Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.282
Filtrar
2.
Rev Infirm ; 70(269): 24-25, 2021 Mar.
Artigo em Francês | MEDLINE | ID: mdl-33742587

RESUMO

The team of the geriatric department of the Grenoble-Alpes (38) University Hospital Center has created the Accompagner therapeutic education program to meet the needs of patients suffering from neurocognitive disorders in the context of a neurodegenerative disease and their families. Presentation and current organization of the workshops.


Assuntos
Cuidadores , Doenças Neurodegenerativas , Educação de Pacientes como Assunto , Idoso , Cuidadores/educação , França , Hospitais Universitários , Humanos , Doenças Neurodegenerativas/terapia
3.
Medicine (Baltimore) ; 100(4): e24154, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33530205

RESUMO

ABSTRACT: This study intended to discover the effect of education and muscle relaxation (EMR) program on anxiety, depression and care burden among caregivers of acute stroke survivors.This randomized, controlled study enrolled a total of 110 caregivers of first-ever acute stroke patients, and randomly assigned to EMR (N = 55) and control (N = 55) groups. The caregivers in the EMR group received 12-month health education and progressive muscle relaxation, and those in control group were provided common rehabilitation advices. Hospital Anxiety and Depression Scale (HADS) and Zarit Caregiver Burden Scale in caregivers were evaluated at the time of patients' discharge from hospital (M0), then at month(M) 3, M6 and M12 after the discharge.HADS-anxiety score, anxiety rate and severity were similar at M0, M3, while were reduced at M6 and M12 in EMR group compared to control group. Furthermore, HADS-depression score was similar at M0 and M3 but was decreased at M6 and M12 in EMR group compared with control group, however, there was no difference of depression rate and severity between the 2 groups at each time point. Moreover, Zarit Caregiver Burden Scale score was similar at M0 and M3, but was decreased at M6 and M12; meanwhile, degree of care burden was similar at M0, M3 and M6, but was reduced at M12 in EMR group compared to control group.EMR program decreases anxiety, depression and care burden in caregivers of acute stroke survivors, suggesting its potential in improving mental health and further promoting quality of lives in these caregivers.


Assuntos
Ansiedade/terapia , Treinamento Autógeno/métodos , Cuidadores/psicologia , Depressão/terapia , Educação em Saúde/métodos , Acidente Vascular Cerebral/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Treinamento Autógeno/educação , Cuidadores/educação , Depressão/epidemiologia , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença
4.
Cochrane Database Syst Rev ; 2: CD012006, 2021 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-33625741

RESUMO

BACKGROUND: Pressure ulcers (PUs) are injuries to the skin and underlying tissues that occur most commonly over bony prominences, such as the hips and heels as a result of pressure and shear forces. PUs cause pain, discomfort, longer hospital stays, and decreased quality of life. They are also very costly to treat and consume substantial parts of healthcare budgets. PUs are largely preventable, and education targeted at patients and their carers is considered important. OBJECTIVES: To assess the effects of patient and/or lay carer education on preventing pressure ulceration in at-risk people, in any care setting. SEARCH METHODS: In June 2019 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase; Ovid PsycINFO and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies.  There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA: We included randomised controlled trials (RCTs) that recruited people of any age at risk of pressure ulceration, and RCTs that recruited people who informally care for someone at risk of pressure ulceration. DATA COLLECTION AND ANALYSIS: Two review authors independently performed study selection, data extraction, 'Risk of bias' assessment, and GRADE assessment of the certainty of the evidence. MAIN RESULTS: We included 10 studies with 11 publications (2261 participants analysed). Seven targeted their intervention at people at risk of ulceration and measured outcomes on these at risk people; two targeted those at risk and their family carers and measured outcomes on the at risk people cared for by their families; and one targeted lay carers only and measured outcomes on the at risk people they cared for. There were two main types of interventions: the provision of information on prevention of pressure ulcers, and the use of different types of education programmes. Provision of information on the prevention of pressure ulcers Three studies (237 participants) reported data for this comparison: two provided information directly to those at risk and their carers, and the third provided information to lay carers. As data could not be pooled we present individual study data. The evidence for primary outcomes is of very low certainty (downgraded twice for study limitations and twice for imprecision). We are uncertain whether the combined use of a self-instruction manual and one-to-one patient training and counselling versus a self-instruction manual alone reduces the proportion of at risk people developing a new PU (risk ratio (RR) 0.40, 95% confidence interval (CI) 0.14 to 1.18), or whether carer self-instruction and one-to-one counselling versus self-instruction alone reduces the proportion of at risk people developing a new PU (RR 2.05, 95% CI 0.19 to 21.70). We are uncertain whether the use of home-based training, compared with routine ward-based training, reduces the proportion of at risk people developing a new PU (RR 0.53, 95% CI 0.27 to 1.02). One study explored the secondary outcome patient knowledge of pressure ulcer prevention; however, as usable data were not provided, we were unable to carry out further analysis, and no effect estimate could be calculated. Educational programmes on the prevention of pressure ulcers Seven studies (2024 participants analysed) provided data for this comparison. In all studies the intervention was aimed at people at risk of ulceration. Risk of pressure ulceration One secondary report of an included study reported the primary outcome as time to PU development or occurrence and three studies and one secondary report of an included study reported this as the proportion of at risk people developing a new PU. One study reported the secondary outcome grade of PU and five studies and one secondary report of an included study reported on patient knowledge. There is low certainty evidence of there being no clear difference in the proportion of participants developing a new PU between use of a pressure ulcer prevention care bundle (PUPCB) and standard care: HR 0.58, 95% CI 0.25 to 1.33 (downgraded twice for imprecision). One secondary report of an included study explored whether individualised PU education and monthly structured telephone follow-up reduces the mean time to PU occurrence. Not all participants in this study developed a pressure ulcer, therefore the mean time to pressure ulcer occurrence could not be calculated from the data. We are uncertain whether the following three interventions reduce the proportion of at risk people developing a new PU as we assessed the certainty of evidence as very low: individualised PU education and monthly structured telephone follow-up (RR 0.55, 95% CI 0.23 to 1.30), education delivery (RR 3.57, 95% CI 0.78 to 16.38), (downgraded twice for risk of bias and twice for imprecision); and computerised feedback and one-to-one consultations (no clear data provided), (downgraded twice for risk of bias and once for indirectness). Grade of pressure ulcer There is low certainty evidence that use of a PU prevention care bundle may make no difference to the severity of new PU development when compared with standard care. Patient knowledge We are uncertain whether the following interventions improve patient knowledge: enhanced educational intervention and structured follow-up (mean difference (MD) 9.86, 95% CI 1.55 to 18.17); multi component motivational interviewing/self-management with a multi component education intervention (no clear data provided); Spinal Cord Injury Navigator programme (no clear data provided); individualised PU education and monthly structured telephone follow-up (no clear data provided); computerised feedback (no clear data provided), structured, patient-centric PU prevention education event (MD 30.15, 95% CI 23.56 to 36.74). We assessed the certainty of the evidence for this outcome as low or very low (downgraded for risk of bias, imprecision, or indirectness). AUTHORS' CONCLUSIONS: We are uncertain whether educational interventions make any difference to the number of new PUs that develop, or to patient knowledge based on evidence from the 10 included studies, which we assessed as of low or very low certainty due to problems with risk of bias, serious imprecision and indirectness. The low certainty of evidence means that additional research is required to confirm these results.


