Browsing by Author "Bravo Valenzuela, Paulina Fabiola"

Now showing 1 - 20 of 35
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    Adaptación y validación del instrumento genérico collaboRATE™ para medir la participación de mujeres en la toma de decisiones en salud durante el proceso reproductivo
    (2018) Bravo Valenzuela, Paulina Fabiola; Contreras, Aixa; Dois C., Angelina M.; Villarroel del Pino, Luis A.
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    Assessment of Patient Empowerment - A Systematic Review of Measures
    (2015) Barr, Paul J.; Scholl, Isabelle; Bravo Valenzuela, Paulina Fabiola; Faber, Marjan J.
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    Balancing the presentation of information and options in patient decision aids: an updated review
    (2013) Bravo Valenzuela, Paulina Fabiola; Abhyankar, Purva.; Volk, Robert J.; Blumenthal-Barby, Jennifer.; Buchholz, Angela.; Ozanne, Elissa.; Vidal, Dale Colins.; Col, Nananda.; Stalmeier, Peep.
    Abstract Background Standards for patient decision aids require that information and options be presented in a balanced manner; this requirement is based on the argument that balanced presentation is essential to foster informed decision making. If information is presented in an incomplete/non-neutral manner, it can stimulate cognitive biases that can unduly affect individuals’ knowledge, perceptions of risks and benefits, and, ultimately, preferences. However, there is little clarity about what constitutes balance, and how it can be determined and enhanced. We conducted a literature review to examine the theoretical and empirical evidence related to balancing the presentation of information and options. Methods A literature search related to patient decision aids and balance was conducted on Medline, using MeSH terms and PubMed; this search supplemented the 2011 Cochrane Collaboration’s review of patient decision aids trials. Only English language articles relevant to patient decision making and addressing the balance of information and options were included. All members of the team independently screened clusters of articles; uncertainties were resolved by seeking review by another member. The team then worked in sub-groups to extract and synthesise data on theory, definitions, and evidence reported in these studies. Results A total of 40 articles met the inclusion criteria. Of these, six explained the rationale for balancing the presentation of information and options. Twelve defined “balance”; the definition of “balance” that emerged is as follows: “The complete and unbiased presentation of the relevant options and the information about those options—in content and in format—in a way that enables individuals to process this information without bias”. Ten of the 40 articles reported assessing the balance of the relevant decision aid. All 10 did so exclusively from the users’ or patients’ perspective, using a five-point Likert-type scale. Presenting information in a side-by-side display form was associated with more respondents (ranging from 70% to 96%) judging the information as “balanced”. Conclusion There is a need for comparative studies investigating different ways to improve and measure balance in the presentation of information and options in patient decision aids.
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    Buen trato en Centros de Atención Primaria chilena: ¿privilegio o derecho humano?
    (2019) Dois C., Angelina M.; Bravo Valenzuela, Paulina Fabiola
    Introducción: El derecho a la salud garantiza el acceso a todos los individuos a iguales oportunidades para alcanzar el grado máximo de salud. Objetivo: Describir la vinculación entre derechos humanos irrenunciables y la atención centrada en la persona según usuarios de centros de salud de Atención Primaria y expertos en Atención Primaria de Salud de Chile. Métodos: Estudio cualitativo, descriptivo y prospectivo, desarrollado entre enero y diciembre de 2015, considera análisis de contenido de Krippendorff de 5 grupos focales con 41 usuarios y Delphi electrónico de 3 rondas con 29 expertos chilenos. Criterio de finalización saturación de la información y el Coeficiente de Concordancia. Resultados: Según los usuarios, la percepción de buen trato en la atención de salud implica que esta sea coherente, integrada y que no fragmente los requerimientos de los usuarios, lo que se vincula directamente con el respeto al derecho a la salud. Esto es consistente con lo planteado por los expertos, pero es discordante respecto a la experiencia vivida por los usuarios en los centros de la Atención Primaria de Salud, lo que es parte de prácticas vinculadas a la violencia institucional. Conclusiones: El respeto de los derechos humanos en salud debe posicionarse como un tema de primer orden en la agenda pública de salud, ya que el trato digno es un derecho propio de todas las personas.
