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[PMID]:29412225
[Au] Autor:Gomes MC; Neves ÉT; Perazzo MF; Souza EGC; Serra-Negra JM; Paiva SM; Granville-Garcia AF
[Ad] Endereço:Universidade Estadual da Paraíba - UEPB, Dental School, Department of Dentistry, Campina Grande, PB, Brazil.
[Ti] Título:Evaluation of the association of bruxism, psychosocial and sociodemographic factors in preschoolers.
[So] Source:Braz Oral Res;32:e009, 2018 Feb 05.
[Is] ISSN:1807-3107
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:The aim of the present study was to evaluate factors associated with sleep bruxism in five-year-old preschool children. A preschool-based cross-sectional study was conducted with 761 pairs of children and their parents/caregivers. Sleep bruxism was diagnosed using a questionnaire administered to the parents/caregivers, who also answered questionnaires addressing sociodemographic data and parent's/caregiver's sense of coherence. Clinical oral evaluations of the children to determine dental caries, traumatic dental injuries, malocclusion and tooth wear were performed by two researchers who had undergone a training exercise (interexaminer Kappa: 0.70 to 0.91; intraexaminer Kappa: 0.81 to 1.00). Descriptive analysis and logistic regression for complex samples were carried out (α = 5%). The prevalence of sleep bruxism among the preschool children was 26.9%. The multivariate analysis revealed that bruxism was associated with poor sleep quality (OR = 2.93; 95 CI: 1.52-5.65) and tooth wear (OR = 2.34; 95%CI: 1.39-3.96). In the present study, sleep bruxism among preschool children was associated with tooth wear and poor sleep quality of the child. In contrast, psychosocial aspects (sense of coherence) were not associated with sleep bruxism.
[Mh] Termos MeSH primário: Bruxismo do Sono/etiologia
Bruxismo do Sono/psicologia
[Mh] Termos MeSH secundário: Brasil/epidemiologia
Cuidadores
Pré-Escolar
Estudos Transversais
Feminino
Seres Humanos
Modelos Logísticos
Masculino
Pais
Prevalência
Senso de Coerência
Bruxismo do Sono/epidemiologia
Bruxismo do Sono/fisiopatologia
Fatores Socioeconômicos
Inquéritos e Questionários
Desgaste dos Dentes/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:180208
[St] Status:MEDLINE


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[PMID]:29258980
[Au] Autor:Boots LM; de Vugt ME; Smeets CM; Kempen GI; Verhey FR
[Ad] Endereço:Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neurosciences, Maastricht University Medical Center+, Maastricht, Netherlands.
[Ti] Título:Implementation of the Blended Care Self-Management Program for Caregivers of People With Early-Stage Dementia (Partner in Balance): Process Evaluation of a Randomized Controlled Trial.
[So] Source:J Med Internet Res;19(12):e423, 2017 Dec 19.
[Is] ISSN:1438-8871
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Caring for a family member with dementia puts caregivers at risk of overburdening. Electronic health (eHealth) support for caregivers offers an opportunity for accessible tailored interventions. The blended care self-management program "Partner in Balance" (PiB) for early-stage dementia caregivers was executed in Dutch dementia care organizations. The program combines face-to-face coaching with tailored Web-based modules. Next to an evaluation of program effectiveness, an evaluation of sampling and intervention quality is essential for the generalizability and interpretation of results. OBJECTIVE: The aim of this study was to describe the process evaluation from the perspective of both family caregivers (participants) and professionals delivering the intervention (coaches) to determine internal and external validity before the effect analysis and aid future implementation. METHODS: Implementation, sampling, and intervention quality were evaluated with quantitative and qualitative data from logistical research data, coach questionnaires (n=13), and interviews with coaches (n=10) and participants (n=49). Goal attainment scaling was used to measure treatment-induced change. Analyses were performed with descriptive statistics and deductive content analysis. RESULTS: The participation rate of eligible caregivers was 51.9% (80/154). Recruitment barriers were lack of computer and lack of need for support. Young age and employment were considered recruitment facilitators. All coaches attended training and supervision in blended care self-management. Deviations from the structured protocol were reported on intervention time, structure, and feedback. Coaches described an intensified relationship with the caregiver post intervention. Caregivers appreciated the tailored content and positive feedback. The blended structure increased their openness. The discussion forum was appreciated less. Overall, personal goals were attained after the program (T>50). Implementation barriers included lack of financing, time, and deviating target population. CONCLUSIONS: Participants and coaches were satisfied with the intervention, but adapting the content to specific subgroups, for example, younger caregivers, was recommended. Implementation of the program requires more awareness of the benefits of blended care self-management programs and training in tailored self-management skills. TRIAL REGISTRATION: Dutch Trial Register (NTR): NTR4748; http://www.trialregister.nl (Archived by WebCite at http://www.webcitation.org/6vSb2t9Mg).
