Recommendations For Health Professionals Research Articles

Problems with adherence to treatment among adolescents with diabetes mellitus type 1

Introduction: Diabetes Mellitus type 1 (DM1) is a chronic degenerative disease with high impact on the lives of children and adolescents. The DM1 affects mainly children and young adults under 30 years old, with a predominance from 10 to 14 years old. As a chronic disease, involves changes in daily habits, being following the recommendations of health professionals one of the main conducts to achieve such changes, however, this follow-up is not easy and can directly infl uence the glycemic control and lead to complications. Objective: Identify the diffi culties of adolescent with DM1 to treatment adherence. The recommendations of this treatment are related to the blood glucose measurements, using a diet plan and insulin application. Methods: The study included 15 adolescent with DM1, of both genders, aged 10-19 years participating in a multidisciplinary group at an outpatient unit in São Paulo, Brazil, aged 13,93 ± 2.4 years, diagnosed with DM1 with an average time of 4.5 years. The following evaluations were employed:1) individual interviews for identifi cation and clinical characterization; 2) characterization of cardiovascular and metabolic parameters; 2) anthropometric assessment and 4) application of a questionnaire with questions about problems of blood glucose measurements, diet plan and insulin application. Data collection was performed before medical appointment with an endocrinologist in a hospital in São Paulo state. Results: The identifi ed diffi culties and cardio-metabolic variables showed the adolescents presented uncontrolled blood glucose levels, doing the rotation of insulin incompletely and face many daily diffi -culties to perform the appropriate treatment, being the most frequently reported the insulin application and proper nutrition. Conclusion: Adolescents with type 1 diabetes presented diffi culties in adherence to treatment, mainly o follow insulin treatment and proposals for changes in eating habits by following a diet. It is necessary that health professionals offer strategies and orientation to these individuals to improve the handling of their diffi culties that directly affect the course of the disease and leave them more susceptible to developing complications.

Do Adolescent Employees Perceive the Risks of Workplace Violence? A Mixed Methods Study.

Objective: Adolescents are at risk for workplace violence (WPV) exposure but may not perceive it as a risk. The purpose of this study was to explore adolescent employees’ perceptions of safety from WPV. Methods: Using a qualitative dominant mixed methods design, 30 adolescent employees were recruited to complete a 36-item survey and individual interviews. Analyses included descriptive statistical techniques for survey responses, conventional content analysis for qualitative interview data, and mixed data analyses to explore differences in qualitative themes based on WPV exposure and gender. Results: Participants expressed mostly positive perceptions of safety despite 50% (n = 15) reporting WPV exposure. WPV exposure and gender did not appear to be associated with overall perceptions of safety but may be associated with safety in numbers. Most males had positive perceptions of safety. Conclusions: Adolescent employees want and deserve WPV training. Recommendations for nurses and other health professionals to assist adolescents with addressing health and safety issues in the workplace are provided.

Attitudes, Knowledge, Use, and Recommendation of Complementary and Alternative Medicine by Health Professionals in Western Mexico

The use of complementary and alternative medicine (CAM) has increased in many countries, and this has altered the knowledge, attitudes, and treatment recommendations of health professionals in regard to CAM. Considering Mexican health professionals׳ lack of knowledge of CAM, in this report we surveyed 100 biomedical researchers and Ph.D. students and 107 specialized physicians and residents of a medical specialty in Guadalajara, México (Western Mexico) with a questionnaire to address their attitudes, knowledge, use, and recommendation of CAM. We observed that significantly more researchers had ever used CAM than physicians (83% vs. 69.2%, P = .023) and that only 36.4% of physicians had ever recommended CAM. Female researchers tended to have ever used CAM more than male researchers, but CAM use did not differ between genders in the physician group or by age in either group. Homeopathy, herbal medicine, and massage therapy were the most commonly used CAMs in both the groups. Physicians more frequently recommended homeopathy, massage therapy, and yoga to their patients than other forms of CAM, and physicians had the highest perception of safety and had taken the most courses in homeopathy. All CAMs were perceived to have high efficacy (>60%) in both the groups. The attitude questionnaire reported favorable attitudes toward CAM in both the groups. We observed a high rate of Mexican health professionals that had ever used CAM, and they had mainly used homeopathy, massage therapy, and herbal medicine. However, the recommendation rate of CAM by Mexican physicians was significantly lower than that in other countries, which is probably due to the lack of CAM training in most Mexican medical schools.

