Averiguando os caminhos da psicoterapia domiciliar / Ascertaining the ways of home psychotherapy

A psicoterapia domiciliar é uma prática pouco conhecida que, entretanto, adquire importância junto a pacientes com dificuldade de locomoção ou com presença de patologias que dificultem o acesso à hospitais/ clínicas. Tendo em vista a escassez de estudos sobre o tema, este artigo apresenta os resultados de uma pesquisa exploratória sobre o atendimento psicológico domiciliar, realizado com 21 psicólogos da cidade de Curitiba (PR). O objetivo foi identificar o tipo de clientela atendida, quais as abordagens e quais as principais vantagens e desvantagens relacionadas a esse tipo de atendimento. Identificou-se que essa modalidade é mais cômoda para o cliente, mas nem sempre para o profissional. Há predominância de algumas vantagens na psicoterapia realizada em domicílio como manutenção do vínculo terapêutico, maior acesso a informações importantes advindas da observação do ambiente e dos comportamentos espontâneos devido à familiaridade do paciente com o ambiente, o que possibilita novas referências para análise diagnóstica.

Home psychotherapy is a little-known practice that, however, acquires importance among patients with locomotion difficulties or with the presence of pathologies that make access to hospitals / clinics difficult. Considering the lack of studies on the subject, this article presents the results of an exploratory research on home psychological care, performed with 21 psychologists from the city of Curitiba (PR). The objective was to identify the type of clientele served, which approaches and what are the main advantages and disadvantages related to this kind of service. It was identified that this modality is more comfortable for the client, but not always for the professional. There is a predominance of some advantages in home psychotherapy as maintenance of the therapeutic link, greater access to important information from the observation of the environment and spontaneous behaviors due to the patient’s familiarity with the environment, which makes possible new references for diagnostic analysis.

A Study of Home Therapy in Hemophilia Patients / 임상소아혈액종양

BACKGROUND: Home therapy has merits, enabling rapid treatment thereby reducing complications, but difficulty with venous access is a barrier to treatment. There is a paucity of data on this. This study investigated the current status of home therapy for patients with hemophilia, and examined problems and potential solutions.METHODS: Patients and their families who were performing home therapy and who attended the camp of the Korea Hemophilia Association in 2014 were asked to complete questionnaires. The questionnaires pertained to complications of infusion and whether (or not) factor infusion was properly performed. Responses were scored on a scale from 1-5, with a high frequency of complications and adequate performance of infusion being allocated relatively higher scores.RESULTS: The mean score of complications arising from infusion was 1.56±0.46. This was relatively low and was not correlated with the factor infusion training method. The performance of home therapy obtained a relatively high score: 4.46±0.56. The performance score was significantly higher for patients who had practiced infusion with medical personnel, an injection simulator or a video clip.CONCLUSION: Although most patients properly performed home therapy, further improvement is needed in training of infusion and keeping records of bleeds. It is essential to establish guidelines on home therapy, develop a standardized patient and family training program, and reinforce the role of hemophilia treatment centers in educating patients and their families.

A Study of Home Therapy in Hemophilia Patients / 임상소아혈액종양

BACKGROUND: Home therapy has merits, enabling rapid treatment thereby reducing complications, but difficulty with venous access is a barrier to treatment. There is a paucity of data on this. This study investigated the current status of home therapy for patients with hemophilia, and examined problems and potential solutions. METHODS: Patients and their families who were performing home therapy and who attended the camp of the Korea Hemophilia Association in 2014 were asked to complete questionnaires. The questionnaires pertained to complications of infusion and whether (or not) factor infusion was properly performed. Responses were scored on a scale from 1-5, with a high frequency of complications and adequate performance of infusion being allocated relatively higher scores. RESULTS: The mean score of complications arising from infusion was 1.56±0.46. This was relatively low and was not correlated with the factor infusion training method. The performance of home therapy obtained a relatively high score: 4.46±0.56. The performance score was significantly higher for patients who had practiced infusion with medical personnel, an injection simulator or a video clip. CONCLUSION: Although most patients properly performed home therapy, further improvement is needed in training of infusion and keeping records of bleeds. It is essential to establish guidelines on home therapy, develop a standardized patient and family training program, and reinforce the role of hemophilia treatment centers in educating patients and their families.

Survey of the Demands of the Parents of Children with Cerebral Palsy

OBJECTIVE: Because the treatment of children with cerebral palsy needs much time and efforts, the parents are suffering from longstanding treatment and financial problems. Home therapy based on the neurodevelopmental treatment strategy might help to solve these problems extending the time of treatment and helping carry over the effects of the treatment. The purpose of this study is to evaluate current difficulties in managing the children with cerebral palsy and needs of the parents, so that we can obtain a basic information to make the educational program for home therapy. METHOD: A cross-sectional study was performed by questionnaire from the parents of cerebral palsy. RESULTS: The parents recognized the importance of home therapy and were enthusiastic to manage their children at home in 72.7%. However, 38.2% of the parents were lack of practical idea about the skill and knowledge of home therapy, and 51.7% had much burden about time and the expenses of the treatment. CONCLUSION: The needs of home therapy for cerebral palsy by parents were high enough to develop the home program. Thus, practical program of home therapy with education of the parents can improve motor development of the children with cerebral palsy and reduce the time and expenses.

Current Physical Therapy Status for the Children with Cerebral Palsy in Korea

OBJECTIVE: Treatment of children with cerebral palsy needs much time and effort, so it is very hard for many patients to get hospital based treatment. To develop the home treatment program with the parents, we tried to elucidate the current difficulties to which therapists were facing during the treatment of cerebral palsies. METHOD: A cross-sectional study was performed to 250 physical therapists in 110 hospitals with a questionaire by mail. Sixty two universities and general hospitals, 37 rehabilitation centers and 31 community rehabilitation centers were involved in treatment for cerebral palsy, 51% of them are located in Seoul and Kyungi-do. RESULTS: 1) The current treatment time was 33.7 minutes, but most therapists replied that 45 minutes would be optimal. 2) Fifty four therapists (86.1%) had reviewed on introduction or basic course of the Bobath or Vojta program; the duration of the course ranged from 5 days to 1 to 2 months. 3) Fifty five cerebral palsy patients (66.7%) continued treatment for 1 to 2 years and 25% received treatment for more than 2 years. 4) Twenty nine patients (35%) received home therapy from trained parents, 75% of the cases noted significant improvement. CONCLUSION: Cerebral palsy treatment programs require more time than the actural duration of time given during therapy sessions. Thus, parent education for home therapy is considered to be an essential part of cerebral palsy management.