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1.
Med Clin North Am ; 104(2): 327-343, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32035572

RESUMEN

Aging-associated anatomic and physiologic decline begins during the fourth decade of life and progresses over the ensuing decades sometimes to a state of frailty, with the decline amplified when there is deconditioning. Aging-related gait and balance disorders leading to an increased risk of falling can be compensated for with the use of exercise interventions, durable medical equipment, and environmental modifications. Caregiver training is an essential component of geriatric rehabilitation.


Asunto(s)
Accidentes por Caídas/prevención & control , Evaluación Geriátrica/métodos , Enfermedad de Parkinson , Velocidad al Caminar , Anciano , Cuidadores/educación , Humanos , Enfermedad de Parkinson/diagnóstico , Enfermedad de Parkinson/fisiopatología , Enfermedad de Parkinson/rehabilitación
2.
BMC Public Health ; 19(1): 1721, 2019 Dec 23.
Artículo en Inglés | MEDLINE | ID: mdl-31870334

RESUMEN

BACKGROUND: Community acquired pneumonia is responsible for 16% of under 5 mortality in India, probably due to delayed recognition and qualified care seeking. Therefore these deaths could possibly be averted by creating community awareness and promoting care seeking from qualified physicians in the government system. The objective of study was to assess the effectiveness of facility-based and village-based behavior change communication interventions delivered to community using validated information, education and communication materials, along with infrastructural strengthening of health facilities, for change in care seeking from government system for community acquired pneumonia in rural Lucknow, India. METHOD: Community based open labeled behavioral trial in 2 by 2 factorial design was conducted in eight rural blocks of Lucknow, northern India. Trained community health workers conducted Pneumonia Awareness Sessions once a month for the care givers of children using validated information, education and communication materials either at the villages or at government health facilities. Prior infrastructural strengthening of public health facilities was done to provide optimal care to cases. Pre packed pneumonia drug kits were provided which had amoxicillin, paracetamol and an instruction card on their use as well as pictorial representation of danger signs of pneumonia. RESULTS: Study lasted from October 2015 to September 2018. Adherence to conduct of facility-based intervention was 93.0% (279/300) and to village-based intervention was 73.4% (7638/10410). In village-based intervention there was 79.3% (p < 0.0001) increase from a baseline of 3.3% (14/420) and facility-based intervention 68.9% (p = 0.02) increase from a baseline of 5.35% (21/392) in cases of possible pneumonia treated at government health facilities. CONCLUSION: Conduct of structured pneumonia awareness session using validated information, education and communication material at village level with infrastructural strengthening resulted in improved qualified care seeking from government facilities for community acquired pneumonia. TRIAL REGISTRATION: AEARCTR-0003137, retrospectively registered on 10/July/2018.


Asunto(s)
Infecciones Comunitarias Adquiridas/prevención & control , Comunicación en Salud/métodos , Neumonía/prevención & control , Servicios de Salud Rural , Cuidadores/educación , Cuidadores/psicología , Preescolar , Agentes Comunitarios de Salud/psicología , Infecciones Comunitarias Adquiridas/mortalidad , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , India/epidemiología , Lactante , Masculino , Aceptación de la Atención de Salud , Neumonía/mortalidad , Evaluación de Programas y Proyectos de Salud
3.
BMC Health Serv Res ; 19(1): 817, 2019 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-31703681

RESUMEN

BACKGROUND: This study evaluated the Health Works (HWs) nutritional counselling skills and information shared with caregivers. This was a cross-sectional study in which an observation checklist was used to examine Growth Monitoring and Promotion (GMP) activities and educational/counselling activities undertaken by health workers (HWs) to communicate nutrition information to caregivers, depending on the ages of the children. METHODS: A total number of 528 counselling interactions between health workers and caregivers in 16 Child welfare Clinics (CWCs) in two rural districts in Ghana were observed. Frequencies were presented for the information that was obtained from each caregiver and those that were provided by the HWs during the nutritional counselling sessions. RESULTS: About 95.1 and 61.8% of the caregiver-HW interactions involved mothers of children who were less than 6 months of age and those above 6 months respectively. HWs counselled the caregivers on appropriate nutrition for the child. Health talk messages that were shared with caregivers focused mainly on the importance of attending CWCs and vaccination of children and rarely included any teaching materials. In most of the interactions, HWs made of child's feeding practices the past 1 month; and also did not provide advice on specific issues of IYCF. Nutritional counselling information given for non-breastfeeding children was inadequate and in some cases absent. Little attention was given to the feeding of children with animal products during counselling. CONCLUSION: Generally nutritional information given to caregivers who had children above 6 months was inadequate.


