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1.
Support Care Cancer ; 30(1): 669-676, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34363494

RESUMO

PURPOSE: The availability of psychosocial support measures has a significant impact on the quality of life of terminally ill and dying patients and the burden experienced by their relatives. To date, no intervention has specifically focused on promoting interaction within the dyads of the following: (1) terminally ill adult children and their parents and (2) terminally ill parents and their adult children. A national Delphi study was conducted to provide appropriate recommendations for dyadic psychosocial support measures. METHODS: Recommendations were formulated from qualitative interview data on the experiences and wishes of patients and family caregivers within these two dyads. Experts from palliative and hospice care providers rated the relevance and feasibility of 21 recommendations on two 4-point Likert-type scales, respectively. Additional suggestions for improvement were captured via free text fields. Individual items were considered consented when ≥ 80% of participants scored 1 (strongly agree) or 2 (somewhat agree) regarding both relevance and feasibility. RESULTS: A total of 27 experts (35% response rate) completed two Delphi rounds. Following the first round, 13 recommendations were adjusted according to participants' comments. After the second round, consensus was achieved for all 21 of the initially presented recommendations. CONCLUSION: The Delphi-consented recommendations for parents and adult children at the end of life provide the first guidance for hands-on dyadic psychosocial support measures for parent-adult child relationships, specifically. The next step could involve the structured implementation of the recommendations, accompanied by scientific research. This study was registered on October 27, 2017, with the German Clinical Trials Register (DRKS00013206).


Assuntos
Crianças Adultas , Sistemas de Apoio Psicossocial , Adulto , Criança , Consenso , Morte , Técnica Delfos , Alemanha , Humanos , Pais , Qualidade de Vida
2.
Washington, D.C.; OPS; 2021-12-17. (OPS/NMH/MH/COVID-19/21-0018).
Não convencional em Espanhol | PAHO-IRIS | ID: phr-55389

RESUMO

La pandemia de COVID-19 sigue imponiendo una carga sustancial a los sistemas de salud mental de muchos países, muchos de los cuales carecían de recursos suficientes antes de la pandemia. Los países ahora enfrentan el desafío de satisfacer la creciente demanda de servicios esenciales de salud mental y apoyo psicosocial (SMAPS) provocada por las consecuencias directas e indirectas del COVID-19. La encuesta nacional rápida sobre la continuidad de los servicios de salud esenciales durante la Pandemia de COVID-19, desarrollada por la Organización Mundial de la Salud (OMS) e implementada por la OMS y la Organización Panamericana de la Salud (OPS), está rastreando las interrupciones en los servicios de salud esenciales. La OPS ha realizado dos rondas de la encuesta, en el 2020 y 2021, para comprender mejor el impacto de la pandemia en la prestación de servicios para los trastornos mentales, neurológicos y por uso de sustancias (MNS) en la Región de las Américas, reuniendo respuestas de personal designado de salud mental. puntos focales en los ministerios de salud de los Estados Miembros de la OPS. El propósito de esta publicación es informar sobre el estado y las causas de las interrupciones de los servicios MNS en las Américas. Los hallazgos brindan información inmediata de informantes clave sobre la experiencia actual del país, el alcance de las interrupciones en un conjunto de servicios de rastreo en un contexto que cambia rápidamente, las razones de esas interrupciones y las estrategias de mitigación implementadas. Esta información se usará en la asistencia a los países de la Región para ofrecer respuestas fundamentadas en datos a fin de mitigar los efectos de la pandemia.


