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‣ Adaptação transcultural e validação da versão em português de questionário de qualidade de vida para pacientes com câncer em cuidados paliativos no contexto cultural brasileiro; Cross-cultural adaptation and validation of the Brazilian Portuguese version of quality of life questionnaire for cancer patients in palliative care in cultural Brazilian context

Faria, Sheilla de Oliveira
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 07/11/2013 Português
Relevância na Pesquisa
47.357%
Introdução: Como o enfoque principal nos cuidados paliativos é a qualidade de vida, a avaliação deste item é de suma importância para verificar o cuidado proposto ao paciente. Existem poucos questionários específicos para avaliar a qualidade de vida do paciente em cuidado paliativo. Entre eles, o McGill Quality of Life Questionnaire (MQOL) é o que apresenta maior número de validações em outras línguas e as melhores pontuações pelas suas propriedades de medidas. No Brasil existem poucos questionários validados para avaliação da qualidade de vida, e apenas um é específico para pacientes em cuidados paliativos. Objetivos: Produzir uma versão do McGill Quality of Life Questionnaire (MQOL) em português, adaptada ao contexto cultural brasileiro, e verificar a validade e a confiabilidade da versão adaptada. Método: A versão original foi traduzida para o português de acordo com as recomendações da literatura, e então adaptada ao contexto brasileiro a partir de entrevistas iniciais com pacientes com câncer em cuidados paliativos do Instituto de Câncer do Estado de São Paulo (ICESP), até que se obteve uma versão final (MQOL-Br). Esta versão foi retrotraduzida para o inglês e aprovada pela autora da escala original. Para verificar a validade do MQOL-Br...

‣ Use of Health Professionals for Delivery Following the Availability of Free Obstetric Care in Northern Ghana

Mills, S.; Williams, J. E.; Adjuik, M.; Hodgson, A.
Fonte: Banco Mundial Publicador: Banco Mundial
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
47.162236%
OBJECTIVES: To assess the factors associated with the use of health professionals for delivery following the implementation of a free obstetric care policy in the poorest regions of Ghana. METHODS: All 4,070 women identified in the Navrongo demographic surveillance system with pregnancy outcomes in the Kassena-Nankana district between January 1 and December 31, 2004 were eligible for the study. Three thousand four hundred and thirty three women completed interviews on socio-demographic and pregnancy related factors. Information on 259 communities including travel distance to the nearest health facility was also obtained. Multilevel logistic regression analyses were conducted. RESULTS: ninety eight percent of women received antenatal care but only 38% delivered with the assistance of health professionals. In a multilevel logistic model, physical access factors {such as availability of public transport, odds ratio (OR) = 1.50 (1.15-1.94), travel distance to the district hospital [for 20+ km, OR = 0.31 (0.23-0.43)] as well as community perception of access to the nearest health facility [for highest quintile, OR = 4.44 (2.88-6.84)]} showed statistically significant associations with use of health professionals at last delivery. Women who knew that delivery care was free of charge were 4.6 times more likely to use health professionals. Higher parity was strongly negatively associated with use of health professionals [OR = 0.37 (0.29-0.48) for parity > or = 4 compared to parity 0-1]. However...

‣ A cross-sectional survey to assess community attitudes to introduction of human papillomavirus vaccine

Marshall, H.; Ryan, P.; Roberton, D.; Baghurst, P.
Fonte: Public Health Assoc Australia Inc Publicador: Public Health Assoc Australia Inc
Tipo: Artigo de Revista Científica
Publicado em //2007 Português
Relevância na Pesquisa
47.25714%
Objective: A vaccine to prevent human papilloma virus (HPV) infection has been licensed recently in the United States of America and Australia. The aim of this study was to assess community attitudes to the introduction of HPV vaccine in the State of South Australia. Methods: A cross-sectional survey was conducted by computer-aided telephone interviews in February 2006. The survey assessed adult and parental attitudes to the introduction of HPV vaccine to provide protection against a sexually transmitted disease caused by HPV and against cervical cancer. Two thousand interviews were conducted in metropolitan and rural households. Results: Two per cent of respondents knew that persistent HPV infection caused cervical cancer and a further 7% were aware that the cause was viral. The majority of adults interviewed (83%) considered that both men and women should receive HPV vaccine and 77% of parents agreed that they would have their child/children immunised. Parents were mainly concerned about possible side effects of the vaccine (66%), with only 0.2% being concerned about discussing a sexually transmitted disease with their children and 5% being concerned that use of the vaccine may lead to promiscuity. Implications: Our findings suggest that public health education campaigns for HPV vaccination will find a majority of parents receptive to their children being vaccinated...

