Application of obstetric nurse-led family group pregnancy care mode in elderly multiparas / 中国实用护理杂志

Objective:To investigate the effect of obstetric nurse-led family group pregnancy care mode on gestational health behaviors, gestational complications and pregnancy outcomes of elderly multiparas.Methods:This study was a randomized controlled trial, a total of 120 elderly multiparas who were registered, received regular production inspection and gave birth in Obstetrics Department of Yantai Affiliated Hospital of Binzhou Medical University from January to December 2021 were selected by convenience sampling method, and divided into the experimental group and the control group by random number table method with 60 cases in each group. The control group was given routine pregnancy care, while the experimental group was given obstetric nurse-led family group pregnancy care mode. The intervention effect was evaluated by Health Promotion Lifestyle Profile II (HPLP-II). The occurrence of gestational complications and pregnancy outcomes in both groups were recorded.Results:There was no significant difference in the scores of HPLP-II before intervention between the two groups ( P>0.05). After intervention, scores of health responsibility, nutrition behaviors, exercise and stress management, and total score of HPLP-II in the experimental group were (25.06±2.73), (28.93 ± 3.04), (22.18 ± 2.67), (24.09 ± 2.88), (151.94 ± 11.78) points, higher than those in the control group (24.12 ± 2.27), (27.46 ± 2.59), (20.54 ± 2.25), (22.97 ± 2.63), (146.43 ± 10.35) points, the differences were statistically significant between the two groups ( t values were 2.05-3.64, all P<0.05). The incidence of gestational complications in the experimental group (11.67%, 7/60) was lower than that in the control group (26.67%, 16/60), the difference was statistically significant between the two groups ( χ2=4.36, P<0.05). The proportion of natural delivery in the experimental group (83.33%, 50/60) was higher than that in the control group (66.67%, 40/60), the difference was statistically significant between the two groups ( χ2=4.44, P<0.05). The total labor duration in the experimental group was (237.64 ± 66.48) min, shorter than (262.79 ± 60.57) min in the control group, the difference was statistically significant between the two groups ( t=2.17, P<0.05). There was no statistically significant difference between the two groups in terms of premature delivery, 2-hour postpartum bleeding volume, neonatal 1-minute Apgar score and neonatal weight (all P>0.05). Conclusions:The obstetric nurse-led family group pregnancy care mode can improve gestational health behaviors and lower the risk of gestational complications in elderly multiparas while reducing cesarean section rate and shortening total labor duration.

A importância da atividade em grupo para familiares de pessoas com transtornos mentais em centro de atenção psicossocial ­ um olhar do terapeuta ocupacional / The importance of group activity for families of people with mental disorders in a psychosocial care center - an occupational therapist view

Introdução: O grupo de apoio às famílias tem a finalidade de promover interação e convivência, incentivar uma vida social mais ativa, bem como entender a codependência e estimular a independência dos portadores de transtornos mentais. Objetivo: relatar a experiência da atuação do Terapeuta Ocupacional em um grupo de familiares e cuidadores de usuários de um Centro de Atenção Psicossocial. Método: trata-se de um relato de experiência, que teve como instrumento para a coleta de dados a observação sistemática e os relatos dos participantes registrados em diário de campo. Para a análise dos resultados foi utilizada a técnica de análise de conteúdo de Bardin. Resultados: O grupo busca proporcionar o entendimento de que somente a medicação não faz efeito; o transtorno mental é consequência de muito sofrimento devido a perdas e xingamentos na vida, problemas biológicos, absorção das coisas ruins, momentos traumáticos e julgamento da sociedade. Com o grupo os familiares conseguem sabedoria para lidar com os sintomas de crises e da própria doença, e promoção de sentimentos de apoio, orientação e segurança, compreendendo a família como parte essencial ao tratamento do transtorno mental. A Terapia Ocupacional é essencial para viabilização da autonomia do portador de transtorno mental. Conclusão: O grupo é importante para inserção dos familiares no processo do tratamento, sendo que a participação nos grupos oportuniza a verbalização de sentimentos como angústia, tristeza, medo, decepção, entre outros, bem como elaboração de estratégias para enfrentamento das dificuldades inerentes aos transtornos mentais.

