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1.
Sultan Qaboos Univ Med J ; 19(1): e4-e10, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31198588

RESUMEN

This review aimed to examine the literature related to non-medical strategies used to improve pregnancy outcomes of women with gestational diabetes mellitus (GDM) and to determine the risk of bias of the selected studies. Treatment for GDM is changing due to the increased prevalence of GDM-related maternal and neonatal complications. A growing body of evidence suggests that early detection, aggressive monitoring and management of GDM using non-medical strategies can greatly improve outcomes for pregnant women and their babies. PubMed® (National Library of Medicine, Bethesda, Maryland, USA), Cumulative Index to Nursing and Allied Health Literature® (EBSCO Information Services, Ipswich, Massachusetts, USA), SCOPUS® (Elsevier, Amsterdam, Netherlands) and other electronic databases were searched for relevant literature published between 2005-2015. A total of 15 studies on women with GDM that met the inclusion criteria were included in this review and assessment of risk of bias was performed for each study. The results of the studies were consistent with findings of significant improvement in maternal and neonatal outcomes when diet was combined with moderate exercise, self-monitoring of blood glucose and individualised health education. Future intervention studies in this area should be focussed on identifying and implementing factors that enhance and encourage adherence to the healthy behaviours mentioned above.


Asunto(s)
Diabetes Gestacional/terapia , Complicaciones del Embarazo/prevención & control , Resultado del Embarazo , Diabetes Gestacional/psicología , Dietoterapia/psicología , Ejercicio/psicología , Femenino , Humanos , Embarazo , Complicaciones del Embarazo/psicología , Complicaciones del Embarazo/terapia
2.
Artículo en Inglés | MEDLINE | ID: mdl-30332977

RESUMEN

The pathophysiology of the intervertebral discs plays a significant role in the people's life quality. There is not adequate research done in the pathogenesis and treatment of intervertebral disc degeneration. Alternately, self-educated physiology offers a novel and noninvasive method to reverse the degenerated discs. In this single case study, report attempts have been made to highlight the effect of the self-educative physiology, on magnetic resonance imaging investigations, of progressive healing, on the degenerated intervertebral discs. Based on this novel method, an effort has been made to review literature on the degeneration of intervertebral discs and available mode of treatments and then to propose a hypothesis for the biochemical mechanisms of healing. The idea is that transforming growth factor-ß1 from seminal plasma secretions may contribute to releasing the osteogenic protein- 1 which induces nucleus pulposus and annulus fibrosus cells in intervertebral discs for repairs. In addition, the patient's medical history is presented with background information.


Asunto(s)
Degeneración del Disco Intervertebral/diagnóstico por imagen , Degeneración del Disco Intervertebral/terapia , Disco Intervertebral/diagnóstico por imagen , Vértebras Lumbares/diagnóstico por imagen , Terapias Mente-Cuerpo/métodos , Dietoterapia/métodos , Dietoterapia/psicología , Humanos , Degeneración del Disco Intervertebral/psicología , Masculino , Terapia por Relajación/métodos , Terapia por Relajación/psicología , Resultado del Tratamiento , Yoga/psicología
3.
J Ren Care ; 45(1): 41-50, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30585418

RESUMEN

BACKGROUND: Gastrointestinal (GI) symptoms are associated with poor psychosocial wellbeing among people receiving peritoneal dialysis (PD). The mind-gut axis represents one possible explanatory mechanism for this relationship. Despite existing evidence, the individual's experience of GI symptoms and their potential psychosocial consequences have not been explored. OBJECTIVE: To understand the experiences of people receiving peritoneal dialysis regarding their gastrointestinal health and psychosocial wellbeing. METHOD: Ten people undergoing automated PD (five females, five males) aged 31-77 years (Mean = 59.3, SD = 15.67) participated in a single one-on-one qualitative interview. Interviews ceased at thematic saturation. Transcripts were analysed using the framework approach. RESULTS: A central theme of Autonomy emerged from the data representing participants' experiences of the psychosocial consequences of dialysis, GI symptoms, and dietary changes. This overarched two main themes: 1) Loss of Autonomy [Sub-themes: Interference to Daily Life (Dialysis process and sleep, Impacts on relationships), Powerlessness, Frustration, Food Aversion, and Restriction (Friendships and social life, Impacts on partner)] and 2) Attempts to Gain Autonomy (Sub-themes: Coping Well, Pragmatism, and Maintaining Normality). A related sub-theme of Partner as a Carer emerged as part of Loss of Autonomy. CONCLUSION: GI symptoms and diet and fluid restrictions have psychosocial consequences resulting in multiple losses of autonomy for people receiving PD, who employ strategies to attempt to regain autonomy in the face of these issues. Dietary and GI symptom management advice should aim to enhance patient autonomy within the confines of PD therapy and thus reduce its psychosocial impacts.