‣ (Using) complementary and alternative medicine: The perceptions of palliative patients with cancer

Eliott, J.; Kealey, C.; Olver, I.
Fonte: Mary Ann Liebert, Inc. Publishers Publicador: Mary Ann Liebert, Inc. Publishers
Tipo: Artigo de Revista Científica
Publicado em //2008 Português
Relevância na Pesquisa
47.176113%
Use of complementary and alternative medicine (CAM) is increasingly common within Western societies, including Australia. This parallels calls for or claims of integration of CAM into mainstream medical practice, with oncology and palliative care specifically nominated as appropriate arenas for integration. However, there is an absence of studies examining patient perceptions of both CAM and CAM users. In this study, 28 adult patients with cancer close to death were interviewed regarding treatment decisions at the end of life, including decisions about CAM. Thematic analysis of transcribed interviews found consistent differences in talk around CAM between 12 users and 16 nonusers of CAM, primarily related to the perceived value of these treatments. Drawing upon a mind–body discourse that holds individuals responsible for their health, users valued CAM for the perceived benefit to physical or psychological well-being and compatibility with a holistic approach to health care, deemed to complement or augment conventional medicine. However, some were selfcritical of their failure to continue with CAM, despite practical and financial difficulties experienced. Nonusers devalued CAM as unable to cure their disease (but did not similarly devalue conventional medicine)...

‣ Qualities men value when communicating with general practitioners: implications for primary care settings

Smith, J.; Braunack-Mayer, A.; Wittert, G.; Warin, M.
Fonte: Australasian Med Publ Co Ltd Publicador: Australasian Med Publ Co Ltd
Tipo: Artigo de Revista Científica
Publicado em //2008 Português
Relevância na Pesquisa
47.57015%
OBJECTIVE: To determine the core qualities that men value when communicating with general practitioners in primary care settings. DESIGN, SETTING AND PARTICIPANTS: In a qualitative study using semi-structured interviews in non-clinical environments, 36 white Australian men drawn from the Florey Adelaide Male Ageing Study, stratified by age and marital status, discussed their help-seeking behaviour and health service use. Participants were from the North West Adelaide region. Interviews were conducted between January and November 2005. RESULTS: The core qualities men value when communicating with GPs in primary care settings include the adoption of a "frank approach", demonstrable competence, thoughtful use of humour, empathy, and prompt resolution of health issues. CONCLUSIONS: The core qualities men value when communicating with GPs are concordant with most key dimensions of a patient-centred approach, but not necessarily all. Adopting these qualities has the potential to enhance communication with and care of men in primary care settings.; James A. Smith, Annette J. Braunack-Mayer, Gary A. Wittert and Megan J. Warin

‣ Prevalence and associations of hand pain in the community: results from a population-based study

Cole, A.; Gill, T.; Taylor, A.; Hill, C.
Fonte: Taylor & Francis As Publicador: Taylor & Francis As
Tipo: Artigo de Revista Científica
Publicado em //2011 Português
Relevância na Pesquisa
56.8784%
Objectives: To assess the prevalence and associations of hand symptoms in a community setting. Methods: The North West Adelaide Health Study (NWAHS) is a longitudinal cohort study of people aged ≥ 18 years. Analysis was performed in participants who completed a telephone interview, a quality of life questionnaire [the 36‐item short-form health survey, (SF-36)], and the Australian/Canadian (AUSCAN) Osteoarthritis (OA) Hand Index, and underwent grip strength measurement. Results: Overall, 477 (13.7%) reported hand pain, aching, or stiffness. Of these, 169 (35.8%) had been diagnosed with hand arthritis. Women were more likely to have hand symptoms than men, as were those aged ≥ 50 years (p < 0.001). Hand symptoms were associated with lower quality of life scores (p < 0.05). Participants with hand arthritis had more severe pain, stiffness, and poorer physical functioning as reflected by higher AUSCAN scores. Grip strength was reduced in those with hand symptoms and hand arthritis (p < 0.05) and inversely associated with mean AUSCAN subscores and SF-36 physical functioning scores (p < 0.001). Conclusions: Hand symptoms were present in 14% of the population and were more common in women and those aged ≥ 50 years. Hand symptoms were associated with reduced grip strength and reduced quality of life. Hand arthritis was associated with higher AUSCAN scores. Hand symptoms and hand arthritis have a significant impact on physical functioning and quality of life.; A Cole...

