RESUMEN
INTRODUCTION: The intersecting vulnerabilities of migrant agricultural workers (MAWs) impact both their health and their access to health care in rural areas, yet rural clinicians' voices are rarely documented. The purpose of this study was to explore health professionals' perspectives on health care for MAWs in sending countries and rural Ontario, Canada. METHODS: Qualitative research design occurred over three distinct projects, using a multi-methodological approach including semi-structured interviews in Mexico, Jamaica and rural Ontario (n=43), and session field notes and questionnaires administered to healthcare providers (n=65) during knowledge exchange sessions in rural Ontario. A systematic analysis of these data was done to identify common themes, using NVivo software initially and then Microsoft Excel for application of a framework approach. RESULTS: Structural challenges posed by migrant workers' context included difficulties preventing and managing work-related conditions, employers or supervisors compromising confidentiality, and MAWs' fears of loss of employment and return to countries of origin prior to completing treatments. Structural challenges related to health services included lack of adequate translation/interpretation services and information about insurance coverage and MAWs' work and living situations; scheduling conflicts between clinic hours and MAWs' availability; and difficulties in arranging follow-up tests, treatments and examinations. Intercultural challenges included language/communication barriers; cultural barriers /perceptions; and limited professional knowledge of MAWs' migration and work contexts and MAWs' knowledge of the healthcare system. Transnational challenges arose around continuity of care, MAWs leaving Canada during/prior to receiving care, and dealing with health problems acquired in Canada. A range of responses were suggested, some in place and others requiring additional organization, testing and funding. CONCLUSION: Funding to strengthen responses to structural and intercultural challenges, including research assessing improved supports to rural health professionals serving MAWs, are needed in rural Canada and rural Mexico and Jamaica, in order to better address the structural and intersecting vulnerabilities and the care needs of this specific population.
Asunto(s)
Actitud del Personal de Salud , Accesibilidad a los Servicios de Salud/organización & administración , Atención Primaria de Salud/organización & administración , Migrantes , Barreras de Comunicación , Confidencialidad/normas , Continuidad de la Atención al Paciente , Características Culturales , Femenino , Humanos , Entrevistas como Asunto , Jamaica/etnología , Masculino , México/etnología , Salud Laboral/normas , Ontario/epidemiología , Atención Primaria de Salud/normas , Investigación Cualitativa , Población Rural , Estaciones del Año , Lugar de Trabajo/organización & administraciónRESUMEN
PURPOSE: The purpose of this paper is to evaluate the nonlinear impact of users' memories on their general evaluation of outpatient healthcare services by the integration of two methodologies: critical incidents technique (CIT) and penalty-reward contrast analysis (PRCA). DESIGN/METHODOLOGY/APPROACH: The authors carried out a survey with 356 respondents, users of seven outpatient clinics located in the city of Blumenau/SC, Brazil, during 2016. The participants were asked about their perceptions of positive and negative aspects of the service; and, using CIT, the answers were categorized according to the following dimensions: empathy, communication, facilities, access, promptness, medicines availability, complementary services, safety/confidentiality and service performance. Then, the authors evaluated the nonlinear impact of critical incidents on users' general evaluation of the service using the identified incidents as input variables in a PRCA. FINDINGS: The findings show that users of healthcare services tend to remember emotion and health aspects positively, while technical and formal aspects tend to be more negatively than positively remembered. On the other hand, PRCA identifies that incidents of three dimensions positively influence the overall perception of the service (empathy, complementary services and privacy) and five negatively (empathy, facilities, speed, drugs/pharmacy and health performance), explaining 26.3 percent of the variation in clients' general satisfaction. ORIGINALITY/VALUE: The present paper explores the integration of two methodologies, showing how we can use open listening to healthcare service users to identify the nonlinear impact of different incidents on their general evaluation of the service. The results show that what customers remember does not necessarily influence overall customer satisfaction. The present approach allows companies to improve the process of listening to customers. There are no other papers exploring this approach, particularly in relation to healthcare services.
