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1.
Washington, D.C.; PAHO; 2021-02-03. (PAHO/FPL/CLP/20-0017).
en Inglés | PAHO-IRIS | ID: phr-53245

RESUMEN

In this abridged version of the Evidence-based Clinical Practice Guidelines for the Follow-Up of at-risk neonates, we provide recommendations for the care of newborns up to 2 years of age, corresponding to the first phase of their follow-up. The recommendations are intended for all health sector staff responsible for the primary care of these neonates: general practitioners, family practitioners, pediatricians, neonatologists, pediatric ophthalmologists, pediatric otolaryngologists, nursing professionals, specialists in other fields, and multidisciplinary staff involved in the care process. The purpose of these guidelines is to facilitate policy implementation processes carried out by decision-makers and members of government bodies, and will also be useful for parents, mothers, and caregivers. The main topics covered by this document include the hospital discharge criteria, including screening tests; information and support for parents, mothers, and caregivers; screening at the follow-up visit, and the frequency of follow-ups until the infant is 2 years of age. These guidelines do not address matters related to nursing or comorbidities.


Asunto(s)
Recién Nacido , Directrices para la Planificación en Salud , Cuidado Intensivo Neonatal , Mortalidad Infantil , Recien Nacido Prematuro , Factores de Riesgo , Familia , Promoción de la Salud
2.
Holist Nurs Pract ; 35(2): 60-64, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33555718

RESUMEN

Presence of support persons enhances patient and family satisfaction. The introduction of the coronavirus disease-2019 (COVID-19) pandemic has impacted hospital operations and has reduced visitation. A virtual visitation program was implemented in critical care units to replicate visitation by video chat to ease stress on patients and family members to improve communication.


Asunto(s)
Cuidados Críticos/métodos , Telecomunicaciones/normas , Visitas a Pacientes , Actitud del Personal de Salud , /transmisión , Cuidados Críticos/tendencias , Familia/psicología , Humanos , Unidades de Cuidados Intensivos/organización & administración , Unidades de Cuidados Intensivos/tendencias , Pandemias/prevención & control , Pacientes/psicología , Telecomunicaciones/tendencias
3.
J. healthc. qual. res ; 36(1): 12-18, ene.-feb. 2021. tab
Artículo en Español | IBECS | ID: ibc-196571

RESUMEN

ANTECEDENTES Y OBJETIVO: La calidad asistencial se ha podido ver afectada por las dimensiones de la pandemia de COVID-19 y el estricto aislamiento hospitalario al que han sido sometidos los pacientes. Por ello, se plantea describir el proceso diseñado para facilitar la comunicación de los pacientes aislados con sus familias, detectar sus necesidades y realizar intervenciones individualizadas. MÉTODO: Estudio cualitativo con metodología de investigación acción, respondiendo al siguiente algoritmo: planificar la acción, diagnóstico de la necesidad e hipótesis-acción; aplicar la acción, creación del grupo de gestores de casos y formación de los miembros; observar la acción, recoger y analizar la información. Durante el mes de abril del 2020. RESULTADOS: Se realizaron 1.754 interacciones que afectaron a 490 pacientes. Los gestores de casos realizaron 767 llamadas dirigidas principalmente a facilitar información sobre el ingreso (71,45%) y cambios de ubicación o funcionamiento de las unidades (18,84%). Recibieron un total de 1.098 llamadas de familiares solicitando: información médica (43,8%), comunicación con los pacientes (18,48%), entrega de enseres personales o gestión de objetos extraviados (12,84%) e información sobre la ubicación del paciente o gestión del alta (10,20%). En el 66% de los casos las llamadas fueron resueltas por los gestores, el 30% fueron derivadas y el 4% fallidas. CONCLUSIONES: La puesta en funcionamiento del grupo de gestores de casos ha contribuido a mejorar la comunicación de los pacientes ingresados y aislados por COVID-19 con sus familias, dando respuesta a las necesidades planteadas, mejorando la calidad asistencial y favoreciendo la humanización en los cuidados


