Estudio cualitativo sobre información, confianza y acceso a la vacunación contra COVID-19 en adolescentes en un centro de salud de Buenos Aires / Qualitative study on information, trust in and access to COVID-19 vaccines among adolescents at a healthcare center in Buenos Aires

Introducción. En la adolescencia, se comienzan a tomar decisiones autónomas sobre la salud. En la vacunación intervienen dimensiones contextuales, grupales y relativas a cada vacuna. Se busca conocer el proceso de información, confianza y decisión de vacunarse contra COVID-19 en adolescentes usuarios de un centro de salud en Buenos Aires. Objetivos. Identificar ámbitos y canales a través de los cuales los adolescentes accedieron a información sobre la vacuna contra COVID-19 en un centro de salud de Buenos Aires. Describir sus opiniones respecto a los distintos discursos sobre vacunación. Describir su participación en la vacunación contra COVID-19. Identificar barreras y facilitadores respecto del acceso a la vacunación contra COVID-19 en esta población. Población y métodos. Investigación cualitativa. Se hicieron entrevistas semiestructuradas a adolescentes usuarios del efector. La muestra fue heterogénea; su tamaño se definió por saturación teórica. Se realizó un análisis temático de los datos. Resultados. Se realizaron 14 entrevistas. Los entrevistados recibieron información sobre la vacuna contra COVID-19 de sus familias, la televisión y las redes sociales. Todos recibieron tanto publicidad oficial como discursos reticentes a la vacunación. Analizaron la información recibida y formaron opinión autónoma. Su decisión sobre vacunarse no siempre fue respetada. La desconfianza, la baja percepción del riesgo, el temor a las inyecciones, las barreras administrativas y geográficas fueron motivos de no vacunación. Conclusiones. Se requieren estrategias de comunicación destinadas a adolescentes que promuevan su participación en el acceso a la vacunación.

Introduction. During adolescence, individuals start to make autonomous decisions about their health. Vaccination involves contextual, group, and vaccine-specific dimensions. We sought to know the information, trust, and decision to receive the COVID-19 vaccine among adolescents who attended a healthcare center in Buenos Aires. Objectives. To identify settings and channels through which adolescents accessed information about the COVID-19 vaccine at a healthcare center in Buenos Aires. To describe their opinions about the different statements on vaccination. To describe their participation in COVID-19 vaccination. To identify barriers and facilitators to COVID-19 vaccination in this population. Population and methods. Qualitative study. Semi-structured interviews with adolescents who attended this healthcare facility. The sample was heterogeneous; the sample size was estimated by theoretical saturation. A thematic analysis of data was done. Results. A total of 14 interviews were conducted. Interviewees obtained information about the COVID-19 vaccine from their families, TV, and social media. All received information from both official campaigns and anti-vaccine communications. They analyzed the information they received and formed their own opinion. Their decision about the vaccine was not always respected. Hesitancy, a low perception of risk, fear of needles, administrative and geographic barriers were reasons for not receiving the vaccine. Conclusions. Communication strategies targeted at adolescents are required that encourage their involvement in access to vaccination.

Analysis of pre-exposure prophylaxis awareness, willingness, uptake patterns, barriers and needs among MSM students and its influencing factors / 中国学校卫生

Objective@#To explore the pre-exposure prophylaxis (PrEP) awareness, willingness, uptake patterns, barriers and needs among Chinese student men who have sex with men (MSM), so as to provide relevant evidence for targeted interventions with PrEP.@*Methods@#A proportional sampling method was used to conduct a cross sectional survey of MSM aged 16 years and older residing in 21 provinces, municipalities, and autonomous regions in mainland China between October 20 and December 20, 2021, to collect information on demographic and sexual behavioral characteristics, and 923 students of them were selected as the subjects of this study. The chi-square test and Fisher s test were used for univariate analysis, followed by multivariate Logistic regression to analyze the influencing factors of PrEP awareness and uptake.@*Results@#According to the cascade analysis method, the awareness, willingness, uptake and adherence rates of PrEP among the student MSM were obtained as 88.95%, 67.36%, 13.20% and 45.21 %, respectively. HIV testing more than once in the last 3 months, and all of them were aware of the HIV test results of their sexual partners, and those with high frequency of condom use had a higher rate of awareness ( OR =2.32, 1.79, 1.69, P <0.05). Willingness rates were higher for those from the pilot city, using substances, and HIV testing more than once in the last 3 months ( OR =2.13, 1.65, 1.69, P <0.05). Higher rates of uptake were found among those from high risk and pilot areas, presence of commercial sex, substance use, and high literacy ( OR =5.60, 3.54,2.81, 1.92, 4.54, P <0.05). Adherence rates were higher among those who used one pill per day or both ( OR =12.77, 13.26, P <0.05). The barriers and needs faced by student MSM were primarily personal concerns about medication side effects, preventative effects, and confidence in sexual behavioral styles, and the high cost of medication and related service costs.@*Conclusions@#The student MSM population in China is characterized by high awareness, low willingness, low uptake, and low adherence to PrEP. Targeted interventions should be considered and tailored by the departments to facilitate PrEP promotion among student MSM.

Current status of AIDS knowledge, attitudes, practices and associated factors of high risk sexual behavior among college students in Tianjin City / 中国学校卫生

Objective@#To understand the current status of acquired immunodeficiency syndrome (AIDS) knowledge, attitudes, and practices of college students in Tianjin City and to further investigate the associated factors of high risk sexual behaviors, so as to provide a scientific and theoretical basis for accurate prevention and treatment of AIDS.@*Methods@#A stratified cluster random sample of 64 697 students in 56 colleges and universities in Tianjin City in November to December 2022 was investigated about the current status of AIDS knowledge, attitudes and practices. Information was collected using online survey via Questionnaire Star. Descriptive analysis was used for the current status of AIDS knowledge, attitudes and practices among college students. Chi square test and multiple Logistic regression analysis were used to analyze the influencing factors of high risk sexual behavior among college students.@*Results@#The AIDS awareness rate of college students in Tianjin City reached 87.33%. The sexual openness rate was 70.73 %. Among the 3 463 students who had sex during the past year, 42.13% of students reported high risk sexual behavior. Multivariate Logistic regression showed that female, having a romantic partner, having received sex education and prevention and treatment knowledge of AIDS were negatively associated with high risk sexual behavior ( OR =0.66, 0.59, 0.81, 0.59, P <0.05). Being in sophomore year, non heterosexuality (homosexuality, bisexuality, not knowing), prejudice against AIDS, and misunderstanding the testing methods for AIDS showed positive correlations with highrisk sexual behavior ( OR =1.22, 2.49, 2.30, 3.17, 1.43, 1.22 , P <0.05).@*Conclusions@#The awareness rate of AIDS in college students in Tianjin is high, but high risk sexual behaviors are still at a high level. Further targeted knowledge education and behavioral interventions are needed to scientifically prevent the spread of AIDS.

A multicenter survey on nurses'knowledge and practice of children's sleep management in pediatric ICU / 中华护理杂志

Objective To investigate the current status of nurses'knowledge,attitude and practice regarding sleep management of critically ill children in pediatric ICU,and to analyze its impact factors.Methods A self-designed questionnaire on general information and a questionnaire on knowledge and practical behaviors of pediatric ICU nurses on child's sleep management were used.In March 2023,902 pediatric ICU nurses from 24 hospitals in China were surveyed using a convenient sampling method,and the impact factors were analyzed using multiple stepwise linear regression.Results 893 valid questionnaires were collected and the recovery rate of valid questionnaires was 99.00％.Nurses in pediatric ICU scored(33.71±7.76)in knowledge dimension,(37.38±4.86)in attitude dimension and(80.60±16.78)in practice dimension,with a total score of(151.78±24.27).The scores of knowledge and attitude,knowledge and practice,attitude and practice are all positively correlated(r=0.393,P＜0.001;r=0.495,P＜0.001;r=0.320,P＜0.001).The results of multiple stepwise linear regression analysis showed that gender,region,whether they had received sleep management training were the influencing factors of pediatric ICU nurses'total score of knowledge,attitude and practice towards children's sleep management(P＜0.05).Conclusion Nurses in pediatric ICU are positive about sleep management for critically ill children,but their knowledge and practice levels need to improve.Nursing managers should strengthen the theoretical knowledge and practical behavioral training of pediatric ICU nurses on child sleep management,develop scientific sleep management plans,and guide nurses to make reasonable evaluation and interventions to improve children's sleep quality.