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    Características de la atención de salud efectiva para la población que se identifica con el colectivo LGBTI
    (2020) Cabezas Oyarce, Yasna Karina; Bravo Valenzuela, Paulina Fabiola; Pontificia Universidad Católica de Chile. Facultad de Medicina
    El propósito de este proyecto de investigación es identificar las necesidades de los usuarios del colectivo LGBTI en el contexto de la atención primaria de salud en Chile. Para poder determinar las brechas existentes en las políticas públicas asociadas a los servicios de salud, se ha efectuado un grupo focal conformado por usuarios pertenecientes al colectivo, dirigentes de organizaciones involucradas y especialistas en la atención de salud. Se identifican las características con las que debiesen contar los equipos integrales de atención, revelando a través de las vivencias de los usuarios circunstancias y experiencias que permiten el acercamiento a una atención efectiva que dé respuesta a sus necesidades y al reconocimiento de sus derechos, deberes y acceso.
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    Conceptualising patient empowerment : a mixed methods study
    (2015) Bravo Valenzuela, Paulina Fabiola; Edwards, Adrian.; Barr, Paul James.; Scholl, Isabelle.; Elwyn, Glyn.; McAllister, Marion.
    Abstract Background In recent years, interventions and health policy programmes have been established to promote patient empowerment, with a particular focus on patients affected by long-term conditions. However, a clear definition of patient empowerment is lacking, making it difficult to assess effectiveness of interventions designed to promote it. The aim in this study was to develop a conceptual map of patient empowerment, including components of patient empowerment and relationships with other constructs such as health literacy, self-management and shared decision-making. Methods A mixed methods study was conducted comprising (i) a scoping literature review to identify and map the components underpinning published definitions of patient empowerment (ii) qualitative interviews with key stakeholders (patients, patient representatives, health managers and health service researchers) to further develop the conceptual map. Data were analysed using qualitative methods. A combination of thematic and framework analysis was used to integrate and map themes underpinning published definitions of patient empowerment with the views of key UK stakeholders. Results The scoping literature review identified 67 articles that included a definition of patient empowerment. A range of diverse definitions of patient empowerment was extracted. Thematic analysis identified key underpinning themes, and these themes were used to develop an initial coding framework for analysis of interview data. 19 semi-structured interviews were conducted with key stakeholders. Transcripts were analysed using the initial coding framework, and findings were used to further develop the conceptual map. The resulting conceptual map describes that patient empowerment can be conceived as a state ranging across a spectrum from low to high levels of patient empowerment, with the level of patient empowerment potentially measurable using a set of indicators. Five key components of the conceptual map were identified: underpinning ethos, moderators, interventions, indicators and outcomes. Relationships with other constructs such as health literacy, self-management and shared decision-making are illustrated in the conceptual map. Conclusion A novel conceptual map of patient empowerment grounded in published definitions of patient empowerment and qualitative interviews with UK stakeholders is described, that may be useful to healthcare providers and researchers designing, implementing and evaluating interventions to promote patient empowerment.
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    Conceptualization of patient‐centered care in Latin America: A scoping review
    (2023) Klimesch, Anne; Martínez Pereira, Marcela María Alejandra; Topf, Cheyenne; Härter, Martin; Scholl, Isabelle; Bravo Valenzuela, Paulina Fabiola
    Introduction: Patient-centered care (PCC) has been declared as a desirable goal for health care in Latin American countries, but a coherent definition of what exactly PCC entails for clinical practice is missing. This article's aim was to identify how PCC is conceptualized in Latin American countries. Methods: Scientific databases (MEDLINE, EMBASE, PsycINFO, CINAHL, Scielo, Scopus, Web of Science) and webpages of the ministries of health were searched, and experts were contacted for suggestions of literature. References were included if they contained one of a range of a priori defined keywords related to PCC in the title, were published between 2006 and 2021, and were carried out in or concerned Latin America. Definitions of PCC were extracted from the included articles and analyzed using deductive and inductive coding. Deductive coding was based on the integrative model of patient-centeredness, which unites the definitions of PCC in the international literature (mainly North America and Europe) and proposes 16 dimensions describing PCC. Results: Thirty-two articles were included in the analysis and about half of them were from Brazil. Numerous similarities were found between the integrative model of patient-centeredness and the definitions of PCC given in the selected literature. The dimensions of the integrative model of patient-centeredness that were least and most prominent in the literature were physical support and patient information, respectively. A differentiation between PCC and family-centered care (FCC) was observed. Definitions of PCC and FCC as well as their cited references were diverse. Conclusion: A considerable overlap between the conceptualization of PCC in Latin America and the integrative model of patient-centeredness has been identified. However, there are substantial differences between countries in Latin America regarding the emphasis of research on PCC versus FCC and diverse conceptualizations of PCC and FCC exist. Patient Contribution: This scoping review takes the patient's perspective based on the integrative model of patient-centeredness. Due to the study being a review, no patients, neither caregivers, nor members of the public, were involved.