Asunto(s)
Atención Ambulatoria/organización & administración , Satisfacción del Paciente/estadística & datos numéricos , Calidad de la Atención de Salud/organización & administración , Adulto , Factores de Edad , Atención Ambulatoria/normas , Brasil , Comunicación , Confidencialidad/normas , Empatía , Femenino , Humanos , Masculino , Memoria , Persona de Mediana Edad , Aceptación de la Atención de Salud/estadística & datos numéricos , Percepción , Investigación Cualitativa , Calidad de la Atención de Salud/normas , Factores Sexuales , Factores Socioeconómicos , Factores de TiempoRESUMEN
BACKGROUND: Community-based primary care focuses on health promotion, awareness raising, and illnesses treatment and prevention in individuals, groups, and communities. Community Health Workers (CHWs) are the leading actors in such programs, helping to bridge the gap between the population and the health system. Many mobile health (mHealth) initiatives have been undertaken to empower CHWs and improve the data collection process in the primary care, replacing archaic paper-based approaches. A special category of mHealth apps, known as mHealth Data Collection Systems (MDCSs), is often used for such tasks. These systems process highly sensitive personal health data of entire communities so that a careful consideration about privacy is paramount for any successful deployment. However, the mHealth literature still lacks methodologically rigorous analyses for privacy and data protection. OBJECTIVE: In this paper, a Privacy Impact Assessment (PIA) for MDCSs is presented, providing a systematic identification and evaluation of potential privacy risks, particularly emphasizing controls and mitigation strategies to handle negative privacy impacts. METHODS: The privacy analysis follows a systematic methodology for PIAs. As a case study, we adopt the GeoHealth system, a large-scale MDCS used by CHWs in the Family Health Strategy, the Brazilian program for delivering community-based primary care. All the PIA steps were taken on the basis of discussions among the researchers (privacy and security experts). The identification of threats and controls was decided particularly on the basis of literature reviews and working group meetings among the group. Moreover, we also received feedback from specialists in primary care and software developers of other similar MDCSs in Brazil. RESULTS: The GeoHealth PIA is based on 8 Privacy Principles and 26 Privacy Targets derived from the European General Data Protection Regulation. Associated with that, 22 threat groups with a total of 97 subthreats and 41 recommended controls were identified. Among the main findings, we observed that privacy principles can be enhanced on existing MDCSs with controls for managing consent, transparency, intervenability, and data minimization. CONCLUSIONS: Although there has been significant research that deals with data security issues, attention to privacy in its multiple dimensions is still lacking for MDCSs in general. New systems have the opportunity to incorporate privacy and data protection by design. Existing systems will have to address their privacy issues to comply with new and upcoming data protection regulations. However, further research is still needed to identify feasible and cost-effective solutions.
Asunto(s)
Confidencialidad/normas , Atención Primaria de Salud/métodos , Telemedicina/normas , Brasil , Seguridad Computacional/normas , Recolección de Datos/métodos , Recolección de Datos/normas , Programas de Gobierno/métodos , Programas de Gobierno/tendencias , Humanos , Aplicaciones Móviles/tendencias , Atención Primaria de Salud/tendencias , Telemedicina/instrumentaciónRESUMEN
Awareness of the discussion surrounding the social and ethical challenges regarding gamete donation is crucial for good governance of assisted reproduction techniques. In this article, we analyze the topics that guided the debate in the Portuguese ethics organizations, discussing their connections with themes addressed internationally. To that end, in March 2018, we systematically searched the websites of the National Council of Medically Assisted Procreation and of the National Ethics Council for Life Sciences. We carried out a thematic content analysis of 25 documents. Results indicate that the debate was focused on accessibility, anonymity and donors' compensation and, to a lesser extent, on professional responsibilities. We observed heterogeneous positions and tensions between multiple rights and ethical principles associated with recipients, donor-conceived individuals and donors. These invoke three similar arguments: the scarcity of scientific evidence; experiences from other countries; and regulations from in international entities. Literature addressed additional topics, namely: a double track that combines donor anonymity/identification; the implementation of reproduction registries for recipients and donors; limits to the genetic screening of donors; donations by family members/acquaintances; and donors' role in decisions regarding the fate of cryopreserved embryos and in choosing the characteristics of recipients of their gametes. There is room to expand the debate and to promote research on the social and ethical implications of gamete donation, considering the participation of all citizens.
