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1.
Aging Clin Exp Res ; 35(11): 2843-2846, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37581860

RESUMO

This paper presents findings from a qualitative study conducted in Ontario, Canada, exploring healthcare professionals' perceptions of barriers and solutions for implementing Web-Based Reminiscence Therapy (WBRT) in an institutionalized settings for dementia care during the COVID-19 pandemic. The study identified five major barriers, including the lack of on-boarding/educational training, need for technology availability and technical support, limited attention span of persons with dementia (PWD), availability of multi-sensory features, and time constraints due to staff workload. Seven major themes emerged related to proposed solutions/suggestions: (1) involving younger generations, (2) focusing on technology training, (3) integrating with other digital platforms, (4) adding narratives/descriptions to recollect memories, (5) ensuring accessibility, (6) adding QR codes for retrieving information, and (7) combining digital/traditional reminiscence methods. These findings provide valuable insights for implementing WBRT to facilitate dementia care and for the future refinement of its application.


Assuntos
Demência , Pandemias , Humanos , Demência/terapia , Pessoal de Saúde , Memória , Atenção à Saúde
2.
Aging Clin Exp Res ; 35(5): 1127-1138, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37009966

RESUMO

BACKGROUND: Reminiscence therapy (RT) is the most common non-pharmacological treatment for dementia care. The therapy stimulates the senses to evoke memories having the potential to reduce Behavioral and Psychological Symptoms of Dementia (BPSD). Digital RT, such as web-based reminiscence therapy (WBRT), has the potential to support dementia care and reduce the caregiving burden. AIMS: This study aimed to explore healthcare professionals (HCPs) perceptions of utilizing WBRT in institutionalized settings to support persons with dementia during the COVID-19 pandemic. METHODS: A qualitative phenomenological descriptive study was adopted and guided by Graham's Knowledge to Action framework. Online training on the use of WBRT was conducted, followed by interviews with HCPs. RESULTS: Four major themes were identified on the potential use of WBRT in dementia care, including usability and efficacy, impact on caregiving, capability of reducing BPSD, and. feasibility during COVID-19 social distancing. DISCUSSION: This study recognized the potential use of WBRT to support the person with dementia during the pandemic in institutionalized settings. CONCLUSION: The knowledge generated from this study will guide the future application of WBRT to support dementia care in diverse healthcare settings.


Assuntos
COVID-19 , Demência , Humanos , Demência/terapia , Pandemias , Atenção à Saúde , Percepção
3.
J Pediatr Nurs ; 72: 135-145, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37506540

RESUMO

BACKGROUND: Suboptimal breastfeeding rates are a public health priority. Interventions that include both breastfeeding women and their co-parents can increase breastfeeding initiation, duration, and exclusivity. eHealth can be an effective means of designing such interventions, as parents increasingly use the internet to access health information. The objective of this study was to determine maternal and co-parent satisfaction with an eHealth intervention. METHODS: The study was part of a larger randomized controlled trial that took place in Canada between March 2018 and April 2020. Data was collected from mothers (n = 56) and co-parents (n = 47). INTERVENTION: The eHealth intervention group received: 1) continued access to an eHealth breastfeeding co-parenting resource from the prenatal period to 52 weeks postpartum; 2) a virtual meeting with a research assistant; and 3) 6 weekly emails reminders. Follow-up data were collected via online questionnaires completed at 2 weeks post enrollment and 4, 12, 26, and 52 weeks postpartum to determine use and satisfaction with the intervention components. FINDINGS: The majority of mothers and co-parents independently reviewed the eHealth resource (95% and 91%, respectively), with higher use in the prenatal period. Participants found the resource to be useful (92%), informative (93%), targeted both parents (90%), and easy to understand (97%). Participants indicated the resource was comprehensive, easily navigated, convenient, and engaging. APPLICATION TO PRACTICE: Providing mothers and their co-parents with breastfeeding co-parenting support via an eHealth intervention delivers accessible, comprehensive information which may assist them in meeting their breastfeeding goals.


