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1.
J Assoc Physicians India ; 69(8): 11-12, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34472801

RESUMO

OBJECTIVES: The purpose of this study was to identify the relationship between socio-psychological factors and TB patients as well as to determine whether the association differs from treated and untreated persons. METHODS: This was a prospective study in a municipal corporation hospital in Pune district. A total 104 patient sample were selected from the population; criteria covered age group of 25 to 60 years along with their education and economic background. Trained study nurses then collected baseline information from consenting participants using a questionnaire. RESULTS: After being cured from the disease, patients share clothes or utensils with their family members. For a few patients psychological improvements were observed after some period of treatment whereas as in majority of patients psychological support by their family and friends was not received. This caused increase in emotional stress despite patients got cured off the TB infection. CONCLUSION: The important point noticed about the cured patients was augmented fighting spirit against this deadly disease. Recovered patients want to live more with the same joy and happiness after treatment.


Assuntos
Tuberculose , Adulto , Aconselhamento , Humanos , Índia/epidemiologia , Pessoa de Meia-Idade , Estudos Prospectivos , Tuberculose/epidemiologia
2.
BMJ Case Rep ; 14(9)2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479890

RESUMO

A university student with a background of atopy presented to her general practitioner (GP) 2 weeks following an episode of throat tightening and dizziness occurring after touching cashew nut to her lip. She took antihistamine medication immediately and went to sleep, fearing for her life. On waking, she felt astounded to be alive. Her symptoms resolved gradually over the following week. She waited 2 weeks for an appointment with her GP, who referred her to allergy clinic. Eight months later, she was still waiting for her clinic appointment, and was left fearing a future fatal reaction, having been provided with no interim treatment. Not all patients who have severe allergic reactions present to the emergency department. Living with the constant fear of anaphylaxis can be overwhelming for patients and their families, and it can negatively impact mental health. Therefore, we advise early allergy counselling and early EpiPen prescription.


Assuntos
Anafilaxia , Alérgenos , Anafilaxia/tratamento farmacológico , Aconselhamento , Epinefrina , Feminino , Antagonistas dos Receptores Histamínicos H1 , Humanos
3.
Artigo em Inglês | MEDLINE | ID: mdl-34501650

RESUMO

COVID-19 has caused nearly 4.3 million deaths all around the world. People who have experienced loss during this special period may find it difficult to adapt to life after loss, and may even suffer from prolonged grief disorder or other mental health problems. However, there is a huge gap of grief research in China, with almost no comprehensive grief intervention training system or very few professional grief consultants. Considering the large number of bereaved individuals who are suffering from grief and other mental health problems, it is significant to develop a suitable and effective intervention protocol immediately. This article illustrates a study protocol initiated by a Chinese university to investigate the mental health of bereaved individuals during the COVID-19 pandemic and train grief counselors to provide grief counseling to the bereaved, as well as to evaluate the effectiveness of the grief counseling. The method is as follows: (1) 300 psychological counselors will be recruited to attend the grief counseling training. Assessments will be conducted at three time points: baseline (T0), after the basic training (T1), and after the advanced training (T2); (2) 500 bereaved Chinese will be recruit to join the online survey and will be assessed at two time points with a six-month interval; and (3) a two-armed (grief counseling versus wait-list controls) RCT (random control trials) will be conducted with 160 bereaved individuals. Assessments will be conducted at three time points: before randomization (baseline, T0), at the post-counseling (T1), and three months after the post-counseling (T2). Primary outcomes will be assessed by the Prolonged Grief Questionnaire (PG-13), the 20-item PTSD Checklist for DSM-5 (PCL-5), the Depression Anxiety and Stress Scale (DASS-21), and the Posttraumatic Growth Inventory (PTGI). This research will help develop grief research and grief counseling in China, as well as provide professional mental health services for individuals who may suffer from grief-related disorders in the future.