Asunto(s)
Dietoterapia/psicología , Enfermedades Gastrointestinales/complicaciones , Enfermedades Gastrointestinales/psicología , Diálisis Peritoneal/psicología , Adaptación Psicológica , Adulto , Cuidadores/psicología , Dietoterapia/normas , Femenino , Humanos , Entrevistas como Asunto/métodos , Masculino , Diálisis Peritoneal/normas , Autonomía Personal , Australia del Sur
4.
J Am Coll Cardiol ; 72(23 Pt B): 2951-2963, 2018 12 11.
Artículo en Inglés | MEDLINE | ID: mdl-30522630

RESUMEN

Reduction in excess calories and improvement in dietary composition may prevent many primary and secondary cardiovascular events. Current guidelines recommend diets high in fruits, vegetables, whole grains, nuts, and legumes; moderate in low-fat dairy and seafood; and low in processed meats, sugar-sweetened beverages, refined grains, and sodium. Supplementation can be useful for some people but cannot replace a good diet. Factors that influence individuals to consume a low-quality diet are myriad and include lack of knowledge, lack of availability, high cost, time scarcity, social and cultural norms, marketing of poor-quality foods, and palatability. Governments should focus on cardiovascular disease as a global threat and enact policies that will reach all levels of society and create a food environment wherein healthy foods are accessible, affordable, and desirable. Health professionals should be proficient in basic nutritional knowledge to promote a sustainable pattern of healthful eating for cardiovascular disease prevention for both healthy individuals and those at higher risk.


Asunto(s)
Enfermedades Cardiovasculares/dietoterapia , Enfermedades Cardiovasculares/prevención & control , /métodos , Promoción de la Salud/métodos , Enfermedades Cardiovasculares/psicología , Dietoterapia/métodos , Dietoterapia/psicología , /psicología , Dieta Mediterránea/psicología , Dieta Occidental/efectos adversos , Dieta Occidental/psicología , Ingestión de Energía/fisiología , Conducta Alimentaria/fisiología , Conducta Alimentaria/psicología , Humanos
5.
Medicine (Baltimore) ; 97(50): e13632, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30558051

RESUMEN

BACKGROUND: Health education has been considered as the effectiveness method to increase the self-care skills of diabetes patients. However, limited studies to investigate the association of health education via Wechat platform on increased the basic self-care skills and glycemic control rate in patients with type 2 diabetes. METHODS: A total number of 120 type 2 diabetes patients were randomized into intervention (health education by Wechat platform plus usual care) and the control group (usual care). Biochemical parameters including fasting plasma glucose (FPG), 2-hour plasma glucose (2hPG), glycosylated hemoglobin A1c (HbA1c) were measured among the 2 groups at baseline 6-month and 12-month. Diabetes Management Self-Efficacy (SE) Scale was completed at baseline 6-month and 12-month. RESULTS: Significant difference of HbA1c concentration and SE were found between intervention and control groups at 6-month and 12-month (P <.05). The effect of groups and health education duration times was found on reduced HbA1c concentration and increased the total score of SE (P <.05). No significant difference of FPG and 2hPG concentrations were found between intervention and control groups at 6 months and 12 months (P >.05). CONCLUSION: Health education of diabetic individuals via Wechat platform in conjunction with conventional diabetes treatment could improve glycemic control and positively influence other aspects of diabetes self-care skills.


Asunto(s)
Automonitorización de la Glucosa Sanguínea/métodos , Diabetes Mellitus Tipo 2 , Hemoglobina A Glucada/análisis , Educación del Paciente como Asunto/métodos , Autocuidado , Adulto , Glucemia/análisis , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/psicología , Diabetes Mellitus Tipo 2/terapia , Dietoterapia/métodos , Dietoterapia/psicología , Ejercicio , Femenino , Humanos , Masculino , Cumplimiento de la Medicación , Persona de Mediana Edad , Autocuidado/métodos , Autocuidado/psicología , Resultado del Tratamiento
6.
Complement Ther Clin Pract ; 33: 118-123, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30396608