Assuntos
Poder Familiar , Telemedicina , Feminino , Humanos , Gravidez , Aleitamento Materno , Canadá , Mães , Pais , Satisfação Pessoal , Recém-Nascido , Lactente
4.
Can J Respir Ther ; 59: 256-269, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38084109

RESUMO

Rationale: Extremes of temperature and humidity are associated with adverse respiratory symptoms, reduced lung function, and increased exacerbations among individuals living with chronic obstructive pulmonary disease (COPD). Objectives: To describe the reported effects of temperature and humidity extremes on the health outcomes, health status and physical activity (PA) in individuals living with COPD. Methods: A cross-sectional self-reported survey collected the effects on health status (COPD Assessment Test [CAT]), PA, and health outcomes in 1) moderate/ideal (14 to 21°C, 30 to 50% relative humidity [RH]), 2) hot and humid (≥ 25°C, > 50% RH) and 3) cold and dry (≤ 5°C, < 30% RH) weather conditions. Participants were ≥ 40 years old with COPD or related chronic respiratory diseases (e.g., asthma, sleep apnea, interstitial lung disease, lung cancer) and residing in Canada for ≥ 1 year. Negative responders to weather extremes were a priori defined as having a change of ≥ 2 points in the CAT. Main Results: Thirty-six participants responded; the mean age (SD) was 65 (11) years, and 23 (64%) were females. Compared to ideal conditions, 23 (66%) and 24 (69%) were negatively affected by cold/dry and hot/humid weather, respectively. Health status was significantly lower, and PA amount and difficulty level were reduced in hot/humid and cold/dry conditions compared with ideal conditions. The number of exacerbations in hot/humid was significantly higher compared to ideal conditions. Conclusions: More participants were negatively affected by extremes of weather: health status worsened, PA decreased, and frequency of exacerbations was higher compared to ideal. Future prospective studies should directly and objectively investigate different combinations of extreme temperature and humidity levels on symptoms and PA to understand their long-term health outcomes.

5.
Aging Clin Exp Res ; 34(2): 309-324, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34319511

RESUMO

BACKGROUND/AIMS: Despite the proven benefits of vaccine prevention and the continuous development of this important public health measure, vaccine hesitancy is among the top ten threats to global health according to the World Health Organization in 2019. Those who contract the influenza virus will typically develop a mild illness. However, for populations at a higher risk, including those diagnosed with dementia, influenza is proven to be more detrimental. Persons with dementia (PWD) face a serious threat to influenza on an annual basis, and vaccine hesitancy may further potentiate this risk. The purpose of this paper is to explore and understand the barriers PWD face in receiving the influenza vaccine. METHODS: A literature review was conducted to examine the barriers that prevent PWD from seeking out the annual influenza vaccine. A thematic analysis provided an understanding of the overarching relationships found among the influences between the identified themes. RESULTS: Three main influences were identified: (1) intra-personal, (2) inter-personal, and (3) extra-personal, with each influence containing several subsequent sub-themes. DISCUSSION/CONCLUSION: The literature review found that there is a lack of research involving this high-risk population and the barriers they face, especially within the extra-personal influences. Further research is required to understand how each barrier relates and connects with each other. Understanding this connection will aid public health organizations in decreasing the threat of vaccine hesitancy, thus decreasing the incidents of preventable deaths.


Assuntos
Demência , Vacinas contra Influenza , Influenza Humana , Humanos , Influenza Humana/prevenção & controle , Vacinação , Hesitação Vacinal
6.
Aging Clin Exp Res ; 34(9): 2231-2235, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35534763

RESUMO

This paper reports the findings of a qualitative study conducted in Ontario, Canada with the purpose of identifying the barriers and facilitating factors of access to dementia care by foreign-born individuals, including immigrants and refugees. Interview data revealed seven overarching themes related to access and participation in dementia care programs by migrants, including structural, process, and outcome barriers. Our study findings suggest that incorporating culturally inclusive activity components in recreational dementia care programs will promote program participation by individuals from ethno-cultural backgrounds. It is essential to train health care providers to assist with building competence in working with people from different cultural and linguistic backgrounds. To prevent normalization of symptoms of dementia and promote timely access to dementia care, it is important to focus on generating awareness and acknowledgement of dementia as an illness rather than as a normal part of aging or a condition associated with stigmatization.


