Isabel C Posada-Zapata

Physician-patient relationship: Impact on promotion and prevention campaigns for patients with HIV in Medellin

Objective To understand the impact that healthcare professionals have on the perception of health promotion and disease prevention campaigns of individuals with HIV in Medellin, Colombia in 2012. MATERIALS AND METHODS The research was conducted using a qualitative approach, based on the Strauss and Corbin´s Grounded Theory; thirteen people were interviewed during two sequential steps. The interviews were transcribed and analyzed in accordance with the theory mentioned above, by performing an open and axial coding on the data found. Results A total of 1 324 codes were generated in the open coding process (creating six descriptive categories) and axial coding process (identifying four analytical categories; one of them is developed as a result in this paper). The most relevant findings included the importance given by the participants to the role of health professionals when supporting HIV-positive patients in the acquisition of healthy lifestyles to properly manage their condition. Also, the role that those people who already contracted the virus have for the promotion of sexual behaviors to minimize the risk of infection is stated. Conclusion The doctor-patient relationship poses great challenges in terms of health services management for the different actors of the system. Likewise, these challenges must be taken into account when creating future public policies.

Relación médico-paciente: impacto en las campañas de promoción y prevención para personas con VIH en Medellín

Objective To understand the impact that healthcare professionals have on the perception of health promotion and disease prevention campaigns of individuals with HIV in Medellin, Colombia in 2012. MATERIALS AND METHODS The research was conducted using a qualitative approach, based on the Strauss and Corbin´s Grounded Theory; thirteen people were interviewed during two sequential steps. The interviews were transcribed and analyzed in accordance with the theory mentioned above, by performing an open and axial coding on the data found. Results A total of 1 324 codes were generated in the open coding process (creating six descriptive categories) and axial coding process (identifying four analytical categories; one of them is developed as a result in this paper). The most relevant findings included the importance given by the participants to the role of health professionals when supporting HIV-positive patients in the acquisition of healthy lifestyles to properly manage their condition. Also, the role that those people who already contracted the virus have for the promotion of sexual behaviors to minimize the risk of infection is stated. Conclusion The doctor-patient relationship poses great challenges in terms of health services management for the different actors of the system. Likewise, these challenges must be taken into account when creating future public policies.

Rabies exposures in Colombia: An evaluation by the actors of the surveillance system

Objetivo: identificar la percepcion que tienen los actores frente a los atributos del sistema de vigilancia de las exposiciones rabicas para generar las recomendaciones que se requieran. Metodologia: se utilizo la teoria fundada hasta analisis de categorias interpretativas; once entrevistas semiestructuradas enmarcadas en los atributos considerados por los Centros de Control y Prevencion de Enfermedades (cdc) para la evaluacion de sistemas de vigilancia se realizaron a personas con un rol activo (desde notificacion hasta administrador del sistema), en los departamentos con mayor y menor notificacion del evento en el pais. Resultados: emergieron catorce categorias descriptivas relacionadas con los nueve atributos, sistema de vigilancia, rabia y propuestas para la mejora; de estas, cinco categorias analiticas las enmarcan con recursos para la operacion, experiencia, control directo de la rabia y papel de los actores en el proceso. Se destaco la importancia del sistema en la recoleccion de informacion en Salud Publica; se desconocen publicaciones relacionadas y se percibio como baja la participacion de los actores en la planificacion. Se manifestaron dificultades con la calidad de la informacion: clasificacion de casos, afectando la representatividad y sensibilidad. La aceptabilidad se relaciona con las tareas del sistema y el tiempo dedicado al proceso. La oportunidad varia en procesos de notificacion y ajuste. Conclusiones: la percepcion sobre los atributos denota la articulacion de conceptos del sistema y la experiencia adquirida; aspectos positivos como representatividad e historia y negativos relacionados con calidad, sensibilidad, utilidad y aceptabilidad. Recomendaciones: realizar publicaciones y mejorar la participacion en la planificacion del sistema. Objective: to identify the perception of the actors regarding the attributes of the rabies exposures surveillance system to generate any required recommendations. Methodology: Grounded theory was used up to the analysis of interpretive categories. The researchers used semi-structured interviews in the Colombian departments with the highest and lowest notified instances of rabies exposure. The interviewees were individuals with active roles (i.e. ranging from personnel in charge of notifying to system administrators). Finally, the topic of the interviews was the attributes taken into account by the Centers for Disease Control and Prevention. Results: fourteen descriptive categories emerged. These were related to nine attributes, surveillance, rabies and proposals for improvement. Of these, five analytical categories are considered resources for operation, experience, direct control of rabies and the role of actors in the process. The importance of the system in gathering information on public health was highlighted. Related publications are disregarded, and the participation of the actors in the planning process was perceived as low. The participants mentioned shortcomings related to the quality of the information, i.e. case classification, which affects its representativeness and sensitivity. Acceptability was associated with system tasks and the time spent in the process. Timeliness varies in the notification and adjustment processes. Conclusions: The perception of the attributes shows the articulation of the system concepts with the lessons learned by the actors. Some positive aspects are history and representativeness, while some of the negative traits are related to quality, sensitivity, usefulness and acceptability. Recommendations: to publish and improve participation in the system planning process.