Assuntos
Cuidadores/educação , Educação de Pacientes como Assunto/métodos , Lesão por Pressão/prevenção & controle , Intervalos de Confiança , Instalações de Saúde/estatística & dados numéricos , Humanos , Lesão por Pressão/epidemiologia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Risco , Higiene da Pele , Traumatismos da Medula Espinal/complicações , Cicatrização
5.
J Altern Complement Med ; 27(4): 365-372, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33601933

RESUMO

Objectives: Complementary therapy (CT) use is prevalent among individuals living with cancer, who often consult family and friends (i.e., support persons) in making decisions about CT. This study examines the effect of an education seminar for adult cancer patients and support persons on the support persons' use, knowledge, and decision-making processes related to CT. Design: A patient education seminar that included support persons was developed and evaluated as part of a CT decision support research program. Survey data were collected before and after the education seminar to examine its impact on support persons' knowledge and use of CT, as well as their engagement in the CT decision-making process. Setting: The study was conducted in Western Canada. Subjects: 62 adult support persons. Interventions: Participants attended a 4-h CT education seminar at one in four provincial cancer centers. The seminar provided recommendations regarding how to make informed decisions about CT, where to find credible information, and key issues to consider to avoid potential risks of CT use. The evidence related to popular CT was also reviewed. Outcome Measures: The primary outcome was support persons' CT knowledge. Secondary outcomes included CT use, information-seeking behavior, decision self-efficacy, decision conflict, and distress. Results: A significant increase in support persons' CT knowledge was observed, as well as improved confidence in CT decision making. There was no significant difference in participants' CT use following the education seminar. Most indicated they would continue to locate information about CT using the Internet. A significant decrease in support persons' decisional conflict was reported; however, there were no significant change in distress related to CT decision making. Conclusions: This study demonstrates the importance of including support persons in patient education related to CT and the positive impact on their knowledge and treatment decision-making processes. No significant change in CT use, information seeking behavior and distress related to CT decisions, however, was observed in the study.


Assuntos
Cuidadores/educação , Terapias Complementares/educação , Neoplasias/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Tomada de Decisão Clínica , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto
6.
Aten. prim. (Barc., Ed. impr.) ; 53(1): 60-66, ene. 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-200090

RESUMO

OBJETIVO: Evaluar la eficacia de una intervención a cuidadores no profesionales (CNP). DISEÑO: Estudio cuasiexperimental de tipo antes/después, sin grupo control. Emplazamiento: Atención primaria; 5 Zonas Básicas de Salud (ZBS) en Castelló. Período: Entre el mes de enero de 2018 y el mes de enero de 2019. PARTICIPANTES: 72 CNP participantes en una intervención específica de reciente implementación en el Departament de Salut de Castelló. Intervención: Formación a CNP buscando mejorar el conocimiento del cuidado de personas dependientes y facilitando apoyo. Diez sesiones grupales de 120 min. Mediciones principales: Descriptivo sociodemográfico. Comparación de las variables sobrecarga, dolor lumbar (DL), apoyo social y calidad de vida relacionada con la salud (CVRS) antes-después de la intervención. Variable respuesta: sobrecarga del cuidador. Análisis descriptivo y bivariante. RESULTADOS: Todos los CNP presentaban sobrecarga basal (59,93 ± 14,71); el 73,3% manifestaban DL, con un nivel medio de 5,13 ± 2,56 e incapacidad moderada (41,7%). El 50% percibían escaso apoyo social y gran afectación de la CVRS, sobre todo en términos de dolor y ansiedad. Tras la intervención se encontró una mejora significativa (p = 0,004) en el apoyo social, así como cambios positivos de carácter descriptivo en la incapacidad por DL y dimensiones de la CVRS. No se hallaron progresos (p > 0,05) para la presencia y en el nivel de DL, así como en los niveles de sobrecarga. CONCLUSIONES: La intervención resulta efectiva para mejorar el apoyo social percibido. Sin embargo, el escaso impacto sobre otras variables aconseja reconsiderar sus contenidos, así como animar a nuevos estudios prospectivos que puedan ofrecer resultados más alentadores


