Qualidade da atenção à saúde do idoso atenção primária: uma revisão integrativa

Objective: To investigate, through an integrative literature review, the quality of health care for the elderly in primary care. Material and Methods: Integrative literature review conducted in MEDLINE/PubMed, SciELO, LILACS and BDENF databases between April and May 2020, which generated 780 references. After removal of the duplicates and use of inclusion and exclusion criteria, the final sample consisted of 15 articles. Results: The quality of health care for the elderly in primary care was associated with potential and weaknesses that involved the availability and training of human resources, adoption of evaluation protocols, monitoring and follow-up, supply of inputs and structural variables linked to infrastructure and intersectoral support network. The effectiveness of actions to the elderly in primary care was related to the implementation of the Family Health Strategy, combined with the active action of the community health agent in the territory and the participation of the elderly in the decisions. Conclusion: Strengthening the health care of the elderly in primary care involves short, medium and long-term efforts related to education, human and material resources management, networking, and the formation of ties with the territory and the elderly person. Objetivo: Investigar, a través de una revisión integradora de la literatura, la calidad de la atención en salud del adulto mayor en atención primaria.Materiales y Métodos: Revisión bibliográfica integradora realizada en las bases de datos MEDLINE / PubMed, SciELO, LILACS y BDENF entre abril y mayo de 2020, que generó 780 referencias. Después de eliminar los duplicados y utilizar los criterios de inclusión y exclusión, la muestra final fue de 15 artículos.Resultados: La calidad de la atención en salud del adulto mayor en atención primaria se asoció con fortalezas y debilidades que involucraron la disponibilidad y formación de recursos humanos, adopción de protocolos de evaluación, seguimiento y seguimiento, suministro de insumos y variables estructurales vinculadas a la infraestructura y red de apoyo intersectorial. La efectividad de las acciones para el adulto mayor en atención primaria estuvo relacionada con la implementación de la Estrategia Salud de la Familia, combinada con el desempeño activo del agente comunitario de salud en el territorio y la participación del adulto mayor en las decisiones.Conclusión: El fortalecimiento de la atención a la salud del anciano en la atención primaria implica esfuerzos a corto, mediano y largo plazo relacionados con la educación, la gestión de los recursos humanos y materiales, el trabajo en red y la formación de vínculos con el territorio y el anciano. Objetivo: Investigar, por meio de uma revisão integrativa da literatura, a qualidade da atenção à saúde do idoso na atenção primária. Materiais e Métodos: Revisão integrativa da literatura realizada nas bases de dados MEDLINE/PubMed, SciELO, LILACS e BDENF entre os meses de abril e maio de 2020, as quais geraram 780 referências. Após remoção das duplicatas e emprego dos critérios de inclusão e exclusão a amostra final foi composta por 15 artigos. Resultados: A qualidade da atenção à saúde do idoso na atenção primária esteve associada a potencialidades e fragilidades que envolveram a disponibilidade e treinamento dos recursos humanos, adoção de protocolos de avaliação, acompanhamento e monitoramento, oferta de insumos e variáveis estruturais ligadas à infraestrutura e à rede de apoio intersetorial. A efetividade das ações à pessoa idosa na atenção primária esteve relacionada à implantação da Estratégia Saúde da Família, conjugada com a atuação ativa do agente comunitário de saúde no território e a participação do idoso nas decisões. Conclusão: Fortalecer a atenção à saúde do idoso na atenção primária envolve esforços a curto, médio e longo prazo relacionados à educação, gestão de recursos humanos e materiais, atuação em rede e a formação de vínculo com o território e a pessoa idosa.

Health Problems & Barriers to Healthcare Services for the Transgender Community in Lahore, Pakistan

