scholarly journals Adult vaccination in Brazil: a cross-sectional survey on physicians’ prescription habits

Author(s):  
Fernando B Serra ◽  
Diogo Ribeiro ◽  
Paula M Batista ◽  
Thais N F Moreira

ABSTRACTOBJECTIVETo characterize adult and older adult vaccination practices of physicians from various medical specialties in Brazil, identify the barriers influencing prescription of vaccines to these populations, and evaluate the physicians’ knowledge on routinely prescribed vaccines.METHODSCross-sectional survey conducted in Brazil between June-August 2018. Eligible physicians included those from general practice/family medicine, geriatrics, cardiology, gynecology, endocrinology, infectious disease and pulmonology. The survey’s questions addressed the physicians’ prescription habits, sociodemographic and clinical practice characteristics, barriers to vaccines’ prescription to adult and older adult patients, and physicians’ knowledge regarding routinely prescribed vaccines. The study focused on the vaccines recommended by the Brazilian Society of Immunization (SBIm) for adults and older adults. Study sample was stratified according to the number of physicians per specialty and Brazilian region.RESULTSA total of 1068 surveys were completed. The vaccines prescribed by the highest proportions of physicians were Influenza (>90% of physicians for adults and older adults), Hepatitis B (adults: 87%; older adults: 59%) and Yellow Fever (adults: 77.7%; older adults: 58.5%). Underprescription was reported by less than 20% of prescribing physicians for all adult and older adult recommended vaccines. The most common barriers to vaccination were the high vaccine cost, lack of time during appointments and lack of patient interest. Knowledge on target populations, dosage schedule and availability in the Unified Public Health System (SUS) was generally low.CONCLUSIONSThe results showed a considerable variability of prescribing habits across recommended vaccines and medical specialties. Although most prescribing physicians seem to be aware of the importance of adult and older adults vaccination, knowledge deficits on vaccines’ target populations, dosage schedule and availability in the SUS may hamper their ability to prescribe vaccines to all patients with an indication.

2019 ◽  
Vol 15 (1) ◽  
pp. 10-16
Author(s):  
Shreyan Kar ◽  
Tushar Kanti Das ◽  
Prasanta Kumar Mohapatra ◽  
Brajaballav Kar ◽  
Anupama Senapati ◽  
...  

Background: While it is apparent that old age is associated with multiple health concerns, the extent of its multiplicity and burden is often not clear. It was intended to find out self-reported health concerns for one month and cardiovascular risk factors in middle and older adults. Methods: In the cross-sectional survey, attendees of a Healthy Ageing Conference were approached with a semi-structured questionnaire about their health concerns and cardiovascular risks. Risk of a cardiovascular event in 10 years based on QRISK3 was calculated. Results: A considerable proportion of older adults had a range of physical symptoms, depressive mood state and memory problems. Mean number of health problems reported were 4.8±3.3 (male 4.4±3.1 and female 5.0±4.3). Cardiovascular risk was high, mean QRISK3 score for males were 22.2% (±14.4), and for females 10.3% (±6.6) (p<0.05). On average, the heart age was increased by 7.9±6.2 years (8.6±6.6 years for males and 5.0±3.3 for females). The relative risk of participants was 2.1 for males and 1.5 for females for heart attack or stroke within the ten years, compared to healthy persons. The symptoms and risk factors were elicited easily, and the process probably facilitated improving the awareness about the health concerns holistically. The survey also identified issues related to the engagement of older adults in the existing health care systems. Conclusions: The results suggested that questionnaire-based health screening in a community can identify a range of health concerns and identify multi-morbidity in general and cardiovascular risks in particular. This process may help to focus on the appropriate public health awareness and intervention programmes required in the community.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Suleyman Utku Celik ◽  
Alperen Aslan ◽  
Eylul Coskun ◽  
Beyza Nur Coban ◽  
Zeynep Haner ◽  
...  

