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1.
Glob Health Action ; 15(sup1): 2006469, 2022 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-36098957

RESUMO

Increasing coverage of evidence-based maternal, neonatal, child, reproductive health and nutrition (MNCRHN) programs in low- and middle-income countries has coincided with dramatic improvements in health despite variable quality of implementation. Comprehensive evaluation to inform program improvement requires standardized but adaptable tools, which the Real Accountability, Data Analysis for Results (RADAR) project has developed. To inform selection of tools and methods packages ('packages') to measure program quality of care (QoC), we documented experiences testing the packages, which were developed and adapted based on global and local expertise, and pre- and pilot-testing. We conducted cross-sectional studies in 2018-2019 on the quality of 1) integrated community case management, 2) counseling on maternal, infant, and young child feeding, 3) intrapartum care, and 4) family planning counseling in Mali, Mozambique, Tanzania, and Malawi. Herein we describe package performance and highlight experiences that inform their selection and use. Direct observation packages provided high-quality, immediately applicable results but they required specialized expertise, in-person collection, adequate patient volume, reasonable wait times, and unambiguously 'correct' provision of care. General satisfaction questions from exit interview packages produced unvaryingly positive responses despite variable observed quality of care. Variation increased when questions were more targeted, but findings on caregiver and client's recall of recommendations were more actionable. When interactive, clinical vignettes can capture knowledge of clinical care. But for conditions that can be simulated, like provision of family planning counseling, we could capture provider practice from simulated clients. Clinicians could more easily demonstrate tactile aspects of intrapartum care using observed structured clinical examinations, but this method required storage and transport of the required mannequins. Based on our findings we recommend ten questions upon which evaluators can base package selection. Findings from these packages inform programs and, in the context of comprehensive program evaluation enable us to link programs with impact.


Assuntos
Aconselhamento , Saúde Reprodutiva , Criança , Estudos Transversais , Atenção à Saúde , Humanos , Lactente , Recém-Nascido , Malaui
2.
PLoS One ; 17(9): e0274251, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36107947

RESUMO

PURPOSE: In Malaysia, the trend of HIV transmission has shifted from intravenous drug use to sexual intercourse, and men who have sex with men (MSM) have become the main driver due to high-risk sexual behaviour. Thus, treatment and care, which also involves counselling, for men who have sex with men and who are living with HIV (MSM living with HIV) are crucial. This study aims to explore the experiences of MSM living with HIV and participating in counselling session during treatment and care at two public hospitals. METHOD: This qualitative study with a grounded-theory approach was conducted at two public hospitals in Malaysia. Five participants who were MSM living with HIV were selected through purposive sampling. They participated in semi-structured interviews, non-participant observations, and diary entries, each of which was conducted three times. The data were analysed using grounded theory with N-Vivo 8 to determine themes. RESULT: The participants were found to experience feelings of emptiness and hopelessness because of their unreadiness to accept their HIV status. These feelings made their participation in counselling sessions challenging. Consequently, the participants found counselling sessions unhelpful due to their unwillingness to participate in the counselling relationship. CONCLUSION: The findings of the study highlight the need for counselling sessions to focus more on feelings related to unreadiness to improve the self-esteem and ability to create positive relationships with others of MSM living with HIV. It is also important to strengthen the training and skills among HIV counsellors to enhance counselling services for these men.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Coito , Aconselhamento , Homossexualidade Masculina , Humanos , Malásia , Masculino
3.
PLoS One ; 17(9): e0273848, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36048849