OBJECTIVE: Evaluate the effectiveness of an intervention to family caregivers. DESIGN: Quasi-experimental study of type before/after, without control group. SETTING: Primary care; 5 primary care centers of Castelló city. Period: Between the month of January 2018 and the month of January 2019. PARTICIPANTS: 72 family caregivers, participants in a specific intervention recently implemented in the Department de Salut de Castelló. Intervention: Training to family caregivers, seeking to improve knowledge of dependent care, and provide support. Ten group sessions of 120 minutes. Principal measurements: Descriptive of sociodemographic data. Comparison of the variables overload, low back pain, social support and health-related quality of life before-after the intervention. Variable response: caregiver overload. Bivariate and multivariate analysis. RESULTS: All family caregivers had baseline overload (59.93 ± 14.71); 73.3% showed low back pain, with an average level of 5.13 ± 2.56 and moderate disability (41.7%). 50% received little social support and a great impact on health-related quality of life, especially in terms of pain and anxiety. After the intervention, there was a significant improvement (P = .004) in social support, as well as positive descriptive changes in disability due to low back pain and health-related quality of life dimensions. No progress was found (P > .05) for the presence and level of low back pain, as well as overload levels. CONCLUSIONS: The resulting effective intervention to improve perceived social support. However, the low impact on other variables suggests reconsidering its contents, as well as encouraging new prospective studies that may offer more encouraging results


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Atenção Primária à Saúde , Educação em Saúde/métodos , Cuidadores/educação , Avaliação de Programas e Projetos de Saúde , Ensaios Clínicos Controlados não Aleatórios como Assunto , Cuidadores/estatística & dados numéricos , Qualidade de Vida , Dor Lombar/prevenção & controle , Apoio Social
7.
Cochrane Database Syst Rev ; 1: CD006440, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33417236

RESUMO

BACKGROUND: Many people with dementia are cared for at home by unpaid informal caregivers, usually family members. Caregivers may experience a range of physical, emotional, financial and social harms, which are often described collectively as caregiver burden. The degree of burden experienced is associated with characteristics of the caregiver, such as gender, and characteristics of the person with dementia, such as dementia stage, and the presence of behavioural problems or neuropsychiatric disturbances. It is a strong predictor of admission to residential care for people with dementia. Psychoeducational interventions might prevent or reduce caregiver burden. Overall, they are intended to improve caregivers' knowledge about the disease and its care; to increase caregivers' sense of competence and their ability to cope with difficult situations; to relieve feelings of isolation and allow caregivers to attend to their own emotional and physical needs. These interventions are heterogeneous, varying in their theoretical framework, components, and delivery formats. Interventions that are delivered remotely, using printed materials, telephone or video technologies, may be particularly suitable for caregivers who have difficulty accessing face-to-face services because of their own health problems, poor access to transport, or absence of substitute care. During the COVID-19 pandemic, containment measures in many countries required people to be isolated in their homes, including people with dementia and their family carers. In such circumstances, there is no alternative to remote delivery of interventions. OBJECTIVES: To assess the efficacy and acceptability of remotely delivered interventions aiming to reduce burden and improve mood and quality of life of informal caregivers of people with dementia. SEARCH METHODS: We searched the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group, MEDLINE, Embase and four other databases, as well as two international trials registries, on 10 April 2020. We also examined the bibliographies of relevant review papers and published trials. SELECTION CRITERIA: We included only randomised controlled trials that assessed the remote delivery of structured interventions for informal caregivers who were providing care for people with dementia living at home. Caregivers had to be unpaid adults (relatives or members of the person's community). The interventions could be delivered using printed materials, the telephone, the Internet or a mixture of these, but could not involve any face-to-face contact with professionals. We categorised intervention components as information, training or support. Information interventions included two key elements: (i) they provided standardised information, and (ii) the caregiver played a passive role. Support interventions promoted interaction with other people (professionals or peers). Training interventions trained caregivers in practical skills to manage care. We excluded interventions that were primarily individual psychotherapy. Our primary outcomes were caregiver burden, mood, health-related quality of life and dropout for any reason. Secondary outcomes were caregiver knowledge and skills, use of health and social care resources, admission of the person with dementia to institutional care, and quality of life of the person with dementia. DATA COLLECTION AND ANALYSIS: Study selection, data extraction and assessment of the risk of bias in included studies were done independently by two review authors. We used the Template for Intervention Description and Replication (TIDieR) to describe the interventions. We conducted meta-analyses using a random-effects model to derive estimates of effect size. We used GRADE methods to describe our degree of certainty about effect estimates. MAIN RESULTS: We included 26 studies in this review (2367 participants). We compared (1) interventions involving training, support or both, with or without information (experimental interventions) with usual treatment, waiting list or attention control (12 studies, 944 participants); and (2) the same experimental interventions with provision of information alone (14 studies, 1423 participants). We downgraded evidence for study limitations and, for some outcomes, for inconsistency between studies. There was a frequent risk of bias from self-rating of subjective outcomes by participants who were not blind to the intervention. Randomisation methods were not always well-reported and there was potential for attrition bias in some studies. Therefore, all evidence was of moderate or low certainty. In the comparison of experimental interventions with usual treatment, waiting list or attention control, we found that the experimental interventions probably have little or no effect on caregiver burden (nine studies, 597 participants; standardised mean difference (SMD) -0.06, 95% confidence interval (CI) -0.35 to 0.23); depressive symptoms (eight studies, 638 participants; SMD -0.05, 95% CI -0.22 to 0.12); or health-related quality of life (two studies, 311 participants; SMD 0.10, 95% CI -0.13 to 0.32). The experimental interventions probably result in little or no difference in dropout for any reason (eight studies, 661 participants; risk ratio (RR) 1.15, 95% CI 0.87 to 1.53). In the comparison of experimental interventions with a control condition of information alone, we found that experimental interventions may result in a slight reduction in caregiver burden (nine studies, 650 participants; SMD -0.24, 95% CI -0.51 to 0.04); probably result in a slight improvement in depressive symptoms (11 studies, 1100 participants; SMD -0.25, 95% CI -0.43 to -0.06); may result in little or no difference in caregiver health-related quality of life (two studies, 257 participants; SMD -0.03, 95% CI -0.28 to 0.21); and probably result in an increase in dropouts for any reason (12 studies, 1266 participants; RR 1.51, 95% CI 1.04 to 2.20). AUTHORS' CONCLUSIONS: Remotely delivered interventions including support, training or both, with or without information, may slightly reduce caregiver burden and improve caregiver depressive symptoms when compared with provision of information alone, but not when compared with usual treatment, waiting list or attention control. They seem to make little or no difference to health-related quality of life. Caregivers receiving training or support were more likely than those receiving information alone to drop out of the studies, which might limit applicability. The efficacy of these interventions may depend on the nature and availability of usual services in the study settings.


