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2.
Indian J Ophthalmol ; 70(6): 2125-2130, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35647997

RESUMO

Purpose: To assess the feasibility of measuring patients' visual acuity (VA) in their homes by their caregivers. Methods: Patients consulting in a tertiary eye care institute were prospectively enrolled with informed consent. All underwent standard COMPlog distance VA testing. Patients and caregivers were oriented to test distance VA using the Peek Acuity app. The app was installed on the caregiver's or patient's smartphone. The patient's VA was measured by the caregiver in the clinic (baseline value) under supervision. After 1 week, the caregivers recorded the patient's VA with the Peek Acuity app at their home and reported the value in a telephone consultation. A questionnaire to assess the ease of using the app was administered at both the baseline visit and 1 week later. Results: A total of 100 patients (age group: 13 to 76 years) and 100 caregivers (age group: 17 to 65 years) participated. VA measurements with the Peek Acuity app were comparable with COMPlog (P > 0.1) both during the baseline and after 1-week measurement, regardless of the underlying ocular condition or educational level of the caregivers/patients. Most caregivers (95%) felt the app was easy to use. Conclusion: Though the Peek Acuity app was originally developed for health care workers to be used in field visits, we found that with proper orientation, the layperson can also use it. Such orientation can enable caregivers to effectively measure VA at home. Such a tool would enhance teleophthalmology consultations and can minimize the need for short follow-up visits.


Assuntos
Oftalmologia , Telemedicina , Adolescente , Adulto , Idoso , Cuidadores , Estudos de Viabilidade , Humanos , Pessoa de Meia-Idade , Encaminhamento e Consulta , Telefone , Acuidade Visual , Adulto Jovem
3.
Am J Occup Ther ; 76(3)2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35648119

RESUMO

IMPORTANCE: Occupational therapy practitioners address the occupational performance and participation needs of people with Parkinson's disease (PD) and their care partners. OBJECTIVE: This Practice Guideline is informed by systematic reviews on the use of occupational therapy interventions to promote participation in occupations for people with PD and to facilitate their caregivers' participation in the caregiver role. This guideline is meant to support practitioners' clinical decision making when working with people with PD and their care partners. METHOD: We examined and synthesized the results of four systematic reviews and integrated those results into clinical recommendations for practice. RESULTS: Thirty-three articles from the systematic reviews served as the basis for the clinical recommendations in this Practice Guideline. Clinical recommendations are provided for interventions that have strong or moderate supporting evidence. CONCLUSION AND RECOMMENDATIONS: Multidisciplinary, tailored, goal-oriented intervention is recommended for people with PD. Various forms of exercise can be used to improve activities of daily living and instrumental activities of daily living performance and social participation, and interventions should incorporate health behavior change techniques to support adequate physical activity levels in daily life. Mindfulness meditation and exercise can be used to support sleep, and task-oriented training can be used to improve performance of specific tasks. Occupational therapy practitioners should incorporate self-management, coaching, compensatory, cognitive-behavioral, and other approaches into multicomponent treatment plans depending on the client's needs and goals. Additional potentially appropriate intervention approaches or areas to address are discussed on the basis of existing or emerging evidence and expert opinion. What This Article Adds: This Practice Guideline provides a summary and applications of the current evidence supporting occupational therapy intervention for people with PD. It includes case examples and suggested decision-making algorithms to support practitioners in addressing client goals.


Assuntos
Terapia Ocupacional , Doença de Parkinson , Atividades Cotidianas , Cuidadores , Humanos , Terapia Ocupacional/métodos , Participação Social
4.
Am J Occup Ther ; 76(3)2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35648120