Validação de conteúdo e análise semântica de inquérito CAP sobre conhecimentos, atitudes e práticas das avós no contexto da amamentação / Content validation and semantic analysis of a KAP survey on grandmothers' knowledge, attitudes, and practices in the context of breastfeeding / Validación del contenido y análisis semántico de una encuesta CAP sobre conocimientos, actitudes y prácticas de las abuelas en el contexto de la lactancia materna

Objetivo: avaliar a validade de conteúdo e a semântica de um inquérito sobre conhecimentos, atitudes e práticas das avós no contexto da amamentação. Métodos: pesquisa metodológica, de validação de conteúdo de inquérito Conhecimentos, Atitudes e Práticas (CAP) por especialistas e análise semântica por meio da compreensibilidade dos itens pelas avós de crianças em amamentação. Foram calculados os índices de validade de conteúdo, dos itens e da escala, e teste binomial. Para análise semântica foram calculadas as frequências absolutas e as relativas da compreensão dos itens. Resultados: participaram 22 especialistas, e dez avós. O índice de validade de conteúdo do inquérito CAP tanto para versão pré-teste como pós-teste foi de 0,94. Uma questão da versão pré-teste e duas questões da versão pós-teste não alcançaram compreensão > 90%. Foi excluída uma questão do inquérito e 21 foram reformuladas, resultando em 45 itens distribuídos em três domínios: conhecimentos (23 itens), atitudes (oito itens) e práticas (14 itens). Conclusão:as versões finais do pré e pós-teste do inquérito de conhecimentos, atitudes e práticas das avós sobre a amamentação, alcançaram validade de conteúdo e de semântica compatível para sua utilização.

Objective: assessing the content and semantic validity of a survey on grandmothers' knowledge, attitudes, and practices in the context of breastfeeding. Methods: methodological research for content validation of a Knowledge, Attitudes, and Practices (KAP) survey by experts and semantic analysis through the comprehensibility of the items by grandmothers of breastfeeding children. Content validity indices were calculated for the items and the scale, as well as the binomial test. Absolute and relative frequencies of understanding of the items were calculated for the semantic analysis. Results: participants were 22 experts and ten grandmothers. The content validity index of the KAP survey for both the pre-test and post-test versions was 0.94. One question in the pre-test version and two questions in the post-test version did not reach > 90% comprehension. One question was excluded from the survey and 21 were reworded, resulting in 45 items distributed into three domains: knowledge (23 items), attitudes (8 items), and practices (14 items). Conclusion: the final pre- and post-test versions of the survey of grandmothers' knowledge, attitudes, and practices on breastfeeding achieved content and semantic validity compatible with its use.

Objetivo: evaluación de la validez semántica y de contenido de una encuesta sobre conocimientos, actitudes y prácticas de las abuelas en el contexto de la lactancia materna. Métodos: investigación metodológica, validación del contenido de la encuesta Conocimiento, Actitudes y Prácticas (CAP) por expertos y análisis semántico a través de la comprensibilidad de los ítems por abuelas de niños lactantes. Se calcularon índices de validez de contenido para los ítems y la escala, así como la prueba binomial. Para el análisis semántico, se calcularon las frecuencias absolutas y relativas de comprensión de los ítems. Resultados: participaron 22 expertos y diez abuelas. El índice de validez de contenido de la encuesta CAP, tanto para la versión pre-test como para la post-test, fue de 0,94. Una pregunta de la versión pre-test y dos preguntas de la versión post-test no alcanzaron > 90% de comprensión. Se excluyó una pregunta de la encuesta y se reformularon 21, con lo que se obtuvieron 45 ítems distribuidos en tres ámbitos: conocimientos (23 ítems), actitudes (8 ítems) y prácticas (14 ítems). Conclusión: las versiones finales pre y post de la encuesta sobre conocimientos, actitudes y prácticas de las abuelas en materia de lactancia materna alcanzaron validez de contenido y semántica compatible con su uso.

COVID-19 nas prisões: validação de um inquérito de conhecimento, atitude e prática / COVID-19 en las cárceles: validación de un estudio de conocimiento, actitud y práctica / COVID-19 in prisons: validity of a knowledge, attitude and practice survey

Resumo Objetivo Validar um inquérito de conhecimento, atitude e prática sobre medidas preventivas da COVID-19 para os funcionários do sistema penitenciário, fundamentado na teoria ambientalista. Métodos Estudo metodológico desenvolvido em quatro etapas: estabelecimento da estrutura conceitual, elaboração do instrumento, validação do conteúdo por juízes e avaliação da aparência pelo público-alvo. O conteúdo de cada item foi validado quanto a objetividade, clareza e relevância. A aparência do inquérito foi avaliada quanto ao objetivo, a organização, ao estilo da escrita e a motivação. Utilizou-se o coeficiente de validação de conteúdo para avaliar a concordância entre os juízes e entre o público-alvo. Os dados foram analisados por meio de distribuições brutas, percentuais, medidas de posição e de dispersão. O índice alfa de Cronbach foi utilizado para analisar a consistência das avaliações dos juízes e do público-alvo. Resultados Quanto ao conteúdo e a aparência, os requisitos avaliados obtiveram concordância superior a 0,9. Na avaliação da consistência, obteve-se índice alfa de Cronbach > 0,9 e > 0,7, quanto ao conteúdo e à aparência, respectivamente, indicando que juízes e público-alvo tenderam a fazer avaliações similares. Conclusão O inquérito apresentou validade de conteúdo e aparência para a coleta de dados referentes a conhecimento, atitude e prática sobre prevenção da COVID-19, para os funcionários do sistema penitenciário, indicando que poderá contribuir para o planejamento e a avaliação de ações de educação em saúde.

Resumen Objetivo Validar un estudio de conocimiento, actitud y práctica sobre medidas preventivas de COVID-19 para los empleados del sistema penitenciario, fundamentado en la teoría ambientalista. Métodos Estudio metodológico llevado a cabo en cuatro etapas: establecimiento de la estructura conceptual, elaboración del instrumento, validación del contenido por jueces y evaluación de la apariencia por el público destinatario. Se validó el contenido de cada ítem respecto a la objetividad, claridad y relevancia. Se evaluó la apariencia del estudio respecto al objetivo, la organización, el estilo de escritura y la motivación. Se utilizó el coeficiente de validez de contenido para evaluar la concordancia entre los jueces y entre el público destinatario. Los datos se analizaron mediante distribuciones brutas, porcentajes, medidas de posición y de dispersión. Se utilizó el índice alfa de Cronbach para analizar la consistencia de las evaluaciones de los jueces y del público destinatario. Resultados Respecto al contenido y a la apariencia, los requisitos evaluados obtuvieron concordancia superior a 0,9. En la evaluación de la consistencia, se obtuvo un índice alfa de Cronbach > 0,9 respecto al contenido y > 0,7 respecto a la apariencia, lo que indica la tendencia de los jueces y del público destinatario a realizar evaluaciones similares. Conclusión El estudio presentó validez de contenido y apariencia para la recopilación de datos referentes a conocimiento, actitud y práctica sobre prevención de COVID-19 para empleados del sistema penitenciario, lo que indica que podrá contribuir a la planificación y evaluación de acciones de educación para la salud.

Abstract Objective To validate a knowledge, attitude and practice survey on preventive measures against COVID-19 for penitentiary system staff based on environmental theory. Methods This is a methodological study developed in four stages: conceptual structure establishment; instrument elaboration; content validity by judges; and appearance assessment by the target audience. The content of each item was validated for objectivity, clarity and relevance. Survey appearance was assessed regarding objective, organization, writing style and motivation. Content validity coefficient was used to assess agreement among judges and the target audience. Data were analyzed using gross distributions, percentages, position and dispersion measures. Cronbach's alpha index was used to analyze the consistency of judges' and target audience's assessments. Results Regarding content and appearance, the assessed requirements achieved agreement greater than 0.9. In consistency assessment, a Cronbach's alpha index > 0.9 and > 0.7 was obtained for content and appearance, respectively, indicating that judges and target audiences tended to make similar assessments. Conclusion The survey presented content and appearance validity for collecting data regarding knowledge, attitude and practice regarding COVID-19 prevention for penitentiary system staff, indicating that it could contribute to health education action planning and assessment.

