Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 143.999
Filtrar
1.
Medicine (Baltimore) ; 100(4): e23920, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33530192

RESUMO

BACKGROUND: Lamaze breathing has been widely used as a breathing training method. Nursing intervention including postural nursing, delivery ball, doula nursing, massage and psychological nursing is usually provided by nurses during labor. A number of clinical studies have investigated the effect of Lamaze breathing training combined with nursing intervention on maternal pain relief and outcomes improvement. But there were some scholars who were against it. METHODS: Randomized controlled trials from January 2000 to November 2019 in PubMed, Cochrance Library, Medline, Web of Science, Embase, Chinese Academic Journals, Chinese Biomedical Literature Database, VIP Database, Wanfang Database were searched. Two researchers independently screened the literature according to the criteria. After extracting the data, the researchers used Cochrane system to evaluate the literature quality. Statistical analyses were performed by using Comprehensive Meta Analysis V2 software. RESULTS: Twenty-two randomized controlled trials conducted on 7035 primiparas were eligible. The results revealed that Lamaze breathing training combined with nursing intervention increased the rate of natural delivery (relative risk [RR] = 2.97, 95% confidence interval [CI] [2.48, 3.56]), shortened the length of labor (-2.604, 95% CI [-3.120, -2.087]), alleviated labor pain (RR = 0.194, 95% CI [0.115, 0.325]) and reduced postpartum bleeding (-2.966, 95% CI [-4.056, -1.877]). CONCLUSIONS: Lamaze breathing training combined with nursing intervention was effective for ameliorating the process and outcomes of childbirth in primiparae and deserves to be promoted and applied in clinical practice.


Assuntos
Trabalho de Parto/fisiologia , Parto Normal/métodos , Parto Normal/enfermagem , Parto/fisiologia , Feminino , Humanos , Dor do Parto/terapia , Paridade , Hemorragia Pós-Parto/prevenção & controle , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo
2.
Oncol Nurs Forum ; 48(2): 131-145, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33600397

RESUMO

OBJECTIVES: To identify research priorities addressing COVID-19 that build on the 2019-2022 Oncology Nursing Society (ONS) Research Agenda, in alignment with ONS's mission to promote excellence in oncology nursing and quality cancer care. METHODS & VARIABLES: Priority areas were identified using a multistep approach combining rapid review of the literature; consultation with experts/stakeholders; and review of priorities from other funding agencies, public health, and cancer-focused organizations. RESULTS: The rapid research response team identified five priority areas for research related to COVID-19. IMPLICATIONS FOR NURSING: Oncology nurses are well positioned to address the research priorities and cross-cutting themes identified through this review. The use of innovative methodologic approaches and attention to disparities are necessary to advance cancer care related to COVID-19.


Assuntos
/epidemiologia , Neoplasias/enfermagem , Pesquisa em Enfermagem , Enfermagem Oncológica , Sociedades de Enfermagem , Humanos
3.
Soins Psychiatr ; 42(332): 32-35, 2021 Feb.
Artigo em Francês | MEDLINE | ID: mdl-33602456

RESUMO

In the psychological care of separation disorders in child psychiatry, hospitalisation intervenes as a last resort, when care in an out-of-hospital structure but also in environments close to the child is no longer sufficient to contain his anxiety. A clinical example illustrates how nurses are led to position themselves and to think about care. It shows to what extent our containing functions can be an adapted response to the needs of the child in hospital.


Assuntos
Ansiedade de Separação , Psiquiatria Infantil , Ansiedade de Separação/enfermagem , Criança , Humanos
4.
Soins Psychiatr ; 42(332): 36-39, 2021 Feb.
Artigo em Francês | MEDLINE | ID: mdl-33602457

RESUMO

The subjective recognition by those involved in care, of people with psychiatric disorders, is not self-evident. Caregivers, in the general sense of the term, often find it difficult to recognise the personal freedom and dignity of psychiatric patients. Care is, however, inseparable from the relationship of trust and the mobilisation of the patient's ability to freely express choices and to participate in decisions concerning him; a central ability in the caregiver-patient relationship. Although the objectives of access to care and protection of the patient's rights are clearly stated, the question of the mental patient's freedom of choice, as well as his inner moral freedom, remains open to question, as does the questioning of these same freedoms among care providers.


