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1.
Home Healthc Now ; 36(3): 181-184, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29722708

RESUMO

As people age, physiological changes can occur causing deterioration of one or more of the senses, including hearing, vision, taste, and smell. The loss of sensory function can decrease the extent to which older adults can communicate, especially with their healthcare providers. The purpose of this article is to examine communication between older adults and healthcare providers, focusing on best practices and devices that can enhance and benefit their health and well-being. One consideration is the use of digital technology, such as smart phones, electronic tablets, and computers, to help mitigate the effects of aging on communication.


Assuntos
Comunicação , Aplicativos Móveis/estatística & dados numéricos , Autocuidado/métodos , Transtornos das Sensações/prevenção & controle , Terapia Assistida por Computador/métodos , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Educação de Pacientes como Assunto , Qualidade de Vida , Transtornos das Sensações/terapia
2.
Home Healthc Now ; 36(2): 74-83, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29498987

RESUMO

Dry eye disease is a chronic condition of the corneal surface marked by persistent symptoms of irritation or burning that can cause inflammatory damage to the cornea and conjunctiva if untreated. Common risk factors for this syndrome include advancing age, female sex, low humidity environments, systemic medications, and autoimmune disorders. Treatments to relieve symptoms include tear replacement, humidification, improved nutrition, and anti-inflammatory ocular agents. Home healthcare nurses can identify signs and symptoms of dry eye syndrome and initiate strategies that range from warm compresses to physician referrals for more aggressive treatment. Consistent management of this condition improves quality of life and minimizes damage to the ocular surface.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Soluções Oftálmicas/uso terapêutico , Xeroftalmia/epidemiologia , Xeroftalmia/terapia , Distribuição por Idade , Idoso , Doença Crônica , Gerenciamento Clínico , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/epidemiologia , Síndromes do Olho Seco/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Medição de Risco , Índice de Gravidade de Doença , Distribuição por Sexo , Xeroftalmia/fisiopatologia
3.
JAMA Intern Med ; 174(4): 535-43, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24515422

RESUMO

IMPORTANCE Socioeconomic and behavioral factors can negatively influence posthospital outcomes among patients of low socioeconomic status (SES). Traditional hospital personnel often lack the time, skills, and community linkages required to address these factors. OBJECTIVE To determine whether a tailored community health worker (CHW) intervention would improve posthospital outcomes among low-SES patients. DESIGN, SETTING, AND PARTICIPANTS A 2-armed, single-blind, randomized clinical trial was conducted between April 10, 2011, and October 30, 2012, at 2 urban, academically affiliated hospitals. Of 683 eligible general medical inpatients (ie, low-income, uninsured, or Medicaid) that we screened, 237 individuals (34.7%) declined to participate. The remaining 446 patients (65.3%) were enrolled and randomly assigned to study arms. Nearly equal percentages of control and intervention group patients completed the follow-up interview (86.6% vs 86.9%). INTERVENTIONS During hospital admission, CHWs worked with patients to create individualized action plans for achieving patients' stated goals for recovery. The CHWs provided support tailored to patient goals for a minimum of 2 weeks. MAIN OUTCOMES AND MEASURES The prespecified primary outcome was completion of primary care follow-up within 14 days of discharge. Prespecified secondary outcomes were quality of discharge communication, self-rated health, satisfaction, patient activation, medication adherence, and 30-day readmission rates. RESULTS Using intention-to-treat analysis, we found that intervention patients were more likely to obtain timely posthospital primary care (60.0% vs 47.9%; P = .02; adjusted odds ratio [OR], 1.52; 95% CI, 1.03-2.23), to report high-quality discharge communication (91.3% vs 78.7%; P = .002; adjusted OR, 2.94; 95% CI, 1.5-5.8), and to show greater improvements in mental health (6.7 vs 4.5; P = .02) and patient activation (3.4 vs 1.6; P = .05). There were no significant differences between groups in physical health, satisfaction with medical care, or medication adherence. Similar proportions of patients in both arms experienced at least one 30-day readmission; however, intervention patients were less likely to have multiple 30-day readmissions (2.3% vs 5.5%; P = .08; adjusted OR, 0.40; 95% CI, 0.14-1.06). Among the subgroup of 63 readmitted patients, recurrent readmission was reduced from 40.0% vs 15.2% (P = .03; adjusted OR, 0.27; 95% CI, 0.08-0.89). CONCLUSIONS AND RELEVANCE Patient-centered CHW intervention improves access to primary care and quality of discharge while controlling recurrent readmissions in a high-risk population. Health systems may leverage the CHW workforce to improve posthospital outcomes by addressing behavioral and socioeconomic drivers of disease. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01346462.


