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Medicine (Baltimore) ; 100(32): e26880, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34397904


ABSTRACT: Poor oral hygiene can be potentially life-threatening in inpatients. However, no basic protocol on oral hygiene customized for inpatients exists, and lack of oral care related knowledge, attitude, and skills among caregivers could be detrimental to the general health of patients. This study sought to identify the oral care practices and oral health status of inpatients with varying physical activity limitations in a rehabilitation ward.Sixty-one inpatients in a rehabilitation ward were evaluated for their medical and physical conditions and oral health status. These were assessed using the bedside oral exam, decayed, missing, filled teeth index, plaque index, gingival index, and caries activity test.In total, 40 men and 21 women (mean age, 56.6 years) were included in this study. Among them, 50.8% of the patients could brush their teeth unassisted, whereas 49.2% required assistance from an assistant for oral care. The proportion of patients receiving nasogastric tube feeding was higher in the group that could not provide oral self-care; 36.7% and 33.3% of these patients showed moderate and severe dysfunction, respectively, based on bedside oral exam. Scores for the swallowing, tongue, and total domains of bedside oral exam were poorer for patients who could not provide oral self-care (P < .01). The caries activity test indicated a moderate risk for both groups.Our findings suggest that an oral care protocol that considers the physical activity limitations in inpatients in rehabilitation wards is necessary to minimize negative influences on the systemic health of these patients.

Atividades Cotidianas , Cárie Dentária , Saúde Bucal/normas , Higiene Bucal , Autocuidado , Cuidadores/educação , Cárie Dentária/diagnóstico , Cárie Dentária/prevenção & controle , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Higiene Bucal/educação , Higiene Bucal/métodos , Índice Periodontal , Desempenho Físico Funcional , Centros de Reabilitação/estatística & dados numéricos , República da Coreia/epidemiologia , Autocuidado/métodos , Autocuidado/estatística & dados numéricos
Nutrients ; 13(7)2021 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-34371967


Interventions that address binge eating and food insecurity are needed. Engaging people with lived experience to understand their needs and preferences could yield important design considerations for such interventions. In this study, people with food insecurity, recurrent binge eating, and obesity completed an interview-based needs assessment to learn facilitators and barriers that they perceive would impact their engagement with a digital intervention for managing binge eating and weight. Twenty adults completed semi-structured interviews. Responses were analyzed using thematic analysis. Three themes emerged. Participants shared considerations that impact their ability to access the intervention (e.g., cost of intervention, cost of technology, accessibility across devices), ability to complete intervention recommendations (e.g., affordable healthy meals, education to help stretch groceries, food vouchers, rides to grocery stores, personalized to budget), and preferred intervention features for education, self-monitoring, personalization, support, and motivation/rewards. Engaging people with lived experiences via user-centered design methods revealed important design considerations for a digital intervention to meet this population's needs. Future research is needed to test whether a digital intervention that incorporates these recommendations is engaging and effective for people with binge eating and food insecurity. Findings may have relevance to designing digital interventions for other health problems as well.

Bulimia/psicologia , Bulimia/terapia , Insegurança Alimentar , Obesidade/psicologia , Obesidade/terapia , Design Centrado no Usuário , Adulto , Idoso , Custos e Análise de Custo , Dieta Saudável , Feminino , Acesso aos Serviços de Saúde/economia , Humanos , Masculino , Refeições , Pessoa de Meia-Idade , Motivação , Determinação de Necessidades de Cuidados de Saúde , Educação de Pacientes como Assunto/métodos , Autocuidado/métodos
Health Qual Life Outcomes ; 19(1): 177, 2021 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-34246255