Assuntos
Transtornos Mentais , Relações Enfermeiro-Paciente , Enfermagem Psiquiátrica , Liberdade , Humanos , Transtornos Mentais/enfermagem , Direitos do Paciente
5.
Syst Rev ; 10(1): 43, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33526095

RESUMO

BACKGROUND: Cancer patients are particularly vulnerable to COVID-19, partially owing to their compromised immune systems and curbed or cut cancer healthcare services caused by the pandemic. As a result, cancer caregivers may have to shoulder triple crises: the COVID-19 pandemic, pronounced healthcare needs from the patient, and elevated need for care from within. While technology-based health interventions have the potential to address unique challenges cancer caregivers face amid COVID-19, limited insights are available. Thus, to bridge this gap, we aim to identify technology-based interventions designed for cancer caregivers and report the characteristics and effects of these interventions concerning cancer caregivers' distinctive challenges amid COVID-19. METHODS: A systematic search of the literature will be conducted in PubMed, PsycINFO, CINAHL, and Scopus from the database inception to the end of March 2021. Articles that center on technology-based interventions for cancer caregivers will be included in the review. The search strategy will be developed in consultation with an academic librarian who is experienced in systematic review studies. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process. CONCLUSIONS: COVID-19 has upended cancer care as we know it. Findings of this study can shed light on evidence-based and practical solutions cancer caregivers can utilize to mitigate the unique challenges they face amid COVID-19. Furthermore, results of this study will also offer valuable insights for researchers who aim to develop interventions for cancer caregivers in the context of COVID-19. In addition, we also expect to be able to identify areas for improvement that need to be addressed in order for health experts to more adequately help cancer caregivers weather the storm of global health crises like COVID-19 and beyond. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020196301.


Assuntos
Cuidadores/psicologia , Invenções , Neoplasias/enfermagem , Assistência à Saúde , Humanos
6.
Artigo em Inglês | MEDLINE | ID: mdl-33579729

RESUMO

BACKGROUND: The global COVID-19 pandemic has impacted on the mental health of individuals, particularly those with chronic illnesses. We aimed to quantify stress, anxiety and depression among individuals with Inflammatory bowel disease (IBD) in Australia during the pandemic. METHODS: An electronic survey was made available to IBD patients Australia-wide from 17 June to 12 July 2020. Respondents with an underlying diagnosis of IBD and over 18 years of age were included. A validated questionnaire (Depression, Anxiety, Stress Score-21, DASS21) was used to assess depression, anxiety and stress. Data on potential predictors of depression, anxiety and stress were collected. RESULTS: 352 participated in the survey across Australia. 60.5% of respondents fulfilled DASS criteria for at least moderate depression, anxiety or stress. 45% reported a pre-existing diagnosis of depression and/or anxiety. Over 2/3 of these respondents reported worsening of their pre-existing depression/anxiety due to the current pandemic. Of those without a pre-existing diagnosis of anxiety or depression, high rates of at least moderate to severe depression (34.9%), anxiety (32.0%) and stress (29.7%) were noted. Younger age (OR 0.96, 95% CI 0.94 to 0.98, p<0.001), lack of access to an IBD nurse (OR 1.81, 95% CI 1.03 to 3.19, p=0.04) and lack of education on reducing infection risk (OR 1.99, 95% CI 1.13 to 3.50, p=0.017) were associated with significant stress, anxiety and/or depression. CONCLUSION: High prevalence of undiagnosed depression, anxiety and stress was identified among respondents. Improved access to IBD nurse support and greater attention to education are modifiable factors that may reduce depression, anxiety and/or stress among patients with IBD during the pandemic.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Doenças Inflamatórias Intestinais/psicologia , Pandemias , Estresse Psicológico/epidemiologia , Adulto , Austrália/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Doenças Inflamatórias Intestinais/enfermagem , Masculino , Pessoa de Meia-Idade , Cuidados de Enfermagem , Educação de Pacientes como Assunto , Prevalência , Comportamento de Redução do Risco
7.
Int Heart J ; 62(1): 148-152, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33518653

