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Multimedia | Recursos Multimídia | ID: multimedia-9958
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Multimedia | Recursos Multimídia | ID: multimedia-9959
3.
Front Public Health ; 10: 964944, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36091550

RESUMO

Background: The unprecedented crisis during the fifth wave of the COVID-19 pandemic in Hong Kong placed a significant burden on the health care system. Therefore, the Hong Kong government advocated that individuals with no or mild COVID-19 symptoms should self-care at home. This study aimed to understand intrapersonal and interpersonal level factors that shaped self-care practices among home-quarantined individuals with COVID-19 during the peak of the pandemic. Methods: This study used convenience and snowball sampling whereby a total of 30 semi-structured telephone interviews were conducted between March and April 2022. Inductive content analysis was used to analyze the data. Results: Factors reported at the intrapersonal level included socioeconomic status and housing conditions, information and knowledge about COVID-19, long COVID, and psychological adjustments brought about by home quarantine. Factors identified at the interpersonal level included caregiving responsibilities, family relationships, and social support. Conclusions: Findings from this study identified a combination of intra and interpersonal level factors influenced an individual's self-care practices as a result of pandemic-induced quarantine. It was particularly concerning for those individuals in socially and economically deprived groups, where access to services was challenging. This study also raised awareness of the ineffectual and insufficient knowledge individuals held of self-medication and overall COVID-19 management. A key recommendation is developing family-based resilience programmes to support and empower vulnerable families to better cope with the realities of self-quarantine.


Assuntos
COVID-19 , COVID-19/complicações , Hong Kong , Humanos , Pandemias , Autocuidado
4.
Reprod Health ; 19(1): 191, 2022 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-36109756

RESUMO

BACKGROUND: Discussions around quality of abortion care have been focused mainly on service-delivery aspects inside healthcare facilities. More recently, with availability of medical abortion (MA), increase in its self-use, and emergence of other delivery platforms such as telemedicine, the responsibility of quality care has broadened to actors outside of facilities. BODY OF TEXT: This commentary discusses the meaning of quality of abortion care with the paradigm shift brought by medical and technological advancement in abortions, and raises questions on the role of the state in ensuring quality in abortion management-especially in settings where abortion is decriminalized, but also in countries where abortion is permitted under certain circumstances. It consolidates the experience gained thus far in the provision of safe abortion services and also serves as a forward-thinking tool to keep pace with the uptake of newer health technologies (e.g., availability of medical abortion drugs), service delivery platforms (e.g., telemedicine, online pharmacies), and abortion care providers (e.g., community based pharmacists). CONCLUSIONS: This commentary provides context and rationale, and identifies areas for action that different stakeholders, including health advocates, policymakers, program managers, and women themselves, can adopt to fit into an alternative regime of abortion care.


Assuntos
Aborto Induzido , Autocuidado , Feminino , Instalações de Saúde , Humanos , Gravidez , Qualidade da Assistência à Saúde
5.
Comput Intell Neurosci ; 2022: 7727085, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36120688

RESUMO

Objective: To explore the effect of early rehabilitation nursing on motor function and living ability of patients with traumatic brain injury (TBI) based on Orem's self-care theory. Methods: A total of 60 patients with TBI treated in our hospital from February 2019 to June 2021 were enrolled. The patients were randomly divided into a control group and a research group. The control group adopted the early rehabilitation nursing model, while the research group adopted the early rehabilitation nursing model based on Orem's self-nursing theory. Nursing satisfaction, Fugl-Meyer score, NIH-SS score, Barthel index, quality of life score, and compliance were in the comparison of the two groups. Results: The nursing satisfaction of the research group was higher than that of the control group (P < 0.05). Compared with the control group, the Fugl-Meyer scores of the research group were higher at 1 month, 2 months, and 3 months after nursing (P < 0.05). After nursing, the NIH-SS score of the two groups decreased. In the comparison of the two groups, the NIH-SS score of the research group at 1 month, 2 months, and 3 months after nursing was lower (P < 0.05). After nursing, the Barthel index of the two groups increased. In the comparison of the two groups, the Barthel index of the research group was higher compared to the control group at 1 month, 2 months, and 3 months after nursing (P < 0.05). The scores of physiological function, psychological function, social function, and health self-cognition in the research group were lower (P < 0.05). The compliance rate of the research group was higher than that of the control group (P < 0.05). Conclusion: Patients with TBI receive early rehabilitation nursing based on Orem's self-care theory, which can effectively improve patient satisfaction and compliance and achieve the purpose of improving motor function and living ability. This nursing program is worth popularizing in the clinic.


