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1.
Med Clin North Am ; 104(2): 327-343, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32035572

RESUMO

Aging-associated anatomic and physiologic decline begins during the fourth decade of life and progresses over the ensuing decades sometimes to a state of frailty, with the decline amplified when there is deconditioning. Aging-related gait and balance disorders leading to an increased risk of falling can be compensated for with the use of exercise interventions, durable medical equipment, and environmental modifications. Caregiver training is an essential component of geriatric rehabilitation.


Assuntos
Acidentes por Quedas/prevenção & controle , Avaliação Geriátrica/métodos , Doença de Parkinson , Velocidade de Caminhada , Idoso , Cuidadores/educação , Humanos , Doença de Parkinson/diagnóstico , Doença de Parkinson/fisiopatologia , Doença de Parkinson/reabilitação
2.
PLoS One ; 15(1): e0227282, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31961882

RESUMO

BACKGROUND: We aimed to explore clinicians' communication, including the discussion of diagnosis, cause, prognosis and care planning, in routine post-diagnostic testing consultations with patients with Mild Cognitive Impairment (MCI). METHODS: Thematic content analysis was used to analyze audiotaped consultations in which 10 clinicians (eight neurologists and two geriatricians) from 7 memory clinics, disclosed diagnostic information to 13 MCI patients and their care partners. We assessed clinician-patient communication regarding diagnostic label, cause, prognosis and care planning to identify core findings. RESULTS: Core findings were: clinicians 1) differed in how they informed about the MCI label; 2) tentatively addressed cause of symptoms; 3) (implicitly) steered against further biomarker testing; 4) rarely informed about the patient's risk of developing dementia; 5) often informed about the expected course of symptoms emphasizing potential symptom stabilization and/or improvement, and; 6) did not engage in a conversation on long-term (care) planning. DISCUSSION: Clinicians' information provision about the underlying cause, prognosis and implications for long-term (care) planning in MCI could be more specific. Since most patients and care partners have a strong need to understand the patient's symptoms, and for information on the prognosis and implications for the future, clinicians' current approach may not match with those needs.


Assuntos
Disfunção Cognitiva/diagnóstico , Comunicação , Educação de Pacientes como Assunto , Relações Médico-Paciente , Encaminhamento e Consulta , Idoso , Idoso de 80 Anos ou mais , Cuidadores/educação , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Planejamento de Assistência ao Paciente , Prognóstico , Pesquisa Qualitativa , Inquéritos e Questionários
3.
Am J Nurs ; 120(2): 55-60, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31977423

RESUMO

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home.The articles in this new installment of the series provide simple and useful instructions that nurses should reinforce with family caregivers. This article is the second of two that provide an update on urinary incontinence and its management in older adults. It includes an informational tear sheet-Information for Family Caregivers-that contains links to the instructional videos. To use this series, nurses should read the articles first, so they understand how best to help family caregivers, and then encourage caregivers to watch the videos and ask questions. For additional information, see Resources for Nurses.


Assuntos
Cuidadores/educação , Tampões Absorventes para a Incontinência Urinária , Incontinência Urinária/enfermagem , Idoso , Cuidadores/psicologia , Humanos , Tampões Absorventes para a Incontinência Urinária/economia , Relações Enfermeiro-Paciente , Incontinência Urinária/psicologia
4.
Neurology ; 94(5): 217-228, 2020 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-31907286

