Effect of home-based peer support on maternal-infant interactions among women with postpartum depression: a randomized, controlled trial

Approximately 15% of new mothers experience postpartum depression, representing the most common source of maternal morbidity post-delivery. Postpartum depression may impair maternal-infant interactions, contributing to poor developmental outcomes in the offspring of mothers with depression. The purpose of this study was to test the effectiveness of home-based peer support that included maternal-infant interaction teaching for mothers with symptoms of postpartum depression and their infants. Mothers with postpartum depression were randomly assigned to control (n = 33) or intervention groups (n = 27). Intervention group mothers received 12 weeks of home-based peer support that included maternal-infant interaction teaching; peers were mothers who had recovered from postpartum depression and were trained to provide support. Data were collected from all mothers at baseline, as well as 6 and 12 weeks' post-randomization. Contrary to the hypothesized direction of relationships, results favoured the control group. A significant difference between the groups was observed for one of the two measures of maternal-infant interactions. Several other measures favoured the control group, including mothers' depressive symptoms and social support scores. No significant treatment effects were observed in infant IQ scores or diurnal salivary cortisol levels in mothers or infants. The findings suggest that maternal-infant interaction teaching by peers is not well received by mothers with postpartum depression and might be more optimally delivered by professional nurses.     

心脏起搏器植入者生活质量评价研究

从生活质量(QOL)概念的界定、QOL测评在起搏治疗领域中的应用、QOL评价方法与量表的应用、研究中存在的问题等方面介绍了国内外心脏起搏器植入者生活质量评价研究。     

心脏起搏器植入者生活质量评价研究

从生活质量（QOL）概念的界定、QOL测评在起搏治疗领域中的应用、QOL评价方法与量表的应用、研究中存在的问题等方面介绍了国内外心脏起搏器植入者生活质量评价研究。     

社区随访干预对起搏器植入病人生活质量的影响

[目的]探讨社区随访对起搏器植入病人生活质量的影响。[方法]将106例植入永久起搏器的病人按社区随机分为干预组50例和对照组56例。对照组给予常规随访,干预组在常规随访的基础上于术后3个月、6个月、12个月实施社区随访,两组在出院前及植入术后6个月、12个月采用简明健康状况调查问卷(SF-36)评价病人的生活质量,包括躯体功能(PF)、生理职能(RP)、躯体疼痛(BP)、一般健康状况(GH)、生命活力(VT)、社会功能(SF)、情感职能(RE)和精神健康(MH)。[结果]两组病人出院前SF-36评分比较,差异无统计学意义(P>0.05)。除术后6个月干预组BP评分与对照组差异无统计学意义(P>0.05)外,术后6个月、12个月其他维度干预组评分均高于对照组,差异有统计学意义(P<0.01)。[结论]对起搏器植入术病人行社区随访干预有助于提高病人的生活质量。     

The impact of a nurse-led support and education programme for spouses of stroke patients: a randomized controlled trial

Aims and objectives. The aim of the present study was to determine the impact of a nurse‐led support and education programme for improving the spouses’ perceived general quality of life, life situation, general well‐being and health state. Background. Stroke is a disease with great consequences for the patients and their families. The spouses often feel obligated to care for the patient, providing psychological and physical support and having to cope with the patient's physical and cognitive impairments. This might lead to increased problems, as family members struggle to adapt to their new roles and responsibilities. Design and methods. Longitudinal, randomized controlled trial. One hundred spouses were randomly assigned to intervention or control groups, 50 in each group. The intervention group participated in a support and education programme, six times during six months, led by stroke specialist nurses. Both groups were followed for 12 months. Results. No significant differences were found, between intervention and control groups, over time. In the sub analyses, we found that the group attending 5–6 times had a significant decrease in negative well‐being and increased quality of life over time, while the group attending fewer times had a significant decrease in positive well‐being and health state, similar to the control group, which also had a significant decrease in negative and general well‐being. Conclusions. A support and education programme might have a positive effect on spouses’ well‐being, on condition that they attend at least five times. Relevance to clinical practice. To facilitate the spouses’ role as informal caregivers to the stroke patients, further development of the support and education programme used in the present study is needed, including empowerment approach and implementation of coping strategies.     

Long-term mortality and pacing outcomes of patients with permanent pacemaker implantation after cardiac surgery

