ABSTRACT
Objective: To study the link between coronavirus disease 2019 (COVID-19) vaccination status and adherence to public health and social measures in Members of the Eastern Mediterranean Region and Algeria. Methods: We analysed two rounds of a large, cross-country, repeated cross-sectional mobile phone survey in JuneJuly 2021 and OctoberNovember 2021. The rounds included 14 287 and 14 131 respondents, respectively, from 23 countries and territories. Questions covered knowledge, attitudes and practices around COVID-19, and demographic, employment, health and vaccination status. We used logit modelling to analyse the link between self-reported vaccination status and individuals' practice of mask wearing, physical distancing and handwashing. We used propensity score matching as a robustness check. Findings: Overall, vaccinated respondents (8766 respondents in round 2) were significantly more likely to adhere to preventive measures than those who were unvaccinated (5297 respondents in round 2). Odds ratios were 1.5 (95% confidence interval, CI: 1.31.8) for mask wearing; 1.5 (95% CI: 1.31.7) for physical distancing; and 1.2 (95% CI: 1.01.4) for handwashing. Similar results were found on analysing subsamples of low- and middle-income countries. However, in high-income countries, where vaccination coverage is high, there was no significant link between vaccination and preventive practices. The association between vaccination status and adherence to public health advice was sustained over time, even though self-reported vaccination coverage tripled over 5 months (19.4% to 62.3%; weighted percentages). Conclusion Individuals vaccinated against COVID-19 maintained their adherence to preventive health measures. Nevertheless, reinforcement of public health messages is important for the public's continued compliance with preventive measures.
Subject(s)
Therapeutics , Hand Disinfection , Public Health , Patient Compliance , Physical Distancing , COVID-19 Vaccines , COVID-19 , Cross-Sectional Studies , Immunization , Algeria , Facial MasksABSTRACT
Background: The COVID-19 outbreak response in Nigeria was challenged by the existing weak health sector and the frontline health workers for COVID-19 pandemic response are exposed to the pathogen. One militating factor undermining the control and prevention of COVID-19 in Nigeria was poor compliance to preventive measures. This study assessed the compliance with COVID-19 prevention protocols among healthcare workers in Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria. Methods: A cross sectional study and subjects were selected through a multi-stage sampling technique. Data collection was done using interviewer-administered semi-structured questionnaire over a period of five months (JuneOctober, 2021). Data was analyzed using IBM, Statistical Package for Social Sciences (SPSS) version 27.0 and p value was set at <0.05 as the threshold for statistical significance. Results: Majority (60.1%), of the respondents got information on COVID-19 protocols through seminars and workshops. However, more than a quarter (28.8%) of the respondents said the use of available PPE was suboptimal. More than one-third, (35.8%), of respondents believe the protocols are too strict. There is, however, good perception (93.3%), but relatively lower compliance (58.7%) of COVID-19 protocols among the staff. Age, marital status and sex were associated with compliance towards COVID-19 protocols in this study (P<0.05). Identified significant predictors (p<0.05) of compliance include age (AOR=1.944), female sex (AOR=7.829). Conclusion: Most respondents had good knowledge of availability, perception of effectiveness, but relatively lower compliance with the COVID-19 protocols in this facility. The government or hospital authority make sure that necessary steps to further boost compliance are taken
Subject(s)
Humans , COVID-19 , Medical Staff, Hospital , Perception , Patient Compliance , Disease Prevention , Health FacilitiesABSTRACT
Objetivo: Analisar os fatores associados à adesão a terapia imunossupressora em indivíduos transplantados renais. Métodos: Trata-se de estudo de corte transversal, com indivíduos transplantados renais em acompanhamento ambulatorial, na cidade do Recife, Nordeste do Brasil. Utilizou-se a Assessment of Adherence with Immunosuppressive Medication Scale para avaliar a adesão aos imunossupressores. Resultados: Em 147 transplantados renais, foi observada uma prevalência de mulheres (51,70%) com baixa escolaridade e baixo nível socioeconômico (60,54%). A amostra foi composta, em sua maioria, por receptores de enxerto renal proveniente de doador cadáver (50,34%), com tempo de espera para o transplante de até 48 meses (62,59%). A taxa de adesão dos participantes foi de 56,42%, e esteve associada ao tempo médio pós-transplante (p=0,033), com maior índice naqueles com menos de 5 anos de transplante renal. Os fatores associados a não adesão foram atrasos e esquecimentos. Conclusão: Considerando a necessidade de ampliar a taxa de adesão, é fundamental considerar o tempo de transplante renal no planejamento das ações. Além disso, é preciso utilizar estratégias que auxiliem na manutenção da tomada dos imunossupressores conforme prescrição médica a fim de contribuir para a manutenção do enxerto renal. (AU)
Objective: To analyze the factors associated with adherence to immunosuppressive therapy in kidney transplant patients. Methods: This is a cross-sectional study, with kidney transplant patients undergoing outpatient follow-up, in the city of Recife, Northeast Brazil. The Assessment of Adherence with Immunosuppressive Medication Scale was used to assess adherence to immunosuppressants. Results: In 147 kidney transplant recipients, there was a prevalence of women (51,70%), with low education and low socioeconomic status (60,54%). The sample consisted, mostly, of kidney graft recipients from cadaver donors (50,34%), with a waiting time for transplantation of up to 48 months (62,59%). The adherence rate of the participants was 56.42%, and was associated with the average post-transplant time (p = 0.033), with a higher rate in those with less than 5 years of kidney transplantation. The factors associated with non-adherence were delays and forgetfulness. Conclusion: Considering the need to increase the adherence rate, it is essential to consider the time of kidney transplantation when planning actions. In addition, it is necessary to use strategies that assist in maintaining the intake of immunosuppressants according to medical prescription in order to contribute to the maintenance of the renal graft. (AU)
