Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.182
Filtrar
1.
Urology ; 135: 32-37, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31626856

RESUMO

OBJECTIVE: To ascertain whether a poor response and adverse events (voiding dysfunction and urinary tract infection) were predictable for first time botulinum toxin-A (BTX-A) injections in a patient cohort of refractory idiopathic overactive bladder with detrusor overactivity. METHODS: Patients who received BTX-A injections for the first time between the dates of March 2004-August 2017 were analyzed in this single center study. Urogenital Distress Inventory short form (UDI-6) questionnaires were collected both preinjection and postinjection prospectively. A poor response was defined as a decrease of less than 16.7 on the UDI-6 questionnaire. Additional information was gathered from patient records in a retrospective fashion. Predictors of poor response, voiding dysfunction, and UTI were analyzed with multivariate logistic regression analysis. RESULTS: Seventy-four patients were analyzed. The only predictor of poor response was male gender (OR, 5.45; 95% CI 1.83-16.47; P = .002). Lower maximum urinary flow rates (OR, 0.91; 95% CI, 0.83-0.99; P = .023), male gender (OR, 5.14; 95% CI 1.41-18.72; P = .013), and hysterectomy in females (OR, 4.55; 95% CI, 1.09-18.87; P = .038) were predictors of clean intermittent self catheterisation (CISC). There was an increased risk of UTIs in patients who performed CISC (OR, 5.26; 95% CI 1.38-20.0; P = .015). CONCLUSION: Male gender was associated with a poor response to BTX-A injections and increased risk of CISC. Lower maximum urinary flow rates and women with hysterectomies were at increased risk of requiring CISC postinjection. Performing CISC was associated with increased risk of UTI. These factors could be helpful when counselling or selecting patients.


Assuntos
Toxinas Botulínicas Tipo A/administração & dosagem , Fármacos Neuromusculares/administração & dosagem , Bexiga Urinária Hiperativa/terapia , Administração Intravesical , Toxinas Botulínicas Tipo A/efeitos adversos , Feminino , Humanos , Injeções Intramusculares/métodos , Cateterismo Uretral Intermitente/efeitos adversos , Cateterismo Uretral Intermitente/métodos , Cateterismo Uretral Intermitente/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Fármacos Neuromusculares/efeitos adversos , Prognóstico , Estudos Retrospectivos , Autocuidado/métodos , Autocuidado/estatística & dados numéricos , Fatores Sexuais , Inquéritos e Questionários , Resultado do Tratamento , Bexiga Urinária/efeitos dos fármacos , Bexiga Urinária/fisiopatologia , Bexiga Urinária Hiperativa/diagnóstico , Bexiga Urinária Hiperativa/fisiopatologia , Infecções Urinárias/epidemiologia , Infecções Urinárias/etiologia , Transtornos Urinários/diagnóstico , Transtornos Urinários/epidemiologia , Transtornos Urinários/etiologia
2.
Artigo em Inglês | MEDLINE | ID: mdl-31505892

RESUMO

This study investigated the effect of applying a customized diabetes education program through pattern management (PM), using continuous glucose monitoring system (CGMS) results, on individual self-care behaviors and self-efficacy in patients with type 2 diabetes mellitus. Patients with type 2 diabetes who had never received diabetes education, enrolled from March to September 2017, were sequentially assigned to either PM education or control groups. In the PM education group, the CGMS test was first conducted one week before diabetes education and repeated three times by PM in order to obtain data on self-care behaviors and self-efficacy. These results were then compared before and after education at three and six months. The control group received the traditional diabetes education. Self-efficacy showed statistically significant interactions between the two groups over time, indicating a significant difference in the degree of self-efficacy between the PM education and control groups. Diabetes education by PM using CGMS result analysis improved life habits with a positive influence on self-care behaviors and self-efficacy for diabetes management. Further studies are needed to further develop and apply individual diabetes education programs in order to sustain the effects of self-care behaviors and self-efficacy in patients with diabetes who experience a decrease in self-efficacy after three months of education.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Educação em Saúde/métodos , Educação de Pacientes como Assunto/estatística & dados numéricos , Autocuidado/estatística & dados numéricos , Autoeficácia , Adulto , Idoso , Automonitorização da Glicemia , Feminino , Educação em Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes/estatística & dados numéricos , República da Coreia , Adulto Jovem
3.
BMC Res Notes ; 12(1): 591, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533833