RESUMO

Crucial to its success is that physicians enhance their competence in Lifestyle Medicine and take on their role as Health Advocates in Health Counseling and Promotion (HC&P). However, studies on patients' views of lifestyle counseling in clinical practice demonstrate that many patients neither perceived a need to adopt a healthy lifestyle nor having had any discussion with their physician about their lifestyle. This study is part of a participatory action research project focusing on identifying areas of improvement for health promotion in the practice of internists. Within this project, we interviewed 28 internists from six different subspecialties of an academic medical center in the Netherlands. This study aims to gain insight into how internists understand their role in HC&P by a qualitative analysis of their beliefs and attitudes in the interview data. Participants claimed that promoting a healthy lifestyle is important. However, they also reflected a whole system of beliefs that led to an ambivalent attitude toward their role in HC&P. We demonstrate that little belief in the success of HC&P nurtured ambivalence about the internists' role and their tasks and responsibilities. Ambivalence appeared to be reinforced by beliefs about the ability and motivation of patients, the internists' motivational skills, and the patient-doctor relationship, and by barriers such as lack of time and collaboration with General Practitioners. When participants viewed HC&P as a part of their treatment and believed patients were motivated, they were less ambivalent about their role in HC&P. Based on our data we developed a conceptual framework that may inform the development of the competences of the Health Advocate role of internists in education and practice.


Assuntos
Clínicos Gerais , Medicina Interna , Atitude do Pessoal de Saúde , Aconselhamento , Humanos , Pesquisa Qualitativa
4.
Trials ; 23(1): 773, 2022 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-36100943

RESUMO

BACKGROUND: Many patients suffering from schizophrenia spectrum disorders continue having distressing auditory hallucinations in spite of treatment with antipsychotic medication. The aim of this trial is to examine the effect of a targeted virtual reality therapy for persistent auditory hallucinations in individuals with psychosis. The trial explores whether this type of therapy can decrease the severity, frequency and distress of auditory hallucinations and, additionally, whether it can reduce clinical symptoms and enhance daily functioning in individuals with psychosis. METHODS: The study is a randomised, assessor-blinded parallel-group superiority clinical trial, allocating a total of 266 patients to either the experimental intervention or supportive counselling. The participants will be randomised to either (1) seven sessions of virtual reality therapy or (2) seven sessions of supportive counselling to be delivered within the first 12 weeks after inclusion in the study. All participants will be assessed at baseline and 12 and 24 weeks post-baseline. Independent assessors blinded to the treatment allocation will evaluate the outcome. The primary outcome is the level of auditory hallucinations measured with the Psychotic Symptoms Rating Scales (PSYRATS-AH) total score at the cessation of treatment at 12 weeks. Secondary outcomes are frequency of auditory hallucinations, the distress caused by auditory hallucinations, perceived voice power, patient acceptance of voices, patients' ability to respond to voices in an assertive way and social and daily function. DISCUSSION: Promising evidence of the efficacy of this immersive virtual reality-based therapy for auditory hallucinations exist, but evidence needs to be established in a large, methodological rigorous trial. If the therapy proves to be beneficial in reducing the severity of refractory auditory hallucinations, a large group of patients with schizophrenia and related disorders could be the target group of this short-term psychotherapeutic intervention.


Assuntos
Terapia Implosiva , Transtornos Psicóticos , Terapia de Exposição à Realidade Virtual , Realidade Virtual , Aconselhamento , Alucinações/diagnóstico , Alucinações/terapia , Humanos , Transtornos Psicóticos/complicações , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto
5.
J Korean Med Sci ; 37(35): e269, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36065653

RESUMO

BACKGROUND: In this context, discharge training and telephone counseling given to patients who underwent coronary artery bypass graft surgery increase the ability of patients to cope with and adapt to their self-care. METHODS: This study was a randomized controlled, experimental design. Both experimental and control groups consisted of 35 individuals with G*power analysis (n = 70). Patients in the experimental group were given discharge training and telephone counseling for two months. At the end of the process, data collection forms were administered to both groups for the last time. Necessary ethical approvals were taken and consent was taken from the patients. RESULTS: After the discharge training and telephone counseling given to the experimental group, the mean Exercise of Self-Care Agency Scale (ESCA) score of the patients increased by 13.94; the mean Coping and Adaptation Processing Scale (CAPS) increased by 13.6. The mean ESCA score of the control group increased by 7.86; the mean CAPS score increased by 9.14. The effect size that occurred for both groups was statistically significant (P < 0.05). CONCLUSION: Positive results were achieved in the experimental group which received given discharge training and telephone counseling. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05104996.