RESUMO

OBJECTIVE: In the past decade, an increasing number of studies have examined the efficacy of physical therapy interventions in people with Huntington disease (HD). METHODS: We performed a mixed-methods systematic review using Joanna Briggs Institute (JBI) methodology and included experimental and observational study designs. The search resulted in 23 quantitative studies and 3 qualitative studies from which we extracted data using JBI standardized extraction tools. Results of this review suggested that physical therapy interventions may improve motor impairments and activity limitations in people with HD. Here, we expand on the review findings to provide specific recommendations to guide clinical practice. RESULTS: We recommend the following specific physical therapy interventions for people with HD: aerobic exercise (grade A evidence), alone or in combination with resistance training to improve fitness and motor function, and supervised gait training (grade A evidence) to improve spatiotemporal features of gait. In addition, there is weak (grade B) evidence that exercise training improves balance but does not show a reduction in the frequency of falls; inspiratory and expiratory training improves breathing function and capacity; and training of transfers, getting up from the floor, and providing strategies to caregivers for involvement in physical activity in the midstages of HD may improve performance. There is expert consensus for the use of positioning devices, seating adaptations, and caregiver training in late stages of HD. CONCLUSIONS: There is strong evidence to support physical therapy interventions to improve fitness, motor function, and gait in persons with HD.


Assuntos
Doença de Huntington/reabilitação , Modalidades de Fisioterapia , Acidentes por Quedas/prevenção & controle , Exercícios Respiratórios , Cuidadores/educação , Exercício Físico , Humanos , Doença de Huntington/fisiopatologia , Movimentação e Reposicionamento de Pacientes , Guias de Prática Clínica como Assunto , Treinamento de Resistência
5.
Pediatr Emerg Care ; 36(1): 43-49, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895201

RESUMO

OBJECTIVE: This study aimed to determine caregiver's knowledge of appropriate car restraint systems (CRSs) use and compare this with the actual use among children presenting to the pediatric emergency department (PED), and to determine the efficacy of PED-based intervention on improving knowledge. METHODS: We conducted a prospective, intervention study of children (<8 years old) during a 12-month period in the PED. Based on their height and weight, children were assigned to group 1 (rear facing), group 2 (forward facing), or group 3 (booster). Caregivers were surveyed in their baseline CRS knowledge. Certified child passenger safety technicians evaluated each CRS and gave caregivers one-on-one education. Participants were called back to answer a posttest to determine if the information given was retained. RESULTS: Of the 170 children enrolled, 64 (37.6%) were assigned to group 1, 68 (40%) to group 2, and 38 (22.3%) to group 3. Of these, 63% were not aware of the state law regarding CRS use. Among those without a CRS, 18% belonged to group 1, 36% to group 2, and 46% to group 3. Even among those who reportedly had CRS, 13% of children did not have one-on-on inspection. After inspection, 84% of group 1, 71% of group 2, and 70% of group 3 were in the appropriate one. Nearly 45% were not compliant with American Academy of Pediatrics guidelines of children riding in rear-facing CRS until 2 years of age. CONCLUSIONS: A significant proportion of children visiting the PED are not in appropriate CRS, and caretaker knowledge about correct CRS types and installation is poor. Future educational efforts should focus on rear-facing and booster seat age-group children.


Assuntos
Cuidadores/educação , Sistemas de Proteção para Crianças , Serviço Hospitalar de Emergência , Conhecimentos, Atitudes e Prática em Saúde , Lesões Acidentais/prevenção & controle , Adulto , Criança , Pré-Escolar , Feminino , Educação em Saúde , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Pais , Estudos Prospectivos , Análise de Regressão , Segurança , Inquéritos e Questionários , Adulto Jovem
6.
J Nurs Care Qual ; 35(1): 88-94, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30889081

RESUMO

BACKGROUND: Despite the role caregivers play in the delivery of care, the interactions and training methods used with caregivers during an inpatient stay are not clear. PURPOSE: The purpose was to examine interactions and training methods used with caregivers during hospital care. METHODS: A mixed-methods case study was conducted. Observations were summarized and interviews were analyzed using thematic analysis. RESULTS: The frequency of caregiver engagement varied at different points in the care process but was highest among observations during the stay care point. Providers were most commonly using written and verbal instructions to train caregivers. Three themes emerged from the interviews and were described to be both facilitators and barriers to caregiver involvement: experience, time, and relationship. CONCLUSIONS: High-quality person and family-centered care depends upon coordinated efforts among health care systems, providers, patients, and caregivers. Future caregiver initiatives should aim to decrease disengagement, increase assessment, and broaden the use of training methods.


