Relato de experiência de atendimentos em psicoterapia breve a partir da Abordagem Centrada na Pessoa: o cuidado ao processo de luto / Experience report of brief psychotherapy sessions from the person-centered approach: caring for the bereavement process of a family / Informe de experiencia de sesiones breves de psicoterapia desde el enfoque centrado en la persona: atención al proceso de duelo de un familiar

INTRODUÇÃO: A psicoterapia breve tem sido um importante recurso no atendimento aos casos de luto relacionados à perda de um familiar, de modo que estudos têm evidenciado a necessidade de aprofundamento nesta modalidade de atendimento. OBJETIVO: Este artigo tem como objetivo a apresentação e discussão de um relato de experiência de atendimento em psicoterapia breve a partir da Abordagem Centrada na Pessoa (ACP) e tem como tema central o processo de luto. METODOLOGIA: O relato de experiência se referiu a um processo de atendimento psicoterápico que ocorreu através do Projeto de Acolhimento da Universidade Federal da Bahia, entre setembro e dezembro de 2022, totalizando 10 encontros, sendo uma sessão semanal com duração de 50 minutos cada. Os atendimentos foram realizados remotamente. Através do relato de experiência, este trabalho buscou compreender o processo de luto de um familiar sob a luz do Modelo do Processo Dual do Luto, analisando a experiência da psicóloga no processo psicoterápico breve. RESULTADOS: Como resultados principais, observou-se que o processo de luto é um fenômeno natural e complexo e deve ser compreendido dentro das particularidades contextuais e culturais de cada indivíduo/família. CONCLUSÃO: Concluiu-se pontuando a importância da temática do luto na formação dos profissionais de saúde, em especial daqueles que lidam com essa demanda na sua prática profissional.

INTRODUCTION: Brief psychotherapy has been an important resource in the care of bereavement cases related to the loss of a family member, thus studies have shown the need to deepen this modality of care OBJECTIVE: This article aims to present and discuss an experience report of brief psychotherapy care from the person-centered approach, which has as its central theme the grieving process. METHODOLOGY: The experience report referred to a psychotherapeutic service that took place through the Projeto de Acolhimento da Universidade Federal da Bahia, between September and December 2022, totaling 10 meetings, with a weekly session lasting 50 minutes each. The consultations were carried out remotely. Through an experience report, this paper sought to understand the grieving process of a family member under the Dual Grief Process Model, analyzing the psychologist's experience in the brief psychotherapeutic process. RESULTS: As the main results, the study observed that the grieving process is a natural and complex phenomenon. In this sense, the necessary study points to understanding the grieving process within the contextual and cultural particularities of each individual/family. CONCLUSION: It was concluded by pointing out the importance of the theme of mourning in the training of health professionals, especially those who deal with this demand in their professional practice.

INTRODUCCIÓN: La psicoterapia breve ha sido un recurso importante en la atención de casos de duelo relacionados con la pérdida de un familiar, por lo que los estudios han mostrado la necesidad de profundizar en esta modalidad de atención. OBJETIVO: Este artículo tiene como objetivo presentar y discutir un relato de experiencia de atención psicoterapéutica breve desde el enfoque centrado en la persona, que tiene como tema central el proceso de duelo. METODOLOGÍA: El informe de la experiencia se refirió a un servicio psicoterapéutico que tuvo lugar a través del Projeto de Acolhimento da Universidade Federal da Bahia, entre septiembre y diciembre de 2022, con un total de 10 reuniones, con una sesión semanal de 50 minutos cada una. Las consultas se realizaron a distancia. A través del relato de la experiencia, este trabajo trató de comprender el proceso de duelo de un familiar a la luz del Modelo Dual de Proceso de Duelo, analizando la experiencia de la psicóloga en el proceso psicoterapéutico breve. RESULTADOS: Como principales resultados, se concluyó que el proceso de duelo es necesario, delicado y debe ser comprendido dentro de las particularidades contextuales y culturales de cada individuo/familia. CONCLUSIÓN: Se concluyó señalando la importancia del tema del duelo en la formación de los profesionales de la salud, especialmente de aquellos que atienden esta demanda en su práctica profesional.

Terapia Centrada na Pessoa e Processo de Reorganização da Autoimagem e Autoestima: Pesquisa-Ação / Person-Centered Therapy and the Reorganizing Self-Image and Self-Esteem Process: Action Research / Terapia No Dirigida y el Proceso de Reorganización de la Autoimagen y la Autoestima: Investigación-Acción

Este artigo objetivou compreender o processo terapêutico proporcionado por uma prática interventiva de curta-duração centrada em pessoas com problemas de autoimagem corporal e autoestima. Seguindo um delineamento metodológico qualitativo, a pesquisa e as intervenções terapêuticas aconteceram sob a influência do desenho de pesquisa-ação. Trabalhou-se com as seguintes etapas: planejamento do processo terapêutico à luz das condições necessárias e suficientes para mudança de personalidade e as fases do processo terapêutico; desenvolvimento da prática de ajuda; monitoramento da ação a partir da supervisão, revisão dos atendimentos e entrevistas semiestruturadas com os participantes; análise fenomenológica empírica dos impactos afetivos da terapia a partir da perspectiva dos clientes atendidos; entendimento disso a partir do referencial rogeriano. Foram elaborados e discutidos os seguintes eixos temáticos relacionados ao processo terapêutico: fatores que levaram à busca por ajuda psicológica e constituíram a atmosfera terapêutica; significação negativa da experiência corporal; significação real da experiência de autoestima em relação ao corpo; mudanças de atitudes em relação à percepção de si e ao autocuidado. Concluiu-se que a terapia centrada na pessoa produziu impactos afetivos significativos que ajudaram esses clientes a lidar com suas experiências de imagem corporal e autoestima.