Assuntos
Lesões Encefálicas Traumáticas , Enfermagem em Reabilitação , Humanos , Modelos de Enfermagem , Qualidade de Vida , Autocuidado
6.
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
7.
Sex Reprod Health Matters ; 29(3): 2110671, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36083099

RESUMO

Adolescents experience significant barriers, including stigma and discrimination, to accessing voluntary family planning and reproductive health (FP/RH) services in Rwanda. Self-care interventions have been shown to reduce social barriers to FP/RH care, but little is known about the effectiveness of digital self-care for adolescents, particularly in low-resource settings. This paper presents findings from a pilot study of CyberRwanda, a digital self-care intervention providing comprehensive sexuality education and confidential online ordering of contraceptives for school-aged youth in Rwanda through a rights-based approach. A mixed-methods pilot study was conducted from November 2019 to February 2020 to assess feasibility, acceptability, and engagement and to inform a future impact evaluation. Surveys were administered to a random sample of 158 students aged 12-19 years in three secondary schools. In-depth interviews were conducted with students, parents, teachers, pharmacists, district-level administrators, and youth centre staff. Descriptive statistics were calculated and qualitative data were analyzed using a thematic coding approach. One hundred and fifty-eight surveys and 28 interviews were conducted. Results revealed high demand for CyberRwanda in schools. Students were interested in engaging with the program and found the FP/RH content relevant to their needs. However, few purchased contraceptive products through the online ordering system. There are preliminary indications that CyberRwanda may improve access to FP/RH information. An extended implementation period and further research are needed to measure the long-term impacts of the program and evaluate whether this digital self-care intervention can increase uptake of contraceptive methods and reduce adolescent pregnancy among school-aged youth.


Assuntos
Serviços de Planejamento Familiar , Serviços de Saúde Reprodutiva , Adolescente , Criança , Anticoncepcionais , Feminino , Humanos , Projetos Piloto , Gravidez , Saúde Reprodutiva , Ruanda , Autocuidado , Educação Sexual
8.
Aust J Gen Pract ; 51(9): 705-711, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36045628

RESUMO

BACKGROUND AND OBJECTIVES: Self-care strategies are important to maintain psychological wellbeing. The aim of this study was to explore how self-care changed during the first COVID-19 lockdown in winter 2020 and identify targets for interventions. METHOD: This was a cross-sectional study. Participants attending a COVID-19 testing clinic completed the Mindful Self-Care Scale (MSCS) and Hospital Anxiety and Depression Scale (HADS). RESULTS: A total of 332 participants completed questionnaires (mean age 38 years, 55% female). Self-care strategies used less frequently during lockdown when compared with pre-lockdown were in MSCS domains of Physical Care (P <0.001), Supportive Relationships (P <0.001), Supportive Structures (P <0.001) and Mindful Awareness (P <0.001). Mean anxiety and depression scores were 5.97 (standard deviation [SD] = 4.36) and 4.12 (SD = 3.594). DISCUSSION: Several pre-pandemic strategies were used less frequently, including individual activities not restricted during lockdown ('listening'; 'using images' to relax). This study provides insight into activities that are practised and reduced during a lockdown, which can guide wellbeing interventions to assist people in isolation.


Assuntos
COVID-19 , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Teste para COVID-19 , Controle de Doenças Transmissíveis , Estudos Transversais , Feminino , Humanos , Masculino , Saúde Mental , Autocuidado
9.
Artigo em Inglês | MEDLINE | ID: mdl-36078271

RESUMO

Diabetes numeracy skills are required in the interpretation of food labels, insulin pump dosage, the interpretation of blood glucose meter data, and the determination of carbohydrate intake. This study assessed the levels and correlates of numeracy skills in Lebanese adults with diabetes to identify those most at risk of uncontrolled diabetes. In total, 299 adults with diabetes, mean age 47.4 ± 19.8 years, took the questionnaire. It consisted of self-developed items on sociodemographic and health-related factors, in addition to the Diabetes Numeracy Test-15 (DNT-15) and the Single Item Literacy Screener. Many participants (62%) scored < 10 on the DNT-15 indicating insufficient numeracy skills. DNT-15 scores were positively associated with literacy, exercise, healthy diet, perceived diabetes control, frequency of glycaemia measurement, ability to afford treatment, and ease of understanding information related to diabetes. Age, BMI, and complications were negatively correlated with DNT-15 score. Numeracy skills were higher in males, single individuals, and in people with type 1 diabetes, fewer complications, controlled HbA1c, higher income, higher education, a prior visit to a dietician, and ability to maintain personal care despite COVID-19. Interventions to strengthen numeracy skills would empower individuals with diabetes, lead to appropriate self-management behaviors, and prevent health complications in at-risk individuals.


