Compliance of patient companions and visitors with hand hygiene: an observational study.

BACKGROUND: Hand hygiene is a simple and low-cost practice to prevent the spread of many micro-organisms that cause healthcare-associated infections. AIM: This is a descriptive study designed to investigate the compliance of patient companions and visitors with hand hygiene. METHODS: The study included 209 companions and visitors of patients hospitalized in a university hospital in the west of Turkey. A demographics and hand hygiene questionnaire and a hand hygiene practice observation form were used to acquire data. FINDINGS: Of the patient companions and visitors, 96.2% stated that they did not receive training on the importance of handwashing during their stay in the hospital, and 74.6% stated that handwashing was very important in the prevention of diseases. The patient families reported that they most often washed their hands after touching bodily fluids (91.7%), and that they rarely washed their hands before touching a patient (34.0%). The rates were decreased in the observations; the lowest rate for handwashing was before touching a patient (22.4%) and the highest rate for handwashing was after the risk for contamination with body fluids of the patient (68.6%). CONCLUSION: The patient companions and visitors received no training on the importance of hand hygiene during the hospital stay, and the observed rate of compliance with hand hygiene was lower than stated. Recommendations include delivering planned handwashing training to patient companions and visitors using different teaching methods, and to conduct longer observational studies.

Infográfico para gestantes e acompanhantes: tecnologia educacional no contexto do atendimento obstétrico / Infographic for pregnant women and caregivers: educational technology in the context of obstetric care / Infografía para embarazadas y acompañantes tecnología educativa en el contexto de la atención obstétrica

RESUMO: Objetivo: descrever o processo de construção e validação de infográfico educativo com orientações para gestantes e acompanhantes em atendimento obstétrico no contexto da Covid-19. Método: pesquisa metodológica baseada nas diretrizes da Instrucional System Design. Realizada de janeiro de 2021 a março de 2022, no Estado de Santa Catarina - Brasil, em três momentos: revisão de escopo; entrevistas com enfermeiros de uma Emergência Obstétrica; e elaboração da tecnologia educativa e validação com experts. A análise foi ancorada na análise de conteúdo com Índice de Validade de Conteúdo. Resultados: o infográfico aborda cuidados para prevenção da infecção Covid-19, orientações sobre início do trabalho de parto, quando procurar a maternidade e os cuidados na internação das gestantes. O infográfico obteve Índice de Validade de Conteúdo de 83,3%. Conclusão: a tecnologia educacional foi considerada adequada para disseminação de informações e auxílio dos profissionais na promoção de saúde e na prevenção de agravos à população obstétrica.

ABSTRACT Objective: to describe the process of construction and validation of an educational infographic with guidelines for pregnant women and companions in obstetric care in the context of Covid-19. Method: methodological research based on Instructional System Design guidelines and conducted from January 2021 to March 2022, in the State of Santa Catarina - Brazil, in three moments: scoping review, interviews with nurses from an Obstetric Emergency, and elaboration of educational technology and validation with experts. The analysis was anchored in content analysis with Content Validity Index. Results: the infographic addresses care for the prevention of Covid-19 infection, guidance on the onset of labor, when to seek maternity care, and care during hospitalization of pregnant women. The infographic obtained a Content Validity Index of 83.3%. Conclusion: educational technology was considered adequate for disseminating information and assisting professionals in promoting health and preventing injuries to the obstetric population.

RESUMEN Objetivo: describir el proceso de construcción y validación de una infografía educativa con directrices para embarazadas y acompañantes en la atención obstétrica en el contexto de Covid-19. Método: investigación metodológica basada en las directrices del Instrucional System Design. Realizado de enero de 2021 a marzo de 2022, en el Estado de Santa Catarina - Brasil, en tres momentos: revisión de alcance; entrevistas con enfermeros de una Emergencia Obstétrica; y elaboración de tecnología educativa y validación con expertos. El análisis se ancló en el análisis de contenido con el Índice de Validez del Contenido. Resultados: La infografía abarca los cuidados para la prevención de la infección por Covid-19, las orientaciones sobre el inicio del parto, cuándo acudir a la maternidad y los cuidados durante la hospitalización de las embarazadas. La infografía obtuvo un índice de validez del contenido del 83,3%. Conclusión: La tecnología educativa se consideró apropiada para difundir información y ayudar a los profesionales a promover la salud y prevenir lesiones en la población obstétrica.

Knowledge and Attitudes about Organ Donation among Patient Companion at a Tertiary Hopsital in Ethiopia.

