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O aplicativo móvel CalcVAN foi desenvolvido para auxiliar os profissionais de saúde para otimizar as doses de vancomicina em pacientes hospitalizados. Porém, é imprescindível avaliar a sua usabilidade antes de disponibilizá-lo para prática clínica. Assim, o objetivo do estudo é avaliar a usabilidade do aplicativo móvel na perspectiva dos profissionais de saúde. Trata-se de um estudo descritivo, de avaliação heurística da usabilidade de um aplicativo móvel. Foram convidados profissionais da área de saúde com expertise no tema de gerenciamento de antimicrobianos e vancomicina. O instrumento validado Smartphone Usability questionnaiRE (SURE) foi utilizado para mensuração da usabilidade por meio de um questionário on-line. Vinte e um especialistas participaram do estudo, com média de idade de 32,6 anos, sendo a maioria de mulheres (n = 14, 66,7%), profissionais farmacêuticos (n = 13, 61,9%), com pós-graduação lato sensu (n = 10, 47,6%), que trabalhavam em hospitais públicos ou privados (n = 15, 71,4%) e com média de experiência em 9,7 anos. Com base na interpretação dos resultados obtidos pelo instrumento SURE, a média de usabilidade geral do CalcVAN foi de 83 pontos, com escore menor de 78 e maior de 90 pontos. O teste de usabilidade foi enquadrado nos dois últimos níveis, 70 e 80, onde os profissionais de saúde passaram a concordar fortemente e totalmente, indicando que o aplicativo móvel apresenta uma usabilidade satisfatória. O CalcVAN atingiu uma usabilidade satisfatória e atende as necessidades e exigências dos profissionais de saúde, mostrando--se eficiente para realizar as funções propostas.
The CalcVAN app was developed to assist healthcare professionals in optimizing vancomycin doses for hospitalized patients. However, the usability test before making it available for clinical practice is essential. Therefore, the study aims to evaluate the usability of the app from the perspective of health professionals. A descriptive study, a heuristic evaluation of the usability of a mobile application was conducted. Healthcare professionals with expertise in antimicrobial management and vancomycin were invited to participate. The validated Smartphone Usability questionnaiRE (SURE) was used to measure usability through an online questionnaire. Twenty-one experts participated in the study, with a mean age of 32.6 years, mostly of them women (n = 14, 66.7%), pharmacists (n = 13, 61.9%), with postgraduate education (n = 10, 47.6%), working in private or public hospitals (n = 15, 71.4%), and a mean experience of 9.7 years. Overall usability score for CalcVAN was 83 points, ranging from a minimum of 78 to a maximum of 90 points. The usability test registered within the last two levels, 70 and 80, with users expressing strongly and fully agreed, indicating that the app demonstrates satisfactory usability. CalcVAN achieved satisfactory usability, fulfilling the needs and requirements of health professionals, proving to be efficient in performing the intended functions.
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Humanos , Masculino , Feminino , AdultoRESUMO
In the Brazilian Amazon, snakebite envenomations (SBEs) disproportionately affect Indigenous populations, and have a significantly higher incidence and lethality than in non-Indigenous populations. This qualitative study describes the Indigenous and biomedical healthcare domains for SBE care from the perspective of the Indigenous medical and nursing students in Manaus, Western Brazilian Amazon. In-depth interviews were conducted with five Indigenous students from the Amazonas State University, between January and December 2021. The interviews were analyzed using inductive content analysis. We organized an explanatory model with five themes: (1) participants' identities; (2) causality levels in Indigenous and biomedical systems; (3) therapeutic itineraries in Indigenous and biomedical systems; (4) ideological implications of adding biomedical devices to Indigenous healing systems; and (5) therapeutic failure in and efficacy of Indigenous and biomedical systems. From a noncolonial perspective and seeking to increase the quality and acceptability of health care for the Indigenous populations of the Brazilian Amazon, the training of Indigenous health professionals presents itself as a promising strategy. For this goal, universities should serve as empowering settings for Indigenous health students that support them in their growth and development, raise their awareness of injustice, and catalyze change toward a culturally adapted and effective service for the users.
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OBJECTIVES: Candida spp. is an opportunistic pathogen that causes superficial and invasive infections with nosocomial outbreaks without strict hygiene protocols. Herein, we assessed oral colonisation by Candida spp. in 209 Intensive Care Unit (ICU) patients between July 2021 and April 2022, conducting clinical, epidemiological, and microbiological characterisation of those developing oral or invasive candidiasis. METHODS: Initial oral swabs were collected within 24 h of admission in the ICU, followed by collections on Days 2, 4, 6 and 8. Swabs from denture-wearing patients, abiotic surfaces, healthcare professionals' hands, and retroauricular regions were also obtained. Recovered yeasts and filamentous fungi were identified using MALDI-TOF MS and morphological characteristics, respectively. Genetic similarity of Candida spp. isolates was evaluated using Amplified fragment length polymorphism (AFLP), and the antifungal susceptibility profile was determined by broth microdilution. RESULTS: In the study, 64.11% of patients were orally colonised by Candida spp. Of these, 80.59% were colonised within the first 24 h. Oral colonisation also occurred on subsequent days: 50%/Day 2, 26.92%/Day 4, and 11.53%/Days 6 and 8. Of the patients, 8.61% had oral candidiasis, mainly pseudomembranous. Among orally colonised patients, 2.23% developed invasive candidiasis. Besides, 89.47% of healthcare professionals evaluated were colonised. MALDI-TOF MS identified different yeast species, and C. albicans (45.34%), C. tropicalis (15.7%), and C. parapsilosis sensu stricto (9.88%) were the most prevalent. AFLP analysis indicated a high genetic correlation (≥97%) between C. parapsilosis sensu stricto isolates from patients and professionals. Three resistant C. albicans isolates were also found. CONCLUSION: This study reported a diversity of yeast and filamentous fungi species in ICU patients and highlighted early Candida spp. colonisation risks for invasive candidiasis, as well as the potential horizontal transmission in the nosocomial setting, emphasising the need for effective infection control measures.
