以家庭为中心的干预对精神分裂症患者的社会功能及照料者心理健康的影响

目的 探讨以家庭为中心的干预对精神分裂症患者社会功能与照料者心理健康的影响.方法 将临床"痊愈"出院的精神分裂症患者112例随机分为研究组(56例)和对照组(56例).对照组给予抗精神药物维持治疗和一般的心理教育;研究组在此基础上,实施以家庭为中心的护理干预.出院后每3个月深入家庭进行家访或给予针对性具体指导,观察时间为1年.采用症状自评量表(SCL-90)和社会功能缺陷筛查量表(SDSS)、服药依从性量表,分别对家庭照料者和患者于人组时、1年后进行评定.结果 1年后,家庭照料者的SCL-90各因子分除偏执、精神病性两因子外其余各因子研究组均低于对照组,有显著性差异(P＜0.05或P＜0.01);研究组服药依从性高于对照组,有显著性差异(P＜0.01);研究组患者SDSS各因子分低于对照组,有显著性差异(P＜0.05或P＜0.01).结论 以家庭为中心的护理干预对提高精神分裂症患者服药依从性,改善精神分裂症患者的社会功能,提高家庭照料者心理健康水平.

Abstract：

Objective To investigate the effects of family centered intervention on schizophrenia patient's social function and mental health of their caregivers.Methods The patients with schizophrenia who had been cured and discharged were randomly divided into study group (56 cases) and control group (56cases).The patients in control group were treated with drugs and routiine psychological education and those in study group received additional family centered nursing intervention.After discharged, every3 months home visit and customized guidance were done, observation time was 1 year.Caregivers and patients were sccessed by Symptom Check List (SCL-90), Social Dysfunction Screening Scale (SDSS) and Medicine Compliance Check List when divided groups and after 1 year.Results After 1 year,each factor score that caregivers got in study group was lower than that of control group except the fsctors of paranoid ideation and psychoticism.There was significant difference between two groups(P<0.05或P<0.01).Medicine compliance in study group was higher than that of control group(P<0.01).Each factors of SDSS in study group was lower than that of control group(P<0.05或P<0.01).clusions Family centered nursing intervention can increase medicine compliance of schizophrenia patients, improve the pstients'social function, raise the level of caregivers'mental health.     

脑卒中患者及其照顾者生存质量研究进展

脑卒中具有高患病率、高病死率、高致残率和高复发率的特点,它影响着全球约1500万人,其中有60％的脑卒中患者死亡或遗留永久的残疾.大多数脑卒中患者生活在社区,需要家庭照顾者(主要是他们的配偶)给予帮助.然而,脑卒中导致的功能缺损和各种相关因素阻碍了患者的康复,并使得患者及其照顾者的生存质量下降.本文对影响脑卒中患者及其照顾者生存质量的相关因素进行全面性回顾分析,从而为制定脑卒中患者的康复治疗方案提供客观依据.     

Attitudes and dilemmas of caregivers supporting people with intellectual disabilities who have diabetes

Objective

To explore how professional caregivers in communal living arrangements support people with a mild or moderate intellectual disability (ID) who have diabetes.

Methods

A qualitative study, 13 caregivers participated in semi-structured interviews.

Results

Professional caregiver support in diabetes care is almost solely directed towards administering medication and controlling food intake. Caregivers want to provide person-centered care but are hindered by a conflict between protecting a client's health and at the same time respecting autonomy. None of the caregivers had received training in supporting self-management; their knowledge about diabetes is limited. The few that engaged their client in self-management stressed the importance of a positive and collaborative approach.

Conclusion

This study provides a first insight into the challenges that professional caregivers experience when a client with ID has diabetes. More education for caregivers seems needed. Self-management support is likely to benefit from consensus among caregivers about what comprises person-centered care and self-management in people with ID who have a chronic disease.

Practice implications

Increasing caregivers’ awareness of the importance of supporting self-management in people with ID and a chronic disease is essential. Discussing practice examples in the light of existing knowledge about developing autonomy will contribute to their awareness.     

痴呆照料者经济负担因素的多元分析

目的了解痴呆照料者经济负担的影响因素。方法收集来我院就诊的46例痴呆患者,自行设计《痴呆患者经济负担调查表》,对46例痴呆患者家属进行经济负担调查。结果1伴有精神行为症状((BPSDt=-2.287,P=0.028)、应用抗痴呆药物(t=-3.53,P=0.001)2个因素与医疗费用相关;2简明智力状况检查(MMSEt=-2.910,P=0.006)评分对非医疗费用有影响;3MMSE评分(t=-7.758,P=0.000)和伴有BPSD(t=-4.36,P=0.000)与每日所需的照料时间相关。结论痴呆照料者的经济负担与低MMSE评分、伴有BPSD和应用抗痴呆药物等因素密切相关。     

Self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their informal caregivers: associations with symptoms and distress

This study examined self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their caregivers, and associations between self-efficacy and patient and caregiver adjustment. One hundred and fifty-two patients with early stage lung cancer completed measures of self-efficacy, pain, fatigue, quality of life, depression, and anxiety. Their caregivers completed a measure assessing their self-efficacy for helping the patient manage symptoms and measures of psychological distress and caregiver strain. Analyses indicated that, overall, patients and caregivers were relatively low in self-efficacy for managing pain, symptoms, and function, and that there were significant associations between self-efficacy and adjustment. Patients low in self-efficacy reported significantly higher levels of pain, fatigue, lung cancer symptoms, depression, and anxiety, and significantly worse physical and functional well being, as did patients whose caregivers were low in self-efficacy. When patients and caregivers both had low self-efficacy, patients reported higher levels of anxiety and poorer quality of life than when both were high in self-efficacy. There were also significant associations between patient and caregiver self-efficacy and caregiver adjustment, with lower levels of self-efficacy associated with higher levels of caregiver strain and psychological distress. These preliminary findings raise the possibility that patient and caregiver self-efficacy for managing pain, symptoms, and function may be important factors affecting adjustment, and that interventions targeted at increasing self-efficacy may be useful in this population.     