RESUMO

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is erupting and spreading globally. Cardiovascular complications secondary to the infection have caught notice. This study aims to delineate the relationship of cardiac biomarkers and outcomes in severe cases of corona virus disease 2019 (COVID-19). One hundred forty-eight critically ill adult patients with COVID-19 were enrolled. From these patients, the demographic data, symptoms, cardiac biomarkers, treatments, and clinical outcomes were collected. Data were compared between survivors and non-survivors. Four patients in the non-survivor group were selected, and their cardiac biomarkers were collected and analyzed. Among the 148 patients, the incidence of cardiovascular complications was 19 (12.8%). Five of them were survivors (5.2%), and 14 of them were non-survivors (26.9%). Compared with the survivors, the non-survivors had higher levels of high-sensitivity cardiac troponin I, creatine kinase isoenzyme-MB, myoglobin, and N-terminal pro-brain natriuretic peptide (P < 0.05). The occurrence of cardiovascular events began at 11-15 days after the onset of the disease and reached a peak at 14-20 days. COVID-19 not only is a respiratory disease but also causes damage to the cardiovascular system. Cardiac biomarkers have the potential for early warning and prognostic evaluation in patients with COVID-19. It is recommended that cardiac biomarker monitoring in patients with COVID-19 should be initiated at least from the 11th day of the disease course.


Assuntos
Biomarcadores/metabolismo , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/metabolismo , Adulto , Idoso , Fator Natriurético Atrial/metabolismo , /epidemiologia , Doenças Cardiovasculares/epidemiologia , Estudos de Casos e Controles , China/epidemiologia , Creatina Quinase Forma MB/metabolismo , Estado Terminal/mortalidade , Estado Terminal/enfermagem , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , Precursores de Proteínas/metabolismo , Taxa de Sobrevida , Sobreviventes/estatística & dados numéricos , Troponina I/metabolismo
8.
Nurs Clin North Am ; 56(1): 79-89, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33549288

RESUMO

Viral infections and their emergence continue to pose a threat to human lives. Up to the present, there are limited numbers of vaccines that effectively work and few antivirals licensed for use in clinical practice. Added to this is the increase in antiviral resistance, meaning that drugs that do work are at risk of reduced efficacy. The recent global pandemic of coronavirus 2019 has provided evidence for the risk of a preventative vaccination and effective treatment of viruses' subsequent consequences. The aim of this article is to review traditional and herbal treatments for infections, specifically addressing gastrointestinal and respiratory viral infections.


Assuntos
Fitoterapia , Viroses/tratamento farmacológico , Prática Avançada de Enfermagem , Humanos , Papel do Profissional de Enfermagem , Fitoterapia/enfermagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Viroses/epidemiologia , Viroses/enfermagem
9.
Medicine (Baltimore) ; 100(6): e23970, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578514

RESUMO

BACKGROUND: This study will assess the effect of advanced nursing care (ANC) on psychological disorder (PD) in hypertensive retinopathy of pregnancy (HTRP). METHODS: This study will search electronic databases from inception to the present (Cochrane Library, MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, CNKI, and Chinese Biomedical Literature Database), and other sources. All literature sources will be searched without limitations to language and study status. All eligible case-controlled study (CCS) will be included in this study. Two authors will independently carry out literature selection, data collection, and study quality assessment. Any confusion will be solved by a third author through discussion. Statistical analysis will be conducted using RevMan 5.3 software. In addition, a narrative synthesis will be elaborated if it is necessary. RESULTS: This study will summarize most recent high quality evidence to appraise the effect of ANC on PD in HTRP. CONCLUSION: The results of this study will seek to identify the effect of ANC on PD in HTRP among pregnancy population. OSF REGISTRATION: osf.io/hgp93.