BACKGROUND AND GOAL: Quality of healthcare has been affected by the current dimensions of the COVID-19 pandemic and the strict hospital isolation to which some inpatients have been subjected. Therefore, we propose to describe the process designed to facilitate the communication of inpatients with their families to detect their needs and perform individualized treatments in each case. METHOD: Qualitative study with action research methodology, responding to the following algorithm: plan the action, diagnosis of the need and hypothesis-action; apply the action, creation of the group of case managers and training of the members; observe the action, collect and analyse the information. During the month of April 2020. RESULTS: 1,754 interactions were undertaken, that affected 490 inpatients. Case Managers made 767 calls, to provide information about admissions (71.45%), changes in inpatient location or operation of units (18.84%), among others. One thousand and ninety-eight calls from family members were received requesting medical information (43.8%), to talk to inpatients (18.48%), to deliver personal articles or manage lost objects (12.84%), and seeking information about patient location or medical discharge (10.20%). Sixty-six percent of the requests were solved by Case Managers, 30% were referred on and 4% could not be solved. CONCLUSIONS: Implementation of the Case Manager Group contributed to encourage communication of inpatients isolated due to COVID-19 with their families, responding to needs raised, improving quality of care and promoting humanization of care


Asunto(s)
Humanos , Infecciones por Coronavirus , Neumonía Viral , Pandemias , Comunicación , Sistemas de Comunicación en Hospital , Familia , Aislamiento de Pacientes , Humanización de la Atención
4.
J Occup Health ; 63(1): e12198, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33527667

RESUMEN

OBJECTIVES: The health effects of telework, which was introduced extensively in the immediate context of the COVID-19 pandemic crisis in Japan, on teleworkers, their families, and non-teleworkers, are unknown. Accordingly, we developed a rapid health impact assessment (HIA) to evaluate positive and negative health effects of telework on these groups and recommended easily implementable countermeasures. METHODS: Immediately after an emergency was declared in Japan, we implemented a rapid, five-step HIA. We screened and categorized health effects of telework for the three above-mentioned groups, extracting their content, directionality, and likelihood. Following a scoping exercise to determine the HIA's overall implementation, five experienced occupational health physicians appraised and prioritized the screened items and added new items. We outlined specific countermeasures and disseminated the results on our website. A short-term evaluation was conducted by three external occupational health physicians and three nurses. RESULTS: Following screening and appraisal, 59, 29, and 27 items were listed for teleworkers, non-teleworkers, and family members of teleworkers, respectively, covering work, lifestyle, disease and medical care, and home and community. Targeted countermeasures focused on the work environment, business management, communications, and lifestyles for teleworkers; safety and medical guidelines, work prioritization, and regular communication for non-teleworkers; and shared responsibilities within families and communication outside families for family members of teleworkers. CONCLUSION: The HIA's validity and the countermeasures' practical applicability were confirmed by the external evaluators. They can be easily applied and adapted across diverse industries to mitigate the wider negative effects of telework and enhance its positive effects.


Asunto(s)
Evaluación del Impacto en la Salud , Salud Laboral , Actitud del Personal de Salud , Comunicación , Seguridad Computacional , Ejercicio Físico , Familia , Evaluación del Impacto en la Salud/métodos , Estado de Salud , Humanos , Japón , Estilo de Vida , Seguridad , Administración del Tiempo , Trabajo/psicología , Lugar de Trabajo/organización & administración
5.
Artículo en Inglés | MEDLINE | ID: mdl-33578678

RESUMEN

The COVID-19 emergency has imposed distanced education and has interrupted most rehabilitation services. Adolescents with disabilities have been isolated, and the burden on their families has been exacerbated. A cross-sectional survey was administered to adolescents with disability and to parents of disabled children to describe their experience during lockdown and their concerns or expectations about rehabilitation. A sample of 53 adolescents and 239 parents completed the survey. Adolescents were ages 13-18 years old (45.3% female). Most parents were between 35 and 55 years old (84.9% female). While 53.6% of the parents reported no positive effects of the lockdown, 92.5% of the adolescents expressed favorable consequences. The increased time spent with family members was judged positively by 27.2% of parents and by 64.2% of adolescents. Concern for their child's disability was expressed by 47.3% of parents, while 73.6% of adolescents expressed concerns regarding the ban on meeting friends. In both groups, anxiety symptoms were correlated with the fear of contracting COVID-19 and with financial problems. Parents would have liked even more remote support from school and healthcare professionals, which was available for most participants. Thus, socioeconomic support, assistive technology and telerehabilitation strategies might help families with disabilities during a lockdown.


