Perinatal depression (PND), depression that occurs during pregnancy or in the first year following delivery, is a common and debilitating mental health condition. In New York City, it is estimated that at least one in ten women suffer from PND. The clinicians who serve these women require training in acceptable, feasible, and effective treatments. Interpersonal psychotherapy (IPT) is a time-limited, evidence-based psychotherapy that has been found to be effective in the treatment of PND in community and primary care settings. The present study investigates the nuances of an IPT training program for licensed mental health providers who treat perinatal depression within integrated care settings in NYC. Using a qualitative-focused mixed-methods design, this study aims to systematically and comprehensively evaluate the acceptability, feasibility, sustainability, and preliminary effectiveness of the training program, and of the providers’ perceptions of IPT as a treatment for the patients they serve. To achieve these aims, five of the eight providers who participated in the training program were interviewed at two timepoints and quantitative data including demographics, use of IPT, satisfaction with training experience, and effectiveness of the training program were collected. Results indicate that providers viewed their training experience as acceptable and feasible and viewed IPT as an appropriate, relevant, and helpful treatment for their perinatal patients’ depression. Quantitative results provide preliminary support for the training model’s potential effectiveness, demonstrating that provider-trainees were able to obtain and retain knowledge of IPT and achieve certification as IPT practitioners. Overall, Patient Health Questionnaire (PHQ-9) scores show that patients who were treated by the study’s provider-trainees self-reported depression symptoms improved over the course of their IPT treatment. Recommendations for future directions and implications for future provider training programs are discussed.

Yes / Fidelity to the treatment protocol is key to successful trials but often problematic. This article reports the staff's views on delivering a complex rehabilitation intervention: patient-led therapy during inpatient stroke care. An exploratory qualitative study using focus groups with staff involved in a multicenter (n = 12) feasibility trial of patient-led therapy (the MAESTRO trial) was undertaken as part of the evaluation process. Purposive sampling ensured that participants represented all recruiting sites, relevant professions and levels of seniority. Data analysis used a Framework Approach. Five focus groups were held involving 30 participants. Five main themes emerged: the effect of the interventions, practical problems, patient-related factors, professional dilemmas, and skills. Staff felt the main effect of the therapies was on patients' autonomy and occupation; the main practical problems were the patients' difficulties in achieving the correct position and a lack of space. Staff clearly identified characteristics that made patient-led therapy unsuitable for some patients. Most staff experienced dilemmas over how to prioritize the trial interventions compared to their usual therapy and other clinical demands. Staff also lacked confidence about how to deliver the interventions, particularly when adapting the interventions to individual needs. For each barrier to implementation, possible solutions were identified. Of these, involving other people and establishing a routine were the most common. Delivering rehabilitation interventions within a trial is complex. Staff require time and support to develop the skills, strategies and confidence to identify suitable patients, deliver new treatments, adapt the new treatments to individuals' needs and balance the demands of delivering the trial intervention according to the treatment protocol with other clinical and professional priorities. TRIAL REGISTRATION: ISRCTN: ISRCTN29533052 . October 2011.

Although the recent annual growth rate in the US paramedic field has been 4%, Latino and African American men have been significantly underrepresented in the field compared to their proportion in the US population at large. This problem threatens both the quality and quantity of available emergency health care. The purpose of this study was to describe how men of color (MOC) in community college paramedical programs experienced their awareness, interest, and proactive choice of paramedicine as a course of study. Using a qualitative phenomenological approach and social cognitive career theory as a theoretical framework, I interviewed 23 MOC enrolled during one semester across three community college paramedical programs in the southwestern US: 9 Latino and 14 African American, aged 18-29 with mean age 22 years. The focus of the interviews was the participants' lived experiences at various career points, as well as the enablers and disablers they had encountered. I identified three primary themes for possible use in enhancing recruitment of MOC to the paramedic field: strategic use of new digital media, promotion of the vocation's quasi-familial characteristics, and augmentation of neighborhood-based outreach. Identified areas for further research included recruitment dynamics of female paramedics, MOC persistence issues, and MOC job satisfaction assessments.