[Mh] Termos MeSH primário: Demência/terapia
Autogestão/métodos
[Mh] Termos MeSH secundário: Idoso
Cuidadores
Feminino
Seres Humanos
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.2196/jmir.7666


  3 / 28412 MEDLINE  
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[PMID]:27776566
[Au] Autor:Khusaifan SJ; El Keshky ME
[Ad] Endereço:Department of Psychology,Faculty of Arts and Humanities,King Abdulaziz University,Jeddah,Saudi Arabia.
[Ti] Título:Social support as a mediator variable of the relationship between depression and life satisfaction in a sample of Saudi caregivers of patients with Alzheimer's disease.
[So] Source:Int Psychogeriatr;29(2):239-248, 2017 02.
[Is] ISSN:1741-203X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Caring for someone with Alzheimer's disease (AD) is very challenging. Social support may play a crucial role in helping caregivers to adapt better to their caregiving role. The aim of this study is to explore the role of social support as a moderator variable of the relationship between depression and life satisfaction in caregivers for patients with AD in Saudi Arabia. METHODS: In this cross-sectional study, 122 caregivers for patients with AD completed questionnaires assessing informal social support, depressive symptoms, and general life satisfaction. RESULTS: The demographic characteristics showed that 79% (n = 96) of caregivers were females and between the ages of 20 and 50. Higher levels of social support positively correlated with reported higher levels of life satisfaction (r = 0.483, p < 0.001). Depression was negatively correlated with social support (r = -0.418, p < 0.001) and life satisfaction scores (r = -0.553, p = < 0.001). Social support was found to be a partial mediator variable, mediating approximately 23.05% of the total effect of depression on life satisfaction (Sobel = -3.065, p = 0.002). CONCLUSION: Informal social support can act as a mediator variable in the relationship of depression and life satisfaction in caregivers of AD patients. Improving the informal social support networks may help in coping with caregiving burden and better quality of life.
[Mh] Termos MeSH primário: Doença de Alzheimer/enfermagem
Cuidadores/psicologia
Depressão/psicologia
Satisfação Pessoal
Apoio Social
[Mh] Termos MeSH secundário: Adaptação Psicológica
Adulto
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Qualidade de Vida/psicologia
Análise de Regressão
Arábia Saudita
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1017/S1041610216001824


  4 / 28412 MEDLINE  
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[PMID]:29179827
[Au] Autor:Oruche UM; Robb SL; Aalsma M; Pescosolido B; Brown-Podgorski B; Draucker CB
[Ad] Endereço:School of Nursing, Indiana University-Purdue University Indianapolis, United States. Electronic address: uoruche@iu.edu.
[Ti] Título:Developing a Multiple Caregiver Group for Caregivers of Adolescents With Disruptive Behaviors.
[So] Source:Arch Psychiatr Nurs;31(6):596-601, 2017 12.
[Is] ISSN:1532-8228
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This article describes the development of a 6-week multiple caregiver group intervention for primary caregivers of adolescents diagnosed with Oppositional Defiant Disorder or Conduct Disorder in low-income African American families. The intervention is aimed at increasing the primary caregivers' self-efficacy in managing interactions within the family and especially with child serving educational, mental health, juvenile justice, and child welfare systems. Development of the intervention involved seven iterative activities performed in a collaborative effort between an interdisciplinary academic team, community engagement specialists, members of the targeted population, and clinical partners from a large public mental health system. The intervention development process described in this article can provide guidance for teams that aim to develop new mental health interventions that target specific outcomes in populations with unique needs.
[Mh] Termos MeSH primário: Cuidadores/educação
Cuidadores/psicologia
Comportamento Problema/psicologia
Autoeficácia
[Mh] Termos MeSH secundário: Adolescente
Grupo com Ancestrais do Continente Africano
Transtorno da Conduta/terapia
Feminino
Seres Humanos
Transtornos Mentais/psicologia
Pais/psicologia
Pobreza
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


  5 / 28412 MEDLINE  
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[PMID]:28743253
[Au] Autor:Greenwood N; Smith R; Akhtar F; Richardson A
[Ad] Endereço:Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, 6th Floor Hunter Wing, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK. Nan.Greenwood1@gmail.com.
[Ti] Título:A qualitative study of carers' experiences of dementia cafés: a place to feel supported and be yourself.
[So] Source:BMC Geriatr;17(1):164, 2017 Jul 25.
[Is] ISSN:1471-2318
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Unpaid, informal carers or caregivers play an important role in supporting people living with dementia but the role can be challenging and carers themselves may benefit from support. Alzheimer's, dementia or memory cafés are one such form of support . These cafés are usually provided in the voluntary sector and are a place where people with dementia and those supporting them, usually family carers, can meet with others in similar situations. METHODS: Using semi-structured interviews, this qualitative study explored the experiences of 11 carers from five dementia cafés in and around London, England. RESULTS: Thematic analysis resulted in the identification of four key themes. Cafés provide a relaxed, welcoming atmosphere where carers can go where they feel supported and accepted. Café attendance often brought a sense of normality to these carers' lives. Carers and those they care for look forward to going and often enjoy both the activities provided and socialising with others. Other highlighted benefits included peer support from other carers, information provision and support from the volunteer café coordinators. Despite diversity in how the cafés were run and in the activities offered, there were many reported similarities amongst carers in the value ascribed to attending the cafés. CONCLUSIONS: Dementia cafés appear to be a valuable, perhaps unique form of support for carers giving them brief respite from their caring role. Future research incorporating mixed methods is needed to understand the perspectives of those living with dementia.
[Mh] Termos MeSH primário: Cuidadores/psicologia
Cuidadores/normas
Demência/psicologia
Demência/terapia
Pesquisa Qualitativa
Apoio Social
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Aconselhamento/métodos
Inglaterra/epidemiologia
Feminino
Seres Humanos
Londres/epidemiologia
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1186/s12877-017-0559-4


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[PMID]:28464924
[Au] Autor:Clark DA; Khan U; Kiberd BA; Turner CC; Dixon A; Landry D; Moffatt HC; Moorhouse PA; Tennankore KK
[Ad] Endereço:Division of Nephrology, Dalhousie University, 5070 Dickson Building, 5820 University Avenue, Halifax, B3H 2Y9, NS, Canada.
[Ti] Título:Frailty in end-stage renal disease: comparing patient, caregiver, and clinician perspectives.
[So] Source:BMC Nephrol;18(1):148, 2017 May 02.
[Is] ISSN:1471-2369
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Frailty is associated with poor outcomes for patients on dialysis and is traditionally measured using tools that assess physical impairment. Alternate measurement tools highlight cognitive and functional domains, requiring clinician, patient, and/or caregiver input. In this study, we compared frailty measures for incident dialysis patients that incorporate patient, clinician, and caregiver perspectives with an aim to contrast the measured prevalence of frailty using tools derived from different conceptual frameworks. METHODS: A prospective cohort study of incident dialysis patients was conducted between February 2014 and June 2015. Frailty was assessed at dialysis onset using: 1) modified definition of Fried Phenotype (Dialysis Morbidity Mortality Study definition, DMMS); 2) Clinical Frailty Scale (CFS); 3) Frailty Assessment Care Planning Tool (provides CFS grading, FACT-CFS); and 4) Frailty Index (FI). Measures were compared via correlation and sensitivity/specificity analyses. RESULTS: A total of 98 patients participated (mean age of 61 ± 14 years). Participants were primarily Caucasian (91%), male (58%), and the majority started on hemodialysis (83%). The median score for both the CFS and FACT-CFS was 4 (interquartile range of 3-5). The mean FI score was 0.31 (standard deviation ± 0.16). The DMMS identified 78% of patients as frail. The FACT-CFS demonstrated highest correlation (r = 0.71) with the FI, while the DMMS was most sensitive (97%, 100%) and a CFS ≥ 5 most specific (100%, 77%) at corresponding FI cutoff values (>0.21, >0.45). CONCLUSIONS: Frailty assessments of incident dialysis patients that include clinician, caregiver and patient perspectives have moderate to strong correlation with the FI. At specified FI cutoff values, the FACT-CFS and DMMS are highly sensitive measures of frailty. The CFS and FACT-CFS may represent viable alternative screening tools in dialysis patients.
[Mh] Termos MeSH primário: Autoavaliação Diagnóstica
Avaliação Geriátrica/métodos
Falência Renal Crônica/diagnóstico
Falência Renal Crônica/terapia
Programas de Rastreamento/métodos
Diálise Renal/estatística & dados numéricos
Índice de Gravidade de Doença
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Atitude do Pessoal de Saúde
Cuidadores/estatística & dados numéricos
Feminino
Fragilidade
Avaliação Geriátrica/estatística & dados numéricos
Seres Humanos
Falência Renal Crônica/epidemiologia
Masculino
Meia-Idade
Nova Escócia/epidemiologia
Satisfação do Paciente/estatística & dados numéricos
Prevalência
Reprodutibilidade dos Testes
Fatores de Risco
Sensibilidade e Especificidade
Avaliação de Sintomas/métodos
Avaliação de Sintomas/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1186/s12882-017-0558-x


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[PMID]:29206977
[Au] Autor:Brandão D; Ribeiro O; Martín I
[Ad] Endereço:Research and Education Unit on Ageing (UNIFAI/ICBAS-UP), Institute of Biomedical Sciences Abel Salazar, Department of Behavioral Sciences, University of Porto, Porto.
[Ti] Título:Underuse and Unawareness of Residential Respite Care Services in Dementia Caregiving: Constraining the Need for Relief.
[So] Source:Health Soc Work;41(4):254-262, 2016 Nov 20.
[Is] ISSN:0360-7283
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This article describes an analysis of the use of residential respite care services and the factors that influence the use of such services among informal caregivers of people with dementia. The authors studied a sample of 223 caregivers participating in a community-based intervention project in northern Portugal. Participants provided information on their overall caregiving situation and on their use or willingness to use respite care services. Results showed that fewer than 6 percent of caregivers accessed the services and that although most caregivers were not familiar with these services, they recognized their importance and strongly considered the possibility of using them. Part-time care, lower levels of gratification, higher burden, and the care receiver's attendance of day center supported the willingness to use residential respite services. The limited offer, not knowing about the services, and cultural issues related to the family duties within the caregiving role can explain the low use of these services. Social work professionals have an important role in promoting residential respite care services, and thereby helping to reduce caregiving overload.
[Mh] Termos MeSH primário: Conscientização
Cuidadores/psicologia
Demência/enfermagem
Cuidados Intermitentes/utilização
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Portugal
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1093/hsw/hlw041


  8 / 28412 MEDLINE  
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[PMID]:29206976
[Au] Autor:Brotman S; Drummond J; Silverman M; Sussman T; Orzeck P; Barylak L; Wallach I; Billette V
[Ad] Endereço:School of Work, McGill University, 3506 University Street, Montreal, Quebec, Canada.
[Ti] Título:Talking about Sexuality and Intimacy with Women Spousal Caregivers: Perspectives of Service Providers.
[So] Source:Health Soc Work;41(4):263-270, 2016 Nov 20.
[Is] ISSN:0360-7283
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This article reports the findings of an exploratory study examining service provider perceptions and experiences of addressing sexuality and intimacy with women spousal caregivers. The caregiver-provider encounter is examined, and challenges faced by service providers in addressing sexuality are considered. Themes identified include ambivalence and discomfort, personal and institutional barriers, meanings attributed to sexuality and intimacy, and lack of opportunities to discuss experiences. Strategies to overcome silence and invisibility on the part of service providers in the health and social services system are considered.
[Mh] Termos MeSH primário: Cuidadores/psicologia
Papel Profissional
Sexualidade
Assistentes Sociais
Cônjuges/psicologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Entrevistas como Assunto
Masculino
Meia-Idade
Pesquisa Qualitativa
Comportamento Sexual
Parceiros Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1093/hsw/hlw040


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[PMID]:29206951
[Au] Autor:Hong M; Harrington D
[Ad] Endereço:School of Social Work, Indiana University, 902 West New York Street, Education/SW Building ES 4109, Indianapolis, IN 46202-5156; School of Social Work, University of Maryland, Baltimore.
[Ti] Título:The Effects of Caregiving Resources on Perceived Health among Caregivers.
[So] Source:Health Soc Work;41(3):155-163, 2016 Aug 01.
[Is] ISSN:0360-7283
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study examined how various types of resources influence perceived health of caregivers. Guided by the conservation of resources theory, a caregiver health model was built and tested using structural equation modeling. The caregiver health model consisted of caregiving situations (functional limitations and cognitive impairments of older adults and caregiving time), resources (financial resources, mastery, social support, family harmony, and service utilization), caregiver burden, and perceived health of caregivers. The sample included 1,837 unpaid informal caregivers drawn from the 2004 National Long-Term Caregiver Survey. The model fit indices indicated that the first structural model did not fit well; however, the revised model yielded an excellent model fit. More stressful caregiving situations were associated with fewer resources and higher burden, whereas greater resources were associated with lower burden and better perceived health of caregivers. The results suggest explicit implications for social work research and practice on how to protect the health of caregivers.
[Mh] Termos MeSH primário: Cuidadores/psicologia
Transtornos Cognitivos/enfermagem
Pessoas com Deficiência
Relações Familiares
Recursos em Saúde
Autoeficácia
Apoio Social
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Inquéritos e Questionários
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1093/hsw/hlw025


  10 / 28412 MEDLINE  
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[PMID]:29383710
[Au] Autor:Behbod B; Sharma M; Baxi R; Roseby R; Webster P
[Ad] Endereço:Nuffield Department of Population Health, University of Oxford, Oxford, UK.
[Ti] Título:Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke.
[So] Source:Cochrane Database Syst Rev;1:CD001746, 2018 01 31.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Children's exposure to other people's tobacco smoke (environmental tobacco smoke, or ETS) is associated with a range of adverse health outcomes for children. Parental smoking is a common source of children's exposure to ETS. Older children in child care or educational settings are also at risk of exposure to ETS. Preventing exposure to ETS during infancy and childhood has significant potential to improve children's health worldwide. OBJECTIVES: To determine the effectiveness of interventions designed to reduce exposure of children to environmental tobacco smoke, or ETS. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group Specialised Register and conducted additional searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsycINFO, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resource Information Center (ERIC), and the Social Science Citation Index & Science Citation Index (Web of Knowledge). We conducted the most recent search in February 2017. SELECTION CRITERIA: We included controlled trials, with or without random allocation, that enrolled participants (parents and other family members, child care workers, and teachers) involved in the care and education of infants and young children (from birth to 12 years of age). All mechanisms for reducing children's ETS exposure were eligible, including smoking prevention, cessation, and control programmes. These include health promotion, social-behavioural therapies, technology, education, and clinical interventions. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies and extracted data. Due to heterogeneity of methods and outcome measures, we did not pool results but instead synthesised study findings narratively. MAIN RESULTS: Seventy-eight studies met the inclusion criteria, and we assessed all evidence to be of low or very low quality based on GRADE assessment. We judged nine studies to be at low risk of bias, 35 to have unclear overall risk of bias, and 34 to have high risk of bias. Twenty-one interventions targeted populations or community settings, 27 studies were conducted in the well-child healthcare setting and 26 in the ill-child healthcare setting. Two further studies conducted in paediatric clinics did not make clear whether visits were made to well- or ill-children, and another included visits to both well- and ill-children. Forty-five studies were reported from North America, 22 from other high-income countries, and 11 from low- or middle-income countries. Only 26 of the 78 studies reported a beneficial intervention effect for reduction of child ETS exposure, 24 of which were statistically significant. Of these 24 studies, 13 used objective measures of children's ETS exposure. We were unable to pinpoint what made these programmes effective. Studies showing a significant effect used a range of interventions: nine used in-person counselling or motivational interviewing; another study used telephone counselling, and one used a combination of in-person and telephone counselling; three used multi-component counselling-based interventions; two used multi-component education-based interventions; one used a school-based strategy; four used educational interventions, including one that used picture books; one used a smoking cessation intervention; one used a brief intervention; and another did not describe the intervention. Of the 52 studies that did not show a significant reduction in child ETS exposure, 19 used more intensive counselling approaches, including motivational interviewing, education, coaching, and smoking cessation brief advice. Other interventions consisted of brief advice or counselling (10 studies), feedback of a biological measure of children's ETS exposure (six studies), nicotine replacement therapy (two studies), feedback of maternal cotinine (one study), computerised risk assessment (one study), telephone smoking cessation support (two studies), educational home visits (eight studies), group sessions (one study), educational materials (three studies), and school-based policy and health promotion (one study). Some studies employed more than one intervention. 35 of the 78 studies reported a reduction in ETS exposure for children, irrespective of assignment to intervention and comparison groups. One study did not aim to reduce children's tobacco smoke exposure but rather sought to reduce symptoms of asthma, and found a significant reduction in symptoms among the group exposed to motivational interviewing. We found little evidence of difference in effectiveness of interventions between the well infant, child respiratory illness, and other child illness settings as contexts for parental smoking cessation interventions. AUTHORS' CONCLUSIONS: A minority of interventions have been shown to reduce children's exposure to environmental tobacco smoke and improve children's health, but the features that differentiate the effective interventions from those without clear evidence of effectiveness remain unclear. The evidence was judged to be of low or very low quality, as many of the trials are at a high risk of bias, are small and inadequately powered, with heterogeneous interventions and populations.
[Mh] Termos MeSH primário: Cuidadores
Família
Prevenção do Hábito de Fumar
Poluição por Fumaça de Tabaco/prevenção & controle
[Mh] Termos MeSH secundário: Fatores Etários
Criança
Pré-Escolar
Ensaios Clínicos Controlados como Assunto
Cotinina/urina
Aconselhamento
Exposição Ambiental/prevenção & controle
Seres Humanos
Lactente
Recém-Nascido
Abandono do Hábito de Fumar
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Tobacco Smoke Pollution); K5161X06LL (Cotinine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD001746.pub4



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