神经管畸形患者直接照料者的生命质量研究

目的 通过测量直接照料者的生命质量,对神经管畸形的无形负担进行定量描述. 方法 对37例NTDs患者进行日常生活能力评价,采用EQ-5D生命质量量表,测量神经管畸形患者直接照料者的生命质量.结果 37例神经管畸形患者直接照料者,在行动、自己照顾自己、日常活动3个方面均完全没有问题,62.2％的直接照料者表示有不同程度的焦虑或抑郁,32.4％的直接照料者表示有一些疼痛或不舒服.神经管畸形患者直接照料者健康指数均数为0.84、四分位数间距为0.28;EQ VAS健康分值均数为0.72、四分位数间距为0.15.未发现神经管畸形患者年龄、患者日常生活能力水平、直接照料者的年龄及其健康状况对直接照料者生命质量产生影响.结论 神经管畸形患者一定程度上影响了直接照料者的生命质量,反映了患者家庭所承担的无形负担.     

Prevalence,determinants, and reasons for malaria vaccine hesitancy among caregivers of under-five children in Nigeria: Results from a nationwide cross-sectional survey

ObjectiveMalaria contributes to an enormous global burden of disease and mortality, especially in children. Approximately one in every four global cases and deaths from malaria occurs in Nigeria. This study aims to evaluate the prevalence and correlates of community hesitancy to the malaria vaccine, including the reasons for the hesitancy, following the approval of the RTS,S malaria vaccine by the World Health Organization (WHO).MethodsThis was a nationwide cross-sectional online survey of Nigerian adults conducted from 20th October to 30th November 2021. Participants who replied ‘no' or ‘maybe’ to a question assessing their willingness to accept the RTS,S malaria vaccine were considered “hesitant”. We fit a multivariate logistic regression model to report the adjusted odds ratio (aOR) and 95 % confidence interval (CI) for the factors associated with vaccine hesitancy.FindingsAmong 3377 total respondents (1961 [57.86 %] males; mean age [SD]: 30[9.1]), 1010 (29.91 %) were hesitant. Receiving information about the RTS,S malaria vaccine initially from healthcare workers (vs. the internet) (aOR:0.55; 95 % CI:0.35–0.87) was significantly associated with lower odds of hesitancy. Conversely, earning a high income of over NGN100, 000 (vs. < NGN 30,000) per month (aOR: 2.10, 95 % CI: 1.36–3.24), belonging to other religious groups (vs. Islam) (aOR:3.25, 95 % CI:1.18–8.98), and having a family size of more than ten (vs. < 5) (aOR:1.84; 95 % CI:1.08–3.13) were significantly associated with a higher odds of hesitancy. The main reasons for vaccine hesitancy included fear of vaccine adverse effects (34.95 %), availability of other malaria preventive measures (33.96 %) and not seeing the positive effect of the vaccine in others first (32.97 %).ConclusionThe findings of this survey provide a valuable blueprint for the development of targeted interventions to facilitate caregiver acceptance of the RTS,S vaccine.     

Implementation of paediatric intensive care unit diaries: Feasibility and opinions of parents and healthcare providers

BackgroundThe implementation of paediatric intensive care unit (PICU) diaries has been reported as feasible in routine care. To date no feasibility study has compared PICU healthcare providers’ (HCPs) and parents’ opinions on this tool.ObjectivesThe aim of this study is to describe the feasibility and perception of PICU diaries in an Italian PICU from the point of view of parents and HCPs.MethodsThis is a single-centre, prospective, observational study conducted in a tertiary care paediatric hospital from August 2020 to May 2021. Children admitted to the emergency department PICU, intubated, and sedated for ≥48 h were enrolled. To explore their perceptions and attitudes with the PICU diary, parents were interviewed at 30 days from their child's discharge from the PICU, whereas PICU HCPs were surveyed at the end of the study. Data were analysed as proportions for categorical variables and means and medians for continuous variables according to the distribution, whereas qualitative data were summarised in categories by two independent researchers.ResultsTwenty families were enrolled in this study. A total of 275 daily PICU diary entries were collected. Children's median age was 9 years (interquartile range = 2–13.25), and the length of stay ranged from 6 to 39 days. PICU diary applicability was rated high by parents and HCPs (>8 on a 1–10 Likert scale). Parents and HCPs perceived PICU diaries as beneficial for communication between staff and families, for parents by expressing their emotions and for staff by becoming aware of how parents experienced their child's admission. Reported barriers were the lack of a private environment, the risk of exposure to public reading, and PICU workload.ConclusionsPICU diaries were feasible and perceived as beneficial both by parents and HCPs. Future research is warranted to understand the effect of PICU diaries on post-PICU outcomes.