ABSTRACT
The healthcare industry is inadvertently a teamwork industry - and yet - little time is devoted to improving teamwork on the field. As a response to this issue, team development intervention (TDI) tools have flourished. Findings suggest the capability for TDIs to better team competencies, and potentially mitigate prominent healthcare problems. However, team coaching has been excluded as a potential TDI for healthcare. For this reason, we seek to 1) discuss existing team coaching models, integrating findings across the literature, 2) highlight the advantages of Hackman and Wageman (2005)'s model over others, 3) display its empirically-corroborated propositions, and finally, 4) provide general guidance on how to move forward. We move beyond extant literature by providing an outline on what outcomes team coaching can and cannot yield, accumulating evidence from fields outside of healthcare and incorporating team coaching into the TDI literature. By doing so, we hope empirical research on team coaching is incentivized, resulting in an efficient and accessible TDI for healthcare professionals and the field of interprofessional care.
Subject(s)
Mentoring , Humans , Interprofessional Relations , Patient Care Team , Health Personnel , Delivery of Health CareABSTRACT
OBJECTIVE: To identify the type of infections and risk factors for infection-related mortality (IRM) after allogeneic hematopoietic stem cell transplantation (HSCT). METHODS: Retrospective cohort study of patients <16 years of age treated in 2010-2019 was conducted. Unadjusted hazard ratios (HR) and adjusted hazard ratios (aHR) with 95% confidence intervals (95% CIs) were estimated using Cox regression. Cumulative incidence was calculated. RESULTS: Data for 99 pediatric patients were analyzed. The myeloablative conditioning was the most used regimen (78.8%) and the hematopoietic stem cell source was predominantly peripheral blood (80.8%). Primary graft failure occurred in 19.2% of patients. Frequency of acute graft-versus-host disease was 46.5%. Total of 136 infectious events was recorded, the most common of which were bacterial (76.4%) followed by viral infection (15.5%) and then fungal infection (8.1%). The best predictors for infection subtypes where the following: a) for bacterial infection (the age groups of 10.1-15 years: aHR = 3.33; 95% CI: 1.62-6.85 and. >15 years: aHR = 3.34; 95% CI: 1.18-9.45); b) for viral infection (graft versus host disease: aHR = 5.36; 95% CI: 1.62-17.68), however, for fungal infection statistically significant predictors were not identified. Related mortality was 30% (n = 12). Increased risk for infection-related mortality was observed in patients with unrelated donor and umbilical cord stem cells recipients (HR = 3.12; 95% CI: 1.00-9.85). CONCLUSIONS: Frequencies of infections and infection-related mortality appear to be similar to those reported. Unrelated donors and stem cells from umbilical cord recipients were associated with a high risk of mortality.
Subject(s)
Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Mycoses , Humans , Child , Adolescent , Retrospective Studies , Mexico/epidemiology , Transplantation, Homologous/adverse effects , Hematopoietic Stem Cell Transplantation/adverse effects , Graft vs Host Disease/etiology , Risk Factors , Unrelated Donors , Mycoses/etiology , Transplantation Conditioning/adverse effectsABSTRACT
BACKGROUND: Hemophilia is a hemorrhagic disease characterized by the deficiency of either coagulation factor VIII or IX. It impacts negatively in people's quality of life and it causes side effects, such as depression. The objective was to describe and analyze the health-related quality of life (HRQoL) and depression levels in a group of 50 pediatric patients with hemophilia (PPwH) and their parents. The specific objectives were: to analyze the correlation between HRQoL levels reported by patients and their parents, and to analyze the correlation between HRQoL levels and depression in PPwH. METHODS: Descriptive, cross-sectional and correlational study with a group of 50 PPwH and their parents. The Pediatric Life Quality Questionnaire [PedsQLTM 4.0] was completed by PPwH and their parents and the Children's Depression Inventory (CDI) was answered only by PPwH. RESULTS: The average age of PPwH was 10.66 years (SD = 2.61) and that of parents was 36.28 years (SD = 6.4). 82% suffered from hemophilia A and 70% suffered from severe hemophilia. 78% of participants felt at risk or at high risk with regards to their quality of life, and, concerning their depression levels, we found moderate symptoms in 54% and severe symptoms in 10%. CONCLUSIONS: The HRQoL and depression levels we found are alarming. They show the importance of evaluating objective and subjective indicators; in addition, we emphasize the need of assisting the severe cases detected and suggest the activities to face these health issues.
