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1.
BMC Ophthalmol ; 19(1): 181, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31409325

RESUMO

BACKGROUND: Retinitis pigmentosa (RP) are a group of incurable and inherited eye conditions, and the leading cause of inherited blindness in people under the age of 60. The aim of this systematic review and meta-synthesis was to present a comprehensive overview of qualitative papers on experiences and coping strategies of adults living with RP, and how these influence quality of life. METHODS: A pre-registered search strategy was applied in nine databases and 12 articles met eligibility criteria. Studies included were from Australia, Brazil, Ireland, Netherlands, Republic of Korea, United Kingdom, and USA. The overall sample was based on 126 people with RP (ages ranging from 18 to 85; at least 65 female). Principles of meta-ethnography were used to synthesise the articles revealing five higher-level meta-themes. RESULTS: The five higher-level meta-themes were, 1) managing identity: making sense of RP, managing autonomy and independence; 2) living with RP: practical and emotional issues; 3) experiences with healthcare professionals and other social support; 4) adaptive and maladaptive coping strategies; and 5) impact of RP on work and career. A conceptual model was developed by grouping higher-level meta-themes as intra- and inter-individual factors and how they may be implicated with coping strategies and quality of life. CONCLUSIONS: This review established factors that can be explored as potential psychosocial influences in the relationship between coping strategies and quality of life in people with RP. Further understanding of these factors and mechanisms can help inform intervention development to support adaptive coping in living with RP and positively impact quality of life.


Assuntos
Adaptação Psicológica/fisiologia , Qualidade de Vida/psicologia , Retinite Pigmentosa/psicologia , Acuidade Visual , Humanos
2.
Arq Gastroenterol ; 56(2): 131-140, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31460575

RESUMO

BACKGROUND: Crohn's disease is chronic, requires prolonged treatment, affects the physical and psychosocial health of patients and may alter their routine, quality of life and well-being. Recent studies recommend monitoring the health of these patients considering physical, psychological and psychosocial aspects, because they are directly related to the disease activity. These studies highlight the relevance of patients' emotional and behavioral conditions and suggest that the identification of the factors that influence the psychological well-being, resilience and Coping in these patients can favor the proper treatment. OBJECTIVE: To relate psychological well-being, resilience and Coping with social and clinical features of Crohn's disease patients. METHODS: Prospective study including 104 patients with Crohn's disease, both genders and mean age of 39 years. Standardized scales were used to assess and to relate psychological well-being, resilience and Coping with social and clinical variables. A questionnaire to characterize the sample and standardized scales in data collection (psychological well-being, resilience pillars and Coping strategies inventory - Folkman & Lazarus) were used. Descriptive analysis of data and statistics for comparison of results were performed. RESULTS: There were significant differences (P<0.05) showing better psychological well-being for male patients, those who without children, were not religious, were employed and were doing complementary activities in addition to clinical treatment. More resilience for the male gender, those who without children, were not religious, divorced, separated or widowed, that received some monthly income; who did not undergo surgery, had the first symptoms after 30 years old and who had complementary activity. There were also significant differences in the use of Coping: usually, women used more developed escape and avoidance strategies; single, married or in stable-union patients used more self-control; not religious used positive revaluation strategy; the ones who were employed showed more self-control and positive reassessment; the ones who had lower family income indicated that they used less the self-control; the ones who had higher family income used more positive re-evaluation; patients who were diagnosed with Crohn's disease between the second decade of life showed to use mores more the positive reassessment strategy than those who were 20 years old or younger. CONCLUSION: Social aspects influenced psychological well-being, resilience and Coping in patients with Crohn's disease more strongly than clinical aspects. It was possible to identify the profiles with better and worse psychological well-being, resilience and Coping of those who need more support, as well as to know the most used Coping strategies in the studied group.