‣ Age and gender differences in disabling foot pain using different definitions of the manchester foot pain and disability index

Menz, H.; Gill, T.; Taylor, A.; Hill, C.
Fonte: BioMed Central Ltd. Publicador: BioMed Central Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2011 Português
Relevância na Pesquisa
47.191416%
Background: The Manchester Foot Pain and Disability Index (MFPDI) has been used to determine the prevalence of disabling foot pain in several studies, however there is some debate as to which case definition is most appropriate. The objective of this study was to explore age and gender differences in the proportion of people with disabling foot pain using three different case definitions of the MFPDI and for each individual MFPDI item. Methods: A random sample of 223 participants aged 27 to 90 years (88 males and 135 females) from the North West Adelaide Health Study, who reported having pain, aching or stiffness in either of their feet on most days in the last month, completed the MFPDI by telephone interview. The proportion of people with disabling foot pain was determined using three definitions: (i) Definition A-at least one of the 17 items documented on at least some days in the last month; (ii) Definition B-at least one of the 17 items documented on most/every day(s) in the last month, and; (iii) Definition C-at least one of the ten functional limitation items documented on most/every day(s) in the last month. Cross-tabulations and chi-squared statistics were used to explore differences in responses to the MFPDI items according to age and gender. Results: The proportion of people with disabling foot pain according to each definition was as follows: Definition A (100%)...

‣ CareTrack: assessing the appropriateness of health care delivery in Australia

Runciman, W.B.; Hunt, T.D.; Hannaford, N.A.; Hibbert, P.D.; Westbrook, J.I.; Colera, E.W.; Day, R.O.; Hindmarsh, D.M.; McGlynn, E.A.; Braithwaite, J.
Fonte: MJA Group Australia Publicador: MJA Group Australia
Tipo: Artigo de Revista Científica
Publicado em //2012 Português
Relevância na Pesquisa
47.421475%
OBJECTIVE: To determine the percentage of health care encounters at which a sample of adult Australians received appropriate care (ie, care in line with evidence-based or consensus-based guidelines). DESIGN, SETTING AND PARTICIPANTS: Computer-assisted telephone interviews and retrospective review of the medical records (for 2009-2010) of a sample of at least 1000 Australian adults to measure compliance with 522 expert consensus indicators representing appropriate care for 22 common conditions. Participants were selected from households in areas of South Australia and New South Wales chosen to be representative of the socioeconomic profile of Australians. Health care encounters occurred in health care practices and hospitals with general practitioners, specialists, physiotherapists, chiropractors, psychologists and counsellors. MAIN OUTCOME MEASURE: Percentage of health care encounters at which the sample received appropriate care. RESULTS: From 15 292 households contacted by telephone, 7649 individuals agreed to participate, 3567 consented, 2638 proved eligible, and 1154 were included after gaining the consent of their health care providers. The adult Australians in this sample received appropriate care at 57% (95% CI, 54%-60%) of 35 573 eligible health care encounters. Compliance with indicators of appropriate care at condition level ranged from 13% (95% CI...

