Therapeutic education, the premise of adherence to the type 2 diabetes therapeutic regimen

Background: type 2 diabetes mellitus includes changes in lifestyle in its etiology of prevention, but the evidence is clear —even when people know what to do and what they want to do, they simply do not adopt adherence behaviors. Structured education will allow improving not only metabolic control, but also the adjustment process to a new situation of disease, as well as to develop the patient’s skills in order to make him the key manager of his illness. Objectives: To determine patients’ adherence to prescribed therapeutic regimens. Material and methods: Quantitative, cross-sectional, non-experimental, descriptive, correlational study, with a sample of 102 people with type 2 diabetes, aged between 40 and 85 years old, mostly male (51.96%). The evaluation protocol included social-demographic and clinical questionnaire, Diabetes Self-care Scale and a questionnaire on Diabetes’ knowledge. We also used HbA1c in order to directly assess adherence. Results: It appears that there is no statistically signiicant correlation between socio-demographic variables such as gender and age and adherence. Variables, such as blood glucose monitoring, speciic diet compliance and knowledge, reveal a statistically signiicant effect on adherence (P < .05). Conclusion: The evidence is clear on the urgent need to recognize the importance of measuring patient adherence to a diabetes treatment plan for the maintenance of glycaemic control. We suggest the reinforcement of educational programs in people with type 2 diabetes so as to improve adherence to self-care.

Caregivers’ burden experienced by relatives living with a person suffering from schizophrenia

Abstract: Schizophrenia is a complex chronic disease that turns the affected person into a dependent and disorganized patient. This pathology is responsible for a major burden on the family members who are in charge of taking care of that person. Analyze to what extant can socio-demographic, clinical and environmental variables interfere with the burden felt by family members who live with someone suffering from schizophrenia; to analyze the relationship between a depressive mood state and the burden on the family members who live with a person suffering from schizophrenia were our objectives. As a methodology, quantitative and non-experimental, cross-sectional, descriptive and correlational study. The data collection was done through socio-demographic questionnaires; Vaz Serra and Pio Abreu’s Portuguese version of Beck Depression Inventory (1973); Zarit Burden Interview adapted by Sequeira (2007). 95 informal caregivers taking care of schizophrenic patients were assessed. Participants are mainly female (66%), aged 40 or over (79%) and 36 % are the patients’ mothers. Gender, age and existing family ties variables interfered significantly with the impact caused on the caregiver’s burden. There was a statistically significant correlation between the depressive symptomatology and the burden experienced by the family caregivers. Family/ informal caregiver experience several difficulties when they have to go through a daily process of taking care of a family member suffering from schizophrenia. This situation may cause exhaustion, conflicts, emotional suffering and even depressive symptomatology. This burden of care grows stronger as the patients are older, when they are male and when there are no families ties binding patient and caregiver. These variables must be taken into account in these caregivers’ service plans.

Parental Adjustment to Disability, Stress Indicators and the Influence of Social Support

Research into families of children and young people with disability maintain that parents or caregivers seem to experience higher levels of global stress than parents of children without disabilities, thereby presenting a high risk of developing disorders in their health and quality of life. The aim of this study is to understand the differences in parental stress and social support among groups of parents whose children have different disabilities in the context of parental adjustment to disability. Considering that adjustment is related to the effectiveness with which the family uses its resources and the support of their social network, we intend to analyse the differences of stress and social support among groups of parents of children with different problems and to clarify the relationships between the variables under study in order to adapt family intervention strategies. For this purpose a comparative, descriptive-correlational study was undertaken. The convenience sample included 152 parents of children with different disabilities (82 with intellectual disability, 37 with motor problems and 33 with autism) supported by schools and institutions in Viseu. The instruments used were: a Portuguese version of the Parenting Stress Index (Abidin, 1995), the Social Support Questionnaire – short version (Pinheiro & Ferreira, 2001) and a Parental Questionnaire (demographic and family data). Data were collected in schools and institutions that support people with disabilities, located in the Municipality of Viseu (Portugal). The results revealed significant differences between groups of parents in the partial results of parental stress, specifically in the Hyperactivity/Distract (DI), Acceptability (AC) and Adaptability (AD), dimensions of the Child Domain subscale (CD stress) and the Role Restriction (RO), dimension of Parent Domain subscale (PD stress). With regard to social support dimensions, we found significant differences between parents in the extent and availability of the social support network (SSQN).