Objetivo: Analizar los factores asociados a la adherencia a la terapia inmunosupresora en receptores de trasplante renal. Métodos: Se trata de un estudio transversal con pacientes con trasplante renal en seguimiento ambulatorio, en la ciudad de Recife, noreste de Brasil. Se utilizó la Assessment of Adherence with Immunosuppressive Medication Scale para evaluar la adherencia a los inmunosupresores. Resultados: En 147 receptores de trasplante renal, hubo una prevalencia de mujeres (51,70%), con bajo nivel educativo y nivel socioeconómico bajo (60,54%). La muestra estuvo compuesta, mayoritariamente, por receptores de injerto renal de donante cadáver (50,34%), con un tiempo de espera para el trasplante de hasta 48 meses (62,59%). La tasa de adherencia de los participantes fue del 56,42% y se asoció con el tiempo medio pos trasplante (p = 0,033), con una tasa mayor en aquellos con menos de 5 años de trasplante renal. Los factores asociados a la no adherencia fueron los retrasos y el olvido. Conclusión: Considerando la necesidad de incrementar la tasa de adherencia, es fundamental considerar el momento del trasplante renal a la hora de planificar acciones. Además, es necesario utilizar estrategias que ayuden a mantener la ingesta de inmunosupresores según prescripción médica para contribuir al mantenimiento del injerto renal. (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Immunosuppression Therapy , Kidney Transplantation , Medication Adherence , Immunosuppressive Agents/therapeutic use , Cross-Sectional Studies , Patient Compliance , Self ReportABSTRACT
RESUMEN Objetivos: Evaluar la adherencia a las recomendaciones de tamización para la prevención de la sepsis neonatal, describir la prevalencia de colonización por estreptococo del grupo B y los desenlaces perinatales asociados a la colonización por esta bacteria. Materiales y métodos: Estudio de cohorte retrospectiva que incluyó gestantes a término y sus recién nacidos, en una clínica universitaria privada de alta complejidad en Bogotá, entre el 1 de julio y el 31 de diciembre de 2019. Se evaluó la adherencia a la tamización y a la profilaxis antibiótica intraparto para las gestantes colonizadas con EGB, la prevalencia de colonización y los desenlaces perinatales adversos tempranos. Resultados: Se incluyeron 1.928 mujeres. La adherencia a la tamización fue de 68,0 % (IC 95 %: 66-70,1), a la administración de antibióticos intraparto de 87,9 % (IC 95 %: 87,8 -88), pero hubo uso no indicado de antibióticos en 14,7 % de mujeres para una adherencia final a profilaxis antibiótica de 86,3 %. La prevalencia de colonización por EGB fue 12,5 % (IC 95 %: 10,7-14,3), la incidencia de hospitalización neonatal fue de 27,5 % (IC 95 %: 16,3-33,7); no hubo casos de mortalidad ni sepsis neonatal temprana atribuibles al estado de tamización, colonización o profilaxis antibiótica para EGB. Conclusiones: Se requieren nuevos estudios en otras instituciones para determinar la adherencia a esta guía, en especial en aquellas regiones que atienden usuarias adscritas al régimen subsidiado, con cobertura a la población más vulnerable, así como nuevos estudios poblacionales de prevalencia de EGB y costo-efectividad de la estrategia de tamización universal en comparación con la profilaxis antibiótica basada en factores de riesgo.
ABSTRACT Objectives: To assess adherence to screening recommendations for the prevention of neonatal sepsis, and describe the prevalence of colonization by Group B streptococcus (GBS) as well as the perinatal outcomes associated with colonization by this bacterium. Material and methods: Retrospective cohort study that included pregnant women at term and their newborns, seen at a private high-complexity clinic in Bogota, between July 1 and December 31, 2019. Adherence to screening and intrapartum antibiotic prophylaxis in pregnant women colonized with group B streptococcus, as well as the prevalence of colonization and early adverse perinatal outcomes were assessed. Results: Overall, 1928 women were included. Adherence to screening was 68.0 % (95 % CI: 66-70.1) and 87.9 % to intrapartum antibiotic administration (95 % CI: 87.8-88); non-indicated use of antibiotics occurred in 14.7 % of the women, for 86.3 % final adherence to antibiotic prophylaxis. The prevalence of GBS colonization was 12.5 % (95 % CI: 10.7-14.3); the incidence of neonatal hospitalization was 27.5 % (95 % CI: 16.3-33.7). There were no cases of mortality or early neonatal sepsis attributable to screening status, colonization or prophylactic antibiotics for GBS. Conclusions: Additional studies in other centers are required in order to determine adherence to this guideline, particularly in those that receive users affiliated to the subsidized regime which covers the most vulnerable population. Also, new population studies of GBS prevalence and cost-effectiveness of universal screening compared to risk factor-based antibiotic prophylaxis are needed.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adult , Young Adult , Streptococcal Infections/epidemiology , Streptococcus agalactiae , Mass Screening/statistics & numerical data , Patient Compliance , Neonatal Sepsis/prevention & control , Prevalence , Retrospective Studies , Colombia/epidemiology , Anti-Bacterial Agents/therapeutic useABSTRACT
Objective. To determine the effect of interdisciplinary discharge planning on treatment adherence and readmission in the patients undergoing coronary artery angioplasty in the south of Iran in 2020. Methods. This experimental study had an intervention group and a control group with pre-test and post-test. 70 patients participated in the study who were randomly divided into the groups (intervention group (n=35) and control group (n=35)). In the intervention group, discharge planning was performed based on an interdisciplinary approach. Treatment adherence before, immediately, and one month after the intervention was evaluated with a 10-question survey scored from 1 to 5 (maximum score = 50), as well as readmission three months after the discharge was examined in both groups. Results. Before the intervention, there was no statistically significant difference between the intervention and the control groups in the treatment adherence score (18.22 versus 17.37; p=0.84) but immediately and one month after the intervention statistically significant differences between the groups were showed (21.51 versus 46.14 and 23.28 versus 43.12, respectively; p<0.001). Within three months after discharge, the readmission rate was 11.4% in the control group, while no readmission was reported in the intervention group. Within three months after discharge, the readmission rate was 11.4% in the control group, while no readmission was reported in the intervention group. Conclusion. The implementation of interdisciplinary discharge planning had positive effects on treatment adherence and readmission rate in patients undergoing coronary artery angioplasty; therefore, it is suggested that health care system managers make the necessary plans to institutionalize this new educational approach for other patients discharge planning
