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Resumo O estigma da obesidade, também popularmente chamado de gordofobia, é uma realidade atual e sua superação é um desafio complexo. As concepções negativas acerca do excesso de peso também se encontram presentes entre profissionais de saúde, prejudicando a assistência prestada e trazendo danos ainda maiores na saúde de pacientes com obesidade. O objetivo do artigo é apresentar o processo de desenvolvimento de uma intervenção para redução do estigma da obesidade voltada para profissionais de saúde, que utilizou como referencial teórico o protocolo Mapeamento de Intervenções. Descreveu-se como foi realizada a avaliação de necessidades e detalharam-se as etapas referentes ao desenho e à produção da intervenção, tendo como produto final um protocolo de intervenção para redução do estigma da obesidade em profissionais de saúde pronto para ser implementado. O protocolo tem carga horária total de 20h, organizado em dez módulos, cada um com a descrição do formato e duração, objetivo, conteúdo, estratégias pedagógicas, materiais, referências e resultados esperados. O produto final representa uma contribuição para a área de saúde, que tem a intervenção elaborada minuciosamente sobre um arcabouço teórico, passível de ser aplicada e reaplicada em diferentes contextos.
Abstract The stigma of obesity, also popularly called fatphobia, is a current reality and overcoming it is a complex challenge. Negative conceptions about being overweight are also present among health professionals, compromising the care provided and causing even greater damage to the health of obese patients. The article aims to present the process of developing an intervention to reduce the stigma of obesity aimed at health professionals, which used the Intervention Mapping protocol as a theoretical framework. It was described how the needs assessment was carried out and the steps relating to the design and production of the intervention were detailed, with the final product being an intervention protocol to reduce the stigma of obesity in healthcare professionals ready to be implemented. The protocol has a total workload of 20 hours, organized into ten modules, each with a description of the format and duration, objective, content, pedagogical strategies, materials, references and expected results. The final product represents a contribution to the health area, with the intervention being meticulously elaborated on a theoretical framework, capable of being applied and reapplied in different contexts.
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Objective:To investigate the application value of intervention mapping-based health education on therapeutic cognitive perception of pulmonary arterial hypertension patients.Methods:Totally, 60 patients with pulmonary arterial hypertension from January 2018 to January 2021 in Huazhong Fuwai Central Vascular Disease Hospital were assigned to the experimental group and control group according to admission time, with 30 cases in each group. The control group received routine health education, while the experimental group implemented intervention mapping-based health education. The intervention effects were assessed by Beliefs about Medicine Questionnaire-Specific (BMQ-S), Morisky Medication Adherence Scale (MMAS), 6MWT as well as Borg Scale (BS).Results:At 1 month and 3 months after discharge, the scores of MMAS in the experimental group were significantly higher than in the control group[(5.43±1.17) points, (5.57±1.17) points vs (4.60±1.54) points and (4.87±1.41) points], the differences were statistically significant ( t=2.36, 2.10, both P<0.05). At 3 months after discharge, the scores of necessity belief subscale in the experimental group were higher than those in the control group [(22.93±2.63) points vs (21.27±2.73) points], concern belief subscale scores lower than in the control group [(12.40±2.54) points vs (14.13±3.01) points], 6MWT distance in the experimental group higher than in the control group [(532.13±38.51) m vs (507.03±51.13) m], BS scores lower than in the control group [(3.53±1.20) points vs (4.10±0.84) points], the differences were statistically significant ( t values were 2.12-2.41, all P<0.05). Conclusions:Intervention mapping-based health education can improve therapeutic cognitive perception and medication adherence of pulmonary arterial hypertension, it is helpful to promote rehabilitation of patients.
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Intervention mapping (IM) is a framework for formulating theory-and evidence-based health education projects with participatory approaches from ecological perspectives.The intervention program designed via IM plays a role in reducing the exposure of cancer risk factors,increasing cancer prevention behaviors,and promoting early cancer screening and rehabilitation of cancer patients.This study summarizes the characteristics,implementation steps,and application status of IM in tertiary prevention of cancer,aiming to provide reference for the application of IM in the health education projects for cancer in China.
