Coming and going to a surgical center, the evaluation of risks in transport of patients in a university hospital in Brazil

The patient’s in-hospital transport is an activity that must be performed with safety and quality and involves considerable risks, especially for surgical patients. The objective of this study was to evaluate the adequacy or not of transport of surgical patients from inpatient units to surgical centers and vice-versa. The transport and patient profile, the nursing workload, the professionals and conditions involved were assessed for each patient (or transport), and subsequently the transports were evaluated as inadequate (some non-conformity) or adequate. The transport was inadequate in 39.3% of the evaluations. The most common non-conformities were the lack of knowledge of the transport at the patient’s destination, incorrect documents, patient alone during the route, and absence of health professional during transport (when necessary). In this institution and in the period evaluated, the transport was mainly run by porter. Patients in rout to inpatient units have higher frequency of inadequate transport, mainly because of lack of communication with the destination unit. The increase in workload, evaluated by the Santos Score, also increased the risk of having inappropriate transport (OR = 1.21, CI95%: 1.08-1.16), and when the patients were grouped in minimal care versus non-minimal care, the latter also showed higher risk of inadequate transport. When the transports were evaluated separately by route, patients going to surgical centers had a higher risk when the Santos Score increased (OR = 1.168, CI95%: 1.07-1.27), and patients going to inpatient units had a lower risk when the Santos Score increased (OR = 0.605, CI95%: 0.46-0.80). In the last case, patients with a high workload were also accompanied by health professionals. The presence of a health professional when the patient was going to an inpatient unit also decreased the risk of inadequate transport (OR = 0.011, CI95%: 0.002-0.070). The patient returning to their origin unit showed more transport non-conformities. Perhaps the reason is the discredit attributed to risk in these patients once the surgical problem was solved. Thus, it is a fact that the patient nursing workload and the route of the transport were effective in predicting the risk of inadequate transport, being of great potential for practical use.

Download Full-text

Ações educativas para identificação correta do paciente: relato de experiência

Revista Recien - Revista Científica de Enfermagem ◽

10.24276/rrecien2021.11.34.152-159 ◽

2021 ◽

Vol 11 (34) ◽

pp. 152-159

Author(s):

Gabriele Malta da Costa ◽

Paloma Vitória Serra Batista ◽

Luana Ferreira de Almeida ◽

Ronilson Gonçalves Rocha ◽

Bruna Maiara Ferreira Barreto Pires ◽

...

Keyword(s):