Relationships, Priorities, and a Life Worth Living

The use of complementary and alternative medicine (CAM) has increased in many countries, and this has altered the knowledge, attitudes, and treatment recommendations of health professionals in regard to CAM.Considering Mexican health professionals׳ lack of knowledge of CAM, in this report we surveyed 100 biomedical researchers and Ph.D. students and 107 specialized physicians and residents of a medical specialty in Guadalajara, México (Western Mexico) with a questionnaire to address their attitudes, knowledge, use, and recommendation of CAM.We observed that significantly more researchers had ever used CAM than physicians (83% vs. 69.2%, P = .023) and that only 36.4% of physicians had ever recommended CAM. Female researchers tended to have ever used CAM more than male researchers, but CAM use did not differ between genders in the physician group or by age in either group. Homeopathy, herbal medicine, and massage therapy were the most commonly used CAMs in both the groups. Physicians more frequently recommended homeopathy, massage therapy, and yoga to their patients than other forms of CAM, and physicians had the highest perception of safety and had taken the most courses in homeopathy. All CAMs were perceived to have high efficacy (>60%) in both the groups. The attitude questionnaire reported favorable attitudes toward CAM in both the groups.We observed a high rate of Mexican health professionals that had ever used CAM, and they had mainly used homeopathy, massage therapy, and herbal medicine. However, the recommendation rate of CAM by Mexican physicians was significantly lower than that in other countries, which is probably due to the lack of CAM training in most Mexican medical schools.

Guidance for community-based caregivers in assisting people with moderate to severe traumatic brain injury with transfers and manual handling: evidence and key stakeholder perspectives.

Adults with moderate to severe traumatic brain injury (TBI) rely on assistance from paid and unpaid caregivers upon return to the community. An inability to move independently makes these adults highly dependent on caregivers for transfers and manual handling tasks. Evidence-based guidelines are therefore important to ensure that caregivers and people in the community are protected and that practices are standard and consistent. This study commenced with a rapid review of evidence-based recommendations between 2000 and 2015 pertaining to transfers and manual handling in people with TBI; and ended with a structured stakeholder dialogue that reflected upon this evidence and gathered perspectives on how to address key issues in community-based manual handling following TBI. Three relevant guidelines were identified, providing nine recommendations encompassing assessment of the person's ability to assist caregivers, manual handling and appropriate equipment use. Due to the low number of recommendations and low level of supporting evidence, these recommendations alone could not provide comprehensive guidance. Three systematic reviews and two primary studies were also identified, and these suggest that comprehensive training programmes in transfers and manual handling tasks are effective. Further to this, a structured stakeholder dialogue was conducted, which revealed six major themes - (i) comprehensive risk assessment, (ii) presence of two caregivers, (iii) provision of training, (iv) home environment modification, (v) equipment, and (vi) policy implementation context. Recommendations for health professionals include providing information packs to caregivers, risk assessment and mitigation for those at high risk, and strategies to prevent and minimise injury in caregivers. Development of comprehensive guidance for caregivers in transfers and manual handling in people with moderate to severe TBI living in the community is a hidden but important priority.

