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1.
Rev. bras. educ. méd ; 46(1): e009, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1360851

ABSTRACT

Abstract: Introduction: Medical residency can cause burnout syndrome, a physical, emotional and mental state of extreme exhaustion. Objective: This research sought to describe and analyze the prevalence of burnout in resident physicians linked to a teaching Hospital and to verify whether there is a correlation with sociodemographic and socioeconomic data. Method: This is an analytical, cross-sectional and quantitative study using the MBI (Malasch Burnout Inventory) version HSS (Human Services Survey), the Brazilian Economic Classification Criterion (CCEB) of ABEP and sociodemographic questions. Result: Of the enrolled residents, 102 participated in the survey. Of these, 76.47% showed a high level in at least one of the three domains of the burnout index and 21.57% of the residents showed a high level of burnout. There was a significant relationship between a larger number of children and the presence of emotional exhaustion (P=0.047), a higher frequency of depersonalization for surgical area residents (P=0.013) and reduced professional accomplishment, with an average income of R$ 2,965.69 and R$ 10,386.52 (P=0.006). No significant relationship was found between burnout and sociodemographic and socioeconomic variables. Conclusion: The results show that resident physicians are exposed to situations that contribute to high levels of stress and distress. Further studies on the subject are still necessary.


Resumo: Introdução: A residência médica pode causar a síndrome de burnout, um estado físico, emocional e mental de exaustão extrema. Objetivo: Buscou-se com esta pesquisa descrever e analisar a prevalência de burnout em médicos residentes vinculados a um hospital-escola e verificar se há correlação com dados sociodemográficos e socioeconômicos. Método: Este é um estudo analítico, transversal e quantitativo realizado por meio do Maslach Burnout Inventory (MBI) versão Human Services Survey (HSS), do Critério de Classificação Econômica Brasil (CCEB) da Abep e de perguntas sociodemográficas. Resultado: Dos 221 residentes matriculados, 102 participaram da pesquisa. Destes, 76,47% apresentaram alto nível em pelo menos um dos três domínios do índice de burnout e 21,57% dos residentes exibiram alto nível de burnout. Houve relação significativa entre maior número de filhos e presença de exaustão emocional (p = 0,047), maior frequência de despersonalização para residentes da área cirúrgica (p = 0,013) e reduzida realização profissional com a renda média de R$ 2.965,69 e R$ 10.386,52 (p = 0,006). Não foi encontrada relação significativa entre burnout e as variáveis sociodemográficas e socioeconômicas. Conclusão: Os resultados evidenciam que os médicos residentes estão expostos a situações que contribuem para os altos níveis de estresse e angústia. Ainda são necessários mais estudos sobre o tema.

2.
Rev. Soc. Bras. Clín. Méd ; 19(1): 14-19, março 2021.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1361689

ABSTRACT

Objetivo: Determinar o perfil socioprofissional dos médicos que atuam em serviços hospitalares de urgência e emergência. Métodos: Realizou-se uma pesquisa descritiva com delineamento transversal. Foram avaliadas as informações de 60 médicos que atuavam em três hospitais com serviços de urgência e emergência do município de Imperatriz (MA), no período de janeiro a março de 2018. Para coleta de dados, utilizou-se um questionário autoaplicável contendo 18 questões. Resultados: Dos 60 participantes, 70% eram do sexo masculino, e 53,3% não ingressaram em programas de Residência Médica. A média de idade dos profissionais foi de 37 anos, enquanto a média do tempo de atuação no setor de urgência e emergência foi de 11 anos. Dos participantes, 85% referiram ter realizado cursos complementares voltados para a área da emergência. Os cursos mais citados foram o Advanced Cardiac Life Support (39,3%) e o Advanced Trauma Life Support (38,1%). Conclusão: Os perfis dos médicos foram de jovens, com predominância do sexo masculino e com pouco tempo de experiência profissional em atuação no setor de urgência e emergência. Identificou-se grande adesão aos cursos complementares na área de emergência e de educação continuada. Entretanto, apenas uma minoria dos participantes possuía especialidade e pós-graduação stricto e lato sensu.


Objective: To establish the social and professional profile of physicians working in emergency hospital services. Methods: A descriptive study with cross-sectional design was carried out. The information of 60 physicians working in hospitals with emergency services in the municipality of Imperatriz, MA, from January to March 2018 was assessed. A self-administered questionnaire with 18 questions was applied for data collection. Results: Of the 60 participants, 70% were men and 53.3% did not enroll in Medical Residency Programs. The physicians' mean age was 37 years, while the mean time of work in the emergency department was 11 years. Of the participants, 85% declared taking complementary courses on the emergency area. The most cited courses were Advanced Cardiac Life Support (39.3%) and Advanced Trauma Life Support (38.1%). Conclusion: The physicians' profiles were being young, a predominance of men, and little experience in on the emergency area. There was high adhesion to complementary courses in the area of emergency and of Continuing Education. However only a minority of participants had a graduate certificate or a graduate degree.