Assuntos
/prevenção & controle , Cuidadores/educação , Demência/enfermagem , Afeto , Viés , Cuidadores/psicologia , Família , Acesso aos Serviços de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , Institucionalização/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
8.
JMIR Mhealth Uhealth ; 9(1): e21708, 2021 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-33480852

RESUMO

BACKGROUND: While nonprofessional caregivers often experience a sense of fulfillment when they provide care, there is also a significant risk of emotional and physical burnout. Consequently, this can negatively affect both the caregiver and the person being cared for. Intervention programs can help empower nonprofessional caregivers of people with chronic diseases and develop solutions to decrease the physical and psychological consequences resulting from caregiving. However, most clinically tested intervention programs for nonprofessional caregivers require face-to-face training, and many caregivers encounter obstacles that hinder their participation in such programs. Consequently, it is necessary to design internet-based intervention programs for nonprofessional caregivers that address their needs and test the efficacy of the programs. OBJECTIVE: The aim of this study was to evaluate the effectiveness of a smartphone app-based intervention program to increase positive mental health for nonprofessional caregivers. METHODS: This study was a randomized controlled trial of 3 months' duration. A total of 152 caregivers over 18 years of age with a minimum of 4 months' experience as nonprofessional caregivers were recruited from primary health care institutions. Nonprofessional caregivers were randomized into two groups. In the intervention group, each caregiver installed a smartphone app and used it for 28 days. This app offered them daily activities that were based on 10 recommendations to promote positive mental health. The level of positive mental health, measured using the Positive Mental Health Questionnaire (PMHQ), and caregiver burden, measured using the 7-item short-form version of the Zarit Caregiver Burden Interview (ZBI-7), were the primary outcomes. Users' satisfaction was also measured. RESULTS: In all, 113 caregivers completed the study. After the first month of the intervention, only one factor of the PMHQ, F1-Personal satisfaction, showed a significant difference between the groups, but it was not clinically relevant (0.96; P=.03). However, the intervention group obtained a higher mean change for the overall PMHQ score (mean change between groups: 1.40; P=.24). The results after the third month of the intervention showed an increment of PMHQ scores. The mean difference of change in the PMHQ score showed a significant difference between the groups (11.43; P<.001; d=0.82). Significant changes were reported in 5 of the 6 factors, especially F5-Problem solving and self-actualization (5.69; P<.001; d=0.71), F2-Prosocial attitude (2.47; P<.001; d=1.18), and F3-Self-control (0.76; P=.03; d=0.50). The results of the ZBI-7 showed a decrease in caregiver burden in the intervention group, although the results were inconclusive. Approximately 93.9% (46/49) of the app users indicated that they would recommend the app to other caregivers and 56.3% (27/49) agreed that an extension of the program's duration would be beneficial. CONCLUSIONS: The app-based intervention program analyzed in this study was effective in promoting positive mental health and decreasing the burden of caregivers and achieved a high range of user satisfaction. This study provides evidence that mobile phone app-based intervention programs may be useful tools for increasing nonprofessional caregivers' well-being. The assessment of the effectiveness of intervention programs through clinical trials should be a focus to promote internet-based programs in health policies. TRIAL REGISTRATION: ISRCTN Registry ISRCTN14818443; http://www.isrctn.com/ISRCTN14818443. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12889-019-7264-5.


Assuntos
Cuidadores/educação , Cuidadores/psicologia , Promoção da Saúde/métodos , Saúde Mental/estatística & dados numéricos , Aplicativos Móveis , Motivação , Smartphone , Adulto , Idoso , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Avaliação de Programas e Projetos de Saúde , Qualidade de Vida , Inquéritos e Questionários , Adulto Jovem
9.
J Med Internet Res ; 23(1): e16495, 2021 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-33410759

