Health Professionals In Interventions Research Articles

Food Supplements and Their Use in Elderly Subjects-Challenges and Risks in Selected Health Issues: A Narrative Review.

The European population is ageing. Food Supplements (FSs) are foods with particular characteristics, consumed by elderly people for various purposes, including combating nutritional deficits. Their consumption in this age group, associated with a high prevalence of polypharmacy, can enhance interactions. Potential drug-food (or food supplements), drug-drug interactions and polypharmacy are common health issues among older adults. The prevalence of polypharmacy is high, and preliminary data also indicate that there is significant FS use, increasing the risk of the duplication of therapies and various adverse reactions as well as drug-FS and FS-FS interactions. Therefore, the intervention of health professionals in mitigating these risks is essential. This review highlights and discusses the association between FSs, polypharmacy, and adverse reactions due to the risk of potential interactions between these products. Moreover, it also provides current scientific evidence regarding the use of FSs by the elderly. A review of the challenges, advantages, and risks of using FSs in elderly people who are malnourished and/or polymedicated, focusing on the good practises needed to support healthy ageing, is presented. In this regard, this paper aims to help health professionals better deal with the issue of the use of multiple FSs and polypharmacy, overcome the malnutrition problem, and improve the health and well-being of older adults.

Counseling intervention on iron-folic acid adherence and clinical outcomes among pregnant women and women planning to be pregnant: a scoping review

Anemia during pregnancy is a major health problem that affects 25-50% of the world's population and around 50% of pregnant women. One of the causes of stunting is Low Birth Weight, which most often occurs in mothers who suffer from anemia. Making sure pregnant women have access to iron-folic acid supplement programs is challenging. People's inability to comply often occurred as the result of a lack of understanding of the benefits or harms of the supplement. Providing counseling to pregnant women to improve adherence to taking blood-added supplements has resulted in significant benefits and impacts on changes discussed in several studies that have been conducted in several countries. Through a review of the literature, this study seeks to ascertain the contribution that counseling interventions have to improving iron-folic acid prescription adherence. This study used a literature study research method by examining 8 journals published on the SCOPUS, PubMed, and Garuda Websites. After that, descriptive analysis was used to examine the data from the selected journals. The 8 journals supported the idea that counseling can improve adherence to iron and folic-acid supplementation. There are numerous ways to provide counseling, including the traditional face-to-face approach, the 5A brief approach, leaflet/brochure-based approaches, and counseling through illustrated books. This study concludes that counseling interventions are more effective due to the careful planning of tailored interventions with more regular follow-ups, various forms of interactive educational media, patient characteristics, and direct health professional intervention related to counseling.

Health Care Is Not Enough to Prevent Dementia.

With an aging population, an increase in cases of Alzheimer's disease and dementia worldwide poses a significant health burden. While we hope for a cure, preventing dementia by reducing risks is important for global population health. Prevention strategies are difficult to implement when facing inequality across the world for access to healthy lifestyles. An approach that centers on individual responsibility and health professional interventions for targeted groups may risk missing the policy and environmental drivers of change. Barriers and enablers need to be explored and interventions are needed at individual, structural and social levels to normalize mid-life risk reduction.

Programa de exercícios multicomponentes domiciliar (VIVIFRAIL®) para longevos durante a pandemia da covid-19

