Home About us Contact
|
Home About us Contact | ||
|
|
||
Support Interventions (support + intervention)
Selected AbstractsPartner-assisted emotional disclosure for patients with gastrointestinal cancer,CANCER, Issue S18 2009Results from a randomized controlled trial Abstract BACKGROUND: For patients with cancer who are married or in an intimate relationship, their relationships with their partners play a critical role in their adaptation to illness. However, cancer patients and their partners often have difficulty in talking with each other about their cancer-related concerns. Difficulties in communication ultimately may compromise both the patient-partner relationship and the patient's psychological adjustment. The current study tested the efficacy of a novel partner-assisted emotional disclosure intervention in a sample of patients with gastrointestinal (GI) cancer. METHODS: One hundred thirty patients with GI cancer and their partners were assigned randomly to receive 4 sessions of either partner-assisted emotional disclosure or a couples cancer education/support intervention. Patients and partners completed measures of relationship quality, intimacy with their partner, and psychological distress before randomization and at the end of the intervention sessions. Data were analyzed using multilevel modeling. RESULTS: Compared with an education/support condition, the partner-assisted emotional disclosure condition led to improvements in relationship quality and intimacy for couples in which the patient initially reported higher levels of holding back from discussing cancer-related concerns. CONCLUSIONS: Partner-assisted emotional disclosure is a novel intervention that builds on both the private emotional disclosure and the cognitive-behavioral marital literature. The results of this study suggested that this intervention may be beneficial for couples in which the patient tends to hold back from discussing concerns. The authors concluded that future research on methods of enhancing the effects of partner-assisted emotional disclosure is warranted. Cancer 2009;115(18 suppl):4326,38. © 2009 American Cancer Society. [source] Effectiveness of interventions that assist caregivers to support people with dementia living in the community: a systematic reviewINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 2 2008Deborah Parker BA, MSocSci Executive summary Objectives, The objective of this review was to assess the effectiveness of interventions that assist caregivers to provide support for people living with dementia in the community. Inclusion criteria, Types of participants, Adult caregivers who provide support for people with dementia living in the community (non-institutional care). Types of interventions, Interventions designed to support caregivers in their role such as skills training, education to assist in caring for a person living with dementia and support groups/programs. Interventions of formal approaches to care designed to support caregivers in their role, care planning, case management and specially designated members of the healthcare team , for example dementia nurse specialist or volunteers trained in caring for someone with dementia. Types of studies, This review considered any meta-analyses, systematic reviews, randomised control trials, quasi-experimental studies, cohort studies, case control studies and observational studies without control groups that addressed the effectiveness of interventions that assist caregivers to provide support for people living with dementia in the community. Search strategy, The search sought to identify published studies from 2000 to 2005 through the use of electronic databases. Only studies in English were considered for inclusion. The initial search was conducted of the databases, CINAHL, MEDLINE and PsychINFO using search strategies adapted from the Cochrane Dementia and Cognitive Improvement Group. A second more extensive search was then conducted using the appropriate Medical Subject Headings (MeSH) and keywords for other available databases. Finally, hand searching of reference lists of articles retrieved and of core dementia, geriatric and psycho geriatric journals was undertaken. Assessment of quality, Methodological quality of each of the articles was assessed by two independent reviewers using appraisal checklist developed by the Joanna Briggs Institute and based on the work of the Cochrane Collaboration and Centre for Reviews and Dissemination. Data collection and analysis, Standardised mean differences or weighted mean differences and their 95% confidence intervals were calculated for each included study reported in the meta-analysis. Results from comparable groups of studies were pooled in statistical meta-analysis using Review Manager Software from the Cochrane Collaboration. Heterogeneity between combined studies was tested using standard chi-square test. Where statistical pooling was not appropriate or possible, the findings are summarised in narrative form. Results, A comprehensive search of relevant databases, hand searching and cross referencing found 685 articles that were assessed for relevance to the review. Eighty-five papers appeared to meet the inclusion criteria based on title and abstract, and the full paper was retrieved. Of the 85 full papers reviewed, 40 were accepted for inclusion, three were systematic reviews, three were meta-analysis, and the remaining 34 were randomised controlled trials. For the randomised controlled trials that were able to be included in a meta-analysis, standardised mean differences or weighted mean differences and their 95% confidence intervals were calculated for each. Results from comparable groups of studies were pooled in statistical meta-analysis