Background: Approximately 20,000 permanent pacemakers (PPMs) are implanted annually for bradycardia or atrioventricular (AV) block after cardiac surgery. Little is known about the long‐term pacing and mortality outcomes and the temporal trends of these patients. Methods: We examined 6,268 consecutive patients who underwent cardiac surgery at the Minneapolis Veterans Administration Medical Center between 1987 and 2010. Patients who had a PPM within 30 days of cardiac surgery were identified. Pacemaker interrogation records were retrospectively reviewed and mortality was ascertained. Results: Overall, 141 (2.2%) patients underwent PPM implantation for high‐degree AV block (55%) and bradycardia (45%), 9 ± 6 days after surgery. Age, diuretic use, cardiopulmonary bypass time (CPBT), and valve surgery were independent predictors of PPM requirement. After 5.6 ± 4.2 years of follow‐up, 40% of the patients were PPM dependent. Longer CPBT (P = 0.03), PR interval >200 ms (P = 0.03), and QRS interval > 120 ms (P = 0.04) on baseline electrocardiogram predicted PPM dependency . In univariable analysis, PPM patients had a higher long‐term mortality than those without PPM (45% vs 36%; P = 0.02). However, after adjusting for age, sex, type of surgery, and CPBT, PPM requirement was not associated with long‐term mortality (hazard ratio 1.3; 95% confidence interval 0.9–1.9; P = 0.17). Compared to before, incidence of PPM implantation increased after the year 2000 (1.9% vs 2.6%; P = 0.04). Conclusion: The majority of patients who require PPM after cardiac surgery are not PPM dependent in the long term. Requiring a PPM after surgery is not associated with long‐term mortality after adjustment for patient‐related risk factors and cardiac surgical procedure. (PACE 2011; 34:331–338)     

同伴支持对社区空巢老年糖尿病患者自我管理行为及生活质量的影响

目的探讨同伴支持对空巢老年糖尿病患者自我管理行为及生活质量的影响。方法选取社区空巢老年糖尿病患者76例,分为对照组（40例）和干预组（36例）。对照组采用常规健康教育,干预组进行为期3个月的同伴支持干预。在干预前、干预3个月时分别对两组患者进行糖化血红蛋白测定,并应用糖尿病患者自我管理活动问卷及中国糖尿病患者生存质量特异性量表进行调查。结果干预3个月后,干预组自我管理行为、生活质量水平明显提高,糖化血红蛋白值维持在正常范围内,与对照组比较差异具有统计学意义（P〈0．05）。结论同伴支持能够帮助社区空巢老年糖尿病患者有效改变糖尿病自我管理行为,提高患者生活质量,有效控制血糖水平。     

Liminality in the occupational identity of mental health peer support workers: A qualitative study

Peer support is increasingly provided as a component of mental health care, where people in recovery from mental health problems use their lived experiences to provide support to those experiencing similar difficulties. In the present study, we explored the evolution of peer support workers’ (PSW) occupational identities. A qualitative study was undertaken alongside a pilot randomized, controlled trial of peer support for service users discharged from a mental hospital in London, UK. Two focus groups were conducted with eight PSW. Semistructured interviews were conducted with 13 service users receiving peer support and on two occasions with a peer support coordinator. The data were analysed using theoretical thematic analysis, focussing on occupational identity formation. We discuss how the occupational identity of PSW evolved through the interplay between their lived experience, their training, and their engagement in the practice environment in such a way as to construct a liminal identity, with positive and negative outcomes. While the difficulties associated with the liminality of PSW could be eased through the formalization and professionalization of the PSW role, there are concerns that this could lead to an undermining of the value of PSW in providing a service by peers for peers that is separate from formal mental health care and relationships. Skilled support is essential in helping PSW negotiate the potential stressors and difficulties of a liminal PSW identity.     

Postpartum depression peer support: Maternal perceptions from a randomized controlled trial

Background

Peer support in the early postpartum period is effective in the prevention of postpartum depression among women identified as high-risk.

Objectives

To describe maternal perceptions of peer support received while participating in a trial.

Design

Cross-sectional survey of women participating in a randomized controlled trial to evaluate the effect of peer support in the prevention of postpartum depression.

Setting

Seven health regions across Ontario Canada.

Participants

701 women were recruited between November 2004 and September 2006. Women eligible for the study were all mothers with an Edinburgh Postnatal Depression Scale score >9 who were within 2 weeks postpartum, at least 18 years of age, able to speak English, had a live birth, and had been discharged home from the hospital. Exclusion criteria included an infant not discharged home with the mother and current use of antidepressant or antipsychotic medication. Two hundred and twenty-one mothers completed the mailed questionnaire.

Methods

Women were randomly allocated to receive usual postpartum care (control group) or usual postpartum care plus telephone-based peer support (intervention group). Maternal perceptions of peer support were evaluated at 12 weeks postpartum using the validated Peer Support Evaluation Inventory.

Results

Interactions provided by the peer volunteer included the provision of emotional (92.7%), informational (72.4%), and appraisal (72.0%) support. Mothers reported high levels of positive relationship qualities such as trust (83.6%) and perceived acceptance (79.1%). Most (80.5%) mothers indicated they were very satisfied with their peer support experience. Maternal satisfaction was associated with the number and duration of peer volunteer contacts.

Conclusions

The majority of mothers perceived their peer volunteer experience positively lending further support to telephone-based peer support as a preventative strategy for postpartum depression. The following program modifications were suggested: (a) adapt training to enhance the provision of appraisal support; (b) improve matching of volunteers to participants based on age, number of children, and breastfeeding status; and (c) ensure participating mothers want to receive peer support in order to facilitate the development of relationships with their assigned peers.     

