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Building on Existing Tools To improvE chronic disease pRevention and screening in primary care Wellness of cancer survIvorS and patiEnts (BETTER WISE) was designed to assess the effectiveness of a cancer and chronic disease prevention and screening (CCDPS) programme. Here, we compare outcomes in participants living with and without financial difficulty.
Secondary analysis of a cluster-randomised controlled trial.
Patients of 59 physicians from 13 clinics enrolled between September 2018 and August 2019.
596 of 1005 trial participants who responded to a financial difficulty screening question at enrolment.
1-hour CCDPS visit versus usual care.
Eligibility for a possible 24 CCDPS actions was assessed at baseline and the primary outcome was the percentage of eligible items that were completed at 12-month follow-up. We also compared the change in response to the financial difficulty screening question between baseline and follow-up.
55 of 265 participants (20.7%) in the control group and 69 of 331 participants (20.8%) in the intervention group reported living with financial difficulty. The primary outcome was 29% (95% CI 26% to 33%) for intervention and 23% (95% CI 21% to 26%) for control participants without financial difficulty (p=0.01). Intervention and control participants with financial difficulty scored 28% (95% CI 24% to 32%) and 32% (95% CI 27% to 38%), respectively (p=0.14). In participants who responded to the financial difficulty question at both time points (n=302), there was a net decrease in the percentage of participants who reported financial difficulty between baseline (21%) and follow-up (12%, p
The BETTER intervention improved uptake of CCDPS manoeuvres in participants without financial difficulty, but not in those living with financial difficulty. Improving CCDPS for people living with financial difficulty may require a different clinical approach or that social determinants be addressed concurrently with clinical and lifestyle needs or both.
As a chronic skin disease, psoriasis often affects the physical, psychological and social status of the patient, which in turn impacts on their experience of illness and needs. However, there is no review of qualitative research that integrates and analyses the experiences and needs of these three influences from a holistic perspective.
This review follows the ENTREQ guidelines. Six English databases (JBI, Cochrane Library, PubMed, PsyINFO, CINAHL and Embase) and three Chinese databases (CNKI, VIP and Wanfang) were searched from January 2012 to October 2022. Literature was included if it was relevant to the experience of illness and caring needs of patients with psoriasis. The JBI-QARI was used to rate the quality of included studies.
Eleven studies were included in the meta-synthesis. Four analytical themes were identified for analysis: physical challenges, psychological discomfort, social phenomena and caring needs.
The combined physical, psychological and social effects of psoriasis and the consequent caring needs should be emphasised. Health professionals, including doctors and nurses, should be aware of the multiple changes in patients and their coping strategies, provide information about psoriasis, monitor and follow-up regularly over time and obtain feedback to inform further treatment and care so as to develop high-quality therapeutic interventions to help and guide patients with their coping strategies.
These findings describe the physical, psychological and social experiences of illness and caring needs of patients with psoriasis. Healthcare professionals should be more aware of patients' easily overlooked psychological and social distress, providing prompt attention and recognition of patients' experiences and needs, offering relevant assistance and support and enhancing daily, regular follow-up to help them improve their understanding of and ability to manage their illness.
This is a meta-synthesis without direct patient involvement.
Early identification and intervention of the frailty of the elderly will help lighten the burden of social medical care and improve the quality of life of the elderly. Therefore, we used machine learning (ML) algorithm to develop models to predict frailty risk in the elderly.
A prospective cohort study.
We collected data on 6997 elderly people from Chinese Longitudinal Healthy Longevity Study wave 6–7 surveys (2011–2012, 2014). After the baseline survey in 1998 (wave 1), the project conducted follow-up surveys (wave 2–8) in 2000–2018. The osteoporotic fractures index was used to assess frailty. Four ML algorithms (random forest [RF], support vector machine, XGBoost and logistic regression [LR]) were used to develop models to identify the risk factors of frailty and predict the risk of frailty. Different ML models were used for the prediction of frailty risk in the elderly and frailty risk was trained on a cohort of 4385 elderly people with frailty (split into a training cohort [75%] and internal validation cohort [25%]). The best-performing model for each study outcome was tested in an external validation cohort of 6997 elderly people with frailty pooled from the surveys (wave 6–7). Model performance was assessed by receiver operating curve and F2-score.
Among the four ML models, the F2-score values were similar (0.91 vs. 0.91 vs. 0.88 vs. 0.90), and the area under the curve (AUC) values of RF model was the highest (0.75), followed by LR model (0.74). In the final two models, the AUC values of RF and LR model were similar (0.77 vs. 0.76) and their accuracy was identical (87.4% vs. 87.4%).