Asunto(s)
Control de Enfermedades Transmisibles , Niños con Discapacidad/rehabilitación , Adolescente , Adulto , Estudios Transversales , Familia , Femenino , Humanos , Relaciones Interpersonales , Italia , Masculino , Persona de Mediana Edad , Pandemias , Conducta Social , Encuestas y Cuestionarios
7.
Hu Li Za Zhi ; 68(1): 97-103, 2021 Feb.
Artículo en Chino | MEDLINE | ID: mdl-33521924

RESUMEN

This case report describes a nursing care experience that applied Swanson's Caring Theory to a patient who was suffering from the rapid progression of cellulitis, which had impaired physical mobility and induced anxiety. The associated health problems, including infection, impaired physical mobility, and anxiety, were affirmed after an integrated physical, psychological, social, and spiritual assessment was conducted during the nursing care period, which lasted between March 8th and March 22nd, 2020. After Applying Swanson's Caring Theory through five caring processes, the therapeutic relationships with the patient and his family members were established and their concerns and care needs were well known. Emotional support was provided through listening and accompaniment. In addition, the patient was encouraged to participate in strength training to improve physical mobility and maintain a positive outlook. In line with this, diaphragmatic breathing, muscle relaxation, shoulder massage, and divided attention were used to reduce anxiety and to assist the patient to face life after discharge positively and optimistically. It is hoped that this case report provides medical staffs with a reference for providing care to patients suffering from cellulitis, physical impairment, and anxiety.


Asunto(s)
Celulitis (Flemón) , Empatía , Celulitis (Flemón)/terapia , Familia , Humanos
8.
BMC Palliat Care ; 20(1): 3, 2021 Jan 04.
Artículo en Inglés | MEDLINE | ID: mdl-33397361

RESUMEN

BACKGROUND: Those who survive critical illness only to become chronically critically ill (CCI) experience a high symptom burden, repeat episodes of illness exacerbation, communication barriers, and poor health outcomes. Yet, it is unclear how CCI individuals and their family understand their health and the importance of prognostic information following hospitalization. The research purpose was to examine expectations about health and disease prognosis of CCI residents in long-term care from the perspectives of the CCI themselves and their family members, as well as to describe healthcare provider (HCP) interpretations of, and reactions to, these health-related expectations. METHODS: In this qualitative interpretive descriptive study, conducted in British Columbia, Canada, 38 semi-structured interviews were conducted (6 CCI residents, 11 family members, and 21 HCPs) and inductively analyzed using thematic and constant comparative techniques. RESULTS: There was divergence in CCI resident, family and HCP expectations about health and the importance of disease prognosis, which contributed to conflict. CCI residents and family viewed conflict with HCPs in relation to their day-to-day care needs, while HCPs viewed this as arising from the unrealistically high expectations of residents and family. The CCI residents and family focussed on the importance of maintaining hope, and the HCPs highlighted the complexity of end-of-life decisions in conjunction with the high expectations and hopes of family. CONCLUSIONS: The emotional and ongoing process of formulating health-related expectations points to the need for future research to inform the development and/or adapting of existing communication, psychosocial and health services interventions to ease the burden experienced by those who are CCI.


Asunto(s)
Actitud del Personal de Salud , Actitud Frente a la Salud , Enfermedad Crónica , Enfermedad Crítica , Familia , Motivación , Adulto , Directivas Anticipadas , Canadá , Toma de Decisiones , Femenino , Esperanza , Hospitalización , Humanos , Cuidados a Largo Plazo , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Instituciones Residenciales , Respiración Artificial , Órdenes de Resucitación , Cuidado Terminal , Adulto Joven
9.
BMC Pregnancy Childbirth ; 21(1): 59, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33451292