Assuntos
Retinopatia Hipertensiva/psicologia , Transtornos Mentais/enfermagem , Cuidados de Enfermagem/métodos , Adulto , Estudos de Casos e Controles , Gerenciamento de Dados , Feminino , Humanos , Retinopatia Hipertensiva/complicações , Transtornos Mentais/etiologia , Transtornos Mentais/psicologia , Cuidados de Enfermagem/estatística & dados numéricos , Gravidez , Complicações na Gravidez/epidemiologia , Projetos de Pesquisa
10.
Medicine (Baltimore) ; 100(3): e24276, 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33546050

RESUMO

ABSTRACT: Pompe disease or glycogen storage disease type II is a rare autosomal recessive disorder caused by a deficiency of the lysosomal enzyme a-glucosidase. Although enzyme replacement therapy (ERT) with 2 weekly intervals following was considered an effective treatment for Pompe disease in 2006, few patients can afford to receive treatment in China because of the high cost. This study aimed to examine the standard management of enzyme replacement therapy for late-onset Pompe disease among patients over the age of 14 years from a nursing perspective in order to assess operating procedures. ERT injection fluid dispensing and infusion procedures using different methods were analyzed and compared in 3 patients with advanced Pompe disease for forming standard operation procedures. In addition, the impact of different methods on time consumption was analyzed by 1-way analysis of variance. There were significant differences in time consumption between different dispensing and infusion methods. The time of dispensing and infusing the injection fluids using the cooperative method was 15.97 minutes shorter than that using the conventional method (95% CI: 4.51-27.43, P = .012); the time using the modified method was 20.93 minutes shorter than that using the conventional method (95% CI: 9.47-32.39, P = .012); and there was no significant difference between the cooperative and modified methods (P = .431). Enzyme replacement therapy entails frequent treatment and strict nursing requirements related to the intravenous infusion process. In this context, a standard operating procedure can be used to control nursing times and labor costs effectively while ensuring a safe and effective infusion process.


Assuntos
Terapia de Reposição de Enzimas/enfermagem , Doença de Depósito de Glicogênio Tipo II/enfermagem , Padrões de Referência , Fatores de Tempo , Adolescente , China/epidemiologia , Terapia de Reposição de Enzimas/normas , Feminino , Doença de Depósito de Glicogênio Tipo II/epidemiologia , Humanos , Masculino
11.
Medicine (Baltimore) ; 100(3): e24290, 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33546055

RESUMO

ABSTRACT: This retrospective cohort study aimed to compare the effectiveness of conventional treatment and ultra-early application of negative pressure wound therapy (NPWT) in patients with snakebites.Patients who visited the emergency department within 24 hours after a snakebite were assigned to the non- NPWT or NPWT group. Swelling resolution time and rates of necrosis, infection, and operations were compared between the 2 groups. The Stony Brook Scar Evaluation Scale was used to measure short- and long-term wound healing results.Among the included 61 patients, the swelling resolution time was significantly shorter in the NPWT group than in non- NPWT group (P = .010). The NPWT group showed lower necrosis (4.3% versus 36.8%; P = .003) and infection (13.2% and 4.3%; P = .258) rates than the non- NPWT group. The median Stony Brook Scar Evaluation Scale scores were higher in the NPWT group than in the non- NPWT group (P< .001).These findings suggest that ultra-early application of NPWT reduces edema, promotes wound healing, and prevents necrosis in patients with snakebites.


Assuntos
Necrose/prevenção & controle , Tratamento de Ferimentos com Pressão Negativa/normas , Pele/lesões , Mordeduras de Serpentes/complicações , Idoso , Estudos de Coortes , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Necrose/terapia , Tratamento de Ferimentos com Pressão Negativa/métodos , Tratamento de Ferimentos com Pressão Negativa/estatística & dados numéricos , República da Coreia/epidemiologia , Estudos Retrospectivos , Pele/fisiopatologia , Mordeduras de Serpentes/epidemiologia , Mordeduras de Serpentes/enfermagem , Resultado do Tratamento
12.
Am J Nurs ; 121(2): 28-38, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33470615

