PURPOSEThe treatment a patient receives is greatly affected by what he or she chooses to disclose to a physician. This qualitative study investigated such factors as culture and background that contribute to Latina patients' nondisclosure of medical information.METHODS Participants were 28 Latina women living in Brooklyn. In-depth interviews in English or Spanish were conducted and documented by extensive notes. We used a grounded theory approach to fi nd emerging themes, which were coded using a continuous iterative process.RESULTS Six primary themes emerged: the physician-patient relationship, language, physician sex and age, time constraints, sensitive health issues, and culture and birthplace. Such qualities as compassion, caring, human interest, and kindness were important to many Latinas, who did not feel safe sharing information if these qualities were absent. Language barriers caused problems with physician-patient interaction, which were complicated by the presence of a translator. Physicians being male or younger could make disclosure diffi cult, especially around issues of sexuality and genital examination. Time constraints and cultural differences sometimes resulted in physicians' lack of awareness of sensitive areas that patients did not wish to discuss, such as sexuality, family planning, domestic abuse, and use of recreational drugs. Birthplace (foreign born vs US born) played a role in how the women perceived barriers to disclosure. CONCLUSIONS Staff training in techniques for building rapport can foster better communication, increase empathy and compassion, and lead to the establishment of trusting relationships in which disclosure is more likely.
Our results revealed that higher circulating levels of SP-D are associated with higher mortality risk in critically ill A/H1N1 patients. SP-D might be a predictive factor of poor outcomes in viral pneumonia.
This study sought to understand the meaning that women place on the health care practices carried out during labor. We used techniques from Grounded Theory such as coding, categorization, and constant comparison. A total of 18 interviews were conducted with 16 women who had given birth at least once in Colombia. Based on our results, we argue that obstetric violence is an expression of violence during the provision of health care, which occurs in a social environment favoring the development of power relationships between patients and health care staff. Its origin might lie in a health care system whose political and economic foundations encourage inequality on the basis of the patients' purchasing power. We conclude that rethinking and redefining the concept of obstetric violence is essential for understanding its nature and having an impact on it.
La calidad es considerada un factor clave en la diferenciación y en la excelencia de los ser vicios de salud, y la percepción de un paciente sobre la prestación del ser vicio determina en forma definitiva su nivel de calidad. Se han descrito indicadores que ayudan a evaluar la calidad de los ser vicios de salud, entre estos, indicadores de efectividad, de oportunidad y de adhesión. Sin embargo, la evaluación integral de la calidad percibida en los ser vicios de salud es aún compleja. Se realizó una búsqueda en Medline, Embase, OVID, Lilacs, Ebsco, Scielo y The Cochrane Library para identificar instrumentos de tipo cualitativo o cuantitativo que permitieran medir la calidad de los ser vicios de salud percibida por los pacientes. Se encontraron estudios que validaron y aplicaron la escala Ser vqual y Ser vqhos en el ámbito hospitalario. Adicionalmente, en nuestro país se intentó validar escalas diferentes a estas, pero no contaron con un rigor estadístico importante.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.