scholarly journals Development of an index to assess Covid-19 hospital care installed capacity in the 450 Brazilian Health Regions

Author(s):  
Claudia C. A. Pereira ◽  
Fernando Soares ◽  
Gustavo Frio ◽  
Carla Machado ◽  
Layana Alves ◽  
...  

Objective: We assessed the Brazilian health system's ability to respond to the challenges imposed by the Covid-19 pandemic considering hospital capacity in the 450 Health Regions of the country in 2020. Hospital capacity referred to the availability of hospital beds, equipment, and human resources. Methods: Data came from National Register of Health Facilities on the availability of Covid-19 resources in inpatient facilities from January to December,2020. Assessed resources were health professionals, hospital beds, and medical equipment. A synthetic indicator, Installed Capacity Index (ICI) was calculated using Principal Component Analysis. Results: There was an increase in all selected indicators between January and December 2020. We observed differences between the Northeast, North regions, and the other regions of the country. Most Health Regions presented low ICI. The ICI increased especially in regions with considerably high baseline capacity in January 2020. The Northeast and North had a higher concentration of low ICI regions. Conclusion: The information here provided may be used by health authorities, providers, and managers in planning and adjusting for future Covid-19 care and in dimensioning the adequate supply of hospital beds, health care professionals, and devices in Health Regions to reduce associated morbidity and mortality.

1997 ◽  
Vol 3 (1) ◽  
pp. 1-22 ◽  
Author(s):  
D. R. Elford

The University Hospital of Tromso has been involved in a variety of telemedicine activities since the late 1980s, including teleradiology, telepathology, teledermatology, remote endoscopy, remote gastroscopy, teleechocardiography, transmission of electrocardiograms, telepsychiatry, electronic delivery of laboratory results and distance learning for health professionals. Since 1993 the department of telemedicine in Tromsl has been designated the national centre of competence in telemedicine. With a wealth of experience to draw from, a critical number of health-care professionals exposed to and using telemedicine routinely, the support of the Norwegian health authorities, a national centre guiding telemedicine research, no licensing barriers within the country, nationwide ISDN and reimbursement for telemedicine services, the future of telemedicine in Norway looks promising.


BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Linda Messineo ◽  
Luciano Seta ◽  
Mario Allegra

Abstract Background The efficient management of relational competences in healthcare professionals is crucial to ensuring that a patient’s treatment and care process is conducted positively. Empathy is a major component of the relational skills expected of health professionals. Knowledge of undergraduate healthcare students’ empathic abilities is important for educators in designing specific and efficient educational programmes aimed at supporting or enhancing such competences. In this study, we measured first-year undergraduate nursing students’ attitudes towards professional empathy in clinical encounters. The students’ motivations for entering nursing education were also evaluated. This study takes a multi-method approach based on the use of qualitative and quantitative tools to examine the association between students’ positive attitudes towards the value of empathy in health professionals and their prosocial and altruistic motivations in choosing to engage in nursing studies. Methods A multi-method study was performed with 77 first-year nursing students. The Jefferson Scale of Empathy (JSE) – Health Professions Student Version was administered. Students’ motivations for choosing nursing studies were detected through an open question and thematically analysed. Using explorative factor analysis and principal component analysis, a dimensional reduction was conducted to identify subjects with prosocial and altruistic motivations. Finally, linear models were tested to examine specific associations between motivation and empathy. Results Seven distinct themes distinguishing internal and external motivational factors were identified through a thematic analysis of students’ answers regarding their decision to enter a nursing degree course. Female students gained higher scores on the empathy scale than male ones. When students’ age was considered, this difference was only observed for younger students, with young females’ total scores being higher than young males'. High empathy scores were positively associated with altruistic motivational factors. A negative correlation was found between external motivational factors and the scores of the Compassionate Care subscale of the JSE. Conclusions Knowing the level of nursing students’ empathy and their motivational factors for entering nursing studies is important for educators to implement training paths that enhance students’ relational attitudes and skills and promote the positive motivational aspects that are central to this profession.


2001 ◽  
Vol 11 (4) ◽  
pp. 373-378 ◽  
Author(s):  
H Gentles ◽  
J Potter

The National Bed Inquiry indicated that up to 20% of older people might be inappropriately occupying acute hospital beds and could be discharged if alternative services were available. The report proposed the concept of ‘Intermediate Care’ as a scenario that might contribute to resolving issues around the use of acute hospital beds. The Department of Health (DoH) Circular to Health Authorities and Local Councils with regard to Intermediate Care and the publication of the National Service Framework for Older People have brought intermediate care into mainstream health policy.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masaki Kobayashi ◽  
Mio Ito ◽  
Yasuyuki Iwasa ◽  
Yoshiko Motohashi ◽  
Ayako Edahiro ◽  
...  