Assuntos
Adaptação Psicológica , Doença de Crohn/psicologia , Qualidade de Vida/psicologia , Resiliência Psicológica , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Apoio Social , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
3.
Am J Occup Ther ; 73(4): 7304205100p1-7304205100p10, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31318674

RESUMO

OBJECTIVE: A reliable, valid, and readily usable method of measuring coping is essential for occupational therapy practitioners and researchers working with children with developmental disabilities. The aim of this study was to examine evidence for the construct validity and internal and test-retest reliability of the Coping Inventory (CI), a 48-item survey designed for use with children. METHOD: School staff (N = 39) completed CIs for 79 students with developmental disabilities age 5-13 yr (mean = 8.0, standard deviation = 2.0) who were primarily boys (n = 52; 68%) with autism spectrum disorder (n = 40 of 47 diagnoses provided). We used Rasch analysis to examine construct validity, internal reliability, and possible redundancy of items and intraclass correlations, Pearson correlations, Bland-Altman plots, and t tests were used to examine test-retest reliability. RESULTS: Rasch analysis provided evidence of construct validity: All items correlated positively with the overall measure; data from 94% of items conformed with Rasch expectations, and the items form a logical hierarchy. Intraclass correlations revealed an average coefficient of .96, providing evidence of test-retest reliability. CONCLUSION: The CI demonstrated good evidence for construct validity and internal and test-retest reliability. Redundancy of items suggests that some items could be eliminated after further research.


Assuntos
Transtorno do Espectro Autista , Deficiências do Desenvolvimento , Adaptação Psicológica/fisiologia , Criança , Humanos , Masculino , Reprodutibilidade dos Testes , Inquéritos e Questionários
4.
Medicine (Baltimore) ; 98(29): e16532, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335734

RESUMO

Multiple sclerosis (MS) is a chronic demyelinating autoimmune disorder affecting the central nervous system and targets the myelin sheaths around nerves. Local problem: Medical advances have enabled patients to lead a better quality of life (QoL) than before. However, because of its chronicity and unpredictability, it remains a very challenging disease for both patients and their families, as it involves the continued use of medication to slow down progression. The aim of this study is to assess drug adherence in patients with MS. In particular, we will examine how the way drugs are administered (oral or injective) affects compliance with therapy, including the correlation with coping strategies and the QoL of each patient.We enrolled 88 patients with MS, divided into 2 groups according to therapy (injective or oral). The Morisky Medication Adherence scale was administered to evaluate adherence to treatment, the MS QoL 54 to estimate mental and physical health, and Brief coping orientation to problems experienced Inventory for coping strategies.The results showed that in both groups the patients showed a good therapeutic alliance and trust in treatment. In particular, a correlation has been found between therapeutic adherence, adaptive coping strategies, and mental health when drug therapy is administered by injection. In conclusion, this result suggests that for patients receiving injection treatment to have greater adherence to therapy, appropriate coping strategies and good mental health must be developed in order for patients receiving injection therapy to have greater adherence to therapy; they need to develop appropriate coping strategies and good mental health to address this mode of administration successfully.


Assuntos
Adaptação Psicológica , Esclerose Múltipla/tratamento farmacológico , Esclerose Múltipla/psicologia , Cooperação e Adesão ao Tratamento , Administração Oral , Adulto , Humanos , Fatores Imunológicos/administração & dosagem , Injeções , Pessoa de Meia-Idade , Qualidade de Vida
5.
Health Qual Life Outcomes ; 17(1): 113, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31262316

RESUMO

BACKGROUND: Irritable Bowel Syndrome (IBS) is a chronic gastrointestinal disorder characterised by recurrent abdominal pain and disturbed bowel habits and unclear aetiology. IBS is also associated with psychosocial factors, impaired quality of life and lost work productivity. This study sought to determine whether the association between IBS and lost work productivity might be accounted for by poor coping strategies and loss of confidence in the healthcare system. METHODS: Case-control design was employed sampling IBS and non-gastrointestinal (non-GI) primary healthcare seekers in a defined region in Sweden. Non-GI patients were of similar age and sex distribution to the IBS patients. Questionnaires applied in this study included instruments designed to measure confidence in the social security system and in the community, as well as questions about whether gastrointestinal problems might affect working life and Sense of coherence (SOC) questionnaire. The study's primary hypothesis was evaluated via an a priori path model. RESULTS: Statistically significant differences were found between IBS cases (n = 305) and controls (n = 369) concerning abdominal pain or discomfort affecting everyday performance at work (p <  0.0001). IBS cases also showed significantly lower (p = 0.001) confidence in public healthcare. The study's hypothesis was supported with the finding of a statistically significant indirect association via poor coping strategies, although the indirect associations were lesser in magnitude than the direct association. CONCLUSIONS: This study found a clear association between clinically diagnosed IBS status and interference in work by gastrointestinal symptoms in which sense of coherence might be of importance.


