ABSTRACT
OBJECTIVE: Limited Health Literacy implies an insufficient understanding of relevant health information, being associated with various variables. The objective of the study was to measure the prevalence of the level of Limited Sexual and Reproductive Health Literacy (AS-SR), its associated variables and the differences in scores between levels of AS-SR, universities and science of study in Chilean university students. METHODS: A multicenter and cross-sectional study, which applied a validated scale to measure levels of AS-SR, was carried out in a sample of 2,186 Chilean university students, categorizing it as high, medium high, medium low and low. The level of Limited AS-SR was obtained by adding the medium-low and low categories. Tests were carried out: descriptive, psychometric and reliability; association, logistic regression and differences between variables of interest. RESULTS: The prevalence of Limited AS-SR was 52.7%. The variables most associated with the level of Limited AS-SR were: low interest in information about health care (OR=2.819; 95% CI: 2.132-3.726), prevention (OR=2.564; 95% CI: 1.941-3.388), sexuality (OR=2.497; 95% CI: 1.807-3.452) and health promotion (OR=1.515; 95% CI: 1.239-1.853); certain sources of Information (OR=1.915; 95% CI:1.614-2.272); low economic income (OR=1.661; 95% CI: 1.361-2.026), among others. There were statistically significant differences in scores between categories of AS-SR levels, universities and study science. The scale had a reliability of 0.940. CONCLUSIONS: More than half of the students have Limited AS-SR, mainly associated with low interest in health information. The scale presents excellent psychometric indicators, being recommended for diagnoses of health situations.
OBJECTIVE: La Alfabetización en Salud Limitada implica una comprensión insuficiente de la información relevante en salud, asociándose con diversas variables. El objetivo del estudio fue medir la prevalencia del nivel de Alfabetización en Salud Sexual y Reproductiva (AS-SR) Limitada, sus variables asociadas y las diferencias de puntajes entre niveles de AS-SR, universidades y ciencia de estudio en universitarios chilenos. METHODS: Se realizó un estudio multicéntrico y transversal, que aplicó una escala validada para medir niveles de AS-SR, en una muestra de 2.186 estudiantes universitarios chilenos, categorizándola en alta, media-alta, media-baja y baja. El nivel de AS-SR Limitada se obtuvo mediante el sumatorio de categorías media-baja y baja. Se realizaron pruebas: descriptivas, psicométricas y fiabilidad; asociación, regresión logística y de diferencias entre variables de interés. RESULTS: La prevalencia de AS-SR Limitada fue del 52,7%. Las variables mayormente asociadas al nivel de AS-SR Limitada fueron: bajo interés en información sobre atención en salud (OR=2,819; IC 95%:2,132-3,726), prevención (OR=2,564; IC 95%: 1,941-3,388), sexualidad (OR=2,497; IC 95%: 1,807-3,452) y promoción de la salud (OR=1,515; IC 95%: 1,239-1,853); ciertas fuentes de Información (OR=1,915; IC 95%:1,614-2,272); bajo ingreso económico (OR=1,661; IC 95%: 1,361-2,026), entre otras. Existieron diferencias estadísticamente significativas de puntajes entre categorías de niveles de AS-SR, universidades y ciencia de estudio. La escala presentó fiabilidad de 0,940. CONCLUSIONS: Más de la mitad de los estudiantes poseen AS-SR Limitada, asociada principalmente al bajo interés en información en salud. La escala presenta excelentes indicadores psicométricos, siendo recomendable para diagnósticos de situación de salud.
