Subject(s)
Gender Dysphoria , International Classification of Diseases , Child , Human Rights , HumansABSTRACT
OBJETIVO: Conocer la opinión de profesionales sanitarios sobre los servicios en cuidados paliativos (CP), así como identificar barreras y facilitadores en la implementación del Plan Andaluz de CP. MÉTODO: Diseño observacional transversal. Muestreo aleatorizado estratificado por perfiles de profesionales sanitarios de Andalucía (500 personas, error global ± 0,044, tasa de respuesta del 78%). Entrevista telefónica. Análisis univariante y bivariante. RESULTADO: El 72,8% valoraron como buena o muy buena la situación de CP y el 91,9% consideraron que es mejor o mucho mejor que 5 años atrás. Las 3 razones de calificación positiva de CP más frecuentemente identificadas coincidieron con las 3 primeras fortalezas identificadas en su ejercicio de CP: «mejor atención, trato, accesibilidad del paciente», «organización y coordinación» y «creación de unidades de CP». Por el contrario, identificaron como lo más negativo: la falta de «medios»; la de «personal», y la de «formación/información». Estas 2 últimas razones coincidieron también con las 2 principales carencias o dificultades en el ejercicio de CP, situando como tercera carencia la «falta de organización/coordinación de profesionales». Los profesionales de atención primaria presentaron valoraciones más altas, mientras que los de recursos avanzados de CP presentaron las mayores diferencias entre todos los perfiles, sin que se observaran diferencias destacables según sexo o la experiencia en CP. CONCLUSIONES: Evaluar las opiniones de los diferentes profesionales que intervienen en CP proporciona información valiosa para orientar las decisiones sobre la mejora de la atención al paciente y la organización del sistema de salud en general
OBJECTIVE: To evaluate the opinions of healthcare professionals on Palliative Care (PC) services and the implementation of a PC Strategy. METHOD: A cross-sectional study was conducted by interview on a random sample of 500 Andalusian healthcare professionals with stratification by work profiles (Overall error of ± 0.044). Univariate and bivariate analysis were used to analyse the RESULTS: RESULT: A total of 72.8% of the health professionals assessed PC in the region as good or very good, and 91.9% considered it to be better or much better than 5 years before. The most frequent reasons identified for a positive assessment of PC were: increased patient access to better quality personalised services; better organization and coordination of the system; and the creation of PC units in the region. On the other hand, professionals identified the following as three important negative aspects of regional PC: lack of resources; insufficient staff; and lack of adequate training and information support. Primary care practitioners had the highest levels of satisfaction with PC, while specialists had the greatest differences in opinion when compared with other professionals. There were no differences by gender or level of expertise in PC. CONCLUSIONS: Assessing the opinions of different professionals involved in PC provides valuable insights to guide decisions on the improvement of patient care and the organization of the healthcare system in general
Subject(s)
Humans , Palliative Care/trends , Primary Health Care/organization & administration , Quality of Health Care/statistics & numerical data , /statistics & numerical data , Hospital Units/organization & administration , Health Personnel/statistics & numerical dataABSTRACT
Objetivo. La publicación del Real Decreto-ley 16/2012 (RDL 16/2012), que introduce cambios estructurales en el Sistema Sanitario Público Español, puede situarse en el contexto más amplio de políticas de ajuste en el momento actual de crisis económica. En el análisis de la interrelación de crisis económica, políticas sanitarias y salud, la participación ciudadana se nombra entre las potenciales estrategias para mitigar un impacto de la situación en la población. Desde esta valoración, se plantea el interés de un conocimiento de la perspectiva de la ciudadanía sobre las modificaciones introducidas por el RDL 16/2012. Métodos. Revisión narrativa de publicaciones de organizaciones de la sociedad civil y asociaciones profesionales relacionadas con el RDL 16/2012 en el contexto español. Resultados. Se observa una amplia respuesta ciudadana a la introducción del RDL 16/2012. Los documentos revisados incluyen un análisis del cambio del modelo sanitario inherente al RDL 16/2012, así como la previsión de su impacto en el acceso sanitario, la calidad asistencial y la salud. Las organizaciones de la sociedad civil y las asociaciones profesionales aportan recomendaciones y propuestas, además de ofrecer su colaboración en la elaboración de estrategias alternativas de ahorro. Conclusiones. La respuesta al RDL 16/2012 por parte de organizaciones de la sociedad civil y asociaciones profesionales indica el interés de fomentar canales de participación ciudadana para el desarrollo de políticas sanitarias basadas en el objetivo de mantener el carácter universal y la sostenibilidad del Sistema Sanitario Público Español en el momento actual de crisis económica y sistémica (AU)
