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Hoy — Abril 13th 2021Tus fuentes RSS

Addressing HIV care, mental health and substance use among youth and young adults in the Bay Area: description of an intervention to improve information, motivation and behavioural skills

Por: McCuistian · C. · Wootton · A. R. · Legnitto-Packard · D. · Gruber · V. A. · Dawson-Rose · C. · Johnson · M. O. · Saberi · P.
Objective

Youth represent a population disparately impacted by the HIV epidemic. With most new HIV diagnoses occurring among adolescents and young adults, novel approaches to address this disparity are necessary. The objective of the current study was to describe the Youth to Telehealth and Text to Improve Engagement in Care (Y2TEC) intervention, which aims to fill this gap. The Y2TEC intervention (trial registration NCT03681145) offers an innovative approach to improve HIV treatment engagement among youth living with HIV by focusing on treatment barriers related to mental health and substance use. This allows for a holistic approach to providing culturally informed intervention strategies for this population.

Participants and setting

The Y2TEC intervention was developed for youth with HIV in the large metropolitan area of the San Francisco Bay Area. The Y2TEC intervention was developed based on formative interdisciplinary research and is grounded in the information–motivation–behavioural skills model.

Results

The intervention includes 12 sessions each lasting 20–30 minutes, which are delivered through videoconferencing and accompanying bidirectional text messaging. The intervention sessions are individualised, with session dosage in each major content area determined by participant’s level of acuity.

Conclusions

The Y2TEC intervention is well positioned to help decrease HIV-related disparities in youth living with HIV through its innovative use of video-counselling technologies and an integrated focus on HIV, mental health and substance use.

AnteayerTus fuentes RSS

Hopelessness during acute hospitalisation is a strong predictor of mortality

Por: Gruber · R. · Schwanda · M.

Commentary on: Reichardt LA, Nederveen FE, van Seben R, et al. Hopelessness and other depressive symptoms in adults 70 years and older as predictors of all-cause mortality within 3 months after acute hospitalisation: the Hospital-ADL Study. Psychosom Med 2019;81:477–85.

Implications for practice and research

  • Being aware of the importance of mental health in acute hospitalisation can be life-saving.

  • In further research data of psychiatric/psychological interventions during the patients hospital stay as well as the cause of death after discharge are necessary to find out more about the relationship between feeling hopeless and mortality.

  • Context

    Late-life depression (LLD) is a very common mental health disorder in elderly people (after age 60) all over the world.

    Increased morbidity and mortality as well as a higher risk for dementia, coronary heart disease or suicide are associated with LLD.1

    Anhedonia and a depressed mood through most of the...

    Feeling fearful and lonely are indicative experiences of emotional distress for people with dementia

    Por: Gruber · R. · Schwanda · M.

    Commentary on: Petty S, Harvey K, Griffiths A, et al. Emotional distress with dementia: a systematic review using corpus-based analysis and meta-ethnography. Int J Geriatr Psychiatry 2018;33:679–87.

    Implications for practice and research

  • Using the advanced nursing process could provide individual as well as evidence-based care for people with dementia who suffer from emotional distress.

  • Further research is necessary to demonstrate all emotional aspects of individuals with dementia.

  • Context

    People who suffer from dementia have a decline in thinking, memory, orientation and behaviour.1 Furthermore, this syndrome is accompanied by a lack of ability to act appropriately in everyday activities. Currently, about 50 million people have dementia worldwide.1 This disease does not only affect the person concerned but also their caregivers, their families and society. The signs and symptoms linked to dementia are forgetfulness, getting lost in familiar places, and at home, or...

    Increased knowledge of oral anticoagulants and treatment satisfaction leads to better adherence to oral anticoagulants in patients with atrial fibrillation

    Por: Schwanda · M. · Gruber · R.

    Commentary on: Smet L, Heggermont WA, Goossens E, et al. Adherence, knowledge, and perception about oral anticoagulants in patients with atrial fibrillation at high risk for thromboembolic events after radiofrequency ablation. J Adv Nurs 2018;74:2577–87.

    Implications for practice and research

  • Increased knowledge about oral anticoagulants (OACs) and treatment satisfaction may increase the adherence to OAC in patients with atrial fibrillation (AF).

  • There is a need for long-term effects of educational interventions regarding adherence and the intake of OAC in patients with AF.

  • Context

    AF occurs frequently and leads to a higher incidence of thromboembolic events and stroke. Therefore, OACs are crucial and recommended. This therapy can be carried out with vitamin K antagonists (VKAs) or non-VKA OAC (NOACs). Both have demonstrated a significant reduction in the risk of thromboembolic events. Additionally, an effective rhythm control strategy, the catheter ablation, is useful and reduces the...

