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AIMS: To conduct a needs assessment of public hospitals in Mexico to determine workforce specific capacity building needs in the care of older people. BACKGROUND: The older population in Mexico is growing rapidly. The healthcare system and workforce may not be prepared to handle the needs of older people, especially those with chronic illnesses who are also disadvantaged socioeconomically. Determining workforce and system needs is important to strategically develop capacity. METHODS: A needs assessment using a pragmatic qualitative approach structured this study. Semi-structured interviews and focus groups were conducted with healthcare professionals at five public hospitals in Mexico. Directed content analysis techniques analysed the data. RESULTS: Ninety-two healthcare professionals participated in the study. Three themes emerged, including geriatric service delivery, social changes and human resources for health. Participants reported a lack of gerontology knowledge and related clinical skills deficits to provide care for hospitalised elders and expressed emotional distress related to the lack of resources in their institutions. All healthcare professionals expressed strong concern at the social toll the ageing population had on families. The support of government organisations emerged as a facilitator for adoption of geriatric care principles. CONCLUSIONS: This qualitative study uncovered important data to inform the implementation of quality improvement and capacity building models for older people care in Mexico. There appears to be strong potential for a culturally appropriate translation of high-income country older people care models within the Mexican healthcare context. IMPLICATIONS FOR PRACTICE: Findings suggests there is a need to increase geriatric capacity building among helathcare professionals in Mexico. This will be an important step in improving care for hospitalised older people.

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RESUMO

Desde 1899 se inició la enseñanza de técnicos en enfermería en Cuba. En los sesenta los planes y programas en enfermería fueron perfeccionados. Actualmente ofrecen a los estudiantes la posibilidad de afinar sus hábitos y habilidades en el cuidado de los individuos, así como el desarrollo del análisis, la solución de problemas, la utilización del método epidemiológico y el trabajo en equipo. La educación en el trabajo es considerada el eje central de la formación donde los aspectos sociales, psíquicos y biológicos son abordados de una manera conjunta. En 1976 se inició la licenciatura en enfermería, la cual ha sufrido varias modificaciones. Su duración es de cinco años y se ha hecho énfasis en el cuidado primario a la salud. Algunas de las características que tienen los egresados son destreza para ofrecer un cuidado enfermero integral; capacidad para promover la salud y brindar cuidados tanto a pacientes ambulatorios como hospitalizados que requieren rehabilitación física, psíquica y social; capacidad para conducir y colaboraren la educación formal, en el entrenamiento de personal, así como, para tomar parte en proyectos de investigación biomédica y de enfermería. En la actualidad el avance en la ciencia y tecnología obliga a cambios en planes y programas centrados en la atención primaria a la salud, hacia el cuidado enfermero hospitalario y multidisciplinario, así como a la enseñanza de una nueva disciplina en salud: la sanología. Se considera a la capacitación como un proceso sistemático y científico de aprendizaje permanente. Para el año 2000 se contará con la cantidad suficiente de recursos humanos para el cuidado enfermero, tanto en cantidad como en calidad.

Since 1899, technical nursing began training in Cuba. During the 60's nursing plans and programs were perfected. This programs offer the possibility to perfect their habits and skills for the care of individuals. The abilities related to the analysis and solution of problems were also developed, as well as the utilization of the epidemiologic method and team work. Education "on - the - job" is considered as a central axis for training, where the social, psychic and biological aspects come together. On the other hand, the bachelor's degree program in nursing started in 1976 and has gone through several modifications in time. The emphasis has been placed on the aspects concerning primary health care. Among the noteworthy characteristics of the graduate's profile are ability for offering integral nursing care promoting health, care for ambulatory and hospitalized patients, to collaborate in the formal education and training of personnel, as well as take part in biomedical and nursing research projects. The advancement in sciences and technology requires a change centered on primary health care and with a major shifting of the nursing hospital teaching to poli-clinical learning, a type of teaching based on a new health science: "healtho-logy". The actualization is considering learning process permanent, scientific and systemic. At 2000, there will be sufficient amounts of human resources in nursing, in both quantity as well as quality.

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