Introduction: The family support group has the purpose of promoting interaction and coexistence, encouraging a more active social life, as well as understanding codependency and stimulating the independence of the individuals with mental disorders. Objective: to report on the experience of the Occupational Therapist in a family group of relatives and caregivers of users of a Psychosocial Care Center. Method: it is an experience report that had, as instrument for data collection, the systematic observation and the reports of the participants registered in field diary. For the analysis of the results, the Bardin content analysis technique was used. Results: The group seeks to provide understanding that only medication has no effect; mental disorder is the consequence of much suffering due to loss and cursing in life, biological problems, absorption of bad things, traumatic moments and judgment of society. With the group, the family members are given the wisdom to deal with the symptoms of crisis and the illness itself, and the promotion of feelings of support, guidance and security, understanding the family as an essential part of the treatment of mental disorders. Occupational Therapy is essential to enable the autonomy of the mentally disordered person. Conclusion: The group is important for the insertion of the family members in the treatment process. Participation in the groups facilitates the verbalization of feelings such as anguish, sadness, fear, disappointment, among others, as well as strategies for coping with the difficulties inherent in mental disorders.

Lucas: un fin de análisis / Lucas: end of analysis

En este trabajo se trata de dar cuenta de un final de análisis, en el caso de un niño diagnosticado como “autista”. El mismo considera la labor de la terapeuta tanto en las indicaciones sobre la frecuencia del tratamiento respecto del niño, como con la de los padres, conteniendo así al grupo familiar. También, queda destacada la transferencia establecida entre la terapeuta y el niño y la actitud de los padres a través de la aceptación de las propuestas planteadas. Del mismo modo describe la finalización del tratamiento teniendo en cuenta sus particularidades, considerando los efectos tanto en el niño y sus padres como en la terapeuta.

This paper is to account for the end of an analysis, in the case of a childdiagnosed as “autistic”. It considers the work of the therapist in bothdirections on the frequency of treatment for the child, as with that of parentsto contain the family group. Transfer established between the therapist andthe child and parental attitudes through acceptance of the proposals alsoremains outstanding. Similarly describes the completion of treatment takinginto account their particularities, considering the effects on both the childand parents and the therapist.

Ce document est de rendre compte de la fin du traitement, dans le casd’un enfant diagnostiqué comme “autiste”. Il estime que le travail duthérapeute dans les deux sens sur la fréquence du traitement de l’enfant,comme celui de parents et contenant le groupe de la famille. Transfert établientre le thérapeute et l’enfant et l’attitude des parents par l’acceptation despropositions reste également remarquable. Décrit même la fin du traitementen tenant compte de leurs particularités, en tenant compte des effets surl’enfant et les parents et le thérapeute.

Results of study on family group practice’s human resources / Монголын Анагаах Ухаан

Introduction: First family group practices (FGPs) started to function in 1999 and there are 225 FGPs in Mongolia. FGP is a primary health care unit that renders medical assistance for all urban population in the country. Privatized FGPs act as contractors for state responsibility service and this one of the innovations that raises challenges to make primary health care services more accessible improve their quality and strengthen their human resources. Greater equity of service access and provision depends on structure and capacity of human resources of FGPs. Therefore, there is a need to study human resources provision and their specialization profile in FGPs.Objectives: To study human resource provision and its specialization profile in FGPs of Ulaanbaatar city.Design: Cross-sectional study Material and Methods: Developed registration checklists and questionnaire were used for collection data on human resources, their specialization and training needs.Settings: 77 FGPs in Ulaanbaatar were covered by the studyResults: There were 2273 people per one family doctor and 2233 people per one family nurse. This means that a family doctor and a family nurse provide services for population almost twice greater compared to required standards and it was observed in all districts of Ulaanbaatar. Most of family doctors (71.6%) graduated as basic doctors and only 10.5% of them specialized as family doctors or general practitioners. Some 15.5% of all selected family doctors attended an upgrading training in family practice and only 1.6% attended specialization training. There were 180 nurses covered by the study and 143 (79.4%), 24 (13.3%), 4 (2.2%) and only 2 (1.1%) of them were trained as general nurse, midwife, nursing assistant and family practice nurse, respectively. Some 20(11.1%) of nurses participated in the study attended some specialization training. Some 28% of family doctors stressed that they would like to attend upgrading training courses in family practice, 13% of them training on public health, 12% on healthcare management, 11% on imaging diagnostics, 8% on internal medicine, 6% on traditional medicine and 5% on child health. FGP’s nurses preference of training were as follows: 40%, 22%, 11%, and 18% were on general practice nursing, public health, management and physiotherapy, respectively.Conclusions: The FGP’s physicians and nurses have been provided service to population twice greater than in required standards, and there were only 1.6% and 1.1% of doctors and nurses attended family practice training, respectively. Therefore, there is a need to increase number of professionals in FGPs and provide specialization training to strengthen FGPs human resources.