Abstract Objective To investigate the acceptability and adequacy of a multicomponent exercise program via videoconferencing for the oldest-old in Porto Alegre, a city in southern Brazil. Method This is a quasi-experimental study. Fourteen participants were enrolled in the multicomponent exercise program Vivifrail® for 12 weeks, 5 days a week, with weekly video calls for assessment of acceptability and adequacy. The acceptability and adequacy questionnaire was based on 6 barriers that older adults face when engaging in physical exercise. Responses were measured using a 5-point Likert scale ranging from 0 to 4 points, with a maximum score of 24 points (maximum acceptability). Results Fourteen participants (89.07±6.30 years) concluded the protocol, with an acceptability rate of 70%. Internal consistency was moderate, with a Cronbach’s coefficient alpha of 0.7. Participants showed an overall increase in acceptability and adequacy (from 17.8±3.51 points in the first week to 22.0±2.94 in the 12th week). Four participants (28.6%) required some modification to the exercise protocol. Conclusion The Vivifrail® protocol, together with weekly follow-up via videoconferencing, was well accepted and adequate. It could be an important tool for promoting quality of life, especially in the oldest-old with difficulty leaving home. The acceptability questionnaire was able to detect exercise barriers and suggest possible modifications to the training program and could be presented as a suggestion for the evaluation of intervention protocols in the oldest-old population. Therefore, the Vivifrail® protocol, with weekly follow-up via videoconferencing, could be a new field of intervention for health professionals.

Educational interventions for health professionals managing chronic obstructive pulmonary disease in primary care.

Educational interventions for health professionals managing chronic obstructive pulmonary disease in primary care.

Oral health professional intervention and child physical abuse-European legal approach.

An oral health professional's notification of the event is a fundamental step of the judicial process.The timeline is the core of traumatic injury assessment in a child physical abuse scenario.Medicolegal evaluation impacts disability prevention, imputability, and notification of the crime.

The development of a behaviour-change intervention for health professionals during the Covid-19 pandemic

BackgroundIn May 2020, a National Health Service (NHS) hospital within the East Midlands requested a needs analysis and development of an intervention to optimise the wellbeing of healthcare professionals (HCPs).MethodUsing the Behaviour Change Wheel (BCW), the Capability, Opportunity, and Motivation Behaviour( COM-B) model, and the Areas of Worklife model we conducted a needs analysis (two independent surveys assessing wellbeing and behavioural contributors to wellbeing) for the Pulmonary Rehabilitation (PR, N=11), Cardiac Rehabilitation (CR, N=19), COPD nurse specialist (N=6), Home Oxygen (N=6), and Research teams (N=10) between June-July 2020. The results were used in conjunction with the taxonomy of Behaviour Change Techniques (BCTv1) to identify the most appropriate strategies for facilitating behaviour change in our intervention. To identify what needed to change for HCPs to engage in each target behaviour, HCPs were asked to complete the COM-B self-evaluation questionnaire.A multidisciplinary team guided intervention delivery (trainee Health Psychologist, N=1, Health Psychologist, N=2, NHS clinical lead, N=1).ResultsIn survey one (N=25), 52% of HCPs reported client-related burnout, 92% reported work-related burnout. In survey two (N=19), HCPs reported poor focus and concentration, insufficient time to attend to self-care/oneself, and an inability to ‘switch off conscious thoughts about work at the end of the working day’ at the end of the day as fundamental contributors to burnout. Due to theorised spill over effects, our behavioural target was enabling HCPs to ‘switch off conscious thoughts about work at the end of the working day’. From the BCW steps and BCTv1, we developed a three-pronged behaviour change intervention involving a relaxation toolkit, an educational webinar, and wellbeing one-to-ones.ConclusionThe BCW, COM-B model, and BCTv1 can be used successfully to develop a workplace intervention to tackle HCPs perceived burnout. We hypothesise our intervention will increase HCPs attentional rest and self-care behaviours, thereby reducing their perceived burnout. Results of a pilot study will be reported soon.

Efficacy of a training programme for the management of diabetes mellitus in the hospital: A randomized study (stage 2 of GOVEPAZ healthcare).

