Penelope Morrison

Informed consent for inguinal herniorrhaphy and cholecystectomy: describing how patients make decisions to have surgery

BACKGROUND We describe how patients perceive the process of informed consent and its influence on decision making for elective surgery. METHODS A cohort of 38 patients documented consent for cholecystectomy or inguinal herniorrhaphy using the Veterans Affairs computer-based tool for documenting informed consent for clinical treatment. Participants completed semistructured telephone interviews exploring their attitudes about informed consent, iMed, and the decision-making process. We used qualitative methods to code and analyze the data. RESULTS Sixty-nine percent of patients decided to have surgery before meeting their surgeon, and 47% stated that the surgeon did not influence their decision. Although the surgeon was an important source of information for most patients (81%), patients frequently described using information gathered before meeting the surgeon, such as other health care providers (81%) or family members (58%). Most (68%) patients perceived iMed as a legal formality with little influence on decision making. CONCLUSIONS Future research should examine whether patient decision making regarding elective surgery becomes better informed if nonsurgeon clinicians connect patients to educational resources such as iMed closer to the time of initial diagnosis and before meeting the surgeon.

Youth Perspectives on Risk and Resiliency A Case Study From Juiz de Fora, Brazil

The present work seeks to contribute to studies of cross-cultural risk and resiliency by presenting results from qualitative research with adolescents attending programs for at-risk youth in Juiz de Fora, Brazil. In 1990, Brazil introduced the Child and Adolescent Act (ECA), a significant piece of legislation that has had a direct impact on how at-risk youth are conceptualized both nationally and locally, through programs that target them. Little, however, is known about how youth in Brazil understand risk behaviors, what factors they believe contribute to risk taking or what they believe promotes resiliency. Furthermore, virtually no qualitative information exists on adolescents who are engaged in programs that use ECA as a prioritizing principle. By examining adolescent perspectives on risk and resiliency in such a context, we highlight the cultural differences in how youth negotiate their daily lives and the implications that continued exclusion of youth has on Brazilian society.

Substance use and sexual risk among at-risk adolescents in Juiz de Fora, Minas Gerais State, Brazil

We examined the difference in prevalence of substance use and sexual risk behaviors among at-risk youth participants in programs offered by community-based organizations in Juiz de Fora, Minas Gerais State, Brazil, by gender and organization type (governmental vs. non-governmental). 388 adolescents were recruited from 25 intervention-based organizations servicing at-risk youth between the ages of 12 and 17 in Juiz de Fora. Participants completed a 15-item survey assessing substance use and sexual risk behaviors, along with socio-demographic predictors of these behaviors. Males were more likely to report drug and alcohol use associated with homelessness and abandonment. Females were more likely to report sexual risk taking associated with neighborhood crime. Participants from non-governmental organizations were less likely to engage in all measured risk behaviors. The present analysis points to the need to understand how Brazils Child and Adolescent Act is being applied and the implications this has for intervention and the promotion of positive health outcomes for young people.

O uso de substâncias e o risco sexual entre adolescentes em situação de risco social em Juiz de Fora, Minas Gerais, Brasil

We examined the difference in prevalence of substance use and sexual risk behaviors among at-risk youth participants in programs offered by community-based organizations in Juiz de Fora, Minas Gerais State, Brazil, by gender and organization type (governmental vs. non-governmental). 388 adolescents were recruited from 25 intervention-based organizations servicing at-risk youth between the ages of 12 and 17 in Juiz de Fora. Participants completed a 15-item survey assessing substance use and sexual risk behaviors, along with socio-demographic predictors of these behaviors. Males were more likely to report drug and alcohol use associated with homelessness and abandonment. Females were more likely to report sexual risk taking associated with neighborhood crime. Participants from non-governmental organizations were less likely to engage in all measured risk behaviors. The present analysis points to the need to understand how Brazils Child and Adolescent Act is being applied and the implications this has for intervention and the promotion of positive health outcomes for young people.

Consumo de sustancias estupefacientes y riesgo sexual entre adolescentes en situaciones de riesgo en Juiz de Fora, Minas Gerais, Brasil

We examined the difference in prevalence of substance use and sexual risk behaviors among at-risk youth participants in programs offered by community-based organizations in Juiz de Fora, Minas Gerais State, Brazil, by gender and organization type (governmental vs. non-governmental). 388 adolescents were recruited from 25 intervention-based organizations servicing at-risk youth between the ages of 12 and 17 in Juiz de Fora. Participants completed a 15-item survey assessing substance use and sexual risk behaviors, along with socio-demographic predictors of these behaviors. Males were more likely to report drug and alcohol use associated with homelessness and abandonment. Females were more likely to report sexual risk taking associated with neighborhood crime. Participants from non-governmental organizations were less likely to engage in all measured risk behaviors. The present analysis points to the need to understand how Brazils Child and Adolescent Act is being applied and the implications this has for intervention and the promotion of positive health outcomes for young people.