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3.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1052936

RESUMEN

Objetivo: Descrever sobre a experiência em arte educação do Serviço Social em equipe multiprofissional, no cuidado preventivo à asma, e as mudanças sentidas pelos participantes do "Coral Voices em Superação", mediante as (inter)experiências e vivências de cantar e conviver com a asma. Método: Pesquisa qualitativa, empírica, bibliográfica e fenomenológica. Com uso de diário de campo, entrevista semiestruturada e análise de conteúdo. Participaram 14 mulheres e um homem entre 23 e 75 anos, acompanhados no Centro de Referência em Asma. Resultado: Arte educação, por meio da música, é um recurso para o assistente social potencializar a autoestima de pessoas em tratamento de asma. Conclusão: O convívio de pessoas com asma, em uma atividade de arte educação, influencia na sua qualidade de vida


Objective: The purpose of this article is to describe the experience in art education of Social Work in a multiprofessional team, in the preventive care for asthma, and the changes felt by the participants of the "Choir Voices in Overcoming", through the (inter) experiences and experiences of singing and living with to asthma. Methods: Qualitative, empirical, bibliographical and phenomenological research. Using field diary, semi-structured interview and content analysis. A total of 14 women and a man between the ages of 23 and 75 participated in the Asthma Reference Center. Results: Art education, through music, is a resource for the social worker to enhance the self-esteem of people in asthma treatment. Conclusion: The conviviality of people with asthma, in an activity of art education, influences their quality of life


Objetivo: Describir sobre la experiencia en arte educación del Trabajo Social en equipo multiprofesional, en el cuidado preventivo del asma, y los cambios sentidos por los participantes del "Coral Voices en Superación", mediante las (inter) experiencias y vivencias de cantar y convivir con el asma. Métodos: Investigación cualitativa, empírica, bibliográfica y fenomenológica. Con uso de diario de campo, entrevista semiestructurada y análisis de contenido. Participaron 14 mujeres y un hombre entre 23 y 75 años, acompañados en el Centro de Referencia en Asma. Resultado: El arte de la educación, a través de la música, es un recurso para que el asistente social potencializar la autoestima de las personas en el tratamiento del asma. Conclusión: La convivencia de personas con asma, en una actividad de arte educación, influye en su calidad de vida


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Asma/prevención & control , Servicio Social , Terapias de Arte Sensorial/métodos , Música , Grupo de Atención al Paciente , Calidad de Vida , Educación en Salud , Investigación Cualitativa
5.
Estud. pesqui. psicol. (Impr.) ; 19(3): 604-622, dez. 2019.
Artículo en Portugués | LILACS, Index Psicología - Revistas técnico-científicas | ID: biblio-1045920

RESUMEN

O presente artigo tece considerações acerca da terminologia "escuta qualificada" no contexto do Sistema Único de Assistência Social (SUAS). Com o objetivo de ampliar a instrumentalização e intervenção da Psicologia na proteção social, foi feita uma pesquisa documental e bibliográfica acerca do conceito de escuta, como ela se articula nas produções acadêmicas na área da Assistência Social e nos materiais parametrizadores da política. Foi possível identificar a presença de uma escuta diagnóstica nos parâmetros do trabalho social que entendemos encontrar-se fortemente articulada com o conceito de "exame" de Foucault (1999). Por outro lado, em diálogo com Mèlich (2001) e Larrosa (2014), consideramos outras maneiras de realizar o processo de escuta das populações atendidas na referida política pública, subvertendo a lógica de vigilância-punição.(AU)


This article discusses the term "qualified listening" in the context of the Sistema Único de Assistência Social (SUAS). In order to broaden the instrumentalization and intervention of Psychology in social protection, a documental and bibliographic research about the concept of listening was made, as it was articulated to the academic productions in the area of Social Work and in the parameterizing materials of public politics. It was possible to identify the presence of a diagnostic listening in the parameters of social work, which we believe that is strongly articulated with the concept of "examination" by Foucault (1999). On the other hand, in dialogue with Mèlich (2001) and Larrosa (2014), we considered other ways to perform the process of listening to the populations served in the referred public policy, subverting the logic of surveillance-punishment.(AU)


Este artículo aborda el término "escucha calificada" en el contexto del Sistema Unificado de Asistencia Social (SUAS). Con el fin de ampliar la instrumentalización e intervención de la psicología en la protección social, se realizó una investigación documental y bibliográfica sobre el concepto de escucha, tal como se articula en las producciones académicas en el área de asistencia social y en los materiales de parametrización de la política. Fue posible identificar la presencia de la audición diagnóstica en los parámetros del trabajo social que creemos estar fuertemente articulados con el concepto de "examen" de Foucault (1999). Por otro lado, en diálogo con Mèlich (2001) y Larrosa (2014), consideramos otras formas de llevar a cabo el proceso de escuchar a las poblaciones atendidas en la política pública referida, subvirtiendo la lógica de la vigilancia-castigo.(AU)