Our study developed a preliminary prediction model based on two different ML approaches to help predict frailty risk in the elderly.
The presented models from this study can be used to inform healthcare providers to predict the frailty probability among older adults and maybe help guide the development of effective frailty risk management interventions.
Detecting frailty at an early stage and implementing timely targeted interventions may help to improve the allocation of health care resources and to reduce frailty-related burden. Identifying risk factors for frailty could be beneficial to provide tailored and personalized care intervention for older adults to more accurately prevent or improve their frail conditions so as to improve their quality of life.
The study has adhered to STROBE guidelines.
No patient or public contribution.
This scoping review mapped and synthesised original research that identified low-value care in hospital settings as part of multicomponent processes.
Scoping review.
Electronic databases (EMBASE, PubMed, CINAHL, PsycINFO and Cochrane CENTRAL) and grey literature were last searched 11 July and 3 June 2022, respectively, with no language or date restrictions.
We included original research targeting the identification and prioritisation of low-value care as part of a multicomponent process in hospital settings.
Screening was conducted in duplicate. Data were extracted by one of six authors and checked by another author. A framework synthesis was conducted using seven areas of focus for the review and an overuse framework.
Twenty-seven records were included (21 original studies, 4 abstracts and 2 reviews), originating from high-income countries. Benefit or value (11 records), risk or harm (10 records) were common concepts referred to in records that explicitly defined low-value care (25 records). Evidence of contextualisation including barriers and enablers of low-value care identification processes were identified (25 records). Common components of these processes included initial consensus, consultation, ranking exercise or list development (16 records), and reviews of evidence (16 records). Two records involved engagement of patients and three evaluated the outcomes of multicomponent processes. Five records referenced a theory, model or framework.
Gaps identified included applying systematic efforts to contextualise the identification of low-value care, involving people with lived experience of hospital care and initiatives in resource poor contexts. Insights were obtained regarding the theories, models and frameworks used to guide initiatives and ways in which the concept ‘low-value care’ had been used and reported. A priority for further research is evaluating the effect of initiatives that identify low-value care using contextualisation as part of multicomponent processes.
This study aimed to understand how staff in children’s hospitals view their responsibility to reduce health inequalities for the children and young people who access their services.
We conducted an exploratory qualitative study.
The study took place at nine children’s hospitals in England.
217 members of staff contributed via interviews and focus groups conducted January–June 2023. Staff were represented at all levels of the organisations, and all staff who volunteered to contribute were included in the study.
Data were analysed using Rapid Research Evaluation and Appraisal (RREAL) methodology for rapid assessment procedures (RAP).
All of the children’s hospitals were taking some action to reduce health inequalities. Two key themes were identified. First, it was clear that reducing health inequalities was seen as something that was of vital import and should be part of staff’s day-to-day activity, framed as ‘everyone’s business.’ Many staff felt that there was an obligation to intervene to ensure that children and young people receiving hospital treatment were not further disadvantaged by, for example, food poverty. Second, however, the deeply entrenched and intersectional nature of health inequalities sometimes meant that these inequalities were complex to tackle, with no clear impetus to specific actions, and could be framed as ‘no-one’s responsibility’. Within a complex health and social care system, there were many potential actors who could take responsibility for reducing health inequalities, and staff often questioned whether it was the role of a children’s hospital to lead these initiatives.
Broadly speaking, senior leaders were clear about their organisational role in reducing health inequalities where they impacted on access and quality of care, but there was some uncertainty about the perceived boundaries of responsibility. This led to fragility in the sustainability of activity, and a lack of joined-up intervention. Most hospitals were forging ahead with activity, considering that it was more important to work to overcome health inequalities rather than debate whose job it was.
Introducción: Existe una tendencia mundial de incremento en los índices de sobrepeso y obesidad en niños menores de 5 años. Las creencias, percepciones y actitudes de las madres hacia las prácticas de alimentación y la obesidad tienen implicaciones directas sobre la salud del hijo. Objetivo: Explorar creencias sobre prácticas de alimentación y obesidad infantil entre madres con hijos menores de cinco años del noroeste de México. Metodología: Estudio cualitativo de aproximación etnográfica. Mediante un muestreo propositivo se realizaron nueve entrevistas semiestructuradas a mujeres que contaban con un promedio de 12 años de educación. Resultados: Las creencias incluyeron inseguridad para asumir el rol de madre, una baja percepción de apoyo familiar y creencias que no se alineaban con las recomendaciones de la lactancia materna exclusiva e introducción de alimentos complementarios. Además, estas tenían la creencia de que la obesidad no es un problema debido a la corta edad de sus hijos. Conclusiones: Existe una ambivalencia entre las creencias de las participantes y sus prácticas con relación a la alimentación y la obesidad infantil. Es imperativo desarrollar estrategias de educación y comunicación que proporcionen información basada en evidencia, de fácil acceso y disponible para madres con la intención de prevenir problemas de nutrición durante la primera infancia.