BACKGROUND: Worldwide, the supply of organs continues to be much less than the demand. Many studies identify poor knowledge and negative attitude about organ donation for this. The purpose of this study was to assess knowledge and attitude towards organ donation and associated factors among people who accompany patient during hospital visit at tertiary hospital in Ethiopia. METHODS: A hospital-based cross-sectional study was conducted from March 1st to May 31, 2019, at a tertiary hospital and the only transplant center in Ethiopia. The patient companions were interviewed with structured questionnaires. Descriptive statistics were presented and factors associated with good knowledge and favorable attitude were assessed using Binary logistic regression. RESULTS: A total of 414 patient companion participated in the study. The mean age of the respondents was 35±13years, and 252(60.9%) were males. Forty-four (10.6%) of the study participants had good knowledge about organ donation. Male gender was significantly associated with improved knowledge (AOR=2.127 95% CI: 1.036, 4.368). A favorable attitude towards donation was found in 219(52.9%) of the study participants. Participants who had completed secondary education were more likely to have unfavorable attitude towards organ donation (AOR =0.498, 95% CI: 0.290, 0.857). CONCLUSION: Knowledge about organ donation was found to be poor, and attitudes towards organ donation were found to be unfavorable among patient companions at a major medical center in Ethiopia. Strategies focused on education of the general public and broad dissemination of information on the benefits of organ donation will be critical for improving the organ donor pool.

Evaluating the principles of radiation protection in diagnostic radiologic examinations: collimation, exposure factors and use of protective equipment for the patients and their companions.

INTRODUCTION: Producing appropriate diagnostic images along with patient radiation protection is the goal of radiography. Due to the advancements of radiography, concerns about observing the principles of radiation protection exist. Therefore, this study aimed to evaluate the observance of the principles of radiation protection in radiographic examinations with emphasis on field size collimation, suitability of exposure factors and the use of protective equipment for the patients and their companions. METHODS: Using a cross-sectional study design, two radiography students on their final year of study observed 100 radiographic examinations from the imaging departments of five educational hospitals. The SPSS version 24 software was used to analyse the results. RESULTS: The radiation field collimation was obtained in 46% of the studied radiographs. Patients had companions present during the examination in 26% of the studies; however, protective equipment was only used for 4% of the patients' companions, and no protective equipment was applied for patients. The observance rate of the various principles of radiation protection including field size restriction, the use of protective equipment for the patients and their companions, and suitability of the selected exposure factors was on average 44.6%. CONCLUSION: The observance rate of the principles of radiation protection was insufficient in the studied educational hospitals, specifically in field size collimation and the use of protective equipment for the patients and their companions. Therefore, emphasis on the strict implementation of the radiation protection guidelines and continuous training of radiographers are required.

An exploration of patient and family engagement in routine primary care visits.

BACKGROUND: Older adults are commonly accompanied to routine medical visits. Whether and how family companion behaviours relate to visit processes is poorly understood. OBJECTIVE: To examine family companion behaviours in relation to older adults' medical visit processes. DESIGN AND PARTICIPANTS: Observational study of 78 accompanied primary care patients ages 65 and older. MAIN OUTCOME MEASURES: Medical visit communication (coded using RIAS), patient verbal activity (as a proportion of visit statements) and visit duration (in min), from audio recordings. RESULTS: Companions' facilitation of patient involvement was associated with greater patient question asking (P = 0.017) and orienting statements, less passive agreement (P = 0.004) and social talk (P = 0.013) and visits that were 3.4 min longer (P = 0.025). Facilitation of patient understanding was associated with less physician question asking (P = 0.004), visits that were 3.0 min longer (P = 0.031), and lower patient verbal activity (30.3% vs. 36.9% of visit statements; P = 0.028). Facilitation of doctor understanding was associated with greater patient biomedical information giving (P = 0.049). Autonomy detracting behaviours were not associated with visit duration but were associated with lower levels of patient verbal activity (36.3% vs. 29.1% of visit statements; P = 0.041). When companions assumed more behaviours, medical visits were incrementally longer (16.1, 19.5, 21.7 min, corresponding to 0-1, 2-4 and 5+ behaviours; P < 0.001 both contrasts), and patients were less verbally active (35.6%, 33.9%, 27.1% of visit statements; P = 0.09 and P = 0.009, respectively). DISCUSSION: Behaviours assumed by patients' companions were associated with visit communication, patient verbal activity and visit duration. CONCLUSIONS: Interventions to capitalize on family companions' presence may benefit medical visit processes.

