Estudio cualitativo sobre información, confianza y acceso a la vacunación contra COVID-19 en adolescentes en un centro de salud de Buenos Aires / Qualitative study on information, trust in and access to COVID-19 vaccines among adolescents at a healthcare center in Buenos Aires

Introducción. En la adolescencia, se comienzan a tomar decisiones autónomas sobre la salud. En la vacunación intervienen dimensiones contextuales, grupales y relativas a cada vacuna. Se busca conocer el proceso de información, confianza y decisión de vacunarse contra COVID-19 en adolescentes usuarios de un centro de salud en Buenos Aires. Objetivos. Identificar ámbitos y canales a través de los cuales los adolescentes accedieron a información sobre la vacuna contra COVID-19 en un centro de salud de Buenos Aires. Describir sus opiniones respecto a los distintos discursos sobre vacunación. Describir su participación en la vacunación contra COVID-19. Identificar barreras y facilitadores respecto del acceso a la vacunación contra COVID-19 en esta población. Población y métodos. Investigación cualitativa. Se hicieron entrevistas semiestructuradas a adolescentes usuarios del efector. La muestra fue heterogénea; su tamaño se definió por saturación teórica. Se realizó un análisis temático de los datos. Resultados. Se realizaron 14 entrevistas. Los entrevistados recibieron información sobre la vacuna contra COVID-19 de sus familias, la televisión y las redes sociales. Todos recibieron tanto publicidad oficial como discursos reticentes a la vacunación. Analizaron la información recibida y formaron opinión autónoma. Su decisión sobre vacunarse no siempre fue respetada. La desconfianza, la baja percepción del riesgo, el temor a las inyecciones, las barreras administrativas y geográficas fueron motivos de no vacunación. Conclusiones. Se requieren estrategias de comunicación destinadas a adolescentes que promuevan su participación en el acceso a la vacunación.

Introduction. During adolescence, individuals start to make autonomous decisions about their health. Vaccination involves contextual, group, and vaccine-specific dimensions. We sought to know the information, trust, and decision to receive the COVID-19 vaccine among adolescents who attended a healthcare center in Buenos Aires. Objectives. To identify settings and channels through which adolescents accessed information about the COVID-19 vaccine at a healthcare center in Buenos Aires. To describe their opinions about the different statements on vaccination. To describe their participation in COVID-19 vaccination. To identify barriers and facilitators to COVID-19 vaccination in this population. Population and methods. Qualitative study. Semi-structured interviews with adolescents who attended this healthcare facility. The sample was heterogeneous; the sample size was estimated by theoretical saturation. A thematic analysis of data was done. Results. A total of 14 interviews were conducted. Interviewees obtained information about the COVID-19 vaccine from their families, TV, and social media. All received information from both official campaigns and anti-vaccine communications. They analyzed the information they received and formed their own opinion. Their decision about the vaccine was not always respected. Hesitancy, a low perception of risk, fear of needles, administrative and geographic barriers were reasons for not receiving the vaccine. Conclusions. Communication strategies targeted at adolescents are required that encourage their involvement in access to vaccination.

Continence App® Impact on Puerperal Women's Knowledge, Attitude and Practice: Randomized Clinical Trial.

INTRODUCTION AND HYPOTHESIS: Enhancing women's knowledge, attitude, and practice (KAP) concerning urinary incontinence (UI) through diverse educational strategies has been a focal point for professionals in recent years. This study was aimed at assessing the impact of the educational application Continence App® on the KAP of postpartum women experiencing UI. We hypothesized that access to the app would lead to improved KAP among these women. METHODS: Postpartum women who had undergone vaginal birth, aged 18 years or above, literate, admitted in a maternity ward, delivered a full-term or large-for-gestational-age infant, and possessed a smartphone or compatible device for app usage were included. Changes in KAP were evaluated using a survey specifically designed for this purpose. The Mann-Whitney U test was employed to compare KAP scores between control and intervention groups, as well as between baseline and post-intervention assessments. RESULTS: Among the 542 women screened for eligibility, 349 were enrolled in the study, with 138 completing post-intervention assessments. The mean (standard deviation [SD]) age of participants was 25.9 (5.8) years. Post-intervention scores for knowledge and practice demonstrated a decline among non-app users, whereas a significant increase was observed among those in the intervention group. Attitudinal changes remained insignificant. CONCLUSIONS: The findings highlight the effectiveness of an app-based educational intervention in enhancing the knowledge and practice related to UI among postpartum women.

Práticas de cuidado e necessidades de saúde de homens em atenção domiciliar / Care practices and health needs of men in home care / Prácticas de cuidado y necesidades de salud de los hombres en el cuidado domiciliario

Objetivo: Analisar as práticas de cuidado desenvolvidas para atender às necessidades de saúde de homens em atenção domiciliar. Métodos: Pesquisa observacional e qualitativa, realizada com 34 cuidadores e 24 homens assistidos pelo serviço de atenção domiciliar do município de João Pessoa. A coleta de dados foi realizada por meio de um roteiro com variáveis sociodemográficas e perguntas abertas. A Análise Crítica do Discurso foi utilizada como método de análise, com destaque para os significados representacional e identificacional dos discursos. Resultados: As práticas de cuidado e necessidades de saúde foram apontadas com base na relação hegemônica entre os atores do cuidado, associação do cuidado ao processo de trabalho informal, atuação da família, da atividade corresponsabilizada, e prática da autonomia e autocuidado. Conclusão: Evidenciou-se um cuidado multifacetado e executado por diversos atores com suporte de equipes multiprofissionais de atenção domiciliar. (AU)

Objective: To analyze the care practices developed to meet the health needs of men in home care. Methods: Observational and qualitative research, carried out with 34 caregivers and 24 men assisted by the home care service in the city of João Pessoa. Data collection was performed through a script with sociodemographic variables and open questions. Critical Discourse Analysis was used as a method of analysis, with emphasis on the representational and identificational meanings of the discourses. The research was approved according to the opinion number 1.829.326. Results: Care practices and health needs were identified based on the hegemonic relationship between the care actors, association of care with the informal work process, family activities and co-responsibility activities, and the practice of autonomy and self-care. Conclusion: There was evidence of a multifaceted care performed by different subjects with the support of multidisciplinary home care teams. (AU)

Objetivo: Analizar las prácticas asistenciales desarrolladas para satisfacer las necesidades de salud de los hombres en la atención domiciliaria. Métodos: Investigación observacional y cualitativa, realizada con 34 cuidadores y 24 hombres asistidos por el servicio de atención domiciliaria en la ciudad de João Pessoa. La recolección de datos se realizó mediante un guión con variables sociodemográficas y preguntas abiertas. Se utilizó el Análisis Crítico del Discurso como método de análisis, con énfasis en los significados representativos e identificativos de los discursos. La investigación fue aprobada de acuerdo al dictamen número 1.829.326. Resultados: Se identificaron prácticas de cuidado y necesidades de salud a partir de la relación hegemónica entre los actores del cuidado, la asociación del cuidado con el proceso de trabajo informal, las actividades familiares y de corresponsabilidad, y la práctica de la autonomía y el autocuidado. Conclusión: Se evidenció una atención multifacética realizada por diferentes sujetos con el apoyo de equipos multidisciplinares de atención domiciliaria. (AU)

Qualitative study on information, trust in and access to COVID-19 vaccines among adolescents at a healthcare center in Buenos Aires. / Estudio cualitativo sobre información, confianza y acceso a la vacunación contra COVID-19 en adolescentes en un centro de salud de Buenos Aires.

