Training Family Members Research Articles

Measuring the quality of self-care of elderly patients with dementia in a developing country.

In developing countries like Uganda, people with dementia are cared for by non-medically trained family members with minimal support from the formal healthcare system. The quality of care in this setting is largely unknown but significantly affects the well-being of those with dementia. A tool designed to measure the quality of informal care for old frail adults with or without dementia was translated into Luganda. A committee of experts reviewed and finalized the translation, which was pilot-tested and then used to measure the quality of dementia self-care. We consecutively enrolled 105 caregivers of elderly people with dementia; the median age was 35 years (Interquartile Range 26-47 years), and 67% were females, taking care of a grandparent (44%) or a parent (34%). We used confirmatory factor analysis to assess for structural validity and computed correlation coefficients and Cronbach's alpha to assess for discriminant validity and internal reliability, respectively. The three-factor model applied to the 20 items, adequately fit the data (Comparative Fit Index = 0.88, Tucker-Lewis Index = 0.87, Root Mean Square Error of Approximation = 0.08; 90% Confidence Interval (0.06-0.09), Standardized Root Mean Square Residual = 0.089). There was good discriminant validity, and correlation coefficients between dimensions/scales and the Dementia Knowledge Assessment Scale scores were low. There was good internal reliability with all items Cronbach's alpha ranging from 0.69 to 0.89. Our findings demonstrated that this culturally adapted, shorter measurement tool is valid and reliable. The tool can be used by researchers, health workers, and agencies to assess the quality of self-care for elderly people with dementia in Uganda.

Mental Healthcare Consumers' Experiences of Mental Health Care: Variation in Knowledge by the Family Members and Support.

Knowledge and support by members of the family towards the care of the consumers of mental health services is the core priority and is noticeable by the users as it gives and eases the life of the users during therapy and rehabilitation. However, there have been documented instances of families that neglect their relatives with mental illnesses. This study explored the experiences of mental healthcare consumers regarding family members' knowledge of mental disorders and support. Participants who were granted leave of absence were selected through nonprobability, purposive sampling. Data were collected using face-to-face unstructured discussions. Data were analyzed using Colaizzi's technique. Findings revealed misconceptions versus insight on the cause of mental disorders, knowledge deficit on the effect of treatment, poor support from family members, financial challenges perceived as a source of poor support, and lack of psychological support and its consequences. Mental healthcare consumers verbalized limited support from family members. They reported variation in terms of family members' knowledge of their mental condition. Training family members on mental health illness is critical to the future of health care as there will be no misunderstanding between them and the consumers of mental health care. Healthcare consumers' feelings of sadness and anxiety could be avoided by avoiding conflicts over their social grants. The government should invest in assisting family members of mental healthcare consumers.

Firearm use risk factors and access restriction among suicide decedents age 75 and older who disclosed their suicidal intent.

A majority of older adult suicide decedents used firearms. In this study, we focused on suicide decedents age 75+ who disclosed their suicidal intent within a month of their injury/death to examine demographic and clinical characteristics associated with firearm use and firearm access restriction attempts by their family members. The 2017-2019 U.S. National Violent Death Reporting System provided data (N = 1,734 suicidal intent disclosers; 1,476 males and 258 females; 21.4% of decedents age 75+). Generalized linear model (GLM) for a Poisson distribution with a log link was used to examine firearm use risk factors. Firearm access restriction attempts by decedents' family members were examined based on coroner/medical examiner and law enforcement (CME/LE) reports. Nearly three quarters of disclosers disclosed their intent to family members, and 82.9% of males and 27.5% of females used firearms. GLM results showed males, non-Hispanic white people, and residents in the South and West regions had higher likelihood of firearm use. CME/LE reports of 140 out of 1,294 firearm decedents included narratives related to firearm restriction attempts or lack thereof. Firearm access restrictions were not attempted in 65 cases because family members did not take suicidal intent disclosure seriously or because decedents promised no self-harm. Partial or complete removal of firearms in 75 cases were not effective as decedents had hidden a firearm or purchased a new one. Others used different lethal methods. The findings indicate a need for: (a) training family members of older adults who are at risk of suicide in effective means safety/access restriction and strategies to prevent means substitution; (b) more comprehensive legislative reforms reducing access to firearms by those at risk of suicide; and (c) more comfort and palliative care and counseling for psychosocial risk factors.

