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Posadas JJB, Abad PJB, Gayeta JR, Cacatian CJV, Reveche KDPB, Tomanan KJL. Leadership Development Program for Public Health Nurses: An Evaluation of Workplace Application. ACTA MEDICA PHILIPPINA 2024; 58:56-69. [PMID: 39071528 PMCID: PMC11272891 DOI: 10.47895/amp.v58i12.10045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Background and Objective Public health nurses (PHNs) are vital in the local implementation of the provisions of the Universal Healthcare (UHC) Act of 2019. However, they need adequate competencies in health systems approach to successfully implement the provisions of the law. In response to this, a leadership development course for public health nurses (LDC-PHN), anchored on the building blocks of health systems, was developed and implemented. This paper aims to describe the extent to which training participants have applied the competencies acquired from the LDC-PHN as manifested by the workplace application of their capstone projects. Methods Following Kirkpatrick's Model of Evaluation, we used a multi-method study design to evaluate the extent of the participants' workplace application of acquired competencies. Sources of data included the Workplace Application Plan (WAP) accomplished by each participant, a questionnaire to determine the perceived implementation status of the participants' capstone project, interviews, and focus group discussions (FGDs) conducted with selected participants and their supervisors, and observation visits. Data were collected from May to December 2022. Data from the semistructured interviews and FGDs were analyzed through content analysis, while the participants' perceived status of their capstone project implementation was summarized as frequencies. Results Majority of the participants (61.9%) reported partial implementation of their capstone project while 16.77% reported full implementation. Capstone project implementation was facilitated by the support received from their supervisors and local chief executives. Barriers identified included the demands of the COVID-19 pandemic and the challenges imposed by the events before and after the 2022 Philippine National elections. Major themes emerged from the interviews conducted among participants and their supervisors. The workplace application of the training program outcomes, based on participants' perspectives, yielded increased capacity to lead and innovate, improved ability to advocate for capstone project implementation, transferability of acquired skill sets, and improved population outcomes. From supervisors' perspectives, workplace application of training program outcomes include increased ability of PHNs to deliver health services, and visible enhancement of leadership and supervision skills among PHNs. Conclusion Given ample support and opportunities, and despite the barriers and challenges they faced, LDC-PHN participants, in general, utilized and applied the competencies they gained from the course in their actual work setting. Course graduates participated in health systems strengthening at various capacities by acting upon their capstone projects that addressed UHC challenges within their particular work settings.
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Affiliation(s)
| | - Peter James B. Abad
- College of Nursing, University of the Philippines Manila, Manila, Philippines
- College of Nursing, University of Iowa, Iowa, USA
| | - Jazryl R. Gayeta
- College of Nursing, University of the Philippines Manila, Manila, Philippines
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Yanful B, Kirubarajan A, Bhatia D, Mishra S, Allin S, Di Ruggiero E. Quality of care in the context of universal health coverage: a scoping review. Health Res Policy Syst 2023; 21:21. [PMID: 36959608 PMCID: PMC10035485 DOI: 10.1186/s12961-022-00957-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 12/28/2022] [Indexed: 03/25/2023] Open
Abstract
INTRODUCTION Universal health coverage (UHC) is an emerging priority of health systems worldwide and central to Sustainable Development Goal 3 (target 3.8). Critical to the achievement of UHC, is quality of care. However, current evidence suggests that quality of care is suboptimal, particularly in low- and middle-income countries. The primary objective of this scoping review was to summarize the existing conceptual and empirical literature on quality of care within the context of UHC and identify knowledge gaps. METHODS We conducted a scoping review using the Arksey and O'Malley framework and further elaborated by Levac et al. and applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews reporting guidelines. We systematically searched MEDLINE, EMBASE, CINAHL-Plus, PAIS Index, ProQuest and PsycINFO for reviews published between 1 January 1995 and 27 September 2021. Reviews were eligible for inclusion if the article had a central focus on UHC and discussed quality of care. We did not apply any country-based restrictions. All screening, data extraction and analyses were completed by two reviewers. RESULTS Of the 4128 database results, we included 45 studies that met the eligibility criteria, spanning multiple geographic regions. We synthesized and analysed our findings according to Kruk et al.'s conceptual framework for high-quality systems, including foundations, processes of care and quality impacts. Discussions of governance in relation to quality of care were discussed in a high number of studies. Studies that explored the efficiency of health systems and services were also highly represented in the included reviews. In contrast, we found that limited information was reported on health outcomes in relation to quality of care within the context of UHC. In addition, there was a global lack of evidence on measures of quality of care related to UHC, particularly country-specific measures and measures related to equity. CONCLUSION There is growing evidence on the relationship between quality of care and UHC, especially related to the governance and efficiency of healthcare services and systems. However, several knowledge gaps remain, particularly related to monitoring and evaluation, including of equity. Further research, evaluation and monitoring frameworks are required to strengthen the existing evidence base to improve UHC.
