scholarly journals The Effect of Family Psychoeducation on Tuberculosis Treatment Adherence of Children in Indonesia

2022 ◽  
Vol 5 (S2) ◽  
pp. 44-49
Author(s):  
Yuni Kusmiyati ◽  
Suherni ◽  
Yuliasti Eka Purnamaningrum ◽  
Sih Rini Handajani ◽  
Agung Jaya Endranto ◽  
...  
Keyword(s):  
Treatment Adherence ◽  
Health Workers ◽  
Controlled Trial ◽  
Primary Caregivers ◽  
Control Group ◽  
P Value ◽  
Family Psychoeducation ◽  
Randomized Controlled ◽  
Tb Treatment ◽  
End Of Treatment

Tuberculosis (TB) is an infectious disease leading cause of death in the world but treatment adherence the most underrated and understudied factor affecting the outcome of TB therapy. The aim of this study was to determine the effect of family psychoeducation on TB treatment adherence of children. The study used a randomized controlled trial (RCT). The sample was 40 pairs of primary caregivers and children who received TB treatment and experienced no side effects of anti-TB drugs in Wonosari Hospital Indonesia in 2019. The treatment group was given psychoeducation by trained health personnel psychoeducators, while the control group was given education by health workers. Psychoeducation was carried out individually, 3 meetings in the first week of the study. Adherence was measured at the sixth month which was the end of treatment period, using a questionnaire. Data were analyzed by using multiple logistic regression. The results showed that family psychoeducation had a significant effect on TB treatment adherence in children after controlling for mother’s knowledge (P-value 0.05 ≤ 0.05). Family psychoeducation is a preventive factor for non-adherence to TB treatment. It is important that psychoeducation is provided to all TB patients to reduce psychological problems that can lead to treatment non-adherence.

scholarly journals Impact of a tuberculosis treatment adherence intervention versus usual care on treatment completion rates: results of a pragmatic cluster randomized controlled trial

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Lisa M. Puchalski Ritchie ◽  
Monique van Lettow ◽  
Austine Makwakwa ◽  
Ester C. Kip ◽  
Sharon E. Straus ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Treatment Adherence ◽  
Health Workers ◽  
Controlled Trial ◽  
Demographic Data ◽  
Treatment Success ◽  
Randomized Controlled ◽  
Tb Treatment ◽  
Adherence Intervention ◽  
Cluster Randomized

Abstract Background With the global shortage of skilled health workers estimated at 7.2 million, outpatient tuberculosis (TB) care is commonly task-shifted to lay health workers (LHWs) in many low- and middle-income countries where the shortages are greatest. While shown to improve access to care and some health outcomes including TB treatment outcomes, lack of training and supervision limit the effectiveness of LHW programs. Our objective was to refine and evaluate an intervention designed to address common causes of non-adherence to TB treatment and LHW knowledge and skills training needs. Methods We employed a pragmatic cluster randomized controlled trial. Participants included 103 health centres (HCs) providing TB care in four districts in Malawi, randomized 1:1 stratified by district and HC funding (Ministry of Health, non-Ministry funded). At intervention HCs, a TB treatment adherence intervention was implemented using educational outreach, a point-of-care reminder tool, and a peer support network. Clusters in the control arm provided usual care. The primary outcome was the proportion of patients with successful TB treatment (i.e., cure or treatment completion). We used a generalized linear mixed model, with district as a fixed effect and HC as a random effect, to compare proportions of patients with treatment success, among the trial arms, with adjustment for baseline differences. Results We randomized 51 HCs to the intervention group and 52 HCs to the control group. Four intervention and six control HCs accrued no eligible patients, and 371 of 1169 patients had missing outcome, HC, or demographic data, which left 74 HCs and 798 patients for analysis. Randomization group was not related to missing outcome, however, district, age, and TB type were significantly related and included in the primary analysis model. Among the 1153 patients with HC and demographic data, 297/605 (49%) and 348/548 (64%) in the intervention and control arms, respectively, had treatment success. The intervention had no significant effect on treatment success (adjusted odds ratio 1.35 [95% confidence interval 0.93–1.98]). Conclusion We found no significant effect of the intervention on TB treatment outcomes with high variability in implementation quality, highlighting important challenges to both scale-up and sustainability. Trial registration ClinicalTrials.gov NCT02533089. Registered August 20, 2015.

scholarly journals Community Health Workers as a Strategy to Tackle Psychosocial Suffering Due to Physical Distancing: A Randomized Controlled Trial