This article aimed to understand the therapeutic process provided by a short-term interventional practice centered on people with body self-esteem and self-image problems. Following a qualitative methodological design, the research and therapeutic interventions took place under the influence of the action research design. The following stages were used: planning the therapeutic process in light of the necessary and sufficient conditions for personality change and the therapeutic process phases; development of aid practice; action monitoring based on supervision, service review and semi-structured interviews with the participants; empirical phenomenological analysis of the affective impacts of therapy from the perspective of the clients assisted; understanding of this from the Rogerian framework. The following thematic axes related to the therapeutic process were elaborated and discussed: factors that led to the search for psychological help and constituted the therapeutic atmosphere; negative meaning of bodily experience; real meaning of the self-esteem experience in relation to the body; changes in attitudes towards self-perception and self-care. It was concluded that person-centered therapy produces significant affective impacts that helped these clients to deal with their body image and self-esteem experiences.

Este articulo tuvo como objetivo comprender el proceso terapéutico proporcionado por una práctica intervencionista de corta duración centrada en personas con problemas de autoimagen corporal y autoestima. Siguiendo un diseño metodológico cualitativo, la investigación y las intervenciones terapéuticas se desarrollaron bajo la investigación-acción. Se trabajó con los siguientes pasos: planificación del proceso terapéutico a la luz de las condiciones necesarias y suficientes para el cambio de personalidad y las fases del proceso terapéutico; desarrollo de prácticas de ayuda; seguimiento de la acción basado en la supervisión, revisión del servicio y entrevistas semiestructuradas con los participantes; análisis fenomenológico empírico de los impactos afectivos de la terapia desde la perspectiva de los clientes atendidos; comprensión de esto desde el referencial rogeriano. Fueron elaborados los siguientes ejes: factores que llevaron a búsqueda de ayuda psicológica y constituyen una atmósfera terapéutica; significado negativo de la experiencia corporal; significación real de la experiencia de la autoestima en relación con el cuerpo; cambios en las actitudes en relación con la autopercepción y autocuidado. Se concluyó que la terapia centrada en la persona produjo impactos afectivos significativos que ayudaron a estos clientes a lidiar con sus experiencias de imagen corporal y autoestima.

Client Satisfaction with Services Provided at Integrated Counselling and Testing Centre in a Rural Hospital, Panvel, Maharashtra, India

Introduction : HIV is a global pandemic and has been a serious concern for public health among individuals and communities. Measuring client satisfaction can help the country to carry out an evaluation of the health service system as well as, clients can develop a long-lasting relationship with the service provider. Objectives: 1) To assess the client satisfaction by the services provided at the Integrated Counselling and Testing Centre at the Rural Hospital, Panvel. 2) To provide recommendations to improve the services provided at the Integrated Counselling and Testing Centre. Method: A descriptive, cross- sectional, facility-based study was conducted in an Integrated Counselling and Testing Centre (ICTC) at a Rural Hospital, Panvel using simple random sampling technique. Exit interviews were conducted for three hundred clients after the required consent was obtained. Clients were stratified into pregnant and non- pregnant females. All clients above 18 years were included in the study however, clients not giving consent or severely ill were excluded. The data was analyzed using Microsoft Excel, and Epi Info Version 7.2. Results: Among 300 clients, 66% (198) of the clients belonged to the age group of 18-28 years and 54.3% (163) were literate. The study found that nearly74% (222) of the clients were referred and about 71.7% (215) clients were unsatisfied with the ICTC services. Conclusion: Majority of the clients were unsatisfied with the services provided at ICTC. Literate clients were more unsatisfied as compared to illiterate clients.It is further recommended that the counsellors at ICTCs should spend more time with the clients and tere should be a mandatory requirement of female counsellors.

Clients' Perspective for Quality of Services at One of the Urban Primary Health Centres (U-PHC) at Municipal Corporation Area in One of the cities of Western India

Introduction: Client satisfaction surveys are central to quality improvement at health facility. It helps in identifying areas of low satisfaction and steps to maximize patient satisfaction. Objectives: To assess client satisfaction towards services at Out Patient Department (OPD) of at an U-PHC under Ahmedabad Municipal Corporation (AMC), identify areas of low satisfaction and suggest feasible remedial measures for improvement. Method: Out of 74 U PHCs under AMC, 1 was selected through simple random sampling. Quality of care was evaluated through client's feedback which was gathered through 10 check points (on structure, process and outcome) developed by state level quality team. Responses of 300 adult (> 18 years) subjects and their mean ± standard deviation scores were calculated. These subjects were selected nd thconsecutively as 25 cases (new cases who came first and were willing) on every 2 and 4 Mondays for 6 months (Sep 2019 – Feb 2020). Results: While availability of drugs was perceived as very satisfying that of investigations was relatively an area of concern. Overall, only 1 client rated the services as average while all rest (99.6%) rated services as very good to excellent. Conclusion: Quality of services at this U PHC was good to excellent and had wider acceptability among its client.