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Candida , Pessoal de Saúde , Unidades de Terapia Intensiva , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Candida/genética , Candida/isolamento & purificação , Candida/efeitos dos fármacos , Candida/classificação , Idoso , Adulto , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Infecção Hospitalar/microbiologia , Infecção Hospitalar/epidemiologia , Testes de Sensibilidade Microbiana , Candidíase Bucal/microbiologia , Candidíase Bucal/epidemiologia , Candidíase Invasiva/microbiologia , Candidíase Invasiva/epidemiologia , Idoso de 80 Anos ou mais , Análise do Polimorfismo de Comprimento de Fragmentos Amplificados , Boca/microbiologiaRESUMO
Abstract This article aims to analyze the prevalence of reporting and notification of violence in children and adolescents in the work of clinical health professionals. The search was performed in six electronic databases and the gray literature for studies published until June 1, 2022. Estimates of interest were calculated using random effects meta-analyses. Two reviewers independently evaluated the potentially eligible studies according to the following criteria: cross-sectional studies carried out with health professionals who provided clinical care for children and adolescents and dealt with violence cases. Two reviewers extracted data on included trial characteristics, methods, and outcomes. Expectations of interest were transformed using random effects meta-analyses. The meta-analysis of the prevalence of reports of violence performed with 42 articles was 41%. The notification meta-analysis occurred with 39 articles and was 30%. About one in two health professionals face situations of violence against children and adolescents in their clinical practice (41%), and approximately one in three health professionals report the cases (30%).
Resumo O objetivo do artigo é analisar a prevalência de relato e notificação de violência em crianças e adolescentes no trabalho de profissionais clínicos da saúde. A busca foi realizada em seis bases de dados eletrônicas e na literatura cinzenta para estudos publicados até 1º de junho de 2022. As estimativas de interesse foram calculadas usando meta-análises de efeitos aleatórios. Dois revisores avaliaram de maneira independente os estudos potencialmente elegíveis de acordo com os seguintes critérios: estudos transversais com profissionais da saúde que prestavam atendimentos clínicos voltados a crianças e adolescentes e que se depararam com casos de violência. Dois revisores extraíram dados sobre as características dos estudos incluídos, métodos e resultados. As estimativas de interesse foram calculadas usando meta-análises de efeitos aleatórios. A meta-análise de prevalência de relato de violência realizada com 42 artigos foi de 41%. A meta-análise da notificação ocorreu com 39 artigos e foi de 30%. Aproximadamente um a cada dois profissionais da saúde se deparam com situações de violência contra crianças e adolescentes em sua prática clínica (41%) e cerca de um a cada três profissionais da saúde notificam os casos (30%).
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This study evaluated the barriers that interfere with access to diagnosis and treatment of tuberculosis (TB) from the perspective of the patient and health professionals globally. Using the PICo acronym, the question we asked was "What are the barriers that interfere with access to tuberculosis diagnosis and treatment (I) from the perspective of patients and/or health professionals (P) across countries globally (Co)?". We searched the following databases: EMBASE, Scopus, MEDLINE, Latin American and Caribbean Literature in Health Sciences (LILACS), and Web of Science. On Rayyan, duplicates were removed and extraction was done afterward by two authors independently, followed by a tiebreaker. Using a Critical Appraisal Tool proposed by the Joanna Briggs Institute, the methodological quality of the article was assessed. From 36 published articles, the barriers to tuberculosis diagnosis as obtained from our study include information scarcity/low TB knowledge, exorbitant cost of transport, sample collection challenges, long distance to health facility, gender limitations, lack of decentralized diagnostic services, payment for diagnosis and testing, medication side effects, multiple visits during therapy, delayed diagnosis, poor human resources, low knowledge of medical practitioners, concerns regarding the efficacy of treatment, poor facility coordination, poor socioeconomic factors, fear and stigmatization of TB, and wrong initial diagnosis. The review of studies on TB diagnosis and treatment barriers evidences the diverse barriers to the eradication of tuberculosis. Eliminating these barriers is an onus that lies on policy makers, citizens, and health workers alike, with the joint aim of reducing the global TB burden.
