Base de dados : MEDLINE
Pesquisa : M01.526.225 [Categoria DeCS]
Referências encontradas : 58 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 6 ir para página                

  1 / 58 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
[PMID]:29267419
[Au] Autor:de Pierrefeu I; Corbière M; Pachoud B
[Ad] Endereço:Laboratoire CRPMS, Université Sorbonne Paris Cité, France.
[Ti] Título:[Supervisors and Employment Counselors in Messidor Transitional Social Firms Supporting People with Psychiatric Disability to Gain Competitive Employment].
[Ti] Título:Les accompagnants à l'insertion professionnelle en milieu ordinaire pour les personnes en situation de handicap psychique au sein des ESAT de transition Messidor..
[So] Source:Sante Ment Que;42(2):155-171, 2017.
[Is] ISSN:0383-6320
[Cp] País de publicação:Canada
[La] Idioma:fre
[Ab] Resumo:Objectives Some programs have been developed in France for helping people with a psychiatric disability to get competitive employment, especially prevocational programs such as transitional social firms. However, these programs have not been studied until now. Studies on supported employment programs (evidence-based practices) conducted in other countries demonstrated that variation of work outcomes is due, among other factors, to employment specialists' competencies. These results highlight the need for describing more specifically the work of the two professionals, employment counselors and supervisors, working in transitional social firms in order to better understand their role, tasks and competencies. Therefore, the objective of this study aims at describing the roles, tasks and competencies of these two professionals working in transitional social firms, to better understand how they support people with psychiatric disability for eventually obtaining competitive employment.Methods A qualitative method was used to describe roles, tasks and competencies of employment counselors and supervisors working in the transitional social firms of the Messidor's association (7 regions). In sum, 24 individual interviews with employment counselors and supervisors of these social firms as well as 7 focus groups with the two types of professionals, were conducted.Results This study allowed to define the work of the two professionals (role and tasks) and a list of 110 competencies for employment counselors as well as 155 competencies for supervisors working in these transitional social firms, emerged from qualitative analyses. This "double support" has been defined as a complementary approach helping workers to change their own perceptions, becoming more confident in their work abilities, and thus helping them to gain competitive employment. On the one hand, the employment counselor supports each worker in developing strategies and actions to reach competitive employment, and put in place "job development skills" to coordinate his role with key stakeholders (e.g. psychiatrist, employers) involved in the work integration of people with severe mental disorders. On the other hand, the supervisor is following each worker all day long, training and helping them to overcome potential difficulties regarding the work to do, and building confidence and self-esteem in the workers under their supervision, which are all key elements to gain competitive employment.Conclusion Clinical implications are suggested regarding the recruitment of professionals working in transitional social firms, and thus improving work outcomes for people with a severe mental illness.
[Mh] Termos MeSH primário: Conselheiros
Readaptação ao Emprego
Pessoas com Deficiência Mental
[Mh] Termos MeSH secundário: França
Seres Humanos
Transtornos Mentais
Apoio Social
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE


  2 / 58 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28715481
[Au] Autor:Lee JS; You S; Choi YK; Youn HY; Shin HS
[Ad] Endereço:Department of Psychology, Kangwon National University, Chuncheon, Kangwon, Korea.
[Ti] Título:A preliminary evaluation of the training effects of a didactic and simulation-based psychological first aid program in students and school counselors in South Korea.
[So] Source:PLoS One;12(7):e0181271, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The present study aimed to examine the training effects of a didactic and simulation-based psychological first aid (PFA) program. Based on the competency-based model, the study sought to examine whether the PFA training would enhance knowledge, skills, and attitudes. Study 1 examined the training effects of the PFA program in a sample of undergraduate and graduate students in psychology. Study 2 was conducted with school counselors. In both studies, all participants completed a one-day PFA workshop with a 3-hour didactic lecture and a 3-hour simulation-based practice. Assessments were conducted prior to the didactic lecture and upon completion of the simulation-based practice. In study 1, an examination of pre- and posttest comparisons indicated that the training significantly improved students' PFA knowledge and perceived competence in PFA skill. In study 2, the same PFA training significantly improved school counselors' PFA knowledge, perceived competence in PFA skill, perceived preparedness and confidence to provide psychological assistance for future disasters, but their perceived willingness to participate in psychological assistance did not significantly change after the training. This study provides preliminary evidence supporting the effectiveness of the PFA training program using a combined method of didactic and simulation-based practice for disaster mental health providers in Korea.
