Interprofessional Education: Perception of Professors and Students of Nursing, Physiotherapy, and Medicine Courses

Background The problems for training in interprofessional education (IPE) of health professionals for this new century are systemic: limitation in competencies for teamwork, persistent stratification of gender relations in the status of health workers, a focused emphasis on technical skills, difficulty in analysis and understanding of broader problematic issues of the context, sporadic instead of continuous care, quantitative and qualitative imbalances in the professional labor market, and fragility in leadership skills to improve the performance of the health system. This study evaluated the perception of students and teachers of health area courses at a private university in São Paulo regarding interprofessional education. Methods A sociodemographic questionnaire to delineate the participants’ profile and the RIPLS questionnaire that assesses the attitudes and perceptions of students and professionals to determine their readiness for interprofessional learning were applied. RIPLS is proposed to measure the change in attitudes, the effects of different interventions, and the effectiveness of interventions in changing attitudes and perceptions. Results The main results were that training in Medicine and Nursing is easier for interprofessional education than that in Physiotherapy. By comparing the perception of the academic community regarding gender, we find that participating women are more available for teamwork and collaborative practices. Conclusion To improve the perception of students and teachers in collaborative practice, the need for a teacher training program on IPE principles and an early and more frequent insertion of IPE practices in the curricula of courses is evident.

Congenital Zika Virus Syndrome: care in light of the Brazilian Unified Health System principles

ABSTRACT Objective: to know health professionals’ perceptions about care actions provided to children with Congenital Zika Virus Syndrome and their families. Methods: this is a qualitative study, carried out in a capital of center-western Brazil, based on the Unified Health System theoretical precepts. Data were collected in September and October 2020, through audio-recorded interviews with 12 health professionals from a specialized service and submitted to analysis of content, thematic modality. Results: the implementation of care actions with these children occurs through multidimensional assessment of children and their families, use of the Unique Therapeutic Project, therapeutic interventions for the development of children and the communication and exchange of interprofessional and family experiences, in addition to considering professionals’ prior knowledge and their search for it. Final considerations: children with CZS and their families need individualized, frequent, integrated and continuous care.

Feasibility of remote technical support for electrophysiological ablation procedures during the current CoVid-19 pandemic

The treatment of heart rhythm disorders has been significantly impacted by direct consequences of the current CoVid-19 pandemic, as well as by restrictions aimed towards constraining viral spread. Usually, catheter ablations of cardiac arrhythmias are guided by electro-anatomic mapping systems. Technical staff with medical training, or medical staff with technical training, is needed to assist the operator. Travel restrictions due to the current COVID-19 pandemic have limited the in-person availability of technical support staff. To overcome these limitations, we explored the feasibility of a trans-atlantic remote technical support for electro-anatomic mapping, with an internet based communication platform, for complex electrophysiological ablation procedures. Our first experience, based on nine ablation procedures of different arrythmias, highlights the feasibility of this approach. Remote support for electro-anatomic mapping might therefore facilitate continuous care for patients with arrhythmias during the COVID-19 pandemic, particularly in insular settings. Beyond COVID-19 related challenges, this approach will likely play a greater role in the cardiology field in years to come, due to its significant advantages.

The Experiences of Home Care Nurses in Regard to the Care of Vulnerable Populations: A Qualitative Study

Home care nurses have become the main references in home care for vulnerable patients. In patients’ homes they offer comprehensive and continuous care to both the vulnerable population and their families. The aim of this qualitative study was to explore experiences and perspectives of home care nurses regarding the care of vulnerable patients in Spain. We conducted in-depth semi-structured interviews with 15 home care nurses working with a vulnerable population. From a data analysis, two themes and four subthemes emerged: (1) “barriers to providing home care to vulnerable populations”, with the following subthemes: “the particularities of the patient and their home caregivers” and “perceived barriers for the involvement of home care nurses in the care”; and (2) “the emotional cost of home care” with the subthemes “home care is draining for caregivers” and “the impact of home care on the home care nurses”. These findings show us that nurses face a number of difficulties in home care for vulnerable patients. The training of nurses in certain competencies and skills by the social health services would enhance the quality of care offered to these patients.

Impact of COVID-19 Lockdown, during the Two Waves, on Drug Use and Emergency Department Access in People with Epilepsy: An Interrupted Time-Series Analysis

