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1.
BMC Health Serv Res ; 24(1): 1051, 2024 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-39261901

RESUMO

BACKGROUND: Stroke patients often experience limb dysfunction, which can significantly impact their quality of life and daily living abilities. This study aimed to explore the effectiveness of nursing programs that incorporate multidisciplinary continuing care with the participation of nursing staff for patients with stroke and limb dysfunction. METHODS: This was a randomized controlled trial (RCT) conducted from August 2021 to August 2023. Ninety stroke patients were randomly assigned to a control group (n = 45) and an observation group (n = 45). The control group received routine discharge care, while the observation group received multidisciplinary continuing care with the participation of nursing staff. Outcomes measured included Fugl-Meyer Assessment (FMA) scores for upper and lower limb function, quality of life, daily living ability (Barthel Index, MBI), and adverse reactions. RESULTS: The FMA scores for upper and lower limbs were significantly higher in the observation group compared to the control group. The observation group also had significantly higher scores in all quality of life dimensions and MBI scores compared to the control group. There were 10 adverse reactions reported in the observation group and 22 in the control group. CONCLUSIONS: Implementing multidisciplinary continuing care with the participation of nursing staff for stroke patients with limb dysfunction has a positive effect on improving limb function, quality of life, and daily living abilities, while also being relatively safe.


Assuntos
Atividades Cotidianas , Qualidade de Vida , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Acidente Vascular Cerebral/enfermagem , Acidente Vascular Cerebral/complicações , Reabilitação do Acidente Vascular Cerebral/métodos
2.
J Asthma ; : 1-8, 2024 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-39316453

RESUMO

BACKGROUND AND AIMS: To construct a set of scientific and effective quality evaluation indicators of continuing care for children with asthma, and to promote the development of continuing care for children with asthma toward a more specialized and standardized direction. METHODS: Through literature research and semi-structured interview, the item pool of evaluation index was drawn up, and the first draft of expert inquiry questionnaire was formed based on the three-dimensional quality theoretical model of structure-process-result, and the construction of quality evaluation index was completed through two rounds of expert inquiry and analytic hierarchy process. RESULTS: The effective recovery rate was 94.44% in the first round and 100.00% in the second round, the expert authority coefficient was 0.852 and 0.863, and the Kendal coordination coefficient was 0.129 and 0.126, respectively (p < 0.01). Finally, the evaluation index of continuing care quality for children with asthma was formed, including 3 first-level indicators, 9 s-level indicators and 36 third-level indicators, and then the weight and combination weight of each index were obtained by AHP. CONCLUSIONS: The evaluation index of continuing care quality for children with asthma is scientific and specific, which is of great significance to the improvement of continuing care quality for children with asthma.

3.
Soc Sci Med ; 357: 117181, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39121568

RESUMO

Young people who attend intensive alcohol and other drug (AoD) treatment commonly do so more than once. This paper aims to understand precipitators, enablers and barriers to young people's re-engagement in programs. Data come from a longitudinal qualitative study involving three waves of interviews with Australian young people recruited while attending intensive AoD programs (n = 38 at wave 1). We found that young people's ambitions for what they might achieve with a new stay and capacity to benefit from programs, evolved. Skills learnt in earlier stays or changed life circumstances often helped them achieve better outcomes subsequently. Ongoing contact with an AoD worker was the most important enabler to service re-engagement. Across the span of a year, we saw most young people in our study sample develop a stronger sense of wellbeing and control over substance use. While researchers tend to focus on evaluating outcomes associated with single stays at specific programs, young people think about their trajectories towards managing substance use and their lives as occurring more holistically, supported by engagements with a range of services. We argue that the notion of incremental treatment is useful in depicting the synergistic effects of service engagement over time.