Carl Rogers e a Recepção da Fenomenologia na Psicologia Estadunidense / Carl Rogers and the Phenomenology' Reception in American Psychology

Resumo Objetivou-se revisitar a relação de Rogers com o movimento de recepção da Fenomenologia na Psicologia estadunidense, empregando a noção historiográfica de recepção para investigar o que foi contatado por ele, em seus aspectos históricos internalistas e externalistas. Baseados nas menções de Rogers à Fenomenologia, identificaram-se sete momentos característicos de tal relação, entre 1940-1970. Como resultado, foi constatado que a Fenomenologia que Rogers menciona não é a oriunda da Filosofia europeia, mas advém de um paradigma de ciência alternativo ao positivismo hegemônico no behaviorismo. No contexto clínico, Rogers percebeu implicações desse movimento para o desenvolvimento de pesquisas e intervenções sobre o self. No campo filosófico, ele esboçou uma teoria do conhecimento baseada na experiência tácita e pré-conceitual. Na pesquisa, ele foi simpático ao desenvolvimento de investigações fenomenológicas empíricas, mas não chegou a desenvolver uma. Conclui-se que a Filosofia fenomenológica não influenciou diretamente Rogers, mas o movimento fenomenológico na Psicologia estadunidense sim.

Abstract We aim to revisit Rogers' relationship with the reception movement of Phenomenology in American Psychology. We use the historiographical notion of reception to investigate what was contacted in its internal-external historical aspects. Based on the Rogers mentions to the Phenomenology, we identify seven moments of such relationship, among 1940-1970. The Phenomenology that Rogers mentions does not derives from the European Philosophy, but it rather comes from a paradigm alternative to the hegemonic positivism in the behaviorism. In the clinic, Rogers perceived the implications of this movement for the development of research and interventions on the self. In the philosophy, he outlined a knowledge theory, based on tacit and pre-conceptual experiences. In the research, he was sympathetic to the development of empirical phenomenological investigations but did not develop any. We conclude that the phenomenological Philosophy did not influence Rogers directly, but the phenomenological movement in American Psychology did.

Are clients satisfied with communication with health workers? A study among pregnant women attending primary health care centers in Nasarawa State, Nigeria

An effective communication between health workers and clients is known to improve clients' perception, compliance, and treatment outcomes. The main objective of this study was to determine the level of client satisfaction with health workers'-client communication among pregnant women attending ANC in selected PHC facilities Nasarawa State. The study was a cross-sectional design conducted among 450 respondents consenting pregnant women during their ANC sessions. Data was collected using a structured, interviewer-administered structured questionnaire. Analysis was done using SPSS software version 20. Chi-square test and logistic regression were used for the test of significance. Results showed that 132 (29.3%) of the respondents were completely satisfied with client health worker communication. The elements of communication with the highest satisfaction were: explanation of condition to clients: 193 (42.9%); use of appropriate language: 189 (42.0%) and courtesy and respect by the provider: 188 (41.0%). Conclusion. Clients with a secondary level of education and more were more likely to be satisfied with communication with health workers. There is a need to carry out regular reorientation of PHC workers on communication with clients. (Afr J Reprod Health 2022; 26[6]:55-63)

Teoría de los cuidados, aplicada en el cuidado de niños con enfermedades neuropsiquiátricas durante la estimulación cerebral no invasiva / Theory of care, applied in the care of children with neuropsychiatric diseases during non-invasive brain stimulation

Introducción: el cuidado es la razón de ser de la profesión de enfermería y constituye su objeto de estudio, convertirlo en el centro de interés de la investigación en enfermería, es una necesidad, pues permitirá robustecer su cuerpo de conocimientos, con fundamentos y principios científicos, humanistas sustentado en modelos teóricos que orientan la disciplina y práctica profesional. Objetivo: describir la vinculación de la teoría de los cuidados al cuidado de niños con enfermedades neuropsiquiátricas durante la estimulación cerebral no invasiva. Material y métodos: revisión no sistemática de la literatura para desarrollar un análisis crítico reflexivo de documentos como: libros, tesis y artículos científicos. Se utilizaron las bases de datos bibliográficas: PubMed, CUMED, CINAHL, CUIDEN, Lilacs y Google académico. Se siguieron los principios de análisis de contenido, integrando la identificación de significados que se señalaban de forma más repetitiva, la consistencia, explicaciones y relaciones de éstos, a través de todos los estudios incluidos en esta revisión. Conclusiones: se evidencia la importancia de realizar una gestión enfocada estratégicamente en los cuidados donde se consideren valores, actitudes y conocimientos de la disciplina que conlleven a realizar un liderazgo dirigido a la meja continua de los cuidados.

Introduction: care is the raison d'être of the nursing profession and constitutes its object of study, making it the center of interest for nursing research, it is a necessity, which will strengthen its body of knowledge, with foundations and scientific, humanistic principles based on theoretical models that guide discipline and professional practice. Objective: describe the link of theory of care to the care of children with neuropsychiatric diseases during non-invasive brain stimulation. Material and methods: a non-systematic review of the literature was carried out to develop a reflective critical analysis of different documents that included books, theses and scientific articles. Bibliographic databases: PubMed, CUMED, CINAHL, CUIDEN, Lilacs and Google Scholar were used. The principles of content analysis were followed, including the identification of meanings that were indicated more repetitively, their consistency, explanations and relationships, throughout all the studies included in this review. Conclusions: Swanson's theory of care describes the relationships between nursing professionals and clients; It contributes to the nursing professional assuming responsible decisions regarding care that ensure their quality.