Asunto(s)
Servicio Social , Psicología
6.
Artículo en Ruso | MEDLINE | ID: mdl-31884767

RESUMEN

The main causes of aging of the population are decreasing of birth rate, increasing of life expectancy, increasing of mortality rate of population of able-bodied age. The continuing aging of population results in increasing of number of elderly people requiring social and medical care. The role of social service institutions is increasing. The purpose of study is to assess activities of the division's centers of social services to elderly age and disabled citizen in the Russia for 2007-2017. The article presents analysis of the indices of functioning of the centers of social support of elderly population and disabled persons in the Russian Federation. In 2007-2017 in the conditions of aging of population most of the indices of divisions of the centers of social support of elderly population and disabled persons decreased except social rehabilitation divisions and divisions of social service at home. The methods. The normative documents regulating activity of the centers of social services and their structural divisions are investigated. The indices of functioning of divisions centers of the social support of elderly population and disabled persons such as day care, temporary residence, social and rehabilitation services, social services at home, specialized social and medical services at home, urgent social services in Russia, were analyzed according to the Federal State Statistics Service (Rosstat) for period of 11 years. The analytical and statistical methods were used. Conclusion. In the Russian Federation, the last decade has been characterized by significant increase in the total proportion number of persons over working age (from 20,8 to 25,0%). At the same time, decreasing of indices of functioning of divisions of temporary residences, day care, specialized divisions of social and medical services at home, urgent social services divisions, reduction in the number of social workers centers of social services to elderly age and disabled citizens was established.


Asunto(s)
Personas con Discapacidad , Apoyo Social , Anciano , Humanos , Esperanza de Vida , Federación de Rusia , Servicio Social
7.
PLoS One ; 14(12): e0226306, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31887152

RESUMEN

BACKGROUND: Persons experiencing homelessness and vulnerable housing or those with lived experience of homelessness have worse health outcomes than individuals who are stably housed. Structural violence can dramatically affect their acceptance of interventions. We carried out a systematic review to understand the factors that influence the acceptability of social and health interventions among persons with lived experience of homelessness. METHODS: We searched through eight bibliographic databases and selected grey literature sources for articles that were published between 1994 and 2019. We selected primary studies that reported on the experiences of homeless populations interacting with practitioners and service providers working in permanent supportive housing, case management, interventions for substance use, income assistance, and women- and youth-specific interventions. Each study was independently assessed for its methodological quality. We used a framework analysis to identify key findings and used the GRADE-CERQual approach to assess confidence in the key findings. FINDINGS: Our search identified 11,017 citations of which 35 primary studies met our inclusion criteria. Our synthesis highlighted that individuals were marginalized, dehumanized and excluded by their lived homelessness experience. As a result, trust and personal safety were highly valued within human interactions. Lived experience of homelessness influenced attitudes toward health and social service professionals and sometimes led to reluctance to accept interventions. Physical and structural violence intersected with low self-esteem, depression and homeless-related stigma. Positive self-identity facilitated links to long-term and integrated services, peer support, and patient-centred engagement. CONCLUSIONS: Individuals with lived experience of homelessness face considerable marginalization, dehumanization and structural violence. Practitioners and social service providers should consider anti-oppressive approaches and provide, refer to, or advocate for health and structural interventions using the principles of trauma-informed care. Accepting and respecting others as they are, without judgment, may help practitioners navigate barriers to inclusiveness, equitability, and effectiveness for primary care that targets this marginalized population.


Asunto(s)
Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Personas sin Hogar/psicología , Confianza/psicología , Manejo de Caso , Técnica Delfos , Femenino , Humanos , Masculino , Investigación Cualitativa , Problemas Sociales , Servicio Social
8.
PLoS Med ; 16(11): e1002963, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31743335

