Browsing by Author "Bravo, Paulina"

Now showing 1 - 13 of 13
  • Thumbnail Image
    Item
    Adaptation and validation of a questionnaire to measure stigma toward mental illness among health professionals working in primary care in Chile
    (2019) Sapag Muñoz de la Peña, Jaime; Velasco Grandón, Paola Renée; Parra, Claudia; Anríquez, Samanta; Villarroel, Luis; Alvarado, Rubén; Poblete, Fernando; Jofré, Ana; Aracena Álvarez, Marcela; Bravo, Paulina; Mascayano, Franco; Álvarez, Cinthia; Chacón, Sergio; De Arcas, Michelle; Ulloa, Viviana; Barrios, Daniela; Díaz, Andrés; Sena, Brena
  • Thumbnail Image
    Item
    Attributes and features of a community health model from the perspective of practitioners
    (SOC MEDICA SANTIAGO, 2017) Dois, Angelina; Bravo, Paulina; Soto, Gabriela
    Background: The Family and Community Health Model is based on three essential principles: user-centered care, comprehensive care and continuity of care. Aim: To describe the attributes and characteristics of the guiding principles of the Family and Community Health Model (FHM) from the perspective of primary care experts. Material and Methods: This was a qualitative study. An electronic Delphi was conducted with 29 national experts on primary care. Results: The experts agree that user centered care must be based on a psycho-social model integrating the multiple factors that influence health problems. It also must integrate patients' individual features, family and environmental issues. The proposed actions promote shared decision making. To promote integral care, anticipatory guidelines should be expanded and health care of patients with chronic conditions should be improved. Continuity of care should be promoted increasing working hours of medical centers and easing access to integrated electronic medical records, thereby generating efficient links between the different care levels. Conclusions: The results of the study can guide the clinical and administrative management of health teams, allowing the strengthening of primary health care according to the local realities.
  • Thumbnail Image
    Item
    Consideraciones éticas para investigaciones con niños, niñas y adolescentes como coinvestigadores, reflexión desde la experiencia chilena
    (2023) Santana López, Alejandra Isabel; Leisewitz, Andrea V.; Bravo, Paulina; Nogueira, Amanda
  • Thumbnail Image
    Item
    CONSTRUCCIÓN Y VALIDACIÓN GUÍA PARA LAS BUENAS PRÁCTICAS DE COMUNICACIÓN DE RIESGO DURANTE CRISIS SANITARIAS
    (Pontificia Universidad Católica de Chile. Escuela de Enfermería, 2024) Dois C., Angelina M.; Fernández-González, Loreto; Martínez-Pereira, Alejandra; Villarroel del Pino, Luis A.; Russo, Moisés; Sepulveda, Dino; Bravo, Paulina
    © 2024, Escuela de Enfermeria Pontificia Universidad Catolica de Chile. All rights reserved.INTRODUCTION. The COVID-19 pandemic evidenced the need for effective risk communication strategies that promote informed community decision making. OBJECTIVE. to describe the construction and validation process by experts of a Guideline for Best Practice for Risk Communication during a health crisis (GBP-RC) in the Chilean context. METHODS. A multi methods study and validity study was carried out for the evaluation elements of the guideline. RESULTS. A GBP-RC was built that addresses central theoretical contents on risk communication (RC), ways of institutionalizing the strategy, its approach, and analysis of the implementation context. It includes recommendations on how to build, transmit and evaluate the message for an effective RC and rubrics to assess three central aspects of the CONCLUSION. The first Guideline for Best Practices for Risk Communication was built during a health crisis based on evidence and adjusted to the local reality.
