Uso do modelo teórico da organização sistêmica na avaliação familiar / Use of the framework of systemic organization in family assessment

Objetivo: produzir um levantamento de estudos sobre a aplicação do modelo teórico da organização sistêmica na avaliação da eficácia do funcionamento familiar e construir o estado da arte. Método: trata-se de estudo bibliográfico, descritivo, do tipo revisão integrativa, entre 2001 a 2017, nas bases de dados MEDLINE, LILACS, Google Scholar e na Biblioteca Virtuais SciELO, com consulta a especialistas via ResearchGate. Resultados: apresentaram-se 21 estudos desenvolvidos por enfermeiros em seis países, nos quais se evidenciaram a validade e a confiabilidade do instrumento ASF-E, avaliando a eficácia do funcionamento familiar, principalmente, em condições crônicas ou de vulnerabilidade. Utilizaram-se metodologia adequada e nível de evidência IV. Conclusão: conclui-se que o modelo teórico da organização sistêmica tem sido utilizado por ser considerado uma ferramenta válida para avaliar a saúde da família na em diferentes contextos de atuação da Enfermagem de famílias.(AU)

Objective: to produce a survey of studies on the application of the Framework of Systemic Organization to evaluate the effectiveness of family functioning and build the state of the art. Method: this is a descriptive bibliographic study, integrative review, from 2001 to 2017, in the databases MEDLINE, LILACS, Google Scholar and the Virtual Library SciELO, with consultation with experts via ResearchGate. Results: 21 studies developed by nurses in six countries were presented, showing the validity and reliability of the ASF-E instrument, assessing the effectiveness of family functioning, especially in chronic or vulnerable conditions. Appropriate methodology and level of evidence IV were used. Conclusion: it is concluded that the Framework of Systemic Organization has been used as it is considered a valid tool to evaluate family health in different contexts of family nursing.(AU)

Objetivo: producir una encuesta de estudios sobre la aplicación del modelo teórico de la organización sistémica para evaluar la efectividad del funcionamiento familiar y construir el estado del arte. Método: este es un estudio bibliográfico descriptivo, tipo revisión integradora, de 2001 a 2017, en las bases de datos MEDLINE, LILACS, Google Scholar y SciELO Virtual Library, con consulta con expertos a través de ResearchGate. Resultados: se presentaron 21 estudios desarrollados por enfermeros en seis países, que muestran la validez y confiabilidad del instrumento ASF-E, evaluando la efectividad del funcionamiento familiar, especialmente en condiciones crónicas o vulnerables. Se utilizó la metodología apropiada y el nivel de evidencia IV. Conclusión: se concluye que el modelo teórico de la organización sistémica se ha utilizado porque se considera una herramienta válida para evaluar la salud familiar en diferentes contextos de Enfermería familiar.(AU)

Proposta de adaptação transcultural e validação de um instrumento / Proposal for cross-cultural adaptation and validation of the instrument

Objetivos: apresentar uma proposta de um protocolo para a adaptação transcultural do instrumento The Assessment of Strategies in Families-Effectiveness (ASF-E) para o idioma português do Brasil e validar para uso com famílias brasileiras. Método: estudo quantitativo, transversal. Para o desenvolvimento do processo de adaptação transcultural serão seguidos os padrões metodológicos recomendados para uso em outro contexto cultural. Este estudo será realizado em Unidades Básicas de Saúde, que serão selecionados os participantes por indicação dos agentes comunitários de saúde para em visita domiciliar: a) Avaliação qualitativa do instrumento com 15 participantes; b) Realizar o pré-teste do instrumento com 30 participantes e c) Validar o instrumento com 200 participantes. Serão utilizados dois instrumentos, um formulário para caracterização sociodemográfica e instrumento que avaliará a eficácia familiar. Para a análise dos dados será utilizado o programa Statistical Package Social Science. Para a análise do teste de confiabilidade serão aplicados os "coeficientes de Alpha Cronbach". O modelo teórico da organização sistêmica para entender a partir desta perspectiva a eficácia familiar. Resultados esperados: O instrumento adaptado apresentará consistência interna alta (0,70) tanto entre os itens quanto entre os itens e os domínios.(AU)

Is adherence therapy an effective adjunct treatment for patients with schizophrenia spectrum disorders? A systematic review and meta-analysis.

BACKGROUND: Poor adherence to medication in schizophrenia spectrum disorders leads to inadequate symptom control. Adherence therapy (AT) is an intervention that seeks to reduce patients' psychiatric symptoms by enhancing treatment adherence. We aimed to systematically review the trial evidence of the effectiveness of AT on improving clinical outcomes in these patients. METHOD: Systematic review and meta-analysis of published RCTs. We included studies testing AT as an adjunct intervention against treatment as usual or a comparator intervention in the general adult psychiatric population. The primary outcome of interest was improvement in psychiatric symptoms. RESULTS: We included six studies testing AT in schizophrenia spectrum disorders published since 2006. A meta-analysis showed AT significantly reduced psychiatric symptoms compared to usual treatment over a follow-up period of less than 1 year. We found no significant effects of AT on patients' adherence and adherence attitudes. CONCLUSIONS: AT is an effective adjunctive treatment for people with schizophrenia spectrum disorders. PROSPERO: CRD42015016779.

Assessment of Barriers to Screening Mammograms for Rural, Poor, Uninsured Women and a Community Plan of Action.

This project determined the barriers to obtaining screening mammograms for women aged 40-64 years in rural northwest Georgia, sampling 20 poor and uninsured women and 5 key community professionals. Data were collected from the women participants regarding mammogram screening beliefs about their susceptibility, barriers encountered, and benefits identified. The same women and key community providers were interviewed about their perception of barriers to receiving mammograms. The women experienced more barriers and believed that they had a greater susceptibility to developing breast cancer compared to previous research. The most overwhelming barrier was cost. A community plan was developed to address screening needs.