Assuntos
Demência , Emigrantes e Imigrantes , Refugiados , Demência/terapia , Humanos , Pesquisa Qualitativa , Participação Social
7.
Aging Ment Health ; 26(10): 1949-1962, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-34353187

RESUMO

Objectives: This evaluation study was designed to examine the factors that contribute the promotion of social connectedness among people with dementia and their caregivers through social recreational programs; develop an understanding of volunteer's impact on program success; and identify the barriers and facilitators to improve the volunteer-based programs to promote social connectedness.Method: A qualitative descriptive research design was used to explore the study participants' lived experiences of social recreational programs from Alzheimer's Society of Durham Region (ASDR) in Ontario, Canada. A final sample of 31 participants was recruited including people with dementia, informal caregivers, and community volunteers. Qualitative data was collected through face-to-face semi-structured interviews. Emerging themes were derived from the qualitative descriptive data using thematic analysis.Results: The qualitative interviews highlighted the impact of social recreational programs on people with dementia, caregivers and volunteers in the promotion of social connectedness, as well as the examination of barriers and facilitators to identify opportunities for the future improvement of ASDR programs that would benefit the dementia populations. The study findings revealed that the project 'Living Well with Dementia' has been able to successfully foster social connectedness through its volunteer-led social recreational programs by promoting the physical and mental well-being of people with dementia and their caregivers.Conclusion: Our study findings underscored the critical roles of volunteers who contributed to the success of community-based programs. Future research is needed to identify the opportunities to address current gaps in services and to strengthen the social recreational programs using evidence-based practices and client-centered approaches.Supplemental data for this article can be accessed online at http://doi.org/10.1080/13607863.2021.1950614.


Assuntos
Cuidadores , Demência , Humanos , Ontário , Pesquisa Qualitativa , Voluntários
8.
BMC Womens Health ; 21(1): 189, 2021 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-33957910

RESUMO

BACKGROUND: Many factors influence the menopausal transition and the complexity of this transition increases with the addition of immigration transition. This review aims to identify the factors that influence the menopausal transition for immigrant women based on ecosocial theory. METHODS: A scoping review of English publications was conducted according to PRISMA guidelines using CINAHL, AgeLine, MEDLINE, PsycINFO, ERIC, Nursing and Allied Health Database, PsycARTICLES, Sociology Database, and Education Research Complete. Thirty-seven papers were included for this review. RESULTS: The factors which influence the menopausal transition for immigrant women were grouped into three categories: (a) personal factors, (b) familial factors, and (c) community and societal factors. Personal factors include income and employment, physical and psychological health, perceptions of menopause, and acculturation. Familial factors include partner support, relationships with children, and balancing family, work, and personal duties. Community and societal factors encompassed social network, social support, healthcare services, traditional cultural expectations, and discrimination in host countries. CONCLUSIONS: Interventions addressing the menopausal transition for immigrant women should be designed considering different psychosocial factors and actively work to address systemic barriers that negatively impact their transition.


Assuntos
Emigrantes e Imigrantes , Emigração e Imigração , Criança , Feminino , Nível de Saúde , Humanos , Menopausa , Apoio Social
9.
Aging Clin Exp Res ; 33(2): 391-397, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32297177

RESUMO

BACKGROUND: Evidence suggests that informal caregivers who are providing care for seniors with dementia experience daily stressors due to their demanding caregiving roles. Current research recognizes the positive impact of mindfulness on caregivers' well-being. However, there is an existing gap in the current literature about informal caregivers' own perceptions and understanding of mindfulness intervention. OBJECTIVE: To address this gap, this pilot study aims to explore informal caregivers' experience of a single mindfulness session and the feasibility of mindfulness to be integrated into their daily lives. METHODS: Six informal caregivers who are providing care for seniors living with dementia participated in this qualitative descriptive study. Thematic analysis was used to derive themes to understand the participants' experience of a brief mindfulness session. RESULTS: The findings of the study generated five major themes: (1) Comparison of mindfulness with other relaxation techniques; (2) Single mindfulness session as a social learning opportunity; (3) Positive impact of practicing mindfulness; (4) Perception about barriers to practicing mindfulness; and (5) Perception of self-efficacy to practice mindfulness in the future. DISCUSSION: The study participants perceived mindfulness to be beneficial for their overall well-being. In addition, as participants were beginners of mindfulness, they considered mindfulness technique to be easy to learn through single practice session and feasible to be integrated into their daily lives. CONCLUSION: This qualitative study highlights that as little as brief 15 min of mindfulness session is perceived positively by informal caregivers. There is a need for further research on the long-term outcomes of practicing mindfulness among informal caregivers of seniors.