Assuntos
Cuidadores/educação , Família/psicologia , Cuidados de Enfermagem/métodos , Ensino/tendências , Cuidadores/psicologia , Cuidadores/estatística & dados numéricos , Humanos , Entrevistas como Assunto/métodos , Cuidados de Enfermagem/tendências , Pesquisa Qualitativa
7.
Am J Nurs ; 120(1): 57-62, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31880731

RESUMO

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aim to help nurses provide caregivers with the tools they need to manage their family member's health care at home.The articles in this new installment of the series provide simple and useful instructions that nurses should reinforce with family caregivers. This article is the first of two that provide an update on urinary incontinence and its management in older adults. The second article will contain an informational tear sheet-Information for Family Caregivers-that contains links to the instructional videos. To use this series, nurses should read the articles first, so they understand how best to help family caregivers, and then encourage caregivers to watch the videos and ask questions. In this article, the videos can be found in Resources for Nurses.


Assuntos
Cuidadores/educação , Cuidadores/psicologia , Família/psicologia , Cuidados de Enfermagem/normas , Guias de Prática Clínica como Assunto , Incontinência Urinária/enfermagem , Incontinência Urinária/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade
8.
J Clin Psychiatry ; 80(6)2019 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-31846243

RESUMO

​​​​Effective multifactorial management of Alzheimer's disease (AD) requires a triadic alliance of the clinician, the patient, and the patient's family and/or care partner(s). During the evaluation process and when the diagnosis of AD is delivered, these parties must work together to set goals and develop care plans. Care plans should be designed to help the patient maintain safety and autonomy as long as he or she can and, once autonomy is no longer possible, to allow the patient and care partner(s) to experience as much comfort and the best possible quality of life for as long as possible. In this Academic Highlights, faculty members from neurology, psychiatry, neuropsychology, and primary care share their recommendations, supported by current evidence and guidelines, for handling the complexities of providing care for patients with AD.


Assuntos
Doença de Alzheimer/terapia , Adaptação Psicológica , Idoso , Doença de Alzheimer/psicologia , Cuidadores/educação , Cuidadores/psicologia , Inibidores da Colinesterase/uso terapêutico , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/psicologia , Transtornos Cognitivos/terapia , Terapia Combinada , Efeitos Psicossociais da Doença , Feminino , Humanos , Comportamento de Doença , Estilo de Vida , Masculino , Memantina/uso terapêutico , Pessoa de Meia-Idade , Planejamento de Assistência ao Paciente , Equipe de Assistência ao Paciente , Educação de Pacientes como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto
9.
BMC Public Health ; 19(1): 1721, 2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31870334

RESUMO

BACKGROUND: Community acquired pneumonia is responsible for 16% of under 5 mortality in India, probably due to delayed recognition and qualified care seeking. Therefore these deaths could possibly be averted by creating community awareness and promoting care seeking from qualified physicians in the government system. The objective of study was to assess the effectiveness of facility-based and village-based behavior change communication interventions delivered to community using validated information, education and communication materials, along with infrastructural strengthening of health facilities, for change in care seeking from government system for community acquired pneumonia in rural Lucknow, India. METHOD: Community based open labeled behavioral trial in 2 by 2 factorial design was conducted in eight rural blocks of Lucknow, northern India. Trained community health workers conducted Pneumonia Awareness Sessions once a month for the care givers of children using validated information, education and communication materials either at the villages or at government health facilities. Prior infrastructural strengthening of public health facilities was done to provide optimal care to cases. Pre packed pneumonia drug kits were provided which had amoxicillin, paracetamol and an instruction card on their use as well as pictorial representation of danger signs of pneumonia. RESULTS: Study lasted from October 2015 to September 2018. Adherence to conduct of facility-based intervention was 93.0% (279/300) and to village-based intervention was 73.4% (7638/10410). In village-based intervention there was 79.3% (p < 0.0001) increase from a baseline of 3.3% (14/420) and facility-based intervention 68.9% (p = 0.02) increase from a baseline of 5.35% (21/392) in cases of possible pneumonia treated at government health facilities. CONCLUSION: Conduct of structured pneumonia awareness session using validated information, education and communication material at village level with infrastructural strengthening resulted in improved qualified care seeking from government facilities for community acquired pneumonia. TRIAL REGISTRATION: AEARCTR-0003137, retrospectively registered on 10/July/2018.