Subject(s)
Health Literacy , Reproductive Health , Sexual Health , Humans , Cross-Sectional Studies , Female , Male , Chile/epidemiology , Reproductive Health/statistics & numerical data , Health Literacy/statistics & numerical data , Young Adult , Adult , Adolescent , Students/statistics & numerical data , Students/psychology , UniversitiesABSTRACT
BACKGROUND: A large volume of evidence and reviews about COVID-19 recommendations have been published; however, only a few provide recommendations on maternal health services ready for their adoption in Indonesia. This review aims to identify a set of potential recommendations for improving maternal care in the Indonesian primary care setting under the COVID-19 pandemic. METHODS: A literature search to identify articles that cover a set of recommendations, or maternal guideline under the SARS-COV-1 outbreak or COVID-19 pandemic that were published from 2020 to 1 November 2022 was applied in six academic databases. The search used various keywords and phrases of 'maternal', 'model' and 'coronavirus', and excluded reviews and those evaluating interventions or medicine prescription. The eligible guidelines were appraised using AGREE II instrument, coded, and thematically analysed for their potential adoption to Indonesian settings. FINDINGS: Fourteen guidelines were fully reviewed, and most of them had high AGREE II scores. Two main themes emerged from the analysis: clinical and supporting arrangements for maternal health services. Potential challenges for the implementation of these recommendations in Indonesia were also discussed. CONCLUSION AND IMPLICATION FOR PRACTICE: Potential recommendations for improving maternal health for women in Indonesia under the COVID-19 pandemic both on the clinical and supporting services arrangements have been identified. Available clinical resources, different context of providers' practice authority and patients' literacy may challenge their implementation in practice. Further research is needed to seek consensus on the recommendation adoption in practice and to desirably redesign maternal health service in Indonesia.
Subject(s)
COVID-19 , Maternal Health Services , Pregnancy , Humans , Female , Indonesia , Pandemics , Primary Health CareABSTRACT
INTRODUCCIÓN: La incidencia de enterocolitis necrotizante (ECN), en Chile es de 0,3 a 2,4 por mil recién nacidos vi vos, siendo principalmente afectados los neonatos prematuros, y de 8 a 12 por ciento en prematuros menores a 1.500 gramos. OBJETIVO: Describir la percepción de profesionales de salud sobre el uso de calostro en recién nacidos prematuros, como factor protector de enterocolitis necrotizante. SUJETOS Y MÉTODO: Estudio cualitativo, mediante entrevista semiestructurada a 18 profesionales de la salud en tres hospitales públicos de la región de Valparaíso. La pauta de entrevista incluyó 3 temas: Conocimientos, percepción del suministro temprano de calostro y opinión acerca de la extensión de la medida, y 6 subtemas, 2 para cada tema respectivamente: Autopercepción del nivel de conocimiento y fuentes de información; Experiencia: aspectos positivos/eventos adversos y opinión del calostro como factor protector de enterocolitis; aspectos facilitadores u obstaculizadores y opinión acerca de la medida como política nacional. Procesamiento de datos mediante análisis de contenido cualitativo, temático. RESULTADOS: El uso de calostro en prematuros se da de modo protocolizado en dos de las tres unidades de alta complejidad neonatal de la región de Valparaíso. Los participantes opinan positivamente acerca de los resultados preventivos de esta medida. Aun cuando en un tercer estable cimiento no se aplique, hay una percepción favorable acerca de su potencial beneficio y su bajo costo de implementación. Se señala, no obstante, que ésta requiere de mayor evidencia y de un protocolo de aplicación. Otras limitantes serían la insuficiente dotación y formación del personal, y la necesidad de adquirir equipamiento e insumos. CONCLUSIONES: Profesionales que han aplicado un protocolo de administración de calostro en neonatos prematuros en la Región de Valparaíso, reportan buenos resultados de salud, y promueven la motivación del equipo hacia esta praxis. Sin embargo, se considera relevante la difusión y discusión de protocolos nacionales e internacionales, así como el desarrollo de investigación local. Dadas las experiencias en curso en Chile, y el debate internacional, se considera oportuno que el tema sea abordado y discutido en la comunidad sanitaria nacional.
