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3.
Soins ; 64(838): 25-27, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31542114

RESUMO

While the benefits of support groups are proven, caregivers are still a little wary of them. There are multiple reasons for this reticence. However, wherever they take place, talking becomes freer, relationships become more fluid and cooperation is facilitated.


Assuntos
Cuidadores/psicologia , Grupos de Autoajuda , Humanos
4.
Z Psychosom Med Psychother ; 65(3): 272-287, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31477000

RESUMO

Development of an evaluation system for online self-help groups by using the example of German-speaking cancer forums Objectives: This paper pursues the question how the quality of forums can be evaluated. Therefor a grading system was designed and 23 German-speaking cancer forums were evaluated by content and formal criteria Methods: Using a keyword-based internet search, 23 forums were identified. Data was gathered about: number of themes, posts and members, structure, key subjects and type of financing. Furthermore, an evaluation system was developed, with which the forums where assessed. Results: The forums were divided in forums with (n = 10) and without (n = 9) focus on a type of cancer. Four are health portals with forum-function. The quality of online cancer forums is heterogeneous, the evaluation resulted an average quality index of 2.7 for the total cancer forums Conclusion: A good information editing, moderation, data protection and transparency are important quality criteria. The evaluation of forums may help the patients, to autonomously value the quality of the presented information.


Assuntos
Internet , Linguagem , Neoplasias , Avaliação de Programas e Projetos de Saúde/métodos , Grupos de Autoajuda/normas , Mídias Sociais/normas , Alemanha , Humanos
5.
Crim Behav Ment Health ; 29(4): 227-238, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31478289

RESUMO

BACKGROUND: Sexual behaviour towards another person who does not or cannot consent to it causes serious harm to its victims. Understandable tendencies towards isolating or shaming the offenders, however, may actually increase risks of recidivism and further such harms. AIM: The study aims to consider evidence for the effectiveness of interventions for sex offenders, mainly in a U.K. context, across four areas: criminal justice system programmes, medication, interventions for sex offenders with personality disorder and a community-based model for the reintegration-Circles of Support and Accountability, and identify key evidence gaps. METHODS: We searched for reviews in the following four strands of work-psychosocial programmes, medication, personality focused therapies, and Circles of Support and Accountability-and identified gaps in knowledge. FINDINGS: Randomised controlled trials in this field are rare but have been achieved. Findings from more naturalistic outcome studies of sex offender treatment programmes are disappointing, but recidivism rates among released sex offender prisoners are low, regardless. Medication relying on substantial physiological change raises substantial ethical concerns. Not all sex offenders have a mental disorder but up to half have been diagnosed with a personality disorder, which may need specific treatment. Evidence is growing that lay work such as Circles of Support and Accountability is a valuable adjunct to other interventions. CONCLUSIONS AND IMPLICATIONS FOR FUTURE RESEARCH: In this field, where tensions between attributions swing between "madness" and "badness," there is growing evidence for optimism that complexity of history and presentation can be met through cooperation between the many disciplines, integrative strategies, and wider community engagement. The need now is for large, prospective controlled trials of interventions, with long periods of follow-up. Perhaps, the most exciting developments have come from the wider public. More research into the qualities of these volunteers might inform public education and health strategies supporting wider safety.


Assuntos
Antagonistas de Androgênios/uso terapêutico , Antipsicóticos/uso terapêutico , Criminosos/psicologia , Libido/efeitos dos fármacos , Transtornos Mentais/tratamento farmacológico , Grupos de Autoajuda , Delitos Sexuais/prevenção & controle , Comportamento Sexual/efeitos dos fármacos , Responsabilidade Social , Apoio Social , Adulto , Antagonistas de Androgênios/efeitos adversos , Antipsicóticos/efeitos adversos , Feminino , Humanos , Masculino , Transtornos Mentais/etiologia , Prisioneiros , Reincidência/prevenção & controle , Delitos Sexuais/psicologia
6.
Br J Community Nurs ; 24(9): 436-443, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31495214

RESUMO

Quality of life is significantly impacted for those with pituitary conditions, and patients need support to meet ongoing physical and psychological needs. This study aimed to explore the support needs and experiences of patients with pituitary conditions in the community. Ten self-selected members of the Pituitary Foundation were interviewed about their conditions, needs and experiences. Data were analysed using thematic analysis. Secondary thematic analysis was conducted on data from a sample of 748 members of the Pituitary Foundation. Four themes were revealed, under one over-arching theme of geography: (1) life-changing diagnosis, (2) the Foundation as a source of support, (3) access to the Foundation and (4) attendance at support groups. On the basis of the findings of this study, the authors concluded that better training is required for health professionals about pituitary conditions, their long-term consequences and the need to signpost patients to wider services offering essential support.


Assuntos
Acesso aos Serviços de Saúde , Doenças da Hipófise , Qualidade de Vida , Grupos de Autoajuda , Adolescente , Adulto , Idoso , Feminino , Fundações , Geografia , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Apoio Social , Inquéritos e Questionários , Adulto Jovem
9.
J Consult Clin Psychol ; 87(10): 927-940, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31556669

RESUMO

OBJECTIVE: Despite the heightened urgency of the current prescription opioid crisis, few psychotherapies have been evaluated for chronic pain patients receiving long-term opioid analgesics. Current psychological pain treatments focus primarily on ameliorating negative affective processes, yet basic science suggests that risk for opioid misuse is linked with a dearth of positive affect. Interventions that modulate positive psychological processes may produce therapeutic benefits among patients with opioid-treated chronic pain. The aim of this study was to conduct a theory-driven mechanistic analysis of proximal outcome data from a Stage 2 randomized controlled trial of Mindfulness-Oriented Recovery Enhancement (MORE), an integrative intervention designed to promote positive psychological health. METHOD: Patients with opioid-treated chronic pain (N = 95; age = 56.8 ± 11.7; 66% female) were randomized to 8 weeks of therapist-led MORE or support group (SG) interventions. A latent positive psychological health variable comprised of positive affect, meaning in life, and self-transcendence measures was examined as a mediator of the effect of MORE on changes in pain severity at posttreatment and opioid misuse risk by 3-month follow-up. RESULTS: Participants in MORE reported significantly greater reductions in pain severity by posttreatment (p = .03) and opioid misuse risk by 3-month follow-up (p = .03) and significantly greater increases in positive psychological health (p < .001) than SG participants. Increases in positive psychological health mediated the effect of MORE on pain severity by posttreatment (p = .048), which in turn predicted decreases in opioid misuse risk by follow-up (p = .02). CONCLUSIONS: Targeting positive psychological mechanisms via MORE and other psychological interventions may reduce opioid misuse risk among chronic pain patients receiving long-term opioid therapy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Dor Crônica/terapia , Atenção Plena , Grupos de Autoajuda , Adulto , Afeto , Idoso , Analgesia/psicologia , Analgésicos Opioides/uso terapêutico , Dor Crônica/tratamento farmacológico , Dor Crônica/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Opioides/psicologia , Transtornos Relacionados ao Uso de Opioides/terapia , Processos Psicoterapêuticos , Resultado do Tratamento
10.
Trials ; 20(1): 486, 2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31399138

RESUMO

BACKGROUND: The treatment of mental health issues among people living with HIV (PLH) in Botswana is yet to be addressed. A recent study revealed that depressive symptoms are highly prevalent in a sample of PLH in Botswana. Based on empirical findings of a study that investigated intervention targets for PLH in Botswana, a self-help program with coaching in booklet format in the Setswana and English languages was developed, composed of cognitive behavioral techniques, coping skills interventions, and goal adjustment training. We will investigate the program for effectiveness in the treatment of depressive symptoms among PLH. Additionally, we will investigate treatment moderators and mediators. This paper describes the study protocol. METHODS/DESIGN: A randomized controlled trial will be conducted to compare the booklet self-help program with coaching with an attention-only control condition, by including pre-test, post-test, and follow-up assessments. We aim to enroll 200 participants with mild to moderate depressive symptoms into the study. The self-help program contains the following main components: activation, relaxation, changing maladaptive cognitions, and the attainment of new personal goals. This content is covered over six lessons to be completed in a maximum of 8 weeks. It uses a combination of psycho-education, assignments, and exercises. The participants will work on the program 1-2 h every week for 6 weeks (maximum 8 weeks). Coaches will offer support and motivate the participants. For both groups, depressive symptoms and possible mediators will be measured three times during the intervention, and at pre-test, post-test, and follow-up. DISCUSSION: If the intervention is found to effectively treat depressive symptoms, it will be implemented and thus help improve the psychological health of PLH in Botswana. TRIAL REGISTRATION: Netherlands Trial Register, NTR7428 . Registered on 23 August 2018.


Assuntos
Depressão/prevenção & controle , Infecções por HIV/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Emoções , Humanos , Grupos de Autoajuda , Inquéritos e Questionários
11.
Stud Health Technol Inform ; 264: 1893-1894, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438394

RESUMO

People with Type 2 Diabetes (T2D) control much of their illness by making daily decisions regarding their health behaviours. They require certain skills, information, and support, which might not be obtainable from healthcare providers, and they may seek support through other media, such as online support groups (OSGs). This study seeks to understand the role of OSGs in empowering people with T2D by thematically analysing threads and posts from two UK OSGs.


Assuntos
Diabetes Mellitus Tipo 2 , Tomada de Decisões , Pessoal de Saúde , Humanos , Grupos de Autoajuda
12.
Geriatr Psychol Neuropsychiatr Vieil ; 17(3): 327-335, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31449051

RESUMO

Caregivers in dependent elderly people facilities may develop a burn-out, but few studies have been conducted on the subject. The aim of this study is to evaluate the feelings of professional stress and social support, coping strategies and caregivers' burn-out including nurses, caregivers and medical psychologists, to identify the different coping strategies according to the burn-out level, and to analyze the links between burn-out, perceived work stress and perceived social support. Seven facilities were contacted, but only three sent back valid response questionnaires. Twenty-one caregivers completed the questionnaires (socio-demographic data, MBI, Brief Cope, SSQ6, JSS). Results showed a low level of burn-out and perceived stress and a satisfactory perceived social support. Functional coping strategies were used, especially by caregivers with lower burn-out level (positive reinterpretation) unlike caregivers with moderate or high burn-out level that used more dysfunctional strategies (substance abuse). Significant links were found between perceived work stress and emotional exhaustion, and between personal accomplishment, perceived social support and emotional exhaustion, and between perceived work stress and perceived social support. These results show the relevance of creating working groups for caregivers in stress situations. The groups help to develop or maintain functional coping strategies and provide adequate social support for the healthcare team. Taking into account burn-out improves caregivers' job satisfaction and care quality for the residents.


Assuntos
Adaptação Psicológica , Esgotamento Profissional/psicologia , Cuidadores/psicologia , Estresse Ocupacional/psicologia , Apoio Social , Adulto , Feminino , Pessoal de Saúde , Humanos , Satisfação no Emprego , Masculino , Fadiga Mental/psicologia , Pessoa de Meia-Idade , Casas de Saúde , Grupos de Autoajuda , Inquéritos e Questionários , Adulto Jovem
13.
Br J Health Psychol ; 24(4): 913-930, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31449732

RESUMO

Tinnitus is a chronic condition for which there is no medical treatment. Tinnitus groups are a widely available resource for people with tinnitus. OBJECTIVES: Our objectives were to explore the active ingredients of tinnitus support groups in terms of their mechanisms for providing support, the contextual factors that elicit such mechanisms, and the outcomes in terms of coping enhancement. DESIGN: We adopted a pluralist and iterative approach informed by the realist evaluation method. METHODS: We conducted ethnographic data generation at tinnitus support groups involving observations (n = 160), focus groups (n = 130), and individual interviews (n = 20). Inductive analyses were conducted following the constant comparison method of grounded theory. We then interrogated the inductive themes to identify evidence of Contexts, Mechanisms, and Outcomes. We then produced a model which was tested in a survey of tinnitus group members (n = 65) in effect providing large-scale respondent validation of the data-driven model created through our inductive analysis. RESULTS: We identified that tinnitus groups can facilitate social connectedness between group members. This experience appeared to build resilience among those experiencing tinnitus-related distress. Groups also played a role in building a sense of control related to knowledge and information sharing. Additionally, we identified risks associated with not accessing social support in a group environment. CONCLUSIONS: Our findings contribute to the growing understanding of the power of social connectedness as building shared social identity when living with tinnitus. Statement of contribution What is already known on this subject? Tinnitus is a prevalent condition with approximately 10-15% of the population experiencing a spontaneous sound without obvious source. Tinnitus is an invisible health and chronic condition. People with tinnitus experience high levels of distress, anxiety, and depression. Group support is beneficial to people with many health problems. What does this study add? This study describes the mechanisms by which tinnitus support groups can support coping in tinnitus. This is the first study to comprehensively explore the views of those who attend tinnitus groups. The study identifies the key features of support groups that facilitate social connectedness among group members. The most valued features of groups are the knowledge and information provided, the sense of belonging communicated to group members, and the creation and maintenance of a sense of hope towards the tinnitus. This study contributes new insights to both the tinnitus field and adds to the literature on support groups in health.


Assuntos
Adaptação Psicológica , Relações Interpessoais , Grupo Associado , Grupos de Autoajuda/estatística & dados numéricos , Apoio Social , Zumbido/psicologia , Adulto , Doença Crônica , Feminino , Humanos , Masculino , Reino Unido
14.
Psychiatriki ; 30(2): 108-119, 2019.
Artigo em Grego Moderno | MEDLINE | ID: mdl-31425139

RESUMO

Psychosocial rehabilitation for people with chronic-severe mental illness mainly aims to social integration by restoring independent functioning in the community, improving quality of life, and addressing risk factors that lead to social disability. Support groups (SG) are usually part of this multilevel mental health process. Given that non-adherence to treatment is a common phenomenon in people with chronic- severe mental illness, the aim of the current study was to identify which factors influence members' attendance in a support group in a vocational training Program of the Psychosocial Rehabilitation Unit of Byron-Kaissariani Community Mental Health Centre. The SG sessions were weekly, with 45-minute duration, opened to any new member of the Program and coordinated by two therapists. Members' demographic and psychiatric data were gathered from the medical records of the Center. Information about SG was obtained from the reports of the sessions. The sample consisted of 18 women, with mean age 38.56 (±6.92) years. Most of them were high school graduates (61.1%), unmarried (83.3%), with low socioeconomic status (55.5%), suffering from a schizophrenic spectrum disorder (61.1%) with a mean duration 15.22 (±8.44) years. Out of 83 sessions in total, twenty-two (26.5%) were in absence of a co-therapist, 11 (13.3%) after a member's entrance or withdrawal and 11 (13.3%) after a session cancellation. Furthermore, an average of four issues was discussed per session, with mental illness (62.7%) and interpersonal relationships (73.5%) being the most popular topics during the sessions. The statistical analysis demonstrated that members' demographic (age, education, marital status, residence, socioeconomic status, working experience) and psychiatric characteristics (diagnosis, illness duration, rehabilitation program experience) were not associated with the attendance rate in the SG. Similarly, the proportion of participants attending the sessions did not seem to be significantly related to the absence of a co-therapist, to a member's entrance or withdrawal and to a session cancellation. In contrast, attendance seemed to be significantly reduced when the topic of a session focused on members' future expectations/goals (having a family, further education, finding a job) (Beta=-0.32, p=0.006). This finding highlights the need for future research in order to incorporate interventions that promote and address future goals and expectations of people with chronic-severe mental illness in psychosocial rehabilitation services.


Assuntos
Transtornos Mentais/reabilitação , Cooperação do Paciente/estatística & dados numéricos , Reabilitação Psiquiátrica/organização & administração , Grupos de Autoajuda/estatística & dados numéricos , Adulto , Doença Crônica , Centros Comunitários de Saúde Mental , Feminino , Humanos , Relações Interpessoais , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Reabilitação Psiquiátrica/estatística & dados numéricos , Psicoterapia de Grupo , Esquizofrenia/reabilitação , Fatores Socioeconômicos
15.
Trials ; 20(1): 515, 2019 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-31426835

RESUMO

BACKGROUND: Current population surveys suggest around 20% of Australians meet diagnostic criteria for an alcohol use disorder. However, only a minority seek professional help due to individual and structural barriers, such as low health literacy, stigma, geography, service operating hours and wait lists. Telephone-delivered interventions are readily accessible and ideally placed to overcome these barriers. We will conduct a randomised controlled trial (RCT) to examine the efficacy of a standalone, structured telephone-delivered intervention to reduce alcohol consumption, problem severity and related psychological distress among individuals with problem alcohol use. METHODS/DESIGN: This is a single site, parallel group, two-arm superiority RCT. We will recruit 344 participants from across Australia with problem alcohol use. After completing a baseline assessment, participants will be randomly allocated to receive either the Ready2Change (R2C) intervention (n = 172, four to six sessions of structured telephone-delivered intervention, R2C self-help resource, guidelines for alcohol consumption and stress management pamphlets) or the control condition (n = 172, four phone check-ins < 5 min, guidelines for alcohol consumption and stress management pamphlets). Telephone follow-up assessments will occur at 4-6 weeks, 3 months, 6 months and 12 months post-baseline. The primary outcome is the Alcohol Use Disorders Identification Test (AUDIT) score administered at 3 months post-baseline. Secondary outcomes include change in AUDIT score (6 and 12 months post-baseline), change in number of past-month heavy drinking days, psychological distress, health and wellbeing, quality of life, client treatment evaluation and cost effectiveness. DISCUSSION: This study will be one of the first RCTs conducted internationally to examine the impact of a standalone, structured telephone-delivered intervention to address problem alcohol use and associated psychological morbidity. The proposed intervention is expected to contribute to the health and wellbeing of individuals who are otherwise unlikely to seek treatment through mainstream service models, to reduce the burden on specialist services and primary care providers and to provide an accessible and proportionate response, with resulting cost savings for the health system and broader community. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12618000828224 . Pre-registered on 16 May 2018.


Assuntos
Alcoolismo/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Telefone , Consumo de Bebidas Alcoólicas/psicologia , Humanos , Projetos de Pesquisa , Tamanho da Amostra , Grupos de Autoajuda
16.
Br J Health Psychol ; 24(4): 787-805, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31273908

RESUMO

OBJECTIVES: Although many health interventions are delivered in groups, it is unclear how group context can be best used to promote health-related behaviour change and what change processes are most helpful to participants. This study explored participants' experiences of attending type 2 diabetes prevention and management programme, and their perceptions of how group participation influenced changes in diet and physical activity. DESIGN: Qualitative. METHODS: Semi-structured telephone interviews were conducted with 20 participants (twelve men) from nine groups in the Norfolk Diabetes Prevention Study. Interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis in NVivo. RESULTS: Participants benefited from individual change processes, including information provision, structuring and prioritizing health goals, action planning, self-monitoring, and receiving feedback. They also benefited from group processes, including having a common purpose, sharing experiences, making social comparisons, monitoring and accountability, and providing and receiving social support in the groups. Participants' engagement with, and benefits from, the groups were enhanced when there was a supportive group context (i.e., group cohesion, homogeneous group composition, and a positive group atmosphere). Optimal facilitation to develop an appropriate group context and initiate effective change processes necessitated good facilitator interpersonal and professional skills, credibility and empathy, and effective group facilitation methods. Participants reported developing a sense of responsibility and making behaviour changes that resulted in improvements in health outcomes and weight loss. CONCLUSIONS: This study highlights the role of individual and group processes in facilitating health-promoting behaviour change, and the importance of group context and optimal facilitation in promoting engagement with the programme. Statement of contribution What is already known on this subject? Many health interventions, including programmes to help prevent or manage diabetes and facilitate weight loss, are delivered in groups. Such group-based behaviour-change interventions are often effective in facilitating psychological and behaviour change. There is considerable research and theory on individual change processes and techniques, but less is known about which change processes and techniques facilitate behaviour change in group settings. What does this study add? This study contributes to our understanding of how participating in group-based health programmes may enhance or impede individual behaviour change. It identified individual (intrapersonal) and group (interpersonal, facilitated through group interaction) change processes that were valued by group participants. The findings also show how these change processes may be affected by the group context. A diagram summarizes the identified themes helping to understand interactions between these key processes occurring in groups. The study offers an insight into participants' views on, and experiences of, attending a group-based diabetes prevention and management programme. Thus, it helps better understand how the intervention might have helped them (or not) and what processes may have influenced intervention outcomes. Key practical recommendations for designing and delivering group-based behaviour-change interventions are presented, which may be used to improve future group-based health interventions.


Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Mellitus Tipo 2/terapia , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Avaliação de Programas e Projetos de Saúde/métodos , Grupos de Autoajuda , Dieta , Inglaterra , Exercício , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Apoio Social
17.
MCN Am J Matern Child Nurs ; 44(4): 228-233, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31261300

RESUMO

PURPOSE: The purpose of this study was to explore experiences of women currently with or at high risk for developing postpartum depression (PPD) who were participating in a postpartum support group facilitated by mental health providers. STUDY DESIGN AND METHODS: Using a qualitative design, women ≥18 years of age, who had given birth within the past 2 years, and who were currently attending, or had attended the PPD support group within the past year were invited to participate. The women provided demographic data and participated in a semistructured face-to-face interview. Data were analyzed using qualitative content analysis. RESULTS: Seven women between 27 and 38 years of age participated. Most were married and college educated. At time of the interviews, participants were between 5 months and 2 years postpartum and all reported taking antidepressant medications for their symptoms. Qualitative content analysis revealed three overall themes: attendance, impact, and medication adherence, with associated subthemes. CLINICAL IMPLICATIONS: Women attending a PPD support group facilitated by mental health providers felt supported, were more likely to disclose their symptoms to other women in the same situation, and were able to share their feelings without fear of judgment. Having concerns about antidepressant medication addressed at each meeting promoted medication adherence. Nurses working with childbearing women should be aware of community support services available for women at risk for developing PPD.


Assuntos
Depressão Pós-Parto/diagnóstico , Mães/psicologia , Grupos de Autoajuda , Adulto , Depressão Pós-Parto/epidemiologia , Feminino , Pessoal de Saúde , Humanos , Entrevistas como Assunto/métodos , Serviços de Saúde Mental , Mães/estatística & dados numéricos , Pesquisa Qualitativa , Fatores de Risco , Apoio Social
18.
BMC Public Health ; 19(1): 993, 2019 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-31340787

RESUMO

BACKGROUND: Breastfeeding has important positive long-term health consequences for infants and mothers. The World Health Organization recommends that all infants should be exclusively breastfed for six months or longer, and advises continuation of breastfeeding for two years or beyond. However, these recommendations are not met in many countries. This study examined whether a comprehensive, evidence-based breastfeeding intervention, the Breastfeeding Support Programme (BSP), promotes prolonged duration and exclusivity of breastfeeding among its participants. METHODS: A quasi-experimental design was used to compare breastfeeding duration and exclusivity in the BSP group (N = 66) to breastfeeding duration and exclusivity in a control group (N = 72). Participants who followed the BSP were provided with 6 consults delivered by a lactation consultant. The consults started during pregnancy and continued up until 10 weeks after delivery. Participants in the control group did not follow the BSP. Pretest and posttest questionnaires were administered through the internet. A Cox proportional hazards regression analysis was used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for cessation of any and exclusive breastfeeding, while controlling for differences at baseline. RESULTS: The effect of the BSP on survival rates for any and exclusive breastfeeding were significant while controlling for differences between the two groups at baseline (respectively HR = 0.34, p < .001 [95% CI = 0.18-0.61] and HR = 0.46, p < .001 [95% CI = 0.29-0.72]). Among mothers in the BSP group there was on average 66% less risk of cessation of any breastfeeding and on average 54% less risk of cessation of exclusive breastfeeding at any point in time compared to those in the control group. CONCLUSIONS: The BSP appears to be an effective means to delay cessation of any and exclusive breastfeeding cessation and therefore to increase breastfeeding duration and exclusivity. This is an important finding, because earlier cessation of breastfeeding than desired is a common problem in many countries. Future research into the effectiveness of the BSP could consider random assignment to conditions and test the effectiveness of the intervention in other populations to investigate further whether wide-scale implementation of this intervention could be useful to promote breastfeeding.


Assuntos
Aleitamento Materno/psicologia , Mães/psicologia , Grupos de Autoajuda , Fatores de Tempo , Adulto , Aleitamento Materno/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Ensaios Clínicos Controlados não Aleatórios como Assunto , Gravidez , Avaliação de Programas e Projetos de Saúde , Modelos de Riscos Proporcionais
19.
Rev. pesqui. cuid. fundam. (Online) ; 11(4): 968-975, jul.-set. 2019. il
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1005817

RESUMO

Objetivo: Descrever o desenvolvimento de estratégias educativas utilizadas em um grupo educativo para gestantes. Métodos: Estudo descritivo, desenvolvido em Acarape/CE, no qual foram realizados oito encontros semanais no período de janeiro a março de 2015. Em cada encontro, foram realizadas dinâmicas de apresentação, exposição do tema proposto em forma de diálogo e atividades para fixação do conhecimento. Resultados: As mulheres foram muito receptivas demonstrando interesse e satisfação com as atividades. Algumas informações já eram de conhecimento das participantes e outras precisaram ser mais detalhadas, no intuito de fornecer subsídios para que elas pudessem se auto cuidar e cuidar de seus filhos com mais propriedade. Conclusão: A atividade oportunizou a reunião de primíparas e multíparas, sendo esta vivência recomendada e considerada muito apropriada ao compartilhamento de experiências, ao aprendizado e à promoção do cuidado na gestação e no puerpério


Objective: The study's purpose has been to describe the development of educational strategies used in an educational group for pregnant women. Methods: It is a descriptive study that was carried out during eight weekly meetings over the period from January to March 2015, in Acarape city, Ceará State. At each meeting, were performed dynamics of presentation; exhibition of the proposed theme in dialogues and activities towards the knowledge capturing process. Results: The women were very receptive showing both interest and satisfaction concerning the activities. The women were already aware of some information, nonetheless, other kinds of information needed to be more detailed in order to provide subsidies, so that women could self-care and care for their children in a better way. Conclusion: The activity provided an opportunity to meeting primiparous and multiparous women, and this experience was considered very appropriate to share experiences, and also to learn and promote the care during pregnancy and postpartum period


Objetivo: Describir el desarrollo de estratégias educativas utilizadas en um grupo educativo para mujeres embarazadas. Métodos: Estudio descriptivo, desarrollo en Acarape-Ce, donde se realizaron ocho reuniones semanales en el período de enero a marzo de 2015. En cada encuentro, se realizaron dinámicas de presentación, exposición del tema propuesto en diálogo y actividades para fijación del conocimiento. Resultados: Las mujeres fueran muy receptivas demonstrando interés y satisfacción con las actividades. Algunas informaciones ya eran conocidas por las mujeres y otras necesitaron ser más detalladas, con el fin de proporcionar subsidios para que las mujeres pudieran autocuidarse y cuidar de sus hijos con más propiedad. Conclusión: La actividad oportunizó la reunión de primíparas y multíparas, siendo esta vivencia recomendada y considerada muy apropriada al compartir experiências, al aprendizaje y la promoción del cuidado durante el embarazo y el puerpério


Assuntos
Humanos , Feminino , Gravidez , Cuidado Pré-Natal/métodos , Educação em Saúde/métodos , Serviços de Saúde Materno-Infantil , Cuidado Pré-Natal/tendências , Grupos de Autoajuda , Educação em Saúde/tendências , Promoção da Saúde
20.
BMC Public Health ; 19(1): 725, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31182064

RESUMO

BACKGROUND: Depression, the world's leading cause of disability, disproportionately affects women. Women in India, one of the most gender unequal countries worldwide, face systemic gender disadvantage that significantly increases the risk of common mental disorders. This study's objective was to examine the factors influencing women's participation in psychosocial support groups, within an approach where community members work together to collectively strengthen their community's mental health. METHODS: This community-based qualitative study was conducted from May to July 2016, across three peri-urban sites in Dehradun district, Uttarakhand, Northern India. Set within an NGO-run mental health project, data were collected through focus group discussions with individuals involved in psychosocial support groups including women with psychosocial disabilities as well as caregivers (N = 10, representing 59 women), and key informant interviews (N = 8) with community members and mental health professionals. Data were analyzed using a thematic analysis approach. RESULTS: The principal barrier to participating in psychosocial support groups was restrictions on women's freedom of movement. Women in the community are not normally permitted to leave home, unless going to market or work, making it difficult for women to leave their home to participate in the groups. The restrictions emanated from the overall community's attitude toward gender relations, the women's own internalized gender expectations, and most significantly, the decision-making power of husbands and mothers-in-law. Other factors including employment and education shaped women's ability to participate in psychosocial support groups; however, the role of these additional factors must be understood in connection to a gender order limiting women's freedom of movement. CONCLUSIONS: Mental health access and gender inequality are inseparable in the context of Northern India, and women's mental health cannot be addressed without first addressing underlying gender relations. Community-based mental health programs are an effective tool and can be used to strengthen communities collectively; however, attention towards the gender constraints that restrict women's freedom of movement and their ability to access care is required. To our knowledge, this is the first study to clearly document and analyze the connection between access to community mental health services in South Asia and women's freedom of movement.


Assuntos
Serviços Comunitários de Saúde Mental/estatística & dados numéricos , Liberdade , Relações Interpessoais , Participação do Paciente/psicologia , Participação Social/psicologia , Adulto , Ásia , Atitude , Tomada de Decisões , Depressão/psicologia , Emprego/psicologia , Família , Feminino , Grupos Focais , Identidade de Gênero , Humanos , Índia , Transtornos Mentais/psicologia , Saúde Mental , Pesquisa Qualitativa , Grupos de Autoajuda , Cônjuges , Saúde da Mulher
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