Assuntos
Infecções Comunitárias Adquiridas/prevenção & controle , Comunicação em Saúde/métodos , Pneumonia/prevenção & controle , Serviços de Saúde Rural , Cuidadores/educação , Cuidadores/psicologia , Pré-Escolar , Agentes Comunitários de Saúde/psicologia , Infecções Comunitárias Adquiridas/mortalidade , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Índia/epidemiologia , Lactente , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , Pneumonia/mortalidade , Avaliação de Programas e Projetos de Saúde
10.
BMC Health Serv Res ; 19(1): 781, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31676005

RESUMO

BACKGROUND: Present demographic trends show a considerable rise in elderly populations with aging disorders, such as dementia. The current article focused on the exploitation of e-learning as an informal support for caregivers of people with dementia and considered its benefits and limitations to provide proper and relevant care for this target group of people as well as maintain the quality of life of their caregivers. METHODS: The methodology of this study is based on a literature review of accessible peer-review articles from three recognized databases: Web of Science, Scopus, and PubMed. The findings of the selected studies were compared and evaluated. RESULTS: The findings showed that e-learning educational programs/courses helped caregivers feel more confident about dementia care, reduced their perceived stress and enhanced their feelings of empathy, understanding and concern. CONCLUSIONS: The findings of this study reveal that the exploitation of e-learning as a support tool, especially for informal caregivers, in the management of dementia may be a promising method, but its implementation requires professional training of informal caregivers in the use of this technology. More evidence-based studies are needed on this topic.


Assuntos
Cuidadores/educação , Cuidadores/psicologia , Instrução por Computador , Demência/terapia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Clin Interv Aging ; 14: 1705-1717, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31686796

RESUMO

Purpose: As an intermediate prodromal stage of dementia, mild cognitive impairment (MCI) causes functional, emotional, and social challenges for both of the person with MCI (PwMCI) and their family caregiver. However, major attention has only been placed on the PwMCI's for cognitive training. This study evaluated a more comprehensive intervention, which integrated both strength-based and empowerment approaches, to address their complex needs in a dyadic fashion. Patients and methods: This randomized controlled trial allocated 103 MCI patient-caregiver dyads to receive a 14-week dyadic strength-based empowerment program (D-StEP-MCI, n=52) or usual care (n=51). The D-StEP-MCI program consisted of group-based session to the PwMCI, home-based dyadic sessions, and telephone follow-up, with the activities supported the care dyads to navigate their own strengths and resources for integration, together with the trained skills, to optimize role and social engagement in everyday life. Dyadic health outcomes in terms of subjective and objective cognitive function, and neuro-psychiatric symptoms of PwMCI, stress in symptom management of their family caregivers, and depression of the dyads were evaluated at baseline, after the D-StEP-MCI and at 3 months thereafter. Results: By using general estimating equation, the D-StEP-MCI significantly improved the cognitive function, subjective memory, and mood status of the PwMCI, and the positive changes were maintained at the 3-month endpoints. It also has significantly positive effects on caregivers' stress in symptom management and level of depression. Conclusion: Our findings showed the health benefit of combining strength-based and empowerment approach in supporting the disease adaptation of PwMCI and caregiver in a dyadic fashion. This study also supports the use of a social interaction approach to optimize the everyday engagement of the PwMCI.