Assuntos
COVID-19 , Diabetes Mellitus Tipo 1 , Letramento em Saúde , Adulto , Idoso , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Autocuidado , Inquéritos e Questionários
10.
Artigo em Inglês | MEDLINE | ID: mdl-36078563

RESUMO

Self-care agency plays an important role in an individual's health. Considering the particularities of their education, it can be a protective factor for the mental health of medical students. This study aims to validate the Portuguese version of the Appraisal of Self-care Agency Scale-Revised (ASAS-R) in Portuguese medical students. A cross-sectional, quantitative, and analytical online study was conducted between 23 April 2021, and 15 July 2021. Exploratory factor analysis (EFA) was performed to test the internal structure of the ASAS-R. Correlations with the SHS (Subjective Happiness Scale), SWLS (Satisfaction with Life Scale), and MHI (Mental Health Inventory) were calculated using Pearson's coefficient so as to test convergent validity. Internal consistency was evaluated using inter-item correlation, corrected item-total correlation, and Cronbach's alpha. The total sample included 781 individuals. EFA yielded a 3-factor solution accounting for 53.9% of the explained variance. Pearson's coefficients obtained between the 3 factors of ASAS-R and the total scores of the 3 construct-related scales demonstrated adequate convergent validity. Total Cronbach's alpha value was 0.85, while the Cronbach's alpha of the three factors was 0.81, 0.55, and 0.83, respectively. This study demonstrated that ASAS-R is a valid and reliable instrument for measuring self-care agency among Portuguese medical students.


Assuntos
Autocuidado , Estudantes de Medicina , Estudos Transversais , Análise Fatorial , Humanos , Portugal , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
12.
Nephrol Nurs J ; 49(4): 359-365, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36054809

RESUMO

Jamaican adults with diabetes mellitus (DM) living in South Florida often believe taking conventional medications can cause harm. In an effort to limit adverse effects of these medicines, they frequently engage in folk care. However, this practice could actually increase risks of DM-associated complications, such as chronic kidney disease. Little is known about what folk care Jamaican adults are integrating into everyday health care. This focused ethnography explored and described how Jamaican adults with DM who live in South Florida use folk care for managing their DM. Knowing what folk care is part of everyday health practices among ethnical and racially diverse populations, such as Jamaican adults in this study, can help inform nephrology nursing practice and support future research.


Assuntos
Complicações do Diabetes , Diabetes Mellitus , Adulto , Florida , Humanos , Jamaica , Autocuidado
13.
J Christ Nurs ; 39(4): E74-E79, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36048608

RESUMO

ABSTRACT: Health promotion strategies offered in a faith-based setting can be effective in influencing positive self-care behaviors related to hypertension. Faith-based organizations are ideal places to reach vulnerable populations to improve blood pressure management and make a lasting impact. The purpose of this pilot study was to provide a 4-week management program to improve hypertension self-care among a congregation of African Americans. Results revealed improvements among participants related to self-care as well as lowered blood pressure readings.


Assuntos
Organizações Religiosas , Hipertensão , Promoção da Saúde/métodos , Humanos , Hipertensão/terapia , Projetos Piloto , Autocuidado
14.
BMC Health Serv Res ; 22(1): 1160, 2022 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-36104690