Assuntos
Atitude Frente a Saúde , Efeitos Psicossociais da Doença , Emprego/psicologia , Síndrome do Intestino Irritável/psicologia , Qualidade de Vida , Dor Abdominal/etiologia , Dor Abdominal/psicologia , Adaptação Psicológica , Adulto , Estudos de Casos e Controles , Eficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Senso de Coerência , Inquéritos e Questionários , Suécia
6.
Lancet ; 393(10191): 2582-2583, 2019 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-31258120
7.
Rev. pesqui. cuid. fundam. (Online) ; 11(4): 849-856, jul.-set. 2019.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1005488

RESUMO

Objetivos: Descrever e compreender como uma paciente com câncer de mama utilizava a religiosidade e a espiritualidade como recursos para enfrentar a doença. Método: Estudo descritivo, de natureza metodológica qualitativa. Referencial teórico da Antropologia Médica; método de estudo de caso etnográfico. Coleta de dados utilizou entrevistas semiestruturadas e observação. Resultados: A religiosidade e a espiritualidade foram exercitadas e tiveram grande importância no enfrentamento do câncer de mama para lidar com o adoecimento e as repercussões do tratamento, sendo evidenciadas na prática de orações, fé e frequência habitual à igreja. Conclusão: A espiritualidade e a religiosidade são recursos amplamente utilizados entre pacientes oncológicos, pois possibilitam novo sentido à experiência do adoecimento e do tratamento, modificando como as pessoas enxergam sua trajetória, promovendo menor desgaste e maior alívio em situações difíceis e estressantes, como no caso estudado. É importante que, desde a formação, o enfermeiro olhe para o indivíduo como ser biopsicossocioespiritual, buscando compreender suas dimensões e proporcionar melhor bem-estar


Objectives: The purpose was to describe and to understand how a patient with breast cancer used religiosity and spirituality as resources to face the disease. Method: Descriptive study, qualitative methodology. Theoretical reference of Medical Anthropology; ethnographic case study method. Data collection used semi-structured interviews and observation. Results: Religiosity and spirituality were exercised and have had great importance in breast cancer coping, for to get along with illness and treatment repercussions. That was evidenced through prayers, faith and usual attendance at church. Conclusion: Spirituality and religiosity are resources widely used among cancer patients. They give new meaning to illness and treatment experience, and change the way how people see their trajectory, promoting less tiredness and relief in difficult and stressful situations, as in the case studied. It is important that since the college, nurse looks to people as biopsychosocial and spiritual subject, seeking to understand their dimensions and give better well-being


Objetivos: Describir y comprender cómo una paciente con cáncer de mama utilizaba la religiosidad y la espiritualidad como recursos para enfrentar la enfermedad. Método: Estudio descriptivo, de naturaleza metodológica cualitativa. Referencial teórico de la Antropología Médica; Método de estudio de caso etnográfico. La recolección de datos utilizó entrevistas semiestructuradas y observación. Resultados: La religiosidad y la espiritualidad fueron ejercitadas y tuvieron gran importancia en el enfrentamiento del cáncer de mama, para lidiar con la enfermedad y las repercusiones del tratamiento, siendo evidenciadas en la práctica de oraciones, fe, frecuencia habitual a la iglesia. Conclusión: La espiritualidad y la religiosidad son recursos ampliamente utilizados entre pacientes oncológicos. Posibilitan nuevo sentido a la experiencia de la enfermedad y el tratamiento, modificando cómo las personas ven su trayectoria, promoviendo menor desgaste y mayor alivio en situaciones difíciles y estresantes, como en el caso estudiado. Es importante que desde la formación, el enfermero mira al individuo como ser biopsicosocioespiritual, buscando comprender sus dimensiones y proporcionar mejor bienestar