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Acessibilidade aos Serviços de Saúde , Tuberculose , Humanos , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico , Saúde Global , Pessoal de SaúdeRESUMO
INTRODUCTION: Home care provided by dentists is crucial for ensuring adequate oral care. However, oral health professionals face challenges in delivering treatment at patients' residences due to a lack of resources. Our objective was to explore dentists' perspectives and experiences of dental home care and potential challenges for its implementation. METHODS: The study took a qualitative approach. Guided by a semi-structured interview schedule, data were gathered using recorded interviews with 22 dental professionals. After transcription, data were analysed thematically using the Discourse of the Collective Subject (DCS) method, using Qualiquantisoft. RESULTS: The majority of participants were female (n = 20), aged between 30 and 40 years old, and predominantly specialising in primary care (n = 6) or endodontics (n = 6). All participants provided home care, performing general dental procedures, normally responding to requests from the work team (n = 13) or family (n = 7). Six main categories on to the topic emerged: importance and access to home care, procedures performed during home visits, discussions about post-home care, professional competence and patient-centred care, positive aspects of home care, and negative aspects and challenges faced in this type of care. CONCLUSION: This study highlights the fundamental, yet complex, role of home care in dentistry. Continuity of treatment through adaptability and a patient-centred approach are important.
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O estudo tem como objetivo analisar os fatores associados ao uso adequado dos Equipamentos de Proteção Individual (EPI) pelos trabalhadores da Atenção Primária à Saúde (APS). Estudo transversal, realizado no Brasil, em ambiente virtual entre os meses de agosto/2020 e março/2021. Para a coleta de dados utilizou-se o instrumento validado "E.P.I. - APS COVID-19". Foram utilizados testes qui-quadrado ou exato de Fisher, razão de prevalência, Intervalo de Confiança de 95% e regressão de Poisson com significância p≤0,005. Pesquisa aprovada pelo Comitê de Ética em Pesquisa com Seres Humanos. Participaram da pesquisa 455 trabalhadores. Os trabalhadores com 37 anos ou mais apresentaram prevalência de 1,59 vezes maior para uso adequado de óculos/protetor facial, 1,39 vezes maior para máscara N95 e 1,23 vezes maior para a higienização correta das mãos. O uso de luvas apresentou uma prevalência 35% maior para os trabalhadores com carga horária ≤ 40 horas. A faixa etária 37 anos ou mais foi associada ao uso de máscara N95 (RP=1,107) e a higiene das mãos (RP=1,075). A carga horária ≤ 40 horas foi associada ao uso de luvas (RP=0,846). Conclui-se que são fatores associados ao uso adequado de EPI a faixa etária 37 anos ou mais e a carga horária ≤ 40 horas.
This study aims to analyze the factors associated with the proper use of Personal Protective Equipment (PPE) by Primary Health Care (PHC) workers. Cross-sectional study, carried out in Brazil, in a virtual environment between August/2020 and March/2021. For data collection, the validated instrument "P.P.E. - PHC COVID-19" was used. Chi-square or Fisher's exact tests, prevalence ratio, 95% confidence interval, and Poisson regression with p≤0.005 significance were used. The research was approved by the Ethics Committee for Research with Human Beings and 455 workers participated in the survey. Workers aged 37 years or older had a prevalence of 1.59 times higher for proper use of glasses/face shields, 1.39 times higher for N95 masks, and 1.23 times higher for correct hand hygiene. The use of gloves showed a 35% higher prevalence for workers with working hours of ≤ 40 hours. The age group 37 years or older was associated with the use of N95 masks (PR=1.107) and hand hygiene (PR=1.075). Working hours of ≤ 40 hours were associated with the use of gloves (PR=0.846). It is concluded that the factors associated with the proper use of PPE are age group 37 years or older and working hours of ≤ 40 hours.
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Atenção Primária à Saúde , Equipamento de Proteção Individual , COVID-19RESUMO
Introdução: A pandemia da COVID-19 tem impactado signicativamente a saúde mental dos profissionais de saúde, especialmente dos enfermeiros que estão na linha de frente do combate à doença. Nesse contexto, a síndrome de Burnout é um fenômeno que tem recebido destaque, pois pode levar ao esgotamento físico e emocional desses profissionais. Objetivo: Este artigo tem como objetivo analisar a relação entre enfermeiros e a síndrome de Burnout diante da pandemia da COVID-19. Método: Trata-se de revisão de literatura cientíca que abordam a temática em questão. Resultados: Os resultados apontam que a pandemia da COVID-19 aumentou a sobrecarga de trabalho dos enfermeiros, que têm enfrentado condições adversas de trabalho, como falta de equipamentos de proteção individual e o medo de contaminação. Essas condições têm levado a um aumento dos níveis de estresse e ansiedade entre os enfermeiros, o que pode contribuir para o desenvolvimento da síndrome de Burnout. Portanto, é necessário que sejam implementadas medidas de proteção aos profissionais de saúde, como a oferta de suporte emocional e psicológico, além de uma carga de trabalho adequada. Conclusão: A pandemia da COVID-19 teve um impacto signicativo na saúde mental dos profissionais da equipe de enfermagem, com aumento da prevalência de sintomas de depressão, ansiedade e estresse. É essencial fornecer suporte psicológico e emocional, melhorar as condições de trabalho e garantir o acesso a equipamentos de proteção adequados. Investir na saúde mental desses profissionais é fundamental para o bem-estar individual e a qualidade do cuidado aos pacientes. Instituições de saúde, gestores e profissionais devem reconhecer essa importância e trabalhar juntos para fornecer o suporte necessário durante e após a pandemia.(AU)
