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Rujumba, Joseph, Mathias Akugizibwe, Nicole E. Basta, and Cecily Banura. "Why don’t adolescent girls in a rural Uganda district initiate or complete routine 2-dose HPV vaccine series: Perspectives of adolescent girls, their caregivers, healthcare workers, community health workers and teachers." PLOS ONE 16, no. 6 (June 29, 2021): e0253735. http://dx.doi.org/10.1371/journal.pone.0253735.
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Introduction Vaccination with the 2-dose HPV vaccine series among adolescent girls in Uganda remains low after almost 5 years since the vaccine was included into the routine national immunization program and barriers are not well understood. Objective We explored barriers that prevent eligible girls from initiating or completing the recommended 2-dose HPV vaccine series in Oyam District, Northern Uganda. Methods A qualitative study was conducted in Oyam District, Northern Uganda. Forty interviews were conducted with adolescent girls, their caregivers, Village Health Team Members, health workers and school administrators involved in HPV vaccination. All interviews were audio recorded and transcribed. NVivo version 11 was used for data management and content thematic approach for analysis guided by the Social Ecological Model. Results At individual level, low levels of knowledge about the vaccine, girls’ frequent mobility between vaccine doses, school absenteeism and drop out, fear of injection pain and discouragement from caregivers or peers were key barriers. At the health facilities level, reported barriers included: few healthcare workers, inadequate knowledge about HPV vaccine, limited social mobilization and community engagement to promote the vaccine, limited availability of the HPV vaccine, unreliable transportation, lack of reminder strategies after the first dose of the vaccine, lack of vaccination strategy for out-of-school girls and un-friendly behaviour of some healthcare workers. Concerns about safety and efficacy of the vaccine, negative religious and cultural beliefs against vaccination, rumors and misconceptions about the vaccine, mistrust in government intentions to introduce the new vaccine targeting girls, busy schedules and the gendered nature of care work were key community level barriers. Conclusion Our study revealed an interplay of barriers at individual, health facility and community levels, which prevent initiation and completion of HPV vaccination among adolescent girls. Strengthening HIV vaccination programs and ensuring high uptake requires providing appropriate information to the girls plus the community, school and health facility stakeholders; addressing cold chain challenges as well as adequate training of vaccinators to enable them respond to rumors about HPV vaccination.
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Brondani, M., and L. Donnelly. "The HIV and SARS-CoV-2 Parallel in Dentistry from the Perspectives of the Oral Health Care Team." JDR Clinical & Translational Research 6, no. 1 (September 18, 2020): 40–46. http://dx.doi.org/10.1177/2380084420961089.
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Objectives: The aim of this study was to unravel the professional and social consequences of COVID-19 as compared with the AIDS pandemic according to oral health care providers, staff, and administrators. Methods: An exploratory qualitative inquiry via at-a-distance, semistructured interviews engaged a purposefully recruited sample of oral health care team workers in British Columbia. Interviews took place between April 20 and May 15, 2020; they were audio recorded, transcribed verbatim, and deidentified for interactive thematic analysis. An inductive process of coding was used to identify themes, subthemes, and categories of information. Results: Forty-five interviews were conducted with 18 dentists, 12 dental hygienists, 6 certified dental assistants, and 9 administrators; 22 were females. Interviews each lasted an average of 48 min. After the transcripts were coded, 3 subthemes emerged: 1) personal protective equipment and universal precautions as commonsense approaches to care during both pandemics; 2) an (un)collapsed world in terms of global lockdowns; and 3) social unrest in terms of the potential for stigma and discrimination caused by both pandemics. These subthemes made up the COVID-19–AIDS parallel theme. Conclusion: This study explored the extent to which the current COVID-19 pandemic is leading to professional and social consequences when a parallel is drawn with the AIDS pandemic. This is the first qualitative study that identifies the potential social unrest of the pandemic from the perspective of oral health care providers and administrators. Future studies should include other providers across Canada, as well the patients receiving oral health care during this pandemic. Knowledge Transfer Statement: The COVID-19 pandemic has unraveled potential societal implications in a parallel to the HIV/AIDS era from the perspectives of oral health care providers and their staff. Such implications are changing the way that oral health care is delivered; it may also be leading to social unrest in the form of stigma and discrimination. This study discusses some of these implications from the perspective of oral health care providers and administrators.
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Ferrari, Carolina Ferdinatta, Edimara Ceolin Abreu, Tatiane Herreira Trigueiro, Marly Bittencourt Gevársio Marton Da Silva, Kátia Antunes Kochla, and Silvana Regina Rossi Kissula Souza. "Orientações de cuidado do enfermeiro para a mulher em tratamento para câncer de mama." Revista de Enfermagem UFPE on line 12, no. 3 (March 3, 2018): 676. http://dx.doi.org/10.5205/1981-8963-v12i3a23299p676-683-2018.
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RESUMOObjetivo: identificar as principais queixas de saúde que os enfermeiros recebem ao cuidar de mulheres em tratamento quimioterápico para câncer de mama e quais as principais orientações de cuidado são realizadas. Método: estudo qualitativo, descritivo, com dez enfermeiros que trabalham em uma unidade de internação de um hospital privado e em ambulatório referência para tratamento quimioterápico, por meio de entrevista semiestruturada. As entrevistas foram realizadas em sala privativa, audiogravadas e, posteriormente, transcritas na íntegra, analisadas por meio da técnica de Análise de Conteúdo na modalidade Análise Temática. Resultados: foram encontradas 32 unidades de significado, as quais posteriormente foram agrupadas, formando duas categorias: Resposta corporal diante da quimioterapia e O cuidado do enfermeiro frente às queixas. Conclusão: as intervenções que os enfermeiros expuseram ao estudo foram pontuais, respaldadas cientificamente e relevantes frente às queixas relatas pelas mulheres, salientando o protagonismo desse profissional no cuidado, e na supervisão do mesmo. Descritores: Câncer de Mama; Enfermagem; Quimioterapia; Saúde da Mulher.ABSTRACTObjective: identify the main health complaints the nurses receive in their care practice for women undergoing chemotherapy for breast cancer, as well as the main care orientations they provide. Method: qualitative and descriptive study involving ten nurses who work at an inpatient ward of a private hospital and a referral outpatient clinic for chemotherapy, through semistructured interviews. The interviews were held at a private room, audio recorded and later fully transcribed and analyzed by means of thematic content analysis. Results: 32 units of meaning were found, which were later grouped in two categories, which were called: Physical response to the chemotherapy and Nursing care in response to the complaints. Conclusion: the interventions the nurses presented in the study were punctual, scientifically supported and relevant for the women’s complaints, highlighting this professional’s protagonist role in care and care supervision.Descriptors: Breast Neoplasms; Community Health Nursing; Drug Therapy; Women’s Health.RESUMEN Objetivo: identificar las principales quejas de salud que los enfermeros reciben en su cuidado a mujeres en tratamiento quimioterapéutico para cáncer de mama y cuales son las principales orientaciones de cuidado proporcionadas. Método: estudio cualitativo, descriptivo con diez enfermeros que trabajan en una unidad de hospitalización de un hospital privado y en ambulatorio de referencia para tratamiento quimioterapéutico, mediante entrevista semiestructurada. Las entrevistas fueron realizadas en sala privada, audio grabadas e posteriormente transcritas por complete, analizadas mediante la técnica de Análisis de Contenido en la modalidad Análisis Temático. Resultados: fueron encontradas 32 unidades de significado, posteriormente grupadas en dos categorías, llamadas: Respuesta corporal ante la quimioterapia y El cuidado del enfermero ante las quejas. Conclusión: las intervenciones que los enfermeros expusieron al estudio fueron puntuales, apoyadas científicamente y relevantes ante las quejas relatadas por las mujeres, subrayando el protagonismo de ese profesional en el cuidado y en su supervisión. Descriptores: Neoplasias de la Mama; Enfermería en Salud Comunitaria; Quimioterapia; Salud de la Mujer.
