Actitudes de los médicos de un hospital pediátrico de tercer nivel ante la muerte / Attitudes of physicians in a tertiary care children's hospital in the face of death

Introducción. La muerte involucra, para los médicos, un análisis complejo que determina su actitud hacia el paciente, principalmente los comportamientos en situaciones de diagnóstico, tratamiento y la relación médico-paciente. Objetivos. 1) Describir las actitudes del personal médico de un hospital pediátrico ante la muerte. 2) Explorar si existen factores asociados a esas actitudes. Población y métodos. Estudio transversal, por encuesta. Se invitó a los médicos de un hospital pediátrico de tercer nivel de la Ciudad Autónoma de Buenos Aires, Argentina, a completar el Cuestionario de actitud ante la muerte (CAM). Se investigaron variables sociodemográficas, categoría profesional y área laboral, haber presenciado la muerte de pacientes, autopercepción de actitud positiva ante la muerte y actitud ante la muerte según CAM. Resultados. Entre el 01 de junio de 2021 y el 01 de junio de 2022 se incluyeron 362 participantes, con edad media de 39,88 (± 11,56) años y experiencia médica asistencial de 14,06 (± 11,97) años. Presentaron actitud positiva 35 (9,67 %). Encontramos significancia estadística para mayor probabilidad de actitud positiva en edad ≥ 40 años (p = 0,02, IC95 % 1,1-3,9), experiencia médica asistencial ≥ 14 años (p = 0,042, IC95 % 1-4,1), creencia religiosa (p = 0,003, IC95 % 1,4-10,5), práctica religiosa activa (p <0,001, IC95 % 1,6-6,9) y autopercepción positiva ante la muerte (p = 0,002, IC95 % 1,7-30,8). Conclusiones. El 9,67 % de los encuestados presentó actitud positiva ante la muerte. Los factores asociados a ella fueron edad ≥ 40 años, experiencia médica asistencial ≥ 14 años, creencia religiosa, práctica religiosa activa y la autopercepción personal de actitud positiva ante la muerte.

Introduction. For physicians, death involves an intricate analysis that determines their attitude towards the patient. Objectives. 1) To describe the attitudes towards death among medical staff working at a children's hospital. 2) To explore factors associated with such attitudes. Population and methods. Cross-sectional, survey study. The physicians working at a tertiary care children's hospital completed the Questionnaire of attitudes towards death (QAD). Sociodemographic variables, professional category, work setting, having witnessed the death of patients, self-perception of a positive attitude towards death, and attitude towards death according to the QAD were studied. Results. Between June 1st, 2021 and June 1st, 2022, 362 participants were included; mean age: 39.88 years (± 11.56), health care experience: 14.06 years (± 11.97). A positive attitude was observed in 35 (9.67%). A statistical significance was observed for a greater probability of a positive attitude among those who were ≥ 40 years old (p = 0.02, 95% CI: 1.1­3.9), had health care experience for ≥ 14 years (p = 0.042, 95% CI: 1­4.1), had a religious belief (p = 0.003, 95% CI: 1.4­10.5), actively practiced their religion (p < 0.001, 95% CI: 1.6­6.9), and had a positive self-perception in the face of death (p = 0.002, 95% CI: 1.7­30.8). Conclusions. A positive attitude towards death was observed in 9.67% of surveyed participants. Associated factors were age ≥ 40 years, health care experience for ≥ 14 years, religious belief, active religious practice, and self-perception of a positive attitude towards death.

Seroprevalencia de anticuerpos anti SARS-CoV-2 en médicos de un hospital pediátrico / Seroprevalence of SARS-CoV-2 antibodies among physicians from a children's hospital