RESUMO

BACKGROUND: Although web-based psychoeducational programs may be an efficient, accessible, and scalable option for improving participant well-being, they seldom are sustained beyond trial publication. Implementation evaluations may help optimize program uptake, but few are performed. When the US Department of Veterans Affairs (VA) launched the web-based psychoeducational workshop Building Better Caregivers (BBC) for informal caregivers of veterans nationwide in 2013, the workshop did not enroll as many caregivers as anticipated. OBJECTIVE: This study aims to identify the strengths and weaknesses of initial implementation, strategies likely to improve workshop uptake, whether the VA adopted these strategies, and whether workshop enrollment changed. METHODS: We used mixed methods and the Promoting Action on Research Implementation in Health Services (PARIHS) implementation evaluation framework. In stage 1, we conducted semistructured interviews with caregivers, local staff, and regional and national VA leaders and surveys with caregivers and staff. We collected and analyzed survey and interview data concurrently and integrated the results to identify implementation strengths and weaknesses, and strategies likely to improve workshop uptake. In stage 2, we reinterviewed national leaders to determine whether the VA adopted recommended strategies and used national data to determine whether workshop enrollment changed over time. RESULTS: A total of 54 caregivers (n=32, 59%), staff (n=13, 24%), and regional (n=5, 9%) and national (n=4, 7%) leaders were interviewed. We received survey responses from 72% (23/32) of caregivers and 77% (10/13) of local staff. In stage 1, survey and interview results were consistent across multiple PARIHS constructs. Although participants from low-enrollment centers reported fewer implementation strengths and more weaknesses, qualitative themes were consistent across high- and low-enrollment centers, and across caregiver, staff, and leadership respondent groups. Identified strengths included belief in a positive workshop impact and the use of some successful outreach approaches. Implementation weaknesses included missed opportunities to improve outreach and to better support local staff. From these, we identified and recommended new and enhanced implementation strategies-increased investment in outreach and marketing capabilities; tailoring outreach strategies to multiple stakeholder groups; use of campaigns that are personal, repeated, and detailed, and have diverse delivery options; recurrent training and mentoring for new staff; and comprehensive data management and reporting capabilities. In stage 2, we determined that the VA had adopted several of these strategies in 2016. In the 3 years before and after adoption, cumulative BBC enrollment increased from 2139 (2013-2015) to 4030 (2016-2018) caregivers. CONCLUSIONS: This study expands the limited implementation science literature on best practices to use when implementing web-based psychoeducational programs. We found that robust outreach and marketing strategies and support for local staff were critical to the implementation success of the BBC workshop. Other health systems may want to deploy these strategies when implementing their web-based programs.


Assuntos
Cuidadores/educação , Pesquisa sobre Serviços de Saúde/métodos , Ciência da Implementação , Adolescente , Adulto , Humanos , Internet , Pessoa de Meia-Idade , Projetos de Pesquisa , Estados Unidos , United States Department of Veterans Affairs/organização & administração , Veteranos , Adulto Jovem
10.
Am J Nurs ; 121(1): 57-63, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33350702

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. Nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet-Information for Family Caregivers-and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses.


Assuntos
Cuidadores/educação , Hemodiálise no Domicílio/métodos , Serviços Hospitalares de Assistência Domiciliar , Falência Renal Crônica/terapia , Diálise Renal/efeitos adversos , Diálise Renal/métodos , Gerenciamento Clínico , Hemodiálise no Domicílio/educação , Humanos
11.
Artigo em Inglês | MEDLINE | ID: mdl-33322334

RESUMO

INTRODUCTION: In South Africa (SA), home-based carers (HBCs) play a crucial role at the community level for non-communicable diseases (NCDs) including diabetes mellitus (DM) public health care. The work of HBCs requires them to be knowledgeable about diabetes, and lack of knowledge has implications on their roles for the provision of health information and dietary advice. HBCs need to be provided with specific training to develop their knowledge and skills necessary to enable them to provide care to people with diabetes (PWD) because organizations need to benefit from a pool of well-trained HBCs. Therefore, a training program was developed to improve care for chronic conditions based on local needs. AIM: To implement and evaluate the training program for the HBCs for PWD in Ga-Dikgale village. METHODS: HBCs working at Ga- Dikgale villages in four clinics-namely, Dikgale, Seobi Dikgale, Sebayeng, and Makotopong-participated voluntarily. Fifty-five (55) HBCs who attended the training program completed satisfaction survey tools, and furthermore, 45 HBCs completed both pre-training and post-training knowledge questionnaires. Training divided into two sessions which each lasted for two days was conducted. Satisfaction with the training, improvement of knowledge, and perceived impact on daily practice were evaluated using both qualitative and quantitative approaches. RESULTS: Quantitative results indicate that 72% had poor knowledge of pre-training and only 9% post-training. They scored more in a post-test with the following differences: Post-test (mean = 6.00, SD = 1.26); pre-test (mean = 3.31, SD = 1.77). The t-test results indicated the difference to be significant, t = -9.241, p = 0.000. From the qualitative results, the themes that emerged during data analysis from group discussions were HBCs' achievements from the training, challenges related to diabetes and diet, and suggestions for further training. CONCLUSIONS: A context-specific training increased diabetes knowledge among the HBCs for PWD. The results highlighted the importance of training in improving the knowledge of HBCs about the care of PWD. The improvement in diabetes knowledge among HBCs needs to be maintained and sustained to achieve major health benefits for PWD.


Assuntos
Cuidadores/educação , Conhecimentos, Atitudes e Prática em Saúde , Avaliação de Programas e Projetos de Saúde , Diabetes Mellitus/terapia , Humanos , Doenças não Transmissíveis/terapia , África do Sul , Inquéritos e Questionários
12.
Rev. enferm. UERJ ; 28: e44488, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1096023

RESUMO

Objetivo: identificar dúvidas de puérperas e familiares sobre cuidados domiciliares com o recém-nascido de baixo risco e analisar a roda de conversa, mediada por simulador realístico de baixa fidelidade, como uma tecnologia educativa para o preparo de famílias no processo de alta da maternidade. Método: pesquisa qualitativa, incluindo dezenove familiares de recém-nascidos de baixo risco em um hospital municipal de Rio das Ostras, Rio de Janeiro, de maio a outubro de 2018, por entrevista semiestruturada. Dados submetidos à Análise Temática. Resultados: as dúvidas dos familiares versaram sobre cuidados com higiene, alimentação, ambiente, afeto, saúde, sono e doenças. A roda de conversa com simulador de baixa fidelidade foi considerada uma estratégia positiva para mediar o aprendizado. Conclusão: a tecnologia educativa revelou-se útil na instrumentalização de famílias no processo de alta da maternidade, visto que o cuidador fortalece suas potencialidades, retira dúvidas e troca informações e experiências no grupo.