using Review Manager Software and heterogeneity between combined studies was assessed by using the chi-square test. Where statistical pooling was not appropriate or possible, the findings are summarised in narrative form. The results are discussed in two main sections. Firstly it was possible to assess the effectiveness of different types of caregiver interventions on the outcome categories of depression, health, subjective well-being, self-efficacy and burden. Secondly, results are reported by main outcome category. For each of these sections, meta-analysis was conducted where it was possible; otherwise, a narrative summary describes the findings. Effectiveness of intervention type, Four categories of intervention were included in the review , psycho-educational, support, multi-component and other. Psycho-educational Thirteen studies used psycho-educational interventions, and all but one showed positive results across a range of outcomes. Eight studies were entered in a meta-analysis. No significant impact of psycho-educational interventions was found for the outcome categories of subjective well-being, self-efficacy or health. However, small but significant results were found for the categories of depression and burden. Support Seven studies discussed support only interventions and two of these showed significant results. These two studies were suitable for meta-analysis and demonstrated a small but significant improvement on caregiver burden. Multi-component Twelve of the studies report multi-component interventions and 10 of these report significant outcomes across a broad range of outcome measures including self-efficacy, depression, subjective well-being and burden. Unfortunately because of the heterogeneity of study designs and outcome measures, no meta-analysis was possible. Other interventions Other interventions included the use of exercise or nutrition which resulted in improvements in psychological distress and health benefits. Case management and a computer aided support intervention provided mixed results. One cognitive behavioural therapy study reported a reduction in anxiety and positive impacts on patient behaviour. Effectiveness of interventions using specific outcome categories, In addition to analysis by type of intervention it was possible to analyse results based on some outcome categories that were used across the studies. In particular the impact of interventions on caregiver depression was available for meta-analysis from eight studies. This indicated that multi-component and psycho-educational interventions showed a small but significant positive effect on caregiver depression. Five studies using the outcome category of caregiver burden were entered into a meta-analysis and findings indicated that there were no significant effects of any of interventions. No meta-analysis was possible for the outcome categories of health, self-efficacy or subjective well-being. Implications for practice, From this review there is evidence to support the use of well-designed psycho-educational or multi-component interventions for caregivers of people with dementia who live in the community. Factors that appear to positively contribute to effective interventions are those which: ,,Provide opportunities within the intervention for the person with dementia as well as the caregiver to be involved ,,Encourage active participation in educational interventions for caregivers ,,Offer individualised programs rather than group sessions ,,Provide information on an ongoing basis, with specific information about services and coaching regarding their new role ,,Target the care recipient particularly by reduction in behaviours Factors which do not appear to have benefit in interventions are those which: ,,Simply refer caregivers to support groups ,,Only provide self help materials ,,Only offer peer support [source] Oral quinolones in hospitalized patients: an evaluation of a computerized decision support intervention,JOURNAL OF INTERNAL MEDICINE, Issue 4 2004T. Hulgan Abstract. Objective., To determine whether a computerized decision support system could increase the proportion of oral quinolone antibiotic orders placed for hospitalized patients. Design., Prospective, interrupted time-series analysis. Setting., University hospital in the south-eastern United States. Subjects., Inpatient quinolone orders placed from 1 February 2001 to 31 January 2003. Intervention., A web-based intervention was deployed as part of an existing order entry system at a university hospital on 5 February 2002. Based on an automated query of active medication and diet orders, some users ordering intravenous quinolones were presented with a suggestion to consider choosing an oral formulation. Main outcome measure., The proportion of inpatient quinolone orders placed for oral formulations before and after deployment of the intervention. Results., There were a total of 15 194 quinolone orders during the study period, of which 8962 (59%) were for oral forms. Orders for oral quinolones increased from 4202 (56%) before the intervention to 4760 (62%) after, without a change in total orders. In the time-series analysis, there was an overall 5.6% increase (95% CI 2.8,8.4%; P < 0.001) in weekly oral quinolone orders due to the intervention, with the greatest effect on nonintensive care medical units. Conclusions., A web-based intervention was able to increase oral quinolone orders in hospitalized patients. This is one of the first studies to demonstrate a significant effect of a computerized intervention on dosing route within an antibiotic class. This model could be applied to other antibiotics or other drug classes with good oral bioavailability. [source] Planned telephone support for