RESUMO

BACKGROUND: Although person-centred care (PCC) is growing globally in popularity it is often vague and lacks conceptual clarity and definition. The ambiguity stretches from PCC's underlying philosophical principles and definitions of the concept to how it is operationalised and practised on the ground by health care professionals. We explore how the PCC model by the Gothenburg University Centre for Person-centred Care (GPCC) was operationalised in a real-world setting by using a set of recommendations by Fixsen and others that define and structure the core components of innovations in four distinct but interrelated components: philosophical principles and values, contextual factors, structural elements and core practices. Thus, this study aimed to increase knowledge about core practices in PCC in six health care units in real-world circumstances. METHODS: A case study with six embedded health care units was conducted from 2016 to 2019. We collected data from three sources: interviews (n = 12) with change agents, activity logs and written documents. Data were triangulated, and core practices were identified and deductively coded to the PCC model's structural elements: initiating, working and safeguarding the partnership with patients. RESULTS: We identified operationalisations of PCC in line with the three structural elements in the GPCC model at all included health care units. A range of both similarities and dissimilarities between units were identified, including the level of detail in describing PCC practices, when these practices were conducted and by whom at the workplace. The recommendations for describing the core components of PCC also helped us identify how some operationalisations of PCC seemed more driven by contextual factors, including a new regulation for planning and documenting care across health care specialities. CONCLUSIONS: Our findings show how PCC is operationalised in different health care units in a real-world setting based on change agents' understanding of the concept and their unique context. Increased knowledge of PCC and its philosophical principles and values, contextual factors, structural elements and core practices, is necessary to build a common understanding of the PCC-concept. Such knowledge is essential when PCC is operationalised as part of implementation efforts in health care.


Assuntos
Assistência Centrada no Paciente , Autocuidado , Atenção à Saúde , Pessoal de Saúde , Humanos , Projetos de Pesquisa
15.
BMC Health Serv Res ; 22(1): 1146, 2022 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-36088408

RESUMO

BACKGROUND: Worldwide healthcare systems face challenges in assessing and monitoring chronic care pathways and, even more, the value generated for patients. Patient-reported outcomes measures (PROMs) represent a valid Real-World Evidence (RWE) source to fully assess health systems' performance in managing chronic care pathways. METHODS: The originality of the study consists in the chance of adopting PROMs, as a longitudinal assessment tool for continuous monitoring of patients' adherence to therapies and self-care behavior recommendations in clinical practice and as a chance to provide policy makers insights to improve chronic pathways adopting a patient perspective. The focus was on PROMs of patients with chronic heart failure (CHF) collected in the Gabriele Monasterio Tuscan Foundation (FTGM), a tertiary referral CHF centre in Pisa, Italy. During the hospital stay, CHF patients were enrolled and received a link (via SMS or email) to access to the first questionnaire. Follow-up questionnaires were sent 1, 7 and 12 months after the index hospitalisation. Professionals invited 200 patients to participate to PROMs surveys. 174 answers were digitally collected at baseline from 2018 to 2020 and analysed. Quantitative and qualitative analyses were conducted, using Chi2, t-tests and regression models together with narrative evidence from free text responses. RESULTS: Both quantitative and qualitative results showed FTGM patients declared to strongly adhere to the pharmacological therapy across the entire pathway, while seemed less careful to adhere to self-care behavior recommendations (e.g., physical activity). CHF patients that performed adequate Self-Care Maintenance registered outcome improvements. Respondents declared to be supported by family members in managing their adherence. CONCLUSIONS: The features of such PROMs collection model are relevant for researchers, policymakers and for managers to implement interventions aimed at improving pathway adherence dimensions. Among those, behavioral economics interventions could be implemented to increase physical activity among CHF patients since proven successful in Tuscany. Strategies to increase territorial care and support patients' caregivers in their daily support to patients' adherence should be further explored. Systematic PROMs collection would allow to monitor changes in the whole pathway organization. This study brings opportunities for extending such monitoring systems to other organizations to allow for reliable benchmarking opportunities.


Assuntos
Insuficiência Cardíaca , Autocuidado , Doença Crônica , Procedimentos Clínicos , Insuficiência Cardíaca/terapia , Humanos , Cooperação do Paciente
16.
N Z Med J ; 135(1561): 31-44, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36049788

RESUMO

AIMS: This study investigated differences in illness perceptions and self-care behaviours between Maori and New Zealand (NZ) Europeans with type 2 diabetes mellitus (T2DM), and how these perceptions were related to clinical outcomes. METHODS: Participants were 85 Maori and 85 NZ European adults, recruited from outpatient clinics, who completed a cross-sectional questionnaire on illness perceptions and self-care behaviours. Clinical data, including HbA1c, retinopathy, neuropathy and nephropathy, were collected from medical records. RESULTS: Compared to NZ Europeans, Maori had higher HbA1c, lower adherence to medication and a healthy diet, and were more likely to smoke. Maori reported greater perceived consequences of diabetes on their lives, and more severe symptoms than NZ Europeans did. Maori were more likely to attribute T2DM to food and drink, whereas NZ Europeans were more likely to attribute T2DM to weight. Perceiving that treatment could help control diabetes was associated with lower HbA1c and higher medication adherence in Maori and NZ Europeans independently. CONCLUSIONS: Maori experienced and perceived worse T2DM outcomes than NZ Europeans did. Research is needed to develop and test clinical interventions to address these inequities and improve outcomes, possibly by asking patients about their perceptions, providing tailored and culturally appropriate education, and discussing patients' concerns.