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Vieira, Flávia De Siqueira, Helena Megumi Sonobe, Marissa Silva De Oliveira, Nariman De Felício Bortucan Lenza, Luciana Scatralhe Buetto, and Mariza Silva De Lima. "The life on clinical treatment of Cohn’s Disease." Revista de Enfermagem UFPE on line 6, no. 2 (January 5, 2012): 288. http://dx.doi.org/10.5205/reuol.2052-14823-1-le.0602201206.
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ABSTRACTObjective: to describe the clinical and social needs of patients with Crohn´s disease (CD) and identify the experiences of these patients during clinical treatment. Method: this is an exploratory qualitative study with participants with CD, over 18 years, admitted to a public teaching hospital, who agreed to participate signed a consent form after being informed (HCRP. 1149/2009). The interviews were recorded in audio and transcribed to Word for Windows. Data were analyzed following the steps in capturing the sense of data; identification of an initial set of theme or categories; establishment of the main categories and discussion. Results: the theme developed demonstrated the need of the specific tests and the qualification of the health’s professional for care these patients. Conclusion: The nurse must have knowledge about the patient’s reaction to the clinical treatment and realize a following with data collection to contribute with the diagnostic, besides the realize education interventions to contribute the adherence to clinical treatment, to prevent the complications and the possibility to disease’s control. Therefore the knowledge of the patient’s experience is important to better quality of care. Descriptors: Crohn’s disease; patient; nursing. RESUMOObjetivos: descrever as características clínicas e sociais dos pacientes com Doença de Crohn (DC) e identificar as experiências desses pacientes durante o tratamento clínico. Método: estudo exploratório, de abordagem qualitativa, com 14 pacientes maiores de 18 anos com DC, internados em hospital de ensino público, que consentiram em participar da pesquisa ao assinarem o Termo de Consentimento pós-informado, após aprovação do Comitê de Ética em Pesquisa do Hospital das Clínicas da Universidade de São Paulo, Ribeirão Preto (SP) sob número 11495/2009. As entrevistas foram gravadas e transcritas em Programa Word for Windows. Os dados foram analisados seguindo-se as etapas de captação dos sentidos dos dados; identificação de um conjunto inicial de temas ou categorias; estabelecimento de categorias-chaves e discussão. Resultados: o tema desenvolvido demonstrou a necessidade de exames específicos e a qualificação dos profissionais de saúde para prestar assistência a esses pacientes. Conclusão: O enfermeiro deve ter conhecimento sobre as reações do paciente ao tratamento clínico e realizar um seguimento com coleta de dados para contribuir no estabelecimento do diagnóstico, além de investir em intervenções educativas para favorecer a adesão ao tratamento clínico, como forma de prevenção de complicações e possibilidade de controle da doença. Portanto, o conhecimento da experiência destes pacientes é importante para melhorar a qualidade da assistência. Descritores: doença de Crohn; paciente; enfermagem.RESUMENObjetivo: describir las necesidades clínicas y sociales de los pacientes con enfermedad de Crohn (EC) e identificar las experiencias de estos pacientes durante el tratamiento clinico. Método: estudio exploratorio cualitativo con 14 participantes con EC, con más de 18 años, admitidos en un hospital escuela, que aceptaron participar con firma del consentimiento informado (HCRP 11495/2009). Las entrevistas fueron grabadas en audio y transcritas en el programa Word for Windos. Los datos fueron analizados siguiendo los pasos para capturar de los sentidos de los datos, la identificación de un conjunto inicial de temas o categorías, el establecimiento de las categorías principales y el debate. Resultados: el tema desarrollado demuestra la necesidad de pruebas específicas y la cualificación de los profesionales de la salud para ayudar a estos pacientes. Conclusión: la enfermera debe tener conocimiento sobre las reacciones del paciente al tratamiento médico y realizar una recolección de datos de seguimiento para contribuir en el diagnóstico, y la inversión en intervenciones educativas para promover la adhesión al tratamiento médico como medio de precención de las complicaciones y la posibilidad de control de la enfermedad. Así, el conocimiento de la experiencia de estos pacientes es importante para mejorar la calidad de la atención. Descriptores: enfermedad de Crohn; paciente; enfermería.
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Schindel, Theresa J., Phillip Woods, Amary Mey, Michelle A. King, Margaret Gray, and Javiera Navarrete. "Hospital Pharmacists’ Experiences with Medical Assistance in Dying: A Qualitative Study." Canadian Journal of Hospital Pharmacy 75, no. 4 (October 3, 2022): 294–301. http://dx.doi.org/10.4212/cjhp.3213.
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Background: Pharmacists in many countries have long been involved in some aspect of assisted dying. Since 2016, when Canada enacted legislation permitting medical assistance in dying (MAiD), the number of patients seeking the procedure has increased yearly. Despite the global nature of pharmacists’ involvement, little is known about how they experience MAiD practice. Objective: To study how pharmacists experience the practice of caring for patients who seek MAiD. Methods: This qualitative study used semistructured interviews with pharmacists who had cared for patients seeking MAiD. Interviews, conducted between June 2019 and October 2020, were audio-recorded and transcribed verbatim. Data were examined using a modified framework analysis approach. Data were coded and sorted using Quirkos and Microsoft Excel software. Themes were defined through an iterative process involving constant comparison. Results: Nineteen hospital pharmacists representing a range of practice settings in Alberta participated in the study. The experience of caring for patients seeking assistance in dying brought to light 3 themes: finding a place in the process, serving in a caring role, and bearing emotional burdens. Pharmacists’ experiences were personal, relational, emotional, and dynamic. Conclusions: Each of the pharmacists experienced MAiD practice in a unique way. Although their roles in MAiD were primarily medication-focused, their experiences highlighted the centrality of patient choices, autonomy, and needs. The results of this study will inform pharmacists (including those not yet engaged in MAiD practice) about the role, and will also be valuable for pharmacy organizations and educators seeking to support pharmacists and the profession, as well as policy-makers seeking to expand pharmacists’ roles in MAiD. RÉSUMÉ Contexte : Les pharmaciens de nombreux pays participent depuis longtemps à certains aspects de l’aide médicale à mourir (AMM). Depuis que le Canada a adopté une loi l’autorisant en 2016, le nombre de patients qui demandent l’intervention a augmenté chaque année. Malgré la nature mondiale de l’implication des pharmaciens, on sait peu de choses sur la façon dont ils vivent la pratique de l’AMM. Objectif : Étudier comment les pharmaciens vivent la pratique de la prise en charge des patients qui sollicitent l’AMM. Méthodes : Cette étude qualitative a utilisé des entretiens semi-structurés avec des pharmaciens qui avaient pris en charge des patients ayant fait une demande d’AMM. Un enregistrement sonore des entretiens, menés entre juin 2019 et octobre 2020, a été effectué et ils ont été transcrits mot à mot. Les données ont été examinées en adoptant une approche d’analyse du cadre modifié. Les données ont été codées et triées à l’aide des logiciels Quirkos et Microsoft Excel. Les thèmes ont été définis par un processus itératif impliquant une comparaison constante. Résultats : Dix-neuf pharmaciens d’hôpitaux représentant un éventail de milieux de pratique en Alberta ont participé à l’étude. L’expérience de la prise en charge de patients cherchant à recevoir l’aide médicale à mourir a mis en lumière 3 thèmes : trouver sa place dans le processus; jouer un rôle de proche aidant; et supporter des charges émotionnelles. Les expériences des pharmaciens étaient personnelles, relationnelles, émotionnelles et dynamiques. Conclusions : Chaque pharmacien a vécu la pratique de l’AMM d’une manière unique. Bien que leurs rôles dans l’AMM étaient principalement axés sur la médication, leurs expériences ont mis en évidence la centralité des choix, de l’autonomie et des besoins des patients. Les résultats de cette étude informeront les pharmaciens (y compris ceux qui ne sont pas encore engagés dans la pratique de l’AMM) sur le rôle. Ils seront également précieux pour les organismes pharmaceutiques et les éducateurs cherchant à soutenir les pharmaciens et la profession, ainsi que pour les décideurs politiques qui cherchent à élargir les rôles de pharmaciens dans l’AMM.