2021 ◽  
Vol 18 (6) ◽  
pp. 3097
Author(s):  
Dorien Vanden Bossche ◽  
Susan Lagaert ◽  
Sara Willems ◽  
Peter Decat
Keyword(s):  
Randomized Controlled Trial ◽  
Community Health ◽  
Health Workers ◽  
Psychosocial Support ◽  
Controlled Trial ◽  
Intervention Group ◽  
Psychosocial Health ◽  
Control Group ◽  
Randomized Controlled ◽  
The Impact

Background: During the COVID-19 pandemic, many primary care professionals were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psychosocial support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received ‘care as usual’. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW interventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.

scholarly journals CADRES COMPETENCE IN COMMUNITY-BASED MANAGEMENT OF CHILD ILLNESS IN BANYUMAS DISTRICT, CENTRAL JAVA, INDONESIA

2018 ◽  
Vol 4 (5) ◽  
pp. 492-501
Author(s):  
Umi Solikhah ◽  
Hari Kusnanto ◽  
Fitri Haryanti ◽  
Yayi Suryo Prabandari
Keyword(s):  
Randomized Controlled Trials ◽  
Health Center ◽  
Health Workers ◽  
Intervention Group ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Controlled Trials ◽  
Child Illness ◽  
Randomized Controlled

Background: One of the efforts in the health sector for programs to reduce infant and under-five mortality and morbidity rates is by the competence-based integrated management childhood illness (CB-IMCI) program. However, the program has been poorly implemented by health workers at the health center. Thus, the involvement of cadres is needed and their competency remains important to be improved.Objective: To quantitatively analyze cadre knowledge and competencies in the CB-IMCI program, and its relationship with the implementation of CB-IMCI, as well as to qualitatively explore and analyze the responses of cadres, health workers, and the community to the addition of cadre roles to the management of sick children.Methods: This was a mixed methods study with randomized controlled trials and qualitative method. For randomized controlled trials, 100 cadres were selected, which 50 randomly assigned in the intervention and control group. And for quantitative methods, informants included 10 cadres, 4 health workers, and 20 mothers. Paired t-test and independent t-test were employed for quantitative analysis, and triangulation was used for qualitative analysis.Results: The improvement of knowledge in the intervention group was better (I=14.42/C=4.44/p-value 0.00). The intervention group was more competent in the management of child illness (p-value 0.00). In addition, the cadres have additional competencies assisted by health workers to confidently detect cases earlier, and health center services reach a wider coverage in the community.Conclusion: The addition of cadres roles and competencies in the management of child illness in the community can be implemented in Banyumas Regency. It is suggested that the implementation of this program should be followed up in other health centers by the health department of Indonesia.

scholarly journals Community Health Workers as a Strategy to Tackle Psychosocial Suffering due to Physical Distancing: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Dorien Vanden Bossche ◽  
Susan Lagaert ◽  
Sara Willems ◽  
Peter Decat
Keyword(s):  
Randomized Controlled Trial ◽  
Community Health ◽  
Health Workers ◽  
Psychosocial Support ◽  
Controlled Trial ◽  
Intervention Group ◽  
Psychosocial Health ◽  
Control Group ◽  
Randomized Controlled ◽  
The Impact

Background: During the COVID-19 pandemic some family physicians were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psycho-social support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received ‘care as usual’. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW in-terventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.

scholarly journals Effect of a breastfeeding educational intervention: a randomized controlled trial

2020 ◽  
Vol 28 ◽  
Author(s):  
Erdnaxela Fernandes do Carmo Souza ◽  
Alfredo Almeida Pina-Oliveira ◽  
Antonieta Keiko Kakuda Shimo
Keyword(s):  
Randomized Controlled Trial ◽  
Educational Intervention ◽  
Exclusive Breastfeeding ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Postpartum Women ◽  
Significance Level ◽  
Randomized Controlled

Objective: to assess the effect of a breastfeeding educational intervention on the counseling provided to postpartum women. Method: this is a randomized controlled trial including 104 postpartum women (intervention group = 52 and control group = 52) from a private hospital, whose educational intervention was based on the pragmatic theory and on the use of a soft-hard technology called Breastfeeding Educational Kit (Kit Educativo para Aleitamento Materno, KEAM). Women were followed-up for up to 60 days after childbirth. Chi-Squared Test, Fischer’s Exact Test, and Generalized Estimating Equation were used, with a significance level of 5% (p-value <0.05). The analyses were performed using the Statistical Package for the Social Sciences, version 24. Results: the postpartum women in the intervention group had fewer breastfeeding difficulties and a higher percentage of exclusive breastfeeding at all time points compared with those in the control group. Conclusion: the educational intervention based on active methodologies and stimulating instructional resources was effective in developing greater practical mastery among postpartum women with regard to adherence and maintenance of exclusive breastfeeding. Registry REBEC RBR – 8p9v7v.