RESUMEN

BACKGROUND: COVID-19 caused some worries among pregnant women. Worries during pregnancy can affect women's well-being. We investigated worry and well-being and associated factors among pregnant women during the COVID-19 pandemic. METHODS: This descriptive cross-sectional study was conducted on 484 pregnant women using an online questionnaire. Sampling was performed in a period between May 5 and Aug 5, 2020. Inclusion criteria were having a single healthy fetus and having no significant psychological disorder. We collected the data using the Persian versions of the World Health Organization's Well-Being Index (WHO-5 Well-Being Index) and the Cambridge Worry Scale. We used univariate and multivariate logistic regression analyses to identify predictors of women's worry and well-being. RESULTS: The mean total scores of the WHO-5 Well-Being Index and the percentage of WHO-5 score < 50 were 64.9 ± 29.0 and 24.4%, respectively. Predictors of women's worry are the increased level of fear of COVID-19 (OR = 6.40, p <  0.001), a low family income (OR = 3.41, p <  0.001), employment status (OR = 1.86, p = 0.019), nulliparity (OR = 1.68, p = 0.024), having a COVID-19 infected person among relatives (OR = 2.45, p = 0.036), having a history of abortion (OR = 1.86, p = 0.012), having participated in the study after the first wave of COVID-19 outbreak (OR = 2.328, p = 0.003), and women's age < 30 year (OR = 2.11, p = 0.002). Predictors of low level of well-being in pregnant women are worry about their own health and relationships (OR = 1.789, p = .017), worry about fetus health (OR = 1.946, p = 0.009), and having at least one infected person with COVID-19 among relatives (OR = 2.135, p = 0.036). CONCLUSIONS: The percentage of women experiencing a low well-being state was relatively high. This result is worthy of attention by health care providers and policy makers. Providing care and support to pregnant women should have high priority during the COVID-19 pandemic.


Asunto(s)
Ansiedad/psicología , Edad Materna , Salud Mental , Paridad , Mujeres Embarazadas/psicología , Estrés Psicológico/psicología , Adolescente , Adulto , Ansiedad/epidemiología , Estudios Transversales , Escolaridad , Empleo/estadística & datos numéricos , Familia , Femenino , Edad Gestacional , Humanos , Renta/estadística & datos numéricos , Internet , Irán/epidemiología , Modelos Logísticos , Persona de Mediana Edad , Análisis Multivariante , Embarazo , Estrés Psicológico/epidemiología , Encuestas y Cuestionarios , Adulto Joven
10.
Prax Kinderpsychol Kinderpsychiatr ; 70(1): 6-23, 2021 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-33459215

RESUMEN

Legal Aspects of Child Protection Several legal codes (e. g. family, social and criminal law) are of importance in child protection cases in Germany. The intention of legal codes differs between family law (relations between family members), social law (support for families) and criminal law (penal aspects). Mental health professionals have to know the prevailing legal norms concerning child-welfare. Collaborative work between medicine and youth welfare and child protection services (CPS) requires a weighing of data protection issues and the risk for the child. German child protection law provides a stepped model for health care professionals to inform CPS. This includes a careful weighing of the risk for child abuse and own competences to provide support. Medical personnel should be aware of several further legislative regulations concerning child protection issues.


Asunto(s)
Maltrato a los Niños/legislación & jurisprudencia , Maltrato a los Niños/prevención & control , Servicios de Protección Infantil/legislación & jurisprudencia , Bienestar del Niño/legislación & jurisprudencia , Niño , Familia , Alemania , Humanos
11.
Nervenarzt ; 92(1): 81-89, 2021 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-33410960

RESUMEN

In the context of intensive care medicine, patients, their relatives, and more infrequently members of the ICU team can be affected by potential trauma. Acute stress disorder often results. Psychological symptoms of critically ill patients should therefore be regularly screened in a standardized manner in order to be able to identify and treat patients with a high symptom burden. Some traumatic stressors in intensive care medicine can be reduced using trauma-sensitive communication. Psychological and psychotherapeutic interventions can complement this basic care. High quality communication with relatives contributes to a risk reduction with regard to their subsequent psychological stress. On the part of the ICU team, stress should be differentiated from potentially traumatizing events and both problem areas should be dealt with preventively. After experiencing a traumatic event during work, a procedure analogous to physical work accidents is recommended.