Assuntos
Alta do Paciente , Telefone , Ponte de Artéria Coronária , Aconselhamento/métodos , Humanos , Autocuidado
6.
Lancet Healthy Longev ; 3(8): e558-e571, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36102765

RESUMO

One in five older adults experience symptoms of depression and anxiety. Digital mental health interventions are promising in their ability to provide researchers, mental health professionals, clinicians, and patients with personalised tools for assessing their behaviour and seeking consultation, treatment, and peer support. This systematic review looks at existing randomised controlled trial studies on digital mental health interventions for older adults. Four factors have been found that contributed to the success of digital mental health interventions: (1) ease of use; (2) opportunities for social interactions; (3) having human support; and (4) having the digital mental health interventions tailored to the participants' needs. The findings also resulted in methodological considerations for future randomised controlled trials on digital mental health interventions: (1) having a healthy control group and an intervention group with clinical diagnoses of mental illness; (2) collecting data on the support given throughout the duration of the interventions; (3) obtaining qualitative and quantitative data to measure the success of the interventions; and (4) conducting follow-up interviews and surveys up to 1 year post-intervention to determine the long-term outcomes. The factors that were identified in this systematic review can provide future digital mental health interventions researchers, health professionals, clinicians, and patients with the tools to design, develop, and use successful interventions for older users.


Assuntos
Ansiedade , Depressão , Idoso , Ansiedade/diagnóstico , Transtornos de Ansiedade/diagnóstico , Aconselhamento , Depressão/diagnóstico , Humanos , Saúde Mental , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
FP Essent ; 520: 15-19, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36069718

RESUMO

The fact that up to one-third of the 800,000 yearly cardiovascular disease (CVD) deaths in the United States may be preventable by diet and physical activity makes a compelling case for lifestyle interventions as a primary prevention strategy. The U.S. Preventive Services Task Force (USPSTF) recommends offering or referring adults with CVD risk factors to behavioral counseling interventions to promote a healthy diet and physical activity. Although few US adults have ideal cardiovascular health, there exists a dose-response relationship whereby an increasing number of ideal cardiovascular health metrics is associated with lower CVD and all-cause mortality. The Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean diet have proven benefits in reducing CVD. Among individuals without CVD, high levels of physical activity are associated with an approximately 32% reduced risk of CVD death, and moderate levels are associated with approximately a 22% reduction. Resistance exercises confer additional benefits.


Assuntos
Doenças Cardiovasculares , Adulto , Doenças Cardiovasculares/prevenção & controle , Aconselhamento , Exercício Físico , Humanos , Estilo de Vida , Prevenção Primária , Estados Unidos
8.
Artigo em Inglês | MEDLINE | ID: mdl-36078603

RESUMO

INTRODUCTION: Suicide is a key issue impacting children and young people. Helplines offer unique benefits, such as anonymity, varied communication avenues and low cost, which help to promote help-seeking behaviour. The aim of this study was to explore the views and experiences of helpline organisations of identifying, assessing, and managing suicide risk among children and young people. METHODS: Thirteen professionals from three UK-based helplines and online counselling services took part in semi-structured interviews between November 2020 and January 2021 via Zoom. Interviews were transcribed verbatim and analysed using Thematic Analysis. RESULTS: Three superordinate themes were identified: (i) Starting conversations about suicide; (ii) Identifying and responding to "imminent" suicide risk; and (iii) Responses to suicide risk in relation to safeguarding. LIMITATIONS: Recruitment was limited by COVID-19 due to the demands needed from helplines at this time. CONCLUSIONS: Our findings highlight not only the different types and range of services helpline organisations offer to young people who might be at risk of suicide, but most importantly the distinct role they have in young people's help-seeking pathway.