Objectives: To find out the major health problems and barriers in getting health care by transgender community in Lahore, Pakistan. Methods: An analytical cross-sectional study was conducted in transgender community of Lahore from January to October 2020. The study included 214 participants from different areas of Lahore by targeting their “gurus”. Non-probability, snow-ball sampling technique was used to collect required sample size. Data was collected by using a structured questionnaire. Data were analyzed using SPSS version 23. Results were generated in form of tables and graphs. Chi square test and Fischer’s exact test were used to find out associations between health seeking behavior with their transgender status and p value was fixed as ≤ 0.05 as significant. Results: Among total 214, 78.5% were transgender females and 21.5% were transgender male. Among the common health problems were depression (56%), anxiety (59%) and genital tract ulcers (45%). About 70% transgender seek health care from government hospitals. Among total 214 participants, 70% reported that they receive poor quality of health care. The main reasons of not getting proper care is non acceptance (20.7%), feeling ashamed (28.7%), non-availability of CNIC (44.5%) and un-affordability (6.1%). Significant association of transgender female with consultation with doctors (p=0.013), seeking care at government hospitals (p =0.038) poor experience at health care facility (0.050), neglect during medical treatment (p=0.015) and feeling of discrimination during treatment (p= 0.042). Conclusion: Transgender community face physical, mental, social and reproductive health issues. About 70% trans-genders receive poor quality of health care services. Non acceptance, feeling ashamed, non-availability of CNIC and non-affordability have been reported as major barriers in getting desired health care. doi: https://doi.org/10.12669/pjms.38.1.4375 How to cite this:Manzoor I, Khan ZH, Tariq R, Shahzad R. Health Problems & Barriers to Healthcare Services for the Transgender Community in Lahore, Pakistan. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4375 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Trend Analysis of Vital Statistics in India - A Key to Improve Quality of Health Care Services and Infrastructure

Aim: The aim of this study is to assess the trends of vital statistics in India for improving the quality of health care services and infrastructure. Materials and Methods: This study was carried out to improve the quality of health care services and infrastructure by analysing the trends of vital statistics in India. The data regarding vital statistics which includes birth rate, death rate, infant mortality rate, neonatal mortality rate and total fertility rate were obtained from the year 2011-2017 using electronic sources such as sample registration system, National health profile and NITI Aayog. Results: The death rate found to be increased in various states and union territories of India. Over all the states and union territories in India Chhattisgarh, Madhya Pradesh, Odisha, Assam, Puducherry, Punjab and Uttar Pradesh has the highest death rate whereas the Nagaland, Chandigarh and Delhi has the lowest death rate. The rural areas of India have the highest number of mortality rate when compared to urban areas. Conclusion: The government of India should pay more attention to the health care services and increase the health care expenditure of the public from the Gross Domestic Product (GDP) for the beneficiaries of people. Keywords: Trend analysis, Vital statistics, India, Gross Domestic Product, Health care services, Infrastructure.

Understanding Satisfaction with Health care Services among Congolese Refugees in Bujumbura, Burundi

Background3502 Congolese refugees based in Bujumbura possess the United Nations Higher Commissioner for Refugees (UNHCR) health insurance covering primary health care needs offered by CMC SOLIS clinic. This study sought to assess the quality of health care services received by Congolese refugees and determine factors affecting satisfaction. MethodsA cross-sectional survey was conducted on 400 refugees visiting CMC SOLIS for health care from June to August 2018. A questionnaire based on SERQUAL tool composed of five health quality dimensions was used to collect data on reliability, tangibility, assurance, responsiveness, and empathy. Logistic models were used to determine factors affecting satisfaction. ResultsOverall, 43% of refugees reported satisfaction with health care services. Age and gender significantly determined overall satisfaction. Other determinants such as education did not have significant effects. ConclusionsOverall, results from this study claim that CMC SOLIS does not offer quality health care services to Congolese refugees living in Bujumbura. Most importantly, the quality of health care services worsened with an increasing age as older ages were associated with less likelihood of satisfaction. Also, health care services offered to females seem to be deficient. Trial registration: N/A

The perceptions of professional nurses regarding factors affecting the provision of quality health care services at selected rural public clinics in the Capricorn district, Limpopo Province

