Reflexões de profissionais sobre o uso do Portal Estimule para o desenvolvimento de crianças autistas

The Estimule Portal is a technological tool for healthcare for autistic children, incorporating 97 playful activities with communicative, social and motor skills. The objective was to understand the experiences of using the Estimule Portal from the perspective of health professionals who monitor autistic children in public and private outpatient services, in a capital city in the Brazilian Northeast. Methodological research, with a qualitative approach. The Portal was used by 32 health professionals, who completed an instrument on their socioeconomic profile and the use of technology. The analysis was based on Semiotics. Positive and relevant experiences are reflected, evidencing the increase of technology as a supporting resource for professional practices regarding child development. It also brings negative aspects and needs for improvement. The Estimule Portal emerges as a tool in healthcare for autistic children, if it is conducted by trained health professionals. Its implementation can foster collaboration between multidisciplinary health teams, promoting specialized monitoring.

BackgroundFamily caregivers in palliative care have a need for knowledge and support from health professionals, resulting in the need for educational and supportive interventions. However, research has mainly focused on the experiences of family caregivers taking part in interventions. To gain an increased understanding of complex interventions, it is necessary to integrate the perspectives of health professionals and family caregivers. Hence, the aim of this study is to explore the perspectives of health professionals and family caregivers of delivering and participating in a psycho-educational intervention in palliative home care.MethodsA psycho-educational intervention was designed for family caregivers based on a theoretical framework describing family caregiver’s need for knowing, being and doing. The intervention was delivered over three sessions, each of which included a presentation by healthcare professionals from an intervention manual. An interpretive descriptive design was chosen and data were collected through focus group discussions with health professionals and individual interviews with family caregivers. Data were analysed using framework analysis.ResultsFrom the perspectives of both health professionals and family caregivers, the delivering and participating in the intervention was a positive experience. Although the content was not always adjusted to the family caregivers’ individual situation, it was perceived as valuable. Consistently, the intervention was regarded as something that could make family caregivers better prepared for caregiving. Health professionals found that the work with the intervention demanded time and engagement from them and that the manual needed to be adjusted to suit group characteristics, but the experience of delivering the intervention was still something that gave them satisfaction and contributed to them finding insights into their work.ConclusionsThe theoretical framework used in this study seems appropriate to use for the design of interventions to support family caregivers. In the perspectives of health professionals and family caregivers, the psycho-educational intervention had important benefits and there was congruence between the two groups in that it provided reward and support. In order for health professionals to carry out psycho-educational interventions, they may be in need of support and supervision as well as securing appropriate time and resources in their everyday work.

Therapy for autistic children causes outcry in France

Cooperation between families of individuals with mental illnesses and mental health professionals is very important for the quality of mental health care, and there are many barriers to the establishment of cooperation between mental health professionals and families. It is highly important to identify/define barriers to cooperation between families and health professionals from a cultural perspective. The present study was aimed at identifying barriers to cooperation between mental health professionals and families from the perspectives of mental health professionals and family caregivers in Turkey. In the sample of this descriptive qualitative study, 12 family caregivers and 11 health professionals were included. The results of the study indicated seven themes regarding the perceptions of family caregivers and mental health professionals. The themes related to perceptions of family caregivers about barriers are as follows: "learning the process by living," the perception of "my patient comes first," and the perception of "being neglected." The themes related to perceptions of mental health professionals about barriers are as follows: "lack of collaboration within the team," "family itself as a barrier," and "lack of education about working with families." The common theme mentioned by both groups included the "patient-oriented service understanding." The results obtained from this study are believed to be a guide for planning and implementing interventions to eliminate the barriers defined from the perspectives of both mental health professionals and family caregivers. Both mental health professionals and family caregivers need psychosocial interventions for strengthening "family cooperation."

ObjectivesAdoption of healthy lifestyle behaviours has shown promising effectiveness in reducing the high morbidity burden of cancer survivors. Health professionals (HPs) are well suited to provide lifestyle advice but few...

O objetivo deste estudo foi compreender, na perspectiva dos profissionais de saúde, o significado do uso do brincar/brinquedo em sala de espera de um ambulatório infantil. Realizaram-se entrevistas semiestruturadas com 11 trabalhadores. Procedeu-se à análise qualitativa dos dados, os quais foram organizados ao redor de dois temas: reconhecimento da importância do brincar/brinquedo e lidando com limitações. O brincar mostra-se como uma estratégia de cuidado à criança, pois ameniza o tempo de espera neste ambiente, altera positivamente o comportamento e valoriza o processo de desenvolvimento das mesmas, além de melhorar a comunicação e a interação com os profissionais da saúde. É preciso, entretanto, que exista uma estrutura física adequada do hospital, aliada aos profissionais de saúde e à equipe gestora sensíveis para a inclusão de novas estratégias de cuidado, a exemplo do brincar, a fim de humanizar a assistência à saúde da criança.