Asunto(s)
Cuidadores/educación , Bienestar del Niño/estadística & datos numéricos , Consejo/normas , Educación en Salud/normas , Estado Nutricional , Niño , Preescolar , Enfermería en Salud Comunitaria/normas , Enfermería en Salud Comunitaria/estadística & datos numéricos , Consejo/estadística & datos numéricos , Estudios Transversales , Femenino , Ghana , Educación en Salud/estadística & datos numéricos , Personal de Salud/educación , Humanos , Lactante , Masculino , Madres/educación , Relaciones Profesional-Paciente , Salud Rural
4.
BMC Health Serv Res ; 19(1): 781, 2019 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-31676005

RESUMEN

BACKGROUND: Present demographic trends show a considerable rise in elderly populations with aging disorders, such as dementia. The current article focused on the exploitation of e-learning as an informal support for caregivers of people with dementia and considered its benefits and limitations to provide proper and relevant care for this target group of people as well as maintain the quality of life of their caregivers. METHODS: The methodology of this study is based on a literature review of accessible peer-review articles from three recognized databases: Web of Science, Scopus, and PubMed. The findings of the selected studies were compared and evaluated. RESULTS: The findings showed that e-learning educational programs/courses helped caregivers feel more confident about dementia care, reduced their perceived stress and enhanced their feelings of empathy, understanding and concern. CONCLUSIONS: The findings of this study reveal that the exploitation of e-learning as a support tool, especially for informal caregivers, in the management of dementia may be a promising method, but its implementation requires professional training of informal caregivers in the use of this technology. More evidence-based studies are needed on this topic.


Asunto(s)
Cuidadores/educación , Cuidadores/psicología , Instrucción por Computador , Demencia/terapia , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto
5.
Clin Interv Aging ; 14: 1705-1717, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31686796

RESUMEN

Purpose: As an intermediate prodromal stage of dementia, mild cognitive impairment (MCI) causes functional, emotional, and social challenges for both of the person with MCI (PwMCI) and their family caregiver. However, major attention has only been placed on the PwMCI's for cognitive training. This study evaluated a more comprehensive intervention, which integrated both strength-based and empowerment approaches, to address their complex needs in a dyadic fashion. Patients and methods: This randomized controlled trial allocated 103 MCI patient-caregiver dyads to receive a 14-week dyadic strength-based empowerment program (D-StEP-MCI, n=52) or usual care (n=51). The D-StEP-MCI program consisted of group-based session to the PwMCI, home-based dyadic sessions, and telephone follow-up, with the activities supported the care dyads to navigate their own strengths and resources for integration, together with the trained skills, to optimize role and social engagement in everyday life. Dyadic health outcomes in terms of subjective and objective cognitive function, and neuro-psychiatric symptoms of PwMCI, stress in symptom management of their family caregivers, and depression of the dyads were evaluated at baseline, after the D-StEP-MCI and at 3 months thereafter. Results: By using general estimating equation, the D-StEP-MCI significantly improved the cognitive function, subjective memory, and mood status of the PwMCI, and the positive changes were maintained at the 3-month endpoints. It also has significantly positive effects on caregivers' stress in symptom management and level of depression. Conclusion: Our findings showed the health benefit of combining strength-based and empowerment approach in supporting the disease adaptation of PwMCI and caregiver in a dyadic fashion. This study also supports the use of a social interaction approach to optimize the everyday engagement of the PwMCI.


Asunto(s)
Cuidadores/educación , Disfunción Cognitiva/rehabilitación , Afecto , Anciano , Cuidadores/psicología , Cognición , Disfunción Cognitiva/psicología , Emociones , Femenino , Humanos , Relaciones Interpersonales , Masculino , Memoria , Persona de Mediana Edad
6.
Clin Interv Aging ; 14: 1527-1553, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31692559