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    Decisional conflict among people with diabetes mellitus or hypertension attending primary care
    (2018) Bravo Valenzuela, Paulina Fabiola; Dois C., Angelina M.; Jose Hernandez, Maria; Villarroel del Pino, Luis A.
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    Do interventions designed to support shared decision- making reduce health inequalities? a systematic review and meta-analysis
    (2014) Duránd, M.; Carpenter, L.; Dolan, H.; Bravo Valenzuela, Paulina Fabiola; Mann, M.; Bunn, F.; Elwyn, G.
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    Early postnatal hospital discharge: The consequences of reducing length of stay for women and newborns
    (2011) Bravo Valenzuela, Paulina Fabiola; Uribe Torres, Claudia; Contreras Mejías, 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.
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    Effective interventions to improve the health literacy of cancer patients
    (2019) Fernández González, Loreto; Bravo Valenzuela, Paulina Fabiola
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    El buen trato en el encuentro clínico de enfermería: características y atributos
    (2022) Dois C., Angelina M.; Bravo Valenzuela, Paulina Fabiola; Martínez Pereira, Marcela María Alejandra
    Objetivo principal: describir características, atributos y acciones específicas del cuidado de enfermería respetuoso del Buen Trato. Metodología: estudio de métodos mixtos basado en el análisis de contenido de Kyngäs sobre una muestra de enfermeras y estudiantes de enfermería. Se realizaron grupos focales y encuestas. Resultados principales: se identificaron cuatro dimensiones: (a) significado del Buen Trato en la atención de Enfermería, (b) conductas que reflejan una atención de enfermería que respeta el Buen Trato, (c) conductas que vulneran el Buen Trato y (d) dificultades de los estudiantes para otorgar cuidado respetuoso. Conclusión principal: El Buen Trato se basa en una relación enfermera-usuario construida sobre el respeto y reconocimiento de la dignidad de las personas. El proceso de enseñanza/aprendizaje orientado al Buen Trato en enfermería requiere que integrar conocimientos teóricos, prácticos y actitudinales, que permita a los profesionales contar con las competencias necesarias para brindar cuidado respetuoso.
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    En busca de una salud más participativa: compartiendo decisiones de salud
    (2013) Bravo Valenzuela, Paulina Fabiola; Contreras Mejías, Aixa; Perestelo-Pérez, Lilisbeth; Pérez-Ramos, Jeanette; Málaga, Germán
    El modelo de atención en salud paternalista está derivando hacia modelos más participativos, como lo es la toma de decisiones compartidas (TDC), en el que se considera al paciente como agente responsable y autónomo. La TDC representa un enfoque terapéutico en el que profesionales y pacientes comparten la mejor evidencia científica disponible para tomar una decisión, incorporando los valores y preferencias del paciente. Este intercambio de información puede facilitarse mediante el uso de herramientas de ayuda para la TDC, que han demostrado ser efectivas para mejorar el conocimiento, la satisfacción del paciente, y reducir el conflicto decisional. En este sentido, las habilidades comunicacionales ejercen un rol fundamental en el establecimiento de la relación profesional - paciente, facilitando el intercambio de información y preferencias de manera efectiva y respetuosa. Esta aproximación terapéutica podría apoyar la reducción de las disparidades en salud que prevalecen en Latinoamérica, al facilitar que las personas puedan participar informada y activamente en el cuidado de su salud.