BACKGROUND: Caregivers are major contributor to the self-care of patients with heart failure. The Caregiver Contribution to Self-Care of Heart Failure Index (CC-SCHFI) measures these contributions across three scales: self-care maintenance (symptom monitoring and treatment adherence); self-care management (dealing with symptoms); and confidence in contributing to the self-care (self-efficacy in managing self-care) of patients with heart failure. Informal caregivers play a vital role in supporting family members with heart failure in Thailand, yet no validated tool exists to measure their contribution. We examined the psychometric properties of the CC-SCHFI in a Thai population. METHODS: The CC-SCHFI was translated into Thai using a standard forward and backward translation procedure. A cross-sectional design was used to examine the psychometric properties of the Thai version of the CC-SCHFI in 100 family caregivers of heart failure patients in Southern Thailand. Confirmatory factor analysis was used to assess construct validity, and factor score determinacy coefficients were computed to evaluate internal consistency reliability. RESULTS: The Thai version of the CC-SCHFI demonstrated acceptable internal consistency (composite reliability of each scale ranged from 0.76 to 0.99). Reliability estimates were adequate for each scale (McDonald's omega ranged from 0.75 to 0.96). Confirmatory factor analysis supported the original factor structure of the instrument, with good fit indices for all three scales (comparative fit index = 0.98-1.00; root-mean-square error of approximation = 0.00-0.07). CONCLUSIONS: The Thai version of the CC-SCHFI appears to be a valid and reliable instrument for measuring caregiver contributions to self-care maintenance and self-care management as well as contributing to caregiver confidence in the self-care of Thai heart failure patients.

Cuidadores , Insuficiência Cardíaca/enfermagem , Autocuidado/métodos , Inquéritos e Questionários/normas , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Qualidade de Vida , Reprodutibilidade dos Testes , Tailândia , Traduções
Medicine (Baltimore) ; 100(25): e26349, 2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34160401


BACKGROUND: Functional constipation is a disease with a high incidence, which has a bad effect on general health, mental health, and social functioning. However, current treatment is sometimes unsatisfactory. Acupuncture has been proven effective in some randomized controlled trials. Acupressure is a subtype of acupuncture and can be manipulated by the patients at home. But the evidence is limited now. This study aims to provide some strict evidence for the use of self-administered acupressure in the treatment of functional constipation. METHODS: This 2-armed, parallel, nonspecific controlled, randomized trial will be conducted at The Third Affiliated Hospital of Zhejiang Chinese Medical University in Hangzhou. A total of 154 FC patients will be enrolled into the acupoint group and the sham acupoint group with a ratio of 1:1 into this trial and it will consist of a 2-week run-in period, an 8-week intervention period, and an 8-week follow-up period. The treatment will be done by the patients themselves at home twice a day and they should sign in on the WeChat APP every day to make sure they have done the acupressure. The outcome will also be collected in WeChat APP through the diary and questionnaires. For the one who is unable to use the WeChat, the print edition of the diary and questionnaires are provided and the supervision will be done by the short message. The primary outcome will be the proportion of participants whose CSBM≥3 during week 3 to 10. The secondary outcome will be the proportion of participants whose CSBM ≥3 between 2 groups in week 11 to 18, Spontaneous bowel movements, Bristol Stool Form Scale, Straining severity scores, Patient assessment of constipation quality of life, and Medicine use. DISCUSSION: Acupressure is not an invasive method and can be done by the patient itself at home. We hope this trial will provide credible evidence to the application of self-acupressure for the management of severe chronic functional constipation. TRIAL REGISTRATION: This trial has been registered at the Chinese Clinical Trial Registry (ChiCTR2000038594).

