METODE INTERPRETATIVE PHENOMENOLOGICAL ANALYSIS (IPA): PERSEPSI TENAGA KESEHATAN DAN PASIEN TERHADAP PENGOBATAN ASMA

Pharmaceutical care by pharmacists in the management have an important role of treatment monitoring. Optimal asthma treatment for patients requires cooperation between patients, healthcares, involving doctors, nurses, and pharmacists. Therefore the purpose of this study is to know the perception of healthcares and patients about asthma treatment and pharmaceutical cares on asthma mangement. The method of this study is based on phenomenological perspective with interpretative phenomenological analysis (IPA) on pulmonologist, outpatient asthma, pharmacist and nurse who directly correlated with asthma treatment at a hospital in Surabaya conducted for two years using purposive sampling. The results of this study indicate that asthma patients know how to manage asthma and use asthma drugs well. In addition it is known that asthma patients feel the role of doctors in the treatment of asthma is very dominating; pulmonologists and nurses perceive that the role of pharmacists is limited to drug delivery; and pharmacists assume that their role has been well done although not all patients get the same asthma treatment education. It is therefore necessary to evaluate the role of pharmacist in performing its role in the treatment of this asthma in order for a more harmonious collaboration.

Experiences and preferences with sexually transmitted infection care and partner notification in Gaborone, Botswana

Partner notification and treatment are essential to sexually transmitted infection (STI) management. However, in low- and middle-income countries, half of partners do not receive treatment. A mixed methods study was conducted to explore experiences and preferences around partner notification and treatment in patients seeking STI care in Gaborone, Botswana. Thirty participants were administered a quantitative survey, followed by a semi-structured interview on partner notification, treatment, and expedited partner therapy (EPT). Among the 30 participants, 77% were female with a median age of 28 years (IQR = 24–36), 87% notified their partner, and 45% of partners requiring treatment received treatment. Partners who received a contact slip were more likely to have been treated than those who did not (75% vs. 25%). Contact slips were identified as facilitators of notification and treatment, while asymptomatic partners and limited clinic resources were identified as barriers to treatment. Few participants expressed a preference for EPT and concerns included preference for medical supervision, a belief their partner would refuse, and an inability to explain the treatment. Despite successful notification, partner treatment was modest within this population. Information for partners, provider counseling, and improved access to services may increase partner treatment. Education on STIs and treatment options may improve EPT acceptability.

Ocular Injury Caused by the Bombardier Beetle

We report a case of ocular injury caused by a bombardier beetle in a young boy. Ocular injuries due to this coleoptera have not previously been reported. An 11-year-old boy experienced an eye injury while trying to place a bombardier beetle inside an anthill. The boy was diagnosed with a second-degree burn on the skin of the upper right eyelid and conjunctival and corneal erosion in the right eye. The condition resolved completely after 2 weeks of appropriate treatment. Education about the dangers of playing with insects is crucial to prevent this type of lesions.

Deciding on treatment duration for unprovoked venous thromboembolism: what is important to patients?

Background After 3 months of anticoagulation for unprovoked venous thromboembolism (VTE), a decision must be made to stop or continue indefinitely by weighing risks of recurrence and bleeding through shared decision-making (SDM). Despite the importance of patient involvement, patients’ perspectives on treatment duration are understudied. Aim To describe knowledge of VTE and anticoagulation, need for education, perception of risks and benefits of extended treatment and factors influencing patient’s preference to stop or continue treatment after unprovoked VTE. Methods: Semi-structured interviews were conducted between May 2019 and August 2020 with adults with unprovoked VTE in one university hospital and one general hospital. Interviews were audio-recorded and transcribed verbatim. Data were analyzed using conventional content analysis. Results 18 patients were interviewed (median age 64, range 32-83 years). Three major themes were identified: diagnosis and initial treatment, SDM and perception of treatment. Education, knowledge, coping and attitude towards healthcare suffused the major themes. The impact of VTE on daily life varied between individuals, as did the preferred extent of SDM. Overall, patients who felt involved and informed were more satisfied with received care, more aware of risks and benefits of treatment and more likely to be treatment adherent. Generally, patients were more concerned with risk of recurrent VTE than risk of bleeding during anticoagulation. We identified a multitude of aspects important to patients when deciding to stop or continue anticoagulation. Conclusion Sufficient information and an individualized extent of SDM are of crucial importance for patients when deciding on treatment duration after unprovoked VTE.