Objetivo. Determinar el efecto de la planificación interdisciplinaria del alta en la adherencia al tratamiento y el reingreso en los pacientes sometidos a angioplastia de la arteria coronaria en el sur de Irán en 2020. Métodos. Este estudio experimental contó con un grupo de intervención y un grupo de control con evaluación pre-test y post-test. Participaron en el estudio 70 pacientes que se dividieron aleatoriamente en los grupos. En el grupo de intervención, la planificación del alta se realizó sobre la base de un enfoque interdisciplinario. En ambos grupos se examinó la adherencia al tratamiento antes, inmediatamente y un mes después de la intervención con una encuesta de 10 preguntas puntuadas de 1 a 5 (máximo puntaje = 50), así como el reingreso hasta tres meses después del alta. Resultados. Antes de la intervención, no hubo diferencias estadísticamente significativas entre el grupo de intervención y el de control en la puntuación de la adherencia al tratamiento (18.22 versus 17.37; p=0.84), pero inmediatamente y un mes después de la intervención los grupos mostraron una diferencia estadísticamente significativa (21.51 versus 46.14 y 23.28 versus. 43.12, respectivamente; p<0.001). A los tres meses del alta, la tasa de reingreso fue del 11.4% en el grupo de control, mientras que no se registró ningún reingreso en el grupo de intervención. Conclusión. La aplicación de la planificación interdisciplinaria del alta tuvo efectos positivos la adherencia del tratamiento y la tasa de reingreso en los pacientes sometidos a angioplastia de las arterias coronarias; por lo tanto, se sugiere que los gestores del sistema sanitario hagan los planes necesarios para institucionalizar este nuevo enfoque educativo para la planificación del alta de otros pacientes
Objetivo. Determinar o efeito do planejamento de alta interdisciplinar na adesão ao tratamento e readmissão em pacientes submetidos à angioplastia de artéria coronária no sul do Irã em 2020. Métodos. Este estudo experimental contou com um grupo intervenção e um grupo controle com avaliação pré-teste e pós-teste. Participaram do estudo 70 pacientes que foram divididos aleatoriamente em grupos. No grupo intervenção, o planejamento da alta foi realizado com base na abordagem interdisciplinar. Em ambos os grupos, a adesão ao tratamento foi examinada antes, imediatamente e um mês após a intervenção com um questionário de 10 questões pontuadas de 1 a 5 (pontuação máxima = 50), bem como a readmissão até três meses após a alta. Resultados. Antes da intervenção, não houve diferenças estatisticamente significativas entre os grupos intervenção e controle na pontuação de adesão ao tratamento (18.22 vr. 17.37; p = 0.84), mas imediatamente e um mês após a intervenção os grupos apresentaram diferença estatisticamente significativa (21.51 vr. 46.14 e 23.28 vr. 43.12, respectivamente; p <0.001). Aos três meses após a alta, a taxa de readmissão foi de 11.4% no grupo de controle, enquanto nenhuma readmissão foi registrada no grupo de intervenção. Conclusão. A aplicação do planejamento de alta interdisciplinar teve efeitos positivos na adesão ao tratamento e na taxa de readmissão em pacientes submetidos à angioplastia de artéria coronária; portanto, sugere-se que os gestores do sistema de saúde façam os planos necessários para institucionalizar essa nova abordagem educativa para o planejamento da alta de outros pacientes
Subject(s)
Humans , Patient Discharge , Patient Readmission , Patient Compliance , Angioplasty , Interprofessional RelationsABSTRACT
La craneotomía con paciente despierto (CPD) demanda un manejo multidisciplinario particular debido al componente de conciencia transoperatoria que aporta beneficios en la resección tumoral y preservación neurológica, pero también implica el manejo de los riesgos asociados a la necesidad de cooperación del paciente durante el procedimiento. En este trabajo se describen los beneficios y las complicaciones en pacientes operados bajo la modalidad de CPD. Además, se abordan los retos documentados tanto para el equipo profesional a cargo, como para los pacientes, los cuales tienen un rol activo durante la cirugía. En ese sentido, se exponen los criterios para la selección, preparación psicológica y neuropsicológica tanto previo como durante la cirugía. A su vez, se proponen las consideraciones para lograr un procedimiento exitoso y evitar las posibles secuelas psicológicas a largo plazo, como insumos para la protocolización de este tipo de procedimientos con base en nuestra experiencia.
Awake craniotomy (AC) requires a multidisciplinary management due to trans operative awareness, which benefits the tumor resection and neurologic preservation, but it also implies risks for the patient cooperation during the procedure. This article describes the benefits and complications in patients operated under AC. Besides, it approaches the documented challenges for both the professional team and patients, who have an active role during surgery. In this regard, the criteria for selection and psychological and neuropsychological preparation before and during surgery are set out. It suggests considerations to achieve a successful procedure and to avoid possible long- term psychological sequelae, as a resource for the protocol of this type of procedures based on our experience.
Subject(s)
Humans , Wakefulness , Neurosurgical Procedures/methods , Craniotomy/methods , Postoperative Period , Patient Compliance , ConscienceABSTRACT
Resumo Objetivo: identificar o perfil das gestações e prevalência de adesão à consulta puerperal entre puérperas adolescentes comparadas a não adolescentes, assistidas em um ambulatório de hospital de ensino do interior de Minas Gerais. Método: estudo transversal aninhado a uma coorte de puérperas; amostra não probabilística, por conveniência; gestação na adolescência - variável dependente; sociodemográficas, clínicas e obstétricas - variáveis independentes. Utilizado instrumento próprio, testado mediante piloto. Calculadas razões de prevalência e intervalos de confiança; aplicados testes qui-quadrado e exato de Fisher, considerando nível de significância de 5%, e regressão de Poisson com variância robusta. Resultados: entrevistadas 121 puérperas, 18,2% (22) adolescentes, verificou-se entre elas baixa escolaridade (p<0,001); menor número de gestações cursando com patologias (p = 0,016); predomínio de primíparas (p<0,001) e maiores índices de parto normal (p = 0,032). A prevalência de adesão à consulta puerperal foi de 34,7% e de 31,8% para adolescentes. Não houve diferenças em relação à adesão e idade das puérperas. Conclusão: adolescentes não apresentaram desfechos obstétricos e neonatais negativos, embora tenha sido observada menor escolaridade. Identificou-se associação entre idade precoce e ausência de doenças na gestação e maiores índices de partos vaginais normais. A adesão ao retorno puerperal apresentou-se pouco inferior, porém sem significância estatística.