Introduction. During adolescence, individuals start to make autonomous decisions about their health. Vaccination involves contextual, group, and vaccine-specific dimensions. We sought to know the information, trust, and decision to receive the COVID-19 vaccine among adolescents who attended a healthcare center in Buenos Aires. Objectives. To identify settings and channels through which adolescents accessed information about the COVID-19 vaccine at a healthcare center in Buenos Aires. To describe their opinions about the different statements on vaccination. To describe their participation in COVID-19 vaccination. To identify barriers and facilitators to COVID-19 vaccination in this population. Population and methods. Qualitative study. Semi-structured interviews with adolescents who attended this healthcare facility. The sample was heterogeneous; the sample size was estimated by theoretical saturation. A thematic analysis of data was done. Results. A total of 14 interviews were conducted. Interviewees obtained information about the COVID-19 vaccine from their families, TV, and social media. All received information from both official campaigns and anti-vaccine communications. They analyzed the information they received and formed their own opinion. Their decision about the vaccine was not always respected. Hesitancy, a low perception of risk, fear of needles, administrative and geographic barriers were reasons for not receiving the vaccine. Conclusions. Communication strategies targeted at adolescents are required that encourage their involvement in access to vaccination.

Introducción. En la adolescencia, se comienzan a tomar decisiones autónomas sobre la salud. En la vacunación intervienen dimensiones contextuales, grupales y relativas a cada vacuna. Se busca conocer el proceso de información, confianza y decisión de vacunarse contra COVID-19 en adolescentes usuarios de un centro de salud en Buenos Aires. Objetivos. Identificar ámbitos y canales a través de los cuales los adolescentes accedieron a información sobre la vacuna contra COVID-19 en un centro de salud de Buenos Aires. Describir sus opiniones respecto a los distintos discursos sobre vacunación. Describir su participación en la vacunación contra COVID-19. Identificar barreras y facilitadores respecto del acceso a la vacunación contra COVID-19 en esta población. Población y métodos. Investigación cualitativa. Se hicieron entrevistas semiestructuradas a adolescentes usuarios del efector. La muestra fue heterogénea; su tamaño se definió por saturación teórica. Se realizó un análisis temático de los datos. Resultados. Se realizaron 14 entrevistas. Los entrevistados recibieron información sobre la vacuna contra COVID-19 de sus familias, la televisión y las redes sociales. Todos recibieron tanto publicidad oficial como discursos reticentes a la vacunación. Analizaron la información recibida y formaron opinión autónoma. Su decisión sobre vacunarse no siempre fue respetada. La desconfianza, la baja percepción del riesgo, el temor a las inyecciones, las barreras administrativas y geográficas fueron motivos de no vacunación. Conclusiones. Se requieren estrategias de comunicación destinadas a adolescentes que promuevan su participación en el acceso a la vacunación.

Screening and prevention of preterm birth: how is it done in clinical practice?

Objective: To ascertain how screening for preterm birth is performed among obstetricians working in public and private practice in a middle-income country. Methods: Cross-sectional study of 265 obstetrician-gynecologists employed at public and private facilities. An online questionnaire was administered, with items designed to collect data on prematurity screening and prevention practices. Results: The mean age of respondents was 44.5 years; 78.5% were female, and 97.7% had completed a medical residency program. Universal screening (i.e., by ultrasound measurement of cervical length) was carried out by only 11.3% of respondents in public practice; 43% request transvaginal ultrasound if the manual exam is abnormal, and 74.6% request it in pregnant women with risk factors for preterm birth. Conversely, 60.7% of respondents in private practice performed universal screening. This difference in screening practices between public and private practice was highly significant (p < 0.001). Nearly all respondents (90.6%) reported prescribing vaginal progesterone for short cervix. Conclusion: In the setting of this study, universal ultrasound screening to prevent preterm birth was used by just over half of doctors in private practice. In public facilities, screening was even less common. Use of vaginal progesterone in cervical shortening was highly prevalent. There is an unmet need for formal protocols for screening and prevention of preterm birth in middle-income settings.

The power of us: breaking barriers and bridging the gap of ultrasound in rheumatology to empower a new generation.

OBJECTIVE: This study assesses musculoskeletal ultrasound (MSUS) knowledge, attitudes, and practices among young rheumatologists in Mexico, aiming to identify barriers and facilitators to its clinical use. METHODS: An online survey distributed to a network of young rheumatologists captured demographics, institutional, and personal MSUS information. Multivariable analysis identified factors associated with positive MSUS attitudes. RESULTS: Ninety-six rheumatologists (39.18% national response rate) completed the survey. Of respondents (54.2% females, median age 35.1 years), 81.2% deemed MSUS necessary in clinical rheumatology. The main barriers included limited training access (56.2%) and required training time (54.1%). Lack of scientific evidence was not a major barrier (60.4%). Positive MSUS attitudes were associated with learning from conferences (p = 0.029) and colleagues (p = 0.005), formal (p = 0.043), and in-person training (p = 0.020), MSUS use in practice (p = 0.027), and use by radiologists in their institute (p < 0.001). Interest in learning MSUS (88.5%) was significantly higher in those with positive attitudes (94.4%, p < 0.001). Elastic net analysis identified key drivers, including learning MSUS from conferences, colleagues, and in residency; using MSUS in practice; respondent-performed MSUS; and MSUS use by radiologists. Statistically significant associations were found with using MSUS for synovitis/inflammatory joint disease (OR = 1.43, 95% CI 1.00-2.05) and MSUS use by radiologists in respondent's institutes (OR = 1.70, 95% CI 1.20-2.90). CONCLUSION: Most young rheumatologists in Mexico recognize the necessity of MSUS in clinical practice. By addressing identified barriers, encouraging rheumatologist-radiologist collaboration, and establishing a regulatory body to certify rheumatologist's MSUS experience, there is an opportunity to empower them with the necessary skills for effective MSUS use, ultimately benefiting patient care.