RESUMO

BACKGROUND: School nurses' knowledge about and confidence in managing concussions are important to ensure continuity of care between a student's school and home environments. This mixed-methods study explored concussion-related knowledge, confidence, and management experiences among urban and rural school nurses in Washington State. METHODS: Public school nurses, identified via state educational service district websites and recruited by e-mail, completed an online survey assessing their concussion knowledge and confidence levels. Following the survey, a subset of respondents participated in semistructured interviews aimed at exploring their confidence in managing concussions. RESULTS: Of the 945 school nurses to whom the survey was sent, 315 responded (33% response rate). Most survey respondents held an RN license (89.6%) and were from urban areas (90.8%). Overall, the respondents exhibited accurate concussion knowledge; only one significant difference was noted based on rural-urban status. Correct responses were given for most questions (67.4% to 98.7% correct responses). In interviews with a subset of six school nurses, emergent themes pertained to communication, assessment, and monitoring, and the nurse's role in postconcussion management. Barriers can include a lack of relevant school policies, low concussion awareness among teachers and parents, and limited resources. CONCLUSIONS: The study findings suggest that school nurses possess high levels of concussion knowledge and confidence in managing concussions. Continuing education remains important to ensure that current research and evidence inform practice regarding ongoing concussion management among school-age children.


Assuntos
Concussão Encefálica/enfermagem , Competência Clínica/normas , Serviços de Enfermagem Escolar/métodos , Concussão Encefálica/diagnóstico , Competência Clínica/estatística & dados numéricos , Estudos Transversais , Humanos , Incidência , Washington
13.
Medicine (Baltimore) ; 100(2): e23972, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33466136

RESUMO

BACKGROUND: The purpose of this experiment is to evaluate the impact of the care of Parkinson disease nurse specialist on improving motor symptoms and life quality for patients with Parkinson disease (PD). METHOD: This is a randomized controlled research, and it will be conducted from April 2021 to October 2021 at Sichuan Provincial People's Hospital. The experiment was granted through the Research Ethics Committee of Sichuan Provincial People's Hospital (004510293). All the patients suffer from PD, age 18 years or older, both female and male, regardless of the duration or severity of this disease are eligible. The exclusion criteria contains: lack sufficient knowledge to complete questionnaires, serious physical comorbidities or refuse to take part in the program. In our experiment, the major result measures are motor symptoms and life quality. For the measurement of life quality, we will utilize Parkinson disease Questionnaire-39, the most extensively utilized the scale of life quality in PD. The evaluation of motor symptoms severity is carried out with the revision of Unified Parkinson Disease Rating Scale sponsored by Movement Disorder Society. RESULTS: Table 1 indicates clinical outcomes at different time points. CONCLUSION: The Parkinson's disease nurse specialist care may promote the life quality in the PD patients. TRIAL REGISTRATION NUMBER: researchregistry 6284.


Assuntos
Doença de Parkinson/enfermagem , Doença de Parkinson/psicologia , Qualidade de Vida/psicologia , Humanos , Planejamento de Assistência ao Paciente/organização & administração , Educação de Pacientes como Assunto/organização & administração , Autogestão/métodos , Índice de Gravidade de Doença
14.
Clin J Oncol Nurs ; 25(1): 76-84, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33480870

RESUMO

BACKGROUND: In the environment of an infectious pandemic, vaccines are a primary public health strategy to prevent the spread of disease. With the COVID-19 pandemic, there is heightened interest in safe and effective vaccines and their use in the context of clinical oncology practice. OBJECTIVES: This article provides foundational information about vaccines in general and vaccines developed to protect against the SARS-CoV-2 virus in the United States, as well as clinical nurse strategies to apply vaccines in clinical oncology practice. METHODS: The article is based on a review of public health literature and reputable websites about vaccines and their development in clinical care. FINDINGS: This foundational information about vaccines reviews their history and development, as well as the development of COVID-19 vaccines specifically, and discusses COVID-19 vaccines as part of clinical oncology care. Supporting best practices in clinical oncology care, nurses can provide factual, evidence-based information about vaccine safety, effectiveness, and safe administration.