RESUMEN

BACKGROUND: In light of the accelerating and rapidly evolving overdose crisis in the United States (US), new strategies are needed to address the epidemic and to efficiently engage and retain individuals in care for opioid use disorder (OUD). Moreover, there is an increasing need for novel approaches to using health data to identify gaps in the cascade of care for persons with OUD. METHODS AND FINDINGS: Between June 2018 and May 2019, we engaged a diverse stakeholder group (including directors of statewide health and social service agencies) to develop a statewide, patient-centered cascade of care for OUD for Rhode Island, a small state in New England, a region highly impacted by the opioid crisis. Through an iterative process, we modified the cascade of care defined by Williams et al. for use in Rhode Island using key national survey data and statewide health claims datasets to create a cross-sectional summary of 5 stages in the cascade. Approximately 47,000 Rhode Islanders (5.2%) were estimated to be at risk for OUD (stage 0) in 2016. At the same time, 26,000 Rhode Islanders had a medical claim related to an OUD diagnosis, accounting for 55% of the population at risk (stage 1); 27% of the stage 0 population, 12,700 people, showed evidence of initiation of medication for OUD (MOUD, stage 2), and 18%, or 8,300 people, had evidence of retention on MOUD (stage 3). Imputation from a national survey estimated that 4,200 Rhode Islanders were in recovery from OUD as of 2016, representing 9% of the total population at risk. Limitations included use of self-report data to arrive at estimates of the number of individuals at risk for OUD and using a national estimate to identify the number of individuals in recovery due to a lack of available state data sources. CONCLUSIONS: Our findings indicate that cross-sectional summaries of the cascade of care for OUD can be used as a health policy tool to identify gaps in care, inform data-driven policy decisions, set benchmarks for quality, and improve health outcomes for persons with OUD. There exists a significant opportunity to increase engagement prior to the initiation of OUD treatment (i.e., identification of OUD symptoms via routine screening or acute presentation) and improve retention and remission from OUD symptoms through improved community-supported processes of recovery. To do this more precisely, states should work to systematically collect data to populate their own cascade of care as a health policy tool to enhance system-level interventions and maximize engagement in care.


Asunto(s)
Trastornos Relacionados con Opioides/terapia , Trastornos Relacionados con Sustancias/terapia , Analgésicos Opioides/uso terapéutico , Protocolos Clínicos , Estudios Transversales , Sobredosis de Droga/psicología , Sobredosis de Droga/terapia , Humanos , Naltrexona/uso terapéutico , Antagonistas de Narcóticos/uso terapéutico , Tratamiento de Sustitución de Opiáceos , Rhode Island/epidemiología , Medición de Riesgo/métodos , Factores de Riesgo , Servicio Social , Participación de los Interesados , Estados Unidos/epidemiología
9.
BMC Public Health ; 19(1): 1528, 2019 Nov 14.
Artículo en Inglés | MEDLINE | ID: mdl-31727031

RESUMEN

BACKGROUND: Youth often experience unique pathways into homelessness, such as family conflict, child abuse and neglect. Most research has focused on adult homeless populations, yet youth have specific needs that require adapted interventions. This review aims to synthesize evidence on interventions for youth and assess their impacts on health, social, and equity outcomes. METHODS: We systematically searched Medline, Embase, PsycINFO, and other databases from inception until February 9, 2018 for systematic reviews and randomized controlled trials on youth interventions conducted in high income countries. We screened title and abstract and full text for inclusion, and data extraction were completed in duplicate, following the PRISMA-E (equity) review approach. RESULTS: Our search identified 11,936 records. Four systematic reviews and 18 articles on randomized controlled trials met the inclusion criteria. Many studies reported on interventions including individual and family therapies, skill-building, case management, and structural interventions. Cognitive behavioural therapy led to improvements in depression and substance use, and studies of three family-based therapies reported decreases in substance use. Housing first, a structural intervention, led to improvements in housing stability. Many interventions showed inconsistent results compared to services as usual or other interventions, but often led to improvements over time in both the intervention and comparison group. The equity analysis showed that equity variables were inconsistently measured, but there was data to suggest differential outcomes based upon gender and ethnicity. CONCLUSIONS: This review identified a variety of interventions for youth experiencing homelessness. Promising interventions include cognitive behavioural therapy for addressing depression, family-based therapy for substance use outcomes, and housing programs for housing stability. Youth pathways are often unique and thus prevention and treatment may benefit from a tailored and flexible approach.