Higiene das mãos dos profissionais de saúde: perspectivas do estudante de enfermagem no papel de paciente/familiar / Higiene de manos de los profesionales de la salud: perspectiva de estudiantes de enfermería en el papel de paciente/familiar / Healthcare professionals' hand hygiene: perspectives of nursing student's in patients/relatives role

Resumo Objetivo Investigar as opiniões e atitudes dos estudantes de enfermagem no papel de pacientes ou familiares de pacientes, a respeito do comportamento de higiene das mãos dos profissionais de saúde e da participação dos pacientes na campanha de higiene das mãos. Métodos Estudo transversal prospectivo realizado entre 2021-2022 no Nursing Department, Faculty of Health Sciences, de duas universidades turcas. A amostra do estudo foi composta por 330 alunos. Os dados foram coletados por meio de questionário autoaplicável. A taxa de resposta do questionário foi de 89,43%. O teste qui-quadrado foi utilizado na análise dos dados. Resultados A média de idade dos estudantes foi de 19,80±1,30 anos, 76,1% eram do sexo feminino, 50,9% afirmaram ter recebido instrução sobre Infecções Associadas aos Cuidados de Saúde (IACS). Enquanto 30,1% dos estudantes relataram realizar a higiene das mãos "9 a 11 vezes" em sua vida diária, 54,6% relataram "12 a 15 vezes" no hospital, e 96,4% dos estudantes se perguntaram se os profissionais de saúde realizavam a higiene das mãos antes de fornecer cuidados durante as internações. De acordo com 30,5% dos estudantes, lembretes dos pacientes e seus familiares sobre a realização da higiene das mãos antes do contato com os pacientes os deixariam satisfeitos. Houve diferença estatisticamente significativa entre a instrução anterior dos estudantes sobre IACS e a higiene das mãos como cuidado importante a pacientes hospitalizados (p<0,05). Conclusão Os estudantes de enfermagem apresentaram conhecimento suficiente sobre a higiene das mãos e uma atitude positiva frente aos comportamentos de higiene das mãos dos profissionais de saúde. Estudantes de enfermagem como pacientes e familiares dos pacientes podem ser incluídos nas campanhas de higiene das mãos dos profissionais de saúde, desde que as etapas do programa sejam bem planejadas.

Resumen Objetivo Investigar las opiniones y actitudes de los estudiantes de enfermería en el papel de pacientes o familiares de pacientes respecto al comportamiento de higiene de manos de los profesionales de la salud y de la participación de los pacientes en la campaña de higiene de manos. Métodos Estudio transversal prospectivo realizado entre 2021 y 2022 en el Nursing Department, Faculty of Health Sciences, de dos universidades turcas. La muestra del estudio estuvo compuesta por 330 alumnos. Los datos se recopilaron mediante cuestionario autoaplicado. El índice de respuesta del cuestionario fue de 89,43 %. Se utilizó la prueba ji cuadrado en el análisis de los datos. Resultados El promedio de edad de los estudiantes fue de 19,80±1,30 años, el 76,1 % era de sexo femenino, el 50,9 % afirmó haber recibido instrucción sobre infecciones asociadas a los cuidados de la salud (IACS). Mientras el 30,1 % de los estudiantes relató realizar la higiene de manos "9 a 11 veces" en su vida diaria, el 54,6 % relató "12 a 15 veces" en el hospital, el 96,4 % de los estudiantes se preguntó si los profesionales de la salud realizaban la higiene de manos antes de brindar cuidados durante las internaciones. El 30,5 % de los estudiantes estuvo satisfecho con los recordatorios de los pacientes y sus familiares sobre la realización de la higiene de manos antes del contacto con los pacientes. Hubo diferencia estadísticamente significativa entre la instrucción anterior de los estudiantes sobre IACS y la higiene de manos como cuidado importante en pacientes hospitalizados (p<0,05). Conclusión Los estudiantes de enfermería presentaron conocimientos suficientes sobre la higiene de manos y una actitud positiva frente a los comportamientos de higiene de manos de los profesionales de la salud. Puede incluirse a los estudiantes de enfermería como pacientes y familiares de los pacientes en las campañas de higiene de manos de los profesionales de la salud, siempre que las etapas del programa estén bien planificadas.

Abstract Objective To investigate the views and attitudes of nursing students, as patients or relatives, on healthcare professionals' hand hygiene behavior and patient participation hand hygiene campaign. Methods This prospective cross-sectional study was conducted in the nursing departments of the health and science faculties at two Turkish universities between 2021-2022. The study sample comprised 330 students. Data were collected using a self-administered questionnaire. The response rate of the questionnaire was 89.43%. Chi-square test was used in data analysis. Results The mean age of students was 19.80±1.30 years, 76.1% were female, 50.9% stated they had received education regarding healthcare-associated infections (HAI). While 30.1% of students reported they performed hand hygiene "9-11 times" in their daily lives, 54.6% reported performing "12-15 times" in the hospital, and 96.4% of students expressed wondering if healthcare professionals performed hand hygiene before offering care during hospitalizations. Among students, 30.5% stated that reminders from patients and their relatives about performing hand hygiene before contact with patients would make them happy. There was a statistically significant difference between students' previous training in HAIs and hand hygiene as an important inpatient care (p<0.05). Conclusion Nursing students had sufficient knowledge of hand hygiene and a positive attitude towards hand hygiene behaviors of healthcare professionals. Nursing students, such as patients and their relatives, can be included in hand hygiene campaigns for healthcare professionals, provided that the program steps are well planned.

Screening and prevention of preterm birth: how is it done in clinical practice?

Abstract Objective: To ascertain how screening for preterm birth is performed among obstetricians working in public and private practice in a middle-income country. Methods: Cross-sectional study of 265 obstetrician-gynecologists employed at public and private facilities. An online questionnaire was administered, with items designed to collect data on prematurity screening and prevention practices. Results: The mean age of respondents was 44.5 years; 78.5% were female, and 97.7% had completed a medical residency program. Universal screening (i.e., by ultrasound measurement of cervical length) was carried out by only 11.3% of respondents in public practice; 43% request transvaginal ultrasound if the manual exam is abnormal, and 74.6% request it in pregnant women with risk factors for preterm birth. Conversely, 60.7% of respondents in private practice performed universal screening. This difference in screening practices between public and private practice was highly significant (p < 0.001). Nearly all respondents (90.6%) reported prescribing vaginal progesterone for short cervix. Conclusion: In the setting of this study, universal ultrasound screening to prevent preterm birth was used by just over half of doctors in private practice. In public facilities, screening was even less common. Use of vaginal progesterone in cervical shortening was highly prevalent. There is an unmet need for formal protocols for screening and prevention of preterm birth in middle-income settings.

Knowledge about sudden infant death syndrome prevention among postpartum women in Southern Brazil, 2019: a cross-sectional survey / Conocimiento sobre la prevención del síndrome de muerte súbita del lactante en puérperas del Sur de Brasil, 2019: un estudio transversal / Conhecimento sobre prevenção da síndrome da morte súbita do lactente entre puérperas no Sul do Brasil, 2019: um estudo transversal

ABSTRACT Objective To assess knowledge on sudden infant death syndrome (SIDS) prevention among postpartum women who received prenatal care in public and private services in Rio Grande, Rio Grande do Sul, Brazil, in 2019. Methods A cross-sectional study was conducted with postpartum women who gave birth in that municipality in 2019; the outcome was the indication of incorrect sleeping position (side/supine position) to prevent SIDS; the chi-square test was used to compare proportions between those who underwent prenatal care in public and private services. Results Among all 2,195 postpartum women, 67.7% (95%CI 65.7;69.6) were unaware of the position that prevents SIDS, 71.6% were public care service users; 77.8% of them feared choking/suffocation; 1.9% were informed about SIDS during prenatal care; doctors/nurses (70.5%) and grandmothers (65.1%) were influential regarding the baby's sleeping position. Conclusion Most postpartum women were unaware of the sleeping position that prevents SIDS, especially those receiving care in the public sector; in general, this subject is not discussed in prenatal care.