Assuntos
/administração & dosagem , Oncologia/organização & administração , Neoplasias/enfermagem , Recursos Humanos de Enfermagem no Hospital/psicologia , Enfermagem Oncológica/organização & administração , Vacinação/psicologia , Adulto , Atitude do Pessoal de Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Estados Unidos/epidemiologia , Vacinação/estatística & dados numéricos
15.
Clin J Oncol Nurs ; 25(1): 48-55, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33480874

RESUMO

BACKGROUND: The COVID-19 pandemic has required healthcare systems to transform the delivery of care. Although the core principles of care for patients with cancer have not changed, this pandemic has led to heightened awareness concerning the fragility of patients with cancer and how healthcare systems can protect them. OBJECTIVES: The aims were to identify and implement inpatient and ambulatory care clinical practice changes during the COVID-19 pandemic, based on defining moments and coping strategies from clinical oncology nurses, advanced practice RNs, nurse leaders, and researchers. METHODS: This article presents a Lean Six Sigma framework, accompanied by numerous rapid cycle tests of change. FINDINGS: The COVID-19 pandemic required clinical healthcare providers at the authors' institution to focus on seven priority areas. Nurses tested and implemented practice changes.


Assuntos
Adaptação Psicológica , Assistência Ambulatorial/normas , Pessoal de Saúde/psicologia , Neoplasias/enfermagem , Enfermagem Oncológica/normas , Medicina Preventiva/normas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Guias de Prática Clínica como Assunto , Estresse Psicológico
16.
Clin J Oncol Nurs ; 25(1): 61-68, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33480884

RESUMO

BACKGROUND: The disruption in the supply chain of resources and interruptions in cancer treatments caused by the pandemic presented tremendous challenges to the healthcare system. OBJECTIVES: This article describes the National Academy of Medicine-defined states of medical and nursing care delivery for which local plans should be drawn and the shifting and evolving systems framework that can guide decisions to optimize the crisis standards of care. METHODS: A case study is presented to describe the process of shifting the state of medical and nursing care delivery and bioethical nursing considerations during the pandemic and beyond. FINDINGS: An evolving and shifting systems framework for crises rooted in deontology, principlism, and the ethics of care model provide meaningful guidance for establishing priorities for patient care.


Assuntos
/enfermagem , Tomada de Decisões/ética , Assistência à Saúde/ética , Neoplasias/enfermagem , Enfermagem Oncológica/ética , Enfermagem Oncológica/normas , Pandemias/ética , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Guias de Prática Clínica como Assunto
17.
Clin J Oncol Nurs ; 25(1): 41-47, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33480885

RESUMO

BACKGROUND: The COVID-19 pandemic generated challenges to the delivery of safe, efficient, and high-quality cancer care. In ambulatory oncology, where most cancer care is delivered, these challenges required the rapid development of infrastructure. OBJECTIVES: This article describes challenges to the design and implementation of ambulatory oncology infrastructures that support clinical oncology care during a pandemic. METHODS: This article reviews clinical experiences in interprofessional, multicenter, academic, and community settings during the COVID-19 pandemic. Cohesive and efficient services, collaborative processes, and workflows; patient triage and symptom management; technology and equipment; and communication strategies are discussed. National ambulatory care guidelines and practice recommendations are included as applicable and available. FINDINGS: Continued treatment delivery and support for patients with cancer, as well as infrastructure to minimize viral exposure to patients and oncology healthcare workers, are essential when caring for this high-risk population.


Assuntos
Assistência Ambulatorial/normas , Oncologia/normas , Neoplasias/enfermagem , Enfermagem Oncológica/normas , Guias de Prática Clínica como Assunto , Telemedicina/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Estados Unidos/epidemiologia
18.
Cochrane Database Syst Rev ; 1: CD006440, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33417236

RESUMO

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.