RESUMEN

OBJECTIVE: The aims of the survey were to determine: (i) the percentage of fish oil supplement users in a sample population; (ii) why people take fish oil supplements; (iii) where fish oil supplements are stored as well as the average daily dosage; (iv) what dietary and lifestyle behaviours are associated with fish oil supplement use. DESIGN: An online cross-sectional survey. SETTING: New Zealand. RESPONDENTS: A total of 334 New Zealand residents over the age of 18. RESULTS: Fish oil supplements were taken by 21.9% of respondents. Reasons for taking fish oil supplements were - 72.6% for 'general well-being', 54.8% to 'improve brain function', 31.5% for 'pain/inflammation', 12.3% to 'lower cholesterol levels' and 11% for 'a dietary insufficiency'. Approximately 26% of fish oil users reported taking a dose of fish oil supplements that would meet the recommended daily intake of 400-600 mg combined docosahexaenoic acid and eicosapentaenoic acid, and only 6.8% of fish oil users reported storing their fish oil supplements in the refrigerator. After controlling for other characteristics including age, gender, ethnicity and body mass index, fish oil supplementation use was most likely among respondents who already eat oily fish and least likely in respondents who regularly eat nuts and seeds. CONCLUSIONS: Fish oil supplements are a commonly used supplement in New Zealand, yet questions remain about the role of these supplements in improving health outcomes. Safety issues related to manufacturing and storage conditions indicate that there is an urgency in answering these questions.


Asunto(s)
Actitud Frente a la Salud , Suplementos Dietéticos , Ácidos Docosahexaenoicos/farmacología , Ácido Eicosapentaenoico/farmacología , Aceites de Pescado , Adulto , Estudios Transversales , Dietoterapia/métodos , Dietoterapia/psicología , Femenino , Aceites de Pescado/farmacología , Aceites de Pescado/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Nueva Zelanda/epidemiología
7.
J Ren Care ; 44(4): 238-250, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30259677

RESUMEN

BACKGROUND: Dietary modification is an integral part of chronic kidney disease (CKD) management. However, adherence to the renal diet is often suboptimal. METHODS: The aims of this study were to (i) describe the experiences of patients with CKD and their carers in their process of interpreting and implementing renal dietary advice; (ii) to explore strategies they used to make sense of and apply renal diet information and (iii) to develop recommendations for improved clinical practice. To achieve these aims, individual semi-structured interviews with 26 patients and 10 carers were conducted, using interview questions guided by Sensemaking theory. FINDINGS: Six themes emerged from the data which did not differ according to CKD stage, geographic location or renal replacement therapy (RRT) type. The renal diet was perceived by patients and carers to be overwhelming, frustrating and emotionally demanding; as well as being complex and challenging. To help make sense of and apply renal dietary advice, participants highly valued the input of the dietitian; and patients believed that their carer support was important. Individual problem-solving strategies were developed by participants to help them make sense of the renal diet, and many of them expressed a desire for additional resources and/or support. CONCLUSIONS: This study highlights that learning to make sense of renal diet information is an emotionally challenging journey for patients and carers. In addition to utilising the expertise of dietitians, carer support was perceived to be integral to learning and using renal dietary advice. The study describes a number of important problem-solving strategies utilised by patients and carers, as well as recommendations to help improve sensemaking and adherence to the renal diet.


Asunto(s)
Cuidadores/psicología , Dietoterapia/normas , Política Nutricional/tendencias , Pacientes/psicología , Insuficiencia Renal Crónica/dietoterapia , Adulto , Anciano , Anciano de 80 o más Años , Dietoterapia/métodos , Dietoterapia/psicología , Femenino , Promoción de la Salud/métodos , Promoción de la Salud/normas , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Insuficiencia Renal Crónica/psicología
8.
G Ital Nefrol ; 35(5)2018 Sep.
Artículo en Italiano | MEDLINE | ID: mdl-30234240

RESUMEN

The increasing technological effectiveness has undoubtedly produced an improvement in clinical parameters of dialysis patients, but this satisfactory therapeutic result did not follow an adequate improvement in mortality or in the perception of quality of life as per patients. Furthermore, dialysis treatment is often associated with "inapparent charges" that reduce the perception of well-being, independently of clinical changes. Thirty years ago, we carried out a national survey on inapparent charges, which represent frustrating aspects that negatively affect patients' perception of their quality of life. Thirty years later, it seemed important for us to repeat the survey to understand if Italian legislative remodeling have introduced changes in procedures and social aspects of dialysis, as preservation of quality of life is an important aspect of the replacement treatment.