  • Thumbnail Image
    Item
    Cross-cultural adaptation of four instruments to measure stigma towards people with mental illness and substance use problems among primary care professionals in Chile
    (2022) Parra Videla, Claudia; Sapag Muñoz de la Peña, Jaime; Klabunde, Rachel; Velasco, Paola R.; Anríquez, Samanta; Aracena Álvarez, Marcela; Mascayano, Franco; Bravo, Paulina; Sena, Brena F.; Jofré Escalona, Ana; Bobbili, Sireesha J.; Corrigan, Patrick W.; Bustamante, Inés; Poblete, Fernando; Alvarado, Rubén
    Stigma toward people with mental illness and substance use problems is a significant global concern, and prevents people with these conditions from accessing treatment, particularly in primary health care (PHC) settings. Stigma is a cultural phenomenon that is influenced by particular contexts and can differ by country and region. The majority of stigma research focuses on Europe or North America leading to a lack of culturally relevant stigma research instruments for the Latin American context. The present study describes and discusses the methodology for cross-culturally adapting four stigma measurement scales to the Chilean context. The cross-cultural adaptation process included nine phases: (1) preparation; (2) independent translations; (3) synthesis 1 with expert committee; (4) focus groups and interviews with researchers, PHC professionals, and PHC users; (5) synthesis 2 with expert committee; (6) independent back translations; (7) synthesis 3 with expert committee; (8) pilot with PHC professionals; and (9) final revisions. The adaptation process included an array of diverse voices from the PHC context, and met three adaptation objectives defined prior to beginning the process (Understandability, Relevance, and Acceptability and Answer Options). The resulting, culturally adapted questionnaire is being validated and implemented within PHC settings across Chile to provide in-depth insight into stigma among PHC professionals in the country. The authors hope it will be useful for future research on mental illness and substance use stigma in similar settings across Latin America.
  • No Thumbnail Available
    Item
    Early postnatal hospital discharge: the consequences of reducing length of stay for women and newborns
    (2011) Bravo, Paulina; Uribe, Claudia; Contreras, Aixa
    The objective of this study is to examine the literature and identify most salient outcomes of early postnatal discharge for women, newborns and the health system. An electronic search strategy was designed including the following sources: Web of Science, Scopus, ProQuest and PubMed/MEDLINE, using the following terms: (early AND discharge) OR (length AND stay) AND (postpartum OR postnatal) AND (effect* OR result OR outcome). Content analysis was used to identify and summarise the findings and methods of the research papers. The evidence available is not enough to either reject or support the practice of early postnatal discharge; different studies have reported different outcomes for women and newborns. The need of systematic clinical research is discussed.
  • No Thumbnail Available
    Item
    Facilitators and barriers perceived by health professionals in the implementation of Managing Cancer and Living Meaningfully (CALM) psychotherapy in Santiago
    (2021) Fernandez-Gonzalez, Loreto; Russo Namias, Moises; Bravo, Paulina
    Introduction: Palliative care (PC) for advanced cancer is guaranteed by law in Chile, but the formal training for it is insufficient. Training models have emerged internationally that enable professionals to be better prepared for the provision of psychotherapy in PC. The objective of this study is to explore health professionals' perceptions of the 'Managing Cancer and Living Meaningfully' (CALM) psychotherapy and the perceived barriers and facilitators to its implementation, based on a theoretical training.
  • No Thumbnail Available
    Item
    Needs and satisfaction levels of breast cancer patients
    (2024) Ramis, Sylvia; Acevedo, Francisco; Bravo, M. Loreto; Pena, Jose; Bravo, Paulina; Medina, Lidia; Muniz, Sabrina; Ibanez, Carolina; Walbaum, Benjamin; Merino, Tomas; Marin-Olivo, Erick; Pinto, Mauricio P.; Sanchez, Cesar
    Introduction. Knowing and satisfying the needs of breast cancer (BC) patients (P) and their caregivers (CG) during treatment can help to improve their quality of life. This study assessed the needs of BC-P, their CG and health professionals (HP) and their perception before and after an intervention aiming to improve healthcare. Methods. The study included an academic center (AC) and a public hospital (PH). Data were obtained from interviews, focus groups and self-completed surveys. A content analysis was performed using Nvivo software. Due to COVID19 restrictions, educational videos were delivered to HPs describing the identified needs. Finally, satisfaction surveys were applied to P and CG, before and after this intervention. Results. A total of 22 participants were interviewed (7P, 5CG and 10HP). Three main needs were identified: 1) Healthcare related needs, 2) Financial issues and 3) Social support. Subsequently, a satisfaction survey was applied to users (stage I; n=93) and the identified needs were used to design an intervention that consisted of educational videos directed towards HP. Following the intervention a second survey was applied (stage II; n=71). Both surveys revealed high levels of satisfaction among users. Following the second survey, we noticed the emergence of other needs, mainly related to nutrition and the improvement of facilities. Conclusions. This is the first study in Chile assessing BC-P needs from the perspective of P, their CG and HP. All participants indicated that information and social/financial support were the most relevant needs.