Assuntos
Luto , COVID-19 , China , Aconselhamento , Pesar , Humanos , Estudos Longitudinais , Pandemias , Ensaios Clínicos Controlados Aleatórios como Assunto , SARS-CoV-2
5.
Artigo em Inglês | MEDLINE | ID: mdl-34444351

RESUMO

The progress of new media has promoted the development of online health consultations. Previous research has investigated the impact of media richness on user satisfaction; however, little attention has been given to the mixed effects of the nesting of multiple media. The purpose of this study is to analyze the impact and differences of the use of single or mixed media on users' perceived effect from the perspectives of social support and satisfaction by mining user reviews on online health platforms. The data were collected from a professional online psychological counseling platform. We collected data on 48,807 reviews from 11,694 users. Text annotation and sentiment analysis were then used to extract variable eigenvalues from the reviews. One-way analysis of variance (ANOVA) and hierarchical regression analysis were used for statistical analysis. The results show that mixed media with different richness has a significant impact on the users' perceived effects. Among them, compared to "text + audio," using "text + audio + video/face to face" can significantly improve the users' perceived social support and satisfaction. However, compared to single medium, mixed media with higher richness may not necessarily achieve a better effect. We found that the inclusion of "video/face to face" mixed media significantly reduced the users' perceived social support and satisfaction compared to text or audio use alone. These research results complement the blank media richness theory in the field of online health care and provide guidance for improving the personalized customization of online psychological counseling platforms.


Assuntos
Mídias Sociais , Envio de Mensagens de Texto , Aconselhamento , Humanos , Psicoterapia , Apoio Social
6.
Obstet Gynecol Surv ; 76(8): 493-503, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34449852

RESUMO

Importance: Ten years have passed since the Institute of Medicine (IOM) released its recommendations for gestational weight gain (GWG), based on a woman's prepregnancy body mass index. Despite this, the majority of women do not gain the appropriate gestational weight; most women gain too much weight, and a small but substantial number gain too little. Objective: We review the literature concerning GWG, the opinions and practices of clinicians in managing their patients' weight, and how these practices are perceived by patients. We also review several randomized control trials that investigate the efficacy of clinical intervention in managing GWG. Evidence Acquisition: A literature review search was conducted with no limitations on the number of years searched. Results: The number of clinicians who are aware of and use the IOM recommendations has increased, but the prevalence of inappropriate GWG has not decreased. Clinicians report feeling less than confident in their ability to have an impact on their patients' weight gain, and there are discrepancies between what clinicians and patients report regarding counseling. Many randomized control trials demonstrate a beneficial impact of clinical intervention, highlighting the importance of collaboration and technology to provide educational information and support throughout a pregnancy. Conclusions: Pregnancy provides an opportunity for clinicians to have open and direct conversations with their patients about their weight. Providing clinicians with the tools, skillset, and confidence to assist in the management of GWG is essential to the health of women and their children, and warrants further investigation.


Assuntos
Gerenciamento Clínico , Ganho de Peso na Gestação , Papel do Médico , Guias de Prática Clínica como Assunto/normas , Terapia Comportamental , Aconselhamento , Grupos Étnicos , Feminino , Humanos , National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division , Gravidez , Fatores Raciais , Tecnologia , Estados Unidos/epidemiologia
7.
BMJ Open Qual ; 10(Suppl 1)2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34344746

RESUMO

BACKGROUND: Unintended pregnancies have a negative impact on the health and economy of a nation, which can be prevented by effective family planning (FP) services. Postpartum intrauterine device (PPIUCD) is a safe and effective FP method which allows women to obtain long-acting contraception before discharge from the point of delivery. We observed poor coverage of deliveries with PPIUCD at our facility. This was the trigger to initiate a quality improvement (QI) initiative to increase the PPIUCD coverage from current rate of 4.5%-10% in 3-month period. METHOD: A fishbone analysis of the problem was done and the following causes were identified: lack of focused counselling for FP, lack of sensitisation and training of resident doctors and inconsistent supply of intrauterine contraceptive devices (IUCDs). A QI team was constituted with representatives from faculty members, residents, interns, nursing officers and FP counsellors. The point of care quality improvement methodology was used. INTERVENTIONS: Daily counselling of antenatal women was started by the counsellors and interns in antenatal wards. A WhatsApp group of residents was made initially to sensitise them; and later for parking of problems and trouble shooting. The residents were provided hands-on training at skills lab. Uninterrupted supply of IUCDs was ensured by provision of buffer stock of IUCDs with respective store keepers. RESULT: The PPIUCD insertion rates improved from 4.5% to 19.2% at 3 months and have been sustained to a current 30%-35% after 1 ½ years of initiation of the project tiding through the turbulence during the COVID-19 pandemic using QI techniques. CONCLUSION: Sensitisation and training of residents as well as creation of awareness among antenatal women through targeted counselling helped improve PPIUCD coverage at the facility. QI initiatives have the potential to facilitate effective implementation of the FP programmes by strategic utilisation of the resources.