Carl rogers e emmanuel lévinas: caminhos éticos na Abordagem Centrada na Pessoa / Carl Rogers and Emmanuel Lévinas: ethical paths in the Person-Centered Approach / Carl Rogers y Emmanuel Lévinas: caminos éticos em el Enfoque Centrado em la Persona

O desenvolvimento da Abordagem Centrada na Pessoa foi dividido em fases que apresentam as atitudes que fazem parte da relação terapêutica, independente do público atendido. Contudo, na especificidade da psicoterapia infantil, o desenvolvimento teórico e prático da própria abordagem aponta para a existência de peculiaridades. Este estudo tem como objetivo apresentar, através de uma revisão narrativa de literatura, fundamentada na hermenêutica filosófica de Gadamer, as possíveis características relativas ao atendimento de crianças a partir de um retorno às fases da ACP. Discutimos os fundamentos iniciais do atendimento com crianças em Rogers ena perspectiva clássica de Axline, compreendendo como a ludoterapia com crianças se caracteriza nas fases não-diretiva, reflexiva, experiencial e pós-rogeriana. Discutimos sobre propostas contemporâneas nos contextos europeu, estadunidense e brasileiro. Concluímos que essa delimitação do atendimento infantil possibilita uma percepção mais clara das mudanças e aprimoramentos em relação aos trabalhos pioneiros de Rogers e Axline, sempre tendo como eixo a dimensão relacional e a tendência ao crescimento como motor do processo terapêutico.

The development of the Person-Centered Approach was divided into phases that presents the attitudes that are part of therapeutic relationship, regardless of the public served. However, in the specificity of child psychotherapy, the theoretical and practical development of the approach points to the existence of peculiarities. This study aims to present, through narrative literature review, based on Gadamer's philosophical hermeneutics, the possible characteristics related to the child therapy, starting from a return to the PCA phases. We discuss the foundations of child therapy in Rogers and Axline's classic perspective, understanding how child play therapy is characterized in non-directive, reflective, experiential and post-Rogerian phases. We discuss contemporary proposals in the European, American, and Brazilian contexts. We conclude that this delimitation enables a clearer perception of changes and improvements amongst to the Rogers and Axline's pioneering work, always having as its axis the relational dimension and the tendency to growth as a motor of the therapeutic process.

El desarrollo del Enfoque Centrado en la Persona se dividió en fases que presentan las actitudes de la relación terapéutica, independiente del público. Sin embargo, en la especificidad de la psicoterapia infantil, el desarrollo teórico y práctico del enfoque en sí mismo apunta la existencia de peculiaridades. Este estudio tiene como objetivo presentar, a través de una revisión narrativa de la literatura, basado em la hermenéutica filosófica de Gadamer, las posibles características de la psicoterapia con niños, desde el retorno a las fases de ECP. Discutimos los fundamentos de la psicoterapia con niños en Rogers, la perspectiva clásica de Axline, comprendiendo como la terapia de juego com los niños se caracterizan em las fases no directiva, reflexiva, experiencial y pos-rogeriana. Discutimos propuestas contemporáneas en los contextos europeo, estadounidense y brasileño. Concluimos que esta delimitación permite una percepción más clara de los cambios y mejoras en relación con los trabajos pioneros de Rogers y Axline, teniendo siempre como eje la dimensión relacional y la tendencia al crecimiento como motor del proceso terapéutico.

Da ludoterapia não-diretiva à ludoterapia centrada na criança - desenvolvimento histórico / From non-directive play therapy to child-centered play therapy - historical development / De la terapia de juego no-directiva a terapia de juego centrada en el nino - desarollo histórico

O desenvolvimento da Abordagem Centrada na Pessoa foi dividido em fases que apresentam as atitudes que fazem parte da relação terapêutica, independente do público atendido. Contudo, na especificidade da psicoterapia infantil, o desenvolvimento teórico e prático da própria abordagem aponta para a existência de peculiaridades. Este estudo tem como objetivo apresentar, através de uma revisão narrativa de literatura, fundamentada na hermenêutica filosófica de Gadamer, as possíveis características relativas ao atendimento de crianças a partir de um retorno às fases da ACP. Discutimos os fundamentos iniciais do atendimento com crianças em Rogers ena perspectiva clássica de Axline, compreendendo como a ludoterapia com crianças se caracteriza nas fases não-diretiva, reflexiva, experiencial e pós-rogeriana. Discutimos sobre propostas contemporâneas nos contextos europeu, estadunidense e brasileiro. Concluímos que essa delimitação do atendimento infantil possibilita uma percepção mais clara das mudanças e aprimoramentos em relação aos trabalhos pioneiros de Rogers e Axline, sempre tendo como eixo a dimensão relacional e a tendência ao crescimento como motor do processo terapêutico.

The development of the Person-Centered Approach was divided into phases that presents the attitudes that are part of therapeutic relationship, regardless of the public served. However, in the specificity of child psychotherapy, the theoretical and practical development of the approach points to the existence of peculiarities. This study aims to present, through narrative literature review, based on Gadamer's philosophical hermeneutics, the possible characteristics related to the child therapy, starting from a return to the PCA phases. We discuss the foundations of child therapy in Rogers and Axline's classic perspective, understanding how child play therapy is characterized in non-directive, reflective, experiential and post-Rogerian phases. We discuss contemporary proposals in the European, American, and Brazilian contexts. We conclude that this delimitation enables a clearer perception of changes and improvements amongst to the Rogers and Axline's pioneering work, always having as its axis the relational dimension and the tendency to growth as a motor of the therapeutic process.

El desarrollo del Enfoque Centrado en la Persona se dividió en fases que presentan las actitudes de la relación terapéutica, independiente del público. Sin embargo, en la especificidad de la psicoterapia infantil, el desarrollo teórico y práctico del enfoque en sí mismo apunta la existencia de peculiaridades. Este estudio tiene como objetivo presentar, a través de una revisión narrativa de la literatura, basado em la hermenéutica filosófica de Gadamer, las posibles características de la psicoterapia con niños, desde el retorno a las fases de ECP. Discutimos los fundamentos de la psicoterapia con niños en Rogers, la perspectiva clásica de Axline, comprendiendo como la terapia de juego com los niños se caracterizan em las fases no directiva, reflexiva, experiencial y pos-rogeriana. Discutimos propuestas contemporáneas en los contextos europeo, estadounidense y brasileño. Concluimos que esta delimitación permite una percepción más clara de los cambios y mejoras en relación con los trabajos pioneros de Rogers y Axline, teniendo siempre como eje la dimensión relacional y la tendencia al crecimiento como motor del proceso terapéutico.

