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1.
Rev Lat Am Enfermagem ; 27: e3154, 2019 Aug 19.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31432914

RESUMO

OBJECTIVE: to analyze the metabolic syndrome concept and to identify its essential features, antecedents, and outcomes within the context of nursing. METHOD: conceptual analysis, based on the methodological steps of a model. We carried out an integrative review by accessing four databases online: Medical Literature Analysis and Retrieval System Online, Scientific Electronic Library Online, Latin American and Caribbean Health Sciences Literature, and Índice Bibliográfico Español en Ciencias de la Salud. RESULTS: the essential features most frequently involved the diagnostic criteria of metabolic syndrome. Inadequate nutrition and physical inactivity were highlighted as the most common antecedents of the syndrome, and the outcomes were occurrences of cardiovascular disease and diabetes mellitus type 2. As implication, we highlight relevant empirical data to the broad definition of the concept. CONCLUSION: we could analyze the concept under study regarding essential features, antecedents, and outcomes, operationally defining it as a potential nursing phenomenon, which demands health care focusing on reducing risks and morbidity and mortality for cardiovascular diseases.


Assuntos
Síndrome Metabólica/enfermagem , Enfermagem , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/enfermagem , Doenças Cardiovasculares/prevenção & controle , Humanos , Síndrome Metabólica/complicações , Fatores de Risco
2.
Nursing ; 49(4): 47-49, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30893204

RESUMO

This article provides an integrative review of the literature on long-term opioid use, its effects on the cardiovascular system, and its implications for nurses.


Assuntos
Analgésicos Opioides/efeitos adversos , Doenças Cardiovasculares/induzido quimicamente , Doenças Cardiovasculares/enfermagem , Transtornos Relacionados ao Uso de Opioides/enfermagem , Humanos , Fatores de Tempo
3.
PLoS One ; 14(2): e0212169, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30753213

RESUMO

OBJECTIVE: To explore the experiences of patients at risk for cardiovascular disease in primary care with the Activate intervention in relation to their success in increasing their physical activity. METHODS: A convergent mixed methods study was conducted, parallel to a cluster-randomised controlled trial in primary care, using a questionnaire and semi-structured interviews. Questionnaires from 67 patients were analysed, and semi-structured interviews of 22 patients were thematically analysed. Experiences of patients who had objectively increased their physical activity (responders) were compared to those who had not (non-responders). Objective success was analysed in relation to self-perceived success. RESULTS: The questionnaire and interview data corresponded, and no substantial differences among responders and non-responders emerged. Participating in the intervention increased patients' awareness of their physical activity and their physical activity level. Key components of the intervention were the subsequent support of nurses with whom patients' have a trustful relationship and the use of self-monitoring tools. Patients highly valued jointly setting goals, planning actions, receiving feedback and review on their goal attainment and jointly solving problems. Nurses' support, the use of self-monitoring tools, and involving others incentivised patients to increase their physical activity. Internal circumstances and external circumstances challenged patients' engagement in increasing and maintaining their physical activity. CONCLUSION: Patients experienced the Activate intervention as valuable to increase and maintain their physical activity, irrespective of their objective change in physical activity. The findings enable the understanding of the effectiveness of the intervention and implementation in primary care. TRIAL REGISTRATION: ClinicalTrials.gov NCT02725203.


Assuntos
Doenças Cardiovasculares/terapia , Exercício , Comportamentos Relacionados com a Saúde , Atenção Primária à Saúde , Inquéritos e Questionários , Idoso , Doenças Cardiovasculares/enfermagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
4.
Am J Nurs ; 119(2): 19, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30681472

RESUMO

Editor's note: This is a summary of a nursing care-related systematic review from the Cochrane Library. For more information, see http://nursingcare.cochrane.org.


