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Adv Mind Body Med ; 35(1): 9-15, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33513581


Holistic medicine is the art and science of healing that addresses the whole person-body, mind and spirit. It is a broad discipline comprising a wide range of practices aimed at the overall health of the patient. More often than not, holistic medicine takes spirituality into account and incorporates practices like group therapy led by trained therapists. One problem, however, is that the words 'holistic' and 'medicine' are not specific, adding to the general confusion on what holistic medicine is. The aim of this review is to describe holistic medicine as a form of integrative medicine, combining both conventional and alternative medical practices. Furthermore, in light of the heterogeneous definitions and practices found in existing literature, we present arguments on the need for a proper terminology in order to create a system for fully evaluating the patient as a whole, which we call 'holology'.

Saúde Holística , Medicina Integrativa , Terapias Espirituais , Espiritualidade , Humanos
Rev. enferm. UERJ ; 28: e50353, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1122745


Objetivo: estabelecer relações entre os fundamentos Nightingaleanos na sustentabilidade de uma clínica de cuidado humano em diálogo com conceitos que sustentam duas atuais políticas de saúde brasileiras. Conteúdo: a ciência da enfermagem se afirma em uma abordagem holística do ser humano, com vistas à saúde integral, ressaltando a pessoa na sua dimensão física, mental, emocional e espiritual. Este princípio sustenta práticas humanizadas de cuidado e também integrativas, na proposição de cuidados integrais centrados na pessoa e relacionamento terapêutico para promover a saúde e o bem-estar. As fontes principais foram a obra seminal de Nigthingale, teorias de enfermagem, textos aplicados da Política Nacional de Humanização e de Práticas Integrativas e Complementares de Saúde. Conclusão: os princípios básicos do cuidado propostos por Nightingale refletem-se em atuais políticas de saúde, contribuindo para ampliar a autonomia dos profissionais de enfermagem, na oferta de cuidados baseados em conceitos próprios, em favor de uma Enfermagem Integrativa e Humana.

Objective: to establish relations between Nightingale fundamentals on the sustainability of human clinical care in dialogue with concepts underpinning two of Brazil's current health policies. Content: nursing science is grounded on a holistic approach of the human being, with a view to comprehensive health, emphasizing subjects in their physical, mental, emotional and spiritual dimensions. This principle underpins integrative, humanized care practices in proposing comprehensive care centered on the human person and a therapeutic relationship designed to promote health and wellbeing. The main sources were Nightingale's seminal work, nursing theories, and applied texts from Brazil's National Policy of Humanization and Integrative, Complementary Healthcare Practices. Conclusion: The basic health care principles proposed by Nightingale, reflected in current health policies, contribute to expanding the autonomy of nursing personnel in the providing care based on concepts specific to nursing, in favor of Integrative, Human Nursing.

Objetivo: establecer relaciones entre los fundamentos de Nightingale sobre la sostenibilidad de la atención clínica humana en diálogo con los conceptos que sustentan dos de las políticas de salud actuales de Brasil. Contenido: la ciencia de la enfermería se fundamenta en un enfoque holístico del ser humano, con miras a la salud integral, enfatizando los sujetos en sus dimensiones física, mental, emocional y espiritual. Este principio sustenta las prácticas de atención integral y humanizada al proponer una atención integral centrada en la persona humana y una relación terapéutica orientada a promover la salud y el bienestar. Las fuentes principales fueron el trabajo fundamental de Nightingale, las teorías de enfermería y los textos aplicados de la Política Nacional de Humanización y Prácticas de Atención Integrativa y Complementaria de Salud de Brasil. Conclusión: Los principios básicos del cuidado de la salud propuestos por Nightingale, reflejados en las políticas de salud vigentes, contribuyen a ampliar la autonomía del personal de enfermería en la prestación de cuidados basados en conceptos propios de la enfermería, a favor de la Enfermería Integrativa, Humana.