RESUMO

OBJECTIVE: Diabetes, a rising global health problem, requires continuous self-care practice. There are limited studies about self-care practice, and most of the studies conducted in Ethiopia focused on some parts of the recommended self-care practices. Therefore, this study aimed to assess diabetes self-care practice and associated factors among diabetic patients attending at University of Gondar Referral Hospital, Gondar, Northwest Ethiopia. RESULTS: The study revealed that 51.86% (95% CI 46.95-56.72%) of the patients have poor self-care practice. Unable to read and write (AOR = 3.36; 95% CI 1.42-7.90), primary level of education (AOR = 2.62; 95% CI 1.20-5.70), living in rural area (AOR = 3.33; 95% CI 1.61-6.88), having strong social support (AOR = 0.31; 95% CI 0.15-0.62), having diabetes related complication (AOR = 2.20; 95% CI 1.12-4.30), and poor socio-economic status (AOR = 2.16; 95% CI 1.17-3.98) were factors significantly associated with poor self-care practice of patients with diabetes. The study indicates that the prevalence of poor self-care practice was high. Education, residence, socio-economic status, complication and social support were significantly associated with poor self-care practice. Therefore, strategies should be developed to support patients with information, glucometer, and enhance patient's social support.


Assuntos
Diabetes Mellitus/terapia , Conhecimentos, Atitudes e Prática em Saúde , Encaminhamento e Consulta , Autocuidado/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Etiópia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Autocuidado/métodos , Classe Social , Adulto Jovem
4.
Int J Med Inform ; 130: 103941, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31437618

RESUMO

BACKGROUND AND SIGNIFICANCE: Data-driven interventions for health can help to personalize self-management of Type 2 Diabetes (T2D), but lack of sustained engagement with self-monitoring among disadvantaged populations may widen existing health disparities. Prior work developing approaches to increase motivation and engagement with self-monitoring holds promise, but little is known about applicability of these approaches to underserved populations. OBJECTIVE: To explore how low-income, Latino adults with T2D respond to different design concepts for data-driven solutions in health that require self-monitoring, and what features resonate with them the most. MATERIAL AND METHODS: We developed a set of mockups that incorporated different design features for promoting engagement with self-monitoring in T2D. We conducted focus groups to examine individuals' perceptions and attitudes towards mockups. Multiple interdisciplinary researchers analyzed data using directed content analysis. RESULTS: We conducted 14 focus groups with 25 English- and Spanish-speaking adults with T2D. All participants reacted positively to external incentives. Social connectedness and healthcare expert feedback were also well liked because they enhanced current social practices and presented opportunities for learning. However, attitudes were more mixed towards goal setting, and very few participants responded positively to self-discovery and personalized decision support features. Instead, participants wished for personalized recommendations for meals and other health behaviors based on their personal health data. CONCLUSION: This study suggests connections between individuals' degree of internal motivation and motivation for self-monitoring in health and their attitude towards designs of self-monitoring apps. We relate our findings to the self-determination continuum in self-determination theory (SDT) and propose it as a blueprint for aligning incentives for self-monitoring to different levels of motivation.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Comportamentos Relacionados com a Saúde , Hispano-Americanos/psicologia , Monitorização Fisiológica , Motivação , Autocuidado/estatística & dados numéricos , Adulto , Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Mellitus Tipo 2/psicologia , Feminino , Grupos Focais , Humanos , Renda/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
5.
Diabetes Metab Syndr ; 13(4): 2431-2435, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31405655

RESUMO

BACKGROUND: Diabetes in Sudan is real health challenge for health authorities especially optimum glycemic control and complications in particular diabetic septic foot. This is study aimed to assess knowledge of individuals with diabetes about self-foot care. METHODS: This is descriptive cross sectional, health facility-based study conducted in diabetes center in Khartoum, Sudan. The study recruited 150 individuals with diabetes. Data was collected using a standardized pretested questionnaire. RESULTS: Among the participants 64.7% were females and 35.3% were males, 36% of the participants were between the age of 51-60 years old. Good glycemic control (HbA1c) were achieved by 41.3% only. The participants who had good knowledge about diabetic foot self-care were 46.7%, poor knowledge 29.3% and moderate knowledge 24%. Good self-practice toward diabetic foot self-care was reported by 42.6%, moderate by 36.7% and poor practice by 20.7%. The awareness and practices significantly correlated with an increase in ages (≥51 years), higher level of education, medium income, unemployment, longer duration of diabetes > 10years, family history, controlled diabetes mellitus and education about diabetes complications and diabetic foot care (P value < 0.05). CONCLUSIONS: Only (46.7%) of participants address good awareness and practices about self-foot care. Accordingly, there is a great need to provide continuous health education to the patients about diabetic foot self-care and this knowledge-application gap must be narrowed down.