Objective. The recent publication of the Royal Decree-Law 16/2012 (RDL 16/2012), which introduces structural changes in the Spanish Public Healthcare System, can be placed in the broader context of budgetary adjustments in response to the current economic crisis. An analysis of the interrelationships among economic crisis, healthcare policies, and health reveals that citizen participation is one of several potential strategies for reducing the impact of this situation on the population. This observation raises the interest to know the citizens perspectives on the modifications introduced by the RDL 16/2012. Methods. Narrative review of documents related to the RDL 16/2012 published by civil society organizations and professional associations in the Spanish context. Results. A broad citizen response can be observed to the introduction of RDL 16/2012. The documents reviewed include an analysis of changes in the healthcare model inherent to the RDL 16/2012, as well as predictions on its impact on access to healthcare, healthcare quality, and health. The civil society organizations and professional associations offer recommendations and proposals, as well as collaboration in elaborating alternative strategies to reduce costs. Conclusions. The response of civil society organizations and professional associations underscores the importance of strengthening citizen participation in the development of healthcare policies aimed at maintaining the universal character and sustainability of the Spanish Public Healthcare System in the current moment of economic and systemic crisis (AU)
Subject(s)
Humans , Male , Female , Equity in Access to Health Services , Gatekeeping/standards , Gatekeeping/trends , Health Services Accessibility/standards , Health Services Accessibility/trends , Health Surveillance/legislation & jurisprudence , Community Participation , Economic Recession/legislation & jurisprudence , Risk Groups , Vulnerable Populations/legislation & jurisprudence , Human Rights/legislation & jurisprudence , /legislation & jurisprudence , Quality of Health Care/legislation & jurisprudenceABSTRACT
OBJECTIVE: The recent publication of the Royal Decree-Law 16/2012 (RDL 16/2012), which introduces structural changes in the Spanish Public Healthcare System, can be placed in the broader context of budgetary adjustments in response to the current economic crisis. An analysis of the interrelationships among economic crisis, healthcare policies, and health reveals that citizen participation is one of several potential strategies for reducing the impact of this situation on the population. This observation raises the interest to know the citizens' perspectives on the modifications introduced by the RDL 16/2012. METHODS: Narrative review of documents related to the RDL 16/2012 published by civil society organizations and professional associations in the Spanish context. RESULTS: A broad citizen response can be observed to the introduction of RDL 16/2012. The documents reviewed include an analysis of changes in the healthcare model inherent to the RDL 16/2012, as well as predictions on its impact on access to healthcare, healthcare quality, and health. The civil society organizations and professional associations offer recommendations and proposals, as well as collaboration in elaborating alternative strategies to reduce costs. CONCLUSIONS: The response of civil society organizations and professional associations underscores the importance of strengthening citizen participation in the development of healthcare policies aimed at maintaining the universal character and sustainability of the Spanish Public Healthcare System in the current moment of economic and systemic crisis.
Subject(s)
Community Participation , Health Services Accessibility/legislation & jurisprudence , Human Rights/legislation & jurisprudence , National Health Programs/legislation & jurisprudence , Cost Savings , Cost-Benefit Analysis , Economic Recession , Ethics, Professional , Health Care Costs , Health Services Accessibility/economics , Health Services Needs and Demand , Humans , National Health Programs/economics , Public Opinion , Societies , Spain , Vulnerable PopulationsABSTRACT
BACKGROUND: The recent introduction of adjustment measures in the Spanish context by means of the Royal Decree-law 16/2012 (RDL 16/2012), which limits access to health care for undocumented migrants, raises the question about the state of the matter in different European Union member states. METHODS: Narrative review of comparative studies published between 2009 and 2012 that analyzes the right to health care for undocumented migrants in the European context. RESULTS: The review shows a high degree of variability regarding health care entitlements of undocumented migrants in different European countries, a frequent legal restriction of access to health care, as well as barriers in the effective access to health care. The studies coincide in recommending access at all health care levels, regardless of the administrative status of the person seeking treatment. The analysis of the impact of the current economic crisis on access and quality of the health care directed to undocumented migrants, as well as the knowledge of the migrants' perspective are identified as future research areas. CONCLUSIONS: Compared with other European countries, the introduction of the measures established in the RDL 16/2012 modifies the place of the Spanish Public Health Care System from being situated in the group of countries that permit undocumented migrants access to all health care levels, towards the category of highest restriction.