  • Thumbnail Image
    Item
    Percepción del cuidado centrado en la persona y autonomía en la atención clínica de usuarios que viven con multimorbilidad
    (2024) Dois C., Angelina M.; Bravo, Paulina
    Objetivo: Promover autonomía significa transitar desde un modelo paternalista hacia uno que posicione en un rol activo a las personas durante el encuentro clínico, con participación en la toma de decisiones relativas al cuidado de su salud. Este manuscrito describe la percepción de usuarios que viven con multimorbilidad respecto del ejercicio de su autonomía durante la atención clínica. Método: Estudio de caso cualitativo en usuarios con multimorbilidad atendidos en un Centro de Salud Familiar de Santiago, Chile. Se realizó análisis de contenido según Krippendorf. Resultados: La muestra quedó conformada por 19 participantes adultos con un promedio de 2,7 condiciones crónicas de salud. Del análisis de contenido de las entrevistas emergen tres categorías: a) Significado atribuido por los usuarios a la autonomía en la atención de salud, b) Elementos que debe considerar una atención en salud que respete la autonomía del usuario y c) Participación durante la atención clínica. Conclusiones: Frente al aumento de las condiciones crónicas de salud imperativo repensar la forma de brindar atención de salud, relevando el valor de la participación usuaria a través de la toma de decisiones compartida como expresión de respeto de su autonomía y una forma de fomentar el cuidado centrado en las personas.
  • Thumbnail Image
    Item
    Perception of users about an Integral Model of Family and Community Health care in Santiago, Chile
    (SOC MEDICA SANTIAGO, 2016) Dois, Angelina; Contreras, Aixa; Bravo, Paulina; Mora, Isabel; Soto, Gabriela; Solis, Claudia
    Background: The integral Model of Family and Community Health care is based on three essential principles: patient centered care, comprehensive care and continuity of care. Aim: To know the perception of primary care clinic users about the elements that should be considered in a patient centered integrated health care. Material and Methods: Ten males and 31 females aged 18 to 78 years, users of two public family primary care centers participated in focus groups, which were recorded. A qualitative descriptive research design based on content analysis according to Krippendorf was done. Results: Seven issues emerged from the description of patients' experiences: professional-patient relationship, fragmentation of care, continued care with the same professional, promotion and prevention, availability of services and patient records. Conclusions: There are difficulties to install an integral model of family and community health care. The concerns raised by participants should be considered in order to modify the design of these models.
  • No Thumbnail Available
    Item
    Reducing stigma toward mental illness and substance use issues in primary health care in Chile: Protocol of a cluster controlled trial study
    (2022) Sapag, Jaime C.; Traub, Carolina; Velasco, Paola R.; Arratia, Tamara; Alvarado, Ruben; Aracena, Marcela; Poblete, Fernando C.; Villarroel, Luis; Bravo, Paulina; Alvarez-Huenchulaf, Cinthia; Jofre Escalona, Ana; Vargas-Malebran, Nelson; Bobbili, Sireesha; Bustamante, Ines; Khenti, Akwatu; Corrigan, Patrick W.