Assuntos
Cuidadores/educação , Disfunção Cognitiva/reabilitação , Afeto , Idoso , Cuidadores/psicologia , Cognição , Disfunção Cognitiva/psicologia , Emoções , Feminino , Humanos , Relações Interpessoais , Masculino , Memória , Pessoa de Meia-Idade
12.
BMC Health Serv Res ; 19(1): 817, 2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31703681

RESUMO

BACKGROUND: This study evaluated the Health Works (HWs) nutritional counselling skills and information shared with caregivers. This was a cross-sectional study in which an observation checklist was used to examine Growth Monitoring and Promotion (GMP) activities and educational/counselling activities undertaken by health workers (HWs) to communicate nutrition information to caregivers, depending on the ages of the children. METHODS: A total number of 528 counselling interactions between health workers and caregivers in 16 Child welfare Clinics (CWCs) in two rural districts in Ghana were observed. Frequencies were presented for the information that was obtained from each caregiver and those that were provided by the HWs during the nutritional counselling sessions. RESULTS: About 95.1 and 61.8% of the caregiver-HW interactions involved mothers of children who were less than 6 months of age and those above 6 months respectively. HWs counselled the caregivers on appropriate nutrition for the child. Health talk messages that were shared with caregivers focused mainly on the importance of attending CWCs and vaccination of children and rarely included any teaching materials. In most of the interactions, HWs made of child's feeding practices the past 1 month; and also did not provide advice on specific issues of IYCF. Nutritional counselling information given for non-breastfeeding children was inadequate and in some cases absent. Little attention was given to the feeding of children with animal products during counselling. CONCLUSION: Generally nutritional information given to caregivers who had children above 6 months was inadequate.


Assuntos
Cuidadores/educação , Bem-Estar da Criança/estatística & dados numéricos , Aconselhamento/normas , Educação em Saúde/normas , Estado Nutricional , Criança , Pré-Escolar , Enfermagem em Saúde Comunitária/normas , Enfermagem em Saúde Comunitária/estatística & dados numéricos , Aconselhamento/estatística & dados numéricos , Estudos Transversais , Feminino , Gana , Educação em Saúde/estatística & dados numéricos , Pessoal de Saúde/educação , Humanos , Lactente , Masculino , Mães/educação , Relações Profissional-Paciente , Saúde da População Rural
13.
Clin Interv Aging ; 14: 1527-1553, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692559

RESUMO

Purpose: There are few interventions on an individual basis to support community-dwelling people with dementia to continue to fulfill their potential in society and to support their informal caregivers via e-Health. This study explored the effectiveness of the individualized Meeting Centers Support Program (iMCSP) consisting of DemenTalent (people with dementia work as volunteers in a society based on their talents), Dementelcoach (telephone coaching), and STAR e-Learning for caregivers, compared to regular MCSP and No day care support. Method: An explorative randomized controlled trial with pre/post measurements (M0-M6) and two groups (iMCSP and regular MCSP). In addition, a comparison was made between iMCSP and a reference No day care control group. Standardized questionnaires were administered on self-esteem, neuropsychiatric symptoms, experienced autonomy and quality of life of the person with dementia, and on caregiver's sense of competence, quality of life, and happiness. Results: The iMCSP interventions resulted in a broader group of participants utilizing the Meeting Centers. Compared to regular MCSP, DemenTalent had a moderate positive effect on neuropsychiatric symptoms, which also proved less severe. Positive affect of participants improved within the DemenTalent and regular MCSP group after six months. Caregivers of DemenTalent participants experienced less emotional impact of neuropsychiatric symptoms. No differences were found in experienced burden, sense of competence, or quality of life in caregivers using iMCSP or regular MCSP. Compared to those receiving No day care support, caregivers of DemenTalent participants and caregivers using Dementelcoach or STAR e-Learning proved happier. Post-hoc analyses, accounting for potential between-group differences in outcome measures at baseline, generally showed results in the same direction. People with dementia and caregivers highly appreciated iMCSP and regular MCSP. Conclusion: iMCSP can be effectively applied as alternative or additional support via regular Meeting Centers for people with dementia and caregivers who prefer individualized activities/support. DemenTalent decreased the severity of neuropsychiatric symptoms of people with dementia and emotional burden of caregivers. All iMCSP interventions tended to result in caregivers being happier compared to those receiving no support. Larger-scale studies are needed to investigate the effect of iMCSP on other domains of quality of life of participants.