Objetivo: evaluar cualitativamente la experiencia de pacientes con esclerosis múltiple (PEM) y cuidadores familiares (CFPEM) vinculados al programa de esclerosis múltiple del Hospital Universitario Nacional de Colombia (PrEM-HUNC), durante la formación y consolidación de una comunidad compasiva (CC), para la inclusión social y promoción de calidad de vida. Materiales y Método: estudio cualitativo interpretativo, con entrevistas a profundidad a nueve colaboradores. Con el método de análisis de espiral de Creswell y Poth, emergieron cuatro categorías y un tema. Resultados: el tema “Un nido comunitario de crecimiento y transformación” señala el proceso de conformación de la CC como una experiencia que posibilitó cambios de significados en torno a la enfermedad, la situación personal y familiar; revela un proceso de descubrimiento y aprendizaje de conformación de diferentes relaciones y roles. Conclusiones: La CC es una opción para construcción de redes de apoyo, fortalecimiento de las capacidades personales y familiares, una forma para hacer frente a los diferentes impactos y retos que implica vivir con esclerosis múltiple, se constituye en una alternativa para la promoción de la calidad de vida y la inclusión social.
Objeto del presente ensayo reflexivo: mostrar y reflexionar sobre la utilidad que tiene la investigación cualitativa y/o fenomenológica en la atención del paciente que presenta diabetes. Desarrollo: la atención integral de una forma biopsicosocial, cultural y espiritual tanto al paciente como a la familia del mismo por parte del profesional sanitario, juega un papel importante a la hora de tener calidad de vida en el nuevo estilo de vida. Conclusiones y reflexiones finales: La investigación cualitativa en enfermería, ayuda a interpretar el sufrimiento del paciente, su relación con su entorno social y cultural y sus sentimientos e inquietudes dentro de la diabetes.
Actualmente el fenómeno de la relación de la perdida significativa de un ser querido y el consumo excesivo de alcohol ha minimizado las implicaciones sobre mecanismos de afrontamientos para generar conductas saludables. Este artículo se basa en entrevistas semiestructuradas a profundidad en hombres de entre 30 y 70 años, miembros con más de 10 años de Alcohólicos Anónimos del Estado de Tamaulipas, México, con el objetivo de reflexionar y analizar sobre los significados de la relación de la pérdida significativa de un ser querido y el consumo de alcohol. En la búsqueda del significado, se explica que lo que en realidad es un factor que lleva al alcoholismo no es una sola pérdida significativa y no solo de personas queridas o cercanas, sino más bien un cumulo de pérdidas inmateriales que suceden sobre todo en los primeros años de vida. Por otro lado se reflejaron recursos limitados para afrontar las pérdidas que iban experimentando, es decir, vivieron los duelos de forma compleja, lo que los llevó a seguir dependientes del alcohol, sin embargo se observan aprendizajes y características de ser resilientes ante emociones negativas y conductas dependientes.
Resumen
La función del ajuar funerario para el viaje al más allá forma parte esencial de los ritos y rituales funerarios de Oaxaca. La ideología de la iglesia es que una vez que estas muerta, el alma va directa al cielo, al purgatorio o al infierno. Los pueblos indígenas de Oaxaca tienen una visión mucho más compleja y matizada. La sombra, no el alma, sigue presente en estado liminal, observadora consciente. Hay pocos estudios sobre prácticas funerarias de rituales del ajuar funerario y la cosmovisión en regiones indígenas. El objetivo es describir prácticas funerarias en comunidades indígenas del sur de Oaxaca y su sentido simbólico. Se realizaron entrevistas en profundidad con 73 personas mayores indígenas quien describieran los objetos enterrados, sus propósitos, el viaje durante la novena y el final, la Tierra de los Muertos. El conocimiento de las creencias y prácticas representa un acercamiento a las estrategias cognitivas y emocionales de las comunidades. Nos permite adentrarnos en el conocimiento y respeto de su organización social y cosmovisión. La enseñanza y práctica no pueden ser adecuada sin una conciencia de las diversidades en las creencias sobre la muerte, el viaje al más allá y la Tierra de los Muertos.
