901 resultados para Caregivers
Resumo:
A community sample of 362 married couples participated in a study of attachment and spousal caregiving, which combined qualitative and quantitative components. The qualitative component focused on actual experiences of caregiving, assessed by participants' semi-structured accounts of a situation involving their role as caregiver for their spouse, Attachment styles and their underlying dimensions (comfort with closeness, anxiety over relationships) were related to the type of support provided, the coping strategies used in the situation, caregivers' feelings about the quality of their care, perceived effects on the couple bond, and the emotional tone of the accounts. The quantitative component tested a theoretical model of factors predicting willingness to provide care for the spouse if he or she should become dependent in later life. Measures of attachment and caregiving styles, attachment to spouse, and anticipated burden provided reliable prediction of willingness to care. The results support the conceptualization of attachment and caregiving as interrelated features of marital bonds, and they have important implications for patterns of family caregiving.
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Development of a self-report measure of coping specific to multiple sclerosis (MS) caregiving is needed to advance our understanding of the role of coping in adaptation to caring for a person with MS and to contribute to a lack of empirical data on MS caregiving. A total of 213 MS caregivers and their care recipients completed a Coping with MS Caregiving Inventory (CMSCI) and measures of adjustment (psychological distress), appraisal and illness. A subsample (n = 64) also completed the Ways of Coping Checklist (WCC) and additional adjustment measures (depression, caregiving impact. dyadic adjustment, and relationship conflict and reciprocity). Factor analyses revealed 5 factors: Supportive Engagement, Criticism and Coercion, Practical Assistance, Avoidance, and Positive Reframing. Subscales had internal reliabilities comparable to similar scales and were empirically distinct. Preliminary construct validation data are consistent with recent MS caregiving research that links passive avoidant emotion-focused coping with poorer adjustment, and relationship-focused coping caregiving research that links greater reliance on positive relationship-focused coping and less reliance on criticism with better adjustment. Results extend this research by revealing new relations between coping and adaptation to MS caregiving. Convergent validation data suggest that although the inventory differs from the WCC, it does share certain conceptual similarities with this scale.
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Development of a self-report measure of stress specific to HIV/AIDS is needed to advance our understanding of the role of stress in adaptation to HIV/AIDS: hence, the aim of this study was the development of the HIV/AIDS Stress Scale. A total of 132 homosexual/bisexual men with HIV/AIDS v ere interviewed and completed the HIV/AIDS Stress Scale and measures of coping strategies, appraisal, social support and adjustment (global distress, depression, social adjustment, number of HIV symptoms, and subjective health status) at three time points. Thirty-nine primary caregivers were interviewed and completed measures of stress and adjustment. Exploratory factor analyses of the HIV/AIDS Stress Scale items revealed three factors: Social, Instrumental and Emotional/Existential Stress. Factors had adequate internal reliabilities and were stable over 12 months. Construct validation data are consistent with recent stress/coping research that links higher levels of stress with more HIV symptoms. reliance on emotion-focused coping, lower social support, poorer levels of adjustment and higher levels of caregiver stress. Results extend this research by revealing new differential relations between various stress dimensions and stress/coping variables. Convergent validation data suggest that the HIV/AIDS Stress Scale shares conceptual similarity with threat appraisal. and differs from control liability and challenge appraisals. The HIV/AIDS Stress Scale shows potential for the elucidation of the role of stress in coping and adaptation to HIV/AIDS and disease progression in both research and clinical applications.
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This study assessed the impact of a randomized trial of nursing-based case management for patients with chronic obstructive pulmonary disease, their caregivers, and nursing and medical staff. Sixty-six patients were matched by FEV1 on admission to hospital, and randomized into an intervention or control group. Intervention group patients reported significantly less anxiety at 1 month postdischarge; however, this effect was not sustained. There was little difference between groups in terms of unplanned readmissions, depression, symptoms, support, and subjective well being. Interviews with patients and caregivers found that the case management improved access to resources and staff-patient communication. Interviews with nursing and medical staff found that case management improved communication between staff and enhanced patient care.