Knowledge about sudden infant death syndrome prevention among postpartum women in Southern Brazil, 2019: a cross-sectional survey / Conocimiento sobre la prevención del síndrome de muerte súbita del lactante en puérperas del Sur de Brasil, 2019: un estudio transversal / Conhecimento sobre prevenção da síndrome da morte súbita do lactente entre puérperas no Sul do Brasil, 2019: um estudo transversal

ABSTRACT Objective To assess knowledge on sudden infant death syndrome (SIDS) prevention among postpartum women who received prenatal care in public and private services in Rio Grande, Rio Grande do Sul, Brazil, in 2019. Methods A cross-sectional study was conducted with postpartum women who gave birth in that municipality in 2019; the outcome was the indication of incorrect sleeping position (side/supine position) to prevent SIDS; the chi-square test was used to compare proportions between those who underwent prenatal care in public and private services. Results Among all 2,195 postpartum women, 67.7% (95%CI 65.7;69.6) were unaware of the position that prevents SIDS, 71.6% were public care service users; 77.8% of them feared choking/suffocation; 1.9% were informed about SIDS during prenatal care; doctors/nurses (70.5%) and grandmothers (65.1%) were influential regarding the baby's sleeping position. Conclusion Most postpartum women were unaware of the sleeping position that prevents SIDS, especially those receiving care in the public sector; in general, this subject is not discussed in prenatal care.

RESUMEN Objetivo Evaluar el conocimiento sobre la prevención del síndrome de muerte súbita del lactante (SMSL) entre puérperas que realizaron prenatal en servicios públicos y privados en Rio Grande, Rio Grande do Sul, Brasil, en 2019. Métodos Estudio transversal, con puérperas que dieron a luz en Rio Grande, en 2019; el resultado consistió en la indicación de posición incorrecta para dormir (lado/supino) para prevenir el SMSL; utilizando chi-cuadrado, se compararon las proporciones entre mujeres que recibieron atención prenatal en servicios públicos y privados. Resultados Entre las 2.195 puérperas, 67,7% (IC95% 65,7;69,6) desconocían como se previene el SMSL, estando el 71,6%, en la red pública; 77,8% temía asfixiarse/ahogarse; el 1,9% fue informado sobre el SMSL durante el prenatal; los médicos(as)/enfermeros(as) (70,5%) y los abuelos (65,1%) influyeron en la posición para dormir del bebé. Conclusión La mayoría de las puérperas desconocían la posición que previene el SMSL, especialmente en la red pública; en general, este tema no está cubierto en la atención prenatal.

RESUMO Objetivo Avaliar o conhecimento sobre prevenção da síndrome da morte súbita do lactente (SMSL) entre puérperas com pré-natal realizado nos serviços público e privado de Rio Grande, Rio Grande do Sul, Brasil, 2019. Métodos Estudo transversal, com puérperas do município; seu desfecho constituiuse da indicação de posição incorreta para dormir (decúbito lateral ou dorsal), visando prevenir a SMSL; utilizou-se o teste qui-quadrado para comparar proporções do desfecho e de exposição entre puérperas que realizaram pré-natal nos serviços público e privado. Resultados De 2.195 puérperas, 67,7% (IC95% 65,7;69,6), majoritariamente atendidas na rede pública (71,6%), desconheciam a posição preventiva da SMSL; 77,8% temiam engasgo/afogamento; 1,9% foram informadas sobre SMSL no pré-natal; médicos(as)/enfermeiros(as) (70,5%) e avós (65,1%) mostraram-se influentes na decisão sobre como posicionar o bebê adormecido. Conclusão A maioria das puérperas, especialmente as atendidas na rede pública, desconhecia a posição que previne SMSL; geralmente, o tema não é abordado no pré-natal.

Higiene das mãos dos profissionais de saúde: perspectivas do estudante de enfermagem no papel de paciente/familiar / Higiene de manos de los profesionales de la salud: perspectiva de estudiantes de enfermería en el papel de paciente/familiar / Healthcare professionals' hand hygiene: perspectives of nursing student's in patients/relatives role

Resumo Objetivo Investigar as opiniões e atitudes dos estudantes de enfermagem no papel de pacientes ou familiares de pacientes, a respeito do comportamento de higiene das mãos dos profissionais de saúde e da participação dos pacientes na campanha de higiene das mãos. Métodos Estudo transversal prospectivo realizado entre 2021-2022 no Nursing Department, Faculty of Health Sciences, de duas universidades turcas. A amostra do estudo foi composta por 330 alunos. Os dados foram coletados por meio de questionário autoaplicável. A taxa de resposta do questionário foi de 89,43%. O teste qui-quadrado foi utilizado na análise dos dados. Resultados A média de idade dos estudantes foi de 19,80±1,30 anos, 76,1% eram do sexo feminino, 50,9% afirmaram ter recebido instrução sobre Infecções Associadas aos Cuidados de Saúde (IACS). Enquanto 30,1% dos estudantes relataram realizar a higiene das mãos "9 a 11 vezes" em sua vida diária, 54,6% relataram "12 a 15 vezes" no hospital, e 96,4% dos estudantes se perguntaram se os profissionais de saúde realizavam a higiene das mãos antes de fornecer cuidados durante as internações. De acordo com 30,5% dos estudantes, lembretes dos pacientes e seus familiares sobre a realização da higiene das mãos antes do contato com os pacientes os deixariam satisfeitos. Houve diferença estatisticamente significativa entre a instrução anterior dos estudantes sobre IACS e a higiene das mãos como cuidado importante a pacientes hospitalizados (p<0,05). Conclusão Os estudantes de enfermagem apresentaram conhecimento suficiente sobre a higiene das mãos e uma atitude positiva frente aos comportamentos de higiene das mãos dos profissionais de saúde. Estudantes de enfermagem como pacientes e familiares dos pacientes podem ser incluídos nas campanhas de higiene das mãos dos profissionais de saúde, desde que as etapas do programa sejam bem planejadas.

Resumen Objetivo Investigar las opiniones y actitudes de los estudiantes de enfermería en el papel de pacientes o familiares de pacientes respecto al comportamiento de higiene de manos de los profesionales de la salud y de la participación de los pacientes en la campaña de higiene de manos. Métodos Estudio transversal prospectivo realizado entre 2021 y 2022 en el Nursing Department, Faculty of Health Sciences, de dos universidades turcas. La muestra del estudio estuvo compuesta por 330 alumnos. Los datos se recopilaron mediante cuestionario autoaplicado. El índice de respuesta del cuestionario fue de 89,43 %. Se utilizó la prueba ji cuadrado en el análisis de los datos. Resultados El promedio de edad de los estudiantes fue de 19,80±1,30 años, el 76,1 % era de sexo femenino, el 50,9 % afirmó haber recibido instrucción sobre infecciones asociadas a los cuidados de la salud (IACS). Mientras el 30,1 % de los estudiantes relató realizar la higiene de manos "9 a 11 veces" en su vida diaria, el 54,6 % relató "12 a 15 veces" en el hospital, el 96,4 % de los estudiantes se preguntó si los profesionales de la salud realizaban la higiene de manos antes de brindar cuidados durante las internaciones. El 30,5 % de los estudiantes estuvo satisfecho con los recordatorios de los pacientes y sus familiares sobre la realización de la higiene de manos antes del contacto con los pacientes. Hubo diferencia estadísticamente significativa entre la instrucción anterior de los estudiantes sobre IACS y la higiene de manos como cuidado importante en pacientes hospitalizados (p<0,05). Conclusión Los estudiantes de enfermería presentaron conocimientos suficientes sobre la higiene de manos y una actitud positiva frente a los comportamientos de higiene de manos de los profesionales de la salud. Puede incluirse a los estudiantes de enfermería como pacientes y familiares de los pacientes en las campañas de higiene de manos de los profesionales de la salud, siempre que las etapas del programa estén bien planificadas.

Abstract Objective To investigate the views and attitudes of nursing students, as patients or relatives, on healthcare professionals' hand hygiene behavior and patient participation hand hygiene campaign. Methods This prospective cross-sectional study was conducted in the nursing departments of the health and science faculties at two Turkish universities between 2021-2022. The study sample comprised 330 students. Data were collected using a self-administered questionnaire. The response rate of the questionnaire was 89.43%. Chi-square test was used in data analysis. Results The mean age of students was 19.80±1.30 years, 76.1% were female, 50.9% stated they had received education regarding healthcare-associated infections (HAI). While 30.1% of students reported they performed hand hygiene "9-11 times" in their daily lives, 54.6% reported performing "12-15 times" in the hospital, and 96.4% of students expressed wondering if healthcare professionals performed hand hygiene before offering care during hospitalizations. Among students, 30.5% stated that reminders from patients and their relatives about performing hand hygiene before contact with patients would make them happy. There was a statistically significant difference between students' previous training in HAIs and hand hygiene as an important inpatient care (p<0.05). Conclusion Nursing students had sufficient knowledge of hand hygiene and a positive attitude towards hand hygiene behaviors of healthcare professionals. Nursing students, such as patients and their relatives, can be included in hand hygiene campaigns for healthcare professionals, provided that the program steps are well planned.