Humanos , Teoria de Enfermagem , Humanização da Assistência , Política de Saúde , Terapias Complementares , Brasil , Padrões de Prática em Enfermagem , Saúde Holística , Cuidados de Enfermagem
J Fam Pract ; 69(10): 493-498, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33348344


Family medicine's leadership in primary care is slipping as it loses its vision of whole-person care. This model of care can help us better manage and combat chronic disease.

Doença Crônica/terapia , Medicina de Família e Comunidade/normas , Saúde Holística/normas , Guias de Prática Clínica como Assunto , Atenção Primária à Saúde/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
PLoS One ; 15(10): e0238605, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33064723


To "put oneself in the place of other road users" may improve understanding of the global traffic situation. It should be useful enabling drivers to anticipate and detect obstacles in time to prevent accidents to other road users, especially those most vulnerable. We created a pioneering Hazard Perception and Prediction test to explore this skill in different road users (pedestrians, cyclists and drivers), with videos recorded in naturalistic scenarios: walking, riding a bicycle and driving a car. There were 79 participants (30 pedestrians, 14 cyclists, 13 novice drivers and 22 experienced drivers). Sixty videos of hazardous traffic situations were presented, divided into 2 blocks of 30 videos each: 10 walking, 10 riding a bicycle, 10 driving a car. In each situation presented, we evaluated the performance of the participants carrying out the task of predicting the hazard and estimating the risk. In the second block, after they had carried out the task, we gave them feedback on their performance and let them see the whole video (i.e., checking what happened next). The results showed that the holistic test had acceptable psychometric properties (Cronbach's alpha = .846). The test was able to discriminate between the different conditions manipulated: a) between traffic hazards recorded from different perspectives: walking, riding a bicycle and driving a car; b) between participants with different user profiles: pedestrians, cyclists and drivers; c) between the two test blocks: the first evaluation only and the second combining evaluation with this complex intervention. We found modal bias effects in both Hazard Perception and Prediction; and in Risk Estimation.

Acidentes de Trânsito/prevenção & controle , Acidentes de Trânsito/psicologia , Condução de Veículo/psicologia , Ciclismo/psicologia , Caminhada/psicologia , Prevenção de Acidentes/métodos , Adolescente , Adulto , Conscientização , Comportamento Perigoso , Feminino , Saúde Holística , Humanos , Masculino , Pessoa de Meia-Idade , Pedestres/psicologia , Adulto Jovem
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(9): 852-857, 2020 Sep 25.
Artigo em Chinês | MEDLINE | ID: mdl-32927508


Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the digestive tract. Although GIST has only been recognized as a separate entity for several decades, management strategies for GIST have changed dramatically over time. Advances in treatment have yielded dramatic successes in improving prognosis of patients with GIST. However, the meaningful progress also brings escalating social and economic burdens. There is a long distance between technological breakthroughs and its real benefits of society. Due to the rapid development in a short period, successful experience in disease diagnosis and treatment and the accompanying problems have appeared in a more concentrated and obvious manner. Any medical science exploration and practice initially aim to have the essence of humanism. As practitioners of medical technology, doctors should treat patients as a whole "human" in the process of diagnosis and treatment instead of just focusing on the technology itself. Moreover, doctors should comprehensively consider patients' physical, psychological and social attributes, pay attention to their physical, mental and social needs, find and try to solve problems, so as to promote the developement of medical science in the correct direction.

