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1.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(5): 1260-1265, out.-dez. 2019.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1022614

RESUMO

Objective: The study's purpose has been to scrutinize the changes in women's daily life, as well as to investigate how they stand after the diagnosis of HIV/AIDS and the introduction of Antiretroviral Therapy (ART). Methods: It is a descriptive and prospective study with a qualitative approach. Semi-structured interviews were performed with twenty-two HIV positive women, who were enrolled in the immunology ambulatory of a university hospital located in the Rio de Janeiro city. This research was approved by the Research Ethics Committee (CAAE: 45955315.0.0000.5285). Results: Most women dealt positively with the changes in their daily lives after discovering the disease, looking for a way of life with quality, although they still show some difficulties in that regard. Concerning the ART, there was struggle in its beginning; however, as the time went by the adaptations occurred mainly with the family support. Conclusion: It is essential to provide better support towards women during both HIV diagnosis and treatment, so that they can improve their coping strategies


Objetivo: Investigar as mudanças no cotidiano e analisar o enfrentamento de mulheres após o diagnóstico do HIV/AIDS e a introdução da Terapia Antirretroviral (TARV). Método: Estudo descritivo e prospectivo de natureza qualitativa. Realizadas entrevistas semiestruturadas com vinte e duas mulheres HIV positivas, matriculadas no ambulatório de imunologia de um hospital universitário do Rio de Janeiro. Aprovado pelo Comitê de Ética CAAE: 45955315.0.0000.5285. Resultados: A maioria das mulheres enfrentou positivamente as mudanças no seu cotidiano após a descoberta da doença, buscando viver com qualidade, embora ainda apresentem dificuldades na retomada de suas vidas. Com relação à TARV houve dificuldade em seu início, no entanto com o passar do tempo ocorreram adaptações principalmente com o apoio da família. Conclusão: É fundamental que haja um maior apoio as mulheres durante o diagnóstico e tratamento do HIV, para que possam elaborar melhor suas estratégias de enfrentamento


Objetivo: Investigar los cambios en la rutina y hacer un análisis del enfrentamiento de mujeres tras el diagnóstico del VIH/sida y la introducción de la Terapia Antirretroviral (TARV). Método: Estudio descriptivo y prospectivo de naturaleza cualitativa. Se realizaron entrevistas semiestructuradas con veintidós mujeres VIH positivas, matriculadas en el ambulatorio inmunológico de un hospital universitario de Río de Janeiro. Aprobado por el Comité de Ética CAAE: 45955315.0.0000.5285. Resultados: La mayoría de las mujeres enfrentó positivamente los cambios en su cotidiano después del descubrimiento de la enfermedad, buscando vivir con calidad, aunque todavía presentan dificultades en la reanudación de sus vidas. En cuanto a la TARV hubo dificultad en su inicio, sin embargo con el paso del tiempo ocurrieron adaptaciones principalmente con el apoyo de la familia. Conclusión: El apoyo a las mujeres durante el diagnóstico y tratamiento del VIH es fundamental, para que puedan elaborar sus estrategias de enfrentamiento


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Apoio Social , Síndrome de Imunodeficiência Adquirida/psicologia , HIV , Terapia Antirretroviral de Alta Atividade/psicologia , Família/psicologia
2.
Rev. pesqui. cuid. fundam. (Online) ; 11(4): 857-861, jul.-set. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1005534

RESUMO

Objetivo: Investigar o estresse vivenciado por pais ou mães que cuidam de filhos com câncer. Métodos: Pesquisa quantitativa realizada com 22 mães que recebiam apoio na Casa da Criança com Câncer em João Pessoa/Paraíba, Brasil. Os dados foram coletados entre março e maio de 2016 por meio de questionário sociodemográfico e de vulnerabilidade ao estresse. Os dados foram processados pela frequência absoluta e relativa, média e desvio padrão da média, mínimo e máximo. Aprovado CAAE: 49175015100005176. Resultados: Verificouse que 59,1% (13) eram crianças do sexo masculino e 100% (22) mulheres (mães) que cuidavam dos filhos; o tratamento mais prevalente foi à quimioterapia; 100% dos cuidadores apresentaram alta vulnerabilidade de desenvolver estresse. Conclusão: É necessária uma assistência multiprofisisonal direcionada não apenas à criança diagnosticada com câncer, mas ao cuidador e à família que participa e auxília em todos os momentos de sofrimento


Objective: To investigate the stress experienced by parents who care for children with cancer. Method: Quantitative research performed with 22 mothers who received support at the House of the Child with Cancer in João Pessoa/Paraíba, Brazil. Data were collected between March and May 2016 through a sociodemographic and stress vulnerability questionnaire. Data were processed by absolute and relative frequency, mean and standard deviation of the mean, minimum and maximum. Approved CAAE: 49175015100005176. Results: It was verified that 59.1% (13) were male children and 100% (22) female (mothers) who cared for their children; The most prevalent treatment was chemotherapy; 100% of caregivers presented high vulnerability to developing stress. Conclusion: Multiprofisisonal assistance is 1 Enfermeira pela Faculdade de São Francisco da Paraíba (FASP), Especialista em Oncologia, Hematologia Cirúrgica e Molecular. 2 Enfermeira pela Universidade Federal do Rio Grande do Norte (UFRN), Estudante PhD no Programa de pós-graduação em Enfermagem da UFRN. 3 Graduanda em Enfermagem pelo Centro Universitário de João Pessoa (UNIPÊ). 4 Graduanda em Enfermagem pelo Centro Universitário de João Pessoa (UNIPÊ). 5 Enfermeiro pelo Centro Universitário de João Pessoa (UNIPÊ). 6 Enfermeiro pelo Centro Universitário de João Pessoa (UNIPÊ), Estudante PhD no Programa de pós-graduação em Enfermagem da UFRN. DOI: 10.9789/2175-5361.2019.v11i4.857-861 Vulnerabilidade ao estresse: pais cuidadores de filhos com câncer ISSN 2175-5361 Anna Luiza CF, Anna Cláudia FAP, Lidianne ML, et al. J. res.: fundam. care. online 2019 abr/jun 11(4): 857-861 858 needed not only for the child diagnosed with cancer, but also for the caregiver and the family that participates and assistance in all moments of suffering


Objetivo: Investigar el estrés vivido por padres o madres que cuidan hijos con cáncer. Método: Investigación cuantitativa realizada con 22 madres que recibían apoyo en la Casa del Niño con Cáncer en João Pessoa/ Paraíba, Brasil. Los datos fueron recolectados entre marzo y mayo de 2016 a través de cuestionario sociodemográfico y de Vulnerabilidad al estrés. Los datos fueron procesados por la frecuencia absoluta y relativa, media, desviación estándar de la media, mínimo y máximo. Aprobado CAAE: 49175015100005176. Resultados: Se verificó que el 59,1% (13) eran niños del sexo masculino y 100% (22) mujeres (madres) que cuidaban a los hijos; El tratamiento más prevalente fue a la quimioterapia; 100% de los cuidadores presentaron una alta vulnerabilidad de desarrollar estrés. Conclusión: Es necesaria una asistencia multiprofisisonal dirigida no sólo para el niño diagnosticado con cáncer, sino al cuidador y la familia que participa y auxilia en todos los momentos de sufrimiento


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adulto , Adulto Jovem , Cuidadores/psicologia , Neoplasias , Relações Pais-Filho , Família/psicologia , Criança Hospitalizada/psicologia
3.
Rev. pesqui. cuid. fundam. (Online) ; 11(4): 931-936, jul.-set. 2019.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1005745

RESUMO

Objetivo: Descrever a experiência de familiares cuidadores de pacientes oncológicos em cuidados paliativos e analisar as implicações para o cuidado de enfermagem. Métodos: Estudo descritivo de abordagem qualitativa, com coleta por meio de entrevista semiestruturada aberta e transcrições submetidas à análise de conteúdo. Resultados: Mediante análise construíram-se três unidades: "Adeus céu azul: a terminalidade da vida, o câncer e os cuidados paliativos", abordando o impacto e a migração para os cuidados paliativos sugerindo auxilio ao enfrentamento; "Respire fundo: desafios dos familiares cuidadores", tocante à escolha do cuidador, às privações e às dificuldades financeiras; "Maior que palavras: vivências que marcaram", enfatizando o impacto do diagnóstico e a dor oncológica como vivências mais significativas. Considerações finais: É necessário ouvir, dar voz e conhecer a história de vida dos familiares cuidadores para o planejamento e promoção satisfatórios da assistência de enfermagem e educação em saúde


Objectives: Describing the experience of family caregivers of cancer patients in palliative care and to analyze the implications for nursing care. Methods: Descriptive study of a qualitative approach, with collection through open semi-structured interview and transcripts submitted to Content Analysis. Results: Through of analyze was constructed three units: "Goodbye Blue Sky: Life Terminality, Cancer and Palliative Care," approaching the impact and migration to palliative care suggesting coping aid; "Take a deep breath: challenges of family caregivers", regarding caregiver choice, deprivation and financial hardship; "Bigger than words: experiences that marked", emphasizing the impact of diagnosis and cancer pain as more significant experiences. Final considerations: It is necessary to listen, give voice and know the life history of family caregivers for the satisfactory planning and promotion of nursing care and health education


Objetivos: Describir la experiencia de familiares cuidadores de pacientes oncológicos en cuidados paliativos y analizar las implicaciones para el cuidado de enfermería. Métodos: Estudio descriptivo de abordaje cualitativo, con colecta a través de entrevista semiestructurada abierta y transcripciones sometidas a Análisis de Contenido. Resultados: Mediante análisis se construyeron tres unidades: "Adiós cielo azul: la terminalidad de la vida, el cáncer y los cuidados paliativos", abordando el impacto y la migración para los cuidados paliativos sugiriendo auxilio al enfrentamiento; "Respire fondo: desafíos de los familiares cuidadores", con respecto a la elección del cuidador, las privaciones y las dificultades financieras; "Mayor que palabras: vivencias que marcaron", enfatizando el impacto del diagnóstico y el dolor oncológico como vivencias más significativas. Consideraciones finales: Es necesario escuchar, dar voz y conocer la historia de vida de los familiares cuidadores para la planificación y promoción satisfactorias de la asistencia de enfermería y educación para la salud


Assuntos
Humanos , Masculino , Feminino , Cuidados Paliativos/métodos , Cuidados Paliativos/psicologia , Família/psicologia , Cuidadores/psicologia , Enfermagem Oncológica/métodos , Neoplasias/enfermagem , Neoplasias/terapia
4.
Cochrane Database Syst Rev ; 7: CD012582, 2019 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-31264707

RESUMO

BACKGROUND: The diagnosis and treatment of a brain or spinal cord tumour can have a huge impact on the lives of patients and their families with family caregiving often resulting in considerable burden and distress. Meeting the support needs of family caregivers is critical to maintain their emotional and physical health. Although support for caregivers is becoming more widely available, large-scale implementation is hindered by a lack of high-quality evidence for its effectiveness in the neuro-oncology caregiver population. OBJECTIVES: To assess the effectiveness of supportive interventions at improving the well-being of caregivers of people with a brain or spinal cord tumour. To assess the effects of supportive interventions for caregivers in improving the physical and emotional well-being of people with a brain or spinal cord tumour and to evaluate the health economic benefits of supportive interventions for caregivers. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 7), MEDLINE via Ovid, and Embase via Ovid. We also handsearched relevant published conference abstracts (previous five years), publications in the two main journals in the field (previous year), searched for ongoing trials via ClinicalTrials.gov, and contacted research groups in the field. The initial search was in March 2017 with an update in August 2018 (handsearches completed in January 2019). SELECTION CRITERIA: We included all randomised controlled trials (RCTs) where caregivers of neuro-oncology patients constituted more than 20% of the sample and which evaluated changes in caregiver well-being following any supportive intervention. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies and carried out risk of bias assessments. We aimed to extract data on the outcomes of psychological distress, burden, mastery, quality of patient-caregiver relationship, quality of life, and physical functioning. MAIN RESULTS: In total, the search identified 2102 records, of which we reviewed 144 in full text. We included eight studies. Four interventions focused on patient-caregiver dyads and four were aimed specifically at the caregiver. Heterogeneity of populations and methodologies precluded meta-analysis. Risk of bias varied, and all studies included only small numbers of neuro-oncology caregivers (13 to 56 participants). There was some evidence for positive effects of caregiver support on psychological distress, mastery, and quality of life (low to very low certainty of evidence). No studies reported significant effects on caregiver burden or quality of patient-caregiver relationship (low to very low certainty of evidence). None of the studies assessed caregiver physical functioning. For secondary outcomes (patient emotional or physical well-being; health economic effects), we found very little to no evidence for the effectiveness of caregiver support. We identified five ongoing trials. AUTHORS' CONCLUSIONS: The eight small-scale studies included employed different methodologies across different populations, with low certainty of evidence overall. It is not currently possible to draw reliable conclusions regarding the effectiveness of supportive interventions aimed at improving neuro-oncology caregiver well-being. More high-quality research is needed on support for family caregivers of people diagnosed, and living, with a brain or spinal cord tumour.


Assuntos
Adaptação Psicológica , Cuidadores/psicologia , Qualidade de Vida , Estresse Psicológico/prevenção & controle , Assistência Terminal/psicologia , Neoplasias Encefálicas/psicologia , Família/psicologia , Amigos/psicologia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Apoio Social , Neoplasias da Medula Espinal/psicologia
5.
JAMA ; 322(3): 216-228, 2019 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-31310297

RESUMO

Importance: The effects of intensive care unit (ICU) visiting hours remain uncertain. Objective: To determine whether a flexible family visitation policy in the ICU reduces the incidence of delirium. Design, Setting and Participants: Cluster-crossover randomized clinical trial involving patients, family members, and clinicians from 36 adult ICUs with restricted visiting hours (<4.5 hours per day) in Brazil. Participants were recruited from April 2017 to June 2018, with follow-up until July 2018. Interventions: Flexible visitation (up to 12 hours per day) supported by family education (n = 837 patients, 652 family members, and 435 clinicians) or usual restricted visitation (median, 1.5 hours per day; n = 848 patients, 643 family members, and 391 clinicians). Nineteen ICUs started with flexible visitation, and 17 started with restricted visitation. Main Outcomes and Measures: Primary outcome was incidence of delirium during ICU stay, assessed using the CAM-ICU. Secondary outcomes included ICU-acquired infections for patients; symptoms of anxiety and depression assessed using the HADS (range, 0 [best] to 21 [worst]) for family members; and burnout for ICU staff (Maslach Burnout Inventory). Results: Among 1685 patients, 1295 family members, and 826 clinicians enrolled, 1685 patients (100%) (mean age, 58.5 years; 47.2% women), 1060 family members (81.8%) (mean age, 45.2 years; 70.3% women), and 737 clinicians (89.2%) (mean age, 35.5 years; 72.9% women) completed the trial. The mean daily duration of visits was significantly higher with flexible visitation (4.8 vs 1.4 hours; adjusted difference, 3.4 hours [95% CI, 2.8 to 3.9]; P < .001). The incidence of delirium during ICU stay was not significantly different between flexible and restricted visitation (18.9% vs 20.1%; adjusted difference, -1.7% [95% CI, -6.1% to 2.7%]; P = .44). Among 9 prespecified secondary outcomes, 6 did not differ significantly between flexible and restricted visitation, including ICU-acquired infections (3.7% vs 4.5%; adjusted difference, -0.8% [95% CI, -2.1% to 1.0%]; P = .38) and staff burnout (22.0% vs 24.8%; adjusted difference, -3.8% [95% CI, -4.8% to 12.5%]; P = .36). For family members, median anxiety (6.0 vs 7.0; adjusted difference, -1.6 [95% CI, -2.3 to -0.9]; P < .001) and depression scores (4.0 vs 5.0; adjusted difference, -1.2 [95% CI, -2.0 to -0.4]; P = .003) were significantly better with flexible visitation. Conclusions and Relevance: Among patients in the ICU, a flexible family visitation policy, vs standard restricted visiting hours, did not significantly reduce the incidence of delirium. Trial Registration: ClinicalTrials.gov Identifier: NCT02932358.


Assuntos
Delírio/prevenção & controle , Família/psicologia , Unidades de Terapia Intensiva/organização & administração , Visitas a Pacientes , Ansiedade , Brasil , Esgotamento Profissional , Cuidados Críticos/psicologia , Estudos Cross-Over , Depressão , Feminino , Educação em Saúde , Hospitalização , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
6.
JAMA ; 322(3): 229-239, 2019 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-31310299

RESUMO

Importance: Keeping a diary for patients while they are in the intensive care unit (ICU) might reduce their posttraumatic stress disorder (PTSD) symptoms. Objectives: To assess the effect of an ICU diary on the psychological consequences of an ICU hospitalization. Design, Setting, and Participants: Assessor-blinded, multicenter, randomized clinical trial in 35 French ICUs from October 2015 to January 2017, with follow-up until July 2017. Among 2631 approached patients, 709 adult patients (with 1 family member each) who received mechanical ventilation within 48 hours after ICU admission for at least 2 days were eligible, 657 were randomized, and 339 were assessed 3 months after ICU discharge. Interventions: Patients in the intervention group (n = 355) had an ICU diary filled in by clinicians and family members. Patients in the control group (n = 354) had usual ICU care without an ICU diary. Main Outcomes and Measures: The primary outcome was significant PTSD symptoms, defined as an Impact Event Scale-Revised (IES-R) score greater than 22 (range, 0-88; a higher score indicates more severe symptoms), measured in patients 3 months after ICU discharge. Secondary outcomes, also measured at 3 months and compared between groups, included significant PTSD symptoms in family members; significant anxiety and depression symptoms in patients and family members, based on a Hospital Anxiety and Depression Scale score greater than 8 for each subscale (range, 0-42; higher scores indicate more severe symptoms; minimal clinically important difference, 2.5); and patient memories of the ICU stay, reported with the ICU memory tool. Results: Among 657 patients who were randomized (median [interquartile range] age, 62 [51-70] years; 126 women [37.2%]), 339 (51.6%) completed the trial. At 3 months, significant PTSD symptoms were reported by 49 of 164 patients (29.9%) in the intervention group vs 60 of 175 (34.3%) in the control group (risk difference, -4% [95% CI, -15% to 6%]; P = .39). The median (interquartile range) IES-R score was 12 (5-25) in the intervention group vs 13 (6-27) in the control group (difference, -1.47 [95% CI, -1.93 to 4.87]; P = .38). There were no significant differences in any of the 6 prespecified comparative secondary outcomes. Conclusions and Relevance: Among patients who received mechanical ventilation in the ICU, the use of an ICU diary filled in by clinicians and family members did not significantly reduce the number of patients who reported significant PTSD symptoms at 3 months. These findings do not support the use of ICU diaries for preventing PTSD symptoms. Trial Registration: ClinicalTrials.gov Identifier: NCT02519725.


Assuntos
Cuidados Críticos/psicologia , Unidades de Terapia Intensiva , Respiração Artificial/psicologia , Transtornos de Estresse Pós-Traumáticos/prevenção & controle , Idoso , Família/psicologia , Feminino , Pessoal de Saúde/psicologia , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Registros
7.
BJOG ; 126 Suppl 4: 50-57, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31257691

RESUMO

OBJECTIVE: To assess the effectiveness of a counselling intervention in antenatal care settings for pregnant women who report domestic violence. DESIGN: Pre-experimental study with pretest-posttest design. SETTINGS: Two public hospitals in Mumbai, India. SAMPLE: In all, 2778 pregnant women accessing antenatal care (ANC) in the hospitals from February to November 2016 were approached for study participation; 2515 women consented. These women were screened by trained counsellors for domestic violence during pregnancy (domestic violence during pregnancy). Domestic violence during pregnancy was reported by 16.2% (408) of women. Of these, 155 women sought counselling services. Post-intervention analyses were carried out with 142 women at 6 weeks post-delivery; 13 women were not contactable. METHODS: The 442 women who reported domestic violence during pregnancy were provided a minimum of two counselling sessions by trained counsellors during their ANC visits. A counselling intake form was used to collect pre- and post-intervention data. MAIN OUTCOME MEASURES: Prevalence of domestic violence during pregnancy, change in women's ability to cope, safety, and health. RESULTS: Prevalence of domestic violence during pregnancy (16.1%) was comparable to those of common obstetric complications routinely screened for during ANC. In all, 60-65% women reported cognitive changes such as recognising impact of violence and need to speak out against it. In all, 50.7% women took action at the individual level to address domestic violence during pregnancy. This change was not statistically significant (P-value 0.193). Of the women studied, 35.9% adopted at least one safety measure, and 84% of the women reported better health status post-intervention. CONCLUSIONS: Routine enquiry and counselling for domestic violence during pregnancy are effective in improving women's ability to cope, safety, and health. FUNDING: This study was funded by The John D. and Catherine T. MacArthur Foundation. TWEETABLE ABSTRACT: Improving coping strategies, safety and health of pregnant women who reported domestic violence by providing counselling in antenatal care setting.


Assuntos
Aconselhamento , Violência Doméstica/psicologia , Gestantes/psicologia , Cuidado Pré-Natal/psicologia , Adulto , Terapia Cognitivo-Comportamental/métodos , Violência Doméstica/prevenção & controle , Violência Doméstica/estatística & dados numéricos , Família/psicologia , Feminino , Humanos , Índia/epidemiologia , Projetos Piloto , Período Pós-Parto/psicologia , Gravidez , Complicações na Gravidez/psicologia , Adulto Jovem
8.
BMC Public Health ; 19(1): 756, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31200674

RESUMO

BACKGROUND: Difficulties engaging families with overweight children to enrol into programs aimed at reducing childhood obesity have been well documented. During the implementation of the Parenting, Eating and Activity for Child Health Program (PEACH™) over a large geographical area (Queensland (QLD), Australia), a natural experiment developed. This experiment provided an opportunity to observe if there was a difference in enrolment for families with overweight children with a weight criterion (referred to as the period with a Targeted Eligibility Criterion (TEC)) compared to when a weight criterion was removed (the period referred to as Universal Eligibility Criterion (UEC)). We also examined the eligibility criterion's relationship with attendance, parental concern about their child's weight, estimation of overweight and obesity from parent-reported data. METHODS: A secondary analysis of baseline data from 926 overweight/obese children from 817 families enrolled in PEACH™ QLD was performed. Analyses were adjusted to control for the presence of clustered data. Bivariate statistics were performed using Pearson chi-square test with the second-order Rao-Scott correction, and Mann-Whitney U-test for non-parametric continuous variables. Generalized Estimating Equations (GEE) explored the association between weight status-based eligibility criteria and enrolment of overweight children. GEE were adjusted for sex, age and socioeconomic index and stratified for weight category. RESULTS: Compared to obese children, overweight children were almost twice as likely to be enrolled when the program did not have weight status-based eligibility criteria (during UEC period) (OR = 1.90 (CI 95% 1.35-2.68, p <  0.001)). Parents of overweight children enrolled during the UEC period were more likely to regard their child's weight as less of a concern than during the TEC period (UEC 67% vs. TEC 45%, p = 0.036). Children whose parent-reported data underestimated their weight category were more likely to be enrolled while the program did not have weight-related eligibility criteria OR = 2.27 (CI 1.38-3.70, p <  0.01). Program session attendance did not appear to be impacted by the changes in eligibility criteria. CONCLUSIONS: The omission of weight criteria for healthy lifestyle programs is a consideration for health professionals and decision-makers alike when encouraging the enrolment of children who are overweight into healthy lifestyle programs. TRIAL REGISTRATION: ACTRN12617000315314 . Retrospectively registered 28 February 2017.


Assuntos
Peso Corporal , Família/psicologia , Obesidade Pediátrica/prevenção & controle , Programas de Redução de Peso/estatística & dados numéricos , Criança , Feminino , Humanos , Masculino , Queensland
9.
BMC Public Health ; 19(1): 759, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31200685

RESUMO

BACKGROUND: Due to multiple and interacting factors, Latino children are disproportionately at risk for overweight and obesity in the United States. Childhood obesity increases the risk for adverse physical and psychosocial outcomes throughout the lifespan. Intensive behavioral interventions recommended in primary care settings may not conform to current practices, and the most vulnerable populations are often unable to access these services. Community Health Workers (CHWs) offer a promising approach to bridging the gap between vulnerable communities and culturally competent services. La Vida Buena (The Good Life) is an 8-week family-focused intervention for Latino children 5-8 years old and their parents or caregivers who are patients at a Federally-Qualified Community Health Center (FQHC). It is a culturally and linguistically appropriate curriculum, facilitated by CHWs, that targets family behaviors to foster a healthy lifestyle in order to prevent and mitigate childhood overweight and obesity. METHODS: The primary objective is to test the effectiveness of the La Vida Buena (LVB) childhood obesity program among Latino children 5-8 years old and their families as compared with a single educational session. This study uses a parallel two-arm quasi-experimental design. The intervention group receives the 8-week La Vida Buena intervention and the comparison group receives a single educational session. The primary outcome is the change in the child's BMI z-score from baseline to 6 months. DISCUSSION: The implementation and evaluation of La Vida Buena may inform research and practice for linking Latino patients in FQHCs to culturally responsive community-based childhood obesity interventions. It will also contribute to the literature about CHWs as facilitators of behavior change for families underserved by health services and preventive programs. La Vida Buena can serve as a culturally and linguistically appropriate early intervention curriculum that will foster a healthy home environment for childhood obesity mitigation and prevention. TRIAL REGISTRATION: The trial was retrospectively registered on December 18, 2018. The ClinicalTrials.gov Identifier is NCT03781856.


Assuntos
Agentes Comunitários de Saúde , Família/etnologia , Hispano-Americanos/psicologia , Obesidade Pediátrica/etnologia , Programas de Redução de Peso/organização & administração , Criança , Pré-Escolar , Família/psicologia , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , México , Obesidade Pediátrica/prevenção & controle , Avaliação de Programas e Projetos de Saúde , Estados Unidos
10.
Rech Soins Infirm ; (136): 80-89, 2019 03.
Artigo em Francês | MEDLINE | ID: mdl-31210504

RESUMO

BACKGROUND: Type 1 diabetes in children in Switzerland is becoming increasingly prevalent. The coordination of care seems to be a determining element and is essential for effective and efficient care. OBJECTIVE: Identify the difficulties and the levers of coordination faced by healthcare workers and families during the discovery of type 1 diabetes in children aged from birth to fifteen. METHOD: Qualitative analysis using semi-directed interviews. RESULTS: Three families and five healthcare workers participated in the study. Confirmation of the diagnosis was received badly and was a shock for the families. Nurses specializing in pediatric diabetes are recognized for being experts in diabetes care and education. Non-specialist nurses consider diabetes care to be stressful and complex. Collaboration between units is described as compartmentalized. ICT tools are not shared between units. Psychological support is considered to be unsatisfactory by the families. DISCUSSION: Interdisciplinary nurses need to work together and with a structured coordination of care.


Assuntos
Prática Avançada de Enfermagem , Continuidade da Assistência ao Paciente/organização & administração , Diabetes Mellitus Tipo 1/enfermagem , Família/psicologia , Papel do Profissional de Enfermagem , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Pesquisa Qualitativa , Suíça
11.
Ann Agric Environ Med ; 26(2): 304-308, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31232063

RESUMO

INTRODUCTION: In spite of the rapid development in various communication-support technologies for those waking up from a coma, studies describing the sole process of reconstructing communication in this group of patients are scarce. OBJECTIVE: The aim of this study was to analyze communication reactions in a minimal state of consciousness and describe the nonverbal behaviours characteristic for each stages significant for the therapy of communication. MATERIAL AND METHODS: 18 severely brain-injured patients in a minimal state of consciousness participated in the half-year observation study, which included people experiencing at least 4 weeks of consciousness disorder/coma. Age of patients 25±5 years. Psychological assessment included: observation of various attempts of communications undertaken by patients, caregivers and family interview, the Glasgow Coma Scale (GCS) and Individual Communication Sheet. RESULTS: Data analysis showed a significant increase in preverbal communication, both in primal and sensory areas when compared between Stage II (GCS=6-8 points) and Stage III (GCS=9-12 points). After a time, primary communication reached a high level. Patients produced communication attempts from the behaviour organization level, and an increase in the nonverbal communication level was noted. Based on observations, nonverbal communication profiles for each stage of waking up from a coma were introduced. CONCLUSIONS: It was found that in the process of waking up from a coma the patients communicate with the use of the preverbal level of primal communication, the sensory and behaviour organization activities. The characteristics of the communication reactions show that in Stage III there is a significant increase in two preverbal communication areas: primal and sensory acts, when compared with Stage II.


Assuntos
Lesões Encefálicas Traumáticas/psicologia , Coma/psicologia , Comunicação não Verbal , Adulto , Lesões Encefálicas Traumáticas/reabilitação , Coma/reabilitação , Estado de Consciência , Família/psicologia , Feminino , Escala de Coma de Glasgow , Humanos , Masculino , Adulto Jovem
12.
Prax Kinderpsychol Kinderpsychiatr ; 68(5): 359-375, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31250716

RESUMO

The Sense of Family - Developmental Lines and Problems In spite of multiple criticism and diversification of family types family remains a "destination of yearning". Family stays always in contradiction to the culture of the surrounding society. The sense of family describes the sense of one's own family as a whole. It is composed of the experiences in dyads, triads, tetrades and polyades as well as the emotional atmosphere and the life style of the family as a whole. To the construction of the family as a whole as an internal object, the inner self-image of the family and corresponding the sense of family contribute the "missions" the family passes on to the children, the dynamics of loyalty, the multigenerational network, family narratives and family myths as mediators of the collective memory as well as the active shaping of relationships by the activity of the child itself. The change of family structures by "verticalisation", new communication technologies, and the "anthropo-technologies" of reproduction are still to be explored in respect to their possible consequences for the sense of family.


Assuntos
Características da Família , Família/psicologia , Psicologia da Criança , Criança , Humanos , Narração , Autoimagem
13.
Transplant Proc ; 51(5): 1540-1544, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31155188

RESUMO

OBJECTIVE: The study focuses on the experience of family members of deceased potential donors in deciding to refuse donation when their loved one had expressed his or her wish in life not to donate organs and tissues for transplantation. METHOD: This is a qualitative study that uses social phenomenology as the theoretical reference, interviewing 8 family members of deceased potential donors. RESULTS: The family members' experiences were represented by the following categories: beliefs related to donation, fear in the face of the loved one's death, and the ethical dilemma of deciding to refuse the donation. The meaning of the refusal to donate was represented by the following categories: respect for the loved one's wishes and the family's peace of mind with the decision. CONCLUSIONS: The study shed light on the experience of family members of deceased potential donors in making the decision to refuse donation. The concerns that motivate refusal were elucidated and the meanings of the decision's intentionality were unveiled. The resulting knowledge about these families' experiences provides backing for experts in donation and transplantation who work in different realities, pointing to strategies for improving care for such family members.


Assuntos
Família/psicologia , Doadores de Tecidos/ética , Obtenção de Tecidos e Órgãos/ética , Tomada de Decisões , Feminino , Humanos , Masculino , Princípios Morais , Pesquisa Qualitativa
14.
Am J Occup Ther ; 73(3): 7303205120p1-7303205120p11, 2019 May/Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31120842

RESUMO

IMPORTANCE: A growing body of evidence supports service dogs' positive psychosocial impact on people with a chronic condition, but very little is known about the effect of service dogs on the family members with whom they live. OBJECTIVE: To measure the impact that a service dog may have on family member functioning. DESIGN: Cross-sectional with a single time-point assessment. SETTING: Data were collected via a self-report survey completed online, over the phone, or by mail. PARTICIPANTS: Potential participants were recruited from national service dog provider Canine Assistants. Participants were caregivers or spouses of a person with a disability or illness who either currently had a service dog (n = 51) or was on the waitlist to receive one (n = 77). Participants were 50 family members (46 parents-caregivers and 4 spouses-partners) living with a service dog and 76 family members (68 parents-caregivers and 8 spouses-partners) whose family member was on the waitlist to receive one. OUTCOMES AND MEASURES: Participants completed standardized measures to quantify psychosocial health and functioning, health-related quality of life (HRQOL), and family functioning. RESULTS: Living with a service dog was most closely associated with less health-related worry and better overall psychosocial health and emotional functioning, less total family impact from the chronic condition, and better emotional HRQOL. CONCLUSIONS AND RELEVANCE: These findings provide preliminary evidence that, in addition to having an impact on recipients, service dogs can affect several aspects of family members' psychosocial health and functioning. WHAT THIS ARTICLE ADDS: This research demonstrates that the impact of a service dog may extend beyond the recipient and have positive impacts on family members' psychosocial functioning as well. Occupational therapy practitioners should include family members in discussions regarding the integration of a service dog into the home and recognize the potential for family-wide effects from the service dog's assistance.


Assuntos
Cuidadores/psicologia , Cães , Família/psicologia , Qualidade de Vida , Animais , Estudos Transversais , Inquéritos e Questionários
15.
Malawi Med J ; 31(1): 39-44, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-31143395

RESUMO

Background: The family provides support in the care of their ill members and suffers some burden during caregiving. This study assessed the burden of family caregivers and associated factors in an ophthalmic clinic situated in a university teaching hospital in southwest Nigeria. Methods: This was a descriptive cross-sectional study where consenting family caregivers of ophthalmic patients completed a semi-structured questionnaire containing information on their socio-demographic characteristics and caregiving burden using the Zarit burden interview. Descriptive and inferential statistics analyses were done. Results: A total of 273 caregivers completed the study. The caregivers were parents (23.5%), spouses (20.1%), siblings (3.3%), children (35.9%) and other relatives (14.2%) with mean age (SD) of 38.9 (14.9) years (range 8-79 years). Majority (81.2%) experienced caregiver burden with prayer (89%) as a coping strategy. Financial support (56%) was a major caregiver need with majority (59.3%) satisfied with their relatives' hospital care. Neither the patients nor their caregivers were on health insurance scheme. Statistical significant factors associated with caregivers' burden included young age (AOR=4.63, 95%CI=1.55-13.90; p=0.01), higher education (AOR=5.51, 95%CI=2.30-13.2, p=0.01), being employed (AOR=1.72, 95CI=1.30-4.76, p=0.04), longer caregiving (AOR=3.37, 95%CI=1.27-7.02, p=0.02), and having patient on hospital admission (AOR=1.90, 95%CI=1.26-3.09, p=0.02). Conclusion: Family caregivers of ophthalmic patients experienced significant burden. Hence, they need more assistance from the health care institutions and community, including policy makers, so that they can cope with their caregiving activities. Enrollment in the social health insurance scheme will reduce out of pocket payment of hospital bills.


Assuntos
Cuidadores/psicologia , Efeitos Psicossociais da Doença , Oftalmopatias/terapia , Família/psicologia , Adolescente , Adulto , Idoso , Criança , Estudos Transversais , Oftalmopatias/psicologia , Feminino , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Apoio Social , Inquéritos e Questionários , Adulto Jovem
16.
An. psicol ; 35(2): 181-187, mayo 2019. graf
Artigo em Inglês | IBECS | ID: ibc-181687

RESUMO

In breast cancer patients, quality of life has been associated with treatment response and overall survival. One hundred women undergoing chemotherapy treatment for breast cancer completed questionnaires including demographic and clinical information, the EORTC-Quality of Life Questionnaire, Hospital Anxiety and Depression Scales, Body Image Scale, Index of Family Relations and the Life Orientation Test. The results showed that higher optimism and better body image were associated with improved quality of life. Distress significantly predicted physical and emotional quality of life, but recurrence only predicted physical quality of life. Family stress was a moderator in the relationship between psychological distress and emotional quality of life, showing the need to screen and intervene on family stress in patients with breast cancer. The results may help in designing interventions for women with breast cancer in order to promote quality of life


En pacientes con cáncer de mama, la calidad de vida se ha asociado con la respuesta al tratamiento y la supervivencia global. Cien mujeres sometidas a tratamiento de quimioterapia para el cáncer de mama completaron cuestionarios incluyendo información demográfica y clínica, Cuestionario de Calidad de Vida EORTC, Escalas de Ansiedad y Depresión Hospitalaria, Escala de Imagen Corporal, Índice de Relaciones Familiares y el Test de Orientación Vital. Los resultados mostraron que un mayor optimismo y una mejor imagen corporal se asociaron con una mejor calidad de vida. La morbilidad psicológica predijo significativamente la calidad de vida física y emocional, pero la recurrencia sólo predijo la calidad de vida física. El estrés familiar fue un moderador en la relación entre la morbilidad psicológica y la calidad de vida emocional, mostrando la necesidad de detectar e intervenir en el estrés familiar en pacientes con cáncer de mama. Los resultados pueden ayudar en el diseño de intervenciones para las mujeres con cáncer de mama con el fin de promover la calidad de vida


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Neoplasias da Mama/psicologia , Qualidade de Vida/psicologia , Família/psicologia , Estresse Psicológico/psicologia , Autoimagem , Perfil de Impacto da Doença , Apoio Social , Relações Familiares/psicologia , Imagem Corporal/psicologia , Estudos Transversais
17.
J Cross Cult Gerontol ; 34(2): 131-148, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31134463

RESUMO

Native American grandparents by tradition are expected to play a role in rearing grandchildren. However, in many Native grandfamilies, grandparents are rearing grandchildren not by choice or tradition, but as the result of family crises that necessitated grandparent intervention. European American grandparents have likewise been called to rear their grandchildren when their adult children are unable or unwilling to perform parental duties. Less is known about these custodial grandparents' resilience pathways, particularly among rural grandfamilies. Guided by the Resiliency Model of Family Stress, Adjustment, and Adaptation, this study examined the relationships between stressors, resources, and resilience among rural Native and European American custodial grandparents. Correlates of resilience were economic stress and stress management. Significant interactions were found between economic stress and government assistance and economic stress and stress management, indicating complex resilience pathways. Implications of study findings for research and intervention are discussed.


Assuntos
Adaptação Psicológica , Custódia da Criança , Educação Infantil/etnologia , Família/psicologia , Avós/psicologia , Relação entre Gerações/etnologia , Resiliência Psicológica , Adulto , Cuidadores , Criança , Educação Infantil/psicologia , Família/etnologia , Feminino , Humanos , Índios Norte-Americanos , Masculino , Pessoa de Meia-Idade , Poder Familiar , População Rural , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia
18.
Hautarzt ; 70(7): 520-526, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31134287

RESUMO

BACKGROUND: Numerous studies have shown that psoriasis is associated with severe losses in almost all dimensions of health-related quality of life. An important aspect is the stigmatization experience of those affected. OBJECTIVE: The aim of this study was to examine the perception of stigmatization from the perspective of patients, relatives and healthcare professionals using a qualitative approach. MATERIAL AND METHODS: Qualitative surveys in the form or focus groups and interviews with patients, relatives and healthcare providers were conducted. The data were analyzed by qualitative content analysis. RESULTS: The results show that stigmatization is perceived by all groups surveyed. It also became clear that self-stigmatization plays a special role. Affected persons, relatives and medical care providers described self-stigmatization as the greatest burden or restriction of affected persons in various areas of life, such as work, leisure and partnership. There were no crucial differences between sex or age groups. CONCLUSION: Possible knowledge deficits of non-affected persons and wrong assumptions of the affected persons about the attitudes of non-affected persons can be reduced, for example, in the context of encounters between affected persons and non-affected persons as well as between affected persons and medical care providers and thus reduce the public as well as the self-stigma.


Assuntos
Família/psicologia , Pessoal de Saúde/psicologia , Psoríase/psicologia , Qualidade de Vida/psicologia , Estigma Social , Estereotipagem , Atitude , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Entrevistas como Assunto , Percepção , Pesquisa Qualitativa
19.
J Autism Dev Disord ; 49(8): 3426-3439, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31115773

RESUMO

High levels of emotional/behavioural difficulties are frequently reported in children on the autism spectrum. However, given the diversity in profiles, there is a need to explore such behaviours in relation to individual factors. Parents of 130 children aged 4-5 on the autism spectrum completed measures of behaviour and adaptive behaviour. Hierarchical multiple regressions explored child and family characteristics in relation to children's emotional/behavioural presentation. Different aspects of the behavioural profile were associated with different factors, with child autism characteristics, medication use, and parent mental health making significant unique contributions to a range of behavioural subscales. Understanding individual profiles beyond total scores is therefore needed to truly understand the emotional and behavioural profile of specific subgroups.


Assuntos
Transtorno Autístico/diagnóstico , Lista de Checagem/normas , Comportamento Infantil , Desenvolvimento Infantil , Adaptação Psicológica , Transtorno Autístico/psicologia , Criança , Pré-Escolar , Família/psicologia , Feminino , Humanos , Masculino
20.
Estud. pesqui. psicol. (Impr.) ; 19(1): 206-222, jan.-abr. 2019. tab
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-999358

RESUMO

As mudanças societárias nos modos e costumes referentes às composições familiares suscitam novos questionamentos acerca de como a filiação e a transmissão operam atualmente no interior das "novas" configurações familiares. Desenvolve-se, através da análise das Narrativas Memorialísticas de jovens moradores de periferia, envolvidos ou não com a criminalidade, a hipótese de que a família contemporânea opera seu espaço de transmissão através de uma lógica processual continuísta na qual não há mais um núcleo articulador e gerador de unidade semântica. Dessa forma, a transmissão acontece pela composição de diferentes lógicas que, em continuidade processual, incidem sobre o objeto de desejo a partir de seu ponto de impossibilidade de tradução.(AU)


The societal changes concerning the modes and customs related to family compositions raise new questions in terms of how filiation and transmission operate nowadays within "new" family configurations. Through the analysis of the narrative memoirs of slum-dwelling youths in Brazil, who have and who have not been involved in criminal activities, the hypothesis developed in this article claims that the contemporary family operates its space of transmission through a processual continuist logic in which there is no longer an articulating core that could generate semantic unit. Thus, transmission happens through the composition of different logics that, in a processual continuity, affect the object of desire from its point of impossibility of translation.(AU)


Los cambios sociales en los modos y las costumbres referentes a las composiciones familiares suscitan nuevos cuestionamientos acerca de cómo la filiación y la transmisión operan en la actualidad en el interior de las "nuevas" configuraciones familiares. Se desarrolla, a través del análisis de las Narrativas Memorialísticas de jóvenes residentes de periferias involucrados o no con la criminalidad, la hipótesis de que la familia contemporánea opera su espacio de transmisión a través de una lógica procesal continuista en la que ya no hay un núcleo articulador y generador de unidad semántica. De esta forma, la transmisión sucede por la composición de diferentes lógicas que, en continuidad procesal, inciden sobre el objeto de deseo a partir de su punto de imposibilidad de traducción.(AU)


Assuntos
Humanos , Família/psicologia , Adolescente , Crime/psicologia , Relações Familiares , Identificação Social , Áreas de Pobreza , Cultura
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