Conhecer a discussão em torno dos desafios sociais e éticos da doação de gametas é fundamental para a boa governança das técnicas de reprodução assistida. Neste artigo, analisam-se os tópicos que orientaram o debate nas organizações de ética portuguesas, discutindo as suas conexões com os temas abordados internacionalmente. Para tal, em março de 2018, pesquisamos sistematicamente os websites do Conselho Nacional de Procriação Medicamente Assistida e do Conselho Nacional de Ética para as Ciências da Vida. Procedemos à análise de conteúdo temática de 25 documentos. Os resultados indicam que o debate se centrou na acessibilidade, no anonimato e na compensação de doadores e, em menor extensão, nas responsabilidades profissionais. Observaram-se posicionamentos heterogêneos e tensões entre múltiplos direitos e princípios éticos associados a receptores, a pessoas nascidas com recurso à doação de gametas e a doadores. Esses têm em comum três alegações: a escassez de evidência científica; as experiências de outros países; e regulamentações oriundas de entidades internacionais. Na literatura abordam-se tópicos adicionais, nomeadamente: uma via dupla que conjugue anonimato/identificação de doadores; implementação de sistemas de registo reprodutivo para receptores e doadores; limites do rastreio genético a doadores; doação por familiares/conhecidos; e o papel dos doadores na decisão quanto ao destino de embriões criopreservados e na escolha das características dos receptores dos seus gametas. Há espaço para expandir o debate e promover a pesquisa em torno das implicações sociais e éticas da doação de gametas, considerando a participação de todos os cidadãos.
Conocer la discusión en torno a los desafíos sociales y éticos de la donación de gametos es fundamental para el buen gobierno de las técnicas de reproducción asistida. En este artículo se analizan los temas que orientaron el debate en las organizaciones de ética portuguesas, discutiendo sus conexiones con los temas abordados internacionalmente. Para este fin, en marzo de 2018, investigamos sistemáticamente las páginas webs del Conselho Nacional de Procriação Medicamente Assistida y del Conselho Nacional de Ética para as Ciências da Vida. Asimismo, procedimos al análisis de contenido temático de 25 documentos. Los resultados indican que el debate se centró en la accesibilidad, anonimato y compensación de donadores y, en menor extensión, en las responsabilidades profesionales. Se observaron posicionamientos heterogéneos y tensiones entre múltiples derechos y principios éticos, asociados a receptores, a personas nacidas gracias a la donación de gametos y a donadores. Estos tienen en común tres alegaciones: la escasez de evidencias científicas; las experiencias de otros países; y las regulaciones procedentes de entidades internacionales. En el literatura se abordan temas adicionales, en particular: una vía doble que conjugue anonimato/identificación de donadores; implementación de sistemas de registro reproductivo para receptores y donadores; límites del rastreo genético a donadores; donación por familiares/conocidos; y el papel de los donadores en la decisión respecto al destino de embriones criopreservados y en la elección de las características de los receptores de sus gametos. Existe espacio para abrir más el debate y promover la investigación en torno de las implicaciones sociales y éticas de la donación de gametos, considerando la participación de todos los ciudadanos.
