Browsing by Author "Bravo, Paulina"
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Item Patient-centred care and shared decision-making in Chile: Rising momentum for progress and implementation in clinical practice(Elsevier, 2017) Bravo, Paulina; Dois, Angelina; Cabieses, Báltica; Bustamante, Claudia; Campos, Solange; Stacey, DawnThe Chilean legislation establishes that patients have rights and responsibilities in regards to their healthcare. This is an important statement as it declares that people must be informed and become actively involved in their care; meanwhile, the health system needs to coordinate the provision of personalised and effective services. Although patient-centred care (PCC) and shared decision making (SDM) are relatively new concepts in Chile, the country is experiencing an interesting political momentum to create more interventions to achieve PCC and SDM and explore clinical implementation. Currently, research efforts in Chile have focused on better understanding the state of the art related to both concepts and how new clinical approaches could help to operationalize them.Item Shared decision making in Chile: Supportive policies and research initiatives(2011) Bravo, Paulina; Cabieses, Báltica; Bustamante, Claudia; Campos, Solange; Stacey, DawnWHAT ABOUT POLICY REGARDING SDM? Since 1999, there has been a small but growing interest by academics, the government, and society as a whole in strengthening patients' and professionals' involvement in shared decision making (SDM). Two governmental policy documents that indicate support for SDM are (1) Health Reform in 2003 and (2) Sanitary Objectives 2011-2020, which includes a brief section on client participation and SDM. WHAT ABOUT TOOLS - DECISION SUPPORT FOR PATIENTS? Research by Chilean academics has highlighted the patients' desire to participate in health decisions and effective approaches for enhancing health professionals' skills in interprofessional SDM; however, little has been done to support this need and the work is centralised in only one academic institution. Decision support tools and coaching interventions are limited to patients considering decisions about managing type 2 diabetes. WHAT ABOUT PROFESSIONAL INTEREST AND IMPLEMENTATION? Although there is increasing attention to studying patients' participation and involvement on their healthcare, little has been studied in relation to professionals' interest in SDM. As well, there are significant challenges for implementation of a country-wide SDM policy. WHAT DOES THE FUTURE LOOK LIKE? The future looks promising given the new health policies, local Chilean research projects, and international initiatives. Collaboration between health professionals, academics, and government policy makers, with public involvement needs to be strengthened in order to promote concrete strategies to implement SDM in Chile.Publication Vitamin D deficiency/insufficiency on healthy infants receiving standard supplementation(2022) Bravo, Paulina; Navarro, Ernesto; Mora, Marcela; Calvanese, Marlene; Taub, Marianne; Pérez, Diego; Barros, José Ignacio; Guevara, Mercedes; Pérez, Angélica; Canals, AndreaLa vitamina D (VD) es indispensable para el metabolismo del calcio y fósforo, su deficiencia puede causar raquitismo. En Chile se suplementa con 400 UI /diarias desde el primer mes hasta el año de vida. Objetivo: Describir las concentraciones plasmáticas de VD en lactantes sanos suplementados y secundariamente, evaluar la asociación del estatus de VD con estacionalidad y estado nutricional. Sujetos y Método: Estudio de corte transversal. Se evaluó a lactantes con lactancia materna exclusiva o mixta que acudían a controles pediátricos mensuales y recibían suplementación de VD a dosis de 400 UI diarias. A los 6 meses de edad se midió la concentración plasmática de VD, el peso y la talla. Posteriormente se clasificó el estado nutricional (peso/edad y peso/talla) según los referentes de la OMS. De acuerdo a la concentración plasmática de VD, se definió como normal ≥ 30 ng/ml, insuficiencia si esta fue entre 20 y 29 ng/ml y deficiencia < 20 ng/ml. Resultados: Se estudiaron 40 lactantes, 40% tuvieron concentracio nes de VD insuficientes y 40% deficientes. En el modelo de regresión lineal múltiple, las variables que se asociaron, de modo significativo, con una menor concentración de VD fueron: el periodo del año invierno-primavera (p = 0,007) y el riesgo de desnutrición (p = 0,038). Conclusiones: La frecuencia de deficiencia e insuficiencia de VD es elevada en nuestra población suplementada, dicho déficit es mayor durante el invierno y la primavera y en sujetos con riesgo de desnutrición.