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    Estudio de familia en Atención Primaria : construcción y validación de una herramienta para la valoración familiar
    (2019) Dois C., Angelina M.; Bravo Valenzuela, Paulina Fabiola; Mora, Isabel; Soto, Gabriela
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    Experiencia usuaria en salud : hacia un modelo de atención que escucha a los usuarios
    (Centro de Políticas Públicas UC, 2021) Montenegro Cortés, Cristián; Bravo Valenzuela, Paulina Fabiola; Dois C., Angelina M.; Rodríguez Ruiz, Cecilia
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    Exploring women’s experiences of participation in shared decision-making during childbirth : a qualitative study at a reference hospital in Spain
    (2021) López-Toribio, María; Bravo Valenzuela, Paulina Fabiola; Llupià, Anna
    Background: Women’s engagement in healthcare decision-making during childbirth has been increasingly emphasised as a priority in maternity care, since it increases satisfaction with the childbirth experience and provides health benefits for women and newborns. The birth plan was developed as a tool to facilitate communication between health professionals and women in Spain, but their value in routine practice has been questioned. Besides, little is known about women’s experiences of participation in decision-making in the Spanish context. Thus, this study aimed to explore women’s experiences of participation in shared decision-making during hospital childbirth. Methods: An exploratory qualitative study using focus groups was carried out in one maternity unit of a large reference hospital in Barcelona, Spain. Participants were first-time mothers aged 18 years or older who had had a live birth at the same hospital in the previous 12 months. Data collected were transcribed verbatim and analysed using a six-phase inductive thematic analysis process. Results: Twenty-three women participated in three focus groups. Three major themes emerged from the data: “Women’s low participation in shared decision-making”, “Lack of information provision for shared decision-making”, and “Suggestions to improve women’s participation in shared decision-making”. The women who were willing to take an active role in decision-making encountered barriers to achieving this and some women did not feel prepared to do so. The birth plan was experienced as a deficient method to promote women’s participation, as health professionals did not use them. Participants described the information given as insufficient and not offered at a timely or useful point where it could aid their decision-making. Potential improvements identified that could promote women’s participation were having a mutually respectful relationship with their providers, the support of partners and other members of the family and receiving continuity of a coordinated and personalised perinatal care. Conclusion: Enhancing women’s involvement in shared decision-making requires the acquisition of skills by health professionals and women. The development and implementation of interventions that encompass a training programme for health professionals and women, accompanied by an effective tool to promote women’s participation in shared decision-making during childbirth, is highly recommended.
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    Facilitadores y barreras que enfrentan las personas al tomarse el test de ELISA para el diagnóstico del VIH : revisión de la literatura
    (2013) Araya Gutiérrez, Alejandra; Bravo Valenzuela, Paulina Fabiola; Carrasco Aldunate, Paola; Urrutia Soto, María Teresa; Vega Vega, Paula; Rubio Acuña, Miriam; Lira, M. Jesús
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    Factors influencing the implementation of shared decision-making in breast cancer care: protocol for a mixed-methods study
    (2023) Bravo Valenzuela, Paulina Fabiola; Dois C., Angelina M.; Villarroel Del Pino, Luis Antonio; González Aguero, Marcela Margot; Fernandez González, Loreto; Sánchez Rojel, César Giovanni; Martínez, Alejandra; Turen Croquevielle, Valentina; Quezada, Constanza; Guasalaga María, Elisabeth; Härter, Martin
    Chile is committed to actively involving patients in their healthcare. However, little is known about how this is translated into clinical encounters. Breast cancer (BC) is the first cause of cancer-related death in Chilean women. National policy guarantees standard care, and treatment decisions should be made along this process that can have long-term consequences for women. So, BC is a particularly well-suited case study to understand the complexity of patient participation in decision-making.
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    Glosario para universidades promotoras de la salud
    (2013) Bravo Valenzuela, Paulina Fabiola; Cabieses, B.; Zuzulich Pávez, María Soledad; Muñoz Quilodrán, Mónica Alejandra; Ojeda, M.
    La promoción de la salud en el contexto universitario surge como una iniciativa relevante para facilitar el desarrollo de conductas y estilos de vida saludable en el entorno donde estudiantes, académicos y personal universitario desarrollan parte importante de sus vidas. El movimiento de Universidades Promotoras de Salud (UPS) cuenta con más de 20 años de experiencia, sin embargo aún carece de un lenguaje común que permita una comunicación efectiva entre quienes lo planifican e implementan. El propósito de este artículo es desarrollar conceptos esenciales en el movimiento internacional de UPS. Este documento está organizado considerando cinco aspectos que facilitan la comprensión del mismo: 1. La Universidad y la promoción de la salud; 2. La Universidad y su responsabilidad social; 3. La Universidad, la desigualdad y la equidad; 4. La Universidad y la evidencia en promoción de la salud, y; 5. Estrategias para desarrollar una UPS.