Abstract Background The prevalence of oral diseases in people with dementia has increased, and patients with dementia have worse oral health than people without dementia. However, in the provision of oral care, these patients often exhibit care-resistant behaviours. Empathy is important for health care professionals who provide dental care for people with dementia. A study was conducted to assess whether a multimodal comprehensive care methodology training programme, Humanitude™, was associated with an improvement in empathy for people with dementia among oral health care professionals. Methods This research was a pre-post prospective study. A total of 45 dentists and dental hygienists participated in a 7-h multimodal comprehensive care methodology training programme. Participants’ empathy for their patients was evaluated with the Jefferson Scale of Physician Empathy-Health Professionals Version (JSPE-HP) before the training and 1 month after the training (primary outcome). Each participant listed 3 patients with poor oral health due to the refusal of usual oral care or dental treatment from his or her clinical practice. The oral health of the 3 care-resistant patients listed by each participant was evaluated by the Oral Health Assessment Tool (OHAT) before the training and 1 month after the training (secondary outcome). Results The post-training response rate was 87% (21 dentists and 18 dental hygienists). From pre-training to post-training, the multimodal comprehensive care methodology training significantly increased the mean empathy score (from 113.97 to 122.95, P < 0.05, effect size = 0.9). Regardless of gender, profession and years of clinical experience, all post-training subgroup scores were higher than the pre-training subgroup scores. The tongue, natural teeth, and oral hygiene scores of patients with dementia who resisted usual oral care or dental treatment, as assessed by the OHAT, were significantly improved compared with those before the training. Conclusions The multimodal comprehensive care methodology training was associated with an improvement in oral health professionals’ empathy for patients with dementia. These findings suggest that randomized controlled trials with large sample sizes will be needed. Trial registration UMIN Clinical Trials Registry (UMIN-CTR), UMIN000041687. Registered 4 September 2020 – Retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047586


2004 ◽  
Vol 2 (4) ◽  
pp. 371-378 ◽  
Author(s):  
ELIZABETH GRANT ◽  
SCOTT A. MURRAY ◽  
MARILYN KENDALL ◽  
KIRSTY BOYD ◽  
STEPHEN TILLEY ◽  
...  

Objective: Health care professionals and policy makers acknowledge that spiritual needs are important for many patients with life-limiting illnesses. We asked such patients to describe their spiritual needs and how these needs may impinge on their physical, psychological, and social well-being. Patients were also encouraged to explain in what ways their spiritual needs, if they had any, could be addressed.Methods: We conducted two qualitative interviews, 3 months apart, with 20 patients in their last year of life: 13 patients with advanced cancer and 7 with advanced nonmalignant illness. We also interviewed each patient's general practitioner. Sixty-six interviews were tape-recorded, transcribed, and analyzed.Results: Patients' spiritual needs centered around their loss of roles and self-identity and their fear of dying. Many sought to make sense of life in relation to a nonvisible or sacred world. They associated anxiety, sleeplessness, and despair with such issues, which at times resulted in them seeking support from health professionals. Patients were best able to engage their personal resources to meet these needs when affirmed and valued by health professionals.Significance of results: Enabling patients to deal with their spiritual needs through affirmative relationships with health professionals may improve quality of life and reduce use of health resources. Further research to explore the relationship between spiritual distress and health service utilization is indicated.


2018 ◽  
Vol 5 (2) ◽  
pp. 67-73
Author(s):  
Inês Stafin ◽  
Virgílio Ribeiro Guedes ◽  
Seyna Ueno Rabelo Mendes