disadvantaged parents in North Wales: perceptions of service usersCHILD & FAMILY SOCIAL WORK, Issue 4 2007Iolo Madoc-Jones ABSTRACT This paper draws on the findings of a qualitative evaluation to examine user perceptions of a planned telephone support intervention based in a disadvantaged area in North Wales. Telephone support services are tailored differentially to offer information, advice and/or counselling on a crisis-led or planned-intervention basis. Research focusing on telephone support, for the most part (and particularly in the UK) has examined crisis-led as opposed to planned support services. The findings of our study resonate with earlier research findings about telephone support that suggest provision of non-visual support in social care can overcome some practical and financial difficulties for users with little discernible loss to their experience of satisfaction with the service. In addition, the paper suggests that planned support may provide a valuable service to users who are most disadvantaged and marginalized and who have found traditional forms of support unsatisfactory. For such users, planned telephone support can offer one-to-one communication tailored to specific client needs. Moreover, it can enable the development of user trust in the service which empowers users to operationalize strategies in the context of a reliable, sustained, unthreatening (and thus minimal risk) relationship. [source] Toward a Multidimensional Construct of Social Support: Implications of Provider's Self-Reliance and Request CharacteristicsJOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 7 2004Anat Drach-Zahavy The two studies reported here sought to propose a multidimensional taxonomy for providing social support, and to use an attachment-theory framework to investigate provision of support at work. Additionally, the studies sought to explore the distinct contextual considerations that affect decisions on the type of support provided. In Study 1, case studies were presented to 164 hospital nurses, who, taking the role of the head nurse, were asked to deal with a distressed staff nurse who was either high or low tenured, and whose cause of distress was either personal or job-related. In the second study, 55 nurses with various job tenures described the support behaviors of their superiors. In both studies, support interventions and attachment styles were measured. Results provided partial evidence of the multidimensionality of social support, and indicated that it contains 4 distinct support behaviors: helping, maintenance, referral, and encouragement of self-coping. Furthermore, the distinct support behaviors were affected by different attachment styles and contextual considerations. [source] A literature review comparing the experiences and emergent needs of adult patients with permanent pacemakers (PPMs) and implantable cardioverter defibrillators (ICDs)JOURNAL OF CLINICAL NURSING, Issue 15-16 2010Jenny Tagney Aims and objectives., This literature review aims to critically appraise any published studies that compare the experiences of patients with permanent pacemakers and those with implantable cardioverter defibrillators. It seeks to identify issues that are similar or unique to one or other group; whether identified needs are being met by current nursing practice and considers how any gaps might be addressed. Background., Increasing numbers of patients are receiving pacemakers and implantable cardioverter defibrillators (ICDs) as indications for devices continue to expand worldwide. Technical follow-up of such patients is well structured. There is an increasing body of knowledge regarding ICD patients' experiences with promising work testing recovery interventions but less seems to be known about pacemaker patients. Design., Systematic review. Methods., Using an integrative approach, electronic searches using comprehensive search terms were supplemented by following reference lists and key journals from 1975,2008. Conclusion., From the direct comparison studies identified, ICD patients who experience shocks are more likely to report lifestyle limitations than pacemaker patients. However, ICD and pacemaker patients share similar outcomes, with both groups reporting increased anxiety and depression. Whilst experiences of ICD patients have been well reported, experiences of patients receiving pacemakers for any reason and pacemakers or ICDs for heart failure (bi-ventricular devices or cardiac resynchronisation therapy , CRT) remain largely unknown. Although psychosocial interventions are suggested for both groups, these have apparently only been tested and reported for ICD patients. Relevance to clinical practice., Nurses internationally encounter increasing numbers of patients with pacemakers and ICDs from primary to tertiary clinical care settings, therefore knowledge of patient experiences relating to such devices and their impact is important to inform care planning. Whilst interventions to assist ICD patients are being tested, further research is required regarding the experiences of patients with contemporary pacemakers to inform care planning and potential nursing support interventions. [source] A systematic review of professional support interventions for breastfeedingJOURNAL OF CLINICAL NURSING, Issue 9 2008Leena Hannula PhD Objectives., The objectives of this systematic review were first, to describe how breastfeeding is professionally supported during pregnancy, at maternity hospitals and during the postnatal period. Secondly, to find out how effective interventions are in supporting breastfeeding. Background., Breastfeeding is an effective way to promote the health of infants. In many countries, the rates for breastfeeding remain