Patients with incurable end-stage cancer (IESC) who are parenting minor-age children often experience parenting-related distress. Parenting concerns are not always addressed as part of routine hospital-based psychosocial care. Currently, there is a lack multidisciplinary health professional (HP) perspectives in this area. An exploratory study of hospital-based HP perspectives of adult patients' and coparents' parenting experiences, support needs, and parenting supportive care practice was conducted. Twelve multidisciplinary HPs from one Australian tertiary hospital participated in a semistructured focus group and interviews. Data were audio recorded, transcribed, and analyzed using thematic analysis. Results showed HPs were cognizant of patients' and coparents' diverse parenting support needs and experiences and other aspects that comprise best practice. However, multilevel organization, HP, and patient/coparent barriers impeded optimal practice. Barriers included a nonsystemized approach to screening patients' parenting status and parenting support needs, inadequate resources, limited professional support, hospital environment, and parent psychosocial factors. This article provides feasible options for addressing practice barriers. Reviewing what factors influence optimal parenting focus from interdisciplinary HP perspectives helped identify potential strategies that could influence a shift from medical-focused care to more holistic family-focused patient care.

Many autistic children experience motor skill deficits which can impact other areas of functioning, and research on therapeutic interventions for motor skills in autism is in a preliminary stage. Music-based therapies have been used extensively to address motor skills in non-autistic populations. Though a handful of studies exist on the effects of music-based therapies for movement in autistic children, none have investigated the possibility of administering sessions via telehealth. This mixed-methods pilot study investigated whether nine Neurologic Music Therapy (NMT)® sessions via telehealth would improve motor and attention skills in autistic children. Five autistic children between five and 10 years of age participated in the study, with support from their caregivers. Motor skills were assessed using the Bruininks-Oseretsky Test of Motor Proficiency second edition, short form (BOT-2 SF), and a selective attention and sustained attention task were taken from the Test of Everyday Attention for Children, Second Edition (TEA-Ch2). Caregivers and the two neurologic music therapists involved in the study provided qualitative input about the perceived effectiveness of telehealth NMT for the children involved. Their responses were analyzed using qualitative content analysis. Caregivers also filled out a Sensory Profile 2 assessment prior to the onset of sessions so that each child's sensory profile could be compared to their motor and attention results. Statistically significant improvements in motor skills were observed between pre-test assessment and a two-week follow-up assessment. Results from attention test scores were not significant. Caregivers and neurologic music therapists generally perceived sessions positively and noted the importance of having caregivers actively involved. When compared with individual progress on the BOT-2 SF assessment, sensory profile results revealed that children with fewer sensory sensitivities tended to improve the most on motor skills. The improvements in motor skills and positive caregiver and therapist views of telehealth indicate that NMT motor interventions administered via telehealth are a promising avenue of therapeutic support for movement skill development in autistic children.

Providing safe and accessible transportation for children with disabilities and medical conditions can be challenging and complex, as they are particularly vulnerable during road vehicle transportation. Health professionals and organisations play a vital role in supporting families and other involved individuals to ensure their child is transported safely. To obtain a better understanding of the experiences and perspectives of health professionals and organisations involved in the safe transportation of children with disabilities and medical conditions, a large-scale national survey was undertaken in Australia. A total of 295 responses were obtained from 234 health professionals and 61 organisations. Responses were analysed to explore the experiences, difficulties, and demands related to supporting the provision of safe transportation for these children. Although these key stakeholders believed safe transportation to be an important right, health professionals faced many challenges and had low confidence in their abilities to address the barriers associated with it. The findings suggest that health professionals may benefit from additional training, support, and resources. Organisations need access to evidence-based information to address this transportation topic in their strategies and plans. Without adequate support for health professionals to improve their knowledge and capability in this area, and organisational commitment in their strategies and plans that include the transport needs of children with disabilities and medical conditions, these children and their families will remain at a disproportionate risk of injury and fatality on the roads.