Assuntos
Anticoncepção , Serviços de Planejamento Familiar , Dispositivos Intrauterinos , Período Pós-Parto , Melhoria de Qualidade , Adulto , COVID-19 , Anticoncepção/estatística & dados numéricos , Aconselhamento , Feminino , Pessoal de Saúde , Humanos , Índia , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde , Alta do Paciente , Gravidez
9.
BMC Res Notes ; 14(1): 320, 2021 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-34419155

RESUMO

OBJECTIVES: Peer support is rapidly being introduced into mental health services internationally, yet peer support interventions are often poorly described, limiting the usefulness of research in informing policy and practice. This paper reports the development of a peer support intervention that aims to improve outcomes of discharge from inpatient to community mental health care. People with experiential knowledge of using mental health services-peer workers and service user researchers-were involved in all stages of developing the intervention: generating intervention components; producing the intervention handbook; piloting the intervention. RESULTS: Systematic review and expert panels, including our Lived Experience Advisory Panel, identified 66 candidate intervention components in five domains: Recruitment and Role Description of Peer Workers; Training for Peer Workers; Delivery of Peer Support; Supervision and Support for Peer Workers; Organisation and Team. A series of Local Advisory Groups were used to prioritise components and explore implementation issues using consensus methods, refining an intervention blueprint. A peer support handbook and peer worker training programme were produced by the study team and piloted in two study sites. Feedback workshops were held with peer workers and their supervisors to produce a final handbook and training programme. The ENRICH trial is registered with the ISRCTN clinical trial register, number ISRCTN 10043328, and was overseen by an independent steering committee and a data monitoring committee.


Assuntos
Transtornos Mentais , Serviços de Saúde Mental , Aconselhamento , Humanos , Pacientes Internados , Transtornos Mentais/terapia , Saúde Mental
10.
Int J Chron Obstruct Pulmon Dis ; 16: 2337-2350, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34421298

RESUMO

Objective: The aim of this study was to explore to what extent a combined counselling and pulmonary rehabilitation program (PR) influences the perception of physical activity (PA) and motivation for behavioral change in PA in individuals with COPD. The results of previous quantitative trial that investigated the effect of this combined treatment on daily PA were inconclusive. It is conjectured that a more targeted tailoring of the counselling and PR intervention could improve its effectiveness. Patients and Methods: Eighteen individuals with COPD (median age 69, 8 females) who had participated in the PneumoReha program were interviewed twice (following PR and at three-month follow-up). These interviews were transcribed and analyzed thematically. Based on the codes thus identified, three categories 'perception of PA intensity', 'quality of motivation to perform PA', and 'strategies to cope with barriers' were used to differentiate 'types' of participants. Results: Four different types of COPD individuals were distinguished. Study findings indicate that those individuals who participated in the PR program combined with embedded counselling tended to be more active and intrinsically motivated. Conclusion: A typology of four types of people with COPD was developed, characterized by their perception of activity, individual motivation and strategies for managing barriers. The patients' physical activity level might be influenced by their concept of physical activity and the quality of motivation. Recognizing patients' different activity behaviors is important for improving the quality of outpatient PR programs and developing tailored (according to each type) counselling interventions embedded in outpatient PR programs. Clinical Trial Registration: The study was registered on the website of https://www.clinicaltrials.gov/ with the identifier NCT02455206 (27/05/2015), as well as on the Swiss National Trails Portal SNCTP000001426 (05/21/2015).


