A qualitative study on patients’ and physicians’ perceptions

Funding: The present publication was funded by Fundação Ciência e Tecnologia, IP national support through CHRC (UIDP/04923/2020).Background: Digitization in everyday medical practice has gained importance along with the drive to expand teleconsultations arising from the COVID-19 pandemic. Previous qualitative research on teleconsultations has focused on synchronous communication between patients and clinicians. This study aims to explore physicians’ and patients’ perspectives on the adoption of teleconsultations between primary care and the referral cardiology department. Methods: Participants were recruited for semi-structured interviews between September 2019 and January 2020. The interviews were audio-recorded and pseudonymized. The transcribed interviews were stored, coded, and content analysis was performed in MAXQDA. Results: A total of 29 participants were interviewed. Patients and physicians merged in their views on ‘process’ issues, i.e., those concerning a better prioritization of patients and an improved collaborative practice, albeit with possible technological constraints. Physicians recognized that teleconsultations presented an educational opportunity for managing patients’ health problems. Our findings suggest that not all patients would require equally intensive collaborative activities across the health system. The barriers described included difficulties using the system (technical issues) and concerns about workload as a consequence of the disruption of traditional clinical routines. Increasing the range of collaborative strategies available to health care providers may require a broader assessment of the way that care processes are structured between levels of care. Patients revealed strong support for teleconsultation on the grounds of interprofessional collaboration and avoidance of unnecessary hospital visits. Conclusions: The implementation of teleconsultations between levels of care may be facilitated when patients, caregivers and physicians see the added value of this service, that adequate resources are put in place and that there is flexible implementation. This work adds an in-depth understanding of participants’ perceptions of this intervention in a case study. Obtaining context-dependent knowledge will help program leaders better understand how to establish telemedicine services as a real-world sustainable option.publishersversionpublishe

Aplicação da manutenção centrada na fiabilidade a dispositivos médicos

A generalidade dos estabelecimentos de prestação de cuidados de saúde é de opinião de que os custos de manutenção dos equipamentos médicos de sua propriedade são demasiado elevados. É também conhecida a ausência de procedimentos rigorosos visando a certificação da calibração e do desempenho adequado dos instrumentos de medida, comprometendo assim a segurança dos profissionais da saúde e até mesmo dos utentes. A gestão da manutenção de dispositivos médicos surge como uma ferramenta fundamental para garantir níveis elevados de fiabilidade, disponibilidade, segurança e eficiência técnica e económica. O objectivo da presente dissertação é de criar a base teórica para a implementação de uma metodologia de gestão da manutenção de dispositivos médicos em estabelecimentos de prestação de cuidados de saúde, com ênfase na redução de custos e melhoria da qualidade do serviço. Esta metodologia é baseada na utilização do processo RCM e da distribuição de probabilidade de falhas Weibull. É apresentado um caso de estudo como exemplo de aplicação do método proposto.It is generally accepted among health care establishments that the cost of medical equipment maintenance is too high. There is also a lack of strict procedures for the accreditation of calibration and proper performance of the measuring instruments, thus compromising the safety of healthcare professionals and even patients. The maintenance management of medical devices presents itself as an essential tool to ensure high levels of reliability, availability, security, and technical and economic efficiency. The purpose of this dissertation is to establish the theoretical basis for the implementation of a methodology for managing the maintenance of medical devices in health care establishments, with emphasis on reducing costs and improving service quality. This methodology is based on the use of the RCM process and the Weibull probability distribution function. A case study is presented to exemplify the proposed method

Where to find the answers - a cross-sectional study

Funding: The present publication was funded by Fundac¸ão Ciência e Tecnologia, IP national support through CHRC (UIDP/04923/2020).INTRODUCTION: Clinicians raise at least one question for every two patients they see, but search for an answer to less than half of these questions, and rarely use evidence-based resources. One barrier to evidence-based practice is doubt that the search would yield an answer, and we found insufficient evidence to refute this concern. This study aims to identify what proportion of clinical questions in primary care can be answered with online evidence-based practice resources, and what proportion of these can be answered with pre-appraised evidence. MATERIALS AND METHODS: Cross-sectional study in two primary care practices. The inclusion criteria were family doctors, generalists and residents working in 2 selected practices. We collected a total of 238 questions from 19 family medicine specialists, 9 family medicine residents and 3 generalist doctors. Doctors were asked to record any clinical question that arose during 4 days of appointments. The primary outcome was the proportion of clinical questions answered with online evidence-based practice resources. The secondary outcome was the level of evidence needed to reach to find the answers (clinical summaries, systematic guidelines, systematic reviews or primary studies), according to Haynes' pre-appraised evidence pyramid model. RESULTS: 191 of the 206 valid clinical questions could be answered with online evidence-based practice resources (92.7% [95% CI 88.3%-95.9%]). Most of these questions (90.8% CI 95% 85.9%-94.4%) were successfully answered using clinical summaries (BMJ Best Practice, DynaMed or UpToDate), with a median search time of 4 minutes (range 1-16.5). CONCLUSIONS: Contrary to clinician's beliefs, the majority of clinical questions can be answered with online evidence-based practice resources, and most of them with pre-appraised evidence. This study could encourage family doctors to increase the use of clinical summaries. Furthermore, these results highlight the importance of teaching how to search for and apply pre-appraised evidence.publishersversionpublishe

