Browsing by Subject "Public health education"
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Item Open Access Daily activities and their relationship with positive mental health for orphaned and separated children caregiver(2019) Liu, XiaoqianThere are many orphaned and separated children (OSC) in the world and caregivers play a crucial role in caring for, supervising, and educating them. However, caregiving work is stressful and overwhelming, which sometimes bring negative influences to caregivers’ physical and mental health such as depression and anxiety that can be a great threat to caregivers’ mental health. Current studies mainly focus on caregivers’ mental illness instead of caregivers’ positive mood and mental health which are also very important. Besides, there is little information on caregivers’ daily life and work schedule which likely have a strong relationship with their positive mental health. This study’s objective was to describe OSC caregivers’ daily lives and how their work and activities are related to their positive mental health. Data collected included diary entries, surveys, and interviews from caregivers from five geographic locations: Hyderabad, India; Nagaland, India; Ethiopia; Kenya; and Cambodia. A total of 82 participants completed surveys and diary entries, and 69 of them finished interviews. Diary data were coded to learn about time spent on every activity; how caregivers perceived an activity’s importance, meaningfulness, pleasantness, and unpleasantness; and how time spent on activities related to caregivers’ daily mood. We focused on five main activities: cleaning, cooking, caring for children, supervising children and teaching children. We found that caregivers sometimes spend more hours on cleaning and cooking than staying with children in terms of caring for children, supervising children, or teaching children. These findings are important for OSC residential care centers to consider rearranging caregivers’ work schedules and planning more activities for caregivers to improve their positive mental health.
Item Open Access Implementation Analysis of a Patient Safety Program in a Pediatric Perioperative Unit in Guatemala(2019) Sico, Isabelle Rae PapillaBackground: Patient safety is critical to prevent medical errors and to improve clinical outcomes. The need to implement programs in patient safety is increasingly recognized as a prime component of healthcare delivery in low- and middle- income countries (LMICs). The goal for our study is to assess the implementation of a patient safety program in Guatemala.
Methods: We used a mixed-methods approach to assess implementation of a patient safety program in the pediatric perioperative unit in Hospital Roosevelt, Guatemala. We collected data from unit staff respondents (n=16) using a qualitative de novo survey, the Evidence-Based Practice Attitude Scale-36 (EBPAS-36) survey, and a semi-structured interview. Interviews and surveys were conducted in Spanish, translated, and analyzed in English using NVivo v12. Quantitative data were analyzed to compare group means across survey domains. Data were triangulated, with final analysis guided by the Consolidated Framework for Implementation Research (CFIR). Data were collected over a 10-day period in July 2018.
Results: Responses underscored several emergent thematic determinants representing the Inner Setting and Characteristics of Individuals CFIR domains, indicating a gap in knowledge of patient safety programs and attitude towards the use of evidence-based patient safety programs. Though respondents expressed an openness and willingness to adopt patient safety practices, few existing practices are in place to prevent medical errors.
Conclusions: The main determinants which affect the implementation of an evidence-based patient safety program in the pediatric perioperative unit in Guatemala are related to the internal structure and culture of the unit, and not to external factors or the intervention itself. Positive attitudes and knowledge of patient safety practices are insufficient to overcome the challenges towards implementation. A framework for future implementation should include education and communication programs, adaptation of existing practices to increase leadership engagement, and use of tools to create a strong culture of safety.
Item Open Access Important Pediatric Conditions in Low- and Middle-Income Countries: A Clinician and Data-Driven Approach(2022) Kozhumam, Arthi ShankarBackground: Emergency care sensitive conditions are defined as those for which rapid diagnosis and early intervention improve patient outcomes. This thesis aimed to develop a list of important pediatric conditions in low- and middle-income countries (LMIC) to be used for further studies on pediatric epidemiology and resource utilization. Methods: A survey of 79 conditions was sent to LMIC physicians, who rated each condition on three categories (time sensitivity, preventability, and commonality) on a scale of 1-9. Responses were matched to Brazil pediatric hospitalization, ambulatory, and mortality data from 2015-2020. Results: 17 physicians completed the first Round of the survey, and 3 of these (17.65%) completed the second Round. Overall, 67 of the 79 (84.21%) were rated as highly time-sensitive and 26 (32.91%) highly preventable. Survey conditions with the highest ratings overall or country overlap (n=11), that were country-specific but highly rated in all three categories (n=8), or that comprised ~1%+ of hospitalizations (n=9), ~0.5%+ of ambulatory visits (n=6), and ~0.5%+ of mortality cases (n=8) were combined with the most common acute non-elective causes of hospitalizations (n=7) and mortality (n=9) into a list of 29 consolidated conditions overall (excluding overlap). These 29 accounted for 37.83% of hospitalizations, 8.97% of ambulatory visits, and 29.17% of mortality cases. 31 of the 79 survey conditions were age-specific and 32 context-specific. Conclusions: These 29 should be targeted in future health system utilization and burden studies. The modified Delphi approach is important in reaching provider consensus.
Item Open Access What are the characteristics of effective caregivers as perceived by directors of institutions for orphaned and vulnerable children?(2018) Biru, Blen MengeshaCaring for, raising, and educating orphaned and vulnerable children (OVC) is important work that is critical to the long-term well-being of those children. Despite the importance of caregiving, it can be overwhelming and stressful. A large part of the available literature addresses the burden of caregiving, such as burnout and fatigue. There is little information about the characteristics that caregivers need to deliver effective care in institutions for OVC, and yet such information would be very useful to the directors of these institutions as they hire and train caregivers. This study’s objective was to identify the characteristics of effective caregivers through qualitative interviews with directors of institutions for OVC across four countries: Cambodia, Ethiopia, India and Kenya. A total of twenty-eight interviews were conducted across all countries in their local languages. Interviews were translated, transcribed in English and analyzed using NVivo (Version 11) software. A thematic analysis of the data yielded three domains: personal qualities, skills, and religion. Each domain is comprised of themes that participants perceived as contributing to good caregiving. Across the four sites, most participants looked for similar characteristics in caregivers. That being said, there were also some participants who indicated unique characteristics they sought in caregivers. These findings can inform plans to enhance effective and sustainable caregiving at institutions.