ntroduction: The COVID-19 pandemic has signicantly impacted the mental health of health professionals, especially nurses who are on the front lines of ghting the disease. In this context, the Burnout syndrome is a phenomenon that has been highlighted, as it can lead to physical and emotional exhaustion of these professionals. Objective: This article aims to analyze the relationship between nurses and the Burnout syndrome in the face of the COVID-19 pandemic. Method: For this purpose, books and scientic articles that address the subject in question were consulted. Results: The results show that the COVID-19 pandemic has increased the workload of nurses, who have been facing adverse working conditions, such as lack of personal protective equipment and fear o f contamination. These conditions have led to increased levels of stress and anxiety among nurses, which may contribute to the development of the Burnout syndrome. Therefore, it is necessary to implement protective measures for health professionals, such as offering emotional and psychological support, in addition to an adequate workload. Conclusion: The COVID-19 pandemic had a signicant impact on the mental health of nursing staff, with an increased prevalence of symptoms of depression, anxiety and stress. It is essential to provide psychological and emotional support, improve working conditions and ensure access to adequate protective equipment. Investing in the mental health of these professionals is essential for individual well-being and the quality of patient care. Health institutions, managers and professionals must recognize this importance and work together to provide the necessary support during and after the pandemic.(AU)
Introducción: La pandemia de COVID-19 ha impactado signi cativamente la salud mental de los profesionales de la salud, especialmente las enfermeras que están en primera línea luchando contra la enfermedad. En este contexto, el síndrome de Burnout es un fenómeno que ha recibido atención, ya que puede provocar agotamiento físico y emocional de estos profesionales. Objetivo: Este artículo tiene como objetivo analizar la relación entre enfermeras y síndrome de Burnout ante la pandemia de COVID-19. Método: Se trata de una revisión de la literatura cientí ca que aborda el tema en cuestión. Resultados: Los resultados indican que la pandemia de COVID-19 ha aumentado la carga de trabajo de las enfermeras, quienes han enfrentado condiciones laborales adversas, como falta de equipos de protección personal y miedo a la contaminación. Estas condiciones han provocado mayores niveles de estrés y ansiedad entre las enfermeras, lo que puede contribuir al desarrollo del síndrome de Burnout. Por ello, es necesario implementar medidas de protección para los profesionales sanitarios, como ofrecer apoyo emocional y psicológico, además de una carga de trabajo adecuada. Conclusión: La pandemia de COVID-19 tuvo un impacto signi cativo en la salud mental de los profesionales del equipo de enfermería, con aumento en la prevalencia de síntomas de depresión, ansiedad y estrés. Es fundamental brindar apoyo psicológico y emocional, mejorar las condiciones laborales y garantizar el acceso a equipos de protección adecuados. Invertir en la salud mental de estos profesionales es fundamental para el bienestar individual y la calidad de la atención al paciente. Las instituciones, gestores y profesionales de la salud deben reconocer esta importancia y trabajar juntos para brindar el apoyo necesario durante y después de la pandemia. (AU)
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Saúde Mental , Pessoal de Saúde , Esgotamento Psicológico , COVID-19 , EnfermeirosRESUMO
The communication of e-Health has been transformed with the advancement of information technologies, therefore it is feasible to carry out studies in the context of health professionals' interactions. Objective: This study aimed to design and validate a preliminary questionnaire to investigate the context of the communications of health professionals through information technologies considering three significant dimensions. Method: The stages provided by Hernández Sampieri guided the building, validation through Cronbach's alpha and factorial analysis. The questionnaire was applied to 43 participants who simulated health professionals. Results: We obtained an instrument that includes a demographic data section and 20 items distributed into three factors. Internal consistency reliability with Cronbach's alpha values generally of 0.848 and higher than 0.811 was obtained in each dimension. Kaiser-Meyer-Olkin's measure of sampling adequacy was regular, with 0.781, and Bartlett's test of sphericity was significant (p < 0.001). Conclusion: It is necessary to apply in real-world environments to reaffirm the results obtained.
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Pessoal de Saúde , Humanos , Inquéritos e Questionários , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Reprodutibilidade dos Testes , Feminino , Tecnologia da Informação/estatística & dados numéricos , Masculino , Adulto , Psicometria/instrumentação , Psicometria/métodos , Comunicação , Análise FatorialRESUMO
In this study, we aimed to identify how Information Technology professionals make sense of digital transformation, in order to compare this perception with the scientific literature on the topic. To conduct the research, we adopted the Social Representation Theory. Thus, via an online tool, we applied the words evocation technique as well as an ancillary questionnaire comprising open and closed questions. The expressions collected were then semantically treated and categorized, being then analyzed vis-à-vis their frequency of evocation, relevance, connectedness, and cooccurrence. Then, we performed similarity and content analyses for the open answers received. In doing so, we detected dissonance between scientific production on the concept of digital transformation and the perception of Information Technology professionals on this construct, concluding that such professionals have a technocentric view of digital transformation, based mainly on its technological aspects, which can prevent digital transformation initiatives from fully achieving the desired objectives.