Assuntos
Pesquisa Qualitativa , Transtornos Relacionados ao Uso de Substâncias , Humanos , Masculino , Feminino , Transtornos Relacionados ao Uso de Substâncias/terapia , Adolescente , Austrália , Estudos Longitudinais , Adulto Jovem , Centros de Tratamento de Abuso de Substâncias/organização & administração , Alcoolismo/psicologia , Alcoolismo/terapia
4.
AME Case Rep ; 8: 78, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39091549

RESUMO

Background: Reasonable nutritional intervention is very important to promote wound healing and rehabilitation in patients with radical esophagectomy for esophageal cancer. This report aims to summarize the experience of nutritional and continuous nursing intervention in a patient who underwent radical resection of esophageal cancer after liver transplantation, by testing a comprehensive approach to optimize nursing plans in similar clinical practice. We hope that the implementation of home enteral nutrition can improve the nutrition status and quality of life of postoperative patients. Case Description: A patient with liver transplantation was admitted to The Fourth Hospital of Hebei Medical University for postoperative care. The nursing intervention were subsequently summarized and analyzed. In July 2023, the patient successfully underwent radical resection for esophageal cancer. Following the operation, the patient received regular medication and on-site nutritional intervention with the consent of her family. At discharge, the prealbumin, albumin, total protein and hemoglobin values of the patient were low, and body weight was 91 kg. The patient's nutritional risk screening (NRS2022) score was 5 points, and the Patient-Generated Subjective Global Assessment (PG-SGA) score was 4 points. After discharge, the patient continued to receive family enteral nutrition treatment, dietary guidance and psychological nursing. A follow-up review conducted 4 weeks after discharge showed improvements in the patient's NRS2022, albumin, total protein, hemoglobin, and body weight. Conclusions: Strengthening postoperative nutritional intervention are vital for promoting rehabilitation in patients who undergo radical resection of esophageal cancer after liver transplantation.

5.
BMC Nurs ; 23(1): 486, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39014456

RESUMO

BACKGROUND: Continuing care is needed for the growing number of chronically ill patients who struggle with health problems after discharge. This study aims to elucidate the development process, functionalities, service protocols, and utilization of an Internet Plus Care (IPC) platform devised by our hospital to offer healthcare services to discharged patients. METHODS: This was a mixed study. After describing the development process, function and usage of IPC platform, we retrospectively collect data such as the general information of service recipients and service providers, service items, and service prices through the IPC platform from January 2021 to September 2023 to characterize these services. RESULTS: 69 nurses delivered a total of 788 services to 211 patients through the IPC platform. The majority of services (N = 652, 82.7%) were delivered offline, with almost half of the recipients (N = 384, 48.7%) being elderly individuals. 46.4% of nurses provided services ≥ 3 times. Furthermore, 26.5% of patients received services three or more times. Notably, patients' care requirements exhibited variations across age groups, with wound care (n = 243, 63.3%), pressure injuries care (n = 50, 13.0%), and replacement of indwelling nasogastric tubes (n = 20, 5.2%) emerging as the top three services favored by the elderly. CONCLUSIONS: The IPC platform demonstrates potential in delivering diverse health services to patients; however, the involvement of nurses and patients needs to be enhanced. It is necessary to implement relevant safeguard policies to promote the effective use of IPC platform for health management of discharged patients in the future. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: The prevalence of chronic diseases is on the rise, and patients with chronic diseases continue to struggle with health problems after discharge and require extended treatment and rehabilitation. Our study proves that IPC platform presents a promising avenue for addressing these challenges. It is anticipated that governmental authorities will undertake comprehensive policy, legislative, and medical insurance reforms to facilitate the extensive adoption of IPC platform-based services.

6.
Healthcare (Basel) ; 12(14)2024 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-39057540

RESUMO

Quality indicators (QIs) play a vital role in enhancing the care of older adults. This study aimed to identify existing QIs relevant to the health and care of older adults in community-care, continuing-care, and acute-care settings, along with available information such as definitions and calculation methods. A systematic review of published review studies, grey literature, and guidelines was undertaken, utilizing six electronic databases searched for materials dated from 2010 to 2 June 2023. To be included in this study, the literature had to provide data on QIs in a setting involving older adults. This study included 27 reviews and 44 grey literature sources, identifying a total of 6391 QIs. The highest number of indicators (37%) were relevant to continuing care; 32% and 28% were pertinent to community- and acute-care settings, respectively. The process domain had the highest number of QIs (3932), while the structure domain had the fewest indicators (521). A total of 39 focus areas were identified, with the five most common areas being, in descending order, orthopedics/hip fractures, end-of-life/palliative care, appropriate prescribing, neurocognitive conditions, and cardiovascular conditions; these areas ranged between 10% and 6%. When mapped against the Quadruple Aim framework, most QIs (85%) were linked to improving health outcomes. This inclusive compilation of QIs serves as a resource for addressing various focus areas pertinent to the Quadruple Aims. However, few quality indicators have been designed to provide a comprehensive and thorough evaluation of a specific aspect, taking into account all three key domains: structure, process, and outcomes. Addressing the description and psychometric properties of QIs is foundational for ensuring their trustworthiness and effective application.