3.
Rev. méd. hered ; 32(1): 12-19, ene-mar 2021. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1251958

ABSTRACT

RESUMEN Objetivo: Validar una encuesta para medir el nivel de satisfacción de los médicos residentes sobre el programa de segunda especialización en un hospital público de Lima, Perú. Material y métodos: Estudio transversal. El nuevo constructo se elaboró considerando los requisitos de satisfacción según opinión de los residentes y los 5 componentes de calidad de la encuesta SERVQUAL. Previo a su aplicación, fue sometida a opinión de expertos y prueba piloto para evaluar el grado de entendimiento de las preguntas y tiempo para su aplicación. La confiabilidad se evaluó con el alfa de Cronbach y la validez de constructo mediante análisis factorial. Realizamos estadística descriptiva y Chi cuadrado considerando significativo p<0,05. Resultados : Se analizaron 218 (82,0%) encuestas. 54,1% fueron del sexo femenino, 57,7% tenía edad ≤30 años, 86,2% era de plaza libre. El grado de entendimiento fue 9,98 y el tiempo de aplicación promedio fue 5,45 minutos. El alfa de Cronbach 0,919. Según el análisis factorial los 5 componentes principales de satisfacción explicaron el 65,5 % de la varianza de las 22 preguntas. La satisfacción global fue 71,8 %, fiabilidad 79,2%, capacidad de respuesta 80,2 %, seguridad 60,8%, empatía 82,8% y aspectos tangibles 55,9%. No se encontró diferencia significativa por género, grupo etario, modalidad de ingreso y especialidad. Conclusiones: La validación de la encuesta para medir satisfacción de los médicos residentes sobre el programa de segunda especialización demostró ser válida y confiable, constituyendo una herramienta útil para identificar las oportunidades de mejora para el perfeccionamiento continuo del programa de Residentado Médico.


SUMMARY Objective: To validate a survey aimed at measuring satisfaction of residents about a specialization program in Lima, Peru. Methods: A cross-sectional study was carried-out. The survey was built considering resident´s opinions on the satisfaction requirements of each program and the five components of the SERVQUAL quality survey. A pilot study was undertaken to evaluate the degree of understanding of the questions and an expert evaluation was also performed before applying the survey. Reliability was evaluated with Cronbach´s alpha test and validity was evaluated with a multifactorial analysis. Descriptive statistics was applied, Chi square test with a p value <0.05 was used. Results: 218 (82.0%) surveys were analyzed; 54.1% were females; 57.7% were younger than 30 years of age; 86.2% were of free position. Degree of understanding was 9.98 and time to complete the survey was 5.45 minutes. Cronbach´s alpha was 0.919. The factorial analysis of the five most important components of satisfaction explained 66.5% of the variance of the 22 questions. Overall satisfaction was 71.8%, reliability was 79.2%, ability to respond was 80.2%, security was 60.8%, empathy was 82.8% and tangible aspects was 55.9%. No difference by sex, age group, specialty and modality of admission was found. Conclusions: The survey tested showed to be reliable and valid to evaluate the satisfaction of residents to their programs and it is a useful tool to identify opportunities to improve the residency program.

4.
Article in Chinese | WPRIM | ID: wpr-909513

ABSTRACT

Objective:To explore the mediating effect of resilience between perceived stress and insomnia in medical staff.Methods:A questionnaire survey was conducted among 1 163 medical staff. All subjects were assessed with the insomnia severity index (ISI), simplified Chinese version of Connor-Davidson resilience scale (CD-RISC-10) and perceived stress scale (PSS-10). SPSS 20.0 software was used for common method biases test, descriptive statistics, difference analysis, correlation analysis, hierarchical regression analysis, and SPSS PROCESS V3.4 was used for Bootstrap mediating effect.Results:①The perceived stress (16.28±6.35) was positively correlated with insomnia (6.14±5.80)( r=0.404, P<0.01), and psychological resilience was negatively correlated with insomnia and perceived stress in medical staff ( r=-0.279, P<0.01, r=-0.399, P<0.01). ②Psychological resilience played a partial mediating role between perceived stress and insomnia in medical staff, with the mediating effect as 0.051, accounting of 13.82% of the total effect. Conclusion:Psychological resilience can reduce the negative effects of perceived stress on sleep and is a protective factor for insomnia in medical staff. Clinically, reducing perceived stress and improving psychological resilience can reduce insomnia in medical staff.