To assess the efficacy of a structured educational intervention for health professionals on the appropriateness of inpatient diabetes care and on some clinical outcomes in hospitalised subjects. A multicentre (6 regional hospitals) cluster-randomized (2:1) two parallel-group pragmatic intervention trials, as a part of the GOVEPAZ study, was conducted in three clinical settings, that is, Internal Medicine, Surgery and Intensive Care. Intervention consisted of a 2-month structured education of clinical staff to inpatient diabetes care. Twelve wards - 2 for each hospital - and 6 wards - 1 for each hospital - were randomized to usual care and to the intervention arm, respectively. Consecutively hospitalised diabetic subjects (n=524, age 74±14years, 57% males, median HbA1C 57mmol/mol) were included. The clinical appropriateness of inpatient diabetes management was assessed by a previously validated multi-domain performance score (PS). Clinical outcomes included hypoglycemia, glucose control biomarkers, clinical conditions at discharge and inpatient mortality rate. A numerically, but not statistically significant, higher PS (+0.94; 95% C.I.: -0.53 - +2.4) was achieved in the intervention than in the usual care wards. Hypoglycemias (p=0.32), glucose control (p=0.89) and survival rates (p=0.71) were similar in the two experimental arms. Plasma glucose on admission (OR=1.52 per 1 SD; C.I. 1.07-2.17; p=0.021) and the number of hypoglycemic events per patient (OR=1.55 per 1 SD; C.I.:1.11-2.16; p=0.011) were independently associated with the inpatient mortality rate. Structured education of the clinical staff failed to improve the inpatient appropriateness of diabetes care or clinical outcomes. In-hospital hypoglycemia was confirmed to be an independent indicator of death risk.

Barriers in completing the checklist for safe deliveries: integrative review

Objective: To identify, in the scientific literature, the barriers that make it difficult to apply the Safe Childbirth Checklist of the World Health Organization. Methods: An integrative review was conducted from November 2020 to May 2022, using the following data sources: Scopus, MEDLINE®/PubMed®, Web of Science, and CINAHL. This study was conducted according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Results: The sample consisted of 14 studies published mainly in 2021, when South America predominated as a publishing continent. The English language, methodological studies, and quantitative approaches prevailed. Level IV evidence prevailed in the sample. In the identified studies, there was a strong description of cultural factors, followed by structural factors and factors related to the work process. Conclusion: Cultural (interpersonal relationships, hierarchy of professional classes, and poor communication) and structural (design and fonts used in the checklist) factors, and those related to the work process (such as the checklist implemented in the health service, the manager’s attitude regarding presenting it, and need for educational/training intervention for health professionals) are the main barriers that make it difficult to apply the Safe Childbirth Checklist.

Food Sustainability Knowledge, Attitudes, and Dietary Habits among Students and Professionals of the Health Sciences

The importance of a sustainable diet is an emerging concept within sustainable food systems. Food systems emit 30% of greenhouse gases, which needs to change. A cross-sectional study was carried out to determine the knowledge, attitudes, and habits of students and professionals in the health sciences regarding a sustainable diet, comparing these to the Spanish population. We further aimed to analyse the consistency between the knowledge and attitudes of these individuals and their dietary habits and analyse the consumption of different food groups that are typical of a sustainable diet. A survey was completed by a total of 415 participants, both university students in the health sciences and health professionals. These two groups were more knowledgeable of sustainable diets than the general population, although certain concepts are unfamiliar to both populations. A positive attitude towards sustainable food habits was also observed among the population studied. The health sector reported having better eating habits than the overall population. A significant positive correlation was observed between higher fruit and vegetable consumption and deeper knowledge and more favourable attitudes. People with less knowledge and worse attitudes reported consuming more red and processed meat. The findings of this study could inform targeted interventions for health professionals given the need to promote a healthy diet but also a healthy and sustainable diet for planetary health.