Asunto(s)
Síndrome Nefrótico/terapia , Pacientes/psicología , Diálisis Renal/psicología , Terapia por Quelación/psicología , Pruebas Diagnósticas de Rutina/psicología , Dietoterapia/psicología , Eritropoyetina/uso terapéutico , Frustación , Geografía Médica , Humanos , Italia , Síndrome Nefrótico/psicología , Satisfacción del Paciente , Transferencia de Pacientes , Utilización de Procedimientos y Técnicas , Calidad de Vida , Encuestas y Cuestionarios
9.
BMJ Open ; 8(9): e023073, 2018 09 19.
Artículo en Inglés | MEDLINE | ID: mdl-30232115

RESUMEN

OBJECTIVE: To examine the perspectives of adults with heart failure (HF) about numerical concepts integral to HF self-care. SETTING: This qualitative study took place at an urban academic primary care practice. PARTICIPANTS: Thirty men and women aged 47-89 years with a history of HF were recruited to participate. Eligibility criteria included: a history of HF (≥1 year), seen at the clinic within the last year, and a HF hospitalisation within the last 6 months. Non-English speakers and those with severe cognitive impairment were excluded. METHODS: In-depth semistructured interviews were conducted. Participants were interviewed about numeracy across three domains of HF self-care: (1) monitoring weight,(2) maintaining a diet low in salt and (3) monitoring blood pressure. Interviews were audio-taped, transcribed verbatim and analysed using grounded theory and word cloud techniques. RESULTS: Five key themes reflecting participants' attitudes towards numerical concepts pertaining to weight, diet and blood pressure were identified: (1) Communication between healthcare providers and patients is a complex, multistage process; (2) Patients possess a wide range of knowledge and understanding; (3) Social and caregiver support is critical for the application of numerical concepts; (4) Prior health experiences shape outlook towards numerical concepts and instructions and (5) Fear serves as a barrier and a facilitator to carrying out HF self-care tasks that involve numbers. The findings informed a theoretical framework of health numeracy in HF. CONCLUSION: Effective communication of numerical concepts which pertain to HF self-care is highly variable. Many patients with HF lack basic understanding and numeracy skills required for adequate self-care. As such, patients rely on caregivers who may lack HF training. HF-specific training of caregivers and research that seeks to elucidate the intricacies of the patient-caregiver relationship in the context of health numeracy and HF self-care are warranted.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Dietoterapia , Insuficiencia Cardíaca , Vida Independiente/psicología , Autocuidado , Anciano , Anciano de 80 o más Años , Actitud , Monitoreo Ambulatorio de la Presión Arterial/psicología , Monitoreo Ambulatorio de la Presión Arterial/estadística & datos numéricos , Comprensión , Dietoterapia/psicología , Dietoterapia/estadística & datos numéricos , Femenino , Teoría Fundamentada , Insuficiencia Cardíaca/epidemiología , Insuficiencia Cardíaca/psicología , Insuficiencia Cardíaca/rehabilitación , Humanos , Masculino , Matemática , Persona de Mediana Edad , Prioridad del Paciente , Investigación Cualitativa , Autocuidado/métodos , Autocuidado/psicología , Autocuidado/estadística & datos numéricos , Apoyo Social , Estados Unidos/epidemiología
10.
Midwifery ; 63: 1-7, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29751291

RESUMEN

INTRODUCTION: Excessive gestational weight gain, regardless of initial BMI, is associated with perinatal risks for both mother and offspring and contributes to obesity in women. Studies report that healthcare professionals find it difficult to communicate about weight and pregnant women perceive healthcare professionals as unconcerned, leaving many women uninformed about weight recommendations and risks. We aimed to explore how midwives approach communication about gestational weight gain recommendations, and to characterize communication barriers and facilitators. METHODS: Seventeen midwives from different areas in Sweden were interviewed by a therapist using semi-structured interviews. Interviews were transcribed verbatim and analysed by three researchers using latent content analysis. Recurrent themes were identified and formulated. RESULTS: The main theme identified in the latent part of the analysis was "midwives use avoidant behaviours to cope with fear of inflicting worries, shame or feelings of guilt in pregnant women". Avoidant behaviours include: adjusting weight recommendations, toning down risks and avoid talking about weight. Subthemes identified were (I) Conflicting responsibilities in midwives' professional identity (II) Perceived deficiencies in the working situation. CONCLUSION: Midwives' empathy and awareness of weight stigma strongly affects communication about weight with pregnant women, and midwives' use of avoidant behaviours constitutes salient information barriers. More research is needed on whether gestational weight guidelines and weighing routines for all women, resources for extra visits, training in specific communication skills and backup access to other professions can facilitate for midwives to initiate and communicate about healthy gestational weight development, enabling more pregnant women to make well-informed lifestyle choices.