5.
Article in Chinese | WPRIM | ID: wpr-908133

ABSTRACT

Objective:To understand the perceptions and suggestions of emergency medical staff on the evaluation of nursing quality in the resuscitation room, and to provide reference for the construction of nursing quality evaluation standards in the resuscitation room.Methods:Phenomenological research methods in qualitative research were used to conduct semi-structured personal in-depth interviews with 15 physicians and nursing staff from August to October 2020 using a purposive sampling method, and the results of the interviews were organized and themes were refined using the Colaizzi 7-step analysis.Results:Three themes related to the evaluation criteria of nursing quality in the structure category of the resuscitation room were extracted, namely, nursing management system, nursing human resources, and environment and facilities; three themes related to the evaluation criteria of nursing quality in the process category of the resuscitation room were extracted, namely, sterile isolation/nosocomial infection, quality of specialty care, and standard of nursing documentation; and three themes related to the evaluation criteria of nursing quality in the outcome category of the resuscitation room were extracted, namely, patient health outcome, satisfaction, and incidence of adverse events.Conclusions:At present, the evaluation of the quality of emergency room care needs to be further standardized, and the themes related to the evaluation of the quality of emergency room care extracted based on the perspective of medical and nursing staff can provide a reference basis for the construction of a reasonable, scientific and comprehensive evaluation standard of nursing quality of emergency room.

6.
Article in Chinese | WPRIM | ID: wpr-907135

ABSTRACT

ObjectiveTo provides suggestions to improve the mental health of the medical staff by investigation and effect analysis of mental health status of the medical staff in the public medical institutions in Shanghai. MethodsTo conducted a survey of medical staff in public medical institutions including tertiary general hospitals and tertiary specialized hospitals in Shanghai, using random stratified sampling method. The stratified standard includes hospital classification, title, and practice type. ResultsTotally 3 437 valid questionnaires were collected. Depression, anxiety and compulsion in medical staff were significantly higher than that in the general population. The top three factors that make medical staff anxious were examination, professional promotion, and academic research. The top three stressors were heavy workload, unstable working hours, and promotion pressure. Among the ways to relieve the pressure, the top three were taking a tour, talking with family or friends, and participating in recreational activities. Comparing with female medical staff, male medical staff had a lower level of resilience. ConclusionGovernment should speed up to establish the scientific performance appraisal and salary distribution system, and to guide the society to form a good atmosphere in caring for medical staff. Hospitals should promote the construction of health hospitals, and strengthen the construction of health archives. Individuals should have a healthy lifestyle and actively participate in physical examination and training that can improve mental health.

7.
Article in Chinese | WPRIM | ID: wpr-907112

ABSTRACT

ObjectiveTo provides suggestions to improve the mental health of the medical staff by investigation and effect analysis of mental health status of the medical staff in the public medical institutions in Shanghai. MethodsTo conducted a survey of medical staff in public medical institutions including tertiary general hospitals and tertiary specialized hospitals in Shanghai, using random stratified sampling method. The stratified standard includes hospital classification, title, and practice type. ResultsTotally 3 437 valid questionnaires were collected. Depression, anxiety and compulsion in medical staff were significantly higher than that in the general population. The top three factors that make medical staff anxious were examination, professional promotion, and academic research. The top three stressors were heavy workload, unstable working hours, and promotion pressure. Among the ways to relieve the pressure, the top three were taking a tour, talking with family or friends, and participating in recreational activities. Comparing with female medical staff, male medical staff had a lower level of resilience. ConclusionGovernment should speed up to establish the scientific performance appraisal and salary distribution system, and to guide the society to form a good atmosphere in caring for medical staff. Hospitals should promote the construction of health hospitals, and strengthen the construction of health archives. Individuals should have a healthy lifestyle and actively participate in physical examination and training that can improve mental health.