Abstract Background Burnout resulting from long-term and unmanaged workplace stress is high among healthcare professionals, especially surgeons, and affects both individuals and the quality of patient care. The objective of this study was to determine the prevalence and associated factors for burnout among attending general surgeons and to identify possible preventive strategies. Methods A national cross-sectional survey using a 35-item questionnaire was conducted among members of the Turkish Surgical Society. The survey evaluated demographics, professional and practice characteristics, social participation, and burnout as well as interventions to deal with burnout. Burnout was defined as a high score on the emotional exhaustion (EE) and/or depersonalization (DP) subscales. Surgeons with high scores on both the EE and DP and a low score on personal accomplishment (PA) were considered to have severe burnout. Results Six hundred fifteen general surgeons completed the survey. The median EE, DP, and PA scores were 34 (IQR, 20–43), 9 (IQR, 4–16), and 36 (IQR, 30–42), respectively. Overall, the prevalence of burnout and severe burnout were 69.1 and 22.0%, respectively. On multivariable analysis, factors independently associated with burnout were working in a training and research hospital (OR = 3.34; P < 0.001) or state hospital (OR = 2.77; P = 0.001), working ≥ 60 h per week (OR = 1.57; P = 0.046), and less frequent participation in social activities (OR = 3.65; P < 0.001). Conclusions Burnout is an important problem among general surgeons with impacts and consequences for professionals, patients, and society. Considering that burnout is a preventable condition, systematic efforts to identify at-risk populations and to develop strategies to address burnout in surgeons are needed.


BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017757 ◽  
Author(s):  
Ingrid Hjulstad Johansen ◽  
Valborg Baste ◽  
Judith Rosta ◽  
Olaf G Aasland ◽  
Tone Morken

ObjectivesThe aim of this study was to investigate whether reported prevalence of experienced threats, real acts of violence and debilitating fear of violence among Norwegian doctors have increased over the last two decades.DesignRepeated cross-sectional survey.SettingAll healthcare levels and medical specialties in Norway.ParticipantsRepresentative samples of Norwegian doctors in 1993 (n=2628) and 2014 (n=1158).Main outcome measuresRelative risk (RR) of self-reported prevalence of work-time experiences of threats and real acts of violence, and of being physically or psychologically unfit during the last 12 months due to fear of violence, in 2014 compared with 1993, adjusted by age, gender and medical specialty.ResultsThere were no differences in self-reported threats (adjusted RR=1.01, 95% CI 0.95 to 1.08) or real acts (adjusted RR=0.90, 95% CI 0.80 to 1.03) of violence when comparing 2014 with 1993. The proportion of doctors who had felt unfit due to fear of violence decreased from 1993 to 2014 (adjusted RR=0.53, 95% CI 0.39 to 0.73). Although still above average, the proportion of doctors in psychiatry who reported real acts of violence decreased substantially from 1993 to 2014 (adjusted RR=0.75, 95% CI 0.60 to 0.95).ConclusionsA substantial proportion of doctors experience threats and real acts of violence during their work-time career, but there was no evidence that workplace violence has increased over the last two decades. Still, the issue needs to be addressed as part of the doctors’ education and within work settings.


2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Lori Suet Hang Lo ◽  
Linda Yin King Lee ◽  
Irene Yuen Fung Wong ◽  
Yuen Yan Lai ◽  
Hoi Tong Au ◽  
...  

Globally, in-home drug-storage compliance is often unsatisfactory, especially among older adults, and can lead to negative health outcomes. This study used a cross-sectional and descriptive design to examine in-home drug-storage compliance among older adults. Convenience sampling was used to recruit 117 older adults in Hong Kong. An in-home drug-storage checklist was used to assess the in-home drug-storage environments (light, temperature, and humidity) and drug-storage methods (drug safety, packaging, information, and expiration) of each older adult. The findings showed that Hong Kong older adults’ overall compliance rate in drug storage was 87.25%, and their compliance rate for drug-storage methods (84.59%) was lower than that for drug-storage environments (97.02%). Older adults who were of advanced age, who were less educated or who lived alone demonstrated lower in-home drug-storage compliance. This indicates the need to revise existing health-education strategies to encourage in-home drug-storage compliance. Healthcare professionals should assess older adults’ drug-storage compliance to identify less compliant subgroups and deliver specific drug-storage support as required. Family members should also be involved in this process.