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Silveira, Andressa Da, and Eliane Tatsch Neves. "“Enfrentei tudo sozinha” cuidado de adolescentes com necessidades especiais." Revista Recien - Revista Científica de Enfermagem 11, no. 36 (December 22, 2021): 102–11. http://dx.doi.org/10.24276/rrecien2021.11.36.102-111.
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Objetiva-se compreender o cotidiano de cuidadores familiares de adolescentes com necessidades especiais de saúde atendidos em ambulatório de especialidades. Trata-se de uma pesquisa qualitativa descritiva desenvolvida no ambulatório referência no atendimento de adolescentes. Utilizou-se a leitura prévia de prontuários, associada a entrevista semiestruturada com 35 cuidadores familiares, transcritas e submetidas à análise de discurso Pecheutiana. Evidenciou-se o cuidado essencialmente feminino, algumas vezes compartilhado com outros membros da família. As estratégias de cuidado são consolidadas na busca por informações, na procura de auxílio nos serviços de saúde, no desenvolvimento de procedimentos. A sobrecarga materna foi evidenciada, o cotidiano de cuidados é permeado por estratégias construídas com o tempo por meio do saber da experiência feita. Sugere-se que o enfermeiro desenvolva uma abordagem ampliada sobre a rede que ampara e acolhe os adolescentes e sua família. O cuidado deve ser compartilhado por meio da troca de saberes, reflexão, dialogicidade e vínculo.Descritores: Família, Mãe, Saúde do Adolescente, Enfermagem. “I faced it all alone” care for teenagers with special needsAbstract: Objective is to understand the daily life of family caregivers of adolescents with special health needs attended in an outpatient clinic. This is a descriptive qualitative research developed at the reference outpatient clinic for adolescents. The previous reading of medical records was used, associated with a semi-structured audio interview recorded with 35 family caregivers, which were double transcribed and subjected to Pêcheux’s discourse analysis. The care is essentially feminine sometimes shared with other family members. Care strategies are consolidated in the search for information, in the search for help in health services, in the development of procedures. Maternal overload was evidenced, the daily care is permeated by strategies built over time through the knowledge of the experience made. We suggest that nurses develop an expanded approach to the network that supports and welcomes adolescents and their families. Care must be shared through the exchange of knowledge, reflection, dialog and bonding.Descriptors: Family, Mother, Adolescent Health, Nursing. “Lo enfrenté todo solo” atención a adolescentes con necesidades especialesResumen: El objetivo es comprender el día a día de los cuidadores familiares de adolescentes con necesidades especiales de salud atendidos en una clínica especializada. Se trata de una investigación cualitativa descriptiva desarrollada en la consulta externa de referencia para adolescentes. Se utilizó la lectura previa de historias clínicas, asociada a una entrevista semiestructurada con 35 cuidadores familiares, transcrita y sometida al análisis del discurso pecheutiano. Se evidenció el cuidado esencialmente femenino, en ocasiones compartido con otros miembros de la familia. Las estrategias de atención se consolidan en la búsqueda de información, en la búsqueda de ayudas en los servicios de salud, en el desarrollo de procedimientos. Se evidenció sobrecarga materna, el cuidado diario está impregnado de estrategias construidas en el tiempo a través del conocimiento de la experiencia realizada. Se sugiere que las enfermeras desarrollen un enfoque ampliado de la red que apoye y dé la bienvenida a los adolescentes y sus familias. El cuidado debe compartirse mediante el intercambio de conocimientos, la reflexión, el diálogo y la vinculación.Descriptores: Familia, Madre, Salud del Adolescente, Enfermería.
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Ferreira, R. J. O., C. Costa, A. Marques, A. J. Barata Cavaleiro, S. Makri, K. Parperis, S. Psarelis, et al. "OP0264-HPR “I LITERALLY CONVINCED MYSELF I WAS GOING TO CATCH IT AND DIE”: LIVED EXPERIENCES OF THE COVID-19 PANDEMIC BY PEOPLE WITH RHEUMATIC DISEASES FROM FOUR EUROPEAN COUNTRIES." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 161.1–161. http://dx.doi.org/10.1136/annrheumdis-2021-eular.1586.
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Background:The COVID-19 pandemic has resulted in unforeseen challenges for humanity, taking a significant toll, especially the immune-suppressed individuals. In this regard, the health and general well-being of people with rheumatic diseases, the great majority users of immunosuppressives, have been at stake.Objectives:To explore the impact of the COVID-19 pandemic on people with rheumatic diseases on immunosuppression during the first wave, concerning a) (self-)management of their disease; b) interaction with the health care team; c) emotional well-being and d) overall health.Methods:A qualitative study was conducted following a phenomenological approach. Adults (>18 years) with a rheumatic disease from four European countries (Cyprus, England, Greece, Portugal). Patients were recruited through patient’s associations and social media and were invited to participate in semi-structured, audio-recorded interview or focus groups, between July - August 2020. Following a pilot study the information provided was transcribed verbatim, anonymized and translated into English where necessary. An inductive approach was adopted to carry out a thematic framework analysis with the assistance of ATLAS.ti to identify key themes and subthemes. Data validation strategies were employed, and Ethical approval and informed consent were obtained.Results:Participants were 24 patients (21 women, age range 33 to 74 years) divided by 7 focus-groups and 1 individual interview. Most frequent diagnoses were rheumatoid arthritis (n=7), lupus (n=4), juvenile idiopathic arthritis (n=3).Three key themes with 3-7 subthemes were identified within the analytical framework, centred around the impact of the Covid-19 on patients’ lives (Figure 1): i) individual person (e.g. fear for myself and family, social isolation and lack of personal freedom, more time with family) ii) health settings (e.g. (un)clear information about risks of contamination, fear or risk of shortages of medication, remote consultations), and iii) work and community (e.g. persistent stress due to mass media exposure, lack of awareness by others about patients’ rheumatic disease and its disclosure, hope and suspicion about new vaccine development: “I hear that they will ask vulnerable groups to have the vaccine first (...) Why is that? we will be again the innocent victims”). Findings were similar across countries, except for spirituality (i.e. the pandemic as “the hand of God”), a coping subtheme particular to Portugal. These main themes resonated well with the social ecological model and Walsh’s Family Resilience Process [1,2].Conclusion:When experiencing a significant life-event people require some time to process the different lived experiences. This study provides insights on how patients from four countries coped with the new challenges. Such insights are invaluable for health care providers and policy makers, in guiding more meaningful support tailored to individual needs, especially at times of crisis. The study highlights the impact of COVID-19 on the lives of people with rheumatic disease. A follow-up study is currently underway to examine the effect of subsequent waves of the pandemic.References:[1]Golden SD, Earp JA. Social ecological approaches to individuals and their contexts: twenty years of health education & behavior health promotion interventions. Health Educ Behav. 2012;39(3):364-72. doi: 10.1177/1090198111418634.[2]Walsh F. Family resilience: a framework for clinical practice. Fam Process. 2003;42(1):1-18. doi: 10.1111/j.1545-5300.2003.00001.Acknowledgements:We thank the participants of this study.Disclosure of Interests:None declared
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Baldissera, Ana Elisa, Luana Cristina Bellini, Ana Lucia Mendes Ferrer, Mayckel Da Silva Barreto, Jorseli Angela Henriques Coimbra, and Sonia Silva Marcon. "Perspectiva de profissionais de enfermagem sobre a morte na emergência." Revista de Enfermagem UFPE on line 12, no. 5 (May 1, 2018): 1317. http://dx.doi.org/10.5205/1981-8963-v12i5a234545p1317-1324-2018.