Satisfaction of health care and services for parents and guardians with 0–5 years-old children / Монголын Анагаах Ухаан

Introduction@#Within the framework of health sector reform, the development of the organization, the responsibility of doctors and medical professionals, and the improvement of ethics, quality and safety of care and services are top priorities. Customer satisfaction is important for the implementation of this operation based on results and quality. The WHO Recommendation states that health professionals have a key role to play in providing information and advice to citizens and their families on how to prevent, mitigate and address air pollution, and how to inform the general public and decision-makers. ADB, the Ministry of Health, and UNICEF report that information and promotional materials on air pollution prevention are scarce and do not provide advice to clients. Therefore, it is the reason for conducting a survey to determine the level of satisfaction of clients receiving child health care.@*Materials and methods@#The survey data were collected using quantitative and qualitative research methods. In this study, totally 1160 guardians of children aged 0-5 participated from Songinokhairkhan and Bayanzurkh district and Bayankhongor aimag center. The overall satisfaction of health services is calculated using the three dimensions namely: satisfaction with health service, operation and environment of Health Organization. Satisfaction scores were assessed using an even-point scale. These are “Very Dissatisfied-1 point”, “Dissatisfied-2 point”, “Satisfied-3 point”, “Very satisfied-4 point”. The results were calculated after entering the survey data into SPSS-23, creating a database, and performing error control. Research methodology discussed at the meeting of the Academic Council of the National Center for Public Health on December 25, 2019, and the methodology was approved by the Medical Ethics Committee of the MOH (Stagnant №2).@*Results@#84.7 percent of the respondents were parents of children aged 0-5 years. Their average age is 34, most of them have higher education, and 43.0 percent of them have a household income of 500,000-1 million MNT. Guardians of children aged 0-5 years in Bayanzurkh District were “dissatisfied” with the Family Health Center’s dressing room, wardrobe, toilet and parking lot. Guardians of children aged 0-5 years in Songinokhairkhan district were “dissatisfied” in the parking lot and toilet of the health organization. Guardians of children aged 0-5 years in Bayankhongor aimag were satisfied with the services, operation and environment of the health organization. Studies have shown that 76.5 percent of the guardians did not receive air pollution risk training. As for difficulties in preventing air pollution, 31.4 percent of the surveyed population answered that they cannot change their living and working environment to prevent air pollution.@*Conclusion@#It shows the health care organizations need to improve the hospital environment as well as to provide training how to protect children from air pollution risk for guardians.

Increasing hepatitis virus screening uptake at worksites in Japan using nudge theory and full subsidies

BACKGROUND@#Despite the importance of hepatitis screening for decreasing liver cancer mortality, screening rates remain low in Japan. Previous studies show that full subsidies increase screening uptake, but full subsidies are costly and difficult to implement in low-resource settings. Alternatively, applying nudge theory to the message design could increase screening at lower costs. This study examined the effects of both methods in increasing hepatitis virus screening rates at worksites.@*METHODS@#1496 employees from a Japanese transportation company received client reminders for an optional hepatitis virus screening before their general health checkups. Groups A and B received a client reminder designed based on the principles of "Easy" and "Attractive," while the control group received a client reminder not developed using nudge theory. Additionally, hepatitis virus screening was offered to the control group and group A for a co-payment of JPY 612, but was fully subsidized for group B. The hepatitis virus screening rates among the groups were compared using a Chi-square test with Bonferroni correction, and the risk ratios of group A and group B to the control group were also calculated. To adjust for unobservable heterogeneity per cluster, the regression analysis was performed using generalized linear mixed models.@*RESULTS@#The screening rate was 21.2%, 37.1%, and 86.3% for the control group, group A, and group B, respectively. And the risk ratio for group A was 1.75 (95% confidence interval [CI] 1.45-2.12) and that of group B was 4.08 (95% CI 3.44-4.83). The parameters of group A and group B also were significant when estimated using generalized linear mixed models. However, the cost-effectiveness (incremental cost-effectiveness ratio (ICER)) of the nudge-based reminder with the full subsidies was lower than that of only the nudge-based reminder.@*CONCLUSIONS@#While fully subsidized screening led to the highest hepatitis screening rates, modifying client reminders using nudge theory significantly increased hepatitis screening uptake at lower costs per person.

A Ideia da Consideração Positiva Incondicional como Epoché: Limites e Suspensão do Quê? / The Unconditional Regard Idea as Epoché: Limits and Suspension of What? / La Idea de la Consideración Positiva Incondicional como Epoché: ¿Límites y Suspensión de Qué?

Este artigo objetiva refletir os limites da ideia de consideração positiva incondicional como uma epoché, de modo questionar o que é suspenso. Para isso, apresenta as noções husserliana de epoché e rogeriana de consideração positiva incondicional. Depois, situa as origens das apropriações da epoché pela clínica fenomenológica e pela abordagem rogeriana. Posteriormente, desenvolve reflexões que demarcam alguns limites entre essas atitudes. Conclui que a consideração positiva incondicional poderia ser a suspensão dos juízos que procedem dos afetos de simpatia, apatia e antipatia. Em uma meta-teoria, isso serve para descrever o procedimento de escuta não-diretiva sem julgamentos, a qual parte da assimilação de uma visão de mundo oriunda da Fenomenologia, mas não se trata de uma Fenomenologia pura, filosofia fenomenológica ou Psicologia Fenomenológica. A consideração positiva incondicional é uma atitude de escuta que se desenvolveu fora do método fenomenológico e não precisa ser legitimada pela epoché, não propõe nenhuma redução, não suspende a crença na tendência à autorrealização e sua suspensão não é fenomenológica. (AU)

