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Objective:To analyze the characteristics of the circular cases violating the " nine prohibitions" in recent years, so as to provide a basis for further strengthening the moral culture construction of the healthcare industry.Methods:Data came from the reported cases released on official websites of the discipline inspection committees, supervision committees and health committees at all levels in China from December 2013 to August 2021, which were identified by searching the keyword " case or report or moral culture and nine prohibitions" . Descriptive analysis and frequency analysis were conducted on the reported time, region and province, as well as the involved units, departments, persons, punishment results and case classification data of all the cases.Results:A total of 102 cases violating the " nine prohibitions" were included, of which the cases from 2014 to 2015 topped the rest, accounting for 51.96%(53 cases). Top three regions of these cases were central China, east China and southwest China, with 31 cases, 27 cases and 18 cases respectively. The units involved were mainly tertiary medical institutions, accounting for 44.12%(45 cases). More medical staff(134 people) than administrative staff(85 people) were involved in the cases. The largest number of cases was receiving kickbacks, with 52 cases(50.98%). The punishment results of cases included judicial procedures(76 people), Party discipline and government discipline punishment(67 people) and organizational punishment(76 people).Conclusions:Moral culture problem in China′s healthcare sector is characterized in wide coverage, complexity, comprehensiveness and long-term. Relevant authorities should keep up their efforts in enhancing the awareness of medical workers, improving the synergy mechanism in this regard, and strengthening the internal management of medical institutions.
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ABSTRACT Objective We evaluated the psychometric properties of a new instrument "Mental Illness Sexual Stigma Questionnaire" (MISS-Q). Methods We interviewed 641 sexually active adults (ages 18-80) attending public outpatient psychiatric clinics in Rio de Janeiro about their stigma experiences. Results Nine factors were extracted through exploratory factor analysis (EFA) and labeled: 'individual discrimination by others'; 'staff willingness to talk about sexuality'; 'staff and family prohibitions'; 'sexual devaluation of self'; 'perceived attractiveness'; 'mental illness concealment'; 'perceived sexual role competence'; 'withdrawal'; and 'locus of social-sexual control'. 'Withdrawal' and 'locus of social-sexual control' showed poor psychometric properties and were excluded from further analysis. The remaining seven factors had high factorial loadings (.39 to .86), varying from sufficient to optimal reliability (Ordinal α ranged from .57 to .88), and good convergent and discriminant validity. Conclusions The resulting MISS-Q is the first instrument assessing mental illness sexual stigma with demonstrated psychometric properties. It may prove useful in reducing stigma, protecting sexual health, and promoting recovery.
RESUMO Objetivo Avaliamos as propriedades psicométricas de um novo instrumento "Mental Illness Sexual Stigma Questionnaire" (MISS-Q; Questionário de Estigma Sexual na Doença Mental). Métodos Entrevistamos 641 adultos sexualmente ativos (18 a 80 anos), frequentando clínicas psiquiátricas ambulatoriais públicas no Rio de Janeiro sobre suas experiências de estigma. Resultados Foram extraídos nove fatores por meio da análise exploratória fatorial e rotulados: 'discriminação individual por parte de outros'; 'disposição pessoal para falar sobre sexualidade'; proibições pessoais e familiares; 'desvalorização sexual de si mesmo'; 'percepção de atratividade'; 'dissimulação da doença mental'; 'percepção da competência de papel sexual'; 'retirada'; e 'locus de sociosexual ao controle'. 'Retirada' e 'locus de controle social-sexual' mostraram propriedades psicométricas fracas e foram excluídos da análise posterior. Os sete fatores restantes tinham altas cargas fatoriais (0,39 a 0,86), variando de suficiente até confiabilidade ótima (Ordinal α variou de ,57 a ,88), e boa validade convergente e discriminante. Conclusões O resultante MISS-Q é o primeiro instrumento que avalia o estigma sexual da doença mental com propriedades psicométricas demonstradas. Pode ser útil na redução do estigma, proteção da saúde sexual e promoção à recuperação.
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Objetivo Conhecer as repercussões no cotidiano de pacientes submetidos a transplante cardíaco. Métodos Trata-se de estudo descritivo, qualitativo, conduzido em um centro de transplantes do nordeste brasileiro. Nove pacientes submetidos ao transplante cardíaco participaram do estudo, tendo sido utilizada para coleta dos dados a técnica de grupo focal, facilitada em quatro reuniões. Os recortes de suas falas resultaram em duas categorias temáticas: ser transplantado cardíaco - o antes e o depois; e sentimentos e percepções sobre o transplante cardíaco. Resultados A pessoa submetida ao transplante identificou as modificações positivas obtidas após o procedimento, porém ressentiu-se com as inúmeras proibições, com interferência direta em seu cotidiano; as limitações decorrentes do transplante ganharam destaque e não permitiram que os pacientes se sentissem realmente curados. Conclusão Os participantes reconheceram o transplante cardíaco como uma solução para seus sintomas clínicos, contudo, com significativa perda de autonomia, obrigando-os a um intenso esforço adaptativo.
Objective To learn the repercussions on the daily living of patients that underwent heart transplantation. Methods A descriptive and qualitative study was conducted in a transplantation center in the Brazilian Northeast region. Nine patients who underwent heart transplantation participated in the study. Data were collected using the focus group technique, facilitated in four meetings. The excerpts of their statements resulted in two thematic categories: being a heart transplantation patient - before and after; and feelings and perceptions on heart transplantation. Results The people submitted to transplantation identified positive changes achieved after the surgery, but suffered with the countless prohibitions that directly interfered on their daily living; the limitations resulting from transplantation were highlighted and hindered patients from feeling effectively healed. Conclusion Participants recognized heart transportation as a solution for their clinical symptoms, but with a significant loss of autonomy that compel them to intensive adaptation efforts.