RESUMEN Objetivo Evaluar el conocimiento sobre la prevención del síndrome de muerte súbita del lactante (SMSL) entre puérperas que realizaron prenatal en servicios públicos y privados en Rio Grande, Rio Grande do Sul, Brasil, en 2019. Métodos Estudio transversal, con puérperas que dieron a luz en Rio Grande, en 2019; el resultado consistió en la indicación de posición incorrecta para dormir (lado/supino) para prevenir el SMSL; utilizando chi-cuadrado, se compararon las proporciones entre mujeres que recibieron atención prenatal en servicios públicos y privados. Resultados Entre las 2.195 puérperas, 67,7% (IC95% 65,7;69,6) desconocían como se previene el SMSL, estando el 71,6%, en la red pública; 77,8% temía asfixiarse/ahogarse; el 1,9% fue informado sobre el SMSL durante el prenatal; los médicos(as)/enfermeros(as) (70,5%) y los abuelos (65,1%) influyeron en la posición para dormir del bebé. Conclusión La mayoría de las puérperas desconocían la posición que previene el SMSL, especialmente en la red pública; en general, este tema no está cubierto en la atención prenatal.

RESUMO Objetivo Avaliar o conhecimento sobre prevenção da síndrome da morte súbita do lactente (SMSL) entre puérperas com pré-natal realizado nos serviços público e privado de Rio Grande, Rio Grande do Sul, Brasil, 2019. Métodos Estudo transversal, com puérperas do município; seu desfecho constituiuse da indicação de posição incorreta para dormir (decúbito lateral ou dorsal), visando prevenir a SMSL; utilizou-se o teste qui-quadrado para comparar proporções do desfecho e de exposição entre puérperas que realizaram pré-natal nos serviços público e privado. Resultados De 2.195 puérperas, 67,7% (IC95% 65,7;69,6), majoritariamente atendidas na rede pública (71,6%), desconheciam a posição preventiva da SMSL; 77,8% temiam engasgo/afogamento; 1,9% foram informadas sobre SMSL no pré-natal; médicos(as)/enfermeiros(as) (70,5%) e avós (65,1%) mostraram-se influentes na decisão sobre como posicionar o bebê adormecido. Conclusão A maioria das puérperas, especialmente as atendidas na rede pública, desconhecia a posição que previne SMSL; geralmente, o tema não é abordado no pré-natal.

Validação de conteúdo e análise semântica de inquérito CAP sobre conhecimentos, atitudes e práticas das avós no contexto da amamentação / Content validation and semantic analysis of a KAP survey on grandmothers' knowledge, attitudes, and practices in the context of breastfeeding / Validación del contenido y análisis semántico de una encuesta CAP sobre conocimientos, actitudes y prácticas de las abuelas en el contexto de la lactancia materna

Objetivo: avaliar a validade de conteúdo e a semântica de um inquérito sobre conhecimentos, atitudes e práticas das avós no contexto da amamentação. Métodos: pesquisa metodológica, de validação de conteúdo de inquérito Conhecimentos, Atitudes e Práticas (CAP) por especialistas e análise semântica por meio da compreensibilidade dos itens pelas avós de crianças em amamentação. Foram calculados os índices de validade de conteúdo, dos itens e da escala, e teste binomial. Para análise semântica foram calculadas as frequências absolutas e as relativas da compreensão dos itens. Resultados: participaram 22 especialistas, e dez avós. O índice de validade de conteúdo do inquérito CAP tanto para versão pré-teste como pós-teste foi de 0,94. Uma questão da versão pré-teste e duas questões da versão pós-teste não alcançaram compreensão > 90%. Foi excluída uma questão do inquérito e 21 foram reformuladas, resultando em 45 itens distribuídos em três domínios: conhecimentos (23 itens), atitudes (oito itens) e práticas (14 itens). Conclusão:as versões finais do pré e pós-teste do inquérito de conhecimentos, atitudes e práticas das avós sobre a amamentação, alcançaram validade de conteúdo e de semântica compatível para sua utilização.

Objective: assessing the content and semantic validity of a survey on grandmothers' knowledge, attitudes, and practices in the context of breastfeeding. Methods: methodological research for content validation of a Knowledge, Attitudes, and Practices (KAP) survey by experts and semantic analysis through the comprehensibility of the items by grandmothers of breastfeeding children. Content validity indices were calculated for the items and the scale, as well as the binomial test. Absolute and relative frequencies of understanding of the items were calculated for the semantic analysis. Results: participants were 22 experts and ten grandmothers. The content validity index of the KAP survey for both the pre-test and post-test versions was 0.94. One question in the pre-test version and two questions in the post-test version did not reach > 90% comprehension. One question was excluded from the survey and 21 were reworded, resulting in 45 items distributed into three domains: knowledge (23 items), attitudes (8 items), and practices (14 items). Conclusion: the final pre- and post-test versions of the survey of grandmothers' knowledge, attitudes, and practices on breastfeeding achieved content and semantic validity compatible with its use.

Objetivo: evaluación de la validez semántica y de contenido de una encuesta sobre conocimientos, actitudes y prácticas de las abuelas en el contexto de la lactancia materna. Métodos: investigación metodológica, validación del contenido de la encuesta Conocimiento, Actitudes y Prácticas (CAP) por expertos y análisis semántico a través de la comprensibilidad de los ítems por abuelas de niños lactantes. Se calcularon índices de validez de contenido para los ítems y la escala, así como la prueba binomial. Para el análisis semántico, se calcularon las frecuencias absolutas y relativas de comprensión de los ítems. Resultados: participaron 22 expertos y diez abuelas. El índice de validez de contenido de la encuesta CAP, tanto para la versión pre-test como para la post-test, fue de 0,94. Una pregunta de la versión pre-test y dos preguntas de la versión post-test no alcanzaron > 90% de comprensión. Se excluyó una pregunta de la encuesta y se reformularon 21, con lo que se obtuvieron 45 ítems distribuidos en tres ámbitos: conocimientos (23 ítems), actitudes (8 ítems) y prácticas (14 ítems). Conclusión: las versiones finales pre y post de la encuesta sobre conocimientos, actitudes y prácticas de las abuelas en materia de lactancia materna alcanzaron validez de contenido y semántica compatible con su uso.

