ABSTRACT
Resumen Los eventos altamente estresantes son sucesos que potencialmente generan consecuencias negativas en las personas afectadas, como síntomas postraumáticos y depresivos. El presente estudio evalúa un protocolo de intervención preventiva, orientado a personas que han vivido un evento altamente estresante reciente, basado en la Terapia Sistémica Breve. Cuatro terapeutas aplicaron el protocolo a cuatro usuarias. Se entrevistó a estas ocho personas acerca de su experiencia en la aplicación y recepción del protocolo. Mediante escalas de fiabilidad y validez contrastada se evaluaron los cambios pre-post en sintomatología postraumática, sintomatología depresiva, crecimiento postraumático y satisfacción con la vida; también se midió la relación terapéutica. Los resultados muestran apreciaciones positivas en terapeutas y usuarias, el desarrollo de una relación terapéutica adecuada y avances en tres de los cuatro indicadores cuantitativos de cambio. Se concluye que el protocolo está en condiciones de utilizarse en estudios controlados.
Abstract Highly stressful events are occurrences that potentially create negative consequences for the affected people, such as post-traumatic and depressive symptoms. This study assesses a preventive intervention protocol, aimed to people who have lived a recent highly stressful event, based on the Brief Systemic Therapy. Four therapists applied the protocol to four female users. These eight persons were interviewed about the experience in relation to the application and reception of the protocol. Through contrasted reliability and validity scales, pre and post changes in posttraumatic symptomatology, depressive symptomatology, posttraumatic growth and satisfaction with life were assessed; the therapeutic relation was also measured. The results show positive appraisals in therapists and female users, the development of a proper therapeutic relation and progress in three out of four quantitative change indicators. It is concluded that the protocol is suitable to be used in controlled studies.
Subject(s)
Stress, Psychological/therapy , Clinical Protocols , Psychological Trauma , Therapeutics , Evaluation Study , Depression , Posttraumatic Growth, PsychologicalABSTRACT
AIM: To provide advice for the clinical trials during the outbreak by analyzing the clinical trial registration information of COVID-19 in China. METHODS: Clinical protocols of COVID-19 registered at the Chinese Clinical Trials Registry and clinicaltrials.gov before February 17, 2020 were collected and the type, distribution, design and interventions of the studies were analyzed.RESULTS:A total of 172 trials were retrieved, mainly distributed in Hubei, Zhejiang, Guangdong and Beijing. Among the 120 interventional studies, chemical drugs and biological products accounted for 45%, traditional Chinese medicine or integrative medicine therapy accounted for 40%, cell therapy accounted for 7%, and plasma therapy accounted for 2%. There were only 13 randomized, blinded and placebo controlled studies, accounting for 11%. Blank control reached 46% (control group with clinical routine treatment without placebo,test group with clinical routine treatment as the basic). HIV and antimalarial drugs were the most frequently used. CONCLUSION: Chinese clinical research capacity and awareness have been greatly improved, but it is somewhat disordered. It is necessary to pay attention to the necessity, scientific nature, ethics and quality management of clinical research. It is recommended to initiate clinical trials coordinated and unified demonstration and to collect the national case information for big data analysis by the state during an emergency outbreak.
ABSTRACT
Introducción: se han hallado dos herramientas de evaluación fiables y válidas que miden las repercusiones psíquicas que las técnicas coercitivas tienen sobre los pacientes mentales. La existencia de estas herramientas habilita la continuidad en la investigación sobre la temática. Objetivo: revisar las preferencias de los pacientes de las instituciones de salud ante las distintas medidas coercitivas. Métodos: se realizó una búsqueda bibliográfica sistemática en bases de datos digitales y otras fuentes. Se realizó revisión por pares de los trabajos, utilizando como criterio temático de inclusión, la pertinencia en los temas a tratar. Tras el examen del resumen, cuerpo y conclusiones, se seleccionaron aquellos cuyo contenido se refería a: (1) las vivencias de los pacientes y personal cuando se aplicaban las medidas coercitivas; (2) preferencias de los pacientes sobre estas; (3) medidas preventivas; y (4) cuidados necesarios. Desarrollo: Los estudios revisados apuntan al peligro ético que desarrolla el uso o la mala aplicación de estos protocolos coercitivos. Se debe tener en cuenta que la integridad física del personal sanitario también corre peligro en el tratamiento de pacientes psiquiátricos. En esta disyuntiva entre preservación de la dignidad del paciente y seguridad del personal, han sido propuestas diversas medidas tanto accesorias/compensatorias como sustitutivas de estas técnicas perjudiciales para la salud mental de los pacientes. Conclusiones: La comunicación entre el personal que implementa estas medidas y el paciente que las recibe, es esencial para una buena alianza terapéutica y el correcto desarrollo del tratamiento(AU)
Introduction: Two reliable and valid assessment tools have been found that measure the psychic impact of coercive techniques on mental patients. The existence of these tools enables continuity in research on the subject. Objective: This paper reviews the preferences of the patients of the health institutions about different coercive measures. Methods: A systematic bibliographic search was carried out in digital databases and other sources. Peer review of the works was carried out, using as a thematic criterion of inclusion, the relevance in the topics to be treated. After examining the summary, body and conclusions, those whose content referred to were selected: (1) the experiences of the patients and staff when the coercive measures were applied; (2) patients' preferences about these; (3) preventive measures; and (4) necessary care.. Body: The studies reviewed point to the ethical danger that leads to the use or misapplication of these coercive protocols. It should be taken into account that the physical integrity of health personnel is also at risk in the treatment of psychiatric patients. In this dilemma between the preservation of the patient's dignity and the safety of the personnel, various measures have been proposed, both ancillary and compensatory, as well as substitute for these techniques that are detrimental to the mental health of patients. The purpose of these measures is to avoid the use of these coercive techniques. Conclusion: communication between the personnel implementing these measures and the patient receiving them is essential for a good therapeutic alliance and the correct development of the treatment(AU)
Subject(s)
Humans , Psychiatric Nursing/ethics , Mentally Ill Persons/psychology , Mental Health Assistance , Therapeutic Alliance , Review Literature as Topic , Databases, BibliographicABSTRACT
The main purpose of this methodological study was to develop an assessment tool and intervention protocol for child and family with childhood cancer at early diagnosis stage. The assessment tool and intervention protocol was developed by extensive literature review and consultation with experts. Review of nine domestic and sixty-six international journal articles were done to identify stress, interventions, coping strategies and adjustment of children with cancer and their family. Results were as follows; First, assessment at the early diagnosis stage need to include information on patient, family, and patient/family attitude toward diagnosis and treatment. Second, intervention protocol for children with cancer includes control physical symptoms, manage the side effects of chemotherapy and diagnostic or therapeutic procedures, control emotional responses, provide support and information, assist decision-making and adjust to environment. Third, intervention protocol for family includes controlling emotional responses, provision of informations, inducing family support to patient, improving family cohesion, supporting siblings and supporting spiritual growth. In conclusion, the early diagnosis stage in cancer treatment is important for child and family since this stage greatly affects the overall adjustment of child and family to live with cancer. Therefore, pediatric nurses need to be sensitive to the need of patient/family and systematically manage their needs at this stage.
Subject(s)
Child , Humans , Diagnosis , Drug Therapy , Early Diagnosis , Methods , Nursing , Siblings , Child HealthABSTRACT
Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=0.80 were chosen. 4. Nursing intervention protocols which showed above ICV=0.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation /impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.