RESUMEN

Purpose: There are few interventions on an individual basis to support community-dwelling people with dementia to continue to fulfill their potential in society and to support their informal caregivers via e-Health. This study explored the effectiveness of the individualized Meeting Centers Support Program (iMCSP) consisting of DemenTalent (people with dementia work as volunteers in a society based on their talents), Dementelcoach (telephone coaching), and STAR e-Learning for caregivers, compared to regular MCSP and No day care support. Method: An explorative randomized controlled trial with pre/post measurements (M0-M6) and two groups (iMCSP and regular MCSP). In addition, a comparison was made between iMCSP and a reference No day care control group. Standardized questionnaires were administered on self-esteem, neuropsychiatric symptoms, experienced autonomy and quality of life of the person with dementia, and on caregiver's sense of competence, quality of life, and happiness. Results: The iMCSP interventions resulted in a broader group of participants utilizing the Meeting Centers. Compared to regular MCSP, DemenTalent had a moderate positive effect on neuropsychiatric symptoms, which also proved less severe. Positive affect of participants improved within the DemenTalent and regular MCSP group after six months. Caregivers of DemenTalent participants experienced less emotional impact of neuropsychiatric symptoms. No differences were found in experienced burden, sense of competence, or quality of life in caregivers using iMCSP or regular MCSP. Compared to those receiving No day care support, caregivers of DemenTalent participants and caregivers using Dementelcoach or STAR e-Learning proved happier. Post-hoc analyses, accounting for potential between-group differences in outcome measures at baseline, generally showed results in the same direction. People with dementia and caregivers highly appreciated iMCSP and regular MCSP. Conclusion: iMCSP can be effectively applied as alternative or additional support via regular Meeting Centers for people with dementia and caregivers who prefer individualized activities/support. DemenTalent decreased the severity of neuropsychiatric symptoms of people with dementia and emotional burden of caregivers. All iMCSP interventions tended to result in caregivers being happier compared to those receiving no support. Larger-scale studies are needed to investigate the effect of iMCSP on other domains of quality of life of participants.


Asunto(s)
Enfermedad de Alzheimer/rehabilitación , Cuidadores/psicología , Centros de Día/organización & administración , Procesos de Grupo , Apoyo Social , Anciano , Enfermedad de Alzheimer/psicología , Cuidadores/educación , Instrucción por Computador , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Autonomía Personal , Calidad de Vida/psicología , Encuestas y Cuestionarios , Revisión de Utilización de Recursos
7.
Clin Interv Aging ; 14: 1515-1525, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31692560

RESUMEN

Introduction: Paternalism, assuming control of aged care, is a widespread orientation in older adults care. Paternalistic attitudes and practices are commonly understood as a threat to the freedom and autonomy of a person, making patients more dependent. Therefore, the reduction of these attitudes and behaviors is a primary goal for any older adult health and social care situation. The aim of this preliminary study is to develop a behavioral intervention to decrease paternalistic behaviors in formal caregivers and to increase those care behaviors which promote autonomy at post-intervention (1 week) and at follow-up (14 weeks). Methods: A sample of 118 professional caregiver volunteers working in day care centers and nursing homes were assigned to quasi-experimental (N=47) and control (N=71) conditions. The intervention consisted of 3 weekly group sessions. Individual and contextual measures were collected: 1) the primary outcome variable was the type of care (paternalistic versus autonomist) measured through the self-report Paternalist/Autonomist Care Assessment (PACA); 2) A 10-item caregiver self-register of paternalistic behaviors was carried out, 3) Finally, in order to assess the potential effects on observed behavior both in caregiver and older adult functioning at a contextual level, the five institutions were assessed through the SERA-RS. Results: Compared with the control group, caregivers in the behavioral intervention group displayed significantly lower paternalistic appraisals at posttest and follow-up. Regarding the intervention group, caregivers at posttest and follow-up showed significantly greater occurrence of autonomist behaviors being promoted and lower paternalistic appraisal. The results regarding the effect on the institutions showed better personnel performance and older adult functioning. Conclusion: Caregivers who followed the intervention learned to better identify older adult needs; although we did not find significant differences in autonomy occurrence compared with the control group, a behavioral intervention may promote more autonomist environments and, therefore, better personnel and older adult functioning.