Asunto(s)
Medicina , Trastornos por Estrés Postraumático , Cuidados Críticos , Enfermedad Crítica , Familia , Humanos , Unidades de Cuidados Intensivos , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/terapia , Estrés Psicológico
13.
Epidemiol Psychiatr Sci ; 30: e3, 2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-33416043

RESUMEN

AIMS: Family carers supporting an individual with psychosis often experience poorer mental health, however, little is known about specific risk factors among these carers. We investigated the associations between demographic, caregiving characteristics and mental health outcomes in family carers supporting an individual with psychosis and compared carers' outcomes with general population norms. METHODS: We analysed baseline data from the COPe-support randomised controlled trial of online psychoeducation and peer support for adult carers supporting an individual with psychosis between 2018 and 2020. We collected carers' demographic and health outcome data, including wellbeing using Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS as primary outcome), quality of life using EQ-5D-5L and caregiving experience assessed with Experience of Caregiving Inventory. We tested associations between carers' demographic and caregiving characteristics for each outcome in turn and meta-analysed carers' WEMWBS and EQ-5D-5L with Health Survey England (HSE) general population data from 2016 and 2017, respectively. RESULTS: The 407 carers of people with psychosis had a mean WEMWBS score of 42.2 (s.d. 9.21) and their overall weighted pooled WEMWBS score was 7.3 (95% confidence interval (CI) -8.6 to -6.0, p < 0.01) lower than the HSE general population sample, indicating carers have poorer mental wellbeing by more than double the minimum clinically important difference of 3 points on WEMWBS. Among all caring relationships, partners had poorer wellbeing compared to parents with lower WEMWBS score (-6.8, -16.9 to 3.3, p = 0.03). Single carers had significantly poorer wellbeing (-3.6, -5.6 to -1.5, p < 0.01) and a more negative caregiving experience than those who were cohabiting. Spending more than 35 h per week caregiving increased carers' negative experience significantly (p = 0.01). CONCLUSION: Carers of people with psychosis have poorer mental health than non-carers. Partners, lone carers and those spending more than 35 h per week on caring were found to be most at risk of poor mental health. Based on the results, we advocate that the details of carers for individuals with psychosis should be added to the existing carers or severe mental illness registers at all general practitioner surgeries and for their wellbeing screened routinely. Future large-scale prospective studies are needed to develop a predictive model to determine risk factors, hence to aid early identification of carers' support needs. Such understandings are also useful to inform tailored intervention development.


Asunto(s)
Cuidadores/psicología , Familia/psicología , Salud Mental/estadística & datos numéricos , Trastornos Psicóticos/psicología , Calidad de Vida/psicología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
14.
Medicina (Kaunas) ; 57(1)2021 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-33430175

RESUMEN

Background and objectives: To explore the impacts that Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) has on the patient and their family members using the WHOQOL-BREF (Abbreviated World Health Organisation Quality of Life questionnaire) and FROM-16 (Family Reported Outcome Measure-16) quality of life assessments. Materials and Methods: A quantitative research study using postal questionnaires was conducted. A total of 39 adult volunteers expressed an interest in participating in the study: 24 returned appropriately completed questionnaires. Patients with ME/CFS completed the WHOQOL-BREF and up to four of their family members completed the FROM-16 questionnaire. Results: ME/CFS negatively affects the quality of life of the patient (median scores WHOQOL-BREF: Physical health = 19, Psychological = 44, Social relationships = 37.5, Environment = 56, n = 24) and their family members' quality of life (FROM-16: Emotional = 9.5, Personal and social = 11.5, Overall = 20.5, n = 42). There was a significant correlation between the patient's reported quality of life scores and their family members' mean FROM-16 total scores. Conclusions: This study identifies the major impact that having an adult family member with ME/CFS has on the lives of partners and of other family members. Quality of life of ME/CFS patients was reduced most by physical health compared to the other domains. Quality of life of family members was particularly impacted by worry, family activities, frustration and sadness. This highlights the importance of measuring the impact on the lives of family members using tools such as the FROM-16 in the ME/CFS clinical encounter and ensuring appropriate support is widely available to family members.