Empoderamento dos enfermeiros : estudo de alguns fatores intervenientes

Enquadramento O empoderamento é um processo que resulta no fortalecimento pessoal e profissional, na forma de aquisição de competências, motivação, satisfação e tomada de decisão. Está vinculado á autonomia profissional e concretiza-se na tomada de decisão autónoma do enfermeiro. Objetivos:; Identificar as variáveis sociodemográficas, socioprofissionais e de contexto formativo que influenciam o Empoderamento dos enfermeiros. Método:Realizamos um estudo de natureza quantitativa, descritiva-analítico e correlacional com amostra não probabilística de 240 enfermeiros que responderam ao questionário sociodemográfico, á escala “ Perceptions of Empowerment in Midwifery Scale” (Mathews, Scott e Gallagher (2009)1 e á escala da motivação para o exercício profissional. Os enfermeiros possuíam idades entre os 26 e os 66 anos, maioritariamente com vinculo por tempo indeterminado á instituição onde trabalham. Revelaram uma boa perceção sobre o Empoderamento com percentuais a oscilar entre os 50,0% no reconhecimento organizacional e os 100% no reconhecimento por pares. Os mais jovens possuem melhor perceção sobre o Empoderamento no reconhecimento por pares, organizacional e empoderamento global, e os mais velhos maior empoderamento na dimensão pessoal. São os Enfermeiros com mestrado e doutoramento que possuem uma menor perceção na dimensão multidimensional, reconhecimento por pares e reconhecimento organizacional. Quanto à motivação 40,0%dos participantes do estudo encontram-se muito motivados, Conclusão. Pelos resultados obtidos podemos concluir que são os enfermeiros com maior motivação e com mais formação que revelam melhor perceção sobre o Empoderamento. e consequentemente maior capacidade de decisão.

Estilos de Liderança dos Diretores Técnicos e Satisfação dos Colaboradores : Estudo realizado em IPSS`s dos Distritos da Guarda e Viseu

Introdução: Este trabalho trata-se de um estudo quantitativo, transversal, descritivo e correlacional. Objetivos: O presente estudo teve como principal objetivo conhecer, na perspetiva dos colaboradores, a relação entre os estilos de liderança utilizados pelos diretores técnicos e a satisfação dos colaboradores em nove IPSS`s dos distritos da Guarda e Viseu, atendendo ainda à relevância de variáveis sociodemográficas e profissionais no âmbito da satisfação no trabalho. Métodos: A amostra é constituída por 85 colaboradores e o instrumento de recolha de dados agrega questões de caracterização sociodemográfica e profissional e duas escalas, já validadas para avaliar: i) o grau de satisfação nas várias dimensões do trabalho (elaborada pelo Instituto da Segurança Social, 2007) e ii) o estilo de liderança dos diretores técnicos (elaborada por Melo, 2004), segundo a perspetiva dos colaboradores. Resultados: Os resultados obtidos indicam que o estilo de liderança relacional é o que promove maior satisfação e o estilo de liderança voltado para a tarefa menor satisfação. Conclusões: O estudo das hipóteses permitiu observar que as variáveis: género, tipo de contrato, tempo de serviço e habilitações literárias interferem na satisfação dos colaboradores com o trabalho.

Apoio social, saúde mental e bem-estar em idosos institucionalizados e não institucionalizados