Assuntos
Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Pé Diabético/terapia , Conhecimentos, Atitudes e Prática em Saúde , Educação de Pacientes como Assunto , Autocuidado/estatística & dados numéricos , Autocuidado/normas , Adulto , Estudos Transversais , Pé Diabético/etiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , Sudão/epidemiologia , Inquéritos e Questionários
6.
Pan Afr Med J ; 33: 83, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31448045

RESUMO

Introduction: The empowerment of young people aged 15-24 years is a key component of an effective AIDS response. HIV self-testing (HIVST) is progressively being implemented in the Democratic Republic of Congo (DRC). Methods: Socio-demographic and behavioural factors associated with acceptability of HIVST were evaluated among university students in Bunia, DRC. A representative cross-sectional study was conducted using a self-administered semi-structured questionnaire. Results: A total of 1,012 students were recruited. Acceptability of unsupervised HIVST was higher in the group of young students as compared with older students and was markedly associated with prior knowledge on HIVST. Conclusion: Adapted communication about HIVST appears likely essential to increase the supply and use of HIVST among students in DRC.


Assuntos
Infecções por HIV/diagnóstico , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Autocuidado/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Adolescente , Estudos Transversais , República Democrática do Congo , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Inquéritos e Questionários , Universidades , Adulto Jovem
7.
PLoS One ; 14(8): e0220632, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31408474

RESUMO

OBJECTIVE: To assess triage compliance and the effect of the time from screening to triage on follow-up among HPV-positive women. METHODS: We recruited 1232 women in a screening campaign in Madagascar from February to October 2015. In the first period (February-May), HPV tests were performed remotely using the cobas test. In the second period (May-October), testing was performed on-site using the Xpert HPV assay. HPV-positive women were invited for triage with visual inspection with acetic acid (VIA) and Lugol's iodine (VILI). Systematic biopsy and endocervical brushing were performed on all HPV-positive women for quality control. Three groups were defined according to time from HPV testing to triage invitation for HPV-positive women-Group I: delayed (> 3 months), Group II: prompt (24-48 hours), and Group III: immediate (< 24 hours). RESULTS: A total 1232 self-sampled HPV tests were performed in the study period (496 in Group I, 512 in Group II, and 224 in Group III). Participants' mean age was 43.2 ± 9.3 years. Mean time from screening to VIA/VILI testing was 103.5 ± 43.6 days. Overall HPV prevalence was 28.0%. HPV prevalence was 27.2% in Group I (cobas test), 29.2% in Group 2 (Xpert test), and 26,7% in Group III (Xpert test). The VIA/VILI compliance rate was 77.8% for Group I, 82.7% for Group II, and 95.0% for Group III. Of women undergoing VIA/VILI, 56.3% in Group I and 43.5% in Groups II/III had positive results. Prevalence of cervical intraepithelial neoplasia grade 2 or worse among HPV-positive women was 9.8% for Group I and 6.8% for Groups II/III. Non-adherence was higher among rural women, uneducated women, and women in Group I. CONCLUSION: HPV-positive women with immediate VIA/VILI triage invitation had the best triage compliance. A single-day test and triage strategy is preferred for low-resource settings.


Assuntos
Detecção Precoce de Câncer/estatística & dados numéricos , Infecções por Papillomavirus/complicações , Cooperação do Paciente/estatística & dados numéricos , Autocuidado/estatística & dados numéricos , Neoplasias do Colo do Útero/diagnóstico , Adulto , Idoso , Biópsia , Colo do Útero/patologia , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/psicologia , Feminino , Humanos , Madagáscar/epidemiologia , Pessoa de Meia-Idade , Cooperação do Paciente/psicologia , Autocuidado/psicologia , Triagem , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/virologia
8.
J Surg Res ; 244: 181-188, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31299434