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RESUMOObjetivo: conhecer a perspectiva dos profissionais de Enfermagem, que atuam na sala de emergência, sobre o processo de morte e morrer. Método: estudo qualitativo, descritivo e exploratório, realizado com 17 profissionais de Enfermagem que atuavam na sala de emergência de um hospital universitário. Os dados foram coletados por meio de entrevistas semiestruturadas, audiogravadas que, após transcritas, foram submetidas à Análise de Conteúdo na modalidade Temática. Resultados: emergiram as categorias - Sentimentos e percepções frente ao processo de morte e morrer e Alterações na percepção da morte em diferentes fases da vida. Ambas mostram sentimentos, experiências iniciais com a morte enquanto profissional e a falta de preparo acerca do tema durante a formação. Conclusão: os profissionais entendem que a morte faz parte do processo de viver, mas sentem tristeza, frustração e impotência, especialmente, quando o paciente permanece por mais tempo na emergência. Acredita-se que este estudo possa contribuir para que os profissionais se sintam motivados para refletir e discutir sobre cuidados mais humanos e solidários no serviço hospitalar de urgência. Descritores: Morte; Profissionais de Enfermagem; Serviços Médicos de Emergência; Serviço Hospitalar de Emergência; Percepção; Relações Profissional-Paciente.ABSTRACT Objective: to know the perspective of Nursing professionals, who work in the emergency room, about the process of death and dying. Method: a qualitative, descriptive and exploratory study, carried out with 17 Nursing professionals who worked in the emergency room of a university hospital. Data was collected through semi-structured, audio-taped interviews that, after being transcribed, were submitted to Content Analysis in the Thematic modality. Results: categories emerged - Feelings and perceptions regarding the process of death and dying and Alterations in the perception of death in different phases of life. Both show feelings, initial experiences with death as a professional, and lack of preparation on the subject during training. Conclusion: professionals understand that death is part of the process of living, but they feel sadness, frustration and impotence, especially when the patient stays for longer in the emergency room. It is believed that this study may contribute to the professionals feel motivated to reflect and discuss more humane and supportive care in the hospital emergency service. Descriptors: Death; Nurse Practitioners; Emergency Medical Services; Emergency Service Hospital; Perception; Professional-Patient Relations.RESUMEN Objetivo: conocer la perspectiva de los profesionales de Enfermería, que actúan en la sala de emergencia, sobre el proceso de muerte y morir. Método: estudio cualitativo, descriptivo y exploratorio, realizado con 17 profesionales de Enfermería que actuaban en la sala de emergencia de un hospital universitario. Los datos fueron recolectados por medio de entrevistas semiestructuradas, audiogravadas que, tras transcritas, fueron sometidas al Análisis de Contenido, en la modalidad Temática. Resultados: surgieron dos categorías - Sentimientos y percepciones frente al proceso de muerte y morir y Alteraciones en la percepción de la muerte en diferentes fases de la vida. Ambos muestran sentimientos, experiencias iniciales con la muerte como profesional y la falta de preparación acerca del tema durante la formación. Conclusión: los profesionales entienden que la muerte es parte del proceso de vivir, pero sienten tristeza, frustración e impotencia, especialmente cuando el paciente permanece por más tiempo en la emergencia. Se cree que este estudio puede contribuir a que los profesionales, se sientan motivados para reflexionar y discutir sobre cuidados más humanos y solidarios en el servicio hospitalario de urgencia. Descriptores: Muerte; Enfermeras Practicantes; Servicios Médicos de Urgencia; Servicio de Urgencia en Hospital; Percepción; Relaciones Profesional-Paciente.
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Cruz-Vadillo, Rodolfo, and Miguel Ángel Casillas-Alvarado. "El papel de las experiencias escolares preuniversitarias en la conformación de un proyecto de vida ligado a la educación superior en estudiantes con discapacidad." Revista Electrónica Educare 20, no. 2 (May 1, 2016): 1. http://dx.doi.org/10.15359/ree.20-2.12.
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This article aims to approach the school experiences of 13 students with disabilities. It corresponds to a cross, synchronous and non experimental study, whose scope is mainly descriptive. The data collection was carried out through a semi-structured interview and transcribed from audio recordings to make a category analysis. The main results showed that in the case of students who were born with disabilities, the fact that an institution was inclusive turned out essential for them to have adequate transit through the educational system and thus become apt for higher education. The combination disability-inclusion-right to education-higher education is what this paper aimed to weave, trying to follow as thread or anchor, the previous school experiences of students with disabilities. We recognize that an adequate, inclusive, positive experience besides a subjective construction of the body and disability by family members, become important conditions to access schooling. Education is a right, therefore it can not be seen as an act of charity; it should be required as a quality practice.
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De Oliveira, Ana Paula Amestoy, Janete De Souza Urbanetto, and Rita Catalina Aquino Caregnato. "Adaptação transcultural e validação da national early warning score 2 para o Brasil." Revista de Enfermagem UFPE on line 12, no. 11 (November 6, 2018): 3154. http://dx.doi.org/10.5205/1981-8963-v12i11a235114p3154-3157-2018.
