks, by encouraging people to change their negative attitude towards the use of preventive measures, individual and social protection campaigns, and by fostering a sense of responsibility.
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Affiliation(s)
- Mehdi Nosratabadi
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zohreh Halvaiepour
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran.
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de Castro CPF, Aredes JDS, Giacomin KC, Firmo JOA. Greater Care Program in the face of the challenges of aging: a qualitative analysis. Rev Saude Publica 2023; 57:70. [PMID: 37878856 PMCID: PMC10547383 DOI: 10.11606/s1518-8787.2023057004859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/17/2022] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE To understand the perception of different actors involved in the older adults care process in the intersectoral strategy of the Programa Maior Cuidado (PMC - Greater Care Program), aiming at the development of actions that contribute to the improvement of the services provided. METHODS Eleven qualitative interviews guided by a semi-structured script were conducted in 2020 with key informants directly involved in the PMC: the older adults and their families, caregivers, health professionals and social assistance. In addition, to understand the functioning and proposals of the PMC, a documentary analysis was also carried out with the tracking of existing information on the guidelines, protocols, and management instruments. The content analysis technique was used to classify textual data, and the interpretation process was mediated by the theoretical-methodological framework of hermeneutic anthropology. RESULTS Two categories were identified: "Repercussions of the care offered by the PMC: the 'little' that makes a difference" and "Problems beyond the PMC: the limits of family care in the face of violence against the older adults". For all interviewees, the perception the PMC is very necessary is unison, being able to minimize the occurrence of health problems and avoid transfers of the older adults to hospitals and Long Stay Institutions for the Elderly (Instituição de Longa Permanência - ILPI in Portuguese). Chronic comorbidities increase the demands of health care and generate situations that can be managed by the PMC caregiver. Population aging requires the planning of strategies and public policies aimed at providing continuous care for the older adults, including those living in communities. The PMC emerges as an intersectoral alternative to assist in this issue. CONCLUSIONS The PMC can be considered a good practice model to be expanded to other locations, however there are gaps that need to be rediscussed so that its processes are improved and its results enhanced.
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Affiliation(s)
- Cláudio Phillipe Fernandes de Castro
- Fundação Oswaldo CruzInstituto René RachouPrograma de Pós-graduação em Saúde ColetivaBelo HorizonteMGBrazil Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-graduação em Saúde Coletiva. Belo Horizonte, MG, Brazil
| | - Janaína de Souza Aredes
- Fundação Oswaldo CruzInstituto René RachouNúcleo de Estudos em Saúde Pública e EnvelhecimentoBelo HorizonteMGBrazil Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brazil
| | - Karla Cristina Giacomin
- Secretaria Municipal de Saúde de Belo HorizonteBelo HorizonteMGBrazil Secretaria Municipal de Saúde de Belo Horizonte. Belo Horizonte, MG, Brazil
| | - Josélia Oliveira Araújo Firmo
- Fundação Oswaldo CruzInstituto René RachouNúcleo de Estudos em Saúde Pública e EnvelhecimentoBelo HorizonteMGBrazil Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brazil
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Celuppi IC, Meirelles BHS, Mendes M, Schneider DG, de Pires DEP. Ethical problems in nursing teleconsultations for people living with HIV during the Covid-19 pandemic. Rev Bras Enferm 2023; 76Suppl 3:e20220754. [PMID: 37820188 PMCID: PMC10561423 DOI: 10.1590/0034-7167-2022-0754] [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: 12/21/2022] [Accepted: 03/23/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVES to understand the ethical problems experienced by primary health care nurses in using nursing teleconsultations for people living with the human immunodeficiency virus during the coronavirus pandemic. METHODS qualitative research, anchored in Constructivist Grounded Theory. Data was collected between July and September 2020, with 17 participants. RESULTS the first category highlights the ethical problems in conducting teleconsultations, managing high demand, communication barriers, and risks related to data security. The second emphasizes the potential of teleconsultations in communication and access, by generating changes in the work process and the use of protocols to guide clinical practice. CONCLUSIONS nurses' work in digital mode requires professional qualification, with a view to stimulating reflection on teleconsultation practice, ethical-moral deliberation and combating stigma, and also adopting data security-centered conduct.
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Affiliation(s)
| | | | - Mariana Mendes
- Universidade Federal de Santa Catarina. Florianópolis, Santa Catarina, Brazil
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Bicalho JMF, Guimarães EADA, Magalhães KA, Menezes MCD, Oliveira CDL, Lopes ACS. Evaluating the Adequate and Healthy Food Promotion Program in Primary Care: a mixed methods research. CIENCIA & SAUDE COLETIVA 2023; 28:2247-2260. [PMID: 37531533 DOI: 10.1590/1413-81232023288.06452023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 04/17/2023] [Indexed: 08/04/2023] Open
Abstract
This article aims to analyze the implementation of an Adequate and Healthy Food Promotion Program in Primary Health Care in the municipalities of Minas Gerais. Mixed Methods Research with Data Concomitant Embedded Strategy. Evaluative research from the perspective of the implementation analysis was employed in the quantitative approach. An exploratory-descriptive study was conducted using content analysis in the qualitative approach. Qualitative and quantitative data were incorporated for analysis from their imbrication. The Program Implementation Level (IL) was 92.5%, representing an adequate implementation. The methodology of the actions proposed in the program and the implementation of Continuing Education were convergent strengths that emerged from data imbrication. The need for more human resources for planning and implementing the program and the lack of a kitchen for cooking workshops were identified as challenges. The Program's implementation was adequate and can be extended to other Brazilian municipalities to help professionals structure interventions to promote adequate and healthy food in the Primary Care work routine.
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Affiliation(s)
- Juliana Mara Flores Bicalho
- Universidade Federal de São João del-Rei (UFSJ), Campus Centro-Oeste Dona Lindu. R. Sebastião Gonçalves Coelho 400, Chanadour. 35501-296 Divinópolis MG Brasil.
| | | | - Kelly Alves Magalhães
- Programa de Pós-Graduação em Ciências da Saúde, Centro de Pesquisas René Rachou/Fiocruz. Belo Horizonte MG Brasil
| | | | - Claudia Di Lorenzo Oliveira
- Universidade Federal de São João del-Rei (UFSJ), Campus Centro-Oeste Dona Lindu. R. Sebastião Gonçalves Coelho 400, Chanadour. 35501-296 Divinópolis MG Brasil.
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Carvalho GDS, Beserra EP, Bandeira EDS, Rodrigues AB, Farias ILD, Oliveira PMD, Oliveira RM. Normalization of deviance in pediatric hospital: perception of health workers. Rev Gaucha Enferm 2023; 44:e20220236. [PMID: 37377272 DOI: 10.1590/1983-1447.2023.20220236.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/26/2022] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE To know the perception of health workers about the phenomenon of normalization of deviance in a pediatric hospital. METHOD Exploratory, descriptive, and qualitative study conducted in a public pediatric hospital in northeastern Brazil in 2021. An in-depth interview was applied to 21 health workers, submitted to Thematic Categorical Content Analysis in the MAXQDA® Software. RESULTS 128 context units emerged from the content analysis. These data were presented in three analytical categories, which address conceptions about normalization of deviance, examples and contributing factors. The omission of the practice of hand hygiene and the correct use of personal protective equipment,and turning off alarms stand out as the main deviance perceived by health workers. As contributing factors, human factors and organizational factors prevailed. CONCLUSION Workers perceive the normalization of deviance as negligence, recklessness, and violations of good practices, with consequences for patient safety.
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Affiliation(s)
| | - Eveline Pinheiro Beserra
- Universidade Federal do Ceará (UFC). Faculdade de Farmácia, Odontologia e Enfermagem. Departamento de Enfermagem. Fortaleza, Ceará, Brasil
| | - Erika da Silva Bandeira
- Centro Universitário Christus (UNICHRISTUS). Curso de Graduação em Enfermagem. Fortaleza, Ceará, Brasil
| | - Ana Barbosa Rodrigues
- Universidade Federal do Ceará (UFC). Faculdade de Farmácia, Odontologia e Enfermagem. Departamento de Enfermagem. Fortaleza, Ceará, Brasil
| | - Isaque Lima de Farias
- Universidade Federal do Ceará (UFC). Faculdade de Farmácia, Odontologia e Enfermagem. Departamento de Enfermagem. Fortaleza, Ceará, Brasil
| | - Paloma Moreira de Oliveira
- Universidade Federal do Ceará (UFC). Faculdade de Farmácia, Odontologia e Enfermagem. Departamento de Enfermagem. Fortaleza, Ceará, Brasil
| | - Roberta Meneses Oliveira
- Universidade Federal do Ceará (UFC). Faculdade de Farmácia, Odontologia e Enfermagem. Departamento de Enfermagem. Fortaleza, Ceará, Brasil
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Worku WZ, Azale T, Ayele TA, Mekonnen DK. Women's voices: the lived experience of HIV-positive women in the postpartum period at the University of Gondar comprehensive specialized referral hospital, Ethiopia: a phenomenological study. BMC Womens Health 2023; 23:325. [PMID: 37344854 DOI: 10.1186/s12905-023-02470-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 06/09/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Pregnancy and the postpartum period are incredibly challenging for women living with the Human Immune Deficiency Virus (HIV) due to the multidimensional influence of HIV infection. These women experience the challenges of navigating pregnancy and motherhood while living with HIV. It is poorly understood how women living with HIV (WLWH) experience pregnancy and postpartum. Therefore, the current study aimed to explore the lived experience of pregnancy and postpartum among women living with HIV. METHODS A phenomenological qualitative study design was employed. A semi-structured, interview guide was used to conduct in-depth interviews with HIV-positive postpartum women from April to May 2022. All interviews were recorded using a voice recorder and note was taken. The collected data were transcribed and translated into English for analysis. Inductive thematic analysis was applied to analyze the data. RESULTS Six main themes about the lived experience of women living with HIV were identified: (1) Fear and distress related to maternal and child Health, (2) HIV status self-disclosure dilemma, (3) Courage and commitment of HIV-positive women to prevent HIV, (4) Challenges faced and coping mechanisms used by HIV-positive women, (5) Health care providers and HIV-positive women interaction, and (6) Solution from their voices. CONCLUSION HIV infection also has a multidimensional impact on women's life during pregnancy and postpartum. The findings of this study improve our understanding of the lived experience of HIV-positive women while pregnant and in the postpartum period. These women's descriptions showed that they have been experiencing various challenges that are not often addressed in antenatal clinics, such as distress and uncertainties related to vertical transmission of HIV. These women need specialized support and all-encompassing care to have a healthy pregnancy and postpartum period. Moreover, it is essential to understand the circumstances of women's lives, their relationships with others, and their decision-making processes. Healthcare professionals and other responsible bodies working with women living with HIV should encourage and support these mothers to appraise and maintain their commitment to protecting their children from acquiring HIV infection and maintaining their Health to the maximum to raise their children.