Asunto(s)
Depresión/terapia , Relaciones Familiares , Personas sin Hogar , Jóvenes sin Hogar , Vivienda , Psicoterapia , Trastornos Relacionados con Sustancias/terapia , Adolescente , Manejo de Caso , Niño , Terapia Cognitivo-Conductual , Grupos Étnicos , Terapia Familiar , Personas sin Hogar/psicología , Humanos , Salud Mental , Factores Sexuales , Servicio Social
10.
Psicol. ciênc. prof ; 39(2,n.esp): 74-86, ago.-nov. 2019.
Artículo en Portugués | LILACS, Index Psicología - Revistas técnico-científicas | ID: biblio-1050374

RESUMEN

Este artigo busca problematizar a noção de território na saúde mental por meio da experiência de trabalhadores, usuários e pesquisadores no município de Santa Maria-RS. Trabalhamos com pesquisa de documentos do campo da saúde e da saúde mental, buscando identificar o modo que a noção de território é apresentada nesses textos. Descrevemos e analisamos uma experiência desenvolvida por diversos atores sociais envolvidos na experiência ocorrida em Santa Maria, a partir de dois movimentos. O primeiro é o de usuários em direção à academia, e o segundo, o do cuidado em saúde do serviço de referência para além dos muros. A experiência de trânsito dos diferentes atores sociais em vivências de multiterritorialidades revelou-se um importante vetor de mudança subjetiva e institucional. Vimos em ambos a emergência de uma reivindicação por um direito mais extenso do que o simples acesso aos serviços públicos de saúde. Buscava-se também um "direito à cidade", ou mesmo um trânsito além dela. Enfim, uma busca pela ampliação da experiência de multiterritorialidade e as transformações decorrentes dela...(AU)


This article seeks to problematize the notion of territory in mental health through the experience of workers, users, and researchers in the field of mental health in the municipality of Santa Maria/RS. We work with the research of documents of the field of health and mental health, trying to identify the way that the notion of territory is presented in these texts. We describe and analyze an experience developed by several social actors involved in the experience that occurred in Santa Maria / RS, from two movements. The first is that of users towards academia, and the second is that of the health care of the referral service beyond the walls. The experience of transit of the different social actors in multi-territorial experiences has proved to be an important vector of subjective and institutional change. We have seen in both movements the emergence of a claim for a more extensive right than simple access to public health services. A "right to the city," or even a transit beyond it. Finally, a search for the amplification of the multi territoriality experience and the transformations arising from it...(AU)


Este artículo busca problematizar la noción de territorio en la salud mental por medio de la experiencia de trabajadores, usuarios e investigadores en el municipio de Santa Maria/RS. Trabajamos con la investigación de documentos del campo de la salud y de la salud mental, buscando identificar el modo que la noción de territorio es presentada en esos textos. Describimos y analizamos una experiencia desarrollada por diversos actores sociales involucrados en la experiencia ocurrida en Santa Maria/RS, a partir de dos movimientos. El primero es de los usuarios hacia la academia, y el segundo es del cuidado en salud del servicio de referencia más allá de los muros. La experiencia de tránsito de los diferentes actores sociales en vivencias de multiterritorialidades se ha revelado un importante vector de cambio subjetivo e institucional. Vimos en ambos la emergencia de una reivindicación por un derecho más extenso que el simple acceso a los servicios públicos de salud. Se buscaba también un "derecho a la ciudad", o incluso un tránsito más allá de ella. En fin, una búsqueda por la ampliación de la experiencia de multiterritorialidad, y las transformaciones resultantes de ella...(AU)


Asunto(s)
Humanos , Adulto , Política Pública , Territorialidad , Salud Mental , Personeidad , Desinstitucionalización , Grupos Minoritarios , Servicio Social , Servicios Comunitarios de Salud Mental , Funciones Esenciales de la Salud Pública , Derechos Humanos
11.
Psicol. ciênc. prof ; 39(2,n.esp): 6-18, ago.-nov. 2019.
Artículo en Portugués | LILACS, Index Psicología - Revistas técnico-científicas | ID: biblio-1025767

RESUMEN

O artigo tem como objetivo discutir o desmantelamento das políticas públicas, em específico, das políticas de saúde e da assistência social. A discussão situa-se no campo da Psicologia Social e inspira-se no pós-estruturalismo para análise desta problemática, tendo como questionamento norteador como se constitui o desmonte, considerando-o como processo dinâmico e inerente à produção das políticas. Por meio do método cartográfico, foi possível percorrer materialidades que emergem como pistas para compreender tal processo. Entende-se que há uma tensão na própria construção dessas políticas, com o intuito de substituir modelos anteriores que não se extinguem pela incorporação do SUS e do SUAS à Constituição. Esta se caracteriza pelo esvaziamento de conceitos norteadores das políticas, como as noções de território e vulnerabilidade. Esse esvaziamento potencializa a emersão de uma nova lógica de governo dentro das políticas públicas, não somente por via da regulação, normatização das condutas e criminalização de certa categoria da população, mas também por uma necropolítica, que visa a colocar no jogo democrático uma política de morte....(AU)