Assuntos
Saúde Mental , Transtornos Mentais , Sistemas de Apoio Psicossocial , COVID-19 , Pandemias , Betacoronavirus , Coronavirus , Serviços de Saúde , Doenças do Sistema Nervoso
3.
BMC Palliat Care ; 20(1): 193, 2021 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-34963453

RESUMO

BACKGROUND: Worldwide, millions of people with advanced cancer and their family caregivers are experiencing physical and psychological distress. Psychosocial support and education can reduce distress and prevent avoidable healthcare resource use. To date, we lack knowledge from large-scale studies on which interventions generate positive outcomes for people with cancer and their informal caregivers' quality of life. This protocol describes the DIAdIC study that will evaluate the effectiveness of two psychosocial and educational interventions aimed at improving patient-family caregiver dyads' emotional functioning and self-efficacy. METHODS: We will conduct an international multicenter three-arm randomized controlled trial in Belgium, Denmark, Ireland, Italy, The Netherlands, and the United Kingdom. In each country, 156 dyads (936 in total) of people with advanced cancer and their family caregiver will be randomized to one of the study arms: 1) a nurse-led face-to-face intervention (FOCUS+), 2) a web-based intervention (iFOCUS) or 3) a control group (care as usual). The two interventions offer tailored psychoeducational support for patient-family caregiver dyads. The nurse-led face-to-face intervention consists of two home visits and one online video session and the web-based intervention is completed independently by the patient-family caregiver dyad in four online sessions. The interventions are based on the FOCUS intervention, developed in the USA, that addresses five core components: family involvement, optimistic outlook, coping effectiveness, uncertainty reduction, and symptom management. The FOCUS intervention will be adapted to the European context. The primary outcomes are emotional functioning and self-efficacy of the patient and the family caregiver, respectively. The secondary outcomes are quality of life, benefits of illness, coping, dyadic communication, and ways of giving support of the patient and family caregiver. DISCUSSION: DIAdIC aims to develop cost-effective interventions that integrate principles of early palliative care into standard care. The cross-country setup in six European countries allows for comparison of effectiveness of the interventions in different healthcare systems across Europe. By focusing on empowerment of the person with cancer and their family caregiver, the results of this RCT can contribute to the search for cost-effective novel interventions that can relieve constraints on professional healthcare. TRIAL REGISTRATION: Registration on ClinicalTrials.gov on 12/11/2020, identifier NCT04626349 . DATE AND VERSION IDENTIFIER: 20211209_DIAdIC_Protocol_Article.


Assuntos
Cuidadores , Neoplasias , Humanos , Internet , Estudos Multicêntricos como Assunto , Neoplasias/terapia , Sistemas de Apoio Psicossocial , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
4.
J Cyst Fibros ; 20 Suppl 3: 31-38, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34930540

RESUMO

BACKGROUND: Depression and anxiety are two to four times more prevalent in people with CF (pwCF) than the general population. COVID-19 may exacerbate mental health challenges, increasing demand for psychological services, while decreasing their availability. We assessed the impact of the pandemic on depression and anxiety in pwCF, including how COVID-19 affected the frequency of mental health screening and the types of services provided. METHODS: A 38-item internet survey, completed in June 2020, assessed how COVID-19 affected: 1) the mental health clinician's role and screening processes; 2) barriers to screening and resource needs; 3) impact of COVID-19 on depression and anxiety, and 4) positive outcomes and confidence in sustaining mental health screening and treatment, including telehealth services, after the pandemic. RESULTS: Responses were obtained from 131 of the 289 US CF programs. Overall, 60% of programs (n=79) continued mental health screening and treatment, although less frequently; 50% provided individual tele-mental health interventions, and 9% provided telehealth group therapy. Clinically elevated depression symptoms (PHQ-9≥10; moderate to severe), were found in 12% of 785 pwCF, with 3.1% endorsing suicidal ideation. Similarly, elevated anxiety (moderate to severe; GAD-7≥10) was found in 13% of pwCF (n=779). CONCLUSIONS: The COVID-19 pandemic created an opportunity to implement innovative solutions to disruptions in mental health screening and treatment in CF programs. We found that pwCF had increased access to psychological interventions during the pandemic via telehealth, supporting the continued integration of tele-mental health screening and treatment into CF care.


Assuntos
Ansiedade , COVID-19 , Fibrose Cística , Depressão , Saúde Mental , Intervenção Psicossocial , Telemedicina , Ansiedade/diagnóstico , Ansiedade/fisiopatologia , Ansiedade/terapia , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Fibrose Cística/epidemiologia , Fibrose Cística/psicologia , Fibrose Cística/terapia , Atenção à Saúde/métodos , Atenção à Saúde/tendências , Depressão/diagnóstico , Depressão/fisiopatologia , Depressão/terapia , Acesso aos Serviços de Saúde/normas , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Programas de Rastreamento/métodos , Determinação de Necessidades de Cuidados de Saúde , Intervenção Psicossocial/métodos , Intervenção Psicossocial/tendências , Sistemas de Apoio Psicossocial , SARS-CoV-2 , Inquéritos e Questionários , Telemedicina/métodos , Telemedicina/organização & administração , Estados Unidos/epidemiologia
5.
BMC Pregnancy Childbirth ; 21(1): 840, 2021 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-34937548

RESUMO

BACKGROUND: The COVID-19 pandemic poses an unprecedented risk to the global population. Maternity care in the UK was subject to many iterations of guidance on how best to reconfigure services to keep women, their families and babies, and healthcare professionals safe. Parents who experience a pregnancy loss or perinatal death require particular care and support. PUDDLES is an international collaboration investigating the experiences of recently bereaved parents who suffered a late miscarriage, stillbirth, or neonatal death during the global COVID-19 pandemic, in seven countries. In this study, we aim to present early findings from qualitative work undertaken with recently bereaved parents in the United Kingdom about how access to healthcare and support services was negotiated during the pandemic. METHODS: In-depth semi-structured interviews were undertaken with parents (N = 24) who had suffered a late miscarriage (n = 5; all mothers), stillbirth (n = 16; 13 mothers, 1 father, 1 joint interview involving both parents), or neonatal death (n = 3; all mothers). Data were analysed using a template analysis with the aim of investigating bereaved parents' access to services, care, and networks of support, during the pandemic after their bereavement. RESULTS: All parents had experience of utilising reconfigured maternity and/or neonatal, and bereavement care services during the pandemic. The themes utilised in the template analysis were: 1) The Shock & Confusion Associated with Necessary Restrictions to Daily Life; 2) Fragmented Care and Far Away Families; 3) Keeping Safe by Staying Away; and 4) Impersonal Care and Support Through a Screen. Results suggest access to maternity, neonatal, and bereavement care services were all significantly reduced, and parents' experiences were notably affected by service reconfigurations. CONCLUSIONS: Our findings, whilst preliminary, are important to document now, to help inform care and service provision as the pandemic continues and to provide learning for ongoing and future health system shocks. We draw conclusions on how to enable development of safe and appropriate services during this pandemic and any future health crises, to best support parents who experience a pregnancy loss or whose babies die.


Assuntos
Aborto Espontâneo/psicologia , Luto , COVID-19/psicologia , Pesar , Pais/psicologia , Morte Perinatal , Natimorto/psicologia , Continuidade da Assistência ao Paciente/normas , Feminino , Acesso aos Serviços de Saúde/normas , Humanos , Recém-Nascido , Masculino , Gravidez , Dados Preliminares , Sistemas de Apoio Psicossocial , Pesquisa Qualitativa , Quarentena/psicologia , SARS-CoV-2 , Reino Unido/epidemiologia
8.
PLoS One ; 16(10): e0256077, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34613988

RESUMO

BACKGROUND: Despite recent advances in the development and provision of mental health and psychosocial support (MHPSS) in humanitarian settings, inadequate supervision remains a significant barrier to successful implementation. The present study sought to incorporate broad stakeholder engagement as part of the first phase of development of a new Integrated Model for Supervision (IMS) for use within MHPSS and protection services in humanitarian emergencies. METHODS: Semi-structured interviews were conducted with 26 global mental health professionals. Data was analysed thematically, using a combination of inductive and deductive methods. Codes and themes were validated through co-author cross-checks and through a webinar with an expert advisory group. RESULTS: Results reinforce the importance of effective supervision to enhance the quality of interventions and to protect supervisees' wellbeing. Participants generally agreed that regular, supportive supervision on a one-to-one basis and as a separate system from line management, is the ideal format. The interviews highlight a need for guidance in specific areas, such as monitoring and evaluation, and navigating power imbalances in the supervisory relationship. Several approaches to supervision were described, including some solutions for use in low-resource situations, such as group, peer-to-peer or remote supervision. CONCLUSION: An integrated model for supervision (IMS) should offer a unified framework encompassing a definition of supervision, consolidation of best practice, and goals and guidance for the supervisory process.


Assuntos
Emergências/psicologia , Saúde Mental/normas , Reabilitação Psiquiátrica/métodos , Reabilitação Psiquiátrica/normas , Altruísmo , Humanos , Sistemas de Apoio Psicossocial , Pesquisa Qualitativa
10.
Curr Psychiatry Rep ; 23(12): 82, 2021 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-34652557

RESUMO

PURPOSE OF REVIEW: This review aimed to identify and describe evidence published in the past 3 years from trials of psychosocial support programs for children and adolescents affected by natural disasters. RECENT FINDINGS: Previous reviews have indicated these programs are beneficial overall. Positive impacts were documented in school-based programs conducted by trained teachers and paraprofessionals with stronger effects achieved by more qualified professionals. The review found supporting evidence for positive impacts of post-disaster psychosocial programs. However, the strength of evidence is limited due to heterogeneity in interventions and evaluations. The stepped care model was found to be useful in differentiating between programs and level of available evidence. Hobfoll's five essential elements of mass trauma intervention provide an additional means of guiding program content and assessments, particularly for universal programs. Identified gaps in evidence included groups likely to be at most risk: preschool children, ethnically diverse groups, those with disability, and social disadvantage. There were promising indications of program benefits for groups with repeated exposure to natural disasters.


Assuntos
Pessoas com Deficiência , Desastres , Desastres Naturais , Adolescente , Pré-Escolar , Família , Humanos , Sistemas de Apoio Psicossocial
15.
PLoS One ; 16(9): e0255318, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34534225

RESUMO

BACKGROUND: Patients with cancer and their relatives often suffer from psychosocial burdens following a cancer diagnosis. Psychosocial cancer support services offer support for cancer patients and their relatives. Only a few studies have focused on associations of psychological factors within patient-relative dyads. This study aims to assess associations between the patients' or relatives' self-efficacy and their levels of distress and anxiety who seek help together at psychosocial cancer support centres. METHODS: Participants were recruited at two psychosocial cancer support centres in a major city in Germany. Patients with cancer and their relatives seeking support together received the questionnaire before their first support session. Self-efficacy was assessed with the Pearlin sense of mastery scale, distress with the distress thermometer and anxiety with the General Anxiety Disorder questionnaire (GAD-7). For the analysis, the actor-partner interdependence model was applied. RESULTS: The data analysis was based on 41 patient-relative dyads (patients: 39% women, mean age 53.5; relatives: 66% women, mean age 52.16). A significant actor effect from self-efficacy to distress was found for patients (r = -0.47) but not for relatives (r = -0.15). Partner effects from self-efficacy to distress were not significant (r = -0.03, r = -0.001). The actor effect from self-efficacy to anxiety for patients (r = -0.61) as well as relatives was significant (r = -0.62), whereas the partner effect was significant for patients (r = 0.16) but not for relatives (r = -0.46). CONCLUSION: The results suggest that patients' and relatives' self-efficacy is associated with their distress and anxiety. Partner effects were visible for patients' self-efficacy and relatives' anxiety. These findings suggest that self-efficacy is an important factor for the psychological well-being of patients and relatives and that it may additionally be associated with the partners' well-being. Longitudinal research with larger samples is needed to support the findings.


Assuntos
Ansiedade/terapia , Depressão/terapia , Família/psicologia , Neoplasias/psicologia , Sistemas de Apoio Psicossocial , Autoeficácia , Estresse Psicológico/terapia , Ansiedade/epidemiologia , Ansiedade/psicologia , Depressão/epidemiologia , Depressão/psicologia , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Reabilitação Psiquiátrica , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários
16.
PLoS One ; 16(9): e0257420, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34534231

RESUMO

The COVID-19 pandemic has dramatically impacted cancer care worldwide. Disruptions have been seen across all facets of care. While the long-term impact of COVID-19 remains unclear, the immediate impacts on patients, their carers and the healthcare workforce are increasingly evident. This study describes disruptions and reorganisation of cancer services in Australia since the onset of COVID-19, from the perspectives of people affected by cancer and healthcare workers. Two separate online cross-sectional surveys were completed by: a) cancer patients, survivors, carers, family members or friends (n = 852) and b) healthcare workers (n = 150). Descriptive analyses of quantitative survey data were conducted, followed by inductive thematic content analyses of qualitative survey responses relating to cancer care disruption and perceptions of telehealth. Overall, 42% of cancer patients and survivors reported experiencing some level of care disruption. A further 43% of healthcare workers reported atypical delays in delivering cancer care, and 50% agreed that patient access to research and clinical trials had been reduced. Almost three quarters (73%) of patients and carers reported using telehealth following the onset of COVID-19, with high overall satisfaction. However, gaps were identified in provision of psychological support and 20% of participants reported that they were unlikely to use telehealth again. The reorganisation of cancer care increased the psychological and practical burden on carers, with hospital visitation restrictions and appointment changes reducing their ability to provide essential support. COVID-19 has exacerbated a stressful and uncertain time for people affected by cancer and healthcare workers. Service reconfiguration and the adoption of telehealth have been essential adaptations for the pandemic response, offering long-term value. However, our findings highlight the need to better integrate psychosocial support and the important role of carers into evolving pandemic response measures. Learnings from this study could inform service improvements that would benefit patients and carers longer-term.


Assuntos
COVID-19/epidemiologia , Pessoal de Saúde/psicologia , Neoplasias/epidemiologia , Pandemias , Austrália/epidemiologia , Estudos Transversais , Acesso aos Serviços de Saúde , Humanos , Sistemas de Apoio Psicossocial , Inquéritos e Questionários
17.
Artigo em Inglês | MEDLINE | ID: mdl-34501572

RESUMO

The aim is to provide meta-analytical evidence on eHealth interventions' efficacy in supporting the psychosocial and physical well-being of adults with type 1 or type 2 Diabetes Mellitus (DM), and to investigate differences in interventions primarily targeted at providing glycemic control vs. psychosocial support. A PRISMA-guided systematic search was conducted. Randomized Controlled Trials (RCTs) regarding eHealth interventions for adults (18-65 years) with DM were included. Data were pooled using Standard Mean Difference (SMD); sub-group analysis and meta-regressions were performed when appropriate. Outcomes were Hemoglobin A1c (HbA1c), diabetes distress, quality of life, anxiety, stress, and depression. Intervention acceptability was assessed performing the Odds Ratio (OR) of drop-out rates. Thirteen RCTs comprising 1315 participants were included (52.09% females; Mage = 46.18, SD = 9.98). Analyses showed intervention efficacy on HbA1c (SMD = -0.40; 95% CI = -0.70, -0.12; k = 13) and depressive symptoms (SMD = -0.18; 95% CI = -0.33, -0.02; k = 6) at RCTs endpoint and were well accepted (OR = 1.43; 95% CI = 0.72, 2.81; k = 10). However, efficacy on HbA1c was not maintained at follow-up (SMD = -0.13; 95% CI = -0.31, 0.05; k = 6). eHealth interventions providing medical support were acceptable and effective in fostering glycemic control and decreasing depressive symptoms in the short-term only. Digital solutions should be developed on multiple levels to fully support the psychophysical well-being of people with DM.


Assuntos
Diabetes Mellitus Tipo 2 , Telemedicina , Adulto , Ansiedade , Depressão/terapia , Diabetes Mellitus Tipo 2/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sistemas de Apoio Psicossocial , Qualidade de Vida
18.
Artigo em Inglês | MEDLINE | ID: mdl-34501668

RESUMO

This study aimed to describe experiences of managing mental health and psychosocial activities during the first six months of the COVID-19 pandemic in Sweden. A national survey was answered by a non-probability sample of 340 involved in the psychosocial response. The psychosocial response operations met several challenges, mainly related to the diverse actors involved, lack of competence, and lack of preparations. Less than 20% of the participants had received specific training in the provision of psychosocial support during major incidents. The interventions used varied, and no large-scale interventions were used. The psychosocial response organizations were overwhelmed by the needs of health care staff and failed to meet the needs of patients and family members. An efficient and durable psychosocial response in a long-term crisis requires to be structured, planned and well-integrated into the overall pandemic response. All personnel involved need adequate and specific competence in evidence-based individual and large-scale interventions to provide psychosocial support in significant incidents. By increasing general awareness of mental wellbeing and psychosocial support amongst health professionals and their first-line managers, a more resilient health care system, both in everyday life and during major incidents and disasters, could be facilitated.


Assuntos
COVID-19 , Pandemias , Humanos , Sistemas de Apoio Psicossocial , SARS-CoV-2 , Suécia/epidemiologia
19.
PLoS One ; 16(9): e0256454, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34473755

RESUMO

BACKGROUND: The COVID-19 pandemic has placed a significant burden on the mental health and wellbeing of frontline health and social care workers. The need to support frontline staff has been recognised. However, there is to date little research specifically on how best to support the mental health needs of frontline workers, and none on their own experiences and views about what might be most helpful. AIMS: We set out to redress this research gap by qualitatively exploring UK frontline health and social care workers' own experiences and views of psychosocial support during the pandemic. METHOD: Frontline health and social care workers were recruited purposively through social media and by snowball sampling via healthcare colleagues. Workers who volunteered to take part in the study were interviewed remotely following a semi-structured interview guide. Transcripts of the interviews were analysed by the research team following the principles of Reflexive Thematic Analysis. RESULTS: We conducted 25 interviews with frontline workers from a variety of professional groups working in health and social care settings across the UK. Themes derived from our analysis showed that workers' experiences and views about psychosocial support were complex. Peer support was many workers' first line of support but could also be experienced as a burden. Workers were ambivalent about support shown by organisations, media and the public. Whilst workers valued psychological support services, there were many disparities in provision and barriers to access. CONCLUSIONS: The results of this study show that frontline health and social care workers are likely to need a flexible system of support including peer, organisational and professional support. More research is needed to fully unpack the structural, systemic and individual barriers to accessing psychosocial support. Greater collaboration, consultation and co-production of support services and their evaluation is warranted.


Assuntos
COVID-19/prevenção & controle , Pessoal de Saúde/psicologia , Sistemas de Apoio Psicossocial , Pesquisa Qualitativa , Assistentes Sociais/psicologia , COVID-19/epidemiologia , COVID-19/virologia , Feminino , Humanos , Entrevistas como Assunto , Masculino , Saúde Mental , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribuição , SARS-CoV-2/fisiologia , Apoio Social
20.
Br J Community Nurs ; 26(8): 384-389, 2021 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-34343046

RESUMO

The COVID-19 pandemic has increased workload demands for many NHS staff including those working in the community. Nurse managers can make a difference by being authentic leaders, nurturing a supportive organisation where the workload is managed participatively and self-kindness is legitimate. Unfortunately some staff may experience burnout and this article presents a personal management plan to address the symptoms of burnout and aid recovery, although it cannot promote a total recovery if the cause of the symptoms remains unaddressed.


Assuntos
Esgotamento Profissional/prevenção & controle , COVID-19/epidemiologia , Enfermeiros de Saúde Comunitária/psicologia , Estresse Ocupacional/prevenção & controle , Pandemias , Enfermagem em Saúde Comunitária/organização & administração , Humanos , Liderança , Modelos Psicológicos , Sistemas de Apoio Psicossocial , SARS-CoV-2 , Reino Unido , Tolerância ao Trabalho Programado , Carga de Trabalho
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