Introducción. En pocos meses, la enfermedad por coronavirus 2019 (COVID-19) se transformó en una pandemia, alcanzando millones de casos y centenas de miles de muertos. Por la enorme capacidad de contagio, el personal de salud se encuentra más expuesto a contraerla. Sin embargo, aún hay muy poca información al respecto, particularmente, entre pediatras.Objetivo. Evaluar la seroprevalencia de anticuerpos anti SARS-CoV-2 en médicos de un hospital pediátrico, a 3 meses del primer caso en la Argentina. Explorar si algunas características demográficas, profesionales y epidemiológicas son factores de riesgo para presentar seropositividad para SARS-CoV-2.Métodos. Estudio transversal, con médicos seleccionados aleatoriamente de la nómina de un hospital pediátrico. En todos, se pesquisaron anticuerpos anti SARS-CoV-2por quimioluminiscencia (inmunoglobulinas G/M -IgG/IgM-) y se recogieron antecedentes epidemiológicos (edad, lugar de residencia, categoría profesional, contacto con enfermos), para explorar asociación entre los predictores y seropositividad.Resultados. Se incluyeron 116 médicos, con una edad promedio de 45,6 ± 13,3 años. El 62,9 % eran médicos de planta, y el resto, residentes. El 42,2 % prestaban servicios en áreas dedicadas a la asistencia directa de pacientes con COVID-19.Cuatro (el 3,5 %) refirieron contacto con enfermos sin la debida protección, y 6 (el 5,2 %), viaje previo a zonas de riesgo. Solo se identificaron anticuerpos anti-SARS-CoV-2 (IgG) en un profesional. Debido a ello, no se pudo evaluar asociación entre los potenciales predictores y la presencia de anticuerpos anti-SARS-CoV-2.Conclusión. Se encontró que solo el 0,9 % de los médicos de un hospital pediátrico presentaban anticuerpos anti-SARS-CoV-2.

Introduction. In just a few months, coronavirus disease 2019 (COVID-19) has become a pandemic, causing millions of cases and hundreds of thousands of deaths. Due to its high infectiousness, the health care staff is even more exposed. Nevertheless, there is still very limited information about it, especially among pediatricians.Objective. To assess the seroprevalence of SARS-CoV-2 antibodies among physicians from a children's hospital 3 months after the first case in Argentina. To explore if certain demographic, occupational, and epidemiological characteristics are risk factors for SARS-CoV-2 seropositivity.Methods. Cross-sectional study of physicians randomly selected from the list of workers of a children's hospital. All of them were screened for SARS-CoV-2 antibodies by chemiluminescence (immunoglobulins G/M [IgG/IgM]) and their epidemiological history was collected (age, place of residence, professional category, contact with infected people) in order to explore the association between predictors and seropositivity.Results. A total of 116 physicians were included; their average age was 45.6 ± 13.3 years. Of them, 62.9 % were staff physicians, and the rest, residents; 42.2 % worked in areas designated for direct care of COVID-19 patients. Four (3.5 %) referred contact with infected people without the appropriate protection, and 6 (5.2 %), having traveled to risk areas. SARS-CoV-2 antibodies (IgG) were only detected in one of the professionals. Because of this, it was impossible to assess the association between potential predictors and the presence of SARS-CoV-2 antibodies.Conclusion. It was observed that only 0.9 % of the physicians from a children's hospital had SARS-CoV-2 antibodies

Encuesta sobre conocimiento, hábitos de prescripción y manejo de la fiebre en pediatras de un hospital pediátrico / Survey on knowledge, prescription habits, and management of fever among pediatricians at a children's hospital

Introducción. Existen discrepancias en el abordaje de la fiebre por parte de los pediatras. El objetivo fue describir conocimientos, hábitos de prescripción e indicaciones de tratamiento farmacológico y no farmacológico de la fiebre por parte de los médicos de un hospital pediátrico de la Ciudad de Buenos Aires.Material y métodos. Estudio observacional, descriptivo, analítico, de corte transversal, realizado en el Hospital de Niños Ricardo Gutiérrez durante 2018.Resultados. Se realizaron 100 encuestas. El 37 % de los pediatras siempre indicaba medios físicos, mientras que el 54 %, ocasionalmente. El 68 % alternaba antitérmicos, aunque el 72 % consideraba que esta práctica aumentaba el riesgo de toxicidad. El 32 % respondió que el tratamiento precoz disminuía el riesgo de convulsiones.Conclusiones. Existen hábitos de prescripción e indicaciones de tratamiento farmacológico y no farmacológico de la fiebre por parte de los pediatras con escasa evidencia de su eficacia.