Objective: to identify puerperal and family members' questions about home care with low-risk newborns and to analyze the conversation circle, mediated by a realistic low fidelity simulator, as an educational technology for the preparation of families in the maternity discharge process. Method: qualitative research conducted with nineteen relatives of low-risk newborns in the municipal hospital in Rio das Ostras, Rio de Janeiro, Brazil, from May to October 2018, through semi-structured interview. Data submitted to thematic analysis. Results: the family members' doubts were about care with hygiene, food, environment, affection, health, sleep and diseases. The conversation wheel with low fidelity simulator was considered a positive strategy to mediate learning. Conclusion: the educational technology proved to be useful in the instrumentalization of families in the maternity discharge process, as the caregiver strengthens their potential, removes doubts and exchanges information and experiences in the group.


Objetivo: identificar dudas puerperales y familiares sobre atención domiciliaria con recién nacidos de bajo riesgo y analizar el círculo de conversación, mediado por simulador realista de baja fidelidad, como una tecnología educativa de preparación de familias en el proceso de alta de la maternidad. Método: investigación cualitativa, con diecinueve familiares de recién nacidos de bajo riesgo en un hospital municipal en Río das Ostras, Río de Janeiro, de mayo a octubre de 2018, a través de entrevistas semiestructuradas. Se utilizó a Análisis temático. Resultados: las dudas fueron sobre higiene, alimentación, medio ambiente, afecto, salud, sueño y enfermedades. El círculo de conversación con simulador se consideró una estrategia positiva para mediar en el aprendizaje. Conclusión: la tecnología educativa demostró ser útil en la instrumentalización de familias en el proceso de alta de la maternidad, porque el cuidador fortalece su potencial, elimina dudas e intercambia información y experiencias en el grupo.


Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Alta do Paciente , Recém-Nascido , Família , Cuidadores/educação , Tecnologia Educacional , Assistência Domiciliar/educação , Brasil , Tecnologia Educacional/métodos , Pesquisa Qualitativa , Treinamento por Simulação , Maternidades , Hospitais Municipais
13.
PLoS One ; 15(12): e0244337, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33370370

RESUMO

PURPOSE: The purpose of this study was to examine the effectiveness of an experiential learning program based on Kolb's theory in increasing dementia supporters' motivation and activity involvement within the community. METHOD: In this interventional study, the sample was divided into two groups. The intervention group underwent dementia supporter training and participated in an experiential learning program, which was conducted two weeks after the initial training session. The control group underwent only the dementia supporter training. RESULTS: Kolb's experiential learning model consists of four stages: concrete experience, reflective observation, conceptualization, and active experimentation. A total of 37 and 44 individuals constituted the intervention and control groups, respectively. The Wilcoxon signed-rank test revealed that there was a significant increase in motivation among the intervention group participants, when compared to the control group participants. Moreover, the activity rate was higher among the intervention group participants. DISCUSSION: The experiential learning program was effective in increasing motivation levels and activity involvement among the dementia supporters. CONCLUSIONS: The experiential learning program for dementia supporters can be used to improve other volunteer and professional programs. Moreover, Kolb's theory can be used to support individuals with dementia within the community.


Assuntos
Cuidadores/educação , Cuidadores/psicologia , Demência/psicologia , Aprendizagem Baseada em Problemas/métodos , Idoso , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Motivação , Teoria Psicológica
14.
Medicine (Baltimore) ; 99(50): e23129, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327233

RESUMO

BACKGROUND: Exercise training has a lot of potential benefits for hemodialysis patients. And some guidelines emphasize the importance of exercise for maintenance hemodialysis. However, there are many barriers to encourage hemodialysis patients to increase their level of physical activity. A broader understanding of the specific barriers is needed. METHODS: MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, PubMed, CBM, CNKI, and WangFang will be searched electronically. The Reference lists of included studies will be retrieved manually. If the study is designed with qualitative or mixed methods and directly explores the factors related to the exercise of dialysis patients, the study will be selected. The Critical Appraisal Skills Programme Qualitative Checklist will be applied for the study appraisal. The study search, selection and evaluation of the study will be conducted by 2 independent reviewers. Thematic synthesis will be used for synthesizing the findings of the primary studies. RESULTS: This study will provide a high-quality synthesis to examine the barriers and facilitators affecting exercise in hemodialysis patients from the perspective of patients, caregivers, and health care providers. CONCLUSION: This systematic review will contribute to the in-depth understanding of barriers and facilitators affecting exercise in hemodialysis patients, and improve the prognosis of this population. ETHIC AND DISSEMINATION: The content of this article does not involve moral approval or ethical review because no individual data will be collected. PROSPERO REGISTRATION: CRD42020200278. (https://www.crd.york.ac.uk/prospero/#recordDetails).