Implementing a primary care simulation to improve interprofessional competencies

Learners from six health professions programs (athletic training, nursing, optometry, osteopathic medicine, pharmacy, and physical therapy) participated in a telehealth primary care simulation. The learners’ purpose of the simulated visit was to evaluate and manage a patient experiencing complications of type 2 diabetes, including vision changes, frequent falls, and a foot wound. ObjectivesThe objectives of the activity were to: 1) assess changes in perceived interprofessional abilities in the areas of communication, collaboration, roles and responsibilities, patient/family-centered care, conflict management and resolution, and team functioning, and 2) assess learner perceptions regarding the value of the interprofessional primary care simulation. ActivityLearners were divided into teams with 1–2 learners from each program (8–9 total learners per team) and each team interacted face-to-face in small individual classrooms. Trained faculty served as simulation facilitators in each classroom. Each team conducted a two-phase videoconference encounter with a trained standardized patient and family member. Between the two phases, each team conducted an interprofessional care planning session. Learner evaluation of the exercise used two validated tools, the revised Interprofessional Collaborative Competency Attainment Survey (ICCAS-R), and the modified Simulation Effectiveness Tool (SET-M) to inform the faculty. FindingsPaired t-test values on all 20 items of the ICCAS-R indicated statistically significant results (p < .001), and SET-M results indicated that over 88 % of learners strongly agreed or somewhat agreed with questions pertaining to their satisfaction with the activity. Findings from this activity can be used by other educational institutions to develop a primary care simulation based on the health professions available, thus enhancing interprofessional learning opportunities and overcoming a common barrier of limited clinical sites for interprofessional practice.

Effectiveness of the Breastfeeding Self-efficacy and Family Support Enhancement Program among First-time Postpartum Mothers: A Randomized Controlled Trial

First-time mothers often lack effective breastfeeding techniques and may perceive they have insufficient milk due to inadequate experience in breastfeeding. There are limited programs for enhancing effective breastfeeding and perceived sufficient milk among first-time mothers in Thailand. This randomized controlled trial study investigated the effects of the Breastfeeding Self-Efficacy and Family Support Enhancement Program on effective breastfeeding and perceived sufficient milk among first-time mothers. The participants included 64 pairs of first-time mothers with normal labor and their family members. They were recruited from an antenatal clinic in a province of Thailand and randomly assigned to the experimental arm (n = 32) to receive the program in addition to standard care or the control arm (n = 32) to receive only standard care. Data were collected using the Demographic and Obstetric Data Questionnaires, the Bristol Breastfeeding Assessment Tool, H&amp;H Lactation Scale for first-time mothers, and a demographic data questionnaire for family members. Data analysis was performed with descriptive statistics, Chi-square test, and two-way mixed ANOVA. The results indicated that, after receiving the program, the mean scores on effective breastfeeding and perceived sufficient milk at days 3, 10, and 28 postpartum in the experiment group were significantly higher than before receiving the program and significantly higher than that of the control group. Nurses can integrate this program to train family members to support first-time mothers in breastfeeding continuously and increase first-time mothers’ confidence in their ability to breastfeed effectively and perceive milk sufficiency. However, further testing of the program effectiveness is warranted.

Outcomes of family-centred auditory and tactile stimulation implementation on traumatic brain injured patients.