Patient Safety ◽

Nursing Students ◽

Health Professionals ◽

Rio De Janeiro ◽

Inservice Training ◽

University Hospital ◽

Correct Identification ◽

Patient Identification ◽

Interactive Training ◽

Inpatient Units

Relatar a experiência vivenciada por discentes e docentes de enfermagem na realização de atividades extensionistas para o aumento da adesão à identificação correta do paciente. Relato de experiencia acerca da importância da identificação correta do paciente realizadas em um hospital universitário do Estado do Rio de Janeiro de setembro de 2019 a março de 2020. Participaram profissionais de saúde, pacientes e acompanhantes. Para profissionais de saúde, foram desenvolvidos treinamentos interativos. Para pacientes e acompanhantes, elencou-se orientações acerca da importância da identificação do paciente. Realizados dezoito treinamentos, a maioria com técnicos de enfermagem (54 - 37,76%) e enfermeiros (23 - 16,08%). Alcançadas 2.050 orientações, sendo com 998 (48,68%) pacientes. As atividades ocorreram em 32 unidades de internação. Pode-se contribuir com atividades da Meta 1 de Segurança do Paciente, além de destacar a importância de Projetos de Extensão Universitária para melhor assistência. Descritores: Segurança do Paciente, Sistemas de Identificação de Pacientes, Capacitação em Serviço, Hospitais Universitários. Educational actions for correct patient identification: experience reportAbstract: To report the experience lived by nursing students and teachers in carrying out extension activities to increase adherence to the correct identification of the patient. Experience report about the importance of correct patient identification performed at an university hospital in the State of Rio de Janeiro from September 2019 to March 2020. The group of participants was health professionals, patients and companions. For health professionals, was developed interactive training. For patients and companions, guidelines were listed on the importance of patient identification. Eighteen training sessions were carried out, most with nursing technicians (54 - 37.76%) and nurses (23 - 16.08%). 2,050 guidelines were reached, with 998 (48.68%) patients. The activities took place in 32 inpatient units. It is possible to contribute to the activities of Patient Safety of Goal 1, in addition to highlighting the importance of University Extension Projects for better assistance.Descriptors: Patient Safety, Patient Identification Systems, Inservice Training, Hospital University. Acciones educativas para la identificación correcta del paciente: informe de experienciaResumen: Relatar la experiencia vivida por estudiantes y docentes de enfermería en la realización de actividades de extensión para incrementar la adherencia a la correcta identificación del paciente. Relato de experiencia sobre la importancia de la correcta identificación del paciente realizado en un hospital universitario del Estado de Rio de Janeiro de septiembre de 2019 a marzo de 2020. Participaron profesionales de la salud, pacientes y acompañantes. Para los profesionales de la salud, se desarrolló una formación interactiva. Para pacientes y acompañantes, se enumeraron pautas sobre la importancia de la identificación del paciente. Se realizaron 18 capacitaciones, la mayoría con técnicos de enfermería (54 - 37,76%) y enfermeras (23 - 16,08%). Se alcanzaron 2.050 guías, con 998 (48,68%) pacientes. Las actividades se desarrollaron en 32 unidades de internación. Es posible contribuir a las actividades de la Meta 1 de Seguridad del Paciente, además de resaltar la importancia de los Proyectos de Extensión Universitaria para una mejor atención.Descriptores: Seguridad del Paciente, Sistemas de Identificación de Pacientes, Capacitación em Servicio, Hospitais Universitarios.

Download Full-text

Reducción de la exposición en residentes de Cirugía frente al brote de COVID-19

Revista Argentina de Cirugía ◽

10.25132/raac.v112.n2.1492.es ◽

2020 ◽

Vol 112 (2) ◽

pp. 105-108

Author(s):

Agustín Morales ◽

◽

Mora Achával ◽

Juan Cruz López Meyer ◽

Carla Vega ◽

...

Keyword(s):

Human Resources ◽

Health Professionals ◽

Disease Transmission ◽

Emotional Health ◽

University Hospital ◽

Surgical Patients ◽

Academic Training ◽

Online Classes ◽

Risk Of Exposure ◽

And Shifts

The worldwide outbreak of COVID-19 during the first quarter of 2020 constitutes an unprecedented challenge for the health system. The aim is to describe the strategies adopted by residents of General Surgery of a university hospital of Argentina, to safeguard the health of residents, reduce the risk of exposure of surgical patients, maintain continuous academic training and promote teamwork. Minimize resident exposure by dividing the group into two teams that work by fortnights; divide activities, hours within hospital, and shifts equally among residents; use telemedicine for postoperative / ambulatory controls; suspend office activity; organize daily online classes and reviews of published articles. In the context of the COVID-19 pandemic, all means should be used to minimize the risk of exposure in order to optimize human resources. Although these strategies can easily be applied to other residencies, more research is needed to assess their impact on disease transmission, and on the physical and emotional health of health professionals

Download Full-text

Testing Consultation Recordings in a Clinical Setting With the SecondEars Smartphone App: Mixed Methods Implementation Study (Preprint)

10.2196/preprints.15593 ◽

2019 ◽

Author(s):

Amelia Hyatt ◽

Ruby Lipson-Smith ◽

Bryce Morkunas ◽

Meinir Krishnasamy ◽

Michael Jefford ◽

...

Keyword(s):