Assuntos
Diabetes Mellitus Tipo 2 , Havaiano Nativo ou Outro Ilhéu do Pacífico , Brancos , Adulto , Estudos Transversais , Diabetes Mellitus Tipo 2/psicologia , Diabetes Mellitus Tipo 2/terapia , Hemoglobina A Glicada , Humanos , Nova Zelândia , Autocuidado
17.
J Med Internet Res ; 24(9): e40108, 2022 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-36069782

RESUMO

BACKGROUND: The demand for health services to meet the chronic health needs of the aging population is significant and remains unmet because of the limited supply of clinical resources. Specifically, in managing heart failure (HF), digital health sought to address this gap during the COVID-19 pandemic but highlighted an access issue for those who could not use technology-mediated health care services without the support of their informal caregivers (ICs). The complexity of managing HF symptoms and recurrent exacerbations requires many patients to comanage their illness with their ICs in a care dyad, working together to optimize patient outcomes and health-related quality of life. However, most HF programs have missed the opportunity to consider the dyadic perspective despite interdependencies on HF outcomes. OBJECTIVE: This study aims to characterize the value of technology in supporting caregiving for individuals living with HF. METHODS: Motivated by an observed unique pattern of engagement in patients enrolled in our Medly HF management program at the Peter Munk Cardiac Centre in Toronto, Canada, we conducted 20 semistructured interviews with a convenience sample of ICs. All interviews were analyzed using the iterative refinement of a codeveloped codebook. The team maintained reflexivity journals to reflect the impact of their positionality on their coding. Themes were first derived deductively using HF typologies (patient-oriented dyads, caregiver-oriented dyads, and collaboratively oriented dyads) and then inductively refined and recategorized based on concepts from the van Houtven et al framework. RESULTS: We believe that there is a need to formally and intentionally expand HF technologies to include dyadic needs and goals. We suggest defining 3 opportunities in which value can be added to technological design. First, identify how technology may be leveraged to increase psychological bandwidth by reducing uncertainty and providing peace of mind. We found that actionable feedback was highly desired by both partners. Second, develop technology that can serve as a member of the dyad's support system. In our experience, automated prompts for patients to take measurements can mimic the support typically provided by ICs and ease their workload. Third, consider how technology can mitigate the dyad's clinical knowledge requirements and learning curve. Our approach includes real-time actionable feedback paired with a human-in-the-loop, nurse-led model of care. CONCLUSIONS: Our findings identified a need to focus on improving the dyadic experience as a whole by building IC functionality into digital health self-management interventions. Through a shared model of care that supports the role of the patient in their own HF management, includes ICs to expand and enhance the patient's capacity to care, and acknowledges the need of ICs to care for themselves, we anticipate improved outcomes for both partners.


Assuntos
COVID-19 , Insuficiência Cardíaca , Idoso , Insuficiência Cardíaca/terapia , Humanos , Pandemias , Qualidade de Vida , Autocuidado , Tecnologia
18.
Curr Oncol ; 29(8): 5368-5369, 2022 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-36005163

RESUMO

Lesack et al. recently published a cross-sectional study that focused on human papillomavirus (HPV) self-sampling in the screened population, a population not conventionally thought of for HPV self-sampling. They found 52% of well-screened, highly educated women who participated in the Human Papillomavirus For Cervical Cancer (HPV FOCAL) screening trial in British Columbia, Canada, would be willing to self-collect an HPV sample. We published a similar study in 2021 on well-screened, highly educated women affiliated with a family medicine clinic in Edmonton, Alberta, Canada, and found that 60% of these women preferred to have the option of HPV self-sampling. Our findings reinforce Lesack et al.'s results and together provide evidence for offering HPV self-sampling as an option for the well-screened population.