Conhecimento, atitude e prática de emergência pré-hospitalar e seus fatores de influência entre cuidadores de idosos: pesquisa transversal / Conocimientos, actitudes y prácticas de emergencias prehospitalarias y sus factores de influencia en cuidadores de personas mayores: estudio transversal / Knowledge, attitude, and practice of pre-hospital emergency and their influencing factors among caregivers for older adults: a cross-sectional survey

Resumo Objetivo Investigar a situação atual e analisar os fatores influenciadores do conhecimento, atitude e prática de emergência pré-hospitalar entre cuidadores de idosos. Métodos Estudo transversal com amostragem por conveniência, conduzido entre dezembro de 2021 e junho de 2022, e seleção de 133 cuidadores de idosos em instituições de longa permanência na província de Guangdong, China, como participantes. Todos receberam um questionário de informações gerais e um questionário de conhecimento, atitude e prática de emergência pré-hospitalar. Na análise dos dados foi utilizada estatística descritiva e inferencial. Resultados As pontuações nas dimensões conhecimento, atitude e prática foram 24,65 ± 4,49, 24,52 ± 4,34 e 24,05 ± 4,67, respectivamente. A análise de regressão mostrou que a idade, o nível de habilidade profissional e a experiência em educação em saúde dos cuidadores foram os principais fatores que influenciaram seu conhecimento de emergência pré-hospitalar. A presença/ausência dos cuidadores na participação direta na emergência pré-hospitalar foi o principal fator de influência na atitude, enquanto o nível educacional e a situação profissional foram os fatores que influenciaram principalmente a prática na emergência pré-hospitalar. Conclusão O atual nível de conhecimento, atitude e prática em emergência pré-hospitalar dos cuidadores de idosos é de baixo a médio. Para os cuidadores chineses, os principais fatores que afetam a implementação da emergência pré-hospitalar são a idade avançada, os baixos níveis de escolaridade, o emprego temporário e as deficiências do sistema de segurança ocupacional.

Resumen Objetivo Investigar la situación actual y analizar factores influyentes de los conocimientos, actitudes y prácticas de emergencias prehospitalarias en cuidadores de personas mayores. Métodos Estudio transversal con muestreo por conveniencia, llevado a cabo entre diciembre de 2021 y junio de 2022. Se seleccionaron 133 participantes cuidadores de personas mayores de instituciones de larga estadía en la provincia de Guangdong, China. Todos recibieron un cuestionario de información general y un cuestionario de conocimientos, actitudes y prácticas de emergencias prehospitalarias. En el análisis de los datos se utilizó estadística descriptiva e inferencial. Resultados El puntaje en la dimensión conocimientos fue 24,65 ± 4,49, en actitudes fue 24,52 ± 4,34 y en prácticas 24,05 ± 4,67. El análisis de regresión demostró que los principales factores que influyeron en los conocimientos de los cuidadores sobre emergencias prehospitalarias fueron la edad, el nivel de habilidad profesional y la experiencia en educación para la salud. La presencia/ausencia de los cuidadores en la participación directa en emergencias prehospitalarias fue el factor principal de influencia en la actitud, mientras que el nivel educativo y la situación profesional fueron los que más influyeron en la práctica de emergencias prehospitalarias. Conclusión El nivel actual de conocimientos, actitudes y prácticas en emergencias prehospitalarias de los cuidadores de personas mayores es de bajo a mediano. En los cuidadores chinos, los principales factores que afectan la implementación de emergencias prehospitalarias son la edad avanzada, los bajos niveles de escolaridad, el empleo temporario y las deficiencias del sistema de seguridad laboral.

Abstract Objective To investigate the status quo and analyze the influencing factors of the knowledge, attitude, and practice of pre-hospital emergency among caregivers for older adults. Methods In this cross-sectional study, 133 caregivers for older adults in Guangdong province, China, nursing homes were selected as survey participants from December 2021 to June 2022 via convenience sampling. All participants were administered a general information questionnaire and a Pre-Hospital Emergency Knowledge, Attitude, and Practice Questionnaire. For data analysis, we used descriptive and inferential statistics. Results The scores on the knowledge, attitude, and practice dimensions were 24.65 ± 4.49, 24.52 ± 4.34, and 24.05 ± 4.67, respectively. Regression analysis showed that the age, professional skill level, and healthcare education experience of the caregivers were the main influencing factors of their pre-hospital emergency knowledge. Additionally, the presence/absence of direct participation in the pre-hospital emergency of the caregivers was the primary influencing factor of attitude, while education level and employment status were the factors mainly influencing pre-hospital emergency practice. Conclusion Caregivers for older adults currently have a low-to-medium level of knowledge, attitude, and practice of pre-hospital emergency. The main factors affecting the implementation of pre-hospital emergency for caregivers in China are their older age, low education levels, temporary employment and imperfect occupational security system.

Abordagem profissional e o comportamento suicida na Atenção Primária à Saúde / Conducta profesional y comportamiento suicida en la Atención Primaria de Salud / Professional approach and suicidal behavior in Primary Health Care

Resumo Objetivo Descrever a abordagem profissional à pessoa com comportamento suicida na Atenção Primária à Saúde e suas associações com as variáveis sociodemográficas, de escolaridade e ocupacionais dos trabalhadores de saúde. Métodos Estudo transversal. Participaram 192 profissionais de saúde de 20 Unidades Básicas de Saúde de um município da grande São Paulo. Foram aplicados um questionário para caracterização sociodemográfica, de escolaridade e ocupacional, e a Avaliação da Assistência Profissional às Pessoas com Comportamento Suicida. Os resultados foram apresentados por meio de medidas de tendência central e dispersão, e a análise utilizou testes paramétricos e não-paramétricos, considerando a natureza das variáveis. Utilizou-se nível de significância de 5%. Resultados Houve predominância do sexo feminino, média etária de 43,27 anos, nível superior e tempo médio de trabalho de 10,71 anos. Os domínios Percepção Profissional e Conhecimento/Habilidade obtiveram as maiores pontuações. Experiência Profissional e Organização da Rede de Atenção obtiveram menores pontuações, demonstrando fragilidade na atuação profissional e na articulação em rede requeridas na abordagem ao comportamento suicida. Idade, tempo de atuação na unidade e a frequência com que são atendidas as populações de risco para o comportamento suicida estiveram associadas às pontuações na Percepção Profissional, Experiência e Conhecimento/Habilidade. Conclusão Percepção, conhecimentos e habilidades dos profissionais de saúde da Atenção Primária contribuem para a abordagem ao comportamento suicida, associando-se às características ocupacionais e de escolaridade. Experiência profissional e Organização da rede de atenção denunciam as fragilidades na articulação necessária para a abordagem ao comportamento suicida, indicando caminhos para formação e trabalho em saúde.

Resumen Objetivo Describir la conducta profesional hacia personas con comportamiento suicida en la Atención Primaria de Salud y su relación con las variables sociodemográficas, de escolaridad y ocupacionales de los trabajadores de la salud. Métodos Estudio transversal. Participaron 192 profesionales de la salud de 20 Unidades Básicas de Salud de un municipio de la Región Metropolitana de São Paulo. Se aplicó un cuestionario para la caracterización sociodemográfica, de escolaridad y ocupacional y la Evaluación de la Atención Profesional a Personas con Comportamiento Suicida. Los resultados fueron presentados mediante medidas de tendencia central y dispersión, y se utilizaron pruebas paramétricas y no paramétricas para el análisis, considerando la naturaleza de las variables. Se utilizó un nivel de significación del 5 %. Resultados Se observó predominancia del sexo femenino, de 43,27 años de edad promedio, nivel superior y con 10,71 años de tiempo de trabajo promedio. Los dominios que obtuvieron puntaje más alto fueron Percepción profesional y Conocimiento/habilidad. Los dominios Experiencia profesional y Organización de la red de atención recibieron el menor puntaje, lo que demuestra la debilidad de la actuación profesional y del trabajo en red requeridos para la adopción de una conducta profesional ante el comportamiento suicida. Las variables edad, tiempo de trabajo en la unidad y frecuencia con que se atiende a las poblaciones de riesgo de comportamiento suicida se asociaron con los puntajes de Percepción profesional, Experiencia y Conocimiento/Habilidad. Conclusión La percepción, los conocimientos y las habilidades de los profesionales de la salud de la Atención Primaria, junto con las características ocupacionales y de escolaridad, contribuyen para la adopción de una conducta profesional ante el comportamiento suicida. La experiencia profesional y la organización de la red de atención demuestran la debilidad de la unión necesaria para adoptar una conducta profesional ante el comportamiento suicida, e indican los caminos a seguir para la formación y el trabajo en el área de la salud.