Asunto(s)
Terapia Conductista , Cuidadores/educación , Capacitación en Servicio , Paternalismo , Autonomía Personal , Adulto , Centros de Día para Mayores , Anciano , Actitud del Personal de Salud , Curriculum , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados no Aleatorios como Asunto , Casas de Salud , España
8.
Artículo en Inglés | MEDLINE | ID: mdl-31590312

RESUMEN

Background: The Bishesta campaign is a menstrual hygiene management (MHM) intervention developed to meet the specific needs of people with intellectual impairments and their carers. It was designed and delivered in the Kavre district, Nepal. This paper explores the campaign's feasibility and acceptability. Methods: The Bishesta campaign was delivered to ten people with an intellectual impairment and their eight carers. Data on the feasibility and acceptability of the intervention was collected through: Structured questionnaire to participants before and after the intervention, process monitoring data, post-intervention in-depth interviews with all carers, observation of people with intellectual impairments, key informant interviews with all facilitators and staff involved in the campaign, as well as ranking of the perceived appropriateness and acceptability of campaign components by carers and facilitators. Results: The Bishesta campaign was acceptable for the target groups, facilitators, and implementers. It was largely delivered with fidelity. Participants used most of the campaign components; these made the target behaviours attractive and enabled participants to carry them out with ease. There were improvements across all target behaviours. The focus of this study was feasibility, not limited-efficancy; however, indicative positive outcomes from this small sample were observed, such as an increase in young people's levels of confidence, comfort, and autonomy during menstruation. Conclusion: Within the sample, the Bishesta campaign appears to be a feasible intervention to ensure that one of the groups most vulnerable to exclusion from MHM interventions is not left behind.


Asunto(s)
Cuidadores/educación , Educación de las Personas con Discapacidad Intelectual/organización & administración , Higiene/normas , Menstruación , Adolescente , Analgésicos/uso terapéutico , Países en Desarrollo , Estudios de Factibilidad , Femenino , Productos para la Higiene Femenina , Humanos , Nepal , Adulto Joven
9.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(5): 1194-1201, out.-dez. 2019. tab
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1022257

RESUMEN

Objetivo: Analisar o conhecimento de cuidadores de pacientes com câncer gástrico, identificar os principais fatores de risco em cuidadores e propor ações de educação em saúde junto aos cuidadores sobre o câncer gástrico. Método: Estudo descritivo do tipo qualitativo. A coleta de dados foi realizada por meio da entrevista semiestruturada com cuidadores de pacientes com câncer gástrico. A análise dos dados deu-se por meio da análise de conteúdo de Bardin. Resultados: Os entrevistados possuíam conhecimento insuficiente sobre a prevenção do câncer gástrico, levando a aquisição de hábitos não saudáveis, que comprometem a saúde. Conclusão: É necessário a implementação de ações educativas em todos os níveis de atenção a saúde e cabe aos profissionais a difusão de conhecimentos sobre o assunto e aos usuários a mudança de comportamentos que gerem saúde e o abandono de hábitos que contribuam para a aquisição de doenças


Objective: The study's purpose has been to scrutinize the knowledge of caregivers of patients bearing gastric cancer, to identify the main risk factors in caregivers and to propose actions of health education among caregivers regarding the gastric cancer. Methods: It is a descriptive study with a qualitative approach. Data collection was carried out through a semi-structured interview with caregivers of patients with gastric cancer. Data analysis was performed according to Bardin's perspective. Results: The interviewees had insufficient knowledge about the prevention of gastric cancer, then leading to unhealthy habits that compromise their health. Conclusion: It is necessary to implement educational engagement at all levels of health care, furthermore, it is the responsibility of professionals to disseminate knowledge about the subject, as well as it is up to users to choose behaviors that produce health rather than habits that lead to illnesses


Objetivo: Analizar el conocimiento de cuidadores de pacientes con cáncer gástrico, identificar los principales factores de riesgo en cuidadores y proponer acciones de educación en salud junto a los cuidadores sobre el cáncer gástrico. Método: Estudio descriptivo del tipo cualitativo. La recolección de datos fue realizada por medio de la entrevista semiestructurada con cuidadores de pacientes con cáncer gástrico. El análisis de los datos se dio a través del análisis de contenido de Bardin. Resultados: Los entrevistados poseían conocimiento insuficiente sobre la prevención del cáncer gástrico, llevando la adquisición de hábitos no saludables, que comprometen la salud. Conclusión: Es necesario la implementación de acciones educativas en todos los niveles de atención a la salud y corresponde a los profesionales la difusión de conocimientos sobre el tema y los usuarios el cambio de comportamientos que generan salud y el abandono de hábitos que contribuyan a la adquisición de enfermedades


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Neoplasias Gástricas , Cuidadores/educación , Prevención Secundaria/educación , Brasil , Conocimientos, Actitudes y Práctica en Salud , Educación en Salud
10.
Res Dev Disabil ; 94: 103458, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31525613