Health Care ◽

Mixed Methods ◽

Health Professional ◽

Clinical Setting ◽

Health Professionals ◽

Implementation Strategy ◽

Smartphone App ◽

Implementation Study ◽

Pilot Testing ◽

Effective Implementation

BACKGROUND Health care systems are increasingly looking to mobile device technologies (mobile health) to improve patient experience and health outcomes. SecondEars is a smartphone app designed to allow patients to audio-record medical consultations to improve recall, understanding, and health care self-management. Novel health interventions such as SecondEars often fail to be implemented post pilot-testing owing to inadequate user experience (UX) assessment, a key component of a comprehensive implementation strategy. OBJECTIVE This study aimed to pilot the SecondEars app within an active clinical setting to identify factors necessary for optimal implementation. Objectives were to (1) investigate patient UX and acceptability, utility, and satisfaction with the SecondEars app, and (2) understand health professional perspectives on issues, solutions, and strategies for effective implementation of SecondEars. METHODS A mixed methods implementation study was employed. Patients were invited to test the app to record consultations with participating oncology health professionals. Follow-up interviews were conducted with all participating patients (or carers) and health professionals, regarding uptake and extent of app use. Responses to the Mobile App Rating Scale (MARS) were also collected. Interviews were analyzed using interpretive descriptive methodology; all quantitative data were analyzed descriptively. RESULTS A total of 24 patients used SecondEars to record consultations with 10 multidisciplinary health professionals. In all, 22 of these patients used SecondEars to listen to all or part of the recording, either alone or with family. All 100% of patient participants reported in the MARS that they would use SecondEars again and recommend it to others. A total of 3 themes were identified from the patient interviews relating to the UX of SecondEars: empowerment, facilitating support in cancer care, and usability. Further, 5 themes were identified from the health professional interviews relating to implementation of SecondEars: changing hospital culture, mitigating medico-legal concerns, improving patient care, communication, and practical implementation solutions. CONCLUSIONS Data collected during pilot testing regarding recording use, UX, and health professional and patient perspectives will be important for designing an effective implementation strategy for SecondEars. Those testing the app found it useful and felt that it could facilitate the benefits of consultation recordings, along with providing patient empowerment and support. Potential issues regarding implementation were discussed, and solutions were generated. CLINICALTRIAL Australia and New Zealand Clinical Trials Registry ACTRN12618000730202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373915&isClinicalTrial=False

Download Full-text

Medication Experience and Adherence to Oral Chemotherapy: A Qualitative Study of Patients’ and Health Professionals’ Perspectives

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084266 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4266

Author(s):

Amparo Talens ◽

Mercedes Guilabert ◽

Blanca Lumbreras ◽

María Teresa Aznar ◽

Elsa López-Pintor

Keyword(s):

Qualitative Study ◽

Health Professionals ◽

Real Life ◽

Positive Influence ◽

Barriers And Facilitators ◽

University Hospital ◽

Nominal Group ◽

Care Plans ◽

Individualized Care ◽

Medication Experience

Lack of adherence constitutes one of the most important challenges in patients undergoing treatment with oral antineoplastic drugs (ANEO). Understanding cancer patients’ experiences with respect to their medication is key for optimizing adherence and therapeutic results. We aimed to assess the medication experience (ME) in patients with cancer in treatment with ANEO, to describe the barriers and facilitators related to the disease and its treatment and to compare them with the healthcare professionals’ perspectives. We carried out an exploratory qualitative study in the University Hospital of San Juan de Alicante, Spain. Three focus groups and two nominal group discussions were conducted with 23 onco-hematological patients treated with ANEO and 18 health professionals, respectively. The data were analyzed using content analyses and were eventually triangulated. The most impactful aspects in patients’ ME were the presence of adverse effects; lack of information about treatment; beliefs, needs and expectations regarding medications; social and family support; and the relationship with the health professionals. Both patients and professionals agreed on considering the negative side effects and the information about treatment as the main barriers and facilitators of adherence, respectively, although the approaches differed between both profiles. The professionals offered a more technical vision while patients prioritized the emotional burden and motivation associated with the disease and medication. This study allowed us to understand the real-life experiences of patients being treated with ANEO and explore the factors which had an impact on adherence to treatment. This understanding enables professionals to have a positive influence on patients’ behavior and provide individualized care plans. Pharmacists’ assistance is relevant to support patients’ adherence and self-management.

