RESUMO
PURPOSE: The study purposes were to assess the efficacy of a caregiver problem-solving intervention (CPSI) on stroke caregiver physical and psychosocial adaptation compared with a wait-list control (WLC) treatment, and to assess the mediation effects of coping on outcomes. METHODS: A stress and coping model guided the study design. Outcomes were depression, anxiety, preparedness, life changes, and family functioning. CPSI started during acute rehabilitation and continued 3 months postdischarge. Data were collected at baseline (T1), postintervention (T2), and 6 (T3) and 12 months postdischarge (T4). RESULTS: Of 255 caregivers, 75% were depressed at baseline. Repeated measures ANOVA of study completers (n = 121) indicated improved T2 depression, life change, and health (ps < .04) favoring the CPSI group. Improvements faded by 6 months. Although no group differences in outcomes were found in the intention-to-treat analysis, growth curve modeling indicated a difference in depression rate of change, favoring the CPSI (p = .04). Perceived health, threat appraisal and rational problem-solving were significant mediators (ps < .05). CONCLUSIONS: Findings provide direction for future interventions to promote and sustain healthy caregiver adaptation.
Assuntos
Adaptação Psicológica , Cuidadores/psicologia , Enfermagem em Reabilitação/métodos , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/enfermagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Enfermagem Familiar/métodos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Resolução de Problemas , Estresse Psicológico/enfermagem , Estresse Psicológico/psicologia , Estresse Psicológico/reabilitação , Acidente Vascular Cerebral/psicologia , Adulto JovemRESUMO
The decomposed body of a 45-year-old female was found, face down, in a mobile home, along with a suicide note and two antifreeze containers. Analysis of the body fluid collected from the decedent showed the presence of 58 mg/dL ethanol, but suspected ethylene glycol was not found in the sample. However, an unusually large peak of internal standard, 1,3-propanediol, was found in the sample. Gas chromatography-mass spectrometry analysis confirmed the presence of 1,3-propanediol in the sample. Using gas chromatography-flame-ionization detection, the concentration of 1,3-propanediol was determined to be 445 mg/dL. To our knowledge, this is the first report involving 1,3-propanediol as the cause of death. The study also highlights the importance for the close scrutiny of data, as 1,3-propanediol is a frequently used internal standard for the assay of glycols.