Acupressão/métodos , Constipação Intestinal/terapia , Autocuidado/métodos , Adulto , Doença Crônica/terapia , Constipação Intestinal/diagnóstico , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
Enferm. glob ; 20(62): 531-556, abr. 2021. graf
Artigo em Espanhol | IBECS | ID: ibc-202241


La automedicación forma parte del autocuidado y es considerada como un recurso de salud pública primaria en el sistema de atención de la salud. OBJETIVO: Determinar la prevalencia y patrones de consumo que influyen en la automedicación de los estudiantes de la Universidad del Magdalena. MÉTODOS: El estudio corresponde a una investigación de carácter descriptivo, de corte transversal, y enfoque cuantitativo; la muestra se determinó por conglomerados, conformada por 312 estudiantes activos matriculados en pregrado de la Universidad del Magdalena de la ciudad de Santa Marta. RESULTADOS: La práctica de la automedicación se vio reflejado en un 97%; los motivos por los cuales se automedican los estudiantes tienen relación con la aparición de síntomas tales como el dolor y síntomas gripales, los cuales son tratados a partir del consumo de medicamentos tipo analgésicos, antiinflamatorios, con una prevalencia del 84,26%. El principal motivo para automedicarse se relaciona con la levedad de los sintomas; el consejo de familiares en un 46,87% refleja su fuente de información; existe influencia por la publicidad especialmente televisión e internet; finalmente el 71% tiene conocimiento de las consecuencias que acarrea el automedicarse. CONCLUSIONES: La práctica de la automedicación en la población universitaria es alta; los factores influyentes se relacionan con aparición de sintomas, el consejo de familiares, la influencia de la publicidad, la levedad de los sintomas y la falta de tiempo para visitar al médico

Self-medication is part f self-care and is considered as a primary public health resource in the health care system. OBJECTIVE: To determine the prevalence and consumption patterns that influence the automation of the students of the Universidad del Magdalena. METHODS: The study corresponds to a descriptive cross-sectional and quantitative approach investigation; the sample was determined by conglomerates, made up of 312 active students enrolled in undergraduate studies at the Universidad del Magdalena the city of the Santa Marta. RESULTS: The practice of self-medication was reflected in 97%; the reasons for which the students self-medicate are related to the appearance of symptoms stories, such as pain and flu-like symptoms, which are treated from the consumption at analgesic, anti-inflammatory drugs with prevalence of 84,26%.The main reason for self-medication is related to the mildness of the symptoms; the council of relatives in 46,87% reflects their source of information; there is influence by advertising especially television and internet; finally 71% are aware of the consequences of self-medication. CONCLUSIONS: The practice of self-medication in the University population is high; influencing factors are related to the appearance of symptoms the advice of relatives, the influence of advertising the mildness of symptoms and lack of the time to visit the doctor

Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Automedicação/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Prevalência , Medicamentos sem Prescrição/uso terapêutico , Autocuidado/métodos , Colômbia , 50230 , Estudos Transversais , Análise por Conglomerados , Inquéritos e Questionários
Med Care ; 59(7): 616-621, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33827106


BACKGROUND: Front-line workers (FLW) are at risk for secondary traumatic stress, burnout, and related psychiatric sequelae: depression, anxiety, suicidality, posttraumatic stress disorder, and sleep and substance use disorders. FLW are in need of self-care programs to support their mental health. METHODS: Quasi-experimental study to assess the impact of a simple mental well-being and emotional regulation training, the Community Resiliency Model (CRM), using a convenience sample of FLW. Baseline scores of mental well-being and stress measures were compared with follow-up scores at 3 time points. Outcomes were psychological wellness (World Health Organization-5 Well-being Index); resilience (Connor-Davidson Resilience Scale-10); traumatic stress (Secondary Traumatic Stress Scale); physical symptoms (Somatic Symptom Scale-8). RESULTS: Of the 104 participants who enrolled and attended the CRM training, 73 (70.2%) completed at least 1 posttest. Well-being scores increased at 1 year with a small-moderate effect size (Cohen d=0.32). Resilience scores increased with a small-moderate effect size by 1 year (Cohen d=0.36). Secondary traumatic stress scores declined, with the largest effect at 1 week (Cohen d=0.49). Somatic symptoms decreased at each posttest, with the largest change occurring from baseline to 1 week (d=0.39). Participants reported an awareness of body sensations helped them when overwhelmed as a means of calming themselves. CONCLUSIONS: After a 3-hour CRM training, participants reported improved mental well-being and decreased secondary traumatic stress and somatic symptoms. This simple body awareness intervention may be a good resource during the COVID-19 pandemic.