[Mh] Termos MeSH primário: Conselheiros
Primeiros Socorros
Aprendizagem
Estudantes
[Mh] Termos MeSH secundário: Adolescente
Adulto
Conselheiros/psicologia
Planejamento em Desastres
Educação de Pós-Graduação
Feminino
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Masculino
Meia-Idade
Percepção
Avaliação de Programas e Projetos de Saúde
Trauma Psicológico/terapia
Psicologia/educação
República da Coreia
Estudantes/psicologia
Universidades
Adulto Jovem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170718
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0181271


  3 / 58 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28529048
[Au] Autor:Zeh C; Rose CE; Inzaule S; Desai MA; Otieno F; Humwa F; Akoth B; Omolo P; Chen RT; Kebede Y; Samandari T
[Ad] Endereço:Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States.
[Ti] Título:Laboratory-based performance evaluation of PIMA CD4+ T-lymphocyte count point-of-care by lay-counselors in Kenya.
[So] Source:J Immunol Methods;448:44-50, 2017 Sep.
[Is] ISSN:1872-7905
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: CD4+ T-lymphocyte count testing at the point-of-care (POC) may improve linkage to care of persons diagnosed with HIV-1 infection, but the accuracy of POC devices when operated by lay-counselors in the era of task-shifting is unknown. We examined the accuracy of Alere's Pima™ POC device on both capillary and venous blood when performed by lay-counselors and laboratory technicians. METHODS: In Phase I, we compared the perfomance of POC against FACSCalibur™ for 280 venous specimens by laboratory technicians. In Phase II we compared POC performance by lay-counselors versus laboratory technicians using 147 paired capillary and venous specimens, and compared these to FACSCalibur™. Statistical analyses included Bland-Altman analyses, concordance correlation coefficient, sensitivity, and specificity at treatment eligibility thresholds of 200, 350, and 500cells/µl. RESULTS: Phase I: POC sensitivity and specificity were 93.0% and 84.1% at 500cells/µl, respectively. Phase II: Good agreement was observed for venous POC results from both lay-counselors (concordance correlation coefficient (CCC)=0.873, bias -86.4cells/µl) and laboratory technicians (CCC=0.920, bias -65.7cells/µl). Capillary POC had good correlation: lay-counselors (CCC=0.902, bias -71.2cells/µl), laboratory technicians (CCC=0.918, bias -63.0cells/µl). Misclassification at the 500 cells/µl threshold for venous blood was 13.6% and 10.2% for lay-counselors and laboratory technicians and 12.2% for capillary blood in both groups. POC tended to under-classify the CD4 values with increasingly negative bias at higher CD4 values. CONCLUSIONS: Pima™ results were comparable to FACSCalibur™ for both venous and capillary specimens when operated by lay-counselors. POC CD4 testing has the potential to improve linkage to HIV care without burdening laboratory technicians in resource-limited settings.
[Mh] Termos MeSH primário: Contagem de Linfócito CD4/instrumentação
Técnicas de Laboratório Clínico
Agentes Comunitários de Saúde
Conselheiros
Infecções por HIV/diagnóstico
HIV-1/imunologia
Sistemas Automatizados de Assistência Junto ao Leito
Testes Imediatos
[Mh] Termos MeSH secundário: Contagem de Linfócito CD4/métodos
Erros de Diagnóstico
Desenho de Equipamento
Infecções por HIV/sangue
Infecções por HIV/imunologia
Infecções por HIV/virologia
Seres Humanos
Quênia
Variações Dependentes do Observador
Valor Preditivo dos Testes
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170523
[St] Status:MEDLINE


  4 / 58 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28394820
[Au] Autor:Seña AC; Donovan J; Swygard H; Clymore J; Mobley V; Sullivan K; LeViere A; Heine A; Quinlivan EB
[Ad] Endereço:*Department of Medicine, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC; †NC Department of Health and Human Services, Communicable Disease Branch, Raleigh, NC; and ‡Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, NC.
[Ti] Título:The North Carolina HIV Bridge Counselor Program: Outcomes From a Statewide Level Intervention to Link and Reengage HIV-Infected Persons in Care in the South.