This paper aims to discuss the dismantling of public policies, particularly those related to health and social assistance. With a post-structuralist inspiration, and situated in the field of Social Psychology, this discussion questions how that dismantling has occurred, considering it as a dynamic process that is inherent to the production of policies. By means of the cartographic method, it has been possible to address materials that have emerged as hints to understand that process. There is a tension in the very formulation of those policies aiming at replacing previous models that have not been extinguished with the incorporation of SUS and SUAS to the Constitution. The latter is characterized by the emptying of guiding concepts of those policies, such as the notions of territory and vulnerability. This emptying potentiates the emergence of a new governmental logic within the public policies, by means of not only regulation, conduct normalization, and criminalization of a certain population category, but also through necropolitics, aiming at introducing a death policy in the democratic game....(AU)


El artículo tiene como objetivo discutir el desmantelamiento de las políticas públicas, específicamente las políticas de salud y de asistencia social. La discusión se ubica en el campo de la Psicología Social y se inspira en el postestructuralismo para el análisis de este problema, teniendo como cuestionamiento orientador cómo se constituye el desmantelamiento, considerándolo como un proceso dinámico e inherente a la producción de políticas. A través del método cartográfico, fue posible transitar por materialidades que emergen como pistas para comprender este proceso. Se entiende que existe una tensión en la propia construcción de estas políticas, para sustituir modelos anteriores que no se extinguen por la incorporación del SUS y del SUAS a la Constitución. Esto se caracteriza por el vaciado de los conceptos que orientan las políticas, como las nociones de territorio y vulnerabilidad. Ese vacío potencializa la emergencia de una nueva lógica de gobierno dentro de las políticas públicas, no sólo mediante la regulación, normalización de conductas y criminalización de una determinada categoría de la población, sino también a través de una necropolítica, que busca colocar una política de muerte en el juego democrático....(AU)


Asunto(s)
Humanos , Psicología , Psicología Social , Política Pública , Servicio Social , Sistema Único de Salud , Vulnerabilidad Social , Política de Salud , Vulnerabilidad ante Desastres , Democracia
12.
Psicol. ciênc. prof ; 39(2,n.esp): 141-152, ago.-nov. 2019.
Artículo en Portugués | LILACS, Index Psicología - Revistas técnico-científicas | ID: biblio-1025950

RESUMEN

Partimos da reflexão acerca das políticas públicas de Assistência Social e como as interfaces raça, racismo e branquitude emergem na produção de conhecimento. Inspiradas na ideia de pluriversalidade questionamos o universo conceitual branco, trazendo como reflexão as produções em Psicologia que se centram em um ideário eurocêntrico, masculinista e heterocentrado. Apresentamos uma discussão sobre o tema da raça e racismo, pensando como estes se articulam tanto na constituição e implementação das políticas públicas, quanto na sua precarização. Para finalizar, afirmamos a necessidade de descolonizar a produção em Psicologia Social, colocar a branquitude em jogo, dissolver a ideia de sujeito universal e assumir a necessidade de pensarmos e publicarmos a partir de uma perspectiva polirracional. Acreditamos que as políticas de produção de saberes e fazeres em Psicologia devem estar atentas à geopolítica do conhecimento, dialogando com diversidades epistêmicas espalhadas em distintas regiões do planeta, sobretudo aquelas do Sul Global....(AU)


This paper presents a reflection on public policies for Social Assistance and the way that interfaces such as race, racism and whiteness have appeared in knowledge production. Inspired by the idea of pluriversality, we have questioned the white conceptual universe by bringing reflections on psychology productions focused on a Eurocentric, masculinist, and heterocentered ideology. We present a discussion on race and racism, thinking about the way they have been articulated in the constitution and implementation of public policies as well as in their precariousness. Finally, we state the need to decolonize the production in Social Psychology, in order to bring whiteness into play, dissolve the idea of universal subject, and admit our need to think and publish from a multi-rational perspective. We believe that policies for the production of knowledges and actions in psychology should be attentive to the geopolitics of knowledge, in a dialogue with epistemic diversities spread in different regions over the world, particularly in the Global South....(AU)


Se parte de la reflexión sobre las políticas públicas de Bienestar Social e interfaces como la raza, el racismo y la blanquitud surgen en la producción de conocimiento. Inspirados en la idea de la pluriversidad, cuestionamos el universo conceptual blanco, trayendo como reflejo las producciones en psicología que se centran en una idea eurocéntrica, masculinista y heterocéntrica. Presentamos una discusión sobre el tema de la raza y el racismo, pensando cómo se articulan tanto en la constitución y la implementación de las políticas públicas, como en su precariedad.Finalmente, afirmamos la necesidad de descolonizar la producción en Psicología Social, poner en juego la blanquitud, disolver la idea del tema universal y asumir la necesidad de pensar y publicar desde una perspectiva múltiplemente racional. Creemos que la política de producción de conocimiento y las actividades en psicología deben estar atentas a la geopolítica del conocimiento, dialogando con diversidades epistémicas diseminadas en diferentes regiones del planeta, especialmente en las del Sur Global....(AU)