Initial healthcare to pediatric population under the radiation events

The objective of this paper is to analyze the data from scientific literature and available recommendations for health professionals on healthcare providing to pediatric population in the events associated with risk of radiation exposure. Over the past sixty years there were several large scale radiological events with a large number of chil dren affected, namely the atomic bombing of Hiroshima and Nagasaki, accident at the Chornobyl nuclear power plant, contact to 137Cs radiation source unutilized at the hospital shutdown in Brazil etc. Further research has crys tallized injuries and health disorders in the survived children in all cases being much more significant vs. other pop ulations. Analysis of circumstances and features of a number of emergency situations or incidents in the nuclear industry for several decades has shown a high probability of radioactive materials release into the environment. The danger of terrorism with the use of ionizing radiation sources resulting in a considered inevitable hazard to the chil dren is estimated as serious in recent years and deserves an especial mention here.

Contributions of healthcare staff to promote patient safety in intensive care

Objective: Presenting the recommendations of health professionals from an Intensive Care Unit for the improvement of patient safety culture. Methods: Descriptive-exploratory study, with a quantitative approach, resulting from the application of the Survey about Patient Safety in Hospitals, 59 professional staff participated between November 2013 and January 2014. Results: Were obtained 124 recommendations, which were categorized according to aspects of the instrument. Highlighting recommendations related to the support of the hospital management to patient safety, in particular, the supply of material resources; and also to organizational learning and continuous improvement, with suggestions for training and implementation of protocols aimed at standardizing the assistance. Conclusion: The study permitted to list significant recommendations for improvements in patient safety, and made it possible to identify the dimensions of safety culture that have more vulnerabilities.

What Does Asexuality Teach Us About Sexual Disinterest? Recommendations for Health Professionals Based on a Qualitative Study With Asexually Identified People

This article draws on qualitative in-depth interviews with 30 asexually identified individuals living in the United States in order to contribute to our understanding of when low sexual desire should be treated as a medical or mental health issue and when it should be treated as a benign sexual variation. The article discusses five findings of relevance to health professionals: (1) the line between a desire disorder and asexuality is not clear-cut; (2) asexually identified individuals may experience distress, so distress alone does not separate a desire disorder from asexuality; (3) asexually identified individuals may face sexual pressure from a partner or may have difficulty negotiating sexual activity with a partner; (4) asexuality does not need to be distressing, rather it can be experienced as a fulfilling form of sexuality; and (5) many asexually identified individuals believe in the usefulness of low sexual desire as a diagnostic category and support medical and mental health professionals in their efforts to develop treatments for sexual desire disorders. Based on these five findings, this article offers four concrete suggestions for health professionals working with clients with low sexual desire, whether or not those clients identify as asexual.

Comparison Study of Uptake of Colorectal Cancer Testing between Ethnic Minorities and the General Population in Hong Kong.

Colorectal cancer (CRC) is one of the most common cancers. This study aimed to compare the uptake of CRC testing in the general public and in ethnic minorities in Hong Kong. This cross-sectional survey covered 2,327 South Asian and Chinese adults aged over 50, recruited from two separate studies. A structured questionnaires were administered by research staff over the telephone or in face- to-face interviews. The uptake rate of CRC testing among South Asians was significantly lower than that of the general population in Hong Kong. Factors associated with the uptake rate were health professional's recommendation, perception of regular visits to doctor, use of complementary therapy, ethnicity, perceived susceptibility to cancer, presence of chronic illness, and education level. In addition, a significant interaction (p<0.05) between ethnicity and health professionals' recommendations was found, after adjustment for the main independent factors identified. Older people with lower educational attainment, without chronic illness and those have lower perceived susceptibility to cancer may be targeted for CRC testing promotion in the society. In addition, health professionals can play a highly influential role in promoting such testing, particularly among ethnic minorities.

Recommendations for mental health professionals in the NICU.

This article describes recommended activities of social workers, psychologists and psychiatric staff within the neonatal intensive care unit (NICU). NICU mental health professionals (NMHPs) should interact with all NICU parents in providing emotional support, screening, education, psychotherapy and teleservices for families. NMHPs should also offer educational and emotional support for the NICU health-care staff. NMHPs should function at all levels of layered care delivered to NICU parents. Methods of screening for emotional distress are described, as well as evidence for the benefits of peer-to-peer support and psychotherapy delivered in the NICU. In the ideal NICU, care for the emotional and educational needs of NICU parents are outcomes equal in importance to the health and development of their babies. Whenever possible, NMHPs should be involved with parents from the antepartum period through after discharge.

