ABSTRACT
Background: Clinical practice guidelines (CPGs) promote better quality and equity in health care and potentially they could improve patients' outcomes. However, their implementation is hindered by a number of factors including some related to health care professionals. Aim: To assess the perceptions and attitudes of primary care physicians regarding CPGs developed by the Chilean Ministry of Health in the context of the Health Sector Reform. Material and Methods: An adaptation of the survey "Knowledge, perceptions and attitudes towards Clinical Practice Guidelines" was sent to 1,264 primary care physicians in Chile and answered completely by 354. The analysis assessed the attitudes towards CPG, their use in primary care and their relationship with socio demographic features of respondents. Results: Eighty two percent of respondents reviewed the flowcharts of the guidelines, 85% consulted their online version. The classification of evidence levels and the strength of recommendations generated a high level of confidence with the guidelines in 70 and 64% of respondents. Eighty five percent considered that CPG could help to standardize clinical practice. The most relevant barrier hindering CPG use was the lack of a brief, simple and easy to access format in 63% of respondents. The three dimensions of the theory of planned behavior (attitude toward behavior, subjective norms, and perceived behavioral control) were associated with a greater frequency of guideline use. A higher age and not being Chilean were associated with a lower frequency of use. Conclusions: The identified factors associated with CPG use should be considered in future guideline design.
Subject(s)
Humans , Male , Female , Adult , Primary Health Care/standards , Practice Patterns, Physicians'/standards , Health Knowledge, Attitudes, Practice , Practice Guidelines as Topic , Physicians, Primary Care/standards , Practice Patterns, Physicians'/statistics & numerical data , Attitude of Health Personnel , Chile , Cross-Sectional Studies , Surveys and Questionnaires , Guideline Adherence/standards , Guideline Adherence/statistics & numerical data , Physicians, Primary Care/statistics & numerical dataABSTRACT
Existe la creencia popular de que los pollos, durante su crianza, reciben hormonas para acelerar su desarrollo y así lograr, en forma rápida, un mayor peso. En la actualidad no existen estudios que avalen esta presunción. Objetivos: conocer y cuanti¬car la creencia referida, la frecuencia de consumo de pollo, las fuentes de información utilizadas para fundamentar las recomendaciones y la percepción de este producto como un alimento saludable.Materiales y métodos: se realizó un estudio observacional, descriptivo, de corte transversal. El muestreo fue no probabilístico, por conveniencia. Se entrevistaron 116 médicos de diferentes especialidades de instituciones de salud públicas y privadas de la Ciudad de Buenos Aires y del Gran Buenos Aires, entre octubre de 2013 y abril de 2014. Se tabularon las 116 encuestas documentadas en un Excel con los datos registrados y se procedió al análisis estadístico utilizando el STATA y Excel. Resultados: el 98,3% de los médicos encuestados mencionó consumir pollo. De éstos, el 55,3% lo hacía dos o más veces por semana. Del total, el 79,3% lo consideró un alimento saludable ya sea por su valor nutricional (50%) o su bajo contenido de grasa (40,2%). El 60,3% recomendó pollo a sus pacientes por su valor nutricional (61,4%) y su bajo contenido lipídico (31,4%), mientras que un 16,4% lo desaconsejó, principalmente debido a la presencia de hormonas agregadas (73,7%, 14 médicos)...