Assuntos
Exercício Físico/fisiologia , Diálise Renal/efeitos adversos , Diálise Renal/enfermagem , Cuidadores/educação , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/educação , Humanos , Prognóstico , Pesquisa Qualitativa
15.
Am Psychol ; 75(9): 1376-1388, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33382320

RESUMO

In today's world of global migration and urbanization, millions of children are separated from parents. Their mental health and future competences as citizens depend on the quality of care from foster parents and group home staff in nonparental care settings. Caregivers are challenged by poor work conditions, too many children, and a lack of knowledge about care for traumatized children. How can our profession match this challenge by upscaling interventions? Digital designs for applications of psychology are growing, recently accelerated by the COVID-19 crisis. From 2008, the author developed a blended learning intervention. In partnerships with nongovernmental organizations and government agencies, care recommendations from an international network of researchers are transformed into start-up seminars for staff, followed by a 6-month online classroom education. Students learn and practice how to train local caregiver groups in attachment-based care, using training sessions developed in local languages, adjusted to culture. At present, the author's Fairstart Foundation educated 500 staff from partners in 26 countries, who have trained the caregivers of some 40,000 children. The theoretical, logistic and technical steps from research to daily caregiver-child practices are described, to inspire discussions of how online designs and international partnerships may benefit underserved populations. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Cuidadores/educação , Cuidado da Criança , Criança Abandonada , Educação a Distância , Cuidados no Lar de Adoção , Lares para Grupos , Desenvolvimento de Programas , Trauma Psicológico/enfermagem , Capacitação de Professores , Adulto , Criança , Cuidado da Criança/métodos , Cuidado da Criança/organização & administração , Cuidado da Criança/normas , Cuidado da Criança/estatística & dados numéricos , Criança Abandonada/estatística & dados numéricos , Educação a Distância/métodos , Educação a Distância/organização & administração , Educação a Distância/estatística & dados numéricos , Cuidados no Lar de Adoção/métodos , Cuidados no Lar de Adoção/organização & administração , Cuidados no Lar de Adoção/estatística & dados numéricos , Lares para Grupos/organização & administração , Lares para Grupos/estatística & dados numéricos , Humanos , Cooperação Internacional , Colaboração Intersetorial , Desenvolvimento de Programas/métodos , Desenvolvimento de Programas/normas , Desenvolvimento de Programas/estatística & dados numéricos , Capacitação de Professores/métodos , Capacitação de Professores/organização & administração , Capacitação de Professores/estatística & dados numéricos
16.
Artigo em Inglês | MEDLINE | ID: mdl-33327452

RESUMO

Facilitated self-help and problem-solving strategies can empower and support family carers to cope with caregiving for people with severe mental illnesses. This single-blind multi-site randomised controlled trial examined the effects of a five-month family-facilitated problem-solving based self-learning program (PBSP in addition to usual care), versus a family psychoeducation group program and usual psychiatric care only in recent-onset psychosis, with a six-month follow-up. In each of three study sites (integrated community centres for mental wellness), 114 people with early psychosis (≤5 years illness onset) and their family carers were randomly selected and allocated to one of three study groups (n = 38). Caregiving burden (primary outcome) and patients' and carers' health conditions were assessed at recruitment, and one-month and six-months post-intervention. Overall, 106 (94.7%) participants completed the assigned intervention and ≥1 post-test. Generalised estimating equations and subsequent contrast tests indicated that the PBSP participants showed significantly greater improvements in carers' burden, caregiving experiences and problem-solving ability, and patients' psychotic symptoms, recovery, and duration of re-hospitalisations over the six-month follow-up, compared with the other two groups (moderate to large effect size, η2 = 0.12-0.24). Family-assisted problem-solving based self-learning programs were found to be effective to improve both psychotic patients' and their carers' psychosocial health over a medium term, thus reducing patients' risk of relapse.


Assuntos
Cuidadores , Resolução de Problemas , Instruções Programadas como Assunto , Transtornos Psicóticos , Adaptação Psicológica , Adolescente , Adulto , Cuidadores/educação , Cuidadores/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Instruções Programadas como Assunto/normas , Transtornos Psicóticos/terapia , Método Simples-Cego , Resultado do Tratamento , Adulto Jovem
17.
Psychiatr Pol ; 54(3): 421-436, 2020 Jun 30.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-33038878

RESUMO

SARS-CoV-2 poses a particular risk to the elderly and people with many comorbidities. In the case of people with dementia, the compliance with sanitary recommendations and the necessary physical isolation can have far-reaching negative consequences in terms of limiting the continuation of tailored care, support and treatment. The recommendations related to the SARS-CoV-2 pandemic must take into account not only the medical consequences of lack of access to medical care, but also their long-term effects and the disease progression in accordance with the concept of social health. A plan of action for the psychoeducation of informal carers, adapted to the elderly group (including people with dementia), is also necessary. Prepared under the auspices of the Polish Psychiatric Association, the recommendations for people living alone, with their family and in long-term care facilities are intended to draw attention to key epidemiological issues that can be planned by medical staff within the organization of patient care. However, mental and social needs of patients, whose fulfilment is particularly significant in times of restrictions related to everyday activities, are of equal importance. Further monitoring of the epidemiological situation and scientific reports related to the SARS-CoV-2 pandemic are necessary to verify and update the guidelines.


Assuntos
Betacoronavirus , Cuidadores/estatística & dados numéricos , Infecções por Coronavirus/terapia , Demência/terapia , Pneumonia Viral/terapia , Atividades Cotidianas , Idoso , Cuidadores/educação , Infecções por Coronavirus/epidemiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Polônia , Guias de Prática Clínica como Assunto , Medição de Risco , Isolamento Social , Sociedades Médicas
18.
Enferm. clín. (Ed. impr.) ; 30(5): 326-332, sept.-oct. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-196775