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Helicobacter pylori infection is common among adults with intellectual disability. The acceptabilities and accuracies of different diagnostic tests in this population are unknown. We aimed to determine (i) patient acceptability and (ii) performance characteristics of serology, fecal-antigen, and urea breath tests among adults with intellectual disability. One hundred sixty-eight such adults underwent H. pylori testing with serology and fecal-antigen tests, and a portion underwent treatment. One year later, the participants were retested with fecal-antigen, serology, and urea breath tests. The numbers of specimens obtained and difficulties in collection reported by caregivers were noted. Test performance characteristics were assessed among participants and 65 of their caregivers, using serology as the reference. All participants provided at least one specimen, despite reported collection difficulties for 23% of fecal and 27% of blood specimens. Only 25% of the participants provided breath specimens; failure to perform this test was associated with lower intellectual ability and higher maladaptive behavior. The sensitivity, specificity, and positive and negative predictive values of the fecal test (baseline and 12 months versus caregivers) were 70 and 63 versus 81, 93 and 95 versus 98, 96 and 92 versus 93, and 53 and 74 versus 93%, respectively; those of the urea breath test (12 months versus caregivers) were 86 versus 100, 88 versus 95, 75 versus 89, and 94 versus 100%, respectively. With assistance, fecal or blood specimens for H. pylori assessment can be provided by most patients with intellectual disability regardless of their level of function or behavior. Only those with greater ability can perform the urea breath test. Using serology as the reference test, the limitations of performance characteristics of the fecal-antigen and urea breath tests are similar to those among a control group of caregivers.
Resumo:
Objetivo: Estimar o risco de infeco tuberculosa em agentes comunitrios de sade envolvidos no controle da doena. Mtodos: Foi seguida uma coorte prospectiva, de abril de 2007 a maio de 2008, no municpio de Cachoeiro de Itapemirim, ES. A coorte foi composta por 61 agentes comunitrios, divididos em no-expostos (n=37) e expostos (que acompanharam pacientes com tuberculose, n=24). Durante os 12 meses de seguimento, foi realizado teste tuberculnico, utilizando a tuberculina PPD RT23. Foi calculado o risco relativo e intervalo com 95% de confiana e foi avaliada a correlao entre a viragem tuberculnica e a histria ocupacional dos agentes por meio do coeficiente de correlao de Pearson. Resultados: A incidncia da viragem foi de 41,7% no grupo dos expostos e 13,5% no grupo dos no expostos. O risco anual de infeco foi de 52,8% no grupo dos expostos e de 14,4% no grupo dos no expostos (p= 0,013). Observou-se associao entre viragem tuberculnica e exposio a paciente com tuberculose (RR= 3,08; IC 95%: 1,201;7,914). Concluses: Os agentes que acompanharam pacientes com tuberculose em suas rotinas de servio apresentaram risco de infeco maior que aqueles que no acompanharam pacientes com essa doena. A implementao de medidas administrativas de biossegurana de rotina, entre as quais a prova tuberculnica, devem ser priorizadas, considerando o alto risco de infeco tuberculosa entre os agentes comunitrios de sade.
Resumo:
Objetivou-se investigar o padro de adeso ao tratamento por cuidadores de crianas e adolescentes HIV positivos e identificar as estratgias de enfrentamento adotadas diante de estressores da soropositividade. Participaram 30 cuidadores e utilizou-se entrevista semiestruturada, Escala Modos de Enfrentamento de Problemas e pronturio clnico, este como fonte de dados secundrios. Os cuidadores foram classificados em Grupo Adeso e Grupo No-Adeso com base em seus relatos sobre condutas de uso dos medicamentos antirretrovirais e outros critrios. Vinte e cinco cuidadores foram includos no Grupo Adeso. No se observaram diferenas significativas quanto ao enfrentamento entre os grupos, excetuando a busca de prticas religiosas/pensamento fantasioso. Os resultados do subsdios para intervenes visando reduzir impactos psicossociais da soropositividade a cuidadores, crianas e adolescentes. ______________________________________________________________________________ ABSTRACT
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Purpose The health and social care sector is receiving growing attention due to the increased life expectancy and to the public demand for a better quality of life and better health services. New cost-efficient approaches are required, and the paper aims to present and discuss the main results of a study undertaken in a Portuguese municipality on the perceived relevance of an e-marketplace of social and healthcare services for the inhabitants in general, and for people with special needs in particular, and the identification of the most relevant services to be offered through this platform. Design/methodology/approach A wide survey was undertaken to identify the needs of potential users and their expectancies with relation to the proposed platform. The results of the study are a support for the project promoters to understand the viability of the solution and the requirements to the deployment of the pilot experiment, as well as to drive the selection of domains of activities/classes of services to be offered by the platform. Findings Services such as information about healthcare services, home monitoring/accompanying services 24 hours per day, and personal hygiene services provided at home are the ones recognized by the inquired citizens as the most important, which indicates that the potential users will be mostly people with special needs or their family or caregivers. Originality/value While still at a preliminary development phase, the project represents a good opportunity to develop a totally innovative service with high potential impact for the senior population and for individuals with special needs.