COVID-19 nas prisões: validação de um inquérito de conhecimento, atitude e prática / COVID-19 en las cárceles: validación de un estudio de conocimiento, actitud y práctica / COVID-19 in prisons: validity of a knowledge, attitude and practice survey

Resumo Objetivo Validar um inquérito de conhecimento, atitude e prática sobre medidas preventivas da COVID-19 para os funcionários do sistema penitenciário, fundamentado na teoria ambientalista. Métodos Estudo metodológico desenvolvido em quatro etapas: estabelecimento da estrutura conceitual, elaboração do instrumento, validação do conteúdo por juízes e avaliação da aparência pelo público-alvo. O conteúdo de cada item foi validado quanto a objetividade, clareza e relevância. A aparência do inquérito foi avaliada quanto ao objetivo, a organização, ao estilo da escrita e a motivação. Utilizou-se o coeficiente de validação de conteúdo para avaliar a concordância entre os juízes e entre o público-alvo. Os dados foram analisados por meio de distribuições brutas, percentuais, medidas de posição e de dispersão. O índice alfa de Cronbach foi utilizado para analisar a consistência das avaliações dos juízes e do público-alvo. Resultados Quanto ao conteúdo e a aparência, os requisitos avaliados obtiveram concordância superior a 0,9. Na avaliação da consistência, obteve-se índice alfa de Cronbach > 0,9 e > 0,7, quanto ao conteúdo e à aparência, respectivamente, indicando que juízes e público-alvo tenderam a fazer avaliações similares. Conclusão O inquérito apresentou validade de conteúdo e aparência para a coleta de dados referentes a conhecimento, atitude e prática sobre prevenção da COVID-19, para os funcionários do sistema penitenciário, indicando que poderá contribuir para o planejamento e a avaliação de ações de educação em saúde.

Resumen Objetivo Validar un estudio de conocimiento, actitud y práctica sobre medidas preventivas de COVID-19 para los empleados del sistema penitenciario, fundamentado en la teoría ambientalista. Métodos Estudio metodológico llevado a cabo en cuatro etapas: establecimiento de la estructura conceptual, elaboración del instrumento, validación del contenido por jueces y evaluación de la apariencia por el público destinatario. Se validó el contenido de cada ítem respecto a la objetividad, claridad y relevancia. Se evaluó la apariencia del estudio respecto al objetivo, la organización, el estilo de escritura y la motivación. Se utilizó el coeficiente de validez de contenido para evaluar la concordancia entre los jueces y entre el público destinatario. Los datos se analizaron mediante distribuciones brutas, porcentajes, medidas de posición y de dispersión. Se utilizó el índice alfa de Cronbach para analizar la consistencia de las evaluaciones de los jueces y del público destinatario. Resultados Respecto al contenido y a la apariencia, los requisitos evaluados obtuvieron concordancia superior a 0,9. En la evaluación de la consistencia, se obtuvo un índice alfa de Cronbach > 0,9 respecto al contenido y > 0,7 respecto a la apariencia, lo que indica la tendencia de los jueces y del público destinatario a realizar evaluaciones similares. Conclusión El estudio presentó validez de contenido y apariencia para la recopilación de datos referentes a conocimiento, actitud y práctica sobre prevención de COVID-19 para empleados del sistema penitenciario, lo que indica que podrá contribuir a la planificación y evaluación de acciones de educación para la salud.

Abstract Objective To validate a knowledge, attitude and practice survey on preventive measures against COVID-19 for penitentiary system staff based on environmental theory. Methods This is a methodological study developed in four stages: conceptual structure establishment; instrument elaboration; content validity by judges; and appearance assessment by the target audience. The content of each item was validated for objectivity, clarity and relevance. Survey appearance was assessed regarding objective, organization, writing style and motivation. Content validity coefficient was used to assess agreement among judges and the target audience. Data were analyzed using gross distributions, percentages, position and dispersion measures. Cronbach's alpha index was used to analyze the consistency of judges' and target audience's assessments. Results Regarding content and appearance, the assessed requirements achieved agreement greater than 0.9. In consistency assessment, a Cronbach's alpha index > 0.9 and > 0.7 was obtained for content and appearance, respectively, indicating that judges and target audiences tended to make similar assessments. Conclusion The survey presented content and appearance validity for collecting data regarding knowledge, attitude and practice regarding COVID-19 prevention for penitentiary system staff, indicating that it could contribute to health education action planning and assessment.

Knowledge regarding extracorporeal membrane oxygenation management among Brazilian pediatric intensivists: a cross-sectional survey.

OBJECTIVE: To assess Brazilian pediatric intensivists' general knowledge of extracorporeal membrane oxygenation, including evidence for its use, the national funding model, indications, and complications. METHODS: This was a multicenter cross-sectional survey including 45 Brazilian pediatric intensive care units. A convenience sample of 654 intensivists was surveyed regarding their knowledge on managing patients on extracorporeal membrane oxygenation, its indications, complications, funding, and literature evidence. RESULTS: The survey addressed questions regarding the knowledge and experience of pediatric intensivists with extracorporeal membrane oxygenation, including two clinical cases and 6 optional questions about the management of patients on extracorporeal membrane oxygenation. Of the 45 invited centers, 42 (91%) participated in the study, and 412 of 654 (63%) pediatric intensivists responded to the survey. Most pediatric intensive care units were from the Southeast region of Brazil (59.5%), and private/for-profit hospitals represented 28.6% of the participating centers. The average age of respondents was 41.4 (standard deviation 9.1) years, and the majority (77%) were women. Only 12.4% of respondents had taken an extracorporeal membrane oxygenation course. Only 19% of surveyed hospitals have an extracorporeal membrane oxygenation program, and only 27% of intensivists reported having already managed patients on extracorporeal membrane oxygenation. Specific extracorporeal membrane oxygenation management questions were responded to by only 64 physicians (15.5%), who had a fair/good correct response rate (median 63.4%; range 32.8% to 91.9%). CONCLUSION: Most Brazilian pediatric intensivists demonstrated limited knowledge regarding extracorporeal membrane oxygenation, including its indications and complications. Extracorporeal membrane oxygenation is not yet widely available in Brazil, with few intensivists prepared to manage patients on extracorporeal membrane oxygenation and even fewer intensivists recognizing when to refer patients to extracorporeal membrane oxygenation centers.

Different words for stroke: the same concept? an analysis of associated symptoms and intended reaction in Brazil.

BACKGROUND: Different names for stroke might mislead physicians and emergency medical service workers. This study aimed to assess the different words for stroke in Brazil and both intended response and related symptoms associated with those names. METHODS: Cross-sectional study enrolling healthy individuals from urban areas in Northeast of Brazil for an open-ended survey. We presented a typical clinical case of a stroke (an elderly who had sudden onset of hemiparalysis and slurred speech) and asked "what is happening?", "what would you do?" and "which other symptoms could happen in this condition?". RESUTS: From 1,475 interviewed individuals, 1,220 (82,7%) recognized the scenario as a stroke. There were 3 words to correctly identify (based on correct intended response and spontaneously evoked associated symptoms) the stroke, which were "AVC" (acronym for cerebrovascular accident, in Portuguese), "derrame" (spillage) and "trombose" (thrombosis). There were significant differences among them concerning demographic, economic, educational and geographical aspects, but there was no difference according to the intended reaction among them. The most cited associated symptoms (excluding those present in the case) were impaired consciousness (10.6%), headache (8.9%) and dysesthesia (7.7%). "Aneurisma" (aneurism) was also cited, by 3 individuals. CONCLUSION: There are at least three words for stroke in Portuguese ("AVC", "derrame" and "trombose"); they were similar in terms of correct intended responses and spontaneously cited accompanying symptoms. Stroke campaigns should apply different names to reach a broader audience and to improve stroke recognition.