Abstract Objective To describe the professional approach to people with suicidal behavior in Primary Health Care and its associations with the sociodemographic, educational and occupational variables of health workers. Methods Cross-sectional study of 192 health professionals from 20 Basic Health Units in a municipality in greater São Paulo. A questionnaire for sociodemographic, educational and occupational characterization was applied, as well as the instrument for Evaluating Professional's Assistance to People with Suicidal Behavior. The results were presented using measures of central tendency and dispersion, and parametric and non-parametric tests were used in the analysis, considering the nature of the variables. A significance level of 5% was adopted. Results There was a predominance of females, average age of 43.27 years, higher education, and average working time of 10.71 years. The higher scores were reached in the Professional Sensibility and Knowledge/Abilities domains. Lower scores were obtained for Professional Experience and Organization of the Care Network, demonstrating frailty in the professional performance and in network coordination needed in the approach to suicidal behavior. Age, working time in the unit and the frequency of treatment of populations at risk for suicidal behavior were associated with scores in Professional Sensibility, Experience and Knowledge/Abilities. Conclusion Sensibility, knowledge and abilities of Primary Care health professionals contribute to the approach to suicidal behavior, associated with occupational and educational characteristics. Professional experience and Organization of the care network reveal the weaknesses in the coordination necessary to approach suicidal behavior, indicating paths for training and work in health.

Conocimientos y actitudes de madres mexicanas en la no aceptación de la vacuna del virus del papiloma humano / Knowledge and attitudes of Mexican mothers in the non-acceptance of the human papillomavirus vaccine / Conhecimento e atitudes de mães mexicanas sobre a não aceitação da vacina contra o papilomavírus humano

Introducción. El virus del papiloma humano tiene una prevalencia del 11.7% en mujeres, siendo la vacunación la estrategia de prevención más efectiva; sin embargo, en México solo se aplica al 14.4% del total de las niñas de 9 a 12 años. Objetivo. Identificar los conocimientos y actitudes de madres de familia en la no aceptación de la vacuna del virus del papiloma humano para sus hijas. Metodología. Estudio cualitativo fenomenológico hermenéutico, con entrevista a seis madres mexicanas quienes no aceptaron la vacuna para sus hijas. Muestreo intencional, se aplicó en el 2021 una guía fundamentada en la revisión de literatura con formato en línea, con transcripción, análisis temático y procesamiento en el software MAXQDA versión 18.2.0. Resultados. Se realizaron entrevistas a madres de entre 30 a 40 años, la mayoría con licenciatura, religión católica y empleadas de institución gubernamental. Se obtuvieron tres categorías centrales: 1) significado del virus del papiloma humano; 2) vacuna del virus del papiloma humano y 3) prevención y promoción de la salud para la vacuna del virus del papiloma humano, con 9 subcategorías que abordan: conocimiento, creencias, desinformación, beneficios, motivación y falta de aceptación de la vacuna. Discusión. Estudios evidencian que la falta de información provoca la no aceptación de la vacuna del virus del papiloma humano, lo que limita la inmunización oportuna en las niñas, coincidiendo con los resultados encontrados. Conclusión. El bajo conocimiento y falta de información confiable afecta a que las madres presenten actitudes negativas de no aceptación de la vacuna del virus del papiloma humano para sus hijas. Las intervenciones de enfermería con información pertinente y de impacto aportarán a un comportamiento saludable individual y familiar.

Introduction. The human papillomavirus has a prevalence of 11.7% among women, and vaccination is the most effective prevention strategy; however, in Mexico it is only applied to 14.4% of all girls between 9 and 12 years of age. Objective. To identify the knowledge and attitudes of Mexican mothers in the non-acceptance of the human papillomavirus vaccine for their daughters. Methodology. Qualitative hermeneutic phenomenological study, with interviews with six Mexican mothers who did not accept the vaccine for their daughters. Purposive sampling, a guide based on the literature review was applied in 2021 with online format, transcription, thematic analysis and processing in MAXQDA software version 18.2.0. Results. Interviews were conducted with mothers between 30 and 40 years of age, most of whom had a bachelor's degree, were Catholic and were employed by government institutions. Three core categories were obtained: 1) meaning of human papillomavirus; 2) human papilomavirus vaccine; and 3) prevention and health promotion for human papillomavirus vaccine, with 9 subcategories addressing: knowledge, beliefs, misinformation, benefits, motivation, and lack of acceptance of the vaccine. Discussion. Studies show that lack of information leads to non-acceptance of the human papillomavirus vaccine, which limits timely immunization of girls, coinciding with the results found. Conclusion. Limited knowledge and lack of reliable information affect the negative attitudes of mothers who refuse the human papillomavirus vaccine for their daughters. Nursing interventions with relevant and impactful information will contribute to healthy individual and family behaviors.

Introdução. O papilomavírus humano tem uma prevalência de 11.7% em mulheres, sendo a vacinação a estratégia de prevenção mais eficaz; no entanto, no México, apenas 14.4% do total de meninas de 9 a 12 anos são vacinadas. Objetivo. Identificar o conhecimento e as atitudes das mães quanto à não aceitação da vacina contra o papilomavírus humano por suas filhas. Metodologia. Estudo hermenêutica fenomenológico qualitativo, com entrevistas com seis mães mexicanas que não aceitaram a vacina para suas filhas. Amostragem intencional, foi aplicado em 2021 um guía baseado na revisão de literatura em formato online, com transcrição, análise temática e processamento no software MAXQDA versão 18.2.0. Resultados. Foram realizadas entrevistas com mães entre 30 e 40 anos, a maioria com graduação, religião católica e funcionárias de instituição governamental. Foram obtidas três categorias centrais: 1) significado do papilomavírus humano; 2) vacina contra o papilomavírus humano e 3) prevenção e promoção da saúde para a vacina contra o papilomavírus humano, com 9 subcategorias que abordam: conhecimento, crenças, desinformação, benefícios, motivação e falta de aceitação da vacina. Discussão. Estudos mostram que a falta de informação leva à não aceitação da vacina contra o papilomavírus humano, o que limita a imunização oportuna nas meninas, coincidindo com os resultados encontrados. Conclusão. O baixo conhecimento e a falta de informações confiáveis afetam as atitudes negativas das mães em relação à não aceitação da vacina contra o papilomavírus humano para suas filhas. Intervenções de enfermagem com informações relevantes e impactantes contribuirão para um comportamento saudável individual e familiar.

Conocimiento de infarto cerebral y educación en usuarios del Departamento de Neurología - Hospital de Especialidades Carlos Andrade Marín / Knowledge of ischemic stroke and education in users of the Neurology Department - Carlos Andrade Marín Specialty Hospital