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BACKGROUND: National and international guidelines on frailty assessment and management recommend frailty screening in older people. This study aimed to determine how Brazilian healthcare professionals (HCPs) identify and manage frailty in practice. METHODS: An anonymous online survey on the assessment and management of frailty was circulated virtually through HCPs across Brazil. RESULTS: Most of the respondants used non-specific criteria such as gait speed (45%), handgrip strength (37.6%), and comprehensive geriatric assessment (33.2%). The use of frailty-specific criteria was lower than 50%. The most frequently used criteria were the Frailty Index (19.1%), Frailty Phenotype (13.2%), and FRAIL (12.5%). Only 43.5% felt confident, and 40% had a plan to manage frailty. In the multivariate-adjusted models, training was the most crucial factor associated with assessing frailty, confidence, and having a management plan (p < 0.001 for all). Those with fewer years of experience were more likely to evaluate frailty (p = 0.009). Being a doctor increased the chance of using a specific tool; the opposite was true for dietitians (p = 0.03). Those who assisted more older people had a higher likelihood of having a plan (p = 0.011). CONCLUSION: Frailty assessment was heterogeneous among healthcare professions groups, predominantly using non-specific criteria. Training contributed to frailty assessment, use of specific criteria, confidence, and having a management plan. This data informs the need for standardized screening criteria and management plans for frailty, in association with increasing training at the national level for all the HCPs who assist older people.
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Idoso Fragilizado , Fragilidade , Avaliação Geriátrica , Pessoal de Saúde , Humanos , Brasil/epidemiologia , Masculino , Feminino , Idoso , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Fragilidade/terapia , Avaliação Geriátrica/métodos , Inquéritos e Questionários , Pessoa de Meia-Idade , Adulto , Idoso de 80 Anos ou mais , Gerenciamento ClínicoRESUMO
Objective This study aimed to describe the methodological process for developing a questionnaire to identify the prevalence and risk factors for chronic occupational low back pain in healthcare professionals working at hospitals. Method An exploratory crossectional survey study was carried out in Belo Horizonte, MG, Brazil, and its metropolitan region, in two stages. Initially, the authors prepared a questionnaire based on the Roland Morris disability questionnaire and sent it to a committee of low back pain specialists for validation using the Delphi technique. The second stage consisted of sending the final questionnaire to health professionals working in a hospital environment for at least 2 years and presenting chronic low back pain for at least 3 months. Results Validation occurred in two rounds of questionnaire adjustments by a panel consisting of physical therapists and physician experts in the field (orthopedists with more than 3 years of experience). Both rounds had 13 participants. The questionnaire initially consisted of 27 items, and, after validation, it had 19 items. The study included 65 subjects, with an average age of 40.91 years old and an average time working at a hospital of 40 hours per week. The total sample had 76.9% of physicians, 10.8% of physical therapists, and 12.3% of nurses or nursing technicians. Most (52.3%) subjects reported staying in uncomfortable positions affecting the lower back for 5 to 10 hours per day. Conclusion We developed and validated, using the Delphi technique, a questionnaire on the prevalence and risk factors associated with chronic occupational low back pain among healthcare professionals working at hospitals. This unprecedented tool can benefit the population studied since the questionnaires currently used to evaluate chronic low back pain are not specific for investigating the occupational cause of this condition.
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Abstract Objective This study aimed to describe the methodological process for developing a questionnaire to identify the prevalence and risk factors for chronic occupational low back pain in healthcare professionals working at hospitals. Method An exploratory crossectional survey study was carried out in Belo Horizonte, MG, Brazil, and its metropolitan region, in two stages. Initially, the authors prepared a questionnaire based on the Roland Morris disability questionnaire and sent it to a committee of low back pain specialists for validation using the Delphi technique. The second stage consisted of sending the final questionnaire to health professionals working in a hospital environment for at least 2 years and presenting chronic low back pain for at least 3 months. Results Validation occurred in two rounds of questionnaire adjustments by a panel consisting of physical therapists and physician experts in the field (orthopedists with more than 3 years of experience). Both rounds had 13 participants. The questionnaire initially consisted of 27 items, and, after validation, it had 19 items. The study included 65 subjects, with an average age of 40.91 years old and an average time working at a hospital of 40 hours per week. The total sample had 76.9% of physicians, 10.8% of physical therapists, and 12.3% of nurses or nursing technicians. Most (52.3%) subjects reported staying in uncomfortable positions affecting the lower back for 5 to 10 hours per day. Conclusion We developed and validated, using the Delphi technique, a questionnaire on the prevalence and risk factors associated with chronic occupational low back pain among healthcare professionals working at hospitals. This unprecedented tool can benefit the population studied since the questionnaires currently used to evaluate chronic low back pain are not specific for investigating the occupational cause of this condition.