RESUMEN

BACKGROUND: People with intellectual disabilities (ID) are usually cared for by their own parents, families or informal caregivers. Caring for a person with ID can have a negative impact on caregivers' mental health (burden, depression, anxiety). The main aim of the EDUCA-IV trial was testing the efficacy of a psychoeducational intervention program (PIP) versus standard practice and to see whether the PIP intervention would reduce the caregiver's burden at post-intervention (4 months) and at follow-up (8 months). METHOD: This was a multi-centre randomised controlled trial including 194 caregivers (96 randomised to PIP, 98 to control condition). PIP intervention consists of 12 weekly group sessions. The control group received treatment as usual. Primary outcomes measured included the Zarit Burden Interview (ZBI). Secondary outcomes were caregivers' mental health (GHQ-28), anxiety (STAI) and depression (CES-D). RESULTS: The decrease of ZBI scores was not significant at 4 months. There was significant decrease in the GHQ scores at 4 and 8 months. CES-D showed relevant results at follow-up. Intention to treat analyses showed similar results. CONCLUSIONS: The PIP intervention seems not to be effective reducing burden, but appears to have a positive result on general mental health. The program was well received and valued by caregivers.


Asunto(s)
Adaptación Psicológica , Ansiedad , Cuidadores , Depresión , Educación en Salud/métodos , Discapacidad Intelectual/psicología , Calidad de Vida , Adulto , Ansiedad/etiología , Ansiedad/psicología , Cuidadores/educación , Cuidadores/psicología , Costo de Enfermedad , Depresión/etiología , Depresión/psicología , Femenino , Humanos , Análisis de Intención de Tratar , Masculino , Salud Mental , Estrés Psicológico/etiología , Estrés Psicológico/psicología
11.
J Autism Dev Disord ; 49(12): 4867-4876, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31485815

RESUMEN

The pediatric developmental passport was created to aid service navigation for children with autism spectrum disorder (ASD). A pilot-randomized-control trial was conducted at two developmental clinics. The intervention group received the Passport card versus the control group who received the placebo card. Primary outcome was the proportion of families who contacted ASD services 1-year following diagnosis. Of 40 families, 95% in the intervention group contacted services versus 70% in the control (p = 0.04). All families at the academic site contacted services; at the community site 90% in the intervention group contacted versus 40% in the control (p = 0.02). The Passport shows promise aiding families of children with ASD in service navigation, particularly at community clinics where specialist follow-up is not readily available.


Asunto(s)
Trastorno del Espectro Autista/terapia , Terapia Conductista/métodos , Educación del Paciente como Asunto/métodos , Participación del Paciente/métodos , Trastorno del Espectro Autista/rehabilitación , Cuidadores/educación , Cuidadores/psicología , Niño , Preescolar , Femenino , Humanos , Masculino , Padres/educación , Padres/psicología
12.
Br J Community Nurs ; 24(Sup9): S12-S18, 2019 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-31479335

RESUMEN

Skin tears commonly occur at the extremes of age and are associated with skin changes in ageing skin. They are considered to be acute wounds caused by mechanical forces, such as blunt trauma. While the true prevalence and incidence of skin tears is unknown, the available evidence suggests that these wounds occur in all healthcare settings. Importantly, skin tears are preventable with the implementation of a risk-reduction programme, which includes twice-daily skin moisturisation. Where these injuries do occur, it is important to categorise the extent of damage as well as to choose the most appropriate dressing to avoid adding any risks for further trauma.


Asunto(s)
Vendajes , Laceraciones/prevención & control , Cuidados de la Piel , Piel/lesiones , Cuidadores/educación , Humanos , Laceraciones/enfermería , Educación del Paciente como Asunto , Ropa de Protección
13.
Home Healthc Now ; 37(5): 273-280, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31483359

RESUMEN

Family caregivers can benefit from education-based wellness programs, but many face barriers to attending such programs. The purpose of this research was to explore telehealth as a delivery format for an education-based caregiver wellness program. This qualitative research examined the caregiver experience of a specific program called Powerful Tools for Caregivers (PTC). The traditionally in-person program was delivered via telehealth in four states. Twelve caregivers participated in focus groups the week after completing the telehealth PTC program. Three major themes emerged from the focus groups: Knowledge Gained, Interrelatedness, and Technology Pros and Cons. All affirmed a positive experience of the telehealth delivered PTC program. Participants expressed gratitude for the opportunity to participate in the program and knowledge gained including relaxation techniques, communication skills, resources to support caregiving, and goal setting for self-care. Furthermore, participants were appreciative of the opportunity to connect with other caregivers from the comfort of their home.