INTRODUCTION: In Chile, necrotizing enterocolitis (NEC) mainly affects preterm infants, with an incidence of 0.3 to 2.4 per 1,000 live births, and 8 to 12% in preterm infants weighing less than 1,500 grams. OBJECTIVE: To describe health professionals perceptions on the use of human colostrum as a preventive measu re against necrotizing enterocolitis in preterm newborns. SUBJECTS AND METHOD: Qualitative study, using 18 semi-structured individual interviews of health professionals in three public hospitals of the Valparaíso Region. The interview included 3 topics: Knowledge, Perception of early colostrum supply and Opinion about the extent of the measure, and 6 subtopics, 2 for each topic respectively: Self-perception of knowledge level and Sources of information; Experience: positive aspects/adverse events and Opinion of colostrum as a protective factor for enterocolitis; Facilitating or hindering aspects and Opinion about the measure as national policy. Data were processed through qualitative content analysis. RESULTS: Two of the three high-complexity neonatal units of the Valparaíso Re gion have a protocol for administrating colostrum in premature infants. Participants have a positive opinion about the preventive results of this measure. Even in the third hospital where there is no protocol, they have a favorable perception of its potential benefit and its low cost of implementa tion. However, we observed that this procedure requires more evidence and an application protocol. Other limitations would be the lack of staffing and training and the need for equipment and supplies. CONCLUSIONS: Professionals who have applied a colostrum administration protocol in preterm infants in the Valparaíso Region report good health outcomes and promote team motivation towards this practice. However, it is relevant to the dissemination and discussion of national and international protocols, as well as the development of local research. Given the ongoing experiences in Chile and the international debate, we considered appropriate to address and discuss the topic within the na tional health community.
Subject(s)
Humans , Infant, Newborn , Patient Care Team , Personnel, Hospital , Attitude of Health Personnel , Colostrum , Enterocolitis, Necrotizing/prevention & control , Infant, Premature, Diseases/prevention & control , Infant, Premature , Chile , Clinical Protocols , Interviews as Topic , Treatment Outcome , Clinical Competence , Qualitative Research , Health Policy , Hospitals, PublicABSTRACT
INTRODUCTION: In Chile, necrotizing enterocolitis (NEC) mainly affects preterm infants, with an incidence of 0.3 to 2.4 per 1,000 live births, and 8 to 12% in preterm infants weighing less than 1,500 grams. OBJECTIVE: To describe health professionals perceptions on the use of human colostrum as a preventive measu re against necrotizing enterocolitis in preterm newborns. SUBJECTS AND METHOD: Qualitative study, using 18 semi-structured individual interviews of health professionals in three public hospitals of the Valparaíso Region. The interview included 3 topics: Knowledge, Perception of early colostrum supply and Opinion about the extent of the measure, and 6 subtopics, 2 for each topic respectively: Self-perception of knowledge level and Sources of information; Experience: positive aspects/adverse events and Opinion of colostrum as a protective factor for enterocolitis; Facilitating or hindering aspects and Opinion about the measure as national policy. Data were processed through qualitative content analysis. RESULTS: Two of the three high-complexity neonatal units of the Valparaíso Re gion have a protocol for administrating colostrum in premature infants. Participants have a positive opinion about the preventive results of this measure. Even in the third hospital where there is no protocol, they have a favorable perception of its potential benefit and its low cost of implementa tion. However, we observed that this procedure requires more evidence and an application protocol. Other limitations would be the lack of staffing and training and the need for equipment and supplies. CONCLUSIONS: Professionals who have applied a colostrum administration protocol in preterm infants in the Valparaíso Region report good health outcomes and promote team motivation towards this practice. However, it is relevant to the dissemination and discussion of national and international protocols, as well as the development of local research. Given the ongoing experiences in Chile and the international debate, we considered appropriate to address and discuss the topic within the na tional health community.