BackgroundRates of unplanned adolescent pregnancy and unsafe induced abortions are very high in Sub-Saharan African countries including Tanzania. Despite their availability and accessibility, modern family planning methods are reported to be critically underutilized by adolescents. This study is part of a broader study that aims to develop a curriculum that will be used in training health professionals by investigating the sexual health training needs of health providers and students in Tanzania.AimThis study describes the perceptions of health professionals and students on the provision of contraceptives to adolescents.MethodsQualitative formative assessment type of research was conducted using 18 focus groups stratified among health professionals and students (midwives, nurses, and medical doctors). Study participants were presented with the theoretical scenario of a 14-year-old girl who sought contraceptive services at a family planning clinic. This theoretical scenario was used to determine how health professionals and students would handle the case. Thematic analysis guided the examination and determination of data results.ResultsThree main themes emerged from the data, including (1) knowledge about the provision of contraceptives to adolescents, (2) perception of the adolescents’ right to contraceptive use, and (3) barriers to the provision of contraceptives to adolescents. Participants stated that having a baseline knowledge of contraceptive services for adolescents and their rights to contraceptives would trigger their decision on offering the contraceptive. On the other hand, being unaware of the reproductive health rights for adolescents, judgmental behavior of providers, as well as religious and cultural dynamics were all found to be major barriers for providers to offer contraceptive services to the 14-year-old adolescent girl in the theoretical scenario.ConclusionThese findings support the need for comprehensive sexual health education in Tanzanian health professional training programs.

IntroductionChildren with autism spectrum disorder often face nutrition-related challenges, such as food selectivity, gastrointestinal issues, overweight and obesity, and inadequate nutrient intake. However, the role of routine nutrition-related screening or care by interdisciplinary health professionals is not well understood. This study aimed to compare the beliefs of health professionals with those of parents of autistic children regarding high-priority nutrition-related challenges, barriers and facilitators to care, and desired education and resources related to nutrition for autistic children.ParticipantsInterdisciplinary health professionals (n = 25) (i.e., pediatricians, occupational therapists, speech-language pathologists, board certified behavior analysts, registered dietitians) and parents of autistic children (n = 22).MethodsThe study used semi-structured phone interviews, which were recorded, transcribed, verified, and double-coded using the Framework Method.ResultsThematic analysis of transcripts revealed that while health professionals and parents of autistic children shared some perspectives on nutrition-related challenges and care, they also had distinct viewpoints. Parents emphasized the importance of addressing food selectivity, behavioral eating challenges, sensory issues, and sleep disturbances affecting appetite. Both groups acknowledged the need for tailored support, access to an interdisciplinary care team, and reasonable expectations. Some health professionals perceived parents as lacking motivation or the ability to make changes. In contrast, many parents felt that health professionals lacked the knowledge and motivation to take nutrition or growth concerns seriously. Health professionals acknowledged that their lack of knowledge or capacity to provide nutrition education or referrals was a common barrier to care, particularly given limited community resources.DiscussionHealth professionals who serve autistic children are motivated to address nutrition-related challenges but lack resources related to nutrition. To promote better health outcomes for autistic children, professionals should identify and support parent motivations around nutrition-related care. Both groups expressed interest in accessing autism-specific resources for education, referral, and screening guidance. Future research could explore the development of healthcare training models that improve the competency of health professionals in providing nutrition care and referral for autistic children.

The number of exercise referral schemes expanded rapidly across the UK during the 1990s. Health professionals are thought to be one of the most credible sources of health advice for patients and, hence, are thought to have a pivotal role to play in exercise referral schemes. The aim of the study was to investigate the exercise referral process from the health professional's perspective, specifically examining perceived barriers to referral, priority given to an exercise referral scheme in day-to-day consultations, perceived importance of their role in the process and referring practices. Quantitative and qualitative research methods were utilized with 49% (n = 71) of general practitioners and practice nurses (collectively referred to as health professionals throughout), in a large North West borough (population size approximately 287 000) responding to a postal survey and 11 health professionals (general practitioners n = 9 and practice nurses n = 2) volunteering to take part in a semi-structured interview. Barriers to the referral of patients included lack of time, lack of feedback regarding the patients referred, medico-legal responsibility, a feeling that patients may not take exercise advice given and the belief that physical activity promotion is not a priority during routine consultations. Health professionals refer individuals to an exercise referral scheme on an unsystematic basis and express mixed opinions regarding their perceived role in patient physical activity behaviour change. This study calls for closer partnership working, involving training for promoting physical activity in general practice. Also, greater feedback with regard to patient benefits is needed, in order to overcome some of the practical and perceived barriers for health professionals when referring patients to an exercise referral scheme.