Asunto(s)
Familia/psicología , Síndrome de Fatiga Crónica/fisiopatología , Calidad de Vida , Adolescente , Adulto , Niños Adultos/psicología , Anciano , Anciano de 80 o más Años , Costo de Enfermedad , Emociones , Síndrome de Fatiga Crónica/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Padres/psicología , Esposos/psicología , Adulto Joven
15.
J Med Internet Res ; 23(2): e26254, 2021 02 03.
Artículo en Inglés | MEDLINE | ID: mdl-33468449

RESUMEN

BACKGROUND: The COVID-19 pandemic is affecting people with dementia in numerous ways. Nevertheless, there is a paucity of research on the COVID-19 impact on people with dementia and their care partners. OBJECTIVE: Using Twitter, the purpose of this study is to understand the experiences of COVID-19 for people with dementia and their care partners. METHODS: We collected tweets on COVID-19 and dementia using the GetOldTweets application in Python from February 15 to September 7, 2020. Thematic analysis was used to analyze the tweets. RESULTS: From the 5063 tweets analyzed with line-by-line coding, we identified 4 main themes including (1) separation and loss; (2) COVID-19 confusion, despair, and abandonment; (3) stress and exhaustion exacerbation; and (4) unpaid sacrifices by formal care providers. CONCLUSIONS: There is an imminent need for governments to rethink using a one-size-fits-all response to COVID-19 policy and use a collaborative approach to support people with dementia. Collaboration and more evidence-informed research are essential to reducing COVID-19 mortality and improving the quality of life for people with dementia and their care partners.


Asunto(s)
Cuidadores , Demencia , Familia , Personal de Salud , Medios de Comunicación Sociales , Aflicción , Minería de Datos , Humanos , Casas de Salud , Pandemias , Calidad de Vida , Riesgo , Estrés Psicológico , Visitas a Pacientes
16.
PLoS One ; 16(1): e0244873, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33400700

RESUMEN

BACKGROUND: Multiple studies have highlighted the negative impact of COVID-19 and its particular effects on vulnerable sub-populations. Complementing this work, here, we report on the social patterning of self-reported positive changes experienced during COVID-19 national lockdown in Scotland. METHODS: The CATALYST study collected data from 3342 adults in Scotland during weeks 9-12 of a national lockdown. Using a cross-sectional design, participants completed an online questionnaire providing data on key sociodemographic and health variables, and completed a measure of positive change. The positive change measure spanned diverse domains (e.g., more quality time with family, developing new hobbies, more physical activity, and better quality of sleep). We used univariate analysis and stepwise regression to examine the contribution of a range of sociodemographic factors (e.g., age, gender, ethnicity, educational attainment, and employment status) in explaining positive change. RESULTS: There were clear sociodemographic differences across positive change scores. Those reporting higher levels of positive change were female, from younger age groups, married or living with their partner, employed, and in better health. CONCLUSION: Overall our results highlight the social patterning of positive changes during lockdown in Scotland. These findings begin to illuminate the complexity of the unanticipated effects of national lockdown and will be used to support future intervention development work sharing lessons learned from lockdown to increase positive health change amongst those who may benefit.


Asunto(s)
/psicología , Cuarentena/psicología , Aislamiento Social/psicología , Adulto , Ansiedad/epidemiología , Ansiedad/prevención & control , /prevención & control , Control de Enfermedades Transmisibles/métodos , Estudios Transversales , Ejercicio Físico/psicología , Familia/psicología , Femenino , Humanos , Masculino , Escocia/epidemiología , Sueño/fisiología , Higiene del Sueño , Estrés Psicológico/prevención & control , Estrés Psicológico/psicología , Encuestas y Cuestionarios
18.
Artículo en Alemán | MEDLINE | ID: mdl-33415382

RESUMEN

BACKGROUND: Facilitating participation is part of the mandate of open child and youth work. This also means youths have a voice in the development of youth center offerings. The participatory health research approach can support accomplishing this mandate. OBJECTIVES: As a consequence of the municipal youth congress's demand for more autonomy so-called "Autonomous Openings" (AO) - the opening of youth centers by the youths themselves and spending their time independently - were implemented in Braunschweig, Germany. Participatory research methods were used to scientifically support the center's youths and professionals in evaluating the AOs. This paper reports on one of three contributing youth centers. STUDY DESIGN AND SETTING: After each AO the adolescents reflected on their experiences by filling in a questionnaire jointly developed by researchers and professionals. The survey was accessible via the digital tool "Mentimeter". The professionals' perspective was captured in interviews. Topics such as revealing one's personal interests and the development of competencies were the main interest. The gathered data was assessed by the researchers and reflected upon together with youths and professionals during a workshop. RESULTS: Ten AOs took place throughout a period of ten months. Five adolescents were preliminary responsible and about another 20 were co-responsible. The results show that young people revealed their own interests more substantially. Moreover, the professionals observed a strengthening of competencies in various fields. Several factors were identified that can facilitate transferability to other youth centers. Reliable relationships that enable a trusting and equal exchange between professionals and youths are essential.