Assuntos
Determinação da Pressão Arterial/enfermagem , Hipertensão/enfermagem , Hipertensão/prevenção & controle , Doenças Cardiovasculares/enfermagem , Doenças Cardiovasculares/prevenção & controle , Humanos , Revisão Sistemática como Assunto
5.
Crit Care Clin ; 35(1): 169-186, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30447778

RESUMO

Despite improvements in overall graft function and patient survival rates after solid organ transplantation, complications can lead to significant morbidity and mortality. Cardiovascular complications include heart failure, arrhythmias leading to sudden death, hypertension, left ventricular hypertrophy, and allograft vasculopathy in heart transplantation. Neurologic complications include stroke, posterior reversible encephalopathy syndrome, infections, neuromuscular disease, seizure disorders, and neoplastic disease. Acute kidney injury occurs from immunosuppression with calcineurin inhibitors or as a result of graft failure after kidney transplantation. Gastrointestinal complications include infections, malignancy, mucosal ulceration, perforation, biliary tract disease, pancreatitis, and diverticular disease. Immunosuppression can predispose to infections and malignancy.


Assuntos
Enfermagem de Cuidados Críticos/normas , Controle de Infecções/normas , Nefropatias/enfermagem , Transplante de Órgãos/efeitos adversos , Transplante de Órgãos/enfermagem , Cuidados Pós-Operatórios/normas , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/enfermagem , Idoso , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/enfermagem , Feminino , Gastroenteropatias/etiologia , Gastroenteropatias/enfermagem , Humanos , Nefropatias/etiologia , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/etiologia , Doenças do Sistema Nervoso/enfermagem , Guias de Prática Clínica como Assunto
7.
J Clin Nurs ; 28(5-6): 980-986, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30338867

RESUMO

AIMS AND OBJECTIVES: To describe nurses' attitudes, beliefs, and practices regarding sexuality care for patients with cardiovascular disease. BACKGROUND: Limited sexual activity is common among patients with cardiovascular disease, yet assessment of sexuality and counselling is frequently not undertaken by nurses. DESIGN: Cross-sectional study. METHODS: This study recruited 268 cardiac nurses from seven tertiary hospitals in five cities of Henan province. The Sexual Attitudes and Beliefs Survey, along with investigator-developed questions regarding practices and perceived barriers, was administered to the nurses. The STROBE checklist was used to ensure quality reporting during this observational study (see Supporting Information Data S1). RESULTS: The average age of nurses who participated was 31.81 years (SD = 7.41). The average score of Sexual Attitudes and Beliefs Survey was 47.72 (SD = 7.40), indicating moderate attitudinal barriers for nurses to discuss sexual activities with patients. Most nurses (91%) perceived that sexuality was too private to discuss with patients. Only 20% of nurses expressed that they would provide time to discuss sexual concerns with patients. Eighty per cent of nurses revealed that they felt uncomfortable discussing sexuality; moreover, they believed that hospitalised patients were too sick to be engaged in these types of conversations. Additionally, almost 85% of nurses conveyed that they have never conducted discussions regarding sexuality care in patients with cardiovascular disease. The most frequently reported perceived barriers preventing nurses from discussing sexual concerns included fear of offending patients (77.2%), uncertainty of how to communicate with patients (69.4%), feelings of embarrassment (67.5%), lack of safe and private environments (61.9%) and lack of knowledge (54.9%). CONCLUSION: Nurses in this cross-sectional sample rarely discussed sexual concerns with their patients. There were several key barriers identified by nurses regarding providing sexuality care, including personal attitudes and beliefs, limited skills and knowledge, culture and organizational-related barriers. RELEVANCE TO CLINICAL PRACTICE: Targeted training for nurses and creating a culturally safe environment is recommended to improve management of sexuality in patients with CVD.