Assuntos
Doença de Alzheimer/reabilitação , Cuidadores/psicologia , Hospital Dia/organização & administração , Processos Grupais , Apoio Social , Idoso , Doença de Alzheimer/psicologia , Cuidadores/educação , Instrução por Computador , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Autonomia Pessoal , Qualidade de Vida/psicologia , Inquéritos e Questionários , Revisão da Utilização de Recursos de Saúde
14.
Clin Interv Aging ; 14: 1515-1525, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692560

RESUMO

Introduction: Paternalism, assuming control of aged care, is a widespread orientation in older adults care. Paternalistic attitudes and practices are commonly understood as a threat to the freedom and autonomy of a person, making patients more dependent. Therefore, the reduction of these attitudes and behaviors is a primary goal for any older adult health and social care situation. The aim of this preliminary study is to develop a behavioral intervention to decrease paternalistic behaviors in formal caregivers and to increase those care behaviors which promote autonomy at post-intervention (1 week) and at follow-up (14 weeks). Methods: A sample of 118 professional caregiver volunteers working in day care centers and nursing homes were assigned to quasi-experimental (N=47) and control (N=71) conditions. The intervention consisted of 3 weekly group sessions. Individual and contextual measures were collected: 1) the primary outcome variable was the type of care (paternalistic versus autonomist) measured through the self-report Paternalist/Autonomist Care Assessment (PACA); 2) A 10-item caregiver self-register of paternalistic behaviors was carried out, 3) Finally, in order to assess the potential effects on observed behavior both in caregiver and older adult functioning at a contextual level, the five institutions were assessed through the SERA-RS. Results: Compared with the control group, caregivers in the behavioral intervention group displayed significantly lower paternalistic appraisals at posttest and follow-up. Regarding the intervention group, caregivers at posttest and follow-up showed significantly greater occurrence of autonomist behaviors being promoted and lower paternalistic appraisal. The results regarding the effect on the institutions showed better personnel performance and older adult functioning. Conclusion: Caregivers who followed the intervention learned to better identify older adult needs; although we did not find significant differences in autonomy occurrence compared with the control group, a behavioral intervention may promote more autonomist environments and, therefore, better personnel and older adult functioning.


Assuntos
Terapia Comportamental , Cuidadores/educação , Capacitação em Serviço , Paternalismo , Autonomia Pessoal , Adulto , Centros-Dia de Assistência à Saúde para Adultos , Idoso , Atitude do Pessoal de Saúde , Currículo , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados não Aleatórios como Assunto , Casas de Saúde , Espanha
15.
Artigo em Inglês | MEDLINE | ID: mdl-31590312

RESUMO

Background: The Bishesta campaign is a menstrual hygiene management (MHM) intervention developed to meet the specific needs of people with intellectual impairments and their carers. It was designed and delivered in the Kavre district, Nepal. This paper explores the campaign's feasibility and acceptability. Methods: The Bishesta campaign was delivered to ten people with an intellectual impairment and their eight carers. Data on the feasibility and acceptability of the intervention was collected through: Structured questionnaire to participants before and after the intervention, process monitoring data, post-intervention in-depth interviews with all carers, observation of people with intellectual impairments, key informant interviews with all facilitators and staff involved in the campaign, as well as ranking of the perceived appropriateness and acceptability of campaign components by carers and facilitators. Results: The Bishesta campaign was acceptable for the target groups, facilitators, and implementers. It was largely delivered with fidelity. Participants used most of the campaign components; these made the target behaviours attractive and enabled participants to carry them out with ease. There were improvements across all target behaviours. The focus of this study was feasibility, not limited-efficancy; however, indicative positive outcomes from this small sample were observed, such as an increase in young people's levels of confidence, comfort, and autonomy during menstruation. Conclusion: Within the sample, the Bishesta campaign appears to be a feasible intervention to ensure that one of the groups most vulnerable to exclusion from MHM interventions is not left behind.