scholarly journals Do home pregnancy tests bring women to community health workers for antenatal care counselling? A randomized controlled trial in Madagascar

2019 ◽  
Vol 34 (8) ◽  
pp. 566-573
Author(s):  
Alison B Comfort ◽  
Randall C Juras ◽  
Sarah E K Bradley ◽  
Justin Ranjalahy Rasolofomanana ◽  
Anja Noeliarivelo Ranjalahy ◽  
...  
Keyword(s):  
At Risk ◽  
Randomized Controlled Trial ◽  
Reproductive Health ◽  
Health Services ◽  
Antenatal Care ◽  
Health Workers ◽  
Controlled Trial ◽  
Control Group ◽  
Reproductive Health Services ◽  
Randomized Controlled

Abstract Task-shifting the provision of pregnancy tests to community health workers (CHWs) in low-resource settings has the potential to reach significantly more underserved women at risk of pregnancy with essential reproductive health services. This study assessed whether an intervention to supply CHWs with home pregnancy tests brought more clients for antenatal care (ANC) counselling. We implemented a randomized controlled trial among CHWs providing reproductive health services to women in Eastern Madagascar. We used ordinary least squares regressions to estimate the effect of the intervention, with district- and month-fixed effects and CHW baseline characteristics as control variables. Our outcomes of interest included whether the intervention increased: (1) the number of women at risk of pregnancy who sought services from CHWs; (2) the number of these women who knew they were pregnant by the end of visit; and (3) the number of these women who received ANC counselling during visit. We found that providing pregnancy tests to CHWs to distribute to their clients for free significantly increased the number of women at risk of pregnancy who sought services from CHWs. At follow-up, treatment-group CHWs provided services to 6.3 clients compared with 4.2 clients among control-group CHWs, which represents a 50% relative increase from the control-group mean. A significantly higher number of these clients knew they were pregnant by the end of the visit, with a mean of 0.95 in treatment compared with 0.10 in control (Coeff. 0.86; 95% CI 0.59–1.13). A significantly higher number of these clients received antenatal counselling at the visit (Coeff. 0.4; 95% CI 0.14–0.64). Introducing free home pregnancy tests as part of community-based health services can improve pregnancy care by attracting more clients at risk of pregnancy to services at the community level, enabling more women to confirm they are pregnant and receive antenatal counselling.

scholarly journals Effects of Bupropion on Cognitive Function in Schizophrenia: A Double Blind Randomized Controlled Trial

2016 ◽  
Vol 9 (5) ◽  
pp. 67
Author(s):  
Mansoureh Mirzadeh ◽  
Najmeh Shahini ◽  
Masoud Kashani Lotf Abadi ◽  
Maryam Tavakoli ◽  
Arash Javanbakht ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cognitive Function ◽  
Rating Scale ◽  
Controlled Trial ◽  
Control Group ◽  
P Value ◽  
Double Blind ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Schizophrenic Patients

<p>Smoking habits are common in schizophrenic patients. Nicotine can suppress negative symptoms and cognitive impairments. The aim of this study was to determine the efficacy of bupropion on cognitive function in schizophrenic patients.<strong> </strong>This study is a double blind randomized controlled trial in a large referral psychiatric university hospital in Iran. Ninety smoker schizophrenic patients were randomly allocated (based on DSM -IV TR criteria) in two groups (46 patients for case group and 44 patients in control group). They get risperidone up to 6 mg/d and bupropion up to 400 mg/d .clinical assessment (Positive and Negative Syndrome Scale (PANSS), Brief psychiatric rating scale (BPRS) were taken in beginning of study, 14<sup>th</sup> and 28<sup>th</sup> days of study. Cognitive assessment (Stroop, Digit Span, and Wechsler, Wisconsin) were taken in begging of study, the days 2<sup>nd</sup>, 7<sup>th</sup>, 14<sup>th</sup>, 28<sup>th</sup>. All data were analyzed by SPSS Ver. 17 with analytic and descriptive tests. Mean age of patients was 37.66±1.01. Mean duration of disorder was 11.63±.98 years. The scores were significantly lower at the day 28<sup>th</sup> compared to the beginning of the study in both groups in Wechsler, Stroop color word , Stroop word , Stroop color , BPRS, PANSS p value ≤0.05 .The difference between the two treatments was not significant as indicated by the effect of group, the between-subjects factor<strong> </strong><strong>p </strong>value ≥0.05. In this study, the side effects were examined and there was no significant difference between the two groups p value ≥0.05.<strong> </strong>Augmentation of bupropion to routine treatment improves cognitive symptoms of schizophrenia in abstinence of tobacco.</p>

scholarly journals EVALUASI INTERVENSI MEDIA BOOKLET TERHADAP TINGKAT PENGETAHUAN DAN KEPATUHAN PASIEN DIABETES MELITUS TIPE 2 DI PUSKESMAS BANJARBARU SELATAN

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Valentina Meta Srikartika ◽  
M. Rasyid Akbar ◽  
Herningtyas Nautika Lingga
Keyword(s):  
Diabetes Mellitus ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Level Of Knowledge ◽  
Diabetes Melitus

ABSTRAKKeberhasilan pengobatan diabetes melitus tidak hanya dipengaruhi oleh kualitas pelayanan kesehatan, keterampilan petugasnya, sikap, dan pola hidup pasien, tetapi dipengaruhi juga oleh kepatuhan pasien terhadap pengobatannya. Tingkat kepatuhan minum obat pasien diabetes mellitus di Indonesia mayoritas masih berada dibawah 50%. Tujuan dari penelitian ini adalah mengukur pengaruh edukasi melalui media booklet terhadap pengetahuan dan kepatuhan pasien diabetes melitus tipe 2. Jenis penelitian yang digunakan adalah Randomized Controlled Trial (RCT). Populasi yang didapat dari penelitian ini sebanyak 40 orang dengan kelompok kontrol 20 orang dan kelompok intervensi 20 orang. Kelompok kontrol merupakan kelompok yang tidak mendapatkan booklet, sedangkan kelompok intervensi adalah kelompok yang mendapatkan booklet sebagi media edukasi. Pengetahuan dan kepatuhan responden diukur melalui kuesioner yang diberikan sebelum (pretest) dan 2 minggu kemudian (posttest). Rata-rata skor pengetahuan dan kepatuhan pre-test dibandingkan dengan skor post-test dengan menggunakan uji Wilcoxon. Berdasarkan hasil analisis, terjadi perbedaan tingkat pengetahuan dan kepatuhan yang signifikan (p value < 0,001) antara sebelum dan sesudah pemberian booklet pada kelompok intervensi dan tidak ada perbedaan yang signifikan pada tingkat pengetahuan (p value = 0,83) dan kepatuhan (p value = 0,317) pada kelompok kontrol. Oleh karena itu, dapat disimpulkan bahwa media booklet dapat meningkatkan tingkat pengetahuan dan kepatuhan pada pasien diabetes melitus.Kata-kata kunci: Diabetes melitus, pengetahuan, kepatuhan, bookletABSTRACTThe success of a treatment of diabetes mellitus is not only influenced by the quality of health services, the skills of its officers, attitudes, and lifestyle of patients, but it is also influenced by patient adherence to treatment. The level of medication compliance among diabetes patients in Indonesia were still below 50%. The purpose of this study was to measure the effect of education through booklet media on the knowledge and compliance of patients with type 2 diabetes mellitus. The type of research used was Randomized Controlled Trial (RCT). The population obtained from this study were 40 people with a control group of 20 people and an intervention group of 20 people. The control group was the group that did not get the booklet, while the intervention group was the group that received the booklet as an educational medium. Knowledge and compliance of respondents was measured through questionnaires given before (pretest) and 2 weeks later (posttest). The average score of knowledge and adherence between pretest and posttest will be compared using Wilcoxon analysis. Based on the results of data analysis with the Wilcoxon test, there was a significant difference in the level of knowledge and compliance (p value < 0.001) between before and after booklet administration in the intervention group and no significant difference in knowledge level (p value = 0.83) and compliance (p value = 0.317) in the control group. It can be concluded that the booklet media can increase the level of knowledge and compliance in diabetes mellitus patients.Keywords: Diabetes mellitus, knowledge, compliance, booklet

The Effect of Breast Milk Cells on the Clinical Outcomes of Neonates With Birth Weight Equal to or Less Than 1800 Grams: a Randomized Controlled Trial