    Hospital admission may increase the risk of potentially inappropriate prescribing among older primary care patients

    Por: Schwanda · BSc · MScN · RN · M. · Gruber · BScN · MSc · RN · R.

    Commentary on: Pérez T, Moriarty F, Wallace E, et al. Prevalence of potentially inappropriate prescribing in older people in primary care and its association with hospital admission: longitudinal study. BMJ 2018;363:k4524. doi: 10.1136/bmj.k4524.

    Implications for practice and research

  • The process of medication reconciliation could be a strategy to reduce the risk of potentially inappropriate prescribing among older primary care patients.

  • There exists a significant association between hospital admission and potentially inappropriate prescribing, but further research regarding medication management across all involved healthcare professions is needed.

  • Context

    A crucial approach of the WHO’s third global patient safety challenge is to identify potentially inappropriate prescribing, associated with adverse drug events, hospital admissions and reduced quality of life.1 The omission of beneficial drugs, the use of drugs with a drug–drug interaction, the use of incorrect drug dosages and/or prescribing durations and the prescribing of drugs primarily...

    Does improved postgraduate capacity shift the balance of power for nurse specialists in a low‐income country: A mixed methods study 研究生能力提高是否改变了低收入国家专业护理人员的力量平衡:混合方法研究

    Abstract

    Aim

    To explore nurse specialists’ experiences of change and influence on practice two years after graduating with a postgraduate degree.

    Background

    In the absence of further study opportunities for nurses in their own country, a master's degree was introduced to train the first group of nurse specialists in Mozambique.

    Design

    Within a hybrid evaluation framework an exploratory, sequential mixed methods design was followed.

    Methods

    Qualitative data from focus group interviews with nurse specialists (N = 12) led to five thematic data sets from which survey questions were formulated for the sequential quantitative component.

    Findings

    “Change expectations”, “Ambiguous practice environments”, “Feeling powerless”, “Having some influence” and “Workplace support” were emergent themes from interview data. Areas of positive change occurred in research (100%) and the use of evidence (88.9%) and involvement in decision‐making (77.8%). For some change did not happen as anticipated—reasons included lack of nurse mentors to support new graduates (55.6%); lesser respect compared with doctors (44.4%) and poor understanding of the value of a master's degree (44.4%). Improvements in service quality and elevating the status of nursing were areas of greatest influence (77.8%).

    Conclusion

    Several enabling and limiting factors were identified in the experiences of change and influence on practice of newly qualified nurse specialists. Tacit change with respect to the value of the degree in improving the status of nursing seems not to have affected nurse specialists’ own ability and power to influence practice. Improved postgraduate capacity on its own does not empower nurses in their role as specialists.

    Impact

    The findings point to a two‐tiered strategy to be developed to dismantle barriers to the empowerment and advancement of nurse specialists. The identification of designated nurse mentors is essential to induct and sustain newly graduated nurse specialists. A clear research policy should be developed that supports the conduct of relevant research and the use of evidence in specialist practice.

    目的

    探讨专业护理人员研究生毕业两年后的经验变化及其对护理实践的影响。

    背景

    本国缺乏让护士进一步学习的机会,因此引进了一个硕士学位来培训莫桑比克的第一批专业护理人员。

    设计

    在混合评价框架下,进行了探索性的、顺序混合方法设计。

    方法

    从专业护理人员的小组讨论访谈中获得的定性数据(N = 12)得出了五个专题数据集,从中调查制定的连续定量组成部分。

    发现

    “变化预期”、“模棱两可的实践环境”、“感觉无能为力”、“有一些影响”以及“工作支持”都是采访数据中涌现出来的各个主题。出现正相关改变的领域包括调查(100%)、证据的使用(88.9%)以及参与决策(77.8%)。没有按预期出现某些改变——原因包括缺乏指导刚毕业学生的护理导师(55.6%);与医生相比不受人尊重(44.4%)以及对硕士学位的理解不够(44.4%)。服务质量的改变和护理地位的提高是影响最大的领域(77.8%)。

    结论

    新合格的专业护理人员的实践中确定了一些改变和影响实践的有利因素和限制因素。学位在改善护理状况中价值的隐形改变似乎还未影响专业护理人员自身的能力和影响实践的权力。研究生能力提高本身并不能使他们成为专业护理人员。

    影响

    研究结果指出了一个旨在消除阻碍专业护理人员授权和进步障碍的两级策略。认同指定的护理导师是吸纳和留住刚毕业的专业护理人员的基本。应制定支持相关研究开展和护理实践中证据使用的明确研究政策。

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