    Background: Chile is implementing a Community Mental Health Model with a strong role of primary health care (PHC). PHC has great potential to early detection and provision of accessible and coordinated services to people who present mental illness and/or substance use issues (MISUI). However, stigma toward people with MISUI among PHC professionals is a significant barrier to accessing good quality of care. A wealth of literature supports the importance of reducing stigma for this population. The main goal of this research project is to determine the effectiveness of a comprehensive anti-stigma intervention in reducing stigmatizing attitudes and behaviors among PHC providers toward individuals with MISUI in the Chilean context, using Centros de Salud Familiar (CESFAMs) as the point of intervention. Methods: The intervention is based on an initiative that was previously developed in Canada and then also pilot-tested in Lima, Peru, with the Center for Addiction and Mental Health (Ontario, Canada). The model will be culturally adapted with CESFAM PHC provider and user inputs to be relevant and valid to Chile. The 18-month intervention includes five (5) components that are simultaneously implemented in CESFAMs: (1) Develop a Team of Local Champions in each intervention CESFAM, comprising PHC providers and users; (2) Analysis of Internal CESFAM Policies, Procedures, and Protocols to determine areas of improvement in service delivery for individuals with MISUI; (3) Raising Awareness of stigma toward MISUI using various forms of media within the CESFAM; (4) Innovative Contact-Based Education workshops on anti-stigma and recovery principles, co-lead by academic/clinical trainers and a person with lived experience of MISUI; and (5) Recovery-Based Arts, a multi-week arts workshop for PHC providers and users to produce artwork related to MISUI and recovery, culminating in an exhibition to showcase artwork for the CESFAM providers, users, and community. The expected intervention outcomes are the following: Participation in the experimental group will result in a significant decrease in stigmatizing attitudes among PHC providers toward individuals with MISUI compared with the control group as measured by the Chilean version of the Opening Minds Scale for Health Care Providers Scale (OMS-HC); Participation in the experimental group will result in a significant decrease of PHC users experiences of stigma conveyed by PHC providers compared with the control group as measured by the Internalized Stigma of Mental Illness (ISMI) scale, validated for the Chilean population. The changes in attitudes and behaviors within the experimental group will be sustained over time as measured at 6 months-follow-up. To evaluate the effectiveness of this 18-month intervention, a 4-year, two-arm, cluster-randomized controlled trial is proposed, with CESFAMs being the unit of randomization (or "cluster "). Implementation Science approach will be taken to measure relevant implementation outcomes for each component of the intervention, and through qualitative data collection with CESFAM providers and authorities. Data analysis will be carried out using SAS 9.4 (specifically, using POC MIXED and PROC GENMOD) and R 3.5. Mixed-effect modeling will used for both PHC provider and user data, which will include individuals and CESFAMs as random effects and group (intervention/control) as fixed effects.
  • No Thumbnail Available
    Item
    Validation of the Death and Dying Distress Scale (DADDS-Sp) in a population with advanced cancer in Chile
    (2021) Fernandez-Gonzalez, Loreto; Russo Namias, Moises; Lagos, Rodrigo; Bravo, Paulina; Troncoso, Alexis; Acevedo Echeverria, Claudia
    Introduction: Developing instruments to screen for relevant aspects of advanced illness is key to identifying palliative needs and evaluating the effectiveness of interventions in this population. The objective of this project is to validate the Death and Dying Distress Scale in Spanish (DADDS-Sp) for screening anxiety about death and evaluating psychometric properties for people with advanced cancer.
  • No Thumbnail Available
    Item
    What is needed to effectively communicate risk during a health crisis? A qualitative study with international experts based on the COVID-19 pandemic
    (2023) Bravo, Paulina; Martinez-Pereira, Alejandra; Fernandez-Gonzalez, Loreto; Dois, Angelina
    ObjectiveTo identify a framework for risk communication during health crises by using the current pandemic as a case study.DesignA qualitative study based on individual interviews.SettingDifferent countries with diverse levels of perceived success on risk communication during the COVID-19 health crisis.ParticipantsInternational experts with experience in health crisis management or risk communication.AnalysisA thematic analysis was performed supported by Atlas.ti.ResultsFour men and six women took part in the study (three from Europe, two from Latin America, two from North America, one from Asia and two from Oceania). Three major themes emerged from the data: (1) institutionalising the communication strategy; (2) defining the problem that needs to be faced; (3) developing an effective communication strategy.ConclusionRisk communication during a health crisis requires preparation of governments and of health teams in order to produce and deliver effective messages as well as to help communities to make informed and healthy decisions. This is particularly relevant for slow disasters, such as COVID-19, as the strategy must innovate to avoid information fatigue of the audience. The findings of this article could inform guidelines to best equip countries for a clear communication strategy for future crises.PROSPERO registration numberCRD42021234443.