Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 3 de 3
Filtrar
1.
Ann Behav Med ; 54(3): 202-212, 2020 02 21.
Artículo en Inglés | MEDLINE | ID: mdl-31634392

RESUMEN

BACKGROUND: Pain interferes with people's daily lives and often limits the extent to which they can pursue goals and engage in activities that promote well-being. However, people vary in how much interference they experience at a given level of pain. PURPOSE: The present study tested how optimism affects and is affected by pain interference and goal-directed activity among older women. METHODS: Every 3 months for 2 years, community-dwelling middle- and older-age women (N = 199) completed online daily diaries at home for a 7 day period, in which they reported their daily pain, pain interference, and goal-directed activity. Optimism was measured at the start and end of the study. Multilevel models tested the between- and within-person relationships among pain, optimism, and pain interference or goal-directed activity. Linear regression predicted change in optimism over 2 years from pain interference and goal-directed activity. RESULTS: Pain best predicted pain interference and optimism best predicted goal-directed activity. There were subtle interactions between optimism and pain-predicting interference and goal-directed activity. Accumulated goal-directed activity and pain interference across the study predicted longitudinal changes in optimism, with higher activity and lower pain interference predicting increased optimism over 2 years. CONCLUSIONS: Optimism may play a protective role in disruptions caused by pain on a day-to-day basis, leading to increased goal-directed activity and possibly decreased pain interference. In turn, less interference and more goal-directed activity feed forward into increased optimism, resulting in a virtuous cycle that enhances optimism and well-being among older women.


Asunto(s)
Actividades Cotidianas/psicología , Envejecimiento/psicología , Objetivos , Optimismo/psicología , Dolor/psicología , Psicometría/normas , Calidad de Vida/psicología , Anciano , Femenino , Humanos , Vida Independiente , Estudios Longitudinales , Persona de Mediana Edad , Psicometría/instrumentación , Reproducibilidad de los Resultados
2.
BJOG ; 123(7): 1213-20, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26834046

RESUMEN

OBJECTIVE: To estimate the cost-effectiveness and cost-utility of actively encouraging older community-dwelling women with urinary incontinence to be diagnosed and treated. DESIGN: The study was designed as cost-effectiveness and cost-utility analyses alongside a cluster randomised controlled trial. Analyses were performed from a societal perspective. Direct medical and nonmedical costs were taken into account and valued according to the standard Dutch guidelines for economic evaluations. SETTING: Primary care. POPULATION: Study participants were 350 community-dwelling women 55 years or older with urinary incontinence. METHODS: Women in the intervention group were invited for diagnostic testing and treatment. The control group received usual care according to the Dutch guideline on urinary incontinence. Follow-up period was 12 months. MAIN OUTCOME MEASURES: Incontinence Impact Adjusted Life Years (IIALY), Quality Adjusted Life Years (QALY) and incremental costs calculated per IIALY and per QALY gained. RESULTS: Costs per extra life year without impact on daily life from urinary incontinence amounted to €5179 (95% CI -17 323 to 36 260). Costs per QALY amounted to €23 907 (95% CI -124 849 to 121 849). Assuming a ceiling ratio of €20 000, the probability that the intervention was cost-effective based on IIALYs was 91% and 46% based on QALYs. CONCLUSIONS: Improvements in severity of incontinence in older community-dwelling women can be achieved against reasonable costs, with an improvement of symptom-specific QALYs. Findings support an active role of primary care physicians towards women who hesitate to ask for help for urinary incontinence. TWEETABLE ABSTRACT: Encouraging women with urinary incontinence to be treated, improves symptoms and QOL against reasonable costs.


Asunto(s)
Incontinencia Urinaria/economía , Actividades Cotidianas , Anciano , Análisis por Conglomerados , Análisis Costo-Beneficio , Femenino , Promoción de la Salud/economía , Humanos , Persona de Mediana Edad , Países Bajos , Años de Vida Ajustados por Calidad de Vida , Resultado del Tratamiento , Incontinencia Urinaria/prevención & control
3.
Physis (Rio J.) ; 20(3): 853-872, 2010. ilus, tab
Artículo en Portugués | LILACS | ID: lil-566268

RESUMEN

Este artigo discute a experiência do curso de capacitação de conselheiros de saúde do município de Viçosa-MG, com base na perspectiva de sensibilização para o exercício consciente do controle social, possibilitando assim a construção de um sistema de saúde mais justo e igualitário, segundo o ideal pensado pelo movimento da reforma sanitária brasileira. Realiza uma abordagem qualitativa sobre as dinâmicas apresentadas no curso, sendo este baseado na metodologia ativa de ensino-aprendizagem. A metodologia participativa e a utilização de estratégias que privilegiaram a sistematização do conteúdo, assim como a reflexão sobre os referenciais teóricos, apresentados a partir da correlação dos temas com as experiências práticas, foram fundamentais para ampliar e aprofundar o processo de empoderamento dos conselheiros. Como resultado, foi possível identificar alguns desafios para o exercício do controle social, como a importância da participação ativa e da necessidade de buscar informações e trocar experiências. Destarte, destaca-se que a participação dos conselheiros de saúde em oficinas de capacitação aparece como uma possibilidade de superação das dificuldades de implementação das conquistas legais, ao sensibilizar estes atores sociais para transpor a posição de meros expectadores passivos em protagonistas na construção de um sistema de saúde universal e equitativo.


This paper discusses the experience of the training course for health counselors in the city of Viçosa, Minas Gerais State, from the perspective of awareness of the conscious exercise of social control, thus enabling the construction of a more fair and equitable health system, according to the ideal of the movement of the Brazilian health reform. We perform a qualitative approach on the dynamics presented in the course, which is based on the methodology of active teaching and learning. The participatory methodology and use of strategies that focused on the systematization of content, as well as the reflection on the theoretical frameworks presented from the correlation of topics with practical experiences were essential to broaden and deepen the process of empowerment of the counselors. As a result, it was possible to identify some challenges for the exercise of social control, such as the importance of active participation and the need to seek information and exchange experiences. Thus, it is emphasized that the participation of health counselors in training workshops appears as a possibility of overcoming the difficulties of implementing legal achievements, the awareness of these social actors to implement the position of mere passive spectators into protagonists in the construction of a universal and equitable health care system.


Asunto(s)
Humanos , Consejeros/tendencias , Equidad en Salud , Capacitación Profesional , Participación de la Comunidad/tendencias , Políticas de Control Social , Brasil , Gestión en Salud , Competencia Profesional , Sistema Único de Salud
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...