Village health team-delivered oral HIV self-testing increases linkage-to-care and antiretroviral-therapy initiation among men in Uganda.

Targeted strategies are central to increasing HIV-status awareness and progress on the care cascade among men. We implemented Village-Health-Team (VHT)-delivered HIV self-testing (HIVST) among men in a peri-urban Ugandan district and assessed linkage to confirmatory-testing, antiretroviral-therapy (ART) initiation and HIV-status disclosure following HIVST. We conducted a prospective cohort study from November 2018 to June 2019 and enrolled 1628 men from 30-villages of Mpigi district. VHTs offered each participant one HIVST-kit and a linkage-to-care information leaflet. At baseline, we collected data on demographics, testing history and risk behavior. At one-month, we measured linkage to confirmatory-testing and HIV-status disclosure, and at three months ART-initiation if tested HIV-positive. We used Poisson regression generalized estimating equations to evaluate predictors of confirmatory-testing. We found that 19.8% had never tested for HIV and 43% had not tested in the last 12-months. After receiving HIVST-kits, 98.5% self-reported HIVST-uptake in 10-days, 78.8% obtained facility-based confirmation in 30-days of HIVST with 3.9% tested HIV-positive. Of the positives, 78.8% were newly diagnosed, 88% initiated ART and 57% disclosed their HIV-status to significant others. Confirmatory testing was associated with having a higher level of education and knowing a partner's HIV-status. VHT-delivered HIVST may be effective for boosting testing, ART-initiation and HIV-status disclosure among men.

A Pilot Feasibility Evaluation of a Heart Rate Variability Biofeedback App to Improve Self-Care in COVID-19 Healthcare Workers.

COVID-19 exacerbated burnout and mental health concerns among the healthcare workforce. Due to high work stress, demanding schedules made attuned eating behaviors a particularly challenging aspect of self-care for healthcare workers. This study aimed to examine the feasibility and acceptability of a heart rate variability biofeedback (HRVB) mobile app for improving well-being among healthcare workers reporting elevated disordered eating during COVID-19. We conducted a mixed methods pre-mid-post single-arm pilot feasibility trial (ClinicalTrials.gov NCT04921228). Deductive content analysis of participants' commentary generated qualitative themes. Linear mixed models were used to examine changes in pre- mid- to post-assessment scores on well-being outcomes. We consented 28 healthcare workers (25/89% female; 23/82% Non-Hispanic White; 22/79% nurses) to use and evaluate an HRVB mobile app. Of these, 25/89% fully enrolled by attending the app and device training; 23/82% were engaged in all elements of the protocol. Thirteen (52%) completed at least 10 min of HRVB on two-thirds or more study days. Most participants (18/75%) reported being likely or extremely likely to continue HRVB. Common barriers to engagement were busy schedules, fatigue, and technology difficulties. However, participants felt that HRVB helped them relax and connect better to their body's signals and experiences. Results suggested preliminary evidence of efficacy for improving interoceptive sensibility, mindful self-care, body appreciation, intuitive eating, stress, resilience, and disordered eating. HRVB has potential as a low-cost adjunct tool for enhancing well-being in healthcare workers through positively connecting to the body, especially during times of increased stress when attuned eating behavior becomes difficult to uphold.

Effects of nurse-led self-care interventions on health outcomes among people with heart failure: A systematic review and meta-analysis.

AIM: To estimate the effects of nurse-led self-care interventions on people with heart failure (HF). BACKGROUND: Research evidence of the effects of nurse-led HF self-care interventions on patient outcomes is scant. DESIGN: A systematic review and meta-analysis of randomised controlled trials (RCTs). DATA SOURCES: Six databases (MEDLINE, Embase, Web of Science, CENTRAL, CINAHL and PsycINFO) were searched from the inception to December 2022 to identify eligible studies. METHODS: RCTs published in English that evaluated the impact of nurse-led HF self-care interventions on quality of life, anxiety, symptom burden, sleep quality, healthcare service utilisation and mortality were included. The risk of bias in included studies was assessed using RoB 2.0. We conducted data syntheses using the R software and graded the quality of the evidence using the GRADE approach. The systematic review was conducted in accordance with the PRISMA. RESULTS: Twenty-five studies with 2746 subjects were included. Our findings demonstrated, that compared to the controls, nurse-led self-care interventions improved QOL (SMD: .83, 95% CI: .50-1.15, moderate evidence), anxiety (MD: 1.39, 95% CI: .49-2.29, high evidence) and symptom burden (SMD: .81, 95% CI: .24-1.38, low evidence) in people with HF. No significant effects were found in all-cause hospital readmission and all-cause emergency department visit. Research evidence on sleep quality, cardiac-related hospital readmission, cardiac-related emergency department visit and all-cause mortality remained unclear. CONCLUSIONS: Our review suggests that nurse-led HF self-care interventions have favourable effects on the QOL, anxiety and symptom burden. Further, well-designed RCTs are warranted to address the gaps identified in this review. RELEVANCE TO CLINICAL PRACTICE: The results indicated that nurse-led HF self-care interventions could improve QOL, anxiety and symptom burden in people with HF. Nurse-led self-care intervention could be integrated into current HF management practices.