Asunto(s)
Discusiones Bioéticas/normas , Confidencialidad/ética , Inseminación Artificial Heteróloga/ética , Donación de Oocito/ética , Adulto , Discusiones Bioéticas/legislación & jurisprudencia , Confidencialidad/legislación & jurisprudencia , Confidencialidad/normas , Femenino , Humanos , Inseminación Artificial Heteróloga/legislación & jurisprudencia , Inseminación Artificial Heteróloga/normas , Masculino , Persona de Mediana Edad , Donación de Oocito/legislación & jurisprudencia , PortugalRESUMEN
Resumo: Conhecer a discussão em torno dos desafios sociais e éticos da doação de gametas é fundamental para a boa governança das técnicas de reprodução assistida. Neste artigo, analisam-se os tópicos que orientaram o debate nas organizações de ética portuguesas, discutindo as suas conexões com os temas abordados internacionalmente. Para tal, em março de 2018, pesquisamos sistematicamente os websites do Conselho Nacional de Procriação Medicamente Assistida e do Conselho Nacional de Ética para as Ciências da Vida. Procedemos à análise de conteúdo temática de 25 documentos. Os resultados indicam que o debate se centrou na acessibilidade, no anonimato e na compensação de doadores e, em menor extensão, nas responsabilidades profissionais. Observaram-se posicionamentos heterogêneos e tensões entre múltiplos direitos e princípios éticos associados a receptores, a pessoas nascidas com recurso à doação de gametas e a doadores. Esses têm em comum três alegações: a escassez de evidência científica; as experiências de outros países; e regulamentações oriundas de entidades internacionais. Na literatura abordam-se tópicos adicionais, nomeadamente: uma via dupla que conjugue anonimato/identificação de doadores; implementação de sistemas de registo reprodutivo para receptores e doadores; limites do rastreio genético a doadores; doação por familiares/conhecidos; e o papel dos doadores na decisão quanto ao destino de embriões criopreservados e na escolha das características dos receptores dos seus gametas. Há espaço para expandir o debate e promover a pesquisa em torno das implicações sociais e éticas da doação de gametas, considerando a participação de todos os cidadãos.
Abstract: Awareness of the discussion surrounding the social and ethical challenges regarding gamete donation is crucial for good governance of assisted reproduction techniques. In this article, we analyze the topics that guided the debate in the Portuguese ethics organizations, discussing their connections with themes addressed internationally. To that end, in March 2018, we systematically searched the websites of the National Council of Medically Assisted Procreation and of the National Ethics Council for Life Sciences. We carried out a thematic content analysis of 25 documents. Results indicate that the debate was focused on accessibility, anonymity and donors' compensation and, to a lesser extent, on professional responsibilities. We observed heterogeneous positions and tensions between multiple rights and ethical principles associated with recipients, donor-conceived individuals and donors. These invoke three similar arguments: the scarcity of scientific evidence; experiences from other countries; and regulations from in international entities. Literature addressed additional topics, namely: a double track that combines donor anonymity/identification; the implementation of reproduction registries for recipients and donors; limits to the genetic screening of donors; donations by family members/acquaintances; and donors' role in decisions regarding the fate of cryopreserved embryos and in choosing the characteristics of recipients of their gametes. There is room to expand the debate and to promote research on the social and ethical implications of gamete donation, considering the participation of all citizens.