RESUMO Introdução: O diagnóstico da hanseníase ainda causa grande impacto social, tanto por ser frequentemente tardio e evoluir com sequelas, quanto pelos estigmas que a envolvem. O Brasil persiste como uma área endêmica e possui o segundo lugar em número de casos da doença no mundo. Já o Tocantins é um dos estados com maior endemicidade no país, com um aumento importante no número de diagnósticos em menores de 15 anos e no número de pessoas diagnosticadas com incapacidade grau II. Metodologia: Trata-se de uma revisão de literatura do tipo narrativa, realizada por meio de publicações sobre as ações estratégicas para o diagnóstico precoce de hanseníase, entre o período de 2012 a 2017. Desenvolvimento: A situação atual da hanseníase demonstra a persistência da transmissão, a carência de ações para o seu controle efetivo, a sub detecção e um diagnóstico tardio dessa patologia. O presente artigo aborda as principais ações estratégicas para a realização do diagnóstico precoce da hanseníase, bem como os métodos diagnósticos importantes, proporcionando um maior auxílio aos profissionais de saúde da atenção primária. Considerações finais: Para que se amplie o diagnóstico precoce de forma adequada é essencial a busca e avaliação dos contatos, a qualificação adequada dos profissionais de saúde, a educação em saúde da população e a participação ativa dos gestores.   Palavras-chave: Hanseníase; diagnóstico precoce; estratégias; atenção primária. ABSTRACT Introduction: The diagnosis of leprosy still causes great social impact, both because it is often late and evolves with sequelae, and because of the stigmas that surround it. Brazil persists as an endemic area and has the second largest number of cases of the disease in the world. The state of Tocantins represents one of the areas with high endemicity in the country, with a significant increase in the number of diagnoses in children under 15 years and in the number of people diagnosed with disability grade II. Methodology: This is a literature review of the narrative type, carried out through publications on strategic actions for the early diagnosis of leprosy, between the period of 2012 to 2017. Development: The current situation of leprosy shows the persistence of transmission, lack of actions for effective control, sub detection and a late diagnosis of this pathology. This article discusses the main strategic actions for the early diagnosis of leprosy, as well as the important diagnostic methods, providing greater assistance to primary health care professionals. Final considerations: In order to increase the early diagnosis in an adequate way, it is essential the search and evaluation of contacts, the adequate qualification of health professionals, the health education of the population and the participation of managers. Keywords: Leprosy; early diagnosis; strategies; primary care.


2018 ◽  
Vol 36 (4) ◽  
pp. 506-510 ◽  
Author(s):  
Eugene Y H Tang ◽  
Christopher Price ◽  
Blossom C M Stephan ◽  
Louise Robinson ◽  
Catherine Exley

Abstract Background Memory and cognitive deficits post stroke are common and associated with increased risk of future dementia. Rehabilitation tends to focus on physical recovery; however, once in the community, it is unclear what happens in the longer term to the stroke-survivor with new memory difficulties. Objective The aim of this qualitative study was to examine in stroke-survivors what factors influence contact with health professionals. Method Semi-structured interviews were conducted with stroke-survivors and their family carers where memory difficulties were reported at 6 months post stroke. A topic guide was used which sought to critically examine participants care experience following their stroke diagnosis. All participants were interviewed at baseline (around 6 months post stroke) and offered an interview at around 12 months post stroke. All interviews were conducted in the North East of England. All transcripts were coded and thematically analysed. Results Ten stroke-survivors (age range 72–84 years) were interviewed alongside five carers at baseline; eight stroke-survivors and four carers agreed to a follow-up interview. Three main barriers were identified: (i) fear of a dementia diagnosis; (ii) denial or minimization of symptoms leading to adaptation and (iii) obstacles to seeking help in the community. Conclusions With an ageing population and increase in stroke-survival, the burden of post-stroke cognitive impairment and dementia will only increase. Stroke-survivors and their family carers in this study have identified issues that may hinder their presentation to health care professionals at a personal and organizational level. Health professionals need to be aware of these potential issues when planning services for stroke-survivors.


2019 ◽  
Author(s):  
Miguel Ángel Amor-García ◽  
Roberto Collado-Borrell ◽  
Vicente Escudero-Vilaplana ◽  
Alejandra Melgarejo-Ortuño ◽  
Ana Herranz-Alonso ◽  
...  

