Paulina Bravo

Paulina Bravo
Pontificia Universidad Católica de Chile | UC · Escuela de Enfermería

PhD

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59
Publications
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Introduction

Publications

Publications (59)
Article
In Chile, local normative and guidelines place patient-centred care (PCC) as a desirable means and outcome for each level of health care. Thus, a definition of PCC is provided, and for the first time shared decision-making (SDM) is included as an intended practice. During the past five years the country has shown progress on the implementation of P...
Article
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Background Women’s engagement in healthcare decision-making during childbirth has been increasingly emphasised as a priority in maternity care, since it increases satisfaction with the childbirth experience and provides health benefits for women and newborns. The birth plan was developed as a tool to facilitate communication between health professi...
Article
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Background: The objective of this International Patient Decision Aids Standard (IPDAS) review is to update and synthesize theoretical and empirical evidence on how balanced information can be presented and measured in patient decision aids (PtDAs). Methods: A multidisciplinary team conducted a scoping review using 2 search strategies in multiple...
Article
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Introduction: Palliative care (PC) for advanced cancer is guaranteed by law in Chile, but the formal training for it is insufficient. Training models have emerged internationally that enable professionals to be better prepared for the provision of psychotherapy in PC. The objective of this study is to explore health professionals' perceptions of t...
Article
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Percepción de los profesionales de salud para la toma de decisiones compartida en atención primaria Barreras y facilitadores Perception of health care professionals for shared decision-making in primary care Barriers and facilitators Resumen Objetivo: Identificar la percepción de los profesionales de un Centro de Salud Familiar (CESFAM) respecto a...
Article
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El interés por la experiencia y la participación de los usuarios en los servicios de salud ha aumentado durante las últimas décadas. Agentes internacionales y locales se han sumado al llamado a incorporar las opiniones y perspectivas de los usuarios en el diseño y gestión de políticas y servicios, así como en las decisiones clínicas y administrativ...
Article
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Objective To adapt and validate for the Chilean context the instrument Informed Choice (IC) to measure informed decision for mammography. Location Primary Health Care Center in southeast Santiago, Chile. Design Individual, transversal, analytical and psychometric adaptation and validation study. Methods We 1) translated and back-translated IC; 2...
Article
Introduction: Developing instruments to screen for relevant aspects of advanced illness is key to identifying palliative needs and evaluating the effectiveness of interventions in this population. The objective of this project is to validate the Death and Dying Distress Scale in Spanish (DADDS-Sp) for screening anxiety about death and evaluating p...
Article
Background: Breast cancer (BC) has a high mortality rate in developing countries due to a scarcity of early detection. Risk communication is critical to support women who face the decision to undertake BC screening. Thus, they can balance their perceived and real risk, and make informed choices. Aim: To describe experts’ views on how the provision...
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Background Decades of effectiveness research has established the benefits of using patient decision aids (PtDAs), yet broad clinical implementation has not yet occurred. Evidence to date is mainly derived from highly controlled settings; if clinicians and health care organizations are expected to embed PtDAs as a means to support person-centered ca...
Article
Introducción: El derecho a la salud garantiza el acceso a todos los individuos a iguales oportunidades para alcanzar el grado máximo de salud. Objetivo: Describir la vinculación entre derechos humanos irrenunciables y la atención centrada en la persona según usuarios de centros de salud de Atención Primaria y expertos en Atención Primaria de Salud...
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La alfabetización en salud (AS), alude a las habilidades cognitivas y sociales determinantes en la motivación y capacidad del individuo para el acceso, comprensión y uso de información para el cuidado de la propia salud. En oncología, el aumento de la supervivencia, la navegación en el sistema de salud, la multiplicidad de tratamientos y el manejo...
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Health literacy (HL) refers to the cognitive and social abilities that are determinants in the motivation and capacity of the individual to access, understand and use information for the care of one's own health. In oncology, increased survival, navigation of the healthcare system, the many different forms of treatment and the management of adverse...
Article
Background: The Family and Community Health Model (MAIS) establishes the continuity of care as an essential principle. The Family Study, as a clinical strategy, allows to have sufficient and timely information and knowledge about users of health care services, facilitates their accompaniment and is a source of information to improve the quality of...
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Introducción: La relación de ayuda interpersonal es uno de los pilares del cuidado de enfermería, basándose en la comprensión empática y aceptación incondicional del paciente. El desarrollo de habilidades específicas es fundamental para el establecimiento de relaciones de ayuda efectivas. A pesar de esto, los programas de formación de pregrado en e...
Article
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A nivel mundial existe un interés progresivo por involucrar activamente a las personas en salud. Chile ha potenciado este concepto, promoviendo la participación comunitaria de las personas en salud, y destacando la importancia de mantenerlos como agentes activos durante el proceso de toma de decisiones clínicas. A pesar de ello, no existen reportes...
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Background: Decisional conflict refers to the personal uncertainty about which course of action to take when the choice involves risk, regret, or challenge to personal life values. Aim: To determine the level of decisional conflict (DC) of people with Diabetes Mellitus (DM) or High Blood Pressure (HBP) attending primary care centers (PCC) in Chile....
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RESUMEN Objetivo Describir la experiencia de participación en las decisiones clínicas desde la perspectiva de usuarios de Centros de Salud Familiar (CESFAM) de la Atención Primaria de Salud (APS). Métodos Estudio de diseño cualitativo descriptivo; se realizaron grupos focales con usuarios de CESFAM del área sudeste de Santiago, Chile, y análisis...
Article
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RESUMEN Objetivo Describir las competencias para equipos de atención primaria en salud (APS) en distintos tópicos vinculados a la atención directa del usuario y a la gestión de los centros de salud primarios, de acuerdo a la percepción de expertos chilenos en APS. Métodos Estudio de diseño mixto. Se realizó un Delphi electrónico con 29 expertos n...
Research
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Proyecto financiado por FIENF a cargo de la Dra. Paulina Bravo, docente de la Escuela de Enfermería UC. Validación de instrumento en la población chilena, referente a la toma de decisiones para el screening de cáncer de mamas desarrollado en un Centro de Salud Familiar
Article