Introduction. There are discrepancies in relation to pediatricians' approach to fever. Our objective was to describe the knowledge, prescription habits, and drug and non-drug treatment indications for fever among physicians at a children's hospital in the Autonomous City of Buenos Aires.Material and methods. Observational, descriptive, analytical, cross-sectional study conducted at Hospital de Niños Ricardo Gutiérrez in 2018.Results. A total of 100 surveys were completed: 37 % of pediatricians always indicated physical methods, whereas 54 % did so occasionally; 68 % alternated antipyretic agents, while 72 % considered this practice increased the risk for toxicity; and 32 % stated that early management reduced the risk for seizures.Conclusions. Pediatricians have prescription habits and indicate drug and non-drug treatments for fever that have demonstrated little effectivenes

Pattern and associated socio demographic factors of tobacco use among health care staff in a tertiary care setting at Faridabad

Background: This study aimed at assessing prevailing pattern and risk factors of tobacco consumption among health care workers of tertiary care centre, in Faridabad.Methods: A cross-sectional approach was used. A sample of 306 participants included housekeeping and nursing orderly. Participants were interviewed during their lunch time. Semi structured questionnaire was used for data collection.Results: The overall prevalence of tobacco use was found to be 42.8% (n=306), of which (30.7%) prevalence among housekeeping’s compared to nursing orderlies (12.7%). The consumption of smokeless tobacco was higher among housekeeping staff. Khaini (45%) was the main consumption type, followed by hookah (21%) and cigarettes (19.5%) among the current tobacco user (n=133). The consumption of tobacco was found to be associated with gender (male), education, and nature of job (designation) at the hospital setting.Conclusions: Tobacco use is very common in hospital staff in Faridabad as reflected by results of our study. We should build on success encountered in banning smoking in educational institutions and healthcare facilities. This is important for their health and also overall health of patients also as they can influence the behaviour of people that surrounds them.

Study of staff employee’s satisfaction / Монголын Анагаах Ухаан

Introduction@#Studies in many countries have found that the satisfaction of medical workers is closely linked to the quality and efficiency of medical services, as well as the satisfaction of patients. Satisfied employees will bring about satisfied clients. The satisfaction of employees remains a key factor linking the internal management and external management of an organisation. The World Health Organization (WHO) Global strategy on human resources on health workforce 2030 sets out the policy agenda to ensure a workforce that is ft for purpose to attain the targets of the Sustainable Development Goals (SDGs). Motivation of health care workers can initiate them to exert and maintain an efort towards organizational goals. Motivation depends up on many factors, and job satisfaction is one of the most important factors. Healthcare is a service industry where the overall service experience is important for customer satisfaction and quality of care (even if in different extents according to the professional at stake) and that the literature has been bringing about the pertinence of such a holistic approach, this research was conducted within this perspective. Likewise, it is also known that there is close correlation between the job satisfaction of health care staff and the total quality of health services. Different groups have reported differences between the job satisfaction of doctors and that of other health providers. Various satisfaction levels of health care workers, including general practitioners, nurses and midwives, have been reported previously. @*Materials and Methods@#This study was performed at the Amgalan Maternity Hospital, Urguu Maternity Hospital and Khuree Maternity Hospital The study involved 480 employees of above mentioned hospitals. The short form of the Minnesota Satisfaction Questionnaire, with 20 items, was used to examine satisfaction with professional life. The self-administered questionnaire was distributed to all people at their workplaces. Responses of 4 (satisfied) or 5 (very satisfied) were classified as ‘satisfied’, those of 1 (very dissatisfied) or 2 (dissatisfied) as ‘dissatisfied’.@*Results@#The study recruited total 480 employees consisting of 220 employees working at Urguu Maternity Hospital, 125 employees of Khuree Maternity Hospital and 135 employees of Amgalan Maternity Hospital. 46 administration officials, 75 doctors, 208 nurses and obstetricians, 105 caregivers and service assistants and 46 economic employees involved it. In table, 87.1% of total employees of maternity hospitals were female and 12.9% were male. While there had significantly difference for gender, occupation type and worked year in this sector and workplace between 3 maternity hospitals (p<.001), age and education level had no significantly difference between these 3 groups. The proportion of health care staff satisfied with their work was 80.7%. The chance to tell people what to do’ and ‘Being able to do things that do not go against my conscience’, and mostly dissatisfied with ‘The working conditions’ and ‘My pay and the amount of work I do’. There was no significant difference between satisfaction scores of health care staff according to age, gender, marital status, and experience of profession. When the 20 items constituting job satisfaction were examined specifically, the satisfaction score showed a difference related to profession. The midwives’ satisfaction score was significantly lower than that of the others. In table 4, to assess employee’s satisfaction of each maternal hospital: While the minimum satisfaction was assessed by employees of Urguu maternity hospital whether salary is equal for work performance, the maximum satisfaction was assessed by employees of Amgalan maternity hospital under scope of consistent workplace at 93.9 percent. @*Conclusion@#Maternity satisfy external and internal factors of employees are influenced. Maternity is different, depending on the satisfaction of other working areas of employment.