Introducción: Los jóvenes universitarios están expuestos a cambios y transiciones que marcarán su salud en la adultez. Sus decisiones se traducen en comportamientos que pueden ser saludables o no, y dependen del significado de salud que se construye de conocimientos adquiridos, tradiciones o costumbres culturales. Objetivo: Comprender la influencia que tiene la cultura universitaria en la construcción del significado y prácticas de salud en estudiantes de pregrado de una sede, en una universidad privada en Colombia. Metodología: Estudio cualitativo, tipo etnografía. Participaron 15 estudiantes, 11 profesores y profesionales de Bienestar Universitario. Se aplicó una entrevista semiestructurada virtual, se procesaron los datos, y se sometieron a auditoría. Resultados: El significado de salud responde a una perspectiva individual y biopsicosocial; existe una fuerte influencia del entorno cercano y universitario en la significación y las prácticas de salud. Los hallazgos tienen similitud con otros estudios del ámbito internacional. Conclusiones: Se logró comprender la alta importancia que se da a la salud, entendiéndola principalmente como ausencia de enfermedad, reflejada en creencias, valores y prácticas. Se proponen unos retos, necesarios enfrentar, para hacer a las universidades promotoras del concepto amplio y renovado de la salud.
Non-communicable diseases cause 74% of global deaths, with cardiovascular diseases as the major contributor. Hypertension, a primary risk factor for cardiovascular disease, is highly prevalent in Africa. Diagnosis, treatment and control rates are notably limited in rural areas. This limitation results in increased risks of premature mortality and complications such as stroke due to socioeconomic, cultural and geographical challenges. Progress in African countries enhancing hypertension services through primary health care interventions exists. However, a comprehensive review of all primary health care interventions addressing undiagnosed and uncontrolled hypertension in rural African settings is lacking. This scoping review aims to categorise primary health care interventions targeting undiagnosed and uncontrolled hypertension in rural African adults. Intervention components will be mapped to the four stages outlined in the hypertension care cascade to develop a pilot intervention logic model for rural African adults with hypertension.
The scoping review protocol will adhere to the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Studies considered for inclusion will include any intervention delivered by any healthcare provider in a rural African primary care setting targeting any stage of hypertension care. Eight databases will be searched without date restrictions, supplemented by grey literature and reference list searches. A two-stage screening process (title/abstract and full text) will determine evidence source eligibility. All eligible sources of evidence will be extracted, charted and evaluated using the Template for Intervention Description and Replication checklist. A pilot logic model categorising and mapping interventions to the four stages of the hypertension care cascade will be visually presented and analysed using narrative synthesis.
No primary data will be collected; therefore, ethics approval is not required. Findings will be disseminated to local health authorities in Ghana and other African Regions and through national and international conferences and publications in peer-reviewed journals.
Childhood obesity is an escalating crisis in the United States. Health policy may impact this epidemic which disproportionally affects underserved populations.
The aim was to use the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework to assess health policy impact on preventing or treating school-aged children (5 > 18 years) with obesity in underserved populations.
A scoping review of 842 articles was conducted. Twenty-four articles met the inclusion criteria and underwent data extraction.
Twelve studies included subgroup analysis, with four suggesting an impact of policy on at-risk groups. None of the 24 studies fully applied the RE-AIM framework. Policies positively impacted childhood obesity in 12 studies across the sample.
Our review revealed inconsistent evidence for the effectiveness of policy on childhood obesity, perhaps due to the lack of focus on the social determinants of health. In addition, many studies did not evaluate the outcomes for underserved populations. Therefore, we propose more attention to social determinants in future legislation and evaluation of policy effectiveness on underserved populations. Findings identify an urgent need for the design, implementation, and evaluation of policies specifically directed to address the inequities of racism, social injustices, and social determinants of health that impact childhood obesity in the United States. Future work needs to identify who was reached by the policy, who benefitted from the policy, and how policies were implemented to address obesity-related health disparities. Nurses should advocate for the evaluation of childhood obesity policies, particularly in underserved populations, to determine effectiveness. Nurses, particularly those trained in population and community health and research, should advocate for policy research that considers inequities rather than controls for these variables. Multi-layered interventions can then be tailored to sub-populations and evaluated more effectively.