INTRODUCCIÓN: El riesgo de sufrir un infarto cerebral se relaciona con factores de riesgo, el reconocimiento y actuación del paciente/familia se relaciona con el nivel educativo. Pese al avance en el tratamiento, la mejor forma de enfrentarla es la prevención. OBJETIVO: Determinar el nivel de conocimiento de infarto cerebral en población no médica. Demostrar la hipótesis de que la educación mejora los niveles de conocimiento de la enfermedad. MATERIALES Y MÉTODOS: Ensayo Clínico Cuasiexperimental de tipo antes/después con cohorte única. Población: 113 familiares de pacientes ingresados al área de Neurología del Hospital de Especialidades Carlos Andrade Marín en el periodo marzo ­ septiembre del 2022. Criterios de inclusión: familiares en cuidado/vigilancia directa de pacientes ingresados con diagnóstico clínico/ imagenológico de infarto cerebral agudo, firma de consentimiento informado. Criterios de exclusión: No aceptación de participar. Se realizó a cada participante una encuesta a la admisión, luego se le entregó un documento educativo acerca del tema y posteriormente se aplicó nuevamente la encuesta. Se utilizó la prueba Chi cuadrado de Mcnemar para comprobación de hipótesis y los porcentajes de frecuencias se analizaron con diferencia porcentual. RESULTADOS: El síntoma más conocido fue la alteración del lenguaje con un 44,2% de conocimiento en la población estudiada, 25,7% sospecharon de ictus, 87,6% lo consideraban como emergencia, 31% sabían de la existencia de factores de riesgo, la diferencia porcentual luego de la intervención educativa incrementó en: 76,4% en la necesidad de llamar a una ambulancia, en más de 47,3% y de 111,1% en conocimiento de síntomas y de los factores de riesgo, respectivamente. El nombre del ictus más conocido fue ´Derrame´. DISCUSIÓN: El conocimiento para reconocer a un infarto cerebral es bajo, el de reconocerlo como emergencia es alto, la intervención educativa mejoró notablemente ese conocimiento al igual que literatura publicada. CONCLUSIÓN: Se comprobó la hipótesis de que es necesario incrementar el conocimiento de infarto cerebral y la conciencia de cómo proceder ante la presentación de esta enfermedad.

recognition and action of the patient/family is related to the educational level. Despite advances in treatment, the best way to deal with it is prevention. OBJECTIVE: To determine the level of knowledge of ischemic stroke in the non-medical population. To demonstrate the hypothesis that education improves levels of knowledge of the disease. MATERIALS AND METHODS: Quasi-experimental before/after clinical trial with single cohort. Population: 113 relatives of patients admitted to the Neurology area of the Carlos Andrade Marín Specialties Hospital during the period March - September 2022. Inclusion criteria: family members in direct care/monitoring of patients admitted with clinical/imaging diagnosis of acute ischemic stroke, signature of informed consent. Exclusion criteria: non-acceptance to participate. Each participant was given a survey at admission, then given an educational document about the topic, and then the survey was administered again. The Mcnemar Chi-square test was used for hypothesis testing and the percentages of frequencies were analyzed with percentage difference. RESULTS: The most known symptom was language impairment, with 44,2% of the population studied being aware of it, 25,7% suspected stroke, 87,6% considered it as an emergency, 31% knew of the existence of risk factors, the percentage difference after the educational intervention increased by: 76,4% in the need to call an ambulance, by more than 47,3% and 111,1% in knowledge of symptoms and risk factors, respectively. The name of the most known stroke was ´stroke´. DISCUSSION: The knowledge to recognize a stroke is low, the knowledge to recognize it as an emergency is high, the educational intervention improved notably this knowledge as well as published literature. CONCLUSION: The hypothesis that it is necessary to increase knowledge of stroke and awareness of how to proceed when faced with this disease was proven.

Creencias-prácticas culturales de pacientes con cuidados paliativos domiciliarios, desde la teoría Leininger

Introducción: La cultura del paciente tiene influencia en la selección de sus tratamientos, las expresiones emocionales, la toma de decisiones y en la forma de comunicarse de los pacientes. Los cuidados paliativos permiten el abordaje holístico a personas y familias en sufrimiento por enfermedades potencialmente mortales. Objetivo: Describir las creencias y las prácticas culturales relacionadas con la salud en pacientes adultos de un programa domiciliario de cuidados paliativos en la ciudad de Bogotá. Materiales y Métodos: Estudio cualitativo, de tipo etnografía. Se realizaron entrevistas semiestructuradas virtuales a 9 pacientes requirentes de cuidados paliativos, determinada por saturación teórica. Para el análisis de la información, se consideraron las orientaciones de la teoría de los cuidados culturales de Leininger bajo el modelo del sol naciente. Se realizó la codificación y categorización en el software Nvivo v12. Resultados: Se obtuvieron 3 categorías principales: prácticas culturales, creencias para mantener la poca salud y aliviar síntomas y experiencias en la adaptación a la enfermedad y muerte y se dio lugar a 13 subcategorías Discusión: Tras describir y analizar los resultados obtenidos, se observó que los participantes poseen conocimientos sobre prácticas-creencias culturales, que han sido transmitidas de generación en generación y juegan un papel importante en el proceso de la enfermedad Conclusiones: Se evidenció que existen prácticas consideradas protectoras y otras que generan conductas de riesgo, las cuales deberán reestructurarse, negociarse o preservarse, con el objetivo de fortalecer el proceso de cuidado y así mantener un enfoque culturalmente competente.

Introduction: Patient culture influences treatment selection, emotional expressions, decision making, and patients' communication. Palliative care allows a holistic approach to individuals and families suffering from life-threatening illnesses. Objective: To describe the beliefs and health- related cultural practices of adult patients in a palliative home care program in the city of Bogotá. Materials and methods: Qualitative ethnographic study. Semi-structured online interviews were conducted with 9 patients requiring palliative care, until theoretical saturation was reached. For data analysis, the guidelines of Leininger's Cultural Care Theory based on the Sunrise Model were considered. Results: Three main categories were identified: cultural practices, beliefs about maintaining poor health and alleviating symptoms, and experiences adapting to illness and death, resulting in 13 subcategories. Discussion: After describing and analyzing the results obtained, it was observed that the participants have knowledge of cultural practices-beliefs that have been passed down from generation to generation and play an important role in the disease process. Conclusions: It became clear that there are practices that are considered protective and others that create risky behaviors that should be restructured, negotiated, or maintained in order to strengthen the care process and thus maintain a culturally competent approach.

Introdugáo: A cultura do paciente influencia na escolha de seus tratamentos, nas expressóes emocionáis, na tomada de decisóes e na forma como os pacientes se comunicam. Os cuidados paliativos permitem uma abordagem holística para individuos e familias que sofrem de doengas que ameagam a vida. Objetivo: Descrever as crengas e práticas culturais relacionadas a saúde em pacientes adultos de um programa domiciliar de cuidados paliativos na cidade de Bogotá. Materiais e Métodos: Estudo qualitativo, do tipo etnográfico. Foram realizadas entrevistas semiestruturadas virtuais com 9 pacientes em cuidados paliativos, determinadas pela saturagao teórica. Para a análise das informagóes, foram consideradas as orientagóes da teoria do cuidado cultural de Leininger sob o modelo do sol nascente. A codificagao e categorizagao foram realizadas no software Nvivo v12. Resultados: Obtiveram-se 3 categorias principais: práticas culturais, crengas para manter a saúde precária e aliviar sintomas e experiencias de adaptagao a doenga e a morte, dando origem a 13 subcategorias. Discussao: descrevendo e analisando os resultados obtidos, observou-se que os participantes possuem conhecimento sobre as práticas-crengas culturais, que foram transmitidas de geragao em geragao e desempenham um papel importante no processo de adoecimento. Condusdes: ficou evidenciado que existem práticas consideradas protetoras e outras que geram comportamentos de risco, que devem ser reestruturadas, negociadas ou preservadas, a fim de fortalecer o processo de cuidar e, assim, manter uma abordagem culturalmente competente.

Saberes e práticas de mães ribeirinhas sobre vacinação / Knowledge and practices of riverine mothers about vaccination / Conocimientos y prácticas de las madres ribereñas en materia de vacunación

RESUMO Objetivo: analisar os saberes de mães ribeirinhas sobre vacinação e sua influência na prática de levar seus filhos para vacinar. Método: estudo qualitativo/descritivo, realizado na Unidade de Saúde da Família Combú, Belém-Pará, Brasil, com 30 mães ribeirinhas que tinham filhos em idade vacinal. Os dados foram produzidos por entrevistas individuais, cujo corpus foi analisado com o software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires 0.7, alpha 2, utilizando a Classificação Hierárquica Descendente. Resultados: o software gerou seis classes, compondo duas categorias: "Saberes e práticas de mães ribeirinhas sobre vacinação" e "Importância da educação em saúde e o papel dos profissionais de saúde no compartilhamento de informações sobre vacinação". Conclusão: discutir os saberes de mães ribeirinhas sobre vacinação e sua influência na tomada de decisão permitiu refletir criticamente sobre as práticas no cotidiano dessa população, oportunizando aos profissionais de saúde repensar estratégias, principalmente nas ações educativas.