BACKGROUND The large number of available cancer apps and their impact on the population necessitates a transparent, objective, and comprehensive evaluation by app experts, health care professionals, and users. To date, there have been no analyses or classifications of apps for patients with genitourinary cancers, which are among the most prevalent types of cancer. OBJECTIVE The objective of our study was to analyze the quality of apps for patients diagnosed with genitourinary cancers using the Mobile Application Rating Scale (MARS) and identify high-quality apps. METHODS We performed an observational cross-sectional descriptive study of all smartphone apps for patients diagnosed with genitourinary cancers available on iOS and Android platforms. In July 2019, we searched for all available apps for patients with genitourinary cancers (bladder, prostate, cervical, uterine, endometrial, kidney, testicular, and vulvar) or their caregivers. Apps were downloaded and evaluated, and the general characteristics were entered into a database. The evaluation was performed by 2 independent researchers using the MARS questionnaire, which rates 23 evaluation criteria clustered in 5 domains (Engagement, Functionality, Esthetics, Information, and Subjective Quality) on a scale from 1 to 5. RESULTS In total, 46 apps were analyzed. Of these, 31 (67%) were available on Android, 6 (13%) on iOS, and 9 (20%) on both platforms. The apps were free in 89% of cases (41/46), and 61% (28/46) had been updated in the previous year. The apps were intended for prostate cancer in 30% of cases (14/46) and cervical cancer in 17% (8/46). The apps were mainly informative (63%, 29/46), preventive (24%, 11/46), and diagnostic (13%, 6/46). Only 7/46 apps (15%) were developed by health care organizations. The mean MARS score for the overall quality of the 46 apps was 2.98 (SD 0.77), with a maximum of 4.63 and a minimum of 1.95. Functionality scores were quite similar for most of the apps, with the greatest differences in Engagement and Esthetics, which showed acceptable scores in one-third of the apps. The 5 apps with the highest MARS score were the following: “Bladder cancer manager,” “Kidney cancer manager,” “My prostate cancer manager,” “Target Ovarian Cancer Symptoms Diary,” and “My Cancer Coach.” We observed statistically significant differences in the MARS score between the operating systems and the developer types (<i>P</i>&lt;.001 and <i>P</i>=.01, respectively), but not for cost (<i>P</i>=.62). CONCLUSIONS MARS is a helpful methodology to decide which apps can be prescribed to patients and to identify which features should be addressed to improve these tools. Most of the apps designed for patients with genitourinary cancers only try to provide data about the disease, without coherent interactivity. The participation of health professionals in the development of these apps is low; nevertheless, we observed that both the participation of health professionals and regular updates were correlated with quality.


2021 ◽  
Vol 26 ◽  
Author(s):  
Iram Osman ◽  
Shaista Hamid ◽  
Veena S. Singaram

Background: During the coronavirus disease 2019 (COVID-19) pandemic, health professionals were pushed to the front line of a global health crisis unprepared and resource constrained, which affected their mental well-being.Aim: This study aimed to investigate the effectiveness of a brief online mindfulness-based intervention (MBI) on stress and burnout for health professionals training and working in South Africa during the COVID-19 crisis.Setting: The context of the study is the overburdened, under-resourced health care system in South Africa during a global pandemic.Methods: A mixed method framework was adopted for this study. The quantitative data was analysed using descriptive analysis and the participants’ qualitative experiences were interpreted using interpretative phenomenological analysis.Results: Forty-seven participants took part in this study. The study found a statistically significant (p 0.05) reduction in stress levels and emotional exhaustion as well as an increase in mindful awareness and feelings of personal accomplishment after the intervention. The participants’ shared experiences were analysed in two parts. The pre-intervention analysis presented with central themes of loss of control and a sense of powerlessness because of COVID-19. The post-intervention analysis comprised themes of a sense of acquired control and empowerment through increased mindfulness.Conclusions: The study found that a brief online MBI can be associated with reduced levels of stress and burnout as well as an increased sense of control and empowerment, felt both personally and professionally, during a global crisis.Contribution: The impact of an online MBI for health care professionals amidst a pandemic has not been previously documented.


2019 ◽  
Vol 51 (1) ◽  
pp. 22-30 ◽  
Author(s):  
Diana Wu ◽  
Lamercie Saint-Hilaire ◽  
Andrew Pineda ◽  
Danielle Hessler ◽  
George W. Saba ◽  
...  

Background and Objectives: Health professionals increasingly recognize the role that social determinants play in health disparities. However, little focus is placed on how health care professionals themselves contribute to disparities through biased care. We have developed a curriculum based on an antioppression framework which encourages health professionals to evaluate their biases and combat health care disparities through an active process of allyship. Methods: Teaching methods emphasize skill building and include lectures, guided reflections, and facilitated discussions. Pre- and postsurveys were administered to assess participants’ confidence level to recognize unconscious bias and to be an ally to colleagues, patients, and staff. In total, we conducted 20 workshops with a total of 468 participants across multiple disciplines. Results: The survey response rate was 80%. Using a paired t-test, the mean difference in the pre- and postsurveys revealed a statistically significant improvement across all measures. Participants showed the greatest improvements (large effect size d&gt;0.8) in their understanding of the process of allyship, their ability to describe strategies to address, assess, and recognize unconscious bias, and their knowledge of managing situations in which prejudice, power, and privilege are involved. Conclusions: Results show that an antioppression curriculum can enhance health professionals’ confidence in addressing bias in health care through allyship. For those who value social justice and equity, moving from the role of bystander to a place of awareness and solidarity allows for one’s behaviors to mirror these values. Allyship is an accessible tool that all health professionals can use in order to facilitate this process.


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