Resumo Objetivo Este estudo pretende descrever o processo metodológico para a elaboração de um questionário para identificar a prevalência e os fatores de risco associados à dor lombar ocupacional crônica nos profissionais da área da saúde que atuam em nível hospitalar. Método Foi realizado um estudo transversal exploratório do tipo questionário. O estudo foi realizado na cidade de Belo Horizonte e região metropolitana, em duas etapas. Inicialmente foi elaborado pelos autores um questionário baseado no questionário de deficiências Roland Morris e enviado a um comitê de especialistas em lombalgia para validação do mesmo através da técnica Delphi. A segunda etapa consistiu em enviar o questionário final a profissionais de saúde que atuam em ambiente hospitalar há pelo menos 2 anos e que tenham lombalgia crônica há pelo menos 3 meses. Resultados A validação foi realizada em duas rodadas de adequações do questionário, com painel composto por fisioterapeutas e médicos especialistas na área (ortopedistas com mais de 3 anos de atuação). Ambas as rodadas contaram com 13 participantes. O questionário foi composto inicialmente por 27 itens e, após validação, 19 itens. O estudo incluiu 65 indivíduos, com idade média de 40,91 anos e tempo médio de atuação em nível hospitalar semanal de 40 horas. A amostra total possuía 76,9% médicos, 10,8% fisioterapeutas e 12,3% enfermeiros ou técnicos de enfermagem. A maioria (52,3%) dos indivíduos relatou manter-se em posições desconfortáveis que afetam a região lombar por 5 a 10 horas por dia. Conclusão Foi desenvolvido e validado, pela técnica Delphi, um questionário sobre a prevalência e fatores de risco associados a dor lombar ocupacional crônica entre profissionais da área da saúde que atuam em nível hospitalar. Este instrumento inédito pode trazer benefícios para a população estudada, visto que os questionários utilizados atualmente para a avaliação de dor lombar crônica não são específicos para a investigação da causa ocupacional de tal condição.
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El presente documento resume los principales aportes del conversatorio titulado "Trabajo interdisciplinario en las profesiones de la voz humana: retos, límites y proyecciones", organizado por Vocology Center el 18 de julio de 2023, que reunió a líderes y representantes de diversas agremiaciones relacionadas con la voz humana, incluyendo profesionales del ámbito clínico, artístico, rehabilitación vocal, voz ocupacional, pedagogía vocal y otras disciplinas afines. El propósito de este conversatorio fue promover un debate crítico sobre la naturaleza del trabajo interdisciplinario en el estudio de la voz humana. Se exploraron los desafíos que surgen al configurar equipos de trabajo que incluyan profesionales con diferentes enfoques y experticias en el abordaje de la voz, así como los límites inherentes a los diversos roles y funciones desempeñados por los profesionales especializados en este campo, junto con las cuestiones éticas emergentes en este proceso. Con un enfoque encaminado a fortalecer alianzas interdisciplinarias, el evento se centró en la búsqueda de una comunicación y colaboración más efectiva. Este documento marca un avance significativo en la comprensión y colaboración interdisciplinar en el cuidado de la voz humana.
This document summarizes the main contributions of the panel discussion titled "Interdisciplinary work in the human voice professions: challenges, limits and projections" organized by the Vocology Center on July 18, 2023. The event brought together leaders and representatives from various associations related to the human voice, including professionals from the clinical, artistic, vocal rehabilitation, occupational voice, vocal pedagogy, and other related disciplines. The purpose of this panel discussion was to promote a critical debate on the nature of interdisciplinary work in the study of the human voice. The discussion explored the challenges that emerge when teams that include professionals with different approaches and expertise address voice production, as well as the inherent boundaries of the various roles and functions performed by specialized professionals in this field, along with the emerging ethical issues in this process. With a focus on strengthening interdisciplinary collaborations, the event centered on seeking more effective communication and collaboration. This document represents a significant step forward in understanding and fostering interdisciplinary cooperation in the care of the human voice.
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Leprosy is an infectious neglected tropical disease, which can cause irreversible disabilities if not diagnosed in time. Colombia continues to show high rates of leprosy-related disability, mainly due to a delay in diagnosis. Limited knowledge is available that explains this delay, therefore our study aimed to explore the perceptions and experiences of leprosy health professionals with the delay in leprosy diagnosis in the Cesar and Valle del Cauca departments, Colombia. Nine semi-structured expert interviews with leprosy health professionals were conducted in May-June 2023 in Colombia. Thematic analysis was performed to analyse the interview results. Our analysis highlighted that the main reasons for delay at the health system-level included accessibility issues to obtain a diagnosis, lack of expertise by health staff, and barriers related to the organisation of the care pathway. Individual - and community-level factors included a lack of leprosy awareness among the general population and leprosy-related stigma. Diagnostic delay consists of a fluid interplay of various factors. Structural changes within the health system, such as organising integral leprosy care centres and highlighting leprosy in the medical curriculum, as well as awareness-related interventions among the general population, might help reducing diagnostic delays.