A inserção do acompanhante de parto nos serviços públicos de saúde de Santa Catarina, Brasil / La integracion del acompanate del parto en los servicios de salud publica en Santa Catarina, Brasil / The integration of the birth companion in the public health services in Santa Catarina, Brazil

Pesquisa descritiva, quantitativa, que objetivou descrever a inserção do acompanhante de escolha da parturiente durante o trabalho de parto, parto e pós-parto imediato nos serviços vinculados ao Sistema Único de Saúde que prestam assistência ao parto em Santa Catarina/Brasil, e identificar os aspectos que facilitaram e dificultaram esse processo. A população foi composta pelos 138 serviços do estado. Os dados foram coletados de maio/2010 a junho/2011, por meio de questionário enviado aos diretores e por contato telefônico, e posteriormente analisados por estatística descritiva. Dos 135 serviços contatados, 54,8% referiram que sempre permitem a presença do acompanhante, 32,6% permitem às vezes, 11,9% nunca permitem e 0,7% não responderam. A maioria dos serviços permite a presença do acompanhante. No entanto, em alguns deles essa prática ainda é implementada com restrições, pois a escolha da parturiente não é respeitada e impede-se a permanência do acompanhante no momento do parto.

Estudio descriptivo, cuantitativo, que objetivó describir la integración del acompañante elegido por la parturienta durante el trabajo de parto, parto y posparto, en los servicios vinculados al Sistema Único de Salud, que ofrecen asistencia en Santa Catarina e identificar los aspectos que facilitan o dificultan este proceso. La muestra fue compuesta por 138 servicios públicos. La recolección de datos se hizo de mayo/2010 a junio/2011, a través de un cuestionario enviado a los directores o por teléfono, y se analizaron mediante estadística descriptiva. Se identificó que el 54,8% siempre permite la presencia del acompañante, el 32,6%, a veces la permite, el 11,9% no la permite, y el 0,7% no ha respondido. La mayoría de los servicios permite la presencia del acompañante, sin embargo, en algunos centros, esa práctica es implementada con restricciones: la elección de la madre no es respetada e se impide la presencia del acompañante en el parto.

This is a descriptive, quantitative study which aims to describe the integration of the parturient woman's companion of choice during labor, delivery and immediate postpartum in health services linked to the Unified Health System (SUS) providing childbirth assistance in Santa Catarina, Brazil and to identify the aspects which facilitate or hinder this process. The population consisted of 138 state services. Data was collected from May 2010 to June 2011 through a questionnaire sent to the directors and by telephone contact, subsequently analyzed by descriptive statistics. Of the 135 departments surveyed, 54.8% reported that they always allow the companion to be present, 32.6% allowed them sometimes, 11.9% never allowed the companion and 0.7% did not respond. Most of the services allow the companion to be present. However, in some services this practice is still implemented with restrictions, as the parturient woman's choice is not respected and the presence of the companion is prevented during the birth.

Presença do acompanhante durante o processo departurição: uma reflexão / A reflexion on the emotional support during childbirth / Reflexion sobre la presencia del acompanante durante el parto

Historicamente, o processo de parturição transcorria naturalmente, sendo cuidado pela parteira e cercado pela família. A inserção da medicina culminou na patologização e na institucionalização do parto, a mulher passou a ser admitida no hospital e o acompanhamento foi excluído da prática assistencial. Evidências científicas recentes demonstram que medidas de conforto físico e emocional auxiliam no desencadeamento do parto, diminuindo-lhe a duração e a necessidade de intervenções. Com base nas evidências, a Organização Mundial de Saúde (OMS) e o Ministério da Saúde do Brasil recomendam a presença do acompanhante durante o trabalho de parto, que foi fortalecida em 2005 pela Lei nº 11.108, de 7 de abril de 2005, regulamentada pelo Congresso Nacional brasileiro, que garante o direito de um acompanhante escolhido pela mulher, durante seu processo de parturição, nos hospitais do Sistema Único de Saúde (SUS). Entretanto, poucas instituições incorporaram essa prática na sua rotina. O objetivo com este material é proporcionar reflexões sobre os benefícios da inserção do acompanhante no trabalho de parto e o respeito à individualidade feminina, para garantir maior segurança e satisfação dos pais no nascimento do novo membro da família. É primordial que sejam reconhecidas as evidência científica e a mudança de comportamento dos profissionais e das instituições de saúde para que haja respeito aos direitos das mulheres e à singularidade de cada nascimento.

Traditionally the process of childbirth happened naturally. The labouring women were cared for by midwives and were surrounded by their family. The pathologization and hospitalization of childbirth eliminated from the healthcare practice the personal support and companionship to women in labour. Scientific evidence demonstrates that comfort measures and emotional support help to trigger the labour, to reduce its length and it lessens the need for interventions. Based on these facts, the World Health Organization (WHO) and the Brazilian Ministry of Health recommend the presence of a childbirth helper or doula during delivery. This recommendation was regulated by Decree n. 11.108 dated from the 7th of April 2005 and voted by the Brazilian National Congress. It guarantees the women's right to a helper of their own choosing during childbirth in any Public Health System hospital. And yet only a small number of hospitals incorporate this practice. This study's purpose is to reflect on the advantages of a doula during labour and the respect for the labouring women's individuality so as to ensure as afe delivery and the parents' satisfaction on the birth of a new family member. It is essential to acknowledge the scientific evidence, to change the professionals'approach to childbirth, and the current hospital procedures respecting thus the labouring women's rights and the uniqueness of each birth.