Conhecimento, atitudes e práticas em primeiros socorros no ambiente escolar: uma revisão integrativa / Knowledge, attitudes and practices in first rescue in the school environment: an integrative review / Conocimientos, actitudes y prácticas de primeros auxilios en el entorno escolar: una revisión integradora

Conclusão: Constata-se que há desconhecimento sobre as ações necessárias no atendimento em primeiros socorros, o que impacta nas atitudes e práticas executadas, bem como no tratamento e prognóstico. Assim, intervenções educativas são estratégias que promovem o desenvolvimento de conhecimento, atitudes e práticas necessárias ao atendimento em primeiros socorros

Conclusion: It was observed that there is a lack of knowledge about the necessary actions in first aid care, which impacts the attitudes and practices performed, as well as the treatment and prognosis. Thus, educational interventions are strategies that promote the development of knowledge, attitudes and practices necessary for first aid

Conclusión: Se observó que existe un desconocimiento sobre las acciones necesarias en la atención de primeros auxilios, lo que repercute en las actitudes y prácticas realizadas, así como en el tratamiento y pronóstico. Así pues, las intervenciones educativas son estrategias que promueven el desarrollo de los conocimientos, las actitudes y las prácticas necesarias para la atención de primeros auxilios

Creencias-prácticas culturales de pacientes con cuidados paliativos domiciliarios, desde la teoría Leininger

Introducción: La cultura del paciente tiene influencia en la selección de sus tratamientos, las expresiones emocionales, la toma de decisiones y en la forma de comunicarse de los pacientes. Los cuidados paliativos permiten el abordaje holístico a personas y familias en sufrimiento por enfermedades potencialmente mortales. Objetivo: Describir las creencias y las prácticas culturales relacionadas con la salud en pacientes adultos de un programa domiciliario de cuidados paliativos en la ciudad de Bogotá. Materiales y Métodos: Estudio cualitativo, de tipo etnografía. Se realizaron entrevistas semiestructuradas virtuales a 9 pacientes requirentes de cuidados paliativos, determinada por saturación teórica. Para el análisis de la información, se consideraron las orientaciones de la teoría de los cuidados culturales de Leininger bajo el modelo del sol naciente. Se realizó la codificación y categorización en el software Nvivo v12. Resultados: Se obtuvieron 3 categorías principales: prácticas culturales, creencias para mantener la poca salud y aliviar síntomas y experiencias en la adaptación a la enfermedad y muerte y se dio lugar a 13 subcategorías Discusión: Tras describir y analizar los resultados obtenidos, se observó que los participantes poseen conocimientos sobre prácticas-creencias culturales, que han sido transmitidas de generación en generación y juegan un papel importante en el proceso de la enfermedad Conclusiones: Se evidenció que existen prácticas consideradas protectoras y otras que generan conductas de riesgo, las cuales deberán reestructurarse, negociarse o preservarse, con el objetivo de fortalecer el proceso de cuidado y así mantener un enfoque culturalmente competente.

Introduction: Patient culture influences treatment selection, emotional expressions, decision making, and patients' communication. Palliative care allows a holistic approach to individuals and families suffering from life-threatening illnesses. Objective: To describe the beliefs and health- related cultural practices of adult patients in a palliative home care program in the city of Bogotá. Materials and methods: Qualitative ethnographic study. Semi-structured online interviews were conducted with 9 patients requiring palliative care, until theoretical saturation was reached. For data analysis, the guidelines of Leininger's Cultural Care Theory based on the Sunrise Model were considered. Results: Three main categories were identified: cultural practices, beliefs about maintaining poor health and alleviating symptoms, and experiences adapting to illness and death, resulting in 13 subcategories. Discussion: After describing and analyzing the results obtained, it was observed that the participants have knowledge of cultural practices-beliefs that have been passed down from generation to generation and play an important role in the disease process. Conclusions: It became clear that there are practices that are considered protective and others that create risky behaviors that should be restructured, negotiated, or maintained in order to strengthen the care process and thus maintain a culturally competent approach.

Introdugáo: A cultura do paciente influencia na escolha de seus tratamentos, nas expressóes emocionáis, na tomada de decisóes e na forma como os pacientes se comunicam. Os cuidados paliativos permitem uma abordagem holística para individuos e familias que sofrem de doengas que ameagam a vida. Objetivo: Descrever as crengas e práticas culturais relacionadas a saúde em pacientes adultos de um programa domiciliar de cuidados paliativos na cidade de Bogotá. Materiais e Métodos: Estudo qualitativo, do tipo etnográfico. Foram realizadas entrevistas semiestruturadas virtuais com 9 pacientes em cuidados paliativos, determinadas pela saturagao teórica. Para a análise das informagóes, foram consideradas as orientagóes da teoria do cuidado cultural de Leininger sob o modelo do sol nascente. A codificagao e categorizagao foram realizadas no software Nvivo v12. Resultados: Obtiveram-se 3 categorias principais: práticas culturais, crengas para manter a saúde precária e aliviar sintomas e experiencias de adaptagao a doenga e a morte, dando origem a 13 subcategorias. Discussao: descrevendo e analisando os resultados obtidos, observou-se que os participantes possuem conhecimento sobre as práticas-crengas culturais, que foram transmitidas de geragao em geragao e desempenham um papel importante no processo de adoecimento. Condusdes: ficou evidenciado que existem práticas consideradas protetoras e outras que geram comportamentos de risco, que devem ser reestruturadas, negociadas ou preservadas, a fim de fortalecer o processo de cuidar e, assim, manter uma abordagem culturalmente competente.

Saberes e práticas de mães ribeirinhas sobre vacinação / Knowledge and practices of riverine mothers about vaccination / Conocimientos y prácticas de las madres ribereñas en materia de vacunación

RESUMO Objetivo: analisar os saberes de mães ribeirinhas sobre vacinação e sua influência na prática de levar seus filhos para vacinar. Método: estudo qualitativo/descritivo, realizado na Unidade de Saúde da Família Combú, Belém-Pará, Brasil, com 30 mães ribeirinhas que tinham filhos em idade vacinal. Os dados foram produzidos por entrevistas individuais, cujo corpus foi analisado com o software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires 0.7, alpha 2, utilizando a Classificação Hierárquica Descendente. Resultados: o software gerou seis classes, compondo duas categorias: "Saberes e práticas de mães ribeirinhas sobre vacinação" e "Importância da educação em saúde e o papel dos profissionais de saúde no compartilhamento de informações sobre vacinação". Conclusão: discutir os saberes de mães ribeirinhas sobre vacinação e sua influência na tomada de decisão permitiu refletir criticamente sobre as práticas no cotidiano dessa população, oportunizando aos profissionais de saúde repensar estratégias, principalmente nas ações educativas.