Neoplasias Gastrointestinais/diagnóstico , Neoplasias Gastrointestinais/terapia , Tumores do Estroma Gastrointestinal/diagnóstico , Tumores do Estroma Gastrointestinal/terapia , Saúde Holística , Humanos , Invenções , Assistência ao Paciente/métodos , Prognóstico
Rev. bras. ativ. fís. saúde ; 25: 1-9, set. 2020. fig
Artigo em Inglês | LILACS | ID: biblio-1129587


The Academia da Saúde programme has been considered an important health promotion strategy in the scope of primary health care in Brazil. However, there is little evidence on what and how professional practices have been developed as a means to enact health promotion processes in the programme. The study ́s purpose was to analyse the health promotion work in a Academia da Saúde programme ́s unit from Lajeado city, Brazil. The study employed a qualitative approach and grounded theory research method. Participants included a female Health and Physical Education professional (aged 32y), a female health centre coordinator (aged 41y) and eight users (2 men, 6 women, aged 30-69y). Data were collected through condensed fieldwork, involving interviews and non-participant observation of group sessions. Using salutonegesis theory, qualitative analysis generated key findings on the elements of the health promotion work, namely: holistic care, use of diversification into cognitive, psychosocial and physical activities, development of skills and capacities that served as health resources, and the occurrence of resistance and challenges in the programme. Furthermore, the findings offered practical examples of possibilities to enact health promotion process, which represents a significant contribution to knowledge on health work. The study may support both future interventions and professional education, indicating alternative pathways for practitioners and undergraduate students to widen the scope of health promotion actions beyond the biophysical dimension

O programa Academia da Saúde tem sido considerado uma importante estratégia de promoção da saúde no âmbito da atenção primária à saúde no Brasil. Entretanto, existem poucas evidências sobre quais e como práticas profissionais têm sido desenvolvidas como forma de operacionalizar processos de promoção da saúde no programa. O objetivo do estudo foi analisar o trabalho de promoção da saúde em uma unidade do programa Academia da Saúde de Lajeado, Brasil. O estudo empregou uma abordagem qualitativa e o método de pesquisa da teoria fundamentada nos dados. Os participantes incluíram uma profissional de Educação Física (32 anos), uma coordenadora de centro de saúde (41 anos) e oito usuários (2 homens, 6 mulheres, 30-69 anos). Os dados foram coletados por meio do trabalho de campo condensado, envolvendo entrevistas e observação não-participante das atividades coletivas. Utilizando a teoria da salutogênese, a análise qualitativa gerou os resultados sobre os elementos do trabalho de promoção da saúde, a saber: cuidado holístico, uso da diversificação em atividades cognitivas, psicossociais e físicas, desenvolvimento de habilidades e capacidades que serviram como recursos de saúde, e a ocorrência de resistências e desafios no programa. Além disso, os resultados ofereceram exemplos práticos de possibilidades para mobilizar o processo de promoção da saúde, o que representa uma contribuição significativa para o conhecimento sobre o trabalho em saúde. O estudo pode subsidiar intervenções futuras e a formação profissional, indicando caminhos alternativos para profissionais e estudantes de graduação ampliarem o escopo das ações de promoção da saúde para além da dimensão biofísica

Prática Profissional , Serviços Comunitários de Saúde Mental , Instituições Associadas de Saúde , Saúde Holística , Programas Nacionais de Saúde
J Alzheimers Dis ; 76(1): 33-40, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32538856


BACKGROUND: Fundació ACE is a non-profit organization providing care based on a holistic model to persons with cognitive disorders and their families for 25 years in Barcelona, Spain. Delivering care to this vulnerable population amidst the COVID-19 pandemic has represented a major challenge to our institution. OBJECTIVE: To share our experience in adapting our model of care to the new situation to ensure continuity of care. METHODS: We detail the sequence of events and the actions taken within Fundació ACE to swiftly adapt our face-to-face model of care to one based on telemedicine consultations. We characterize individuals under follow-up by the Memory Unit from 2017 to 2019 and compare the number of weekly visits in 2020 performed before and after the lockdown was imposed. RESULTS: The total number of individuals being actively followed by Fundació ACE Memory Unit grew from 6,928 in 2017 to 8,147 in 2019. Among those newly diagnosed in 2019, most patients had mild cognitive impairment or mild dementia (42% and 25%, respectively). Weekly visits dropped by 60% following the suspension of face-to-face activity. However, by April 24 we were able to perform 78% of the visits we averaged in the weeks before confinement began. DISCUSSION: We have shown that Fundació ACE model of care has been able to successfully adapt to a health and social critical situation as COVID-19 pandemic. Overall, we were able to guarantee the continuity of care while preserving the safety of patients, families, and professionals. We also seized the opportunity to improve our model of care.