Abstract Objective: to determine the profile of pregnancies and prevalence of adherence to puerperal consultation among adolescent puerperal women compared to non-adolescent puerperal women served in an outpatient clinic of a teaching hospital in the rural area of Minas Gerais. Method: cross-sectional study nested in a cohort of puerperal women; non-probabilistic sample, by convenience; adolescent pregnancy - dependent variable; sociodemographic, clinical and obstetric - independent variables. It employed its own instrument, tested by means of a pilot test. Prevalence ratios and confidence intervals were calculated; chi-square and Fisher's exact tests were applied, considering a significance level of 5%, and Poisson regression with robust variance. Results: we interviewed 121 puerperal women, of which 18.2% (22) were adolescents, and observed among them low educational level (p<0.001); fewer pregnancies with pathologies (p=0.016); predominance of primiparous women (p<0.001), and higher rates of normal delivery (p=0.032). The prevalence of adherence to puerperal consultation was 34.7% and 31.8% for adolescents. There were no differences regarding adherence and age of puerperal women. Conclusion: adolescents did not present negative obstetric and neonatal outcomes, although a lower educational level was observed. Association was found between early age and absence of diseases during pregnancy and higher rates of normal vaginal deliveries. Adherence to puerperal return visit was slightly lower, but without statistical significance.
Resumen Objetivo: identificar el perfil de embarazos y la prevalencia de adherencia a las consultas puerperales entre madres adolescentes frente a las no adolescentes, atendidas en un hospital clínico universitario en el interior de Minas Gerais (Brasil). Método: estudio transversal anidado en un grupo de puérperas; muestra no probabilística, por conveniencia; embarazo adolescente - variable dependiente; variables sociodemográficas, clínicas y obstétricas- variables independientes. Se utilizó instrumento propio, prueba piloto. Se calcularon razones de prevalencia e intervalos de confianza; Se aplicaron las pruebas chi-cuadrado y exacta de Fisher, considerando un nivel de significancia del 5%, y regresión de Poisson con varianza robusta. Resultados: se entrevistaron a 121 puérperas, el 18,2% (22) eran adolescentes, siendo confirmado entre ellas una baja escolaridad (p<0,001); menor número de embarazos con patologías (p = 0,016); predominando las primíparas (p<0,001) y mayores tasas de parto normal (p = 0,032). La prevalencia de adherencia a la consulta puerperal fue del 34,7% y de 31,8% en adolescentes. No hubo diferencias en cuanto a la adherencia y la edad de las puérperas. Conclusión: las adolescentes no presentaron resultados obstétricos y neonatales negativos, aunque se observó menor escolaridad. Se identificó una asociación entre la edad precoz y la ausencia de enfermedades durante el embarazo y mayores tasas de partos vaginales normales. La adherencia al retorno puerperal fue ligeramente inferior, pero sin significación estadística.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adolescent , Pregnancy in Adolescence , Referral and Consultation , Cross-Sectional Studies , Patient Compliance , Postpartum Period , Disease PreventionSubject(s)
Humans , Child , Asthma/drug therapy , Medication Adherence , Health Education , Patient ComplianceABSTRACT
El objetivo de este trabajo es referir, a través de un reporte de caso clínico, a una paciente de sexo femenino de 9 años que sufrió una caída de su propia altura en el colegio. Inicialmente, la paciente acudió a urgencias en su ciudad natal, en la que al examen clínico se objetivó un traumatismo dentario en los dientes 11 y 21 y el diente 11 sufrió una luxación extrusiva leve, siendo reposicionada por el odontólogo que le brindó la primera atención. El examen radiográfico reveló una fractura radicular horizontal en el tercio medio de los dos incisivos centrales superiores. Los dientes fueron ferulizados con resina compuesta en los dientes proximales involucrados en el trauma. Posteriormente, la paciente fue remitida a la consulta de odontopediatría de la FOA-Unesp, donde recibió atención clínica y radiográfica por un período de diez años. No fue necesaria la intervención endodóntica en ambos dientes incisivos centrales, y los procesos de cicatrización se dieron de dos maneras diferentes. Cicatrización del diente 11 por interposición de hueso y tejido conectivo, y cicatrización del diente 21 por interposición de tejido conectivo. Después de diez años, los dientes se presentaban sin signos o síntomas significativos que requirieran una intervención invasiva. Se concluye que en un mismo paciente ocurren diferentes procesos de cicatrización en dientes muy próximos entre sí y que la cooperación del paciente en cuanto a cuidados, higiene bucal y asistencia a las citas de retorno, puede ser determinante para el éxito del tratamiento
The objective of this case report is to present a 9-year-old female patient who suffered horizontal root fracture in the middle third of the two upper central permanent incisors. The teeth were splinted with composite resin in the proximal teeth involved in the trauma. After, the patient was referred to the pediatric dentistry clinic, where she received clinical and radiographic care for a period of ten years. Endodontic intervention was not necessary on both central incisors teeth. Tooth 11 healing by interposition of bone and connective tissue, and teeth 21 healing by interposition of connective tissue. After ten years, the teeth presented without any significant signs or symptoms requiring an invasive intervention. It is concluded that the patient's cooperation regarding care, oral hygiene and attendance at the return appointments, can be decisive for the success of the treatment