Subject(s)
Attitude of Health Personnel , Colostrum , Enterocolitis, Necrotizing/prevention & control , Infant, Premature, Diseases/prevention & control , Patient Care Team , Personnel, Hospital , Chile , Clinical Competence , Clinical Protocols , Health Policy , Hospitals, Public , Humans , Infant, Newborn , Infant, Premature , Interviews as Topic , Qualitative Research , Treatment OutcomeABSTRACT
INTRODUCCIÓN Y OBJETIVOS: La visita domiciliaria (VD) es una actividad clave del Programa de Apoyo al Desarrollo Biopsicosocial (PADB) del Chile Crece Contigo (ChCC). Para mejorar su implementación, esta investigación tiene como objetivo analizar la relación entre matrones y la familia que accede a la VD, considerando las competencias y habilidades relacionales de los visitadores. MÉTODOS: Se utilizó un diseño observacional con enfoque cualitativo, de alcance exploratorio. Tres matrones que realizan VD en centros de salud familiar rurales de la provincia de Aconcagua aceptaron participar y ocho visitas del programa ChCC fueron grabadas, de 30 minutos promedio. El análisis cualitativo se realizó en base al Home Visit Rating Scale A+. RESULTADOS: Las cuatro categorías que orientaron la evaluación de las visitas fueron responsividad de la familia, relación con la familia, facilitación de la interacción padres - hijo/a y no intrusividad y colaboración. Estas categorías, en su mayoría,puntuaron con un nivel adecuado. No obstante, se requiere entrenamiento en habilidades relacionales para cumplir con una visita catalogada como buena o excelente, sobre todo en las áreas en las que hay que facilitar el vínculo y la interacción entre padre e hijo/a, con el fin de evitar una atención de carácter paternalista. CONCLUSIONES: Esta investigación pionera en el área rural, entregó información relevante para mejorar la VD en este contexto. Aunque los matrones cuentan con formación técnica en el área biomédica, es importante reforzar y/o capacitar en las características esenciales de una VD, para fortalecer la alianza entre el profesional y la familia.
INTRODUCTION AND OBJECTIVES: The home visit (HV) is a key activity in the Support Program for Biopsychosocial Development of Chile Crece Contigo (ChCC). To improve its implementation, this research aims to analyze the relationship between a midwife and the family that accesses the HV based on the competence and relational skills of the visitor. METHODS: An observational design with a qualitative approach of exploratory scope was used. Three midwives performing HV in rural family health centers in the Aconcagua province accepted to participate, and eight visits of the ChCC program were recorded, with an average of 30 minutes. The Home Visit Rating Scale A + was applied to these visits, for further qualitative analysis. RESULTS: The four categories that guided the evaluation of the visits were family responsiveness, relationship with the family, facilitation of parent-child interaction and non-intrusion and collaboration. These scored mostly with an adequate level but requires training in relational skills is required to meet a visit rated as good or excellent, especially in areas where it is necessary to facilitate the link and interaction between father and son, evidencing a paternalistic character of the attention model. CONCLUSIONS: This pioneering research in the rural area, provided relevant information to improve the HV in this context. Although midwives have technical training in the biomedical area, it is important to reinforce and / or train in the essential characteristics of a HV, to strengthen the alliance between the professional and the family.
Subject(s)
Humans , Male , Female , Primary Health Care , Family , Caregivers , Health Personnel/psychology , Quality of Health Care , Rural Areas , Chile , Surveys and Questionnaires , Qualitative Research , Interpersonal Relations , MidwiferyABSTRACT
Introduction: Partner Notification (NP) has long been considered an essential strategy for the control of sexually transmitted infections (STIs). Although the delivery of clinical services for STIs has improved in Chile, syphilis in the general population is one of the most commonly reported STIs. Objective: To understand PN current practices and challenges, we explored health care providers' (HCPs) perspectives about PN for syphilis in public health services in Chile. Methods: Semi-structured interviews were conducted with HCPs in 14 primary health care centres and 6 sexual health units located at two regional Health Services as well as with key informants from different backgrounds. Interviews were transcribed verbatim and coded using QSR International's NVivo 11 PRO Software, for cross-case thematic analysis, which followed an inductive approach. Selected quotes were translated from Spanish to English. Consensus on codes and themes was reached by the multi-disciplinary research team. Results: A total of 58 interviews were conducted. Forty-eight HCPs were interviewed across both Health Services; most with midwives with more than 10 years of work experience; and ten were key informants. Participants acknowledged PN as a syphilis control strategy with patient referral being the most common approach. Participants commented that index cases do not provide information about their partners easily and the delivery of PN is further impacted by gender and the socio-cultural context of Chile. PN was perceived by HCPs as an exhausting and difficult process. Conclusion: This is the first study to identify the perceptions of Chilean HCPs about PN for syphilis. PN is a valuable strategy for syphilis control in Chile; however, our findings suggest that HCPs consider this strategy a challenge both for them and for the Chilean population. Improving current practices and increasing awareness about PN would strengthen the work that has been done by HCPs for syphilis control and enhance the long-term impact of existing policies.