Resumen: Conocer la discusión en torno a los desafíos sociales y éticos de la donación de gametos es fundamental para el buen gobierno de las técnicas de reproducción asistida. En este artículo se analizan los temas que orientaron el debate en las organizaciones de ética portuguesas, discutiendo sus conexiones con los temas abordados internacionalmente. Para este fin, en marzo de 2018, investigamos sistemáticamente las páginas webs del Conselho Nacional de Procriação Medicamente Assistida y del Conselho Nacional de Ética para as Ciências da Vida. Asimismo, procedimos al análisis de contenido temático de 25 documentos. Los resultados indican que el debate se centró en la accesibilidad, anonimato y compensación de donadores y, en menor extensión, en las responsabilidades profesionales. Se observaron posicionamientos heterogéneos y tensiones entre múltiples derechos y principios éticos, asociados a receptores, a personas nacidas gracias a la donación de gametos y a donadores. Estos tienen en común tres alegaciones: la escasez de evidencias científicas; las experiencias de otros países; y las regulaciones procedentes de entidades internacionales. En el literatura se abordan temas adicionales, en particular: una vía doble que conjugue anonimato/identificación de donadores; implementación de sistemas de registro reproductivo para receptores y donadores; límites del rastreo genético a donadores; donación por familiares/conocidos; y el papel de los donadores en la decisión respecto al destino de embriones criopreservados y en la elección de las características de los receptores de sus gametos. Existe espacio para abrir más el debate y promover la investigación en torno de las implicaciones sociales y éticas de la donación de gametos, considerando la participación de todos los ciudadanos.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Donación de Oocito/ética , Confidencialidad/ética , Discusiones Bioéticas/normas , Inseminación Artificial Heteróloga/ética , Portugal , Donación de Oocito/legislación & jurisprudencia , Confidencialidad/legislación & jurisprudencia , Confidencialidad/normas , Discusiones Bioéticas/legislación & jurisprudencia , Inseminación Artificial Heteróloga/legislación & jurisprudencia , Inseminación Artificial Heteróloga/normasRESUMEN
Objetivos da 303ª reunião ordinária: 1) Apreciar e aprovar os informes e indicações. 2) Realizar o debate sobre os Cenários e Prioridades da Saúde Bucal, Saúde do Trabalhador e da Trabalhadora, Pessoa com Deficiência e População Negra. 3) Apreciar, debater e deliberar sobre a Saúde e Solidariedade no Enfrentamento da Violência. 4) Apreciar, debater e deliberar acerca da Obtenção, Gestão e Tratamento de Dados Pessoais em Saúde. 5) Apreciar e deliberar sobre encaminhamentos das Comissões Intersetoriais e dos Grupos de Trabalho. 6) Apreciar e deliberar sobre os pareceres da Comissão Intersetorial de Recursos Humanos e Relações de Trabalho CIRHRT. 7) Apreciar e deliberar sobre as demandas da Comissão Intersetorial de Orçamento e financiamento COFIN. 8) Apreciar e debater acerca da Cobertura e Acesso Universal à Saúde.
Asunto(s)
Violencia/prevención & control , Salud Bucal , Atención Dental para la Persona con Discapacidad/organización & administración , Confidencialidad/normas , Población Negra , Cobertura Universal de Salud , Servicios de Salud del Trabajador/organización & administraciónRESUMEN
The proper functioning of a hospital computer system is an arduous work for managers and staff. However, inconsistent policies are frequent and can produce enormous problems, such as stolen information, frequent failures, and loss of the entire or part of the hospital data. This paper presents a new method named EMRlog for computer security systems in hospitals. EMRlog is focused on two kinds of security policies: directive and implemented policies. Security policies are applied to computer systems that handle huge amounts of information such as databases, applications, and medical records. Firstly, a syntactic verification step is applied by using predicate logic. Then data mining techniques are used to detect which security policies have really been implemented by the computer systems staff. Subsequently, consistency is verified in both kinds of policies; in addition these subsets are contrasted and validated. This is performed by an automatic theorem prover. Thus, many kinds of vulnerabilities can be removed for achieving a safer computer system.
Asunto(s)
Algoritmos , Seguridad Computacional/normas , Confidencialidad/normas , Minería de Datos/normas , Registros Electrónicos de Salud/organización & administración , Adhesión a Directriz/organización & administración , México , Garantía de la Calidad de Atención de Salud/métodos , Garantía de la Calidad de Atención de Salud/organización & administraciónRESUMEN
AIM: The aim of this study was to explore female community health agents' views about the value of recording qualitative information on contextual health issues they observe during home visits, data that are not officially required to be documented for the Brazilian System of Primary Healthcare Information. BACKGROUND: The study was conducted in community primary healthcare centres located in the cities of Araçatuba and Coroados (state of São Paulo) and Rio de Janeiro (state of Rio de Janeiro), Brazil. METHODS: The design was a qualitative, exploratory study. The purposeful sampling criteria were being female, with a minimum of three years of continuous service in the same location. Data collection with 62 participants was conducted via 11 focus groups (in 2007 and 2008). Audio files were transcribed and submitted to the method of thematic analysis. Four themes guided the analysis: working with qualitative information and undocumented observation; reflecting on qualitative information; integrating/analysing quantitative and qualitative information; and information-sharing with agents and family health teams. In 2010, 25 community health agents verified the final interpretation of the findings. FINDINGS: Participants valued the recording of qualitative, contextual information to expand understanding of primary healthcare issues and as an indicator of clients' improved health behaviour and health literacy. While participants initiated the recording of additional health information, they generally did not inform the family health team about these findings. They perceived that team members devalued this type of information by considering it a reflection of the clientele's social conditions or problems beyond the scope of medical concerns. Documentation of qualitative evidence can account for the effectiveness of health education in two ways: by improving preventative care, and by amplifying the voices of underprivileged clients who live in poverty to ensure the most appropriate and best quality primary healthcare for them.