Históricamente, el proceso de parto ocurría espontáneamente, a cargo de la partera y rodeado de la familia. Con la patologización y la institucionalización del proceso de parto, la mujer es ingresada en el hospital y el acompañante excluido de la práctica asistencial. Evidencias científicas recientes demuestran que medidas de confort físico y emocional ayudan a provocar el parto, reduciendo su duración y la probabilidad de intervenciones. En base a las evidencias, la Organización Mundial de Salud y el Ministerio de Salud de Brasil recomiendan la presencia del acompañante durante el trabajo de parto. Esta recomendación se consolida con el decreto no 11.108 del 7 de abril de 2005 votado por el Congreso Nacional Brasileño. Este decreto garantiza a la mujer el derecho a un acompañante elegido por ella durante el parto en los hospitales del Sistema Único de Salud. Sin embargo, son pocos los hospitales que han incluido esta práctica en su rutina. Este estudio busca reflexionar sobre los beneficios de la inclusión del acompañante en el proceso de parto y el respeto a la individualidad femenina, para garantizar mayor seguridad y satisfacción a los padres en el nacimiento del nuevo integrante de la familia. Para que se respeten los derechos de las mujeres y la singularidad de cada nacimiento es fundamental que se reconozca la evidencia científica y que haya un cambio en el comportamiento de los profesionales de salud y, asimismo, en las instituciones.

Caring relationship: the core component of patients' rights practice as experienced by patients and their companions.

The aim of this article is to describe how Iranian patients and their companions explain their lived experiences with caring relationships in a central teaching hospital in Tehran, Iran. Despite a large number of theoretical articles on this topic, the meaning of caring is still ambiguous, particularly in specific cultures. In Iran, there is not enough qualitative evidence on this topic to indicate what patients actually mean when they refer to caring relationship. This article explores how Iranian patients and their companions perceive and describe caring relationships as an element of patients' rights practice. This is part of a phenomenological research on patients' rights practice in Iran conducted during 2003-2006. Semi-structured interviews were conducted with 16 patients/companions, and van Mannen's approach was used for thematic analysis. The ethics committee of Tehran University of Medical Sciences approved the study. Patient-centered care, compassion, effective communication, support/advocacy, informed participation and meeting patients' basic needs were found to be the key elements in defining caring relationships. These themes were all described as elements of patients' rights practice issues. The results indicated that it is necessary for care givers/nurses to understand the person who will receive care in order to provide zealous and authentic care, because feeling "to be cared for" is even more important than providing the "care" itself.

Estudo terapêutico ocupacional sobre o imaginário social de acompanhantes acerca do espaço hospitalar / An occupational therapist research about the social imaginary of patient companion concerning the hospital space

O hospital é uma instituição imaginária, construída sócio-historicamente e pela ação subjetiva do homem, formado por diversos saberes, práticas e atores sociais, onde destaca-se os acompanhantes, sujeitos que vivenciam todo o processo de hospitalização, porém não são valorizados enquanto usuários dos serviços de saúde. O objetivo desta pesquisa foi identificar o imaginário dos acompanhantes da enfermaria pediátrica acerca do espaço hospitalar. Tratase de uma pesquisa qualitativa do tipo pesquisa-ação e estudo de caso múltiplo de cinco acompanhantes hospitalizados no Hospital Universitário João de Barros Barreto. Realizou-se pesquisa de campo (dois encontros), embasada na teoria de Cornelius Castoriadis. Observouse que o imaginário social, caracterizava-se enquanto espaço de tratamento e subjetividade, incutidos no cotidiano institucional e nas relações interpessoais. Percebeu-se a necessidade de propostas de atenção em saúde para os acompanhantes, pautadas na complexidade, de modo a construir um fazer TO integralizado e humanizado, que caminhe na articulação de saberes e pensares.(AU)

The hospital is an imaginary institution, built by the subjective human action in a social and historic way, constituted of various knowledges, practices and social actors. One of these social actors is the patient companion, which lives the whole process of hospitalization, however, they are not valued as users of health services. The objective of this research was to identify the imagination of the patient companions of a pediatric ward about hospital space. It is a qualitative action research and multiple case study with five patient companions hospitalized in the University Hospital "João de Barros Barreto". The research was built by a theoretical study, based in Cornelius Castoriadis, and pratical research (two meetings). It was noted that the social imagination about the hospital space is characterized as an area of treatment and subjective human; inside the institucional day and relantionships, It was possible to understand the necessity for health care proposals for patient companions, based in the humane complexity. So, the Occupational Therapy could integrate and articulate different knowledges and ways of thinking.(AU)