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RESUMOObjetivo: realizar a tradução e a adaptação transcultural da National Early Warning Score 2 (NEWS2) e validar o uso, no Brasil, para a deterioração clínica de pacientes. Método: trata-se de estudo metodológico. Fundamentar-se-á o processo no modelo de Beaton e colaboradores seguindo-se seis etapas: tradução inicial, síntese das traduções, tradução reversa, comitê de especialistas, teste de versão final e auditoria do processo. Realizar-se-á o teste de versão final em um hospital universitário do Sul do Brasil, com amostra de 40 enfermeiros, que aplicarão a escala a três estudos de caso propostos pelas pesquisadoras. Transcrever-se-ão e analisar-se-ão as respostas por meio do coeficiente de Kappa avaliando-se a concordância dos observadores. Realizar-se-á, para a validação, um estudo de coorte avaliando-se os registros de Enfermagem dos pacientes admitidos na emergência, em maio de 2018, e os desfechos óbito ou transferência não programada para a terapia intensiva em 24h, 48h e 72h. Respeitar-se-ão, pelo estudo, os aspectos éticos obtendo-se, como produto educativo, a escala NEWS2 traduzida e adaptada ao português brasileiro. Resultados esperados: pretende-se traduzir, adaptar e validar a NEWS produzindo-se um produto de valia para a assistência aos pacientes. Descritores: Pacientes; Evolução Clínica; Avaliação; Tradução; Estudos de Validação; Segurança.ABSTRACTObjective: to perform translation and cross-cultural adaptation of the National Early Warning Score 2 (NEWS2) and to validate the use in Brazil of clinical deterioration of patients. Method: this is a methodological study. The process will be based on the model of Beaton and collaborators following six steps: initial translation, synthesis of translations, reverse translation, committee of experts, final version test and process audit. The final version will be tested in a university hospital in the South of Brazil, with a sample of 40 nurses, who will apply the scale to three case studies proposed by the researchers. Transcripts will be transcribed and analyzed using the Kappa coefficient and the agreement of the observers will be evaluated. A cohort study will be performed for the validation of the Nursing records of patients admitted to the emergency room in May 2018, and the outcomes of death or unscheduled transfer to intensive care in 24 hours, 48 hours and 72 hours. The ethical aspects will be respected by the study, obtaining as an educational product the NEWS2 scale translated and adapted to Brazilian Portuguese. Expected results: we intend to translate, adapt and validate NEWS producing a valuable product for patient care. Descriptors: Patients; Clinical Evolution; Evaluation; Translating; Validation Studies; Safety.RESUMEN Objetivo: realizar la traducción y la adaptación transcultural de la National Early Warning Score 2 (NEWS2) y validar el uso, en Brasil, para el deterioro clínico de pacientes. Método: se trata de un estudio metodológico. Se fundamenta el proceso en el modelo de Beaton y colaboradores siguiendo seis etapas: traducción inicial, síntesis de las traducciones, traducción inversa, comité de expertos, prueba de versión final y auditoría del proceso. Se realizará la prueba de versión final en un hospital universitario del sur de Brasil, con muestra de 40 enfermeros, que aplicarán la escala a tres estudios de caso propuestos por las investigadoras. Se transcriben y se analizarán las respuestas a través del coeficiente de Kappa evaluando la concordancia de los observadores. Se realizará, para la validación, un estudio de cohorte evaluando los registros de Enfermería de los pacientes admitidos en la emergencia, en mayo de 2018, y los resultados óbito o transferencia no programada para la terapia intensiva en 24h, 48h y 72h. El respeto será, por el estudio, los aspectos éticos de obtener, como un producto educativo, la escala News2 traducido y adaptado al portugués de Brasil. Resultados esperados: se pretende traducir, adaptar y validar la NEWS produciéndose un producto de valor para la asistencia a los pacientes. Descriptores: Pacientes; Evolución Clínica; Evaluación; Traducción; Estudios de Validación; Seguridad.
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Ring, Erin, Jennifer E. Isenor, Kathryn Slayter, Melanie MacInnis, and Emily K. Black. "Barriers and Facilitators Related to Delivery of Hospital Pharmacy Services to Women, Children, and Their Families during a Pandemic: A Qualitative Study." Canadian Journal of Hospital Pharmacy, May 30, 2022. http://dx.doi.org/10.4212/cjhp.3229.
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Background: When the COVID-19 pandemic was declared in March 2020, health care professionals were challenged to adapt quickly and efficiently to change their work practices. However, an evidence-informed approach has not yet been used to systematically gather data on barriers and facilitators related to delivery of hospital pharmacy services in Canada. Objectives: The primary objective was to identify and describe barriers and facilitators related to the delivery of hospital pharmacy services to women, children, and their families during the COVID-19 pandemic. The secondary objective was to provide recommendations for improvement in delivery of pharmacy services to enhance patient care during pandemics. Methods: This qualitative study involved semistructured virtual interviews with pharmacists who worked in direct or nondirect patient care throughout the pandemic (since March 2020) at women’s and/or children’s hospitals in Canada. Individual interviews were completed virtually using conferencing software. An interview guide mapped to the Theoretical Domains Framework version 2 (TDFV2) was used to facilitate the interviews. Interviews were audio-recorded and transcribed verbatim by the principal investigator. Transcribed interviews were coded, mapped to the TDFV2, and analyzed using thematic analysis. Results: Interviews were completed with 21 pharmacists in 7 provinces across Canada. Barriers and facilitators coded to the TDFV2 were grouped into 4 main themes: communication and collaboration, adaptability, health and well-being, and preparedness. Conclusions: Participants highlighted a significant number of barriers that they experienced during the COVID-19 pandemic; overall, however, participants reported that they felt prepared for subsequent waves of the COVID-19 pandemic and future pandemics RÉSUMÉ Contexte : Lors de la déclaration de la pandémie de COVID-19 en mars 2020, les professionnels de la santé ont été mis au défi de s’adapter rapidement et efficacement à la situation en changeant leurs pratiques professionnelles. Cependant, une approche fondée sur des données probantes pour recueillir systématiquement des données sur les obstacles à la prestation des services de pharmacie hospitalière au Canada et les éléments facilitant celle-ci n’a pas encore été utilisée de manière systématique. Objectifs : L’objectif principal consistait à identifier et à décrire les obstacles à la prestation de services de pharmacie hospitalière aux femmes, aux enfants et à leur famille et les éléments facilitant celle-ci pendant la pandémie de COVID-19. L’objectif secondaire consistait, quant à lui, à fournir des recommandations pour améliorer la prestation de services de pharmacie afin d’améliorer les soins aux patients pendant une pandémie. Méthodes : Cette étude qualitative comprenait des entrevues virtuelles semi-structurées avec des pharmaciens ayant travaillé dans le domaine des soins directs ou non directs aux patients tout au long de la pandémie (depuis mars 2020) dans des hôpitaux pour femmes et/ou enfants au Canada. Les entretiens individuels ont été réalisés virtuellement à l’aide d’un logiciel de conférence. Un guide d’entretien adapté de la 2e version du cadre des domaines théoriques (TDFV2) [Theoretical Domains Framework] a été utilisé pour faciliter les entretiens. Ceux-ci ont été enregistrés sur bande audio et retranscrits textuellement par le chercheur principal. Les entretiens ainsi retranscrits ont été codés, reportés sur le TDFV2 et analysés par thème. Résultats : Des entrevues ont été réalisées auprès de 21 pharmaciens dans 7 provinces du Canada. Les obstacles et les éléments facilitateurs codés selon le TDFV2 ont été regroupés en 4 grands thèmes : communication et collaboration; adaptabilité; santé et bien-être; et état de préparation. Conclusions : Les participants ont mentionné un nombre important d’obstacles qu’ils ont rencontrés pendant la pandémie de COVID-19; dans l’ensemble, cependant, les participants ont déclaré qu’ils se sentaient préparés aux vagues ultérieures de la pandémie de COVID-19 et aux futures pandémies.
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Sanfelice, Clara Fróes de Oliveira, Juliana Vanessa da Silva Costa, and Elenice Valentim Carmona. "Humanização da assistência neonatal na ótica dos profissionais da enfermagem." Revista de Enfermagem UFPE on line 13 (October 4, 2019). http://dx.doi.org/10.5205/1981-8963.2019.242642.