Assuntos
Alphapapillomavirus , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Alberta , Estudos Transversais , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Papillomaviridae , Infecções por Papillomavirus/diagnóstico , Autocuidado/métodos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Esfregaço Vaginal/métodos
19.
J Am Med Dir Assoc ; 23(8): 1313.e15-1313.e46, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35940681

RESUMO

OBJECTIVES: To synthesize published research exploring emergency department (ED) communication strategies and decision-making with persons living with dementia (PLWD) and their care partners as the basis for a multistakeholder consensus conference to prioritize future research. DESIGN: Systematic scoping review. SETTINGS AND PARTICIPANTS: PLWD and their care partners in the ED setting. METHODS: Informed by 2 Patient-Intervention-Comparison-Outcome (PICO) questions, we conducted systematic electronic searches of medical research databases for relevant publications following standardized methodological guidelines. The results were presented to interdisciplinary stakeholders, including dementia researchers, clinicians, PLWD, care partners, and advocacy organizations. The PICO questions included: How does communication differ for PLWD compared with persons without dementia? Are there specific communication strategies that improve the outcomes of ED care? Future research areas were prioritized. RESULTS: From 5451 studies identified for PICO-1, 21 were abstracted. From 2687 studies identified for PICO-2, 3 were abstracted. None of the included studies directly evaluated communication differences between PLWD and other populations, nor the effectiveness of specific communication strategies. General themes emerging from the scoping review included perceptions by PLWD/care partners of rushed ED communication, often exacerbated by inconsistent messages between providers. Care partners consistently reported limited engagement in medical decision-making. In order, the research priorities identified included: (1) Barriers/facilitators of effective communication; (2) valid outcome measures of effective communication; (3) best practices for care partner engagement; (4) defining how individual-, provider-, and system-level factors influence communication; and (5) understanding how each member of ED team can ensure high-quality communication. CONCLUSIONS AND IMPLICATIONS: Research exploring ED communication with PLWD is sparse and does not directly evaluate specific communication strategies. Defining barriers and facilitators of effective communication was the highest-ranked research priority, followed by validating outcome measures associated with improved information exchange.


Assuntos
Cuidadores , Demência , Comunicação , Serviço Hospitalar de Emergência , Humanos , Autocuidado
20.
Prim Health Care Res Dev ; 23: e48, 2022 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-36000174

RESUMO

AIM: This study was to investigate the relationships among health behaviors and quality of life (QOL) and to test a proposed model among people with hypertension and concomitant chronic kidney disease (CKD) in primary care. In addition, the mediation effect of modifiable risk factors between self-care health behaviors and QOL was examined. METHODS: This study was prospective, conducted in the centers of primary medical care in the period from January 2018 to January 2020. In total, 170 patients diagnosed with hypertension and CKD at least 12 months previously were included in this study. The following parameters were measured: self-efficacy, self-care health behaviors with the subscales of health responsibility, exercise, consumption of a healthy diet, stress management, and smoking cessation; modifiable risk score; and QOL (assessed using the 36-item Short-Form Health Survey instrument). RESULTS: Self-efficacy had a significantly positive direct effect on self-care health behaviors, with a standardized regression coefficient of 0.87 (P = 0.007), a negative indirect effect on risk factors, with a standardized regression coefficient of 0.11 (P = 0.006), and a positive indirect effect on QOL, with a standardized regression coefficient of 0.62 (P = 0.008). Self-care health behaviors had a significantly positive direct effect on QOL, with a standardized regression coefficient of 0.72 (P = 0.012); there was also an indirect effect of 0.053 (P = 0.004). The direct effect of risk factors on QOL was significant, with a standardized regression coefficient of 0.44 (P = 0.018). The direct effect of self-care health behaviors on QOL was 0.77 (P = 0.008), which has been reduced to 0.72 (P = 0.012). The reduced effect of 0.05 was significant (P = 0.004), confirming the mediating role of modified risk factors. CONCLUSIONS: This study indicates health-promoting behaviors in hypertensive patients with CKD have a potential impact on their QOL in primary care. Primary care physicians should focus on motivation strategies to encourage individuals to perform self-care health-promoting behaviors associated with the improved QOL, in order to achieve better outcomes in risk factor management.


Assuntos
Hipertensão , Insuficiência Renal Crônica , Estudos Transversais , Humanos , Hipertensão/complicações , Hipertensão/terapia , Atenção Primária à Saúde , Estudos Prospectivos , Qualidade de Vida , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/terapia , Autocuidado
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