Assuntos
COVID-19 , Suicídio , Adolescente , COVID-19/epidemiologia , Criança , Comunicação , Aconselhamento , Humanos , Pesquisa Qualitativa , Suicídio/prevenção & controle
9.
Artigo em Inglês | MEDLINE | ID: mdl-36078806

RESUMO

A healthy lifestyle among the elderly is associated with improved health. However, many older adults are not engaging in such behavior. The purpose of the study was to develop an individually tailored online/telephone program to increase healthy lifestyle behaviors among community-dwelling elderly people. The program includes individually tailored healthy lifestyle recommendations based on participants' functional level. Community-dwelling elderly people aged 60+ years (n = 77; mean age: 72.98 ± 6.49) participated in the study. Significant associations were observed between health promotion activities and health status (r = 0.23, p = 0.04) and physical functional level (r = 0.44, p < 0.001). Twenty-seven percent of participants claimed that they learned "a lot" of new things about themselves, and 31% claimed that the recommendations received were new to them. Most participants engaged in the recommendations at least 1-2 times a week. Regression analyses showed that barriers significantly predicted reduced compliance with the health-related recommendations received (adjusted R2 = 0.18). The main barrier for compliance was inaccessible information about services (32.46% of the participants). The most prevalent facilitator for compliance with the recommendation was health behavior motivation (59.74% of the participants). In conclusion, this study provided evidence on the effectiveness of a multicomponent tailored intervention program among the elderly in increasing health-related knowledge and behavior about the recommendations.


Assuntos
Comportamentos Relacionados com a Saúde , Promoção da Saúde , Idoso , Terapia Comportamental , Aconselhamento , Estilo de Vida Saudável , Humanos , Estilo de Vida
10.
BMC Psychiatry ; 22(1): 581, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-36050679

RESUMO

BACKGROUND: Infertility is among the most unpleasant experiences for couples struggling with it. Therefore, coping with its associated psychological burden has become a concern in many societies due to its negative impacts on couples' lives and intimacy levels. Lack of marital intimacy leads to unfortunate consequences such as dissatisfaction with marital relationships between spouses. Therefore, these people should be encouraged to find an effective solution to cope with infertility. Regarding the importance of the emotional relationship between infertile couples and the success rate of infertility treatment, this study aims to determine the effect of couple-centered counseling by the Gottman method on marital intimacy of infertile couples referred to the infertility ward of Fatemieh Hospital in Hamadan. METHOD: The sample of this quasi-experimental study included 60 infertile couples in the evaluation phase of treatment with primary infertility. We collected data in a referral infertility center in Hamadan (Iran) between December 2020 and May 2021. Marital intimacy was measured using Thompson & Walker's Marital Intimacy Questionnaire. At the beginning of the study, the intervention and control groups completed this questionnaire. The intervention group received Gottman couple-centered counseling based on GATHER principles in 8 sessions. The groups completed the questionnaires 4 weeks after the last intervention session again. If the distribution was normal, the ANCOVA test was used to evaluate the differences between the two groups. Intra-group comparisons were performed using paired t-test, and intergroup comparisons were performed using an independent t-test. RESULTS: The mean score of female intimacy increased significantly after the intervention (P = 0.009). There was no significant difference in socio-demographic characteristics between groups (P < 0.05), both of which were adjusted in ANCOVA. After the intervention, the mean marital intimacy scores were significantly higher in women participating in the intervention group (from 75.6 (±10.63) to 78.86 (±7.87)). In addition, after the ANCOVA test, the difference was statistically significant (P = 0.009; MD: 3.74, CI: 0.95 and 6.52). The mean score of male marital intimacy increased after the intervention (from 78.93 (±10.21) to 78.9 (±9.79)), although the difference was not statistically significant (P = 0.54; MD: -0.58, CI: - 2.51 and 1.34). CONCLUSION: The findings support the effective role of Gottman's couple-centered counseling in increasing marital intimacy by raising couples' awareness about the principles of proper relationships between them. This outcome suggests that counseling with couples, especially in critical life situations, can improve their relationship in the infertility treatment process and prevent emotional divorce and other negative impacts on their lives. TRIAL REGISTRATION: IRCT Registration Number IR.UMSHA.REC.1399.535, registered on 21/09/2020.


Assuntos
Infertilidade , Aconselhamento , Feminino , Hospitais , Humanos , Infertilidade/psicologia , Irã (Geográfico) , Masculino , Parceiros Sexuais/psicologia
11.
Trials ; 23(1): 731, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36056388

RESUMO

BACKGROUND: Medication non-adherence is a prevalent health problem in people with type 2 diabetes mellitus (T2DM). Interventions have previously been developed to improve medication adherence, but inconsistent outcomes have been reported. A potential explanation for this inconsistency is a 'one size fits all' approach, with interventions not tailored to the needs and preferences of individuals. Therefore, the aim of this study is to evaluate the effectiveness of a personalised intervention programme aimed at improving adherence to oral antidiabetic and/or antihypertensive medication in people with T2DM. METHODS: A parallel-group randomised controlled trial will be conducted in 40-50 community pharmacies in the Netherlands and the United Kingdom (UK). A total of 300 participants will be included and followed up for a period of 6 months. Participants will be people with T2DM identified as non-adherent to oral antidiabetic and/or antihypertensive medication, aged 35-75 years and mobile phone users. The intervention group will receive a personalised intervention programme that is based on one or more of the participants' pre-defined non-adherence profile(s), namely (I) Knowledge and perceptions, (II) Practical problems, (III) Side effects and (IV) Negative mood and beliefs. The intervention comprises of one or more supporting modules, namely (I) Brief messaging, (II) Clinical medication review, (III) Medication schedule, (IV) Reminding messaging, (V) Medication dispensing systems, (VI) Smart messaging, (VII) Referral to general practitioner and (VIII) Unguided web-based Self Help Application for low mood. The control group will receive usual care including access to a publicly available informative diabetes website. The primary study outcome is medication adherence measured with a telephone pill count. Secondary outcomes are systolic blood pressure, HbA1c level, self-reported medication adherence, attitude and beliefs toward medication, satisfaction with diabetes treatment, health status and medical consumption and productivity cost. In addition, a process evaluation will be undertaken to establish the fidelity, reach and the extent to which intervention delivery is normalised in the daily practice of community pharmacy teams. DISCUSSION: The study can lead to a personalised intervention programme that improves medication adherence in people with T2DM that are non-adherent to oral antidiabetic and/or antihypertensive medication. TRIAL REGISTRATION: Dutch Trial Register, Trial NL8747 , registered 02 July, 2020; ISRCTN Registry, ISRCTN36009809 , registered 05 February, 2020.


Assuntos
Anti-Hipertensivos , Diabetes Mellitus Tipo 2 , Hipoglicemiantes , Adesão à Medicação , Adulto , Idoso , Anti-Hipertensivos/uso terapêutico , Aconselhamento , Diabetes Mellitus Tipo 2/tratamento farmacológico , Humanos , Hipoglicemiantes/uso terapêutico , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
BMC Health Serv Res ; 22(1): 1130, 2022 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-36071413

RESUMO

BACKGROUND: Pharmacies play the key role in implementing generic substitution (GS) and counselling customers about it. This study aimed to explore dispensers' perceptions of the factors that facilitate or hinder counselling customers on GS and the reference price system (RPS) in community pharmacies. It also studied dispensers' opinions about the benefits and problems of these systems and discusses them from the counselling point of view. METHODS: A postal survey was conducted among Finnish community pharmacy dispensers in spring 2018. The research questions were studied through open-ended questions and analyzed both qualitatively and quantitatively. The questions were analyzed first with inductive content analysis by two researchers independently. The responses were encoded and categorized according to the analytical framework, which was inductively developed alongside the analysis. The categorized responses were further analyzed using frequencies and percentages. RESULTS: The response rate was 50.8% (n = 498). Of the respondents, 75.9% reported factors that facilitated counselling about GS and RPS. The most commonly mentioned factors included customers' characteristics (36.5%), the information systems used in the pharmacy (28.3%), and the features of interchangeable medicines (21.7%). Of the respondents, 89.0% reported factors that hindered counselling, of which customers' characteristics (45.8%), the unavailability of medicines and other availability issues (32.5%), the features of interchangeable medicines (22.6%) and time pressure in the pharmacy (22.1%) were the most commonly reported. The benefits of the systems focused on cost savings for customers and society (74.4%). The most commonly reported problems concerned medicine availability (31.9%), changes in medicine prices and in reference price band (28.9%), as well as how GS is time-consuming and increases workload (24.2%). CONCLUSIONS: Finnish dispensers reported more hindering than facilitating factors in GS and RPS counselling. Customers' characteristics were the most often mentioned in both cases. Customers' knowledge could be increased by providing information and education. However, developing simpler regulations for GS and RPS, intelligent assisting software, and solutions for secured medicine availability would facilitate implementation of GS. Simplified price counselling would also guarantee the time needed and focus on instructions on the correct and safe use of medicines.


Assuntos
Farmácias , Aconselhamento , Substituição de Medicamentos , Finlândia , Humanos , Inquéritos e Questionários
14.
PLoS One ; 17(9): e0274224, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36084129

RESUMO

Mothers-in-law in multicultural families tend to experience psychological burden. This study aimed to verify the effects of the cultural adaptation promotion resilience program (CAPRP) on resilience, acculturation stress, depression, and quality of life among mothers-in-law in multi-cultural families. Forty-two participants from multicultural family support centres in the metropolitan city A were assigned to either the intervention group or the control group. The CAPRP was performed for 60 minutes, twice a week for four weeks. The intervention group showed a significant decrease in the acculturation stress (p = .002), and depression (p = .006), while resilience (p < .001) and quality of life (p < .001) significantly increased compared to the control group. The intervention group reported significant improvements in resilience, acculturation stress, depression, and quality of life in comparison with the control group. The results indicated that the CAPRP, developed based on positive cognitive appraisal, was an efficient nursing intervention for mothers-in-law in multicultural families.


Assuntos
Mães , Resiliência Psicológica , Aculturação , Adaptação Psicológica , Aconselhamento , Diversidade Cultural , Feminino , Humanos , Mães/psicologia , Qualidade de Vida
15.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 2668-2671, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36085663

RESUMO

Online counseling is essential for overcoming mobility restrictions, schedule limitations, and mental health stigma. However, government counseling offices are being inun-dated with consultations for which non-mental health supports are targeted. Therefore, we aim to create a classification model that classifies whether the clients have mental health issues or other issues. We expect to support counselors by presenting the classification results. We conducted the first automatic detection of clients who might be suffering from mental health issues and used almost 1000 actual counseling sessions for our machine learning framework. We achieved an F1-score of 0.646 by classifying dialogue sessions using features such as frequency-inverse, document frequency, document embedding of a large-scale language model, linguistic inquiry and word count, topic modeling, and statistics of dialogue sentences. In addition, we performed dimensionality reduction with principal component analysis. We also conducted evaluation experiments using dialogue sentences from the beginning to the middle of sessions as input and clarified the relationship between the number of messages in the dialogues and the transition in the classification performance. We also identified the words that contribute to detecting mental health issues for each client and counselor. Clinical relevance-This study makes it possible to detect the trends identified in a client's anxieties during counseling. Our findings are critical for designing systems that assist counselors.


Assuntos
Conselheiros , Aconselhamento , Diagnóstico Precoce , Humanos , Idioma , Linguística
16.
Sex Reprod Health Matters ; 30(1): 2111796, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36129725

RESUMO

Immigrant women in Sweden often have unmet sexual and reproductive health (SRH) needs. Successful contraceptive counselling may improve their sexual and reproductive health and rights. The unique Swedish model, with midwives as the main providers of contraceptive counselling, is important for immigrant women's health at both individual and societal levels. This study explored immigrant women's perspectives on receiving contraceptive counselling from midwives in Sweden, in order to obtain deeper knowledge about the factors they perceive as important in the counselling situation. Nineteen in-depth individual interviews were conducted from December 2018 to February 2019, followed by qualitative manifest and latent content analysis. Trust emerged as the overall important factor in the contraceptive counselling meeting. Knowledge was lacking about the midwife's professional role as a contraceptive counsellor. Contraceptive counselling was seen as a private matter not easily shared with unfamiliar midwives or interpreters. Previous experiences of contraceptives and preconceptions were important considerations for contraceptive choice, but communicating these needs required trust. Women also wanted more knowledge about contraceptives and SRH care and rights. Cultural and social norms concerning when and why to use contraceptives needed to be acknowledged in the midwife encounter. Although immigrant women want more knowledge about contraception, a trustful relationship with the midwife is needed to be able to make informed contraceptive choices. Midwives may need increased awareness of the many factors influencing immigrant women's choices to ensure their contraceptive autonomy. Policy changes that promote new ways of counselling and ability to provide continuous care are needed.