‣ Methodological issues associated with collecting sensitive information over the telephone - experience from an Australian non-suicidal self-injury (NSSI) prevalence study

Taylor, A.; Martin, G.; DalGrande, E.; Swannell, S.; Fullerton, S.; Hazell, P.; Harrison, J.
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em //2011 Português
Relevância na Pesquisa
47.176113%
BACKGROUND Collecting population data on sensitive issues such as non-suicidal self-injury (NSSI) is problematic. Case note audits or hospital/clinic based presentations only record severe cases and do not distinguish between suicidal and non-suicidal intent. Community surveys have largely been limited to school and university students, resulting in little much needed population-based data on NSSI. Collecting these data via a large scale population survey presents challenges to survey methodologists. This paper addresses the methodological issues associated with collecting this type of data via CATI. METHODS An Australia-wide population survey was funded by the Australian Government to determine prevalence estimates of NSSI and associations, predictors, relationships to suicide attempts and suicide ideation, and outcomes. Computer assisted telephone interviewing (CATI) on a random sample of the Australian population aged 10+ years of age from randomly selected households, was undertaken. RESULTS Overall, from 31,216 eligible households, 12,006 interviews were undertaken (response rate 38.5%). The 4-week prevalence of NSSI was 1.1% (95% ci 0.9-1.3%) and lifetime prevalence was 8.1% (95% ci 7.6-8.6). Methodological concerns and challenges in regard to collection of these data included extensive interviewer training and post interview counselling. Ethical considerations...

‣ How do surgeons experience and cope with the death and dying of their patients? A qualitative study in the context of life-limiting illnesses

Zambrano Ramos, S.; Chur-Hansen, A.; Crawford, G.
Fonte: Springer Publicador: Springer
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
Relevância na Pesquisa
47.176113%
BACKGROUND: The present qualitative study explores surgeons' experiences and coping mechanisms with the death of their patients in the context of life-limiting illnesses. METHODS: Nine Australian surgeons participated in in-depth interviews. Thematic analysis of the interview transcriptions allowed for identification of themes and subthemes. Methodological trustworthiness and rigor were preserved at all stages of the research process. RESULTS: The essence of surgical practice, comprising participants' descriptions of their identity as surgeons, influenced their experiences and coping mechanisms when dealing with death and dying. The following subthemes were identified: distancing from patients, wanting to fix problems, doing in terms of operating on a patient, prominence of the surgeon's personal ability, and high personal responsibility for patient outcomes. Giving hope and having a mixed surgical practice were some of the coping mechanisms described by participants. DISCUSSION: Death and dying are a part of surgical practice, and surgeons face challenges as they care for dying patients. Although participants stated that they felt less affected by dealing with patients dying of life-limiting illnesses than by unexpected deaths, their descriptions of their encounters...

‣ Parent perspectives on consent for the linkage of data to evaluate vaccine safety: A randomised trial of opt-in and opt-out consent

Berry, J.; Ryan, P.; Duszynski, K.; Braunack-Mayer, A.; Carlson, J.; Xafis, V.; Gold, M.
Fonte: Sage Publications Ltd. Publicador: Sage Publications Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
Relevância na Pesquisa
47.17093%
BACKGROUND: We examined parents' consent preferences and understanding of an opt-in or opt-out invitation to participate in data linkage for post-marketing safety surveillance of childhood vaccines. METHODS: A single-blind parallel-group randomised controlled trial: 1129 families of babies born at a South Australian hospital in 2009 were sent information at 6 weeks post-partum, explaining data linkage of childhood immunisation and hospital records for vaccine safety surveillance, with 4 weeks to opt in or opt out by reply form, telephone, or email. At 10 weeks post-partum, 1026 (91%) parents were followed up by telephone interview. RESULTS: In both the opt-in (n = 564) and opt-out arms (n = 565), four-fifths of the parents recalled receiving the information (81% vs. 83%, P = 0.35), three-fifths reported reading it (63% vs. 67%, P = 0.11), but only two-fifths correctly identified the health records to be linked (43% vs. 39%, P = 0.21). Parents who actively consented (opted in) were more likely than those who passively consented (did not opt out) to recall the information (100% vs. 83%, P < 0.001), report reading it (94% vs. 67%, P < 0.001), and correctly identify the data sources (60% vs. 39%, P < 0.001). Most parents supported data linkage for vaccine safety surveillance (94%) and trusted its privacy protections (84%). Most parents wished to have minimal or no direct involvement...