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Affiliation(s)
- Workie Zemene Worku
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Telake Azale
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dawit Kassahun Mekonnen
- Department of Gynaecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Figueiredo CA, Nunes DP, Fusco SDFB, Saidel MGB. Perspectives of Brazilian Primary Care Nurses on Mental Health Care for Hypertensive Older Adults: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6185. [PMID: 37372771 DOI: 10.3390/ijerph20126185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023]
Abstract
Population longevity has been growing globally. In developing countries such as Brazil, the impact of this reality is enormous. The aging process is challenging for the healthcare system, making individuals more susceptible to chronic health conditions and mental health-related diseases. Primary healthcare (PHC) providers must be able to accompany older adults with their singularities in their work processes. This study aims to understand PHC nurses' perspectives on the mental health care of hypertensive older adults. This is a study with a qualitative approach, using in-depth interviews and a focus group with 16 nurses from the five Brazilian municipalities with the highest number of older adults. The themes that emerged from the data collection were possibilities of PHC, characterization of PHC, and mental health care in PHC. The study findings contribute to the knowledge base on how PHC nurses provide care to hypertensive older adults and which weaknesses they should overcome in their work environment. The different ways providers have been developing strategies to improve their care should be encouraged, improved, and systematized.
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Affiliation(s)
| | - Daniella Pires Nunes
- Escola de Enfermagem, Universidade Estadual de Campinas, Campinas 13083-887, Brazil
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Sousa MDCVB, do Nascimento E, Mendonça SDAM, Chemello C. Professionals' and Patients' Perspectives on Criteria for Referring Hypertensive Patients to Comprehensive Medication Management Services in Public Primary Health Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5233. [PMID: 37047848 PMCID: PMC10094289 DOI: 10.3390/ijerph20075233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/08/2023] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
Patient prioritization in comprehensive medication management services allows coordinating care and guiding patients according to their clinical profile and their medication use. The aim of the study is to identify and describe factors that indicate the need for comprehensive medication management services among primary care hypertension patients within a public health system from the perspective of patients, pharmacists, nurses and physicians. A qualitative study was carried out with interviews with nurses, pharmacists and physicians (n = 20), and two focus groups with hypertensive patients (n = 12) at primary health care facilities and a public outdoor fitness area between January and February 2019 in Brazil. All interviews were transcribed and analyzed using the Atlas.ti® software. The data analysis revealed the following factors indicative of the need to refer hypertension patients to a pharmacist: lifestyle habits, comorbidities, health care utilization and medication use. The issues identified and the information obtained from the qualitative research and compared with literature studies reviewed allowed defining dimensions that should be considered as an aid in the selection of uncontrolled hypertensive patients for comprehensive medication management services.
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Affiliation(s)
- Maria do Carmo Vilas Boas Sousa
- Faculty of Pharmacy, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Elizabeth do Nascimento
- Department of Psychology, Faculty of Philosophy and Human Sciences, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Simone de Araújo Medina Mendonça
- Faculty of Pharmacy, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Clarice Chemello
- Faculty of Pharmacy, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
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Bhering M, Dalcolmo M, Sarubbi V, Kritski A. Barriers faced by patients in the diagnosis of multidrug-resistant tuberculosis in Brazil. Rev Saude Publica 2022; 56:60. [PMID: 35766789 PMCID: PMC9239425 DOI: 10.11606/s1518-8787.2022056004154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/09/2021] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE To understand patients' narratives about the barriers they faced in the diagnosis and treatment of multidrug-resistant tuberculosis, and their consequences in Rio de Janeiro State, Brazil. METHODS This is a qualitative cross-sectional study with non-probabilistic sampling. A theoretical saturation criterion was considered for composing the number of interviewees. Semi-structured interviews were conducted from August to December 2019 with 31 patients undergoing treatment for multidrug-resistant tuberculosis at an outpatient referral center in Rio de Janeiro. Data were transcribed and processed with the aid of the NVIVO software. Interviews were evaluated by content analysis, and their themes, cross-referenced with participants' characterization data. RESULTS Our main findings were: a) participants show a high proportion of primary drug resistance, b) patients experience delays in the diagnosis and effective treatment of multidrug-resistant tuberculosis ; c) healthcare providers fail to value or seek the diagnosis of drug-resistant tuberculosis, thus beginning the inadequate treatment for drug-susceptible tuberculosis, d) primary health units show low report rates of active case-finding and contact monitoring, and e) patients show poor knowledge about the disease. CONCLUSIONS We need to improve referral systems, and access to the diagnosis and effective treatment of multidrug-resistant tuberculosis; conduct an active investigation of contacts; intensify the training of healthcare providers, in collaboration with medical and nursing schools, in both public and private systems; and promote campaigns to educate the population on tuberculosis signs and symptoms.
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Affiliation(s)
- Marcela Bhering
- Fundação Oswaldo CruzEscola Nacional de Saúde Pública Sérgio AroucaRio de JaneiroRJBrasil Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil
- Universidade Federal do Rio de JaneiroFaculdade de MedicinaPrograma Acadêmico de TuberculoseRio de JaneiroRJBrasil Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Programa Acadêmico de Tuberculose. Rio de Janeiro, RJ, Brasil
| | - Margareth Dalcolmo
- Fundação Oswaldo CruzEscola Nacional de Saúde Pública Sérgio AroucaRio de JaneiroRJBrasil Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil
| | - Vicente Sarubbi
- Universidade Estatual de Mato Grosso do SulFaculdade de MedicinaCampo GrandeMSBrasil Universidade Estatual de Mato Grosso do Sul. Faculdade de Medicina. Campo Grande, MS, Brasil
| | - Afrânio Kritski
- Universidade Federal do Rio de JaneiroFaculdade de MedicinaPrograma Acadêmico de TuberculoseRio de JaneiroRJBrasil Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Programa Acadêmico de Tuberculose. Rio de Janeiro, RJ, Brasil
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Almeida Silva HJ, Avila MA, Castro KMS, Pinheiro YT, Lins CAA, Medeiros Barbosa G, de Souza MC. Exploring patient experiences of participating in a real and sham dry cupping intervention for nonspecific low back pain: A qualitative study. PLoS One 2022; 17:e0268656. [PMID: 35587506 PMCID: PMC9119469 DOI: 10.1371/journal.pone.0268656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 05/04/2022] [Indexed: 11/30/2022] Open
Abstract
Background The current quality of evidence supporting dry cupping for individuals with chronic low back pain (CLBP) is low and suggests that nonspecific factors impact experiences reported by patients. Therefore, this study assessed the impacts of social and professional support on the experience of individuals with CLBP treated with dry cupping or sham. Method This is an observational study with qualitative approach. Twenty-four individuals with CLBP who received dry cupping or sham in a previous clinical trial were invited. Data was collected using a semi-structured interview conducted by a trained researcher. Content analysis was used to analyze experiences, systematic procedures, and description of the content of messages. The dimensions of “pain”, “general perceptions”, and “perceived social and professional support” guided the analysis. Results Answers of both groups converged on similar perceptions, especially regarding pain. Physical condition was the most fragile aspect. We also observed an influence of perceived social and professional support on painful symptoms. Thus, the experience of individuals with CLBP treated with dry cupping or sham indicated that factors related to social and professional support impacted results. Conclusions We observed that individuals with CLBP reported similar perceptions of the effects of dry cupping or sham treatment, indicating that contextual factors may influence the perception of these individuals regarding the treatment received.
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Affiliation(s)
- Hugo Jário Almeida Silva
- Faculdade de Ciências da Saúde do Trairi, Postgraduate Program in Rehabilitation Sciences, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil
| | - Mariana Arias Avila
- Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, São Paulo, SP, Brazil
| | - Kamilla Maria Sousa Castro
- Faculdade de Ciências da Saúde do Trairi, Postgraduate Program in Rehabilitation Sciences, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil
| | - Yago Tavares Pinheiro
- Faculdade de Ciências da Saúde do Trairi, Postgraduate Program in Rehabilitation Sciences, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil
| | - Caio Alano Almeida Lins
- Faculdade de Ciências da Saúde do Trairi, Postgraduate Program in Rehabilitation Sciences, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil
| | - Germanna Medeiros Barbosa
- Faculdade de Ciências da Saúde do Trairi, Postgraduate Program in Rehabilitation Sciences, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil
| | - Marcelo Cardoso de Souza
- Faculdade de Ciências da Saúde do Trairi, Postgraduate Program in Rehabilitation Sciences, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil
- * E-mail:
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The Sexual and Emotional Life Experiences Reported by Brazilian Men with Head and Neck Cancer at a Public University Hospital: A Qualitative Study. SEXUALITY AND DISABILITY 2022. [DOI: 10.1007/s11195-022-09732-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractThis study explored the sexual and emotional experiences of male patients with head and neck cancer. This study utilized a clinical-qualitative method. Twelve patients with head and neck cancer were recruited to participate in the research through in-depth semi-directed interviews with open-ended questions recorded. Data was collected at the radiotherapy of a Brazilian hospital. All patients demonstrated negative impacts on the dynamics of affective and sexual relationships caused by a serious disease. Data revealed that impacts mainly affect “The felt/lived body”, and “The affective-sexual body”. Requiring, then, an “Elaboration of the grief of the bodily and sexual changes”. Considering, evaluating and proposing care for a sexual and emotional aspects of patients with head and neck cancer is essential for the creation and implementation of comprehensive health measures, especially in terms of quality of life for patients.