Assuntos
Emigrantes e Imigrantes , Tocologia , Anticoncepcionais , Aconselhamento , Feminino , Humanos , Gravidez , Suécia
17.
Arch Psychiatr Nurs ; 40: 124-131, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36064235

RESUMO

Information technology developments have combined traditional face-to-face counseling with online- or cyber-counseling. As digital natives, Generation Z has easy access to cyber-counseling. However, their attitudes toward cyber-counseling remain unknown. This study explored these attitudes and relevant influencing factors among 1216 Chinese adolescents using self-report questionnaires. Descriptive analyses and structural equation modeling were used for data analysis. The model explained 27.7 % of the total variance, attitudes toward psychological help was the most influential, followed by attitudes toward the Internet and perceived behavioral control. The model was effective in explaining attitudes toward cyber-counseling, emphasizing the influence of attitudes toward psychological help.


Assuntos
Atitude , Aconselhamento , Adolescente , China , Humanos , Inquéritos e Questionários
18.
BMJ Open ; 12(9): e062516, 2022 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-36123105

RESUMO

INTRODUCTION: The mental health status of nurses affects not only their well-being but also the organisational outcomes and the quality of patient care. Hence, stress management strategies are critical as a universal prevention measure that address an entire population and are not directed at a specific risk group to maintain nurses' mental health in the workplace. No systematic review or meta-analysis has been conducted to evaluate the effect of cognitive-behavioural therapy (CBT) that specifically focuses on universal prevention. Therefore, the aim of this study is to examine the effectiveness that is reported in published randomised controlled trial (RCT) studies. METHODS AND ANALYSIS: This systematic review and meta-analysis will analyse published studies selected from electronic databases (ie, Cochrane Central Register of Controlled Trials, PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PsycARTICLES, Web of Science and the Japan Medical Abstracts Society). The inclusion criteria for studies are that they (1) were conducted to assess the effect of CBT on the mental health of nurses as a universal prevention, (2) used an RCT design and (3) provided sufficient results (sample sizes, means and SD) to estimate the pooled effect sizes with 95% CIs. Studies will be excluded if they only targeted nurses who had been screened as being at high risk in terms of their mental health and indicated that they required the prevention. The methodological quality of the included studies will be assessed using the Cochrane Collaboration's risk of bias tool. ETHICS AND DISSEMINATION: Ethical approval is not required because this study is based on information obtained from previous studies. The results and findings of this study will be submitted for publication in a peer-reviewed international scientific journal. Results from this study will be helpful when implementing CBT strategies for nurses as a universal preventative measure in the workplace and for managing stress-related outcomes. PROSPERO REGISTRATION NUMBER: CRD42020152837.


Assuntos
Terapia Cognitivo-Comportamental , Aconselhamento , Atenção à Saúde , Humanos , Saúde Mental , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisões Sistemáticas como Assunto , Local de Trabalho/psicologia
19.
BMJ Paediatr Open ; 6(1)2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-36053612