Orientações de enfermagem para pessoas com estomia intestinal em cenário extra hospitalar: scoping review / Nursing guidelines for people with intestinal ostomy in extra-hospital scenario: scoping review / Directrices de enfermería para personas con ostomía intestinal en escenario extrahospitalario: scoping review

RESUMO Objetivo: mapear na literatura as orientações de enfermagem para pessoas com estomias intestinais na atenção primária à saúde e centros de referência. Método: scoping review desenvolvida em abril e maio de 2022, em bases nacionais e internacionais e fontes de literatura cinzenta. Utilizou-se os descritores: Ostomia; Colostomia; Ileostomia; Educação em Saúde; Atenção Primária; Serviços de Saúde e suas traduções no inglês. Seguiu-se as etapas recomendadas pelo Joana Briggs Institute e registrou-se na plataforma Open Science Framework. Resultados: foram identificados 2242 estudos, sendo 17 selecionados para composição amostral. As orientações versaram predominantemente sobre autocuidado com estomia e pele periestomal, escolha de equipamentos coletores e adjuvantes e aspectos sobre aceitação e adaptação. Conclusão: Identificou-se na literatura as principais orientações de enfermagem dirigidas às pessoas com estomia. O estudo contribui para prática em Enfermagem diante do raciocínio das necessidades e dos cuidados qualificados a serem dispensados à pessoa com estomia na integralidade da atenção(AU)

ABSTRACT Objective: to map in the literature the nursing guidelines for people with intestinal ostomies in primary health care and referral centers. Method: scoping review developed in April and May 2022, in national and international bases and gray literature sources. The descriptors were used: Ostomy; Colostomy; Ileostomy; Health Education; Primary Attention; Health Services and their English translations. Followed the steps recommended by the Joana Briggs Institute and registered on the Open Science Framework platform. Results: were identified 2242 studies, 17 of which were selected for sample composition. The guidelines focused predominantly on self-care with ostomy and peristomal skin, choice of collector and adjuvant equipment, and aspects of acceptance and adaptation. Conclusion: the main nursing guidelines for people with ostomy were identified in the literature. The study contributes to nursing practice in view of the reasoning of the needs and qualified care to be provided to the person with an ostomy in the integrality of care(AU)

RESUMEN Objetivo: mapear en la literatura las directrices de enfermería para personas con ostomías intestinales en la atención primaria de salud y centros de referencia. Método: Scoping Review desarrollado en abril y mayo de 2022, en bases nacionales e internacionales y fuentes de literatura gris. Se utilizaron los descriptores: ostomía; colostomía; ileostomía; Educación en salud; atención primaria; servicios de salud y sus traducciones al inglés. Se siguieron las etapas recomendadas por el Instituto Joana Briggs y se hizo el registro en la plataforma Open Science Framework. Resultados: se identificaron 2242 estudios, de los cuales 17 fueron seleccionados para composición de la muestra. Las orientaciones se centraron predominantemente en el autocuidado con ostomía y piel periestomal, elección de equipos colectores y adyuvantes, y aspectos de aceptación y adaptación. Conclusión: Se identificaron en la literatura las principales orientaciones de enfermería para personas con ostomía. El estudio contribuye a la práctica de enfermería en vista del razonamiento de las necesidades y cuidados calificados a ser prestados a la persona con ostomía en la integralidad del cuidado(AU)

Confluência das práticas alternativas de saúde: caracterização dos recursos humanos nas práticas alternativas de saúde adotadas no Distrito Federal / Confluence of alternative health practices: characterization of human resources in alternative health practices adopted in the Federal District

INTRODUÇÃO: Esta pesquisa insere-se em um esforço maior do Observatório de Recursos Humanos em Saúde (ObservaRH) do Núcleo de Estudos de Saúde Pública do Centro de Estudos Avançados Multidisciplinares da Universidade de Brasília (Nesp/Ceam/UnB), com vistas à caracterização dos recursos humanos nas práticas alternativas de saúde, contribuindo para desvendar dimensões nesse campo, que vem suscitando progressivo interesse e busca de conhecimentos mais sistematizados tanto pelos potenciais usuários como pelos estudiosos. OBJETIVO: No estudo atual, são retomados diversos dos temas abordados no estudo Das medicinas tradicionais às práticas integrativas de saúde, porém sua ênfase é outra, qual seja: examinar o fenômeno que aponta para a confluência de terapêuticas utilizadas pelos recursos humanos das práticas alternativas de saúde na diagnose e na aplicação de terapêuticas. MATERIAL E MÉTODO: Como não se trata de obter respostas apenas por meio de perguntas diretamente afetas a essa questão, estabeleceu-se um percurso no qual se tornou importante obter dados sobre a formação profissional dos entrevistados, sua motivação na escolha da prática, os processos de autocuidado e cura aos quais eles se submetem e a abordagem terapêutica utilizada em sua prática central e nas possíveis outras terapêuticas utilizadas. CONCLUSÃO: Enfim, depois de percorrer tal jornada, por meio de perguntas diretas e por associação de informações, temos a pretensão de fornecer indicações para responder à pergunta indicada pela pesquisa anterior:1 "Quais as tendências apontadas pelos entrevistados no que se refere ao fenômeno de confluências das práticas alternativas de saúde?"