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias da Mama , Adaptação Psicológica , Espiritualidade , Enfermagem Oncológica , Assistência Religiosa , Brasil , Conforto do Paciente
8.
Memorandum ; 36: 1-31, jun. 2019.
Artigo em Português | LILACS | ID: biblio-1007221

RESUMO

O presente trabalho é um estudo teórico que tem por objetivo traçar um panorama do campo de pesquisas sobre resiliência para situar as contribuições atuais das investigações realizadas a partir das Abordagens baseadas em Trajetórias. São retomadas quatro fases das pesquisas e discutidos conceitos relevantes associados a cada uma delas, como adversidades e risco; fatores de resiliência; coping; critérios de avaliação, como competência ou ausência de psicopatologia; e trajetórias de enfrentamento. Considerações são apresentadas sobre as diferenças entre os estudos que focalizam os enfrentamentos de condições estressantes crônicas e aqueles que abordam os enfrentamentos de adversidades pontuais agudas, discutindo as implicações dessas diferenças para os estudos sobre resiliência. Por fim, são discutidas as contribuições que as chamadas Abordagens baseadas em Trajetórias oferecem, com a explanação acerca das várias possibilidades de trajetórias percorridas pelos sujeitos antes e após o enfrentamento de adversidades


The present work is a theoretical study which aims to outline the field of research on resilience, to locate the current contributions of the investigations carried out using the trajectories-based o approaches. Four phases of research are taken up and the associated relevant concepts were discussed, such as adversity and risk; resilience factors; coping; evaluation criteria of competence or of the absenceof psychopathology; and coping trajectories. We present considerations on the differences between studies that focus on coping with chronic stress conditions, and those which focus on coping strategies for acute adversities. We also discuss the implications of these differences for resilience studies. Finally, the contributions of the so-called Trajectories-based Approaches are explored, with an explanation of the various possibilities of trajectories covered by the subjects before and after facing adversities


Assuntos
Resiliência Psicológica , Estresse Psicológico , Adaptação Psicológica
9.
Praxis (Bern 1994) ; 108(8): 554-558, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31185839

RESUMO

When a Parent Falls Severely Ill - Challenges for the Medical Practice from the Children's Perspective Abstract. A serious somatic parental illness affects the whole family. However, children of ill parents rarely attract attention in the medical system. They often feel their parents' distress, show over-adapted behavior and remain trapped in their fears and concerns. Knowledge of the children's stage of development and the nature of communication within the family are essential requirements for effective support. Interventions aim at supporting parents in their responsibility, strengthening communication, exchanging of feelings and therefore facilitating the children's cognitive orientation.


Assuntos
Acidentes por Quedas , Envelhecimento , Nível de Saúde , Relações Pais-Filho , Adaptação Psicológica , Idoso , Criança , Humanos , Pais
10.
Zhonghua Shao Shang Za Zhi ; 35(5): 379-383, 2019 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-31154737