Download Full-text

PARE0005 INTEGRATED REFERRAL OF NEWLY DIAGNOSED RHEUMATOID ARTHRITIS PATIENT TO EDUCATION AND SUPPORT RESOURCES DELIVERED BY PATIENT LED ORGANISATION

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2123 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1288.1-1289

Author(s):

I. Mcnicol ◽

A. Bosworth ◽

C. Jacklin ◽

J. Galloway

Keyword(s):

Rheumatoid Arthritis ◽

Health Professional ◽

Health Professionals ◽

Quality Standard ◽

Self Management ◽

Pharmaceutical Companies ◽

National Audit ◽

Advisory Boards ◽

The Right ◽

The Impact

Background:NRAS follows best practice, evidence-based standards in all we do. Whilst huge strides have been made in the diagnosis and treatment of RA, the impact on quality of life can be significant and for many this disease remains hard to come to terms with. NRAS services and resources can improve the outcomes of people with RA/Adult JIA through a framework of supported self-management resources tailored to individual need. It is particularly important to provide the right support at the beginning of a person’s journey with RA, when unhelpful health beliefs, anxiety and incorrect information can influence how someone responds to prescribed medication and treatment thus impeding their ability to achieve the best outcomes. We know, for example, that many people do not take their medication as prescribed which reduces their chances of achieving remission or low disease activity state.Objectives:To demonstrate that by referring patients online as part of a quality improvement programme to NRAS Right Start Service, we can show improved outcomes for patients with early RA when measured by the MSKHQ. Referred patients will benefit by: a) Better understanding what RA is; b) knowing how it can affect them; c) getting the right support; d) feeling more in control; receiving a tailored pack of information that meets their personal needs; e) be able to talk to a like-minded person who has lived with RA. It’s a 4 step process which starts with the health professional referring their patient to NRAS on line. NICE Quality Standard 3 states that “Adults with rheumatoid arthritis are given opportunities throughout the course of their disease to take part in educational activities that support self-management.” Our service enables health professionals to meet their responsibilities against this national quality standard.Methods:In preparation for the introduction of this service at BSR congress 2019, an audit of the NRAS helpline service was undertaken at the end of 2018 and remains on going. Currently we have 224 responses which have been analysed against specific criteria. An Advisory Board comprising 7 clincians, from different hospitals was appointed to work with NRAS on this important research.Results:In the helpline audit, when asked ‘how concerned are you about your disease’?, alarmingly, 78% of those surveyed scored their level of concern about their disease at 7 or higher out of 10, while only 8% scored it at 5 or below. When asked about the emotional effects of their RA, 62% scored it as 7 or more where 10 was the worst possible impact. 94% of survey respondents said that they would definitely or very likely recommend NRAS and its services to another person. These results led to the development of New2RA Right Start launched in 2019, whereby health professionals across the UK can refer their patients directly to NRAS via a consented online referral which is fully GDPR compliant. To date (31stJan, 2020), we have made calls to 101 patients, from 24 referring hospitals of which 55 have been successfully completed, 34 have had information sent through the post although our helpline team were unable to speak to them, and 12 remain open. Data analysis on the service is being carried out by King’s College Hospital London, comparing the results of patients who have been referred to Right Start within the national audit who have completed a baseline and 3 month follow up MSKHQ and patients in the audit who have not participated in Right Start.Conclusion:Anecdotally, we have had a tremendous response to this service from both patients and referring health professionals. We await data from King’s on the above figures, which we will have within the next 2 months and further data, should this abstract be accepted, will be available prior to June 2020. Right Start enables health professionals to comply with QS3 above, of the NICE Quality Standards in RA, one of the key standards against which they are being audited in the NEIAA national audit. Once data and write up in a peer review journal has been published we plan to roll this service out to people with more established disease.References:[1]To be done, not included in word count.Acknowledgments:I would like to thank Ailsa Bosworth MBE, Clare Jacklin, and James GallowayDisclosure of Interests:Iain McNicol Shareholder of: GSK, Ailsa Bosworth Speakers bureau: a number of pharmaceutical companies for reasons of inhouse training, advisory boards etc., Clare Jacklin Grant/research support from: NRAS has received grants from pharmaceutical companies to carry out a number of projects, Consultant of: I have been paid a speakers fee to participate in advisory boards, in house training of staff and health professional training opportunities, Speakers bureau: Various pharma companies, James Galloway: None declared

Download Full-text

Regulating health professional scopes of practice: comparing institutional arrangements and approaches in the US, Canada, Australia and the UK

Human Resources for Health ◽

10.1186/s12960-020-00550-3 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Kathleen Leslie ◽

Jean Moore ◽

Chris Robertson ◽

Douglas Bilton ◽

Kristine Hirschkorn ◽

...