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Diagnóstico Tardio , Pessoal de Saúde , Entrevistas como Assunto , Hanseníase , Pesquisa Qualitativa , Humanos , Hanseníase/diagnóstico , Colômbia , Masculino , Feminino , Pessoal de Saúde/psicologia , Adulto , Pessoa de Meia-Idade , Conhecimentos, Atitudes e Prática em Saúde , Acessibilidade aos Serviços de SaúdeRESUMO
Background: Burnout syndrome, characterized by physical, mental, and emotional exhaustion due to continuous exposure to high-stress work conditions, has been increasingly recognized as a serious occupational phenomenon, especially amongst healthcare professionals. Recent studies indicate that illegitimate tasks-activities unrelated to one's role are a significant factor contributing to burnout. However, given the variability of work environments across regions, these findings may not apply universally. Objective: To investigate the behavior of the relationship between burnout and illegitimate tasks among healthcare professionals in Guayaquil, Ecuador. Methods: We conducted a survey of 562 healthcare professionals, including physicians, nurses, and medical/nursing interns, employing the Copenhagen Burnout Inventory and Bern Illegitimate Task Scale. Regression models were developed to predict burnout levels based on multiple factors, including demographic characteristics, professional roles, and perceptions of illegitimate tasks. Results: We revealed a statistically significant positive correlation between burnout and illegitimate tasks, with correlation coefficients ranging from 0.320 to 0.588, with higher levels of illegitimate tasks leading to increased burnout. Interestingly, we also found that age and length of service were negatively correlated with burnout, suggesting that these factors may serve as protective elements against burnout. Conclusions: Illegitimate tasks had an impact on burnout amongst healthcare professionals and emphasized the need for organizational strategies aimed at better task management to mitigate burnout risk.
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Fungal infections in neonatal intensive care units (NICU) are mainly related to Candida species, with high mortality rates. They are predominantly of endogenous origin, however, cross-infection transmitted by healthcare professionals' hands has occurred. The aim of this study was to identify Candida species isolated from the hands of healthcare professionals in a NICU before and after hygiene with 70% ethanol-based gel and evaluate virulence factors DNase, phospholipase, proteinase, hemolysin, biofilm biomass production, and metabolic activity. In vitro antifungal susceptibility testing and similarity by random amplified polymorphic DNA (RAPD) were also performed. C. parapsilosis complex was the most frequent species (57.1%); all isolates presented at least one virulence factor; three isolates (Candida parapsilosis complex) were resistant to amphotericin B, two (Candida famata [currently Debaryomyces hansenii] and Candida guilliermondii [currently Meyerozyma guilliermondii]) was resistant to micafungin, and six (Candida parapsilosis complex, Candida guilliermondii [=Meyerozyma guilliermondii], Candida viswanathi, Candida catenulata [currently Diutina catenulata] and Candida lusitaniae [currently Clavispora lusitaniae]) were resistant to fluconazole. Molecular analysis by RAPD revealed two clusters of identical strains that were in the hands of distinct professionals. Candida spp. were isolated even after hygiene with 70% ethanol-based gel, highlighting the importance of stricter basic measures for hospital infection control to prevent nosocomial transmission.
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Antifúngicos , Candida , Infecção Hospitalar , Etanol , Mãos , Testes de Sensibilidade Microbiana , Fatores de Virulência , Humanos , Mãos/microbiologia , Antifúngicos/farmacologia , Fatores de Virulência/genética , Candida/efeitos dos fármacos , Candida/isolamento & purificação , Candida/genética , Candida/patogenicidade , Etanol/farmacologia , Infecção Hospitalar/microbiologia , Infecção Hospitalar/prevenção & controle , Candidíase/microbiologia , Pessoal de Saúde , Técnica de Amplificação ao Acaso de DNA Polimórfico , Biofilmes/efeitos dos fármacos , Biofilmes/crescimento & desenvolvimento , Unidades de Terapia Intensiva Neonatal , Farmacorresistência Fúngica , Géis , Desinfecção das MãosRESUMO
Objetivo: Analisar o perfil dos profissionais da saúde de nível técnico e superior contaminados pela covid-19 no Brasil. Métodos: Estudo transversal, quantitativo, desenvolvido por meio dos dados da Pesquisa Nacional por Amostra de Domicílios (PNAD) COVID 2020, com 2.794 trabalhadores da saúde de nível técnico e superior. Foram consideradas as variáveis disponíveis no banco de dados da PNAD COVID, referentes aos meses de julho, agosto, setembro, outubro e novembro de 2020. Os dados da PNAD COVID foram transportados para um banco de dados criado no MS-Excel e analisados com estatísticas descritivas. Resultados: Os profissionais de nível técnico foram os que mais se contaminaram com a covid-19, principalmente nos estados de São Paulo, Rio de Janeiro e Maranhão; com as seguintes características: sexo feminino; da etnia parda; com domicílio já quitado, sendo este responsável pelo domicílio; não constituindo outro emprego; média de idade 40 anos; o principal sintoma evidenciado foi a dor de cabeça; e, mais de 80% não relataram apresentar comorbidades. Conclusão: O cenário atual pandêmico, para os profissionais da saúde, deixa em evidência os danos atuais e futuros, que podem afetar a saúde mental desses trabalhadores, tornando-se elucidado a necessidade de maiores estudos e olhares para esses trabalhadores. (AU)
Objective: To analyze the profile of technical and higher-level health professionals contaminated by covid-19 in Brazil. Methods: Cross-sectional, quantitative study, developed using data from the National Household Sample Survey (PNAD) COVID 2020, with 2,794 technical and higher-level health workers. The variables available in the PNAD COVID database for the months of July, August, September, October and November 2020 were considered. The PNAD COVID data were transported to a database created in MS-Excel and analyzed with statistics descriptive. Results: Professionals with a technical level were the ones who were most contaminated with covid-19, mainly in the states of São Paulo, Rio de Janeiro and Maranhão; with the following characteristics: female; of the mixed race; with the home already paid off, being responsible for the home; not constituting another job; mean age 40 years; the main symptom evidenced was headache; and more than 80% reported no comorbidities. Conclusion: The current pandemic scenario, for health professionals, highlights the current and future damage, which can affect the mental health of these workers, clarifying the need for further studies and perspectives on these workers. (AU)