Asunto(s)
Familia , Proyectos de Investigación , Adolescente , Niño , Alemania , Humanos
19.
Cochrane Database Syst Rev ; 1: CD006440, 2021 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-33417236

RESUMEN

BACKGROUND: Many people with dementia are cared for at home by unpaid informal caregivers, usually family members. Caregivers may experience a range of physical, emotional, financial and social harms, which are often described collectively as caregiver burden. The degree of burden experienced is associated with characteristics of the caregiver, such as gender, and characteristics of the person with dementia, such as dementia stage, and the presence of behavioural problems or neuropsychiatric disturbances. It is a strong predictor of admission to residential care for people with dementia. Psychoeducational interventions might prevent or reduce caregiver burden. Overall, they are intended to improve caregivers' knowledge about the disease and its care; to increase caregivers' sense of competence and their ability to cope with difficult situations; to relieve feelings of isolation and allow caregivers to attend to their own emotional and physical needs. These interventions are heterogeneous, varying in their theoretical framework, components, and delivery formats. Interventions that are delivered remotely, using printed materials, telephone or video technologies, may be particularly suitable for caregivers who have difficulty accessing face-to-face services because of their own health problems, poor access to transport, or absence of substitute care. During the COVID-19 pandemic, containment measures in many countries required people to be isolated in their homes, including people with dementia and their family carers. In such circumstances, there is no alternative to remote delivery of interventions. OBJECTIVES: To assess the efficacy and acceptability of remotely delivered interventions aiming to reduce burden and improve mood and quality of life of informal caregivers of people with dementia. SEARCH METHODS: We searched the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group, MEDLINE, Embase and four other databases, as well as two international trials registries, on 10 April 2020. We also examined the bibliographies of relevant review papers and published trials. SELECTION CRITERIA: We included only randomised controlled trials that assessed the remote delivery of structured interventions for informal caregivers who were providing care for people with dementia living at home. Caregivers had to be unpaid adults (relatives or members of the person's community). The interventions could be delivered using printed materials, the telephone, the Internet or a mixture of these, but could not involve any face-to-face contact with professionals. We categorised intervention components as information, training or support. Information interventions included two key elements: (i) they provided standardised information, and (ii) the caregiver played a passive role. Support interventions promoted interaction with other people (professionals or peers). Training interventions trained caregivers in practical skills to manage care. We excluded interventions that were primarily individual psychotherapy. Our primary outcomes were caregiver burden, mood, health-related quality of life and dropout for any reason. Secondary outcomes were caregiver knowledge and skills, use of health and social care resources, admission of the person with dementia to institutional care, and quality of life of the person with dementia. DATA COLLECTION AND ANALYSIS: Study selection, data extraction and assessment of the risk of bias in included studies were done independently by two review authors. We used the Template for Intervention Description and Replication (TIDieR) to describe the interventions. We conducted meta-analyses using a random-effects model to derive estimates of effect size. We used GRADE methods to describe our degree of certainty about effect estimates. MAIN RESULTS: We included 26 studies in this review (2367 participants). We compared (1) interventions involving training, support or both, with or without information (experimental interventions) with usual treatment, waiting list or attention control (12 studies, 944 participants); and (2) the same experimental interventions with provision of information alone (14 studies, 1423 participants). We downgraded evidence for study limitations and, for some outcomes, for inconsistency between studies. There was a frequent risk of bias from self-rating of subjective outcomes by participants who were not blind to the intervention. Randomisation methods were not always well-reported and there was potential for attrition bias in some studies. Therefore, all evidence was of moderate or low certainty. In the comparison of experimental interventions with usual treatment, waiting list or attention control, we found that the experimental interventions probably have little or no effect on caregiver burden (nine studies, 597 participants; standardised mean difference (SMD) -0.06, 95% confidence interval (CI) -0.35 to 0.23); depressive symptoms (eight studies, 638 participants; SMD -0.05, 95% CI -0.22 to 0.12); or health-related quality of life (two studies, 311 participants; SMD 0.10, 95% CI -0.13 to 0.32). The experimental interventions probably result in little or no difference in dropout for any reason (eight studies, 661 participants; risk ratio (RR) 1.15, 95% CI 0.87 to 1.53). In the comparison of experimental interventions with a control condition of information alone, we found that experimental interventions may result in a slight reduction in caregiver burden (nine studies, 650 participants; SMD -0.24, 95% CI -0.51 to 0.04); probably result in a slight improvement in depressive symptoms (11 studies, 1100 participants; SMD -0.25, 95% CI -0.43 to -0.06); may result in little or no difference in caregiver health-related quality of life (two studies, 257 participants; SMD -0.03, 95% CI -0.28 to 0.21); and probably result in an increase in dropouts for any reason (12 studies, 1266 participants; RR 1.51, 95% CI 1.04 to 2.20). AUTHORS' CONCLUSIONS: Remotely delivered interventions including support, training or both, with or without information, may slightly reduce caregiver burden and improve caregiver depressive symptoms when compared with provision of information alone, but not when compared with usual treatment, waiting list or attention control. They seem to make little or no difference to health-related quality of life. Caregivers receiving training or support were more likely than those receiving information alone to drop out of the studies, which might limit applicability. The efficacy of these interventions may depend on the nature and availability of usual services in the study settings.