ABSTRACT Objective: to analyze the knowledge of riverine mothers about vaccination and its influence on the practice of taking their children for vaccination. Method: qualitative/descriptive study, conducted at the Combú Family Health Unit, Belém-Pará, Brazil, with 30 riverine mothers who had children of vaccination age. Data were produced by individual interviews, whose corpus was analyzed with the software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires 0.7, alpha 2, using Descending Hierarchical Classification. Results: the software generated six classes, composing two categories: "Knowledge and practices of riverine mothers about vaccination" and "Importance of health education and the role of health professionals in sharing information about vaccination". Conclusion: discussing the knowledge of riverside mothers about vaccination and its influence on decision-making allowed a critical reflection on the practices in the daily life of this population, providing health professionals with the opportunity to rethink strategies, especially in educational actions.

RESUMEN Objetivo: analizar los conocimientos de las madres ribereñas sobre la vacunación y su influencia en la práctica de llevar a sus hijos a vacunar. Método: estudio cualitativo/descriptivo realizado en la Unidad de Salud de la Familia de Combú, Belém-Pará, Brasil, con 30 madres ribereñas que tenían hijos en edad de vacunación. Los datos fueron producidos por entrevistas individuales, cuyo corpus fue analizado con el software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires 0.7, alpha 2, utilizando la Clasificación Jerárquica Descendente. Resultados: el software generó seis clases, que componían dos categorías: "Conocimientos y prácticas de las madres ribereñas sobre la vacunación" e "Importancia de la educación sanitaria y papel de los profesionales de la salud en el intercambio de información sobre la vacunación". Conclusión: discutir el conocimiento de las madres ribereñas sobre la vacunación y su influencia en la toma de decisiones nos permitió reflexionar críticamente sobre las prácticas en el día a día de esta población, dando a los profesionales de la salud la oportunidad de repensar estrategias, especialmente en las acciones educativas.

Educação em saúde na formação acadêmica em enfermagem / Health education in academic nursing training / Educación de salud en la institución académica de enfermería

Com o objetivo de conhecer os limites e potencialidades da formação acadêmica em enfermagem para as atividades de educação em saúde, foi possível desenvolver um estudo exploratório-descritivo de abordagem qualitativa envolvendo 15 participantes. A coleta de dados ocorreu nos meses de maio e junho de 2022 e o processamento dos dados foi feito pelo software Iramuteq. Os resultados apontaram para a dialética envolvendo as potencialidades e limitações. Como potencialidade foi apontado que a disciplina de Educação em Saúde pode ser vista como uma temática transversal que pode ser trabalhada na prática. No que concerne às limitações, as falas elucidaram poucas oportunidades para atividades práticas, além da disciplina se distanciar da realidade. Como considerações finais, foi possível entender que existem abordagens pedagógicas tradicionais no contexto acadêmico em enfermagem desencadeando discussões para uma formação que estimule o aluno a refletir a realidade social que o cerca e aprenda a aprender constantemente.

Aiming to know the limits and the potential of academic nursing training for health education activities, an exploratory-descriptive study with a qualitative approach was developed with 15 participants. Data collection took place in May and June, 2022, and data processing was carried out using the software Iramuteq. The results pointed to the dialectics involving potentialities and limitations. A potentiality was the fact that health education can be seen as a cross-cutting theme that can be worked in practice. Regarding limitations, the speeches pointed to few opportunities for practical activities and to the distance of the subject from reality. As final considerations, it could be understood that there are traditional pedagogical approaches in the academic context of nursing, leading to discussions focused on training that encourages students to reflect on the social reality surrounding them and to learn how to learn continuously.

Con el objetivo de conocer los límites y potencialidades de la formación académica de enfermeros para actividades de educación en salud, fue posible desarrollar un estudio exploratorio-descriptivo con enfoque cualitativo involucrando a 15 participantes. La recolección de datos se realizó en los meses de mayo y junio de 2022 y el procesamiento de datos se realizó mediante el software Iramuteq. Los resultados señalaron a la dialéctica entre fortalezas y limitaciones. Como potencialidad, se apuntó que la asignatura de la educación en salud se ve como un tema transversal que puede ser trabajado en la práctica. En cuanto a las limitaciones, los discursos dilucidaron pocas oportunidades para actividades prácticas, además del hecho de que la asignatura se distancia de la realidad. Como consideraciones finales, fue posible comprender que existen enfoques pedagógicos tradicionales en el contexto académico de enfermería, desencadenando discusiones para una formación que anime a los estudiantes a reflexionar sobre la realidad social que los rodea y aprender a aprender constantemente.

Conhecimento dos profissionais de saúde sobre precauções específicas / Knowledge of health professionals about specific precautions / Conocimiento de profesionales de la salud sobre precauciones específicas

Objetivo: apresentar um diagnóstico situacional sobre o conhecimento dos profissionais de saúde sobre precauções específicas. Métodos: estudo transversal, realizado em um hospital filantrópico mineiro, com 127 profissionais de saúde de nível superior. Para a coleta de dados, utilizou-se o instrumento "Conhecimento dos profissionais de saúde sobre Precauções Específicas" com 29 questões de múltipla escolha, distribuídas em cinco eixos temáticos. Para a análise dos dados, foram executados procedimentos descritivos e diferentes testes estatísticos. Resultados: a média geral de acertos das questões foi 64,7%. O eixo temático "Acomodação e estrutura" apresentou mediana de acertos (43,6%) significativamente menor (p<0,001) que os demais eixos. O eixo "Cadeia epidemiológica de transmissão de microrganismos" apresentou mediana de 60% e os eixos "Cuidado com ambiente" e "Comunicação" tiveram mediana de 66,7%. A maior mediana de acertos ocorreu no eixo "Equipamento de proteção individual (80%)". Conclusão: a assertividade foi baixa em todos os eixos temáticos, o que pode comprometer a qualidade e a segurança da assistência prestada. Assim, verifica-se a necessidade de promover ações educativas com estratégias inovadoras, sensibilizando estes profissionais quanto à adesão dessas medidas de precaução. (AU)

Objective: to present a situational diagnosis about the knowledge of health professionals about specific precautions. Methods: cross-sectional study, conducted in a philanthropic hospital in Minas Gerais, with 127 health professionals of higher education. For data collection, was used the instrument "Knowledge of health professionals on Specific Precautions" with 29 multiple choice questions, distributed in five thematic axes. Descriptive procedures and different statistical tests were performed for the analysis of the data. Results: the overall average number of correct answers was 64.7%. The thematic axis "Accommodation and structure" presented a significantly lower median number of correct answers (p<0.001) than the other axes. The axis "Epidemiological chain of transmission of microorganisms" presented a median of 60% and the axes "Environment Care" and "Communication" had a median of 66.7%. The highest median of correct answers occurred in the axis "Personal protective equipment (80%)". Conclusion: assertiveness was low in all thematic axes, which can compromise the quality and safety of the care provided. Thus, there is a need to promote educational actions with innovative strategies, sensitizing these professionals about the adoption of these precautionary measures. (AU)