Asunto(s)
Humanos , Psicología Social , Política Pública , Servicio Social , Racismo , Psicología , Relaciones Raciales
13.
Health Serv Res ; 54(6): 1246-1254, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31595498

RESUMEN

OBJECTIVE: To measure strategies of interorganizational collaboration among health care and social service organizations that serve older adults. STUDY SETTING: Twenty Hospital Service Areas (HSAs) in the United States. STUDY DESIGN: We developed and validated a novel scale to characterize interorganizational collaboration, and then tested its application by assessing whether the scale differentiated between HSAs with high vs low performance on potentially avoidable health care use and spending for Medicare beneficiaries. DATA COLLECTION: Health care and social service organizations (N = 173 total) in each HSA completed a 12-item collaboration scale, three questions about collaboration behaviors, and a detailed survey documenting collaborative network ties. PRINCIPAL FINDINGS: We identified two distinguishable subscales of interorganizational collaboration: (a) Aligning Strategy and (b) Coordinating Current Work. Each subscale demonstrated convergent validity with the organization's position in the collaborative network, and with collaboration behaviors. The full scale and Coordinating Current Work subscale did not differentiate high- vs low-performing HSAs, but the Aligning Strategy subscale was significantly higher in high-performing HSAs than in low-performing HSAs (P = .01). CONCLUSIONS: Cross-sector collaboration-and particularly Aligning Strategy-is associated with health care use and spending for older adults. This new survey measure could be used to track the impact of interventions to foster interorganizational collaboration.


Asunto(s)
Conducta Cooperativa , Relaciones Interinstitucionales , Medicare/organización & administración , Reproducibilidad de los Resultados , Servicio Social/organización & administración , Encuestas y Cuestionarios/normas , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Medicare/estadística & datos numéricos , Persona de Mediana Edad , Servicio Social/estadística & datos numéricos , Estados Unidos
15.
PLoS Med ; 16(9): e1002919, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31550249

RESUMEN

BACKGROUND: Torture and other forms of ill treatment have been reported in at least 141 countries, exposing a global crisis. Survivors face multiple physical, psychological, and social difficulties. Psychological consequences for survivors are varied, and evidence on treatment is mixed. We conducted a systematic review and meta-analysis to estimate the benefits and harms of psychological, social, and welfare interventions for torture survivors. METHODS AND FINDINGS: We updated a 2014 review with published randomised controlled trials (RCTs) for adult survivors of torture comparing any psychological, social, or welfare intervention against treatment as usual or active control from 1 January 2014 through 22 June 2019. Primary outcome was post-traumatic stress disorder (PTSD) symptoms or caseness, and secondary outcomes were depression symptoms, functioning, quality of life, and adverse effects, after treatment and at follow-up of at least 3 months. Standardised mean differences (SMDs) and odds ratios were estimated using meta-analysis with random effects. The Cochrane tool was used to derive risk of bias. Fifteen RCTs were included, with data from 1,373 participants (589 females and 784 males) in 10 countries (7 trials in Europe, 5 in Asia, and 3 in Africa). No trials of social or welfare interventions were found. Compared to mostly inactive (waiting list) controls, psychological interventions reduced PTSD symptoms by the end of treatment (SMD -0.31, 95% confidence interval [CI] -0.52 to -0.09, p = 0.005), but PTSD symptoms at follow-up were not significantly reduced (SMD -0.34, 95% CI -0.74 to 0.06, p = 0.09). No significant improvement was found for PTSD caseness at the end of treatment, and there was possible worsening at follow-up from one study (n = 28). Interventions showed no benefits for depression symptoms at end of treatment (SMD -0.23, 95% CI -0.50 to 0.03, p = 0.09) or follow-up (SMD -0.23, 95% CI -0.70 to 0.24, p = 0.34). A significant improvement in functioning for psychological interventions compared to control was found at end of treatment (SMD -0.38, 95% CI -0.58 to -0.18, p = 0.0002) but not at follow-up from only one study. No significant improvement emerged for quality of life at end of treatment (SMD 0.38, 95% CI -0.28 to 1.05, p = 0.26) with no data available at follow-up. The main study limitations were the difficulty in this field of being certain of capturing all eligible studies, the lack of modelling of maintenance of treatment gains, and the low precision of most SMDs making findings liable to change with the addition of further studies as they are published. CONCLUSIONS: Our findings show evidence that psychological interventions improve PTSD symptoms and functioning at the end of treatment, but it is unknown whether this is maintained at follow-up, with a possible worsening of PTSD caseness at follow-up from one study. Further interventions in this population should address broader psychological needs beyond PTSD while taking into account the effect of multiple daily stressors. Additional studies, including social and welfare interventions, will improve precision of estimates of effect, particularly over the longer term.