To determine the outcomes of Family-centred Auditory and Tactile Stimulation Implementation on Traumatic Brain Injured Patients in Egypt. Family engagement in the care of their relatives in the Intensive care units is limited due to patients' life-threatening conditions, in addition to the use of high technology in these settings. Auditory and tactile sensory stimulations are among the diverse sensory stimulations that have received more attention in brain injured patients than other senses as being considered safe, and effective measures. A Quasi-experimental design was used to test the hypotheses of this study. A convenience sample of 60 adult patients suffering from Traumatic Brain Injury and admitted to the intensive care units of two University Hospitals in Egypt was included in the study. Patients were assigned into two equal groups: control and study groups (30 patients each). The auditory and tactile stimulations were provided by trained family members, once daily for 2 weeks for the study group. Whereas routine communication was provided by the family of traumatic brain injured patients in the ICU for the control group. Two tools were used for data collection; tool one, the "Glasgow Coma Scale" to assess patient's level of consciousness, and tool two the "Physiological Adverse Events Assessment" to monitor patients for the occurrence of physiological adverse events. January to October 2019. The implementation of an organized auditory and tactile stimulation by trained family members is associated with highly statistically significant positive effects . Patients in the study group showed a higher mean of consciousness, lower incidence rate of physiological adverse events, and a lower mean duration of ICU stay. Implementation of an organized auditory and tactile stimulation by trained family members enhanced the consciousness level of comatose Traumatic Brain Injured patients, decreased the occurrence of physiological adverse events, and ICU length of stay. Thus, it is recommended for use in the daily routine nursing care of comatose Traumatic Brain Injured patients. This study gives a deeper understanding of how family engagement in the care of their critically ill relative enhances their recovery and improve their level of consciousness.

A Different Approach to Breast Self-Examination Training: Family Training

Background. Breast self-examination (BSE) is an effective, cost-free, early diagnosis method that enables women to take responsibility for their own health in the early diagnosis of breast cancer, which is the most common cause of death in women.&#x0D; The objective of the study was to determine the effect of BSE training given by female nursing students to their mothers and sisters on their BSE behavior and self-esteem.&#x0D; Materials and Methods. This study is of one-group pretest-posttest quasi-experimental design. It was carried out at the Faculty of Health Sciences of Erzincan University in Turkey between December 2019 and May 2020. The universe of the study consisted of 140 third- and fourth-year female students over the age of 18 enrolled in the Department of Nursing, Faculty of Health Sciences, Erzincan University, Turkey. The total number of mothers and sisters in the study sample was 126. The data were collected in two stages, before and one month after family training. IBM SPSS Statistics 22 software package was used for statistical data analysis. The percentage, mean, standard deviation, and Student’s t-test were used for statistical processing. The p-value of 0.05 was considered statistically significant for all tests.&#x0D; Results. The knowledge level of study participants about breast cancer and BSE was analyzed, and the source of their knowledge was assessed. Applying family training approach showed a significant increase in BSE knowledge level of participants one month after training. It was accompanied by increasing BSE skills and self-esteem levels (according to the mean values of the Rosenberg Self-Esteem Scale).&#x0D; Conclusions. Training for family members is an effective method to increase women' s knowledge and skills in BSE. In addition, BSE training enabled female students and their families to participate in BSE practice.

Breaking down barriers to help-seeking: preparing first responders’ families for psychological first aid

ABSTRACT Background First responders regularly encounter both operational stressors and potentially traumatic events, increasing their risk of mental health issues (Declercq et al., 2011). Due to unique cultural complexities, they turn mostly to peers for early psychosocial support (Isaac & Buchanan, 2021). However, peer support and/or mental health assistance may not always be available or easy to access and first responders’ mental health suffers. Objective We need more accessible routes to crisis intervention to ensure first responder resilience and wellbeing, so they may continue to function in the service of public safety. Family members and close friends may be ideally placed to provide this immediate care. This article outlines the protective role of social support as an early intervention strategy to mitigate the effects of first responder trauma, exploring the potential opportunity for family members and friends to play an increasingly supportive role in their loved one’s wellbeing. This paper serves as a call to action for practical educational interventions that will prepare family members for these critical conversations. Conclusion We see potential in combining early intervention theory, psychoeducation, and a strengths-based gender specific positive psychology approach. Further study should investigate how best to help first responders break down barriers to support, by bolstering their existing social supports and ultimately reducing the stigma associated with experiencing traumatic stress. HIGHLIGHTS By training family members in psychological first aid, we may strengthen existing social support for first responders, providing more options for, and potentially breaking down stigma associated with help-seeking.