7.
World J Clin Cases ; 12(19): 3701-3707, 2024 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-38994285

RESUMO

BACKGROUND: There are relatively few studies on continuing care of coronary heart disease (CHD), and its research value needs to be further clarified. AIM: To investigate the effect of continuous nursing on treatment compliance and side effect management in patients with CHD. METHODS: This is a retrospective study with patients from January 2021 to 2023. The study was divided into two groups with 30 participants in each group. Self-rating anxiety scale (SAS) and Self-rating depression scale (SDS) were used to assess patients' anxiety and depression, and medical coping questionnaire was used to assess patients' coping styles. The pelvic floor dysfunction questionnaire (PFDI-20) was used to assess the status of pelvic floor function, including bladder symptoms, intestinal symptoms, and pelvic symptoms. RESULTS: SAS score decreased from 57.33 ± 3.01before treatment to 41.33 ± 3.42 after treatment, SDS score decreased from 50.40 ± 1.45 to 39.47 ± 1.57. The decrease of these two indexes was statistically significant (P < 0.05). PFDI-20 scores decreased from the mean 16.83 ± 1.72 before treatment to 10.47 ± 1.3the mean after treatment, which was statistically significant (P < 0.05). CONCLUSION: The results of this study indicate that pioneering research in continuous care of CHD has a positive impact on improving patients' treatment compliance, reducing anxiety and depression levels, and improving coping styles and pelvic floor functional status.

8.
Appl Nurs Res ; 77: 151789, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38796252

RESUMO

OBJECTIVE: To understand the relationship between the need for continuing care services and influencing factors, social support, readiness for discharge among discharged pulmonary tuberculosis (PTB) patients. METHODS: A cross-sectional study was conducted among 170 patients from a database of discharged patients with PTB from September 2023 to January 2024. A demographic and disease characteristics questionnaire, continuing care services basic modality questionnaire, continuing care services need questionnaire, the Social Support Rating Scale (SSRS), and the Readiness for Hospital Discharge Scale (RHDS) were used for this investigation. Univariate analysis and multiple linear regression analysis were used to analyze the associated factors. RESULTS: The mean total score for the need for continuing care services among patients with PTB discharged from the hospital was (121.61 ± 22.98). The dimension with the highest score was health education guidance need. Compared to the the original hospital medical personnel, the primary source of care information after discharge was the local medical institutions was statistically significant and negatively correlated with continuing care service need (P = 0.005). Social support was positively associated with need for continuing care services (P = 0.042). CONCLUSION: Discharged PTB patients had a high degree of continuing care service need. Factors influencing the need for continuing care services are the primary source of care information after discharge was the local medical institutions, the social support. Medical staff need to provide targeted continuing care services based on relevant influencing factors to meet the discharge needs of patients.


Assuntos
Alta do Paciente , Apoio Social , Tuberculose Pulmonar , Humanos , Estudos Transversais , Alta do Paciente/estatística & dados numéricos , Feminino , Masculino , China , Pessoa de Meia-Idade , Adulto , Tuberculose Pulmonar/psicologia , Inquéritos e Questionários , Idoso , Continuidade da Assistência ao Paciente/estatística & dados numéricos
9.
J Subst Use Addict Treat ; 166: 209405, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38772445