2021 ◽  
Vol 9 ◽  
Author(s):  
Rie Suzuki ◽  
Jennifer Blackwood ◽  
Noah J. Webster ◽  
Shailee Shah

Older adults with functional limitations (FLs) often experience obstacles to walking. Although health promotion programs targeting physical activity are available in lower-income areas, few studies have compared the walking experiences of older adults who have FLs with those who do not in the community. The purpose of this cross-sectional survey was to compare perceptions of neighborhood walkability among older adults living in lower-income communities with and without FLs. Participants (N = 132) were recruited in 2018 at regional health clinics in Flint, Michigan. To be eligible, participants had to be 65 years of age or older, report no cognitive decline, and be Flint residents. Of the 132 participants, the mean age was 69.74 (SD = 4.97). The majority were female (66%); African American (77%); single, divorced, or widowed (72%); educated below the General Education Development level (57%), and had a FL (67%). Older adults with FLs were significantly (p &lt; 0.05) less likely than those without to visit many places within walking distance, to have well-lit neighborhoods at night, and to reside in neighborhoods where sidewalks were separated from the road and traffic. Multiple regression analyses revealed that having a FL was associated with poorer neighborhood perceptions of mixed-land-use (b = −0.19, p &lt; 0.05) and more walking hazards (b = −0.26, p &lt; 0.05). Findings suggest that a FL is associated with perceptions of walkability. It is essential to develop disability-friendly support systems and accommodations to encourage walking in lower-income communities.


2021 ◽  
Author(s):  
Kristen R. Haase ◽  
Theodore Cosco ◽  
Lucy Kervin ◽  
Indira Riadi ◽  
Megan E. O'Connell

BACKGROUND Technology has become the most critical approach to maintain social connectedness during the COVID-19 pandemic. Older adults (over age 65) are perceived as most physiologically vulnerable to COVID-19 and at risk of secondary mental health challenges related to social isolation imposed by virus containment strategies. To mitigate concerns regarding sampling bias we used a random sampling of older adults to understand uptake and acceptance of technologies to support socialization during the pandemic. OBJECTIVE To conduct a random population-based assessment of the barriers and facilitators to engaging in technology use for virtual socialization amongst older adults in the Canadian province of British Columbia during the COVID-19 pandemic. METHODS We conducted a cross-sectional population-based survey using random-digit dialing to participants over age 65 living in British Columbia. Data were analyzed using SPSS, with open-text responses analyzed using thematic analysis. RESULTS Respondents included 400 older adults with an average age of 72 years old and 63.7% female. Most respondents (89.5%) were aware of how to use technology to connect with others and slightly more than half (56%) reported using technology differently to connect with others during the pandemic. 55.9% of respondents reported adopting new technology since the beginning of the pandemic. Older adults reported key barriers to using technology including: (1) lack of access (including finance, knowledge, and age); (2) lack of interest (including a preference for telephone, and a general lack of interest in computers); and (3) physical barriers (resultant of cognitive impairments, stroke, and arthritis). Older adults reported numerous facilitators, including: (1) knowledge of technologies (whether self-taught or via external courses); (2) reliance on others (family, friends, and general internet searching); (3) technology accessibility (including environments, user-friendly technology, and receiving clear instructions); and (4) social motivation (because everyone else is doing it). CONCLUSIONS Much data on older adults use of technology is limited by sampling biases, but the current study that used random sampling demonstrated that older adults used technology to mitigate social isolation during the pandemic. Virtual socialization is most promising to mitigate potential mental health effects related to virus containment strategies. Addressing barriers by mobilizing telephone training and task lists, and mobilizing facilitators described by participants such as facilitated socialization activities are important strategies that can be implemented within and beyond the pandemic to bolster the mental health needs of older adults.


2019 ◽  
Vol 15 (6) ◽  
pp. 761-766 ◽  
Author(s):  
Caroline Sirois ◽  
Carlotta Lunghi ◽  
Marie-Laure Laroche ◽  
Alicia Maheux ◽  
Anissa Frini

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