FRAGILITY FRACTURES IN BRAZIL: CROSS-SECTION STUDY.

ABSTRACTObjective: To evaluate the involvement of orthopedists and orthopedic residents with fragility fractures, in its clinical, therapeutic, and social aspects.Methods: Cross-sectional observational and prospective study that took place in the period from June to August 2020.Results: 540 participants were analyzed. The population consisted of orthopedists (85.56%; N = 462) and residents (14.44%; N = 78), with a greater proportion of individuals from 41 to 50 years of age (36.67%; N = 198) and from the Southeast region (57.22%; N = 309). For 47.04% (N = 254) of the participants, the profile of the patient at risk for fragility fracture corresponds to: woman, sedentary, smoker and over 60 years of age. The consensus among the participants (97.96%; N = 529) is that fragility fractures occur in or near home environments. Moreover, 47.59% (N = 257) believe that the first fragility fracture is the most important predictive risk factor for subsequent occurrences and 63.89% (N = 345) of the participants claim to attend more than 15 cases per year. Regarding treatment, 74.44% (N = 402) are dedicated exclusively to orthopedic aspects (68.33%; N = 369). However, 62.41% (N = 337) of the participants believe that patients with fragility fractures should receive medication and supplements. Likewise, 70.74% (N = 382) of the participants consider that home security measures and training of family members are important, and they attribute the role to the multidisciplinary team.Conclusions: Fragility fractures are frequent in the routine of Brazilian orthopedists. However, they are not familiar with adjuvant treatments for fragility fractures, acting almost exclusively in the orthopedics aspects of these injuries. Level of Evidence II, Prospective Study.

International peritoneal dialysis training practices and the risk of peritonitis.

The effects of training practices on outcomes of patients receiving peritoneal dialysis (PD) are poorly understood and there is a lack of evidence informing best training practices. This prospective cohort study aims to describe and compare international PD training practices and their association with peritonitis. Adult patients on PD<3months participating in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) were included. Training characteristics (including duration, location, nurse affiliation, modality, training of family members, use of individual/group training and use of written/oral competency assessments) were reported at patient and facility levels. The hazard ratio (HR) for time to first peritonitis was estimated using Cox models, adjusted for selected patient and facility case-mix variables. A total of 1376 PD patients from 120 facilities across seven countries were included. Training was most commonly performed at the facility (81%) by facility-affiliated nurses (87%) in a 1:1 setting (79%). In the UK, being trained by both facility and third-party nurses was associated with a reduced peritonitis risk [adjusted HR 0.31 (95% confidence interval 0.15-0.62) versus facility nurses only]. However, this training practice was utilized in only 5 of 14 UK facilities. No other training characteristics were convincingly associated with peritonitis risk. There was no evidence to support that peritonitis risk was associated with when, where, how or how long PD patients are trained.

Learning by interactions with outside directors in family business boards: a dynamic perspective

This article focuses on the dynamics and interactions of outside directors with family members within the board of directors. Based on a longitudinal single case study drawn from a French family business, we qualitatively explore and extend the role of outside directors as catalysts for learning. We highlight that the emergence of shared beliefs and shared new practices on the board without threatening the family’s place in the organization follows a three-phase learning process; 1) Difference between professional and cognitive learning, the informative phase; 2) Cognitive learning actions, outside directors become less informative and more transformative. Outside directors share more than they do train; 3) From cognitive learning to behavioral learning. Outside directors train family members for family relation management in the firm.

Contextualising evidence-based recommendations for the second wave of the COVID-19 pandemic in India

Contextualising evidence-based recommendations for the second wave of the COVID-19 pandemic in India

Improving outcomes in opioid-associated cardiac arrest

Improving outcomes in opioid-associated cardiac arrest

The relationship between individual characteristics and the performance of animal farm group institutions