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Affiliation(s)
- Bernice Yanful
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Abirami Kirubarajan
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Dominika Bhatia
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sujata Mishra
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sara Allin
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Erica Di Ruggiero
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Centre for Global Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Sousa RDFD, Rodrigues ILA, Pereira AA, Nogueira LMV, Andrade EGRD, Pinheiro AKC. Condições de saúde e relação com os serviços de saúde na perspectiva de pessoas de quilombo. ESCOLA ANNA NERY 2023. [DOI: 10.1590/2177-9465-ean-2022-0164pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Resumo Objetivos analisar as percepções da população quilombola de Caldeirão sobre suas condições de saúde e identificar as possibilidades e dificuldades na relação com os serviços de saúde em seu território. Método estudo qualitativo, descritivo e exploratório, realizado na Comunidade Quilombola de Caldeirão, Ilha de Marajó, Pará, Brasil. A produção dos dados ocorreu no período de março a abril de 2021, por meio de entrevistas semiestruturadas individuais com 30 moradores, e aplicou-se a análise de conteúdo temática. Resultados originaram-se duas categorias empíricas, revelando as percepções da população quilombola sobre suas condições de saúde e o processo saúde-doença, a relação que a comunidade mantinha com os serviços de saúde locais e as potencialidades e fragilidades inerentes a essa relação. Conclusões e implicações para a prática as percepções dos quilombolas evidenciaram predomínio do saber biomédico e da visão hospitalocêntrica, além de sua relação fragilizada com os serviços de saúde locais. Espera-se que os resultados da pesquisa suscitem o diálogo acerca dessas populações, considerando que representam um grupo tradicional em situação de vulnerabilidade. É necessário realizar outras pesquisas para investigar/fortalecer o papel da Estratégia Saúde da Família e desvelar/problematizar os saberes tradicionais, frente à hegemonia do saber biomédico, no cenário das populações quilombolas.
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Sousa RDFD, Rodrigues ILA, Pereira AA, Nogueira LMV, Andrade EGRD, Pinheiro AKC. Health conditions and relationship with health services from Quilombola people’s perspective. ESCOLA ANNA NERY 2023. [DOI: 10.1590/2177-9465-ean-2022-0164en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Abstract Objectives to analyze the perceptions of the Quilombola population of Caldeirão about their health conditions and to identify the possibilities and difficulties in the relationship with the health services in their territory. Method a qualitative, descriptive and exploratory study, carried out in the Quilombola Community from Caldeirão, Marajó Island, Pará, Brazil. Data production took place from March to April 2021, through individual semi-structured interviews with 30 residents, and thematic content analysis was applied. Results two empirical categories originated, revealing the Quilombola population’s perceptions about their health conditions and the health-disease process, the relationship that the community had with the local health services and the strengths and weaknesses inherent to this relationship. Conclusions and implications for practice Quilombola people’s perceptions showed a predominance of biomedical knowledge and a hospital-centric view, in addition to their weakened relationship with local health services. It is expected that the research results will encourage dialogue about these populations, considering that they represent a traditional group in a vulnerable situation. It is necessary to carry out further research to investigate/strengthen the Family Health Strategy role and unveil/problematize traditional knowledge in the face of biomedical knowledge hegemony in the scenario of Quilombola populations.
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Hosseinnejad A, Rassouli M, Jahani S, Elahi N, Molavynejad S. Community Health Nursing in Iran: A Review of Challenges and Solutions (An Integrative Review). Front Public Health 2022; 10:899211. [PMID: 35832285 PMCID: PMC9271779 DOI: 10.3389/fpubh.2022.899211] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objective In recent decades, nursing has witnessed many changes in Iran. Despite the numerous advances in nursing, the health system faces many challenges in community health nursing. This study aims to review the challenges in community health nursing in Iran and provide an evidence-based solution as well. Materials and Methods This article is an integrated review of the literature regarding the challenges in community health nursing published between 2000 and 2021 in the databases Scopus, Medline, Cochrane Database of Systematic Reviews, Science Direct, Google Scholar, Scientific Information Database (SID). After performing searches, 20 articles were selected and studied. Data analysis was done using Russell approach (2005). Findings The results of this study were summarized in 6 themes consisting of challenges in community health nursing education, practical challenges in community health nursing, policy-making challenges in community health nursing, management challenges in community health nursing, and infrastructural and cultural challenges. Solutions were also proposed to address each of the above issue. Conclusions The results of the study showed that diverse challenges exist in community health nursing in Iran, considering that community health nurses play an important role in providing primary health care and community-based care. In order to solve these challenges, the authors have some recommendations: modifying the structure of the health system with the aim of moving toward a community-oriented approach from a treatment-oriented one, developing laws to support community health nurses, creating an organizational chart for nurses at the community level, modifying nursing students' training through a community-based approach, and covering community-based services and care under insurance.