‣ Perceptions of "good palliative care" orders: A discursive study of cancer patients' comments

Eliott, J.; Olver, I.
Fonte: Center Bioethics Clin Res Inst Montreal Publicador: Center Bioethics Clin Res Inst Montreal
Tipo: Artigo de Revista Científica
Publicado em //2003 Português
Relevância na Pesquisa
47.186133%
Patients' perceptions regarding Good Palliative Care (GPC) orders, a form of advance directives, were sought, and issues inherent in their promotion as policy were identified. Semi-structured interviews with 23 oncology-clinic outpatients, focused on end-of-life decision making, were tape-recorded, transcribed, and analyzed using discursive-analytical techniques. Most patients were unfamiliar with the term GPC orders, preferring the familiar "do-not-resuscitate" orders. GPC orders were negatively perceived as vague, beyond the individual's control, implying dependency on others, and failing to reduce suffering. Positive perceptions of GPC orders saw them as counteracting the impersonality of medical procedure and asserting the value of the whole patient within a social context. Participants' comments on a draft copy of a GPC order form suggest that they view consultation as beneficial, but that a standardized form may be impersonal and inappropriate. The structure and content of the GPC order form constitute it as a quasilegal document that may confuse and disempower patients, and function to protect the interests of the medical profession in the guise of promoting patient autonomy. The potential benefits attributed to GPC orders are achievable without the adoption of a blanket policy that depersonalizes and bureaucratizes the dying process...

‣ Binners, fillers and filers - a qualitative study of GPs who don't return postal questionnaires

Stocks, N.; Braunack-Mayer, A.; Somerset, M.; Gunnell, D.
Fonte: Mediselect BV Publicador: Mediselect BV
Tipo: Artigo de Revista Científica
Publicado em //2004 Português
Relevância na Pesquisa
47.176113%
BACKGROUND AND OBJECTIVES: Postal questionnaires are a frequently used method of obtaining information from general practitioners. However, getting GPs to return questionnaires or participate in research can be challenging. We wanted to ascertain reasons why GPs identified as 'routine non-responders' to postal questionnaires, do not participate in this type of research. METHODS: Qualitative study using semi-structured interviews of 14 GPs who had returned only one or none of five questionnaires sent to them during a five-year period between 1994-1999. RESULTS: Participants were classified into one of three groups--binners, filers and fillers--according to their behavior when faced with a questionnaire. Each group had slightly different attitudes toward research in general practice. Although standard strategies such as incentives and good design could influence the decision to complete a questionnaire, poor research experiences or a poor relationship between the participant and researchers were also very important. CONCLUSION: The decision not to return a postal questionnaire is multifactorial and reflects personal and professional attitudes, experiences and organisation of individual GPs as well as time pressure and interest. The development of a positive relationship with a researcher or academic department may be influential in encouraging the return of postal questionnaires and when trying to enhance response rates amongst 'routine non-responders' researchers should take into account the broader values ans practices GPs bring to their work.; http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15724124&dopt=Abstract; N. Stocks...

‣ Exploring policy makers' perspectives on a clinical controversy: airway surgery for adult obstructive sleep apnoea

Elshaug, A.; Hiller, J.; Moss, J.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2009 Português
Relevância na Pesquisa
47.25714%
Background and objectives: Worldwide, there is increasing focus on measures to reduce ineffective healthcare practices. Upper airway surgeries for the treatment of adult obstructive sleep apnoea (OSA) represent a case-study in this area, given recent publications that draw into question their efficacy. Policy stakeholders were canvassed to assess their perspectives on this. Design and setting: Senior health policy stakeholders from Australia were criterion and snowball sampled (to identify opinion leaders). Participants were presented with preparatory material and took part in individual semistructured interviews. These focused on eliciting responses to recently published evidence and a relevant Cochrane review. Questions were posed relating to clinical effectiveness and associated policy implications. Interviews were taped and transcribed for thematic analysis. Participant comments were de-identified. Findings: Ten stakeholders were interviewed before saturation was reached. Thematic analysis highlighted participant concern with the diversity of procedures on offer, coupled with limited effectiveness (suggesting potential clinical uncertainty) and considerations therefore of resource allocation (potential opportunity cost). Stakeholders seem aware of the methodological complexities...