Parental Health Beliefs, Socio-demographics, and Healthcare Recommendations Influence Micronutrient Supplementation in Youth with Celiac Disease.

To identify parental influences affecting micronutrient supplementation in children and adolescents (2-18 years of age) with Celiac Disease (CD), a multi-method (survey, focus groups) study was conducted. A 35-item questionnaire consisting of open- and closed-ended questions was launched nationally via Canadian Celiac Association internet sites. Five focus groups were conducted using a semi-structured interview guide. The survey and semi-structured interview guide content was vetted for face and content validity. Thematic analyses were conducted on the focus group content and open-ended survey questions, and χ(2) and Fischer's exact analysis were performed on closed-ended survey data. Survey respondents were predominantly mothers (97%) of female children (80 F, 49 M) between the ages of 9-12 (31%) with CD, residing in western provinces (55%) with a combined family income ≥$100 000/year (63%). Seventy-seven percent of parental respondent's children or adolescents consumed micronutrient supplements, for 1-5 years (52%), 7 days a week (65%), as both multi-vitamin and single vitamin preparations (40%). Parental influences on child micronutrient use included health beliefs and knowledge, parental supplement use, supplement characteristics, age of child (above or below 13 years), household routines, and provincial residential status (P < 0.05). Parents relied on health professional recommendation (69%; MD, RD) and the internet (21%) as sources of information regarding child micronutrient supplementation. Parental health beliefs and knowledge, socio-demographic factors, and practitioner recommendation influence micronutrient supplement use in children and adolescents with CD.

Comparison of methods for recruiting and engaging parents in online interventions: study protocol for the Cry Baby infant sleep and settling program.

BackgroundAnticipatory guidance around the management of sleep and crying problems in early infancy has been shown to improve both infant behaviour and parent symptoms of postnatal depression. Digital technology offers platforms for making such programs widely available in a cost-efficient manner. However, it remains unclear who accesses online parenting advice and in particular, whether the parents who would most benefit are represented amongst users. It is also unknown whether the uptake of online programs can be improved by health professional recommendations, or whether parents require additional prompts and reminders to use the program. In this study we aim to: (1) determine whether weekly email prompts increase engagement with and use of a brief online program about infant sleeping and crying, (2) determine whether encouragement from a maternal and child health nurse promotes greater engagement with and use of the program, (3) examine who uses a brief online program about infant sleeping and crying; and, (4) examine the psychosocial characteristics of participants.Methods/DesignThis study is a randomised, parallel group, superiority trial, with all participating primary carers of infants aged 2 to 12 weeks, receiving access to the online program. Two modes of recruitment will be compared: recruitment via an online notice published on a non-commercial, highly credible and evidence-based website for parents and carers and via the parent’s Maternal and Child Health nurse. After baseline assessment, parents will be randomised to one of two support conditions: online program alone or online program plus weekly email prompts. Follow up data will be collected at 4 months of infant age.DiscussionResults from this trial will indicate whether involvement from a health professional, and/or ongoing email contact is necessary to engage parents in a brief online intervention, and promote parental use of strategies suggested within the program. Results of this trial will inform the development of recruitment and engagement strategies for other online interventions.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12613001098729. Registered 01 October 2013.