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Affiliation(s)
- Aazam Hosseinnejad
- Student Research Committee, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Rassouli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Simin Jahani
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- *Correspondence: Simin Jahani
| | - Nasrin Elahi
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahram Molavynejad
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Hughes TL, George M, Shah R, Dias BM, Dohrn JE, De Bortoli Cassiani SH. Nursing engagement in research priorities focused on health systems and services in Latin America countries. HUMAN RESOURCES FOR HEALTH 2022; 20:45. [PMID: 35606802 PMCID: PMC9125952 DOI: 10.1186/s12960-022-00746-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND A strong nursing research agenda in Latin America is fundamental to universal health coverage. Nursing science can make important contributions to the health of Latin American people through knowledge generation that directly informs nursing practice, professional education, and health policy. METHODS We used a cross-sectional survey design to assess nursing involvement in health systems and services research in Latin America in five priority areas: Policies and education related to nursing human resources; Structure, organization and dynamics of health systems and services; Science, technology, innovation, and information systems in public health; Health policies, governance, and social control; and Social studies in the health field. RESULTS Nursing and midwifery participants (N = 856) from Latin American countries completed the survey. Respondents who reported conducting research focused primarily on Policies and Education related to Nursing Human Resources and Structure, Organization, and Dynamics of Health Systems and Services. Across the five priority areas, more nurses reported using research findings and/or being aware of research than conducting research. CONCLUSIONS Survey results indicate that nursing research in Latin America is currently disproportionately focused on nursing education and practice. More research focused on information technology, nurse's impact on public health, and the threats posed by nurse migration is needed to better address health needs of Latin American populations.
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Affiliation(s)
- Tonda L. Hughes
- Columbia University School of Nursing, 560 168th Street, New York, NY 10032 United States of America
| | - Maureen George
- Columbia University School of Nursing, 560 168th Street, New York, NY 10032 United States of America
| | - Ruby Shah
- Columbia University School of Nursing, 560 168th Street, New York, NY 10032 United States of America
| | - Bruna Moreno Dias
- Pan American Health Organization, 525 23rd NW, Washington, DC 20037 United States of America
| | - Jennifer E. Dohrn
- Columbia University School of Nursing, 560 168th Street, New York, NY 10032 United States of America
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Machado RR, Pires DEPD, Trindade LDL, Amadigi FR, Melo TAPD, Mendes M. Management in the Family Health Strategy: workloads and structured institutional violence. Rev Bras Enferm 2022; 75:e20220071. [DOI: 10.1590/0034-7167-2022-0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/19/2022] [Indexed: 12/23/2022] Open
Abstract
ABSTRACT Objectives: to understand the relationship between workloads and institutional violence in Family Health Strategy managers’ practice. Methods: qualitative research using theoretical triangulation and data from semi-structured interviews. Participants were 35 managers of Basic Health Units in the five Regions of Brazil, who worked in the Family Health Strategy. We used thematic analysis and ATLAS.ti for data analysis. Results: workloads were analyzed, showing relationships with institutional violence. Thematic categories emerged: “related to the management work itself”; “related to other instances of health system management”; “related to users and community”. There was an interrelationship between increased managers’ workloads and institutional violence. Final Considerations: the Family Health Strategy is relevant for universal access to health and requires favorable institutional conditions for its effectiveness. Adverse scenarios lead to increased workloads, approaching institutional violence.
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Affiliation(s)
| | | | - Letícia de Lima Trindade
- Universidade do Estado de Santa Catarina, Brazil; Universidade Comunitária da Região de Chapecó, Brazil
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Machado RR, Pires DEPD, Trindade LDL, Amadigi FR, Melo TAPD, Mendes M. Gestão na Estratégia Saúde da Família: cargas de trabalho e violência institucional estruturada. Rev Bras Enferm 2022. [DOI: 10.1590/0034-7167-2022-0071pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO Objetivos: compreender a relação entre cargas de trabalho e violência institucional na prática dos gestores da Estratégia Saúde da Família. Métodos: pesquisa qualitativa com triangulação teórica, por meio de entrevistas semiestruturadas. Participaram 35 gestores de Unidades Básicas de Saúde das cinco regiões do Brasil que atuavam na Estratégia Saúde da Família. Na análise dos dados, utilizaram-se análise temática e o software ATLAS.ti. Resultados: as cargas de trabalho foram analisadas, evidenciando relações com a violência institucional. Surgiram categorias temáticas: “relacionadas com o próprio trabalho de gestão”; “relacionadas com outras instâncias de gestão do sistema de saúde”; “relacionadas aos usuários e população adstrita”. Verificou-se inter-relação entre aumento das cargas de trabalho dos gestores e violência institucional. Considerações Finais: a Estratégia Saúde da Família é relevante para o acesso universal à saúde e requer condições institucionais favoráveis para sua efetividade. Cenários adversos geram aumento de cargas de trabalho, aproximando-se da violência institucional.