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Humanos , Prevenção Terciária , Neoplasias/prevenção & controle , China , Fatores de RiscoRESUMO
Objective:To investigate the effects of intervention mapping on cardiopulmonary function for patients with acute heart failure in compensatory period, so as to provide references for their early rehabilitation activities.Methods:A total of 90 patients with acute heart failure admitted to Fuwai Central China Cardiovascular Hospital from October 2018 to October 2019 were enrolled in the present study. They were divided into experimental group and control group according to draw-lots-method, with 45 cases in each group. The control group received the routine care and activity plan, while the experimental group implemented intervention mapping-based stage early rehabilitation program. The indicators included 6MWT, forced expiratory volume in one second (FEV 1), brain natriuretic peptide (BNP) as well as Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the intervention effects were compared between the two groups. Results:There were no significant differences in FEV 1, 6MWT, BNP and MLHFQ scores between the two groups at admission ( P>0.05). On discharge, FEV 1, 6MWT were (2.17±0.44) L, (273.09±55.80) m in the experimental group, significantly higher than (1.94 ± 0.39) L and (236.44 ± 50.99) m in the control group; the plasma BNP were (676.79 ± 78.75) ng/L in the experimental group, significantly lower than (736.05 ± 78.77) ng/L in the control group; in addition, the physical demention, emotional dimenson, other demension scores and total scores of MLHFQ in the experimental group were (65.39 ± 5.02), (67.56 ± 4.99), (66.05 ± 4.16) and (66.33 ± 2.63) points, significantly higher than (59.79 ± 5.94), (64.33 ± 5.93), (62.76 ± 4.47), (62.36 ± 2.98) points in the control group, the differences were statistically significant ( t values were 2.56-6.51, all P<0.05). Conclusions:Designing and implementing stage early rehabilitation program using intervention mapping can promote cardiopulmonary function and quality of life of patients with acute heart failure in compensatory period.
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Introducción: el automanejo en diabetes de personas mayores en México ha sido abordado de forma inadecuada con intervenciones centradas en el paciente, olvidando aquellas centradas en prevención, la atención primaria a la salud, y en conjunto con su familia, por lo que el Intervention mapping ofrece una propuesta integral. Objetivo: realizar el diagnostico comunitario de las personas mayores con diabetes y sus familias que habitan en la comunidad de San Luis Tlaxialtemalco en Xochimilco para el diseño de un programa de automanejo en diabetes, mediante Intervention mapping. Método: cuantitativo, descriptivo, exploratorio con una fase cualitativa, mediante el análisis de narrativas. Resultados: las características socioculturales de la comunidad, la identificación de los actores claves y las prácticas de cuidado que, aunque a primera vista parecieran ajenas al automanejo en diabetes de las personas mayores, son claves para poder realizar un trabajo de acompañamiento por parte de enfermería. Conclusiones: El diagnostico comunitario proporciono la base para el diseño del programa con intervenciones multinivel, además de mostrar los beneficios potenciales de aplicar el análisis de los determinantes socioculturales con participación de la comunidad dentro de la formación de enfermería, para construir programas orientados a la interdisciplinariedad e investigación en prevención de enfermedades crónicas.
Introduction: The Diabetes mellitus 2 Self-Management the aged in Mexico has been inadequately addressed with interventions focused on the patient, forgetting those focused on prevention, primary health care and in conjunction with the family, so the intervention mapping offers a comprehensive proposal. Objective: to carry out a community diagnosis of aged with diabetes and their families living in the community of San Luis Tlaxialtemalco in Xochimilco for the design of a diabetes self-management program through intervention mapping. Method: quantitative, descriptive, exploratory with a qualitative phase, through the analysis of narratives. Results: sociocultural characteristics of the community, identification of key actors and care practices that, although at first glance seem alien to diabetes self-management, are key to be able to carry out an accompanying work by nursing. Conclusions: The community diagnosis provided the basis for the design of the program with multilevel interventions, in addition to showing the potential benefits of applying the analysis of sociocultural determinants with community participation within nursing education, to build programs oriented to interdisciplinarity and research in chronic disease prevention.