BackgroundUnsettled infant behaviours are a common concern for parents internationally, and have been associated with maternal stress, reduced parenting confidence, and postnatal mental health problems among parents. Little information currently exists regarding available support for the parents of unsettled infants in low-and-middle income countries such as Vietnam. We aimed to describe how unsettled infant behaviour was understood and investigated by Vietnamese health professionals, and what health education was provided to parents regarding infant sleep and settling.MethodsThis qualitative study elicited the perspectives of Vietnamese health professionals working in Thua Thien Hue Province, Vietnam. A semi-structured interview guide included participant demographics, and questions about providing assistance to the parents of unsettled infants, understandings of unsettled infant behaviour, management of unsettled infant behaviour and health education. Individual interviews or small-group discussions were undertaken in Vietnamese, data were translated and analysed in English. The authors used a thematic approach to analysis, supported by Nvivo software.ResultsNine health professionals (four primary care doctors, one paediatrician and four nurses/midwives) working in urban and rural areas of Thua Thien Hue were interviewed. Four themes were created that reflected the responses to the literature-based interview questions. Health professionals described having received little formal training about infant sleep and settling, thus based their advice on personal experience. Information on infant sleep and settling was not included in health education for new mothers, which focused on breastfeeding and preventing malnutrition. Where advice was given, it was generally based on settling strategies involving high levels of caregiver intervention (holding, rocking, breastfeeding on demand and tolerating frequent overnight wakings) rather than behaviour management style strategies. Participants emphasised the importance of recognising and responding to infant behavioural cues (e.g infants cry when hungry).ConclusionsThere is an unmet need for information on infant sleep and settling for new parents and health professionals in Vietnam. Our findings suggest information for caregivers on how to respond sensitively to infant tired signs should be formally included in the training of health professionals in LALMI settings. Sleep and settling information should also be part of culturally appropriate multi-component maternal and child health interventions aimed at promoting early childhood development.

In this scoping review, we evaluated the performance of artificial intelligence (AI) in clinical radiology practice and examined health professionals' perspectives regarding AI use in radiology. This review followed the Joanna Briggs Institute (JBI) methodological guidelines. We searched multiple databases and the gray literature from March 15, 2016 to December 31, 2023. Of 49 articles reviewed, 13 assessed the performance of AI in radiology clinical practice, and 36 examined the attitudes of health professionals toward the use of AI in radiology. In four separate studies, AI significantly improved the diagnostic sensitivity or detection rate. Furthermore, six articles emphasized a significant reduction in case reading times with AI use. Although three studies suggested an increase in specificity with the assistance of AI, these findings did not reach statistical significance. Health professionals expressed the belief that AI would have a significant impact on radiology but would not replace radiologists in the near future. Limited knowledge of AI was observed among health professionals, who supported increased education and explicit regulations and guidelines related to AI. Overall, AI can enhance diagnostic efficiency and accuracy in clinical radiology practice. However, knowledge gaps and the concerns of health professionals should be addressed by prioritizing education and reinforcing ethical and legal regulations to facilitate the advancement of AI use in radiology. This scoping review provides evidence toward a comprehensive understanding of AI's potential in clinical radiology practice, promoting its use and stimulating further discussion on related challenges and implications.

BackgroundWith the aim of increasing benefits and decreasing harms, risk-based breast cancer screening has been proposed as an alternative to age-based screening. This study explores barriers and facilitators to implementing a risk-based breast cancer screening program from the perspective of health professionals, in the context of a National Health Service.MethodsSocio-constructivist qualitative research carried out in Catalonia (Spain), in the year 2019. Four discussion groups were conducted, with a total of 29 health professionals from primary care, breast cancer screening programs, hospital breast units, epidemiology units, and clinical specialties. A descriptive-interpretive thematic analysis was performed.ResultsIdentified barriers included resistance to reducing the number of screening exams for low-risk women; resistance to change for health professionals; difficulties in risk communication; lack of conclusive evidence of the benefits of risk-based screening; limited economic resources; and organizational transformation. Facilitators include benefits of risk-based strategies for high and low-risk women; women’s active role in their health care; proximity of women and primary care professionals; experience of health professionals in other screening programs; and greater efficiency of a risk-based screening program. Organizational and administrative changes in the health system, commitment by policy makers, training of health professionals, and educational interventions addressed to the general population will be required.ConclusionsDespite the expressed difficulties, participants supported the implementation of risk-based screening. They highlighted its benefits, especially for women at high risk of breast cancer and those under 50 years of age, and assumed a greater efficiency of the risk-based program compared to the aged-based one. Future studies should assess the efficiency and feasibility of risk-based breast cancer screening for its transfer to clinical practice.