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BACKGROUND: National palliative care plans depend upon stakeholder engagement to succeed. Assessing the capability, interest, and knowledge of stakeholders is a crucial step in the implementation of public health initiatives, as recommended by the World Health Organisation. However, utilising stakeholder analysis is a strategy underused in public palliative care. OBJECTIVE: To conduct a stakeholder analysis characterising a diverse group of stakeholders involved in implementing a national palliative care plan in three rural regions of an upper-middle-income country. METHODS: A descriptive cross-sectional study design, complemented by a quantitative stakeholder analysis approach, was executed through a survey designed to gauge stakeholders' levels of interest and capability in relation to five fundamental dimensions of public palliative care: provision of services, accessibility of essential medicines, palliative care education, financial support, and palliative care vitality. Stakeholders were categorised as promoters (high-power, high-interest), latent (high-power, low-interest), advocates (low-power, high-interest), and indifferent (low-power and low-interest). Stakeholder self-perceived category and knowledge level were also assessed. RESULTS: Among the 65 surveyed stakeholders, 19 were categorised as promoters, 34 as advocates, 9 as latent, and 3 as indifferent. Stakeholders' self-perception of their category did not align with the results of the quantitative analysis. When evaluated by region and palliative care dimensions the distribution of stakeholders was nonuniform. Palliative care funding was the dimension with the highest number of stakeholders categorised as indifferent, and the lowest percentage of promoters. Stakeholders categorised as promoters consistently reported a low level of knowledge, regardless of the dimension, region, or their level of interest. CONCLUSIONS: Assessing the capability, interest, and knowledge of stakeholders is a crucial step when implementing public health initiatives in palliative care. It allows for a data-driven decision-making process on how to delegate responsibilities, administer financial resources, and establish governance boards that remain engaged and work efficiently.

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CONTEXT: The Global Atlas of Palliative Care (GAPC) ranked Mexico's palliative care services at a preliminary integration stage into mainstream healthcare services. However, this data does not reflect pediatric palliative care (PPC) development. OBJECTIVES: To analyze the current need and level of development of PPC within Mexico. METHODS: PPC need was estimated using causes of death associated with serious health-related suffering from national mortality data from the General Directorate of Health Information. The level of development was measured through six indicators involving access to PPC services and opioids, then classified using the GAPC development categories adapted to regional territories based on available data. RESULTS: In 2021, 37,444 children died in Mexico. Of those, 10,677 (28.29%) died from conditions with serious health-related suffering, averaging a need for PPC of 25/100,000 children. Out of Mexico's 32 states, two (6.2%) had no PPC activity (category 1), twenty (62.6%) were in a capacity-building phase (category 2), eight (25%) had isolated PPC provision (category 3a), while two (6.2%) had generalized PPC provision (category 3b). No state had early (category 4a) or advanced PPC integration (category 4b). Overall, Mexico was classified as category 2. CONCLUSIONS: PPC services are distributed unevenly across the country, leading to inequitable access to care and an inability to meet the needs of patients and families. There is a disparity between the level of development of adult palliative care services and the underdevelopment of PPC in Mexico. This information can help stakeholders guide the development of PPC where it is needed most.

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AIM: To determine the professional profile and the work conditions of nurses working in intensive care units (ICU) in Colombia, Argentina, Peru and Brazil. BACKGROUND: ICUs require a differentiated professional profile to provide quality care, and appropriate working conditions, leading to a transformation of care and management practices. DESIGN: Descriptive multicentre cross-sectional observational study. METHODS: An online survey was applied to identify both the characteristics of the professional profile and the working conditions. 1,427 ICU nursing professionals were included. RStudio statistical software was used for the analysis of the information. Descriptive statistics were used for the presentation of the results. The STROBE checklist for cross-sectional studies was used in this study. RESULTS: Only 33.6% of the professionals had a specialisation degree in intensive care. The skills that were most frequently put into practice were communication (68.5%) and care management (78.5%). The most predominant nurse-to-patient ratios were 1:2, and greater than 1:6. 59.1% of the nurses had an indefinite term contract, 38.8% worked 48 hours per week and 49.8% had rotating shifts. Only 50.4% of them received incentives. The average salary ranged between 348 and 1,500 USD. 64.5% of the participants were satisfied with their job. CONCLUSION: It is necessary to strengthen nurses' professional profile by promoting both postgraduate education and the development of troubleshooting and teamwork skills. It is necessary to standardise the nurse-to-patient ratio, improve wages and increase incentives to achieve greater job satisfaction. RELEVANCE TO PRACTICE: The knowledge and the improvement of both the professional profile and the work conditions of nurses working in intensive care units will improve the quality of the care given to critical patients and, therefore, the quality of health outcomes.