Assuntos
Demência , Atenção Plena , Cuidadores , Humanos , Projetos Piloto , Pesquisa Qualitativa
10.
Geriatr Nurs ; 42(2): 491-501, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32807555

RESUMO

With an increasing number of older people who require homecare services, clients must develop a therapeutic self-care ability in order to manage their health safely in their homes. Therapeutic self-care is the ability to take medications as prescribed, and to recognize and manage symptoms that may be experienced, such as pain. This qualitative research study utilized one-on-one, in-depth, semi-structured interviews with the clients and their informal caregivers recruited from one homecare agency in Ontario, Canada. The goal of the interviews was to gain a better understanding of the relationship between client's therapeutic self-care ability and homecare safety outcomes, and the role of self-care and caregiving activities in supporting homecare safety in relation to chronic disease management. A total of fifteen older homecare clients (over the age of 65) and fifteen informal caregivers were interviewed in their homes. Qualitative description was the methodological approach used to guide the research study. Thematic analyses of the qualitative interview data revealed that homecare clients and their informal caregivers are struggling with multiple aspects of safety challenges. The study findings provided insight into safety problems related to therapeutic self-care at home, and this knowledge is vital to policy formulation related to the role of healthcare professionals in improving client's therapeutic self-care ability to reduce safety related risks and burden for older homecare recipients. Protocol Reference and REB approval (#27223) was obtained from University of Toronto Research Ethics Board.


Assuntos
Serviços de Assistência Domiciliar , Autocuidado , Idoso , Cuidadores , Humanos , Ontário , Pesquisa Qualitativa
11.
BMC Health Serv Res ; 17(1): 206, 2017 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-28292301

RESUMO

BACKGROUND: In an era of a rapidly aging population who requires home care services, clients must possess or develop therapeutic self-care ability in order to manage their health conditions safely in their homes. Therapeutic self-care is the ability to take medications as prescribed and to recognize and manage symptoms that may be experienced, such as pain. The purpose of this research study was to investigate whether therapeutic self-care ability explained variation in the frequency and types of adverse events experienced by home care clients. METHODS: A retrospective cohort design was used, utilizing secondary databases available for Ontario home care clients from the years 2010 to 2012. The data were derived from (1) Health Outcomes for Better Information and Care; (2) Resident Assessment Instrument-Home Care; (3) National Ambulatory Care Reporting System; and (4) Discharge Abstract Database. Descriptive analysis was used to identify the types and prevalence of adverse events experienced by home care clients. Logistic regression analysis was used to examine the association between therapeutic self-care ability and the occurrence of adverse events in home care. RESULTS: The results indicated that low therapeutic self-care ability was associated with an increase in adverse events. In particular, logistic regression results indicated that low therapeutic self-care ability was associated with an increase in clients experiencing: (1) unplanned hospital visits; (2) a decline in activities of daily living; (3) falls; (4) unintended weight loss, and (5) non-compliance with medication. CONCLUSIONS: This study advances the understanding about the role of therapeutic self-care ability in supporting the safety of home care clients. High levels of therapeutic self-care ability can be a protective factor against the occurrence of adverse events among home care clients. A clear understanding of the nature of the relationship between therapeutic self-care ability and adverse events helps to pinpoint the areas of home care service delivery required to improve clients' health and functioning. Such knowledge is vital for informing health care leaders about effective strategies that promote therapeutic self-care, as well as providing evidence for policy formulation in relation to risk mitigation in home care.


Assuntos
Serviços de Assistência Domiciliar/estatística & dados numéricos , Erros Médicos/estatística & dados numéricos , Segurança do Paciente , Indicadores de Qualidade em Assistência à Saúde/estatística & dados numéricos , Autocuidado/estatística & dados numéricos , Atividades Cotidianas , Idoso , Feminino , Humanos , Modelos Logísticos , Masculino , Ontário/epidemiologia , Segurança do Paciente/normas , Qualidade da Assistência à Saúde/normas , Estudos Retrospectivos , Autocuidado/normas
12.
Worldviews Evid Based Nurs ; 11(5): 274-83, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25099877