Dental health professional recommendation and consumer habits in denture cleansing

Statement of problemRegular cleaning of dentures is essential to the oral and general health of denture wearers. Only limited systematic data are available on the recommendations that dental health care professionals (DHCPs) make to patients for denture cleaning. Data on denture wearers’ cleaning regimens are also lacking. PurposeThe purpose of this study was to provide data on recommendations that DHCPs make to patients for denture cleaning and on the cleaning regimens of denture wearers. Material and methodsDHCPs (n=613), including dentists and hygienists, were surveyed in developed (Japan, USA, Italy) and developing (Brazil, India) countries. A questionnaire assessing a range of denture cleaning recommendations was used. The questions addressed products, frequency, how to use remedies, the suggested dilution and duration of cleansing treatment, the location of dentures while cleaning, and the reasoning behind the recommendation of particular products or modes of treatment. Denture cleansing methods and the routine of denture wearers in developed and developing countries were also surveyed with a questionnaire (n=2862) and a 1-week diary (n=1462). ResultsAn average of more than 2 treatments was recommended by DHCPs. Specialist denture cleanser tablets, “regular” toothpaste, mouthwash, soap and water, denture paste, foam or liquid denture cleanser, and dishwashing detergents were most commonly recommended; other product recommendations included baking soda, vinegar, salt water, and bleach. More than 10% of DHCPs made no primary recommendation on cleaning. Denture tablets were more commonly recommended in developed countries, whereas toothpaste was the most common recommendation in developing countries. Denture wearers used products and methods similar to those recommended by DHCPs. Toothpaste, water, and mouthwash were used more frequently than denture tablets. More than 75% of denture wearers reported using denture cleanser tablets for more than 5 minutes, whereas soap and toothpaste were typically used for less than 2 minutes. ConclusionsDHCP recommendations and denture wearer habits are diverse, with no consensus on the most appropriate denture cleaning methods. This reflects a lack of clear, systematic evidence upon which to base recommendations.

Older Adult Perceptions of Participation in Group- and Home-Based Falls Prevention Exercise.

This paper describes why older adults begin, continue, and discontinue group- and home-based falls prevention exercise and benefits and barriers to participation. Telephone surveys were used to collect data for 394 respondents. Most respondents reported not participating in group- (66%) or home-based (78%) falls prevention exercise recently. Reasons for starting group-based falls prevention exercise include health benefits (23-39%), health professional recommendation (13-19%), and social interaction (4-16%). They discontinued because the program finished (44%) or due to poor health (20%). Commonly reported benefits were social interaction (41-67%) and health (15-31%). Disliking groups was the main barrier (2-14%). Home-based falls prevention exercise was started for rehabilitation (46-63%) or upon health professional recommendation (22-48%) and stopped due to recovery (30%). Improvement in health (18-46%) was the main benefit. These findings could assist health professionals in prescribing group-based falls prevention exercise by considering characteristics of older adults who perceive social interaction to be beneficial.

A qualitative study of adolescents with medically unexplained symptoms and their parents. Part 1: Experiences and impact on daily life

Medically unexplained symptoms (MUS) are common among adolescents and are frequently encountered in primary care. Our aim was to explore how these adolescents and their parents experience the condition and its impact on their daily lives and to provide recommendations for health professionals. Using a qualitative approach, six focus groups and two individual interviews were conducted. These involved a total of ten adolescents with different types of MUS and sixteen parents. The respondents were recruited in a university hospital in Switzerland. A thematic analysis was conducted according to the Grounded Theory. The analysis of the data highlighted four core themes: disbelief, being different, concealing symptoms, and priority to adolescent's health. Transcending these themes was a core issue regarding the discrepancy between the strategies that adolescents and their parents use to cope with the symptoms. Health professionals should be made aware of the emotional needs of these patients and their families.

Impact de l’éducation thérapeutique sur les habitudes de vie : perception des patients et de leurs proches

Therapeutic patient education, which advocates a change of behaviour, may affect the patient's and the patient's family's lifestyles. The aim of this survey was to describe the perception of heart failure patients and their families concerning the impact of TPE on their lifestyles. A national self-administered questionnaire survey b was performed from january to May 2013 with patients and their relatives. A total of 2,153 questionnaires were sent to all patients registered in the Heart Failure Observatory registry (Odin), who forwarded them to a relative of their choice. Only relatives of educated patients were included. A total of 2,397 questionnaires were sent to patients. We obtained 149 responses from patient's families (7%). One half of them (50.3%) met our inclusion criteria. We obtained 257 responses from patients (11 %). Respondents noted a change in the patient's daily lifestyle after TPE (85.8% of the total population) and said that the patient had a more positive approach to his/her illness (70.7% of the total population). According to respondents, relatives had changed their lifestyle after their participation of TPE (67.8% of the total population). This study shows that patients and their relatives report a positive change in their lifestyle due to TPE. The patient's relatives appear to comply with the recommendations of health professionals, initially designed for the patient.