Asunto(s)
/prevención & control , Cuidadores/educación , Demencia/enfermería , Afecto , Sesgo , Cuidadores/psicología , Familia , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Humanos , Institucionalización/estadística & datos numéricos , Casas de Salud/estadística & datos numéricos , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto
20.
Rev. eletrônica enferm ; 23: 1-11, 2021. tab
Artículo en Inglés, Portugués | LILACS | ID: biblio-1146858

RESUMEN

Objetivou-se avaliar se as variáveis do ambiente e as sociodemográficas e clínicas do familiar e do lactente verticalmente exposto ao Vírus da Imunodeficiência Humana (HIV) interferem nas oportunidades no domicílio para o desenvolvimento motor infantil. Estudo transversal, no Sul do Brasil, entre dezembro de 2015 a setembro de 2017, com 83 familiares e seus respectivos lactentes verticalmente expostos ao HIV, utilizando dois instrumentos: questionário do lactente e familiar e o Affordances in the Home Environment for Motor Development - Infant Scale. Análise com correlação de Pearson e Spearman e regressão linear simples. As oportunidades foram moderadamente adequadas, com associações positivas significativas entre as variáveis idade do familiar e do lactente, escolaridade e possuir irmão exposto ao HIV e as dimensões espaço físico, variedade de estimulação, brinquedos de motricidade grossa e fina. Conclui-se que as variáveis sociodemográficas do familiar e do lactente interferiram nas oportunidades para desenvolvimento motor infantil no domicílio.


The objective of this study was to evaluate whether the environment and the sociodemographic and clinical variables of the family member and the infant vertically exposed to the Human Immunodeficiency Virus (HIV) interfere in the home opportunities for infant motor development. This is a cross-sectional study, in Southern Brazil, carried out between December 2015 and September 2017, with 83 family members and their respective infants vertically exposed to HIV, using two instruments: infant and family questionnaire and the Affordances in the Home Environment for Motor Development - Infant Scale. Analysis was performed with Pearson and Spearman correlation and simple linear regression. Opportunities (affordances) were moderately adequate, with significant positive associations between the variables of age of the family member and infant, education level, and presence of a sibling exposed to HIV and the dimensions of physical space, variety of stimulation, and toys for gross and fine motor skills. We conclude that the sociodemographic variables of the family member and the infant interfered in the opportunities for infant motor development at home.


Asunto(s)
Humanos , Masculino , Femenino , Lactante , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Infecciones por VIH , Desarrollo Infantil/fisiología , Transmisión Vertical de Enfermedad Infecciosa , Ambiente , Actividad Motora/fisiología , Factores Socioeconómicos , Familia , Estudios Transversales , Encuestas y Cuestionarios , Atención Domiciliaria de Salud
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