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Humanos , Masculino , Feminino , Idoso , Diabetes Mellitus , Atenção Primária à Saúde , Idoso , FamíliaRESUMO
Abstract The holotropic mind perspective, an integral part of the framework of transpersonal psychology, has been considered a revolutionary approach to a certain spectrum of experiences in Non-ordinary states of consciousness (NOSC) which conventional approaches tend to treat indiscriminately as pathological processes, because PHM recognizes in these experiences their healing and evolutionary potential. This article describes the needs assessment, implementation, and evaluation of an experiential and educational program on the holotropic mind perspective and its praxis, Holotropic Breathwork® (HB), with students and professionals from the Group for Early Intervention in First-Episode Mental Crisis of a Psychotic Type of the University of Brasilia. The intervention aimed to establish change goals and objectives that would promote the adoption of the holotropic mind perspective's elements, such as a framework to broaden and strengthen mental health programs that assist people experiencing NOSC. The stages developed, inspired by the Intervention Mapping protocol, included a needs assessment; elaboration of change objective matrices; selection and description of methods based on theory and their applications; conception, planning, and implementation of the intervention; and results evaluation. Participants reported that the intervention allowed the expansion of their theoretical-conceptual and technical frameworks, giving them a less pathologizing understanding of and approach to NOSC and allowing them to perceive and manage such states, not as indiscriminately pathological expressions, but as phenomena inherent to the human condition that can be accepted and cared for without the exclusionary and exhaustive bias of mental disorders. Limitations and practical implications are discussed.
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Humanos , Transtornos Psicóticos/prevenção & controle , Saúde Mental , Estado de Consciência , Intervenção em Crise , Desenvolvimento de ProgramasRESUMO
Along with the significant development on both theory and practice of health promotion programs, the application of behavioral and social science theories has also been advanced in the fields of design and evaluation regarding the intervention-related studies. Intervention mapping is a new planning protocol, efficiently used to develop, implement, and evaluate health promotion related intervention programs. In this article, we are briefly introducing the basic concepts, implementation steps, specific requirements, as well as reviewing the current progress in methodologies, application that are related to intervention mapping, so as to provide reference for health intervention research studies, domestically.
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Introdução: Há evidências de que a comorbidade ansiedade e abuso de substâncias tem demonstrado ter uma forte associação. Altos níveis de ansiedade são críticos para o aumento do risco de abuso de substância, recaída e abandono do tratamento. Enquanto é amplamente aceito que a ansiedade é um dos principais fatores que ajudam na continuação do tratamento. Não há protocolo, e estudos de exequibilidade agindo na ansiedade de usuários de cocaína. Objetivo: 1) Descrever a extensão e aplicação da Teoria Interpessoal em Enfermagem da Peplau no design de uma intervenção para o manejamento da ansiedade em usuários de álcool e outras drogas; 2) Verificar a exequibilidade da intervenção de manejamento de ansiedade em usuários de cocaína. Método: A pesquisa foi baseada em dois momentos. O primeiro foi o desenvolvimento da intervenção (objetivo 1) e o segundo foi a verificação da exequibilidade da intervenção (objetivo 2). No primeiro momento da pesquisa nós utilizamos dois métodos, o modelo da Fawcett e o mapeamento da intervenção para desenvolver a intervenção; e o segundo momento nós avaliamos a exequibilidade da intervenção, por meio da demanda, aceitabilidade, implementação, praticabilidade, adaptação e segurança da intervenção. Resultados: A intervenção focou nos desfechos comportamentais (manejamento de cocaína; melhora do sono, alimentação e atividade física) e ambientais (manejamento da isolação social e reinserção social) que contribui no aumento da ansiedade, baseada nos determinantes da ansiedade (conhecimento, gatilhos, comportamentos de alívio, auto-eficácia e relações). Evidências preliminares suportam a exequibilidade da intervenção com algumas mudanças. O número de participantes que completaram a intervenção foi baixo (5.88%), porém mais que a metade (64.10%) foram até a segunda consulta. A mensuração da ansiedade foi aceita e aparentemente sensível a mudança, pois diminuiu 38 pontos em média após a intervenção. Conclusão: A combinação da abordagem da Fawcett e do mapeamento da intervenção providenciou clareza sobre o processo usado na pesquisa, facilitando a criação e avaliação da teoria. Pois providenciou uma descrição detalhada sobre o processo de construção do modelo teórico da intervenção, por meio da transparência dos determinantes, métodos, e aplicações utilizados com ampla visão de todos os fatores que afetam o problema, facilitando a replicação da intervenção. Além disso, os resultados do estudo de exequibilidade sugerem que o relacionamento interpessoal enfermeiro-cliente tem potencial como uma intervenção barata e exequível. No entanto, um grande ensaio clínico, seguindo as mudanças apontadas no protocolo implementado, é necessário para testar a efetividade da ITASUD.