RESUMO

BACKGROUND: Hernias are one of the most commonly encountered surgical conditions, and every year, more than 20 million hernia repairs are performed worldwide. The surgical management of hernia, however, is largely neglected as a public health priority in developing countries, despite its cost-effectiveness. To date, the prevalence and impact of hernia have not been formally studied in a community setting in Cameroon. The aim of this study was to determine the prevalence and characteristics of untreated hernia in the Southwest region of Cameroon. METHODS: This study was a subanalysis of a cross-sectional community-based survey on injury in Southwest Cameroon. Households were sampled using a three-stage cluster sampling method. Household representatives reported all untreated hernias occurring in the past year. Data on socioeconomic factors, hernia symptoms, including the presence of hernia incarceration, and treatment attempts were collected between January 2017 and March 2017. RESULTS: Among 8065 participants, 73 persons reported symptoms of untreated hernia, resulting in an overall prevalence of 7.4 cases per 1000 persons (95% confidence limit 4.98-11.11). Groin hernias were most commonly reported (n = 49, 67.1%) and predominant in young adult males. More than half of persons with untreated hernia (56.7%) reported having symptoms of incarceration, yet 42.1% (n = 16) of these participants did not receive any surgical treatment. Moreover, 21.9% of participants with untreated hernias never presented to formal medical care, primarily because of the high-perceived cost of care. Untreated hernias caused considerable disability, as 21.9% of participants were unable to work because of their symptoms, and 15.1% of households earned less money. CONCLUSIONS: Hernia is a significant surgical problem in Southwest Cameroon. Despite over half of those with unrepaired hernias reporting symptoms of incarceration, home treatment and nonsurgical management were common. Costs associated with formal medical services are a major barrier to obtaining consultation and repair. Greater awareness of hernia complications and cost restructuring should be considered to prevent disability and mortality due to hernia.


Assuntos
Efeitos Psicossociais da Doença , Hérnia/epidemiologia , Adolescente , Adulto , Fatores Etários , Camarões/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Avaliação da Deficiência , Feminino , Virilha , Gastos em Saúde/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Hérnia/complicações , Hérnia/economia , Hérnia/terapia , Herniorrafia/economia , Herniorrafia/psicologia , Herniorrafia/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Educação de Pacientes como Assunto , Prevalência , Fatores de Risco , Autocuidado/economia , Autocuidado/psicologia , Autocuidado/estatística & dados numéricos , Fatores Sexuais , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-31284406

RESUMO

Atrial fibrillation (AF), common in older adults, increases the risk of heart failure, stroke, and all-cause mortality. Self-care behaviors help avoid adverse events in older patients with AF. However, while frailty and cognitive impairment can contribute to poor self-care behaviors, few studies have explored these relationships in older adults with AF. This cross-sectional study aims to determine associations between frailty, cognitive impairment, and self-care behaviors among older adults with AF by gender. A total of 298 patients with AF aged 60 and over were assessed with a self-reported questionnaire consisting of the Korean version of the FRAIL scale, modified mini-mental state examination, and self-care scale for AF. Prevalence of frailty and prefrailty in men and women was around 11% and 48.4% and 28% and 47.4%, respectively. According to the hierarchical linear regression analysis, in men, prefrailty (ß = -2.874, p = 0.013) and frailty (ß = -7.698, p < 0.001) were associated with self-care behaviors; in women, frailty (ß = -5.476, p = 0.003), and cognitive impairment (ß = -3.350, p = 0.044) were associated with self-care behaviors. Developing individualized care plans will require periodic screening of older patients with AF to determine their frailty status and cognitive function.


Assuntos
Fibrilação Atrial/etiologia , Disfunção Cognitiva/epidemiologia , Idoso Fragilizado/estatística & dados numéricos , Fragilidade/epidemiologia , Autocuidado/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/complicações , Estudos Transversais , Feminino , Fragilidade/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , República da Coreia/epidemiologia , Autorrelato , Fatores Sexuais
11.
PLoS One ; 14(7): e0220304, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31348814

RESUMO

BACKGROUND: The needs of Chinese patients undergoing home-based rehabilitation after hip replacement surgery remain unclear. In this study, we qualitatively investigated the needs of Chinese patients undergoing home-based rehabilitation after hip replacement surgery. METHODS: A total of 21 participants undergoing home-based rehabilitation after hip replacement surgery were included in this study. Individual semi-structured interviews involving all participants were performed to determine the needs and experiences of this patient population during home-based rehabilitation. Data were subjected to qualitative content analysis. RESULTS: The patients had numerous needs during rehabilitation. Three substantive themes, namely, the need to obtain health-related knowledge, the need to obtain care and support, and the needs of those who cannot perform self-care, were identified from the qualitative data. The participants shared valuable insights into their needs during home-based rehabilitation after hip replacement and provided potential suggestions. CONCLUSIONS: Patients undergoing home-based rehabilitation after hip replacement have several strong needs and lack proper guidance. The initial and continuous engagement of rehabilitation professionals and the establishment of related policies based on patient's needs are potential approaches for improving the effectiveness of home-based rehabilitation after hip replacement.


