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2.
Aust J Gen Pract ; 47(4): 168-172, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29621855

RESUMO

BACKGROUND: The Australian Government's Fifth National Mental Health and Suicide Prevention Plan recommends a stepped care model of mental healthcare that focuses on matching the intensity of care to the severity of illness. General practitioners (GPs) need to learn more about low-intensity online interventions to better meet the needs of patients of lower severity. OBJECTIVE: This article provides GPs with information about low-intensity, evidence-based online resources developed in Australia and available for integration into the care of patients with mild-to-moderate mental health conditions. This article has an emphasis on new developments since 2015. DISCUSSION: The internet provides an opportunity to deliver effective mental health treatment to people who would otherwise not seek, or be able to reach, skilled help for their mental health conditions. High-quality, evidence-based cognitive behavioural therapy treatment programs are available to all Australians, at no or low cost. These options can be integrated into a stepped care model of mental healthcare, and provide GPs with an opportunity to help patients access treatment that suits their needs.


Assuntos
Atenção à Saúde/métodos , Acessibilidade aos Serviços de Saúde/normas , Serviços de Saúde Mental/tendências , Austrália , Terapia Cognitivo-Comportamental/instrumentação , Terapia Cognitivo-Comportamental/métodos , Atenção à Saúde/tendências , Aconselhamento a Distância/métodos , Aconselhamento a Distância/tendências , Acessibilidade aos Serviços de Saúde/tendências , Humanos , Internet , Serviços de Saúde Mental/provisão & distribuição
3.
Artigo em Alemão | MEDLINE | ID: mdl-29318339

RESUMO

Digital media, online programs, and electronic health systems are available and easily accessible for diagnostic, prevention, and intervention of somatic and psychiatric disorders. These modern tools can assess objective as well as subjective information about acute symptoms, wellbeing, life quality, sleep, physiological indicators, etc. Wearables and apps collect data over days and weeks in the real world of subjects. This information can be used to document baselines as well as changes over time influenced by events or interventions. Online treatment programs provide information for education about symptoms, course, origin, and treatment options of a disorder. They also support a patient's self-help via self-management, exercises, and techniques. We illustrate and discuss modern diagnostic and therapeutic eHealth options. We also review the empirical evidence for online interventions and refer to typical examples. Most studies have been conducted with subjects suffering from depression and anxiety. Electronic health systems do not work just by recommending a program or providing access to an online platform. Patients need to be motivated to lock in and work with a program. They need support and guidance through online programs. Therefore, we claim that therapists need to become experts in digital media and electronic health systems to support patients and to integrate apps and online programs into their treatment.


Assuntos
Transtornos Mentais/terapia , Relações Profissional-Paciente , Psicoterapia/tendências , Consulta Remota/tendências , Aconselhamento a Distância/tendências , Previsões , Alemanha , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Transtornos Mentais/diagnóstico , Segurança do Paciente , Garantia da Qualidade dos Cuidados de Saúde/tendências
4.
Pediatrics ; 140(4)2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28924062

RESUMO

BACKGROUND AND OBJECTIVES: The American Academy of Pediatrics (AAP) has affirmed breastfeeding as the preferred method of infant feeding; however, there has been little systematic examination of how pediatricians' recommendations, affiliated hospitals' policies, counseling practices, and attitudes toward breastfeeding have shifted over the past 2 decades. These trends were examined from 1995 to 2014. METHODS: Data are from the Periodic Survey (PS) of Fellows, a nationally representative survey of AAP members. PS #30 (1995; response rate = 72%; N = 832), PS #57 (2004; response rate = 55%; N = 675), and PS #89 (2014; response rate = 51%; N = 620) collected demographics, patient and practice characteristics, and detailed responses on pediatricians' recommendations, affiliated hospitals' policies, counseling practices, and attitudes toward breastfeeding. By using bivariate statistics and logistic regression models, the analysis investigated changes over time with predicted values (PVs). RESULTS: From 1995 to 2014, more pediatricians reported their affiliated hospitals applied for "baby-friendly" designation (PV = 12% in 1995, PV = 56% in 2014; P < .05), and more reported that they recommend exclusive breastfeeding (65% to 76% [P < .05]). However, fewer respondents indicated that mothers can be successful breastfeeding (PV = 70% in 1995, PV = 57% in 2014; P < .05) and that the benefits outweigh the difficulties (PV = 70% in 1995, PV = 50% in 2014; P < .05). Younger pediatricians were less confident than older pediatricians in managing breastfeeding problems (P < .01). CONCLUSIONS: Pediatricians' recommendations and practices became more closely aligned with AAP policy from 1995 to 2014; however, their attitudes about the likelihood of breastfeeding success have worsened. These 2 divergent trends indicate that even as breastfeeding rates continue to rise, continued efforts to enhance pediatricians' training and attitudes about breastfeeding are necessary.


Assuntos
Atitude do Pessoal de Saúde , Aleitamento Materno , Pediatras , Padrões de Prática Médica/tendências , Adulto , Aconselhamento a Distância/estatística & dados numéricos , Aconselhamento a Distância/tendências , Feminino , Pesquisas sobre Atenção à Saúde , Hospitais , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Política Organizacional , Padrões de Prática Médica/estatística & dados numéricos , Estados Unidos
7.
Commun Med ; 12(2-3): 187-98, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-29048146

RESUMO

This paper questions the nature of the communicative event that takes place in online contexts between doctors and web-users, showing computer-mediated linguistic norms and discussing the nature of the participants' roles. Based on an analysis of 1005 posts occurring between doctors and the users of health service websites, I analyse how doctor­patient communication is affected by the medium and how health professionals overcome issues concerning the virtual medical visit. Results suggest that (a) online medical answers offer a different service from that expected by users, as doctors cannot always fulfill patient requests, and (b) net consultations use aspects of traditional doctor­patient exchange and yet present a language and a style that are affected by the computer-mediated environment. Additionally, it seems that this new form leads to a different model of doctor­patient relationship. The findings are intended to provide new insights into web-based discourse in doctor­patient communication and to demonstrate the emergence of a new style in medical communication.


Assuntos
Aconselhamento a Distância/tendências , Educação de Pacientes como Assunto/tendências , Relações Médico-Paciente , Consulta Remota/tendências , Acesso à Informação , Comunicação , Humanos , Internet/tendências , Satisfação do Paciente
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