RESUMO

Objective: To investigate the current status of uncertainty in illness and caregiving burden in family members of patients with chronic wounds, and to analyze the relationship between them. Methods: A total of 180 patients with chronic wounds admitted to the Department of Emergency of our hospital from October 2017 to March 2018, conforming to the study criteria, were selected by adopting the convenience sampling method. Then one family member who took care of the patients for the longest time and conformed to the study criteria were included in this cross-sectional survey. General Information Questionnaire made by the authors was conducted to investigate the demographic data and wounds of patients, and demographic data of family members. Chinese version of Parent Perception of Uncertainty Scale-Family Member (PPUS-FM) and Caregiver Burden Inventory (CBI) were used to investigate the uncertainty in illness and caregiving burden. Data were processed with multiple linear regression analysis and partial correlation analysis. Results: The effective recovery rate of questionnaire was 91.7% (165/180). (1) The ages of patients were (71±17) years. Among them, there were 89 males and 76 females. The course of chronic wounds was 0.5 to 120.0 months. The wounds were mainly primary occurrence (86.1%, 142 patients), and the main type of wound was pressure ulcer (43.6%, 72 patients). Fifty-seven patients (34.5%) had wound infection. The ages of family members were (56±13) years, and 61.8% (102 people) of them were female. Their daily time of taking care of patients was (10±8) h. (2) The total scores of PPUS-FM of family members were 33 to 125 (88±17) points, mainly in medium level, in which the item score of unpredictability dimension was the highest. (3) The total scores of CBI of family members were 7 to 79 (43±14) points, in which the item score of time-dependence burden dimension was the highest. (4) Uncertainty in PPUS-FM could independently influence 10% of the total variation of caregiving burden in family members of patients (t=3.18, P<0.01). (5) The total scores of PPUS-FM of family members were in significantly positive correlation with the total scores of CBI and scores of physical burden, emotional burden, and social burden, respectively (r=0.33, 0.32, 0.25, 0.36, P<0.05 or P<0.01), while there was no obvious correlation between total scores of PPUS-FM of family members and time-dependence burden/developmental burden (r=0.14, 0.16, P>0.05). Conclusion: There is positive correlation between uncertainty in illness and caregiving burden.


Assuntos
Adaptação Psicológica , Queimaduras/complicações , Cuidadores/psicologia , Incerteza , Infecção dos Ferimentos/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
11.
Anticancer Res ; 39(6): 3159-3165, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31177162

RESUMO

BACKGROUND: Patients with sarcoma are particularly vulnerable to psychosocial distress. The aim of this study was to collect preliminary data on the prevalence of psychosocial distress in such patients during follow-up care and identify risk factors associated with higher psycho-oncological stress levels. PATIENTS AND METHODS: The study retrospectively enrolled 202 patients with bone or soft-tissue sarcomas who underwent routine psychosocial distress screening during their follow-up care. All patients were screened using an electronic cancer-specific questionnaire. RESULTS: Females and patients who underwent radiotherapy were more distressed. Psychosocial distress levels were markedly higher in the early postoperative phase, but approximately one-third of patients showed high psychosocial distress levels even more than 2 years postoperatively. CONCLUSION: The results underscore the importance of routine psychosocial distress screenings in patients with sarcoma, which should be performed throughout the follow-up period.


Assuntos
Assistência ao Convalescente/psicologia , Neoplasias Ósseas/terapia , Saúde Mental , Osteossarcoma/terapia , Sarcoma/terapia , Neoplasias de Tecidos Moles/terapia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários , Adaptação Psicológica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/psicologia , Efeitos Psicossociais da Doença , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteossarcoma/diagnóstico , Osteossarcoma/psicologia , Valor Preditivo dos Testes , Dados Preliminares , Prevalência , Estudos Retrospectivos , Fatores de Risco , Sarcoma/diagnóstico , Sarcoma/psicologia , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/psicologia , Estresse Psicológico/diagnóstico , Fatores de Tempo , Adulto Jovem
12.
Z Psychosom Med Psychother ; 65(2): 144-161, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31154930