Objetivo: Analizar el perfil de técnicos y profesionales de la salud de alto nivel contaminados por covid-19 en Brasil. Métodos: Estudio transversal, cuantitativo, desarrollado a partir de datos de la Encuesta Nacional por Muestra de Hogares (PNAD) COVID 2020, con 2.794 técnicos y trabajadores de la salud de nivel superior. Se consideraron las variables disponibles en la base de datos PNAD COVID para los meses de julio, agosto, septiembre, octubre y noviembre de 2020. Los datos de la PNAD COVID fueron transportados a una base de datos creada en MS-Excel y analizados con estadística descriptiva. Resultados: Los profesionales con nivel técnico fueron los más contaminados con covid-19, principalmente en los estados de São Paulo, Rio de Janeiro y Maranhão; con las siguientes características: femenino; del mestizo; con el hogar ya pagado, siendo responsable del hogar; no constituir otro trabajo; edad media 40 años; el síntoma principal evidenciado fue el dolor de cabeza; y más del 80% no informaron comorbilidades. Conclusión: El escenario pandémico actual, para los profesionales de la salud, resalta los daños actuales y futuros, que pueden afectar la salud mental de estos trabajadores, aclarando la necesidad de mayores estudios y perspectivas sobre estos trabajadores. (AU)
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COVID-19 , Saúde Ocupacional , Pessoal de Saúde , PandemiasRESUMO
Rapid changes in medical education are being fueled by advancements in science, technology, and societal structures. However, the traditional medical curriculum often struggles to keep pace with the evolving demands of medical practice in light of these advancements. Neurology presents distinctive challenges in modern medicine, requiring innovative solutions to improve patient care and support the well-being of healthcare providers. This essay delves into the intricate issues encountered by neurologists, such as the diminishing interpersonal connections in the medical field and the prevalent issue of burnout among professionals, exacerbated by outdated educational programs. This research advocates for a comprehensive approach to enhancing neurology practice through the perspectives of Medical Humanities (MH) and neurobiology, within the evolving realm of Neurohumanities. By integrating stateof-the-art neurobiological findings, MH/Neurohumanities, and a focus on empathy, the article proposes practical strategies to rejuvenate clinical practice and bolster the resilience of neurology practitioners. Furthermore, it underscores the untapped potential of artificial intelligence and machine learning while examining how the digital ecosystem could revolutionize neurology medical education. Grounded in evidence-based research and practical insights, this article offers valuable guidance for navigating the complexities of contemporary neurology practice and cultivating a workforce of healthcare professionals who possess both technological acumen and compassion.
Mudanças rápidas na educação médica estão sendo impulsionadas pelos avanços na ciência, tecnologia e estruturas sociais. No entanto, o currículo médico tradicional frequentemente luta para acompanhar as exigências em constante evolução da prática médica diante desses avanços. A neurologia apresenta desafios distintos na medicina moderna, exigindo soluções inovadoras para melhorar o cuidado ao paciente e apoiar o bemestar dos profissionais de saúde. Este ensaio explora as questões complexas enfrentadas pelos neurologistas, como a diminuição das conexões interpessoais no campo médico e o problema prevalente do esgotamento entre os profissionais, exacerbado por programas educacionais desatualizados. Esta pesquisa defende uma abordagem abrangente para aprimorar a prática da neurologia por meio das perspectivas das Humanidades Médicas (HM) e da neurobiologia, dentro do campo em evolução das Neuro- Humanidades. Ao integrar descobertas neurobiológicas de ponta, HM/Neuro-Humanidades e um foco na empatia, o artigo propõe estratégias práticas para rejuvenescer a prática clínica e fortalecer a resiliência dos profissionais de neurologia. Além disso, destaca o potencial inexplorado da inteligência artificial e da aprendizagem de máquina ao examinar como o ecossistema digital poderia revolucionar a educação médica em neurologia. Fundamentado em pesquisas baseadas em evidências e insights práticos, este artigo oferece orientações valiosas para navegar pelas complexidades da prática contemporânea da neurologia e cultivar uma força de trabalho de profissionais de saúde que possuam tanto acuidade tecnológica quanto compaixão.
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INTRODUCTION: The experiences of providers and immigrants/refugees related to healthcare in the Latin American context have not yet been aggregated. This study aimed to synthesize the qualitative evidence on this theme. METHOD: A systematic review of qualitative evidence with meta-synthesis. After identification, eligible studies were evaluated for methodological quality, and information was systematically analyzed. RESULTS: The sample comprised 26 articles. The meta-theme shows that the experiences of providers and immigrants/refugees are determined by multilevel factors. In a macro-context, these factors involve the vulnerabilities of immigrants/refugees and the healthcare system/model, and in a closer context, they involve the lack of professional training in cultural skills and communication; language barriers; and prejudice/xenophobia. Within healthcare, the relationship is mostly conflictual, asymmetric, and unable to solve problems, leading to negative repercussions for both. CONCLUSIONS: Managers involved in developing public policies and providers must consider improving the interrelationship between healthcare services and the migrant population.