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Affiliation(s)
| | | | - Letícia de Lima Trindade
- Universidade do Estado de Santa Catarina, Brazil; Universidade Comunitária da Região de Chapecó, Brazil
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Rivasplata H, Dettmann N, LeVan ER, Santos Gutierrez Callisaya E, Sarmiento Callejas R, Blood-Siegfried J, Felsman IC. A Continued Professional Development Nursing Partnership in a Remote Bolivian Hospital. J Contin Educ Nurs 2021; 52:142-149. [PMID: 33631025 DOI: 10.3928/00220124-20210216-09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/23/2020] [Indexed: 11/20/2022]
Abstract
Bolivia's recent enactment of universal health care to increase access and delivery of health services can increase health care demands in underresourced, rural communities. We describe how a global intradisciplinary partnership assessed changing health care needs in a recently expanded hospital in the Bolivian Amazon Basin. The collaboration resulted in designing and implementing an evidence-based triage training program to improve rapid assessment and health outcomes. The interdisciplinary triage training of 19 nurses and physicians showed a significant improvement in their knowledge and implementation capacity, as demonstrated by pre- and posttest scores. As an intradisciplinary team, trainees significantly increased consistency in triage assignments in nine of 10 clinical triage posttraining vignettes. We share insights to overcome unseen challenges and improve future data-driven, evidence-based global implementation projects. [J Contin Educ Nurs. 2021;52(3):142-149.].
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May SY, Clara N, Khin OK, Mar WW, Han AN, Maw SS. Challenges faced by community health nurses to achieve universal health coverage in Myanmar: A mixed methods study. Int J Nurs Sci 2021; 8:271-278. [PMID: 34307775 PMCID: PMC8283707 DOI: 10.1016/j.ijnss.2021.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 11/29/2022] Open
Abstract
Objective This study aimed to identify the challenges of community health nurses (CHNs) in delivering effective community health care to achieve universal health coverage (UHC) in Myanmar. Methods A total of 30 CHNs from township health centers in the northeastern, southern, and western parts of Myanmar were purposefully recruited for quantitative and qualitative interviews. Quantitative data were processed using Microsoft Excel software, and qualitative data were analyzed using thematic analysis. This study is registered with researchregistry6201. Results Around the country, 30 CHNs uncovered their hardships in implementing primary health care to achieve UHC. Over 90% of the participants agreed to the problem of inadequate health infrastructure, while half of them felt unmotivated when they encountered role conflicts among various cadres of healthcare providers and poor opportunities for career promotion. Major problems arose from the lack of standard professional education at the entry point to community settings because most CHNs did not achieve specialized training in providing public health services. Complications are incapable of evaluating health services for policy-making and the inability to conduct health research to develop evidence-based practices. Insecure work and living conditions, unsupportive community relationships, and undereducation in professional practices were supportive major themes explored by CHNs to achieve a deeper understanding of the barriers to UHC. Not only the health system itself but also the population and other geographical factors have contributed to many challenges to CHNs. Conclusion Myanmar's CHNs face many challenges in achieving UHC. These challenges are not confined to the health sector. Some situations, such as geographical barriers and transportation problems, remain persistent challenges for healthcare providers. This study highlights the fact that current health systems should be strengthened by qualified healthcare providers and sufficient infrastructure. Meanwhile, public empowerment plays a critical role in promoting health development.
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Rezende LC, Caram CDS, Rezende LS, Santos TCC, Caçador BS, Brito MJM. A prática do enfermeiro na implementação de políticas públicas para a população negra: à luz da ética feminista. SAUDE E SOCIEDADE 2021. [DOI: 10.1590/s0104-12902021210004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Este estudo analisou as contribuições da prática do enfermeiro na implementação da Política Nacional de Saúde Integral da População Negra em comunidades quilombolas, sob o prisma da ética feminista. Estudo de caso único e integrado de abordagem qualitativa fundamentado na teoria da ética feminista. A coleta de dados ocorreu entre fevereiro e junho de 2018 por meio de entrevistas realizadas com sete enfermeiros da Estratégia Saúde da Família, que atuam em comunidades quilombolas na região metropolitana de Belo Horizonte, MG, Brasil. Os dados foram submetidos à análise de conteúdo com auxílio do software ATLAS.ti, versão 8. Os resultados apontaram contribuições da prática do enfermeiro na implementação da PNSIPN e estão apresentados pelas seguintes categorias: criação de vínculo; enfermeiro na comunidade e; reconhecimento das particularidades da comunidade. Tais aspectos se mostraram importantes para a implementação efetiva da Política Nacional de Saúde Integral da População Negra na comunidade.