Background: Despite many initiatives made by the National Department of Health through the Minister of Health, the provision of quality health care services remains a serious challenge in South Africa, especially in public rural clinics.Aim: The study aims to determine the perceptions of professional nurses on the factors affecting the provision of quality health care services at selected public primary health care clinics in rural areas of the Capricorn District, Limpopo Province.Setting: The study was conducted at selected public primary health care clinics in rural areas of the Capricorn District, Limpopo Province.Methods: This study utilised a quantitative method, descriptive and a cross-sectional study conducted for three months at the selected public primary health care clinics. A structured self-administered questionnaire was used to collect data from 155 professional nurses who met the selection criteria. Data were analysed using Statistical Package for Social Sciences programme version 26.0.Results: The results of 155 professional nurses were only 116 (74%) and reported that the use of modern technology such as electronic blood pressure, sonar machines and pulse reading computers improves the quality of health care services. Also 129 (84%), 124 (77%) and 118 (76%) reported that they were overwhelmed by the workload, the staff attitude and cleanliness of the clinic, respectively, which all affect the quality of health care services rendered. Moreover, only about 29 (19%) were satisfied with the salary they earned.Conclusion: Despite the effort and interventions put in place by the Department of Health with regard to the Ideal Clinic Realisation and Maintenance in response to the current deficiencies in the quality of primary health care services and to lay a strong foundation for the implementation of National Health Insurance. The quality of health care services is still hindered by several factors such as an overwhelming workload, the attitude of the staff and cleanliness in the work environment, poor infrastructure and the professional nurses perceive the environment as lacking equipment.

Key Parameters for Healthcare Quality

Over several decades, a wealth of expertise and experience in improving the quality of health care has accrued globally. Despite this wealth of expertise, the challenge that is often faced by country level policymakers in both high- and low-medium income countries is to know which quality policies are being implemented. The goal of this report is to highlight and critically evaluate quality metrics published in the literature for healthcare establishments. Its goal is to present an integrated quality model that combines both technical and supportive quality indicators in order to reach the highest level of patient satisfaction. As some of the priorities of doctors and nurses are to improve patient satisfaction and patient care in a healthcare system Out of all the most critical criterion for evaluating the quality of service offered to the customer by a service provider is customer satisfaction. The quality of patient care and patient satisfaction can be assessed by the quality of facilities and training, the expertise of staff and the reliability of operating processes indicating that if the personal rights and working environment of health workers are not improved, the quality of health care cannot be expected to increase.

Dermatology and telemedicine: goals, advantages and disadvantages

COVID-19 pandemic has made changes to conventional health care. In view of the need for “social distancing”, telemedicine services became most in demand, which constituted a reform of the previous doctor-patient relationship format; dermatology was no exception. Increased use of teledermatology (TD) all over the world elevated the relevance of the set of challenges related to teledermatology potential and limits, particularly in the light of the expectations of the technology broader application during the post-pandemic period. The review addresses the issues related to accounting for quality of health care, understanding the social and humanitarian context of TD, as well as the impact on professional education.

A atuação do enfermeiro auditor na qualidade da assistência à saúde: revisão bibliográfica integrativa

Objetivo: descrever a atuação do enfermeiro auditor na qualidade da assistência a saúde. Método: trata-se de uma revisão integrativa de artigos publicados no período de 2015 a 2020. A pesquisa e seleção dos artigos foi realizada nas bases de dados: BEDENF, LILACS e MEDLINE, por meio dos descritores “Enfermagem”, “Auditoria de enfermagem” , “Registros de enfermagem” e “ Qualidade da assistência à saúde”. Os critérios de inclusão foram artigos online gratuitos, com textos completos, publicados de 2015 a 2020, nos idiomas português e inglês. Resultados: foram selecionados 11 artigos, por cumprirem os critérios estabelecidos no estudo. Na análise dos resultados foi possível evidenciar a importância significativa da qualidade dos registros no processo de enfermagem. Conclusão: a atuação da enfermagem na auditoria tem ganhado notoriedade nos últimos anos, por ser de grande relevância para a qualidade da assistência prestada e abranger muito mais que a gestão de custos.Palavras-chave: Enfermagem; Auditoria de enfermagem; Registros de enfermagem; Qualidade da assistência à saúde. The auditor's nurse's performance in the quality of health care: integrative bibliographic review ABSTRACTObjective: to describe the role of the nurse auditor in the quality of health care. Method: this is an integrative review of articles published from 2015 to 2020. The research and selection of articles was carried out in the databases: BEDENF, LILACS and MEDLINE, using the descriptors “Nursing”, “Nursing audit "," Nursing records "and" Quality of health care ". The inclusion criteria were free online articles, with full texts, published from 2015 to 2020, in Portuguese and English. Result: 11 articles were selected, as they meet the criteria established in the study. In the analysis of the results, it was possible to highlight the significant importance of the quality of the records in the nursing process. Conclusio: the role of nursing in the audit has gained notoriety in recent years, as it is of great relevance to the quality of care provided and covers much more than cost management.Keywords: Nursing; Nursing audit; Nursing records; Quality of health care.