RESUMO

Objectives: Integrating a stronger focus on patients' existing strengths in traditional psychotherapy approaches is suggested by recent developments in psychological science, positive psychology, and psychotherapy research. However, the empirical status of treatments focusing on patients' existing strengths is unclear. The aim of this study was to conduct a systematic review (PROSPERO registration CRD42017054362) of studies on adaptations of traditional treatment approaches (e. g., cognitive-behavior therapy or psychodynamic therapy) explicitly focused on using patients' existing resources and strengths (hereafter, resource-focused treatments; RFT). Methods: Extensive systematic literature search yielded k = 11 treatment comparisons from 10 studies contrasting RFTs with either an alternative psychotherapeutic approach or wait list. Effect sizes controlling for pre-treatment differences (gPPWC) and standard Hedges's g effect sizes (gPOWC) were aggregated with random-effects methods Results: Across 8 direct comparisons, RFTs were superior to other psychotherapeutic approaches, as indicated by small to moderate (gPPWC = -0.349, 95 % CI -0.576, -0.122, p = .003, I2 = 46.50 %) and small effect sizes (gPOWC = -0.190, 95 % CI -0.355, -0.025, p = .024, I2 = 0.00 %) in favor of RFTs. Sensitivity analyses corroborated results. Many included studies were characterized by limited sample size, risk of bias or researcher allegiance. Conclusions: This meta-analysis showed preliminary evidence for the benefits of RFTs and suggests an intensification of further research efforts. The evidence was most convincing for hypnotherapeutic-systemic interventions as an add-on for cognitive-behavioral therapy.


Assuntos
Pesquisa Comportamental/tendências , Terapia Cognitivo-Comportamental , Pacientes/psicologia , Psicoterapia Psicodinâmica , Adaptação Psicológica , Humanos
13.
Rev Med Liege ; 74(5-6): 287-293, 2019 May.
Artigo em Francês | MEDLINE | ID: mdl-31206268

RESUMO

Clinical care to patients with alcohol dependence by GP's is described in this article. First, we have to destigmatize these patients and their illness. Diagnosis approach is specified. Therapeutic approach is first a motivational approach; subsequently it's like pedagogy : it's coping. Care is both physical and psychological. Empathy all along therapeutic relationship is a priority and how establishing a therapeutic alliance is described. A psychiatrist, a psychologist, a care network, self-help associations have also to be called on when needed. Physicians education creates new opportunities since 2016-2017 : in particular SSMG (Scientific Society of Primary Care) and three Belgian universities (UCL, ULB and ULiège) introduced a special study program called «?certificat interuniversitaire d'alcoologie?¼. Let's hope this new clinical rewarding approach for GP's contribute to reduce the treatment gap as far as clinical care of patients with alcohol dependence is concerned.


Assuntos
Alcoolismo , Clínicos Gerais , Atenção Primária à Saúde , Adaptação Psicológica , Bélgica , Humanos
14.
BMC Public Health ; 19(1): 768, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31208402

RESUMO

BACKGROUND: In Canada, there is a growing need to develop community-based, culturally appropriate palliative care for Indigenous people living in First Nations communities. The public health approach to palliative care, which emphasizes community-based initiatives, is especially relevant in First Nations communities because care is grounded in their distinct social and cultural context. Central to the public health approach are educational strategies that strengthen communities' capacity to care for their vulnerable members as they die. This paper presents community-based research conducted with First Nations communities in Canada that aimed to assess and address local palliative care educational needs to improve community capacity in palliative care. METHODS: Participatory action research (PAR) was conducted with four First Nations communities in Canada over a six-year period (2010-2016). The research occurred in three phases. Phase 1: focus groups, interviews and surveys were employed to assess community specific needs and resources. Phase 2: recommendations were developed to guide the PAR process. Phase 3: educational resources were created to address the identified educational needs. These resources were implemented incrementally over 4 years. Ongoing process evaluation was employed, and revisions were made as required. RESULTS: Educational needs were identified for patients, families, community members and internal and external health care providers. A wide and comprehensive range of educational resources were created to address those needs. Those culturally appropriate educational resources are available in a very accessible and useable workbook format and are available for use by other Indigenous people and communities. CONCLUSIONS: This research provides an example of the public health approach and offers implementation strategies around palliative care education. This paper contributes to the international literature on the public health approach to palliative care by presenting a case study from Canada that includes: conducting a culturally appropriate assessment of educational needs, creating recommendations, facilitating development and implementation of educational resources in the community to improve community capacity in palliative care.