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Development and psychometric evaluation of Nurses and Midwives' Perceptions of their Roles in Primary Healthcare. Int J Nurs Sci 2020; 7:460-465. [PMID: 33195759 PMCID: PMC7644550 DOI: 10.1016/j.ijnss.2020.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/18/2020] [Accepted: 09/15/2020] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed to develop Nurses and Midwives' Perceptions of their Roles in Primary Healthcare (NMPR-PHC) and evaluate its psychometric properties. Methods A cross-sectional survey was performed to recruit a convenient sample of 150 registered nurses and midwives from various primary healthcare settings in Jordan. Reliability was evaluated by examining the internal consistency and split-half reliability of the item. A exploratory factor analysis was performed to assess the factor structure of the NMPR-PHC. Results The final version of NMPR-PHC contained 18 items. Exploratory factor analysis revealed six factors (care coordination and interprofessional collaboration, workplace facilitators of the primary healthcare, management of care, research, workplace constraints of primary healthcare, and advanced education) for the questionnaire which explained 66.49% of the total variance. The Cronbach's α of the total scale was 0.834, the subscales Cronbach's α were ranging between 0.662 and 0.770, and the split-half reliability of the total scale was 0.734. Conclusion The overall performance of the questionnaire showed promising sound psychometric properties. The NMPR-PHC can be recommended for use as a tool for the assessment of nurses and midwives' perceptions of their roles in primary healthcare.
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Tourani S, Malmoon Z, Zaboli R, Jafari M, Nemati A. Training needs assessment of nursing managers for achieving university health coverage. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:139. [PMID: 32766324 PMCID: PMC7377128 DOI: 10.4103/jehp.jehp_114_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 02/23/2020] [Indexed: 05/05/2023]
Abstract
BACKGROUND University health coverage gives everyone accesses to health services focused on the most important causes of illness and death and ensures that the quality of services is high enough to improve the health of those receiving services. Nurses as the largest group of staff in the health system play an important role in achieving UHC. This study aimed to determine the training needs of nursing managers in universities of medical sciences of Iran in achieving UHC. MATERIALS AND METHODS This study was a qualitative study conducted in 2019 using the framework method. There were 15 experts in nursing management, health management, and nursing authorities at the national level using the purposive random sampling. Data were collected from the expert panel. We used the Atlas.ti software version 7.2 and using the framework method for the analysis of qualitative data. A set of codes organized into categories that were jointly developed by the researchers involved in the analysis. The UHC framework used to summarize data in a way that could support answering research questions. RESULTS This study showed that three educational modules leadership and strategic thinking, management, and decision-making, achieving excellence in nursing management to capacity building of nursing managers in the country. CONCLUSION Training leadership skills and strategic thinking in the nursing empowerment modules illuminate global and national health roadmaps and policies and change attitudes to the model of nursing service delivery. Since nurses are the largest group of professionals in the health system, it facilitated by changes in the role and functions of the hospital and nurses to reach UHC.
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Affiliation(s)
- Sogand Tourani
- Department of Health Administration, Iran University of Medical Sciences, Tehran, Iran
| | - Zainab Malmoon
- Department of Health Administration, Iran University of Medical Sciences, Tehran, Iran
| | - Rouhollah Zaboli
- Departmet of Health Administration, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mehdi Jafari
- Department of Health Administration, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Nemati
- Department of Health Administration, Iran University of Medical Sciences, Tehran, Iran
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Dalmolin IS, Heidemann ITSB. Integrative and complementary practices in Primary Care: unveiling health promotion. Rev Lat Am Enfermagem 2020; 28:e3277. [PMID: 32520237 PMCID: PMC7282717 DOI: 10.1590/1518-8345.3162.3277] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 03/03/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to understand the use of integrative and complementary practices as a health promotion action. METHOD qualitative study, action-participant type, with the application of Paulo Freire's Research Itinerary, in which 30 Primary Health Care professionals participated. Thematic research was developed with two Primary Care Units, one that used integrative and complementary practices in daily life and another that focused more on allopathic concepts of assistance. To carry out the three stages of the method used, seven Culture Yarning Circles took place. The critical unveiling took place concurrently with the participation of those surveyed. RESULTS integrative and complementary practices constitute a form of health care, with the purpose of understanding the human being in the health-disease process, making it possible to work with the different aspects that involve them. In this way, they reduce damages resulting from the excessive use of medications, stimulate comprehensiveness and promote health. CONCLUSION integrative and complementary practices are resources for health promotion, through comprehensive care and reducing the use of medications.