[So] Source:J Acquir Immune Defic Syndr;76(1):e7-e14, 2017 Sep 01.
[Is] ISSN:1944-7884
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To improve the HIV continuum of care, a team of field service interventionists (State Bridge Counselors, SBC) was developed through a state public health system and provided brief (1-2) contacts for linkage of newly diagnosed persons with HIV and reengagement of persons living with HIV (PLWH) who were not in care. SETTING: North Carolina, United States. METHODS: Service data from January 2013 to June 2015 were analyzed to determine characteristics of clients referred to SBCs, proportions linked or reengaged in care, and/or achieved viral load suppression (VLs). We evaluated associations between client characteristics and outcomes using multivariable analyses and estimated odds ratios (OR) with 95% confidence intervals (CI). RESULTS: SBCs provided linkage services to 299 newly diagnosed individuals and reengagement services to 606 PLWH throughout North Carolina. Among persons who received linkage services, 189 (63%) had evidence of care within 90 days of referral and 205 (69%) had VLs within a year. Among PLWH who received reengagement services, 278 (46%) had care within 90 days and 308 (51%) had VLs within a year. Persons aged 30-39 years (OR, 2.1; 95% CI, 1.1 to 3.9) and 40-49 years had an increased likelihood (OR, 2.4; 95% CI, 1.1 to 5.2) of linkage within 90 days compared with persons aged 18-29 years. Non-white PLWH had an increased OR of 1.7; (95% CI, 1.2 to 2.5) of reengagement compared with whites. CONCLUSIONS: Our SBC program successfully implemented a "low-touch" approach to provision of linkage and reengagement services, demonstrating that public health resources can be used to address the HIV care continuum on a statewide level.
[Mh] Termos MeSH primário: Continuidade da Assistência ao Paciente/organização & administração
Aconselhamento Diretivo/organização & administração
Prática Clínica Baseada em Evidências/organização & administração
Infecções por HIV/terapia
Encaminhamento e Consulta/organização & administração
[Mh] Termos MeSH secundário: Adulto
Contagem de Linfócito CD4
Conselheiros
Grupos Étnicos
Feminino
Infecções por HIV/epidemiologia
Seres Humanos
Masculino
Meia-Idade
North Carolina/epidemiologia
Avaliação de Programas e Projetos de Saúde
Apoio Social
Carga Viral
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170411
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000001389


  5 / 58 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28335765
[Au] Autor:Joe GW; Becan JE; Knight DK; Flynn PM
[Ad] Endereço:Institute of Behavioral Research, Texas Christian University, TCU Box 298740, Fort Worth, TX, 76129, USA. g.joe@tcu.edu.
[Ti] Título:A structural model of treatment program and individual counselor leadership in innovation transfer.
[So] Source:BMC Health Serv Res;17(1):230, 2017 Mar 23.
[Is] ISSN:1472-6963
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A number of program-level and counselor-level factors are known to impact the adoption of treatment innovations. While program leadership is considered a primary factor, the importance of leadership among clinical staff to innovation transfer is less known. Objectives included explore (1) the influence of two leadership roles, program director and individual counselor, on recent training activity and (2) the relationship of counselor attributes on training endorsement. METHODS: The sample included 301 clinical staff in 49 treatment programs. A structural equation model was evaluated for key hypothesized relationships between exogenous and endogenous variables related to the two leadership roles. RESULTS: The importance of organizational leadership, climate, and counselor attributes (particularly counseling innovation interest and influence) to recent training activity was supported. In a subset of 68 counselors who attended a developer-led training on a new intervention, it was found that training endorsement was higher among those with high innovation interest and influence. CONCLUSIONS: The findings suggest that each leadership level impacts the organization in different ways, yet both can promote or impede technology transfer.
[Mh] Termos MeSH primário: Aconselhamento
Difusão de Inovações
Liderança
Transferência de Tecnologia
[Mh] Termos MeSH secundário: Conselheiros
Pessoal de Saúde/educação
Seres Humanos
Capacitação em Serviço
Modelos Organizacionais
Inovação Organizacional
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170325
[St] Status:MEDLINE
[do] DOI:10.1186/s12913-017-2170-y


  6 / 58 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28135658
[Au] Autor:Braude L; Laidsaar-Powell R; Gilchrist J; Kirsten L; Juraskova I
[Ad] Endereço:School of Psychology, The University of Sydney, NSW, Australia. Electronic address: lbra9325@uni.sydney.edu.au.