O objetivo deste trabalho é referir-se, por meio de um relato de caso clínico, sobre um paciente de 9 anos de idade, sexo feminino, que sofreu queda da própria altura na escola. A paciente recebeu atendimento em sua cidade de origem, em que ao exame clínico foi observado traumatismo dentário sobre os dentes 11 e 21 e o dente 11 sofreu suave luxação extrusiva sendo reposicionado pelo cirurgião dentista que prestou os primeiros atendimentos. Ao exame radiográfico foi constatada fratura radicular horizontal de terço médio nos dois elementos dentários. Foi realizada a contenção dos dentes com resina composta nas proximais dos dentes envolvidos no trauma. A paciente foi encaminhada para a clínica de Odontopediatria da FOA-Unesp onde recebeu atendimento clínico e radiográfico por um período de dez anos, sem que a mesma apresentasse sinais ou sintomas significativos que necessitasse de uma intervenção invasiva. Dessa forma, infere-se que uma correta atuação no primeiro atendimento e a proservação do caso, pode ser determinante para o sucesso do tratamento, assim como a colaboração do paciente quanto aos cuidados, higienização bucal e comparecimento nas consultas de retorno
Subject(s)
Humans , Female , Child , Tooth Injuries , Attention , X-Rays , Patient Compliance , Joint Dislocations , Fractures, BoneABSTRACT
Introdução: Entre os cânceres de mama, aproximadamente 75% das mulheres são receptores hormonais positivos, sendo estas mais propensas a responderem à hormonioterapia com anastrozol e tamoxifeno. Apesar de eficazes, apresentam taxas significativas de não adesão. Objetivo: Avaliar a adesão à terapia hormonal adjuvante com tamoxifeno e anastrozol em pacientes atendidos nos Ambulatórios da Mastologia e de Quimioterapia do Hospital São Paulo entre os anos de 2019 e 2020. Método: Estudo transversal com 102 mulheres, realizado entre os meses de setembro de 2019 e março de 2020. A adesão à terapia hormonal adjuvante foi avaliada utilizando-se as escalas Morisky Medication Adherence Scale (MMAS-4) e Adherence to Refills and Medications Scale of 12 items (ARMS-12). Resultados: A média de idade foi de 61,5 anos (59,3-63,6). Entre as pacientes, 27,7% faziam uso de tamoxifeno e 72,3% de anastrozol. Relataram desconforto em relação ao uso do medicamento 84,4%, sendo as ondas de calor (42,2%) e as dores articulares (55,9%) os mais frequentes. A escala de ARMS>12 foi pontuada por 79,2%; cerca de 90% das mulheres pontuaram a MMAS-4 até dois pontos, porém não houve diferença significativa entre os tipos de hormônios utilizados para escalas de adesão (p=0,815 e p=0,489). Conclusão: A adesão à hormonioterapia observada foi relativamente baixa, independentemente da endocrinoterapia, podendo essas pacientes estarem em risco de inadequação quanto à resposta clínica
Introduction: Among breast cancers, approximately 75% of women are hormone receptors-positive, and these are more likely to respond to hormone therapy with anastrozole and tamoxifen. Although effective, they have significant rates of non-adherence. Objective: To evaluate adherence to adjuvant hormone therapy with tamoxifen and anastrozole in patients consulted at the Mastology and Chemotherapy Outpatient Clinic of Hospital São Paulo between 2019 and 2020. Method: Cross-sectional study carried out with 102 women between September 2019 and March 2020. Adherence to hormone therapy was evaluated using the Morisky Medication Adherence Scale (MMAS-4) and Adherence to Refills and Medications Scale of 12 items (ARMS-12). Results: The mean age was 61.5 years (59.3-63.6). Among the patients, 27.7% used tamoxifen and 72.3%, anastrozole. 84.4% of them reported discomfort in using the medication, the most frequent were hot flashes (42.2%) and joint pain (55.9%). 79.2% scored the ARMS>12 scale, about 90% of the women scored MMAS-4 up to 2 points, but there was no significant difference between the types of hormones used for adhesion scales (p=0.815 to p=0.489). Conclusion: Adherence to hormone therapy was relatively low, regardless of the hormone used, and these patients may be at risk of inadequate clinical response
Introducción: Entre los cánceres de mama, aproximadamente el 75% de las mujeres son receptores hormonales positivos, y estas son más propensas a responder a la terapia hormonal con anastrozol y tamoxifeno. Aunque son eficaces, tienen tasas significativas de no adherencia. Objetivo: Evaluar la adhesión a la terapia hormonal adyuvante con tamoxifeno y anastrozol en pacientes atendidas en las Clínicas Ambulatorias de Mastología y Quimioterapia del Hospital São Paulo entre 2019 y 2020. Método: Este es un estudio transversal realizado con 102 mujeres entre septiembre de 2019 y marzo de 2020. La terapia hormonal adjunta se evaluó utilizando las escalas Morisky Medication Adherence Scale (MMAS-4) e Adherence to Refills and Medications Scale of 12 items (ARMS-12). Resultados: La edad media fue de 61,5 años (59,3-63,6). Entre las pacientes, el 27,7% utilizaron tamoxifeno y el 72,3% anastrozol. El 84,4% de ellas reportaron molestias en relación con el uso del medicamento, siendo los más frecuentes los sofocos (42,2%) y el dolor articular (55,9%). 79,2% puntuaron la escala ARMS>12, alrededor del 90% de las mujeres obtuvieron MMAS-4 hasta dos puntos, pero no hubo diferencia significativa entre los tipos de hormonas utilizadas para escalas de adhesión (p=0,815 a p=0,489). Conclusión: La adherencia de la terapia hormonal observada fue relativamente baja, independientemente de la hormona utilizada, y estas mujeres pueden estar en riesgo de respuesta clínica inadecuada
Subject(s)
Humans , Female , Tamoxifen/therapeutic use , Breast Neoplasms , Patient Compliance , Medication Adherence , Anastrozole/therapeutic useABSTRACT