RESUMO

INTRODUCTION: The continuing care period following residential substance use treatment is a time when adolescents are at especially high risk for relapse, yet few families engage in traditional office-based care. Parent SMART (Substance Misuse among Adolescents in Residential Treatment) is a multi-component continuing care intervention for parents that combines three digital health technologies - an "off the shelf" online parenting program, daily phone notifications, and an online parent networking forum - with support from a parent coach. The current study solicited both qualitative and quantitative user feedback about Parent SMART to ensure responsivity to user preferences, refinement, and continuous improvement of the intervention. METHODS: Exit interviews were conducted with 30 parents who received Parent SMART, which includes (1) a parent networking forum; (2) daily text messages reminders of skills, (3) an "off-the-shelf" online parenting program; and (4) in-person or telehealth parent coaching sessions. The study collected qualitative feedback using semi-structured interviews and obtained quantitative feedback via a series of ratings of each Parent SMART component on a 5-point Likert scale administered at each follow-up assessment. RESULTS: Quantitative feedback suggest that parents rated all four elements of Parent SMART as easy to use. Qualitative feedback revealed that parents valued several aspects of Parent SMART including the brevity and structure of the intervention elements, the reminders to use parenting skills, and the sense of social connectedness fostered by different components. Recommended refinements included a number of strategies to enhance personalization and ease of navigation. CONCLUSIONS: Parent feedback informed enhancements to the Parent SMART intervention prior to implementation in a larger, ongoing pragmatic effectiveness trial. The current study serves as a model for applying a staged person-centered approach and eliciting both quantitative and qualitative feedback to refine digital health technologies.


Assuntos
Poder Familiar , Pais , Transtornos Relacionados ao Uso de Substâncias , Humanos , Pais/psicologia , Pais/educação , Feminino , Adolescente , Masculino , Transtornos Relacionados ao Uso de Substâncias/terapia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Poder Familiar/psicologia , Adulto , Tratamento Domiciliar/métodos , Envio de Mensagens de Texto , Retroalimentação , Telemedicina
10.
BMC Health Serv Res ; 24(1): 308, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38454448

RESUMO

BACKGROUND: International experience shows that the suitability of a high-performance healthcare system for its given purposes is reflected in its ability to provide a continuum of services that match the changing health status of the given population. Although many low- and middle-income countries have sought to bring movement away from hospital-centered and towards patient-centered healthcare, such efforts have often had poor results, and one of the major reasons for this is the inability to accurately identify which inpatients need continuing care and what kind of continuing of care is needed. OBJECTIVES: To measure and assess the continuing care needs of discharged patients and its influencing factors in rural China. METHODS: Data were obtained from the hospital database of Medical Center M in County Z from May to July 2022. County Z is a county of 1 million people in central China. The database includes basic patient information, disease-related information, and information on readiness for hospital discharge. Factors related to the need for continuing care were included in the analysis. The Readiness for Hospital Discharge Scale was used to assess the need for continuing care. The statistical data are expressed in terms of both frequency and composition ratio. Finally, linear regression was used to analyze the factors influencing the need for continuing care. RESULTS: The analysis included a total of 3,791 patients, 123 of whom (3.25%) had continuing nursing needs. The need of continuing nursing was related to patients' age group, mode of admission, occupation and major diagnostic categories (P < 0.05). CONCLUSIONS: Developing continuing care is an important initiative for bridging the fragmentation of health services, and an appropriate supply system for continuing care, interconnected with inpatient services, should be established in rural areas in China as soon as possible. And provide more appropriate care for patients in need.


Assuntos
Hospitalização , Pacientes Internados , Humanos , Atenção à Saúde , Alta do Paciente , China
11.
World J Clin Cases ; 12(2): 314-321, 2024 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-38313633

RESUMO

BACKGROUND: Despite sharing similar pathogenic factors, cancer and coronary heart disease (CHD) occur in comparable populations at similar ages and possess similar susceptibility factors. Consequently, it is increasingly commonplace for patients to experience the simultaneous occurrence of cancer and CHD, a trend that is steadily rising. AIM: To determine the impacts of continuing care on lung cancer patients with CHD following percutaneous coronary intervention (PCI). METHODS: There were 94 lung cancer patients with CHD following PCI who were randomly assigned to the intervention group (n = 38) and the control group (n = 41). In the intervention group, continuing care was provided, while in the control group, routine care was provided. An evaluation of cardiac and pulmonary function, medication compliance, a 6-min walk test, and patient quality of life was performed. RESULTS: Differences between the two groups were significant in left ventricular ejection fraction, 6-min walk test, oxygen uptake, quality of life and medication compliance (P < 0.05). In comparison with the control group, the enhancement in the intervention group was more significant. The intervention group had more patients with high medication compliance than the control group, with a statistically significant difference (P < 0.05). CONCLUSION: After undergoing PCI, lung patients with CHD could benefit from continued care in terms of cardiac and pulmonary function, medications compliance, and quality of life.