Improving Sleep Quality to Prevent Perinatal Depression: The Obstetric Nurse Intervention

Throughout their life, women should pay attention to their mental health. Evidence indicates that poor sleep quality is related to depressive symptoms in pregnancy, justifying the intervention of health professionals in improving sleep quality to promote the mental health of pregnant women. The objective of our study is to analyze the relationship between sleep quality and perinatal depression, and to identify the obstetric nurse’s intervention in improving sleep quality in the perinatal period. A total of 53 pregnant women between the 28th week of pregnancy and the 7th day after delivery completed the Edinburgh Postnatal Depression Scale (EPDS) and Pittsburgh Sleep Quality Index (PSQI). Women were also asked about the strategies used by the obstetric nurse to improve their quality of sleep. Data analysis was performed using IBM SPSS Statistics software, version 25.0. The Mann–Whitney-U and Kruskal-Wallis tests were carried out. A p-value < 0.05 was considered statistically significant. The median PSQI score was 10 (±3.63), and 9.2% (n = 9) had good quality sleep. The median EPDS score was 12 (±4.43), and 27 participants (50.9%) had probable depression. The women with likely depression had worse sleep quality (p = 0.016). Most participants reported that the obstetric nurse showed no interest in their sleep quality during pregnancy. Women of other nationalities have a higher risk of depression (p = 0.013). Based on our results, it is crucial to assess sleep quality in the perinatal period to promote women’s health during the prenatal and postnatal periods, and more action is needed since we are facing one of the most significant challenges of this century, preventing depression.

School nurses’ experience of communicating growth data and weight development to parents of children 8 and 10 years of age

IntroductionThe prevalence of overweight and obesity among children has risen sharply during recent decades. School nurses are key health professionals in interventions targeting the early onset of overweight and obesity during childhood. Understanding how school nurses experience communication with parents concerning their child´s growth and weight development are essential. The aim of the study is to describe school nurses’ experience of communicating growth data and weight development to parents of school children ages 8 and 10 years.MethodThe design of the study is a descriptive, qualitative design with purposive and snowball sampling. Sixteen interviews with school nurses were conducted and analysed with qualitative content analysis.ResultThe analysis resulted in three main categories including subcategories. In Challenges in the professional role, the school nurses expressed a lack of knowledge, skills and tools in communication, described a perception of parental responsibility and stated using several different approaches in communicating growth data and weight development to parents. In Sustainable communication with parents, the school nurses described the value of creating a dialogue, a supportive approach to the parents, and the building of a relation between them and the parents as essential. In Barriers in communicating the child´s weight, the school nurses described the experience of stigma concerning the subject of overweight and obesity, increased concern when they detected underweight as well as an ambivalence towards measuring weight.ConclusionThe study highlights an educational challenge concerning the need for training, skills, and strategies for communication with parents. A variety of ways in school nurses’ communication with parents were identified in the present study and this shows an inconsistency in how School health services was offered and a need for the development of evidence-based procedures for communicating growth data and weight development to parents.

Centering Indigenous knowledge in suicide prevention: a critical scoping review

BackgroundIndigenous peoples of Canada, United States, Australia, and New Zealand experience disproportionately high rates of suicide as a result of the collective and shared trauma experienced with colonization and ongoing marginalization. Dominant, Western approaches to suicide prevention—typically involving individual-level efforts for behavioural change via mental health professional intervention—by themselves have largely failed at addressing suicide in Indigenous populations, possibly due to cultural misalignment with Indigenous paradigms. Consequently, many Indigenous communities, organizations and governments have been undertaking more cultural and community-based approaches to suicide prevention. To provide a foundation for future research and inform prevention efforts in this context, this critical scoping review summarizes how Indigenous approaches have been integrated in suicide prevention initiatives targeting Indigenous populations.MethodsA systematic search guided by a community-based participatory research (CBPR) approach was conducted in twelve electronic bibliographic databases for academic literature and six databases for grey literature to identify relevant articles. the reference lists of articles that were selected via the search strategy were hand-searched in order to include any further articles that may have been missed. Articles were screened and assessed for eligibility. From eligible articles, data including authors, year of publication, type of publication, objectives of the study, country, target population, type of suicide prevention strategy, description of suicide prevention strategy, and main outcomes of the study were extracted. A thematic analysis approach guided by Métis knowledge and practices was also applied to synthesize and summarize the findings.ResultsFifty-six academic articles and 16 articles from the grey literature were examined. Four overarching and intersecting thematic areas emerged out of analysis of the academic and grey literature: (1) engaging culture and strengthening connectedness; (2) integrating Indigenous knowledge; (3) Indigenous self-determination; and (4) employing decolonial approaches.ConclusionsFindings demonstrate how centering Indigenous knowledge and approaches within suicide prevention positively contribute to suicide-related outcomes. Initiatives built upon comprehensive community engagement processes and which incorporate Indigenous culture, knowledge, and decolonizing methods have been shown to have substantial impact on suicide-related outcomes at the individual- and community-level. Indigenous approaches to suicide prevention are diverse, drawing on local culture, knowledge, need and priorities.