Keyword(s):

Health Professional ◽

Health Professionals ◽

Swot Analysis ◽

Institutional Arrangements ◽

Scope Of Practice ◽

Comparative Case Study ◽

Specific Reference ◽

The Public ◽

The Us ◽

The Uk

Abstract Background Fundamentally, the goal of health professional regulatory regimes is to ensure the highest quality of care to the public. Part of that task is to control what health professionals do, or their scope of practice. Ideally, this involves the application of evidence-based professional standards of practice to the tasks for which health professional have received training. There are different jurisdictional approaches to achieving these goals. Methods Using a comparative case study approach and similar systems policy analysis design, we present and discuss four different regulatory approaches from the US, Canada, Australia and the UK. For each case, we highlight the jurisdictional differences in how these countries regulate health professional scopes of practice in the interest of the public. Our comparative Strengths, Weaknesses, Opportunities, Threats (SWOT) analysis is based on archival research carried out by the authors wherein we describe the evolution of the institutional arrangements for form of regulatory approach, with specific reference to scope of practice. Results/conclusions Our comparative examination finds that the different regulatory approaches in these countries have emerged in response to similar challenges. In some cases, ‘tasks’ or ‘activities’ are the basis of regulation, whereas in other contexts protected ‘titles’ are regulated, and in some cases both. From our results and the jurisdiction-specific SWOT analyses, we have conceptualized a synthesized table of leading practices related to regulating scopes of practice mapped to specific regulatory principles. We discuss the implications for how these different approaches achieve positive outcomes for the public, but also for health professionals and the system more broadly in terms of workforce optimization.

Download Full-text

Engaging patients: how to speak so patients want to listen

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1295 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

S Rubinelli

Keyword(s):

Health Professional ◽

Lived Experience ◽

Health Information ◽

Health Professionals ◽

Health Condition ◽

Public Health Institutions ◽

Health Institutions ◽

Basic Approaches ◽

The Impact

Abstract The paternalistic approach to health professional-patient communication is often no longer successful. The main reasons for this include the fact that trust in medicine and health professionals is no longer taken for granted. In many domains, the concepts of 'expert' and 'science' are in shadow. Moreover, patients can access all sorts of health information, including information that is or seems inconsistent with the advice given by their health professionals. This talk aims to illustrate some basic approaches to communication that can enhance health professional-patient interaction. First, health professionals should consider their communication with patients as a form of persuasion. Persuasion, that does not equal manipulation, is a way to communicate that takes into consideration the knowledge, beliefs, and attitudes of interlocutors. By adopting a person-centered style, health professionals should present their advice by contextualizing it into the emotional and cognitive setting of the patients. Second, communication should consider the lived experience of patients, that is the impact that a health condition or a preventive behavior has on their quality of life and their experience of pleasure. Indeed, managing health conditions is not just applying health advice: it often demands a change in lifestyles that can negatively impact how patients live their lives. Third, health professionals should develop clear strategies to engage with information that patients find from other sources. Health professionals must ask patients if they disagree with them, and to clarify any eventual difference of opinion. The information age has positively favored a democratization of health information. Yet, it imposes that health systems care for their communication. This talk concludes by presenting main evidence from on how to reinforce hospitals, public health institutions, and health services in communication so that patients want to listen.

Download Full-text

Factors associated with the decision to prescribe and administer antipsychotics for older people with delirium: a qualitative descriptive study

BMJ Open ◽

10.1136/bmjopen-2020-047247 ◽

2021 ◽

Vol 11 (7) ◽

pp. e047247

Author(s):

Emily J Tomlinson ◽

Helen Rawson ◽

Elizabeth Manias ◽

Nicole (Nikki) M Phillips ◽

Peteris Darzins ◽

...