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Affiliation(s)
- Indiara Sartori Dalmolin
- Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.,Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
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Saif-Ur-Rahman KM, Mamun R, Nowrin I, Hossain S, Islam K, Rumman T, Kabir E, Rahman A, Dahal N, Anwar I. Primary healthcare policy and governance in low-income and middle-income countries: an evidence gap map. BMJ Glob Health 2019; 4:e001453. [PMID: 31478021 PMCID: PMC6703287 DOI: 10.1136/bmjgh-2019-001453] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/25/2019] [Accepted: 05/04/2019] [Indexed: 12/04/2022] Open
Abstract
Introduction Governance is one of the most important aspects for strong primary healthcare (PHC) service delivery. To achieve the targets for the Sustainable Development Goals, good governance may play a prime role in low-income and middle-income countries (LMICs). This evidence gap map (EGM) explored the available evidence in LMICs to identify the knowledge gap concerning PHC policy and governance in these settings. Methods We followed the standard 3ie EGM protocol, finalising the scope of the EGM through a stakeholder workshop. We searched a total of 32 bibliographic databases, systematic review databases, impact evaluation databases, and donor and bilateral agency databases using a comprehensive search strategy. Two reviewers screened retrieved studies, extracted data and performed quality assessment. We plotted the interventions and outcomes derived from the included studies in a dynamic platform to build the interactive EGM and conducted a stakeholder consultation with nominal group technique methods to prioritise the identified gaps. Results The EGM included 24 systematic reviews and 7 impact evaluations focusing on PHC policy and governance in LMICs. Most of the sources emphasised workforce management and supervision. There were noticeable evidence gaps regarding accountability and social responsibility. The most highly prioritised themes were the role of accountability, the role of public–private partnerships and the role of user–provider communication in PHC governance. Conclusions This EGM identified some important aspects of PHC policy and governance such as accountability, social responsibility, public–private partnership, user–provider communication through the methodological approaches of evidence synthesis and stakeholder consultation. Identified gaps will provide directions for an implementation research plan to improve the governance of PHC in LMICs.
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Affiliation(s)
- K M Saif-Ur-Rahman
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Razib Mamun
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Iffat Nowrin
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Shahed Hossain
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Khaleda Islam
- Primary Health Care, Government of Bangladesh Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Tajkia Rumman
- Department of Public Health & Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Ehtesham Kabir
- Directorate General of Health Services, Dhaka, Bangladesh
| | - Aminur Rahman
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | | | - Iqbal Anwar
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
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Cassiani SHDB, Hoyos MC, Barreto MFC, Sives K, da Silva FAM. [Distribution of the nursing workforce in the Region of the AmericasDistribuição de pessoal de enfermagem na Região das Américas]. Rev Panam Salud Publica 2019; 42:e72. [PMID: 31093100 PMCID: PMC6386067 DOI: 10.26633/rpsp.2018.72] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/20/2018] [Indexed: 11/24/2022] Open
Abstract
Objetivo. Describir la distribución de la fuerza de trabajo de enfermería en países de la Región de las Américas y relacionar el número de recursos humanos en enfermería con las tasas de mortalidad materna. Métodos. Análisis descriptivo y exploratorio de 27 países de la Región. Las variables del estudio fueron la proporción de profesionales por país y subregión, la categoría profesional y la razón de enfermero-médico. Se utilizó la proporción de mortalidad materna, que es un indicador general de salud de la población, para analizar la relación con el cuantitativo de los enfermeros. Se analizaron la distribución de frecuencias y la densidad del recurso humano de enfermería por país y subregión. Resultados. La distribución de enfermería es heterogénea. Existen países con más de 80 enfermeros por 10 000 habitantes y otros con menos de cinco profesionales por 10 000 habitantes. En 34,1% de los países, la relación enfermero-médico es menor a uno. Se observan diferencias en la distribución de personal de enfermería por región, subregión y al interior de país. Conclusiones. En varios países, el número de enfermeros por habitantes es menor a lo esperado. La mayoría de los países muestran un retraso importante en la relación del número de enfermeros licenciados respecto al personal técnico y auxiliar. Es necesario implementar iniciativas para aumentar el número de enfermeros licenciados en toda la Región.