12.
Digit Health ; 9: 20552076231197104, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37732135

RESUMO

Objective: To assess the effects of WeChat platform-based continuing care for arthritis on patients' self-management, self-efficiency, quality of life (QoL), and medication compliance. Methods: A study was conducted on arthritis patients recruited between December 2017 and February 2018 and divided into two groups. The intervention group received continuing care from the WeChat platform and regular follow-ups, while the control group only received regular follow-ups. The outcomes in both groups were assessed using questionnaires twice: before the study (T0) and eight weeks after T0 (T1), which consists of the evaluation of self-management, QoL, self-efficacy, and medication compliance. Results: There were 23 people in each of the intervention and control groups completed two outcome measures. At eight weeks, participants in the intervention group showed an improvement in psychological QoL, cognitive symptom management, and self-efficacy, compared to the control group (QoL scores: mean difference in change between groups was 12.29, 95% CI: 4.51, 20.07, p < 0.001; cognitive symptom management: mean difference in change between groups was 0.65, 95% CI: 0.24, 1.05, p < 0.001; self-efficacy: mean difference in change between groups was 0.69, 95% CI: 0.14, 1.24, p < 0.05). Self-management, self-efficacy, and psychological quality of life were significantly improved in the intervention group before and after the intervention (p < 0.05). Conclusion: Using the WeChat platform for continuing care is useful in improving the psychological state, self-efficacy, and self-management ability of patients with arthritis. The study is relevant to Clinical Practice.

13.
Fam Pract ; 2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-37656895

RESUMO

In the United States, individuals with intellectual and developmental disabilities (IDD) consistently experience health disparities. One factor is limited access to quality healthcare services equipped to meet the needs of those with IDD, particularly as they transition to adulthood. The purpose of this work is to describe the development and implementation of Jefferson's Continuing Care Program (JCCP), which was designed to address this care gap. We share how the idea, logistics, and support for the clinic were developed; how JCCP was designed to be uniquely accessible both via physical space and clinic flow; and how those challenges encountered have been crucial for fine-tuning optimal patient care. Since its inception in 2019, JCCP has made large strides towards educating the next generation of medical providers to care for patients with IDD. Looking to the future, JCCP plans to broaden its impact by serving more patients, continuing our advocacy and education work, and continuing to adapt to the needs of our community.

14.
J Am Med Dir Assoc ; 24(9): 1266-1270, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37517805

RESUMO

In response to the COVID-19 pandemic, Canadian governments and healthcare organizations implemented restrictions on continuing care residents. From an ethical lens, governments and healthcare organizations were focused on preventing harm through promoting beneficence and non-maleficence; however, this was at the expense of resident autonomy. The rights of continuing care residents were stripped away when they were not given the opportunity to make informed decisions regarding their care and day-to-day life. Governments and healthcare organizations denied them the dignity to experience the positive outcomes that result from risk-taking based on their personal values and preferences. In an attempt to prevent resident harm from COVID-19 cases and deaths, governments and continuing care facilities forced residents into isolation. This negatively affected residents' quality of life in the form of physical, mental, and cognitive health deterioration. Moving forward, governments and healthcare organizations need to take the time to engage residents in decision-making and policy development that affects their care, treatment, and support system. Governments and healthcare organizations must promote and safeguard resident autonomy to maintain quality of life.


Assuntos
COVID-19 , Qualidade de Vida , Humanos , Pandemias/prevenção & controle , Canadá , Autonomia Pessoal
15.
J Multidiscip Healthc ; 16: 2071-2080, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37496637