Assuntos
Doenças Cardiovasculares/enfermagem , Conhecimentos, Atitudes e Prática em Saúde , Recursos Humanos de Enfermagem no Hospital/psicologia , Comportamento Sexual/psicologia , Sexualidade , Adulto , Doenças Cardiovasculares/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Relações Enfermeiro-Paciente , Recursos Humanos de Enfermagem no Hospital/educação , Inquéritos e Questionários
8.
Rev. latinoam. enferm. (Online) ; 27: e3154, 2019. tab, graf
Artigo em Português | LILACS | ID: biblio-1020696

RESUMO

Objetivo analisar o conceito síndrome metabólica e identificar respectivos atributos essenciais, antecedentes e consequentes no contexto da enfermagem. Método análise conceitual, a partir dos passos metodológicos de um modelo. Realizou-se revisão integrativa, por meio de acesso on-line a quatro bases de dados: Medical Literature Analysis and Retrieval System Online, Scientific Electronic Library Online, Literatura Latino-Americana em Ciências da Saúde e Índice Bibliográfico Español en Ciencias de la Salud. Resultados os atributos essenciais mais frequentes envolveram os critérios diagnósticos da síndrome metabólica. Alimentação inadequada e sedentarismo destacaram-se como antecedentes mais comuns da síndrome, e os consequentes foram ocorrências de doenças cardiovasculares e diabetes mellitus tipo 2. Como implicação, tem-se o destaque de relevantes dados empíricos para definição ampla do conceito. Conclusão foi possível analisar o conceito em estudo no que concerne aos atributos essenciais, antecedentes e consequentes, definindo-o operacionalmente como potencial fenômeno de enfermagem que demanda cuidados direcionados para redução do risco e da morbimortalidade por doenças cardiovasculares.


Objective to analyze the metabolic syndrome concept and to identify its essential features, antecedents, and outcomes within the context of nursing. Method conceptual analysis, based on the methodological steps of a model. We carried out an integrative review by accessing four databases online: Medical Literature Analysis and Retrieval System Online, Scientific Electronic Library Online, Latin American and Caribbean Health Sciences Literature, and Índice Bibliográfico Español en Ciencias de la Salud. Results the essential features most frequently involved the diagnostic criteria of metabolic syndrome. Inadequate nutrition and physical inactivity were highlighted as the most common antecedents of the syndrome, and the outcomes were occurrences of cardiovascular disease and diabetes mellitus type 2. As implication, we highlight relevant empirical data to the broad definition of the concept. Conclusion we could analyze the concept under study regarding essential features, antecedents, and outcomes, operationally defining it as a potential nursing phenomenon, which demands health care focusing on reducing risks and morbidity and mortality for cardiovascular diseases.


Objetivo analizar el concepto síndrome metabólica e identificar respectivos atributos esenciales, antecedentes y consecuentes en el contexto de la enfermería. Método análisis conceptual, desde los pasos metodológicos de un modelo. Se realizó la revisión integrativa, por medio de acceso online a cuatro bases de datos: Medical Literature Analysis and Retrieval System Online, Scientific Electronic Library Online, Literatura Latinoamericana en Ciencias de la Salud y Índice Bibliográfico Español en Ciencias de la Salud. Resultados los atributos esenciales más frecuentes involucraron los criterios diagnósticos del síndrome metabólica. Alimentación inadecuada y sedentarismo se destacaron como antecedentes más comunes del síndrome, y los consecuentes fueron ocurrencias de enfermedades cardiovasculares y diabetes mellitus tipo 2. Como implicación, se tiene el destaque de relevantes datos empíricos para la definición amplia del concepto. Conclusión ha sido posible analizar el concepto en estudio en el que concierne a los atributos esenciales, antecedentes y consecuentes, definiéndolo operacionalmente como potencial fenómeno de enfermería que demanda cuidados direccionados para la reducción del riesgo y de la morbimortalidad por enfermedades cardiovasculares.