Asunto(s)
Comunicación , Dietoterapia/psicología , Enfermeras Obstetrices/psicología , Mujeres Embarazadas/psicología , Vergüenza , Adulto , Actitud del Personal de Salud , Índice de Masa Corporal , Mantenimiento del Peso Corporal , Dietoterapia/métodos , Femenino , Conductas de Riesgo para la Salud , Humanos , Entrevistas como Asunto/métodos , Atención Perinatal/métodos , Embarazo , Investigación Cualitativa , Suecia
11.
J Hum Nutr Diet ; 31(3): 337-348, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29543356

RESUMEN

BACKGROUND: A tailored approach to nutrition and physical activity advice can support women following childbirth in managing barriers (i.e. time and childcare) to making healthy lifestyle changes. The aim of the present study was to evaluate the implementation, acceptability and preliminary efficacy of a personally tailored nutrition and exercise programme for postpartum women delivered via video-consultations by an accredited practising dietitian (APD) and accredited exercise physiologist (AEP). METHODS: In this feasibility study (VITAL change for mums), postpartum (3-12 months) women (body mass index ≥25 or >2 kg above pre-pregnancy weight) who were seeking to achieve a healthy weight participated in a single-arm intervention. Participants received up to five real-time personalised video-consultations (2 × APD, 2 × AEP, 1 × either) over the 8-week intervention period. Implementation (recruitment, retention, utilisation), acceptability (participant satisfaction) and preliminary efficacy (anthropometry, dietary intake, cardiovascular fitness, physical activity level, psychological wellbeing) were assessed. RESULTS: Thirty women [mean (SD) age 31.6 (3.1) years, body mass index 29.0 (4.0) kg m-2 , 100% married/de facto, 80% university level education] were recruited within 10 days and 27 completed the study. Women's mean (SD) ratings (out of a score of 5) indicated satisfaction with the video-consultations [4.4 (0.9)] and the online setting [4.5 (0.8)]. Women agreed that accessing an APD [4.4 (0.8)] and AEP [4.3 (0.9)] was easier using video-consultations than attending an in-person consultation. Statistically significant improvements in waist circumference, body composition, cardiorespiratory fitness, dietary intake and physical activity were observed from baseline to 8 weeks. CONCLUSIONS: The findings of the present study suggest that a nutrition and exercise intervention delivered by qualified health professionals via video-consultations is feasible, acceptable and achieves positive outcomes for women following childbirth.


Asunto(s)
Dietoterapia/métodos , Dietética/métodos , Terapia por Ejercicio/métodos , Periodo Posparto , Consulta Remota/métodos , Adulto , Índice de Masa Corporal , Dietoterapia/psicología , Terapia por Ejercicio/psicología , Estudios de Factibilidad , Femenino , Implementación de Plan de Salud , Estilo de Vida Saludable , Humanos , Nueva Gales del Sur , Aceptación de la Atención de Salud , Embarazo , Resultado del Tratamiento , Grabación de Cinta de Video
12.
Behav Pharmacol ; 29(2 and 3-Spec Issue): 140-151, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29543648

RESUMEN

As the influence of diet on health may take place over a period of decades, there is a need for biomarkers that help to identify those aspects of nutrition that have either a positive or a negative influence. The evidence is considered that heart-rate variability (HRV) (the time differences between one beat and the next) can be used to indicate the potential health benefits of food items. Reduced HRV is associated with the development of numerous conditions for example, diabetes, cardiovascular disease, inflammation, obesity and psychiatric disorders. Although more systematic research is required, various aspects of diet have been shown to benefit HRV acutely and in the longer term. Examples include a Mediterranean diet, omega-3 fatty acids, B-vitamins, probiotics, polyphenols and weight loss. Aspects of diet that are viewed as undesirable, for example high intakes of saturated or trans-fat and high glycaemic carbohydrates, have been found to reduce HRV. It is argued that the consistent relationship between HRV, health and morbidity supports the view that HRV has the potential to become a widely used biomarker when considering the influence of diet on mental and physical health.