RESUMO

IMPORTANCE: Although three sensory factors (hyperresponsiveness [HYPO]; hyporesponsiveness [HYPER]; and sensory interests, repetitions, and seeking behaviors [SIRS]) have been demonstrated among a wide age range of clinical populations, they have not been well validated in the general population, especially with a large community sample of young children. OBJECTIVE: To validate the factor structure of the Sensory Experiences Questionnaire (Version 2.1, Short Form; SEQv2.1) in a community sample and to confirm the factor structure's existence in this sample. DESIGN: Caregivers completed the SEQv2.1, a parent-reported questionnaire designed to capture children's everyday sensory experiences. The latent factors of the SEQv2.1 were examined using confirmatory factor analysis. SETTING: North Carolina. PARTICIPANTS: Caregivers of 2,195 children age 3 yr were initially recruited through state birth records and were eligible to participate if the child did not have a history of serious medical problems and English was the family's primary language. OUTCOMES AND MEASURES: SEQv2.1. RESULTS: The SEQv2.1 showed validity in the community sample. Similar to previous research with clinical populations, the three broad patterns of sensory responsiveness were also confirmed in this large community sample of young children, but associations among the factors differed. CONCLUSIONS AND RELEVANCE: Validation of the three-sensory-factor structure in the general population suggests that these constructs are similar to those found with samples of participants with autism spectrum disorder and developmental disabilities. This finding underscores the importance of understanding the normative development of sensory features across a wider age range to better delineate qualitative differences underlying sensory features between clinical and general populations. What This Article Adds: Occupational therapists seeking to assess children's sensory features can use the SEQv2.1 not only with clinical samples but also with children in the general population.


Assuntos
Transtorno do Espectro Autista , Cuidadores , Criança , Pré-Escolar , Deficiências do Desenvolvimento , Família , Humanos , Inquéritos e Questionários
6.
J Psychiatr Res ; 151: 642-648, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35661521

RESUMO

Experience of natural disaster was related to an increased risk of long-term child internalizing problems. Initial traumatic experiences are hypothesized to work as disaster-related stresses and sensitize neural circuitry, leading to heightened reactivity to subsequent stressful experiences, which in turn results in delayed onset of internalizing problems. However, empirical evidence is lacking. Thus, we aimed to examine the association between heart rate variability (HRV) and internalizing problems among children exposed to the disaster. The Great East Japan Earthquake Follow-up for Children (GEJE-FC) study followed children aged 4-6 years old and their siblings and parents from three affected prefectures (Miyagi, Fukushima, and Iwate) and one unaffected prefecture (Mie) in Japan over four periods: from August 2012 to June 2013 (= T1), August 2013 to April 2014 (= T2), July 2014 to December 2014 (= T3), and August 2015 to December 2015 (= T4) (n = 155). HRV was assessed at T2 and T3 as a biomarker of autonomic nervous system activity. Child internalizing problems were assessed by caregivers at T3 and T4, using the Child Behavior Checklist. HRV measurements at T2 were not associated with child internalizing problems at T3. However, HRV in low frequency domains at T3 showed an inverse association with child internalizing problems at T4 (B = -1.72, 95% CI = -3.12 to -0.31). The findings indicated that later exacerbation of internalizing problems could be predicted by dysfunction of autonomic nervous system measured by HRV.


Assuntos
Desastres , Terremotos , Cuidadores , Criança , Pré-Escolar , Frequência Cardíaca , Humanos , Japão/epidemiologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-35702994

RESUMO

OBJECTIVES: This study investigates the stability of neuropsychiatric symptoms (NPS) assessed biweekly using the Neuropsychiatric Inventory (NPI) in a memory clinic population during a 6 week period. METHODS: Twenty-three spousal caregivers (mean [SD] age = 69.7 [8.8], 82.6% female) of 23 patients (43.5% had dementia) completed all assessments. The NPI was assessed four times during 6 weeks. We examined whether NPI domains were present during all four assessments, studied within-person variation for each NPI domain, and calculated Spearman's correlations between subsequent time-points. Furthermore, we associated repeated NPI assessments with repeated measures of caregiver burden to examine the clinical impact of changes in NPI scores over time. RESULTS: The course of NPS was highly irregular according to the NPI, with only 35.8% of the NPI domains that were present at baseline persisted during all 6 weeks. We observed large within-person variation in the presence of individual NPI domains (61.3%, range 37.5%-83.9%) and inconsistent correlations between NPI assessments (e.g., range rs  = 0.20-0.57 for agitation, range rs  = 0.29-0.59 for anxiety). Higher NPI total scores were related to higher caregiver burden (rs  = 0.60, p < 0.001), but changes in NPI total scores were unrelated to changes in caregiver burden (rs  = 0.16, p = 0.20). CONCLUSIONS: We observed strong fluctuations in NPI scores within very short time windows raising the question whether this represents erratic symptoms and/or scores. Further studies are needed to investigate the origins of these fluctuations.