Pessoal de Saúde/psicologia , Saúde Mental/educação , Atenção Plena/educação , Resiliência Psicológica , Autocuidado/métodos , Adulto , Idoso , Fadiga por Compaixão/prevenção & controle , Feminino , Humanos , Masculino , Sintomas Inexplicáveis , Pessoa de Meia-Idade , Autorrelato , Transtornos Somatoformes/prevenção & controle
Medicine (Baltimore) ; 100(17): e25674, 2021 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-33907136


BACKGROUND: In hyperbaric oxygen therapy (HBOT), a patient is exposed to pure oxygen in a chamber. While HBOT is a long-standing and well-established treatment for a wide variety of medical conditions, one of the main complications is middle ear barotrauma (MEB), which can lead to complaints of ear discomfort, stuffiness or fullness in the ear, and difficulties in equalizing ear pressure. The aim of this study is to evaluate the efficacy of self-acupressure in preventing and reducing the degree of MEB associated with HBOT. METHODS: This is a prospective nonrandomized controlled study. A sample of 152 participants will be assigned to 2 groups in a 1:1 ratio. The participants in the control group will receive conventional Valsalva and Toynbee maneuvers, while those in the experimental group will be given additional self-acupressure therapy. The acupoints used will be TE17 (Yifeng), TE21 (Ermen), SI19 (Tinggong), and GB2 (Tinghui). The Modified Teed Classification, symptoms of MEB, and overall ear discomfort levels will be assessed. Data will be analyzed using the Chi-Squared test or t test. OBJECTIVES: This study aims to evaluate the efficacy of self-acupressure for preventing and reducing the degree of MEB associated with HBOT. TRIAL REGISTRATION: Identifier: NCT04311437. Registered on 17 March, 2020.

Acupressão/métodos , Barotrauma/terapia , Orelha Média/lesões , Oxigenação Hiperbárica/efeitos adversos , Autocuidado/métodos , Pontos de Acupuntura , Adulto , Barotrauma/etiologia , Distribuição de Qui-Quadrado , Feminino , Humanos , Masculino , Estudos Prospectivos , Resultado do Tratamento , Manobra de Valsalva , Adulto Jovem
Br J Community Nurs ; 26(Sup4): S16-S22, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33797940


During the course of the COVID-19 pandemic, lymphoedema and community clinicians have had to modify how they implement intensive treatments for patients with lymphoedema and chronic oedema. Using novel approaches to treat and move patients towards self-management regimes has enabled patients to be in control of their condition, particularly if they are unable to attend normal clinic appointments. This article explores how using Haddenham easywrap instead of time- and resource-intensive bandaging regimes, alongside the Haddenham LymphFlow Advance, as part of self-management programmes, can benefit patients' quality of life, reduce costs and resource use and enable patients to self-manage this long-term chronic condition more effectively.

COVID-19 , Bandagens Compressivas , Atenção à Saúde , Dispositivos de Compressão Pneumática Intermitente , Linfedema/terapia , Drenagem Linfática Manual/métodos , Autocuidado/métodos , Humanos , SARS-CoV-2 , Autogestão
PLoS One ; 16(3): e0247522, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33647039