To explore eating and drinking experiences of patients with idiopathic pulmonary fibrosis (IPF), the impact of any changes associated with their diagnosis and any coping mechanisms developed by patients.
Pulmonary fibrosis support groups around the UK and the regional Interstitial Lung Diseases Clinic, Newcastle upon Tyne.
15 patients with IPF (9 men, 6 women), median age 71 years, range (54–92) years, were interviewed. Inclusion criteria included competent adults (over the age of 18 years) with a secure diagnosis of IPF as defined by international consensus guidelines. Patients were required to have sufficient English language competence to consent and participate in an interview. Exclusion criteria were a history of other lung diseases, a history of pre-existing swallowing problem of other causes that may be associated with dysphagia and individuals with significant communication or other memory difficulties that render them unable to participate in an interview.
A qualitative study based on semistructured interviews used purpose sampling conducted between February 2021 and November 2021. Interviews were conducted via video videoconferencing call platform or telephone call, transcribed and data coded and analysed using a reflexive thematic analysis.
Three main themes were identified, along with several subthemes, which were: (1) Eating, as such, is no longer a pleasure. This theme mainly focused on the physical and sensory changes associated with eating and drinking and their effects and the subsequent emotional and social impact of these changes; (2) It is something that happens naturally and just try and get on with it. This theme centred on the self-determined strategies employed to manage changes to eating and drinking; and (3) What is normal. This theme focused on patients seeking information to better understand the changes in their eating and drinking and the patients’ beliefs about what has changed their eating and drinking.
To our knowledge, this is the first study to report on IPF patients’ lived experience of eating and drinking changes associated with their diagnosis. Findings demonstrate that some patients have substantial struggles and challenges with eating and drinking, affecting them physically, emotionally and socially. There is a need to provide better patient information for this area and further study.
Despite the high number of operations and surgical advancement, rehabilitation after rotator cuff repair has not progressed for over 20 years. The traditional cautious approach might be contributing to suboptimal outcomes. Our aim is to assess whether individualised (early) patient-directed rehabilitation results in less shoulder pain and disability at 12 weeks after surgical repair of full-thickness tears of the rotator cuff compared with current standard (delayed) rehabilitation.
The rehabilitation after rotator cuff repair (RaCeR 2) study is a pragmatic multicentre, open-label, randomised controlled trial with internal pilot phase. It has a parallel group design with 1:1 allocation ratio, full health economic evaluation and quintet recruitment intervention. Adults awaiting arthroscopic surgical repair of a full-thickness tear are eligible to participate. On completion of surgery, 638 participants will be randomised. The intervention (individualised early patient-directed rehabilitation) includes advice to the patient to remove their sling as soon as they feel able, gradually begin using their arm as they feel able and a specific exercise programme. Sling removal and movement is progressed by the patient over time according to agreed goals and within their own pain and tolerance. The comparator (standard rehabilitation) includes advice to the patient to wear the sling for at least 4 weeks and only to remove while eating, washing, dressing or performing specific exercises. Progression is according to specific timeframes rather than as the patient feels able. The primary outcome measure is the Shoulder Pain and Disability Index total score at 12-week postrandomisation. The trial timeline is 56 months in total, from September 2022.
Providing comprehensible information is essential to the process of valid informed consent. Recruitment materials designed by sponsoring institutions in English-speaking, high-income countries are commonly translated for use in global health studies in other countries; however, key concepts are often missed, misunderstood or ‘lost in translation’. The aim of this study was to explore the language barriers to informed consent, focusing on the challenges of translating recruitment materials for maternal health studies into Zambian languages.
We used a qualitative approach, which incorporated a multistakeholder workshop (11 participants), in-depth interviews with researchers and translators (8 participants) and two community-based focus groups with volunteers from community advisory boards (20 participants). Content analysis was used to identify terms commonly occurring in recruitment materials prior to the workshop. The framework analysis approach was used to analyse interview data, and a simple inductive thematic analysis approach was used to analyse focus group data.
The study was based in Lusaka, Zambia.
The workshop highlighted difficulties in translating research terms and pregnancy-specific terms, as well as widespread concern that current templates are too long, use overly formal language and are designed with little input from local teams. Framework analysis of in-depth interviews identified barriers to participant understanding relating to design and development of recruitment materials, language, local context and communication styles. Focus group participants confirmed these findings and suggested potential solutions to ensure the language and content of recruitment materials can be better understood.