Asunto(s)
Cuidadores/educación , Promoción de la Salud , Accesibilidad a los Servicios de Salud , Telemedicina/métodos , Adulto , Anciano , Femenino , Grupos Focales , Promoción de la Salud/organización & administración , Humanos , Masculino , Persona de Mediana Edad
14.
J Stroke Cerebrovasc Dis ; 28(11): 104318, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31416761

RESUMEN

BACKGROUND: Recent studies estimate nearly half of the US population can access mobile medical applications (apps) on their smartphones. The are no systematic data available on apps focused on stroke survivors/caregivers. OBJECTIVE: To identify apps (a) designed for stroke survivors/caregivers, (b) dealing with a modifiable stroke risk factor (SRF), or (c) were developed for other purposes but could potentially be used by stroke survivors/caregivers. METHODS: A systematic review of the medical apps in the US Apple iTunes store was conducted between August 2013 and January 2016 using 18 predefined inclusion/exclusion criteria. SRFs considered were: diabetes, hypertension, smoking, obesity, atrial fibrillation, and dyslipidemia. RESULTS: Out of 30,132 medical apps available, 843 (2.7%) eligible apps were identified. Of these apps, (n = 74, 8.7%) apps were specifically designed for stroke survivors/caregivers use and provided the following services: language/speech therapy (n = 28, 37%), communication with aphasic patients (n = 19, 25%), stroke risk calculation (n = 11, 14%), assistance in spotting an acute stroke (n = 8, 10%), detection of atrial fibrillation (n = 3, 4%), direction to nearby emergency room (n = 3, 4%), physical rehabilitation (n = 3, 4%), direction to the nearest certified stroke center (n = 1, < 2%), and visual attention therapy (n = 1, <2%). 769 apps identified that were developed for purposes other than stroke. Of these, the majority (n = 526, 68%) addressed SRFs. CONCLUSIONS: Over 70 medical apps exist to specifically support stroke survivors/caregivers and primarily targeted language and communication difficulties. Apps encompassing most stroke survivor/caregiver needs could be developed and tested to ensure the issues faced by these populations are being adequately addressed.


Asunto(s)
Cuidadores/educación , Cuidadores/psicología , Conocimientos, Actitudes y Práctica en Salud , Aplicaciones Móviles , Educación del Paciente como Asunto , Teléfono Inteligente , Rehabilitación de Accidente Cerebrovascular/instrumentación , Accidente Cerebrovascular/terapia , Telemedicina/instrumentación , Conductas Relacionadas con la Salud , Humanos , Factores Protectores , Factores de Riesgo , Conducta de Reducción del Riesgo , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/psicología , Resultado del Tratamiento
15.
BMC Public Health ; 19(1): 1156, 2019 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-31438901

RESUMEN

BACKGROUND: Choking is one of the leading causes of death among unintentional injuries in young children. Food choking represents a considerable public health burden, which might be reduced through increased effective preventative education programs. We present a protocol for a community intervention trial termed CHOP (CHOking Prevention project) that aimed to teach Italian families how to prevent food choking injuries and increase knowledge relating to nutrition. METHODS: Italian educational facilities were enrolled. Stratified randomization blocked by geographical area was performed. Each stratum was randomized to one of three different intervention strategies or to a control group. Educational intervention was delivered in the schools by experts and certified trainers as per the following three intervention strategies: directly to families (Strategy A); to teaching staff only, who subsequently delivered the same educational intervention to families (Strategy B); to health service staff only, who then delivered the educational intervention to teaching staff, who subsequently delivered the intervention to families (Strategy C). Participants completed a questionnaire about their knowledge on the topics presented during the educational interventions (pre-, post-, and follow-up of intervention). Information from the questionnaires was synthetized into 6 indicators in order to measure how effective each intervention strategy was. DISCUSSION: The issue of food choking injuries in children is relevant to public health. The protocol we present provides an opportunity to progress towards overcoming such challenges through a working model that can be implemented also in other countries. TRIAL REGISTRATION: ClinicalTrials.gov NCT03218618. The study was registered on 14 July 2017.


Asunto(s)
Obstrucción de las Vías Aéreas/prevención & control , Cuidadores/educación , Fenómenos Fisiológicos Nutricionales Infantiles , Alimentos/efectos adversos , Cuerpos Extraños/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Adolescente , Adulto , Cuidadores/estadística & datos numéricos , Preescolar , Servicios de Salud Comunitaria , Humanos , Lactante , Italia , Persona de Mediana Edad , Evaluación de Programas y Proyectos de Salud , Salud Pública , Proyectos de Investigación , Servicios de Salud Escolar , Encuestas y Cuestionarios , Adulto Joven
16.
Neonatal Netw ; 38(4): 206-216, 2019 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-31470389

RESUMEN

PURPOSE: To evaluate the effect of a NICU parent education program on parents' early language and literacy practices, and on their confidence interpreting and responding to infant signals. DESIGN: Single group, pre- and post-test, mixed-methods evaluation design. SAMPLE: One hundred and four parents and other caregivers completed questionnaires before and after the one-hour program. Ten parents participated in follow-up interviews. MAIN OUTCOME VARIABLES: Before and after sessions, participants reported on frequency of their current and intended early language and literacy practices, and their confidence interpreting and responding to infant signals. Participants also reported program satisfaction. Interview participants reported their behavior change one to two weeks later. RESULTS: The program significantly increased intention to engage in more early language and literacy practices, and increased parent-reported knowledge of how and when to interact with their infants. The majority of interviewed parents reported engaging in these practices one to two weeks later.


Asunto(s)
Cuidadores/educación , Alfabetización en Salud , Cuidado del Lactante/métodos , Unidades de Cuidado Intensivo Neonatal/organización & administración , Enfermería Neonatal/educación , Padres/educación , Adulto , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Encuestas y Cuestionarios
17.
J Clin Nurs ; 28(23-24): 4460-4470, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31408554

RESUMEN

AIM: To examine the needs, barriers and challenges experienced by family carers of people with dementia concerning the management of their care recipients' functional disabilities, and their experiences and opinions of using mobile health (mHealth) applications in health information seeking. BACKGROUND: Functional disability is a significant problem among people with dementia and management can be challenging for family carers. Evidence suggests that mHealth applications can support knowledge needs of patients and families. DESIGN: A qualitative descriptive exploratory study. METHODOLOGY: In-depth interviews were conducted with a purposive sample of family carers using a semi-structured interview guide. An inductive thematic analysis method was used. The COREQ reporting guideline was followed. RESULTS: Five spousal and five child carers participated in this study. Four key themes were identified: (a) Challenges faced that contribute to psychological distress and burden; (b) Essential role of support systems in dementia care; (c) Information and educational needs of family carers, and (d) Experiences and attitudes of mHealth applications as an educational and supportive resource. CONCLUSION: Providing functional care is demanding, challenging and stressful, and leads to carer burden. The complexity of dementia is a barrier in the organisation of functional care and access to a support network is vital to care provision. The information needs of family carers can potentially be addressed through an mHealth application. RELEVANCE TO CLINICAL PRACTICE: This study provides important information on family carers' needs, and the barriers and challenges related to functional care for people with dementia. Findings from this study can assist nurses and other health professionals in the planning of educational and supportive programs for family carers. Furthermore, the use of mHealth applications could positively contribute to the delivery of these programs.


Asunto(s)
Cuidadores/psicología , Demencia/enfermería , Familia/psicología , Telemedicina/métodos , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Cuidadores/educación , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Evaluación de Necesidades , Investigación Cualitativa
18.
Home Healthc Now ; 37(4): 198-207, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31274582

RESUMEN

Transitions of care between settings and clinicians are a time of vulnerability for patients, and can result in fragmented care, medication errors, avoidable readmissions, and patient/nurse dissatisfaction. Through the use of technology and a structured face-to-face handoff, the patient and family can be engaged in the transition across settings. The purpose of this project was to determine the feasibility and effectiveness of videoconference handoffs between inpatient, case management, and home care nurses, and the patients/families during transitions of care from hospital to home care. Videoconferences were conducted for 2 months with patients transitioning from two pediatric inpatient units to the hospital-based home care agency. The nurses and patient/family connected through a secure cloud-based videoconferencing platform. Participants discussed the patient's status, safety concerns, ongoing plan of care, what the patient/family could expect at home, and the coordination of equipment/supply needs and postdischarge visits. Videoconference handoffs (n = 10) were found to be feasible and address gaps in communication, coordination of care, and patient/family engagement during transitions from hospital to home care. Postpilot, nurses agreed the videoconference handoffs should continue with minimal modifications.