Assuntos
Cuidadores/educação , Educação de Pessoa com Deficiência Intelectual/organização & administração , Higiene/normas , Menstruação , Adolescente , Analgésicos/uso terapêutico , Países em Desenvolvimento , Estudos de Viabilidade , Feminino , Produtos de Higiene Feminina , Humanos , Nepal , Adulto Jovem
17.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(5): 1194-1201, out.-dez. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1022257

RESUMO

Objetivo: Analisar o conhecimento de cuidadores de pacientes com câncer gástrico, identificar os principais fatores de risco em cuidadores e propor ações de educação em saúde junto aos cuidadores sobre o câncer gástrico. Método: Estudo descritivo do tipo qualitativo. A coleta de dados foi realizada por meio da entrevista semiestruturada com cuidadores de pacientes com câncer gástrico. A análise dos dados deu-se por meio da análise de conteúdo de Bardin. Resultados: Os entrevistados possuíam conhecimento insuficiente sobre a prevenção do câncer gástrico, levando a aquisição de hábitos não saudáveis, que comprometem a saúde. Conclusão: É necessário a implementação de ações educativas em todos os níveis de atenção a saúde e cabe aos profissionais a difusão de conhecimentos sobre o assunto e aos usuários a mudança de comportamentos que gerem saúde e o abandono de hábitos que contribuam para a aquisição de doenças


Objective: The study's purpose has been to scrutinize the knowledge of caregivers of patients bearing gastric cancer, to identify the main risk factors in caregivers and to propose actions of health education among caregivers regarding the gastric cancer. Methods: It is a descriptive study with a qualitative approach. Data collection was carried out through a semi-structured interview with caregivers of patients with gastric cancer. Data analysis was performed according to Bardin's perspective. Results: The interviewees had insufficient knowledge about the prevention of gastric cancer, then leading to unhealthy habits that compromise their health. Conclusion: It is necessary to implement educational engagement at all levels of health care, furthermore, it is the responsibility of professionals to disseminate knowledge about the subject, as well as it is up to users to choose behaviors that produce health rather than habits that lead to illnesses


Objetivo: Analizar el conocimiento de cuidadores de pacientes con cáncer gástrico, identificar los principales factores de riesgo en cuidadores y proponer acciones de educación en salud junto a los cuidadores sobre el cáncer gástrico. Método: Estudio descriptivo del tipo cualitativo. La recolección de datos fue realizada por medio de la entrevista semiestructurada con cuidadores de pacientes con cáncer gástrico. El análisis de los datos se dio a través del análisis de contenido de Bardin. Resultados: Los entrevistados poseían conocimiento insuficiente sobre la prevención del cáncer gástrico, llevando la adquisición de hábitos no saludables, que comprometen la salud. Conclusión: Es necesario la implementación de acciones educativas en todos los niveles de atención a la salud y corresponde a los profesionales la difusión de conocimientos sobre el tema y los usuarios el cambio de comportamientos que generan salud y el abandono de hábitos que contribuyan a la adquisición de enfermedades


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Neoplasias Gástricas , Cuidadores/educação , Prevenção Secundária/educação , Brasil , Conhecimentos, Atitudes e Prática em Saúde , Educação em Saúde
18.
Home Healthc Now ; 37(5): 273-280, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31483359