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Objetivo: identificar a percepção da equipe de Enfermagem sobre a humanização da assistência prestada em uma Unidade de Terapia Intensiva Neonatal. Método: trata-se de um estudo qualitativo, descritivo, exploratório. Entrevistaram-se 22 profissionais, dos quais um enfermeiro e 21 técnicos de enfermagem. Coletaram-se os dados por meio de entrevistas semiestruturadas, gravadas em áudio, transcritas e analisadas seguindo a técnica de Análise de Conteúdo na modalidade Análise Temática. Resultados: revelaram-se quatro categorias: a) Humanização enquanto segurança para os pais, profissionais e neonatos; b) Cuidado que abrange o recém-nascido e a família; c) Humanização como cultura da equipe e política institucional e d) Contradições do cuidado humanizado. Conclusão: evidencia-se a necessidade de se promover atividades educativas para que a abordagem humanizada seja melhor compreendida e implementada no cuidado neonatal. Descritores: Humanização da Assistência; Recém-Nascido; Unidades de Terapia Intensiva Neonatal; Enfermagem Neonatal; Equipe de Enfermagem; Pesquisa Qualitativa.AbstractObjective: to identify the perception of the Nursing team about the humanization of care provided in a Neonatal Intensive Care Unit. Method: this is a qualitative, descriptive, exploratory study. 22 professionals were interviewed, including one nurse and 21 nursing technicians. Data was collected through semi-structured interviews, audio recorded, transcribed and analyzed following the technique of Content Analysis in the Thematic Analysis modality. Results: four categories were revealed: a) Humanization as safety for parents, professionals and newborns; b) Care that covers the newborn and the family; c) Humanization as a team culture and institutional policy; and d) Contradictions of humanized care. Conclusion: there is a need to promote educational activities so that the humanized approach is better understood and implemented in neonatal care. Descriptors: Humanization of Assistance; Newborn; Neonatal Intensive Care Units; Neonatal Nursing; Nursing, Team; Qualitative Research.ResumenObjetivo: identificar la percepción del equipo de Enfermería sobre la humanización de la atención brindada en una Unidad de Cuidados Intensivos Neonatales. Método: este es un estudio cualitativo, descriptivo, exploratorio. Se entrevistaron 22 profesionales, entre ellos un enfermero y 21 técnicos de enfermería. Los datos fueron recolectados a través de entrevistas semiestructuradas, audio grabado, transcrito y analizado siguiendo la técnica de Análisis de Contenido en la modalidad de Análisis Temático. Resultados: se revelaron cuatro categorías: a) Humanización como seguridad para los padres, profesionales y recién nacidos; b) Cuidado que cubre al recién nacido y la familia; c) La humanización como cultura de equipo y política institucional, y d) Contradicciones de la atención humanizada. Conclusión: es necesario promover actividades educativas para que el enfoque humanizado se entienda mejor y se implemente en la atención neonatal. Descriptores: Humanización de la Atención; Recién Nacido; Unidades de Cuidado Intensivo Neonatal; Enfermería Neonatal; Grupo de Enfermería; Investigación Cualitativa.
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Rodrigues, Meline Rossetto Kron, Guilherme Augusto Rago Ferraz, Silvana Andréa Molina Lima, Wilza Carla Spiri, Carmen Maria Casquel Monti Juliani, Iracema De Mattos Paranhos Calderon, Ana Claudia Molina, and Marilza Vieira Cunha Rudge. "Acceptance of additional alternative medicine by pregnant diabetics." Revista de Enfermagem UFPE on line 13 (November 28, 2019). http://dx.doi.org/10.5205/1981-8963.2019.242061.
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Objetivo: avaliar como as mulheres grávidas com diabetes compreendem e aceitam o uso de práticas integrativas e complementares na saúde, especialmente o Reiki, durante o atendimento pré-natal. Método: trata-se de um estudo qualitativo, descritivo, exploratório, de gestantes diabéticas atendidas num Centro de Investigação do Diabetes Perinatal em um centro terciário, por meio de entrevistas semiestruturadas com 12 gestantes. Audiogravaram-se e transcreveram-se as entrevistas para posterior análise cujos dados foram submetidos à técnica de Análise de Conteúdo. Resultados: demonstrou-se, pela maioria das mulheres gestantes diagnosticadas com diabetes, o conhecimento de algumas práticas integrativas e complementares na saúde. Receber-se-iam, além disso, por um grande número de entrevistadas, tais terapias se essas fossem disponíveis no Sistema Único de Saúde (SUS), porém, a terapia Reiki mostrou ser desconhecida entre as pacientes. Conclusão: serve-se este estudo como ponto de partida para profissionais de saúde introduzirem as terapias integrativas e complementares na saúde pública brasileira. Tornam-se necessários estudos adicionais em outras populações para obter uma visão mais profunda e detalhada do perfil das pacientes em diferentes regiões. Descritores: Terapias Complementares; Pré-natal; Gravidez em Diabéticas; Aceitação pelo Paciente de Cuidados de Saúde; Toque Terapêutico; Análise Qualitativa.AbstractObjective: to evaluate how pregnant women with diabetes understand and accept the use of integrative and complementary health practices, especially Reiki, during prenatal care. Method: this is a qualitative, descriptive, exploratory study of diabetic pregnant women seen at a Perinatal Diabetes Research Center in a tertiary center, through semi-structured interviews with 12 pregnant women. The interviews were audio recorded and transcribed for later analysis whose data were submitted to the Content Analysis technique. Results: it was demonstrated, by most pregnant women diagnosed with diabetes, the knowledge of some integrative and complementary practices in health. In addition, a large number of respondents would receive such therapies if they were available in the Unified Health System (UHS), but Reiki therapy was unknown to patients. Conclusion: this study serves as a starting point for health professionals to introduce integrative and complementary therapies in Brazilian public health. Further studies in other populations are needed to gain a deeper and more detailed view of patients' profiles in different regions. Descriptors: Complementary Therapies; Prenatal Care; Pregnancy in Diabetics; Patient Acceptance of Health Care; Therapeutic Touch; Qualitative Analysis.ResumenObjetivo: evaluar cómo las mujeres embarazadas con diabetes entienden y aceptan el uso de prácticas de salud integradoras y complementarias en salud, especialmente el Reiki, durante la atención prenatal. Método: este es un estudio cualitativo, descriptivo, exploratorio de mujeres embarazadas diabéticas atendidas en un Centro de Investigación de Diabetes Perinatal en un centro terciario, a través de entrevistas semiestructuradas con 12 mujeres embarazadas. Las entrevistas se grabaron en audio y se transcribieron para un análisis posterior cuyos datos fueron sometidos a la técnica de Análisis de Contenido. Resultados: la mayoría de las mujeres embarazadas diagnosticadas con diabetes demostraron el conocimiento de algunas prácticas integradoras y complementarias en salud. Además, un gran número de encuestados recibiría tales terapias si estuvieran disponibles en el Sistema Único de Salud (SUS), pero la terapia de Reiki era desconocida para los pacientes. Conclusión: este estudio sirve como punto de partida para que los profesionales de la salud introduzcan terapias integradoras y complementarias en la salud pública brasileña. Se necesitan más estudios en otras poblaciones para obtener una visión más profunda y detallada de los perfiles de los pacientes en diferentes regiones. Descriptores: Terapias Complementares; Atención Prenatal; Embarazo em Diabéticas; Aceptación de la Atención de Salud; Tacto Terapéutico; Análisis Cualitativo.
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Donnan, Jennifer, Omar Shogan, Lisa Bishop, and Maisam Najafizada. "Drivers of purchase decisions for cannabis products among consumers in a legalized market: a qualitative study." BMC Public Health 22, no. 1 (February 21, 2022). http://dx.doi.org/10.1186/s12889-021-12399-9.
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Abstract Background Cannabis was legalized in Canada for non-medical use in 2018. The goal of legalization was to improve health and safety by creating access to regulated products, with accurate product labels and warnings and no risk of contamination. However, more than 2 years post-legalization, a large proportion of purchases are still suspected to be through unlicensed retailers. This study sought to identify the factors that influenced the purchase decisions of cannabis consumers in Newfoundland and Labrador (NL). Methods Semi-structured focus groups and interviews were conducted in NL with individuals who were > 19 and had purchased cannabis within the last 12 months. All sessions were conducted virtually, audio-recorded, and transcribed. A thematic analysis was conducted, and two members of the research team coded the data using NVivo. A combination of deductive and inductive coding was carried out, themes from the literature were identified, and new themes from the transcripts were discovered. A final coding template of the data was agreed upon by the team through discussion and consensus. Results A total of 23 individuals (30% women) participated, with 83% coming from urban areas. While all cannabis product types were discussed, the conversation naturally focused on dried flower products. Participants discussed a variety of considerations when making purchase decisions categorized around five broad themes: 1) price, 2) quality, 3) packaging and warnings, 4) the source of the cannabis, and 5) social influences. The price difference between licensed and un-licensed sources was commonly discussed as a factor that influenced purchase decisions. Product quality characteristics (e.g. size, color, moisture content) and social influences were also considered in purchase decisions. Participants were generally indifferent to packaging and warning labels but expressed concern about the excessive packaging required for regulated products. Conclusion This study explores the many attributes that influence purchase decisions for dried leaf cannabis. Understanding the drivers of purchase decisions can help inform policy reforms to make regulated cannabis products more appealing to consumers. Further research is needed to measure the effect of each attribute on cannabis purchase decisions.
