Therapeutic trajectories of children attending a Children Psychosocial Care Center

"Healthcare should be the same for everyone": perceived inequities in therapeutic trajectories of adult patients with lung cancer in Chile, a qualitative study

Background

Globally, it has been reported that different social determinants of health affect health outcomes in lung cancer (LC). Research on the therapeutic trajectories of patients (TTP) is a novel field for identifying barriers and facilitators in health. The objective of this study was to reveal perceived differences in TTP with LC in Chile according to selected social determinants of health (SDH) and the experiences of patients, health professionals, and civil society leaders.

Methods

This is a qualitative paradigm, one case-study design. Online semi-structured interviews were conducted with patients with LC, health professionals, and civil society leaders. The strategies for the recruitment process included social networks, civil society organizations, health professionals, and the snowball technique. A thematic analysis was carried out.

Results

Selected SDH impact LC's TTP in Chile, particularly concerning health system access, health services, information, and patient navigation experiences. The analysis of the experiences of the participants allowed us to identify barriers related to the selected SDH in three stages of the TTP: initiation, examinations, and diagnosis and treatment. Individuals with limited education, those residing outside the capital, women, and those in the public health system encountered more barriers throughout their TTP.

Discussion

Study findings suggest that being a woman with low education, from the public health system, and not from the capital might represent one of the most powerful intersections for experiencing barriers to effective healthcare in LC in Chile. It is necessary to monitor the TTP from an SDH perspective to guarantee the rights of access, opportunity, quality, and financial protection.

Child Mental Health in Brazilian Guidelines: A Normative Analysis

This article examines the evolution of the understanding of child mental health based on documents that guide nursing practise in Brazil. Eleven relevant documents were submitted to normative analysis, which revealed four themes: Developmental approach of the child mental health; Brazilian policies and social history of children; Spaces for prevention, promotion, and care in children's mental health; and The (in)visibility of nurses' work in the context of mental health. These are linked through ideological and social constructions that have although transformed through the years yet remained the same in their core. Based on our results, we propose adopting a decolonial perspective to compose nursing knowledge to improve child mental health in Brazil.