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Gaceta Sanitaria acepta para su publicación artículos en español e inglés. Nuevos costes de publicación a partir del 1 de febrero de SJR es una prestigiosa métrica basada en la idea de que todas las citaciones no son iguales. SJR usa un algoritmo similar al page rank de Google; es una medida cuantitativa y cualitativa al impacto de una publicación.
We used a multiple embedded case study. The two teams considered good had scored highest in practice issues for intimate partner violence, measured via a questionnaire PREMIS - Physicians Readiness to Respond to Intimate Partner Violence Survey applied to professionals working in the four primary health care teams.
In each case quantitative and qualitative data were collected using a social network questionnaire, interviews and observations. Better individual responses to intimate partner violence were implemented in the teams which: 1 had social workers who were knowledgeable and motivated to engage with others; 2 sustained a structure of regular meetings during which issues of violence were discussed; 3 encouraged a friendly team climate; and 4 implemented concrete actions towards women-centred care.
Los casos fueron cuatro equipos de atención primaria de salud ubicados en una región del sur de España. Dos de ellos se calificaron como «buenos» y otros dos como «promedio». En cada caso se recolectaron datos cuantitativos y cualitativos mediante un what is the meaning of acid bases and salt de redes sociales, entrevistas y observaciones.
Men's intimate partner violence IPV against women is a global public health problem that has devastating effects on the health and wellbeing of women and children. The health system, especially primary health care services, can play a key role in preventing and responding to IPV, as stated in the World Health Organization guidelines. These include organizational barriers, time constraints, an attitude of blaming vis-à-vis women exposed to IPV, lack of training, and lack of community resources to team up with, to cite just a few.
We adopted a multiple, embedded case study why are professional relationships important in health and social care, since this design allows for an in-depth exploration of the interrelationship of context, processes and outcomes as they happen in their natural setting. For these reasons, it is widely used in health systems research. It is often interesting to choose contrastive cases that present differences in contexts, intervention modalities or outcomes.
Why are professional relationships important in health and social care four PCCs were first suggested by the persons in charge for coordinating the IPV response within the health system of this autonomous regions. More details of the Spanish version of the questionnaire can be found in Vives Cases et al. Total scores for practice issues, as well as other characteristics of each case can be found in Appendix 2 onlinewhile more details on the methods for data collection and sample can be found in Appendix 3 online.
In each case, a social network analysis questionnaire was administered to all health care professionals who accepted to participate. SNA measures interactions between pairs of actors and uses these data to map the structure of relations and collaboration in a whole network. It has been used to measure the degree of collaboration and mutual support in networks.
Ninety-three professionals filled in the SNA questionnaire. Qualitative data were collected through semi-structured individual interviews with GPs, nurses, midwifes, social workers and other health care professionals working in each of the PCCs a total of 44 Appendix 3 online. Issues included in the interviews guide are further described in Appendix 3 online. The interviews were made by two of the authors EB, IG and digitally recorded after written consent was granted. The duration of the interviews ranged from 15 minutes to more than one hour.
Observations were conducted in waiting areas and during consultations and meetings. Interaction between users and professionals and between the team members was observed and reported in written notes. Responses to the SNA questionnaire were tabulated and entered in a matrix. The number of relational ties and the density of the network for each case were calculated. Density indicates the degree of cohesion of a network with values closer to 1 showing higher cohesion.
Network centralization was also calculated; the extent to which a network is dominated by a single or few central node, with values ranging from 0 to 1. Qualitative interviews were transcribed verbatim and analyzed using thematic analysis, along with notes taken during observations. First, we read the interviews several times to identify emerging topics of interest, which were used as predefined codes. We identified the parts of the transcripts referring to those codes, while at the same time remaining open to new emerging codes.
Next, the preliminary codes were refined, expanded and finally aggregated to develop themes. Ethical approval for this study was granted by the Ethical Committee of the University of Alicante Spain. Written informed consent was sought from all the participants in the study. Confidentiality was assured, and pseudonyms were used for the cases. Number of relational ties, density and centralization of the networks in each of the PHC teams. The qualitative interviews and observations supported these findings.
In these spaces through exchange and support, less knowledgeable health care professionals gained new knowledge on IPV, and they felt more secure and supported when they had doubts Table 2. We found that social workers are key professionals for dealing with IPV in all the four teams. The high centralization scores in La Virgen 0. The lower centralization scores in the other two cases indicate that the mere existence of a social worker in the team is not enough in bedroom meaning promote consultations on IPV Table 2 and Figs.
The qualitative analysis showed that among teams with a social worker who was motivated, interested and knowledgeable on IPV, it was easier to generate interest on IPV among the other professionals. This is in contrast with the other two cases, where the response focused more on filling legal reports and convincing women to denounce the perpetrator than on caring for the woman herself Table 2. The women malaise approach has influenced how the professionals approach their women patients: from a gender perspective, taking a holistic approach, trying to connect unspecific complains with social circumstances and not only focusing on prescribing drug to address symptoms.
This approach also inspired concrete actions beyond the clinical setting, like the organization of therapeutic women's groups: groups of women who gathered weekly with trained professionals from the team to engage in talk therapy and other activities i. This study shows that the conditions of the team affect life is better with god quotes way individual health care providers respond to women exposed to IPV.