8.
Journal of Preventive Medicine ; (12): 1203-1208, 2021.
Article in Chinese | WPRIM | ID: wpr-906791

ABSTRACT

Objective @#To investigate the status of occupational stress, burnout, and coping styles, and to explore the moderating effects of coping styles on the relationship between occupational stress and burnout among medical staff from one tertiary first-class hospital in Hubei Province, in order to provide the basis for mental health promotion of medical staff. @*Methods@#From June to October in 2020, using stratified cluster sampling, doctors, nurses, and medical or pharmaceutical technicians on the ratio of 2∶2∶1 were selected from the tertiary first-class hospital. Chinese version of Burnout Questionnaire, Core Occupational Stress Scale (COSS) and Trait Coping Style Questionnaire were used to investigate the levels of burnout, occupational stress and coping styles. A linear stratified regression model was used to analyze the moderating effect of coping styles on the relationship between occupational stress and burnout. @*Results@#Among 735 questionnaires issued, 679 valid ones were collected, with the response rate of 92.38%. The age of the respondents was ( 34.29±8.20 ) years old. There were 165 ( 24.30% ) males and 514 ( 75.70% ) females, including 241 ( 35.49% ) doctors, 358 ( 52.72% ) nurses and 80 (11.78%) medical or pharmaceutical technicians. The burnout score was 2.29±1.11 , and the positive rate of burnout was 44.33%; the COSS score was 47.32±8.31; the positive and negative coping style scores were 30.64±6.06 and 26.81±6.26, respectively. The linear stratified regression analysis suggested that the interactions between social support ( β=0.590, P<0.05 ), organization and reward ( β=0.523, P<0.05 ), and positive coping style were positively associated with burnout, and the interaction between organization and reward (β=-0.666, P<0.05) and negative coping style was negatively associated with burnout. @*Conclusions@#About 44.33% of medical staff investigated have burnout. Coping styles have a moderating effect on the relationship between occupational stress and burnout. Positive coping style helps to perceive social support and organizational support, to alleviate the adverse effects of occupational stress, and to reduce the risk of burnout.

9.
Article in Chinese | WPRIM | ID: wpr-904646

ABSTRACT

@#Objective    To investigate the job satisfaction, emotional state and related factors of medical staff participating in online consultation of West China Internet Hospital during the COVID-19 epidemic. Methods    Through literature review and expert consultation (Delphi method), the questionnaire was developed, and the online consulting medical staff of West China Hospital of Sichuan University were invited to conduct the questionnaire survey from 26 January to 19 June 2020, and finally the statistical analysis was summarized. Results    A total of 132 valid questionnaires were retrieved. Of the 132 subjects, 127 people (96.2%) expressed satisfaction or special satisfaction with the online consulting office format; 103 respondents (78.0%) said that online consulting did not affect or completely did not affect the work and life; 81 people (61.4%) consulted online more than 5 days a week, and 108 people (81.8%) worked within 2 hours a day; the vast majority (97.7%) of the research subjects were satisfied with the content of the training materials and the related support work of the coordination group. Only 29 (22.0%) of the study participants believed that the epidemic caused negative emotions, mainly due to the severity of the epidemic. Conclusion    The online consulting medical staff are satisfied with the office form, training materials and coordination work group of the COVID-19 epidemic, and think that it does not affect their work and life. 22.0% of medical staff have negative emotions, and the severity of the epidemic is   the main reason.

10.
China Occupational Medicine ; (6): 177-181, 2021.
Article in Chinese | WPRIM | ID: wpr-923233

ABSTRACT

OBJECTIVE: To explore the mediating effect of life satisfaction between psychological resilience and depression among medical staffs.METHODS: A total of 472 medical staffs in Shaoguan City were selected as the study subjects by convenience sampling method. The mental health, life satisfaction and depression were investigated and analyzed using the Psychological Resilience Questionnaire, Life Satisfaction Questionnaire and Self-Rating Depression Scale. RESULTS: The scores of mental resilience, life satisfaction and depression were 79.3±17.1, 16.1±6.1 and 53.5±11.8, respectively. There was a negative correlation between mental resilience score and depression score in medical staffs [correlation coefficient(r)=-0.638,P<0.01]. The score of life satisfaction was positively correlated with the scores of mental resilience and its three dimensions of toughness, strength and optimism(r were 0.341, 0.313, 0.306 and 0.336 respectively, all P<0.01). The score of life satisfaction was negatively correlated with the score of depression(r=-0.474,P<0.01). The life satisfaction had mediating role between mental resilience and depression, with the mediating effect value of-0.059, accounting for 13.50% of the total effect. CONCLUSION: Life satisfaction plays a partial intermediary role between mental resilience and depression in medical staffs.

11.
China Occupational Medicine ; (6): 442-446, 2021.
Article in Chinese | WPRIM | ID: wpr-923215

ABSTRACT

Cruise tourism is a modern high-end tourism product. Under the background of the public health emergency response brought about by the outbreak of coronavirus disease 2019, there are some dilemma in cruise tourism, such as the insufficient of doctors and medical services on cruise ships. It is known that the international treaties or rules on the provision of medical equipment formulated by relevant international organizations have not yet been able to meet the needs of cruise passengers in terms of medical treatment. Based on this, this article compares and analyzes the differences between China and the United States in the medical services provided on cruise ships, the judicial practice of medical disputes arising from cruise ships, and the legislation related to the provision of operating doctors on board. According to the characteristics of disease transmission on cruise ships, it is suggested that by reference to the relevant international treaties and the effective practices of the United States, various measures should be taken to solve the problems of insufficient doctors and insufficient medical services provided on cruise ships in China, such as improving domestic relevant legislation, advocating cruise passengers to increase their awareness of purchasing insurance related to cruise travel, clarifying the obligation of doctors on board, the qualifications of the doctors and related responsibilities. The cruise industry association should play an active role in this issue.