Assuntos
Doença Pulmonar Obstrutiva Crônica , Idoso , Aconselhamento , Exercício Físico , Feminino , Humanos , Percepção , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/terapia , Pesquisa Qualitativa
11.
Medicine (Baltimore) ; 100(30): e26563, 2021 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-34397687

RESUMO

AIM: This study aimed to assess the outcome of community-based nutritional counseling interventions on eating habits of rural-dwelling children. METHODS: A group-randomized trial design was used in this study. A total of 108 rural-dwelling children from a community in the Enugu North agricultural zone, Enugu State, who participated in the study. The children were randomly assigned to 2 groups: the treatment group (n = 54) and the no-treatment control group (n = 54). The child eating behavior questionnaire was used for data collection. Parents of the participating children within each study group completed the child eating behavior questionnaire at 3 time points. The data collected were analyzed using an independent sample t test at a probability level of .05. RESULT: The outcome of the study showed that the children's eating habits in the treatment group improved positively following the community-based nutritional counseling intervention. The positive gain from exposure to the community-based nutritional counseling intervention program was sustained during follow-up for children in the treatment group compared with the no-treatment group. CONCLUSION: The community-based nutrition counseling intervention carried out among children in rural communities had a positive adjustment in children's eating habits. The intervention requires the constant collaboration of professional childhood educators, caregivers, home economists, school staff, healthcare specialists, families, and the children themselves. Furthermore, there is a need for future long-term evaluations of the effects of community-based nutritional counseling interventions on children's nutrition and eating habits.


Assuntos
Aconselhamento/métodos , Comportamento Alimentar/psicologia , Terapia Nutricional/normas , Adolescente , Criança , Comportamento Infantil/psicologia , Pesquisa Participativa Baseada na Comunidade/métodos , Feminino , Humanos , Masculino , Nigéria , Terapia Nutricional/métodos , Terapia Nutricional/estatística & dados numéricos , Estado Nutricional
12.
Emerg Med Pract ; 23(9): 1-24, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34402609

RESUMO

High-altitude illness is a continuum of syndromes that includes the potential for death. Understanding how to prevent altitude illness and how to treat it if it occurs is fundamental to trip planning and is an important role of medical advisors to travelers. Gradual ascent, along with pharmacotherapy where indicated, are the mainstays of prevention. Travelers with certain chronic medical conditions may require additional pretravel counseling and preparation. Diagnostic recognition of the differing manifestations of high-altitude illness as well as recommendations on appropriate therapeutic options are discussed in detail.


Assuntos
Doença da Altitude/diagnóstico , Doença da Altitude/prevenção & controle , Comorbidade , Aconselhamento , Humanos , Fatores de Risco , Viagem
13.
Curr Sports Med Rep ; 20(8): 389-394, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34357884

RESUMO

ABSTRACT: Ten percent of all premature deaths and 117 billion dollars in annual health care costs are attributable to physical inactivity in America. The positive impact exercise can have on overall health is irrefutable. While it is the responsibility of health care providers to assess and counsel for exercise, there are logistical, structural, and educational barriers preventing this counseling. A physical activity consultation clinic led by primary care sports medicine physicians would allow for focused exercise counseling by appropriately trained providers to motivated patients. While previously there have been many institutional and logistical barriers to establishing such a clinic, the COVID-19 pandemic has created a window of opportunity for doing so within a large academic medical center. This article reviews the importance of exercise on overall health, outlines the barriers for establishing a clinical experience dedicated to counseling for physical activity, and details how overcoming those barriers was facilitated by the COVID-19 pandemic.


