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Biomedical subjects

Janet Bradley

Publications and source records attributed to Janet Bradley.

7 recordsLinked to original sources
PubMed2006

Providers' constructions of the role of women in cervical cancer screening in Bulgaria and Romania.

The social and institutional context of health-care reform in Eastern Europe has important implications for cervical cancer screening and prevention. The incidence and mortality from cervical cancer in Bulgaria and Romania have risen, which is in sharp contrast to the steady decline in most other countries in Europe during the last 2 decades. To analyze these dynamics we conducted a multi-component study of health systems and psychosocial aspects of cervical cancer screening in Bulgaria and Romania. Following the disappearance of organized preventive programs, the initiative for cervical cancer screening has shifted to providers and clients and depends on the way they perceive their responsibility and interpret their own and each other's roles in prevention. We focus on how providers construct women and their role in prevention of cervical cancer through their accounts. The analysis identified several discourses and themes in providers' constructions of women's responsibility for prevention of disease. These include responsible women as 'intelligent' and 'cultured'; non-attenders as 'irresponsible' and 'negligent'; women as needing monitoring and sanctioning; and women as 'victims' of health-care reform. We discuss the implications for health-care reform and health promotion.

Adult↗
PubMed2006

Differences in perioperative medication errors with regard to organization characteristics.

RESEARCHERS CONDUCTED a descriptive, comparative, secondary analysis using a national database to investigate differences in perioperative medication error characteristics with regard to organization characteristics. PERIOPERATIVE MEDICATION ERROR records reported to the MEDMARX database between Sept 1, 1998, and Aug 31, 2003, were examined (N = 5,210), and variables were analyzed using descriptive and inferential statistics. Statistically significant differences were found for three out of four research questions. THE STUDY'S FINDINGS provide a foundation for perioperative medication error analysis and serve as a starting point for organizations to begin investigating the medication error problem in their facilities.

Bed Occupancy↗
PubMed2006

Women's perspectives on cervical screening and treatment in developing countries: experiences with new technologies and service delivery strategies.

This review of studies conducted by partners in the Alliance for Cervical Cancer Prevention (ACCP) examines women's perspectives on, and acceptability of, new cervical cancer screening and treatment approaches, management by mid-level staff, single-visit strategies, treatment side effects, and post-treatment abstinence requirements in low-resource settings. All screening, managed by female nurses and irrespective of method or constellation of methods, appeared to be highly acceptable. Similarly, cryotherapy treatment, including cryotherapy managed by nurses immediately after screening, was well-received by women in the studies. Minor side effects, although rather prevalent, and difficulties with post-treatment abstinence, did not appear to significantly deter women from recommending the procedure to friends. Rather, a sense of relief was evident, a feeling that it was better to be treated than not treated, and better to be treated sooner rather than later. While full replication may not be possible, this does not lessen the fact that screening and treatment in developing countries, even with new technologies, immediate treatment and even using mid-level providers, can be very acceptable to women if provided in a safe, caring and preferably all-female environment.

Adult↗
PubMed2005

Improving the quality of child health services: participatory action by providers.

OBJECTIVE: To test a quality improvement approach called COPE (Client-Oriented, Provider-Efficient services), for use in strengthening health systems and supporting Integrated Management of Child Health (IMCI) efforts. DESIGN: Pre- and post-intervention observations of client/provider interactions, facility audits, staff and client surveys, and focus groups to evaluate differences between eight COPE intervention and eight matched non-intervention facilities after a 15-month intervention in 2001. SETTING: Primary care clinics in Guinea and Kenya. STUDY PARTICIPANTS: Health care providers and child caregivers. INTERVENTIONS: Over 15 months, the intervention supported four COPE exercises at each intervention site, supported supervisor training in quality management, and organized minimal training in topics selected by site staff as areas where training was needed. MAIN OUTCOME MEASURES: Differences in staff's and child caregiver's knowledge, attitudes, and practices; differences in the quality of services provided. RESULTS: On almost every quality indicator (over 65 indicators), whether reported by staff, observed by evaluators, or reported by clients, the intervention sites performed statistically significantly better than control sites. INTERVENTION: sites were cleaner and more pleasant, with more respect and information for clients, and more privacy. Staff had better personal communication skills, better diagnostic skills, and prescribing practices and gave better home care instructions to carers. Clients in intervention sites were more informed and more satisfied, and their children had better immunization coverage than those in control sites. CONCLUSION: COPE is a simple process, yet our study confirms that it can have a very dramatic effect on the quality of services. This study demonstrated how all areas of quality can be addressed by empowering health care providers to take action by using COPE. We suggest that COPE can complement Integrated Management of Childhood Illness (IMCI) training and can help to achieve better health for children.

Child↗
PubMed2004

Widening the cervical cancer screening net in a South African township: who are the underserved?

Cervical cancer screening services in South Africa have failed to reach the majority of the population and to significantly reduce mortality. A household survey in a predominantly Black African population living in a low-income township on the outskirts of Cape Town was undertaken to ascertain the characteristics of women reporting never having been screened. In our group of 664 representatively sampled women. 45% of women reported having had a cervical screening test. However, in what at first glance appears to be a fairly homogeneous population, there were significant differences in the types of women who access and who do not access cervical smear services. The underserved tend to be the older, poorer, less educated, and unemployed (or working in the informal sector) women. They tend to live in nonpermanent dwellings without a partner, they do not know anyone else who has had a cervical smear, and they have not recently sought care for other ailments, or used contraception. Cervical cancer is a slow-to-develop, eminently preventable disease, and yet opportunistic screening through antenatal and family planning services has failed to reach the women most at risk. Efforts in the future must include targeting older women in health centres where they present for other curative services (diabetes, hypertension). Most importantly, areas of the community with the greatest concentration of marginalized women need to be targeted through peer education and other innovative programs. As the underserved tend to be the poorer and less educated women in the community, we must ensure that messages are culturally relevant and appropriate and have a holistic focus on women's physical, mental, and emotional health.

Adult↗
PubMed2003

Factors affecting utilization of cervical cancer prevention services in low-resource settings.

Strategies for introducing or strengthening cervical cancer prevention programs must focus on ensuring that appropriate, cost-effective services are available and that women who most need the services will, in fact, use them. This article summarizes the experiences of research projects in Bolivia, Peru, Kenya, South Africa, and Mexico. Factors that affect participation rates in cervical cancer prevention programs are categorized in three sections. The first section describes factors that arise from prevailing sociocultural norms that influence women's views on reproductive health, well being, and notions of illness. The second section discusses factors related to the clinical requirements and the type of service delivery system in which a woman is being asked to participate. The third section discusses factors related to quality of care. Examples of strategies that programs are using to encourage women's participation in cervical cancer prevention services are provided. This paper is available too at: http://www.insp.mx/salud/index.html.

Adult↗