Keyword(s):

Decision Making ◽

Older People ◽

Health Professionals ◽

Acute Care Hospital ◽

Nursing Workload ◽

Care Hospital ◽

Antipsychotic Medications ◽

Factors Associated ◽

Multiple Factors ◽

Qualitative Descriptive

ObjectivesTo explore factors associated with decision-making of nurses and doctors in prescribing and administering as required antipsychotic medications to older people with delirium.DesignQualitative descriptive.SettingTwo acute care hospital organisations in Melbourne, Australia.ParticipantsNurses and doctors were invited to participate. Semi-structured focus groups and individual interviews were conducted between May 2019 and March 2020. Interviews were audio-recorded and transcribed verbatim. Data were analysed using thematic analysis.ResultsParticipants were 42 health professionals; n=25 nurses and n=17 doctors. Themes relating to decisions to use antipsychotic medication were: safety; a last resort; nursing workload; a dilemma to medicate; and anticipating worsening behaviours. Nurses and doctors described experiencing pressures when trying to manage hyperactive behaviours. Safety was a major concern leading to the decision to use antipsychotics. Antipsychotics were often used as chemical restraints to ‘sedate’ a patient with delirium because nurses ‘can’t do their job’. Results also indicated that nurses had influence over doctors’ decisions despite nurses being unaware of this influence. Health professionals’ descriptions are illustrated in a decision-making flowchart that identifies how nurses and doctors navigated decisions regarding prescription and administration of antipsychotic medications.ConclusionsThe decision to prescribe and administer antipsychotic medications for people with delirium is complex as nurses and doctors must navigate multiple factors before making the decision. Collaborative support and multidisciplinary teamwork are required by both nurses and doctors to optimally care for people with delirium. Decision-making support for nurses and doctors may also help to navigate the multiple factors that influence the decision to prescribe antipsychotics.

Download Full-text

Bleeding after surgery and application bleeding assessment tool to surgical patients in Hanoi Medicine University Hospital

Tạp chí Sinh lý học Việt Nam ◽

10.54928/vjp.v25i2.17 ◽

2021 ◽

Vol 25 (2) ◽

pp. 94-101

Author(s):

Thi Minh Khue Nguyen ◽

Quang Tung Nguyen

Keyword(s):

Predictive Value ◽

Assessment Tool ◽

Bleeding Risk ◽

University Hospital ◽

Surgical Patients ◽

Risk Of Bleeding ◽

Patients At Risk ◽

Abnormal Bleeding ◽

Medical University ◽

Bleeding History

Objectives: Describe bleeding characteristics and evaluate the correlation between surgical-related bleeding and bleeding risk according by ISTH – BATs. Methods: Research was conducted on 340 surgical patients at Hanoi Medical University Hospital. Results: The percentage of patients with bleeding during and after surgery is 13.5%. The proportion of patients at risk of bleeding according to BATs is 1.8%. There was a correlation between bleeding risk according to ISTH - BAT with bleeding status during and after surgery with p = 0.004. The positive predictive value of ISTH - BATs is 66.7%, negative predictive value is 87.4%, the sensitivity is 8.7%, the specificity is 99.3%. Conclusions: Surgery has a high risk of abnormal bleeding. Bleeding history has important implications in assessing bleeding risk during and after surgery. The ISTH - BATs is a bleeding history assessment tool that can be used to assess the risk of bleeding before surgery.

Download Full-text

Sexual history taking in primary care

Practice Nursing ◽

10.12968/pnur.2021.32.8.308 ◽

2021 ◽

Vol 32 (8) ◽

pp. 308-311

Author(s):

Sarah Kipps

Keyword(s):

Primary Care ◽

Sexual Health ◽

Health Professional ◽

Health Professionals ◽

Sexual History ◽

History Taking ◽

Medical Assessment ◽

Men And Women ◽

Sexual History Taking ◽

The Subject

Sexual history can be neglected in a routine nursing or medical assessment. Sarah Kipps gives tips to assist in making a sexual history taking session as comfortable as possible for both health professional and patient Practitioners in primary care are in a unique position to improve the sexual health of men and women. They can do this by introducing the topic of sexual health into their everyday consultations and thereby normalising the subject as part of routine health for the patient. There is evidence that health professionals find sexual history taking to be one of the more challenging aspects of a consultation. There are a number of different reasons for this: feeling not equipped to ask questions of such a sensitive nature; fear of opening a ‘can of worms’ which cannot be dealt with; and the general social embarrassment and difficulties experienced talking about sex in general. This article will give health professionals some tips and guides to assist in making a sexual history taking session as comfortable as possible for both health professional and patient.

Download Full-text