Asunto(s)
Dieta/psicología , Frecuencia Cardíaca/efectos de los fármacos , Frecuencia Cardíaca/fisiología , Biomarcadores/sangre , Enfermedades Cardiovasculares , Dieta/métodos , Dietoterapia/métodos , Dietoterapia/psicología , Humanos , Estado Nutricional/fisiología , Obesidad
13.
Contemp Clin Trials ; 68: 72-78, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29563043

RESUMEN

BACKGROUND: Engaging in health-promoting behaviors (e.g., healthy fruit- and vegetable-rich diet, physical activity) and living in supportive social and built environments are consistently and significantly associated with reductions in cancer, heart disease, diabetes, and other chronic diseases. Interventions to change diet and physical activity behaviors should aim to educate individuals, change the environments in which people live, work and recreate, improve access, availability, and affordability of healthy foods, and create safe places the facilitate active lifestyles. This trial will assess whether community gardening increases fruit and vegetable consumption and physical activity, improves social support and mental health, and reduces age-associated weight gain and sedentary time among a multi-ethnic, mixed-income population. METHODS/DESIGN: A randomized controlled trial of community gardening began in Denver, Colorado in January 2017. Over 3 years, we will recruit 312 consenting participants on Denver Urban Gardens' waitlists and randomize them to garden or remain on the waitlist. At baseline (pre-gardening), harvest time, and post-intervention, study participants will complete three 24-hour dietary recalls, a 7-day activity monitoring period using accelerometry, a health interview and physical anthropometry. DISCUSSION: This project addresses health-promoting behaviors among a multi-ethnic, mixed-income adult population in a large metropolitan area. If successful, this trial will provide evidence that community gardening supports and sustains healthy and active lifestyles, which can reduce risk of cancer and other chronic diseases. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03089177: Registered on 03/17/17.


Asunto(s)
Participación de la Comunidad , Dietoterapia , Jardinería/métodos , Conductas Relacionadas con la Salud , Promoción de la Salud/métodos , Servicios Preventivos de Salud , Adulto , Participación de la Comunidad/métodos , Participación de la Comunidad/psicología , Dietoterapia/métodos , Dietoterapia/psicología , Ejercicio , Femenino , Frutas , Estilo de Vida Saludable , Humanos , Masculino , Salud Mental , Servicios Preventivos de Salud/métodos , Servicios Preventivos de Salud/organización & administración , Apoyo Social , Verduras
14.
Clin Gerontol ; 41(4): 326-334, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29221431

RESUMEN

OBJECTIVES: This study sought to identify older patients' perceptions of primary care providers' influence on their likelihood of improving diet and physical activity. METHODS: 104 adults ages 65 and older were interviewed immediately following a routine primary care visit about their plans and motivations for behavior change and how their clinic visit would influence their likelihood of making lifestyle changes. All interviews were recorded, transcribed and analyzed using a constant comparison approach. RESULTS: Participants reported that their providers influence their health behaviors by developing strong relationships, addressing concerns and encouraging change, and providing concrete instruction. When providers did not discuss diet or physical activity, or mentioned these topics only briefly, participants often perceived the message that they should continue their current behaviors. CONCLUSIONS: Whether and how diet and physical activity are discussed in primary care influences the likelihood that older adults will make changes in these behaviors. CLINICAL IMPLICATIONS: These findings highlight the need for a patient-centered counseling approach and caution providers to think twice before omitting discussion of the need for lifestyle change.


Asunto(s)
Dietoterapia/psicología , Ejercicio/psicología , Conductas Relacionadas con la Salud/fisiología , Atención Primaria de Salud/métodos , Anciano , Anciano de 80 o más Años , Dietoterapia/métodos , Femenino , Anciano Frágil/psicología , Humanos , Estilo de Vida , Masculino , Motivación/fisiología , Percepción/fisiología , Relaciones Médico-Paciente/ética , Grabación en Cinta/métodos
15.
Gerontologist ; 58(4): 749-758, 2018 07 13.
Artículo en Inglés | MEDLINE | ID: mdl-28082276

RESUMEN

Purpose: Although many older adults suffer from dysphagia and are required to eat texture-modified diets, little is known about the experiences and challenges faced in doing so at home. In this study, we explored the perspectives of community-dwelling older adults as they struggled to balance dysphagia symptoms and recommended diet modifications with their preferred lifestyles. Design and Methods: Using an interpretive descriptive design, we conducted 37 in-home semi-structured interviews and 5 member-checking interviews, participant observations during a meal, and reviewed the medical charts of 20 participants recruited through maximum variation purposeful sampling. Meaning units and codes were identified and synthesized into 4 themes. Results: Participants faced a frightening choice between eating and breathing. Hiding dysphagia symptoms from the public eye was important to preserve self-identity. Following the recommended diet created a feeling that life was "falling apart." We also found that adhering to the diet was not an "all or none" phenomenon. Implications: Given that correct adherence to the restrictive diet is rare, to effectively manage dysphagia symptoms, clinicians must appreciate the full range of impact of dysphagia and texture-modified diets on the lives of older adults.