Asunto(s)
Actitud del Personal de Salud , Agentes Comunitarios de Salud/psicología , Educación en Salud/métodos , Visita Domiciliaria , Atención Primaria de Salud/métodos , Adulto , Brasil , Agentes Comunitarios de Salud/organización & administración , Agentes Comunitarios de Salud/normas , Confidencialidad/normas , Recolección de Datos/métodos , Recolección de Datos/normas , Documentación/métodos , Documentación/normas , Femenino , Grupos Focales , Educación en Salud/normas , Humanos , Difusión de la Información , Relaciones Interprofesionales , Persona de Mediana Edad , Áreas de Pobreza , Atención Primaria de Salud/organización & administración , Investigación Cualitativa , Adulto JovenRESUMEN
Moderation of content in online Health Social Networks (HSN) is critical because information is not only published and produced by experts or health professionals, but also by users of that information. The objective of this paper is to propose a semi-automatic moderation Web Service for assessing the quality (trustworthiness) of health-related videos published on the YouTube social network. The service is relevant for moderators or community managers, who get enabled to control the quality of videos published on their online HSN sites. The HealthTrust metric was selected as the metric to be implemented in the service in order to support the assessment of trustworthiness of videos in Online HSN. The service is a RESTful service which can be integrated into open source Virtual Social Network Platforms, therefore improving trust in the process of searching and publishing content extracted from YouTube. A preliminary pilot evaluation in a simple use case demonstrated that the relevance of videos retrieved using the moderation service was higher compared to the relevance of the videos retrieved using the YouTube search engine.
Asunto(s)
Confidencialidad/normas , Difusión de la Información , Medios de Comunicación Sociales/normas , Red Social , Confianza , Grabación de Cinta de Video/normas , HumanosRESUMEN
Los abusos que se hace del derecho a la información en internet y especialmente en las Redes Sociales Virtuales (en adelante RSV) son constantes y la posibilidad de restringirlos es mínima. Todo parecería indicar que en el mundo virtual no existirá la censura, pero se evidencia todo lo contrario. Muchos grupos de presión, entre ellos quienes buscan la defensa de intereses económicos, han instado a los gobiernos, como el colombiano, y a las empresas de la web (incluidas las RSV) para que constituyan mecanismos de control de todo lo que se difunde por internet y evitar atentados contra el honor, la intimidad y la propiedad intelectual, pero los métodos (legales o de facto) que se han implementado se convirtieron en una forma de censura de las expresiones creativas que reduce la disponibilidad de información y paradójicamente la libertad individual. Para demostrar lo anterior, en escrito se utilizó técnicas de estudio documental en los que se pudiera constatar la influencia de las RSV en el Derecho.
Abuses of the right to information on the Internet and especially in virtual social networks (VSN from now on) are constant and the possibility of restricting them is minimal. Everything would seem to indicate that in the virtual world there is no censorship, but there is evidence of the opposite. Many groups, including those who seek the defense of economic interests, have urged Governments, such as the Colombian one, and the Web companies (including the RSV) so that they constitute control mechanisms of everything that is spread via the Internet and prevent the attacks against honor, privacy, and intellectual property, but the (legal or de facto) methods that have been implemented have become a form of censorship of creative expressions that reduces the availability of information and paradoxically the individual freedom. In order to prove this, techniques of documentary study were used, in which the influence of the VSN in the Law, could be established.