Objetivo: Analisar a associação entre as características sociodemográficas e a adesão aos cuidados domésticos de casos suspeitos de Covid-19 em isolamento domiciliar. Método: Estudo transversal, analítico. A coleta de dados ocorreu em unidade mista de saúde do Ceará, com 50 participantes suspeitos de Covid-19. Aplicou-se formulário de caracterização sociodemográfica, clínica e de avaliação dos cuidados em relação ao isolamento domiciliar. Para análise estatística, foram utilizados os testes Mann-Whitney e a razão de verossimilhança. Os princípios éticos das pesquisas com seres humanos foram seguidos. Resultados: A maioria dos homens (57,9%; p = 0,010) e das pessoas que conheciam alguém, pessoalmente, que teve/tem diagnóstico de Covid-19 (92,1%; p = 0,040) evitou aglomerações; 65,4% dos participantes com companheiro (a) descartaram o lixo adequadamente (p = 0,047); e 81,6% das pessoas com menor escolaridade aderiram à lavagem de roupas pessoais, de cama e toalhas com sabão comum e água (p = 0,043). Conclusão e implicaçoÌes para a praÌtica: As características sociodemográficas influenciaram a adesão a cuidados específicos, como evitamento de aglomerações, tratamento de lixo contaminado e lavagem de roupas pessoais, de cama e toalhas. Os cuidados domiciliares precisam ser mais enfatizados em consultas e pelos veículos de divulgação
Objective: To analyze the association between sociodemographic characteristics and adherence to home care of suspected COVID-19 cases in home isolation. Method: This is a cross-sectional, analytical study, and data collection took place in a health unit in Ceará, with 50 suspected COVID-19 participants. A sociodemographic, clinical characterization, and care evaluation form regarding home isolation was applied. For statistical analysis, the Mann-Whitney and likelihood ratio tests were used. The ethical principles of research with human beings were followed. Results: Most men (57.9%; p = 0.010) and people who personally knew someone diagnosed with COVID-19 (92.1%; p = 0.040) avoided crowded places, 65.4% of the participants with a partner discarded the garbage properly (p = 0.047), and 81.6% of people with less education adhered to washing personal clothes, bedding, and towels with common soap and water (p = 0.043). Conclusions and implications for practice: Sociodemographic characteristics influenced adherence to specific care, such as avoiding crowded places, treating contaminated waste, and washing personal clothes, bedding, and towels. Home care needs to be more emphasized in consultations and by means of dissemination
Objetivo: Analizar la asociación entre características sociodemográficas y adhesión a la atención domiciliaria de casos sospechosos de Covid-19 en aislamiento domiciliario. Método: Estudio transversal, analítico. La recolección de datos se llevó a cabo en una unidad de salud mixta en Ceará, con 50 participantes sospechosos de Covid-19. Se aplicó una forma de caracterización y evaluación sociodemográfica y clínica de los cuidados en relación al aislamiento domiciliario. Para el análisis estadístico se utilizaron pruebas de Mann-Whitney y de razón de verosimilitud. Se siguieron los principios éticos de la investigación con seres humanos. Resultados: La mayoría de los hombres (57,9%; p=0,010) y las personas que conocían a alguien personalmente que tenía/tiene un diagnóstico de Covid-19 (92,1%; p=0,040) evitaron los clusters; el 65,4% de los participantes con pareja (a) descartó la basura correctamente (p=0,047); el 81,6% de las personas con menor nivel educativo se adhirió a lavar la ropa personal, la ropa de cama y las toallas con agua y jabón común (p=0,043). Conclusión e implicaciones para la práctica: Las características sociodemográficas influyeron en la adhesión a cuidados específicos, como evitar aglomeraciones, tratar residuos contaminados y lavar ropa, sábanas y toallas personales. Es necesario hacer más hincapié en la atención domiciliaria en las consultas y mediante la difusión de información
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Patient Isolation , Patient Compliance/statistics & numerical data , Social Determinants of Health/statistics & numerical data , COVID-19/therapy , Cross-Sectional Studies , COVID-19/prevention & controlABSTRACT
Background: Tuberculosis (TB) remains a major public health concern despite being a curable and preventable disease. The treatment of TB using a cocktail of drugs over a period of six months under the directly observed treatment short-course strategy has led to a reduction in cases but is plagued by some challenges that leads to unsuccessful or poor outcomes, which can ultimately result in spread of infections, development of drug resistance and increase in morbidity and mortality. The objectives of this study are to determine outcomes of TB treatment in Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria and the factors that may be associated with the outcomes. Methodology: This was a retrospective study using the medical records of patients who were registered for TB treatment over a five-year period between 2016 to 2020. Data from TB registers including demographic and relevant clinical information, and treatment outcomes, were extracted into a structured data extraction format, and analysed with SPSS version 21.0 software package. Univariate and bivariate analyses were conducted, and Chi square test was used to determine association between TB outcomes and independent variables at 95% confidence interval and p<0.05 was considered as the significant value. Results: Records of 1,313 patients were studied, 744 (56.7%) were males while 569 (43.3%) were females. The age range of the patients was ≤ 1 year - 96 years, with a mean age of 30±16.7 years. Most were pulmonary TB cases (88.8%, n=1,166), newly diagnosed (95.5%, n=1254), and human immunodeficiency virus (HIV) negative at the time of TB diagnosis (63.7%, n=837). Eight hundred and seven (61.5%) patients had successful treatment, and 34% (n=446) had unsuccessful outcomes made of 'loss to follow-up' 25.8% (n=339), deaths 7.8% (n=102) and treatment failure 0.4% (n=5), while 2.3% (n=30) were transferred out and 2.3% (n=30) removed from TB register. Treatment success rate was significantly higher in patients with pulmonary TB (p=0.0024), residents in Lafia LGA (p=0.0005), those treated in 2016 (p=0.0006) and bacteriologically confirmed cases (p<0.0001), while death rate was significantly lower among patients who were HIV-negative at the time of TB diagnosis (p<0.0001). Conclusion: TB treatment success rate in this study fell short of the WHO average rate. High rates of 'loss to followup' and deaths in this study is a wake-up call to all stakeholders in the facility and the State to put in place measures to reduce poor outcomes of TB treatment.