Objectivo: presentar un diagnóstico situacional sobre el conocimiento de los profesionales de la salud sobre precauciones específicas. Métodos: estudio transversal realizado en un hospital filantrópico de Minas Gerais, con 127 profesionales de la salud de nivel superior. Para la recopilación de datos, se utilizó el instrumento "Conocimiento de los profesionales de la salud sobre Precauciones Específicas", con 29 preguntas objetivas de múltiple elección, distribuidas en cinco ejes temáticos. Para el análisis de los datos, se realizaron procedimientos descriptivos y diferentes pruebas estadísticas. Resultados: la media general de respuestas correctas fue del 64,7%. El eje temático "Acomodación y estructura" mostró una mediana de respuestas correctas (43,6%) significativamente menor (p<0,001) que los otros ejes. El eje "Cadena epidemiológica de transmisión de microorganismos" tuvo una mediana del 60% y los ejes "Cuidado del medio ambiente" y "Comunicación" tuvieron una mediana del 66,7%. La mediana más alta de respuestas correctas se dio en el eje "Equipo de protección personal (80%)". Conclusión: el asertividad fue baja en todos los ejes temáticos, lo que puede comprometer la calidad y la seguridad de la atención prestada. Así, se comprueba la necesidad de promover acciones educativas con estrategias innovadoras, sensibilizando a estos profesionales en cuanto a la aplicación de las medidas de precaución. (AU)

Using focus groups to plan culturally acceptable primary cervical cancer screening in Grenada, West Indies.

Objective: To document Grenadian women's knowledge about cervical cancer and human papillomavirus (HPV) infection, as well as their attitudes towards primary cervical cancer screening methods. Methods: In this qualitative study, we used focus groups in Grenada to gather information concerning women's knowledge about, attitudes towards and perceptions of screening for cervical cancer and general knowledge about HPV. Ten focus groups comprising 73 participants representing 5 of the 6 parishes in Grenada were conducted with women aged 19-59. Participants were asked about pelvic exams, Pap smears, HPV, reasons for seeking or avoiding cervical cancer screening and how different modalities of testing might affect their decision-making. Responses were then coded and organized into common themes. Results: While many respondents had heard of HPV, far fewer knew about its causative role in cervical cancer, how to prevent HPV infection or testing for the high-risk HPV types that cause almost all cases of cervical cancer. Many participants were aware that cervical cancer screening was beneficial, but numerous barriers to obtaining that screening were noted, including concerns about privacy and stigma, potential discomfort, and the cost and inconvenience involved. Conclusions: Our findings have implications for future cervical cancer screening efforts in Grenada. Central to these efforts should be a focus on educating Grenadians about the role of HPV infection in cervical cancer and the importance of early detection through screening. In addition, addressing issues of stigma and privacy are key to eliminating cervical cancer in Grenada.

Knowledge regarding extracorporeal membrane oxygenation management among Brazilian pediatric intensivists: a cross-sectional survey / Conhecimento do manejo da oxigenação por membrana extracorpórea de intensivistas pediátricos brasileiros: um inquérito transversal

ABSTRACT Objective: To assess Brazilian pediatric intensivists' general knowledge of extracorporeal membrane oxygenation, including evidence for its use, the national funding model, indications, and complications. Methods: This was a multicenter cross-sectional survey including 45 Brazilian pediatric intensive care units. A convenience sample of 654 intensivists was surveyed regarding their knowledge on managing patients on extracorporeal membrane oxygenation, its indications, complications, funding, and literature evidence. Results: The survey addressed questions regarding the knowledge and experience of pediatric intensivists with extracorporeal membrane oxygenation, including two clinical cases and 6 optional questions about the management of patients on extracorporeal membrane oxygenation. Of the 45 invited centers, 42 (91%) participated in the study, and 412 of 654 (63%) pediatric intensivists responded to the survey. Most pediatric intensive care units were from the Southeast region of Brazil (59.5%), and private/for-profit hospitals represented 28.6% of the participating centers. The average age of respondents was 41.4 (standard deviation 9.1) years, and the majority (77%) were women. Only 12.4% of respondents had taken an extracorporeal membrane oxygenation course. Only 19% of surveyed hospitals have an extracorporeal membrane oxygenation program, and only 27% of intensivists reported having already managed patients on extracorporeal membrane oxygenation. Specific extracorporeal membrane oxygenation management questions were responded to by only 64 physicians (15.5%), who had a fair/good correct response rate (median 63.4%; range 32.8% to 91.9%). Conclusion: Most Brazilian pediatric intensivists demonstrated limited knowledge regarding extracorporeal membrane oxygenation, including its indications and complications. Extracorporeal membrane oxygenation is not yet widely available in Brazil, with few intensivists prepared to manage patients on extracorporeal membrane oxygenation and even fewer intensivists recognizing when to refer patients to extracorporeal membrane oxygenation centers.

RESUMO Objetivo: Avaliar os conhecimentos gerais dos intensivistas pediátricos brasileiros sobre oxigenação por membrana extracorpórea, incluindo evidências de uso, modelo de custeio nacional, indicações e complicações. Métodos: Este estudo foi um inquérito transversal multicêntrico que incluiu 45 unidades de terapia intensiva pediátrica brasileiras. Realizou-se inquérito de conveniência com 654 intensivistas quanto aos seus conhecimentos sobre manejo de pacientes em oxigenação por membrana extracorpórea, suas indicações, complicações, custeio e evidências bibliográficas. Resultados: O inquérito abordou questões relativas aos conhecimentos e à experiência dos intensivistas pediátricos sobre oxigenação por membrana extracorpórea, incluindo dois casos clínicos e seis questões facultativas sobre o manejo de pacientes em oxigenação por membrana extracorpórea. Dos 45 centros convidados, 42 (91%) participaram do estudo, e 412 (63%) dos 654 intensivistas pediátricos responderam ao inquérito. A maioria das unidades de terapia intensiva pediátrica eram da Região Sudeste do Brasil (59,5%), e os hospitais privados com fins lucrativos representavam 28,6% dos centros participantes. A média de idade dos respondentes era de 41,4 (desvio-padrão de 9,1) anos, e a maioria (77%) era mulher. Apenas 12,4% dos respondentes tinham formação em oxigenação por membrana extracorpórea. Dos hospitais pesquisados, apenas 19% tinham um programa de oxigenação por membrana extracorpórea, e apenas 27% dos intensivistas declararam já ter manejado pacientes em oxigenação por membrana extracorpórea. Apenas 64 médicos (15,5%) responderam a questões específicas sobre o manejo de oxigenação por membrana extracorpórea (mediana 63,4%; oscilando entre 32,8% e 91,9%). Conclusão: A maioria dos intensivistas pediátricos brasileiros demonstrou conhecimentos limitados de oxigenação por membrana extracorpórea, incluindo suas indicações e complicações. A oxigenação por membrana extracorpórea ainda não está amplamente disponível no Brasil, com poucos intensivistas preparados para o manejo de pacientes em oxigenação por membrana extracorpórea e ainda menos intensivistas capazes de reconhecer quando devem encaminhar pacientes para centros de oxigenação por membrana extracorpórea.