Asunto(s)
Humanos , Confidencialidad/ética , Confidencialidad/historia , Confidencialidad/legislación & jurisprudencia , Confidencialidad/normas , Confidencialidad/psicología , Confidencialidad/tendencias , Espacio Personal , Privacidad/legislación & jurisprudencia , Privacidad/psicologíaRESUMEN
Data protection regulation is a new and appealing issue in Mexico. The processing of health personal data will require even more specific regulation in the near future. Health care professionals and institutions need to adequate their usual proceedings to comply with the actual regulation in order to protect their patients and customers and avoid fines up to 35 million Mexican pesos and 10 years of prison. The aim of this article is to present a practical approach to the legal and managerial implications of this regulation.
Asunto(s)
Confidencialidad/legislación & jurisprudencia , Confidencialidad/normas , Registros/legislación & jurisprudencia , Registros/normas , HumanosRESUMEN
Quality of information and privacy and safety issues are frequently identified as main limitations to make most benefit from social media in healthcare. The objective of the paper is to contribute to the analysis of healthcare social networks (SN), and online healthcare social network services (SNS) by proposing a formal architectural analysis of healthcare SN and SNS, considering the complexity of both systems, but stressing on quality, safety and usability aspects. Quality policies are necessary to control the quality of content published by experts and consumers. Privacy and safety policies protect against inappropriate use of information and users responsibility for sharing information. After the policies are established and documented, a proof of concept online SNS supporting primary healthcare promotion is presented in the paper.
Asunto(s)
Confidencialidad/normas , Promoción de la Salud/organización & administración , Difusión de la Información/métodos , Internet , Seguridad del Paciente/normas , Garantía de la Calidad de Atención de Salud/organización & administración , Red Social , Alemania , Apoyo SocialRESUMEN
The medical patient's information is private and extremely sensitive. This information has to be stored and transmitted carefully because it can be exposed to a series of threats and it is necessary to be protected. This research contemplates the security mechanisms based on digital certificates applied to a pilot telemedicine network, that guarantees the confidentiality, integrity and availability of the medical information of the patients for the hospitable centers involved. The prototype telemedicine network will interconnect hospitals in the municipalities of Baruta and Hatillo Miranda State, in Venezuela by Internet, to provide and support a health care system in inaccessible areas, and the transmission of patient's biomedical signals and the health education to people through secure mechanisms such as digital certificates.
Asunto(s)
Seguridad Computacional/normas , Telemedicina/normas , Ingeniería Biomédica , Redes de Comunicación de Computadores/normas , Confidencialidad/normas , Humanos , Internet , Proyectos Piloto , VenezuelaRESUMEN
OBJECTIVE: A targeted analysis with transcript data from previous research was designed to study the perceived effects of secret-keeping on individuals with Turner syndrome (TS). STUDY DESIGN: Girls and women (n = 97) and 21 parents participated in the initial interview study. Transcripts were coded and analyzed for constructs related to secret-keeping. RESULTS: Thirty percent of participants spontaneously mentioned that their health care providers (HCP) or parents had withheld all or part of their TS diagnosis. Of those, 15 individuals were not informed of the infertility component of their diagnosis. Individuals reporting secret-keeping were more likely to have had a negative perception of the HCP's role in the disclosure process compared with those participants who did not report that a secret had been kept (P < .025). CONCLUSION: The prevalence of secret-keeping within this sample population suggests it is likely an existing concern in the greater TS population. How HCPs disclose a TS diagnosis may affect whether secrets are kept. Conversely, secret-keeping may result in a negative disclosure experience. These observations suggest the need for interventions aimed at helping HCPs disclose health-related information to parents and their children in a timely, caring, and sensitive manner.