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With the increasing number of aged people, especially in developed countries, Ambient Assisted Living solutions have become an important subject to be explored and developed. Currently, as specialized Institutions in geriatric care cannot cope with the increasing requests for support of quality of life, patients have to remain at their homes having as caregiver the other member of the couple or a member of close family. A solution for supporting the caregiver, during assisting the bedridden person with some basic tasks as eating, taking a bath and/or hygiene care is of utmost importance. This paper presents an approach for supporting the caregiver in moving and repositioning the bedridden elderly people (BEP) with the assistance of a mechanical system conveyer. The conceptual design of the mechanical system must be devoted to assist the caregiver in the handling and repositioning of the BEP. The proposed mechatronic system must, ideally, minimize the system's handling complexity, reduce the number of caregivers and the amount of spended and needed effort.
Resumo:
Ambient Assisted Living is an important subject to be explored and developed, especially in developed countries, due to the increasing number of aged people. In this context the development of mechatronic support systems for bedridden elderly people (BEP) living in their homes is essential in order to support independence, autonomy and improve their quality of life. Some basic tasks as eating, taking a bath and/or hygiene cares become difficult to execute, regarding that often the main caregiver is the other element of the aged couple (husband or wife). This paper presents the conceptual design of a mechanical system especially devoted to assist the caregiver in the handling and repositioning of the BEP. Issues as reducing the number of caregivers, to only one, and reducing the system's handling complexity (because most of the time it will be used by an aged person) are considered. The expertise obtained from the visits to rehabilitation centers and hospitals, and from working meetings, are considered in the development of the proposed mechatronic system.
Resumo:
A Formao Parental, enquanto medida de interveno socioeducativa, tem sido um alvo de interesse gradual, quer a nvel internacional, quer a nvel nacional. As profundas mudanas ocorridas, na esfera social e familiar, so agentes que tm vindo a promover o desenvolvimento de iniciativas de interveno neste domnio. A conscincia dos desafios que acarretam o desempenho das funes parentais nos dias de hoje, tem sido um incentivo na procura de respostas e auxlio aos intervenientes neste difcil processo de educar. Tambm o contributo terico da Psicologia, nomeadamente nas reas de estudo sobre a Formao Parental, a famlia, os estilos parentais, o envolvimento parental, e a sua pertinncia para o desenvolvimento e equilbrio infanto-juvenil, tm vindo e estimular o crescente investimento nesta rea de interveno. O presente estudo teve por objetivo construir, implementar e avaliar a eficcia de um programa de Promoo de Prticas Educativas Parentais. Neste estudo participaram 4 cuidadores (3 do sexo feminino e 1 um do sexo masculino), todos eles residentes no meio urbano (n=4), casados (n=4) e com uma mdia de idades de aproximadamente 42 anos (M=42,25), variando entre os 40 e os 45 anos. A maioria tem o 12 ano (n=3, 75%), apenas 1 (25%), possui habilitaes superiores ao nvel de licenciatura. Os dados foram recolhidos atravs de um Questionrio Sociodemogrfico e do Questionrio de Prticas Parentais (Verso Portuguesa de M. Gaspar & P. Santos de 2008, revisto em 2013). No que respeita aos resultados obtidos, existem algumas modificaes positivas na promoo de competncias parentais ajustada, recorrendo utilizao de estratgias de disciplina positiva em todos os sujeitos, depois da interveno. Referente as outras variveis, nomeadamente, os diferentes estilos de disciplina, promoo do autoconhecimento enquanto pessoas e pais, fomentar a autoestima atendendo a aspetos pessoas e parentais, incentivar o bem-estar subjetivo/felicidade dos participantes com relevncia na parentalidade no houve ocorrncia de alteraes positivas.