RESUMO

OBJETIVO: El objetivo del estudio fue medir la efectividad de la terapia psicoeducativa en la carga familiar de los pacientes con esquizofrenia paranoide. MÉTODOS: En este estudio se utilizó un diseño de investigación experimental con un grupo de control equivalente que utilizó 84 muestras de asignación aleatoria en un hospital psiquiátrico en Semarang. El instrumento del estudio fue la versión indonesia de la escala de carga del cuidador (CBS). Se utilizó la prueba Mann-Whitney para analizar los datos. RESULTADOS: Los hallazgos obtenidos muestran la efectividad de la terapia psicoeducativa sobre la carga familiar en el grupo experimental en comparación con la terapia estándar en el grupo control (antes: Z=−1,27; p = 0,092; después: Z=−3,47; p = 0,002). CONCLUSIÓN: Concluimos que la terapia psicoeducativa de la familia, como la aplicada en el grupo experimental, puede disminuir la carga familiar en las familias de pacientes con esquizofrenia paranoide. La aplicación de una terapia psicoeducativa familiar puede servir de guía a la enfermera psiquiátrica en la reducción de la carga familiar en el cuidado de pacientes con esquizofrenia paranoide


AIM: The study aimed to measure the effectiveness of psychoeducational therapy on the burden of families of paranoid schizophrenia patients. METHODS: An experimental research design was used in this study with an equivalent control group using 84 random allocation samples at a mental hospital in Semarang. The study instrument was the Indonesian version of the care burden scale (CBS). The Mann-Whitney test was used for the data analysis. RESULTS: The findings obtained show the effectiveness of psychoeducational therapy on family burden in the experimental group as opposed to standard therapy in the control group (before: Z=−1.27; P=.092, and after: Z=−3.47; P=.002). CONCLUSION: We conclude that family psychoeducational therapy, as given to the experiment group, can decrease the family burden for the family of a paranoid schizophrenia patient. The application of family psychoeducational therapy can serve as guidance for the psychiatric nurse in reducing the family burden in the care of patients with paranoid schizophrenia


Assuntos
Humanos , Masculino , Feminino , Esquizofrenia Paranoide/enfermagem , Esquizofrenia Paranoide/terapia , Educação de Pacientes como Assunto/métodos , Resultado do Tratamento , Ajustamento Social , Família/psicologia , Cuidadores/educação , Cuidadores/psicologia , Inquéritos e Questionários
19.
J Cross Cult Gerontol ; 35(4): 479-492, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32821996

RESUMO

Caring for a family member with Alzheimer's disease (AD) or a related dementia is stressful, and this may especially be the case for racial/ethnic minority caregivers. This study examined the feasibility and acceptability of a pilot intervention for Vietnamese American dementia caregivers. A secondary, exploratory aim was to examine post-intervention effects on AD knowledge and psychosocial outcomes. Of the 87 individuals contacted, 32 met inclusion criteria. Of this number, 14 enrolled in the study with 11 caregivers completing the intervention, and 10 of the 11 completing 3-month follow-up data. Caregivers provided positive feedback on the intervention and had higher scores on AD knowledge and self-efficacy in seeking support services post-intervention, with the effect on self-efficacy maintained at 3-month follow-up. Recruitment for the intervention was difficult; however, once caregivers came to the first session, they were engaged and found the classes informative. Recommendations for a future intervention are discussed.


Assuntos
Doença de Alzheimer/enfermagem , Americanos Asiáticos/educação , Cuidadores/educação , Idoso , Idoso de 80 Anos ou mais , Americanos Asiáticos/psicologia , Cuidadores/psicologia , Efeitos Psicossociais da Doença , Demência/enfermagem , Estudos de Viabilidade , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto
20.
Pediatrics ; 146(3)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32817268

RESUMO

BACKGROUND: Although required for healing, sleep is often disrupted during hospitalization. Blood pressure (BP) monitoring can be especially disruptive for pediatric inpatients and has few clinical indications. Our aim in this pilot study was to reduce unnecessary overnight BP monitoring and improve sleep for pediatric inpatients. METHODS: The intervention in June 2018 involved clinician education sessions and updated electronic health record (EHR) orders that enabled the forgoing of overnight BP checks. The postintervention period from July 2018 to May 2019 examined patient-caregiver surveys as outcome measures. These surveys measured inpatient sleep and overnight disruptions and were adopted from validated surveys: the Patient Sleep Questionnaire, expanded Brief Infant Sleep Questionnaire, and Potential Hospital Sleep Disruptions and Noises Questionnaire. Uptake of new sleep-friendly EHR orders was a process measure. Reported patient care escalations served as a balancing measure. RESULTS: Interrupted time series analysis of EHR orders (npre = 493; npost = 1472) showed an increase in intercept for the proportion of patients forgoing overnight BP postintervention (+50.7%; 95% confidence interval 41.2% to 60.3%; P < .001) and a subsequent decrease in slope each week (-0.16%; 95% confidence interval -0.32% to -0.01%; P = .037). Statistical process control of surveys (npre = 263; npost = 131) showed a significant increase in sleep duration for patients older than 2, and nighttime disruptions by clinicians decreased by 19% (P < .001). Annual estimated cost savings were $15 842.01. No major adverse events in patients forgoing BP were reported. CONCLUSIONS: A pilot study combining EHR changes and clinician education safely decreased overnight BP checks, increased pediatric inpatient sleep duration, and reduced nighttime disruptions by clinicians.


Assuntos
Determinação da Pressão Arterial/normas , Criança Hospitalizada , Pessoal de Saúde/normas , Análise de Séries Temporais Interrompida/normas , Melhoria de Qualidade/normas , Sono/fisiologia , Adolescente , Determinação da Pressão Arterial/psicologia , Determinação da Pressão Arterial/tendências , Cuidadores/educação , Cuidadores/normas , Cuidadores/tendências , Criança , Criança Hospitalizada/psicologia , Pré-Escolar , Registros Eletrônicos de Saúde/normas , Registros Eletrônicos de Saúde/tendências , Feminino , Pessoal de Saúde/educação , Pessoal de Saúde/tendências , Humanos , Lactente , Recém-Nascido , Análise de Séries Temporais Interrompida/tendências , Masculino , Projetos Piloto , Estudos Prospectivos , Melhoria de Qualidade/tendências
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...