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Kabakian-Khasholian, Tamar, Jihad Makhoul, and Aleni Ghusayni. "“A person who does not have money does not enter”: a qualitative study on refugee women’s experiences of respectful maternity care." BMC Pregnancy and Childbirth 22, no. 1 (October 5, 2022). http://dx.doi.org/10.1186/s12884-022-05083-2.
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Abstract Background Women’s childbirth experiences in health facilities is at the core of quality of care. Their perceptions of poor-quality care, including disrespectful care at health facilities during childbirth, is recognized as a significant barrier to seeking care for subsequent births. Research that explores women’s perspectives of the dimensions of disrespect and mistreatment during childbirth in Arab countries is scarce, and there is none pertaining to refugee groups who carry the burden of multiple vulnerabilities and who suffer from discontinued care, especially in fragile health systems. This paper aims at presenting Palestinian, Iraqi and Syrian refugee women’s experiences, understanding and interpretation of disrespect and mistreatment during childbirth in hospitals in Lebanon. Methods This study employed phenomenology, a qualitative research design to generate data through in-depth interviews. Women who were 3 to 6 months postpartum were recruited through the non-governmental organizations (NGOs) that are actively engaged in providing welfare and healthcare services to different populations of refugee women in Lebanon. In total, 24 women were interviewed. All interviews were audio recorded, transcribed verbatim and subjected to thematic analysis. Results Of the 24 women who participated in this study, 9 were Palestinian, 12 were Syrian and 3 were Iraqi. The participants spoke of restricted choices to hospitals, care providers and to types of birth, while revealing adverse experiences during childbirth in healthcare facilities, including verbal and physical abuse, disrespectful verbal and non-verbal communication by healthcare providers. They also reported sub-standard care, denial of birth companions and breaches to their privacy. Our findings exemplify how the coverage of the cost of facility-based births by UN agencies and NGOs increase refugee women’s vulnerability to disrespect and mistreatment during childbirth. Conclusion This study shows how disrespect and mistreatment are intertwined in a complex system which is devised to ensure access to facility-based birth for displaced populations. Implications for programs and policies point to the need for strengthening capacity and for providing resources for the adaptation of global guidelines into context-specific strategies for the provision of quality maternity care during humanitarian crises and beyond.
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Black, Emily K., Lindsay MacDonald, Heather L. Neville, Kim Abbass, Kathryn Slayter, Lynn Johnston, and Ingrid Sketris. "Health Care Providers’ Perceptions of Antimicrobial Use and Stewardship at Acute Care Hospitals in Nova Scotia." Canadian Journal of Hospital Pharmacy 72, no. 4 (August 21, 2019). http://dx.doi.org/10.4212/cjhp.v72i4.2912.
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ABSTRACTBackground: Antimicrobial use is the major factor in the development of antimicrobial resistance. Antimicrobial stewardship has been recom-mended as a strategy to improve antimicrobial use. Objective: To learn about health care providers’ perceptions of current antimicrobial use and stewardship, including barriers and facilitators to improving antimicrobial use at acute care hospitals in Nova Scotia.Methods: This qualitative research study was conducted at acute care hospitals in Nova Scotia using focus groups and semistructured interviews. Health care providers (nurses, nurse practitioners, pharmacists, pharmacy students, and physicians) were invited to participate. Focus groups and interviews were conducted at each participant’s place of employment. Interviews and focus groups were facilitated with an interview guide, audio-recorded, and transcribed verbatim. Transcripts were independently coded by 2 investigators and analyzed using thematic analysis.Results: A total of 9 focus groups and 3 individual interviews were conducted between June and August 2017. Fifty-four health care professionals and trainees (24 pharmacists and pharmacy students, 14 physicians, and 16 nurses and nurse practitioners) from 5 hospitals participated. The following themes were identified: current practices, prescribing influences, access to information, collaboration and communi -cation, resources, and antimicrobial stewardship. Within each theme, barriers and facilitators to improving antimicrobial use were identified as subthemes. Conclusion: Participants identified current barriers to appropriate use of antimicrobials and suggested facilitators that might improve the use of these drugs. The results of this study could be used by antimicrobial stewardship teams and decision-makers to improve antimicrobial use and stewardship initiatives throughout Nova Scotia, and may be applicable to hospitals outside the province.RÉSUMÉContexte: L’utilisation des antimicrobiens est le principal facteur de développement de la résistance à cette classe de médicaments. La gestion des antimicrobiens a été recommandée comme stratégie visant à améliorer leur utilisation. Objectif : Découvrir la perception des fournisseurs de soins de santé au sujet de l’utilisation et de la gestion actuelles des antimicrobiens, y compris les obstacles et les moyens destinés à favoriser l’amélioration de leur utilisation dans des hôpitaux de soins actifs en Nouvelle-Écosse.Méthodes : Cette recherche qualitative a été menée dans des hôpitaux de soins actifs en Nouvelle-Écosse à l’aide de groupes de discussion et d’entretiens semi-structurés. Les fournisseurs de soins de santé (infirmières, infirmières praticiennes, pharmaciens, étudiants en pharmacie et médecins) ont été invités à y participer. Les groupes de discussion et les entretiens ont été menés sur chaque lieu de travail des participants. Ils ont été facilités grâce à un guide d’entretien. Ils ont aussi été enregistrés (audio) et retran-scrits textuellement. Les transcriptions ont été codées de façon indépen-dante par deux enquêteurs et étudiées à l’aide d’une analyse thématique.Résultats : Neuf groupes de discussion et trois entretiens individuels ont été menés entre juin et août 2017. Cinquante-quatre professionnels et stagiaires de la santé (24 pharmaciens et étudiants en pharmacie, 14 médecins, 16 infirmières et infirmières praticiennes) provenant de cinq hôpitaux y ont participé. Les thèmes suivants ont été soumis à la discussion : pratiques actuelles, influences en matière de prescription, accès aux informations, collaboration et communication, ressources et gestion des antimicrobiens. Chaque thème comportait deux sous-thèmes abordant les obstacles et les mesures favorisant l’amélioration de l’utilisation des antimicrobiens. Conclusion : Les participants ont relevé les obstacles actuels nuisant à une bonne utilisation des antimicrobiens et ont proposé des moyens pour améliorer l’utilisation de ces médicaments. Les résultats de cette étude pourraient être utilisés par les équipes de gestion des antimicrobiens ainsi que par les décideurs qui doivent favoriser l’amélioration de l’utilisation des antimicrobiens et les initiatives relatives à leur gestion partout en Nouvelle-Écosse. Ils sont aussi applicables aux hôpitaux extérieurs à la province.
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Bagri, Harkaryn, Karen Dahri, and Michael Legal. "Hospital Pharmacists’ Perceptions and Decision-Making Related to Drug-Drug Interactions." Canadian Journal of Hospital Pharmacy 72, no. 4 (August 21, 2019). http://dx.doi.org/10.4212/cjhp.v72i4.2915.