Betacoronavirus , Infecções por Coronavirus/terapia , Demência/terapia , Saúde Holística , Assistência Centrada no Paciente/métodos , Pneumonia Viral/terapia , Telemedicina/métodos , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Demência/epidemiologia , Demência/psicologia , Feminino , Seguimentos , Saúde Holística/tendências , Humanos , Masculino , Pandemias , Assistência Centrada no Paciente/tendências , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Espanha/epidemiologia , Telemedicina/tendências
Gan To Kagaku Ryoho ; 47(3): 409-412, 2020 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-32381904


The incidence of breast cancer peaks in women in their 40's and 50's. These women may play an important role in their careers, at home, and as a parent, and therefore need a multifaceted support while undergoing treatment. The concept of survivorship, which is focused on the cancer survivors' and their family's quality of life, is important in providing such support. There are many aspects for which support may be necessary, such as treatment decision-making, fertility preservation, child support, management of genetic conditions, and issues of employment. For providing home care services, the necessary care should be given without compromising their daily lives. For example, consideration should be given as to how to spend their last moments in the presence of their children. It is necessary to understand the patient's course of treatment from the beginning, which includes both hospital and home care services, in making the treatment plan together.

Neoplasias da Mama , Sobreviventes de Câncer , Feminino , Saúde Holística , Humanos , Qualidade de Vida , Sobrevivência
Tog (A Coruña) ; 17(1): 85-86, mayo 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-196310


Este documento pretende hacer reflexionar sobre la importancia de todas las capacidades presentes en las personas. A menudo tendemos a poner el foco en las carencias, pero la Terapia Ocupacional trabaja para identificar las potencialidades de cada individuo, lo cual es un arte y un trabajo que implica poner atención a absolutamente todos los pequeños detalles

This document pretends to reflect on the importance of all the capacities that people have. We often tend to focus on deficiencies, but Occupational Therapy works to identify the potential of each person, which is an art and a job that involves paying attention to absolutely every little detail

Humanos , Terapia Ocupacional/métodos , Aptidão , Destreza Motora , Saúde Holística , Prática Profissional
Infez Med ; 28(1): 17-28, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32172257


The HIV epidemic has not yet ended, and there are ever more challenges: the recent Italian National Plan of Interventions against HIV and AIDS (Piano Nazionale di Interventi Contro HIV e AIDS (PNAIDS) 2017-2019) was hailed for its comprehensiveness. Its likelihood of success across the HIV care continuum was therefore assessed. Awareness interventions are sporadic and continue to miss high risk populations; if effectively implemented, the prescriptive detail in PNAIDS may help address this. Combined prevention needs greater focus and investment. However, there has been recent progress: free anonymous testing is available at multiple settings although improvements to provide access to key vulnerable populations are needed. Clinical management is available to a high standard across the country, with some areas for improvement in ensuring equality of access. Long-term management of people living with HIV is often effective, but discrepancies exist across regions and settings of care. It is recommended to enable implementation of PNAIDS as a matter of urgency, develop integrated awareness and testing interventions for STIs and HIV, make condoms free for high-risk populations, and develop a network of multidisciplinary services for long-term holistic care of people living with HIV.

Infecções por HIV/epidemiologia , Política de Saúde , Programas Nacionais de Saúde , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Testes Anônimos/legislação & jurisprudência , Antirretrovirais/uso terapêutico , Preservativos/provisão & distribução , Diagnóstico Tardio/estatística & dados numéricos , Usuários de Drogas/legislação & jurisprudência , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Sobreviventes de Longo Prazo ao HIV , Acesso aos Serviços de Saúde/legislação & jurisprudência , Transição Epidemiológica , Saúde Holística , Hospitais Especializados , Humanos , Itália/epidemiologia , Assistência de Longa Duração/métodos , Programas Nacionais de Saúde/legislação & jurisprudência , Preconceito/legislação & jurisprudência , Trabalho Sexual/legislação & jurisprudência , Doenças Sexualmente Transmissíveis/diagnóstico , Estereotipagem , Populações Vulneráveis
Pediatr Clin North Am ; 67(2): 293-308, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32122561


This article focuses on the health and health care challenges experienced by young and emerging adult gay men. Evidence is provided on the extent to which young and emerging adult gay men are disproportionally burdened by multidimensional health disparities, barriers to health care access, and inadequate provider-patient interactions. Recommendations are provided for health care providers and public health officials working with populations of emerging adult gay men that might have the greatest overall impact on improving this population's well-being and access to competent health care by increasing providers' awareness of the unique needs of young and emerging adult gay men.

Acesso aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Saúde Holística , Homossexualidade Masculina , Adolescente , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Humanos , Masculino , Adulto Jovem
PLoS One ; 15(3): e0227944, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32196492


BACKGROUND: Pregnancy involves physiological changes in reproductive and endocrine systems, and social role changes that can increase the risk of mental health problems. In China, greater emphasis has been given to postpartum depression and its negative impact on infant development. This study examined depression in pregnant women in Inner Mongolia, who are under the influence of cultural values of collectivism and social factors specific to China. Chinese society adheres firmly to traditional values, while market reform, birth-control policy, together with high parental investment in childcare and rearing construct a unique and sometimes unfavorable environment for Chinese women that may influence their depression expression. THE AIMS OF THIS STUDY ARE TWOFOLD: First, it validated the Chinese Multidimensional Depression Assessment Scale (MDAS), a holistic self-report questionnaire measuring depression severity in four domains of depression-emotional, somatic, cognitive and interpersonal in pregnant women in Inner Mongolia; second, it examined the influences of demographic characteristics (including age, education and employment), pregnancy characteristics (week of gestation, first pregnancy), self-esteem, social support, social activity, work stress, and work-family balance on depression. METHODS: A total of 234 pregnant women, mostly in their third trimester, were recruited in an antenatal hospital in Inner Mongolia and self-reported questionnaires were completed. RESULTS: Using Confirmatory factor analysis (CFA), MDAS gave rise to a best-fit four-factor model corresponding to each subscale when it was first developed. MDAS also reported high Cronbach's alpha (0.96) and good convergent validity. Using hierarchical multiple linear regressions with significant demographic variables controlled for, self-esteem, work-family conflict, and social support were found to be significant predictors for depression. CONCLUSIONS: MDAS is a valid scale to be used with Chinese pregnant women, especially in more collectivistic geographical areas. Risk factors specific to the Chinese context add insights to the experience of antenatal depression in China and contribute to understanding depression in from a global mental health perspective.

Depressão/diagnóstico , Política de Planejamento Familiar , Complicações na Gravidez/diagnóstico , Gestantes/psicologia , Escalas de Graduação Psiquiátrica , Adulto , China , Depressão/epidemiologia , Depressão/psicologia , Feminino , Saúde Holística , Humanos , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/psicologia , Terceiro Trimestre da Gravidez/psicologia , Fatores de Risco , Autorrelato/estatística & dados numéricos , Apoio Social
Med. paliat ; 27(1): 3-9, ene.-mar. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194819


OBJETIVO: Validación mediante análisis factorial confirmatorio de la Escala Humanizar breve en una muestra de adultos consagrados a la vida religiosa y comparación de las puntuaciones obtenidas por los religiosos con los datos publicados en población general. MÉTODO: La Escala Humanizar breve consta de 14 ítems. Sus 2 factores recogen el sentido que se puede dar al sufrimiento como cambio (SS Cambio) y como carga (SS Carga). Con una muestra de N = 190 religiosos consagrados, se realizó un análisis factorial confi rmatorio (estimación, mínimos cuadrados no ponderados sobre matriz de correlaciones policóricas), empleando los paquetes de R Lavaan y Semplot. RESULTADOS: Tras eliminar los ítems 1, 8 y 11, el análisis factorial confirmatorio confirmó el modelo de 2 factores, SS Cambio (5 ítems) y SS Carga (6 ítems). Los índices de ajuste obtenidos fueron adecuados: RMSEA = 0,065; GFI = 0,992; SRMR = 0,079; CFI = 0,974; NNFI = 0,966; X2/gl = 1,79. Los pesos factoriales fueron significativos y mayores de 0,425. El alfa de Cronbach fue de 0,698 para el primer factor y de 0,712 para el segundo. La escala completa de 0,819. Los factores mostraron una correlación de 0,658 (p < 0,01). La media/ítem en la dimensión SS Carga fue mayor en población de religiosos consagrados (en este estudio; M/ítem = 2,36) que en cualquiera de los grupos de población general (M/ítem < 1,85). CONCLUSIÓN: Se confirma la Escala Humanizar breve de 11 ítems para su uso en mayores religiosos, población en la que el sentido que se otorga al sufrimiento como carga es mayor que en el resto de la población. Se evidencia la importancia de valores y creencias, religiosidad y/o espiritualidad, a la hora de tratar el sufrimiento particularmente en cuidados paliativos

OBJECTIVE: Using confirmatory factor analysis, to validate the "Humanizar" scale, short version, in a sample of adults devoted to religious life, and to compare the scores in our sample with those reported for the general population. METHOD: The "Humanizar" scale (14 items with a Likert scale) consists of 2 dimensions that give sense to suffering - as a change (SS Change) and as a burden (SS Burden). With N = 190 subjects devoted to religious life, a confirmatory factor analysis (using unweighted least squares on a polychoric correlation matrix) was done using the R packages Lavaan and Semplot. RESULTS: After excluding items 1, 8, and 11, the confirmatory factor analysis confirmed the 2-dimensional model, SS Change (5 items) and SS Burden (6 items). The fitness indexes obtained were appropriate: RMSEA = 0.065; GFI = 0.992; SRMR = 0.079; CFI = 0.974; NNFI = 0.966; X2/df = 1.79. The weight factor for all items was significant and greater than 0.425. Cronbach's alpha was 0.698 for the first factor and 0.712 for the second one. For the full scale, 0.819. Factors showed a correlation of 0.658 (P < 0.01). Mean score/item for SS Burden was higher for the religious population (in this study; item M = 2.36) than for any of the general population groups (item M < 1.85). CONCLUSION: The validity of the 11-item, short version of the "Humanizar" scale was confirmed for its use in a population devoted to religious life, a population where the meaning given to suffering as a burden is greater than in the general population. It shows the importance of values and beliefs, religion or spirituality, in dealing with suffering, particularly in palliative care

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Espiritualidade , Cuidados Paliativos/métodos , Emoções , Doença , Dor/psicologia , Assistência Terminal/psicologia , Análise Fatorial , Inquéritos e Questionários , Qualidade de Vida/psicologia , Saúde Holística
NeuroRehabilitation ; 46(2): 243-253, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32083599


BACKGROUND: The primary goal of neurorehabilitation for individuals with acquired brain injury (ABI) is successful community reintegration, which commonly focuses on home independence, productivity, and social engagement. Previous research has demonstrated that holistic treatment approaches have better long-term outcomes than other treatment approaches. Holistic approaches go beyond the fundamental components of neurorehabilitation and address metacognition and self-awareness, as well as interpersonal and functional skills. OBJECTIVES: The present study aimed to examine community reintegration of individuals with ABI who completed holistic milieu-oriented neurorehabilitation at the Center for Transitional Neuro-Rehabilitation (CTN), Barrow Neurological Institute (BNI) at up to 30-years post-discharge. We evaluated (a) functional independence, (b) productivity and driving status, and (c) psychosocial profiles of the brain injury survivors. METHOD: Participants included 107 individuals with ABI with heterogeneous etiologies who attended holistic milieu-oriented neurorehabilitation between 1986 and 2016. These participants completed the Mayo-Portland Adaptability Inventory-4 (MPAI-4) and a long-term outcome questionnaire (LOQ) specifically developed for this study. RESULTS: The results demonstrate that 89% of participants were productive at up to 30 years post-discharge (73% engaged in competitive work and/or school) after excluding the retired participants. Almost all of the participants who were engaged in work and/or school reported using compensatory strategies on a long-term basis. Furthermore, only 14% out of 102 study participants were driving at the time of program admission; whereas 58% out of 96 were driving at the time of discharge; and impressively, 70% out of 107 participants were driving at the time of follow-up. Regression analyses revealed that older age at the time of injury, shorter duration between injury and treatment, and better functionality indicated by lower MPAI-4 Ability Index scores significantly predicted a return to driving status at the time of study participation. Psychosocial data from the LOQ revealed positive findings with respect to patients' marital status, living situation, income, and quality of social life. CONCLUSION: The findings from this study suggest that functional gains made during holistic neurorehabilitation have enduring effects and that patients can benefit highly from holistic milieu therapy beyond the early post-acute phases of their recovery. Additionally, they provide evidence that there is potential to return to driving, years after treatment completion.Our holistic milieu treatment approach addressing metacognition, self-awareness, social and coping skills training, and actively transitioning to community settings, is thought to have contributed to the exceptional and long-lasting outcomes in this study.

Lesões Encefálicas/psicologia , Lesões Encefálicas/reabilitação , Integração Comunitária/psicologia , Saúde Holística/tendências , Reabilitação Neurológica/tendências , Alta do Paciente/tendências , Adulto , Idoso , Idoso de 80 Anos ou mais , Condução de Veículo/psicologia , Integração Comunitária/tendências , Aconselhamento/métodos , Aconselhamento/tendências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reabilitação Neurológica/métodos , Fatores de Tempo , Adulto Jovem
J Cross Cult Gerontol ; 35(2): 177-193, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32076928


The views of family carers who provide end of life care to people of advanced age are not commonly known. We conducted a bicultural study with bereaved New Zealand Maori (indigenous) and non-indigenous family carers who, on behalf of their older family member, reflected on the end of life circumstances and formal and informal care experienced by the older person. Semi-structured interviews were undertaken with 58 people (19 Maori and 39 non-Maori), who cared for 52 family members who died aged over 80 years. A Kaupapa Maori thematic analysis of family/whanau perspectives identified examples of good holistic care as well as barriers to good care. These are presented in a proposed Whare Tapa Wha Older Person's Palliative Care model. Good health care was regarded by participants as that which was profoundly relationship-oriented and upheld the older person's mana (authority, status, spiritual power) across four critical health domains: Whanau (social/family), Hinengaro (emotional/mental), Wairua (spiritual) and Tinana (physical) health domains. However, poor health care on one level impacted on all four domains affecting (reducing) mana (status). The "indigenous" model was applicable to both indigenous and non-indigenous experiences of end of life care for those in advanced age. Thus, Indigenous perspectives could potentially guide and inform end of life care for all.

Luto , Grupo com Ancestrais Oceânicos/psicologia , Cuidados Paliativos , Assistência Terminal , Cuidadores , Assistência à Saúde Culturalmente Competente , Feminino , Saúde Holística/etnologia , Humanos , Masculino , Nova Zelândia , Pesquisa Qualitativa