Assuntos
Artroplastia de Quadril/reabilitação , Autocuidado/estatística & dados numéricos , Idoso , Artroplastia de Quadril/psicologia , Feminino , Nível de Saúde , Serviços de Assistência Domiciliar , Humanos , Entrevistas como Assunto , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Pesquisa Qualitativa , Autocuidado/psicologia
12.
BMC Med ; 17(1): 127, 2019 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-31311573

RESUMO

BACKGROUND: Smartphone apps are becoming increasingly popular for supporting diabetes self-management. A key aspect of diabetes self-management is appropriate medication-taking. This study aims to systematically assess and characterise the medication management features in diabetes self-management apps and their congruence with best-practice evidence-based criteria. METHODS: The Google Play and Apple app stores were searched in June 2018 using diabetes-related terms in the English language. Apps with both medication and blood glucose management features were downloaded and evaluated against assessment criteria derived from international medication management and diabetes guidelines. RESULTS: Our search yielded 3369 Android and 1799 iOS potentially relevant apps; of which, 143 apps (81 Android, 62 iOS) met inclusion criteria and were downloaded and assessed. Over half 58.0% (83/143) of the apps had a medication reminder feature; 16.8% (24/143) had a feature to review medication adherence; 39.9% (57/143) allowed entry of medication-taking instructions; 5.6% (8/143) provided information about medication; and 4.2% (6/143) displayed motivational messages to encourage medication-taking. Only two apps prompted users on the use of complementary medicine. Issues such as limited medication logging capacity, faulty reminder features, unclear medication adherence assessment, and visually distracting excessive advertising were observed during app assessments. CONCLUSIONS: A large proportion of diabetes self-management apps lacked features for enhancing medication adherence and safety. More emphasis should be given to the design of medication management features in diabetes apps to improve their alignment to evidence-based best practice.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Adesão à Medicação , Aplicativos Móveis , Autocuidado/métodos , Autogestão/métodos , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/psicologia , Humanos , Adesão à Medicação/psicologia , Adesão à Medicação/estatística & dados numéricos , Aplicativos Móveis/normas , Aplicativos Móveis/estatística & dados numéricos , Autocuidado/normas , Autocuidado/estatística & dados numéricos , Autoeficácia , Autogestão/estatística & dados numéricos , Smartphone
13.
JMIR Mhealth Uhealth ; 7(6): e11917, 2019 05 29.
Artigo em Inglês | MEDLINE | ID: mdl-31199300

RESUMO

BACKGROUND: Tracking of dietary intake is key to enhancing weight loss. Mobile apps may be useful for tracking food intake and can provide feedback about calories and nutritional value. Recent technological developments have enabled image recognition to identify foods and track food intake. OBJECTIVE: We aimed to determine the effectiveness of using photography as a feature of a smartphone weight loss app to track food intake in adults who were overweight or obese. METHODS: We analyzed data from individuals (age, 18-65 years; body mass index≥25 kg/m2; ≥4 days of logged food intake; and ≥2 weigh-ins) who used a mobile-based weight loss app. In a retrospective study, we compared those who used the photo feature (n=9871) and those who did not use the feature (n=113,916). Linear regression analyses were used to assess use of the photo feature in relation to percent weight loss. RESULTS: Weight loss was greater in the group using the photo feature (Δ=0.14%; 95% CI 0.06-0.22; P<.001). The photo feature group used the weight loss app for a longer duration (+3.5 days; 95% CI 2.61-4.37; P<.001) and logged their food intake on more days (+6.1 days; 95% CI 5.40-6.77; P<.001) than the nonusers. Mediation analysis showed that the weight loss effect was absent when controlling for either duration or number of logged days in the program. CONCLUSIONS: This study was the first to examine the effect of a food photo feature to track food intake on weight loss in a free-living setting. Use of photo recognition was associated with greater weight loss, which was mediated by the duration of app use and number of logged days in the program.


Assuntos
Terapia Comportamental/normas , Aplicativos Móveis/normas , Fotografação/instrumentação , Perda de Peso , Adolescente , Adulto , Idoso , Terapia Comportamental/instrumentação , Terapia Comportamental/estatística & dados numéricos , Índice de Massa Corporal , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis/estatística & dados numéricos , Fotografação/normas , Fotografação/estatística & dados numéricos , Estudos Retrospectivos , Autocuidado/métodos , Autocuidado/psicologia , Autocuidado/estatística & dados numéricos , Programas de Redução de Peso/métodos , Programas de Redução de Peso/normas , Programas de Redução de Peso/estatística & dados numéricos
14.
Rev Esc Enferm USP ; 53: e03449, 2019 Jun 03.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31166458