Housing First Combined with Suicide Treatment Education and Prevention (HOME + STEP): study protocol for a randomized controlled trial

Background Youth experiencing homelessness are at high risk for suicide, yet few studies have evaluated risk reduction interventions targeting suicidal ideation in this vulnerable population. A comprehensive approach to risk-reduction is needed that addresses basic needs and provides targeted interventions for those at highest risk. The protocol described builds on the design of the first randomized trial of Housing First (HF) for homeless youth. The primary objective is to determine whether housing combined with supportive services that include suicide screening and targeted psychotherapy (Cognitive Therapy for Suicide Prevention) is effective for reducing suicidal ideation and other secondary outcomes (depression and suicide attempts). Additionally, we will explore mediators of the treatment effect (housing stability and substance use) and determinants of implementation. Methods Youth recruited to the HF trial will be randomized to HF + supportive services (n = 120), or supportive services alone (n = 120). The “Suicide Treatment Education and Prevention” (STEP) protocol will additionally screen youth in both arms at baseline and 3 months for suicidal ideation (SSI-W). Those who screen as moderate risk for suicide (SSI-W ≥ 10) will be offered CTSP, which includes up to 9 sessions over the first 6 months following enrollment. CTSP will be delivered in one-on-one sessions by a trained advocate. Research assessments will be collected to assess outcomes (including suicidal ideation) at baseline, 3, 6, 9 and 12 months. Qualitative interviews with subjects receiving CTSP and other stakeholders will explore implementation determinants. Discussion The study will fill an important gap in the literature about the added benefit of HF combined with supportive services including suicide screening and treatment for reducing suicidal ideation in homeless youth. With the urgent need to address both homelessness and suicide risk, evidence is needed about services that can be integrated into delivery settings for youth experiencing homelessness. Trial registration NCT04135703. Date of registration: October 23, 2019.

Praktijkadvies rond de aanpak van anafylaxie bij (Covid-19-)vaccinatie bij kwetsbare ouderen (incl. e-learning)

Practical advice on the anaphylaxis policy for (COVID-19) vaccination in frail, older patients In view of the imminent start of the COVID-19 vaccination campaign, a practical advice based on the available literature on anaphylaxis in older people was drawn up for use in frail, older patients. The present practical advice provides guidance with regard to the diagnosis of anaphylaxis, the first-line treatment, education and necessary material with the purpose of making nursing homes and vaccination centres well prepared for the large-scale COVID-19 vaccination.

Материнство с ребенком-инвалидом в современной России: стереотипы, риски, общественное мнение

В статье на основе публицистических данных и полевого материала, собранного автором среди городского и сельского населения Архангельской области в 2011–2020 гг., исследуется комплекс проблем, с которыми сталкивается семья, воспитывающая ребенка с инвалидностью. Большое внимание в исследовании уделено роли родителей, особенно матери, т.к. семьи, в которых живут дети с нарушениями развития, часто бывают неполными, с одинокими матерями. В таком случае все проблемы по уходу, лечению воспитанию, реабилитации ребенка, а также зарабатыванию денег берет на себя мать. Она же находится в многолетнем постоянном стрессе. Деквалификация, депрофессионализация, ухудшение здоровья существенно отражаются на качестве жизни матери, воспитывающей ребенка-инвалида. Социальные гарантии и денежная помощь, предлагаемые государством, лишь частично компенсируют экономические расходы, которые несут подобные семьи. Проблемы часто носят внутрисемейный характер. В статье проанализированы общественное мнение людей, работа социальных и реабилитационных служб, СМИ. The article analyzes the complex of problems faced by a family raising a child with disabilities, based on the author's journalistic and field material, collected among the urban and rural population of the Arkhangelsk region in 2011-2020. The study puts a special emphasis on the role of parents, especially the mother, because single-parent families and single mothers are especially common among families having children with developmental disabilities. All problems related to the care, treatment, education, rehabilitation of a child and earning money are taken over by the mother, who suffers constant stress for many years. Dequalification, deprofessionalization, deterioration of health significantly affect the quality of life of a mother raising a disabled child. Social guarantees and financial assistance offered by the state only partially compensate for the economic costs incurred by families raising a disabled child. Problems are often family-based. The article analyzes the work of social and rehabilitation services, mass media, public opinion of people on such families.