RESUMO

BACKGROUND: In 2020, Zimbabwe adopted the WHO's recommendation to use raltegravir (RAL) granule-based regimens for treatment of neonates identified with HIV at the time of birth testing. This study explores the acceptability of RAL granules by caregivers and healthcare workers (HCWs). METHODS: Interviews were conducted with 15 caregivers and 12 HCWs from 8 health facilities in Zimbabwe participating in the introductory pilot of RAL granules treatment for newborns. Eligible caregivers included those who had administered RAL to their infant and attended either 8th or 28th day of life appointments. Caregivers of neonates recently initiated on RAL were selected through convenience sampling. Eligible HCWs who provided RAL preparation, administration instructions and support to caregivers of neonates on RAL for at least 3 months were recruited from the same facilities as the caregivers. Interview transcripts were coded and thematically analysed. RESULTS: Caregivers reported that their babies looked healthier after RAL initiation, with improved skin appearance and weight gain. Some caregivers wanted their child to remain on RAL beyond 28 days instead of switching regimens, as recommended by national guidelines. HCWs observed that RAL granules improved health outcomes compared with other regimens. HCWs reported challenges with caregivers understanding dosing instructions, measuring with a syringe, swirling and not shaking the medicine, discarding unused medication and following the changes in the dosing schedule and amount when RAL was initiated a few days after birth. HCWs stated that adequate counselling and repeat demonstrations were crucial to ensure that caregivers clearly understood RAL dosing and administration instructions. HCWs requested more standardised training targeting nurses with guidance on handling missed doses and clarification on mixing RAL granules with water and not breastmilk. CONCLUSION: While feedback from caregivers and HCWs on RAL implementation was positive, barriers were also noted. Adequate training and sufficient instruction and support for caregivers would help to ensure that RAL granules are prepared, dosed and administered correctly.


Assuntos
Cuidadores , Infecções por HIV , Aconselhamento , Infecções por HIV/tratamento farmacológico , Pessoal de Saúde/educação , Humanos , Lactente , Recém-Nascido , Raltegravir Potássico/uso terapêutico
20.
PLoS One ; 17(9): e0274240, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36094935

RESUMO

BACKGROUND: A birth plan (BP) is a written document in which the pregnant woman explains her wishes and expectations about childbirth to the health professionals and aims to facilitate her decision-making. Midwives' support to women during the development of the BP is essential, but it's unknown if shared decision making (SDM) is effective in birth plan counselling. We hypothesized that women who receive counselling based on SDM during their pregnancy are more likely to present their BP to the hospital, more satisfied with the childbirth experience, and have better obstetric outcomes than women who receive standard counselling. We also aimed to identify if women who presented BP to the hospital have better obstetric outcomes and more satisfied with the childbirth experience. METHODS: This was a randomised cluster trial involving four Primary Care Units. Midwives provided BP counselling based on SDM to the women in the intervention group (IG) during their pregnancy, along with a leaflet with evidence-based recommendations. Women in the control group (CG) only received the standard birth plan counselling from midwives. The primary outcomes were birth plan presentation to the hospital, obstetrics outcomes and satisfaction with childbirth experience. The Mackey Satisfaction with Childbirth Scale (MCSRS) was used to measure childbirth satisfaction. RESULTS: A total of 461 (95.5%) pregnant women received BP counselling (IG n = 214 and CG n = 247). Fewer women in the intervention group presented their BP to the hospital compared to those in the control group (57.8% vs 75.1%; p <0.001). Mean satisfaction with childbirth experience was high in the IG as well as the CG: 150.2 (SD:22.6) vs. 153.4 (SD:21.8); p = 0.224). The information received about childbirth during pregnancy was high in both groups (95.1% vs 94.8%; p = 1.0). Fewer women in the IG used analgesia epidural compared to those in the CG (84.7% vs 91.7%; p = 0.034); women who combined non-pharmacological and pharmacological methods for pain relief were more in number in the IG (48.9% vs 29.5%; p = 0.001) and women who began breastfeeding in the delivery room were more in number in the IG (83.9% vs 66.3%; p = 0.001). Women who presented their BP had a greater probability of using combined non-pharmacological and pharmacological methods for pain relief aOR = 2.06 (95% CI: 1.30-4.30) and early skin-to-skin contact aOR = 2.08 (95% CI: 1.07-4.04). CONCLUSION: This counselling intervention was not effective to increase the presentation of the BP to the hospital and women's satisfaction with childbirth; however, it was related to a lower usage of analgesia epidural, a higher combination of pharmacological and non-pharmacological methods for pain relief and the initiation of breastfeeding in the delivery room. Presenting the BP to the hospital increased the likelihood of using pharmacological and non-pharmacological methods for pain relief, and early skin-to-skin contact.


Assuntos
Tomada de Decisão Compartilhada , Educação Pré-Natal , Aconselhamento/métodos , Feminino , Humanos , Dor , Gravidez , Cuidado Pré-Natal/métodos
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