Assuntos
COVID-19/epidemiologia , Doença Crônica/prevenção & controle , Aconselhamento , Exercício Físico , Promoção da Saúde/métodos , Pandemias , Medicina Esportiva , Humanos , SARS-CoV-2 , Estados Unidos/epidemiologia
14.
BMC Health Serv Res ; 21(1): 784, 2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34372830

RESUMO

BACKGROUND: Clients must recall information from contraceptive counseling sessions to properly use their chosen method. Client recall in community-based settings is challenging given the public nature of these events and the presence of many potential distractions. Understanding the factors that influence client recall during community-based distribution events can guide future training of providers to improve proper use of contraceptive methods and client satisfaction. METHODS: This cross-sectional study employed a convenience sample of 957 women ages 15-49 old who sought contraceptive services from community-based contraceptive distribution events in Kinshasa, Democratic Republic of the Congo, known as Lelo PF. Recall scores were developed by matching direct observations with client exit interviews. The association between recall and client characteristics, provider characteristics and an index for the quality of the provider-client interaction were tested using multivariate linear regression. RESULTS: The average recall score was 67.6%. Recall scores were higher among clients who accepted methods with simpler administration procedures, such as CycleBeads (81.3%), compared to methods requiring more medically advanced administration procedures, such as DMPA-SC (56.6%) and Implanon-NXT (62.1%). This relationship held even after controlling for amount of information each client received. Status as a first-time user was associated with a 5.8 percentage point decrease in recall score (p = 0.002). Time since the provider's initial family planning training and clients' perception of the provider-client interaction were associated with higher client recall scores. CONCLUSION: Results of this study suggest that to improve client recall at Lelo PF events, future provider training should focus on how to deliver clear, specific information to clients, making sure clients feel at ease during the counseling session, and treating clients with respect. First-time family planning users and clients who select methods with more medically advanced administration procedures may require extra attention during the consultation to ensure they are able understand and remember the information. Results suggest that providers who have been offering services longer may be more effective in conveying information in a way that clients can remember. Program managers should consider requesting input from experienced providers to improve training sessions.


Assuntos
Aconselhamento , Serviços de Planejamento Familiar , Adolescente , Adulto , Anticoncepcionais , Estudos Transversais , República Democrática do Congo , Feminino , Humanos , Pessoa de Meia-Idade , Satisfação do Paciente , Adulto Jovem
15.
Nutrients ; 13(7)2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34371909

RESUMO

With an growing number of people on a strict plant-based diet, its potential effect on pregnancy and lactation becomes increasingly important. It is, however, unclear how obstetric caregivers currently handle and think about a strict plant-based diet in pregnancy. The aim of the study was therefore to evaluate the self-reported knowledge and advice given by Dutch obstetric caregivers and dietitians when treating pregnant women on a strict plant-based diet. A cross-sectional study was performed by sending an online survey to Dutch midwife practices, obstetricians, and dietitian practices. Descriptive statistics are reported. A total of 121 midwives, 179 obstetricians, and 111 dietitians participated in this study. The majority of midwives (80.2%) and obstetricians (93.9%) considered a strict plant-based diet to be a significant risk factor for nutrient deficiency during pregnancy. Maternal dietary preferences, including a potential strict plant-based diet, were discussed at the first prenatal appointment by 59.5% of midwives and 24.1% of obstetricians. A self-reported lack of knowledge concerning the strict plant-based diet was mentioned by 66.1% of midwives and 75.4% of obstetricians. Obstetric caregivers mostly considered the identification of this dietary habit and subsequent referral to a dietitian or a reliable website as optimal care for pregnant women on the strict plant-based diet. However, only 38.7% of dietitians indicated to have sufficient knowledge to counsel these women. Although obstetric caregivers thought that a strict plant-based diet in pregnancy may lead to increased risks of nutritional deficiencies, the majority report to have insufficient knowledge to provide adequate advice. Only a minority referred these women to dietitians, of whom a minority indicated to have adequate knowledge on this specific diet. These results suggest that current care is suboptimal for an increasing number of pregnant women. Women on a strict plant-based diet could benefit from increased knowledge about this topic among obstetric caregivers and dietitians, as well as from clear guidelines regarding this diet during pregnancy.