RESUMO

Purpose: To explore the clinical effects of continuous nursing on patients with inflammatory bowel disease (IBD). Methods: Patients with IBD in the digestive department of the hospital from January 2020 to August 2021 were selected as the research participants and divided into an observation and control group by the random number table method. The patients were treated with a routine nursing intervention (control group) or routine plus continuous nursing interventions (observation group). The disease uncertainty, coping strategies, sleep and quality of life before and after the interventions were compared between the two groups. Results: After 6 months of the intervention, the disease uncertainty score of the observation group was significantly lower than that of the control group (p < 0.05). Medical coping style score: There was no significant difference in the three dimensions of medical coping style between the two groups before the intervention (p > 0.05). After 6 months of the intervention, the facial score of the observation group was significantly higher, and the avoidance and yield scores were significantly lower compared with the control group (p < 0.05). Sleep quality and quality of life score: There was no significant difference in the sleep quality score between the two groups before the intervention (p > 0.05). After 6 months of the intervention, the observation group's sleep quality and quality of life scores were significantly higher compared with the control group (p < 0.05). Conclusion: Compared with routine nursing, continuous nursing can reduce the disease uncertainty of patients with IBD, help them to adopt an active coping style, as well as improve their sleep quality and quality of life to relieve physical and mental pain and better restore health.

16.
Glob Chall ; 7(7): 2300070, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37483417

RESUMO

This work explores the effect of a Wechat group on follow-up and continuation of nursing for discharged patients with Colles fracture. A total of 96 patients with Colles fracture are enrolled and randomized into two groups by the random number table method. The control group is followed up and guided by traditional methods. Based on the follow-up method adopted in the control group, a Wechat group is combined with Wechat constant tracking. The regular follow-up rate, a satisfaction of with continuing care, Gartland-Werley wrist score, the exercise of self-care agency score (ESCA score), and complications are compared and analyzed. The regular follow-up rate, satisfaction, Gartland-Werley wrist score, and self-care ability of patients in the Wechat group are significantly higher than those in the control group (p < 0.05). Statistical analysis of postoperative complications showed that although there is no significant difference in the incidence of median nerve irritation and incision infection (p > 0.05), the proportion of joint stiffness in the control group is significantly higher (p < 0.05). The establishment of Wechat groups to follow up and continue nursing for discharged patients with Colles fracture is helpful to achieve better clinical efficacy and improve the effective way for doctor-patient communication, which is worthy of active promotion.

17.
Int J Offender Ther Comp Criminol ; : 306624X231172651, 2023 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-37178158

RESUMO

This study explored factors to reduce drug-related recidivism among paroled methamphetamine users in Japan, especially the significance of continuing care and motivation, internationally shown as positively related to better treatment outcomes. Cox proportional hazards regression analysis was performed on 10-year drug-related recidivism data from 4,084 methamphetamine users paroled in 2007 who received a mandatory educational program conducted by professional and volunteer probation officers. Independent variables included participant characteristics, an index of motivation, and the length of parole as a substitute for the duration of continuing care with consideration of the Japanese legal system structures and socio-cultural context. Older age, lower number of previous prison sentences, shorter imprisonment, longer parole, and index of higher motivation were significantly and negatively associated with drug-related recidivism. The results indicate the benefit of continuing care and motivation on treatment outcomes, regardless of the differences in socio-cultural context and criminal justice system.

18.
Drug Alcohol Rev ; 42(6): 1395-1405, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37248675

RESUMO

INTRODUCTION: To help reduce relapse rates following alcohol and other drug (AOD) treatment, continuing care interventions have been recommended. Previous continuing care interventions have incorporated telephone and face-to-face sessions to help promote participant engagement. The study was conducted as a randomised controlled feasibility study and examined a call centre delivered continuing care intervention for people leaving residential rehabilitation services. METHODS: Participants were attending AOD residential treatment services in NSW, Australia (N = 154). Participants were randomised to either 12- or 4-sessions of continuing care. Follow up assessments were completed at 6-months. The primary outcomes were demand and implementation. Secondary outcomes were AOD use, mental health and physical health at 6-months. RESULTS: Interest in continuing care was high, with 93% of participants approached reporting an interest in being involved. Of the participants who completed the consent and baseline procedures, 29% of people were contacted post residential treatment and randomised. For those people randomised, the average number of sessions completed was 2.78 (SD = 1.65) for the 4-session arm and 4.81 (SD = 4.46) for the 12-session arm. Fidelity to the treatment manual was high. Both treatment arms showed higher complete abstinence at 6-months compared to baseline (12-session OR 28.57 [2.3, 353.8]; 4-session OR 28.11 [3.6, 221.2]). DISCUSSION AND CONCLUSIONS: A major challenge associated with the call centre approach was re-engaging participants once they left the residential facility and delivering the planned dose of treatment. Further work is required to promote greater uptake of these protocols once people leave residential treatment.