This study aims to determine the relation between the characteristics of the breeders and the institutional performance of the groups of breeders of the district of Barru, Barru Regency. This research was conducted from August to September 2020. This research used quantitative methods. By taking the sample using the probability sampling technique that was random cluster sampling using the Slovin formula. The analytical method used in this research was Rank Spearman analysis. The results of the research on the relationship between the characteristics and the institutional performance of herder groups showed that the characteristics of the herders had a significant relationship with the institutional performance of the herders groups, namely the number of head of cattle. Meanwhile, the characteristics of pastoralists that do not have a significant relationship with the institutional performance of the groups of pastoralists are age, duration of breeding, number of family dependents and training of family members. Farmers. Indeed, breeders who have a large number of heads of cattle certainly also have significant capital to be encouraged to optimize their breeding activity. The increase in the herd will encourage herders to be more active in the institutional activities of herder groups, thus directly improving the institutional performance of the group.

Evaluation of mental health first aid training for family members of military veterans with a mental health condition

BackgroundA concerning proportion of former Australian Defence Force (ADF) members meet criteria for a mental health condition. Mental health difficulties not only affect the individual veteran. They have been found to negatively impact the mental health of family, with an increased likelihood for family members of veterans developing a mental health condition. The aim of this study was to evaluate whether participating in a Mental Health First Aid (MHFA) program improved family members of veterans mental health knowledge, reduced personal and perceived mental health stigma, reduced social distancing attitudes and increased confidence and willingness to engage in MHFA helping behaviours. Additionally, the study measured participant’s general mental health and levels of burnout.MethodThe study utilised an uncontrolled design with assessment at three time points (baseline, post-program and three-month follow-up). Participants (N = 57) were immediate and extended family members of former ADF members with a mental health condition, who took part in a two-day standard adult MHFA program. At each time point, participants completed self-report measures assessing mental health knowledge, personal and perceived mental health stigma, social distancing attitudes, confidence and willingness to engage in MHFA helping behaviours, general mental health and burnout. Cochranes Q and repeated measures ANOVA was computed to measure the impact of time on the outcome variables.ResultsResults indicated significant improvements in MHFA knowledge and confidence in providing MHFA assistance. Significant reductions in personal mental health stigma (i.e. an individual’s attitude towards mental health) for schizophrenia were observed and maintained at follow up. High levels of perceived mental health stigma (i.e. the belief an individual holds about others attitudes towards mental health) were reported with no significant changes observed following the MHFA program. Results did not indicate any significant benefit in improving general psychological distress or burnout at follow up. The participant sample had high levels of mental health difficulties with over half reporting a lifetime mental health diagnosis.ConclusionThe study is an important contribution to the international literature on MHFA. The provision of a MHFA program to family members of military veterans has not previously been evaluated. Implications of the findings are discussed with regards to future directions of MHFA research and implementing MHFA programs in this population.

Educating relatives of ICU patients for better compliance: our experience

To reduce the risk of postoperative complications among elderly and senile patients, intensive care units can engage patients’ family members in delivering bedside care and assisting in their rehabilitation after completing a nurse skills training course. The aim of this study was to analyze the legal and ethical framework pertaining to ICU organizational practices, survey the family members of ICU patients and develop a nurse skills training course for family members at the Clinic for Anesthesiology and Intensive Care of Tatarstan Clinical Cancer Center. We analyzed ICU regulations and surveyed 35 family members of ICU patients using a specially designed questionnaire. In 2017-2019, 185 individuals took the proposed training course; 32 ICU patients received additional care from their trained relatives. The mental state of the patients was assessed on the Mini Mental State scale; their physical condition was also assessed (the presence of bedsores, enteral nutrition). Results: 71% of the respondents accept the restrictive policies of ICU, 97% believe they are ready to take care of their family member in ICU, 66% do not have the necessary experience. A 3-h long interactive training course was designed to teach family members nursing skills. A total of 185 volunteers completed the training course, and 32 ICU patients received additional care from their trained relatives. As a result, the quality of their enteral nutrition, skin condition and mental state improved. Engagement of trained family members in the care and rehabilitation of ICU patients creates a friendly atmosphere and promotes positive changes to the patient’s condition, their emotional and cognitive state.