BACKGROUND: A large body of evidence suggests that self-management interventions (SMIs) may improve outcomes in chronic obstructive pulmonary disease (COPD). However, accurate comparisons of the relative effectiveness of SMIs are challenging, partly due to heterogeneity of outcomes across trials and uncertainty about the importance of these outcomes for patients. We aimed to develop a core set of patient-relevant outcomes (COS) for SMIs trials to enhance comparability of interventions and ensure person-centred care. METHODS: We undertook an innovative approach consisting of four interlinked stages: i) Development of an initial catalogue of outcomes from previous EU-funded projects and/or published studies, ii) Scoping review of reviews on patients and caregivers' perspectives to identify outcomes of interest, iii) Two-round Delphi online survey with patients and patient representatives to rate the importance of outcomes, and iv) Face-to-face consensus workshop with patients, patient representatives, health professionals and researchers to develop the COS. RESULTS: From an initial list of 79 potential outcomes, 16 were included in the COS plus one supplementary outcome relevant to all participants. These were related to patient and caregiver knowledge/competence, self-efficacy, patient activation, self-monitoring, adherence, smoking cessation, COPD symptoms, physical activity, sleep quality, caregiver quality of life, activities of daily living, coping with the disease, participation and decision-making, emergency room visits/admissions and cost effectiveness. CONCLUSION: The development of the COPD COS for the evaluation of SMIs will increase consistency in the measurement and reporting of outcomes across trials. It will also contribute to more personalized health care and more informed health decisions in clinical practice as patients' preferences regarding COPD outcomes are more systematically included.

Cuidadores/psicologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Doença Pulmonar Obstrutiva Crônica/terapia , Autocuidado/métodos , Autogestão/métodos , Atividades Cotidianas , Adulto , Análise Custo-Benefício , Técnica Delfos , Exercício Físico , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Cooperação do Paciente , Qualidade de Vida , Autocuidado/economia , Autogestão/economia , Abandono do Hábito de Fumar , Resultado do Tratamento
Gerokomos (Madr., Ed. impr.) ; 32(1): 26-29, mar. 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-202045


Se presenta el caso de una paciente de 80 años, afectada de una gastroenteritis aguda de 2 semanas de evolución en posible relación con un cuadro viral. La causa principal es la infección transmitida por alimentos y superficies contaminadas, que en personas de edad avanzada supone un riesgo para su vida debido a la deshidratación. Por ello, será fundamental una reposición de líquidos oral e intravenosa, además de una introducción temprana de alimentación sólida. La valoración de las respuestas de la paciente se ha realizado a partir de los requisitos de autocuidado de Dorothea Orem. La evolución ha sido favorable, y en el periodo de una semana se redujeron las deposiciones en frecuencia y características favoreciendo así la restauración de la piel perianal, se sustituyó la fluidoterapia con reposición de electrolitos por hidratación oral, y la dieta astringente pasó a dieta basal, con buena tolerancia

We present here the case of an 80 old female patient, affected by an acute gastroenteritis of two weeks of evolution in possible relation with a viral case. The main cause is infection transmitted by food and contaminated surfaces. Therefore, an oral and intravenous fluid replacement will be essential, as well as an early introduction of solid nutrition. The assessment of the patient's responses was based on the self-care requirements of Dorothea Orem. The evolution has been favorable and in a period of one week the depositions in frequency and characteristics were reduced favoring the restoration of the perianal skin, fluid therapy has been replaced with the replacement of electrolytes by oral hydration, and the astringent diet has passed a basal diet, with good tolerance

Humanos , Feminino , Idoso de 80 Anos ou mais , Gastroenterite/terapia , Hidratação/métodos , Desidratação/terapia , Terapia Nutricional/métodos , Cuidados de Enfermagem/métodos , Gastroenterite/diagnóstico , Autocuidado/métodos , Desequilíbrio Hidroeletrolítico/terapia , Atividades Cotidianas/classificação , Anamnese/métodos
Gerokomos (Madr., Ed. impr.) ; 32(1): 57-62, mar. 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-202050