Subject(s)
Health Services Accessibility/legislation & jurisprudence , Human Rights/legislation & jurisprudence , Transients and Migrants/legislation & jurisprudence , Ethnicity , Europe , Humans , SpainABSTRACT
Objetivo: Conocer las opiniones del personal sanitario sobre el consumo de alcohol en menores. Conocer la valoración que hacen los profesionales de la salud acerca de las medidas reguladoras del consumo de alcohol. Metodología: Diseño: Estudio cualitativo. Diseño exploratorio basado en entrevistas semiestructuradas. Emplazamiento: Cuatro ciudades de 4 CC. AA. diferentes: Palma de Mallorca, Granada, Barcelona y Pamplona. Participantes: Treinta y seis médicos/as y enfermeros/as de atención primaria y de urgencias, de 4 CC. AA., seleccionados por muestreo intencional. Mediciones: Treinta y seis entrevistas semiestructuradas analizadas a través del programa Nudist Vivo 4.0.Resultados: Los profesionales de la salud aceptan su papel fundamental en la prevención e intervención sobre el consumo de alcohol en adolescentes. En general, consideran el problema en términos de salud pública. La prevención se asocia a la atención primaria, mientras que el servicio de urgencias actúa en situaciones concretas de consumo abusivo. El acceso de los adolescentes a las consultas es escaso, por lo que la prevención se centra en los centros educativos y necesita la colaboración constante de padres y docente. Los sanitarios tienen un conocimiento insuficiente de la normativa vigente antialcohol y consideran que las medidas educativas son más eficientes que las sancionadoras. Conclusiones: La importancia de asumir responsabilidades y de coordinar la actuación desde los ámbitos sanitario, educativo y familiar requiere la formación específica de los profesionales sanitarios y la adecuación de la normativa vigente(AU)
Objective: To find out the opinions of health professionals on adolescent alcohol drinking and their evaluation of the existing legal regulation measures. Methodology: Design: Qualitative and exploratory study, based on semi-structured interviews. Setting: Four cities representing four different regions in Spain: Palma de Mallorca, Granada, Barcelona and Pamplona. Participants: A total of 36 physicians and nurses from four Spanish regions, working in Primary Care and Emergency Care, selected by intentiones samples. Measurements: A total of 36 deep interviews, analysed using the software Nudist Vivo 4.0.Results: Health professionals accept their important role in preventing and intervening in adolescent alcohol drinking. Generally, they consider it as a public health problem. Prevention is associated with Primary Care, while the Emergency Departments act in specific situations of alcohol abuse. Adolescents infrequently visit Primary Care, thus prevention must centre on education system and constant coordination between health professional and parents. Health personnel do not have sufficient knowledge on legal regulations. They consider educational measures as more efficient than sanctions. Conclusions: Specific professional training is required in order to guarantee the coordination between the health and education systems and the family(AU)
Subject(s)
Humans , Male , Female , Adolescent , Alcohol Drinking , Alcohol Drinking/adverse effects , Alcohol Drinking/prevention & control , Alcohol Drinking/therapy , Alcoholism , Adolescent Behavior , Professional Practice , 25783 , Qualitative Research , Exploratory Behavior , Interviews as Topic , SpainABSTRACT
OBJECTIVE: To find out the opinions of health professionals on adolescent alcohol drinking and their evaluation of the existing legal regulation measures. DESIGN: Qualitative and exploratory study, based on semi-structured interviews. SETTING: Four cities representing four different regions in Spain: Palma de Mallorca, Granada, Barcelona and Pamplona. PARTICIPANTS: A total of 36 physicians and nurses from four Spanish regions, working in Primary Care and Emergency Care, selected by intentiones samples. MEASUREMENTS: A total of 36 deep interviews, analysed using the software Nudist Vivo 4.0. RESULTS: Health professionals accept their important role in preventing and intervening in adolescent alcohol drinking. Generally, they consider it as a public health problem. Prevention is associated with Primary Care, while the Emergency Departments act in specific situations of alohol abuse. Adolescents infrequently visit Primary Care, thus prevention must centre on education system and constant coordination between health professional and parents. Health personnel do not have sufficient knowledge on legal regulations. They consider educational measures as more efficient than sanctions. CONCLUSIONS: Specific professional training is required in order to guarantee the coordination between the health and education systems and the family.