ABSTRACT Objective: to analyze the knowledge of riverine mothers about vaccination and its influence on the practice of taking their children for vaccination. Method: qualitative/descriptive study, conducted at the Combú Family Health Unit, Belém-Pará, Brazil, with 30 riverine mothers who had children of vaccination age. Data were produced by individual interviews, whose corpus was analyzed with the software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires 0.7, alpha 2, using Descending Hierarchical Classification. Results: the software generated six classes, composing two categories: "Knowledge and practices of riverine mothers about vaccination" and "Importance of health education and the role of health professionals in sharing information about vaccination". Conclusion: discussing the knowledge of riverside mothers about vaccination and its influence on decision-making allowed a critical reflection on the practices in the daily life of this population, providing health professionals with the opportunity to rethink strategies, especially in educational actions.

RESUMEN Objetivo: analizar los conocimientos de las madres ribereñas sobre la vacunación y su influencia en la práctica de llevar a sus hijos a vacunar. Método: estudio cualitativo/descriptivo realizado en la Unidad de Salud de la Familia de Combú, Belém-Pará, Brasil, con 30 madres ribereñas que tenían hijos en edad de vacunación. Los datos fueron producidos por entrevistas individuales, cuyo corpus fue analizado con el software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires 0.7, alpha 2, utilizando la Clasificación Jerárquica Descendente. Resultados: el software generó seis clases, que componían dos categorías: "Conocimientos y prácticas de las madres ribereñas sobre la vacunación" e "Importancia de la educación sanitaria y papel de los profesionales de la salud en el intercambio de información sobre la vacunación". Conclusión: discutir el conocimiento de las madres ribereñas sobre la vacunación y su influencia en la toma de decisiones nos permitió reflexionar críticamente sobre las prácticas en el día a día de esta población, dando a los profesionales de la salud la oportunidad de repensar estrategias, especialmente en las acciones educativas.

Educação em saúde na formação acadêmica em enfermagem / Health education in academic nursing training / Educación de salud en la institución académica de enfermería

Com o objetivo de conhecer os limites e potencialidades da formação acadêmica em enfermagem para as atividades de educação em saúde, foi possível desenvolver um estudo exploratório-descritivo de abordagem qualitativa envolvendo 15 participantes. A coleta de dados ocorreu nos meses de maio e junho de 2022 e o processamento dos dados foi feito pelo software Iramuteq. Os resultados apontaram para a dialética envolvendo as potencialidades e limitações. Como potencialidade foi apontado que a disciplina de Educação em Saúde pode ser vista como uma temática transversal que pode ser trabalhada na prática. No que concerne às limitações, as falas elucidaram poucas oportunidades para atividades práticas, além da disciplina se distanciar da realidade. Como considerações finais, foi possível entender que existem abordagens pedagógicas tradicionais no contexto acadêmico em enfermagem desencadeando discussões para uma formação que estimule o aluno a refletir a realidade social que o cerca e aprenda a aprender constantemente.

Aiming to know the limits and the potential of academic nursing training for health education activities, an exploratory-descriptive study with a qualitative approach was developed with 15 participants. Data collection took place in May and June, 2022, and data processing was carried out using the software Iramuteq. The results pointed to the dialectics involving potentialities and limitations. A potentiality was the fact that health education can be seen as a cross-cutting theme that can be worked in practice. Regarding limitations, the speeches pointed to few opportunities for practical activities and to the distance of the subject from reality. As final considerations, it could be understood that there are traditional pedagogical approaches in the academic context of nursing, leading to discussions focused on training that encourages students to reflect on the social reality surrounding them and to learn how to learn continuously.

Con el objetivo de conocer los límites y potencialidades de la formación académica de enfermeros para actividades de educación en salud, fue posible desarrollar un estudio exploratorio-descriptivo con enfoque cualitativo involucrando a 15 participantes. La recolección de datos se realizó en los meses de mayo y junio de 2022 y el procesamiento de datos se realizó mediante el software Iramuteq. Los resultados señalaron a la dialéctica entre fortalezas y limitaciones. Como potencialidad, se apuntó que la asignatura de la educación en salud se ve como un tema transversal que puede ser trabajado en la práctica. En cuanto a las limitaciones, los discursos dilucidaron pocas oportunidades para actividades prácticas, además del hecho de que la asignatura se distancia de la realidad. Como consideraciones finales, fue posible comprender que existen enfoques pedagógicos tradicionales en el contexto académico de enfermería, desencadenando discusiones para una formación que anime a los estudiantes a reflexionar sobre la realidad social que los rodea y aprender a aprender constantemente.

Knowledge regarding extracorporeal membrane oxygenation management among Brazilian pediatric intensivists: a cross-sectional survey / Conhecimento do manejo da oxigenação por membrana extracorpórea de intensivistas pediátricos brasileiros: um inquérito transversal

ABSTRACT Objective: To assess Brazilian pediatric intensivists' general knowledge of extracorporeal membrane oxygenation, including evidence for its use, the national funding model, indications, and complications. Methods: This was a multicenter cross-sectional survey including 45 Brazilian pediatric intensive care units. A convenience sample of 654 intensivists was surveyed regarding their knowledge on managing patients on extracorporeal membrane oxygenation, its indications, complications, funding, and literature evidence. Results: The survey addressed questions regarding the knowledge and experience of pediatric intensivists with extracorporeal membrane oxygenation, including two clinical cases and 6 optional questions about the management of patients on extracorporeal membrane oxygenation. Of the 45 invited centers, 42 (91%) participated in the study, and 412 of 654 (63%) pediatric intensivists responded to the survey. Most pediatric intensive care units were from the Southeast region of Brazil (59.5%), and private/for-profit hospitals represented 28.6% of the participating centers. The average age of respondents was 41.4 (standard deviation 9.1) years, and the majority (77%) were women. Only 12.4% of respondents had taken an extracorporeal membrane oxygenation course. Only 19% of surveyed hospitals have an extracorporeal membrane oxygenation program, and only 27% of intensivists reported having already managed patients on extracorporeal membrane oxygenation. Specific extracorporeal membrane oxygenation management questions were responded to by only 64 physicians (15.5%), who had a fair/good correct response rate (median 63.4%; range 32.8% to 91.9%). Conclusion: Most Brazilian pediatric intensivists demonstrated limited knowledge regarding extracorporeal membrane oxygenation, including its indications and complications. Extracorporeal membrane oxygenation is not yet widely available in Brazil, with few intensivists prepared to manage patients on extracorporeal membrane oxygenation and even fewer intensivists recognizing when to refer patients to extracorporeal membrane oxygenation centers.

RESUMO Objetivo: Avaliar os conhecimentos gerais dos intensivistas pediátricos brasileiros sobre oxigenação por membrana extracorpórea, incluindo evidências de uso, modelo de custeio nacional, indicações e complicações. Métodos: Este estudo foi um inquérito transversal multicêntrico que incluiu 45 unidades de terapia intensiva pediátrica brasileiras. Realizou-se inquérito de conveniência com 654 intensivistas quanto aos seus conhecimentos sobre manejo de pacientes em oxigenação por membrana extracorpórea, suas indicações, complicações, custeio e evidências bibliográficas. Resultados: O inquérito abordou questões relativas aos conhecimentos e à experiência dos intensivistas pediátricos sobre oxigenação por membrana extracorpórea, incluindo dois casos clínicos e seis questões facultativas sobre o manejo de pacientes em oxigenação por membrana extracorpórea. Dos 45 centros convidados, 42 (91%) participaram do estudo, e 412 (63%) dos 654 intensivistas pediátricos responderam ao inquérito. A maioria das unidades de terapia intensiva pediátrica eram da Região Sudeste do Brasil (59,5%), e os hospitais privados com fins lucrativos representavam 28,6% dos centros participantes. A média de idade dos respondentes era de 41,4 (desvio-padrão de 9,1) anos, e a maioria (77%) era mulher. Apenas 12,4% dos respondentes tinham formação em oxigenação por membrana extracorpórea. Dos hospitais pesquisados, apenas 19% tinham um programa de oxigenação por membrana extracorpórea, e apenas 27% dos intensivistas declararam já ter manejado pacientes em oxigenação por membrana extracorpórea. Apenas 64 médicos (15,5%) responderam a questões específicas sobre o manejo de oxigenação por membrana extracorpórea (mediana 63,4%; oscilando entre 32,8% e 91,9%). Conclusão: A maioria dos intensivistas pediátricos brasileiros demonstrou conhecimentos limitados de oxigenação por membrana extracorpórea, incluindo suas indicações e complicações. A oxigenação por membrana extracorpórea ainda não está amplamente disponível no Brasil, com poucos intensivistas preparados para o manejo de pacientes em oxigenação por membrana extracorpórea e ainda menos intensivistas capazes de reconhecer quando devem encaminhar pacientes para centros de oxigenação por membrana extracorpórea.