Recommender System Based on Collaborative Filtering for Personalized Dietary Advice: A Cross-Sectional Analysis of the ELSA-Brasil Study.

This study aimed to predict dietary recommendations and compare the performance of algorithms based on collaborative filtering for making predictions of personalized dietary recommendations. We analyzed the baseline cross-sectional data (2008-2010) of 12,667 participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The participants were public employees of teaching and research institutions, aged 35-74 years, and 59% female. A semiquantitative Food Frequency Questionnaire (FFQ) was used for dietary assessment. The predictions of dietary recommendations were based on two machine learning (ML) algorithms-user-based collaborative filtering (UBCF) and item-based collaborative filtering (IBCF). The ML algorithms had similar precision (88-91%). The error metrics were lower for UBCF than for IBCF: with a root mean square error (RMSE) of 1.49 vs. 1.67 and a mean square error (MSE) of 2.21 vs. 2.78. Although all food groups were used as input in the system, the items eligible as recommendations included whole cereals, tubers and roots, beans and other legumes, oilseeds, fruits, vegetables, white meats and fish, and low-fat dairy products and milk. The algorithms' performances were similar in making predictions for dietary recommendations. The models presented can provide support for health professionals in interventions that promote healthier habits and improve adherence to this personalized dietary advice.

What are the effects of educational interventions for health professionals managing chronic obstructive pulmonary disease (COPD) in primary care?

What are the effects of educational interventions for health professionals managing chronic obstructive pulmonary disease (COPD) in primary care?

Ethical conflicts among physicians and nurses during the COVID-19 pandemic: A qualitative study.

Rationale, Aims and ObjectivesThe healthcare system and professionals working in the sector have experienced a high caseload during the coronavirus disease 2019 (COVID‐19) pandemic. This has increased the potential for morally harmful events that violate professionals' moral codes and values. The aim of this study was to understand and explore experiences of new moral challenges emerging among physicians and nurses caring for individuals during the COVID‐19 pandemic.MethodThe consolidated criteria for reporting qualitative research (COREQ) checklist was used in this qualitative study based on Gadamer's phenomenology. Participants were selected using a convenience sampling method. Thirteen medicine and nursing graduates were interviewed in depth. The participants all worked on the frontline at the start of the COVID‐19 pandemic. Data were gathered in two basic healthcare districts in Spain, encompassing both primary care and hospital care.ResultsFour main themes emerged from the data analysis: (1) Betrayal of moral and ethical values as a key source of suffering; (2) Ethical and moral sense of failure accompanying loss of meaning; (3) Lack of confidence in performance; (4) Self‐demand and self‐punishment as personal condemnation among healthcare workers.ConclusionsHealth institutions must implement interventions for health professionals to help mitigate the consequences of experiencing complex ethical scenarios during the pandemic. In addition, they should promote training in moral and ethical deliberation and prepare them to make decisions of great ethical significance.

Educational interventions for health professionals managing chronic obstructive pulmonary disease in primary care.

Educational interventions for health professionals managing chronic obstructive pulmonary disease in primary care.

Screening Tools Designed to Assess and Evaluate Oropharyngeal Dysphagia in Adult Patients: A Scoping Review.

