ABSTRACT
No disponible
No disponible
Subject(s)
Male , Aged , Humans , Gynecomastia/chemically induced , Omeprazole/adverse effects , Hypercholesterolemia/complications , Hypertension/complicationsABSTRACT
OBJECTIVES: To identify features of health care centers valued by health care workers as positive, to group features into dimensions, and to determine their relative importance. DESIGN: Qualitative phase: focus groups and content analysis. Quantitative phase: survey with a questionnaire developed from the features identified in the qualitative phase. SETTING: Primary care services in Reus and Tarragona (Catalonia, northeastern Spain). PARTICIPANTS: Managers, medical care providers and admissions staff. A total of 33 workers took part in focus groups, and 136 questionnaires were distributed for the survey, with a 78.6% response rate. MAIN MEASURES: Identification by focus groups of the features to be evaluated. Features were grouped into dimensions at different levels by content analysis. Survey to determine the relative importance of different features. RESULTS: We identified 133 features to be evaluated by workers: 36 related with structural features of the center (architecture, staffing and equipment), 33 with organization (accessibility, team functioning), 23 with workers (knowledge and attitudes) 20 with the services provided (needs and information management, care services provided) and 21 with management. The most highly valued dimensions were workers´ attitudes and management. CONCLUSIONS: Relations with patients and colleagues, and management issues, were valued most highly by workers. Some problematic features such as shared decision-making, team work and minority cultures revealed different levels of awareness and sensitivity within the health care system.
Subject(s)
Focus Groups , Health Personnel , Attitude of Health Personnel , Delivery of Health Care , Humans , Primary Health Care , Surveys and QuestionnairesABSTRACT
OBJECTIVES: To identify the factors valued by users of health centres; to weigh the relative importance of each factor. DESIGN: Qualitative stage (4 focus groups) to identify the factors valued. Quantitative stage (questionnaire to 225 people) to weigh their relative importance. SETTING: Primary care. PARTICIPANTS: Citizens from middle-high and middle-low social classes, urban, rural and over 65, were chosen through key informants for their interest in the health services. They were recruited with the assistance of various residents' associations and town councils. METHOD: The factors valued were identified through focus groups and classified in categories. Their relative importance was weighed through a questionnaire and a factorial analysis to identify the main components was run. RESULTS: 60 factors that could be valued by patients were identified. Eight of these referred to the centre and concrete assets, nine to organisation and acessibility, 18 to relationship with the health professionals, and 25 to the services available. The most highly valued factor was: "The centre has sufficient material available for cures, minor surgery, bandages, etc." The factorial analysis confirmed the categories established. Organisation and accessibility, and relationship with professionals were the most highly valued dimensions. CONCLUSIONS: The combination of qualitative and quantitative methods seems very fitting for this kind of study. Although many of the factors were to be expected, other little-expected ones emerged. In addition, users seem to value certain factors in a different way from how the professionals do.
Subject(s)
Patient Satisfaction , Primary Health Care/statistics & numerical data , Quality of Health Care/statistics & numerical data , Aged , Attitude to Health , Community Health Centers/statistics & numerical data , Female , Focus Groups , Humans , Male , Surveys and QuestionnairesABSTRACT
Objetivos. Identificar los aspectos que valoran los pacientes en los centros de salud. Ponderar la importancia relativa de cada uno de ellos. Diseño. Fase cualitativa (4 grupos focales) para identificar los aspectos que se valoran. Fase cuantitativa (encuesta a 225 ciudadanos) para ponderar su importancia relativa. Emplazamiento. Atención primaria. Participantes. Ciudadanos de clase social media-alta, media-baja, urbanos, rurales y mayores de 65 años, seleccionados a través de informantes clave por su interés en los servicios sanitarios. Se reclutaron con la colaboración de diferentes asociaciones de vecinos y ayuntamientos. Método. Mediante grupos focales se identificaron los aspectos que se valoran, y se clasificaron en categorías. Mediante encuesta se ponderó la importancia relativa de los mismos y se realizó un análisis factorial para identificar los componentes principales. Resultados. Se identificaron 60 aspectos valorables por los pacientes. De ellos, 8 se referían al centro y eran tangibles, 9 a organización y accesibilidad, 18 a relación con los profesionales y 25 a servicios disponibles. El aspecto más valorado fue: "el centro dispone de suficiente material para curas, pequeña cirugía, vendajes, etc.". El análisis factorial confirmó las categorías que se habían establecido. La organización y accesibilidad y las relaciones con los profesionales parecen ser las dimensiones más valoradas. Conclusiones. La combinación de métodos cualitativos y cuantitativos parece muy adecuada para este tipo de estudios. Aunque muchos de los aspectos eran de esperar, aparecen otros poco previsibles. Además, los clientes parecen valorar ciertos aspectos de manera distinta a como lo harían los profesionales (AU)
Subject(s)
Aged , Male , Female , Humans , Patient Satisfaction , Quality of Health Care , Surveys and Questionnaires , Primary Health Care , Attitude to Health , Community Health CentersABSTRACT
La transmisión del virus de la inmunodeficiencia humana (VIH), el virus de la hepatitis B (VHB) o el virus de la hepatitis C (VHC), desde un paciente portador a un trabajador sanitario, puede ocurrir a través de pinchazos accidentales con agujas o heridas con instrumentos cortantes. Aunque poco frecuente, la trascendencia médica y legal que una exposición ocupacional puede tener para el personal sanitario es importante. Dado el riesgo de transmisión de enfermedades infecto-contagiosas de elevada morbimortalidad, y la necesidad de tener perfectamente establecida una secuencia de actuación, hacen que estas recomendaciones de profilaxis postexposición deban ser conocidas y estar al alcance de todos los profesionales sanitarios que realicen una labor asistencial. Con este fin realizamos esta revisión y puesta al día de la "actitud a seguir en caso de accidente biológico", primando la practicidad de aplicación dentro de la amplitud que un tema tan interesante conlleva. (AU)