Assuntos
Agentes Comunitários de Saúde , Alta do Paciente , Assistência Centrada no Paciente/organização & administração , Adulto , Feminino , Acesso aos Serviços de Saúde , Humanos , Análise de Intenção de Tratamento , Masculino , Pessoa de Meia-Idade , Readmissão do Paciente/estatística & dados numéricos , Pennsylvania , Atenção Primária à Saúde/estatística & dados numéricos , Método Simples-Cego , Fatores Socioeconômicos
4.
J Nurs Meas ; 21(3): 450-62, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24620517

RESUMO

BACKGROUND AND PURPOSE: Development of a valid, reliable instrument to measure spiritual self-care practices of patients with heart failure. METHODS: African American patients (N = 142) with heart failure participated in the study. Spiritual advisors from several religious groups reviewed the Spiritual Self-Care Practices Scale (SSCPS) for content validity. Construct validity was determined using a principal components factor analysis. Reliability was established using Cronbach's alpha coefficients. RESULTS: Religious advisors provided suggestions to improve content validity. Four factors consistent with spiritual practices (personal spiritual practices, spiritual practices, physical spiritual practices, and interpersonal spiritual practices) emerged from the factor analysis. The alpha coefficient was moderate at 0.64. CONCLUSIONS: Results indicated the SSCPS was reliable and valid for measuring spiritual self-care practices among African Americans with heart failure. Additional testing is needed to confirm results in other patient groups with chronic illnesses.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Insuficiência Cardíaca/reabilitação , Psicometria/instrumentação , Autocuidado/psicologia , Espiritualidade , Adolescente , Adulto , Afro-Americanos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos , Projetos Piloto , Reprodutibilidade dos Testes , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
5.
J Infus Nurs ; 34(4): 260-70, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21734522

RESUMO

An evidence-based study examined the effectiveness of 2 solutions, heparin and normal saline, when used to flush capped pediatric peripheral intravenous (CPP IV) catheters. This experimental study assessed patency, redness, swelling, clotting, bruising, leakage, and patient pain after each intervention/flush. Study participants included 62 children (32 heparin and 30 normal saline) who had CPP IV catheters using 20-, 22-, or 24-gauge catheters. No statistically significant differences were found in IV catheter patency between children in the normal saline group and children in the heparin group. A postimplementation follow-up study with 30 patients who received normal saline only as a flush experienced no patency issues.


Assuntos
Cateteres de Demora , Infusões Intravenosas , Soluções , Criança , Humanos , Enfermagem Pediátrica
6.
Nurs Sci Q ; 24(1): 48-56, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21220576

RESUMO

The authors propose an integration of the concepts of spirituality and spiritual self-care within Orem's self-care deficit nursing theory as a critical step in theory development. Theoretical clarity is needed to understand the contributions of spirituality to health and well-being. Spirituality is the beliefs persons hold related to their subjective sense of existential connectedness including beliefs that reflect relationships with others, acknowledge a higher power, recognize an individual's place in the world, and lead to spiritual practices. Spiritual self-care is the set of spiritually-based practices in which people engage to promote continued personal development and well-being in health and illness.


Assuntos
Autocuidado , Espiritualidade , Cuidados de Enfermagem
7.
J Cardiovasc Nurs ; 22(2): 138-44, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17318041

RESUMO

BACKGROUND: Cardiovascular disease is the number one cause of mortality and morbidity among women in the United States, resulting in 25,000 deaths annually. Despite this high mortality figure, most women survive. Although evidence suggests that depression is common after myocardial infarction (MI), there are limited data on how depression impacts women's recovery after their first event. The purpose of this study was to describe the relationship between depression and quality of life in women after a first MI. METHOD: A convenience sample of 27 women (mean age = 60.7 years) with first MI completed the study. Depression was measured using the Beck Depression Inventory, and quality of life was measured using the Short Form-36. RESULTS: The mean (SD) depression score was 9.4 (5.5), indicating mild to moderate depression. Depression had a significant negative correlation with the mental component summary of the Short Form-36 (r = -0.72, P = .0005) but not the physical component summary (r = -0.191, P = .360). In addition, subjects reported lower scores on 3 of the 8 Short Form-36 subscales when compared with national norms of persons experiencing a recent MI. IMPLICATIONS: Many women continue to report mild to severe depression after MI, and depression seems to be related to some aspects of quality of life. Screening for depression and treating if symptoms are significant is one intervention for improving quality of life after MI.


Assuntos
Depressão/epidemiologia , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/psicologia , Qualidade de Vida , Distribuição por Idade , Causalidade , Comorbidade , Depressão/classificação , Depressão/diagnóstico , Feminino , Inquéritos Epidemiológicos , Humanos , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos/epidemiologia , Valores de Referência , Fatores Socioeconômicos
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