Our findings demonstrate that the way in which recruitment materials are currently designed, translated and disseminated may not enable potential trial participants to fully understand the information provided. Instead of using overly complex institutional templates, recruitment materials should be created through an iterative and interactive process that provides truly comprehensible information in a format appropriate for its intended participants.
This Phase 1b study was designed to evaluate the safety and efficacy of pravibismane, a novel broad-spectrum topical anti-infective, in managing moderate or severe chronic diabetic foot ulcer (DFU) infections. This randomized, double-blind, placebo-controlled, multicenter study consisted of 39 individuals undergoing pravibismane treatment and 13 individuals in the placebo group. Assessment of safety parameters included clinical observations of tolerability and pharmacokinetics from whole blood samples. Pravibismane was well-tolerated and exhibited minimal systemic absorption, as confirmed by blood concentrations that were below the lower limit of quantitation (0.5 ng/mL) or in the low nanomolar range, which is orders of magnitude below the threshold of pharmacological relevance for pravibismane. Pravibismane treated subjects showed approximately 3-fold decrease in ulcer size compared to the placebo group (85% vs. 30%, p = 0.27). Furthermore, the incidence of ulcer-related lower limb amputations was approximately 6-fold lower (2.6%) in the pooled pravibismane group versus 15.4% in the placebo group (p = 0.15). There were no treatment emergent or serious adverse events related to study drug. The initial findings indicate that topical pravibismane was safe and potentially effective treatment for improving recovery from infected chronic ulcers by reducing ulcer size and facilitating wound healing in infected DFUs (ClinicalTrials.gov Identifier NCT02723539).
Fall prevention is crucial for older adults. Enhanced fall risk perception can encourage older adults to participate in fall prevention programs. However, there is still no unified definition of the concept of fall risk perception.
To explore the concept of fall risk perception in older adults.
A concept analysis.
The literature was searched using online databases including PubMed, Cochrane Library, Embase, CINAHL Complete, PsycINFO, Web of Science, China National Knowledge Infrastructure, WangFang and SinoMed. Searches were also conducted in Chinese and English dictionaries. The literature dates from the establishment of the database to April 2023.
The methods of Walker and Avant were used to identify antecedents, attributes and consequences of the concept of “fall risk perception” in older adults.
Eighteen publications were included eventually. The attributes were identified as: (1) dynamic change, with features of continuum and stage; (2) whether falls are taken seriously; (3) a self-assessment of the fall probability, which is driven by individual independence; and (4) involves multiple complex emotional responses. The antecedents were identified as: (1) demographic and disease factors; (2) psychological factors and (3) environmental factors. The consequences were identified as: (1) risk-taking behaviour; (2) risk compensation behaviour; (3) risk transfer behaviour; and (4) emotions.
A theoretical definition of fall risk perception was identified. A conceptual model was developed to demonstrate the theoretical relationships between antecedents, attributes and consequences. This is helpful for the development of relevant theories and the formulation of fall prevention measures based on fall risk perception as the intervention target.
To analyse the process of elaborating social representations about pressure injury preventive measures by the nursing team (nurses and nurse technicians) and how this process relates to preventive practices for hospitalized patients.
Qualitative study, with the application of the theory of social representations in its procedural methodological approach.
The study was carried out in an inpatient clinic of a public hospital in the state of Rondônia, Brazil. Totally, 28 nursing professionals in the medical clinic sectors who had worked directly with patient care for more than 6 months participated. The data were collected between July and September 2021 via in-depth interviews with the application of a semi-structured instrument. Analysis was carried out with the help of ALCESTE software, which performed a lexicographic analysis, and also via thematic analysis. The COREQ guided the presentation of the research report.
The social representations were developed based on the professionals' symbolic beliefs about the visibility/invisibility of the results of applying preventive care. These symbolic constructions mobilized positive and negative feelings among the nursing team, which guided the classification of prevention practices as being of greater or lesser priority among other care activities. There were favourable attitudes among professionals, which included applying prevention measures in their daily routines, and unfavourable attitudes of non-adherence to the institution's protocol for preventing pressure injuries.
The nursing team's perception of pressure injury prevention is influenced by symbolic, affective, values, and social dimensions. Non-adherence behaviours are attributed to the belief in the invisibility of prevention outcomes, resulting in a reluctance to implement preventive measures.
Understanding the subjective logic that explains the thinking and actions of the nursing team suggests the need to incorporate discussions on beliefs, values, sentiments, and attitudes of nursing professionals into educational programs on pressure injury prevention.
No public contribution.
FreshRSS 