This article aims to reflect the limits of the idea of unconditional positive regard as an epoché, to question what is suspended. It presents the husserlian notion of epoché and the rogerian concept of unconditional positive regard. Then, it situates the origins of the epoché's appropriations by the phenomenological clinic and by rogerian approach. Posteriorly, it reflections that demarcate some limits between these attitudes. It concludes that the unconditional positive regard could be the suspension of judgments that proceed from the affections of sympathy, apathy, and antipathy. In a meta-theory, this serves to describe the non-directive listening procedure without judgments, which would come from the assimilation of a worldview from Phenomenology, but it is not a pure Phenomenology, phenomenological philosophy or Phenomenological Psychology. The unconditional positive regard is a listening attitude that has developed outside the phenomenological method, and does not need to be legitimized by epoché, does not propose any reduction, does not suspend the belief of the self-actualization tendency and its suspension is not phenomenological. (AU)

Este artículo objetiva reflejar los límites de la idea de la consideración positiva incondicional como una epoché, para cuestionar lo que es suspendido. Para esto, presenta las nociones husserliana de epoché y rogeriana de consideración incondicional. Después, sitúa los orígenes de las apropiaciones de la epoché por la clínica fenomenológica y por el enfoque rogeriano. Posteriormente, desarrolla reflexiones sobre algunos límites entre estas actitudes. Concluye que la consideración incondicional podría ser la suspensión de los juicios que proceden de los afectos de simpatía, antipatía y apatía. En una meta teoría, esto sirve para describir el procedimiento de escucha no-directiva sin juicios, que parte de la asimilación de una visión de mundo fenomenológica, pero no es una Fenomenología pura, Filosofía Fenomenológica o Psicología Fenomenológica. Consideración incondicional es una actitud de escucha que se ha desarrollado fuera del método fenomenológico y no necesita legitimarse por la epoché, no propone ninguna reducción, no suspende la creencia en la tendencia a la autorrealización y su suspensión no es fenomenológica. (AU)

Quality of routine immunization service: Perception of clients

Background: Immunization prevents over 2�million deaths each year worldwide. In India, even though vaccines are offered free of cost at public health facilities the coverage remains low. Limited scrutiny has been conducted at health service and client interface for routine immunization (RI) services, which may have been affecting the acceptance of vaccines. This emphasizes the importance of assessing the level of satisfaction and perceived quality of clients regarding RI services. Objectives: This study aimed to assess the perceived quality and level of overall general satisfaction with RI services of clients. In addition, determine the association of factors influencing clients perceived quality and overall general satisfaction with RI services. Methods: A community-based cross-sectional study was conducted in an urbanized village of Delhi from November 2015 to April 2017. A total of 279 RI visits were covered in the study, and the clients were interviewed at their residence using a pretested tool. Results: The dissatisfaction toward the domains of perceived quality of RI services was reported to be 3.2% for vaccine availability, 9.7% for vaccine information, 3.2% for staff behavior, 6.1% for doctor behavior, and 7.5% for infrastructure. Multivariable-regression analysis indicated that distance to health facility, literacy and age of the client, doctor behavior, staff behavior, and infrastructure had an effect on overall general satisfaction of client toward RI services. Conclusions: The client's perception is multidimensional; improvement in one domain is likely to strengthen the other. By understanding the client's perspective toward quality of RI service, the health-care mangers may improve the level of overall satisfaction.

Atendimento psicológico e supervisão em terapia analítico-comportamental em um serviço-escola / Psychological care and supervision in analyticbehavior therapy in a school service

Este artigo tem como objetivo descrever o estágio de atendimento individual na abordagem analíticocomportamental, oferecido pelo Laboratório de Pesquisa de Intervenção Cognitivo-Comportamental - LaPICC-USP (CPA - Instituição da FFCLRP-USP). Serão descritos os procedimentos de atendimento e supervisão assim como dados clínicos referentes aos atendimentos realizados entre 2009 e 2016. Trata-se de uma pesquisa descritiva com metodologia documental. As variáveis consideradas foram sexo, idade, escolaridade, ocupação, estado civil, indicação de atendimento, demanda e encaminhamento. Os resultados quantitativos foram analisados a partir de estatística descritiva, sendo atendidos 24 pacientes, havendo prevalência na busca espontânea por atendimento (54,17%), por clientela na faixa dos 20-29 anos (66,67%), com ensino superior completo (54,17%), economicamente ativa (83,33%), solteira (54,17%) e do sexo feminino (75,00%). Os procedimentos específicos relativos à supervisão também foram descritos com detalhes.(AU)

This article aims to describe the stage of individual care in the analytical-behavioral approach offered by the Research Laboratory of Cognitive-Behavioral Intervention - LaPICC-USP (CPA - Institution of FFCLRP-USP). The procedures of care and supervision will be described as well as clinical data referring to the visits performed between 2009 and 2016. It is a descriptive research with documentary methodology. The variables considered were sex, age, schooling, occupation, marital status, indication of care, demand and referral. The quantitative results were analyzed from descriptive statistics, with 24 patients being attended, with prevalence in the spontaneous search for care (54.17%), by clientele in the 20-29 age group (66.67%), with complete higher education (54.17%), economically active (83.33%), single (54.17%) and female (75.00%). Specific oversight procedures have also been described in detail.(AU)