findings from a cross-sectional study with migrant women in Portugal

Funding Information: The present publication was funded by Fundação para a Ciência e Tecnologia, IP national support through CHRC (UIDP/04923/2020). The first author received a grant from the Fundação para a Ciência e Tecnologia [grant number COVID/BD/152616/2022], for her PhD. Funding Information: A.G. thanks FCT for funding through the Scientific Employment Stimulus (CEECINST/00042/2021). The authors would like to show their gratitude to all migrant women who agreed to participate in the study. Publisher Copyright: © 2023, The Author(s).Background: Cervical cancer is a common disease which can be effectively and timely detected by cervical cancer screening. However, access to cervical cancer screening is unequal, and it is known that migrant women have a lower attendance to cervical cancer screening. These inequalities are associated with several factors, including attitudes and beliefs of the women regarding screening practices, which prevents them from participating. This study aims to explore the attitudinal barriers to cervical cancer screening among migrant women in Portugal. Methods: A web-based cross-sectional survey was conducted with 1100 migrant women residing in Portugal. Women were recruited through social media platforms. The survey included items on socioeconomic characteristics, cervical cancer screening history and an 11-item attitudinal questionnaire to assess attitudinal barriers. Logistic regression models were used for statistical analysis. Results: The attitudinal barriers to CCS most often reported by participants were fear of the test result (25.3%), worry about seeing a male health professional (23.8%), perceiving the test as painful (23.1%), embarrassment (18.5%), difficulties scheduling the test (14.3%), and having a negative experience in screening (12.4%). Low perceived need in absence of symptoms and lack of motivation to be screened were reported by less than 5% of the women. However, the results suggest that most of the attitudinal barriers with higher agreement percentage have no association with cervical cancer screening attendance. Among all the attitudinal barriers, low perceived need of screening and lack of motivation were associated with CCS non-attendance. Conclusions: Based on the findings, out of all the factors analyzed, low perceived need of screening and lack of motivation are the most relevant factors associated with non-attendance among migrants in Portugal. Promoting health literacy and empowering women with knowledge about benefits of screening may help overcoming these barriers. Therefore, this study provides a foundation for stakeholders on which areas should be prioritized when developing strategies aiming to reduced cervical cancer screening non-attendance among migrant women.publishersversionpublishe

A cross-sectional study

Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The present publication was funded by Fundação Ciência e Tecnologia, IP national support through CHRC (UIDP/04923/2020). Publisher Copyright: © The Author(s) 2022.Objectives: Cervical cancer has a high mortality rate among women worldwide. Although cervical cancer screening (CCS) is an effective strategy in reducing mortality of the disease, inequalities in accessing screening exist, particularly among migrant women. This study aims to characterize migrant women’s participation in CCS and determine factors associated with non-attendance to CCS. Methods: A cross-sectional study based on a web-based survey targeting adult migrant women living in Portugal was conducted. Prevalence of non-attendance to CCS was examined, and its associations with socioeconomic, migration-related, and health-related factors were determined using adjusted logistic regression models. Results: A total of 1100 migrant women were included in the study. Prevalence of CCS non-attendance was 24.5%. CCS non-attendance was associated with younger age, being born in Africa or Asia, being single/divorced/widowed, never having had a GP appointment in Portugal and not having regular gynecology appointments. Being born in South and Central America, shorter length of stay in Portugal, having had HPV vaccination, and not having children are associated with CCS attendance. Conclusion: These findings point out that an important percentage of migrant women do not attend CCS. Strategies to increase participation should be developed, considering the inequalities identified and designed to target the specific needs of migrant women to improve their CCS attendance and increase cervical cancer prevention.publishersversionepub_ahead_of_prin