Assuntos
Adaptação Psicológica , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Índios Norte-Americanos/psicologia , Cuidados Paliativos/psicologia , Adulto , Canadá , Fortalecimento Institucional/métodos , Feminino , Educação em Saúde , Pesquisa sobre Serviços de Saúde , Serviços de Saúde do Indígena/organização & administração , Humanos , Índios Norte-Americanos/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Saúde Pública
15.
Gan To Kagaku Ryoho ; 46(Suppl 1): 60-62, 2019 May.
Artigo em Japonês | MEDLINE | ID: mdl-31189856

RESUMO

Chemical coping also has an idea that it is an early stage of abuse and dependence of opioids, it is important to grasp the frequency, complaints, and risk factors of chemical coping. In this study, observational research was performed backwardly with 549 people using opioids who were newly requested to the palliative care team. Results revealed that 13 of 549 patients (2.4%)were diagnosed with chemical coping. In terms of a breakdown of the complaint, and it was following rate and reasons, 6 people(46%)felt easy, 2 people(15%)were anxious, 2 people(15%)could sleep, 2 people(15%)had unknown reasons, and 1(8%)was calm. Characteristics of each patient diagnosed with chemical coping included frequent psychiatric symptoms such as life expectancy of 3 months, opioid oral administration period of 1 year or more, disease incidence period of 1 year or more, anxiety, delirium, and depression. One benign disease also confirmed the transition to opioid dependence.


Assuntos
Adaptação Psicológica , Analgésicos Opioides , Depressão , Humanos , Transtornos Relacionados ao Uso de Opioides , Estudos Retrospectivos
16.
Gan To Kagaku Ryoho ; 46(Suppl 1): 84-86, 2019 May.
Artigo em Japonês | MEDLINE | ID: mdl-31189864

RESUMO

This study aimed to clarify the factors for reducing the burden of caregivers caring for terminal patients. We conducted semi-structured interviews with bereaved caregivers, seeking those who had felt neither fear nor anxiety during caregiving; their responses were analyzed using the Steps for Coding and Theorization. The one caregiver who showed neither fear nor anxiety(1)believed in an afterlife,(2)sought a physician who would respect her belief,(3)sought respect for her medical decisions, and(4)found distance to the clinic to be a critical factor. Our findings suggest that doctors' respect for caregivers' beliefs may be an important factor in reducing caregiver burden at the end of life.


Assuntos
Adaptação Psicológica , Cuidadores , Medo , Ansiedade , Morte , Empatia , Feminino , Humanos
17.
BMC Public Health ; 19(Suppl 4): 447, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196141

RESUMO

BACKGROUND: The main aim of this study was to determine the association between Behavioral and Psychological Symptoms of Dementia (BPSD) and caregiver burden, and the mediating role of coping strategy and personality style of caregivers to patients with dementia (PWD). METHODS: This cross-sectional study was conducted among 202 caregivers to PWD in home-based settings. Recruited caregivers were administered questionnaires regarding BPSD which was measured using Neuropsychiatric Inventory-Questionnaire (NPI-Q), caregiver burden using Zarit Burden Interview (ZBI), Brief COPE for coping strategies and Big-Five Inventory which measured personality traits. RESULTS: Majority of the caregivers were female (71.3%), aged 50 and above (55%), single (46%), married (43.6%), working full time (45%) while the rest work part time (22.3%), unemployed (7.4%) and retiree (25.2%), and majority were parents (58.9%) and spouse (18.3%). The duration of caregiving was less than a year (33.7%) while the rest are more than a year. Results demonstrated that the most frequent types of BPSD exhibited by PWD was irritability, followed by apathy and agitation. All of the types of BPSD showed to be significantly correlated to caregiver burden except for anxiety, elation and appetite. Of personality traits, only conscientiousness was found to mediate the relationship between BPSD and caregiver burden (p < .05). Self-distraction, active coping, planning and acceptance were the coping strategies that demonstrated to have mediation effect on the relationship between BPSD and caregiver burden. CONCLUSION: Presentation of BPSD is correlated to caregiver burden which is partially mediated by coping strategies and personality styles.