‣ "I know I have arthritis but I don't know what type". Understanding and knowledge of this chronic condition

Gill, T.; Hill, C.; Adams, R.; Broderick, D.; Black, J.; Taylor, A.
Fonte: BioMed Central Ltd. Publicador: BioMed Central Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2010 Português
Relevância na Pesquisa
47.421475%
Background: “Arthritis” is a common musculoskeletal condition but the knowledge of what type of arthritis people have, may be limited but may have changed over time in response to campaigns, increased awareness and improved health literacy. This paper describes people who did not know what type of arthritis they had, by a range of relevant demographic and socioeconomic variables, and assesses changes over time in the proportion of people who report having arthritis but do not know what type, using representative population surveillance data. Methods: Data were collected using the South Australian Monitoring and Surveillance System (SAMSS), a risk factor surveillance system where each month, a representative random sample of South Australians is selected from the Electronic White Pages, with interviews conducted using computer assisted telephone interviewing (CATI). Data were used for the period January 2006 to December 2008 (n = 16465) for respondents aged 18 years and over. Results: Overall, the proportion of respondents who did not know what type of arthritis they had, among people aged 18 years and over, for 2006 to 2008 was 6.5% (95% CI 6.1-6.9). When considering only those respondents reporting that they had been told by a doctor that they had arthritis...

‣ Hope and hoping in the talk of dying cancer patients

Eliott, J.; Olver, I.
Fonte: Pergamon-Elsevier Science Ltd Publicador: Pergamon-Elsevier Science Ltd
Tipo: Artigo de Revista Científica
Publicado em //2007 Português
Relevância na Pesquisa
47.186133%
Hope is the subject of increasing research and discussion within the healthcare literature. However, although deemed of vital import to patient welfare, there is little examination of how hope features within patients' speech. This qualitative study presents the discursive properties of hope as it emerged unprompted during semi-structured interviews with 28 patients in the final phase of terminal cancer recruited from the oncology clinic of the Royal Adelaide Hospital, Australia. In the context of discussions about decision-making at the end of a terminal illness, when used as a noun, hope invariably referenced the medical domain--focussing either on the objective probability of medical cure (typically taking the negative form "there is no hope"), or the subjective possession of the patient, needed to fight their disease. Positioning the patient as relatively powerless and subject to external forces, this hope was most commonly associated with absolute solutions, and life-and-death stakes. Hope as a verb emphasised the patient's active engagement in life, identifying what was good and positive for them. It was used to assign responsibility to others, to indicate and establish solidarity or agreement between the speaker and others, effectively strengthening interpersonal ties between individuals. Through hoping...

‣ The discursive properties of "hope": A qualitative analysis of cancer patients' speech

Eliott, J.; Olver, I.
Fonte: Sage Publications Inc Publicador: Sage Publications Inc
Tipo: Artigo de Revista Científica
Publicado em //2002 Português
Relevância na Pesquisa
47.454766%
The authors of this article question the usefulness of the empirico-realist search for a definitive definition of hope. Semistructured interviews on “do-not-resuscitate” issues with 23 oncology clinic outpatients were tape-recorded, transcribed, and analyzed following grounded-theory methodology and discursive analytical methodology. Twelve patients spontaneously spoke about hope as objective or subjective, a burden or a resource. Hope represented an evaluation of empirical states of affairs or the wish for desired outcomes and was a warrant for action or an excuse for inaction. It was attributed to both patient and caregiver, to individuals or situations. Hope was present or future oriented, both vulnerable and enduring. The variety of versions of hope has implications for interactions between health care workers and patients. Recognizing a taxonomy of hope might prove more useful than searching for definitions.; Jaklin Eliott ; Ian Olver; © 2002 SAGE Publications

‣ The learner’s perspective in GP teaching practices with multi-level learners: a qualitative study