Assuntos
/prevenção & controle , Cuidadores/educação , Demência/enfermagem , Afeto , Viés , Cuidadores/psicologia , Família , Acesso aos Serviços de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , Institucionalização/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
19.
Rev. enferm. UFPE on line ; 15(1): [1-10], jan. 2021. ilus, tab
Artigo em Português | BDENF - Enfermagem | ID: biblio-1145811

RESUMO

Objetivo: discutir sobre o Processo de Enfermagem diante dos aspectos clínicos respiratórios da COVID-19. Método: trata-se de um estudo qualitativo, descritivo, informativo que partiu de uma revisão narrativa da literatura, documentos da Organização Mundial da Saúde e das taxonomias aplicadas ao Processo de Enfermagem North American Nursing Diagnosis Association, Nursing Interventions Classification e Nursing Outcomes Classification. Realizou-se uma busca bibliográfica de artigos científicos que abordassem o tema na Biblioteca Virtual de Saúde e Biblioteca Virtual SciELO. Utilizaram-se descritores como: Coronavírus OR COVID-19 AND pessoal da saúde OR Enfermagem. Resultados: informa-se que diante da clínica apresentada, os principais diagnósticos são: Hipertermia, Padrão respiratório ineficaz e Troca de gases prejudicada. Ressalta-se que, para isso, são necessárias as intervenções de Enfermagem, as quais terão como resultado esperado a temperatura normalizada, conforto e padrão respiratório normal e a melhora na troca de gases. Conclusão: reconhece-se a importância do Processo de Enfermagem, o qual possibilita reconhecer as necessidades do paciente e atuar diretamente neles, identificando aqueles que forem prioritários e fortificando o cunho científico da profissão, padronizando uma linguagem própria e facilitando a comunicação entre os enfermeiros do mundo. (AU)


Objective: to discuss the Nursing Process in view of the respiratory clinical aspects of COVID-19. Method: It is a qualitative, descriptive, informative study that started with a narrative review of literature, World Health Organization documents and taxonomies applied to the Nursing Process North American Nursing Diagnosis Association, Nursing Interventions Classification and Nursing Outcomes Classification. A bibliographic search of scientific articles addressing the topic was conducted in the Virtual Health Library and the SciELO Virtual Library. Descriptors such as: Coronavirus OR COVID-19 AND health personnel OR Nursing were used. Results: it is informed that in view of the clinic presented, the main diagnoses are: Hyperthermia, ineffective respiratory pattern and impaired gas exchange. It is important to emphasize that, for that, it is necessary the nursing interventions, which will have as an expected result the normalized temperature, comfort and normal respiratory pattern and the improvement in gas exchange. Conclusion: recognizes the importance of the Nursing Process, which makes it possible to recognize the needs of the patient and act directly on them, identifying those that are priority and fortifying the scientific nature of the profession, standardizing its own language and facilitating communication among nurses worldwide.(AU)


Objetivo: discutir el Proceso de Enfermería ante los aspectos clínico-respiratorios del COVID-19. Método: se trata de un estudio cualitativo, descriptivo e informativo que se inició con una revisión narrativa de la literatura, los documentos de la Organización Mundial de la Salud y las taxonomías aplicadas al Proceso de Enfermería North American Nursing Diagnosis Association, Nursing Interventions Classification y Nursing Outcomes Classification. Se realizó una búsqueda bibliográfica de artículos científicos que abordaron el tema en la Biblioteca Virtual en Salud y Biblioteca Virtual SciELO. Se utilizaron descriptores como: Coronavirus o COVID-19 y personal de salud o Enfermería. Resultados: se informa que, a la vista de la clínica presentada, los principales diagnósticos son: Hipertermia, Patrón respiratorio ineficaz y Alteración del intercambio gaseoso. Se enfatiza que, para ello, son necesarias intervenciones de Enfermería, las cuales tendrán el resultado esperado de temperatura normalizada, confort y patrón respiratorio normal y mejora en el intercambio de gases. Conclusión: se reconoce la importancia del Proceso de Enfermería, que permite reconocer las necesidades del paciente y actuar directamente sobre ellas, identificando aquellas que son prioritarias y fortaleciendo el carácter científico de la profesión, estandarizando el lenguaje propio y facilitando la comunicación entre enfermeros en el mundo.(AU)