[Ti] Título:An exploration of Australian psychologists' role in assessing women considering risk-reducing or contralateral prophylactic mastectomy.
[So] Source:Breast;32:105-111, 2017 Apr.
[Is] ISSN:1532-3080
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Given increasing rates of risk-reducing mastectomies (RRM) and contralateral prophylactic mastectomies (CPM), and the potentially significant psychological sequelae of this irreversible procedure, health professionals (HPs) regularly refer patients to psychologists for pre-operative assessment and support. This is the first study to provide qualitative insights from HPs into the role of psychologists who are working with women considering RRM or CPM. MATERIALS AND METHODS: 24 HPs (psychologists, surgeons, breast care nurses and genetic counsellors) experienced in treating patients before or after RRM/CPM completed semi-structured interviews (n = 15) or participated in a focus group (n = 10). Interviews were qualitatively analysed using Framework methods. RESULTS: Qualitative analysis revealed four interconnected themes: (1) perceived patient motivation to undergo RRM/CPM; (2) HP reasons for psychologist referral; (3) role of the psychologist; and (4) value of psychologist involvement. The reported psychologist role included: mental health assessment, checking understanding of information, ensuring informed decision-making, preparation for the procedure, and management of post-surgical challenges. CONCLUSION: Psychologists are perceived by HPs to have a key role in the multi-disciplinary care of patients considering RRM or CPM.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Neoplasias da Mama/prevenção & controle
Equipe de Assistência ao Paciente
Papel Profissional
Mastectomia Profilática/psicologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Austrália
Neoplasias da Mama/psicologia
Conselheiros
Tomada de Decisões
Feminino
Grupos Focais
Seres Humanos
Masculino
Meia-Idade
Enfermagem Oncológica
Papel do Médico
Psicologia
Pesquisa Qualitativa
Radioterapia (Especialidade)
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170320
[Lr] Data última revisão:
170320
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170131
[St] Status:MEDLINE


  7 / 58 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27988144
[Au] Autor:Nadkarni A; Weobong B; Weiss HA; McCambridge J; Bhat B; Katti B; Murthy P; King M; McDaid D; Park AL; Wilson GT; Kirkwood B; Fairburn CG; Velleman R; Patel V
[Ad] Endereço:Sangath Centre, Socorro Village, Bardez-Goa, Goa, India; London School of Hygiene & Tropical Medicine, London, UK.
[Ti] Título:Counselling for Alcohol Problems (CAP), a lay counsellor-delivered brief psychological treatment for harmful drinking in men, in primary care in India: a randomised controlled trial.
[So] Source:Lancet;389(10065):186-195, 2017 01 14.
[Is] ISSN:1474-547X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although structured psychological treatments are recommended as first-line interventions for harmful drinking, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of Counselling for Alcohol Problems (CAP), a brief psychological treatment delivered by lay counsellors to patients with harmful drinking attending routine primary health-care settings. METHODS: In this randomised controlled trial, we recruited male harmful drinkers defined by an Alcohol Use Disorders Identification Test (AUDIT) score of 12-19 who were aged 18-65 years from ten primary health centres in Goa, India. We excluded patients who needed emergency medical treatment or inpatient admission, who were unable to communicate clearly, and who were intoxicated at the time of screening. Participants were randomly allocated (1:1) by trained health assistants based at the primary health centres to enhanced usual care (EUC) alone or EUC combined with CAP, in randomly sized blocks of four to six, stratified by primary health centre, and allocation was concealed with use of sequential numbered opaque envelopes. Physicians providing EUC and those assessing outcomes were masked. Primary outcomes were remission (AUDIT score of <8) and mean daily alcohol consumed in the past 14 days, at 3 months. Secondary outcomes were the effect of drinking, disability score, days unable to work, suicide attempts, intimate partner violence, and resource use and costs of illness. Analyses were on an intention-to-treat basis. We used logistic regression analysis