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1.
BMC Public Health ; 19(1): 1487, 2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31703655

RESUMO

BACKGROUND: Healthcare services are being increasingly digitalised in European countries. However, in studies evaluating digital health technology, some people are less likely to participate than others, e.g. those who are older, those with a lower level of education and those with poorer digital skills. Such non-participation in research - deriving from the processes of non-recruitment of targeted individuals and self-selection - can be a driver of old-age exclusion from new digital health technologies. We aim to introduce, discuss and test an instrument to measure non-participation in digital health studies, in particular, the process of self-selection. METHODS: Based on a review of the relevant literature, we designed an instrument - the NPART survey questionnaire - for the analysis of self-selection, covering five thematic areas: socioeconomic factors, self-rated health and subjective overall quality of life, social participation, time resources, and digital skills and use of technology. The instrument was piloted on 70 older study persons in Sweden, approached during the recruitment process for a trial study. RESULTS: Results indicated that participants, as compared to decliners, were on average slightly younger and more educated, and reported better memory, higher social participation, and higher familiarity with and greater use of digital technologies. Overall, the survey questionnaire was able to discriminate between participants and decliners on the key aspects investigated, along the lines of the relevant literature. CONCLUSIONS: The NPART survey questionnaire can be applied to characterise non-participation in digital health research, in particular, the process of self-selection. It helps to identify underrepresented groups and their needs. Data generated from such an investigation, combined with hospital registry data on non-recruitment, allows for the implementation of improved sampling strategies, e.g. focused recruitment of underrepresented groups, and for the post hoc adjustment of results generated from biased samples, e.g. weighting procedures.


Assuntos
Participação da Comunidade/estatística & dados numéricos , Pesquisa sobre Serviços de Saúde/estatística & dados numéricos , Sujeitos da Pesquisa/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Participação da Comunidade/psicologia , Metodologias Computacionais , Feminino , Humanos , Masculino , Qualidade de Vida , Sujeitos da Pesquisa/psicologia , Participação Social , Fatores Socioeconômicos , Inquéritos e Questionários , Suécia
3.
Clin Interv Aging ; 14: 1615-1630, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31571842

RESUMO

Objective: Support after a diagnosis of dementia may facilitate better adjustment and ongoing management of symptoms. The aim of the Promoting Independence in Dementia (PRIDE) study was to develop a postdiagnostic social intervention to help people live as well and as independently as possible. The intervention facilitates engagement in evidence-based stimulating cognitive, physical and social activities. Methods: Theories to promote adjustment to a dementia diagnosis, including theories of social learning and self-efficacy, were reviewed alongside self-management and the selective optimization model, to form the basis of the intervention. Analyses of two longitudinal databases of older adults, and qualitative analyses of interviews of older people, people with dementia, and their carers about their experiences of dementia, informed the content and focus of the intervention. Consensus expert review involving stakeholders was conducted to synthesize key components. Participants were sourced from the British NHS, voluntary services, and patient and public involvement groups. A tailored manual-based intervention was developed with the aim for this to be delivered by an intervention provider. Results: Evidence-based stimulating cognitive, physical, and social activities that have been shown to benefit people were key components of the proposed PRIDE intervention. Thirty-two participants including people with dementia (n=4), carers (n=11), dementia advisers (n=14), and older people (n=3) provided feedback on the drafts of the intervention and manual. Seven topics for activities were included (eg, "making decisions" and "getting your message across"). The manual outlines delivery of the intervention over three sessions where personalized profiles and plans for up to three activities are developed, implemented, and reviewed. Conclusion: A manualized intervention was constructed based on robust methodology and found to be acceptable to participants. Consultations with stakeholders played a key role in shaping the manualized PRIDE intervention and its delivery. Unlike most social interventions for dementia, the target audience for our intervention is the people with dementia themselves.


Assuntos
Demência/psicologia , Vida Independente , Apoio Social , Adaptação Psicológica , Idoso , Idoso de 80 Anos ou mais , Cuidadores , Consenso , Demência/diagnóstico , Medicina Baseada em Evidências , Exercício , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Desenvolvimento de Programas , Autoeficácia , Participação Social , Participação dos Interessados
4.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(5): 1360-1367, out.-dez. 2019. il
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1022105

RESUMO

Objective: This study aimed at identifying the elements of the Ecological Model by analyzing scientific publications on social participation in health and the role of nursing. Methods: This integrative literature review was carried out in June 2017. The articles were selected using pre-established inclusion and exclusion criteria, obtaining 19 studies for synthesis. Results: Individual, organizational and environmental elements of the Ecological Model were highlighted, allowing the identification of social participation in health and the role of nursing through ecological thinking, environmental and health awareness, and changes in behaviors and lifestyles. These actions were promoted by the community's involvement, health institutions, universities, and health professionals. Conclusion: Nursing professionals should encourage social participation, decision making towards the care service, and the implementation of public policies, then promoting public awareness


Objetivo: Estudo com objetivo de identificar os elementos do modelo ecológico na análise da produção científica acerca da participação social na saúde e o papel da enfermagem. Métodos: revisão integrativa realizada em junho de 2017, os artigos foram selecionados por meio de critérios de inclusão e exclusão pré-estabelecidos, obtendo-se 19 estudos para síntese. Resultados: evidenciaram-se elementos individuais, organizacionais e ambientais do Modelo Ecológico, possibilitando a identificação da participação social na saúde e o papel da enfermagem, por meio do pensamento ecológico, conscientização ambiental e de saúde, mudanças de comportamentos e estilos de vida, além do envolvimento da comunidade, instituições de saúde, universidades e profissionais de saúde nessa promoção. Conclusão: a Enfermagem deve incentivar a participação social, tomada de decisões de cuidados e implementação de políticas públicas, promovendo a conscientização


Objetivo: Estudio con el objetivo de identificar los elementos del modelo ecológico en el análisis de la producción científica acerca de la participación social en la salud y el papel de la enfermería. Métodos: la revisión integrativa realizada en junio de 2017, los artículos fueron seleccionados por medio de criterios de inclusión y exclusión preestablecidos, obteniéndose 19 estudios para síntesis. Resultados: se evidenciaron elementos individuales, organizacionales y ambientales del Modelo Ecológico, posibilitando la identificación de la participación social en la salud y el papel de la enfermería, por medio del pensamiento ecológico, concientización ambiental y de salud, cambios de comportamientos y estilos de vida, además de la participación de la comunidad, instituciones de salud, universidades y profesionales de la salud en esta promoción. Conclusión: la Enfermería debe incentivar la participación social, la toma de decisiones de cuidados y la implementación de políticas públicas, promoviendo la concientización


Assuntos
Humanos , Enfermagem/tendências , Ecossistema , Participação Social , Meio Ambiente , Política Ambiental
5.
Muscle Nerve ; 60(6): 724-731, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31531865

RESUMO

INTRODUCTION: There is currently little evidence regarding oculopharyngeal muscular dystrophy (OPMD) disease burden reported by patients. In this study we aim to elicit direct patient input regarding OPMD disease burden. METHODS: We conducted semistructured interviews with 25 participants with genetically confirmed OPMD and a wide range of disease duration (15 ± 8 years). Using the Framework Technique, themes and categories were then extracted. RESULTS: Analyses revealed 7 themes (physical impact, mental impact, social impact, perception of progression, treatment perceptions, coping strategies, and access to disease information), encompassing 27 categories of OPMD disease burden. The most frequent categories were related to dysphagia, coping strategies for dysphagia, and impaired mobility. DISCUSSION: This study demonstrates the importance of considering, when providing clinical care, the broad range of coping strategies patients use to deal with OPMD symptoms, especially dysphagia, to properly assess limitations and monitor real disease progression.


Assuntos
Distrofia Muscular Oculofaríngea/fisiopatologia , Distrofia Muscular Oculofaríngea/psicologia , Acesso à Informação , Adaptação Psicológica , Adolescente , Adulto , Idoso , Atitude Frente a Saúde , Transtornos Dismórficos Corporais , Criança , Efeitos Psicossociais da Doença , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/fisiopatologia , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Limitação da Mobilidade , Debilidade Muscular/etiologia , Debilidade Muscular/fisiopatologia , Distrofia Muscular Oculofaríngea/complicações , Distrofia Muscular Oculofaríngea/terapia , Dor/etiologia , Dor/fisiopatologia , Medidas de Resultados Relatados pelo Paciente , Pesquisa Qualitativa , Participação Social , Distúrbios da Voz/etiologia , Distúrbios da Voz/fisiopatologia , Desempenho Profissional , Adulto Jovem
6.
Artigo em Inglês | MEDLINE | ID: mdl-31480606

RESUMO

Ecological preservation and sustainable development depend on active public involvement. The emergence of online environmental communities greatly facilitates people's participation in green endeavors. The population penetration of such platforms accelerates as existing users persuade people around them and media coverage further attracts public attention. This snowball effect plays an important role in the user base expansion, but the specific mechanism of social influence involved is yet to be examined. Based on the social influence theory, cognitive response theory, and elaboration likelihood model, this study establishes a research model depicting the relationship between persuasion in terms of social influence and outcomes in terms of behavioral intention and actual participation through the mediation of cognitive responses in terms of perceived value and perceived risk. Empirical results from survey observations show that social influence has both moderated (by education) and mediated (through perceived risk) effects on behavioral intention, which leads to actual participation. Meanwhile, social influence shapes the perceived value, which has a direct and strong impact on actual participation. These central and peripheral routes through which social influence affects individual participation yield useful theoretical and practical implications on human behavior with online environmental communities.


Assuntos
Comportamento de Massa , Redes Sociais Online , Facilitação Social , Participação Social , Desenvolvimento Sustentável , Adolescente , Adulto , Comunicação , Feminino , Humanos , Intenção , Masculino , Pessoa de Meia-Idade , Comunicação Persuasiva , Probabilidade , Inquéritos e Questionários , Adulto Jovem
7.
Am J Occup Ther ; 73(5): 7305205030p1-7305205030p18, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31484027

RESUMO

IMPORTANCE: Developed in California to enable community-dwelling older adults to maintain healthy and meaningful activities, Lifestyle Redesign® is a well-known cost-effective preventive occupational therapy intervention. The impact of a newly adapted French version on older French-Canadians was, however, unknown. OBJECTIVE: To explore the influence of Lifestyle Redesign on older French-Canadians' health, social participation, leisure, and mobility. DESIGN: A mixed-methods design included a preexperimental component (questionnaires administered before and after the intervention and 3 and 6 mo postintervention) and an exploratory descriptive qualitative clinical study. Individual semidirected interviews were digitally audiotaped and transcribed, then underwent thematic content analysis using mix extraction grids. SETTING: Community. PARTICIPANTS: Sixteen volunteers (10 women) aged 65-90 yr (mean = 76.4, standard deviation = 7.6), 10 without and 6 with disabilities. Inclusion criteria were age ≥65 yr, normal cognitive functions, residence in a conventional or senior home, and French speaking. INTERVENTION: French-Canadian 6-mo version of Lifestyle Redesign. OUTCOMES AND MEASURES: Health, social participation, leisure, and mobility were measured using the 36-item Short Form Health Survey, Social Participation Scale, Leisure Profile, and Life-Space Assessment, as well as a semistructured interview guide. RESULTS: The French-Canadian Lifestyle Redesign had a beneficial effect on participants' mental health (p = .02) and interest in leisure (p = .02) and, in those with disabilities, social participation (p = .03) and attitudes toward leisure (p = .04). Participants reported positive effects on their mental health, leisure, mobility, and social participation, including frequency and quality of social interactions, and indicated that having an occupational routine fostered better health. None of the participants reported no effect. CONCLUSION AND RELEVANCE: The translated and culturally adapted Lifestyle Redesign is a promising occupational therapy intervention for community-dwelling older French-Canadians. WHAT THIS ARTICLE ADDS: This study sheds light on the influence of the French-Canadian version of the intervention not only on older adults' health and social participation but also on their leisure activities and life-space mobility, two important outcomes not addressed in previous Lifestyle Redesign studies. Moreover, this study provides an in-depth understanding of the Lifestyle Redesign experience of French-Canadian older adults with and without disabilities, including participants with significant communication and mobility disabilities.


Assuntos
Atividades de Lazer , Participação Social , Idoso , Idoso de 80 Anos ou mais , California , Canadá , Feminino , Humanos , Estilo de Vida
8.
Bull World Health Organ ; 97(8): 570-574, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31384075

RESUMO

Problem: The measures for long-term care prevention that the Japanese government had introduced in 2006 were unsuccessful because of the failures to identify high-risk individuals and to enrol enough participants in the community prevention programme. Approach: The Japanese government shifted its primary strategy from a high-risk strategy to a community-based population strategy in 2015, by reforming the Long-term Care Insurance Act. This act is focusing on community-based care and social determinants of health. The Act and the government's plans for long-term care prevention are inspired by a social participation intervention called ikoino saron, that is gathering salons for people older than 65 years. These salons, managed by local volunteers, are held once or twice a month in communal spaces within walking distance of community members' homes and have a low participation fee. At the gatherings, older people can meet and interact with others through enjoyable, relaxing and sometimes educational programmes. Local setting: Japan has the world's largest ageing population, with 27.7% (35.2 million/126.7 million) of people older than 65 years. Relevant changes: Studies have shown that participation in the salons was associated with a halved incidence in long-term care needs and about one-third reduction in the risk of dementia onset. Evidence also suggests that financially vulnerable older adults were more likely to participate in such interventions. In 2017, 86.5% (1506/1741) of the Japanese municipalities had implemented the salons. Lessons learnt: Integrated care for long-term care prevention should consider interventions targeting the whole community in addition to high-risk individuals.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Promoção da Saúde/organização & administração , Envelhecimento Saudável , Participação Social , Idoso , Idoso de 80 Anos ou mais , Demência/prevenção & controle , Feminino , Humanos , Japão/epidemiologia , Assistência de Longa Duração/organização & administração , Masculino , Determinantes Sociais da Saúde
9.
BMC Public Health ; 19(1): 1124, 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31420061

RESUMO

BACKGROUND: Social participation is a modifiable health determinant influenced by physical and social aspects of the environment. Little is known about aging women's and men's community activities and barriers according to region and population size. This study compared social participation, desire to participate more, and perceived barriers of aging women and men by Canadian region and population size. METHODS: A secondary analysis of the 2008-2009 cross-sectional Canadian Community Health Survey - Healthy Aging was done with 16,274 respondents aged 65+. Respondents were grouped into five regions [Atlantic, Quebec, Ontario, Prairies and British Columbia] and five population size groups [rural (< 1000 inhabitants); small urban (1000-29,999); medium urban (30,000-99,999); large urban (100,000-499,999); and metropolitan (≥500,000) areas]. Social participation was estimated by monthly frequencies of engagement in community activities. If they desired to participate more, respondents were asked to identify barriers to their participation from a list of 13 reasons. RESULTS: There were no differences in total social participation between regions but Prairies and Quebec respondents had the highest and lowest frequency, respectively, of activities with family and friends (5.4 and 4.3 activities/month; p = 0.01). Medium urban centers had the highest participation and metropolises, the lowest (17.4 vs 14.3 activities/month; p < 0.01). About one fourth of all respondents wanted to participate more, regardless of region or population size. Overall, women wanted to participate more than men (26.6 vs 20.7%; p < 0.001), especially in Ontario (28.3 vs 21.1%; p < 0.001) and British Columbia (30.1 vs 22.9%; p < 0.001). Men in Quebec were less likely than men in other regions to report "personal responsibilities" as a barrier to participation (p < 0.001). Men were more likely than women to report being "too busy", especially in rural areas (27.1 vs 6.5%; p < 0.001). Rural women were more likely than rural men to be constrained by transportation problems (15.1 vs 1.2%, p < 0.001). Unavailability of activities was more of a constraint in rural areas than metropolises (13.6 vs 6.0%, p < 0.001). CONCLUSIONS: Overall, there were no practical differences between women's and men's social participation. However, unavailability of activities and transportation problems suggest that local initiatives and further research on environmental characteristics are required to foster aging Canadians' participation.


Assuntos
Participação da Comunidade/estatística & dados numéricos , Participação Social , Idoso , Canadá , Estudos Transversais , Feminino , Geografia , Inquéritos Epidemiológicos , Humanos , Masculino , Densidade Demográfica , Participação Social/psicologia , Transportes/estatística & dados numéricos
10.
Artigo em Inglês | MEDLINE | ID: mdl-31387307

RESUMO

An important goal of building "age-friendly communities" is to help the elderly to access more opportunities for social participation and better health. However, little is known about the complex relationships between neighborhood environment, social participation, and elderly health. This study examined the mediating role of social participation in the area of neighborhood environment affecting elderly health and explored the discrepancy among different age groups in 43 neighborhoods of Shanghai. Both neighborhood environment and social participation had significant positive effects on elderly health in all the samples. Meanwhile, social participation served as a mediator of the relationship between interpersonal environment and elderly health. Furthermore, remarkably, health promotion effects transferred from the physical environment to interpersonal environment and social participation with age; the influence of physical environment on elderly health decreased with the increase of age, while the influence of interpersonal environment and social participation on the health of the elderly increased with the increase of age. This study found that physical environment, interpersonal environment, and social participation had different effects on elderly health of different ages. Different policies should be applied toward improving the interpersonal environment, optimizing of physical environment, and guiding the community activities.


Assuntos
Promoção da Saúde , Nível de Saúde , Características de Residência , Participação Social , Idoso , Envelhecimento , China , Estudos Transversais , Meio Ambiente , Feminino , Humanos , Masculino
11.
Sex., salud soc. (Rio J.) ; (32): 90-118, maio-ago. 2019.
Artigo em Português | LILACS | ID: biblio-1020951

RESUMO

Resumo O presente trabalho visa apresentar os resultados de uma pesquisa conduzida no Centro Estadual de Combate à Homofobia de Pernambuco. Através de entrevistas realizadas com membros e ex-membros do órgão, investigo como ele atua para minimizar a violência contra a população LGBT. Com base neste objetivo, analisei o perfil dos profissionais do equipamento, levantei informações a respeito dos serviços ofertados e verifiquei os avanços e os desafios daquela política pública. Parte significativa desses profissionais era de egressos do Movimento LGBT que realizavam atendimento interdisciplinar e atividades formativas e destacaram, como avanços, a aproximação com outros setores públicos, a visibilidade da temática LGBT e o número de atendimentos contabilizados e, como desafios, o contexto LGBTfóbico do território pernambucano, a LGBTfobia institucional e a estrutura insuficiente do Centro.


Abstract This work presents the results of a research completed at the State Center to Combat Homophobia, in Pernambuco (Brazil). Through interviews with members and former members of the staff, I investigate how it acts to minimize violence against the LGBT population and, based on this objective, I analyzed the profile of the equipment's professionals; collected information about the services offered; and checked the advances and challenges of that public policy. A significant number of these professionals originated from the LGBT Movement, performed interdisciplinary care and training activities, who counted as advances their proximity to other public sectors, the visibility of the LGBT theme, and the number of appointments perfomed; and as challenges the LGBTphobic context of Pernambuco, the institutional LGBTophobia and insufficient structure of the Center.


Resumen Este texto tiene como objetivo presentar los resultados de una investigación completada en el Centro Estatal de Lucha contra la Homofobia de Pernambuco. A través de entrevistas con miembros y ex miembros de la institución, investigo cómo actuó dicho Centro para minimizar la violencia contra la población LGBT y, con base a este objetivo, analicé el perfil de los profesionales del equipo, reuní información sobre los servicios ofrecidos y verifiqué los resultados, los avances y los desafíos de esa política pública. Una parte significativa de estos profesionales fueron integrantes del Movimiento LGBT que realizaron actividades interdisciplinares de atención y capacitación; destacaron como avances, el acercamiento con otros sectores públicos, la visibilidad del tema LGBT y el número de atenciones brindadas y, como desafíos, el contexto LGBTfóbico del territorio pernambucano, la LGBTfobia institucional y la insuficiente estructura del Centro.


Assuntos
Humanos , Masculino , Feminino , Adulto , Política Pública , Violência , Brasil , Pesquisa Qualitativa , Participação Social , Homofobia , Minorias Sexuais e de Gênero , Direitos Humanos
12.
Muscle Nerve ; 60(4): 419-424, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31298728

RESUMO

INTRODUCTION: Limb-girdle muscular dystrophy (LGMD) consists of over 30 genetic conditions with varying clinical phenotypes primarily affecting pelvic girdle, shoulder girdle, and other proximal limb muscles. Studies focusing on the physical, mental, and social effects of this disease from the patient's perspective are limited. METHODS: Adults with LGMD were interviewed and asked to identify issues that have the greatest impact on their quality of life. Each interview was recorded, transcribed, coded, and analyzed. RESULTS: Participants provided 1385 direct quotes. One hundred sixty-five potential symptoms of importance were identified and grouped into 15 larger themes. The most frequently reported themes included limitations with mobility, difficulty performing activities, social role limitations, and emotional distress. DISCUSSION: There are multiple symptoms that alter the lives of adults with LGMD. These affect their physical, emotional, and social health, and may be amenable to medical intervention.


Assuntos
Atividades Cotidianas , Limitação da Mobilidade , Distrofia Muscular do Cíngulo dos Membros/fisiopatologia , Distrofia Muscular do Cíngulo dos Membros/psicologia , Participação Social , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Papel (figurativo) , Adulto Jovem
13.
Br J Nurs ; 28(13): 899, 2019 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-31303041

RESUMO

Sam Foster, Chief Nurse, Oxford University Hospitals, considers what acute services can learn from social care and community models for patient-centred, personalised care.


Assuntos
Participação Social , Medicina Estatal , Inglaterra , Humanos , Assistência Centrada no Paciente , Medicina de Precisão
14.
Folia Med (Plovdiv) ; 61(2): 213-222, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31301654

RESUMO

BACKGROUND: Health-related quality of life (HRQoL) is a parameter that is examined in the area of clinical effectiveness. Like other chronic health conditions, paediatric cystic fibrosis (CF) impacts not only children but also their families. AIM: The present study investigates for the first time the HRQoL of children and parents in the Republic of North Macedonia. MATERIALS AND METHODS: The survey included 22 children (6 to 13 years of age) and their parents and 7 parents of children under 6 years of age by using the CFQ Revised and questions for current medical treatment. RESULTS: Children (6-13 years) reported the highest score for the digestive condition (84.85), while the lowest score was given for social activity (59.74). The highest score for digestive condition was also obtained from the parents of children from 6-13 years and under age of 6. The parents of children (6-13 years) reported the lowest score (60.56) for treatment burden activity, while the lowest score (50.0) for eating condition was obtained from the parents of children under 6 years. CONCLUSION: Nationality and gender have no significant impact on the HRQoL parameters. The highest scores for the digestive condition, respiratory function and physical condition are in a positive correlation with the fact that enzyme, antibiotic and physical therapy are given as a standard medical care. The lowest scores of the social aspect of the CF patients indicate the need for including a psychological support and support of social workers as a part of the standard medical care of these patients.


Assuntos
Fibrose Cística/fisiopatologia , Fibrose Cística/psicologia , Pais , Qualidade de Vida , Adolescente , Imagem Corporal , Criança , Efeitos Psicossociais da Doença , Fibrose Cística/complicações , Fibrose Cística/terapia , Doenças do Sistema Digestório/etiologia , Doenças do Sistema Digestório/fisiopatologia , Doenças do Sistema Digestório/psicologia , Comportamento Alimentar , Feminino , Humanos , Masculino , Doenças Respiratórias/etiologia , Doenças Respiratórias/fisiopatologia , Doenças Respiratórias/psicologia , Participação Social
15.
Neurology ; 93(5): e508-e517, 2019 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-31270220

RESUMO

OBJECTIVE: To evaluate changes from baseline in patient-reported outcomes for measures of functioning and disability among patients with migraine treated with galcanezumab or placebo. METHODS: Patients with episodic migraine (4-14 monthly migraine headache days) were treated with either galcanezumab (Evaluation of LY2951742 in the Prevention of Episodic Migraine [EVOLVE]-1: 120 mg n = 210, 240 mg n = 208; EVOLVE-2: 120 mg n = 226, 240 mg n = 220) or placebo (EVOLVE-1 n = 425; EVOLVE-2 n = 450) during 6 months of treatment. Migraine-Specific Quality of Life Questionnaire v2.1 (MSQv2.1) measured the effect of migraine on patient functioning (physical and emotional) in 3 domains, and the Migraine Disability Assessment (MIDAS) quantified headache-related disability associated with missed or reduced productivity at work or home and social events. Both were collected at baseline and during the treatment period (MSQv2.1 = monthly; MIDAS = months 3 and 6 only). RESULTS: Differences in MSQv2.1 total score least squares (LS) mean change from baseline (month 4-6) for galcanezumab (120 and 240 mg, respectively) were superior to placebo (EVOLVE-1 = 7.3 and 6.7 [both p < 0.001]; EVOLVE-2 = 8.5 and 7.3 [both p < 0.001]). Differences were similar for all domain scores (p < 0.001 for both galcanezumab doses compared with placebo), were observed as early as month 1, and were sustained for 6 months for most domains. Differences of MIDAS LS mean change from baseline (month 6) for galcanezumab (120 and 240 mg, respectively) compared with placebo were: EVOLVE-1 = -6.3 (p < 0.001) and -5.2 (p = 0.002); EVOLVE-2 = -9.2 and -8.2 (both p < 0.001). CONCLUSIONS: Patients with episodic migraine treated with galcanezumab reported significant and clinically meaningful improvements in daily functioning and decreased disability compared with patients who received placebo. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that for patients with migraine, galcanezumab (120 mg or 240 mg) given once monthly improved functioning and reduced disability.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Eficiência , Transtornos de Enxaqueca/tratamento farmacológico , Qualidade de Vida , Licença Médica , Participação Social , Adulto , Efeitos Psicossociais da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
16.
Trials ; 20(1): 411, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288846

RESUMO

BACKGROUND: Acquired joint contractures have a significant impact on functioning and quality of life in nursing home residents. There is very limited evidence on measures for prevention and treatment of disability due to joint contractures. We have developed the PECAN intervention (Participation Enabling CAre in Nursing) to improve social participation in nursing home residents. A cluster-randomised pilot trial was conducted to assess the feasibility of study procedures in preparation for a main trial according to the UK Medical Research Council (MRC) framework. METHODS: Nursing homes in two regions of Germany were randomly allocated either to the intervention or optimised standard care (control group). All residents with joint contractures aged > 65 years were eligible for the study. The residents' data were collected through structured face-to-face interviews by blinded assessors at baseline, after 3 and 6 months. The primary outcome was social participation, measured by a subscale of the PaArticular Scales. Secondary outcomes included activities and instrumental activities of daily living, health-related quality of life, falls and fall-related consequences. Data on the trial feasibility were collected via documentation forms. RESULTS: Seven out of 12 nursing homes agreed to participate and remained in the trial. Of 265 residents who fulfilled the inclusion criteria, 129 were randomised either to the intervention (n = 64) or control group (n = 65) and analysed. A total of 109 (85%) completed the trial after 6 months. The mean age was 85.7 years (SD 7.0), 80% were women. The severity of the residents' disability differed across the clusters. The completion rate was high (> 95%), apart from the Instrumental Activities of Daily Living Scale. Some items of the PaArticular Scales were not easily understood by residents. The frequency of falls did not differ between study groups. CONCLUSION: Our data confirmed the feasibility of the overall study design. We also revealed the need to improve the procedures for the recruitment of residents and for data collection before implementation into a main trial. The next step will be an adequately powered main trial to assess the effectiveness and cost-effectiveness of the intervention. TRIAL REGISTRATION: German clinical trials register, ID: DRKS00010037 . Registered on 12 February 2016.


Assuntos
Contratura/terapia , Instituição de Longa Permanência para Idosos , Articulações/fisiopatologia , Casas de Saúde , Participação Social , Acidentes por Quedas/prevenção & controle , Atividades Cotidianas , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/psicologia , Contratura/diagnóstico , Contratura/fisiopatologia , Contratura/psicologia , Estudos de Viabilidade , Feminino , Avaliação Geriátrica , Alemanha , Humanos , Masculino , Projetos Piloto , Qualidade de Vida , Fatores de Tempo , Resultado do Tratamento
17.
Torture ; 29(1): 97-109, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31264819

RESUMO

INTRODUCTION: Whilst there is some preliminary evidence for the benefits of sports-related interventions for survivors of torture, how sport and exercise can contribute to the rehabilitation of torture survivors needs to be better understood. Specifically, this paper aims to: 1) explore the ways in which a football group contributed to the wellbeing of participants and; 2) suggest characteristics of the football group which could potentially contribute to its effectiveness. METHODS: An exploratory mixed methods study was undertaken with participants and trainers of a joint programme delivered by Arsenal Football Club and Freedom from Torture in London. Individual discussions, group discussions and participatory ranking activities were used which led to the development of an initial programme model. This model was, subsequently, further developed through a variety of data collection methods. RESULTS: Six potential outcomes of involvement in the football group were identified: relationships, a sense of belonging, hope for the future, emotion management, enjoyment, and improved physical health. In addition, the process highlighted factors contributing to the effectiveness of the football group: a sense of safety, therapeutic aims, similar participants, a partnership approach, staff characteristics, other opportunities, and consistency in terms of approach, session content and staff. CONCLUSIONS: This exploratory study outlines the potential benefits of the football programme that would require further validation through a case-control study and participant follow-up. A model is put forward as well as a number of recommendations that serve as a starting point for similar programmes and guides academic research in the area.


Assuntos
Refugiados , Futebol , Sobreviventes , Tortura , Adulto , República Democrática do Congo/etnologia , Amigos , Humanos , Masculino , Pessoa de Meia-Idade , Prazer , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Autogestão , Participação Social , Reino Unido , Adulto Jovem
18.
Cien Saude Colet ; 24(6): 2065-2074, 2019 Jun 27.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31269165

RESUMO

The Social Participation in Health has been consolidated in the Unified Health System through the efforts of the Municipal, State, National Councils and Health Conferences. The division into municipalities isconstitutionally prohibited in the Federal District and, therefore, there is a District Health Council and the Regional Health Councils. The aim was to describe the profile of the Federal District Health Council, analyzing its actions in Primary Health Care from 2016 to 2018. This was a qualitative case study, with documentary collection using the Iramuteq software. A statistical report of the Health Council Monitoring System and public minutes of the Federal District Health Council were collected, dispensing with approval by the Ethics Committee. The Federal District Health Council is in agreement to what was stated in Resolution 453/2012 of the National Health Council. We analyzed 43 minutes, generating two categories and five classes. It was concluded that the Federal District Health Council originated the reform of Primary Health Care during the study period, through the publication of a resolution that established guidelines for the reorganization of the primary care level.


Assuntos
Reforma dos Serviços de Saúde , Programas Nacionais de Saúde/organização & administração , Atenção Primária à Saúde/organização & administração , Participação Social , Brasil , Assistência à Saúde/organização & administração , Guias como Assunto , Humanos
19.
Artigo em Inglês | MEDLINE | ID: mdl-31288464

RESUMO

We analyzed the relationships between forgetfulness and social participation, social contact, and social support by municipality to develop community diagnosing indicators. The analysis subjects included 105 municipalities that agreed to provide data for the 2013 Survey of Needs in Spheres of Daily Life in Japan (n = 338,659 people). Forgetfulness as a risk factor for dementia was used as the dependent variable. The variables of social environment factors were (1) social participation, (2) social contact, and (3) social support. The ratio of people responding that they experienced forgetfulness differed among municipalities, with a mean of 19.0% (7.1-35.6%). Higher levels of social participation, social contact, and social support were associated with lower levels of forgetfulness, even after adjusting for age and regional variables. The results of the present study suggest that it is appropriate to use forgetfulness and social participation at least a few times a year in any social activity as community diagnosing indicators. Municipalities could encourage their inhabitants to participate by developing and providing engaging social activities.


Assuntos
Transtornos Cognitivos , Demência/psicologia , Participação Social , Idoso , Demência/diagnóstico , Feminino , Humanos , Japão , Masculino , Fatores de Risco , Apoio Social , Inquéritos e Questionários
20.
Clin Rehabil ; 33(11): 1705-1712, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31353940

RESUMO

OBJECTIVE: This review aimed to determine the effectiveness of personal smart technologies on outcomes in adults with acquired brain injury. DATA SOURCES: A systematic literature search was conducted on 30 May 2019. Twelve electronic databases, grey literature databases, PROSPERO, reference list and author citations were searched. METHODS: Randomised controlled trials were included if personal smart technology was used to improve independence, goal attainment/function, fatigue or quality of life in adults with acquired brain injury. Data were extracted using a bespoke form and the TIDieR checklist. Studies were graded using the PEDro scale to assess quality of reporting. Meta-analysis was conducted across four studies. RESULTS: Six studies met the inclusion criteria, generating a total of 244 participants. All studies were of high quality (PEDro ⩾ 6). Interventions included personal digital assistant, smartphone app, mobile phone messaging, Neuropage and an iPad. Reporting of intervention tailoring for individual needs was inconsistent. All studies measured goal attainment/function but none measured independence or fatigue. One study (n = 42) reported a significant increase in memory-specific goal attainment (p = 0.0001) and retrospective memory function (p = 0.042) in favour of the intervention. Another study (n = 8) reported a significant increase in social participation in favour of the intervention (p = 0.01). However, our meta-analyses found no significant effect of personal smart technology on goal attainment, cognitive or psychological function. CONCLUSION: At present, there is insufficient evidence to support the clinical benefit of personal smart technologies to improve outcomes in acquired brain injury. Researchers need to conduct more randomised studies to evaluate these interventions and measure their potential effects/harms.


Assuntos
Lesões Encefálicas/reabilitação , Computadores de Mão , Aplicativos Móveis , Metas , Humanos , Memória , Participação Social
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