Assuntos
Humanos , Masculino , Feminino , Infecções por Coronavirus , Infecções por Coronavirus/enfermagem , Síndrome Respiratória Aguda Grave , Terminologia Padronizada em Enfermagem , Betacoronavirus , Processo de Enfermagem , Organização Mundial da Saúde , Epidemiologia Descritiva , Pesquisa Qualitativa
20.
Rev. enferm. UFPE on line ; 15(1): [1-16], jan. 2021.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1145844

RESUMO

Objetivo: descrever as principais estratégias realizadas ao longo dos quatro anos da ação de extensão Agir e Educar (em) frente o Diabetes Mellitus. Método: trata-se de um estudo qualitativo, descritivo, tipo relato de experiência, desenvolvido a partir de relatórios anuais e arquivos diversos da ação de extensão Agir e Educar (em) frente o Diabetes Mellitus. Resultados: elencaram-se os resultados a partir de três categorias: Grupo Agir e Educar; Atenção individual como estratégia do cuidado e Educação em saúde nas redes sociais ou redes sociais como estratégia viável para a educação em saúde. Conclusão: nota-se que o grupo Agir e Educar (em) frente o Diabetes Mellitus desenvolveu diferentes ações educativas no intuito de proporcionar estratégias para a melhoria da qualidade de vida da pessoa com Diabetes Mellitus, a partir da ótica do conceito ampliado de saúde, que preza pela autonomia e pelo empoderamento dos indivíduos. Ressalta-se, como contribuição para a área da Saúde, a utilização das mídias sociais para se alcançar um maior número de pessoas e disseminar conhecimento.(AU)


Objective: to describe the main strategies carried out over the four years of the extension action Act and Educate in the Face of Diabetes Mellitus. Method: it is a qualitative, descriptive, experience report type study, developed from annual reports and various files of the extension action Act and Educate in the face of Diabetes Mellitus. Results: The results were listed from three categories: Act and Educate Group; Individual Care as a Care Strategy and Health Education in Social Networks or Social Networks as a viable strategy for Health Education. Conclusion: It is noted that the group Act and Educate in the face of Diabetes Mellitus developed different educational actions in order to provide strategies for improving the quality of life of the person with Diabetes Mellitus, from the perspective of the expanded concept of health, which values the autonomy and empowerment of individuals. As a contribution to the Health area, the use of social media to reach a greater number of people and spread knowledge is highlighted.


Objetivo: describir las principales estrategias llevadas a cabo durante los cuatro años de la acción de extensión Actuar y Educar contra la Diabetes Mellitus. Método: se trata de un estudio cualitativo, descriptivo, tipo informe de experiencia, desarrollado en base a informes anuales y diferentes archivos de la acción de extensión Actuar y Educar (en) contra la Diabetes Mellitus. Resultados: se enumeraron los resultados mediante tres categorías: Grupo Agir e Educar; La atención individual como estrategia de atención y la Educación para la salud en redes sociales o redes sociales como estrategia viable para la educación en salud. Conclusión: se observa que el grupo Agir y Educar (en) contra a la Diabetes Mellitus desarrolló diferentes acciones educativas con el fin de brindar estrategias para mejorar la calidad de vida de las personas con Diabetes Mellitus, desde la perspectiva del concepto ampliado de salud, que valora la autonomía y el empoderamiento de las personas. Como aporte al área de Salud, se destaca el uso de las redes sociales para llegar a un mayor número de personas y difundir el conocimiento.(AU)


Assuntos
Humanos , Masculino , Feminino , Qualidade de Vida , Autocuidado , Conhecimentos, Atitudes e Prática em Saúde , Educação em Saúde , Relações Comunidade-Instituição , Diabetes Mellitus , Diabetes Mellitus/enfermagem , Cooperação e Adesão ao Tratamento , Epidemiologia Descritiva , Pesquisa Qualitativa , Mídias Sociais
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA