scholarly journals Cuidado à família da criança com doença crônica

2018 ◽  
Vol 12 (5) ◽  
pp. 1397
Author(s):  
Jessica Cardoso Vaz ◽  
Viviane Marten Milbrath ◽  
Ruth Irmgard Bärtschi Gabatz ◽  
Fábio Reis Krug ◽  
Bárbara Hirschmann ◽  
...  

RESUMOObjetivo: conhecer o que vem sendo produzido sobre o cuidado à família da criança com doença crônica. Método: revisão integrativa que buscou conhecer as publicações dos últimos 10 anos nas bases de dados MEDLINE, LILACS, BDENF, INDEX PSICOL e na biblioteca virtual SciELO. Após a leitura dos artigos selecionados, foram analisados os dados dos estudos referentes à autoria, objetivos, ano de publicação, método e nível de evidência. Resultados: com base nos achados, foram definidas duas categorias temáticas << Enfrentando o diagnóstico da doença crônica, mudança de hábitos e reorganização familiar >> e << Rotinas de cuidado das famílias com crianças com condição crônica >>. Conclusão: as famílias das crianças com doença crônica são afastadas de suas rotinas, muitas vezes, perdendo o controle sobre suas vidas. Acredita-se que se a família for bem informada sobre a patologia e empoderada para os cuidados à criança, esta poderá desenvolver autonomia sobre a organização da sua vida. Descritores: Família; Criança; Doença Crônica; Empatia; Enfermagem Pediátrica; Revisão.ABSTRACT Objective: to know what has been produced about the care provided for families of children with chronic disease. Method: integrative review that sought to survey the publications of the last 10 years in the MEDLINE, LILACS, BDENF, INDEX PSICOL databases and in the virtual library SciELO. After reading the selected articles, we analyzed data of the studies regarding authorship, objectives, year of publication, method and level of evidence. Results: the findings led to two thematic categories << Facing the diagnosis of a chronic disease, change of habits and family reorganization >> and << Care routines of families with children with chronic conditions >>. Conclusion: Families of children with chronic diseases have their routines modified, often losing control over their lives. We believe that if families are well informed about the pathology and if they are empowered to care for the child, they will be able to develop autonomy over the organization of their lives. Descriptors: Family; Child; Chronic disease; Empathy; Pediatric Nursing; Review.RESUMEN Objetivo: conocer lo que viene siendo producido sobre el cuidado a la familia del niño con enfermedad crónica. Método: revisión integradora que buscó conocer las publicaciones de los últimos 10 años en las bases de datos MEDLINE, LILACS, BDENF, INDEX PSICOL y en la biblioteca virtual SciELO. Después de la lectura de los artículos seleccionados, fueron analizados los datos de los estudios referentes a la autoría, objetivos, año de publicación, método y nivel de evidencia. Resultados: con base en los hallados, fueron definidas dos categorías temáticas << Enfrentando el diagnóstico de la enfermedad crónica, cambio de hábitos y reorganización familiar >> y << Rutinas de cuidado de las familias con niños con condición crónica >>. Conclusión: las familias de los niños con enfermedades crónica son alejados de sus rutinas, muchas veces, perdiendo el control sobre sus vidas. Se cree que si la familia fuera bien informada sobre la patología y empoderada para los cuidados al niño, esta podrá desarrollar autonomía sobre la organización de su vida. Descriptores: Familia; Niño; Enfermedad Crónica; Empatía; Enfermería Pediátrica; Revisión.

2011 ◽  
Vol 31 (3) ◽  
pp. 109-120 ◽  
Author(s):  
R Pineault ◽  
S Provost ◽  
M Hamel ◽  
A Couture ◽  
JF Levesque

Objectives To examine the extent to which experience of care varies across chronic diseases, and to analyze the relationship of primary health care (PHC) organizational models with the experience of care reported by patients in different chronic disease situations. Methods We linked a population survey and a PHC organizational survey conducted in two regions of Quebec. We identified five groups of chronic diseases and contrasted these with a no–chronic-disease group. Results Accessibility of care is low for all chronic conditions and shows little variation across diseases. The contact and the coordination-integrated models are the most accessible, whereas the single-provider model is the least. Process and outcome indices of care experience are much higher than accessibility for all conditions and vary across diseases, with the highest being for cardiovascular-risk-factors and the lowest for respiratory diseases (for people aged 44 and under). However, as we move from risk factors to more severe chronic conditions, the coordination-integrated and community models are more likely to generate better process of care, highlighting the greater potential of these two models to meet the needs of more severely chronically ill individuals within the Canadian health care system.


2019 ◽  
Vol 12 ◽  
pp. 117863291987942
Author(s):  
Charles D Phillips ◽  
Chau Truong ◽  
Hye-Chung Kum ◽  
Obioma Nwaiwu ◽  
Robert Ohsfeldt

Considerable research has focused on hospitalizations for ambulatory care–sensitive conditions (ACSHs), but little of that research has focused on the role played by chronic disease in ACSHs involving children or youth (C/Y). This research investigates, for C/Y, the effects of chronic disease on the likelihood of an ACSH. The database included 699 473 hospital discharges for individuals under 18 in Texas between 2011 and 2015. Effects of chronic disease, individual, and contextual factors on the likelihood of a discharge involving an ACSH were estimated using logistic regression. Contrary to the results for adults, the presence of chronic diseases or a complex chronic disease among children or youth was protective, reducing the likelihood of an ACSH for a nonchronic condition. Results indicate that heightened ambulatory care received by C/Y with chronic diseases is largely protective. Two of more chronic conditions or at least one complex chronic condition significantly reduced the likelihood of an ACSH.


PEDIATRICS ◽  
1973 ◽  
Vol 51 (4) ◽  
pp. 722-730
Author(s):  
Barton D. Schmitt

The comprehensive management of chronic diseases can be very taxing on the pediatrician. One of the more difficult aspects is how to locate the pertinent data, both past and current, necessary for making medical decisions. The chronic disease flow sheet provides a system for easier monitoring of the multiple interacting variables present in chronic diseases. General recommendations are offered for designing new flow sheets. Sample flow sheets are included as working models for 19 common chronic conditions. The value of chronic disease flow sheets in patient care, teaching, and clinical research is discussed.


2013 ◽  
Vol 37 (3) ◽  
pp. 381 ◽  
Author(s):  
Sarah M. Dennis ◽  
Mark Harris ◽  
Jane Lloyd ◽  
Gawaine Powell Davies ◽  
Nighat Faruqi ◽  
...  

Objective. To examine the effectiveness of telephone-based coaching services for the management of patients with chronic diseases. Methods. A rapid scoping review of the published peer reviewed literature, using Medline, Embase, CINAHL, PsychNet and Scopus. We included studies involving people aged 18 years or over with one or more of the following chronic conditions: type 2 diabetes, congestive cardiac failure, coronary artery disease, chronic obstructive pulmonary disease and hypertension. Patients were identified as having multi-morbidity if they had an index chronic condition plus one or more other chronic condition. To be included in this review, the telephone coaching had to involve two-way conversations by telephone or video phone between a patient and a provider. Behaviour change, goal setting and empowerment are essential features of coaching. Results. The review found 1756 papers, which was reduced to 30 after screening and relevance checks. Most coaching services were planned, as opposed to reactive, and targeted patients with complex needs who had one or more chronic disease. Several studies reported improvements in health behaviour, self-efficacy, health status and satisfaction with the service. More than one-third of the papers targeted vulnerable people and telephone coaching was found to be effective for these people. Conclusions. Telephone coaching for people with chronic conditions can improve health behaviour, self-efficacy and health status. This is especially true for vulnerable populations who had difficulty accessing health services. There is less evidence for improvements in quality of life and patient satisfaction with the service. The evidence for improvements in health service use was limited. This rapid scoping review found that telephone-based coaching can enhance the management of chronic disease, especially for vulnerable groups. Further work is needed to identify what models of telephone coaching are most effective according to patients’ level of risk and co-morbidity. What is known about the topic? With the increasing prevalence of chronic diseases more demands are being made of limited health services and resources. Telephone health coaching for people with or at risk of chronic diseases is seen as a means of supporting people to manage their health and reducing the burden on the healthcare system. What does this paper add? Telephone coaching interventions were effective for vulnerable people with chronic disease(s). Often the vulnerable populations had worse control of their chronic condition at baseline and demonstrated the greatest improvement compared with those with better control at baseline. Planned (i.e. weekly or monthly telephone calls to support the patients with chronic disease) and unscripted telephone coaching interventions appear to be most effective for improving self-management skills in people from vulnerable groups: the planned telephone coaching services had the advantage of regular contact and helping people develop their skills over time, whereas the unscripted aspect allowed the coach to tailor support to the patient’s individual needs What are the implications for practitioners? Telephone coaching is an effective means of supporting people with chronic diseases to manage their own health. Further work is needed to embed telephone coaching within existing services. Good linkages with the patient’s general practitioner are important. This might be a regular report, updates via the patient e-health record, or provision for contact if a problem is identified or linking to the patient e-health record.


2021 ◽  
pp. jech-2020-215626
Author(s):  
Nazrul Islam ◽  
Ben Lacey ◽  
Sharmin Shabnam ◽  
A Mesut Erzurumluoglu ◽  
Hajira Dambha-Miller ◽  
...  

BackgroundGiven the effect of chronic diseases on risk of severe COVID-19 infection, the present pandemic may have a particularly profound impact on socially disadvantaged counties.MethodsCounties in the USA were categorised into five groups by level of social vulnerability, using the Social Vulnerability Index (a widely used measure of social disadvantage) developed by the US Centers for Disease Control and Prevention. The incidence and mortality from COVID-19, and the prevalence of major chronic conditions were calculated relative to the least vulnerable quintile using Poisson regression models.ResultsAmong 3141 counties, there were 5 010 496 cases and 161 058 deaths from COVID-19 by 10 August 2020. Relative to the least vulnerable quintile, counties in the most vulnerable quintile had twice the rates of COVID-19 cases and deaths (rate ratios 2.11 (95% CI 1.97 to 2.26) and 2.42 (95% CI 2.22 to 2.64), respectively). Similarly, the prevalence of major chronic conditions was 24%–41% higher in the most vulnerable counties. Geographical clustering of counties with high COVID-19 mortality, high chronic disease prevalence and high social vulnerability was found, especially in southern USA.ConclusionSome counties are experiencing a confluence of epidemics from COVID-19 and chronic diseases in the context of social disadvantage. Such counties are likely to require enhanced public health and social support.


2018 ◽  
Vol 27 (4) ◽  
pp. 270-276
Author(s):  
Palvinder Kaur ◽  
Nakul Saxena ◽  
Zhecheng Zhu

Objectives: High body mass index (BMI) has been associated with increased mortality, healthcare utilization and costs. This study investigates the one-year chronic disease progression and risk of developing diabetes with varying cardiovascular disease (CVD) risks based on the Asian BMI categories. Methods: Patients with BMI information from 2008 to 2014 were included in the analysis ( N=23,508). Patients were stratified into low, moderate, high and very high CVD risk categories. To study disease progression for patients with varying CVD risks, patients were further segmented into seven mutually exclusive disease states based on prevalence of chronic diseases and their complications. The categories were no known chronic disease, at-risk of developing chronic disease, one chronic condition, more than two chronic conditions, chronic conditions with complications, patients with cancer and death. Logistic regression was used to determine the association of CVD risk categories and risk of having diabetes. Results: High CVD risk patients had more chronic diseases in the following year as compared with low CVD risk patients. With reference to low CVD risk patients, patients in the moderate, high and very high risk categories had an odds ratio of 1.78 (95% confidence interval (CI): 1.60 to 1.98), 2.84 (95% CI: 2.51 to 3.21) and 3.99 (95% CI: 3.30 to 4.82) for having diabetes after adjusting for age, gender and ethnicity. Conclusions: Higher BMI is associated with greater chronic disease progression in the following year. Diet control and lifestyle modifications should be encouraged to prevent people from shifting to higher BMI strata as this can be detrimental in the long run.


2019 ◽  
Vol 13 ◽  
Author(s):  
André Luiz De Souza Braga ◽  
Euzeli Da Silva Brandão ◽  
Gisella De Carvalho Queluci ◽  
Mariana Ferreira Soares ◽  
Julia Santana De Aguiar

Objetivo: descrever os diagnósticos de enfermagem, fatores de risco/relacionados e características definidoras apresentados pelos clientes com afecções cutâneas. Método: trata-se de estudo bibliográfico, tipo revisão integrativa de estudos indexados de 1998 a 2018, em português, inglês e espanhol, nas bases LILACS, MEDLINE e Biblioteca Virtual SciELO. Interpretaram-se os dados com base na comparação das teorias, conclusões e implicações dos estudos, apresentando-os em figuras. Resultados: observa-se precariedade de artigos publicados: apenas três, com nível de evidência 4. Abordaram-se, no primeiro, os diagnósticos de Enfermagem em clientes com diversas afecções cutâneas; o segundo identificou apenas os diagnósticos de Enfermagem em clientes com hanseníase e o terceiro, nos clientes com dermatoses imunobolhosas. Conclusão: verifica-se a escassez de estudos. Encontrou-se o risco de infecção, definido pela “vulnerabilidade à invasão e multiplicação de organismos patogênicos, que pode comprometer a “saúde”, como diagnóstico de enfermagem, em todos os pacientes, em todos os estudos. Descritores: Dermatopatias; Diagnóstico de Enfermagem; Dermatologia; Pele; Enfermagem; Cuidados de Enfermagem.ABSTRACTObjective: to describe the nursing diagnoses, risk/related factors and defining characteristics presented by customers with cutaneous affections. Method: this is a bibliographical study, integrative-review-type of studies indexed from 1998 to 2018, in Portuguese, English and Spanish, on LILACS, MEDLINE and SciELO Virtual Library databases. The data were interpreted based on a comparison of theories, conclusions and implications of the study, presenting them in figures. Results: there was precariousness of published articles: only three, with level of evidence 4. The first one addressed nursing diagnoses in clients with various cutaneous affections; the second identified only nursing diagnoses in customers with leprosy and the third, in clients with autoimmune bullous dermatoses. Conclusion: there is a paucity of studies. All studies identified risk for infection, defined as the “vulnerability to invasion and multiplication of pathogenic organisms”, which can harm the “health”, as nursing diagnosis in all patients. Descriptors: Skin Diseases; Nursing Diagnosis; Dermatology; Skin; Nursing; Nursing Care.RESUMENObjetivo: describir los diagnósticos de enfermería, los factores de riesgo/relacionados y definir las características presentadas por clientes con afecciones cutáneas. Método: este es un estudio bibliográfico, tipo revisión integradora de estudios indexados desde 1998 a 2018, en portugués, inglés y español, en las bases de datos MEDLINE, LILACS y Biblioteca Virtual SciELO. Los datos fueron interpretados con base en una comparación de teorías, conclusiones e implicaciones del estudio, presentándolos en cifras. Resultados: se observó la precariedad de los artículos publicados: sólo tres, con nivel de evidencia 4. El primero artigo discute los diagnósticos de enfermería en clientes con diversas afecciones cutáneas; el segundo identifica sólo diagnósticos de enfermería en clientes con la lepra y el tercero, en clientes con dermatosis imunobolhosas. Conclusión: existe una escasez de estudios. Se encontró el riesgo de infección, definido por la “vulnerabilidad a la invasión y multiplicación de microorganismos patógenos”, que pueden perjudicar la “salud”, como diagnóstico de enfermería en todos los pacientes, en todos los estudios.Descriptores: Enfermedades de la Piel; Diagnóstico de Enfermería; Dermatología; Piel; Enfermería; Atención de Enfermería.


2020 ◽  
Author(s):  
Hyllore Imeri ◽  
Shane Desselle ◽  
Dardan Hetemi ◽  
Kreshnik Hoti

BACKGROUND Patient Activation (PA) has an impact on the management of patients' health condition, clinical outcomes and treatment cost. Mobile electronic devices (MEDs) have shown potential to engage patients in wellness behavior. OBJECTIVE This study was aimed at exploring the impact of MEDs on PA and identifying key motivational factors related to the use of MEDs to search for information on chronic diseases and medications. METHODS Six focus groups were conducted, two focus groups with students, two with health professionals, and another two with patients. A protocol of eight questions was used to guide the discussions. The audio-recorded data were transcribed verbatim and analyzed thematically. With the view of analyzing the relevance of themes and subthemes identified, a ranking system was employed, using a coding system depicted by + symbol, to indicate different relevance levels. RESULTS Findings of this study suggested that MEDs have a positive impact on patients’ activation through facilitating information-seeking behavior on chronic diseases and medications. Key drivers leading to patient activation to seek chronic disease and medication related information through MEDs were accessibility and abundance of available and detailed information, reduced search time, information updates, and convenience to find information at any time and place. In this regard, our findings also suggest a positive relationship between patient’s level of self-care and their activation through use of MEDs. Lack of accurate information in native language, access to incorrect information and limited access to the internet were the key obstacles to seeking information related to chronic conditions and medications via MEDs. CONCLUSIONS Use of MEDs may assist to activate patients in seeking chronic disease and medication-related information, potentially leading to better management of their chronic conditions and medications. Findings also highlight the need for health professionals to empower patients through specific education that addresses MED utilization for chronic disease and medication information seeking. CLINICALTRIAL na


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S815-S816
Author(s):  
Christopher A Taylor ◽  
Erin D Bouldin ◽  
Lisa C McGuire

Abstract While adults aged 65 years and older are most at risk for chronic conditions, studies show that middle-aged adults aged 45–64 years also have growing numbers of comorbid chronic diseases. Regardless of age, managing chronic conditions requires decision-making abilities to manage treatments effectively. Symptoms of memory loss and confusion may impair a person’s ability to manage their health. This study examined chronic conditions in persons with subjective cognitive decline (SCD), defined as the self-reported experience of increased memory problems or confusion. Behavioral Risk Factor Surveillance System data from 2015–2017 were used to define SCD and disease status for eight chronic conditions (heart disease, stroke, cancer, arthritis, asthma, depression, diabetes, and chronic obstructive pulmonary disease) for adults 45–64 years from 49 states, District of Columbia, and Puerto Rico that collected data on cognitive decline. Among adults aged 45–64 years, 10.8% reported SCD. Among those with SCD, 77.4% had at least one chronic disease compared to 47.1% of those without SCD. Those with SCD had a higher prevalence for all eight conditions compared to those similarly-aged without SCD. Adults with at least one chronic condition were more likely to discuss their symptoms of SCD with a health care professional (54.2%) compared to those with no chronic conditions (30.3%). Poor management of chronic conditions can result in increased health care costs and might worsen existing symptoms of confusion and memory problems. Self-care interventions for chronic disease management should consider the importance of an individual’s cognitive status, including SCD.


2019 ◽  
Vol 40 (1) ◽  
pp. 127-146 ◽  
Author(s):  
John P. Allegrante ◽  
Martin T. Wells ◽  
Janey C. Peterson

A majority of the US adult population has one or more chronic conditions that require medical intervention and long-term self-management. Such conditions are among the 10 leading causes of mortality; an estimated 86% of the nation's $2.7 trillion in annual health care expenditures goes toward their treatment and management. Patient self-management of chronic diseases is increasingly essential to improve health behaviors, health outcomes, and quality of life and, in some cases, has demonstrated effectiveness for reducing health care utilization and the societal cost burden of chronic conditions. This review synthesizes the current state of the science of chronic disease self-management interventions and the evidence for their effectiveness, especially when applied with a systematic application of theories or models that account for a wide range of influences on behavior. Our analysis of selected outcomes from randomized controlled trials of chronic disease self-management interventions contained in 10 Cochrane systematic reviews provides additional evidence to demonstrate that self-management can improve quality of life and reduce utilization across several conditions.


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