Introducción: la hemofilia es una enfermedad hemorrágica caracterizada por la deficiencia del factor VIII o IX de la coagulación. Impacta negativamente la calidad de vida de las personas y tiene efectos como la depresión. El objetivo fue describir y analizar los niveles de calidad de vida relacionada con la salud (CVRS) y depresión en una muestra de 50 pacientes pediátricos con hemofilia (PPcH) y sus padres. Los objetivos específicos fueron analizar la correlación entre los niveles de CVRS reportada por PPcH y sus padres, y analizar la correlación entre la CVRS y la depresión en PPcH. Métodos: estudio descriptivo, transeccional y correlacional. Participaron 50 PPcH y sus progenitores, los cuales asistieron a consulta en un hospital del tercer nivel. Se aplicó el Cuestionario de Calidad de Vida Pediátrica (PedsQLTM 4.0) a PPcH y padres, y el Cuestionario de Depresión Infantil (CDI) solo a PPcH. Resultados: la media de edad de los pacientes fue de 10.66 años (desviación estándar [DE] = 2.61) y la de los padres 36.28 (DE = 6.4); el 82% padecía hemofilia A y el 70% tenía hemofilia severa. El 78% de los participantes se sintió en riesgo o alto riesgo respecto a su calidad de vida y en cuanto a los niveles de depresión se encontró sintomatología moderada en el 54% y sintomatología severa en el 10%. Conclusiones: los niveles de CVRS y depresión encontrados son preocupantes. Se evidencia la importancia de evaluar indicadores objetivos y subjetivos, y además se deben canalizar los casos graves detectados y se sugieren actividades para atender estos problemas.
Subject(s)
Depression/etiology , Hemophilia A/psychology , Hemophilia B/psychology , Quality of Life/psychology , Adolescent , Adult , Child , Cross-Sectional Studies , Depression/diagnosis , Female , Health Status Indicators , Humans , Male , Parents , PerceptionABSTRACT
BACKGROUND: Leukemias are the leading cause of childhood cancer. In most developed countries 1-2% of patients die during remission induction; however, in developing countries, this figure is higher and the causes of death apparently vary among the populations studied. The aim was to determine the cause of death during remission induction in pediatric patients with acute lymphoblastic leukemia (ALL) in the hospital "Dr. Gaudencio González Garza" of Centro Médico Nacional La Raza from January 1, 2009, to December 31, 2014. METHODS: A retrospective cohort study was carried out and a descriptive statistical analysis was performed. RESULTS: During the study period, a total of 463 patients with ALL were diagnosed, out of which 5.4% died (n = 25). Among the patients who died, 64% (n = 16) were female and 60% had high-risk clinical features at diagnosis. The main causes of death were septic shock and bleeding. CONCLUSIONS: Early mortality was five times higher than the one reported for developed countries, while the causes of death did not differ. Close monitoring is necessary to detect and promptly treat complications secondary to chemotherapy toxicity in Mexican pediatric patients with ALL.
Introducción: las leucemias son la principal causa de cáncer en la infancia. En la mayoría de países desarrollados fallecen entre 1 y 2% de los pacientes durante la inducción a la remisión; sin embargo, en países en vías de desarrollo, esta cifra al parecer es superior y las causas de muerte varían entre las poblaciones estudiadas. El objetivo fue determinar la causa de mortalidad durante la fase de inducción a la remisión en los pacientes pediátricos con diagnóstico de leucemia linfoblástica aguda (LLA) en el Hospital General "Dr. Gaudencio González Garza" del Centro Médico Nacional La Raza del 1 de enero de 2009 al 31 de diciembre de 2014. Métodos: se realizó un estudio de cohorte retrospectivo y se utilizó estadística descriptiva. Resultados: se diagnosticaron un total de 463 pacientes con LLA durante el periodo de estudio, de los cuales falleció el 5.4% (n = 25). Entre los pacientes que fallecieron, el 64% (n = 16) eran del sexo femenino y el 60% tenía características clínicas de alto riesgo al momento del diagnóstico. Entre las principales causas de muerte estuvieron el choque séptico y las hemorragias. Conclusiones: la frecuencia de mortalidad temprana en los pacientes con LLA fue cinco veces más elevada que la reportada para países desarrollados, mientras que las causas de muerte no difieren. Se requiere de una vigilancia estrecha para detectar y tratar oportunamente las complicaciones secundarias a toxicidad por quimioterapia en pacientes pediátricos mexicanos con LLA.
Subject(s)
Antineoplastic Agents/therapeutic use , Induction Chemotherapy/mortality , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality , Adolescent , Cause of Death , Child , Child, Preschool , Developing Countries , Female , Humans , Infant , Male , Mexico/epidemiology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Prognosis , Retrospective StudiesABSTRACT
The objective of this population-based survey was to assess the peak age of incidence of B-cell precursor acute lymphoblastic leukemia (ALL) in children in Mexico City (MC). All patients were classified according to their immunophenotype, and only B-cell precursor and T-lineage were analyzed. Rates of incidence were calculated x10 children. Of the 364 children from MC who were included in this study, immunophenotyping had been performed for 81.6%. The frequency of B-cell precursor ALL was 76.1%, whereas T lineage ALL showed a frequency of 23.6%. Peak age for ALL was 2 to 3 years of age. B-cell precursor ALL was the major contributor to peak age; T lineage ALL showed a peak among 1 and 3 years of age. We conclude that the age peak for children with ALL in MC is within the ranges reported for developed countries and that B-cell precursor ALL is the main contributor to these peak.