Assisted Peritoneial Dialysis - Opportunity For Equal Access To Renal Replacement Therapy By Peritoneal Dialysis

Advances in science and dialysis technology have allowed patients with end-stage renal disease (ESRD) to continue living by starting renal replacement therapy (RRT) - peritoneal dialysis (PD), hemodialysis (HD) or renal transplantation – “a gifted life”. It is recommended that the initial RRT be PD, and later switch to HD if no renal transplantation has been performed yet. In recent years, there has been an increase of elderly patients with a physical or intellectual inability to perform PD alone - they either begin HD or (all too often) sign an informed disagreement on RRT. Assisted PD (aPD) is appropriate for these patients. Assisted PD is also indicated in patients on PD who have developed complications/illnesses that make them unable to cope on their own. Do all patients have an equal chance of starting assisted PD? In Bulgaria, assisted PD is not regulated as a medico-social activity, but there are patients who need assistance. Usually that is done by trained family members. There are patients, however, who cannot rely on the help of relatives, and those in hospices and nursing homes who do not have the chance to benefit from the assisted PD. In many European countries, there is a medico-social network providing assisted PD. The regulation of assisted PD in Bulgaria as a type of medico-social activity done by trained staff in patients' homes, hospices and nursing homes would allow every patient to have equal access to assisted PD and an equal chance for a better quality of life.

Cambio de cánula de traqueostomía en pediatría

El cambio de cánula de traqueostomía en niños constituye un procedimiento clave, sin embargo, falta claridad en algunos de sus aspectos.Objetivo: Caracterizar el cambio de cánula de traqueostomía en niños de una institución de larga estadía hospitalaria.Pacientes y Método: Estudio retrospectivo observacional analítico en base al registro clínico de 2 años de niños hospitalizados usuarios de traqueostomía. Las variables evaluadas fueron: motivo de cambio de traqueostomía, número y marca de traqueostomía, operador y participantes (ayudantes/espectadores) del procedimiento, complicaciones y contexto educacional.Resultados: 630 cambios de cánula de traqueostomía fueron analizados. Los operadores más frecuentes fueron familiares (33,7%). El principal motivo de cambio fue rutina (83,3%). Un 10,7% de los cambios presentó alguna complicación, siendo la más frecuente el sangrado periostoma (47,37%) y el primer intento frustro (34,21%). No existió asociación entre la presencia de balón y complicaciones (p = 0,24), tampoco con el uso de ventilación mecánica (p = 0,8) u operador (p = 0,74).Conclusión: El cambio de rutina de cánula de traqueostomía en niños con vía aérea artificial prolongada es un procedimiento seguro, realizable tanto por profesionales de la salud como por familiares debidamente instruidos.

Pediatric tracheostomy tube change.

Changing the tracheostomy tube in children is a key procedure, however, some of its aspects re main unclear. To characterize the tracheostomy tube change in children from a long-stay health institution. Retrospective observational analytical study based on the 2-year clinical record of hospitalized children who underwent tracheostomy. The variables evaluated were the reason for tracheostomy tube change, size and brand of the tube, operator and participants (assistants/spectators) of the procedure, complications, and education. We analyzed 630 tracheostomy tube changes. The most frequent operators were relatives (33.7%). The main reason for the change was routine (83.3%). 10.7% of the changes presented some complications, where the most frequent was peristomal bleeding (47.37%) and the first failed attempt (34.21%). There was no association between the presence of balloon and complications (p = 0.24), nor with the use of Mechanical Ventilation (p = 0.8) or the operator (p = 0.74). The routine change of the tracheostomy tube in children with prolonged artificial airway use is a safe procedure, which can be performed by both health professionals and properly trained family members.

Удовлетворенность системой комплексной реабилитации инвалидов в дистанционной форме

the article analyzes the experience of implementing the system of comprehensive rehabilitation of disabled people in the rehabilitation centers of the Republic of Tatarstan in the remote form. The article examines the provision of services for the restoration of communication potential, training of family members of disabled people in rehabilitation skills at home, and the provision of additional services remotely, through information and telecommunications technologies, by the rehabilitation centers for the disabled “Ascension”, “Izgelek”, “Veteran”. Conclusions and recommendations on the effective and rational provision of social services are formulated.