O apoio social e o bem-estar são variantes importantes para a saúde mental, em particular, quando se trata da população idosa. O presente estudo visa avaliar o apoio social, o bem-estar e a saúde mental em idosos não institucionalizados e institucionalizados. O método utilizado é o quantitativo, tendo sido realizado um estudo descritivo-correlacional, comparativo, transversal, com uma amostra de 100 idosos: 50 institucionalizados em lar e 50 não institucionalizados, mas que frequentam o centro de dia. Os instrumentos de recolha de dados foram a Escala de Bem-Estar Mental de Warwick-Edimburgh (WEMWBS); a Escala Continuum de Saúde Mental (MHC-SF); a Escala de Rede de Apoio Social de Lubben (LSNS-6); Questionário Sociodemográfico. Genericamente, os resultados demonstram que a maioria dos participantes apresenta níveis elevados de bem-estar, nomeadamente bem-estar emocional, bem-estar psicológico e bem-estar social, encontrando-se maioritariamente em flourishing. Relativamente ao apoio social, este evidencia-se como razoável ao nível da família e baixo ao nível dos amigos. Na análise da relação entre bem-estar, saúde mental e apoio social nos idosos em estudo, foram encontradas correlações estatisticamente significativas positivas entre todas estas dimensões, quer nos indivíduos não institucionalizados e quer nos institucionalizados. Assim, a relação positiva encontrada entre a maioria das variáveis consideradas permite concluir que o bem-estar, a saúde mental e o suporte social se encontram relacionados. Os idosos mais velhos, em particular os institucionalizados, são os que apresentam resultados mais baixos ao nível do bem-estar mental, emocional e suporte social.

Crenças, atitudes e comportamentos de saúde e de risco de adictos em comunidades terapêuticas

Os comportamentos de saúde e de risco são comuns em toxicodependentes. Este trabalho foi conduzido no âmbito da análise descritiva da amostra, nomeadamente, caracterização sócio-demográfica e variáveis cognitivas, seguindo-se um segundo objectivo que consistiu na descrição dos comportamentos, crenças e atitudes face à saúde que os adictos apresentam. A amostra é constituída por 75 sujeitos, do sexo masculino, com uma média de idade de 34,07 anos. A metodologia utilizada caracteriza o estudo de quantitativo-correlacionai, uma vez que se pretende efectuar a descrição das características da amostra e os comportamentos de saúde e de risco que apresentam. Os resultados revelam que os adictos apresentam comportamentos de risco, logo, são menores os comportamentos de saúde adoptados durante os consumos. É necessário intervir nas várias áreas de saúde do adicto, nomeadamente, nas práticas sexuais, na prevenção de doenças, nos cuidados alimentares, na conduta rodoviária e na preocupação com o exercício físico-desportivo. /ABSTRACT: Health behaviors and risk factors are common in drug addicts. This work was conducted under the descriptive analysis, including socio-demographic and cognitive variables, followed by a second objective was to describe the altitudes, beliefs and altitudes towards health that addicts have. The sample consists of 75 subjects were mala, with a mean age of 34.07 years. The methodology characterizes the quantitative and correlational study, since we intend to perform the description of sample characteristics and health behaviors and risk they present. The results show that addicts exhibit risky behavior, so they are smaller health behaviors adopted during the intake. lt is necessary to intervene in several areas of health of the addict, including sexual practices, disease prevention, care food, conduct road and the concern that physical exercise I sports.

Self-assessment of clinical nurse mentors as dimensions of professional development and the capability of developing ethical values among nursing students : A correlational research study

Date of Acceptance: 08/04/2015 The paper presents, in part, the results of a broader non-profit development project entitled “Advance level of knowledge for quality in clinical mentorship — professional ethics and continuously professional development”. The project was financed by the Ministry of Higher Education, Science and Sport of the Republic of Slovenia (contract no. 3211-11-000263, the number of project OP RCV_VS-11-14). The members of the development group of the project were: Brigita Skela-Savič (leader), Karmen Romih, Sanela Pivač, Katja Skinder Savić and Andreja Prebil. The research report for the entire project is available on the online bibliographic database COBIB.si, at the Faculty of Health Care Jesenice and at the Ministry of Higher Education, Science and Sport of the Republic of Slovenia.

Self-assessment of clinical nurse mentors as dimensions of professional development and the capability of developing ethical values among nursing students : A correlational research study

Date of Acceptance: 08/04/2015 The paper presents, in part, the results of a broader non-profit development project entitled “Advance level of knowledge for quality in clinical mentorship — professional ethics and continuously professional development”. The project was financed by the Ministry of Higher Education, Science and Sport of the Republic of Slovenia (contract no. 3211-11-000263, the number of project OP RCV_VS-11-14). The members of the development group of the project were: Brigita Skela-Savič (leader), Karmen Romih, Sanela Pivač, Katja Skinder Savić and Andreja Prebil. The research report for the entire project is available on the online bibliographic database COBIB.si, at the Faculty of Health Care Jesenice and at the Ministry of Higher Education, Science and Sport of the Republic of Slovenia.