Subject(s)
Tuberculosis , Patient Compliance , Treatment Outcome , Medication Adherence , Health FacilitiesABSTRACT
ABSTRACT Objective: This study aims to evaluate the level of patients' compliance with recall / follow-up visits attending the dental Centre of the University of Benin Teaching Hospital (UBTH).Methods: This study adopted a descriptive retrospective study of case notes retrieved from the medical records department of the dental Centre, University of Benin Teaching Hospital. The period under study covers 2019 to 2021. The data was collected by means of 1232 questionnaire and analyzed using descriptive statistics such as frequency and percentages. Results: The result showed that the participants in the age bracket of 18-40 years of age (277) complied better to recall visit in comparison with the study age distributions which are 41-65 years (218) and age above 65 years (188). As per the influence of gender on compliance of patients with post-extraction recall visits, it was observed that the male participants (288) responded better to the recall visits compared to the female participants (251). The Relationship between distance away from the hospital and compliance of patients with post-extraction recall visits was also evaluated, and it was observed that the patients closer to the hospital within 5km (442) complied better to recall revisit in comparison to the participants who were within 10km (224) from the hospital as well as the participants that were 10km & above (17). Finally, the influence of interval between procedure and recall visit was also evaluated, and the result revealed that the participants that were given 7 days of recall revisit (663) complied better compared with the participants who were given 14days duration for recall revisit (478). Conclusion: The data from this study highlighted the possible need for a paradigm shift in patient-doctor interphase especially as it concerns recall visits. Compliance to recall appointment by the patients depends largely on age, gender, distance from hospital and interval between procedures and is mainly responsible for the noncompliance of patients to recall visit
Subject(s)
Humans , Tooth Extraction , Dental Care , Patient Compliance , Continuity of Patient Care , Hospitals, TeachingABSTRACT
NA
Subject(s)
World Health Organization , Patient Compliance , Disease Prevention , Facial Masks , Hand Hygiene , Personal Protective Equipment , COVID-19ABSTRACT
BACKGROUND :Asthma is an obstructive respiratory disease characterized by wheezing, chest tightness, cough and shortness of breath that is evidenced by expiratory airflow limitation. Patient awareness of asthma control measures is key in ensuring compliance with asthmatic drugs. The main aim of the study was to assess determinants of adherence to asthma control measures among adult asthmatic clients attending chest clinics in Mama Lucy Kibaki Hospital. MATERIALS AND METHOD We employed a descriptive cross-sectional study design involving asthmatic patients interviewed at Mama Lucy Kibaki Hospital in Nairobi, Kenya. The study participants had to have been diagnosed with asthma for at least three months preceding the study, attend the chest clinic and consent to participate in the study. We pretested the study tools at Mbagathi county hospital on 11 asthmatic patients. A systematic random sampling method was used to select 110 study participants and data was collected using a modified questionnaire and lung function test between March to June 2018. Quantitative data was analyzed using SPSS 22.0. The Chi-square test was used to establish the association between independent variables and asthma adherence control measures at a 95% confidence interval. RESULTS Our findings report a response rate of 89% (98). The majority (58.2%) of participants were females. On average 57.1% had good adherence to asthma control measures. Control of asthma was poor, with well-controlled being 27.5%, moderately controlled at 53.1% and poorly controlled at 19.4%, respectively P (0.003). Respondents with adequate knowledge were 56.1% and positive attitude with 71.2%. There was a significant association between adherence to asthma control measures and participants' attitude (P-value=0.000), knowledge (P-value=0.000), level of education (P-value=0.000), level of asthma control (P-value=0.003). Environmental factors were cleaning carpets/curtains (P-value=0.001), type of fuel (P-value=0.003), and use of carpet (Pvalue=0.014). CONCLUSION Adherence to asthma control measures was suboptimal resulting in a generally poor asthma control. Adequate knowledge was associated with a positive attitude. Adherence was strongly associated with attitude, knowledge, education and asthma control.
Subject(s)
Asthma , Patient Compliance , Drug Therapy , Disease PreventionABSTRACT
Background: Graft survival post-kidney transplantation is of paramount importance to patients and nephrologists. Nonadherence to immunosuppressive therapy can be associated with deterioration of renal function and graft rejection. This study aimed to evaluate the adherence to immunosuppressive medications in kidney transplant patients at three centers in Khartoum, Sudan. Methods: In this descriptive cross-sectional hospital-based survey, 277 post-kidneytransplant patients were recruited. Data were collected using a questionnaire and analyzed using the SPSS v.23. Our scoring method was calculated based on Morisky Medication Adherence Scale (MMAS-8) related to immunosuppressive medications and was expressed as questions in the questionnaire; every correct answer was given one mark, then the marks were gathered and their summation was expressed. Results: Overall, 33% ,45%, and 22% of the studied participants reported high, medium, and low adherence, respectively. The major factor for nonadherence was forgetfulness affecting 36.1% of those who did not adhere. The cost of the immunosuppressive medications did not negatively affect any of the participants' adherence (100%). However, a significant association was seen between adherence and occupational status, duration of transplantation, shortage of immunosuppressants, recognizing the name of immunosuppressant, side effect, and forgetfulness (P-values = 0.002, 0.01, 0.006 , 0.000, 0.022, and 0.000, respectively). Logistic regression analysis showed a significant association with occupational status, side effects, and forgetfulness.