Assuntos
Humanos , Doenças Cardiovasculares/enfermagem , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/prevenção & controle , Síndrome Metabólica/complicações , Síndrome Metabólica/enfermagem , Fatores de Risco
9.
J Nurs Meas ; 26(3): 470-482, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30593573

RESUMO

BACKGROUND AND PURPOSE:  To examine the co-occurrence of cardiovascular risk factors and cluster subgroups of college students for cardiovascular risks. METHODS: A cross sectional descriptive study was conducted using co-occurrence patterns and hierarchical clustering analysis in 158 college students. RESULTS: The top co-occurring cardiovascular risk factors were overweight/obese and hypertension (10.8%, n = 17). Of the total 34 risk factors that co-occurred, 30 of them involved being overweight/obese. A six-cluster-solution was obtained, two clusters displayed elevated levels of lifetime and 30-year cardiovascular disease risks. CONCLUSIONS: The hierarchical cluster analysis identified that single White males with a family history of heart disease, overweight/obese, hypertensive or diabetes, and occasionally (weekly) consumed red meat, take antihypertensive medication, and hyperlipidemia were considered the higher risk group compared to other subgroups.


Assuntos
Doenças Cardiovasculares/epidemiologia , Análise por Conglomerados , Comportamentos Relacionados com a Saúde , Estudantes , Adolescente , Adulto , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/enfermagem , Estudos Transversais , Feminino , Humanos , Masculino , Nebraska/epidemiologia , Obesidade Pediátrica/complicações , Estudos Prospectivos , Reprodutibilidade dos Testes , Fatores de Risco , Universidades , Adulto Jovem
10.
BMC Fam Pract ; 19(1): 194, 2018 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-30541460

RESUMO

BACKGROUND: Self-management support is widely accepted for the management of chronic conditions. Self-management often requires behaviour change in patients, in which primary care nurses play a pivotal role. To support patients in changing their behaviour, the structured behaviour change Activate intervention was developed. This intervention aims to enhance physical activity in patients at risk for cardiovascular disease in primary care as well as to enhance nurses' role in supporting these patients. This study aimed to evaluate nurses' perceptions towards the delivery and feasibility of the Activate intervention. METHODS: A qualitative study nested within a cluster-randomised controlled trial using semistructured interviews was conducted and thematically analysed. Fourteen nurses who delivered the Activate intervention participated. RESULTS: Three key themes emerged concerning nurses' perceptions of delivering the intervention: nurses' engagement towards delivering the intervention; acquiring knowledge and skills; and dealing with adherence to the consultation structure. Three key themes were identified concerning the feasibility of the intervention: expectations towards the use of the intervention in routine practice; perceptions towards the feasibility of the training programme; and enabling personal development. CONCLUSIONS: Delivering a behaviour change intervention is challenged by the complexity of changing nurses' consultation style, including acquiring corresponding knowledge and skills. The findings have increased the understanding of the effectiveness of the Activate trial and will guide the development and evaluation of future behaviour change interventions delivered by nurses in primary care. TRIAL REGISTRATION: ClinicalTrials.gov NCT02725203 .


Assuntos
Atitude do Pessoal de Saúde , Terapia Comportamental/métodos , Doenças Cardiovasculares/enfermagem , Exercício/fisiologia , Atenção Primária à Saúde/métodos , Pesquisa Qualitativa , Autogestão/métodos , Adulto , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/psicologia , Estudos de Viabilidade , Feminino , Seguimentos , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Comportamento de Redução do Risco , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
11.
Medicine (Baltimore) ; 97(42): e12895, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30335015

RESUMO

After the implementation of a policy differentiating inpatient nursing fees, no study is found in the nursing literature for intensive care unit (ICU) patients admitted with cardiovascular (CV) disease exclusively in Korea. This study investigates the relationship between ICU nurse staffing and 30-day mortality using large representative claim database.National Health Insurance Service-Senior (NHIS-Senior) claim database from 2002 to 2013, which was released by the Korean National Health Insurance Service (KNHIS), was used in this study. We included CV disease inpatients as a primary diagnostic code (I20-I25) who had their ICU utilization records from differentiating inpatient nursing fees code, resulting in 17,081 subjectsAfter adjusting for confounders, the hazard ratio (HR) for 30-day mortality after discharge (HR: 1.177; P: .018) and in-hospital 30-day mortality (HR: 1.145; P: .058) were higher in general hospital (GH) than in tertiary hospital (TH). In GH setting, HR for 30-day mortality after discharge (HR: 1.499; P: .010) and in-hospital 30-day mortality (HR: 1.377; P: .042) were higher in grade 7 to 9 than grade 1 to 2, but not in TH setting.This study shows that ICU nurse staffing related to improved mortality risk in GHs. Therefore, adequate nurse staffing to provide safe and high-quality care can be ensured by continuous monitoring and evaluation of nurse staffing.


Assuntos
Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/enfermagem , Enfermagem de Cuidados Críticos/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Idoso , Enfermagem de Cuidados Críticos/legislação & jurisprudência , Bases de Dados Factuais , Feminino , Implementação de Plano de Saúde , Política de Saúde , Mortalidade Hospitalar , Hospitais Gerais/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde/estatística & dados numéricos , Recursos Humanos de Enfermagem no Hospital/legislação & jurisprudência , Alta do Paciente/estatística & dados numéricos , República da Coreia , Centros de Atenção Terciária/estatística & dados numéricos
14.
J Clin Nurs ; 27(13-14): 2536-2545, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29493835

RESUMO

AIMS AND OBJECTIVES: To determine what is known about hypertension among adults living in Haiti. BACKGROUND: Hypertension is the leading cause of morbidity, the identified cause of heart failure in 45% of patients and is associated with more than 70% of cardiovascular disease-related hospital admissions in Haiti. DESIGN: An integrative review of the literature. METHODS: Searching four databases from 2007 to 2018, Whittemore and Knafl's method was used to review the literature. Three nurse researchers independently reviewed and appraised each publication applying the Johns Hopkins Evidence-based Practice Appraisal tool. RESULTS: Eight publications were identified and appraised for level and quality of evidence. The synthesis of the literature yielded common themes of (i) high prevalence of hypertension among adults living in rural areas, (ii) public health challenges, (iii) lack of knowledge and awareness of hypertension and (iv) barriers to effective treatment. CONCLUSION: Hypertension is a highly prevalent disease in Haiti that is understudied and warrants attention. To better serve this vulnerable population, culturally tailored prevention strategies and disease management programmes are recommended. RELEVANCE TO CLINICAL PRACTICE: There is a lack of quality evidence to guide nurses in the management of hypertension for this vulnerable population. Identification of barriers to effective treatment among this underserved population will assist nurses and other healthcare professionals in identifying best possible practices for patient care in clinical settings across Haiti.


Assuntos
Doenças Cardiovasculares/enfermagem , Doenças Cardiovasculares/prevenção & controle , Hipertensão/enfermagem , Hipertensão/prevenção & controle , Guias de Prática Clínica como Assunto , Enfermagem em Saúde Pública/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Feminino , Haiti/epidemiologia , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade
15.
J Int Med Res ; 46(6): 2202-2218, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29584539

RESUMO

Objective To evaluate the effectiveness of an interdisciplinary programme led by nurses in relation to metabolic syndrome (MS) and cardiovascular risk (CVR). Methods This randomized, controlled, clinical trial included 74 patients diagnosed with MS (experimental group [EG], n = 37; control group [CG], n = 37). The intervention consisted of a 12-month interdisciplinary programme (pre-test, 6 months of intervention, 12 months of intervention, and 1-year follow-up post-intervention) coordinated by nursing. Results We found a progressive and significant reduction for all clinical, biochemical, and anthropometric parameters analysed at different time points. In the EG, remission of MS by 48.1% in the short term was observed (83.8% in the medium term) and maintained at 1 year post-intervention. In the CG, the prevalence of MS increased by 2.7% from the initial evaluation to study completion. A similar trend was observed for CVR. In the EG, 100% of subjects had a moderate-low risk of CVR at 1 year post-intervention, whereas the CG had CVR in all categories. Conclusion An interdisciplinary, nurse-led programme improves participants' metabolic and cardiovascular health, while maintaining long-term effects. Our findings suggest an important role of the professional nurse as a nexus between the patient, different professionals, and the community.