Assuntos
Dieta Vegetariana , Fenômenos Fisiológicos da Nutrição Materna , Tocologia , Estado Nutricional , Nutricionistas , Obstetrícia , Cuidado Pré-Natal , Adulto , Atitude do Pessoal de Saúde , Competência Clínica , Aconselhamento , Estudos Transversais , Dieta Vegetariana/efeitos adversos , Comportamento Alimentar , Feminino , Pesquisas sobre Serviços de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Valor Nutritivo , Equipe de Assistência ao Paciente , Gravidez , Medição de Risco , Fatores de Risco , Resultado do Tratamento
16.
Front Public Health ; 9: 682634, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34395363

RESUMO

Children and youth are among the most vulnerable to the devastating effects of disaster due to the physical, cognitive, and social factors related to their developmental life stage. Yet children and youth also have the capacity to be resilient and act as powerful catalysts for change in their own lives and wider communities following disaster. Specific factors that contribute to resilience in children and youth, however, remain relatively unexplored. This article examines factors associated with high levels of resilience in 100 children and youth aged 5- to 18-years old who experienced the 2016 Fort McMurray, Alberta wildfire. A mixed-methods design was employed combining quantitative and qualitative data. Quantitative data was obtained from the Children and Youth Resilience Measure (CYRM-28) which measured individual, caregiver, and context factors influencing resilience processes among the participants. Qualitative data was collected through semi-structured interviews to gain further insight into the disaster experiences of children and youth. Quantitative findings reveal higher than average levels of resilience among the participants compared to normative scores. Qualitative findings suggest high levels of resilience were associated with both caregiver factors (specifically physical caregiving), and individual factors (primarily peer support). We discuss how physical caregiving and peer support during and after the wildfire helped mitigate the negative effects of disaster, thus bolstering children and youth's resilience. Implications for understanding the specific social-ecological factors that facilitate and support resiliency processes and overall recovery of children and youth following disaster are also discussed.


Assuntos
Desastres , Incêndios Florestais , Adolescente , Idoso , Alberta , Cuidadores , Criança , Pré-Escolar , Aconselhamento , Humanos
17.
Ned Tijdschr Geneeskd ; 1652021 06 17.
Artigo em Holandês | MEDLINE | ID: mdl-34346630

RESUMO

Smoking cessation yields large health gains, especially in times of COVID-19. Compared to measures to stop COVID-19, tobacco control is lagging behind. We studied smoking-cessation-care in the Netherlands, using qualitative interviews with physicians (N=55) and questionnaires among physicians and other healthcare providers (HCPs; N=883) in 2017. Who is responsible for what? Three actors emerged: the patient who smokes (end responsible for quitting), the HCP (quit-advice, counseling or referral) and the government (create a society that stimulates "smoke-free"). Many HCPs do not ask about smoking, nor advise to quit. The task-division is unclear, as smoking causes multiple diseases that are part of multiple disciplines and specializations. HCPs that see smoking as a serious addiction are more inclined to ensure adequate smoking-cessation-care for their patients. Fortunately, there are positive developments as well, both within healthcare as society, and ways in which you can contribute.


Assuntos
COVID-19 , Abandono do Hábito de Fumar , Aconselhamento , Pessoal de Saúde , Humanos , SARS-CoV-2
18.
Afr J Prim Health Care Fam Med ; 13(1): e1-e10, 2021 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-34342477