12.
China Occupational Medicine ; (6): 379-385, 2021.
Article in Chinese | WPRIM | ID: wpr-923203

ABSTRACT

OBJECTIVE: To establishment the Sense of Security Scale for Medical Staff and test its reliability and validity. METHODS: The pre-test version scale was formulated through methods of literature review, semi-structured interviews with clinical medical staff, discussion with members of research groups, and consultation with medical experts. A total of 350 and 403 medical staff who worked in a tertiary A hospital in Guangdong Province were selected as the prediction and the verification samples, respectively, by convenience sampling method. The reliability and validity of the final version scale were tested by item analysis, exploratory factor analysis and confirmatory factory analysis. RESULTS: Through item analysis, it was determined that the scale was mainly composed of 24 items. Exploratory factory analysis extracted five characteristics: environmental factors, patient factors, self factors, organizational management, and social support, that explained 72.8% of the total variation. The results of confirmatory factory analysis showed that the ratio of chi-square to degree of freedom was 2.851, the mean square error of approximation was 0.068, the standardized mean square residual was 0.078, the goodness of fit index was 0.883, the normative fit index was 0.904, the comparative fit index was 0.935, the non-standard fitting index was 0.924, and the incremental fitting index was 0.936. The results of reliability and validity test showed that the total Cronbach alpha coefficient, Spearman-Brown coefficient and retest reliability were 0.939, 0.967 and 0.808, respectively. The item reliability of each item was 0.420-0.814, the composite reliability was 0.775-0.920, the content validity ratio was 0.904, the convergent validity was 0.514-0.741, and the discriminative validity was 0.717-0.861. CONCLUSION: The reliability and validity of each dimension of the Sense of Security Scale for Medical Staff is good, and it can be used as an evaluation tool to measure the sense of security in medical staff.

13.
China Occupational Medicine ; (6): 283-287, 2021.
Article in Chinese | WPRIM | ID: wpr-923164

ABSTRACT

OBJECTIVE: To explore the mediating role of doctor-patient relationship between occupational stress and job burnout of medical staffs involved in the prevention and treatment of patients with acquired immune deficiency syndrome(AIDS) and the regulating role of personality traits. METHODS: A total of 346 medical staffs who are involved in AIDS prevention and treatment from 29 antiviral treatment sites in Yunnan Province were selected as the study subjects using convenience sampling method. The Questionnaire of Doctor-Patient Interaction, Subscale of Feeling Stress, Questionnaire of Chinese Job Burnout, and China′s Big Five Personality Questionnaire(short version) were used to investigate these subjects. The mediating-regulating model was tested with the Process program. RESULTS: The total scores of doctor-patient relationship, occupational stress, personality traits and job burnout were(43.6±9.2),(153.1±29.5),(156.2±17.9) and(67.7±16.8), respectively. The job burnout was associated with doctor-patient relationship and occupational stress(correlation coefficients were-0.31 and 0.24, respectively, all P<0.05). Occupational stress had a direct effect on job burnout(P<0.01). The doctor-patient relationship had a mediating effect between occupational stress and job burnout(P<0.05), which accounted for 13.1% of the total effect. It was regulated by open personality traits(P<0.01). CONCLUSION: The doctor-patient relationship has a mediating effect between the occupational stress and job burnout of the medical staffs engaged in AIDS prevention and treatment, and the open personality traits plays a moderating role.

14.
Article in Chinese | WPRIM | ID: wpr-912807

ABSTRACT

Objective:To study the willingness of the medical staff of tertiary hospitals to be dispatched to work for a long time at the district hospitals under the " municipal trusteeship of district-ownership hospitals" mode, and explore the key factors that affect their long-term willingness, for references of optimizing the incentive system of the model.Methods:A questionnaire was designed as guided by the two-factor theory. In May 2019, a typical sample survey was made to investigate 103 medical staff of two tertiary hospitals in Beijing on their willingness to be dispatched to hospitals of district ownership. The survey covered such aspects as their basic personal information, hygiene factors(family responsibility, interpersonal connections expansion, mobilization and encouragement of leaders, etc.), and incentive factors(personal career development, greater potential giving play to their own talents, self-achievement, etc.). Descriptive analysis and univariate hypothesis testing were used to compare the differences of the dispatch willingness of staff of different characteristics. Meanwhile, an ordinal multinomial logistic regression model was built to analyze the influence factors of long-term dispatch willingness of these staff along with individual in-depth interviews.Results:The medical staff when they were dispatched to work at the entrusted hospitals for a long time, were concerned mostly with top six factors. These factors refered to a reasonable incentive(rewards)mechanism, family responsibility, colleague evaluation of the entrusted hospital, interpersonal connections expansion, personal career development, and potential unlocking. Those staff with dispatch experience had higher willingness to be dispatched than those without( P <0.05). The former saw higher of their personal career development resulting from the dispatch(3.91 points), while the latter saw higher their post-dispatch salary incentive mechanism(3.95 points). Compared with common medical staff, medium and high level management staff were more willing to be dispatched for a long time( H=14.536, P<0.001). Leadership mobilization in hygiene factors and personal career development in incentives factors were the key drivers for the long-term willingness of medical staff to be dispatched( P<0.05). Conclusions:The willingness of medical staff to be dispatched for a long time needs to be strengthened in the " municipal trusteeship of district-ownership hospitals" mode. Managers of the district-ownership hospitals should take into full consideration, the needs of different categories and levels of medical staff dispatched, guarantee the remuneration and performance pay of these staff, and enable their career track planning, hence mobilizing their incentives, and increase their willingness to work at such hospitals for a long time.