Introduction: The comorbidity of anxiety and substance use disorders has been shown to have a strong association. High levels of anxiety are critical to the increased risk of substance use disorders, relapse and withdrawal of related treatment. While it is broadly accepted that addressing anxiety is a potential factor in helping this population continue with their treatment, there has been no protocol for the same, as well as feasibility studies targeting anxiety in cocaine users. Objectives: 1) To describe the extension and application of the Peplaus Interpersonal Theory of Nursing (ITN) to the design of an anxiety management intervention for people with substance use disorders; 2) To verify the feasibility of the anxiety management intervention for cocaine users. Method: The research was based in two moments. The first one was the development of the intervention (objective 1) and the second one was to check the feasibility (objective 2). For the first moment of the research we used two methods, Fawcetts model and Intervention Mapping to develop the intervention; and the second moment we evaluate feasibility outcomes of demand, acceptability, implementation, practicality, adaptation, and safety. Results: The intervention targeted behavioral (to manage cocaine use; and to improve sleep, eating and physical activity) and environmental outcomes (to manage social isolation and to reengage in society) that contribute to increase of anxiety, based on determinants of anxiety (knowledge, triggers, relief behaviors, self-efficacy and relations). Preliminary evidence supports the feasibility of the trial with some changes. The number of participants that completed the intervention was low (5.88%), however more than a half (64.10%) attendee until the second appointment. The anxiety measure was acceptable and appeared sensitive to change, decreasing in 38 points in average after the intervention. Conclusion: The combination of Fawcett and Intervention Mapping approach provide clarity about the process used in the research based in a nursing model, facilitating the creation of theory and evaluation of theories. By providing a detailed description about the process of construction of the Peplau theoretical framework applied to anxiety in cocaine users, with broad view of all factors that affect the problem, and facilitates replication through transparency of the determinants, methods, and applications used. Besides this, the results of the feasibility trial suggest that Interpersonal Relationship nurse-client have potential as an inexpensive and feasible intervention. A larger trial, following the changes pointed in the implemented protocol, is necessary to fully test the effectiveness of ITASUD.
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Ansiedade , Enfermagem , Transtornos Relacionados ao Uso de SubstânciasRESUMO
Abstract This paper discusses the Intervention Mapping (IM) protocol for planning theory- and evidence-based behavior change interventions. IM has been developed in the field of health promotion in 1998 and has mostly been applied in that field, but applications in other fields are emerging. IM can be used for any intervention that involves changing behavior. The paper discusses the protocol and its basic issues and presents in-depth examples of its use in- and outside the health promotion field: Empowerment, return to work, safety interventions, implementation, energy conservation, and academic performance. IM is characterized by three perspectives: a social ecological approach, participation of all stakeholders, and the use of theories and evidence. Through a series of six iterative steps - from needs assessment to implementation and evaluation - which are each broken down into specific tasks, correct application of the protocol is meant to produce behavior change interventions that fit into the local context and that have the best chances of effectiveness. IM helps intervention planners develop the best possible interventions targeting health behaviors, but also targeting behaviors related to other societal issues, such as environmental concerns, safety and discrimination.