lower than recommended. Many studies have examined breastfeeding promotion interventions; some of them are successful and some fail. It is important to find effective combinations of support. Design. Systematic review. Methods., Search of CINAHL, Medline and Cochrane Central Register databases were conducted for data collection. The search was limited to articles published in Finnish, Swedish and English between the year 2000 and March 2006, focusing on breastfeeding and breastfeeding support interventions. Two reviewers independently analysed 36 articles in the final analysis. Results., Interventions expanding from pregnancy to the intrapartum period and throughout the postnatal period were more effective than interventions concentrating on a shorter period. In addition, intervention packages using various methods of education and support from well-trained professionals are more effective than interventions concentrating on a single method. Conclusions., During pregnancy, the effective interventions were interactive, involving mothers in conversation. The Baby Friendly Hospital Initiative (BFHI) as well as practical hands off -teaching, when combined with support and encouragement, were effective approaches. Postnatally effective were home visits, telephone support and breastfeeding centres combined with peer support. Relevance to clinical practice., Professionals need breastfeeding education and support of their organisations to act as breastfeeding supporters. The BFHI -programme is effective and it would be wise to include the core components of the programme in breastfeeding promotion interventions. Mothers benefit from breastfeeding encouragement and guidance that supports their self-efficacy and feelings of being capable and empowered, and is tailored to their individual needs. [source] Developing a model for quality evaluation in residential care for people with intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 5 2000B. Maes Abstract The present article describes the development of a general model for the evaluation, enhancement and assurance of quality of care processes in residential facilities for children and adults with intellectual disability. The framework is based on current theories regarding quality of life and quality evaluation, on a consensus between several participants in Delphi discussion-rounds, and on a questionnaire for care providers and clients in all Flemish residential facilities. The model describes 13 quality standards and a list of indicators concerning organization and support interventions. Facilities may use this set of criteria and indicators in several ways within a continuous and dynamic system of internal quality assurance. Finally, the prospects of and conditions for the implementation of this model are discussed. [source] Systematic review: self-management support interventions for irritable bowel syndromeALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2010S. D. Dorn Aliment Pharmacol Ther 2010; 32: 513,521 Summary Background, Irritable bowel syndrome is an extremely common and costly condition. Because there is no cure, patients must be supported to manage their own condition. Aim, To assess systematically the interventions used to support irritable bowel syndrome patient self-management. Methods, A search of PubMed, EMBASE, CINAHL and PsycINFO was performed to identify all studies that involved self-management support interventions for irritable bowel syndrome. Studies that compared the self-management-related intervention to a control group were included. Results, Eleven studies that involved a total of 1657 patients were included. For nearly all studies, the intervention was associated with statistically significant benefits. However, across studies there was significant heterogeneity in terms of sample size, diagnostic criteria, study setting, study design, primary outcome, statistical analyses and study quality. Therefore, individual study results could not be statistically combined. Conclusions, Many self-management support interventions appear benefit patients with irritable bowel syndrome. However, studies were limited by methodological flaws. Furthermore, feasibility in ,real world' clinical practice is uncertain. Thus, practical self-management interventions that can be applied across various clinical settings should be developed, and then tested in well-designed clinical trials. [source] Social support buffers the impact of functional impairments on caregiver psychological well-being in the context of brain tumor and other cancersPSYCHO-ONCOLOGY, Issue 10 2010Tamara Ownsworth Abstract Objective: This study investigated the association between functional impairments of individuals with cancer and caregiver psychological well-being, and examined the moderating effect of social support. Methods: Sixty-three caregivers (71% female) of individuals with brain tumor (n=27) and other cancers (n=36) were recruited from community services. Caregivers rated their psychological well-being on the World Health Organisation Quality of Life measure Brief version, social support on a brief version of the Social Support Questionnaire, and the individuals' functional impairments on the Patient Competency Rating Scale. Results: For caregivers of individuals with brain tumor, better psychological well-being was associated with lower functional impairment in all domains (rs=0.33,38, p<0.05), except for cognitive difficulties. For caregivers of individuals with other cancers, better psychological well-being was associated with lower functional impairment in all domains (rs=0.30,0.49, p<0.05), with the exception of activities of daily living. For the total caregiver sample, better psychological well-being was