15.
Rev. bras. ginecol. obstet ; 42(12): 793-799, Dec. 2020. tab
Article in English | LILACS | ID: biblio-1156069

ABSTRACT

Abstract Objective To find out which was the opinion of residents in obstetrics and gynecology about the advantages and disadvantages of medical abortion as compared with surgical procedures. Method Cross-sectional multicenter study among residents in obstetrics and gynecology from 21 maternity hospitals located in 4 different geographical regions of Brazil, using a self-responded questionnaire with 31 questions related to their opinion and experience on providing abortion services. Results Most residents agreed that "being less invasive" (94.7%), "does not require anesthesia" (89.7%), "can be accompanied during the process" (89.1%), "prevents physical trauma" (84.4%) were the main advantages of medical abortion. Conclusion Residents perceived both clinical and personal issues as advantages of medical abortion.


Resumo Objetivo Descobrir qual foi a opinião dos residentes em ginecologia e obstetrícia sobre as vantagens e desvantagens do aborto medicamentoso em relação aos procedimentos cirúrgicos. Métodos Estudo multicêntrico transversal entre residentes de ginecologia e obstetrícia de 21 maternidades localizadas em 4 diferentes regiões geográficas do Brasil, utilizando um questionário autorrespondido com 31 questões relacionadas à sua opinião e experiência na prestação de serviços de aborto. Resultados A maioria dos residentes concordou que "ser menos invasivo" (94,7%), "não necessitar de anestesia" (89,7%), "poder ser acompanhado durante o processo" (89,1%), "prevenir trauma físico" (84,4%) foram as principais vantagens do aborto medicamentoso. Conclusão Os residentes perceberam tanto questões clínicas como pessoais como sendo vantagens do aborto medicamentoso.


Subject(s)
Humans , Male , Female , Pregnancy , Adult , Prenatal Care , Attitude of Health Personnel , Abortion, Induced , Internship and Residency , Brazil , Cross-Sectional Studies , Obstetrics
16.
Medwave ; 20(6): e7958, 31-07-2020.
Article in English, Spanish | LILACS | ID: biblio-1118789

ABSTRACT

INTRODUCCIÓN: El presente estudio examina las posibles relaciones entre la percepción de eficiencia y la calidad de la atención por parte del personal de salud y el bienestar de los usuarios en el contexto chileno. Basados en la literatura, se hipotetiza que, a mayor satisfacción con el sistema de salud, se experimenta mayor bienestar por parte de la ciudadanía que utiliza sus servicios. OBJETIVOS: Determinar las relaciones entre la evaluación del sistema de salud, el personal médico y la eficiencia percibida en las prestaciones por parte de los usuarios y su bienestar subjetivo. MÉTODOS: Utilizando un diseño de corte transversal, y considerando una muestra de 1201 personas (52,4% mujeres, media de la edad de 42,82 años), se realizaron diferentes análisis descriptivos, bivariados, junto con un modelo de ecuación estructural en relación con la evaluación del sistema de salud, la evaluación del personal médico, y la eficiencia percibida en las prestaciones médicas por parte de los usuarios y su relación con el indicador de bienestar subjetivo de satisfacción con la vida. RESULTADOS: Los resultados indican que estas tres variables se relacionan positivamente entre sí y tienen efectos sobre el bienestar subjetivo. DISCUSIÓN: Los sistemas de salud poseen también una función sobre el bienestar subjetivo de sus usuarios, pudiendo asociarse a indicadores de calidad de vida. Se comentan en la discusión algunas implicancias y consideraciones relacionadas con el sistema de salud chileno. También se comentan las posibles limitaciones del presente estudio. Finalmente, se menciona la importancia que tienen los sistemas de salud como parte del aparato estatal y gubernamental.