Self-assessment of clinical nurse mentors as dimensions of professional development and the capability of developing ethical values among nursing students : A correlational research study

Date of Acceptance: 08/04/2015 The paper presents, in part, the results of a broader non-profit development project entitled “Advance level of knowledge for quality in clinical mentorship — professional ethics and continuously professional development”. The project was financed by the Ministry of Higher Education, Science and Sport of the Republic of Slovenia (contract no. 3211-11-000263, the number of project OP RCV_VS-11-14). The members of the development group of the project were: Brigita Skela-Savič (leader), Karmen Romih, Sanela Pivač, Katja Skinder Savić and Andreja Prebil. The research report for the entire project is available on the online bibliographic database COBIB.si, at the Faculty of Health Care Jesenice and at the Ministry of Higher Education, Science and Sport of the Republic of Slovenia.

Resilience and unmet supportive care needs in patients with cancer during early treatment: A descriptive study.

PURPOSE: The concept of resilience is gaining increasing importance as a key component of supportive care but to date has rarely been addressed in studies with adult cancer patients. The purpose of our study was to describe resilience and its potential predictors and supportive care needs in cancer patients during early treatment and to explore associations between both concepts. METHODS: This descriptive study included adult cancer patients under treatment in ambulatory cancer services of a Swiss hospital. Subjects completed the 25-item Connor-Davidson-Resilience Scale and the 34-item Supportive Care Needs Survey. Descriptive, correlational and regression analysis were performed. RESULTS: 68 patients with cancer were included in the study. Compared to general population, resilience scores were significantly lower (74.4 ± 12.6 vs. 80.4 ± 12.8, p = .0002). Multiple regression analysis showed predictors ("age", "metastasis", "recurrence" and "living alone") of resilience (adjusted R2 = .19, p < .001). Highest unmet needs were observed in the domain of psychological needs. Lower resilience scores were significantly and strongly associated with higher levels of unmet psychological needs (Rho = -.68, p < .001), supportive care needs (Rho = -.49, p < .001) and information needs (Rho = -.42, p = .001). CONCLUSION: Ambulatory patients with higher levels of resilience express fewer unmet needs. Further work is needed to elucidate the mechanism of the observed relationships and if interventions facilitating resilience have a positive effect on unmet needs.

A Study of role conflict, role ambiguity, locus of control, job satisfaction and participation in decision making among front-line vocational service workers for mentally retarded adults

This study was an investigation of individual and organizational factors, as perceived by front-line vocational service workers from Adult Rehabilitation Centres (ARC Industries) for mentally retarded adults. The specific variables which were measured included role conflict/role ambiguity (role factors), internal/external locus of control (individual differences), job satisfaction with work and supervision (job attitudes) and participation in deci~ion making (organizational factor). The exploration of these constructs was conducted by means of self-report questionnaires which were completed by sixty-nine out of a total of ninety front-line employees. The surveys were distributed in booklet form to nine distinct rehabilitation facilities from St. Catharines, West Lincoln, Greater Niagara, Port Colborne, WeIland, Fort Erie, Hamilton, Guelph and Brantford. The survey data was evaluated by the statisti.cal Package for the Social Sciences (SPSS) which used the Pearson Product Moment Correlation procedure and a compar~son of means test. A comparison of correlation coefficients test was also conducted. This statistical procedure was calculated mathematically. The results obtained from the statistical evaluation confirmed the prediction that self-reported measures of participation in decision making and satisfaction (work and supervision) would be negatively correlated with role conflict and role ambiguity. As well, the speculation that perceived satisfaction (work and supervision) would be positively correlated with participation in decision making was empirically supported. Internal and external locus of control did not contribute to a significant difference in r~sponses to role perceptions (conflict and ambiguity) , satisfaction (work and supervision) or the correlational relationship between participation in decision making and satisfaction (work and supervision). Overall, the findings from this study substantiated the importance of examining employee perceptions in the workplace and the interrelationships among individual and organizational variables. This research was considered a contribution to the general area of occupational stress and to the study of individuals in work organizations.