Resumo:
O papel de cuidador formal , habitualmente, exercido por profissionais devidamente qualificados, designadamente, mdicos, enfermeiros psiclogos, assistentes sociais, terapeutas ocupacionais, fisioterapeutas e auxiliares. A sua formao acadmica, profissional especfica para o desempenho deste papel, integrada no contexto de uma actividade profissional onde so exercidas competncias, no mbito da sade. Nos lares, hospitais, instituies comunitrias, entre outros, existem indivduos que se enquadram no perfil traado, a actividade desgastante, quer fsica, quer psicologicamente, o que muitas vezes facilita o aparecimento da ansiedade e a percepo do stress. O relaxamento enquanto tcnica teraputica poder atenuar o seu surgimento. Este trabalho teve como objectivo avaliar o impacto de um programa de relaxamento, na percepo de stress, nos cuidadores formais do lar da Liga de Amigos de Aguada de Cima. Para este fim, consideramos adequado um estudo do tipo experimental. Assim aplicmos nossa amostra, dezasseis funcionrias, antes e depois da aplicao do programa de relaxamento progressivo de Jacobson, questionrios de auto-preenchimento, adaptados populao portuguesa. Para alm disso, nas dezasseis sesses que efectumos, medimos a tenso arterial e a frequncia cardaca com um esfigmomanmetro digital de pulso, no perodo antes e depois da implementao do programa. Pela anlise dos resultados que obtivemos, constatmos que no houve diferenas significativas do ponto de vista estatstico, entre a ansiedade e a percepo do stress, aps o programa de relaxamento Jacobson. Confirmmos porm, que existiram diferenas em alguns itens dos questionrios aps a implementao do programa de relaxamento, assim como uma diminuio da presso arterial diastlica e da correlao positiva entre a ansiedade e a percepo de stress. Desta forma, parece existir uma indicao de que o programa de relaxamento progressivo de Jacobson talvez tenha contribudo para minimizar o nvel de stress das funcionrias do lar da Liga de Amigos de Aguada de Cima
Resumo:
Contexto: a bronquiolite aguda a principal patologia a afectar a criana nos primeiros 2 anos de vida, a fisioterapia respiratria uma interveno teraputica utilizada com a inteno de melhorar o curso desta doena mantendo-se a incerteza sobre a sua eficcia. Objectivo: determinar a eficcia e segurana da fisioterapia respiratria em crianas com menos de 2 anos com bronquiolite aguda. Fontes de Informao: Medline (1966 a Agosto 2010), EMBASE(1990 a Agosto 2010), Pedro e Lilacs (1982 a Agosto 2010). Outra fonte de informao incluiu a bibliografia dos estudos obtidos. Seleco de estudos: estudos experimentais comparando a fisioterapia respiratria com cuidados habituais, em crianas com menos de 2 anos e bronquiolite aguda, em ventilao espontnea, em qualquer contexto. Estudos pr-experimentais ou observacionais com os mesmos participantes e intervenes foram admitidos complementarmente aos experimentais. Extraco de dados e anlise: um investigador extraiu os dados dos artigos obtidos e avaliou o risco de vis. A eficcia e segurana da fisioterapia respiratria foram determinadas pelos seguintes outcomes: durao do internamento hospitalar ou do evento, variao de scores de severidade clnica, saturao perifrica e suplementao de oxignio, recidivas, recurso a antibiticos e efeitos deletrios ou deteriorao clnica reportada. Sntese de dados: 6 estudos experimentais foram admitidos. As suas amostras provinham de criana internadas em hospital. As tcnicas de fisioterapia respiratria foram comparadas com cuidados habituais. Nenhum estudo evidenciou melhoria dos outcomes de interesse na comparao entre grupos, excepto avaliaes de curta durao da saturao perifrica de oxignio e scores de severidade clnica. 1 estudo reportou uma percentagem significativamente maior no grupo submetido a fisioterapia respiratria de crianas que vomitaram, tiveram uma desestabilizao respiratria transitria, e na percepo de stress da criana pelos cuidadores. So relatadas ainda fracturas costais a causa de fisioterapia respiratria. Limitaes: o risco de vis era alto em 2 estudos, baixo num estudo e indeterminado nos restantes. Concluses: aparentemente a fisioterapia respiratria no eficaz e pode produzir efeitos deletrios importantes, mas a evidncia pobre, carecendo de novos estudos.