RESUMO

OBJECTIVE: To evaluate the frailty syndrome in the elderly nursing diagnosis in elderly with chronic diseases of a health district of the Federal District. METHOD: A quantitative, descriptive, cross-sectional study was conducted with elderly patients served at the Basic Health Units, who presented arterial hypertension and/or diabetes mellitus. The following were used: a sociodemographic questionnaire, the Mini-Mental State Examination, anthropometric data, evaluation of sarcopenia (measured by body composition), muscle strength and functional capacity, and the identification of NANDA-I nursing diagnosis. A statistical software was used for data analysis. RESULTS: Participation of 78 elderly people, of which 93.6% of had Impaired memory, 93.6% had Impaired physical mobility, 82.1% had Fatigue, 76.9% had Impaired ambulation, 53.8% had Dressing self-care deficit, 43.6% had Activity Intolerance, 35.9% had Social Isolation, 30.8% had Hopelessness, 29.5% had Feeding self-care deficit, 29.5% had Bathing self-care deficit, 12.8% had Toileting self-care deficit, and 10.3% had Decreased cardiac output. CONCLUSION: The nursing diagnosis Frailty Syndrome in the Elderly allows a multidimensional view of the elderly. Since one factor can cause health problems in several health fields, nurses must intervene early, plan and implement actions in the short and long term.


Assuntos
Idoso Fragilizado , Fragilidade/epidemiologia , Atenção Primária à Saúde , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Estudos Transversais , Feminino , Fragilidade/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Diagnóstico de Enfermagem , Autocuidado/estatística & dados numéricos , Inquéritos e Questionários
15.
J Fam Psychol ; 33(7): 788-796, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31021129

RESUMO

Emerging adulthood is a transitional period for type 1 diabetes management, and aspects of family functioning such as family conflict and responsibility for diabetes management likely change following high school graduation. This study examined changes in diabetes-specific family conflict, family responsibility for diabetes management tasks, and associations with glycemic control up to 1 year after high school. Seventy-nine emerging adults with type 1 diabetes (M age = 18.09 ± .43 years; 51% female; 71% Caucasian) and their parents (73% female) completed self-report measures on diabetes-specific family conflict and family responsibility at 3 consecutive clinic visits, beginning in the spring of their senior year of high school. Hemoglobin A1c (HbA1c) was obtained from medical records. Diabetes-specific family conflict was relatively low; scores did not significantly change from baseline to Time 3. Parent responsibility for diabetes care decreased from baseline to Time 3. Higher parent- and emerging adult-reported family conflict and higher parent responsibility for diabetes care were associated with worse glycemic control (ps < .05). Parent-reported family conflict and the interaction between parent-reported family conflict and responsibility predicted HbA1c 1 year after high school. Conversely, HbA1c did not predict diabetes-specific family conflict or responsibility 1 year after high school. Findings indicate that diabetes-specific family conflict is associated with glycemic control after high school, even when emerging adults assume greater responsibility for diabetes self-care. Diabetes-specific family conflict levels were generally low and did not change over time despite this transitional period. If diabetes-specific conflict is present, it should be an important avenue for potential intervention for emerging adults with type 1 diabetes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Automonitorização da Glicemia/estatística & dados numéricos , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 1/terapia , Conflito Familiar/psicologia , Cooperação do Paciente/estatística & dados numéricos , Autocuidado/estatística & dados numéricos , Adolescente , Adulto , Automonitorização da Glicemia/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Cooperação do Paciente/psicologia , Autocuidado/psicologia , Adulto Jovem
16.
Complement Ther Med ; 43: 232-239, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30935536

RESUMO

The purpose of this study was to clarify the relationship of daily hot water bathing at home (DHW) and hot water spa bathing (HSPA) with the number of underlying diseases in middle-aged and elderly ambulatory patients. We defined the number of underlying diseases as the main outcome and dependent (criterion) variable. The frequency and time of DHW and the frequency of HSPA were set as explanatory variables. Multiple logistic regression analysis was performed for each frequency and time, adjusted age and sex. Odds ratio (OR) and 95% confidence interval (95% CI) were calculated. Among the 1261 patients who participated, there was no significant difference in age between males (n = 508, 72.8 ± 6.8 years) and females (n = 753, 73.5 ± 6.9 years). There was also no significant age difference between males (number of diseases: 2.7 ± 2.0 pts.) and females (number of diseases: 2.7 ± 2.1 pts.) in the occurrence of underlying diseases. Frequency and time of DHW were not associated with the occurrence of underlying diseases. However, compared with participants who utilized hot water spa at least once a week, the occurrence of underlying diseases was significantly associated with bathing frequency: one to three times per month (OR 2.72, 95% CI 1.63-4.52); twice or five times a year (OR 1.92, 95% CI 1.25-2.94). In conclusion, lower frequency of HSPA was significantly associated with increased risk of the occurrence of underlying diseases in middle-aged and elderly ambulatory patients. However, the relationship between proactive use of hot water spa and patients' mental and physical support should be clarified by well-designed cohort studies. The present study was registered as UMIN000033018 by the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) in Japan (refer: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000037643).