Thomson, Jennifer S; Anderson, Katrina; Haesler, Emily; Barnard, Amanda; Glasgow, Nicholas
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica Formato: 10 pages
Português
Relevância na Pesquisa
47.4024%
BACKGROUND Medical students, junior hospital doctors on rotation and general practice (GP) registrars are undertaking their training in clinical general practices in increasing numbers in Australia. Some practices have four levels of learner. This study aimed to explore how multi-level teaching (also called vertical integration of GP education and training) is occurring in clinical general practice and the impact of such teaching on the learner. METHODS A qualitative research methodology was used with face-to-face, semi-structured interviews of medical students, junior hospital doctors, GP registrars and GP teachers in eight training practices in the region that taught all levels of learners. Interviews were audio-recorded and transcribed. Qualitative analysis was conducted using thematic analysis techniques aided by the use of the software package N-Vivo 9. Primary themes were identified and categorised by the co-investigators. RESULTS 52 interviews were completed and analysed. Themes were identified relating to both the practice learning environment and teaching methods used.A practice environment where there is a strong teaching culture, enjoyment of learning, and flexible learning methods, as well as learning spaces and organised teaching arrangements...

‣ Comparative Analysis of Exit Interviews and Direct Clinical Observations in Pediatric Ambulatory Care Services in Afghanistan; Int J Qual Health Care

Onishi, J.; Gupta, S.; Peters, D. H.
Fonte: Banco Mundial Publicador: Banco Mundial
Tipo: Journal Article; Journal Article
Português
Relevância na Pesquisa
47.45537%
OBJECTIVE: To assess the receiver operating curves (ROCs) for counseling in the management of common childhood diseases comparing direct observations with exit interviews. DESIGN: Eight thousand six hundred and fifty-nine randomly selected new outpatient consultations of sick children under 5 years were assessed by observation using a standardized checklist and an exit interview with their parent/guardian, taken between 2005 and 2007 from 948 health facilities in Afghanistan. The observation checklist was used as a 'gold standard' for counseling provided. MAIN MEASURE: Sensitivity, specificity and ROCs were estimated for five counseling items, including explanations of: a working diagnosis; what to do at home; possible adverse reactions to medicine; signs that require a return to the health facility; and a time to return. RESULTS: The prevalence of counseling items was relatively low (ranging from 8 to 80%), but generally increasing each year. Exit interviews had relatively low levels of sensitivity for the counseling items, ranging from 33 to 88%, with higher levels of specificity (ranging from 63 to 91%), whereas the ROCs ranged from 61 to 77%. Although ROCs varied significantly from year to year (P < 0.002 for each item), there was little difference based on the sex or type of the health provider. CONCLUSIONS: Exit interviews did not provide reliable measurements of provider performance compared with direct observations. Observations identified low prevalence of counseling tasks though increasing over time. The differences between observation and exit interviews identified significant gaps in communication...

‣ Percurso suicida: observação e análise de alterações no cotidiano do indivíduo com tentativas de suicídio; Suicidal path: observation and analysis of changes in daily life of individuals with suicide attempts

Marquetti, Fernanda Cristina; Vilarubia, Geisy Vilarubia; Milek, Glenda
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 09/09/2014 Português
Relevância na Pesquisa
47.34863%
O objetivo deste trabalho é conhecer as transformações do cotidiano no mês anterior à tentativa de suicídio dos sujeitos. Trata-se de um estudo exploratório-descritivo, composto deum mapeamento do fenômeno, abordando o local e período recortado pelo estudo. A pesquisa é de natureza qualitativa, com entrevistas semi-estruturadas com os sujeitos com tentativas desuicídio. A população estudada foram os sujeitos com tentativa de suicídio no Município de Santos/SP no período de janeiro/08 a junho09. No período e local designados, foram realizadas 8 entrevistas, dos 38 casos de tentativas de suicídio registrados. Foram analisados os resultados das entrevistas e construído um “mapa de risco de suicídio” através das variáveis de alterações do cotidiano.; The objective of this study is to understand the transformations of everyday life in the month preceding the suicide attempt of these subjects. This is a descriptive exploratory study, consisting of mapping of the phenomenon, approaching the site and cut the study period. The research is qualitative, with semi-structured interviews with the subjects with suicideattempts. The studied social group consists of individuals who attempted suicide from January/2008 to June/2009 in Santos – SP. It registered 38 cases of attempted suicide in the time and place designated and eight interviews were conducted. We analyzed the results of interviews of that group and set up a “map about suicide risk” based on the variables of their daily routine alterations.