INTRODUCTION: This cross-sectional study sought to examine the relationships between the perception of efficiency and quality of the service provided by the staff of the health system with users' well-being (satisfaction with life), in the Chilean context. Based on the literature review, we hypothesized that satisfaction with the services provided by the health system would be associated with the well-being of its users. OBJECTIVE: To determine the relationship between the evaluation of the health system, medical staff, and perceived efficiency, with users' subjective well-being. METHODS: On a sample of 1,201 respondents (52.4% women, mean age 42.82 years), descriptive analysis, bivariate analysis, and a structural equation model were performed between the evaluation of the health system, medical staff, and perceived efficiency with users' subjective well-being. RESULTS: These three variables are positively related to each other and have effects on subjective well-being. DISCUSSION: Health systems also influence the subjective well-being of their users and can be associated with indicators of quality of life. Some implications and considerations related to the Chilean health system are discussed. Also, some of the possible limitations of the study are mentioned. Lastly, the importance of the health systems as part of the state and government functions is discussed.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Personal Satisfaction , Patient Satisfaction , Health Personnel/standards , Delivery of Health Care/standards , Quality of Life , Chile , Cross-Sectional Studies , Surveys and Questionnaires
17.
Article | IMSEAR | ID: sea-207746

ABSTRACT

Background: The objective of this study was to study the knowledge, attitude and practice of contraception among nursing and para-medical staff in a tertiary care hospital and also to identify factors that are associated with non-usage of contraception.Methods: The study was conducted on 100 nursing and paramedical staff working at K. D. Medical College and associated hospital at Mathura from November 2019 to January 2020. After obtaining consent, randomly selected married nursing and paramedical staff were given a pre-designed, structured questionnaire on socio-demographic variables, knowledge, attitude and practice towards contraception.Results: In the present study, out of 100 participants, 89 had awareness of contraception. Majority of them knew about condoms, followed by Copper-T/multiload and OCPs. The knowledge about contraception was mainly obtained through social media and health professionals.Conclusions: Health care providers should be equipped with recent information on all the available family planning methods through intensive in-service trainings, seminars/conferences, etc. This will get them informed and all misconceptions will be erased and in turn each health care provider will be able to make informed choice from the various options of family planning methods and practice the best suitable method.

18.
Arq. bras. cardiol ; 114(1): 35-44, Jan. 2020. tab, graf
Article in English | LILACS | ID: biblio-1055080

ABSTRACT

Abstract Background: A significant reduction in the morbidity and mortality related to ST-segment elevation myocardial infarction (STEMI) has been achieved with the development of reperfusion therapies. Early diagnosis and correct initial management are important to ensure this benefit. In Brazil, recent graduates in medicine are responsible for a large part of the initial care provided for these patients. Objective: To assess the clinical competence in the diagnosis and initial treatment of STEMI by newly graduated physicians applying for a medical residency program. Methods: We assessed the performance of 771 applicants for the direct entry selection process of the FMRP-USP Clinical Hospital Medicine Residency Program, performed in a simulated setting of STEMI, with professional actors and medical evaluators, using a standardized checklist following the recommendations of the Brazilian Guidelines for the management of this disease. Results: The general performance score presented a median of 7 and an interquartile range of 5.5-8.0. In relation to the items assessed: 83% required ECG monitoring, 57% requested the insertion of a peripheral venous access catheter, 95% administered acetylsalicylic acid, 80% administered a second antiplatelet agent (p2y12 inhibitor), 66% administered nitrate, 71% administered morphine, 69% recognized the diagnosis of STEMI, 71% assessed the pain duration, 63% recognized the need for immediate transfer, 34% showed adequate communication skills and only 25% insisted on the transfer even in case of non-availability of beds. Conclusions: The initial diagnosis and management of STEMI need to be improved in medical undergraduate courses and inserted into the reality of the hierarchical network structure of the Brazilian Unified Health System (SUS).