Resumo:
Tendo por principal objetivo contribuir para o estudo da qualidade das creches dos Concelhos de Setbal e de Palmela, com este trabalho pretende-se (1) avaliar e descrever a qualidade de 30 salas de berrio atravs da aplicao da Escala de Avaliao do Ambiente de Creche Edio Revista (Infant/Toddler Environment Rating Scale Revised Edition [ITERS-R], Harms, Cryer, & Clifford, 2006), (2) avaliar e descrever as prticas de socializao dos prestadores de cuidados responsveis pelas 30 salas de berrio atravs da aplicao da Escala de Interao do Prestador de Cuidados (Caregiver Interaction Scale [CIS], Arnett, 1989), (3) estudar a associao entre as prticas de socializao dos profissionais e a qualidade das salas de berrio, (4) estudar associaes entre a qualidade das salas de berrio e as prticas de socializao dos profissionais e algumas variveis de estrutura (rcio adulto/criana, tamanho do grupo, educao, formao e experincia dos prestadores de cuidados). Tendo em conta que os estudos efetuados em Portugal revelam qualidade inadequada e mnima nas salas de creche, os resultados obtidos no presente estudo sugerem que as salas observadas possuem qualidade entre o mnimo e o bom. Embora o presente estudo apresente resultados superiores, verificou-se que os itens que apresentam maiores fragilidades (reas deficitrias), assim como os itens que expressam maior qualidade (reas fortes) parecem convergir com os resultados das investigaes j efetuadas, com efeito os itens relacionados com as subescalas Atividades e Rotinas de cuidados pessoais so os que apresentam os resultados mais preocupantes. A subescala Interao foi a que apresentou resultados superiores e as prticas de socializao dos prestadores de cuidados revelaram ser excelentes. Verificou-se, igualmente, que as salas orientadas por educadores de infncia, assim como, as salas em que o principal prestador de cuidados era educador de infncia revelaram qualidade superior do que salas orientadas por assistentes operacionais (auxiliares de ao educativa). Este efeito chama a ateno para a importncia da formao e qualificao dos profissionais de educao, assim como, para a necessidade de se alterarem as polticas educativas, nomeadamente no que diz respeito obrigatoriedade de existirem educadores de infncia nas salas de berrio. - ABSTRACT With the main objective of contributing to the study of quality of infant/toddler center-based child care in the Counties of Setbal and Palmela, this work aims to (1) assess and describe the quality of 30 infant classrooms by applying the Infant/Toddler Environment Rating Scale-Revised Edition ([ITERS-R], Harms, Cryer, & Clifford, 2006), (2) assess and describe the socialization practices of caregivers responsible for 30 infant classrooms by applying the Caregiver Interaction Scale ([CIS], Arnett, 1989), (3) study the association between the socialization practices of professionals and the quality of infant classrooms, (4) to study associations between the quality of infant classrooms and the socialization practices of professionals and some structure variables (ratio adult/child group size, education, training, and experience of carers). Considering that the studies carried out in Portugal reveal minimum or inadequate quality in infant/toddler center-based child care, the results of this study suggest that, in accordance with ITERS-R, the quality of the infant classrooms observed varies between minimum and good. Although the present study reports higher quality scores, it was found that items which present the biggest weaknesses (deficit areas) as well as the items which express higher quality (strengths) appear to converge with the results of the investigations already carried out, since the items related with subscales Activities and Personal Care Routines are those with the most worrisome results. The Interaction subscale from ITERS-R proved to be the one with higher scores, and socialization practices of caregivers proved to be excellent. It was also found that the rooms oriented by early childhood teachers, as well as the rooms in which the primary care provider was also guided by childhood teachers showed higher quality than when guided by operational assistants (educational activities assistants). This effect draws attention to the importance of the education professionals training and qualification, as well as the need for altering the educational policies, in particular as regards the obligation to ensure the existence of early childhood teachers in infant classrooms.
Resumo:
Este estudo tem como objectivo verificar se os cuidadores informais de pessoas com afasia consideram pertinente a sua participao no processo de habilitao/reabilitao do seu familiar, em terapia da fala, tendo em conta o impacto da afasia na sua vida. Foram entrevistados 7 cuidadores. Verificou-se que a sua qualidade de vida diminuiu, que houve alteraes nos padres de comunicao, nos papis desempenhados e nos seus relacionamentos. atribuda importncia terapia da fala na melhoria das competncias comunicativas dos familiares e na relao entre ambos, considerando a sua participao pertinente, apesar de nem sempre conseguirem acompanhar o familiar s sesses.