Bakgrund: Obesitas är en kronisk sjukdom. Ungefär 16% av världens vuxna befolkning var obesa 2022. Personer med obesitas har en ökad risk för att insjukna i olika följdsjukdomar. Syftet med behandling för obesitas är att minska ohälsa och främja livskvalitet. Behandling för obesitas i Sverige kan genomföras antingen genom kombinerad levnadsvanebehandling, läkemedels-behandling eller kirurgi. Syfte: Syftet med litteraturstudien var att belysa hur personer med obesitas upplever mötet med vårdpersonal. Metod: Studien genomfördes som en litteraturstudie med en kvalitativ ansats. Tolv kvalitativa studier som alla var publicerade i vetenskapliga tidskrifter utgjorde datamaterialet. Datan kvalitetsgranskades och analyserades. Resultat: Totalt identifierades tre huvudkategorier: Betydelsen av vårdpersonals bemötande, Behovet av anpassat stöd från vårdpersonal och Att få olika förutsättningar i vården. Konklusion: Personer med obesitas önskar en förtroendefull relation med vårdpersonal. Sjuksköterskor bör arbeta personcentrerat och genom partnerskap kan en förtroendefull relation byggas med patient. / Background: Obesity is a chronic disease. About 16% of adults worldwide were obese in 2022. Being obese causes an increased risk of getting sick in various non- communicable diseases. The aim of all obesity-treatment is to reduce illness and promote quality of life. In Sweden there are three different alternatives for obesity-treatment: combined lifestyle-change treatment, drug treatment and surgery. Aim: the aim of this literature review was to illustrate how people with obesity experience the meeting with health care personnel. Method: The study was conducted as a literature review with a qualitative approach. Twelve qualitative studies, all published in scientific magazines, was quality assessed and analysed. Results: Three themes was identified: The importance of health personnel encounter, The need of customized support from health personnel and To get unequal conditions in health care. Conclusion: People with obesity wishes to have a trusting relationship with health personnel. Nurses should work person- centered and through a partnership with the patient a trusting relationship can be built.

The purpose of this study was to determine the factors associated with choosing mental health nursing as a career, and to explore the possible ways of improving recruitment and retention of mental health nurses in Kenya. Quantitative, explorative descriptive research was conducted. Data collection was done by using questionnaires and focus group discussions. Three groups participated in the study: practicing mental health nurses (n=10), post-basic mental health nursing students (n=10) and final year basic nursing students (n=184). The findings revealed that basic nursing students do not intend to pursue a career in mental health nursing, and that there is an aging population of mental health nurses. The barriers to the mental health field include stigma, a poor working environment and inadequate career guidance. Marketing, policy and regulatory reforms, as well as positive work environments have been identified as strategies for improving the recruitment and retention of mental health nurses in Kenya. / Health Studies / Thesis (M.A. (Health Studies))

The research is a quantitative descriptive survey. The sample is a stratified random sampling of the workforce (n=4,010) of the four hospitals in Gauteng that fall under the jurisdiction of Tshwane, Ekurhuleni and Johannesburg Metropolitan Councils. The research examines the extent of the impact of age, gender, occupation, salary level, tenure and race on workplace absenteeism. The data were collected in three phases involving auditing of hard copy files, structured interviews and information technology system. The findings of the research reflect high workplace absenteeism in females by 83.2%, age group between 45 to 49 years by 22.35%, salary range of 2 to 3 by 35.3%, African race group by 96.3%, tenure of 11 to 20 years by 44.3%, nurses by 20.8% and administration support by 35.4%. The research found that the mature employee in age and of higher year of tenure presented comparatively with lower rate of absenteeism. / Public Administration / M.A. (Public Administration)