RESUMO

BACKGROUND: There are gaps in knowledge about the extent to which home care nurses' practice is based on best evidence and whether evidence-based practice impacts patient outcomes. AIM: The purpose of this study was to investigate the relationship between evidence-based practice and client pain, dyspnea, falls, and pressure ulcer outcomes in the home care setting. Evidence-based practice was defined as nursing interventions based on best practice guidelines. METHODS: The Nursing Role Effectiveness model was used to guide the selection of variables for investigation. Data were collected from administrative records on percent of visits made by Registered Nurses (RN), total number of nursing visits, and consistency of visits by principal nurse. Charts audits were used to collect data on nursing interventions and client outcomes. The sample consisted of 338 nurses from 13 home care offices and 939 de-identified client charts. Hierarchical generalized linear regression approaches were constructed to explore which variables explain variation in client outcomes. RESULTS: The study found documentation of nursing interventions based on best practice guidelines was positively associated with improvement in dyspnea, pain, falls, and pressure ulcer outcomes. Percent of visits made by an RN and consistency of visits by a principal nurse were not found to be associated with improved client outcomes, but the total number of nursing visits was. LINKING EVIDENCE TO ACTION: Implementation of best practice is associated with improved client outcomes in the home care setting. Future research needs to explore ways to more effectively foster the documentation of evidence-based practice interventions.


Assuntos
Acidentes por Quedas/prevenção & controle , Dispneia/enfermagem , Prática Clínica Baseada em Evidências/organização & administração , Serviços de Assistência Domiciliar/organização & administração , Serviços de Assistência Domiciliar/normas , Dor/enfermagem , Úlcera por Pressão/enfermagem , Adulto , Estudos Transversais , Feminino , Serviços de Assistência Domiciliar/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Ontário , Indicadores de Qualidade em Assistência à Saúde , Análise de Regressão
13.
J Am Med Dir Assoc ; 25(9): 105118, 2024 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-38950588

RESUMO

OBJECTIVES: To produce a consensus list of the top 10 signs and symptoms suggestive of adverse drug events (ADEs) for monitoring in residents of long-term care facilities (LTCFs) who use antipsychotics, benzodiazepines, or antidepressants. DESIGN: A 3-round Delphi study. SETTING AND PARTICIPANTS: Geriatricians, psychiatrists, pharmacologists, general practitioners, pharmacists, nurses, and caregivers from 13 Asia Pacific, European, and North American countries. METHODS: Three survey rounds were completed between April and June 2023. In Round 1, participants indicated their level of agreement on a 9-point Likert scale on whether 41 signs or symptoms identified in a systematic review should be routinely monitored. Participants considered signs and symptoms that reduce quality of life or cause significant harm, are observable or measurable by nurses or care workers, and can be assessed at a single time point. Round 1 statements were included in a list for prioritization in Round 3 if ≥ 70% of participants responded ≥7 on the Likert scale. Statements were excluded if ≤ 30% of participants responded ≥7. In Round 2, participants indicated their level of agreement with statements that did not reach initial consensus, plus amended statements based on Round 1 participant feedback. Round 2 statements were included in Round 3 if ≥ 50% of the participants responded ≥7 on the Likert scale. In Round 3, participants prioritized the signs and symptoms. RESULTS: Forty-four participants (93.6%) completed all 3 rounds. Four of 41 signs and symptoms reached consensus for inclusion after Round 1, and 9 after Round 2. The top 10 signs and symptoms prioritized in Round 3 were recent falls, daytime drowsiness or sleepiness, abnormal movements (eg, shaking or stiffness), confusion or disorientation, balance problems, dizziness, postural hypotension, reduced self-care, restlessness, and dry mouth. CONCLUSIONS AND IMPLICATIONS: The top 10 signs and symptoms provide a basis for proactive monitoring for psychotropic ADEs.

14.
Dementia (London) ; 22(5): 1138-1163, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36978250

RESUMO

Health professionals and care partners of persons living with dementia have expressed that learning needs related to dementia care are a priority. There are currently a variety of training programs available in Ontario (Canada) to address aspects of dementia care, but no commonly accepted description of the core knowledge, skills, and abilities, (i.e., competencies) that should underpin dementia-related training and education in the province. The aim of this study was to review current evidence to inform the later development of competency statements describing the knowledge, skills and actions required for dementia care among care providers ranging from laypersons to health professionals. We also sought to validate existing dementia care principles and align new concepts to provide a useful organizing framework for future competency development. We distinguished between micro-, meso- and macro-level concepts to clarify the competencies required by individuals situated in different locations across the healthcare system, linking competency development in dementia care to broader system transformation. This review precedes the co-development of a holistic competency framework to guide approaches to dementia care training in Ontario.