Delivery of acupuncture in clinical trials: Research acupuncturists' perspectives / 中西医结合学报

Delivery of acupuncture in the setting of a clinical trial is a unique practice that diverges significantly from the delivery of acupuncture in a real-world clinical setting. Research acupuncturists, particularly those trained in traditional Chinese medicine (TCM), are often required to set aside valued precepts of traditional care, including diagnosing imbalances, individualizing treatment, and forging a therapeutic relationship with patients. TCM-trained acupuncturists express mixed feelings about participating in clinical trials. Many are eager to play a vital role in the advancement of acupuncture science and appreciate the need for strict protocol adherence to minimize bias. However, the acupuncturist(s) may also have concerns about clinical trial methodology, including but not limited to the delivery of a control condition, e.g., sham acupuncture. Investigators should anticipate certain questions and even a level of resistance to the requirements of research among acupuncturists and be prepared to address them. This manuscript presents a brief review of the subjective experience of the research acupuncturist within the available scientific literature as it pertains to the delivery of active and sham clinical research protocols. Our goals are to better understand the perspectives of acupuncturists who may participate in clinical research, so that their concerns may be addressed in study design and methodology. To that end, we suggest the creation of a novel training program specifically for clinical trial acupuncturists, intended for qualified TCM- and Western-trained practitioners, that would help to standardize the research acupuncturist's role and help to strengthen the design and execution of acupuncture studies. Please cite this article as: Anastasi JK, Capili B, Neumaier J, Hackett L. Delivery of acupuncture in clinical trials: Research acupuncturists' perspectives. J Integr Med. 2023; 21(4):315-319.

Consistency and influencing factors in parents knowledge, attitude and practice about early childhood sex education in rural areas / 中国学校卫生

Objective@#To understand the consistency and factors influencing rural parents knowledge, attitude and practice about early childhood sex education, so as to put forward effective suggestions and countermeasures for improving childhood sex education in rural areas.@*Methods@#A multi stage stratified sampling method was used to investigate the knowledge, attitude and practice of early childhood sex education among 1 015 parents in 16 kindergartens in rural areas of Sichuan from March to May 2019. Chi square text and multivariate Logistic regression analysis were used to analyze factors affecting the consistency of parents knowledge, attitude and practice of childhood sex education.@*Results@#Nearly 64.9%, 85.9% and 44.7% of parents with sufficient knowledge, support, and implement of early children s sex education, respectively, and the consistency rate of knowledge, attitude and practice were 30.2%. The results of the multivariate Logistic regression analysis showed that parents aged <31 years ( OR= 5.35 , 95%CI =2.93-9.77), 31-40 years ( OR=4.82, 95%CI =2.65-8.76) and 41-50 years ( OR=2.37, 95%CI =1.10-5.11), and the mother s education level being middle school ( OR=3.67, 95%CI =1.75-7.69), secondary/high school ( OR=2.83, 95%CI =1.32-6.05) and college/bachelor s degree and above ( OR=5.44, 95%CI =2.23-12.98), sex related questions asked by child ( OR=2.00, 95%CI =1.44-2.78), having sex education in the family ( OR=5.38, 95% CI =3.82-7.59), believing that parents should be responsible for sex education for young children ( OR=2.58, 95%CI =1.40-4.74) had a higher consistency rate of knowledge, attitude and practice in early childhood sex education ( P <0.05).@*Conclusion@#In rural areas of Sichuan, although parents highly support early childhood sex education, the eligible rate of knowledge and the implementing rate are quite low, as well as the consistent rate of knowledge, attitude and practice. Relevant departments should pay attention to strengthen publicity and education, especially among older parents, low educated parents and those opposed to or not yet implementing child sex education.

Survey on knowledge, attitude and practice for diabetic retinopathy among diabetic patients in Shanghai suburb and related influencing factors / 中华全科医师杂志

Objective:To survey the knowledge,attitude and practice (KAP) for diabetic retinopathy (DR) among diabetic patients in Shanghai suburb, and to analyze the related influencing factors.Methods:A cross-sectional survey on KAP for diabetic retinopathy was conducted from January to January 2022,a total of 260 diabetic patients were selected from Huacao Town of Shanghai Minhang District by stratified cluster random sampling method as the investigation subjects. The gender, age, height, weight, education level, occupation, frequency of exercise or outdoor sports, medical insurance status, comorbid chronic diseases, diabetic retinopathy in direct relatives were documented;the KAP of diabetes retinopathy prevention and treatment was investigated by a self-designed questionnaire. The influencing factors were analyzed by univariate and multivariate regression analysis.Results:A total of 260 valid questionnaires were received with a recovery rate of 100.0%. The survey showed that the knowledge awareness rate, attitude positive rate and behavior execution rate were 25.38% (66/260), 50.76% (132/260) and 14.61% (38/260), respectively; scores of knowledge,attitude,behavior and medication compliance of the subjects were 13.74±4.55, 10.40±3.23 and 14.92±4.51, respectively. Univariate analysis showed that the knowledge was significantly related to occupations,frequency of exercise or outdoor exercise,chronic disease, direct relatives with DR( F=5.03, 8.77, 5.08, 32.37,all P<0.05);the attitude was significantly related to age, education level, chronic disease, direct relatives with DR and awareness level of DR( F=2.12, 2.09, 2.75, 3.28,all P<0.05); the behavior was significantly related to age, frequency of exercise or outdoor exercise, direct relatives with DR( F=2.30, 2.70, 3.11,all P<0.05). Multiple stepwise linear regression analysis showed that the knowledge awareness score was significantly associated with age,education levels,direct relatives with DR( t=2.83, 2.46, 6.24,all P<0.05),and the age, chronic disease, awareness score were significantly associated with the attitude toward DR prevention and treatment ( t=3.70, 3.42, 6.03,all P<0.05).Patients with insufficient awareness had worse behavior of DR prevention and treatment( t=11.00, P<0.05). Conclusions:The KAP status of DR prevention and treatment in diabetes patients in Huacao Town is less satisfactory. In order to prevent the occurrence of diabetic retinopathy, it is necessary to strengthen health education, improve self-management ability, enhance lifestyle intervention, and increase the frequency of exercise or outdoor exercise in diabetic patients.

Status quo of knowledge, attitudes and practice of general practitioners on potentially inappropriate medication in the elderly in Shanxi Province and relevant factors / 中华全科医师杂志

Objective:To investigate the levels of knowledge, attitudes and practice of general practitioners on potentially inappropriate medication(PIM)in the elders in Shanxi Province and to explore its relevant factors.Methods:A cross-sectional survey on knowledge, attitudes and practice of general practitioners on PIM in the elders was conducted from January to February 2021. A self-designed questionnaire was used for the survey, which included the basic information of general practitioners and the knowledge, attitudes and practice of elderly PIM. The convenient sampling method was used to select 16 primary, secondary and tertiary hospitals from the general practice alliance units in Shanxi Province, and 257 general practitioners in the selected hospital were recruited as the research objects. The related factors were investigated by univariate regression and multiple stepwise linear regression analyses.Results:A total of 257 questionnaires were distributed, and 248 valid questionnaires were recovered, with an effective rate of 96.5%. The scores of elderly PIM knowledge, attitudes and behavior of 248 general practitioners were (31.4±9.2), (32.9±4.6) and (34.9±8.3), respectively, with the scoring rates of 62.8% (31.4/50.0), 82.3% (32.9/40.0) and 69.8% (34.9/50.0). The total score was (99.2±16.3), and the total score rate was 70.9% (99.2/140.0). There was a statistically significant difference in the total score of elderly PIM knowledge, attitudes and practice among general practitioners with different educational background, work units, professional title, awareness level of PIM and needs for PIM training( F=6.14,4.39 and 5.38, t=2.97 and 2.62, all P<0.05). Multivariate analysis showed that general practitioners with undergraduate and graduate education and higher professional titles had better knowledge, attitudes and practice of PIM ( t=2.69, 2.98 and 2.36, all P<0.05), and general practitioners without knowledge of PIM and no needs for PIM training had worse knowledge, attitudes and practice of PIM ( t=-2.96 and -2.09, all P<0.05). Conclusions:The knowledge, attitudes and behavior intervention of general practitioners on elderly PIM needs to be improved. It is necessary to strengthen the elderly PIM knowledge and skill training for general practitioners with low educational background, lower professional titles without awareness and training of PIM.