CARACTERIZACIÓN DE Staphylococcus aureus OBTENIDO DEL AMBIENTE HOSPITALARIO Y DEL PERSONAL DE SALUD EN UN HOSPITAL DE LA CIUDAD DE CALI / CHARACTERIZATION OF Staphylococcus aureus OBTAINED FROM THE HOSPITAL ENVIRONMENT AND HEALTH CARE STAFF AT A HOSPITAL IN THE CITY OF CALI

RESUMEN Introducción: La colonización nasal de Staphylococcus aureus en el personal de salud y la contaminación de superficies hospitalarias puede preceder a la infección nosocomial. El objetivo de este estudio fue caracterizar los aislamientos de S. aureus que se encuentran en el ambiente hospitalario y en el personal de salud de un hospital de Cali. Material y Métodos: Se empleó un total de 164 muestras (86 del personal de salud y 78 de las salas del hospital). Se realizó antibiograma y se amplificó por PCR los genes mecA y agr. El S. aureus resistente a meticilina asociado al hospital (SARM-AH) o el SARM asociado a la comunidad (SARM-AC) se estableció mediante el análisis de estos genes. Resultados: El S. aureus registró un 21,3% de prevalencia, se detectó en el personal de salud (9,1%) y en el ambiente hospitalario (12,2%). El S. aureus en la unidad de cuidados intensivos fue significativo, con un riesgo mayor de tres (6,1%; OR=3,143, min=1,086, max=9,099; P=0,031). Se identificaron tres perfiles de resistencia (I, II y III), el ambiente hospitalario presentó mayor riesgo de presentar aislamientos con perfil I (20%; OR= 3,500; IC 95% min= 0,050; max = 16,430; p= 0,147). Sin embargo, los aislamientos con el perfil III con multirresistencia a los antibióticos, fueron los más prevalentes en el personal de salud (25,7%) y el ambiente hospitalario (20%).Los aislamientos SARM se encontraron colonizando al 11,4% del personal de salud y en el 17,1% de las superficies del ambiente hospitalario. Todos los aislamientos SARM fueron SCCmec tipo II, compatible con un origen hospitalario. Según el análisis del locus agr, se identificaron tres grupos agr, el 51,4% de los aislamientos pertenecen al grupo agr 1, el 22,8% al agr 2 y el 25,7% al agr 3. Conclusión: Se evidenció la presencia de SARM en el personal y en diferentes salas del hospital. Esta condición podría ser un factor de riesgo para desarrollar infecciones adquiridas en el hospital.

ABSTRACT Introduction: Nasal colonization of Staphylococcus aureus in health personnel and contamination of hospital surfaces may precede nosocomial infection. This study aimed to characterize the isolates of Staphylococcus aureus found in hospital environments and healthcare staff in a hospital in the city of Cali. Materials and Methods: A total of 164 samples (86 from the healthcare staff and 78 from the hospital wards) were used in this study. The characterization was based on the antibiogram analysis and PCR amplification of the mecA and agr genes. The methicillin-resistant S. aureus associated with the hospital (MRSA-AH) or the MRSA associated with the community (MRSA-AC) were established by analyzing these genes. Results: S. aureus recorded 21.3% prevalence, and it was detected in healthcare staff (9.1%) and the hospital environment (12.2%). S. aureus found in the intensive care unit was significant with higher risk than 3 (6.1%; OR = 3.143, min = 1.086, max = 9.099; p = 0.031). Three resistance profiles were identified (I, II, and III), and the hospital environment presented a higher risk of having isolates with resistance profile I (20%; OR = 3.500; CI95% min = 0.050, max = 16.430; p = 0.147). However, isolates classified in profile III with multi-resistance to antibiotics were most prevalent in the healthcare staff (25.7%) and the hospital environment (20%). The MRSA isolates were found colonizing 11.4% health care staff and 17.1% on surfaces of the hospital environment. All MRSA isolates were SCC mec type II, compatible with hospital origin. According to the analysis of agr locus, it was possible to identify three agr groups; 51.4% belonging to agr group 1, 22.8% to agr 2, and 25.7% to agr 3. Conclusion: This study evidenced the presence of MRSA in the healthcare staff and different wards of the hospital. This condition could be a risk factor for developing infections acquired in the hospital.