Assuntos
Doença de Alzheimer , Demência , Idoso , Doença de Alzheimer/psicologia , Cuidadores/psicologia , Demência/diagnóstico , Demência/psicologia , Feminino , Humanos , Masculino , Testes Neuropsicológicos
9.
PLoS One ; 17(6): e0269844, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35709164

RESUMO

BACKGROUND: Fever is one of the common clinical symptoms found among children suffering from various illnesses. India carries a substantial burden of febrile illness among under-five children which heighten the risk of malnutrition, mortality and morbidity. This study aims to determine the factors associated with delay in treatment-seeking for fever among under-five children in India. METHODS: A cross-sectional study was carried out using the large-scale nationally representative data from the National Family Health Survey (NFHS-4), conducted in 2015-2016. The data were collected by using four survey questionnaires i.e., Household Questionnaire, Woman's Questionnaire, Man's Questionnaire, and Biomarker Questionnaire. Delay in treatment-seeking was defined as taking a child for treatment after 24 hours of fever onset. Bivariate and multivariate logistic regression models were performed to assess the factors associated with delay in treatment-seeking behaviour for fever in under-five children. RESULTS: In India, 31.12% (n = 7229) of the caregivers sought treatment for children after 24 hours of the onset of fever. Findings show no significant differences in delay in treatment-seeking behaviour by age groups and sex of children. Multivariate analysis revealed that the odds of delay in treatment-seeking behaviour of fever were higher among children from the poorest wealth quintile (AOR: 2.06; 95% CI: 1.85, 2.31), belonging to the scheduled tribe (AOR: 1.35; 95% CI: 1.24, 1.48), children who resided in rural areas (AOR: 1.14; 95% CI: 1.07, 1.22), children from the northeast region (AOR: 1.29; 95% CI: 1.14, 1.46), and children of caregivers who perceived distance to health facilities as a 'big problem' (AOR: 1.16; 95% CI: 1.09, 1.23). CONCLUSION: The study shows a high prevalence of delay in seeking treatment for fever among caregivers of under-five children in India. Delay in seeking treatment is associated with socio-demographic and socio-economic factors. Therefore, there is a need for intensified health promotion programs to sensitize caregivers on the importance of early health-seeking behaviour.


Assuntos
Cuidadores , Aceitação pelo Paciente de Cuidados de Saúde , Criança , Estudos Transversais , Feminino , Febre/diagnóstico , Febre/epidemiologia , Febre/terapia , Inquéritos Epidemiológicos , Humanos , Lactente , Masculino , Fatores Socioeconômicos , Tempo para o Tratamento
10.
PLoS One ; 17(6): e0269961, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35709170

RESUMO

PURPOSE: Stroke is a leading cause of death and disability worldwide. Despite the prevalence and associated burden of post-stroke cognitive impairment, there is uncertainty regarding optimum interventions to improve cognitive function in people post-stroke. The aim of this study is to explore the perspectives of key stakeholders on the design and development of a multidisciplinary intervention to rehabilitate cognitive deficits in people post-stroke. MATERIALS AND METHODS: Audio-recorded, semi-structured interviews were employed with people post-stroke, caregivers, healthcare professionals and academics. All transcribed interviews were exported to NVivo software and analysed using reflexive thematic analysis. RESULTS: Thirty interviews were conducted across stakeholder groups including people post-stroke (n = 10), caregivers (n = 5), healthcare professionals (n = 14) and academics (n = 1). Four themes relevant to the design and development of the intervention were identified (i) engagement in the intervention must be meaningful, (ii) the point of readiness to engage, (iii) a familiar but flexible setting is key (iv) pragmatics of intervention delivery. CONCLUSIONS: These findings present new perspectives across stakeholder groups on the design and delivery of an intervention to rehabilitate cognitive deficits in people post-stroke. Taken together with existing quantitative evidence, these findings will inform the development of a feasibility trial, examining patient and process outcomes, to rehabilitate cognitive deficits post-stroke.