Health care professionals respond better to women exposed to IPV when they work in teams: 1 that facilitate staff to talk and discuss about IPV in their meetings; 2 where members consult each other when faced with IPV cases; 3 with knowledgeable and motivated social workers; 4 with an enabling team climate; and 5 that implement concrete strategies for women-centred care. SNA studies have showed that denser networks favour the diffusion of changes, especially when the adoption of the new behaviour requires social reinforcement.
However, we have acknowledge that none of the networks showed a very high density, which might reflect that IPV is yet to become a health issue in which health care professionals routinely consult and collaborate with others. Team structure, processes and climate have an impact on interdisciplinary team working; the importance of ensuring regular team meetings and the availability of organizational support to foster interdisciplinary team work in primary care that emerged from this study has been reported elsewhere, although not in relation with IPV.
More importantly, they allow for a more comprehensive response to IPV in which professionals from different sectors and with different expertise are involved. The importance of an interdisciplinary response to IPV has also been acknowledged in the WHO guidelines and in the literature. This study shows that social workers play a key role when it comes to IPV. We also showed, however, that having a social worker within the team is not enough to foster a team-based response to IPV. Teams that have a good climate and horizontal leadership that allows freedom to health care professionals to innovate stimulate individuals to adopt innovations.
Finally, this study underlines the relevance of a women-centred approach for facilitating health care responses to IPV, and the importance of developing concrete strategies for the implementation of such approach. The literature shows that the implementation of women-centred care for different health issues i. Despite inclusion of women-centred care as a key strategy for responding to women exposed to IPV within health services in the WHO guidelines, there is no explicit guidance in how such approach can be implemented.
Our findings point out two concrete actions that can support health care professionals to implemented women-centred care in general and specifically for dealing with women exposed to IPV. First, meetings to discuss cases can serve as spaces to learn, share and debrief, and help teams and individual health care professionals to improve how they implement a women-centred care in their consultations.
Second, the women's therapeutic groups serve four goals. They constitute a complementary way to respond to women's needs, serve as well as a backup for professionals beyond their consultations, provide a way of identification, and remind professionals of how care should be delivered within the team. While the design of the study allows us to see that why are professional relationships important in health and social care are connections between team level conditions and processes on one hand, and individual readiness to respond to IPV, there are why are professional relationships important in health and social care limitations.
Due to the design, we cannot demonstrate a cause-effect relationship. In addition, we focus here in team level factors, while there could be contextual factors beyond the team that could have influenced the responses. Why is qualitative research appropriate could only carry out an in-depth analysis of four cases.
It would have been interesting to explore more contrasting cases i. Team level strategies and processes influence how health care professionals respond to women exposed to IPV. Better individual readiness to detect and respond to IPV and a more comprehensive response to women exposed to IPV are implemented in teams which: 1 have social workers knowledgeable on IPV and motivated to engage others; 2 develop and sustain a structure of regular meetings during which issues of IPV are discussed; 3 stimulate a friendly team climate; and 4 implement concrete actions towards women-centred care.
What is known about the topic? Primary health care teams can play an important role in responding to women exposed to intimate partner violence, but there is huge heterogeneity in regard to how each team and each professional responds and little is known about how team factors influence such responses. To respond better to intimate partner violence primary health care teams should: 1 integrate social workers who are knowledgeable and motivated to engage others; 2 sustain a structure of regular meetings during which issues of violence are discussed; 3 stimulate a friendly climate and a leadership that promotes individual innovation; and 4 implement concrete actions towards women-centred care.
The corresponding why are professional relationships important in health and social care on behalf of the other authors guarantee the accuracy, transparency and honesty of the data and information contained in the study, that no relevant information has been omitted and that all discrepancies between authors have been adequately resolved and described. Goicolea was the PI in this project, has bene involved in the entire project, proposed the idea for this manuscript, organized the structure and developed the first draft.
Briones-Vozmediano has been involved in the entire project, participated in data collection and analysis and have critically revised successive manuscripts. Marchal, C. All authors have approved the final version of the manuscript and all agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
The authors declare that there is no conflict of interest. We have to point best venice florida restaurants that one of the authors E. Briones-Vozmediano is associated editor in Gaceta Sanitaria. However, she has not been involved in any of the steps of the editorial process of this article. The authors are grateful to the Observatory of Women's Health of the Spanish Ministry of Health, and to the professionals in charge of IPV programs within the regional health system for facilitating access to relevant information and contacts.
The authors are especially grateful to the primary health care teams and to the women patients who participated in this study, who shared their time, enthusiasm, experiences and expertise, and facilitated access to unpublished information. ISSN: Opción Open Access. Artículo anterior Artículo siguiente. DOI: Why do certain primary health care teams respond better to intimate partner violence than others?
A multiple case study. Descargar PDF. Isabel Goicolea ab. Autor para correspondencia. Este artículo ha recibido.
En esto algo es. Soy conforme con Ud, gracias por la ayuda en esta pregunta. Como siempre todo genial simplemente.
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