Exposições rábicas na Colômbia: avaliação do sistema de vigilância desde os atores

Objetivo: identificar la percepcion que tienen los actores frente a los atributos del sistema de vigilancia de las exposiciones rabicas para generar las recomendaciones que se requieran. Metodologia: se utilizo la teoria fundada hasta analisis de categorias interpretativas; once entrevistas semiestructuradas enmarcadas en los atributos considerados por los Centros de Control y Prevencion de Enfermedades (cdc) para la evaluacion de sistemas de vigilancia se realizaron a personas con un rol activo (desde notificacion hasta administrador del sistema), en los departamentos con mayor y menor notificacion del evento en el pais. Resultados: emergieron catorce categorias descriptivas relacionadas con los nueve atributos, sistema de vigilancia, rabia y propuestas para la mejora; de estas, cinco categorias analiticas las enmarcan con recursos para la operacion, experiencia, control directo de la rabia y papel de los actores en el proceso. Se destaco la importancia del sistema en la recoleccion de informacion en Salud Publica; se desconocen publicaciones relacionadas y se percibio como baja la participacion de los actores en la planificacion. Se manifestaron dificultades con la calidad de la informacion: clasificacion de casos, afectando la representatividad y sensibilidad. La aceptabilidad se relaciona con las tareas del sistema y el tiempo dedicado al proceso. La oportunidad varia en procesos de notificacion y ajuste. Conclusiones: la percepcion sobre los atributos denota la articulacion de conceptos del sistema y la experiencia adquirida; aspectos positivos como representatividad e historia y negativos relacionados con calidad, sensibilidad, utilidad y aceptabilidad. Recomendaciones: realizar publicaciones y mejorar la participacion en la planificacion del sistema. Objective: to identify the perception of the actors regarding the attributes of the rabies exposures surveillance system to generate any required recommendations. Methodology: Grounded theory was used up to the analysis of interpretive categories. The researchers used semi-structured interviews in the Colombian departments with the highest and lowest notified instances of rabies exposure. The interviewees were individuals with active roles (i.e. ranging from personnel in charge of notifying to system administrators). Finally, the topic of the interviews was the attributes taken into account by the Centers for Disease Control and Prevention. Results: fourteen descriptive categories emerged. These were related to nine attributes, surveillance, rabies and proposals for improvement. Of these, five analytical categories are considered resources for operation, experience, direct control of rabies and the role of actors in the process. The importance of the system in gathering information on public health was highlighted. Related publications are disregarded, and the participation of the actors in the planning process was perceived as low. The participants mentioned shortcomings related to the quality of the information, i.e. case classification, which affects its representativeness and sensitivity. Acceptability was associated with system tasks and the time spent in the process. Timeliness varies in the notification and adjustment processes. Conclusions: The perception of the attributes shows the articulation of the system concepts with the lessons learned by the actors. Some positive aspects are history and representativeness, while some of the negative traits are related to quality, sensitivity, usefulness and acceptability. Recommendations: to publish and improve participation in the system planning process.

Exposiciones rábicas en Colombia: evaluación del sistema de vigilancia desde los actores

Objetivo: identificar la percepcion que tienen los actores frente a los atributos del sistema de vigilancia de las exposiciones rabicas para generar las recomendaciones que se requieran. Metodologia: se utilizo la teoria fundada hasta analisis de categorias interpretativas; once entrevistas semiestructuradas enmarcadas en los atributos considerados por los Centros de Control y Prevencion de Enfermedades (cdc) para la evaluacion de sistemas de vigilancia se realizaron a personas con un rol activo (desde notificacion hasta administrador del sistema), en los departamentos con mayor y menor notificacion del evento en el pais. Resultados: emergieron catorce categorias descriptivas relacionadas con los nueve atributos, sistema de vigilancia, rabia y propuestas para la mejora; de estas, cinco categorias analiticas las enmarcan con recursos para la operacion, experiencia, control directo de la rabia y papel de los actores en el proceso. Se destaco la importancia del sistema en la recoleccion de informacion en Salud Publica; se desconocen publicaciones relacionadas y se percibio como baja la participacion de los actores en la planificacion. Se manifestaron dificultades con la calidad de la informacion: clasificacion de casos, afectando la representatividad y sensibilidad. La aceptabilidad se relaciona con las tareas del sistema y el tiempo dedicado al proceso. La oportunidad varia en procesos de notificacion y ajuste. Conclusiones: la percepcion sobre los atributos denota la articulacion de conceptos del sistema y la experiencia adquirida; aspectos positivos como representatividad e historia y negativos relacionados con calidad, sensibilidad, utilidad y aceptabilidad. Recomendaciones: realizar publicaciones y mejorar la participacion en la planificacion del sistema. Objective: to identify the perception of the actors regarding the attributes of the rabies exposures surveillance system to generate any required recommendations. Methodology: Grounded theory was used up to the analysis of interpretive categories. The researchers used semi-structured interviews in the Colombian departments with the highest and lowest notified instances of rabies exposure. The interviewees were individuals with active roles (i.e. ranging from personnel in charge of notifying to system administrators). Finally, the topic of the interviews was the attributes taken into account by the Centers for Disease Control and Prevention. Results: fourteen descriptive categories emerged. These were related to nine attributes, surveillance, rabies and proposals for improvement. Of these, five analytical categories are considered resources for operation, experience, direct control of rabies and the role of actors in the process. The importance of the system in gathering information on public health was highlighted. Related publications are disregarded, and the participation of the actors in the planning process was perceived as low. The participants mentioned shortcomings related to the quality of the information, i.e. case classification, which affects its representativeness and sensitivity. Acceptability was associated with system tasks and the time spent in the process. Timeliness varies in the notification and adjustment processes. Conclusions: The perception of the attributes shows the articulation of the system concepts with the lessons learned by the actors. Some positive aspects are history and representativeness, while some of the negative traits are related to quality, sensitivity, usefulness and acceptability. Recommendations: to publish and improve participation in the system planning process.