Suicide prevention in neurology patients: evidence to guide practice.

OBJECTIVE: This article is an overview of the neurological diagnoses with highest attempt in suicide. The most common risk factors in suicidal ideation in neurology patients are identified, as well as the description of ways to assess and implement treatment of patients with suicidal ideation, including the recommendations for patients with specific neurological diagnosis. A guideline development is needed to address suicide concerns in these patients. METHODS: A literature search was conducted to find published studies and patient guidelines that were relevant to suicidal ideation, assessment, and treatment in neurology patients. RESULTS: Information found was not always exclusive for neurology patients. Findings often discussed psychiatric patients. The neurological diagnosis most associated with suicidal ideation includes multiple sclerosis, epilepsy, and Parkinson's disease. The most common risk factors for suicidal ideation are hopelessness, depression, and social isolation. As treatment factors, a therapeutic relationship, treatment for depression, assurance of patient safety, and specific interventions for suicidal prevention were identified to provide healthcare professionals in neurology ways to address suicidal issues for patients with neurological diagnoses. Three protocols highlighted staff prevention activities. DISCUSSION: Because patients with neurological disorders experience suicidal ideation with a greater risk of suicide, particularly in multiple sclerosis, epilepsy, and Parkinson's disease, the potential risk for suicide requires active assessment, monitoring, and intervention by nurses and health professionals to address this clinical issue. The assessments available require further psychometric testing for reliability and validity with patient use. There is a need for more research to develop a guideline/protocol exclusively for neurological patients.

Migrant and minority family members in the intensive care unit. A review of the literature.

Statistics show that people with migrant and minority background as patients are significant in numbers in the intensive care unit. This also puts family members in the perspective of nursing because family members are an inherent part of the intensive care unit. Family-centered care is perhaps most applicable to vulnerable populations like migrant family in the intensive care unit to meet family member's needs. But very little is known about the situation of migrant and minority family members in the intensive care unit. The aim of the study was to explore the state of the science regarding family-centered care in the intensive care unit of patients with migration background in general and with a possible focus on major migrant populations in Austria-Former Yugoslavian und Turkish origin. A literature review investigated research articles that contained information on migrant and minority family members in the intensive care unit. Key points in the relevant articles were identified and categorized into themes with an explanation of findings at the end. Seventeen articles fulfilled the inclusion criteria. No article was found regarding groups of major migrant population groups in Austria. The included articles uncovered five predominant themes: importance of cultural norms, communication, family dynamics, universal caring, and nursing/provider deficit in culturally competent care. In order to provide adequate nursing care a more cohesive body of information on more specific geographic and cultural populations is recommended. Because of the complete lack of research regarding migrant families of Former Yugoslavian and Turkish origin into Austria, an exploration of this population is recommended.

Transition of premature infants from hospital to home life.

PURPOSE: To conduct an integrative literature review to studies that focus on the transition of premature infants from neonatal intensive care unit (NICU) to home. METHOD: A literature search was performed in Cumulative Index to Nursing and Allied Health Literature (CIN AHL), PubMed, and MEDLINE to identify studies consisting on the transition of premature infants from hospital to home life. RESULTS: The search yielded seven articles that emphasized the need for home visits, child and family assessment methods, methods of keeping contact with health care providers, educational and support groups, and described the nurse's role in the transition program. The strategy to ease the transition differed in each article. CONCLUSION: Home visits by a nurse were a key component by providing education, support, and nursing care. A program therefore should consist of providing parents of premature infants with home visits implemented by a nurse or staying in contact with a nurse (e.g., via videoconference).

Patients with cancer and family caregivers: management of symptoms caused by cancer or cancer therapy at home.

People are diagnosed with cancer sooner nowadays thanks to increased awareness and improvements in cancer screenings. Patients are able to live longer due to cancer treatment regimens; however, they suffer the consequences of living with cancer and therapy-related symptoms. Symptom management is challenging for both patients and family caregivers. Therefore, family members must be integrated in the patient's care plan. For this review, a literature search was conducted to determine what types of interventions were available that involved family members of cancer patients with the management of cancer and therapy-related symptoms. The following interventions were found that were designed for the family caregivers or both the patient and caregiver to aide with symptom management: pain intervention program, massage therapy, telephone intervention, self-efficacy improvement, coping enhancement and a multidimensional intervention. A positive effect was noted in all the studies, but several had no significance in the patient intervention group but did in the caregiver intervention group. However, studies indicated decreased symptom intensity for various symptoms, decreased symptom distress for both the patient and caregiver, increased self-efficacy of the family member, and increased satisfaction with certain interventions. Further research should be conducted on both existing interventions to better determine their effect and on family symptom management of cancer patients as they need support from healthcare professionals as well.

Strategies to teach family assessment and intervention through an online international curriculum.

A Web-based certificate program for international health professionals to acquire understanding of family health and strategies to implement culturally sensitive health care of families is outlined. In four Web courses and a project, students progress interactively to apply culture, family, and interdisciplinary health system theories to assessments and clinical interventions with families in the interdisciplinary setting. Four online educational strategies to facilitate student success from the virtual classroom to actual clinical care are described: adjusting to the technology, communicating the learning progress openly, giving mutual feedback, and implementing evidence-based family care. Outcomes addressing student learning and skill enhancement, family interaction, and student and faculty experiences in the virtual learning environment are explored. Overall, students learned to work successfully with families in health care, experienced increasing comfort and competency in challenging situations, introduced family care in their work setting, and emerged as leaders while working in interdisciplinary teams.