OBJETIVOS: Identificar el nivel de conocimiento, actitud y práctica orientada a la prevención del pie diabético en personas ingresadas o sus cuidadores principales en la Unidad de Cirugía Vascular. METODOLOGÍA: Se realizó un análisis estadístico descriptivo transversal. Las variables analizadas fueron: conocimiento, actitud y comportamientos relacionados con el cuidado del pie diabético. Desde diciembre de 2016 a diciembre de 2017, un equipo de enfermeras facilitó un cuestionario durante el ingreso de los pacientes en la Unidad de Cirugía Vascular, el cual no se había utilizado anteriormente con población española. RESULTADOS: El tamaño de la muestra se calculó con el objetivo de conseguir 189 personas. Un total de 172 respondió el cuestionario. En la dimensión de conocimiento, la media fue de 6,56 sobre 10 (DE = 2,05). El nivel de conocimiento de un 58,2% fue medio. En la dimensión de actitud, la media fue de 4,42 sobre 5 (DE = 0,95). Un 93% declaró tener actitud favorable hacia el autocuidado de sus pies. En la dimensión de práctica orientada a la prevención, la media fue de 5,45 (DE = 2,55). El 51,5% realizó una práctica media de autocuidado del pie diabético. CONCLUSIONES: Las personas poseían conocimientos medios de los cuidados del pie diabético. Al preguntarles por su actitud, esta fue favorable. Contrasta con el nivel de comportamiento en la práctica de autocuidado, que en la mitad de la muestra fue de carácter medio, repartiendo en partes iguales la buena práctica con la escasa práctica de autocuidado

BACKGROUND: To identify the level of knowledge, attitude and practice oriented to the prevention of diabetic foot in hospitalized persons or their main caregivers in the Vascular Surgery Unit. METHODS: A transversal descriptive statistical analysis was carried out. The variables analyzed were: knowledge, attitude and behavior related to the care of the diabetic foot. A team of six nurses, provided a questionnaire during the period of admission of patients from December 2016 to December 2017, which had not previously been used with Spanish population. RESULTS: The sample size was calculated in order to get 189 people. A total of 172 people answered the questionnaire. In the Knowledge Dimension, the mean was (6.56) out of 10 (SD = 2.05). The level of knowledge of 58.2% was medium. In Attitude, the average was 4.42 out of 5 (SD = 0.95). 93% say they are favorable towards self-care of their feet. In Practice oriented to prevention, the average was 5.45 (SD = 2.55). 51.5% perform an average self-care practice of diabetic foot. CONCLUSIONS: The people in the study had average knowledge of diabetic foot care. When asked about their attitude, this was favorable. It contrasts with the level of behavior in the practice of self-care, which in the middle of the sample was of average character, distributing in equal parts the good practice with the scarce practice of self-care

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Pé Diabético/prevenção & controle , Complicações do Diabetes/epidemiologia , Procedimentos Cirúrgicos Vasculares/métodos , Conhecimentos, Atitudes e Prática em Saúde , Cuidadores/estatística & dados numéricos , Pé Diabético/enfermagem , Autocuidado/métodos , Fragilidade/epidemiologia , Estudos Transversais
Semin Ophthalmol ; 36(4): 310-314, 2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-33689562


Technological advances provide a number of options for glaucoma monitoring outside the office setting, including home-based tonometry and perimetry. This has the potential to revolutionize management of this chronic disease, improve access to care, and enhance patient engagement. Here, we provide an overview of existing technologies for home-based glaucoma monitoring. We also discuss areas for future research and the potential applications of these technologies to telemedicine, which has been brought to the forefront during the ongoing COVID-19 pandemic.

Técnicas de Diagnóstico Oftalmológico/tendências , Glaucoma/diagnóstico , Monitorização Ambulatorial , Telemedicina/tendências , Telemetria/instrumentação , Tecnologia Biomédica/tendências , Glaucoma/fisiopatologia , Humanos , Pressão Intraocular/fisiologia , Oftalmologia/tendências , Autocuidado/métodos , Tomografia de Coerência Óptica/métodos , Tonometria Ocular/métodos , Testes de Campo Visual/métodos
Clín. salud ; 32(1): 37-40, mar. 2021. tab
Artigo em Inglês | IBECS | ID: ibc-201427