Assuntos
Transtornos Cognitivos , Terapia Ocupacional , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Cuidadores , Cognição , Humanos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/psicologia
11.
BMJ Open ; 12(6): e058326, 2022 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-35710237

RESUMO

BACKGROUND: Guideline developers are encouraged to engage patients, carers and their representatives ('consumers') from diverse backgrounds in guideline development to produce more widely applicable guidelines. However, consumers from diverse backgrounds are infrequently included in guidelines and there is scant research to support guideline developers to do this. OBJECTIVES: To identify principles and approaches to broaden the diversity of consumers engaged in guideline development. DESIGN: Scoping review and semi-structured interviews. METHODS: We conducted comprehensive searches to March 2020 for studies, reports and guidance documents. Inclusion criteria included the terms 'consumer' (patients, carers and their representatives), 'diversity' (defined using the PROGRESS-PLUS mnemonic) and 'consumer engagement' (the active involvement of consumers at any stage of guideline development). We also conducted four interviews with consumers and guideline developers. We used descriptive synthesis to identify themes, and summarised information about implemented approaches used to broaden diversity of consumers in guidelines. RESULTS: From 10 included documents, we identified eight themes. Themes covered general engagement concepts (Respectful partnerships; Recruitment; Expectations, process and review); specific concepts about guideline development group (GDG) engagement (Characteristics of guideline personnel; Consumers' role, characteristics and prominence; Preparing and supporting consumers); and other (non-GDG) approaches (Online methods; Consultations and research-based approaches). The most commonly included PROGRESS-PLUS categories were Disability, Race/culture/ethnicity/language, Place of residence and Other vulnerable (eg, 'disadvantaged groups'). Each theme included the views of both consumers and guideline developers. We found descriptions of 12 implemented engagement approaches to broaden diversity of consumers in guidelines. CONCLUSIONS: Relationship-building, mitigating power imbalances and meeting consumers where they are at underpin our findings. Engaging with diverse groups may require greater attention to building formal, respectful partnerships and employing inclusive engagement methods.


Assuntos
Cuidadores , Humanos
12.
Clin Interv Aging ; 17: 937-946, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35711677

RESUMO

Objective: Accumulating evidence of the effects of dementia caregiving on individuals, society, and health has generated intervention studies to reduce the stress among family caregivers of people with dementia. This study aims to evaluate the effectiveness of a family support program, community-based dementia caregiver intervention (CDCI), among family caregivers of people with dementia compared with a control group (no intervention). Patients and Methods: This study is a quasi-experimental, non-randomized controlled trial conducted in six dementia relief centers of a community healthcare center in Korea. Family caregivers of 83 patients with dementia were recruited; of these 78 were included in the final study, with 40 in the intervention group and 38 in the control group. Analysis of covariance (ANCOVA) was used to compare the mean difference in the scores of the total short-form Zarit Burden Interview (SZBI), personal strain, role strain, depression, and attitude between the groups. Results: Compared with controls, in the intervention group, the adjusted mean score of personal strain (F = 4.353, t = 0.041) and attitude toward dementia (F = 10.284, t = 0.002) differed significantly after the intervention, with a small to moderate effect. There was no significant difference in the total SZBI, role strain, or depression mean score. Conclusion: The findings suggest that CDCI may be an effective intervention strategy to reduce personal strain and enhance the attitudes of family caregivers of people with dementia.


Assuntos
Cuidadores , Demência , Atitude , Fardo do Cuidador , Demência/terapia , Depressão/terapia , Humanos
13.
Front Public Health ; 10: 898042, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35712314

RESUMO

Objectives: The objectives of this study are to: (1) describe communication technology use among paid and unpaid middle-aged and older caregivers of adults 50 and older in a natural (non-experimental) setting; and (2) examine the association between communication technology use, perceived social support, and sense of belonging in this population. Methods: Means and standard deviations, or frequencies and percentages, were used to describe study participants. Chi-square tests or independent sample t-tests were used to compare sociodemographic characteristics, communication technology use, perceived social support, and sense of belonging to the local community between paid and unpaid caregivers. Multivariable regression analysis was performed to predict each outcome (i.e., sense of belonging and social support) based on the use of texting or communication applications. Results: The average age of participants was age 64.2 years, and the majority was female (74.8%) and non-Hispanic White (66.9%). Compared to paid caregivers, unpaid caregivers were older (64.5 vs. 62.2 years, p = 0.022) and a larger proportion were non-Hispanic White (70.8% vs. 47.7%, p < 0.001). Nearly 83% of the study participants reported using texting or communication applications (81.5% among paid caregivers and 83.1% among unpaid caregivers, p = 0.718). After adjusting for caregivers' age, sex, race/ethnicity, and education, a significantly higher sense of belonging was observed among paid caregivers than unpaid caregivers (b = 9.40, p = 0.009). After adjusting for caregivers' age, sex, race/ethnicity, and education, the use of texting or other communication applications significantly increased caregivers' perceived availability of social support (b = 0.35, p = 001). Conclusions: These study results showed a greater sense of belonging to the local community among paid caregivers compared to unpaid caregivers. The use of communication technology was associated with an increased sense of belonging to their local community among paid caregivers, yet the use of communication technology did not contribute to feelings of belonging among unpaid caregivers. In an aging society, both paid and unpaid caregivers are essential elements of the care system. Research is needed to understand the social support needs of paid and unpaid caregivers and the types of interventions to promote social support and community engagement for both groups.