Assuntos
Adaptação Psicológica , Cuidadores/psicologia , Demência/psicologia , Personalidade , Pobreza/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Efeitos Psicossociais da Doença , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
18.
Med Probl Perform Art ; 34(2): 63-71, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31152647

RESUMO

This study investigated the life history of performance anxiety in Japanese orchestral players. Twenty-nine players in a Japanese orchestra completed the State Trait Anxiety Inventory (STAI) backstage immediately following a concert. Five players with the longest experience in the orchestra were selected for further data collection. Based on the results of the STAI, the researchers conducted semi-structured interviews to construct the life history of these 5 players in relation to their performance anxiety. In the process of narrative construction, a commentary from a psychiatrist was integrated to examine the underlying personality and ability to cope with the anxiety, as well as the contextual influences in the participants' life-long learning experiences. Results indicated that the anxiety was present throughout the players' musical development, from childhood and into professional status. However, their performance anxiety was reduced and transformed over time. The study also revealed that these 5 players tended to experience anxiety when playing with others and in large groups. The subjects tended to consider anxiety as a necessary psychological state-of-mind to maintain a professional level of performance and to deal with the uncertainty of group playing. Finally, the individual players found their own specific methods to reduce anxiety by focusing on musical expression and/or simply by gaining experience. Instead of generalizing the result, this study explored the life history of performance anxiety in this series of individual players in Japan.


Assuntos
Adaptação Psicológica , Música , Ansiedade de Desempenho , Ansiedade , Humanos , Japão
19.
Artigo em Chinês | MEDLINE | ID: mdl-31177697

RESUMO

Objective: To understand the status quo of sleep quality of nurses in emergency department and explore its influencing factors, so as to provide reference for relevant departments to formulate corresponding policies and ensure the health of nurses. Methods: From July to September 2018, 257 nurses in emergency department of 5 tertiary hospitals in a city were investigated by cluster sampling. Results: The detection rate of sleep among 257 nurses was 63.42%. Logistic regression model showed that having children or not (OR=1.063) , self-rated health (OR=1.639) , stress (OR=1.728) and coping style (OR=1.055) were independent influencing factors of sleep quality of nurses in emergency department. Conclusion: Sleep problems are common among nurses in emergency department. It is helpful to improve sleep quality to ensure physical and mental health, actively cope with work and family stress.


Assuntos
Serviço Hospitalar de Emergência , Enfermeiras e Enfermeiros , Sono , Adaptação Psicológica , Humanos , Inquéritos e Questionários , Centros de Atenção Terciária
20.
Nat Neurosci ; 22(7): 1053-1056, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31209376

RESUMO

The lateral habenula encodes aversive stimuli contributing to negative emotional states during drug withdrawal. Here we report that morphine withdrawal in mice leads to microglia adaptations and diminishes glutamatergic transmission onto raphe-projecting lateral habenula neurons. Chemogenetic inhibition of this circuit promotes morphine withdrawal-like social deficits. Morphine withdrawal-driven synaptic plasticity and reduced sociability require tumor necrosis factor-α (TNF-α) release and neuronal TNF receptor 1 activation. Hence, habenular cytokines control synaptic and behavioral adaptations during drug withdrawal.


Assuntos
Citocinas/fisiologia , Habenula/fisiologia , Morfina/efeitos adversos , Comportamento Social , Síndrome de Abstinência a Substâncias/fisiopatologia , Transmissão Sináptica/fisiologia , Adaptação Psicológica , Animais , Feminino , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Microglia/fisiologia , Naloxona/toxicidade , Plasticidade Neuronal , Distribuição Aleatória , Receptores de Glutamato/análise , Receptores de N-Metil-D-Aspartato/análise , Receptores Tipo I de Fatores de Necrose Tumoral/genética , Receptores Tipo I de Fatores de Necrose Tumoral/fisiologia , Síndrome de Abstinência a Substâncias/psicologia , Fator de Necrose Tumoral alfa/fisiologia
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