Asunto(s)
Trastornos de Deglución , Dietoterapia , Ingestión de Alimentos , Alimentos Formulados , Anciano , Trastornos de Deglución/dietoterapia , Trastornos de Deglución/fisiopatología , Trastornos de Deglución/psicología , Dietoterapia/métodos , Dietoterapia/psicología , Ingestión de Alimentos/fisiología , Ingestión de Alimentos/psicología , Femenino , Humanos , Vida Independiente , Masculino , Apoyo Nutricional/métodos , Cooperación del Paciente , Autoimagen
16.
BMC Urol ; 17(1): 94, 2017 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-29017509

RESUMEN

BACKGROUND: The experience and acceptability of lifestyle interventions for men with localised prostate cancer are not well understood, yet lifestyle interventions are increasingly promoted for cancer survivors. We explored the opinions, experiences and perceived acceptability of taking part in nutritional and physical activity interventions amongst men with prostate cancer and their partners; with the ultimate plan to use such information to inform the development of nutritional and physical activity interventions for men with prostate cancer. METHODS: Semi-structured interviews with 16 men, and seven partners, undergoing curative surgery or radiotherapy for prostate cancer. Interviews explored experiences of lifestyle interventions, acceptable changes participants would make and perceived barriers and facilitators to change. Interviews were thematically analysed using the framework approach. RESULTS: Men were frequently open to lifestyle modification and family support was considered vital to facilitate change. Health beneficial, clinician endorsed, understandable, enjoyable interventions were perceived as attractive. Barriers included 'modern' digital technology, poor weather, competing commitments or physical limitations, most notably incontinence following radical prostatectomy. Men were keen to participate in research, with few negative aspects identified. CONCLUSIONS: Men are willing to change behaviour but this needs to be supported by clinicians and health professionals facilitating lifestyle change. An 'intention-behaviour gap', when an intended behaviour does not materialise, may exist. Digital technology for data collection and lifestyle measurement may not be suitable for all, and post-surgery urinary incontinence is a barrier to physical activity. These novel findings should be incorporated into lifestyle intervention development, and implemented clinically.


Asunto(s)
Dietoterapia/psicología , Ejercicio/psicología , Aceptación de la Atención de Salud/psicología , Prostatectomía/tendencias , Neoplasias de la Próstata/psicología , Conducta de Reducción del Riesgo , Anciano , Actitud Frente a la Salud , Ejercicio/fisiología , Humanos , Masculino , Persona de Mediana Edad , Motivación , Prostatectomía/efectos adversos , Neoplasias de la Próstata/terapia , Investigación Cualitativa , Radioterapia/efectos adversos , Radioterapia/tendencias
17.
Soc Sci Med ; 191: 125-133, 2017 10.
Artículo en Inglés | MEDLINE | ID: mdl-28917621

RESUMEN

RATIONALE: Research shows that acculturation is important to Latinas' dietary intake and related behaviors. Although evidence suggests children may also play a role, it remains unclear whether children's acculturation is related to mothers' dietary intake/behaviors. OBJECTIVES: We examined the relationship between Latino children's acculturation and mothers' dietary intake/behaviors. We also examined the mother-child acculturation gap to identify dyad characteristics associated with mothers' diet. METHODS: Baseline surveys were collected in 2010 from 314 Latino mother-child (7-13 years old) dyads of Mexican-origin enrolled in a family-based dietary intervention in Southern California, USA. Mother's daily intake of fruits, vegetables, and sugary beverages, percent of calories from fat, weekly away-from-home eating, and percent of weekly grocery dollars spent on fruits and vegetables were assessed via self-report. Mothers' and children's bidimensional acculturation were examined using acculturation groups (e.g., assimilated, bicultural) derived from Hispanic and non-Hispanic dimensions of language. We also assessed the acculturation gap between mothers and children with the a) difference in acculturation between mothers' and children's continuous acculturation scores and b) mother-child acculturation gap typologies (e.g., traditional mothers of assimilated children). RESULTS: Findings show that having an assimilated versus a bicultural child was negatively associated with mothers' vegetable intake and positively associated with mothers' sugary beverage intake, percent of calories from fat, and frequency of away-from-home eating, regardless of mothers' acculturation. Traditional mothers of assimilated children reported more sugary beverage intake, calories from fat, and more frequent away-from-home eating than traditional mothers of bicultural children. CONCLUSION: Results suggest that children's acculturation is associated with their mothers' dietary intake/behaviors and traditional mothers of assimilated children require more attention in future research.