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) is an emerging respiratory illness. The World Health Organization declared it a public health emergency of international concern on 30 January 2020 and called for collaborative efforts, such as contact tracing and promoting the public awareness about COVID-19, and recommended prevention and control measures. AIM: The aim of this study was to assess the effect of telephone counselling on the knowledge, attitude and practices (KAPs) of contacts of COVID-19 confirmed cases towards COVID-19 epidemiology and infection prevention and control measures. SETTING: Ten areas in Sharkia Governorate, Egypt divided into six rural and four urban areas. METHODS: A non-randomised controlled trial was conducted in Sharkia Governorate, Egypt, from 26 March 2020 to 12 April 2020 on 208 contacts of confirmed COVID-19 cases, divided equally into two groups: an experiment group that was exposed to telephone counselling by the researchers and a control group that was exposed to routine surveillance by local health authority. A semi-structured questionnaire was used to assess the KAP of both groups towards COVID-19 before and after intervention. RESULTS: After intervention the percent of contacts who achieved good knowledge, positive attitudes and better practice scores in the experimental group was 91.3%, 57.8% and 71.2%, respectively, compared with 13.5%, 7.8% and 16.3%, respectively, in the control group. Male gender and working group were significantly associated with bad practice score. Furthermore, there was a statistically significant positive correlation between differences in knowledge, attitudes and practices of the experimental group before and after the intervention. CONCLUSION: This study proved the effectiveness of telephone counselling in improving COVID-19-related KAP scores of contacts of confirmed COVID-19 cases.


Assuntos
COVID-19/diagnóstico , Busca de Comunicante , Aconselhamento , Conhecimentos, Atitudes e Prática em Saúde , Telefone/estatística & dados numéricos , Adolescente , Adulto , Idoso , COVID-19/psicologia , Estudos Transversais , Egito , Educação em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Isolamento de Pacientes , População Rural , SARS-CoV-2 , Inquéritos e Questionários , População Urbana , Adulto Jovem
19.
BMC Public Health ; 21(1): 1511, 2021 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-34353294

RESUMO

BACKGROUND: Web-based stress management interventions (SMI) fit increasingly digital lifestyles, reduce barriers of uptake and are easily scalable. SMIs might lower levels of stress in employees and thereby contribute to the prevention of depressive symptomatology. Different guidance formats can impact the efficacy of SMIs, with higher intensity assumed to result in larger effects. However, head-to-head comparisons of guidance formats are rare. This is the first trial to examine the impact of adherence-focused guidance compared to self-help on the efficacy of an occupational SMI compared to a wait list control condition. Additionally, it will be investigated if the SMI enfolds its impact on preventing depressive symptomatology by different pathways through reducing health impairing and increasing promoting factors. METHODS: A three-armed randomised controlled trial (RCT) on an occupational SMI was conducted. 404 employees with elevated levels of perceived stress (PSS-10 ≥ 22) were randomly assigned to: adherence-focused guidance (AFG), self-help (SH) or a wait list control group (WLC). The primary outcome was perceived stress (PSS-10). Secondary outcomes included health- and work-related measures. A parallel mediation analysis with stress and resilience as mediators for the effect on depression (CES-D) was carried out. Data collection took place at baseline (T1), after 7 weeks (T2) and 6 months (T3). RESULTS: The SMI was effective for all groups on the primary and secondary outcomes. For stress, analyses of covariance (ANCOVA) revealed significant group effects at T2 (F2,400 = 36.08, P < .001) and T3 (F2,400 = 37.04, P < .001) with large effect sizes for AFG (T2: d = 0.83; T3: d = 0.85) and SH (T2: d = 0.88; T3: d = 0.91) compared to WLC. No significant group differences were found for the efficacy between AFG and SH on the outcomes. Adherence in terms of completed modules was significantly higher for AFG compared to SH. The SMI's impact on depression was mediated by perceived stress: a1b1 = - 0.77, 95% CI [- 1.26, - 0.34] and resilience: a2b2 = - 0.62, 95% CI [- 1.05, - 0.26]. CONCLUSIONS: The SMI was effective for reducing stress and improving other health- and work-related outcomes, irrespective of the guidance format. Results did not demonstrate superiority of adherence-focused guidance for the efficacy but for adherence in terms of completed modules. Among other reasons, better communication strategies about offered guidance and awareness-raising measures are discussed. Results from mediation analysis suggest that preventive SMIs should be designed to reach two goals: reducing the risk factor of stress and simultaneously increasing health promoting factors such as resilience. TRIAL REGISTRATION: German Clinical Trial Registration (DRKS) DRKS00005687 , 6/6/2014.


Assuntos
Intervenção Baseada em Internet , Psicoterapia , Aconselhamento , Comportamentos Relacionados com a Saúde , Humanos , Internet
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