Este artículo tiene como objetivo describir la etapa de atención individual en el abordaje analítico-conductual, ofrecido por el Laboratorio de Investigación de Intervención Cognitiva-Conductual - LaPICC-USP (CPA - Institución de FFCLRP-USP). Se describen los procedimientos de atención y supervisión así como datos clínicos referentes a las atenciones realizadas entre 2009 y 2016. Se trata de una investigación descriptiva con metodología documental. Las variables consideradas fueron sexo, edad, escolaridad, ocupación, estado civil, indicación de atención, demanda y encaminamiento. Los resultados cuantitativos fueron analizados a partir de estadística descriptiva, atendiendo a 24 pacientes, habiendo prevalencia en la búsqueda espontánea por atención (54,17%), por clientela en la franja de los 20-29 años (66,67%), con enseñanza superior completa (54,17%), económicamente activa (83,33%), soltera (54,17%) y del sexo femenino (75,00%). Los procedimientos específicos relativos a la supervisión también se describen con detalle.(AU)

The Client Capital in Nursing Management in Hospitals / El capital del cliente en la Gestión de Enfermería en Hospitales / O Capital do Cliente na Gestão de Enfermagem em Hospitais

Abstract Objective: To analyze how the components of the client's capital are used in the management of nursing in hospitals. Method: A qualitative research carried out in five public hospitals, four private hospitals and three philanthropic hospitals in the period from October 2014 to May 2015. Data were collected through a semi-structured interview with twelve nursing managers and analyzed according to content analysis. Results: The components of the Client's Capital were used by the nurses when performing the management of the client service to promote changes and improve the service after evaluating the satisfaction of the nursing care through active systematic search, with its own evaluation tools and the ombudsman's information and in the interaction with suppliers of materials, equipment and services. Conclusion and implications for practice: The managers use managerial actions for the development of the client's capital of organizations. In order to improve them, they must evaluate the nursing care in a continuous and strategic process to satisfy the clients, throughout their trajectory in the organization, since clients are permanent sources of innovation that affect professional and organizational development and productivity.

Resumen Objetivo: Analizar cómo se utilizan los componentes de capital del cliente en la gestión de enfermería hospitalaria. Método: Investigación cualitativa, realizada en cuatro hospitales privados, cinco hospitales públicos y tres hospitales filantrópicos, de octubre de 2014 a mayo de 2015. Los datos fueron recolectados a través de entrevista semiestructurada con 12 gestoras de enfermería y analizados según el análisis de contenido. Resultados: Los componentes del Capital del Cliente fueron utilizados por las enfermeras al realizar la gestión de la atención al cliente para promover cambios y mejorar el servicio después de realizar la evaluación de la satisfacción de la atención de enfermería a través de búsqueda activa, sistemática, con instrumentos de evaluación propios e informaciones de la Oidoría y en la interacción con proveedores de materiales, equipos y servicios. Conclusión e implicaciones para la práctica: Las gestoras utilizan acciones gerenciales para el desarrollo del capital del cliente de las organizaciones. Para perfeccionarlas, deben evaluar la atención de enfermería en proceso continuo y estratégico para satisfacer a los clientes durante toda su trayectoria en la organización, una vez que los clientes son fuentes permanentes de innovación que generan impacto en el desarrollo y productividad profesional y organizacional.

Resumo Objetivo: Analisar como os componentes do capital do cliente são utilizados na gestão da enfermagem em hospitais. Método: Pesquisa qualitativa, realizada em quatro hospitais privados, cinco hospitais públicos e três hospitais filantrópicos, de outubro de 2014 a maio de 2015. Os dados foram coletados através de entrevista semiestruturada com 12 gestoras de enfermagem e analisados segundo a análise de conteúdo. Resultados: Os componentes do Capital do Cliente foram utilizados pelas enfermeiras ao realizar a gestão do atendimento ao cliente para promover mudanças e aprimorar o serviço após realizar a avaliação da satisfação do atendimento de enfermagem através de busca ativa, sistemática, com instrumentos de avaliação próprios e informações da Ouvidoria e na interação com fornecedores de materiais, equipamentos e serviços. Conclusão e implicação para a prática: As gestoras utilizam ações gerenciais para o desenvolvimento do capital do cliente das organizações. Para aperfeiçoá-las, devem avaliar o atendimento de enfermagem em processo contínuo e estratégico para satisfazer os clientes, durante toda a sua trajetória na organização, uma vez que clientes são fontes permanentes de inovação que geram impacto no desenvolvimento e produtividade profissional e organizacional.

Study of adolescent clinic: holistic approach for women health with dual client methodology

Background: The study is done to understand the gynaecological problems in adolescent girls. Do counseling, imparting knowledge for the girl and her mother, hence creating a holistic approach towards the women health in the family by dual client approach.Methods: 400 adolescent girls attending the clinic were studied (prospective observational study). Hb%, S.TSH was done for all the girls. Ultrasonography abdomen and pelvis was done on patient basis. Treatment was given. Mothers were counseled regarding their gynecological issues and screening tests (pap smear, self breast examination) was done after taking consent.Results: 70% girls had menstrual disturbances, 20% had complains of vaginal discharge. 44% had anemia (4% had severe anemia). Subclinical hypothyroidism was detected in 8% of cases. Ultrasonography was done in 52% of cases in which 81 patients had features suggestive of polycystic ovaries. 85.5% of the adolescent girls were accompanied by their mothers. 12% girls took HPV vaccination and 52% mothers underwent pap smear.Conclusions: Teenage problems need to be dealt very sensitively. Counseling is an integral component of treatment strategies. At present, adolescent gynaecology remains an area to which increased awareness and greater attention should be given to promote the health of teenagers and incult healthy lifestyle practices. In the same set up even the mothers of girls can be given counseling and address their gynaecological issues as majority of times mothers are the accompanying person creating the dual client approach in one setting. Hence adolescent clinic should aim for holistic, dual client approach for improvement of overall women health in the family.