2020 ◽  
Author(s):  
Minoo Fallahi ◽  
Seyed Masoud Shafiei ◽  
Naeeme Taslimi Taleghani ◽  
Maryam Khoshnood Shariati ◽  
Shamsollah Noripour ◽  
...  
Keyword(s):  
Birth Weight ◽  
Breast Milk ◽  
Clinical Outcomes ◽  
Very Low Birth Weight ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Low Birth Weight Infants ◽  
Randomized Controlled

Abstract Background: Most premature and very low birth weight infants cannot tolerate feedings in the first few days of life and are deprived of breast milk's beneficial effects. This study aims to evaluate the breast milk cells' effects on neonates' clinical outcomes with a birth weight of ≤1800 grams.Methods: This research is a randomized controlled trial conducted on 156 infants in the neonatal intensive care unit of Mahdieh maternity Hospital in Tehran, Iran, from May 2019 to April 2020. All neonates with a birth weight of ≤1800 grams were enrolled and randomly divided into intervention and control groups. During the first 6-12 hours of delivery, neonates in the intervention group received the extracted breast milk cells (BMCs) provided by centrifuging their own mothers' breast milk for one time. Demographic data and clinical outcomes were compared between the two groups. We also had a subgroup analysis in neonates with birth weight less than 1500 grams.Results: A total of 156 neonates entered the final analysis. We divided participants into two groups by using a computer-generated block randomization sequence, including 75 patients in the intervention group and 81 neonates in the control group. The mean birth weight of neonates was 1390.1±314.4 grams, with a total mortality rate of 12.2% (n=19). We found that in-hospital mortality was significantly lower in neonates who received BMCs (6.7% vs. 17.3%; P-value: 0.043) compared to the control group, and it was more prominent in neonates with birth weight less than 1500 grams (9.5% vs. 30.2%; P-value: 0.017). We did not find any other significant differences in major complications such as retinopathy of prematurity, necrotizing enterocolitis, and bronchopulmonary dysplasia between the two groups.Conclusion: Our research demonstrated a significantly lower mortality rate in neonates (with a birth weight of ≤1800 grams) who received breast milk cells on the first day of life. Since this is a novel method with minimal intervention, we are looking forward to developing and evaluating this method in larger studies, with more frequent use of BMCs in very low birth weight infants.Trial registration: Iranian Registry of Clinical Trials, IRCT20190228042868N1. Registered 25 May 2019, https://irct.ir/trial/38230.

scholarly journals Possible Role of Court-Type Thai Traditional Massage During Parturition: a Randomized Controlled Trial

2019 ◽  
Vol 12 (1) ◽  
pp. 23-28
Author(s):  
Panya Sananpanichkul, MD ◽  
Chatchai Sawadhichai, MD, PhD ◽  
Yosapon Leaungsomnapa, PhD ◽  
Paweena Yapanya, BATM
Keyword(s):  
Randomized Controlled Trial ◽  
Pain Relief ◽  
Pain Score ◽  
Controlled Trial ◽  
Active Phase ◽  
Secondary Outcome ◽  
Control Group ◽  
P Value ◽  
Second Stage ◽  
Randomized Controlled

Background and Objectives: Court-type Thai traditional Massage (c-TTM) applied during intrapartum may have some benefit other than pain relief. This study aimed to evaluate the effect of c-TTM during the first and second stage of labor, as well as pain alleviation in the first stage.Methods: This was a randomized controlled trial study. Eligible participants were singleton pregnant mothers with cervical dilation between 3–5 cm and no medical complications. Both trial groups received the same routine antepartum care except for 1 hour additional c-TTM given to the experimental group when they were in the active phase of labor. The pain score was taken from the participants at the time before labor pains started, at the time of active labor, 1, 2, 3, and 4 hours after the intervention. Pain was recorded by the researcher using a visual analog scale. The primary outcome during the first and second stages of labor was compared between groups. Pain relief during the first stage of labor and analgesic drugs used were compared as a secondary outcome. This trial is registered under the identification number TCTR20171115003.Results: Fifty-nine participants were enrolled and randomly assigned with 1:1 allocation to groups. The duration of first and second stage labor was significantly shorter in the experimental c-TTM than in the conventional control group (mean ± SD: 198.37 ± 62.80 minutes: 268.52 ± 137.81 minutes, p value =.02 and 17.54 ± 9.49 minutes: 23.35 ± 15.01 minutes, p value =.03, re-spectively). There was no difference of pain score between the groups.Conclusion: One hour of c-TTM can signifi-cantly decrease the duration of the first and second stages of labor. The pain score recorded is not statistically different between the groups.

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