significantly correlated with overall functional impairment (r=0.34, p<0.005) and satisfaction with support (r=0.40, p<0.005). Caregivers supporting individuals with greater functional impairment had better psychological well-being if they were highly satisfied with their social support. Conclusions: Effective social support is particularly important for caregivers who support individuals with poorer functional status, and this study highlights the need to evaluate caregiver social support interventions in the context of cancer. Copyright © 2009 John Wiley & Sons, Ltd. [source] Depression burden, psychological adjustment, and quality of life in women with breast cancer: Patterns over timeRESEARCH IN NURSING & HEALTH, Issue 1 2004Terry A. Badger Abstract The purpose of this study was to examine how level of depression burden influences women's psychological adjustment and quality of life over time and how depression burden interacted with a community-based oncology support program to influence psychological adjustment and life quality. Participants were 169 women who completed a side effects checklist at three data collection points. Women were divided into two groups based on their depression burden scores: 123 women reporting no burden, and 46 women reporting high depression burden. For psychological adjustment, there were significant interaction effects for intervention by time and for intervention by depression burden by time and significant main effects for depression burden. For life quality, there was a significant interaction effect for intervention by time and a significant main effect for depression burden. The findings document the negative impact of depression burden on psychological adjustment and life quality. Oncology support interventions can be effective in reducing this negative impact. © 2004 Wiley Periodicals, Inc. Res Nurs Health 27:19,28, 2004 [source] The Canadian Prehospital Evidence-based Protocols Project: Knowledge Translation in Emergency Medical Services CareACADEMIC EMERGENCY MEDICINE, Issue 7 2009Jan L. Jensen ACP Abstract Objectives:, The principles of evidence-based medicine are applicable to all areas and professionals in health care. The care provided by paramedics in the prehospital setting is no exception. The Prehospital Evidence-based Protocols Project Online (PEP) is a repository of appraised research evidence that is applicable to interventions performed in the prehospital setting and is openly available online. This article describes the history, current status, and potential future of the project. Methods:, The primary objective of the PEP is to catalog and grade emergency medical services (EMS) studies with a level of evidence (LOE). Subsequently, each prehospital intervention is assigned a class of recommendation (COR) based on all the appraised articles on that intervention, in an effort to organize the evidence so it may be put into practice efficiently. An LOE is assigned to each article by the section editor, based on the study rigor and applicability to EMS. The section editor committee consists of EMS physicians and paramedics from across Canada, and two from Ireland and a paramedic coordinator. The evidence evaluation cycle is continuous; as the section editors send back appraisals, the coordinator updates the database and sends out another article for review. Results:, The database currently has 182 individual interventions organized under 103 protocols, with 933 citations. Conclusions:, This project directly meets recent recommendations to improve EMS by using evidence to support interventions and incorporating it into protocols. Organizing and grading the evidence allows medical directors and paramedics to incorporate research findings into their daily practice. As such, this project demonstrates how knowledge translation can be conducted in EMS. [source] People, places and policies , trying to account for health inequalities in impoverished neighbourhoodsAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2009Peter Feldman Abstract Objective: We consider associations between individual, household and area-level characteristics and self-reported health. Method: Data is taken from baseline surveys undertaken in 13 socio-economically disadvantaged neighbourhoods in Victoria (n=3,944). The neighbourhoods are sites undergoing Neighbourhood Renewal (NR), a State government initiative redressing place-based disadvantage. Analysis:This focused on the relationship between area and compositional factors and self-reported health. Area was coded into three categories; LGA, NR residents living in public housing (NRPU) and NR residents who lived in private housing (NRPR). Compositional factors included age, gender, marital status, identifying as a person with a disability, level of education, unemployment and receipt of pensions/benefits. Results: There was a gradient in socio-economic disadvantage on all measures. People living in NR public housing were more disadvantaged than people living in NR private housing who, in turn, were more disadvantaged than people in the same LGA. NR public housing residents reported the worst health status and LGA residents reported the best. Conclusions: Associations between compositional characteristics of disability, educational achievement and unemployment income and poorer self-reported health were shown. They suggested that area characteristics, with housing policies, may be contributing to differences in self-reported health at the neighbourhood level. Implications: The clustering of socio-economic disadvantage and health outcomes requires the integration of health and social support interventions that address the circumstances of people and places. [source] | ||||||||||