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Banhos/estatística & dados numéricos , Autocuidado/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Temperatura Alta , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Água
17.
Mult Scler Relat Disord ; 31: 118-123, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30981190

RESUMO

OBJECTIVE: To examine whether cognitive and physical fatigue are differentially associated with problems in self-care, mobility, relationships, participation, psychological well-being, and quality of life in people with multiple sclerosis. METHODS: A cross-sectional study involving seventy-four community-dwelling people with MS was undertaken. Between-groups analysis was used to compare ratings on the Perceived Impact of Problem Profile (PIPP) in a range of functional domains and the SF-36 quality of life measure, across median-split groups based on level of both physical and cognitive fatigue using the Modified Fatigue Impact Scale. RESULTS: The impact of poor psychological well-being (p = .005), and associated distress (p = .008) on PIPP was greater in the 'high-level' cognitive fatigue group than the 'low-level' cognitive fatigue group. By contrast, the 'high-level' and 'low-level' physical fatigue groups differed significantly in their self-reported impact of problems in the areas of mobility (p = .002), relationships (p = .014), participation (p = .001), and psychological well-being (p = .004). Overall mental quality of life was significantly lower (p < .001) in those high in cognitive fatigue comparative to the low-level group, and overall physical quality of life was significantly lower (p = .002) in people with multiple sclerosis high in physical fatigue as opposed to low. CONCLUSION: Cognitive and physical fatigue were associated with distinct problems in daily functioning, which impact differentially on role fulfilment and quality of life in multiple sclerosis. Therefore, these two types of fatigue should be considered distinct domains of the fatigue experience in MS.


Assuntos
Atividades Cotidianas , Fadiga Mental/psicologia , Esclerose Múltipla/psicologia , Qualidade de Vida , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Fadiga Mental/complicações , Fadiga Mental/epidemiologia , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Esclerose Múltipla/epidemiologia , Autocuidado/estatística & dados numéricos , Adulto Jovem
18.
Rev. pesqui. cuid. fundam. (Online) ; 11(3): 756-762, abr.-maio 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-987728

RESUMO

Objective: The study's purpose has been to identify the technologies focused on the health education of chronic renal patients aiming to promote the self-care. Methods: It is an integrative review that was performed in the databases LILACS, MEDLINE, SCOPUS, CINAHL and in the COCHRANE Library, where the final sample consisted of 16 articles. Results: The publications occurred between 2008 and 2016, prevailing studies with level III of evidence. The findings showed that the technologies used in health education for the promotion of chronic renal patient self-care used written materials (brochures, booklets and handouts), audiovisuals (videos, website, PowerPoint presentation, soap opera and interactive CD) and educational games as a communication vehicle. Conclusion: Among the articles that brought out these technologies, it was not verified their occurrence in the Brazilian scientific literature, then configuring a knowledge gap in that country


Objetivo: C: Identificar as tecnologias direcionadas para a educação em saúde de pacientes renais crônicos para a promoção do autocuidado. Métodos: Trata-se de uma revisão integrativa realizada nas bases de dados LILACS, MEDLINE, SCOPUS, CINAHL e na Biblioteca COCHRANE, sendo a amostra final composta por 16 artigos. Resultados: As publicações ocorreram entre 2008 e 2016, prevalecendo estudos com nível III de evidência. Os achados mostraram que as tecnologias utilizadas na educação em saúde para a promoção do autocuidado do paciente renal crônico utilizaram materiais escritos (folhetos, livretos e apostilas), audiovisuais (vídeos, website, apresentação de Power point, telenovela e CD interativo) e jogos educacionais como veículo de comunicação. Conclusão: Dentre os artigos que trouxeram essas tecnologias, não foram representantes na literatura cientifica brasileira, configurando-se uma lacuna de conhecimento nesse país


Objetivo: Identificar las tecnologías dirigidas a la educación de la salud en pacientes renales crónicos para promover el autocuidado. Método: Se trata de una revisión integradora llevado a cabo en las bases de datos LILACS, MEDLINE, Scopus, CINAHL y Cochrane Library, y la muestra final de 16 artículos. Resultados: Publicaciones ocurrieron entre 2008 y 2016, los estudios ya existe con las pruebas de nivel III. Los resultados mostraron que las tecnologías utilizadas en la educación sanitaria para la promoción de los materiales renal crónica paciente autocuidado utilizados por escrito (folletos, prospectos y folletos), audiovisuales (videos, sitios web, presentaciones de Power Point, series de televisión y CD interactivo) y juegos educativos como vehículo de comunicación. Conclusión: Entre los artículos que trajeron estas tecnologías no eran representantes en la literatura científica brasileña, la creación de un vacío de conocimiento en este país