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Introducción: la enfermedad renal en los niños causa diferentes cambios que pueden alterar su calidad de vida; por esta razón, es importante que el profesional de salud busque estrategias que contribuyan a disminuir las secuelas y mejorar la calidad de vida del niño. Objetivo: caracterizar la calidad de vida de los niños de 8 a 18 años, con diagnóstico de enfermedad renal crónica, según el instrumento KIDSCREEN-27 de una institución de salud de la ciudad de Bogotá (Colombia). Método: estudio descriptivo de corte transversal con una población de estudio de 62 niños con diagnóstico de enfermedad renal crónica con edades entre 8 y 18 años que asistieron a la consulta de nefrología pediátrica. Resultados: se analizaron cinco dimensiones, donde cada una tuvo un puntaje ponderado mayor a 70, que se relaciona con una buena calidad de vida; la dimensión con menor puntaje, la de actividad física, tuvo un puntaje de 70,1, y la dimensión de estado de ánimo y sentimientos obtuvo el mayor puntaje, 80,8. Conclusiones: la enfermedad renal crónica puede alterar la calidad de vida, sobre todo en la dimensión de actividad física y entorno escolar. Es primordial que se planteen programas que tengan en cuenta las cinco dimensiones, especialmente las que obtuvieron menor puntaje, con el fin de mejorar la calidad de vida de los niños con esta enfermedad.

Introduction: In children the kidney disease causes different changes that may affect their quality of life. Therefore, it is important for a health professional to find a strategy contributing to reduce the sequelae and improve their quality of life. Objective: To characterize the quality of life in children with ages of 8-18 years who were diagnosed with chronic kidney disease, based on the instrument KIDSCREEN-27 prepared by health center in Bogotá (Colombia). Method: This is a cross-sectional descriptive study with a study population of 62 children diagnosed with chronic kidney disease, with ages from 8 to 18 years, who attended to pediatric nephrology treatment. Results: Five dimensions were analyzed, each with a weighted score above 70, which indicates a good quality of life. The dimensions with the lowest score [70.1] is the physical activity. The highest score [80.8] was found in the dimension of mood and feelings. Conclusions: The chronic kidney disease may alter the quality of life, mostly regarding the dimension of physical activity and the school environment. It is crucial to set out programs that consider the five dimensions, especially those with the lowest scores, in order to improve the quality of life among the ill children.

Introdução: A doença renal nas crianças causa diferentes alterações que podem mudar sua qualidade de vida; por tal razão, é importante que o profissional de saúde procure estratégias que contribuam para reduzir sequelas e melhorar a qualidade de vida da criança. Objetivo: Caracterizar a qualidade de vida das crianças de 8 a 18 anos com diagnóstico de doença renal crônica, segundo o instrumento KIDSCREEN-27 de uma instituição de saúde da cidade de Bogotá (Colômbia). Método: Estudo descritivo transversal com população de estudo de 62 crianças com diagnóstico de doença renal crônica, entre 8 e 18 anos de idade, que atendidas no ambulatório de nefrologia pediátrica. Resultados: Foram analisadas cinco dimensões, nas quais cada uma obteve pontuação ponderada maior que 70, relacionada à boa qualidade de vida; a dimensão com menor pontuação, a de atividade física, obteve pontuação de 70,1, e a dimensão de humor e sentimentos obteve a maior pontuação, 80,8. Conclusões: A doença renal crônica pode alterar a qualidade de vida, especialmente na dimensão de atividade física e entorno escolar. É essencial projetar programas que levem em conta as cinco dimensões, especialmente as que obtiveram pontuações mais baixas a fim de melhorar a qualidade de vida das crianças com esta doença.

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