Introducción: A nivel internacional existe un interés por disminuir el uso excesivo de tecnologías durante el parto, inclinándose hacia el desarrollo de modelos de atención personalizados y respetuosos. Chile concentra una de las tasas de cesáreas más altas en la región, muchas de ellas sin justificación clínica. En este contexto, un proyecto FONDE...
Poster
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Health literacy (HL), or functional health literacy, refers to the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health (WHO). • People with low HL participate less effectively in activities related to the care of their...
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Objetivo: Identificar las necesidades de las madres adolescentes chilenas y las características de un servicio para apoyarlas. Métodos: Se condujo un estudio cualitativo, utilizando grupos focales y entrevistas con madres adolescentes del área sur oriente de Santiago de Chile. Se realizó un análisis temático utilizando el programa Atlas.ti versión...
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Introduction: There is a worldwide interest in involving patients in health related decisions, so patients can actively search for therapeutic options and choose course of action that allows them to have better quality of life and wellbeing. The majority of the instruments available to capture the degree of participation in medical decision-making...
Article
Background: The Family and Community Health Model is based on three essential principles: user-centered care, comprehensive care and continuity of care. Aim: To describe the attributes and characteristics of the guiding principles of the Family and Community Health Model (FHM) from the perspective of primary care experts. Material and methods:...
Article
The 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 pati...
Presentation
“Evaluación Integral de la Implementación de Servicios de Salud Mental en Centros de Atención Primaria del Sistema Público Chileno: Estudio Multi-Casos Cuali-Cuantitativo” Jaime C. Sapag, María Paz Martínez, Gabriel Bastías, Paulina Bravo, Paula Bedregal, Fernando Poblete. Pontificia Universidad Católica del Perú, 10 al 12 de octubre de 2016.
Article
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Background: The integral Model of Family and Community Health care is based on three essential principles: patient centered care, comprehensive care and continuity of care. Aim: To know the perception of primary care clinic users about the elements that should be considered in a patient centered integrated health care. Material and methods: Te...
Article
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Objective In the light of the shortcomings of curriculum-based health promotion in secondary schools, group motivational interviewing provides a potential alternative approach. This two-phase study set out to establish the key components, feasibility and acceptability of a group motivational interviewing intervention, focused on alcohol consumption...
Article
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In recent years, interventions and health policy programmes have been established to promote patient empowerment, with a particular focus on patients affected by long-term conditions. However, a clear definition of patient empowerment is lacking, making it difficult to assess effectiveness of interventions designed to promote it. The aim in this st...
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Patient empowerment has gained considerable importance but uncertainty remains about the best way to define and measure it. The validity of empirical findings depends on the quality of measures used. This systematic review aims to provide an overview of studies assessing psychometric properties of questionnaires purporting to capture patient empowe...
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Increasing patient engagement in healthcare has become a health policy priority. However, there has been concern that promoting supported shared decision-making could increase health inequalities. To evaluate the impact of SDM interventions on disadvantaged groups and health inequalities. Systematic review and meta-analysis of randomised controlled...
Article
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The healthcare model is shifting from a paternalistic towards a more inclusive and participative approach, such as shared decision making (SDM). SDM considers patients as autonomous and responsible agents. SDM is a therapeutic approach where healthcare providers and patients share the best evidence available to make a decision according to the valu...
Article
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Background: Late diagnosis of HIV is a problem of international and national relevance. Despite the availability of HIV testing in primary health care, it is often performed too late. Aim: To identify facilitators and barriers to early HIV testing in primary health care. Methods: Four databases of nursing, psychological, biomedical, and health...
Article
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Background Standards for patient decision aids require that information and options be presented in a balanced manner; this requirement is based on the argument that balanced presentation is essential to foster informed decision making. If information is presented in an incomplete/non-neutral manner, it can stimulate cognitive biases that can undul...
Article
The health promotion in the university context emerges as an important initiative to facilitate the development of healthy lifestyle behaviors in this environment where students, faculty and university staff spend and share a significant part of their lives. The movement of Health Promoting Universities (HPU) has over 20 years of experience, but st...
Article
Full-text available
The health promotion in the university context emerges as an important initiative to facilitate the development of healthy lifestyle behaviors in this environment where students, faculty and university staff spend and share a significant part of their lives. The movement of Health Promoting Universities (HPU) has over 20 years of experience, but st...
Article
The health promotion in the university context emerges as an important initiative to facilitate the development of healthy lifestyle behaviors in this environment where students, faculty and university staff spend and share a significant part of their lives. The movement of Health Promoting Universities (HPU) has over 20 years of experience, but st...
Article
Full-text available
WHAT 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 Object...
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The objective of this study is to examine the literature and identify most salient outcomes of early postnatal discharge for women, newborns and the health system. An electronic search strategy was designed including the following sources: Web of Science, Scopus, ProQuest and PubMed/MEDLINE, using the following terms: (early AND discharge) OR (leng...
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People living with HIV have faced a new situation since the arrival of the antiretroviral treatments. HIV has become a long-term condition, which not only affects physical health, but also causes psychological and social problems because of stigma and discrimination. These challenges present many decisions and dilemmas for people living with HIV, w...
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Antecedentes: La humanización de la atención de salud constituye un foco de interés social, transformándose en una estrategia que permite incrementar el bienestar de los usuarios. En salud de la mujer, el cuidado humanizado, tiene especial importancia en la atención del parto. En él, mujer e hijo/a experimentan una situación de vulnerabilidad y el...
Article
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Objetivo: Diseñar y validar un instrumento objetivo y autoaplicable para evaluar el nivel de bienestar que experimentan las mujeres en situación de parto. Método: Se consideró la combinación de las metodologías cualitativas y cuantitativas. A través de grupos de focos y entrevistas individuales, se recogió la percepción subjetiva del bienestar mate...