Asunto(s)
Depresión/terapia , Psicoterapia/métodos , Bienestar Social , Servicio Social/métodos , Trastornos por Estrés Postraumático/terapia , Sobrevivientes/psicología , Tortura/psicología , Depresión/diagnóstico , Depresión/psicología , Femenino , Humanos , Masculino , Salud Mental , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicología , Resultado del Tratamiento
16.
Res Dev Disabil ; 94: 103477, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31494354

RESUMEN

BACKGROUND: Disability support organisations have embraced Active Support, but it has proved difficult to embed in services. AIMS: This study aimed to identify the factors associated with increases over time in the quality of Active Support. METHOD: Data were collected on the predicted variable of the quality of Active Support, and predictor variables of service user, staff and service characteristics, including practice leadership, and composition and size of services from 51 services in 8 organisations over 2-7 time points. Data were analysed using multi-level modelling. RESULTS: There was significant linear change in Active Support scores (group mean centered at the organisational level) over time. Individuals with lower support needs received better Active Support and those with higher support needs experienced greater increases over time. Stronger practice leadership and more staff with training in Active Support were significant predictors of the quality of Active Support. Larger services with seven or more individuals and where there was a very heterogeneous mix of individuals were associated with lower quality of support. CONCLUSIONS: Ensuring strong practice leadership, and staff training in Active Support that emphasises the principle of adapting support to each individual's level of ability and preferences are key to delivering high levels of Active Support.


Asunto(s)
Discapacidad Intelectual , Participación en las Decisiones/normas , Rehabilitación Psiquiátrica , Sistemas de Apoyo Psicosocial , Mejoramiento de la Calidad/organización & administración , Servicio Social , Desarrollo de Personal/normas , Compromiso Laboral , Adulto , Australia , Participación de la Comunidad/métodos , Personas con Discapacidad/psicología , Femenino , Humanos , Discapacidad Intelectual/psicología , Discapacidad Intelectual/rehabilitación , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Rehabilitación Psiquiátrica/métodos , Rehabilitación Psiquiátrica/organización & administración , Rehabilitación Psiquiátrica/normas , Calidad de la Atención de Salud , Servicio Social/métodos , Servicio Social/organización & administración , Servicio Social/normas
17.
BMC Neurol ; 19(1): 220, 2019 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-31492151

RESUMEN

BACKGROUND: Stroke patients are often affected by long-term disabilities with needs concerning social issues. There is relatively little consideration of social recovery of patients and the support required to return to work, receive social benefits, participate in daily life activities, maintain contact with family and friends and to organize financial affairs. In our study we aimed to investigate if existing tools record social needs adequately. We analyzed the current provision of social support provided in long-term care after stroke and whether unmet social needs were associated with quality of life, caregiver burden, overall function and degree of disability. METHODS: Our analysis is part of the Managing Aftercare of Stroke study (MAS-I), a cross-sectional exploratory study of patient needs 2-3 years after initial stroke. Assessment tools included the Nikolaus-score (social situation), the EuroQoL (quality of life), the German Burden Scale for Family Caregivers (caregiver burden), the modified Rankin Scale (disability / dependence), Stroke Impact Scale (function and degree of disability) and the Stroke Survivor Needs Questionnaire (unmet needs). RESULTS: Overall 57 patients were included in MAS-I, with ten patients classified in urgent need of socio-economic support according to the Nikolaus-score. Patients with lower than normal Nikolaus-score had a higher degree of disability. Thirty percent of all patients had never received professional social support. Social worker contact happened mostly during the stay in acute hospital or rehabilitation institution. Only four patients (11%) reported long-term support after discharge. Apart from social worker contact during acute care, 43% of patients had unmet needs in the long-term aftercare. Forty percent of all patients included in MAS-I were recommended for social work intervention after an in-depth analysis of their situation. Finally, we saw that unmet social needs were associated with lower quality of life and higher caregiver burden. CONCLUSIONS: Our data suggest significant unmet needs in social care in long-term stroke patients. Screening tools for unmet social needs such as the Nikolaus-score do not holistically report patients' needs. TRIAL REGISTRATION: Clinicaltrials.Gov NCT02320994 . Registered 19 December 2014 (retrospectively registered).