Resumo Fundamento: Houve importante redução da morbimortalidade do infarto agudo do miocárdio com supradesnível do segmento ST (IAMCSST) com o desenvolvimento das terapias de reperfusão. Para garantir este benefício é importante o diagnóstico precoce e manejo inicial correto. No Brasil, recém-formados do curso de medicina são responsáveis por grande parte dos atendimentos iniciais a estes pacientes. Objetivo: Avaliar a competência clínica no reconhecimento e manejo inicial do IAMCSST por médico recém-formado candidato à residência médica. Métodos: Realizada análise do desempenho de 771 candidatos do concurso de acesso direto para residência médica do Hospital das Clínicas da FMRP-USP em estação prática de simulação de atendimento de paciente com IAMCSST com atores profissionais e avaliadores médicos com uma lista de checagem padronizada de acordo com recomendações da diretriz brasileira para manejo desta patologia. Resultados: O escore de desempenho geral apresentou mediana de 7 e intervalo interquartil de 5,5-8,0. Em relação aos itens avaliados: 83% solicitou monitorização eletrocardiográfica, 57% solicitou inserção de um acesso venoso periférico, 95% administrou ácido acetilsalicílico, 80% administrou segundo antiagregante (inibidor do P2Y12), 66% administrou nitrato, 71% administrou morfina, 69% reconheceu o diagnóstico de IAMCSST, 71% avaliou o tempo de duração da dor, 63% reconheceu a necessidade de transferência imediata, 34% apresentou habilidade de comunicação adequada e somente 25% insistiu na transferência mesmo na ausência de vaga. Conclusões: O reconhecimento e gerenciamento inicial do IAMCSST precisa ser aprimorado na graduação médica e inserido dentro da realidade da estrutura de rede hierarquizada do sistema de saúde público brasileiro.


Subject(s)
Male , Female , Adult , Young Adult , Clinical Competence/statistics & numerical data , ST Elevation Myocardial Infarction/therapy , Internship and Residency/statistics & numerical data , Cross-Sectional Studies , Checklist , ST Elevation Myocardial Infarction/diagnosis
19.
Journal of Preventive Medicine ; (12): 573-577, 2020.
Article in Chinese | WPRIM | ID: wpr-822813

ABSTRACT

Objeetive@#To understand the intention and influencing factors of medical staff in community diabetes management to recommend influenza vaccination,so as to provide reference for promotion of influenza vaccination recommendation.@*Methods @#The Doctors, nurses and managers from 8 community health service centers(hospitals)in Jiangbei District of Ningbo,who provided diabetes management services,were recruited to collect their demographic features,job satisfaction and intention to recommend influenza vaccination. Logistic regression model was used to analyze the influencing factors for the intention to recommend. @*Results@#Totally 412 questionnaires were distributed and 399(96.84%)valid questionnaires were recovered. There were 178 general practitioners,161 nurses,20 managers and 40 other staffs,accounting for 44.61%,40.35%,5.01% and 10.03%, respectively. Among them,281 had the intention to recommend influenza vaccination,accounting for 70.43%. The results of multivariate logistic regression analysis showed that the medical staff who aged 30 to 39 years(OR=0.332,95%CI:0.118-0.932),worked for more than 20 years(OR=0.136,95%CI:0.044-0.425), concerned about medical disputes(OR=0.170,95%CI:0.074-0.392)and negative medical opinion(OR=0.336,95%CI:0.141-0.803)were less likely to recommend influenza vaccination;while the medical staff who were general practitioners(OR=3.664,95%CI:1.513-8.869),managers(OR=14.695,95%CI:2.494-86.591),and who were satisfied with professional training opportunities(OR=5.041,95%CI:1.686-15.072),financial or moral rewards(OR=8.216,95%CI:3.213-21.011),personal accomplishment(OR=3.955,95%CI:1.517-10.310)and interest in work(OR=6.669,95%CI:2.667-16.679)were more likely to recommend influenza vaccination.@*Conclusion@#Age,post,working age,medical dispute concern,negative medical opinion,professional training opportunities,financial or moral rewards,personal accomplishment and interest in work are associated with the intention to recommend influenza vaccination of the medical staff in community diabetes management.

20.
Article in Chinese | WPRIM | ID: wpr-843114

ABSTRACT

Objective: To investigate the occurrence of medical staff leaving the COVID-19 isolation room due to discomforts and to provide reference for clinical prevention and treatment. Methods: Stratified sampling method was used to investigate the occurrence of medical staff from Shanghai medical team leaving isolation room earlier due to discomforts, as well as the main symptoms and signs of theirs. Logistic regression was used for risk factor analysis. Results: Among the 227 medical staff working in Leishenshan Hospital in Wuhan, Hubei Province, who were assisted by Shanghai, 69 (30.4%) staff left earlier due to discomforts while working in the isolation room. Two of them had syncope, and sixty-seven of them had symptoms and signs related to presyncope. Symptoms of presyncope include headache, nausea, sweating, dyspnea, and palpitations, etc. Univariate analysis revealed statistically significant differences in occupation (P=0.002), gender (P=0.006), and standing time (P=0.002). Logistic regression analysis showed that occupation (P=0.000), standing time (P=0.025), and hunger (P=0.029) were statistically significant. Conclusion: Different occupation, gender and standing time have different effects on the situation of medical staff leaving the isolation room due to discomforts. Occupation, standing time and feeling of hunger are the influencial factors for medical staff leaving the isolation room earlier.

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