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Affiliation(s)
| | - Maria Cristina Hoyos
- Organización Panamericana de la Salud, Washington D.C., Estados Unidos de América
| | | | - Katie Sives
- Organización Panamericana de la Salud, Washington D.C., Estados Unidos de América
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Marques JF, Áfio ACE, Carvalho LVD, Leite SDS, Almeida PCD, Pagliuca LMF. Physical accessibility in primary healthcare: a step towards the embracement. ACTA ACUST UNITED AC 2018; 39:e20170009. [PMID: 29995068 DOI: 10.1590/1983-1447.2018.2017-0009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 10/06/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess the physical accessibility from the front desk of primary healthcare units. METHOD Descriptive and quantitative research to map the accessibility of the physical space in 157 health units, between August 2014 and May 2015, in the region of Baturité, Ceará, Brazil. The data were collected using a checklist instrument type, and absolute and relative frequencies, binomial and verisimilitude tests for statistical analysis, with statistical significance of p <0.05 were used. RESULTS Of the analyzed items, stairs (24.8%), ramps (47.1%) and floors (75.8%) were inaccessible in most health units. Comparing urban and rural areas, circulation area (0.7x, p=0.293), counter (0.4x, p=0.010), seat (0.7x, p=0.758) and drinking fountain (0.7x, p=0.736) were more inaccessible in the urban area. CONCLUSION The access of persons with physical disabilities to primary care should be seen as a priority. There are physical, architectural and furniture barriers that compromise the full embracement of the user.
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Affiliation(s)
- Juliana Freitas Marques
- Universidade Federal do Ceará (UFC), Faculdade de Enfermagem, Farmácia e Odontologia, Programa de Pós-Graduação em Enfermagem, Fortaleza, Ceará, Brasil
| | - Aline Cruz Esmeraldo Áfio
- Universidade Federal do Ceará (UFC), Faculdade de Enfermagem, Farmácia e Odontologia, Programa de Pós-Graduação em Enfermagem, Fortaleza, Ceará, Brasil
| | - Luciana Vieira de Carvalho
- Universidade Federal do Ceará (UFC), Faculdade de Enfermagem, Farmácia e Odontologia, Programa de Pós-Graduação em Enfermagem, Fortaleza, Ceará, Brasil
| | - Sarah de Sá Leite
- Universidade Federal do Ceará (UFC), Faculdade de Enfermagem, Farmácia e Odontologia, Programa de Pós-Graduação em Enfermagem, Fortaleza, Ceará, Brasil
| | - Paulo César de Almeida
- Universidade Estadual do Ceará (UFC), Centro de Ciências da Saúde, Departamento de Enfermagem. Fortaleza, Ceará, Brasil
| | - Lorita Marlena Freitag Pagliuca
- Universidade Federal do Ceará (UFC), Faculdade de Enfermagem, Farmácia e Odontologia, Programa de Pós-Graduação em Enfermagem, Fortaleza, Ceará, Brasil.,Universidade da Integração Internacional da Lusofonia Afro-Brasileira (UNILAB). Redenção, Ceará, Brasil
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Nora CRD, Schaefer R, Schveitzer MC, Zoboli ELCP, Vieira MM. Double nursing degree: potentialities and challenges of an international student academic experience. Rev Esc Enferm USP 2018; 52:e03311. [PMID: 29668784 DOI: 10.1590/s1980-220x2017019803311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 11/21/2017] [Indexed: 11/22/2022] Open
Abstract
Objective To share the experience of a Double Nursing degree promoted between the Nursing School of the Universidade de São Paulo and the Health Sciences Institute of the Universidade Católica Portuguesa, reflecting on the potentialities and challenges of this opportunity for graduate students. Method This is an experience report presented in chronological order and of a descriptive nature. The double degree in Nursing was accomplished over a period of 6 months in a different institution from the institution of origin. Results Among the activities developed during the Double Degree are: participating in examining boards, congresses, seminars, courses, meetings, lectures, colloquium, classes, research groups and technical visits to health services. A table presents and describes the main benefits of the experience experienced by the authors. Conclusion When well-planned and well-developed, a double degree can promote personal, cultural and professional development of the students, favoring internationalization and contributing to the qualification of graduate programs.
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Primary Care Dentistry in Brazil: From Prevention to Comprehensive Care. J Ambul Care Manage 2018; 40 Suppl 2 Supplement, The Brazilian National Program for Improving Primary Care Access and Quality (PMAQ):S35-S48. [PMID: 28252501 PMCID: PMC5338883 DOI: 10.1097/jac.0000000000000186] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This cross-sectional study aimed to evaluate the association between sociodemographic characteristics, health care indicators, work process characteristics, and the performance of preventive dental procedures by oral health care teams (OHCTs) assessed during the first phase of the PMAQ in Brazil. A census of 10 334 primary OHCTs was conducted. The outcome included topical application of fluoride, application of sealants, detection of oral lesions, and monitoring of suspected or confirmed cases of oral cancer. The multilevel Poisson regression model was used to obtain crude and adjusted prevalence ratios. The performance of preventive dental procedures was 29.46% (3044/10 334; 95% confidence interval, 28.57-30.33), which was considered low.