Background: In 2020, during the COVID-19 pandemic, Italy implemented two national lockdowns aimed at reducing virus transmission. We assessed whether these lockdowns affected anti-seizure medication (ASM) use and epilepsy-related access to emergency departments (ED) in the general population. Methods: We performed a population-based study using the healthcare administrative database of Tuscany. We defined the weekly time series of prevalence and incidence of ASM, along with the incidence of epilepsy-related ED access from 1 January 2018 to 27 December 2020 in the general population. An interrupted time-series analysis was used to assess the effect of lockdowns on the observed outcomes. Results: Compared to pre-lockdown, we observed a relevant reduction of ASM incidence (0.65; 95% Confidence Intervals: 0.59–0.72) and ED access (0.72; 0.64–0.82), and a slight decrease of ASM prevalence (0.95; 0.94–0.96). During the post-lockdown the ASM incidence reported higher values compared to pre-lockdown, whereas ASM prevalence and ED access remained lower. Results also indicate a lower impact of the second lockdown for both ASM prevalence (0.97; 0.96–0.98) and incidence (0.89; 0.80–0.99). Conclusion: The lockdowns implemented during the COVID-19 outbreaks significantly affected ASM use and epilepsy-related ED access. The potential consequences of these phenomenon are still unknown, although an increased incidence of epilepsy-related symptoms after the first lockdown has been observed. These findings emphasize the need of ensuring continuous care of epileptic patients in stressful conditions such as the COVID-19 pandemic.

Functional Profile of Older Adults Hospitalized in Convalescence Units of the National Network of Integrated Continuous Care of Portugal: A Longitudinal Study

Aim: To evaluate the evolution of the functional profile of older adults admitted to a health unit in Portugal; to relate the functional profile of these individuals with age, sex, education level and emotional state; and to evaluate the probability of the degree of dependence as a function of age and sex. Methods: longitudinal, retrospective study with a sample of 59,013 older adults admitted to convalescence units of the National Network of Integrated Continuous Care of Portugal. Results: In the first 75 days of hospitalization, activities of daily living, mobility and cognitive state improved, but there was a decline after 75 days of hospitalization. The ability to perform instrumental activities of daily living improved in the first 15 days of hospitalization, stabilized until 45 days and then began to worsen. Women had a higher probability of having a severe/complete dependence three years earlier than men (88 years to 91 years). A higher education level and stable emotional state were protective factors against functional decline. Conclusions: The functional profile of older adults improved during the length of stay recommended for hospitalization in convalescence units (30 days). It is critical for health systems to adopt strategies to prevent declines in the emotional state of frail individuals.

Jardines renacentistas de la Villa Ducal de Benavente. El sueño de una utopía

Construidos por tres generaciones de los condes-duques de Benavente, entre 1499 y 1621, como instrumento de disfrute y de prestigio familiar de la villa ducal, los jardines de Benavente se convirtieron en uno de los jardines renacentistas más importantes de España. Desgraciadamente, los cambios en los gustos estéticos de los herederos, el paso de los ejércitos franceses de Napoleón y el abandono de una naturaleza necesitada de su continuo cuidado, hicieron que los jardines desaparecieran en los primeros años del siglo XIX. En este artículo nos proponemos hacer su reconstrucción ideal, con la utilización de los numerosos textos y de la documentación existente. Built for three generations of the count-dukes of Benavente, between 1499 and 1621, as an instrument of enjoyment and family prestige of the ducal town, the Benavente gardens became one of the most important Renaissance gardens in Spain. Unfortunately, the changes in the aesthetic tastes of the heirs, the destruction wrought by Napoleon's army and the abandonment of a nature in need of their continuous care, caused the gardens to disappear in the early years of the 19th century. In this article we propose to make its ideal reconstruction, with the use of the numerous texts and existing documentation.

Professional Care Experiences of Persons With Suicidal Ideation and Behavior: Model Development Based on a Qualitative Meta-Synthesis

Background Health care professionals (HCPs) are challenged in caring for persons with suicidal ideation or behavior. For affected persons, professional care is essential, and being interviewed about their experiences can be stressful. The experiences of persons ideating or attempting suicide are essential to designing eHealth products to support them in crises and provide continuous care. Objective This study aimed to synthesize published qualitative research about how persons with suicidal thoughts or behavior experience inpatient or outpatient care. A model will be derived from the meta-synthesis to guide HCPs in their work with affected persons and provide a thorough needs assessment for eHealth development. Methods A qualitative meta-synthesis was conducted using an inductive approach, as proposed by Sandelowski and Barroso. The inclusion criteria were studies in English and German that dealt with persons who ideated or attempted suicide. Relevant articles were identified by searching the PubMed and Cinahl databases and by hand searching relevant journals and reference lists. The findings of each study were analyzed using initial and axial coding, followed by selective coding. Finally, a conceptual model was derived. Results In total, 3170 articles were identified in the systematic literature search. Articles were screened independently by 2 researchers based on the eligibility criteria. Finally, 12 studies were included. The central phenomenon observed among persons ideating or attempting suicide is their process from feeling unanchored to feeling anchored in life again. During inpatient and outpatient care, they experience being dependent on the skills and attitudes of HCPs. While helpful skills and attitudes support persons ideating or attempting suicide to reach their feeling of being anchored in life again, adverse interactions are experienced negatively and might lead to prolonging or maintaining the feeling of being unanchored in life. Conclusions The study promotes a differentiated view of the experiences of persons ideating or attempting suicide. The derived conceptual model can guide HCPs in their work with affected persons to support affected persons during their recovery. Moreover, the conceptual model is useable as a springboard to develop eHealth solutions for crisis situations and long-term care.