A importância da marca própria de lentes de contacto numa loja da especialidade

A presente tese é um "projeto empresa" em cooperação com a Wells, uma empresa que trabalha no sector das parafarmácias e ótica desde 2008 e que pertence ao grupo Sonae. Em 2015 foi efetuado um reposicionamento estratégico nas categorias de óculos graduados (aros e lentes oftálmicas), tendo o negócio crescido em valor 35% nos últimos 3 anos. No entanto, este crescimento não foi suportado pelo crescimento de todas as categorias, como foi o caso das lentes de contacto, o nosso objeto de estudo e análise. Este 2projeto empresa" começa com a identificação de um problema e área de estudo, para depois ser levantada uma questão que poderia ajudar na resolução do mesmo através da análise da importância de marcas próprias de lentes de contacto numa loja da especialidade. A revisão de literatura que apoia este projeto centra-se nos conceitos de desenvolvimento de uma marca própria, para perceber se existem novos caminhos e/ou ideias que podem ser analisadas, exploradas e adotadas. Mais precisamente, o objetivo foi perceber porque e como são criadas, quais os benefícios para o retalhista e consumidor, como integrá-las no portefólio em loja e gama, e que estratégias de preços podemos aplicar. No entanto, com esta etapa apenas tínhamos a informação do produto, sendo por isso necessário a realização de várias análises: macroeconómica, interna e externa ao sector, e por fim, ao consumidor através da aplicação de um questionário, com o intuito de perceber a disponibilidade do cliente para mudar de marcas de lentes de contacto e usar marca própria. Os resultados são animadores porque o segmento de marcas próprias de lentes de contacto está em crescimento, e o cliente não só está "aberto" a mudar de marca como aceita o facto de mudar para uma marca própria, desde que esta tenha uma boa relação preço-qualidade. Para o distribuidor, a introdução da marca própria é relevante, pois fortalece a sua posição competitiva, melhora a imagem da loja, e ajuda na fidelização de clientes.This thesis is a "company project" in cooperation with Wells, which is a company that has been working in the para-pharmaceutical and optical sector since 2008 and that belongs to the Sonae group. In 2015 it went through a strategic repositioning in the categories of prescription glasses (rims and ophthalmic lenses), leading to a business growth of 35% in the last 3 years. However, this growth was not supported by the growth of all categories, like in the case of contact lenses, our object of study and analysis. This "company project" starts with the identification of a problem and area of study. It then presents a hypothesis that could help in solving it through the analysis of the importance of contact lens private labels in a specialty store. The literature review that supports this project focuses on the concepts of developing a private label in order to understand if there are new paths and/or ideas that can be analysed, explored and adopted. More precisely, the objective has been to understand why and how private label brands are created, what are the benefits for the retailer and consumer, how to integrate them into the store portfolio and range and what pricing strategies can be applied to them. However, with this stage we only had the basic product information, so it was necessary to perform several analysis: at macroeconomic level, internal and external to the sector, and finally, to the consumer through the application of a quantitative questionnaire, with the intention of perceiving the customer's willingness to change contact lens brands and use instead private label brands. The results are encouraging because the private label segment of contact lenses is growing and the customer shows to be not only "open" to changing brands but also to accept switching to a private label, as long as it has a good price-quality relation. For the retailer, the introduction of their own private label is relevant, as it strengthens its competitive position, improves the store image and helps customer loyalty

Patients’ and physicians’ perceptions of teleconsultations

Funding Information: The Regional Health Administration of Lisbon and Tagus Valley funded Dr. Maria's salary and had no role in the study design, data collection, analysis or writing of this article. The present publication was funded by Fundação Ciência e Tecnologia, IP national support through CHRC (UIDP/04923/2020). Publisher Copyright: © The Author(s) 2022.Introduction: Previous qualitative research on teleconsultations has focused on synchronous communication between a patient and a clinician. This study aims to explore physicians' and patients' perceptions of the interaction on the interface between primary care and the Cardiology service of a referral hospital through teleconsultations. Methods: This qualitative study was embedded in an organizational case study concerning the introduction and rollout of a new service model that took place at the point of care. The patients and physicians were recruited for semi-structured interviews until thematic saturation was achieved, between September 2019 - January 2020. The interviews were audiorecorded and anonymized. The transcribed interviews were stored, coded, and analyzed in MAXQDA, following the steps for conventional content analysis. Results: A total of 29 participants were interviewed. Patients and physicians presented clear views about the role of the GP and the cardiologist and their function in overall structure of healthcare. GPs felt their role was to bring expertise in the patient which could supplement the cardiologists' expertise on the condition. However, GPs had to renegotiate roles in the teleconsultations when they saw themselves in a new situation, together with another physician and the patient. Conclusions: Our findings suggest that joint teleconsultations can promote continuity of care for patients in the primary/secondary care interface. Active coordination between physicians with delineation of roles throughout primary-secondary care interface is needed to manage selected patients who may benefit the most from shared care.publishersversionpublishe

Factors associated with cervical cancer screening among migrant women in Europe

info:eu-repo/semantics/publishedVersio