Indulgent Parenting and Life Satisfaction of College Students: Examination of Eating, Weight, and Body Image

A cross-sectional design based on social cognitive theory was used to examine the association between mother and daughter perceptions of parental indulgence and family health discussions as they influenced eating motivations, health outcomes, and life satisfaction of college females. Results indicated that daughters perceived greater overall indulgence and overnurturance than mothers. Indulgence had both positive and negative associations with daughters’ life satisfaction. Daughters’ perceptions of parental overnurturance and giving too much had the greatest total effects on life satisfaction. Even as daughters began to transition away from their parents, mothers still played an integral role in their health behaviors and outcomes. Additional research was recommended, along with practice recommendations for family and health professionals.

Use of the theoretical domains framework to further understanding of what influences application of fluoride varnish to children's teeth: a national survey of general dental practitioners in Scotland.

Despite recent improvements in the oral health of Scotland's population, the persistence of childhood dental caries underscores a need to reduce the disease burden experienced by children living in Scotland. Application of fluoride varnish (FV) to children's teeth provides an evidence-based approach to achieving this goal. Despite policy, health service targets and professional recommendations supporting application, not all children receive FV in line with guidance. The objective of this study was to use the theoretical domains framework (TDF) to further an understanding of what may influence fluoride varnish application (FVA) in General Dental Practice in Scotland. A postal questionnaire assessing current behaviour (frequency of FVA) and theoretical domains (TDs) was sent to all General Dental Practitioners (GDPs) in Scotland. Correlations and linear regression models were used to examine the association between FVA and the TDs. One thousand and ninety (53.6%) eligible GDPs responded. Respondents reported applying FV more frequently to increased risk and younger children (aged 2-5 years). Higher scores in eight TDs (Knowledge, Social/professional role and identity, Beliefs about consequences, Motivation and goals, Environmental context and resources, Social influences, Emotion and Behavioural regulation) were associated with greater frequency of FVA. Four beliefs in particular appear to be driving GDPs' decision to apply FV (recognizing that FVA is a guideline recommended behaviour (Knowledge), that FVA is perceived as an important part of the GDPs' professional role (Professional role/identity), that FV is something parents want for their children (Social influences) and that FV is something GDPs really wanted to do (Emotion). The findings of this study support the use of the TDF as a tool to understand GDPs application of FV and suggest that a multifaceted intervention, targeting dental professionals and families, and more specifically those domains and items associated with FVA may have the greatest likelihood of influencing the evidence-based behaviour.

Recommendations for mental health professionals in the NICU

Recommendations for mental health professionals in the NICU

Adolescent mental health: the role of youth and college pastors

The present study investigates the gatekeeping role of youth and college pastors, specifically exploring their psychological training, perceptions, attitudes, and interactions concerning adolescent congregants' mental illness. Texas youth and college pastors were anonymously surveyed regarding referral patterns, mental health interventions and contact, adolescent mental health perceptions, and means of collaboration. While the sample reported actively working with numerous adolescent mental health issues, the majority did not feel qualified to work with significant psychopathology. Despite this, they reported using various intervention methods, with the most common being initial counselling followed by a referral. Although the sample frequently referred to other professionals, they described many perceived barriers in collaborating with others in the mental health field. Overall, a positive role exists for youth and college pastors in adolescent mental health; however, tensions and conflicts between pastors and mental health professionals hinder the usefulness of these unique gatekeepers. Implications and recommendations for mental health professionals are highlighted.