Trend of clients attending an integrated councelling and testing centre of a tertiary care hospital in North Karnataka: a record based study

Background: The prevalence of HIV among the adult population has continued a steady decline at the national level from an estimated peak of 0.4% in 2000 down to 0.26% in 2015. The data generated by ICTC may provide important clues to understand the epidemiology of the disease in a specific area, as well as pattern of risk behavior of the population.Methods: The present retrospective record based cross sectional study was carried out at the ICTC Centre of SDM College of Medical Sciences and Hospital, Dharwad. Retrospective data for the past six years (2012-13 to 2017-18) on clients visiting the ICTC was collected from the ICTC registers.Results: A total of 45,066 clients attended the ICTC over a period of 6 years, among which 61.6% were females and 38.4% were males. Among the total females, 55% were antenatal mothers. Out of the total clients tested, 99.75% of clients underwent post-test counseling. Among the total clients, 669 were HIV sero-positive clients out of which majority (61.7%) were males. The total positivity rate was 1.48% among the ICTC attendees. 47 clients had co-infections with TB.Conclusions: The challenge is to increase access to and uptake of HIV testing priority. Intense IEC activities for behaviour change at grass root level populations should be encouraged.

Socio demographic profile of clients visiting the ICTC at a teaching hospital in Guntur district of Andhra Pradesh

Background: The challenge is to make all HIV-infected people aware of their status so that they may prevent the transmission of HIV to others. Only 25–30% of the people who are HIV positive in India are aware of their HIV status. Guntur district has a high epidemic potential with established transmission among the general population. The objective of the study was to study the socio demographic profile and HIV positivity rates among clients visiting an Integrated Counselling and Testing Centre (ICTC).Methods: This descriptive study is based on secondary data from the records of the ICTC. The data is entered and analysed with MS Office Excel and EPI Info statistical package. Important findings were tested for statistical significance at 5% level of significance.Results: Of the 6940 clients attending the ICTC, 43.34% are antenatal women (HIV positivity of 0.27%). Of the rest, provider initiated clients are 94.02% (HIV positivity 4.38%) and client initiated 5.9% (HIV positivity 20%). The difference of HIV positivity is highly significant (p<0.000001). 61.1% of the clients were found to be between the ages 25 to 49 years. Among the client initiated, more women (7.4%) were seen to be attending the ICTC (p<0.05). High risk professions identified were hotel workers (7.3% HIV positive), local transport workers (6.01%) and petty business (6.22%). Housewives were found to have 3.2% HIV positivity.Conclusions: Self-referral to ICTC is still very poor. The epidemic is shifting to the general populations. HIV/AIDs education efforts aimed at the population in general must be increased.

Satisfacción percebida del servicio de farmacias comunitarias independientes de la ciudad de Sucre / Perceived satisfaction of the independent community pharmacy service of the city of Sucre

El objetivo del presente trabajo fue determinar el grado de satisfacción percibida del cliente interno y externo de las farmacias comunitarias privadas de la Ciudad de Sucre 2019. Se trata de un estudio cuantitativo, correlacional, transversal realizado en 53 farmacias, distribuidos en los diferentes distritos de la ciudad de Sucre, realizándose la entrevista a 1 cliente interno por farmacia y 108 clientes externos mayores de 18 años. Entre los resultados se tiene que la mayoría de los clientes externos son del sexo femenino (61,11%), así como la mayoría señala que es buena la localización y facilidad de acceso a la farmacia (53,7%), el horario de atención (59,26%), el trato y amabilidad del personal farmacéutico (56,48%), sin embargo califican de regular la sala de espera (43,52%). La percepción de los clientes internos sobre la sala de espera es Buena en 41,51%, así como en la información que Brinda al cliente externo (49,06%). En conclusión se puede señalar que los clientes externos se sientes satisfechos por la atención recibida y los clientes internos de la misma manera.

The objective of this work was to determine the degree of perceived satisfaction of the internal and external customer of the private community pharmacies of the City of Sucre 2019. It is a quantitative, correlational, cross-sectional study conducted in 53 pharmacies, distributed in the different districts of the city of Sucre, conducting the interview with 1 internal customer per pharmacy and 108 external clients over 18 years. Among the results is that most of the external clients are female (61.11%), as well as the majority indicates that the location and ease of access to the pharmacy (53.7%), the opening hours are good attention (59.26%), the treatment and friendliness of the pharmaceutical staff (56.48%), however they qualify to regulate the waiting room (43.52%). The perception of internal customers about the waiting room is good at 41.51%, as well as the information provided to the external customer (49.06%). In conclusion, it can be noted that external clients are satisfied with the attention received and internal clients in the same way.

The interplay of C.P.A. in elderly care towards client care satisfaction

@#<p style="text-align: justify;">This study explored the interplay of the care culture (C), caring process (P) and care agent (A) in the care of older adults towards care satisfaction and quality of life. Two elderly care facilities (public and private) were considered as cases of this study. Using case study design, four elderly clients were asked to answer the Modified Patient Satisfaction Questionnaire, and five care facility personnel were interviewed and observed. The cross-case analysis derived the themes: a) a caring governance is a felt privilege for the elderly; b) housing arrangement: security or vulnerability?; c) How did you take care of me?: Its influence on patient care outcomes; and d) Elderly care provider: What am I?. The landscape of elderly care is a combination of the environment, culture, process and the agent who made the care more effective through patient outcomes and satisfaction. These factors have interacting relationship which one to the other but ultimately leads to a question of the elderly clients' present disposition and conditions.</p>