Assuntos
Competência Clínica , Demência , Humanos , Demência/terapia , Pessoal de Saúde/educação , Currículo , Ontário
15.
Med Sci Educ ; 33(2): 551-567, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37261023

RESUMO

Deprescribing involves reducing or stopping medications that are causing more harm than good or are no longer needed. It is an important approach to managing polypharmacy, yet healthcare professionals identify many barriers. We present a proposed pre-licensure competency framework that describes essential knowledge, teaching strategies, and assessment protocols to promote interprofessional deprescribing skills. The framework considers how to involve patients and care partners in deprescribing decisions. An action plan and example curriculum mapping exercise are included to help educators assess their curricula, and select and implement these concepts and strategies within their programs to ensure learners graduate with competencies to manage increasingly complex medication regimens as people age. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-022-01704-9.

16.
J Transl Med ; 10: 33, 2012 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-22369276

RESUMO

BACKGROUND: The immune system strongly influences outcome in patients with ovarian cancer. In particular, the absolute lymphocyte count in peripheral blood (ALC) and the presence of tumor-infiltrating lymphocytes (TIL) have each been associated with favourable prognosis. However, the mechanistic relationships between ALC, TIL and prognosis are poorly understood. We hypothesized that high ALC values might be associated with stronger tumor immunity as manifested by increased TIL, decreased tumor burden and longer survival. METHODS: ALC values were collected from patient records ≥ 2 years before, during or after primary treatment for high-grade serous ovarian cancer (HGSC). Lymphocyte subsets were assessed in peripheral blood by flow cytometry. CD8+ and CD20+ TIL were assessed by immunohistochemistry. RESULTS: Overall, patients had normal ALC values two or more years prior to diagnosis of HGSC. These values were not predictive of disease severity or survival upon subsequent development of HGSC. Rather, ALC declined upon development of HGSC in proportion to disease burden. This decline involved all lymphocyte subsets. ALC increased following surgery, remained stable during chemotherapy, but rarely recovered to pre-diagnostic levels. ALC values recorded at diagnosis did not correlate with CD8+ or CD20+ TIL but were associated with progression-free survival. CONCLUSIONS: Patients with high intrinsic ALC values show no clinical or survival advantage upon subsequent development of HGSC. ALC values at diagnosis are prognostic due to an association with disease burden rather than TIL. Therapeutic enhancement of ALC may be necessary but not sufficient to improve survival in HGSC.


Assuntos
Linfócitos do Interstício Tumoral/imunologia , Neoplasias Ovarianas/imunologia , Estudos de Coortes , Efeitos Psicossociais da Doença , Feminino , Citometria de Fluxo , Humanos , Contagem de Linfócitos , Subpopulações de Linfócitos/imunologia , Pessoa de Meia-Idade , Gradação de Tumores , Neoplasias Císticas, Mucinosas e Serosas/tratamento farmacológico , Neoplasias Císticas, Mucinosas e Serosas/imunologia , Neoplasias Císticas, Mucinosas e Serosas/patologia , Neoplasias Císticas, Mucinosas e Serosas/cirurgia , Neutrófilos/imunologia , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Prognóstico , Análise de Sobrevida , Resultado do Tratamento
17.
Cureus ; 14(1): e21461, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35223245

RESUMO

The purpose of this review is to examine the existing literature about facilitators and barriers influencing equitable access to naloxone programs by individuals who use opioids. A total of 49 published articles were examined, which generated four overarching themes:(1) Stigma as a barrier to access; (2) Lack of a wide range of stakeholder perspectives; (3) Need for a comprehensive understanding of factors affecting equitable access to naloxone programs; (4) Facilitators to increase the access of community naloxone programs. Our review highlighted the importance of advocacy in practice, education, administration, and policy to address the health inequities that exist in naloxone distribution programs. Advocacy activities involve the need for health care professionals to engage in social justice practice through evidence-based informed research about the facts of opioid use; challenging the stigma toward victim-blaming against naloxone users; as well as promoting program development and health policy to bring about equitable access to naloxone programs by marginalized and socially disadvantaged populations.