la Notificación de Pareja (NP) se ha considerado durante mucho tiempo una estrategia esencial para el control de las infecciones de transmisión sexual (ITS). Aunque la prestación de servicios clínicos para las ITS ha mejorado en Chile, la sífilis en la población general es una de las ITS más comúnmente reportadas. Objetivo: Para comprender las prácticas y los desafíos actuales de la NP, exploramos las perspectivas de los proveedores de salud (PS) sobre la NP para la sífilis en los servicios de salud pública en Chile. Métodos: Se realizaron entrevistas semiestructuradas con PS en 14 centros de atención primaria de salud y 6 unidades de salud sexual ubicadas en dos servicios de salud regionales, así como con informantes clave (IC) de diferentes orígenes. Las entrevistas se transcribieron textualmente y se codificaron utilizando el software NVivo 11 PRO de QSR International, para el análisis temático de casos cruzados, que siguió un enfoque inductivo. Las citas seleccionadas fueron traducidas del español al inglés. El equipo de investigación multidisciplinario llegó a un consenso sobre códigos y temas. Resultados: Se realizaron un total de 58 entrevistas. Se entrevistaron 48 PS en ambos Servicios de Salud; la mayoría con matrones con más de 10 años de experiencia laboral; y diez eran IC. Los participantes reconocieron la NP como una estrategia de control de la sífilis, siendo la derivación de pacientes el enfoque más común. Los participantes comentaron que los casos índice no proporcionan información sobre sus parejas fácilmente y que la entrega de NP se ve afectada aún más por el género y el contexto sociocultural de Chile. La NP fue percibida por los PS como un proceso agotador y difícil. Conclusión: Este es el primer estudio que identifica las percepciones de los PS chilenos sobre la NP para la sífilis. La NP es una estrategia valiosa para el control de la sífilis en Chile; sin embargo, nuestros hallazgos sugieren que los PS consideran esta estrategia como un desafío tanto para ellos como para la población chilena. Mejorar las prácticas actuales y aumentar la conciencia sobre la NP fortalecería el trabajo realizado por los profesionales de la salud para el control de la sífilis y mejoraría el impacto a largo plazo de las políticas existentes
Subject(s)
Humans , Syphilis , Sexually Transmitted Diseases , Sexual Health , Chile , Disease Transmission, Infectious , InfectionsABSTRACT
Background Partner notification (PN) in Australia has been studied and improved in recent decades. International researchers have highlighted the use of electronic communication technologies to assist PN (Internet partner notification or IPN). Using the Australian experience as an example, the aim of this study is to explore clinicians' perspectives on the use of specialised websites, such as Let them know, to facilitate PN in the Chilean context. METHODS: Semi-structured interviews were conducted with healthcare providers (HCPs) in 14 primary health care centres and six sexual health units located at two regional Health Services, as well as with key informants from different backgrounds. Interviews were transcribed verbatim and QSR International's NVivo 11 PRO Software was used for cross-case thematic analysis, which followed an inductive approach. Selected quotes were translated from Spanish to English. Codes and themes were reviewed by the research team. RESULTS: Most participants were unaware of IPN and demonstrated interest. Many agreed this could be a feasible strategy considering the high use of mobile technologies and the Internet in Chile. Participants' primary concerns around this approach were confidentiality, privacy and efficacy, given the local cultural context. The use of a counsellor to offer professional support and guidance was identified as essential to strengthen PN in Chile. CONCLUSION: The use of IPN could be an alternative PN strategy for Chile. However, the involvement of local staff and further research to explore patients' perceptions and preferences will be essential in tailoring interventions.