健康教育路径在心脏起搏器植入术患者健康教育中的应用

目的探讨采用健康教育路径对心脏起搏器植入术患者实施健康教育的效果。方法将64例行心脏起搏器植入术患者按住院号的单双数分为观察组和对照组,每组各32例。对照组患者采用常规的健康教育方法,观察组采用健康教育路径方法。比较两组患者健康教育效果和并发症发生情况。结果观察组患者健康教育效果优于对照组,并发症发生率低于对照组,两组比较,均P<0.05,差异具有统计学意义。结论 采用健康教育路径实施健康教育可使患者积极、主动地参与治疗护理过程,增加了患者对疾病知识的掌握程度;护士能有目的、有预见性地进行健康教育,从而减少并发症发生和提高护理质量。     

SF-36量表评价心脏起搏器植入后生活质量的改善

目的采用SF-36量表评价永久性人工心脏起搏术后患者的生活质量及疗效。方法应用SF-36量表，对98例安置永久性人工心脏起搏器患者术前、术后的生活质量进行评价。结果98例患者手术均成功，术后原有心脏病症状得到不同程度的缓解。手术治疗前、后SF-36量表评分比较，差异均有统计学意义（P〈0．01）。结论心脏起搏器植入术治疗缓慢型严重心律失常患者，从生理功能、心理社会功能等方面提高了患者的生活质量，是一种安全、有效、可靠的治疗方法。SF-36量表对于评价心脏起搏器植入术后患者的生活质量是可行的。     

Health-related quality of life in Brazilian pacemaker patients

Background: Most quality of life (QoL) studies of pacemaker patients have been conducted in either North America or Europe and their applicability to Latin American populations is largely unknown. Our aim is to study health-related QoL indices in Brazilian pacemaker patients and their determinants using both a generic (SF-36) and a disease-specific questionnaire (AQUAREL).
Methods: The study enrolled 139 clinically stable patients (aged 59 ± 14, 60.4% female) without any communication or cognitive impairments who went to the Pacemaker Laboratory for postimplantation follow-up. All patients were submitted to a standard protocol, which included an interview, functional class assessment, and QoL questionnaires. Additionally, 74 patients were requested to perform a 6-minute walk test.
Results: Female patients and patients without a partner displayed low QoL scores in both the SF-36 mental component summary and the AQUAREL arrhythmia domain. Chagas disease patients displayed low scores only in AQUAREL domains. All health-related QoL scores were low in patients with the worst, high-numbered functional classes, the strongest determinant of low QoL scores in multivariate analysis.
Conclusion: In this first systematic study of QoL in a Latin American pacemaker population, AQUAREL detected well-impaired health-related QoL scores in different groups of patients, particularly in those with Chagas disease. Heart failure, evaluated by functional class, was the strongest predictor of low QoL in pacemaker patients.     

Participation in peer support groups after a cardiac event: a 12-month follow-up.

All cardiac patients in Sweden are given the opportunity to participate in group activities that are arranged by the Swedish National Association for Heart and Lung Patients through a program called The Heart School. In this study, we compared persons who participated in the Heart School activities (n = 59, intervention group) with persons who declined to participate (n = 125, comparison group) with regard to their: self-rated health, life situation, social support, clinical data, rehospitalization, and mortality. Participants completed a questionnaire at 2 weeks, 3 months, and 12 months after discharge from a hospital. They also visited a healthcare center for physical examinations. The intervention group reported more physical symptoms and a higher degree of social support. No other differences were found between the groups. Differences within groups were that the intervention group had increased their physical activities and had eventually stopped smoking. This study adds to the knowledge about the use of peer support groups as a support strategy and supports their use in long-term rehabilitation after a cardiac event.     

延续护理对永久人工心脏起搏器植入术患者自我护理能力与生活质量的影响

目的探讨延续护理干预对永久人工心脏起搏器植入术后患者自我护理能力与生活质量的影响。方法选取永久人工心脏起搏器植入患者60例为研究对象,根据入院时间先后顺序不同随机分为观察组32例和对照组28例。对照组患者接受传统护理干预,观察组患者出院后接受延续性护理干预,比较2组患者自我护理能力、生活质量、不良反应等。结果干预后,观察组患者的躯体健康、心理健康、社会功能、物质条件评分显著高于对照组患者(P0.05);干预后,观察组患者的遵医行为显著优于对照组患者(P0.05);出院后6个月,观察组自我概念、自护责任感、健康知识水平、自我护理技能显著优于对照组(P0.05)。结论永久人工心脏起搏器植入患者在出院后接受延续性护理干预,可以有效提升患者出院后生活质量。     

延续性运动康复护理对永久人工心脏起搏器植入术患者自我护理能力与生活质量的影响

目的 观察延续性运动康复护理对永久人工心脏起搏器植入术患者自我护理能力与生活质量的影响.方法 将我院进行永久人工心脏起搏器植入术的100例患者随机分为对照组与观察组,各50例.对照组给予常规护理,观察组给予延续性运动康复护理,比较两组的护理效果.结果 护理3、6个月,观察组的心功能指标优于对照组(P<0.05).观察组...