18.
Cureus ; 14(1): e21659, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35233328

RESUMO

Effective communication in healthcare settings allows for the expression of complex or technical terms in a manner that each patient can understand. Communication is also linked to increased trust, patient and family satisfaction, and mutual agreement between patients and healthcare personnel. As a result of aging, the elderly (age 65 and older) may develop physical, cognitive, and social changes that may lead to barriers when interacting with healthcare personnel. As a result of these age-related changes, the elderly ability to receive, retain, and convey information may be affected. Therefore, it is essential that healthcare personnel use appropriate language when communicating with this population. Studies have suggested that simulation can be an effective means to train healthcare personnel to develop context-appropriate communication skills for this specific population. This editorial will explore how the Speech Codes Theory (SCT) can structure simulation encounters to enhance healthcare personnel's proficiency in conversing and connecting with this patient population.

19.
Cureus ; 14(10): e30618, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36426342

RESUMO

The ability of healthcare workers to communicate effectively with dementia patients is critical in the healthcare context. This is because persons with dementia have difficulty expressing their views due to cognitive and language impairments. Therefore, it becomes essential that healthcare workers obtain the necessary training to handle the needs and concerns of persons with dementia. Furthermore, when the severity of the illness worsens, people with dementia may find it difficult to communicate verbally, so they rely heavily on nonverbal communication. Nonverbal communication is very useful for indicating pain and suffering. Identifying these nonverbal indicators by health experts allows them to begin treatment sooner, ultimately increasing the quality of life. Studies have found simulations to be an effective way of educating health professionals in the development/improvement of communication skills; however, they lack the capacity to identify and act on specific nonverbal signs. This editorial suggests that using communication accommodation theory (CAT) could be an effective tool for teaching communication skills to health professionals. CAT can give a framework for an improved understanding of nonverbal indications in dementia patients and strategies for healthcare practitioners to alter and use that information in patient care.

20.
Menopause ; 29(9): 1101-1117, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35944249

RESUMO

IMPORTANCE: Menopausal women are one of the fastest growing demographic groups globally. Virtual interventions have emerged as alternate avenues for menopausal women to manage and cope with their symptoms. OBJECTIVE: The purpose of this review is to summarize existing research on the potential effects of virtual interventions for menopause management. EVIDENCE REVIEW: This systematic review was written in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. MEDLINE, PsychINFO, CINAHL, AgeLine, ERIC, ProQuest, Nursing and Allied Health Database, PsychARTICLES, and Sociology Database were used for literature search and searched from conception to December 2021. Original studies, including randomized controlled trials and quasi-experimental studies, were included if they evaluated a virtual intervention for menopause management and investigated the effects of these interventions on physical and psychosocial outcomes and/or the feasibility of these interventions among menopausal women. Included studies were published in peer-reviewed journals and assessed for quality using the Critical Appraisal Skills Program Checklists. FINDINGS: A total of 16 articles were included in this review. Virtual interventions have the potential to improve physical health outcomes including body weight/body mass index/waist circumference, pain, blood pressure, and cholesterol. However, conflicting results were identified for the outcomes of vasomotor and endocrine symptoms, sleep, and sexual functioning. Virtual interventions might also improve psychosocial outcomes, including knowledge and patient-physician communication, although conflicting results were again identified for treatment decision-making ability, quality of life, and anxiety and depression. Virtual interventions were feasible in terms of being usable and cost-effective, and eliciting satisfaction and compliance among menopausal women. CONCLUSIONS AND RELEVANCE: Virtual interventions might have the potential to improve the physical and psychosocial health outcomes of menopausal women, although some conflicting findings arose. Future studies should focus on including diverse menopausal women and ethnic minorities, conducting research within low- to middle-income countries and communities, further exploring intervention design to incorporate features that are age and culture sensitive, and conducting full randomized controlled trials to evaluate the effects of the interventions.


Assuntos
Ansiedade , Qualidade de Vida , Adaptação Psicológica , Ansiedade/terapia , Feminino , Humanos , Menopausa
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