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ABSTRACTBackground: Pharmacists often overlook drug interaction alerts because of limitations in clinical decision support (CDS) software systems intended to detect evidence-based, clinically significant drug-drug inter-actions (DDIs). Alert fatigue, which occurs when pharmacists become desensitized to an overload of DDIs, may also contribute.Objectives: To gain a better understanding of how pharmacists assess common DDIs and the extent to which computerized drug alerts affect their decision-making, as background for initiatives to overcome alert fatigue and improve detection of DDIs.Methods: This qualitative study used focus group methodology. A structured focus group was planned at each of 3 large tertiary hospitals. Pharmacists were invited to participate if their jobs included patient care and/or dispensary responsibilities. The focus group discussions were audio-recorded and subsequently transcribed, analyzed, and coded into themes using NVivo software. Four main categories of themes were identified: perceived challenges, pharmacists’ assessment of DDIs, barriers to responding to alerts, and proposed solutions.Results: The participants (n = 24) described a large discrepancy among CDS software systems in terms of the severity of specific DDIs, which made it difficult to view these systems as reliable sources. The participants agreed that alert fatigue is present and contributes to DDIs being overlooked. However, lack of patient information to make an initial assessment, as well as the constant need for multitasking, prevents pharmacists from focusing on the evaluation of DDIs. Conclusions: Although alert fatigue was reported to be a common factor responsible for pharmacists missing DDIs, other barriers also exist. Participants suggested ways to limit DDI alerts to those that are clinically relevant. Having a collaborative team of pharmacists periodically review the DDIs embedded in the CDS system, incorporating a colour-code system, and removing duplicate entries were discussed as ways to improve system efficiency.RÉSUMÉContexte : Les pharmaciens ignorent souvent les alertes d’interactions médicamenteuses à cause des limites des logiciels d’aide à la décision clinique (ADC) conçus pour détecter les interactions médicamenteuses (IM) factuelles et significatives d’un point de vue clinique. La fatigue liée aux alarmes (alert fatigue), qui survient lorsque les pharmaciens sont désensibilisés à cause d’une surcharge d’IM, peut aussi contribuer à cette situation.Objectifs : Mieux comprendre comment les pharmaciens évaluent les IM courantes et dans quelle mesure les alertes médicamenteuses affectent leur prise de décision, dans le cadre de la mise en œuvre d’initiatives visant à surmonter la fatigue liée aux alarmes et à mieux détecter les IM.Méthodes : La méthodologie de cette étude qualitative se basait sur les groupes de discussion. Un groupe de discussion structuré était prévu dans chacun des trois grands hôpitaux tertiaires. Les pharmaciens étaient invités à participer si leur travail comprenait des soins offerts aux patients ou des responsabilités dans la distribution de médicaments. Les discussions dans les groupes ont fait l’objet d’un enregistrement audio avant d’être retranscrites, analysées et codées selon les thèmes à l’aide du logiciel NVivo. Quatre catégories de thèmes principaux ont été établies : les défis perçus, l’évaluation des IM par les pharmaciens, les obstacles à lever pour répondre aux alertes et les solutions proposées.Résultats : Les participants (n = 24) ont mentionné un écart important dans les définitions de la gravité [severity] d’IM spécifiques données par les logiciels d’ADC, de sorte qu’il était difficile de se fier à ces systèmes. Les participants ont indiqué que la fatigue liée aux alarmes existait bel et bien et qu’elle contribuait au manque de prise en compte des IM. Cependant, le manque d’information sur les patients pour faire l’évaluation initiale, ainsi que le besoin constant d’effectuer plusieurs tâches à la fois, empêche les pharmaciens de se concentrer sur l’évaluation des IM. Conclusions : Bien que la fatigue liée aux alarmes empêche fréquemment les pharmaciens de remarquer les IM, il existe d’autres obstacles. Les participants ont proposé de limiter les alertes d’IM à celles pertinentes d’un point de vue clinique. Les solutions examinées pour améliorer l’efficacité du système ont porté sur la formation d’une équipe collaborative de pharmaciens qui examine périodiquement les IM intégrés dans le système ADC, l’incorporation d’un système de codes de couleur et l’élimination des entrées dupliquées.
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Hofzmann, Rafaela Da Rosa, Marcia Perondi, Jouhanna Menegaz, Soraia Geraldo Rozza Lopes, and Dayanne Da Silva Borges. "EXPERIÊNCIA DOS FAMILIARES NO CONVÍVIO DE CRIANÇAS COM TRANSTORNO DO ESPECTRO AUTISTA (TEA)." Enfermagem em Foco 10, no. 2 (August 13, 2019). http://dx.doi.org/10.21675/2357-707x.2019.v10.n2.1671.
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Resumo: Objetivo: conhecer a experiência dos familiares no convívio de crianças com TEA. Metodologia: pesquisa qualitativa, realizada através de Grupo Focal com familiares de oito crianças com diagnóstico de TEA. A coleta de dados ocorreu no mês de setembro de 2016, através de questões norteadoras discutidas no grupo. Os relatos foram gravados em áudios e transcrito pelos autores. A análise foi realizada a partir da Análise de Conteúdo. Resultados: A partir da análise dos dados surgiram três categorias: ‘a descoberta do autismo’; ‘experiências dos familiares após o diagnóstico de autismo’ e ‘atendimento em saúde da criança com autismo’. Conclusão: o autismo é um transtorno que causa muitas adaptações e mudanças na vida dos familiares envolvidos, surgindo a necessidade do apoio dos profissionais de saúde no suporte dos cuidados prestado a estas crianças.Descritores: Autismo; Relações Familiares; Acontecimentos que Mudam a Vida; Enfermagem.THE EXPERIENCE OF FAMILIARS IN THE COEXISTENCE OF CHILDREN WITH AUTISTIC SPECTRUM DISORDER (ASD)Abstract: Objective: to know the experience of family members living with children with ASD. Methodology: qualitative research, carried out through a Focal Group with relatives of eight children diagnosed with ASD. Data collection occurred in September 2016, through guiding questions discussed in the group. The reports were recorded in audios and transcribed by the authors. The analysis was made from the Content Analysis. Results: From the analysis of the data emerged three categories: ‘the discovery of autism’; ‘Family experiences after the diagnosis of autism’ and ‘health care of the child with autism’. Conclusion: autism is a disorder that causes many adaptations and changes in the lives of the family members involved, resulting in the need of the support of the health professionals in the support of the care provided to these children.Descriptors: Autism; Family Relations; Life Changing Events; Nursing.LA EXPERIENCIA DE LOS FAMILIARES EN LA CONVIVENCIA DE NIÑOS CON TRANSTORNO DEL ESPECTRO AUTISTA (TEA)Resumen: Objetivo: conocer la experiencia de los familiares en la convivencia de niños con TEA. Metodología: investigación cualitativa, realizada a través de Grupo Focal con familiares de ocho niños con diagnóstico de TEA. La recolección de datos ocurrió en el mes de septiembre de 2016, a través de cuestiones orientadoras discutidas en el grupo. Los relatos fueron grabados en audios y transcrito por los autores. El análisis fue realizado a partir de la Análisis de Contenido. Resultados: A partir del análisis de los datos surgieron tres categorías: ‘el descubrimiento del autismo’; “Experiencias de los familiares después del diagnóstico de autismo” y “atención en salud del niño con autismo”. Conclusión: el autismo es un trastorno que causa muchas adaptaciones y cambios en la vida de los familiares involucrados, surgiendo a la necesidad del apoyo de los profesionales de salud en el soporte de los cuidados prestados a estos niños.Descriptores: Autismo; Relaciones Familiares; Acontecimientos que cambian la vida; Enfermería.