Subject(s)
Humans , Kidney Transplantation , Patient Compliance , Sudan , Immunosuppression TherapyABSTRACT
Introduction. Patients' non-adherence to antiretroviral treatment remains a public health concern in many developing countries, especially in South Africa. Objectives: The objective of the study was to explore the barriers and facilitators of patients' ART adherence in one health care facility in Mpumalanga Province, South Africa. Methods: A qualitative, exploratory, and descriptive design was employed to collect data using a semi-structured interview guide through individual in-depth interviews among twenty (20) purposively selected patients. The thematic analysis approach was used to generate themes from the data. Results: A majority of the participants were female (n=12, 60%), married (n=13, 65%), and employed (n=12, 60%). Barriers to ART adherence include insufficient medical staff at the health center and waiting time being too long. Facilitators included service providers' positive attitude, clear instructions for taking medication, benefits of adhering to ART, and dangers of defaulting treatment. Conclusion: Barriers and facilitators for adherence included several factors related to the health system, health care workers, and the patients. Achievement of optimal adherence to ART requires the commitment of both patients and providers
Subject(s)
Acquired Immunodeficiency Syndrome , HIV , Patient Compliance , Anti-Retroviral Agents , South Africa , Glucose Transport Proteins, Facilitative , Barriers to Access of Health ServicesABSTRACT
Introduction: Keeping HIV-infected adults away from the health care system during the COVID-19 travel restrictions, presents a challenge to HIV treatment adherence. Methods: This study focused on the initial two phases where Phase 1 designed a Makerere College of Health Sciences (MakCHS) Unstructured Supplementary Service Data (USSD)-based application; and Phase 2 piloted patient enrolment onto the application and determined the feasibility of remote follow-up of patients receiving long-term antiretroviral therapy (ART). Results: A off/online user application, MakCHS Health app, was developed. Overall, 112 patients [(66(59%) female] receiving ART at Mulago ISS clinic, Kampala, were enrolled onto the MakCHS Health app. Up to 89 (80%) utilized the app to access medical help. Patients' medical queries included needs for drug refills, missed taking HIV medication, medical illnesses, access to COVID-19 vaccination and other personal needs that required clinicians' attention. Conclusion: Piloting a MakCHS Health application for patient follow-up was feasible and well-received by HIV treatment providers and patients receiving ART. We recommend scale up of the application to enroll all patients receiving long-term treatment for HIV/AIDS, and subsequently expand to. other HIV treatment programs in similar settings
Subject(s)
HIV Infections , Patient Compliance , Continuity of Patient Care , Drug Therapy , COVID-19 , Cell PhoneABSTRACT
BACKGROUND: Some studies have been conducted worldwide onthe preparedness of dentists and even dental students for infectionprevention and control with regard to the ongoing COVID-19 pandemicbut very few studies have been done among other Oral Health CareWorkers (OHCWs). The purpose of this study was to assess theknowledge and practices of dental health care workers in Nigeria oninfection prevention and control with regards to COVID-19.METHODS: This was a descriptive study on the knowledge andpractices regarding infection control protocols and procedures withregard to the COVID-19 pandemic among dental personnel in Nigeria.A validated self-administered questionnaire was utilised for datacollection. Bivariate analysis was done with a Chi-squared test todetermine the association between the participants age, gender,profession and place of practice with knowledge and practicesregarding COVID 19 infection. Statistical significance in associationswas inferred at P-value < 0.05.RESULTS: The majority of the OHCWs (77.4%) had good knowledgeabout infection prevention and control, and regulations regardingCOVID-19, but most of them (58.5%) displayed poor practices withregard to infection prevention and control regulations related toCOVID-19. Male respondents (68.8%), those aged between 5564(83.3%) years and Dental therapists (71.4%) had a higher proportionof those with good practices with the male gender and profession(Dental Therapist) being significantly associated with good practices.(P<0.05).CONCLUSION: Our study identified a high rate of knowledge butlow compliance with infection prevention and control guidelinesregarding COVID-19. Better compliance with recommended infectioncontrol and waste management practices for all OHCWs and continuingeducation programs promoting infection control awareness are vitalto improving the practices of these OHCWs
Subject(s)
Humans , COVID-19 , Group Practice, Dental , Health Knowledge, Attitudes, Practice , Oral Health , Patient Compliance , Immunization Programs , Delivery of Health Care , InfectionsABSTRACT
Objetivo: Avaliar o efeito de mensagens por WhatsApp, mensagem de texto (SMS), ou aplicativos na cooperação dos pacientes ortodônticos para usar elásticos, contenção e para não faltar ou atrasar para as consultas. Métodos:Foram conduzidas buscas em cinco bases de dados eletrônicas, no OpenGrey e Google Scholar sem restrição de data/idioma de publicação. Seleção dos estudos, extração de dados e análise da qualidade metodológica dos artigos com a ferramenta Cochrane foram realizados. Resultados de meta-análises foram apresentados em razão das chances (RC) e intervalo de confiança (IC). Resultados: Oito estudos foram incluídos. Indivíduos que receberam mensagens por aplicativo apresentaram um número menor de comparecimentos falhos (p < 0,05). Indivíduos que receberam mensagens por WhatsApp obtiveram maior eficácia na correção da má oclusão classe II com elásticos e uma menor diminuição da distância intercaninos (p < 0,05) do que aqueles que não receberam mensagens. Para irregularidade dos incisivos, não houve diferença entre quem recebeu ou não recebeu mensagem de texto (p = 0,92). Entre indivíduos que recebiam mensagens por SMS, o número de comparecimentos à consulta foi maior que o número de não comparecimentos (RC = 15,48; IC = 1,04230,24), além do maior uso de elásticos (p = 0,001). Não há diferença no comparecimento à consulta entre indivíduos que receberam uma mensagem prévia por SMS e quem recebeu ligação telefônica prévia (RC = 1,11; IC = 0,30 4,05), ou quem recebeu e-mail (p > 0,05). A qualidade metodológica variou de baixo a alto. Conclusão: Mensagens em celulares são eficientes na redução de faltas nas consultas, no número de comparecimentos falhos, no aumento do uso de elásticos e contenção.
Aim: To evaluate the effect of messages via WhatsApp, text message (SMS), or apps on the cooperation of orthodontic patients during the wearing of elastics and retainers as well as attendance and delay at appointments. Methods: Searches in five electronic databases, OpenGrey, and Google Scholar were performed without restrictions on publication date/language. Selection of the studies, data extraction, and methodological quality analysis of articles with the Cochrane tool were performed. Results of meta-analysis were provided in odds ratio (OR) and confidence intervals (CI). Results: Eight studies were included. Among those who received app messages, a lower number of appointment failures (delay) was observed (p < 0.05), and among those who received WhatsApp messages, a greater effectiveness of correction of class II malocclusion with elastics and a lower intercanine distance reduction (p < 0.05) were observed compared to those who did not receive messages. For incisor irregularity, there was no difference between individuals who received and those who did not receive a text message (p = 0.92). Among those receiving previous SMS messages, the number of appointment attendances was higher than the number of no-shows (OR = 15.48; CI = 1.04230.24). Wearing of elastics was also higher (p = 0.001). No difference was found in appointment attendances between individuals who received previous SMS messages and individuals who received previous phone calls (OR = 1.11; CI = 0.304.05), or those who received e-mails (p > 0.05). The risk of bias varied from low to high. Conclusion: Messages in mobile phones are efficient in reducing consultation no-shows and failure in attendance, as well as in increasing the wearing of intermaxillary elastics and retainers.