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Cited By

Projects

Projects (6)
Project
The overall aim of this international project is to facilitate international collaboration, exchange, and research on the implementation of patient-centered care (PCC) in Chile, Germany and beyond. The specific objectives of the project are: 1) to establish the International network for Patient-Centered Care (PCC NET) to foster exchange in research, education and clinical practice, 2) to understand the needs for PCC implementation and factors influencing implementation in Latin America and adapt the integrative model of PCC for the Latin American context, 3) to develop and implement a workshop program on PCC, 4) to facilitate the international exchange of young researchers between Germany, Germany and beyond. Please visit our network website - https://www.pcc-network.org - and follow us on Twitter - https://twitter.com/pcc_network !
Project
En Chile, desde el inicio de la pandemia, se comenzó a generar información acerca del número de personas afectadas por la enfermedad del COVID-19, las medidas para prevenir la expansión del brote y el curso y tratamiento de la enfermedad. Sin embargo, el conocimiento acerca de las experiencias de los trabajadores de salud (TS), que estaban dando respuesta a esta crisis era limitado. Se volvió necesario explorar las percepciones y reflexiones de los TS del sistema público en relación con la atención de pacientes con COVID-19 y con la respuesta organizacional frente a la pandemia. Durante 2020 un equipo de investigadores de la Escuela de Enfermería de la Pontificia Universidad Católica de Chile llevó a cabo un estudio titulado “Una evaluación rápida de percepciones de trabajadores de salud y usuarios sobre la atención de salud en el contexto de la pandemia de COVID-19 en Chile”, el que contó con financiamiento de la Agencia Nacional de Investigación y Desarrollo (Proyecto ANID COVID0383). A través de una metodología cualitativa de evaluación rápida, el equipo realizó entrevistas en profundidad a profesionales de enfermería, médicos y gestores/jefes de unidad que trabajaran en Atención Primaria, Servicios de Urgencia y Unidades de Cuidados Intensivos en el sistema público de salud. Treinta y cuatro TS aceptaron participar, once de APS, nueve de servicios de urgencia y catorce de UCI. En las entrevistas les pedimos que reflexionaran acerca de cómo la pandemia por COVID-19 había afectado su actividad laboral así como su vida personal y familiar. El proyecto busca rescatar una perspectiva peligrosamente ignorada en la toma de decisión macro sobre respuesta a crisis. La de los trabajadores de salud enfrentando directamente la crisis.