Assuntos
Doenças Cardiovasculares/terapia , Promoção da Saúde , Síndrome Metabólica/terapia , Obesidade/terapia , Idoso , Doenças Cardiovasculares/enfermagem , Centros Comunitários de Saúde , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Síndrome Metabólica/enfermagem , Pessoa de Meia-Idade , Papel do Profissional de Enfermagem , Obesidade/enfermagem , Equipe de Assistência ao Paciente , Serviços Preventivos de Saúde , Avaliação de Programas e Projetos de Saúde , Fatores de Risco
16.
Int J Nurs Stud ; 80: 1-11, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29331655

RESUMO

BACKGROUND: Primary care nurses play a crucial role in coaching patients in shared decision making about goals and actions. This presents a challenge to practice nurses, who are frequently used to protocol-based working routines. Therefore, an approach was developed to support nurses to coach patients in shared decision making. OBJECTIVES: To investigate how the approach was implemented and experienced by practice nurses and patients. DESIGN: A process evaluation was conducted using quantitative and qualitative methods. SETTINGS/PARTICIPANTS: Fifteen female practice nurses (aged between 28 and 55 years), working with people suffering from diabetes, COPD, asthma and/or cardiovascular diseases, participated. Nurses were asked to apply the approach to their chronically ill patients and to recruit patients (n = 10) willing to participate in an interview or an audio-recording of a consultation (n = 13); patients (13 women, 10 men) were aged between 41 and 88 years and suffered from diabetes, COPD or cardiovascular diseases. METHODS: The approach involved a framework for shared decision making about goals and actions, a tool to explore the patient perspective, a patient profiles model and a training course. Interviews (n = 15) with nurses, a focus group with nurses (n = 9) and interviews with patients (n = 10) were conducted. Nurses filled in a questionnaire about their work routine before, during and after the training course. They were asked to deliver audiotapes of their consultations (n = 13). RESULTS: Overall, nurses felt that the approach supported them to coach patients in shared decision making. Nurses had become more aware of their own attitudes and learning needs and reported to have had more in-depth discussions with patients. The on-the-job coaching was experienced as valuable. However, nurses struggled to integrate the approach in routine care. They experienced the approach as different to their protocol-based routines and expressed the importance of receiving support and the need for integration of the approach into the family physician practice. CONCLUSION: This study shows that changing practice nurses' role from medical experts to coaches in shared decision making is very complex and requires paying attention to skills and attitudes, as well as to contextual factors. Our results indicate that more time and training might be needed for this role transition. Moreover, it might be worthwhile to focus on organizational learning, in order to increase an organization's capacity to change work routines in a collaborative process. Future research into the development and evaluation of health coaching approaches, focusing on shared decision making, is necessary.


Assuntos
Tomada de Decisões , Relações Enfermeiro-Paciente , Adulto , Idoso , Idoso de 80 Anos ou mais , Asma/enfermagem , Doenças Cardiovasculares/enfermagem , Doença Crônica , Diabetes Mellitus/enfermagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/enfermagem , Pesquisa Qualitativa
17.
Eur J Public Health ; 28(4): 743-747, 2018 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-29309571

RESUMO

Background: Little is known on the association between weekly hours of informal caregiving and risk of cardiovascular disease (CVD). The objective was to investigate the individual and joint effects of weekly hours of informal caregiving and paid work on the risk of CVD. Methods: Pooled analysis with 1396 informal caregivers in gainful employment, from the Swedish Longitudinal Occupational Survey of Health and the Whitehall II study. Informal caregiving was defined as care for an aged or disabled relative. The outcome was CVD during 10 years follow-up. Analyzes were adjusted for age, sex, children, marital status and occupational grade. Results: There were 59 cases of CVD. Providing care >20 h weekly were associated with a higher risk of CVD compared to those providing care 1-8 h weekly (hazard ratio = 2.63, 95%CI: 1.20; 5.76), irrespectively of weekly work hours. In sensitivity analyzes, we found this risk to be markedly higher among long-term caregivers (6.17, 95%CI: 1.73; 22.1) compared to short-term caregivers (0.89, 95%CI: 0.10; 8.08). Caregivers working ≥55 h weekly were at higher risk of CVD (2.23, 95%CI: 1.14; 4.35) compared to those working 35-40 h weekly. Those providing care >8 h and working ≤40 h weekly had a higher risk of CVD compared to those providing care 1-8 h and working ≤40 h (3.23, 95%CI: 1.25; 8.37). Conclusion: A high number of weekly hours of informal caregiving as opposed to few weekly hours is associated with a higher risk of CVD, irrespectively of weekly work hours. The excess risk seemed to be driven by those providing care over long periods of time.


Assuntos
Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/enfermagem , Cuidadores/psicologia , Cuidadores/estatística & dados numéricos , Emprego/psicologia , Emprego/estatística & dados numéricos , Estresse Psicológico/complicações , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Fatores de Risco , Reino Unido
18.
Aging Ment Health ; 22(1): 92-99, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27661453

RESUMO

OBJECTIVES: To identify the main drivers of the use of respite services and the need for respite services among caregivers of people experiencing dementia relative to family caregivers of people with other health conditions. METHOD: Based on nationally representative secondary data regression analysis was used to test the association between selected health conditions and the utilisation of and need for respite services. RESULTS: For a person living with dementia the odds of using respite care are higher than for a person with either a musculoskeletal or circulatory condition. Family caregivers of people living with dementia report the odds of the need for more respite as 5.3 times higher than for family caregivers of people with musculoskeletal conditions and 7.7 times higher than for family caregivers of people with circulatory conditions. The main reason for never using respite services is largely driven by the type of health condition, age of care recipient, existence of a spouse, and level of disability. CONCLUSIONS: Respite services that cater to the specific needs of families experiencing dementia at home should become a higher priority within the aged care sector. Alternative models of respite care that focus on prevention and early intervention would be cost effective.


Assuntos
Doenças Cardiovasculares/enfermagem , Cuidadores , Demência/enfermagem , Família , Doenças Musculoesqueléticas/enfermagem , Cuidados Intermitentes/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino
20.
Rio de Janeiro; s.n; 2018. 138 p. ilus.
Tese em Português | LILACS, BDENF - Enfermagem | ID: biblio-1024187

