ABSTRACT
ABSTRACT. The United Kingdom-Brazil Dementia Workshop took place in July 2019 in the city of Belo Horizonte, MG, Brazil, with an interdisciplinary group of health and care professionals from the United Kingdom and from Brazil to address challenges in diagnosis, public perception and care of dementia. The aim of this article is to present the results identified in relation to challenges in the care of dementia, including recommendations that could potentially guide local and State/Municipal authorities and care services for people with dementia in the future. Four key issues were prioritised to identify challenges and generate possible solutions in Brazil and the United Kingdom: I) limitations of current health systems; II) continuous and long-term support for family carers (pre-diagnosis, mourning); III) support for people with advanced dementia and end-of-life care; IV) support for people with young-onset dementia. In both countries, carers feel left without post-diagnostic support; information on the progression of dementia is lacking and some people do not even have a specific diagnosis; encouraging and providing training for carers best manage some of the symptoms is imperative; preparation for end of life care and support carers after the death of their loved ones remains highly needed; strengthening services and qualification of health professionals, also creating protocols to guide dementia-related services represent a common challenge to overcome. The authors outline recommendations according to the issues identified to assist future formulation of adequate policies and services for people with dementia and carers.
RESUMO. O United Kingdom-Brazil Dementia Workshop aconteceu em julho de 2019 na cidade de Belo Horizonte, Minas Gerais, Brasil, com a presença de grupo interdisciplinar de profissionais de saúde e assistência do Reino Unido e Brasil, para abordar desafios no diagnóstico, percepção pública e cuidado à pessoa com demência. O objetivo do presente artigo foi apresentar os resultados encontrados em relação aos desafios no tratamento da demência, incluindo recomendações que possam potencialmente orientar autoridades locais e estaduais/municipais e serviços de atenção à pessoa com demência. Quatro questões-chave foram priorizadas para identificar desafios e gerar possíveis soluções no Brasil e no Reino Unido: I) limitações atuais dos sistemas de saúde; II) suporte contínuo e de longo prazo para cuidadores familiares (pré-diagnóstico, luto); III) apoio a pessoas com demência avançada e cuidados no fim de vida; IV) apoio a pessoas com demência precoce. Em ambos os países, cuidadores se percebem sem apoio pós-diagnóstico; faltam informações sobre a progressão da demência e algumas pessoas sequer têm diagnóstico específico; encorajar e providenciar treino para cuidadores melhor lidarem com sintomas é imperativo; preparação para cuidados no fim da vida e apoio aos cuidadores após morte de familiares permanecem necessários; fortalecer os serviços e qualificação de profissionais de saúde, além de elaborar protocolos para guiar serviços relacionados à demência, é desafio comum a ser superado. Os autores apresentam recomendações quanto às questões identificadas para auxiliar na futura formulação de políticas públicas e serviços para pessoas com demência e cuidadores.
Subject(s)
Humans , Health Programs and Plans , Cross-Cultural Comparison , Delivery of Health Care , DementiaABSTRACT
En la literatura se destacan numerosas variables que contribuyen a predecir el rendimiento académico. En tal sentido, el apoyo parentales considerado como una causa distal temprana del mismo. Sin embargo, existen resultados contradictorios en cuanto a su contribución, debido a los diferentes modos de operacionalizar dicho constructo. El objetivo del trabajo que se informa consistió en continuar los estudios de adaptación de la Escala de Apoyo Parental, iniciados por Aparicio y Cupani (2008). Específicamente se obtuvo evidencia de estructura interna y se exploró la contribución explicativa que realiza el apoyo parental en el rendimiento académico de los estudiantes, considerando el tipo de institución a la que asisten (pública o privada) y el nivel socioeconómico de sus padres. Los resultados indican que se logró replicar la estructura original de cuatro factores de la Escala de Apoyo Parental (Sehee & Hsiu-Zu, 2005). El estudio de consistencia interna indicó valores aceptables para tres de las cuatro escalas definidas teóricamente. Tanto en instituciones educativas públicas como privadas se observó que la percepción de apoyo parental se incrementa cuando el desempeño de los alumnos es bajo. Particularmente, la aspiración educacional de los padres y la supervisión que realizan sobre sus hijos contribuyeron a explicar el rendimiento académico de los estudiantes, en colegios públicos y privados, respectivamente. Con respecto al nivel socioeconómico, las familias de nivel medio-alto participan más activamente en la educación de sus hijos. Se discuten los resultados, se sugieren posibles estrategias de intervención y se destacan las limitaciones del estudio realizado.
One of the main purposes in literature related to the field of education has been to identify the variables that contribute to predict academic performance. Particularly, parental support is considered as a distal factor that operates early over time (Byrnes & Miller, 2007). Nevertheless, studies have not identified how parental support triggers the students' academic performance due to the different ways in which this construct has been operationalized. Since in our context it is available an adapted Scale of Parent Support (Aparicio & Cupani, 2008), the present work aims to continue the psychometric studies of the instrument. Specifically, a study of internal structure (confirmatory factor analysis) was developed and explanatory contributions to the academic performance of students were investigated, considering the socioeconomic status of parents and type of institution attended by the students. In this article, participants were 403 adolescents (male and female). They were attending to the third year of high school, in public and private schools of the city of Córdoba (Argentina), and they were between ages 13 to 17 (M = 14.27; SD = .93). The instruments were a questionnaire on socioeconomic status (Comisión de Enlace Institucional, 2006) and a Scale of Parental Support (Aparicio & Cupani, 2008). The students' academic performance was operationalized by the average achieved in the Mathematics during the two semesters of the school year. The results replicated the original four-factor structure of the Scale of Parental Support (Sehee & Hsiu-Zu, 2005). The analysis showed satisfactory internal consistency values for three of the four scales theoretically defined (Communication: .82; Supervision: .77; Parent Educational Aspiration: .77, and Involvement: .61). Both in public and in private schools, it was observed that the perception of parental support increases when student's performance is low. In particular, the educational aspirations of parents and the supervision of their children help to explain the academic performance of students in public and private schools, respectively. With regard to socioeconomic status, it was observed that the families of medium-high status participated more actively in the education of their children. Note that one of the limitations is the way in which the academic performance is measured in Argentina. Indeed, qualifications came from informal assessments designed by the teachers, so that they can be influenced by the particular guidelines of each institution and/or the educational framework of each teacher. Whereas the variables involved in student learning are numerous -among them, not only parental support perceived by students but other propensity factors (personality traits, skills, self-efficacy beliefs, for example) and even the characteristics of the institution-, the results of this study allow an approximation of how the support received by the parents, particularly the Monitoring and Aspiration, contribute to the academic performance of students. These observations have an impact on education because they might be useful to develop programs to maintain and enhance parental involvement in the education of their children. For example, it would be important to work with parents before the school year to encourage communication and participation in their children's educational process.