Assuntos
Cuidadores , Apoio Social , Idoso , Comunicação , Emprego , Feminino , Humanos , Pessoa de Meia-Idade , Tecnologia
14.
Palliat Support Care ; 20(3): 334-341, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35713349

RESUMO

OBJECTIVE: Recently, end-of-life preference in palliative care has been gaining attention in Japan. The Ministry of Health, Labor, and Welfare established the Japanese basic policy in November 2018. Patients' decision-making is recommended; however, patients with dementia or other disorders cannot make such decisions by themselves. Thus, healthcare providers may contact surrogates and consider their backgrounds for better decision-making. Hence, the preferences of home caregivers' and geriatric health service facility (GHSF) residents' families on patient life-sustaining treatment (LST) were investigated. METHOD: This cross-sectional study involved home caregivers' and GHSF residents' families in Japan. We distributed 925 self-reported questionnaires comprising items, such as the number of people living together, care duration, comprehension of doctor's explanations, the Patient Health Questionnaire (PHQ)-9 and Short Form (SF)-8, and families' LST preference for patients. RESULTS: In all, 619 valid responses were obtained [242 men and 377 women (309 in the HOME Caregivers Group, response rate = 61.1%; 310 in the GHSF Group, response rate = 74.0%)]. LST preference was significantly associated with sex, the number of people living together, care duration, and comprehension of doctors' explanations in the HOME Caregivers Group but was not significantly associated with the GHSF Group. Furthermore, PHQ-9/SF-8 scores were not significantly associated with LST preference. SIGNIFICANCE OF RESULTS: There were many differences in opinions about LST preference between home caregivers' and GHSF residents' families. The results suggested that the burden of nursing care was greater and harder in home caregiver families, and these factors may be related to the LST preference for a patient.


Assuntos
Serviços de Saúde para Idosos , Assistência Terminal , Idoso , Cuidadores , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos e Questionários
15.
Front Public Health ; 10: 881889, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35692340

RESUMO

The objective of this paper is to provide an overview of the World Health Organization - International Telecommunication Union MyopiaEd programme - a digital message programme targeting education on myopia and its prevention. The development of the MyopiaEd programme included 4 key steps: (1) Conceptualization and consultation with experts in the field of myopia, mHealth and health behavior change; (2) Creation of SMS message libraries and programme algorithm; (3) Review of the message libraries to ensure relevance to the target audience; and (4) Pre-testing amongst end-user groups to ensure that the design of the programme and the message content were understandable. After reviewing the available evidence and considering input of the experts, the aims, end users and key themes of the programme were finalized. Separate SMS-adapted message libraries were developed, reviewed and pre-tested for four target end-user groups; (1) general population involved in the care of children (2) parents or caregivers of children with myopia; (3) adolescents with myopia; and (4) adults with myopia. The message libraries are part of a comprehensive toolkit, developed through a consultative process with experts in digital health, to support implementation within countries. The development of the MyopiaEd programme aims to provide a basis for Member States and other stakeholders to develop, implement and monitor large-scale mHealth programmes. It is aimed at raising awareness of good eye care behaviors and addressing common reasons for non-compliance to spectacle wear. The next steps will involve adapting and evaluating the MyopiaEd programme in selected settings.


Assuntos
Miopia , Telemedicina , Adolescente , Adulto , Cuidadores , Criança , Humanos , Miopia/prevenção & controle , Pais , Organização Mundial da Saúde
16.
BMC Geriatr ; 22(1): 482, 2022 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-35659258

RESUMO

BACKGROUND: Screening is often recommended as a first step in frailty management. Many guidelines call to implicate frailty screening into practice in the primary care setting. However, few countries or organizations implement it. Understanding and clarifying the stakeholders' views and issues faced by the implementation is essential to the successful implementation of frailty screening. However, the systematic review on stakeholders' views of frailty screening in primary care is decidedly limited. Our objective was to explore the perspective of older adults, caregivers, and healthcare providers on frailty screening and determine the enablers and barriers to implementing frailty screening in primary care. METHODS: A systematic search of six databases and other resources was conducted following JBI's three-step search strategy. The search resulted in 7362 articles, of which 97 were identified for further assessment according to the inclusion criteria. After the full-text screening, quality assessment and data extraction were carried out using the tools from Joanna Briggs Institute (JBI). Moreover, reviewers used the approach of meta-aggregative of JBI to analyze data and synthesis the findings. RESULTS: Six studies were included. A total of 63 findings were aggregated into 12 categories and then further grouped into three synthesized findings:1) capacity of healthcare providers and older adults; 2) opportunity in the implementation of frailty screening; 3) motivation in the implementation of frailty screening. These themes can help identify what influences the implementation of screening from the perspective of stakeholders. CONCLUSIONS: This meta-synthesis provides evidence on the barriers and enablers of frailty screening in primary care, from the aspects of psychological, physical, social, material, etc. However, stakeholder perspectives of frailty screening have not been adequately studied. More research and efforts are needed to explore the influencing factors and address the existing barriers.


Assuntos
Cuidadores , Fragilidade , Idoso , Fragilidade/diagnóstico , Pessoal de Saúde , Humanos , Atenção Primária à Saúde , Pesquisa Qualitativa
17.
Fam Syst Health ; 40(2): 225-231, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35666895

RESUMO

INTRODUCTION: Older adults often rely on care partners, such as family and friends, to assist with their health-related needs associated with aging. Care partner burden is associated with higher rehospitalization rates and poorer health outcomes for older adults. This study examines the relationship between 3 types of health care interactions and care partner burden. METHOD: Secondary data analyses using cross-sectional data from the 2017 National Study of Caregiving were conducted. A total of 2,313 care partners (representing approximately 21.2 million) of living Medicare beneficiaries age 65 and older were included in the analyses. Multivariable logistic regression analyses were used to determine the relationship between health care interactions and care partner burden. RESULTS: Care partners with burden were significantly more likely to be female (p = .049); white (p = .011); and a spouse, adult child, or grandchild of the older adult (p < .001). Logistic regression analyses showed that making medical appointments (Adjusted Odds Ratio [AOR] = 1.53, 95% CI: 1.13-2.07) and coordinating care between providers (AOR = 1.72, 95% CI: 1.27-2.32) were significantly associated with care partner burden. DISCUSSION: Care partners of older adults who helped make medical appointments or coordinated care between providers were significantly more likely to report burden compared to those who did not assist with these health care interactions. It is essential that health care systems and providers determine ways to make health care interactions less burdensome for care partners. Care delivery approaches that align with family systems thinking may help reduce care partner burden by strengthening health care interactions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
Fardo do Cuidador , Cuidadores , Medicare , Crianças Adultas , Idoso , Cuidadores/psicologia , Estudos Transversais , Atenção à Saúde , Feminino , Humanos , Masculino , Cônjuges , Estados Unidos
18.
BMC Geriatr ; 22(1): 490, 2022 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-35672662

RESUMO

INTRODUCTION: Informal carers support persons with dementia to live at home, even with deteriorating physical, social and cognitive issues. This study aims to examine the experiences and impact of Assistive Technology (AT) on carers, providing care for a person with dementia. METHODS: This is an explanatory sequential mixed methods study. The quantitative phase was an online and postal survey using the Carers Assistive Technology Experience Questionnaire and Short Form-12 (SF-12) questionnaire, with carers of persons with dementia in the UK, who used AT. The qualitative phase involved in-depth telephone interviews with a purposive sample of survey respondents and was analysed using hermeneutic phenomenology to develop, compare and explain the findings of the survey. RESULTS: The survey included data from 201 carers. Smartphones (45.5%) and tablet computers (45.0%) were the most frequently used AT. Multiple AT were used in the care of persons with dementia predominantly for safety (78.5%), communication (66.0%), and reminders (62.5%). The SF-12 indicated that carers in the 46-65 age group and carers who were not extremely satisfied with AT had lower mental component scores whilst carers who lived with the person with dementia and older carers had lower physical component scores. Twenty-three carers participated in the interviews, and 5 themes with 14 sub-themes were identified. The interviews helped confirm data from the survey on the impact of AT on the physical, mental and social wellbeing of the carers. It helped describe reasons for satisfaction with AT; how AT was used in daily life and strengthened caring relationships and how wider support systems enhanced the care of a person with dementia using AT. CONCLUSIONS: This study describes the use of AT in the real-world context. AT supplements the care provided to people with dementia in the community. Appropriate use, access to AT and abilities of the carer can enhance the support provided through AT to both carers and the person with dementia.


Assuntos
Demência , Equipamentos de Autoajuda , Cuidadores/psicologia , Comunicação , Demência/psicologia , Demência/terapia , Humanos , Inquéritos e Questionários
19.
BMC Geriatr ; 22(1): 500, 2022 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-35689197

RESUMO

BACKGROUND: Physical activity is important to health and wellbeing. People with dementia are less physically active than their cognitively healthy counterparts. Reasons for this are multifaceted, and are thought to be social, psychological, and physiological. People with dementia often use services such as home care, day care centres and nursing home, and according to the stage of disease they are less or more dependent on other people to take part in activities. To develop appropriate services to this patient group, their needs and preferences regarding physical activity must be recognized. The aim of the study was therefore to provide insight into experiences with physical activity in people with dementia. METHODS: The current study is part of a larger research project on needs in people with dementia. The main project included qualitative semi-structured interviews with 35 persons with dementia. 27 of the participants talked about their experience with physical activity. In the current study, the relevant findings on this theme were analysed separately. A phenomenological hermeneutic research design was applied. RESULTS: The analysis revealed three main categories regarding experiences with physical activity. To be physically active provided positive experiences such as feelings of mastering and post-exercise euphoria. To be physically active was meaningful. The daily walk was an important routine to many, and it gave meaningful content to the day. Keeping up with activities confirmed identity. Lastly, to be active was perceived as challenging. Participants described different barriers to being physically active such as a decline of physical function, lack of motivation and being dependent on others to go out. CONCLUSIONS: Many of the participants expressed that being physically active was important to them. It is essential that informal and formal carers are aware of the role physical activity plays in the lives of many people with dementia, so that appropriate measures can be taken to assure continued active living in order to preserve health and quality of life.


Assuntos
Demência , Cuidadores/psicologia , Demência/psicologia , Demência/terapia , Exercício Físico , Humanos , Casas de Saúde , Pesquisa Qualitativa , Qualidade de Vida/psicologia
20.
BMC Health Serv Res ; 22(1): 762, 2022 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-35689281

RESUMO

BACKGROUND: The majority of people with dementia are cared for by their family members. However, family carers are often unprepared for their caring roles, receiving less education and support compared with professional carers. The consequences are their reduced mental and physical health and wellbeing, and that of care recipients. This study protocol introduces the 'Partnership in iSupport program' that includes five interventional components: managing transitions, managing dementia progression, psychoeducation, carer support group and feedback on services. This health services research is built on family carer and dementia care service provider partnerships. The aims of the study are to evaluate the effectiveness, cost-effectiveness and family carers' experiences in the program. METHODS: A multicentre randomised controlled trial will be conducted with family carers of people living with dementia from two tertiary hospitals and two community aged care providers across three Australian states. The estimated sample size is 185 family carers. They will be randomly assigned to either the intervention group or the usual care group. Outcomes are measurable improvements in quality of life for carers and people with dementia, caregiving self-efficacy, social support, dementia related symptoms, and health service use for carers and their care recipients. Data will be collected at three time points: baseline, 6 months and 12 months post-initiation of the intervention. DISCUSSION: This is the first large randomised controlled trial of a complex intervention on health and social care services with carers of people living with dementia in real-world practice across hospital and community aged care settings in three Australian states to ascertain the effectiveness, cost-effectiveness and carers' experiences of the innovative program. We expect that this study will address gaps in supporting dementia carers in health and social care systems while generating new knowledge of the mechanisms of change in the systems. Findings will strengthen proactive health management for both people living with dementia and their carers by embedding, scaling up and sustaining the 'Partnership in iSupport program' in the health and social care systems. TRIAL REGISTRATION: The Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12622000199718 . Registered February 4th, 2022.


Assuntos
Cuidadores , Demência , Idoso , Austrália , Demência/terapia , Família , Humanos , Estudos Multicêntricos como Assunto , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
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