RESUMO
We conducted interviews with 27 health care personnel in Bogotá, Colombia, to examine provider barriers and facilitators to screening for intimate partner violence (IPV). We used systematic qualitative analysis to identify the range and consistency of beliefs. We found that respondents did not routinely screen for IPV. Providers listed numerous barriers to screening. Ways to improve screening included increased clinician training, installing systematic IPV screening, providing patient education, and implementing health care setting interventions. Improving the care for IPV survivors will involve translating health care personnel preferred solutions into more systematic IPV screening interventions.
Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Relações Profissional-Paciente , Maus-Tratos Conjugais , Adulto , Colômbia , Feminino , Humanos , Entrevistas como Assunto , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Papel Profissional , Pesquisa Qualitativa , Fatores de Risco , Fatores Socioeconômicos , Maus-Tratos Conjugais/diagnóstico , Maus-Tratos Conjugais/prevenção & controle , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To compare mothers' assessments of nutritional status with anthropometric measures and gain further insights into mothers' reasons for their judgment. DESIGN: Each mother was asked to assess the nutritional status of her child and 2 other children and to compare all 3. Rates for "hits" and "misses" between mothers' assessment and physical anthropometry were analyzed using the binomial test. The rationale for the mothers' assessments was explored through open-ended questions. SETTING: A rural clinic in an indigenous area of Mexico. PARTICIPANTS: 31 mothers of children 1-5 years of age. MAIN OUTCOME MEASURES: Physical anthropometry and mothers' assessments. RESULTS: A significant proportion (P Assuntos
Antropometria
, Transtornos da Nutrição Infantil/diagnóstico
, Conhecimentos, Atitudes e Prática em Saúde
, Mães/psicologia
, Criança
, Pré-Escolar
, Feminino
, Humanos
, Lactente
, Masculino
, México
, Mães/educação
, Avaliação Nutricional
, Inquéritos Nutricionais
, Estado Nutricional
, Saúde da População Rural
RESUMO
Background. The objetive was to assess the extent to which similarities in cultural beliefs and practices related to home management of diarrhea would permit general recommendations to improve the content of health care messages. Methods. We studied six communities in Mexico, covering rural and urban conditions, different ethnic groups, and different socioeconomic levels. Systematic data collection relied on open-ended, face-to-face interviews with mothers of children under 5 years of age who had an episode of diarrhea. Similarities among communities were assessed by means of a quadratic assignment procedure applied to signs, symptoms, and treatment matrices. Significant similarity among most of the communities sustained use of a global composite matrix to represent all communities. Results. We suggest specific recommendations to promote sound home management of diarrhea based on significant correlations among signs and symptoms with treatments. Signs and symptoms include those promoted by the National Program for the Control of Diarrheal Diseases(diarrhea, fever, vomiting) and others commonly mentioned by mothers (stomachache, sadness, restlessness, refusal to eat). Similarly, recommendations to use home based treatments based on beliefs related to their use may include the feeding of rice water, soups, and broth to a child who is sad, or rice-gruel and teas for a child with a fever. Conclusion. Our study supports that there are enough similarities among mothers' beliefs and practices for the care of acute diarrhea in childhood to support general recommendations at the program level
Assuntos
Humanos , Criança , Doença Aguda , Características Culturais , Diarreia/terapia , Medicina Tradicional , Casas de Saúde , População Rural , População Urbana , MéxicoRESUMO
Objetivo. Identificar los términos utilizados por las madres para referirse a enfermedades, signos y síntomas relacionados con infecciones respiratorias aguda, así como los signos de alarma que las motivan a buscar atención médica; asimismo, describir prácticas comunes de manejo de la enfermedad en el hogar. Material y métodos. Se trata de un estudio etnográfico en seis comunidades rurales del altiplano mexicano. Se entrevistó a 12 informantes clave, a seis madres de niños fallecidos por infección respiratoria aguda, y a 24 madres de niños menores de cinco años, con diversas técnicas etnográficas para complementar la información obtenida ("triangulación"). Resultados. Las enfermedades comúnmente identificadas incluyeron gripa, anginas, tos, bronquitis, pulmonía, neumonía y "broncomonía". Los síntomas clave para el diagnóstico fueron escurrimiento de moco nasal, dolor de garganta, tos, dolor de cabeza o de cuerpo, calentura, "hervor" de pecho, y referencias a que el niño "está molesto o llorón", y se pone morado o le hace falta el aire. La taquipnea fue referida como "respira fuerte", "respira mucho", "respira rápido" y "tiene sesido", el tiraje, "se le hunde el pecho", el estridor, como "quejido o ronquido de pecho"; la sibilancia, como "ronquido de pecho", y para la cianosis, "se pone morado". Entre los tratamientos ofrecidos en el hogar destacan el uso de tés, aplicación de sebo o pomada en pecho y espalda. No fue común la autoprescripción de antibióticos pero sí la de antipiréticos. La mayoría de las madres reconoció enfermedades leves y, en menor proporción, graves. Ante un caso grave de insuficiencia respiratoria aguda, la opción más frecuentemente elegida fue acudir a la clínica del proyecto; en segundo lugar al médico particular en la cabecera municipal, y al hospital de la Secretaría de Salud en la Jurisdicción. La cercanía y el menor costo fueron razones frecuentemente aducidas para estas elecciones. Conclusiones. Esta información puede resultar útil para mejorar la comunicación con las madres
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Adolescente , Adulto , Infecções Respiratórias/diagnóstico , Entrevistas como Assunto , Terminologia , Antropologia CulturalRESUMO
Acute respiratory infections (ARI) are among the principal causes of mortality of children under 5 years of age. Most deaths are due to pneumonia. which, when timely identified and properly treated, could be avoided. An effective case management scheme, based on early recognition of pneumonia and prompt antibiotic treatment, relies on early recognition of alarm signs by mothers and community health workers. For mothers to undestand and act on advice from health workers, language and concepts commonly used by mothers should be utilized. The present study was carried out to compare the relative effectiveness of two different methods to elicit local terms used by mothers to refer to ARI symptoms/signs/treatments. A comparison was made among the terms elicited by a free listing o common terms mentioned by mothers in relation to ARI, and the terms they recognized when looking at a video that showed children with different ARI signs. The video was shown in a community and a clinical setting, in order to identify strengths and weaknesses of showing it in these settings. The video elicited more signs dealing with serious illness, respiratory distresss and general malaise, but missed non-visual signs, such as fever, lack of appetite or pain. Also, mothers tended to be distracted by trivial signs, such as skin color. Free listing was easier to administer and elicited more non-life-threatenin symptoms/signs, but mothers were more prone to drift away and mention terms not related to respiratory illness. Showing the video in the clinic elicited more medical-related terms, and was easier to show than in the community. In conclusion. choice of either of the two methods depends on the researcher's purpose. Using both methods produced a larger list of terms associated with ARI