RESUMO

Family caregivers can benefit from education-based wellness programs, but many face barriers to attending such programs. The purpose of this research was to explore telehealth as a delivery format for an education-based caregiver wellness program. This qualitative research examined the caregiver experience of a specific program called Powerful Tools for Caregivers (PTC). The traditionally in-person program was delivered via telehealth in four states. Twelve caregivers participated in focus groups the week after completing the telehealth PTC program. Three major themes emerged from the focus groups: Knowledge Gained, Interrelatedness, and Technology Pros and Cons. All affirmed a positive experience of the telehealth delivered PTC program. Participants expressed gratitude for the opportunity to participate in the program and knowledge gained including relaxation techniques, communication skills, resources to support caregiving, and goal setting for self-care. Furthermore, participants were appreciative of the opportunity to connect with other caregivers from the comfort of their home.


Assuntos
Cuidadores/educação , Promoção da Saúde , Acesso aos Serviços de Saúde , Telemedicina/métodos , Adulto , Idoso , Feminino , Grupos Focais , Promoção da Saúde/organização & administração , Humanos , Masculino , Pessoa de Meia-Idade
19.
Res Dev Disabil ; 94: 103458, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31525613

RESUMO

BACKGROUND: People with intellectual disabilities (ID) are usually cared for by their own parents, families or informal caregivers. Caring for a person with ID can have a negative impact on caregivers' mental health (burden, depression, anxiety). The main aim of the EDUCA-IV trial was testing the efficacy of a psychoeducational intervention program (PIP) versus standard practice and to see whether the PIP intervention would reduce the caregiver's burden at post-intervention (4 months) and at follow-up (8 months). METHOD: This was a multi-centre randomised controlled trial including 194 caregivers (96 randomised to PIP, 98 to control condition). PIP intervention consists of 12 weekly group sessions. The control group received treatment as usual. Primary outcomes measured included the Zarit Burden Interview (ZBI). Secondary outcomes were caregivers' mental health (GHQ-28), anxiety (STAI) and depression (CES-D). RESULTS: The decrease of ZBI scores was not significant at 4 months. There was significant decrease in the GHQ scores at 4 and 8 months. CES-D showed relevant results at follow-up. Intention to treat analyses showed similar results. CONCLUSIONS: The PIP intervention seems not to be effective reducing burden, but appears to have a positive result on general mental health. The program was well received and valued by caregivers.


Assuntos
Adaptação Psicológica , Ansiedade , Cuidadores , Depressão , Educação em Saúde/métodos , Deficiência Intelectual/psicologia , Qualidade de Vida , Adulto , Ansiedade/etiologia , Ansiedade/psicologia , Cuidadores/educação , Cuidadores/psicologia , Efeitos Psicossociais da Doença , Depressão/etiologia , Depressão/psicologia , Feminino , Humanos , Análise de Intenção de Tratamento , Masculino , Saúde Mental , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia
20.
J Autism Dev Disord ; 49(12): 4867-4876, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31485815

RESUMO

The pediatric developmental passport was created to aid service navigation for children with autism spectrum disorder (ASD). A pilot-randomized-control trial was conducted at two developmental clinics. The intervention group received the Passport card versus the control group who received the placebo card. Primary outcome was the proportion of families who contacted ASD services 1-year following diagnosis. Of 40 families, 95% in the intervention group contacted services versus 70% in the control (p = 0.04). All families at the academic site contacted services; at the community site 90% in the intervention group contacted versus 40% in the control (p = 0.02). The Passport shows promise aiding families of children with ASD in service navigation, particularly at community clinics where specialist follow-up is not readily available.


Assuntos
Transtorno do Espectro Autista/terapia , Terapia Comportamental/métodos , Educação de Pacientes como Assunto/métodos , Participação do Paciente/métodos , Transtorno do Espectro Autista/reabilitação , Cuidadores/educação , Cuidadores/psicologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pais/educação , Pais/psicologia
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