Assuntos
Humanos , Masculino , Feminino , Autocuidado/estatística & dados numéricos , Educação em Saúde/métodos , Insuficiência Renal Crônica/terapia , Autocuidado/instrumentação , Educação em Saúde/tendências
19.
Diabetes Care ; 42(5): 849-858, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30862659

RESUMO

OBJECTIVE: Marshallese adults experience high rates of type 2 diabetes. Previous diabetes self-management education (DSME) interventions among Marshallese were unsuccessful. This study compared the extent to which two DSME interventions improved glycemic control, measured on the basis of change in glycated hemoglobin (HbA1c). RESEARCH DESIGN AND METHODS: A two-arm randomized controlled trial compared a standard-model DSME (standard DSME) with a culturally adapted family-model DSME (adapted DSME). Marshallese adults with type 2 diabetes (n = 221) received either standard DSME in a community setting (n = 111) or adapted DSME in a home setting (n = 110). Outcome measures were assessed at baseline, immediately after the intervention, and at 6 and 12 months after the intervention and were examined with adjusted linear mixed-effects regression models. RESULTS: Participants in the adapted DSME arm showed significantly greater declines in mean HbA1c immediately (-0.61% [95% CI -1.19, -0.03]; P = 0.038) and 12 months (-0.77% [95% CI -1.38, -0.17]; P = 0.013) after the intervention than those in the standard DSME arm. Within the adapted DSME arm, participants had significant reductions in mean HbA1c from baseline to immediately after the intervention (-1.18% [95% CI -1.55, -0.81]), to 6 months (-0.67% [95% CI -1.06, -0.28]), and to 12 months (-0.87% [95% CI -1.28, -0.46]) (P < 0.001 for all). Participants in the standard DSME arm had significant reductions in mean HbA1c from baseline to immediately after the intervention (-0.55% [95% CI -0.93, -0.17]; P = 0.005). CONCLUSIONS: Participants receiving the adapted DSME showed significantly greater reductions in mean HbA1c immediately after and 12 months after the intervention than the reductions among those receiving standard DSME. This study adds to the body of research that shows the potential effectiveness of culturally adapted DSME that includes participants' family members.


Assuntos
Diabetes Mellitus Tipo 2/etnologia , Diabetes Mellitus Tipo 2/terapia , Educação de Pacientes como Assunto/métodos , Autogestão/educação , Adolescente , Adulto , Idoso , Arkansas/epidemiologia , Glicemia/análise , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/psicologia , Feminino , Hemoglobina A Glicada/análise , Comportamentos Relacionados com a Saúde/fisiologia , Humanos , Masculino , Micronésia/etnologia , Pessoa de Meia-Idade , Educação de Pacientes como Assunto/estatística & dados numéricos , Autocuidado/métodos , Autocuidado/estatística & dados numéricos , Autogestão/métodos , Autogestão/estatística & dados numéricos , Adulto Jovem
20.
Int J Public Health ; 64(4): 595-601, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30868258

RESUMO

OBJECTIVES: Prevalence rate of diabetes is high among migrants. Whether migrants are correctly addressed to a standard quality of care for diabetes and are properly followed up are the questions addressed by this retrospective cohort study. METHODS: Compliance to one or repeated Guideline Composite Indicator (GCI), a standard process indicator of care quality, was tested in migrants compared to non-migrant Italian residents with diabetes, living in Tuscany Region, Italy, in years 2011-2015. For those with no GCI, the analysis was repeated for the chance of being tested by at least one or more HbA1c measurements. RESULTS: GCI compliance, in a single or repeated manner over time, was significantly less likely by about 15-20% among migrants (n = 3992) compared to non-migrants (n = 130,874), even after fully matching both cohorts. For those with no GCI, being tested by HbA1c was still significantly less likely among migrants. CONCLUSIONS: Being addressed to a standard quality of care is impaired among migrant patients with diabetes living in Tuscany compared to non-migrants. Migrants, moreover, have a significantly lower probability of adhering to guidelines or to be tested by HbA1c measurement over time.


Assuntos
Diabetes Mellitus/tratamento farmacológico , Adesão à Medicação/psicologia , Adesão à Medicação/estatística & dados numéricos , Cooperação do Paciente/psicologia , Cooperação do Paciente/estatística & dados numéricos , Migrantes/psicologia , Migrantes/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Autocuidado/psicologia , Autocuidado/estatística & dados numéricos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA