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1.
BMC Public Health ; 24(1): 570, 2024 Feb 22.
Artículo en Inglés | MEDLINE | ID: mdl-38388909

RESUMEN

BACKGROUND: Pancreatic cancer, ranking seventh in global cancer-related deaths, poses a significant public health challenge with increasing incidence and mortality. Most cases are diagnosed at an advanced stage, resulting in low survival rates. Early diagnosis significantly impacts prognosis, making symptom awareness crucial. Symptoms are often subtle, leading to delayed help-seeking behaviour. Patients and their carers prioritise increased public awareness, indicating a need for innovative approaches to promote awareness of the disease. METHODS: This study employed a quasi-experimental pre-test/post-test design to assess the relationship between a serious game and pancreatic cancer awareness. Members of the public (N = 727) were recruited internationally, via social media and with signposting by relevant organisations. Participants completed measures of symptom awareness and help-seeking intentions before and after playing the game. The serious game, co-designed with experts by lived experience, patient advocates and healthcare professionals, presented participants with a human anatomy diagram, with each section linked to a question about pancreatic cancer. RESULTS: The serious game demonstrated a statistically significant improvement on pancreatic cancer awareness based on matched paired t-tests. Due to missing data, paired comparisons were only possible for 489 cases. Symptom awareness scores exhibited a statistically significant increase from pre-test to post-test, with a large effect size (p < 0.001, d = 1.43). Help-seeking intentions also markedly improved, showing a significant increase from pre-test to post-test, with a large effect size (p < 0.001, d = 1.10). Independent-samples t-tests were also conducted to determine if there were any group differences on pre- to post-test changes based on age, gender, and previous knowledge and/or experience of pancreatic cancer. Participants overwhelmingly endorsed the game's usability and educational value, suggesting its potential as an effective tool for enhancing public awareness and proactive health-seeking behaviour. DISCUSSION: This study is the first to explore a serious game's utility in pancreatic cancer awareness. Results suggest that such interventions can effectively increase public awareness and influence help-seeking intentions. The co-design process ensured content relevance, and participant satisfaction was high. Findings highlight the game's potential as an accessible and convenient tool for diverse populations.


Asunto(s)
Neoplasias Pancreáticas , Humanos , Neoplasias Pancreáticas/diagnóstico , Personal de Salud , Conductas Relacionadas con la Salud
2.
BMC Med Educ ; 24(1): 762, 2024 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-39010110

RESUMEN

BACKGROUND: Competence in delirium care begins with pre-registration education for health care professionals. Although a common complication for hospitalised patients, delirium is avoidable and reversible. Delirium requires early recognition in person-centred care. Students need to learn how to identify and effectively care for 'at risk' patients. AIM: To identify and examine literature on how pre-registration health care professional students are prepared to recognise, assess, and deliver interventions to prevent delirium in practice, using digital/web based educational interventions. METHOD: Mixed methods systematic review with narrative synthesis. A protocol was registered with PROSPERO. The review questions and search strategy were guided by the Population, Phenomena of Interest, Context (PICo) framework. The PRISMA framework guided the screening, data extraction and analysis. Database searches (MEDLINE, Web of Science, Embase, CINAHL, Cochrane Central Register of Controlled Trials, PsycINFO & Scopus) were undertaken in April 2023 for publications from 2012 to 2023. Covidence software [30] was used to extract and manage the data. Quality appraisal was guided by the Crowe Critical Appraisal Tool (CCAT) [31]. FINDINGS: Ten papers were included: mixed methods (2), qualitative (1) and quantitative (7). Medical students were the most studied group (n = 5), followed by student nurses (n = 4) and mixed nursing and medical students (n = 1). Length of learning experience varied from 12 min virtual reality (VR) to a two-week 'geriatrics' elective. Learning was enhanced by player autonomy, engagement, safety, applicability, choices, multiple perspectives and moral reasoning opportunities. DISCUSSION: Digital programmes should be visually appealing, interactive with opportunities for practice and timely appropriate feedback.


Asunto(s)
Delirio , Humanos , Delirio/diagnóstico , Delirio/prevención & control , Delirio/terapia , Estudiantes de Medicina , Competencia Clínica , Educación a Distancia , Personal de Salud/educación
3.
BMC Med Educ ; 24(1): 475, 2024 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-38689311

RESUMEN

BACKGROUND: Delirium is a common symptom of acute illness which is potentially avoidable with early recognition and intervention. Despite being a growing concern globally, delirium remains underdiagnosed and poorly reported, with limited understanding of effective delirium education for undergraduate health profession students. Digital resources could be an effective approach to improving professional knowledge of delirium, but studies utilising these with more than one profession are limited, and no evidence-based, interdisciplinary, digital delirium education resources are reported. This study aims to co-design and evaluate a digital resource for undergraduate health profession students across the island of Ireland to improve their ability to prevent, recognise, and manage delirium alongside interdisciplinary colleagues. METHODS: Utilising a logic model, three workstreams have been identified. Workstream 1 will comprise three phases: (1) a systematic review identifying the format, methods, and content of existing digital delirium education interventions for health profession students, and their effect on knowledge, self-efficacy, and behavioural change; (2) focus groups with health profession students to determine awareness and experiences of delirium care; and (3) a Delphi survey informed by findings from the systematic review, focus groups, and input from the research team and expert reference group to identify resource priorities. Workstream 2 will involve the co-design of the digital resource through workshops (n = 4) with key stakeholders, including health profession students, professionals, and individuals with lived experience of delirium. Lastly, Workstream 3 will involve a mixed methods evaluation of the digital resource. Outcomes include changes to delirium knowledge and self-efficacy towards delirium care, and health profession students experience of using the resource. DISCUSSION: Given the dearth of interdisciplinary educational resources on delirium for health profession students, a co-designed, interprofessional, digital education resource will be well-positioned to shape undergraduate delirium education. This research may enhance delirium education and the self-efficacy of future health professionals in providing delirium care, thereby improving practice and patients' experiences and outcomes. TRIAL REGISTRATION: Not applicable.


Asunto(s)
Delirio , Grupos Focales , Humanos , Delirio/diagnóstico , Delirio/terapia , Delirio/prevención & control , Irlanda , Técnica Delphi , Estudiantes del Área de la Salud , Educación de Pregrado en Medicina , Conocimientos, Actitudes y Práctica en Salud
4.
Age Ageing ; 51(10)2022 10 06.
Artículo en Inglés | MEDLINE | ID: mdl-36309975

RESUMEN

BACKGROUND: sexuality, intimacy and relationship needs are often a neglected aspect of the care of older adults in residential care facilities. Improving awareness, knowledge and improving attitudes about these needs among care staff could enhance quality of care and lead to better outcomes for residents. OBJECTIVE: to evaluate the feasibility and acceptability of a co-designed education and training e-resource to help care staff support their residents' sexuality, intimacy and relationship needs. METHODS: we delivered the education and training e-resource to five UK care homes over a 6-month period in a pre-post mixed methods study using surveys, focus groups and individual interviews. RESULTS: fifty-nine members of staff from participating care homes undertook the education and training e-resource. 18/59 (31%) of participants completed all six modules and the pre-post surveys. Eleven participants participated in focus groups/interviews to explore experiences of using the e-resource. The e-resource was successfully implemented in the study homes and found to be acceptable. We found preliminary evidence of positive changes in staff attitudes. Factors that facilitated implementation included support from the care home manager. Barriers identified included IT infrastructure and technology. CONCLUSIONS: the findings provide initial evidence that a co-designed education and training e-resource raised awareness of, and improved attitudes towards, older adults' sexuality and intimacy needs. This work provides the foundation for a next phase to establish the effectiveness of the e-resource on staff practice and resident outcomes.


Asunto(s)
Hogares para Ancianos , Sexualidad , Humanos , Anciano , Estudios de Factibilidad , Conducta Sexual , Actitud del Personal de Salud
5.
J Trauma Stress ; 35(2): 694-705, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-34979045

RESUMEN

The early identification of youth at risk for restraint incidents is an important next step to reducing the likelihood of such incidents. Yet, the extant research has not comprehensively investigated the idiographic factors that contribute to the restraint of youth in psychiatric residential treatment facilities (PRTFs). The current study investigated client-level predictors of restraint incidents, with specific emphasis on youth client trauma history and traumatic stress symptoms as assessed at admission. Participants were children and adolescents (N = 150; 55.3% female, 66.7% White, 33.3% Black or biracial) aged 6-17 (M = 11.8 years) admitted to a PRTF in the northeastern United States. A negative binomial regression with maximum likelihood estimation was conducted to examine the relative contributions of age, gender, length of stay, number of psychiatric diagnoses, body mass index (BMI), and traumatic stress symptoms at intake to the frequency of restraint incidents. The model was significant, χ2 (6, N = 150) = 30.326, p < .001, and both length of stay, ß = .005, p < .001, IRR = 1.005, and traumatic stress symptoms at intake, ß = .072, p = .007, IRR = 1.074, were identified as significant predictors within the model. Although length of stay is an obvious predictor of restraint incidents, the current study is the first of which we are aware to identify traumatic stress symptoms at intake as a potential indicator of restraint frequency following admission. Clinical implications of these results are discussed.


Asunto(s)
Tratamiento Domiciliario , Trastornos por Estrés Postraumático , Adolescente , Niño , Femenino , Hospitalización , Humanos , Masculino , Restricción Física , Trastornos por Estrés Postraumático/psicología
6.
J Adv Nurs ; 78(4): 1128-1139, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34730856

RESUMEN

AIM: To explore undergraduate nursing and midwifery student perspectives of using digital patient systems on clinical placements. DESIGN: This was an interpretative qualitative design study. METHODS: Undergraduate nursing and midwifery students in a large Australian metropolitan university were invited to participate in two focus groups from April to June 2019. Twenty (20) students participated and data on their perspective of using digital systems on placement were collected. Thematic analysis using NVivo 12 software was undertaken. FINDINGS: Students identified benefits and challenges when moving between paper records and digital systems. Whilst paper reporting was more efficient for some processes, the students recognised the advantages of digital technology, such as enabling greater confidentiality and consolidation of patient data in one place. However, they also reported difficulty with student access and the size of the portal digital workstation at the bedside. Generally, the lack of preparation and access was considered frustrating and mitigated some of the benefits described when using digital systems. CONCLUSIONS: Nursing and midwifery students prefer to be prepared for both paper and digital record keeping. Whilst students identify the benefits of digital platforms, not having direct access mitigates the benefits of these systems. Students identified the use of simulation and interactive modules prior to commencement of clinical practice to enable them to feel more confident with using the systems in patient care. IMPACT: Health care students require direct access to digital health platforms whilst on clinical placement to facilitate their learning. Higher Education Institutions (HEIs) are in a unique position to work with health care providers to better prepare health care professionals, including nurses and midwives, to work with digital health care systems. Further research is needed to develop the educational preparation for nurses, midwives, and other health care professionals to work with digital systems in practice.


Asunto(s)
Bachillerato en Enfermería , Partería , Estudiantes de Enfermería , Australia , Femenino , Humanos , Partería/educación , Embarazo , Investigación Cualitativa
7.
Age Ageing ; 50(3): 758-771, 2021 05 05.
Artículo en Inglés | MEDLINE | ID: mdl-33681969

RESUMEN

BACKGROUND: Having positive intimate, sexual and relational experiences is an important issue for older adults in care settings, yet little is known on the extent to which nursing staff and care workers have received education or training in addressing and meeting these needs among older residents. This scoping review aimed to identify and examine what education and training resources exist to assist nursing staff and care workers to meet their residents' needs in this area. METHODS AND ANALYSIS: Using the Arksey and O'Malley framework, we systematically searched papers and grey literature to identify education interventions and resources that aimed to facilitate care home staff to meet their residents' sexuality, intimacy and relational needs. RESULTS: Eleven studies (one dissertation) and three education resources met the inclusion criteria; most were conducted in the USA and Australia. Across the studies and resources identified, the education content was mixed and the methodology, presentation, design and duration varied widely. The focus of the education interventions and resources was to increase knowledge and improve and/or change attitudes towards the: (i) sexual expression of older people living in residential aged care, (ii) sexuality and ageing and (iii) expression of sexuality in people with dementia. CONCLUSION: Few education interventions and training resources were identified. The findings suggest that education interventions can improve knowledge and/or change care staff attitudes, in the short-term, towards older people's sexuality, intimacy and relational needs in care home settings, which can lead to facilitating staff to enhance person-centred care in this area of need.


Asunto(s)
Conducta Sexual , Sexualidad , Anciano , Actitud del Personal de Salud , Australia , Humanos , Parejas Sexuales
8.
J Gerontol Soc Work ; 64(1): 25-31, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33353514

RESUMEN

This article reflects on the foundational contributions of Rosalie A. Kane to the rise of assisted living in the 1980s and 90s. The author, called the founder of the "Oregon model of assisted living," offers an insider's perspective of how Dr. Kane's insights - and personality-inspired a shift in the options for long term care from a model based on safety and medical treatment to one based on personal choice and independence. Along the way, the article offers an example of how sustained dialogue between theory and practice can spark concrete change. The article also assesses the personality traits that made Rosalie Kane a gifted collaborator and a generator of ideas that reached beyond the academy into real life. A brief glance at Dr. Kane's unfinished agenda speaks to her vision for today's gerontologists and social workers.


Asunto(s)
Atención a la Salud , Femenino , Humanos
9.
BMC Geriatr ; 20(1): 525, 2020 12 03.
Artículo en Inglés | MEDLINE | ID: mdl-33272207

RESUMEN

BACKGROUND: Improving public knowledge and understanding about dementia has been identified as a priority area by people living with the condition, researchers, educators, and policymakers for several years. Societies that have a better understanding of the condition are more likely to enable people living with dementia to enjoy a better quality of life. The aim of this study was to explore current public perceptions of dementia along with the facilitators and barriers to living well from the perspective of people living with the condition in Northern Ireland. METHODS: Four focus group interviews were conducted with a total of 20 people living with dementia across three Northern Irish Counties in June 2019. These interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Ethical approval was obtained for this study prior to data collection. FINDINGS: Following thematic analysis, three themes emerged in relation to barriers and facilitators to living well with dementia. These were: 'Emphasis on Disability NOT Capability', which highlighted societal misconceptions about the activities and modes of life which people with dementia could or could not do; 'Normalise Dementia - We Don't Want a Fool's Pardon', which focused on how the public could encourage people living with the condition to enjoy greater independence, and 'Dementia isn't a Death Sentence', which considered how professionals, family members and friends treated the person after diagnosis. CONCLUSIONS: Public perceptions about dementia have the potential to act as both facilitators and barriers to living well with dementia. People with dementia stated that they are more likely sustain wellbeing when they are valued and can maintain independence. On the contrary, poor public and professional attitudes to dementia had the potential to disempower people living with dementia.


Asunto(s)
Demencia , Calidad de Vida , Demencia/diagnóstico , Demencia/epidemiología , Grupos Focales , Humanos , Irlanda del Norte/epidemiología , Opinión Pública , Investigación Cualitativa
10.
BMC Nurs ; 19: 34, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32351326

RESUMEN

BACKGROUND: Delirium is recognised internationally as a common disorder that causes acute deterioration in a person's cognitive abilities. Healthcare professionals play a key role in the early identification and management of delirium and effective education can support timely recognition and treatment. There is currently a lack of research exploring the delirium education provided to undergraduate nursing students. The aim of this study was to evaluate the effectiveness of a co-produced delirium awareness programme on undergraduate nursing students in Northern Ireland. METHODS: The intervention was a 2-h delirium workshop, delivered in April 2019, to a convenience sample of year one undergraduate nursing students (n = 206) completing a BSc Honours Nursing degree programme in a Northern Ireland University. The workshop focused on four core elements: defining delirium, reflecting on practice, recognition of delirium and management of delirium. Participants completed a 35-item true-false Delirium Knowledge Questionnaire (DKQ) at baseline and post intervention using Socrative, a cloud-based student response system. In addition, students also completed a short questionnaire at baseline and post-workshop, designed by the authors, to ascertain perceived confidence about caring for people with delirium. Data were analysed using paired t-tests and descriptive statistics. RESULTS: In the DKQ, Scores were normally distributed around the mean at baseline (71.89%) and post intervention (81.89%). Students improved across all three core areas in the post-test questionnaire, demonstrating improvements in knowledge about symptoms of delirium (7.32% increase), causes and risk factors of delirium (17.91% increase) and management of delirium (5.72% increase). In relation to perceived confidence, students reported a 60.20% increase in confidence related to recognition of delirium, a 49.51% increase in relation to delirium management and a 45.04% increase their ability to communicate about delirium. Both questionnaires were statistically significant (P < 0.01). CONCLUSIONS: A 2-h workshop on delirium improved first year student nurse knowledge about delirium. Nursing students expressed that this approach to delirium education enabled collective thinking about how knowledge could be transferred into individual practises. Students also stated that learning incorporating the voice of the person who has experienced delirium, was an effective and powerful way to deliver education.

11.
BMC Geriatr ; 19(1): 145, 2019 05 24.
Artículo en Inglés | MEDLINE | ID: mdl-31126240

RESUMEN

BACKGROUND: Use of monitoring technologies (e.g. wearable or environmental sensors) in long-term care generates extensive ethical debate, primarily about their potential to enhance resident safety weighed against concerns about their impacts upon resident autonomy. There are a number of other ethical aspects which are far less debated, including questions about the monitoring of the workforce, and equality of access to technologies. In this paper, we explore the extent to which remote monitoring of the workforce, and equality of access to technologies, were seen to influence the implementation of monitoring technologies within long-term care facilities. METHODS: An embedded multiple-case study design was used with three dementia-specialist care facilities in England that had experience using a range of monitoring technologies. Data were collected through 175 h' observation of daily practice, semi-structured interviews with 36 staff, residents and relatives, and examination of organisational documentation and technology manufacturer literature. Data were analysed using Framework Analysis. RESULTS: Use of technologies for workforce monitoring was understood in relation to the ethical obligations to fulfil a duty of care to residents. There was little recognition of any negative implications for the workforce, but staff were susceptible to rumours that technologies were being used for performance management even when this was not the case. There were questions about how far data collected by monitoring technologies could constitute 'evidence' of appropriate care delivery. Equality and access to technologies involved a need to compromise between generic designs that were not universally suitable, but were more affordable than bespoke designs. Contracts with suppliers imposed limitations on product choice. CONCLUSIONS: There is an urgent need for greater consideration of the ethical and legal implications that remote technological monitoring might have upon workforce morale, recruitment and retention. Ensuring variety of technological design to facilitate equitable access for residents is financially extremely challenging. It is possible that considerations of equitable access are not deemed a priority due to the current generation of residents' low levels of technological familiarity and expectation. It might be overstated and unrealistic to view expensive technologies as the pinnacle of innovative practice in care homes.


Asunto(s)
Demencia/terapia , Cuidados a Largo Plazo/normas , Monitoreo Ambulatorio/normas , Seguridad del Paciente/normas , Autonomía Personal , Investigación Cualitativa , Adulto , Anciano , Anciano de 80 o más Años , Atención a la Salud/métodos , Atención a la Salud/normas , Demencia/epidemiología , Inglaterra/epidemiología , Femenino , Humanos , Cuidados a Largo Plazo/métodos , Masculino , Persona de Mediana Edad , Monitoreo Ambulatorio/métodos , Adulto Joven
12.
J Sleep Res ; 27(3): e12635, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29193443

RESUMEN

The present review examines the relations between sleep disturbance and anxiety in children and adolescents. The review begins with a detailed discussion of normative developmental trends in sleep, and the relation between sleep quality and emotion dysregulation in children. The extant literature on sleep disturbance in clinically anxious children with a focus on subjective versus objective measures of sleep is then summarized in detail. Finally, a review of the reciprocal relationship between sleep and emotion regulation is provided. The available research suggests that sleep disturbance is quite prevalent in children with anxiety disorders, although the directionality of the association between sleep disturbance and anxiety in children remains unclear. Despite this limitation, a reciprocal relationship between sleep quality and anxiety appears to be well established. Research using objective measures of sleep quality (e.g. polysomnography, sleep actigraphy, sleep bruxism) is warranted to better understand this relation. Further, complicating factors such as the environment in which sleep quality is measured, the developmental stage of participants, varying severity of anxiety and the timeframe during which assessment takes place should all be considered when examining sleep disturbance in this population.


Asunto(s)
Trastornos de Ansiedad/psicología , Trastornos del Neurodesarrollo/psicología , Trastornos del Sueño-Vigilia/psicología , Actigrafía/métodos , Adolescente , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/epidemiología , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Trastornos del Neurodesarrollo/diagnóstico , Trastornos del Neurodesarrollo/epidemiología , Polisomnografía/métodos , Sueño/fisiología , Trastornos del Sueño-Vigilia/diagnóstico , Trastornos del Sueño-Vigilia/epidemiología
13.
Health Expect ; 21(2): 441-447, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29105227

RESUMEN

CONTEXT: Reflective accounts of public involvement in research (PI) are important for helping researchers plan and deliver more effective PI activities. In particular, there is a need to address power differentials between team members that can prohibit effective and meaningful involvement. OBJECTIVE: To critically reflect on the PI practices that underpinned our research project on intimacy and sexuality in care homes, to develop a series of recommendations for improving future PI activities. SETTING: The research team comprised five academics from nursing, public health, sociology and psychology, and two members of the public with experience of sex education, and lesbian, gay, bisexual and trans issues in older populations. In order to address power differentials within the group, we developed an approach to PI practice that was grounded in values of openness, inclusion and transparency. METHOD: Reflective commentaries on the strengths and weaknesses of the team's approach to PI were gathered through interviews and open-ended questionnaires with research team members. These views were collated and discussed at a workshop comprising research team members and an additional member of the public to generate recommendations for future PI practice. RESULTS: A number of strengths and limitations of our approach to PI were identified. Clear recommendations for improving PI practice were developed for three broad areas of identified difficulty: (i) communication within and between meetings; (ii) the roles and responsibilities of team members; and (iii) PI resources and productivity. DISCUSSION AND CONCLUSION: These recommendations add to the developing body of guidance for conducting effective PI.


Asunto(s)
Participación de la Comunidad/métodos , Relaciones Comunidad-Institución , Relaciones Interpersonales , Proyectos de Investigación , Anciano , Anciano de 80 o más Años , Comunicación , Femenino , Humanos , Relaciones Interprofesionales , Masculino , Casas de Salud , Investigación , Investigadores , Conducta Sexual , Sexualidad , Encuestas y Cuestionarios
14.
J Adv Nurs ; 73(1): 127-137, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-27461845

RESUMEN

AIM: To explore the challenges of conducting research on sexuality and intimacy among older care home residents. BACKGROUND: Sexuality and intimacy are neglected in care policies and practices. DESIGN: Qualitative analytical study drawing on poststructuralist theorizing. METHODS: Semi-structured interviews were conducted with residents and spouses (n = 6) and care staff (n = 16) in two care homes in Northwest England in 2014. The sample was obtained through a network of 'research-ready' care homes. Thematic analysis was used to make sense of narratives with the aid of NVivo10. RESULTS: Participant responses highlight the workings of ageist erotophobic discourse that undergirds the assumption of residents (and old people generally) as postsexual. This materialized in reservations about the research ranging from opposition on moral grounds to doubts about its feasibility given the age-group concerned. However, residents and care home staff can also draw on counter-discourses that resist/challenge ageist erotophobic thinking, which materialized in methodological and ethical recommendations. CONCLUSION: Participants generally agreed with the principle of the research and made recommendations that could counter/resist ageist erotophobic governance and guide researchers on sampling, style of questioning and communicating with (prospective) study participants on a sensitive subject.


Asunto(s)
Anciano Frágil/psicología , Anciano Frágil/estadística & datos numéricos , Personal de Salud/psicología , Hogares para Ancianos/estadística & datos numéricos , Hogares para Ancianos/normas , Sexualidad/psicología , Sexualidad/estadística & datos numéricos , Adolescente , Anciano , Anciano de 80 o más Años , Inglaterra , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
15.
Gerontol Geriatr Educ ; 38(1): 119-138, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-27892805

RESUMEN

Nicaragua is a very low-income country entering a period of rapid aging with limited geriatric training for health care professionals. To help build capacity and to enhance student learning, a short-term international service-learning program was implemented in 2004 in partnership with the Jessie F. Richardson Foundation and Nicaraguan community stakeholders. Graduate and undergraduate students at Portland State University complete coursework for one term in the United States then travel to Nicaragua for about two weeks to participate in educational, research, and service activities, primarily in group homes for older Nicaraguans. Students learn about global aging, gerontology, community development, service learning, and Nicaraguan history and culture, then apply their gerontology-related knowledge by training direct care staff, older adults and their family members, and students. The authors describe the impetus for and evolution of the program, students' evaluation of the program, faculty observations on program benefits and challenges, lessons learned, and future plans.


Asunto(s)
Creación de Capacidad/organización & administración , Relaciones Comunidad-Institución , Geriatría/educación , Cooperación Internacional , Universidades/organización & administración , Envejecimiento , Humanos , Nicaragua , Proyectos Piloto , Investigación/organización & administración
16.
Cochrane Database Syst Rev ; 2: MR000036, 2016 Feb 29.
Artículo en Inglés | MEDLINE | ID: mdl-35658160

RESUMEN

BACKGROUND: Identifying and approaching eligible participants for recruitment to research studies usually relies on healthcare professionals. This process is sometimes hampered by deliberate or inadvertent gatekeeping that can introduce bias into patient selection. OBJECTIVES: Our primary objective was to identify and assess the effect of strategies designed to help healthcare professionals to recruit participants to research studies. SEARCH METHODS: We performed searches on 5 January 2015 in the following electronic databases: Cochrane Methodology Register, CENTRAL, MEDLINE, EMBASE, CINAHL, British Nursing Index, PsycINFO, ASSIA and Web of Science (SSCI, SCI-EXPANDED) from 1985 onwards. We checked the reference lists of all included studies and relevant review articles and did citation tracking through Web of Science for all included studies. SELECTION CRITERIA: We selected all studies that evaluated a strategy to identify and recruit participants for research via healthcare professionals and provided pre-post comparison data on recruitment rates. DATA COLLECTION AND ANALYSIS: Two review authors independently screened search results for potential eligibility, read full papers, applied the selection criteria and extracted data. We calculated risk ratios for each study to indicate the effect of each strategy. MAIN RESULTS: Eleven studies met our eligibility criteria and all were at medium or high risk of bias. Only five studies gave the total number of participants (totalling 7372 participants). Three studies used a randomised design, with the others using pre-post comparisons. Several different strategies were investigated. Four studies examined the impact of additional visits or information for the study site, with no increases in recruitment demonstrated. Increased recruitment rates were reported in two studies that used a dedicated clinical recruiter, and five studies that introduced an automated alert system for identifying eligible participants. The studies were embedded into trials evaluating care in oncology mainly but also in emergency departments, diabetes and lower back pain. AUTHORS' CONCLUSIONS: There is no strong evidence for any single strategy to help healthcare professionals to recruit participants in research studies. Additional visits or information did not appear to increase recruitment by healthcare professionals. The most promising strategies appear to be those with a dedicated resource (e.g. a clinical recruiter or automated alert system) for identifying suitable participants that reduced the demand on healthcare professionals, but these were assessed in studies at high risk of bias.

17.
J Trauma Stress ; 29(4): 317-24, 2016 08.
Artículo en Inglés | MEDLINE | ID: mdl-27472504

RESUMEN

Rumination, defined as repetitive, negative, self-focused thinking, is hypothesized to be a transdiagnostic factor that is associated with depression, anxiety, and posttraumatic stress disorder (PTSD). Theory has suggested that in individuals with PTSD, rumination serves as a cognitive avoidance factor that contributes to the maintenance of symptoms by inhibiting the cognitive and emotional processing of the traumatic event, subsequently interfering with treatment engagement and outcome. Little is known about the neural correlates of rumination in women with PTSD. The current study utilized functional magnetic resonance imaging (fMRI) to examine neural correlates during an emotion interference task of self-reported rumination in women with PTSD. Women with PTSD (39 participants) were recruited at a university-based trauma clinic and completed a clinical evaluation that included measures of PTSD symptoms, rumination, and depressive symptoms, as well as a neuroimaging session in which the participants were administered an emotion interference task. There was a significant relationship between self-reported rumination and activity in the right orbital frontal cortex, BA 11; t(37) = 5.62, p = .004, k = 46 during the task. This finding suggested that women with PTSD, who had higher levels of rumination, may experience greater difficulty inhibiting negative emotional stimuli compared to women with lower levels of rumination.


Asunto(s)
Miedo/fisiología , Rumiación Cognitiva , Trastornos por Estrés Postraumático/fisiopatología , Adolescente , Adulto , Depresión/psicología , Femenino , Lóbulo Frontal/diagnóstico por imagen , Lóbulo Frontal/fisiopatología , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Autoinforme , Trastornos por Estrés Postraumático/diagnóstico por imagen , Trastornos por Estrés Postraumático/psicología , Adulto Joven
18.
Rehabil Psychol ; 69(1): 61-69, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37917458

RESUMEN

PURPOSE: The Symptom Checklist 90-Revised (SCL-90-R; Derogatis, 1992) is a widely used self-report measure of psychiatric symptoms (Prinz et al., 2013), but it is longer than many screening measures used in certain settings. Recently, a nine-item form of the SCL-90-R, the Symptom-Checklist-K-9 (SCL-K-9), has been gaining traction despite the limited research examining its psychometric properties in the United States. The purpose of this study is to conduct a psychometric evaluation of the SCL-K-9 scores in U.S. working-age adults with psychiatric disabilities. DESIGN: Six hundred and thirty participants with self-reported psychiatric disabilities completed the SCL-K-9 and other psychosocial self-report measures. Confirmatory factor analysis (CFA) was conducted to evaluate the SCL-K-9 scores' dimensionality. Coefficient omega was used to assess the scores' internal consistency. Convergent and discriminant validity were assessed by examining the strength and direction of correlation coefficients between the SCL-K-9 and other psychosocial measures. Measurement invariance across sex, age, and primary diagnostic groups was also examined. RESULTS: CFA revealed a one-factor solution with satisfactory reliability (coefficient omega = .828). Convergent validity was supported by the relatively high correlation coefficients between the SCL-K-9 with neuroticism, self-stigma, and psychiatric disability acceptance, and discriminant validity by relatively low correlation coefficients with perceived social stigma and hope. Full measurement invariance for sex and partial invariance for diagnostic groups was supported. CONCLUSIONS: Overall, this study provides preliminary reliability and validity evidence for the SCL-K-9 scores among U.S. working-age adults with psychiatric disabilities. Further investigation is warranted to support its use for research and treatment progress monitoring in recovery-oriented care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Lista de Verificación , Trastornos Mentales , Adulto , Humanos , Escalas de Valoración Psiquiátrica , Psicometría , Reproducibilidad de los Resultados , Trastornos Mentales/diagnóstico
19.
Nurs Rep ; 14(1): 428-443, 2024 Feb 16.
Artículo en Inglés | MEDLINE | ID: mdl-38391078

RESUMEN

BACKGROUND: Incidence of disability secondary to Parkinson's disease is increasing faster globally than any other neurological condition. The diverse appearance of symptomatology associated with Parkinson's, and the degenerative nature and subsequent functional decline, often increase dependence on caregivers for assistance with daily living, most commonly within a care home setting. Yet, primary literature and evidence synthesis surrounding these unique and complex care needs, challenges and the lived experiences of this population living in long-term nursing or residential facilities remains sparce. The aim of this review is to synthesize qualitative literature about the lived experience of people with Parkinson's disease living in care home settings. METHODS: A systematic search of the literature was conducted in October 2023 across six different databases (CINAHL, Medline, EMBASE, PsycINFO, Scopus and Cochrane Library). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to guide this review. RESULTS: Five articles met the inclusion criteria. Four themes were identified following evidence synthesis: (1) Unique pharmacological challenges. (2) Transitioning and adapting to care home life and routines. (3) Dignified care within care homes. (4) Multidisciplinary care vacuum in care homes. CONCLUSION: This review revealed the significant and unique challenges for people with Parkinson's disease when transitioning into care homes. These are exacerbated by wider social care challenges such as staffing levels, skill mixes and attitudes as well as a lack of disease-specific knowledge surrounding symptomatology and pharmacology. The lack of multi-disciplinary working and risk-adverse practice inhibited person-centred care and autonomy and reduced the quality of life of people living with Parkinson's disease in care homes. Recommendations for practice highlight training gaps, the need for consistent and improved interdisciplinary working and better person-centred assessment and care delivery.

20.
J Adv Nurs ; 69(1): 77-90, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22462405

RESUMEN

AIM: The study aimed to develop, deliver, and evaluate a training programme in care homes to enhance the quality of care for people living with dementia based on the principles of relationship-centred care expressed through the Senses Framework. BACKGROUND: There are increasing numbers of people living with dementia worldwide with a growing proportion requiring residential long-term care. This makes the quest for enhancing the quality of care and quality of life for people with dementia ever more pressing. DESIGN: A mixed-methods design was used adopting a Practice Development approach. The findings from one care home in the North West of England are reported. METHODS: Eight facilitated workshops based on the principles of relationship-centred care were completed and evaluated in 2010, using pre- and postintervention design. A focus group was undertaken with staff on completion of the study to gain a more comprehensive understanding of the practice/training context, augmented by case examples of changes in practice identified from the study workshops. RESULTS: Structured questionnaires were used to profile the care home before and after the training. Following the workshops, staff felt more able to collect and use biographical information. In particular, staff reported how this information supported them to initiate meaningful conversations with the person with dementia as part of everyday care routines, thus improving overall feelings of well-being. CONCLUSION: Using a biographical approach to care planning structured through the Senses Framework helped staff to develop a greater understanding of the person with dementia.


Asunto(s)
Demencia/enfermería , Calidad de la Atención de Salud , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Atención Dirigida al Paciente
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