Asunto(s)
Cuidadores , Continuidad de la Atención al Paciente , Pase de Guardia , Participación del Paciente , Videoconferencia , Adolescente , Cuidadores/educación , Niño , Preescolar , Comunicación , Estudios de Factibilidad , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Alta del Paciente , Participación del Paciente/métodos , Satisfacción del Paciente , Evaluación de Programas y Proyectos de Salud
19.
J Clin Nurs ; 28(23-24): 4177-4189, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31323707

RESUMEN

AIMS: To examine prevalence, types, challenges and the impact of medical/nursing tasks (MNT) on caregivers of older adults with dementia. BACKGROUND: Medical/nursing tasks have been perceived as a professional healthcare role; however, research shows that many caregivers of older adults with dementia perform those tasks in the home, such as giving injections, tube feedings or operation of medical equipment. Little is known about the caregivers' challenges in engaging in these MNT. DESIGN: Integrative review. METHODS: Ovid MEDLINE, CINAHL, PsycINFO and Web of Science databases were searched to explore MNT among caregivers of older adults with dementia who lived in a community setting. Four quantitative and nine qualitative studies published between 1980-2018 were included. Overall, process of the review was guided by PRISMA. RESULTS: About 67% of U.S. caregivers of older adults with dementia performed MNT, including managing multiple medications, wound care and nutritional management. Care recipients' cognitive impairment complicated the provision of those tasks due to their limited cognitive functioning, behavioural changes, comorbidities and complex medication regimen. Insufficient information and training from healthcare professionals as well as caregivers' age and their own health problems made performance of those tasks even more challenging. As a result, caregivers frequently suffered from emotional distress such as worrying, anxiety and sleep disturbance. CONCLUSIONS: Medical/nursing tasks have become one of the daily tasks of caregivers of older adults with dementia within the home. However, the tasks are difficult and complicated, and inadequate support from healthcare professionals may compromise the caregivers' well-being. RELEVANCE TO CLINICAL PRACTICE: Healthcare professionals should provide education and should be aware of caregivers' needs related to MNT. Structured-medical information, skill-based instructions and hands-on training may be beneficial to decrease the caregivers' distress from MNT.


Asunto(s)
Cuidadores/psicología , Demencia/enfermería , Anciano , Cuidadores/educación , Humanos , Rol de la Enfermera , Investigación Cualitativa , Revisiones Sistemáticas como Asunto
20.
Am J Health Syst Pharm ; 76(6): 366-373, 2019 Feb 21.
Artículo en Inglés | MEDLINE | ID: mdl-31361837

RESUMEN

PURPOSE: The effectiveness of an asthma question prompt list with video intervention to increase question-asking during pediatric office visits among youth who reported medication problems was evaluated. METHODS: English- or Spanish-speaking youth age 11-17 years with persistent asthma and their caregivers were enrolled from 4 pediatric clinics in a randomized controlled trial. Youth were randomized to intervention or usual care groups. Youth in the intervention group watched an educational video with their caregivers on an iPad. The youth then received a 1-page asthma question prompt list to complete before their visits. The audio of all baseline medical visits was recorded. Youth were interviewed and caregivers completed questionnaires at baseline and 6 months later. RESULTS: A total of 40 providers and 359 of their patients participated. Youth who reported at least 1 medication problem who were in the intervention group were significantly more likely to ask 1 or more questions about medications during their visits than youth in the usual care group (odds ratio = 3.1, 95% confidence interval = 2.0, 4.1). Seventy-four percent of youth and 71% caregivers who reported the youth had problems using asthma medications at baseline still reported 1 or more problems 6 months later. CONCLUSION: Among youth who reported 1 or more problems with using their asthma medications, the intervention significantly increased youth question-asking. Many youth- and caregiver-reported problems with using asthma medications persisted over time.


Asunto(s)
Antiasmáticos/uso terapéutico , Asma/tratamiento farmacológico , Cuidadores/educación , Educación del Paciente como Asunto , Participación del Paciente , Adolescente , Adulto , Niño , Comunicación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Visita a Consultorio Médico , Relaciones Profesional-Paciente , Encuestas y Cuestionarios , Grabación en Video
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