Asunto(s)
Aculturación , Dietoterapia/psicología , Relaciones Madre-Hijo/etnología , Madres/psicología , Adolescente , Adulto , California , Niño , Dieta/etnología , Dietoterapia/métodos , Conducta Alimentaria/etnología , Conducta Alimentaria/psicología , Femenino , Humanos , Masculino , Americanos Mexicanos/psicología , México/etnología , Persona de Mediana Edad , Relaciones Madre-Hijo/psicología
19.
J Frailty Aging ; 6(3): 167-171, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28721435

RESUMEN

Cognitive decline in older adults is a major public health problem and can compromise independence and quality of life. Exercise and diet have been studied independently and have shown to be beneficial for cognitive function, however, a combined Tai Chi, resistance training, and diet intervention and its influence on cognitive function has not been undertaken. The current study used a 12-week non-randomized research design with experiment and control groups to examine the effect of a combined Tai Chi, resistance training, and diet intervention on cognitive function in 25 older obese women. Results revealed improvements in domain specific cognitive function in our sample. Baseline cognitive function was correlated with changes in dietary quality. These findings suggest that Tai Chi and resistance training combined with diet intervention might be beneficial for community-based programs aiming to improve cognitive function.


Asunto(s)
Cognición/fisiología , Dietoterapia , Fragilidad , Vida Independiente/estadística & datos numéricos , Obesidad , Calidad de Vida , Entrenamiento de Resistencia/métodos , Tai Ji , Anciano , Dietoterapia/métodos , Dietoterapia/psicología , Femenino , Fragilidad/diagnóstico , Fragilidad/fisiopatología , Fragilidad/psicología , Fragilidad/terapia , Evaluación Geriátrica/métodos , Humanos , Vida Independiente/psicología , Persona de Mediana Edad , Obesidad/psicología , Obesidad/terapia , Tai Ji/métodos , Tai Ji/psicología , Resultado del Tratamiento , Estados Unidos
20.
Contemp Clin Trials ; 59: 105-112, 2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-28600158

RESUMEN

BACKGROUND/AIMS: Few studies have examined the efficacy of recently approved medications for chronic weight management in facilitating the maintenance of lost weight. This paper provides an overview of the design and rationale for a trial investigating whether lorcaserin, when combined with behavioral weight loss maintenance sessions (WLM), will facilitate the maintenance of losses of ≥5% of initial weight. METHODS: In this two-phase trial, participants with obesity will enroll in a 14-week run-in diet program consisting of weekly group lifestyle modification sessions and a 1000-1200kcal/d meal replacement diet. Participants who complete this weight induction phase and lose at least 5% of initial weight will then be randomized to 52weeks of WLM plus lorcaserin or WLM plus placebo. We hypothesize that at 52weeks post randomization, participants assigned to WLM plus lorcaserin will achieve significantly better maintenance of the prior 5% weight loss. RESULTS: We will recruit 182 adults with obesity to participate in the diet run-in, 136 of whom (75%) are expected to become eligible for the randomized controlled trial. Co-primary outcomes include the percentage of participants who maintain a loss of at least 5% of initial weight at week 52 and change in weight (kg) from randomization to week 52. CONCLUSIONS: This two-phase design will allow us to determine the potential efficacy of chronic weight management using lorcaserin for maintaining initial losses of at least 5% body weight, induced by the use of a structured meal-replacement diet. This combined approach holds promise of achieving larger long-term weight losses. CLINICAL TRIAL REGISTRATION: NCT02388568 on ClinicalTrials.gov.


Asunto(s)
Benzazepinas/administración & dosificación , Restricción Calórica/métodos , Dietoterapia , Obesidad , Adulto , Índice de Masa Corporal , Terapia Combinada/métodos , Dietoterapia/métodos , Dietoterapia/psicología , Femenino , Estilo de Vida Saludable/fisiología , Humanos , Masculino , Persona de Mediana Edad , Obesidad/diagnóstico , Obesidad/psicología , Obesidad/terapia , Proyectos de Investigación , Pérdida de Peso
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