Oropharyngeal Dysphagia (OD) significantly decreases a patient’s quality of life and poses a high economic burden to institutions. In this sense, evaluation and assessment are important interventions for health professionals, although current tools and instruments are multiple and are dispersed in the literature. The aim of this review was to map existing screening tools to assess and evaluate OD in adult patients, identify their relevant clinical parameters and respective contexts of use and provide a systematic approach and summary to better inform practice. A scoping review was developed guided by the JBI methodology and using PRISMA-ScR to report results published between 2014 and 2021, in English, Spanish and Portuguese. Databases included Medline, Academic Search Complete, CINAHL Complete, Scielo, Google Scholar, ScienceDirect, OpenGrey and B-On. Mendeley was used to store and screen data. A total of 33 studies were included in the study, of which 19 tools were identified, some being intervention-based tools and others an algorithm for decision. The most common context used was in the general population and older adults. Regarding clinical parameters, the most common were food consistency, presence of the cough reflex, swallowing effort, voice changes and weight. As oropharyngeal dysphagia concerns important risks for the patient, a rigorous assessment must be performed. In this sense, the review identified specific disease-related tools and more general instruments, and it is an important contribution to more efficient dysphagia screening and prevention.

The effect of mobile health focused on diet and lifestyle on blood pressure: a systematic review and meta-analysis.

To determine the effect of mobile health (mHealth) focused on diet and lifestyle on blood pressure (BP). We performed a systematic review with meta-analysis using the mean difference (MD) of change from baseline as an effect measure. MEDLINE via PubMed, Cochrane Central, and EMBASE were reviewed until 6 May 2020. We included randomized controlled trials of adults who participated in mHealth focused on diet and lifestyle. Interventions were grouped according to the presence of health professional intervention (PI) (PI + mHealth or mHealth only). Eligible controls did not participate in mHealth and were classified as active comparator (PI) or no intervention (NI). Subgroup analyses were performed according to the presence of prior cardiovascular disease and hypertension status. We included 44 trials involving 24 692 participants. Mobile health interventions were superior to NI in reducing SBP in both situations: alone [MD = -1.8 mmHg; 95% confidence interval (CI): -3.6; 0.0] or with PI (MD = -5.3 mmHg; 95% CI: -7.5; -3.1), with a greater effect size in the latter group (P = 0.016). This benefit was not observed when the control was PI. DBP and SBP had consistent results. There was a marked effect of PI + mHealth vs. NI on the BP reduction among hypertensive participants. Current evidence shows that mHealth focused on diet and lifestyle can reduce BP, especially when implemented in hypertensive participants, and PI may provide additional benefit. PROSPERO ID CRD42019141475.

Breastfeeding success and its relation to maternal pain, behaviour, mental health, and social support

ABSTRACT Objective We aimed to understand the maternal experience of breastfeeding onset and how psychological, social and clinical variables as pain during breastfeeding, may interfere with it. Methods A cross-sectional study investigated 395 post-delivery women able to breastfeed from 48 hours to 6 days for unpleasant breastfeeding, maternal stress during pregnancy and postnatal mental state. Social Readjustment Rating Scale evaluated prenatal maternal stress. Perceived Maternal Parenting Self-Efficacy Scale, Pain Catastrophizing Scale – Parent version, and Edinburgh Postnatal Depression Scale evaluated maternal mental state. Results Unpleasant breastfeeding experience showed to be positively related to the longer number of days the pain lasts; late onset of breastfeeding; less search for information about pregnancy and baby care (p < .01); lower catastrophizing behaviour towards infant´s stress and C-section delivery (p < .04). Pain levels were positively correlated to longer periods of pain, later onset of antenatal consultations and depression (p < .05). Binary logistic regression pointed to the effects of lower self-efficacy and pain in breastfeeding, higher depression levels, gestational stress, labour adversities and success in breastfeeding. Conclusions The relationship among maternal perceived self-efficacy, anxious and depressive thoughts, catastrophizing behaviours, and unpleasant breastfeeding need to be evaluated to elucidate the best health professional intervention.