Disturbances in early parenting of depressed mothers and cortisol secretion in offspring: A preliminary study

Background: Disturbances in cortisol secretion are associated with risk for psychiatric disorder, including depression. Animal research indicates that early care experiences influence hypothalamic-pituitary-adrenal (HPA) axis functioning in offspring. Similar effects are suggested in human development, but evidence of longitudinal associations between observed early parenting and offspring cortisol secretion is extremely limited. We studied associations between parenting disturbances occurring in the context of maternal postnatal depression (PND), and elevations in morning cortisol secretion in the adolescent offspring of PND mothers. Methods: We observed maternal parenting behaviour on four occasions through the first year and at five-year follow up in postnatally depressed (n = 29) and well (n = 20) mothers. Observations were coded for maternal sensitivity and withdrawal. Basal offspring salivary cortisol secretion was measured at 13-years, using collections over 10-days. Results: Postnatal, but not five-year, maternal withdrawal predicted elevated mean and maximum morning cortisol secretion in 13-year-old offspring. There were no significant associations between maternal sensitivity and offspring cortisol secretion. Limitations: The sample size was relatively small, and effects tended to be reduced to trend level when covariates were considered. The correlational nature of the study (albeit longitudinal) limits conclusions regarding causality. Conclusions: Individual differences in early maternal parenting behaviour may influence offspring cortisol secretion, and thereby risk for depression. Parenting interventions that facilitate active maternal engagement with the infant may be indicated for high risk populations.

THE SOCIOECONOMIC AND DEMOGRAPHIC CHARACTERIZATION OF CHILDREN AND ADOLESCENTS WHO STUDY AND WORK OUTSIDE THEIR HOME

The objective of this study was to identify the socioeconomic and demographic characteristics of children and adolescents who study and work outside their home. This non-experimental, correlational, cross-sectional study was performed using questionnaires applied to primary education students, enrolled in public schools in Ribeirao Preto (Brazil). Two schools were selected through a draw. Data analysis was performed using Statistical Package for Social Sciences, version 14.0. Of the 133 students who answered the questionnaire, 36 (27.7%) reported working outside their home, 20.6% were between 11 and 13 years of age, and 66.7% were male (p=0.000) and had started working early to help with the family income (p=0.003). The salary they received helped comprise the family income, and it was found that as the family income increased, the need for the youngsters to work was reduced. It was found that many factors contribute to these subjects' early start at work, including family size, structure and poverty.

Oral mucosal findings related to tobacco use and alcohol consumption: a study on Swiss army recruits involving self-reported and clinical data

PURPOSE: The aim of the present study was to assess the oral mucosal health status of young male adults (aged 18 to 24 years) in Switzerland and to correlate their clinical findings with self-reported risk factors such as tobacco use and alcohol consumption. MATERIALS AND METHODS: Data on the oral health status of 615 Swiss Army recruits were collected using a standardised self-reported questionnaire, followed by an intraoral examination. Positive clinical findings were classified as (1) common conditions and anatomical variants, (2) reactive lesions, (3) benign tumour lesions and (4) premalignant lesions. The main locations of the oral mucosal findings were recorded on a topographical classification chart. Using correlational statistics, the findings were further associated with the known risk factors such as tobacco use and alcohol consumption. RESULTS: A total of 468 findings were diagnosed in 327 (53.17%) of the 615 subjects. In total, 445 findings (95.09%) were classified as common conditions, anatomical variants and reactive soft-tissue lesions. In the group of reactive soft-tissue lesions, there was a significantly higher percentage of smokers (P < 0.001) and subjects with a combination of smoking and alcohol consumption (P < 0.001). Eight lesions were clinically diagnosed as oral leukoplakias associated with smokeless tobacco. The prevalence of precursor lesions in the population examined was over 1%. CONCLUSIONS: Among young male adults in Switzerland, a significant number of oral mucosal lesions can be identified, which strongly correlate with tobacco use. To improve primary and secondary prevention, young adults should therefore be informed more extensively about the negative effects of tobacco use on oral health.