There is a common belief in relation to chicken breeding, which is that they receive hormones in order to accelerate their growth and thus, obtain a fast weight gain. Currently, there are no studies supporting this assumption. Objetives: to evaluate and to quantify the evidence associated with physicians belief in relation to chicken, their frequency of consumption, the information sources used by physicians to support their recommendations and their perception of chicken as a healthy food.Materials and methods: we performed an observational, descriptive, cross-sectional study. 116 clinicians from different public and private health institutions in the city of Buenos Aires were interviewed between October 2013 and April 2014. Sampling was non-probabilistic by convenience. Results were tabulated in Excel, and statistical analysis was performed using STATA.Results: 98,3% of the physicians surveyed consume chicken, 55,3% of them consume chicken twice a week or more. 79,3% of the total consider it a healthy food, either due to its nutritional value (50%) or because it is low in fat (40,2%). 60,3% recommended chicken to their patients due to its nutritional value (61,4%) or because it is low in fat (31,4%), whereas 16,4% of them discourage its consumption, mainly because they consider that chicken has added hormones (73,7%, 14 physicians). Among physicians discouraging chicken consumption, mass media is the main source of information used to make their recommendations. On the
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Chickens , Diet , Health Personnel , Physicians, Primary Care/standards , Poultry Products , Argentina , Epidemiology, Descriptive , Observational StudyABSTRACT
A Atenção Básica vem ampliando sua cobertura populacional de forma acelerada desde sua implantação no Brasil, na década de 1990. Em 20 anos, a Estratégia de Saúde da Família estendeu sua cobertura de 5% para 60%, mas a capacidade de formação de médicos para ocupar tais posições não se desenvolveu na mesma velocidade, assim como não se desenvolveram tecnologias suficientes para o planejamento adequado de recursos humanos em saúde. Neste contexto é lançado o Programa Mais Médicos em julho de 2013 com ênfase na vinda de milhares de médicos estrangeiros para atuar na Atenção Básica, causando grande reação negativa das entidades médicas com inúmeras disputas ideológicas e judiciais. Este trabalho se propõe a lançar um olhar sobre os elementos de tensão entre Entidades Médicas e Governo no processo de implantação do Programa Mais Médicos e estudar o processo de evolução da regulação da formação de especialistas no país, na modalidade Residência Médica. Para tanto, optou-se por uma abordagem qualitativa no formato de estudo exploratório, utilizando-se de pesquisa bibliográfica e documental, assim como uma abordagem quantitativa na análise dos números de vagas de residência médica no país, com análise estatística descritiva dos dados. Os resultados apontam para melhora na capacidade de regulação de vagas para formação de especialistas no Brasil nos últimos cinco anos, sobretudo com o advento do PRÓ-RESIDÊNCIA e outras políticas de incentivo de abertura de vagas. A Lei nº12.871/2013 também aponta para importante evolução nas ferramentas de gestão de recursos humanos em saúde, além de mudanças e maior rigor na aplicação das Diretrizes Curriculares Nacionais para formação de médicos no país, com importante ênfase na Atenção Básica. Os resultados...
The population coverage of Primary Care has increased rapidly since its implementation in Brazil in the 1990s. Over 20 years, the Family Health Strategy extended its coverage from 5% to 60%, but the ability to train doctors to occupy such positions did not develop at the same rate, and sufficient technology for the proper planning of human resources for health has not evolved. In this context, the Mais Médicos Program was launched in July 2013 with emphasis on the coming of thousands of foreign doctors to work in Primary Care, causing an overwhelmingly negative reaction by medical organisations with numerous ideological and legal disputes. This paper aims to cast an eye on the elements of tension between Medical Entities and Government in the implementation process of the Mais Médicos Program and to study the process of development of the regulations of training specialists in the country, in Medical Residency. Therefore, we chose a qualitative approach in the exploratory format of the research, using bibliographic and documentary research, as well as a quantitative approach in the analysis of the numbers of medical residency positions in the country, with descriptive statistical analysis. The results indicate improvement in the capacity to regulate positions for training specialists in Brazil in the last five years, particularly with the advent of PRO-RESIDÊNCIA and other vacancy incentive policies. Law no. 12.871/2013 also points to important developments in human resource management tools in health, as well as changes and stricter application of the National Curriculum Guidelines for training doctors in the country, with major emphasis on Primary Care. The results also suggest a lack of understanding, on the part of doctors, regarding the Mais Médicos Program in its entirety, not only in the immediate ...