Asunto(s)
Calidad de Vida , Apoyo Social , Servicio Social , Accidente Cerebrovascular/psicología , Anciano , Anciano de 80 o más Años , Cuidadores , Estudios Transversales , Personas con Discapacidad/estadística & datos numéricos , Femenino , Humanos , Cuidados a Largo Plazo , Masculino , Persona de Mediana Edad , Alta del Paciente , Estudios Retrospectivos , Rehabilitación de Accidente Cerebrovascular , Encuestas y Cuestionarios , Sobrevivientes
18.
N C Med J ; 80(5): 306-311, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31471516

RESUMEN

Given the known impacts of social, behavioral, and economic factors on health and longevity, health policy reforms are being developed and deployed at both the state and federal levels that support the integration and alignment of health care and social services.


Asunto(s)
Accesibilidad a los Servicios de Salud/organización & administración , Determinantes Sociales de la Salud , Prestación de Atención de Salud/organización & administración , Política de Salud , Humanos , Tamizaje Masivo , North Carolina , Derivación y Consulta , Servicio Social/organización & administración , Estados Unidos
19.
Maturitas ; 129: 1-5, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31547907

RESUMEN

BACKGROUND: The care model for supporting elderly people living independently at home relies on the informal and formal assistance of caregivers. Information and communication technology (ICT) offers new approaches for informal care services for this group. METHODS: A longitudinal observational pilot study was carried out in home services in France. Employees of the ADMR home services followed 130 elderly people living at home and who were no more than moderately impaired. A single visual analogue scale (VAS) was used on a smartphone to assess global health every time a person was visited. An alert system was devised to inform the elderly person and/or a responsible person of any deterioration in health status. All medical and social events were recorded throughout the 9-month study. RESULTS: 138 people were enrolled and 106 were evaluated. 37 alerts were observed. 21 were confirmed and 16 were false positives. Only employees untrained in the use of the system generated false positive alerts. Six severe medical alerts were observed, including one cancer undetected by the physician, one hospitalization for diabetes, one hospitalization which led to death 6 months later and one hospitalization which resulted in follow-up care. CONCLUSIONS: Social workers can participate in the health system with all the ethical criteria of medicine. To our knowledge, this is the first ICT-based alert system that has been found to produce severe medical alerts by employees of home services.


Asunto(s)
Prestación de Atención de Salud/métodos , Estado de Salud , Aplicaciones Móviles , Servicio Social , Anciano , Anciano de 80 o más Años , Reacciones Falso Positivas , Femenino , Hospitalización , Humanos , Vida Independiente , Estudios Longitudinales , Masculino , Proyectos Piloto , Teléfono Inteligente
20.
Sex Reprod Healthc ; 21: 15-20, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31395228

RESUMEN

OBJECTIVES: Unsafe abortions are a reproductive health problem in low-income countries, but can be prevented by decreasing unintended pregnancies. The objective was to describe health care providers' (HCPs) perceptions of family planning and contraception education for adolescents in Kampala, Uganda. STUDY DESIGN: A qualitative study with a semi-structured interview guide was used for individual face-to-face interviews. Eight participants from two different Non-governmental organisations were interviewed. Qualitative content analysis was used to analyse the data. RESULTS: Data analysis resulted in three main categories of HCP perceptions: counseling, education and availability; peer-educators and community leaders; and stigma, inequality and myths. The providers emphasized the importance to discuss and eradicate the myths and misconceptions among adolescents regarding family planning methods by giving information, preferably at early ages. Peer-educators and community leaders were the most successful methods for accessing and involving the community. Approaches mentioned for reaching out to adolescents included involving parents, using social media, and offering education in schools. Furthermore, the providers highlighted to involve the males in family planning. CONCLUSIONS: Health care providers emphasized the importance to discuss and eradicate the myths and misconceptions among adolescents regarding different family planning methods by education in school and information in sexual and reproductive health.


Asunto(s)
Servicios de Planificación Familiar , Personal de Salud/psicología , Embarazo en Adolescencia/prevención & control , Educación Sexual , Adolescente , Anticoncepción/efectos adversos , Anticoncepción/métodos , Consejo , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Entrevistas como Asunto , Masculino , Partería , Percepción , Embarazo , Investigación Cualitativa , Estigma Social , Servicio Social , Uganda , Adulto Joven
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