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Perceived satisfaction of prenatal care among women without social security: comparative qualitative analysis between individual and group care models in Mexico

Por: Santivanez Salazar · M. R. · Alcalde-Rabanal · J. E. · Heredia-Pi · I. B. · Darney · B. · Campero · L.
Background

The inadequate handling of obstetrical complications may be attributed to the suboptimal quality of prenatal care (PC) and a lack of trust in healthcare provider (HP) among pregnant women.

Objective

This study explores the perceptions of satisfaction among women without social security regarding the PC provided by public health services, and compares the dimensions of satisfaction between those who received group prenatal care (GPC) and those who received individual prenatal care (IPC), as well as to identify the dimensions of satisfaction most valued by women to support the inclusion of said dimensions in primary health guidelines.

Design

We performed a qualitative analysis to explore women’s satisfaction perception regarding PC. Satisfaction was explored using the following dimensions: women-HP relationship, educational support, opportunity of PC, emotional support and perception of clinical procedures.

Setting

The study was conducted between 2015 and 2018 across eight primary health facilities, from which four implemented IPC and four implemented GPC. Semi-structured interviews were applied: 28 for women with IPC and 18 for women with GPC. The sample size was defined by theoretical saturation. Content analysis was performed using a combination of deductive–inductive process into dimensions and attributes. To analyse the relationship among dimensions and attributes, we performed onto semiotic networks. ATLAS.ti was used to analyse the information.

Participants

Women without social security who received PC care in public health facilities.

Results

Women who received GPC reported higher satisfaction than those who received IPC. In GPC, the most valued dimensions were (1) women-HP relationship, particularly the continuity of care delivered by the same HP and (2) the trust in that same provider. According to semiotic networks, these dimensions showed interconnections with each other, but also connected with attributes of other dimensions. Therefore, they have the potential to enhance trust, communication, the effectiveness of educational activities and emotional support.

Conclusion

A holistic approach to GPC is essential for ensuring a positive prenatal experience. However, a hybrid model that incorporates elements of both IPC can further enhance overall satisfaction among women. Consistency in care, particularly by providing services in public health facilities with the same HP, should be a fundamental strategy in PC, as it can significantly improve women’s satisfaction.

International Registry of thyroid cancer in Latin American (CaTaLiNA): epidemiology, clinical and follow-up study protocol in Latin American countries during the period 2023-2028

Por: Solis Pazmino · P. · Pilatuna · E. · Ron · M. · Ledesma · T. · Alvarado · B. · Rojas · T. · Pazmino · C. · Tite · B. · Figueroa · L. · Lincango · E. · Hernandez · V. · Salazar · J. · Garcia · C. · Rosero · D. · Guerrero · J. · Ruilova · L. · Imaicela · L. · Abad · H. · Paz-Ibarra · J. · Gonz
Introduction

Differentiated thyroid cancer (DTC) is the most common endocrine malignancy, with a high 5-year survival rate of approximately 98%. Despite advances in diagnosis and treatment, up to 20% of patients experience recurrence, adversely affecting their quality of life. Predictive models have been developed to assess recurrence risk and guide clinical decision-making, but these models often face limitations such as retrospective design, lack of diversity in study populations and absence of external validation. The primary aim is to externally validate existing predictive models for DTC recurrence using prospective data from a diverse Latin American cohort. The secondary aim is to explore opportunities for model recalibration to improve their performance in our population.

Methods and analysis

The CaTaLiNA study is a multicentre prospective observational study conducted across 10 hospitals in five Latin American countries, including Ecuador, Peru, Uruguay and Mexico. Patients aged 18 years or older receiving treatment for DTC, such as the first thyroid surgery, active surveillance or radiofrequency ablation will be included. Recruitment will occur from November 2023 to June 2025, with follow-up extending until June 2028. Data collection will include baseline clinical, surgical and histological characteristics, treatment details and follow-up outcomes. Statistical analysis will follow the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis guidelines, using imputation strategies for missing data and evaluating calibration and discrimination of the prediction models. Calibration measures include the ratio of expected and observed events, calibration slope and calibration plot, while discrimination will be assessed using the C-index and area under the receiver operating characteristic curve.

Ethics and dissemination

This study protocol was approved by Comité de Ética de Investigación en Seres Humanos de la Universidad San Francisco de Quito USFQ ‘CEISH-USFQ’ APO-010–2023-CEIHS-USFQ Oficio No. 161-2023-CA-23030M-CEISH-USFQ. Results will be disseminated via peer-reviewed publications.

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