RESUMO

O estudo é integrado a pesquisa "Saberes e práticas criativas em saúde: ampliando fronteiras do conhecimento", CAAE 50683415.2.3001.5279. Tem como objeto a valorização das habilidades empáticas na Consulta de Enfermagem à pessoa que convive doença cardiovascular. Foi definida a seguinte questão de estudo: O modelo de Consulta de Enfermagem baseado na Teoria da Empatia Multidimensional, adotado no ambulatório de Cardiologia, é compreendido pelos usuários como espaço de cuidado, acolhimento e ressignificação da maneira de lidar com a doença cardiovascular e os eventos da vida? Possui os seguintes objetivos: Descrever as diferentes dimensões do Cuidado de Enfermagem que compõe a Consulta de Enfermagem no ambulatório de Cardiologia; identificar a presença das habilidades empáticas na Consulta de Enfermagem baseada na Teoria de Empatia Multidimensional; analisar como as habilidades empáticas são compreendidas pelas pessoas com doença cardiovascular; descrever as motivações dos usuários para frequência e continuidade das Consultas de Enfermagem no Ambulatório de Cardiologia; discutir as contribuições da Consulta de Enfermagem para a saúde das pessoas com doença cardiovascular, na perspectiva dos mesmos. Trata-se de um estudo qualitativo e descritivo. Teve como cenário um ambulatório de Cardiologia de uma Policlínica vinculada a uma Universidade Pública, situada no Município do Rio de Janeiro. Participaram 14 pessoas que convivem com doença cardiovascular a partir dos critérios de inclusão estabelecidos. A coleta de dados foi realizada por meio de Grupo Focal. Para tratamento dos dados, utilizou-se a análise de conteúdo delineado por Bardin e emergiram as categorias: A pessoa além de sua doença cardiovascular: as diferentes dimensões integradoras do ser humano a serem observadas durante a Consulta de Enfermagem; O Processo Empático; Contribuições da Consulta de Enfermagem na perspectiva das pessoas atendidas. Os resultados evidenciaram que a Consulta de Enfermagem atinge as quatro dimensões integradoras do ser humano: emocional, socioeconômica, espiritual e física; que para uma melhor relação interpessoal com a pessoa atendida, o Enfermeiro precisa possuir habilidades empáticas cognitivas, comportamentais e afetivas. Também mostrou que apesar das dificuldades físicas, geográficas e a violência, os participantes vêm à consulta, mantendo continuidade e frequência, pois se sentem acolhidos e compreendidos pelo Enfermeiro, além de terem seus sentimentos, pensamentos e perspectivas reconhecidos e validados. Conclui-se que é possível se utilizar da Consulta de Enfermagem baseada na empatia multidimensional como uma tecnologia de cuidado integral a pessoa, então poderá se constituir em uma estratégia a ser adotada em outros ambulatórios da Policlínica em questão, o que ocorrerá para qualificar o cuidado de enfermagem.


The study is integrated into the research "Knowledge and creative practices in health: broadening the frontiers of knowledge", CAAE 50683415.2.3001.5279. Its objective is the valuation of the empathic skills in the Nursing Consultation to the person who lives cardiovascular disease. The following question of study was defined: The Nursing Consultation model based on the Multidimensional Empathy Theory, adopted in the Cardiology outpatient clinic, is understood by users as a space of care, reception and resignification of the way to deal with cardiovascular disease and events of life? It has the following objectives: Describe the different dimensions of Nursing Care that compose the Nursing Consultation in the Cardiology outpatient clinic; to identify the presence of empathic skills in the Nursing Consultation based on Multidimensional Empathy Theory; analyze how empathic abilities are understood by people with cardiovascular disease; to describe the motivations of the users for frequency and continuity of the Nursing Consultations in the Cardiology Outpatient Clinic; to discuss the contributions of the Nursing Consultation to the health of people with cardiovascular disease from their perspective. This is a qualitative and descriptive study. The scenario was an outpatient clinic of Cardiology of a Polyclinic linked to a Public University, located in the Municipality of Rio de Janeiro. Participants were 14 people living with cardiovascular disease based on established inclusion criteria. Data collection was done through the Focal Group. For data treatment, we used the content analysis outlined by Bardin and the categories emerged: The person besides his cardiovascular disease: the different integrating dimensions of the human being to be observed during the Nursing Consultation; The Empathic Process; Contributions of the Nursing Consultation from the perspective of the people served. The results showed that the Nursing Consultation reaches the four integrating dimensions of the human being: emotional, socioeconomic, spiritual and physical; that for a better interpersonal relationship with the person served, the Nurse must possess empathic cognitive, behavioral and affective skills. It also showed that despite the physical, geographical and violence difficulties, the participants come to the consultation, maintaining continuity and frequency, because they feel welcomed and understood by the Nurse, in addition to having their feelings, thoughts and perspectives recognized and validated. It is concluded that it is possible to use the Nursing Consultation based on multidimensional empathy as a comprehensive care technology for the person, so it can be a strategy to be adopted in other outpatient clinics of the Polyclinic in question, which will occur to qualify the care of nursing.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Cuidados Médicos , Empatia , Enfermagem Cardiovascular/métodos , Assistência Ambulatorial , Relações Enfermeiro-Paciente , Doenças Cardiovasculares/enfermagem , Pesquisa Metodológica em Enfermagem , Cuidados de Enfermagem
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