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Lima MDFG, Pequeno AMC, Rodrigues DP, Carneiro C, Morais APP, Negreiros FDDS. Developing skills learning in obstetric nursing: approaches between theory and practice. Rev Bras Enferm 2017; 70:1054-1060. [PMID: 28977234 DOI: 10.1590/0034-7167-2016-0665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 03/14/2017] [Indexed: 11/22/2022] Open
Abstract
Objective: To analyze the development of professional skills in an obstetric nursing graduate course. Method: Qualitative research, applying semi-structured interviews with 11 students in the obstetric nursing specialization at the State University of Ceará. Data was submitted to thematic review. Results: According to the subjects, the course offers the development of skills to strengthen and expand the range of activities in obstetric nursing. Despite relying on previous knowledge and experience acquired by the students, there is a gap between the content taught and internship practice, presented as challenges and difficulties faced by the students. The findings suggest a need for curricular revision, incorporating active teaching-learning methodologies, to overcome the disjunction between theory and practice. Final considerations: Students are part of a corpus that is potentially implicated in the construction and transformation of thoughts and values set forth by educational and health institutions, and it is necessary to make changes in political and social organizations, with a focus on providing comprehensive and egalitarian care to the population. Objetivo: Analisar o desenvolvimento de competências profissionais em curso de pós-graduação em Enfermagem Obstétrica. Método: Pesquisa qualitativa, utilizando entrevista semiestruturada com 11 egressos da especialização em Enfermagem Obstétrica da Universidade Estadual do Ceará. Dados submetidos à análise temática. Resultados: Na ótica dos sujeitos, o curso confere o desenvolvimento de competências que fortalecem e ampliam o campo de atuação da enfermagem obstétrica. Embora resgate o conhecimento prévio dos discentes e as experiências vivenciadas, há distanciamento entre conteúdos ministrados e a prática de estágios, apresentados como desafios e dificuldades enfrentadas pelos egressos. Os achados sugerem revisão curricular, incorporando as metodologias ativas de ensino-aprendizagem, superando a fragmentação entre teoria e prática. Considerações finais: Os egressos se constituem em um corpus potencialmente implicado na construção e transformação de pensamentos e valores das instituições de saúde e ensino, necessários às mudanças nas organizações políticas e sociais, visando atendimento integral e igualitário à população.
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Affiliation(s)
| | | | - Dafne Paiva Rodrigues
- Universidade Estadual do Ceará, Postgraduate Program in Clinical Care Nursing and Health. Fortaleza, Ceará, Brazil
| | - Cleide Carneiro
- Universidade Estadual do Ceará, Professional Master's in Health Education. Fortaleza, Ceará, Brazil
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Galán González-Serna JM, Ferreras-Mencia S, Arribas-Marín JM. Development and validation of the Hospitality Axiological Scale for Humanization of Nursing Care. Rev Lat Am Enfermagem 2017; 25:e2919. [PMID: 28793127 PMCID: PMC5626177 DOI: 10.1590/1518-8345.1767.2919] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 05/11/2017] [Indexed: 11/22/2022] Open
Abstract
Objective: to develop and validate a scale to evaluate nursing attitudes in relation to
hospitality for the humanization of nursing care. Participants: the sample
consisted of 499 nursing professionals and undergraduate students of the final two
years of the Bachelor of Science in Nursing program. Method: the instrument has been developed and validated to evaluate the ethical values
related to hospitality using a methodological approach. Subsequently, a model was
developed to measure the dimensions forming the construct hospitality. Results: the Axiological Hospitality Scale showed a high internal consistency, with
Cronbach’s Alpha=0.901. The validation of the measuring instrument was performed
using factorial, exploratory and confirmatory analysis techniques with high
goodness of fit measures. Conclusions: the developed instrument showed an adequate validity and a high internal
consistency. Based on the consistency of its psychometric properties, it is
possible to affirm that the scale provides a reliable measurement of the
hospitality. It was also possible to determine the dimensions or sources that
embrace it: respect, responsibility, quality and transpersonal care.
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Affiliation(s)
| | - Soledad Ferreras-Mencia
- PhD, Full Professor, Escuela de Enfermería y Fisioterapia San Juan de Dios, Universidad Pontificia Comillas, Ciempozuelos, Madrid, Spain
| | - Juan Manuel Arribas-Marín
- PhD, Full Professor, Escuela de Enfermería y Fisioterapia San Juan de Dios, Universidad Pontificia Comillas, Ciempozuelos, Madrid, Spain
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