Bakgrund: Ett bra bemötande karaktäriseras av ett respektfullt, kompetent och empatiskt samspel som är individanpassat. Patienter med substansbrukssyndrom är en grupp som uppfattas som vårdkrävande och är föremål för stigmatisering, därmed kan bemötandet ses som en utmaning. Patientcentrerad vård innebär att sträva efter individens välmående. Med hjälp av ett motiverande förhållningssätt kan sjuksköterskan öka patienternas empowerment. Syfte: Att undersöka hur patienter med substansbrukssyndrom upplever bemötandet från vårdpersonal, med fokus på sjuksköterskor. Metod: Litteraturöversikt där både kvalitativa och kvantitativa artiklar ingick. Resultat: Tre kategorier angående bemötande identifierades: att se hela individen, vårdande möte och stigma. Under varje kategori urskildes både positiva och negativa upplevelser av bemötande. Diskussion: Ett patientcentrerat förhållningssätt kan förstås som ett empatiskt, omtänksamt, engagerat och hjälpsamt bemötande. Många patienter hade upplevelser av diskriminering och stigmatisering inom vården, detta kunde delvis förklaras som en maktobalans i relationen mellan vårdgivare och patient.  Slutsats: Sjuksköterskans bemötande kan både öka och minska vårdlidande. Ett gott bemötande är betydelsefullt för att främja hälsa och optimera resultatet av vården. Omvårdnaden av personer med substansbrukssyndrom kan förbättras. / Introduction: The responsibility of the nurse is to have competence and to treat every patient with respect and empathy. Patients with substance use disorders are a group that can be viewed as a group with a large demand of care. They are exposed to stigmatization and therefor they need specialized care. The meaning of patient centered care is to strive to optimize every individual’s well-being. Nurses may increase patient’s empowerment through a motivating approach. Aim: To explore patients’ perceptions of the nurse-patient relation of patients with substance use disorder. Method: A literature review, including both qualitative and quantitative studies. Result: Three categories were identified: To see the whole person, caring encounter and stigma. Both positive and negative aspects of every category were discovered. Discussion: A patient centered approach can be understood as an emphatic, caring, committed and helpful encounter. Many patients had experiences of discrimination and stigma during care. This could partly be understood as an unbalanced power-control relationship between caregiver and patient. Conclusion: The nurses actions can increase as well as decrease patients suffering. A caring encounter is important to promote health and to optimize the results of care. There is room for development of nursing skills in care of patients with substance use disorders.

Bakgrund: Partnerrelaterat våld är ett folkhälsoproblem och kvinnor är de som är mest utsatta. Kvinnor utsatta för partnerrelaterat våld besöker sjukvården dubbelt så ofta jämfört med andra kvinnor. Sjukvårdspersonalen misslyckas ofta med att uppmärksamma och hjälpa kvinnorna. Syfte: Litteraturstudiens syfte är att belysa erfarenheter av mötet med sjukvårdspersonal för kvinnor utsatta för partnerrelaterat våld. Metod: Litteraturstudie av kvalitativ ansats. Tolv vetenskapliga kvalitativa studier har analyserats med hjälp av innehållsanalys. Tre kategorier och åtta underkategorier sammanställdes i resultatet. Resultat: Kvinnorna ville bli tillfrågade om partnerrelaterat våld av sjukvårdpersonalen. En del ansåg att det var svårt att avslöja våldet. Flera kvinnor uppgav att de inte fått den hjälp eller information de behövt. Kvinnorna som hade positiva erfarenheter belyste vikten av god information och ett empatiskt bemötande. Konklusion: Kvinnorna hade främst negativa erfarenheter av möten med sjukvårdspersonal. Sjukvårdspersonalen behöver få mer utbildning för att kunna ge en god vård. / Background: Intimate partner violence is a public health problem and women are more exposed. Women suffering from intimate partner violence are visiting the health care twice as much compared to other women. The health care workers often fails to identify and help the women. Aim: The aim of the study is to illuminate the experience of encounters with health care professionals for women exposed to intimate partner violence. Methods: Literature study with qualitative approach. Twelve scientific qualitative studies have been analyzed with content analysis. Three categories with eight subcategories were compiled into a result. Findings: The women wanted to be asked about intimate partner violence by health care professional. Many women found it difficult disclosing violence. Many women stated that they had not got the help or the information they needed.  Women who had positive experiences described the importance of relevant information and an emphatic approach. Conclusion: The women had mostly negative experiences of the encounters with the health care professionals. The health care professionals needs more education to be able to give a good health care.

Bakgrund: Depression är vanligt förekommande hos äldre och kan få betydande konsekvenser för äldres hälsa. Depression hos äldre skiljer sig i flera hänseenden från depression i yngre åldrar. Skillnaderna framkommer bland annat i symtombild, orsaker, och riskfaktorer för depression. Hos äldre patienter är somatisk samsjuklighet vanligt förekommande vilket kan försvåra sjukdomsförloppet samt upptäckt och behandling av depression.     Syfte: Syftet med litteraturöversikten var att beskriva förhållningssätt till depression hos äldre bland sjukvårdspersonal inom somatisk vård. Metod: En litteraturöversikt utfördes, baserad på tio vetenskapliga artiklar, nio kvalitativa och en av mixad metod. Innehållet analyserades och organiserades i kategorier. Databaser som användes var CINAHL complete, PubMed och PsycINFO. Resultat: Tre kategorier med underkategorier utformades. I vårdpersonals förståelse av depression hos äldre framkom tre underkategorier; Bakomliggande orsaker och riskfaktorer, Hinder för att upptäcka och bedöma depression samt Kunskap och utbildning. Kategorin Attityder till depression är indelad i två underkategorier, Stigma hos äldre samt Depression som en normal del av åldrande. I Kategorin Vårdpersonals förutsättningar att hantera depression hos äldre framkom två underkategorier; Vårdpersonals roller och funktioner samt Tidsramar inom vården. Diskussion: Litteraturöversiktens resultat diskuteras utifrån tidigare studier samt översiktens teoretiska utgångspunkt tidvattenmodellen. För att visa på relevansen och betydelsen av vårdpersonals förhållningssätt kring äldre med depression diskuteras resultatet även ur ett patientperspektiv. / Background: Depression is common in old age and can have a significant impact on older patients’ health. Depression among the elderly differs in several aspects from depression in younger patients. The differences occur in the appearance of symptoms, causes, and risk factors for depression. Somatic comorbidity is common among older patients which can worsen the course of depression and obstruct identification and treatment.   Aim: The aim of the review was to describe approaches to depression in the elderly among health care personnel in somatic care. Method: A literature review was conducted based on ten scientific articles, nine qualitative and one mixed method. The content was analyzed and organized in categories. Databases used were: CINAHL complete, PubMed and PsycINFO. Results: Three categories with subcategories were constructed. In Health personnel's understanding of depression three subcategories emerged; Underlying causes and risk factors, Obstacles to identify and screen for depression, and Knowledge and training. The category Attitudes towards depression is divided in two subcategories; Stigma in old age and Depression as a normal part of ageing. In the category Health personnel’s conditions to manage depression in older patients, two subcategories emerged; Roles and functions of health personnel and Timeframes in healthcare.         Discussion: The results of the literature review are discussed from the perspective of previous studies as well as the theoretical framework of the review, the tidal model. To indicate the relevance and significance of health personnel’s approaches to depression in old age the results are also discussed from a patient perspective.

INTRODUÇÃO: Conhecer o perfil dos fisioterapeutas é o primeiro passo para dar início ao desenvolvimento de ações em busca do crescimento, reconhecimento e valorização da profissão. No Estado de São Paulo estão registrados mais de 34% dos fisioterapeutas brasileiros, é o Estado em que foi criado o primeiro curso de fisioterapia e que possui o maior número de universidades com o curso de fisioterapia em atividade. O curso de fisioterapia da Faculdade de Medicina da Universidade de São Paulo (FMUSP) é o pioneiro no país. Já foi estudado o perfil do fisioterapeuta em outros estados, especialidades, universidades ou locais de trabalho específicos, porém não temos conhecimento do atual perfil do fisioterapeuta do Estado de São Paulo. OBJETIVO: Descrever o perfil do fisioterapeuta do Estado de São Paulo e do egresso do curso de fisioterapia da FMUSP segundo os aspectos demográfico, formativo e de atuação profissional. Como objetivo secundário, avaliar se há associação entre o tipo de instituição cursada, o local de trabalho e o ano de graduação com a renda salarial mensal. MÉTODO: Todos os fisioterapeutas inscritos no Conselho Regional de Fisioterapia e Terapia Ocupacional da 3ª Região com pelo menos um ano de graduado foram convidados a participar do estudo que consistia em responder um questionário online (Survey Monkey®). Para assegurar a confidencialidade da identificação do profissional, o envio foi realizado pelo Crefito-3 e os questionários não exigiam identificação. Todos os dados foram analisados e foram apresentados em frequências absoluta e relativa. As associações foram analisadas pelo Teste de Qui Quadrado. RESULTADOS: No total 2323 fisioterapeutas participaram da pesquisa, provenientes de todo o Estado de São Paulo, sendo 110 graduados na FMUSP. A amostra geral consistiu em 80% de mulheres, 62% graduou-se entre os anos de 2001 e 2010, 83% graduou-se em uma universidade privada, cerca de 85% dos profissionais realizaram alguma pós graduação, sendo 66,7% pós-graduação lato sensu e 18,3% stricto sensu. As áreas de especialização lato sensu mais procuradas foram a ortopedia (12,7%), cardiorrespiratória (12,0%), acupuntura (10,5%) e neurologia (8,5%), porém 19,0% realizaram uma pós-graduação em uma área ainda não reconhecida pelo Conselho Federal de Fisioterapia e Terapia Ocupacional, como a hidroterapia, geriatria, fisiologia do exercício e gestão hospitalar. Em relação ao stricto sensu, 10,8% possuem título de mestre e 7,5% de doutores. Dos entrevistados, 83,2% atua como fisioterapeuta e em 67,3% a fisioterapia é a sua única fonte de renda. O local de trabalho predominante é o atendimento domiciliar (35,4%) e a renda bruta mensal foi de acima de R$3.000,00 em 35,9% dos casos, sendo que os profissionais com mais tempo de formado ganham mais do que os graduados há menos tempo, e os que atuam em universidades são melhores remunerados. Trinta e sete por cento dos participantes estão parcialmente satisfeitos com a profissão, 98% atualizam-se participando de congressos, cursos e leitura de artigos científicos, apresentam baixa adesão aos sindicatos e associações de classe (15,8%) e somente 13% tinha conhecimento sobre o valor do piso salarial atual. O egresso da FMUSP apresentou como diferencial comparado ao perfil do fisioterapeuta do Estado de São Paulo, a maior dedicação à docência e pesquisa, maior atuação nas universidades, melhores remunerações e encontraram menores dificuldades na inserção no mercado de trabalho. Na análise secundária, não foram encontradas associadas entre a renda salarial mensal e o tipo de instituição, a atuação em clínicas próprias está associada a melhores remunerações e os graduados há mais tempo possuem melhores salários. CONCLUSÃO: A classe de fisioterapeutas do Estado de São Paulo é formada predominantemente por mulheres jovens, graduadas após 2001 em uma universidade privada, com pós-graduação lato sensu, autônoma, realizando atendimentos domiciliares, com renda mensal entre R$1.500,00 a R$6.000,00, estão parcialmente satisfeitos com a profissão, possuem a fisioterapia como única fonte de renda e mantém-se atualizados através da participação em congressos, cursos e leitura de artigos científicos / INTRODUCTION: To know of professional profile is the first step to start actions development to pursuit growth, recognition and appreciation of the profession. In Sao Paulo are registered more than 34% of brazilian physical therapists, is the state which first physical therapy course and has the largest number of universities with physical therapy course. The profile of physical therapist in other states or specific area has been studied, but do not know about the current profile of the physical therapist in the State of Sao Paulo. OBJECTIVE: To present the profile of the physical therapist in the Sao Paulo State according to socio-demographics, academic background, scientific and technical knowledge, labor Market and knowledge of current legislation. METHOD: All registered physical therapist in Crefito-3 with at least one year of graduate were invited to participate in the study that consist in to answer an online survey (Survey Monkey®). We did not acess to professional identification and only Crefito-3 sent e-mail to all physical therapist. All data were analyzed and organized in tables with absolute and relative frequences. Results: In total 2363 physical therapists participated in the survey from all over the state. The sample consisted of 80% women, 62% graduated between 2001 and 2010, 83% graduated from a private university, 85% of professional performed some post graduate, 66,7% lato sensu and 18,3% stricto sensu. The main areas of post graduate are orthopedics (12,7%), cardiothoracics (12%), acupuncture (10,5%) and neurology (8,5%), but 19% performed a post graduate not recognized by COFFITO such as hydrotherapy, geriatrics, exercise physiology and hospital management. Regardind the stricto sensu, 10,8% have a master\'s degree and 7,5% of doctors. Of the participants, 83,2% works with physical therapy and 67,3% had the physical therapy such their liny source of money. The predominant place of work is the home care (35,4%) and earn R$1500,00 to R$3000,00 by month in 34,4% of cases and professional with some years of graduation earn more than graduates less time and those who work in universities are better salaries. 37% of participants are partially satisfy with the profession, 98% updated through congress, courses an reading scientifics articles, low subscription in sindicates and class associations and only 13,8% known about current minimum income. CONCLUSION: The physical therapist profile of Sao Paulo State is formed predominantly by Young women, graduated after 2001 in a private university, post-graduation course, autonomous, works in home care and monthly income between R$1500,00 to R$3000,00, are partially satisfied with the profession, the physical therapy as only source of income and remains updated through participation in conferences, courses and reading scientific articles