Atencion Primaria最新文献

The medical history underscores the significance of ethics in each advancement, with bioethics playing a pivotal role in addressing emerging ethical challenges in digital health (DH). This article examines the ethical dilemmas of innovations in DH, focusing on the healthcare system, professionals, and patients. Artificial Intelligence (AI) raises concerns such as confidentiality and algorithmic biases. Mobile applications (Apps) empower but pose challenges of access and digital literacy. Telemedicine (TM) democratizes and reduces healthcare costs but requires addressing the digital divide and interconsultation dilemmas; it necessitates high-quality standards with patient information protection and attention to equity in access. Wearables and the Internet of Things (IoT) transform healthcare but face ethical challenges like privacy and equity. 21st-century bioethics must be adaptable as DH tools demand constant review and consensus, necessitating health science faculties’ preparedness for the forthcoming changes.

Objective

The objective of this work is to describe how the use of the information and communication technologies has been used in the clinical control, follow-up and treatment of all the patients affected by monkeypox in our health area.

Design and site

A descriptive, observational and retrospective work has been carried out to show the clinical management of the monkeypox cases assisted in the Health Area of Ibiza and Formentera (ASEF), in the field of the primary care.

Participants and methods

All patients affected by monkeypox who met the inclusion criteria were included in the study (a total of 79 patients), covering the period from 01/06/22 to 30/11/22. A protocol was designed in order to recruit the patients, extract the samples, monitor the close contacts, notify the cases to the health authorities, clinical assistance and administrative processing of the sick leaves.

Results and conclusions

The adherence of the patients with the control system was majoritarian. Telemedicine has been a useful tool for the exchange of information during the provision of continuous medical care to patients affected by the outbreak of monkeypox infection, guaranteeing their safety and privacy and allowing the management of an infectious disease that requires isolation, control, and medical monitoring.

The clinical interview of immigrant patients requires cultural competence to ensure good understanding and correct communication, in addition to collecting specific information that differs from that of native patients, such as origin and migratory route or cultural identity.

Screening for latent tuberculosis infection is recommended in certain cases and screening for other infections, both cosmopolitan with a higher prevalence in migrants (HIV, syphilis, hepatitis B and C) and imported (Chagas, intestinal parasites, strongyloidiasis, schistosomiasis), depending on origin.

It is essential to check the vaccination status and complete the vaccination schedule, adapting it to the current calendar, prioritizing vaccines such as measles, rubella and poliomyelitis.

We propose preventive activities to be carried out when traveling to countries of origin, due to their special characteristics and risks: general advice, exploring the risk of malaria, assessing specific vaccinations, advice regarding sexually transmitted infections and special considerations if they have chronic diseases; and addressing, if appropriate, the risks of female genital mutilation.

Objective

To evaluate a coding guide for social determinants of health in primary care consultations as an effective tool in the professional's daily workflow.

Design

Mixed sequential explanatory study. Formed by a quantitative part (experimental) and a qualitative part (descriptive-evaluative).

Location

All the primary care teams of the Central Catalonia Management (32 teams).

Participants and setting

All nursing, social work and medical professionals working in the 32 primary care teams of the Catalan Institute of Health in Central Catalonia from February 2023 to July 2023.

Methods

A social determinants of health coding guide was developed. This guide was created in a multidisciplinary and multicenter manner. Purposive sampling. Quantitatively, the number of diagnoses recorded by the experimental group versus the control group was counted. Qualitatively, a thematic analysis was carried out from a socio-constructivist perspective.

Results

The results were significant and satisfactory. Using a quantitative methodology, the effectiveness of the use of the guide was assessed. A significant increase in the use of the social determinants was observed in the intervention group vs. the control group, with a percentage of post-intervention use of 19.53% in the control group and 32.26% in the intervention group (P < .001). The number of diagnoses recorded increased from 312 to 1322 in the intervention group, while it remained the same in the control group. The main factors identified through qualitative methodology that may explain the effectiveness of the guideline were: 1) the effectiveness of the guideline among primary care professionals, 2) the appropriateness of the guideline by assessing its usefulness and practicality, 3) feasibility and 4) specific contributions to the improvement of the guideline.

Conclusions

The social determinants of health coding guide is effective, appropriate and can be implemented in the workflow of primary health care professionals for good recording of the social determinants of health.

In the last years, the digital transformation, has become a reality influencing organizational processes and advancing services for users. This transformation must align with WHO guidelines, addressing the needs of individuals globally and acknowledging Social Determinants of Health and emerging Digital Determinants of Health and the digital divide thas has been created. To accomplish this, the appropriate legislation and infrastructures are required. Correspondingly technology enables enhanced self-care and increased participation in decision-making across various levels, consequently, addressing the digital divide must not be an exception, and needs to include citizens, communities, entities, and professionals to work on how to diminish it and solve it. As a result of this national and supranational campaigns should formulate unified plans and strategies, that include training requirements and establishing programs for both professionals and users, highlighting the significance of incorporating digital knowledge on both groups.