Assuntos
Call Centers , Transtornos Relacionados ao Uso de Substâncias , Humanos , Tratamento Domiciliar , Estudos de Viabilidade , Transtornos Relacionados ao Uso de Substâncias/terapia , Austrália
19.
Acta Psychol (Amst) ; 235: 103898, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37001396

RESUMO

As a chronic disease with consistent relapse rates, substance use disorders (SUD) require a continuity-of-care approach. Unfortunately, many patients do not have access to continuing care. This systematic review analysed the current scientific knowledge to better understand if app-based smartphone interventions can be an effective alternative. The databases Cochrane Library, PubMed, Web of Science, and PsycINFO were used to find experimental and quasi-experimental studies investigating the effectiveness of a smartphone intervention in individuals who had completed treatment for SUD. After removing duplicates, a total of 1488 studies were screened, with 48 being selected for a full-text review. Four studies met all the criteria, with one other being added by identification through other resources, making a total of 5 studies included in the present review. Out of the four studies using a control group, only one found no significant differences in favour of the experimental group. That study used an active control group and compared the smartphone intervention to its therapeutic group equivalent. There were no significant differences between the two experimental groups. Overall, the results indicate that app-based smartphone interventions can be an effective alternative to traditional forms of continuing care. However, literature is still scarce, and more research needs to be made on this subject. This systematic review is registered at PROSPERO with the identifier [CRD42021272070].


Assuntos
Smartphone , Transtornos Relacionados ao Uso de Substâncias , Humanos , Transtornos Relacionados ao Uso de Substâncias/terapia
20.
BMC Geriatr ; 23(1): 85, 2023 02 09.
Artigo em Inglês | MEDLINE | ID: mdl-36755216

RESUMO

BACKGROUND: For the care need of older adults, long-term care (LTC) and assisted living (AL) facilities are expanding in Alberta, but little is known about the caregivers' well-being. The purpose of the study was to investigate the physical health conditions, mental and emotional health (MEH), health behaviour, stress levels, quality of life (QOL), and turnover and absenteeism (TAA) among professional caregivers in Alberta's LTC and AL facilities. METHODS: This cross-sectional survey involved 933 conveniently selected caregivers working in Alberta's LTC and AL facilities. Standardised questions were selected from the Canadian Community Health Survey, Patient Health Questionnaire-9, and Short Form-36 QOL survey revalidated and administered to the participants. The new questionnaire was used to assess the caregivers' general health condition (GHC), physical health, health behaviour, stress level, QOL, and TAA. Data were analysed using descriptive statistics, Cronbach alpha, Pearson's correlation, one-way analysis of variance, and multiple linear regression. RESULTS: Of 1385 surveys sent to 39 facilities, 933 valid responses were received (response rate = 67.4%). The majority of the caregivers were females (90.8%) who were ≥ 35 years (73.6%), worked between 20 to 40 h weekly (67.3%), and were satisfied with their GHC (68.1%). The Registered Nurses had better GHC (mean difference [MD] = 0.18, p = 0.004) and higher TAA than the Health Care Aides (MD = 0.24, p = 0.005). There were correlations between caregivers' TAA and each of MEH (r = 0.398), QOL (r = 0.308), and stress (r = 0.251); p < 0.001. The most significant predictors of TAA were the propensity to quit a workplace or the profession, illness, job stress, and work-related injury, F (5, 551) = 76.62, p < 0.001, adjusted R2 = 0.998. CONCLUSION: Reducing the caregivers' job stressors such as work overload, inflexible schedule, and poor remuneration, and improving their quality of life, health behaviour, and mental, emotional, and physical health conditions may increase their job satisfaction and reduce turnover and absenteeism.


Assuntos
Cuidadores , Qualidade de Vida , Feminino , Humanos , Idoso , Masculino , Qualidade de Vida/psicologia , Cuidadores/psicologia , Estudos Transversais , Assistência de Longa Duração , Alberta/epidemiologia , Inquéritos e Questionários
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