There is now substantial evidence that major depressive episodes can be prevented and treated effectively with psychological interventions administered by trained lay and professional providers. There is also evidence that depression can be prevented and treated using self-help digital interventions such as websites and apps, and that their effectiveness increases if these interventions are supported by guides or coaches. In this commentary we describe digital approaches for depression developed and tested across the world by Palo Alto University's Institute for International Internet Interventions for Health. We recommend the creation of digital apothecaries to increase access to in-person interventions by 1) training more providers, and 2) developing tools providers can use to enhance the effectiveness of these interventions, and to provide access to self-help interventions that can be used directly by anyone with 3) either guides or coaches to reduce dropout, or 4) as fully automated interventions

Existen evidencias importantes que demuestran que los episodios depresivos mayores pueden prevenirse y tratarse eficazmente con intervenciones psicológicas administradas tanto por profesionales como por no profesionales debidamente capacitados. También hay evidencia de que la depresión se puede prevenir y tratar mediante intervenciones digitales de autoayuda tales como páginas web y aplicaciones y que su eficacia aumenta si estas intervenciones son apoyadas por guías o coaches. En este comentario describimos enfoques digitales para la depresión desarrollados y probados en todo el mundo por el Instituto de Intervenciones Internacionales en Salud por Internet de la Universidad de Palo Alto. Recomendamos la creación de apotecarias digitales para aumentar el acceso a las intervenciones: 1) capacitando a más proveedores de ayuda y 2) desarrollando herramientas que estos puedan utilizar para mejorar la eficacia de estas intervenciones y para proporcionar acceso a intervenciones de autoayuda que puedan ser utilizadas directamente por cualquier persona con 3) guías o coaches con el objetivo de reducir el abandono o 4) como intervenciones totalmente automatizadas

Humanos , Transtorno Depressivo Maior/prevenção & controle , Transtorno Depressivo Maior/terapia , Psicoterapia/métodos , Internet , Telemedicina/métodos , Autocuidado/métodos , Aplicativos Móveis
J Midwifery Womens Health ; 66(1): 96-100, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33534190


Cannabis is the most commonly used drug during pregnancy in the United States and Canada, and the American College of Obstetricians and Gynecologists recommends that all pregnant individuals be screened for cannabis use and counseled regarding potential adverse health impacts of use. However, those considering or using cannabis during pregnancy report experiencing stigma and lack of information from health care providers and, thus, frequently rely on friends, family, and the internet for information. This article describes 3 types of decisions individuals may be making about cannabis use during pregnancy and suggests approaches health care providers may take to minimize judgment and provide optimal support for informed cannabis use decisions among pregnant individuals. Desistance decisions involve consideration of whether and how to reduce or stop using during pregnancy. Self-treatment decisions are made by those exploring cannabis to help alleviate troublesome symptoms such as nausea or anxiety. Substitution decisions entail weighing whether to use cannabis instead of another substance with greater perceived harms. Health care providers should be able to recognize the various types of cannabis use decisions that are being made in pregnancy and be ready to have a supportive conversation to provide current and evidence-based information to individuals making desistance, self-treatment, and substitution decisions. Individuals making desistance decisions may require support with potential adverse consequences such as withdrawal or return of symptoms for which cannabis was being used, as well as potentially navigating social situations during which cannabis use is expected. Those making self-treatment decisions should be helped to fully explore treatment options for their symptoms, including evidence on risks and benefits. Regarding substitution decisions, health care providers should endeavor to help pregnant individuals understand the available evidence regarding risks and benefits of available options and be open to revisiting the topic over time.

Cannabis/efeitos adversos , Tomada de Decisões , Fumar Maconha/efeitos adversos , Gestantes/psicologia , Ansiedade/terapia , Canadá , Aconselhamento/métodos , Feminino , Pessoal de Saúde , Humanos , Fumar Maconha/psicologia , Tocologia/métodos , Náusea/terapia , Gravidez , Autocuidado/métodos , Estados Unidos