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Perin MS, São-João T, Gallani MCBJ, Agbadje TT, Rodrigues RCM, Cornélio ME. A mobile phone application intervention to promote healthy salt intake among adults: Protocol for a randomized controlled study (Preprint). JMIR Res Protoc 2022; 11:e37853. [PMID: 35767347 PMCID: PMC9280466 DOI: 10.2196/37853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/11/2022] [Accepted: 05/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background There is sound evidence associating high salt intake and a greater risk of cardiovascular and noncardiovascular diseases. High salt intake has been observed in several populations worldwide. Therefore, promoting healthier salt consumption has been encouraged as a low-cost strategy to reduce this risk factor. However, these strategies need to be sound, built on theoretical and methodological bases, and consider the target population’s context. Objective This protocol aims to describe a mobile phone app intervention to promote healthy salt intake among adults. Methods This is an experimental and longitudinal study protocol conducted in three modules. Module 1 refers to the planning of the intervention based on the Behaviour Change Wheel framework. Module 2 is the development of the mobile phone app intervention based on the date of module 1. In module 3, the intervention will be evaluated using a randomized controlled study, with three steps of data collection in a 2-month follow-up in a sample of 86 adults (43 participants for each group: the control group and intervention group) recruited from the primary health care centers of a Brazilian town. The discretionary salt intake questionnaire will assess salt consumption, the app usability will be assessed using the System Usability Scale, and psychosocial variables (habit, intention, and self-efficacy) will also be measured. Results Recruitment began in October 2021, and the follow-up will end in August 2022. The results of this study are expected to be published in 2023. Conclusions Results from this study will help people to control salt intake when cooking at home, will stimulate self-care, will work as an alternative or supportive method in the relationship between health care professionals and patients, and will contribute to implementing the app intervention to promote healthy salt intake on a large scale. Trial Registration The Brazilian Clinical Trials Registry RBR-4s8qyyq; https://ensaiosclinicos.gov.br/rg/RBR-4s8qyyq International Registered Report Identifier (IRRID) DERR1-10.2196/37853
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Affiliation(s)
| | - Thais São-João
- College of Nursing, University of Rhode Island, Kingston, RI, United States
| | | | - Titilayo Tatiana Agbadje
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Quebec, QC, Canada
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Gomes AKS, Reis MEBTD. EMOÇÕES VIVENCIADAS PELOS PSICOTERAPEUTAS-APRENDIZES NOS SERVIÇOS-ESCOLAS: UMA LEITURA PSICANALÍTICA. PSICOLOGIA EM ESTUDO 2022. [DOI: 10.4025/psicolestud.v27i0.48423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Os atendimentos clínicos realizados nos serviços-escolas são permeados por uma série de experiências emocionais vivenciadas pela díade psicoterapeuta-aprendiz/paciente. Diante das diversas nuances da clínica psicanalítica, o psicoterapeuta-aprendiz vivencia experiências que refletem em sua subjetividade. Este estudo teve como objetivo investigar as vivências emocionais dos estudantes de graduação em psicologia durante os estágios em clínica psicanalítica e analisar as emoções percebidas em si mesmos pelos psicoterapeutas-aprendizes nos atendimentos em psicoterapia psicanalítica. Trata-se de um estudo clínico-qualitativo, utilizando-se o referencial teórico psicanalítico. Participaram 27 estudantes de psicologia, que realizavam atendimentos nos serviços-escolas de quatro Instituições de Ensino Superior. A coleta de dados foi realizada através de entrevistas semidirigidas, as quais foram submetidas à análise de conteúdo. Nos resultados observou-se a presença das vivências de ansiedade, medo, insegurança e nervosismo, presentes no processo psicoterapêutico. A identificação com as vivências emocionais dos pacientes e as dúvidas referentes à percepção das próprias emoções, foram importantes aspectos encontrados neste estudo. Tais resultados podem contribuir para a reflexão sobre a vivência desta experiência para o psicoterapeuta-aprendiz, a fim de melhor prepará-lo para os desafios da prática clínica psicanalítica.
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Trigueiro TH, Arruda KAD, Santos SDD, Wall ML, Souza SRRK, Lima LSD. Experiência de gestantes na consulta de Enfermagem com a construção do plano de parto. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo Descrever a experiência das gestantes atendidas na Consulta de Enfermagem a partir de 37 semanas e que elaboraram seu plano de parto. Método Pesquisa exploratória qualitativa, com 19 gestantes a partir de 37 semanas vinculadas à maternidade de risco habitual em Curitiba, Paraná, e que passaram pela consulta de enfermagem entre novembro de 2019 e março de 2020. Os dados foram coletados mediante entrevista e submetidos a análise de conteúdo temática. Resultados As gestantes apresentaram desconhecimento sobre assuntos relacionados ao parto, o que contribui para o surgimento de dúvidas, medos e inseguranças. Também não conheciam, ou conheciam de forma superficial, o plano de parto. A consulta de enfermagem e o plano de parto na maternidade contribuíram para o esclarecimento de dúvidas, redução da ansiedade, possibilidade de fortalecimento e empoderamento da gestante e do acompanhante diante da oferta de informações para o parto vaginal e o estabelecimento de vínculo com a maternidade. Conclusões e implicações para a prática Adequados à realidade e focados na individualidade da gestante, a consulta de enfermagem e o plano de parto foram respectivamente evidenciados como espaço para educação em saúde e ferramenta educativa, mostrando-se eficientes para a atuação do enfermeiro e melhora da assistência pré-natal.
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Noronha DO, Luz-Santos C, Novais HPDO, Frank MH, Costa CM, Soub JC, Caires RM, Peixoto JMDS, Santos KOB, Miranda JGV. Health care network model for older adults: a co-creation and participatory action research approach. GERIATRICS, GERONTOLOGY AND AGING 2022. [DOI: 10.53886/gga.e0220008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: To develop a collaborative, multidisciplinary care model for older adults that improves interdisciplinary teamwork and increases access to specialized services for frail patients, helping solve management problems in the Brazilian Unified Health System. In the state of Bahia, the health care network for older adults requires better interaction and integration with the Unified Health System and the Unified System of Social Assistance to improve patient flow in the network. Methods: We used a co-creation and participatory action research approach based on reflection, data collection, interaction, and feedback with participants and stakeholders. Data was collected from health professionals, representatives of health agencies, and older adults through collective and individual interviews, reflective diaries, and direct communication. Results: An action plan involving members of the older adult care network was developed to put the new model into practice. A pilot study with a multidisciplinary team allowed adjustments and implementation of the model at our institution. Conclusions: The new model improved both the internal management of the State Reference Center for Older Adult Health Care (Centro de Referência Estadual de Atenção à Saúde do Idoso - CREASI) and its interaction with primary care, optimizing patient flow and establishing rules for shared management between CREASI and primary care institutions. In view of this, restructuring the care model reorganized relations between the agencies, expanding CREASI’s role in the management and systematization of older adult health.
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Schneider KL, Levandowski DC. Perfil de Psicoterapeutas Pais-Bebê de Porto Alegre: Formação e Atuação Profissional. PSICOLOGIA: CIÊNCIA E PROFISSÃO 2022. [DOI: 10.1590/1982-3703003238803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Resumo A psicoterapia pais-bebê é uma modalidade terapêutica que enfoca a relação da díade/tríade pai-mãe/bebê, geralmente embasada no referencial teórico psicanalítico. No Brasil, são escassas as pesquisas sobre o tema. Este estudo teve como objetivo investigar o perfil de profissionais que atuam como psicoterapeutas pais-bebê em Porto Alegre e as características e especificidades deste campo de atuação. Trata-se de estudo qualitativo, de caráter exploratório-descritivo. Os dados foram coletados por meio de entrevista semiestruturada realizada presencialmente. Participaram do estudo 10 psicoterapeutas do sexo feminino, selecionadas por conveniência. Utilizou-se a Análise de Conteúdo proposta por Laurence Bardin para a análise dos dados. A possibilidade de intervir precocemente foi descrita como a principal motivação para a inserção na área, que ocorreu sem uma formação acadêmica estruturada. Possuir conhecimentos sobre desenvolvimento infantil, constituição de vínculos e dinâmica familiar foi citado como imprescindível para a atuação profissional. Quanto às características pessoais e técnicas, foram mencionadas a necessidade de identificação com a técnica e com o trabalho com bebês e de possuir formação sólida, pautada em estudo teórico, supervisão e análise pessoal. A importância da experiência prática e da observação de bebês enquanto ferramentas de aprendizagem também foi destacada, e constatou-se a necessidade de ampliar a visibilidade desse campo de atuação entre profissionais e público em geral.
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Teixeira CC, Bezerra ALQ, Paranaguá TTDB, Afonso TC. Professionals’ beliefs in patient involvement for hospital safety. Rev Bras Enferm 2022; 75:e20210359. [DOI: 10.1590/0034-7167-2021-0359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/22/2021] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objectives: to analyze the beliefs of health care professionals about the benefits of patient involvement in care during hospitalization. Methods: a descriptive, exploratory, qualitative study was conducted with 87 health professionals from a teaching hospital. Semi-structured interviews were conducted between December 2019 and January 2020 - data was submitted to content analysis and interpreted in light of Rosenstock’s Model of Beliefs in Health. Results: participants included nursing technicians, nurses, doctors, and other professionals. The categories “Professionals’ beliefs about patient involvement in care”, “Practices of patient involvement in care” and “Factors favoring patient involvement in hospital care” emerged. The perception of professionals revealed the influence of patient involvement in care outcomes and benefits for the safety of care. Final Considerations: involving the patient in care is associated with the healthcare professional’s belief in the benefits of this practice for reducing incidents.
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Frison FS, Alonzo HGA. Acidente de Trabalho com Exposição a Material Biológico: percepções dos residentes de medicina. SAÚDE EM DEBATE 2022. [DOI: 10.1590/0103-1104202213417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Trata-se de um estudo de abordagem qualitativa, realizado em um complexo hospitalar universitário, com o objetivo de descrever as percepções dos residentes de medicina que sofreram um Acidente de Trabalho com Exposição a Material Biológico quanto aos fatores pessoais, institucionais e sociais associados à ocorrência do acidente. As informações foram coletadas por meio das fichas de notificação dos acidentes e de entrevistas com uma questão aberta norteadora. Foi utilizada a análise de conteúdo de Bardin e o fechamento amostral por saturação. Foram entrevistados vinte e um residentes de medicina e identificados dois eixos temáticos: condições de trabalho e estado emocional do residente médico. Os resultados revelaram que a sobrecarga de trabalho, o acúmulo de atividades, a equipe de saúde reduzida, a ausência de supervisão por um preceptor médico e a imperícia do profissional contribuíram para ocorrência do acidente. Além disso, foram relatados fatores como cansaço, fadiga, privação do sono, desatenção e, sobretudo, estresse emocional. São poucos os estudos sobre o tema, porém, as percepções dos residentes médicos evidenciaram um cenário em que o processo de trabalho interfere no bem-estar físico e psíquico dos profissionais, contribuindo para a ocorrência dos acidentes.
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Almeida LMN, Goulart MDCEL, Góes FGB, Ávila FMVP, Pinto CB, Naslausky SG. A influência do retorno ao trabalho no aleitamento materno de trabalhadoras da enfermagem. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo analisar a influência do retorno ao trabalho de mães trabalhadoras da enfermagem no aleitamento materno. Método pesquisa qualitativa, desenvolvida por meio de formulário semiestruturado, via Google Forms, junto a 49 trabalhadoras de enfermagem do estado do Rio de Janeiro. Os dados foram submetidos à análise lexicográfica, com auxílio do software Interface de R pour Analyses Multidimensionnelles de Textes Et de Questionnaires (IRAMUTEQ), pelo método de Nuvem de Palavras e Classificação Hierárquica Descendente. Resultados o aproveitamento do corpus textual foi de 88,24%, gerando quatro classes de segmentos de texto. As principais influências do retorno ao trabalho na amamentação relatadas pelas participantes foram: a falta de apoio dos chefes e colegas de trabalho, a necessidade de local e tempo adequados para ordenha do leite materno, a diminuição na produção de leite por fatores inerentes ao trabalho e sobrecarga e ambientes insalubres de trabalho na enfermagem. Conclusão e implicações para a prática a identificação desses fatores possibilita a compreensão das demandas das nutrizes participantes e aponta para a necessidade de estratégias inovadoras, que garantam o direito das trabalhadoras, assim como adequações de infraestrutura em seus ambientes laborais.
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Almeida Sousa BS, Almeida CAPL, dos Santos JR, Lago EC, de Oliveira JF, Areas da Cruz T, Lima SVMA, Camargo ELS. Meanings Assigned by Primary Care Professionals to Male Prenatal Care: A Qualitative Study. Open Nurs J 2021. [DOI: 10.2174/1874434602115010351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Considering recent strategies used in prenatal care, the involvement of fathers has been considered an important factor in ensuring that pregnancy and delivery are successful.
Objective:
The aim of this study is to identify the meanings assigned by primary health care professionals to male prenatal care.
Methods:
This is a descriptive study with a qualitative approach. A total of 19 interviews were conducted with primary health care professionals registered in the City Health Department of Teresina, Piauí, Brazil. Data were collected through semi-structured interviews and analyzed according to the Collective Subject Discourse methodology.
Results:
Three themes emerged from the reports’ analysis: The importance of the role of fathers in the gestational process, attitudes of men toward male prenatal care and formal education and training in primary health care. Health practitioners understand the importance of male prenatal care but reported they lack proper training to provide effective care.
Conclusion:
The expansion of continuing education strategies focusing on male prenatal care and directed to primary health care professionals is recommended to promote greater adherence on the part of fathers in prenatal care, with the purpose of strengthening bonds and improving the care provided to the entire family. The humanized care can facilitate the approach of the paternal figure during male prenatal care.
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Mathias A, Santos LAD, Grangeiro A, Couto MT. HIV risk perceptions and post-exposure prophylaxis among men who have sex with men in five Brazilian cities. CIENCIA & SAUDE COLETIVA 2021; 26:5739-5749. [PMID: 34852105 DOI: 10.1590/1413-812320212611.29042020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/10/2020] [Indexed: 05/31/2023] Open
Abstract
In the current context of the HIV epidemic, multiple prevention strategies including biomedical interventions have been presented as alternatives for vulnerable groups. This study investigated homosexuals' and bisexuals' perceptions of the risk of HIV infection and their experiences of using HIV post-exposure prophylaxis (PEP). We conducted a qualitative study with 25 men who have sex with men (MSM) in five Brazilian cities using semi-structured interviews. The results showed that the use of condoms was the main HIV prevention strategy employed by the respondents. In addition, condom failure, inconsistent condom use and intentional non-use are the main prompters of risk perception and the consequent decision to seek PEP. The respondent's perceptions and meanings of the use of PEP were mediated by prior knowledge of PEP. This work broadens the debate on the more subjective aspects of HIV prevention among MSM, especially those related to risk perception and the decision to use PEP in the context of combined prevention.
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Affiliation(s)
- Augusto Mathias
- Programa de Pós-Graduação em Saúde Coletiva, Faculdade de Medicina, Universidade de São Paulo (USP). Av. Dr. Arnaldo 455, Sala 2165, Cerqueira César. 01246-903 São Paulo SP Brasil.
| | - Lorruan Alves Dos Santos
- Programa de Pós-Graduação em Saúde Coletiva, Faculdade de Medicina, Universidade de São Paulo (USP). Av. Dr. Arnaldo 455, Sala 2165, Cerqueira César. 01246-903 São Paulo SP Brasil.
| | - Alexandre Grangeiro
- Departamento de Medicina Preventiva, Faculdade de Medicina, USP. São Paulo SP Brasil
| | - Marcia Thereza Couto
- Departamento de Medicina Preventiva, Faculdade de Medicina, USP. São Paulo SP Brasil
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de Jezus SV, Ilha da Silva A, Alexandre Arcêncio R, de Faria Marcos Terena N, dos Santos Pinheiro J, Souza Sacramento D, de Souza Silva Freitas P, Carminati Siqueira P, Mocelin HJS, Maria Silva Araújo V, da Silva Lima R, Nascimento do Prado T, Maia Martins Sales C, Noia Maciel EL. Local action plan to promote access to the health system by indigenous Venezuelans from the Warao ethnic group in Manaus, Brazil: Analysis of the plan´s development, experiences, and impact through a mixed-methods study (2020). PLoS One 2021; 16:e0259189. [PMID: 34780501 PMCID: PMC8592448 DOI: 10.1371/journal.pone.0259189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 10/14/2021] [Indexed: 11/19/2022] Open
Abstract
Background The provision of care and monitoring of health are essential for indigenous Venezuelans from the Warao ethnic group, who are at risk of decimation. Objective Analyze a Local Action Plan (LAP) to promote access to the health system of indigenous Venezuelans from the Warao ethnic group (IVWEG) in Manaus, Brazil. Method A mixed-methods study was performed. Quantitative data were collected to assess the provision of care and monitoring of health conditions in IVWEG through a survey that was self-completed by healthcare providers. Qualitative narrative data were collected to gain insight into IVWEG that seek care. We applied descriptive statistics, grouping analysis (GA) by hierarchical levels, and multiple correspondence analysis (MCA). Content analysis was applied to qualitative data. Results 106 healthcare providers participated in the study, with the following characteristics: 94 (88.7%) females, 67 (63.2%) pardo race/color, 40 (37.7%) working in primary healthcare, and 49 (46.2%) nurses. In addition, 43 (40.6%) of the healthcare providers reported providing care to IVWEG. Among the providers, 89 (84%) had received training for assisting IVWEG. Additionally, 30 IVWEG were enrolled for interviews in the qualitative phase. The barriers to seeking care were language, distance to health units, and lack of money for transportation. The LAP proved to facilitate access to the health system by indigenous Venezuelans from the Warao ethnic group in Manaus. The study contributed to knowledge on a LAP addressed to IVWEG and helped improved their access to the health system, providing appropriate training for healthcare providers and other relevant actors by implementing a coherent and consistent public health policy at the local level.
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Affiliation(s)
- Sonia Vivian de Jezus
- Graduate Studies Program in Public Health, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
- Instituto de Ciências da Saúde, Universidade Federal de Mato Grosso, Sinop, Mato Grosso, Brazil
| | - Adriana Ilha da Silva
- Epidemiology Laboratory, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Ricardo Alexandre Arcêncio
- Escola de Enfermagem de Ribeirão Preto, Graduate Studies Program in Public Health Nursing, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
- Brazilian TB Research Network, REDE-TB, Rio de Janeiro, Brazil
| | | | - Jair dos Santos Pinheiro
- Brazilian TB Research Network, REDE-TB, Rio de Janeiro, Brazil
- Municipal Health Department, Manaus, Amazonas, Brazil
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Graduate Studies Program in Tropical Medicine (PhD), Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | | | | | | | | | | | | | | | | | - Ethel Leonor Noia Maciel
- Epidemiology Laboratory, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
- Brazilian TB Research Network, REDE-TB, Rio de Janeiro, Brazil
- * E-mail:
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Souza LLL, Santos FLD, Crispim JDA, Fiorati RC, Dias S, Bruce ATI, Alves YM, Ramos ACV, Berra TZ, da Costa FBP, Alves LS, Monroe AA, Fronteira I, Arcêncio RA. Causes of multidrug-resistant tuberculosis from the perspectives of health providers: challenges and strategies for adherence to treatment during the COVID-19 pandemic in Brazil. BMC Health Serv Res 2021; 21:1033. [PMID: 34592970 PMCID: PMC8483800 DOI: 10.1186/s12913-021-07057-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multidrug-resistant tuberculosis (MDR-TB) is a serious phenomenon on a global scale that can worsen with the COVID-19 pandemic. The study aimed to understand the perceptions of health professionals about MDR-TB, their strategies to ensure adherence to treatment and their challenges in the context of the COVID-19 pandemic in a priority municipality for disease control. METHODS We conducted a qualitative study and recruited 14 health providers (four doctors, three nurses, three nursing technicians, three nursing assistants and a social worker) working in a city in the state of São Paulo, Brazil. Remote semi-structured interviews were conducted with the participants. For data analysis, the thematic content analysis technique was applied according to the study's theoretical framework. RESULTS The study revealed the causes of MDR-TB are associated with poverty, vulnerability, and social risk. A pre-judgement from the providers was observed, namely, all patients do not adhere due their resistance and association with drug abuse or alcoholism. The study also observed difficulty among health providers in helping patients reconstruct and reframe their life projects under a care perspective, which would strengthen adherence. Other issues that weakened adherence were the cuts in social protection and the benefits really necessary to the patients and a challenge for the providers manage that. The participants revealed that their actions were impacted by the pandemic and insecurity and fear manifested by patients after acquiring COVID-19. For alleviating this, medical appointments by telephone, delivery of medicine in the homes of patients and visits by health professionals once per week were provided. CONCLUSION The study advances knowledge by highlighting the challenges faced by the health system with the adherence of patients with MDR-TB in a context aggravated by the pandemic. An improvement in DOT is really necessary to help the patients reframe their lives without prejudices, face their fears and insecurity, recover their self-esteem and motivate in concluding their treatment.
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Affiliation(s)
- Ludmilla Leidianne Limirio Souza
- Master of Science, Public Health Nursing Graduate Program, University of São Paulo at Ribeirão Preto College of Nursing, Avenida dos Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, Brazil.
| | - Felipe Lima Dos Santos
- Master of Science, Public Health Nursing Graduate Program, University of São Paulo at Ribeirão Preto College of Nursing, Avenida dos Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, Brazil
| | - Juliane de Almeida Crispim
- Postdoctoral Fellowship in the Interinstitutional Doctoral Program in Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Regina Célia Fiorati
- University of São Paulo at Ribeirão Preto Medical School at Ribeirão Preto, São Paulo, Brazil
| | - Sónia Dias
- Universidade NOVA de Lisboa at National School of Public Health, Lisbon, Portugal
| | - Alexandre Tadashi Inomata Bruce
- Master of Science, Public Health Nursing Graduate Program, University of São Paulo at Ribeirão Preto College of Nursing, Avenida dos Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, Brazil
| | - Yan Mathias Alves
- Public Health Nursing Graduate Program, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Antônio Carlos Vieira Ramos
- Public Health Nursing Graduate Program, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Thaís Zamboni Berra
- Public Health Nursing Graduate Program, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | | | - Luana Seles Alves
- Public Health Nursing Graduate Program, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Aline Aparecida Monroe
- University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
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Silva-Rodrigues FM, de Lucca M, Leite ACAB, Alvarenga WDA, Nunes MDR, Nascimento LC. Management of chemotherapy-related symptoms in children and adolescents: family caregivers' perspectives. Rev Esc Enferm USP 2021; 55:e20200484. [PMID: 34423804 DOI: 10.1590/1980-220x-reeusp-2020-0484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 04/09/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To describe the chemotherapy-associated symptoms and the strategies used for their management from the perspective of pediatric cancer patients' family caregivers. METHODS This is a descriptive study with qualitative data analysis. Data collection took place in a pediatric hospital, from December 2017 to December 2018, with family caregivers of pediatric patients undergoing chemotherapy. Semi-structured interviews, subjected to inductive content analysis, were carried out. Concepts from the Symptom Management Theory were used to discuss the results. RESULTS Eighteen family caregivers participated. The participants mentioned: physical symptoms, especially weakness, alopecia, low immunity, pain, mucositis, constipation, nausea, and vomiting; emotional or psychosocial symptoms such as sadness and mood changes; and constitutional symptoms such as loss of appetite and fever. Pharmacological and non-pharmacological measures were mentioned in the management of symptoms and adverse effects. CONCLUSION Participants demonstrated skills to identify and manage symptoms of chemotherapy. Knowing the experience of these families can help nurses in planning care and interventions to minimize these events.
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Affiliation(s)
| | - Milena de Lucca
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto, SP, Brazil
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Schönholzer TE, Pinto IC, Zacharias FCM, Gaete RAC, Serrano-Gallardo MDP. Implementation of the e-SUS Primary Care system: Impact on the routine of Primary Health Care professionals. Rev Lat Am Enfermagem 2021; 29:e3447. [PMID: 34287545 PMCID: PMC8294795 DOI: 10.1590/1518-8345.4174.3447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/29/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to understand how the implementation of the e-SUS Primary Care system has been processed and its impact on the daily life of the health teams. METHOD a qualitative research study, conducted in a municipality in the inland of the state of São Paulo with professionals who work in Primary Health Care and use the e-SUS Primary Care system as a work tool. Semi-structured interviews and thematic data analysis were used with Kotter's three-phase approach. RESULTS a total of 17 professionals, nurses, physicians, dentists and community agents were interviewed. The implementation of e-SUS Primary Care and its impact on the daily life of health teams were understood in terms of mandatory implementation; weaknesses for implementation, such as absence of material resources and implicit imposition for the use of the system; fragile training for deployment and learning from experience. CONCLUSION a harmful incentive process was observed, conducted from the perspective of institutional pressure, use of the system to justify the work performed and, on the other hand, there was the creation of collaborative learning mechanisms between the teams.
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Affiliation(s)
- Tatiele Estefâni Schönholzer
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Ione Carvalho Pinto
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Fabiana Costa Machado Zacharias
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Rodrigo André Cuevas Gaete
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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Megerso A, Deyessa N, Jarso G, Tezera R, Worku A. Exploring community tuberculosis program in the pastoralist setting of Ethiopia: a qualitative study of community health workers' perspectives in Borena Zone, Oromia Region. BMC Health Serv Res 2021; 21:632. [PMID: 34210297 PMCID: PMC8252211 DOI: 10.1186/s12913-021-06683-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pastoralist community accounts for a significant portion of the population in Ethiopia. This community is different from majority of the country's population. Access to TB prevention and control services is uneven in the country. The community TB program is designed to improve the access. Exploring the program performance from the perspectives of its implemters in a pastoral setting remains important. METHOD We conducted a qualitative study using an interpretive description method in the pastoralist community setting of Ethiopia. Study participants were recruited from geographically dispersed areas. We collected data through in-depth interview using semi-structured interview guides and audio recordings during February 01-30, 2020. The guides were developed in consultation with TB program experts and clinicians treating TB patients in the study area. Notes were taken at the interviews to enrich transcription of the data. Principal investigator conducted the interview. The subsequent interviews were informed by emerging ideas from forgoing interview transcriptions and continued until data saturation was achieved. RESULTS One hundred and fifty six codes, nine categories and three themes emanated. The first theme was inadequate community TB performance and some of its codes include inadequate presumptive TB case identification and compromised directly observed treatment short course service delivery. The second theme was factors contributing to the program performance. Community factors, lack of physical access to health facilities and indirect non-medical cost were some categories under this theme. The final theme was suggested solutions; and its categories include a need for active community involvement and modification of service delivery approaches. CONCLUSIONS Community TB performance was inadequate in the pastoralist community. Multifaceted factors contributed to the inadequate program performance. Socioeconomic and access related factors were major contributers. Aligning the program to the context of the pastoralist community setting is required to improve the performance.
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Affiliation(s)
- Abebe Megerso
- Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia.
| | - Negusie Deyessa
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Godana Jarso
- Department of Medicine, Adama Hospital Medical College, Adama, Ethiopia
| | - Robel Tezera
- Department of Radiology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Ruiz BO, Zerbetto SR, Galera SAF, Barcellos Fontanella BJ, Gonçalves AMDS, Protti-Zanatta ST. Family resilience: perception of family members of psychoactive substance dependents. Rev Lat Am Enfermagem 2021; 29:e3449. [PMID: 34190940 PMCID: PMC8253349 DOI: 10.1590/1518-8345.3816.3449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 11/02/2020] [Indexed: 12/02/2022] Open
Abstract
Objective: to understand the perception of family members of psychoactive substance
dependents on the elements of the functioning of their family in family
resilience. Method: a qualitative approach study, based on the theoretical interpretive framework
of family resilience from a systemic perspective. The participants were
eleven family members of psychoactive substance dependents from a
Psychosocial Care Center - Alcohol and Drugs, from a city in the state of
São Paulo. For data collection, semi-structured interview, genogram and
ecomap were used. Data analysis was based on the Content Analysis technique,
thematic category. Results: from the interviews, three thematic categories were formulated: mobilization
in search of support and social support; positive perspectives that would
strengthen the family, and assertive communication. These categories point
to references to the mobilization and unity of the family in search of
social support in the intra-family, extended family and extra-family
contexts and positive perspectives, such as persistence, perseverance, hope,
faith and religiousness. Conclusion: the situation of having a psychoactive substance dependent in the family
seemed to mobilize coping devices and attempts to overcome them through the
resilience forces. The results may favor the daily clinical reasoning of the
health professionals, helping them to recognize and value the identified
resilience attributes.
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Affiliation(s)
| | | | - Sueli Aparecida Frari Galera
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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Zacharias FCM, Schönholzer TE, Oliveira VCD, Gaete RAC, Perez G, Fabriz LA, Amaral GG, Pinto IC. [Primary Healthcare e-SUS: determinant attributes for the adoption and use of a technological innovation]. CAD SAUDE PUBLICA 2021; 37:e00219520. [PMID: 34190833 DOI: 10.1590/0102-311x00219520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/17/2020] [Indexed: 11/22/2022] Open
Abstract
The study aimed to analyze the adoption and use of the Primary Healthcare e-SUS (PHC e-SUS) as a technological innovation from the perspective of workers in primary healthcare (PHC). This was a sequential exploratory mixed-methods study (QUAN → qual) in municipalities in the interior of São Paulo state, Brazil, drawing on Diffusion of Innovation Theory. The quantitative component was analytical cross-sectional, applying a validated questionnaire to 114 PHC workers. The model was tested by applying partial least squares structural equation modeling (PLS-SEM) using SmartPLS 2.3.0. The qualitative study was descriptive-exploratory, using interviews (n = 10) with thematic content analysis, aimed at understanding the attributes that did not influence the adoption and use of PHC e-SUS. The attributes "experimentation", "ease of use", "relative advantage", and "compatibility" did not display statistical significance, indicating that they were not determinant attributes for the adoption and use of PHC e-SUS. Integration of the data evidenced failures in connectivity; lack of time to feed the system in real time and training; lack of prior experimentation; abrupt presentation of the system; and lack of skill with the technology. The results can assist other municipalities in Brazil with the implementation of the PHC e-SUS in relation to the importance of the organizational infrastructure, as well as training in the technology's use and handling. The study contributes to reflections and proposals for interventions in the problems faced in daily work with the adoption and use of a technological innovation such as the PHC e-SUS.
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Affiliation(s)
| | | | | | | | - Gilberto Perez
- Programa de Pós-graduação em Administração, Universidade Presbiteriana Mackenzie, São Paulo, Brasil
| | | | | | - Ione Carvalho Pinto
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
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Mendes M, Trindade LDL, Pires DEPD, Martins MMFPDS, Ribeiro OMPL, Forte ECN, Soratto J. Nursing practices in the family health strategy in Brazil: interfaces with illness. ACTA ACUST UNITED AC 2021; 42:e20200117. [PMID: 34133684 DOI: 10.1590/1983-1447.2021.20200117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 01/27/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To identify Nursing practices in the Family Health Strategy in Brazil and interfaces in the illness of these professionals. METHOD Qualitative research, carried out in the five Regions of Brazil, with 79 nursing professionals from 20 health units. Data were collected from 2015 to 2017, using interviews, observation and documentary study. The analysis with the aid of the software ATLAS.ti 8.0, guided by the theorization of the Work Process and Workloads. RESULTS The practices of the care dimension prevailed, followed by the administrative-managerial and educational dimensions. The illness resulting from workloads, predominantly psychic, was related to care practices, potentiated by overload and poor working conditions. CONCLUSION The centrality of nursing practices in the dimension of care and administrative management characterized the professional work in Primary Care. The findings indicate that improved working conditions may minimize the wear and tear of these professionals in this scenario.
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Affiliation(s)
- Mariana Mendes
- Universidade Federal de Santa Catarina (UFSC), Programa de Pós-graduação em Enfermagem. Florianópolis, Santa Catarina, Brasil.,Universidade Comunitária da Região de Chapecó (UNOCHAPECÓ), Programa de Pós-graduação em Ciências da Saúde, Chapecó, Santa Catarina, Brasil
| | - Letícia de Lima Trindade
- Universidade Comunitária da Região de Chapecó (UNOCHAPECÓ), Programa de Pós-graduação em Ciências da Saúde, Chapecó, Santa Catarina, Brasil.,Universidade do Estado de Santa Catarina (UDESC), Departamento de Enfermagem. Chapecó, Santa Catarina, Brasil
| | - Denise Elvira Pires de Pires
- Universidade Federal de Santa Catarina (UFSC), Programa de Pós-graduação em Enfermagem. Florianópolis, Santa Catarina, Brasil
| | | | | | - Elaine Cristina Novatzki Forte
- Universidade Federal de Santa Catarina (UFSC), Programa de Pós-graduação em Enfermagem. Florianópolis, Santa Catarina, Brasil
| | - Jacks Soratto
- Universidade do Extremo Sul Catarinense (UNESC), Programa de Pós-graduação em Saúde Coletiva. Criciúma, Santa Catarina, Brasil
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Camargo GG, Saidel MGB, Monteiro MI. Psychological exhaustion of nursing professionals who care for patients with neoplasms. Rev Bras Enferm 2021; 74:e20200441. [PMID: 34037175 DOI: 10.1590/0034-7167-2020-0441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 11/01/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Identify, analyze and understand the social representations of nursing professionals about burnout syndrome. METHOD Qualitative study with nursing professionals who worked in the direct assistance to oncologic patients, conducted through semi-structured interview, using the technique of content analysis, anchoring the interpretations in the theory of social representations. RESULTS Seven professionals participated; after analysis, two categories emerged: "The stress of professionals, the naturalization of suffering and self-care strategies"; and "Ressignifications, learning in the oncologic sector and network gaps". The representations about stress and the relationship of the professionals with the daily practice were predominant. FINAL CONSIDERATIONS The nursing professionals represented the burnout syndrome socially as stress and made important reflections on the subject in the context of daily work. Concepts that determine the behavior of professionals were perceived as mechanisms of confrontation. In the vision of this social group, spirituality was revealed as a therapeutic strategy.
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Oliveira AD, Toledo VP. Patient safety in a general hospital's psychiatric hospitalization unit: a phenomenological study. Rev Esc Enferm USP 2021; 55:e03671. [PMID: 33886902 DOI: 10.1590/s1980-220x2019013103671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 12/19/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To understand the meaning of patient safety for a multiprofessional team in a psychiatric unit of a general hospital. METHOD Qualitative study adopting the social phenomenological framework, employing open-ended interviews whose content was analyzed and discussed based on the literature through the elaboration of categories of analysis. RESULTS Eleven open-ended interviews were conducted. The meaning of psychiatric patient safety was understood to encompass team management experiences that emphasize physical coercion and control of symptomatology while indicating the expectation of elaborating new procedures that account for humanization. It also includes issues regarding organizational composition and experienced difficulties concerning physical structure, its interference in the process of providing safe care and expectations of improvement. CONCLUSION This study analyzed the conception of patient safety in the multiprofessional team viewpoint, considering socio-historical and cultural contexts and the mutual relations that are part of meaning construction in the study setting.
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Affiliation(s)
- Andressa de Oliveira
- Universidade Estadual de Campinas, Faculdade de Enfermagem, Campinas, SP, Brazil
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36
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Oliveira AIBD, Wernet M, Facio BC, Dias PLM, Fabbro MRC. Motivation for vocational training: significance to nurses in neonatal intensive care. Rev Bras Enferm 2021; 74:e20190793. [PMID: 33681951 DOI: 10.1590/0034-7167-2019-0793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 08/28/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To analyze the motivation of neonatal intensive care nurses and the meanings attributed to the continuity of professional training. METHODS qualitative study, developed between August and December 2018, based on interviews with 16 nurses working in Neonatal Intensive Care in cities in seven Health Regions in the State of São Paulo. The theory of self-determination and narrative analysis supported this study. RESULTS the search for specialization and qualification of care is the plot, with the motivation for training initially based on the specialization and qualification of care. Over time, they revisit understandings carried out about care, making considerations about training, factors that influence motivation. FINAL CONSIDERATIONS the motivation expressed by the nurse in the search for training is shown through movements marked by the limitations apprehended in practice on the care of the risk neonate and the acquisition of knowledge to act with quality in this specific health scenario.
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Affiliation(s)
| | - Monika Wernet
- Universidade Federal de São Carlos. São Carlos, São Paulo, Brazil
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Cristino JS, Salazar GM, Machado VA, Honorato E, Farias AS, Vissoci JRN, Silva Neto AV, Lacerda M, Wen FH, Monteiro WM, Sachett JAG. A painful journey to antivenom: The therapeutic itinerary of snakebite patients in the Brazilian Amazon (The QUALISnake Study). PLoS Negl Trop Dis 2021; 15:e0009245. [PMID: 33661895 PMCID: PMC7963098 DOI: 10.1371/journal.pntd.0009245] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/16/2021] [Accepted: 02/15/2021] [Indexed: 12/05/2022] Open
Abstract
Access to antivenoms is not guarranteed for vulnerable populations that inhabit remote areas in the Amazon. The study of therapeutic itineraries (TI) for treatment of snakebites would support strategies to provide timely access to users. A TI is the set of processes by which individuals adhere to certain forms of treatment, and includes the path traveled in the search for healthcare, and practices to solve their health problems. This study aims to describe TIs of snakebite patients in the Brazilian Amazon. This study was carried out at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, in Manaus, state of Amazonas, Brazil. The itinerary from the moment of the bite to the patient's admission to the reference unit was analyzed. Sample size was defined by saturation. After an exploratory survey to collect epidemiological variables, in-depth interviews were conducted following a semi-structured guide. Patients originated from rural areas of 11 different municipalities, including ones located >500 kilometers from Manaus. A great fragmentation was observed in the itineraries, marked by several changes of means of transport along the route. Four themes emerged from the analysis: exposure to snakebite during day-to-day activities, use of traditional therapeutic practices, and personal perception of the severity, as well as the route taken and its contingencies. Access to healthcare requires considerable effort on the part of snakebite patients. Major barriers were identified, such as the low number of hospitals that offer antivenom treatment, poor access to healthcare due to long distances and geographic barriers, low acceptability of healthcare offered in countryside, lack of use of personal protective equipment, common use of ineffective or deleterious self-care practices, late recognition of serious clinical signs and resistance to seeking medical assistance. Health education, promotion of immediate transport to health centers and decentralization of antivenom from reference hospitals to community healthcare centers in the Brazilian Amazon are more effective strategies that would to maximize access to antivenom treatment.
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Affiliation(s)
- Joseir Saturnino Cristino
- Department of Medicine and Nursing, School of Health Sciences, Amazonas State University, Manaus, Brazil
- Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Brazil
| | - Guilherme Maciel Salazar
- Department of Medicine and Nursing, School of Health Sciences, Amazonas State University, Manaus, Brazil
- Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Brazil
| | - Vinícius Azevedo Machado
- Department of Medicine and Nursing, School of Health Sciences, Amazonas State University, Manaus, Brazil
| | - Eduardo Honorato
- Department of Medicine and Nursing, School of Health Sciences, Amazonas State University, Manaus, Brazil
| | - Altair Seabra Farias
- Department of Medicine and Nursing, School of Health Sciences, Amazonas State University, Manaus, Brazil
- Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Brazil
| | - João Ricardo Nickenig Vissoci
- Division of Emergency Medicine, Department of Surgery and Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Alexandre Vilhena Silva Neto
- Department of Medicine and Nursing, School of Health Sciences, Amazonas State University, Manaus, Brazil
- Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Brazil
| | - Marcus Lacerda
- Department of Medicine and Nursing, School of Health Sciences, Amazonas State University, Manaus, Brazil
- Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Brazil
- Instituto Leônidas & Maria Deane, Fiocruz, Manaus, Brazil
| | - Fan Hui Wen
- Bioindustrial Centre, Butantan Institute, São Paulo, Brazil
| | - Wuelton Marcelo Monteiro
- Department of Medicine and Nursing, School of Health Sciences, Amazonas State University, Manaus, Brazil
- Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Brazil
| | - Jacqueline Almeida Gonçalves Sachett
- Department of Medicine and Nursing, School of Health Sciences, Amazonas State University, Manaus, Brazil
- Department of Teaching and Research, Alfredo da Matta Foundation, Manaus, Brazil
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Vieira NRS, Pegoraro RF. EXPLICAÇÕES DE FAMILIARES SOBRE O SOFRIMENTO PSÍQUICO: DIVERSIDADE E INTEGRALIDADE EM QUESTÃO. PSICOLOGIA EM ESTUDO 2020. [DOI: 10.4025/psicolestud.v25i0.41796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Este estudo apresenta como tema as explicações de familiares sobre o sofrimento psíquico pelos itinerários terapêuticos de usuários na atenção em saúde mental a partir da ótica da família. O Itinerário Terapêutico (I.T.) é entendido como todos os movimentos suscitados por grupos ou indivíduos a fim de resguardar ou recuperar a saúde, que podem impulsionar diversos recursos, desde práticas religiosas e cuidados caseiros até os dispositivos biomédicos predominantes. O objetivo deste estudo foi identificar as explicações dadas pelo familiar a respeito do problema de saúde mental da pessoa em sofrimento psíquico. Efetuou-se um estudo qualitativo em que foram realizadas dez entrevistas com familiares de usuários de um Centro de Atenção Psicossocial (CAPS). De acordo com a análise das entrevistas com base na Teoria Fundamentada em Dados foi possível o agrupamento das explicações dadas em: (1) espirituais, (2) orgânicas, (3) histórico familiar, (4) eventos de vida, (5) diagnóstico e (6) outros. As explicações dadas pelos familiares envolvem um olhar múltiplo, que incorpora diferentes causas e motivos, aproximando-se da ideia de integralidade em saúde.
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Melo RCCP, Queirós PJP, Tanaka LH, Henriques LVL, Neves HL. Nursing Students' Relational Skills with Elders Improve through Humanitude Care Methodology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228588. [PMID: 33227990 PMCID: PMC7699295 DOI: 10.3390/ijerph17228588] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/08/2020] [Accepted: 11/15/2020] [Indexed: 11/16/2022]
Abstract
Nursing students have difficulties interacting with cognitively impaired elders. This study aimed to identify students' difficulties in interacting with elders, the causes of the difficulties in interacting with elders, the strategies used to reduce these difficulties, and the importance attributed to the Structured Sequence of Humanitude Care Procedures (SSHCP). It also aimed to assess the contribution of the Humanitude Care Methodology (HCM) to the development of interaction skills in nursing students. An exploratory descriptive study with a quasi-experimental design was conducted with a sample of 64 nursing students during their hospital clinical training. A control group (usual training) and an experimental group (HCM training) were used. Data were collected through a questionnaire applied at baseline and follow-up. Content analysis, chi-square tests, and Student's t-tests were performed. The main difficulty identified was caring for agitated and confused elders. Difficulties were associated with a lack of theoretical-practical teaching, the clinical training context, lack of experience, and personality traits. HCM impacted positively on the development of students' interaction skills. This study shows that HCM is an innovative methodology in nursing education that will allow for moving from an instrumental and technicist education into a more humanized training capable of transforming care.
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Affiliation(s)
- Rosa Cândida Carvalho Pereira Melo
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3046-851 Coimbra, Portugal; (P.J.P.Q.); (L.V.L.H.); (H.L.N.)
- Correspondence:
| | - Paulo Joaquim Pina Queirós
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3046-851 Coimbra, Portugal; (P.J.P.Q.); (L.V.L.H.); (H.L.N.)
| | - Luiza Hiromi Tanaka
- Department of Collective Health, Paulista School of Nursing, Federal University of São Paulo, São Paulo 04024-002, Brazil;
| | - Liliana Vanessa Lúcio Henriques
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3046-851 Coimbra, Portugal; (P.J.P.Q.); (L.V.L.H.); (H.L.N.)
| | - Hugo Leiria Neves
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3046-851 Coimbra, Portugal; (P.J.P.Q.); (L.V.L.H.); (H.L.N.)
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Bhering M, Sarubbi Junior V, Kritski A, Souza F, Duarte R. Multidrug-Resistant Tuberculosis in Portugal: Patients’ Perception of the Challenges Faced during Treatment. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2020. [DOI: 10.1159/000511198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
<b><i>Introduction:</i></b> The increase in drug-resistant tuberculosis (TB) threatens global progress in eliminating TB, and constitutes a major challenge for patients, health-care workers and health services. Treatment for multidrug-resistant TB (MDR-TB) can last almost 2 years, and is more expensive, more toxic, and less effective than treating TB caused by drug-sensitive bacilli. This study aims to analyze patients’ narratives about the challenges they face during MDR-TB treatment and identify the support factors that help patients being treated in the most populous district of Portugal. <b><i>Methods:</i></b> Semi-structured interviews were conducted with patients being treated for MDR-TB. The interviews were coded using thematic analysis. They were audio-recorded, transcribed, and transported into NVivo v12 for data management and coding. <b><i>Results:</i></b> Depression, social discrimination, and the side effects of drugs are the main challenges faced by patients with MDR-TB. A good relationship of the patients with the health team, emotional support, and supervised treatment stand out as the factors that generate better adherence and treatment success. <b><i>Conclusion:</i></b> In addition to modern diagnostic techniques and new treatments, MDR-TB can be fought by focusing on the care and needs of patients. We suggest that the Lisbon Tuberculosis Program adopts the following measures: build the health-care team’s capacity to identify symptoms of depression early, increase public awareness of the disease, expand the multidisciplinary team, and expand the options for individualized social support for patients.
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de França VH, Modena CM, Confalonieri UEC. Equality and poverty: views from managers and professionals from public services and household heads in the Belo Horizonte Metropolitan Area, Brazil. Int J Equity Health 2020; 19:132. [PMID: 32762684 PMCID: PMC7409475 DOI: 10.1186/s12939-020-01243-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 07/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tackling poverty requires reconsideration of quantitative factors related to "who" is poor and by "how much" and qualitative factors addressing "what poverty means in these individuals' lives". Greater understanding is required concerning the types of access actually used by families in poverty in attempts to meet their basic needs. Poverty must be addressed based on the question: "Inequality of what?" It is in reflecting on the realities of such groups when their basic needs are not met that public policies can be improved and implemented with legitimate priorities. OBJECTIVE Describe coverage and access to public health, education and social assistance services and the related effects on the quality of life of families in extreme poverty. METHODS An exploratory mixed methods study was conducted applying Amartya Sen's "Basic Capability Equality" framework, with: 1) 27 interviews with managers and professionals from public services serving territories with extreme poverty; 2) Survey with a systematic proportionate stratified sample of 336 heads of households in extreme poverty from a total 2605 families. The resulting data was analyzed with thematic content analysis and descriptive statistics, respectively. RESULTS The managers and professionals described the lives of families in extreme poverty with phrases such as, "These people suffer. Sadness weighs on their lives!" and "Depression is the most common illness". Their precarious circumstances and inadequate access were cited as causes. Quality of life was considered bad or very bad by 41.4% of heads of households. A total income of less than one-third of the minimum wage was received by 56.9% of the sample. One or more people were unemployed in the family in 55.8% of cases. For 53.3% of heads of households, public services "did not meet any or few of their needs". The main social determinants of health were described as: alcohol and drugs (68.8%); lack of good health care (60.7%); and absence of income/work (37.5%). The following were identified as solutions to improve their quality of life: (1) health (40.5%); (2) education (37.8%); and (3) employment (44.6%). CONCLUSIONS The social determinants of poverty and health must be addressed jointly through intersectoral public policies and egalitarian mechanisms that promote investment in social protection.
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Affiliation(s)
- Viviane Helena de França
- Departamento de Medicina, Campus Avançado de Governador Valadares, Universidade Federal de Juiz de Fora, Rua Manoel Byrro, 241 - Vila Bretas, Governador Valadares, Minas Gerais, CEP: 35032-620, Brazil.
| | - Celina Maria Modena
- Instituto René Rachou, Fundação Oswaldo Cruz Minas, Avenida Augusto de Lima, 1715, Bairro Barro Preto, Belo Horizonte, Minas Gerais, CEP: 30190-009, Brazil
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Rodrigues DMDV, Abrahão AL, Lima FLTD. Do começo ao fim, caminhos que segui: itinerações no cuidado paliativo oncológico. SAÚDE EM DEBATE 2020. [DOI: 10.1590/0103-1104202012505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo desse estudo foi compreender a itineração de usuários com câncer em cuidados paliativos exclusivos pela rede de atenção à saúde, contemplando desde a suspeita diagnóstica até os cuidados paliativos exclusivos. Trata-se de pesquisa qualitativa, a partir de narrativas de vida de pacientes e familiares. Utilizaram-se seis entrevistas semiestruturadas e análise de conteúdo. Emergiram três categorias de análise: Caminhos pelo cuidado oncológico; Cuidados paliativos em oncologia: de mitos e tabus à realidade; e Autonomia e apoio social. Evidenciou-se uma multiplicidade de itinerações na busca por cuidado, não seguindo diretamente os trajetos previamente definidos pelos gestores do sistema de saúde. Além disso, verificou-se a necessidade de estabelecer uma comunicação clara e efetiva com esses sujeitos, esforçando-se na desmistificação do câncer e dos cuidados paliativos. Deve-se aprender a olhar para esses cidadãos de forma a ultrapassar seu corpo adoecido, enxergando-os como pessoas reais, com seus desejos, sentidos, protagonismos, e capacidade de ressignificar a sua própria existência e a sua forma de se perceber e se posicionar perante o mundo.
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da Silva ER, Larentis F. Storytelling from experience to reflection: ERSML cycle of organizational learning. INTERNATIONAL JOURNAL OF HUMAN RESOURCE MANAGEMENT 2020. [DOI: 10.1080/09585192.2020.1737831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Fabiano Larentis
- Management Graduate Program, UCS – Universidade de Caxias do Sul, Caxias do Sul, Brazil
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Almeida ÉS, Souzas R, Dos-Santos EM. ["Affected by the touch": Meanings attributed to prostate cancer prevention practices among men]. Salud Colect 2020; 16:e2176. [PMID: 32222141 DOI: 10.18294/sc.2020.2176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 11/22/2019] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to identify and analyze meanings attributed to practices related to prostate cancer prevention among men. A qualitative methodology was employed, with semi-structured interviews being conducted with 21 men in the city of Vitoria da Conquista, Bahia, between July and August of 2017. Data analysis was based on a dialectical hermeneutic approach. We found that practices related to prostate cancer prevention were based on scarce information and permeated by a sense of fear of the disease, which was thought of as a death sentence. Additionally, these feelings were compounded by the repercussions of rectal examination, perceived as a violation of one's masculinity. We were able to observe that practices devised to prevent prostate cancer reflect the repercussions of conceptions of masculinity regarding men's health care, where manliness and toughness can be susceptible by the touch.
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Affiliation(s)
- Éric Santos Almeida
- Magíster en Salud Colectiva. Docente, Faculdade Pitágoras de Medicina de Eunápolis, Bahía, Brasil.
| | - Raquel Souzas
- Doctora en Salud Pública. Profesora Asociada, Instituto Multidisciplinar em Saúde - Campus Anísio Teixeira, Universidade Federal da Bahia, Bahía, Brasil.
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Baldisserotto ML, Miranda Theme M, Gomez LY, Dos Reis TBQ. Barriers to Seeking and Accepting Treatment for Perinatal Depression: A Qualitative Study in Rio de Janeiro, Brazil. Community Ment Health J 2020; 56:99-106. [PMID: 31512080 DOI: 10.1007/s10597-019-00450-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/05/2019] [Indexed: 01/29/2023]
Abstract
Few studies have investigated the reasons why pregnant and puerperal women fail to seek or accept treatment for perinatal depression in low- and middle-income countries, where there is a high prevalence of this disorder. To help fill this gap, this study investigated the factors influencing the decision not to seek or to refuse treatment for perinatal depression in a low-income community in Rio de Janeiro, Brazil. Qualitative research was conducted in two primary health care units in Rio de Janeiro, Brazil in 2017-2018. Five focus groups were held with 26 women. Convenience sampling was used, and the sample size was determined by data saturation. A content analysis methodology was used to identify theme categories to objectively describe the group's manifest contents. Ten categories were obtained: stigma and misconception, self-image as a mother, socioeconomic stigma, lack of knowledge, lack of a health service approach to mental health, difficulty recognising depression symptoms, fear of children being removed, negative reaction to patient referral, denial of the problem and previous experience with the care unit. Perinatal depression is permeated with stigma and prejudice, and there is a belief that women with depression are unable to be good mothers. It is important to conduct programmes disseminating information about perinatal depression and implementing an approach that includes routine consultations so that women can access perinatal mental health services.
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Affiliation(s)
- Márcia Leonardi Baldisserotto
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Leopoldo Bulhões, 1480 - Manguinhos, Rio de Janeiro, CEP: 21041-210, Brazil.
| | - Mariza Miranda Theme
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Leopoldo Bulhões, 1480 - Manguinhos, Rio de Janeiro, CEP: 21041-210, Brazil
| | - Liliana Yanet Gomez
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Leopoldo Bulhões, 1480 - Manguinhos, Rio de Janeiro, CEP: 21041-210, Brazil
| | - Talita Borges Queiroga Dos Reis
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Leopoldo Bulhões, 1480 - Manguinhos, Rio de Janeiro, CEP: 21041-210, Brazil
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Jamarim MFM, da Silva CZ, Lima GMPDA, Siqueira CL, Campos CJG. Nonverbal Communication through Touch: Meanings for Physical Therapists Working in a Hospital Environment. AQUICHAN 2019. [DOI: 10.5294/aqui.2019.19.4.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives: To know the most used types of touch and understand their meanings for physical therapists working in a hospital environment, from the perspective of their feelings, attitudes and behaviors during care. Materials and methods: Qualitative case study conducted by physical therapists working at a hospital in Brazil. For data collection, participant observation and semi-structured interviews were used as techniques. Data were analyzed according to the thematic content analysis proposed by Minayo. Results: 16 physical therapists participated in the study and, from the analysis of the empirical material, four thematic categories emerged: Instrumental touch as a fundamental resource of hospital physical therapy assistance; expressive touch: Its little presence does not mean absence of affection; physical therapist’s feelings related to touch and difficulty talking about touch means that there is a deficiency in training. Conclusions: The underuse of expressive touch revealed the lack of knowledge and unpreparedness in the formation of the physical therapist, which, added to the lack of self-knowledge, hinders the affection and the creation of bonds in relationships. All of this justifies the rare studies on affective touch in health, which reflects an area to be explored and the need to sensitize professionals to influence the quality and humanization of care.
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Leite ADC, Fontanella BJB. Violência doméstica contra a mulher e os profissionais da APS. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2019. [DOI: 10.5712/rbmfc14(41)2059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introdução: As notificações de casos de violência doméstica contra a mulher são essenciais para o dimensionamento epidemiológico dessa questão. As unidades de saúde brasileiras devem realizá-las, embora essas notificações compulsórias tenham sido repetidamente apontadas pela literatura da área da saúde como não efetivadas ou realizadas com muitas incompletudes. Objetivos: Contribuir para compreender as dificuldades subjetivas de notificar a violência doméstica contra a mulher por profissionais da atenção primária à saúde no Brasil. Métodos: Uma amostra intencional de 14 profissionais da atenção primária à saúde foi entrevistada; eles tinham diferentes formações educacionais e trabalhavam em uma cidade do interior do estado de São Paulo, Brasil. As transcrições das entrevistas semiestruturadas, com questões abertas, foram submetidas a uma análise de conteúdo. Resultados: A análise resultou em seis categorias temáticas: falta de conhecimento dos meios de notificação; serviços de saúde “apropriados” para notificar; boletim de ocorrência policial como principal instrumento de notificação; a notificação seria opcional; o papel da notificação para a prevenção; e a burocracia excessiva. Discussão: Levanta-se a hipótese de uma oposição entre uma disposição atitudinal positiva para atender as mulheres vítimas de violência e aprender como relatar essas situações e, por outro lado, a falta de preparação profissional para realizar as notificações; a oposição entre notificar e denunciar também é discutida, dada a ambiguidade dos termos utilizados na ficha de notificação e no próprio Código Penal brasileiro. Discute-se também se a violência contra a mulher é considerada pelos entrevistados como uma questão de atenção básica à saúde.
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Motivation for alcohol consumption or abstinence during pregnancy: A clinical-qualitative study in Brazil. PLoS One 2019; 14:e0223351. [PMID: 31584967 PMCID: PMC6777787 DOI: 10.1371/journal.pone.0223351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 09/19/2019] [Indexed: 02/08/2023] Open
Abstract
Background In Brazil, alcohol consumption is estimated to range from 7 to 40% in pregnant women. This research investigated the motivation for alcohol consumption or abstinence during pregnancy in a purposive sample of Brazilian women. Methods Clinical-qualitative research was conducted, in which 14 women participated, identified as risk-drinkers during pregnancy by the T-ACE screening tool. Data were collected through semi-structured individual interviews. Reports were recorded, transcribed and investigated by a thematic content analysis approach. The results were discussed based on a comprehensive and interpretive framework. Results Sixteen themes were extracted and these were then classified into three thematic categories: (a) general motives for alcohol use, (b) specific motives for drinking during pregnancy, and (c) reasons for partly or fully abstaining from drinking during pregnancy. Social motives were the most relevant, particularly due to deeply rooted cultural values. Enhancement motives were widely mentioned and associated with a hedonic posture. Consumption also aimed to deal with negative emotions, characterizing two types of coping specifically to pregnancy: first, perceiving pregnancy as a period of less opportunity for social interaction and, therefore, drinking alcohol at home to compensate; secondly, perceiving pregnancy as a period of greater irritability, and hence experiencing difficulties to abstain. On the other hand, concern about fetal health, disapproval of consumption by relatives and health professionals, as well as the social construction of mothering were reported as reasons to abstain. Conclusions Some specificities influence the decision to continue or discontinue alcohol consumption during pregnancy. To reduce consumption, we suggest educational actions based on a collective health perspective, articulated with individualized measures that allow identification and proper intervention for women at risk.
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Smeha LN, Lima LG. A EXPERIÊNCIA DA MATERNIDADE DIANTE DA INTERNAÇÃO DO BEBÊ EM UTI: UMA MONTANHA RUSSA DE SENTIMENTOS. PSICOLOGIA EM ESTUDO 2019. [DOI: 10.4025/psicolestud.v24i0.38179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Nesta pesquisa buscou-se conhecer a experiência de mães que tiveram seus bebês hospitalizados em uma Unidade de Terapia Intensiva Neonatal ou Pediátrica. O estudo se caracterizou como qualitativo, de caráter exploratório-descritivo. Participaram nove mães de bebês internados em seis diferentes Unidades de Terapia Intensiva Neonatal ou Pediátrica, localizadas em cinco cidades do Estado do Rio Grande do Sul. Para a apreensão do material empírico foi utilizado um questionário sociodemográfico e uma entrevista semiestruturada. As entrevistas foram transcritas e submetidas à análise de conteúdo. Desta análise emergiram três categorias. Os resultados revelam que é difícil para as mães não poder levar seus bebês para casa após o nascimento. Elas revelaram sentimentos como medo, insegurança, temor da morte do bebê, impotência e culpa. As mães vivenciaram a sensação de perda de controle da situação, preocupação com os outros filhos e a necessidade de apoio da mãe e do marido. Foi possível elucidar que a equipe de saúde pode minimizar o sofrimento das mães por meio de iniciativas simples com vistas a um maior acolhimento às mães e aos familiares.
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How Brazilian dentists work within a new community care context? A qualitative study. PLoS One 2019; 14:e0216640. [PMID: 31067270 PMCID: PMC6505932 DOI: 10.1371/journal.pone.0216640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 04/26/2019] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to analyze the value and meanings that dental surgeons attribute to the Primary Health Care setting, where health promotion is encouraged over a mechanistic performance of procedures. A qualitative study, involving ten Brazilian dental surgeons working in Primary Care in 2016, was designed. In-depth semi-structured interviews were performed, with all interviews recorded, transcribed and subsequently submitted to Qualitative Content Analysis. Despite the Healthcare Promotion model proposed by the Brazilian oral health policy, dental surgeons demonstrated preferences for private and traditional dental practices. These characteristics are counterproductive in public oral health services, which aim to achieve collective health benefits. Traditional practice is based upon a specific and restricted focus, as opposed to overall patient care, hence maintaining the original professional identity, ruled by manual procedures, while demonstrating scientifically fragile understanding of disease processes. Despite the implementation of public service models that aim at change, counterproductive characteristics associated with the deeply rooted traditional management strategies were evidenced.
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