for remission and zero-inflated negative binomial regression analysis for alcohol consumption. We assessed serious adverse events in the per-protocol population. This trial is registered with the ISCRTN registry, number ISRCTN76465238. FINDINGS: Between Oct 28, 2013, and July 29, 2015, we enrolled and randomly allocated 377 participants (188 [50%] to the EUC plus CAP group and 190 [50%] to the EUC alone group [one of whom was subsequently excluded because of a protocol violation]), of whom 336 (89%) completed the 3 month primary outcome assessment (164 [87%] in the EUC plus CAP group and 172 [91%] in the EUC alone group). The proportion with remission (59 [36%] of 164 in the EUC plus CAP group vs 44 [26%] of 172 in the EUC alone group; adjusted prevalence ratio 1·50 [95% CI 1·09-2·07]; p=0·01) and the proportion abstinent in the past 14 days (68 [42%] vs 31 [18%]; adjusted odds ratio 3·00 [1·76-5·13]; p<0·0001) were significantly higher in the EUC plus CAP group than in the EUC alone group, but we noted no effect on mean daily alcohol consumed in the past 14 days among those who reported drinking in this period (37·0 g [SD 44·2] vs 31·0 g [27·8]; count ratio 1·08 [0·79-1·49]; p=0·62). We noted an effect on the percentage of days abstinent in the past 14 days (adjusted mean difference [AMD] 16·0% [8·1-24·1]; p<0·0001), but no effect on the percentage of days of heavy drinking (AMD -0·4% [-5·7 to 4·9]; p=0·88), the effect of drinking (Short Inventory of Problems score AMD-0·03 [-1·93 to 1·86]; p=0.97), disability score (WHO Disability Assessment Schedule score AMD 0·62 [-0·62 to 1·87]; p=0·32), days unable to work (no days unable to work adjusted odds ratio 1·02 [0·61-1·69]; p=0.95), suicide attempts (adjusted prevalence ratio 1·8 [-2·4 to 6·0]; p=0·25), and intimate partner violence (adjusted prevalence ratio 3·0 [-10·4 to 4·4]; p=0·57). The incremental cost per additional remission was $217 (95% CI 50-1073), with an 85% chance of being cost-effective in the study setting. We noted no significant difference in the number of serious adverse events between the two groups (six [4%] in the EUC plus CAP group vs 13 [8%] in the EUC alone group; p=0·11). INTERPRETATION: CAP delivered by lay counsellors plus EUC was better than EUC alone was for harmful drinkers in routine primary health-care settings, and might be cost-effective. CAP could be a key strategy to reduce the treatment gap for alcohol use disorders, one of the leading causes of the global burden among men worldwide. FUNDING: Wellcome Trust.
[Mh] Termos MeSH primário: Consumo de Bebidas Alcoólicas/prevenção & controle
Alcoolismo/terapia
Aconselhamento/economia
Conselheiros
Atenção Primária à Saúde/métodos
Psicoterapia/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Consumo de Bebidas Alcoólicas/efeitos adversos
Consumo de Bebidas Alcoólicas/economia
Consumo de Bebidas Alcoólicas/psicologia
Alcoolismo/psicologia
Protocolos Clínicos
Análise Custo-Benefício
Seres Humanos
Índia
Masculino
Meia-Idade
Atenção Primária à Saúde/economia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170410
[Lr] Data última revisão:
170410
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161219
[St] Status:MEDLINE


  8 / 58 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27988143
[Au] Autor:Patel V; Weobong B; Weiss HA; Anand A; Bhat B; Katti B; Dimidjian S; Araya R; Hollon SD; King M; Vijayakumar L; Park AL; McDaid D; Wilson T; Velleman R; Kirkwood BR; Fairburn CG
[Ad] Endereço:Sangath Centre, Socorro Village, Bardez-Goa, Goa, India; Centre for Global Mental Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK. Electronic address: vikram.patel@lshtm.ac.uk.
[Ti] Título:The Healthy Activity Program (HAP), a lay counsellor-delivered brief psychological treatment for severe depression, in primary care in India: a randomised controlled trial.
[So] Source:Lancet;389(10065):176-185, 2017 01 14.
[Is] ISSN:1474-547X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although structured psychological treatments are recommended as first-line interventions for depression, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of a brief psychological treatment (Healthy Activity Program [HAP]) for delivery by lay counsellors to patients with moderately severe to severe depression in primary health-care settings. METHODS: In this randomised controlled trial, we recruited participants aged 18-65 years scoring more than 14 on the Patient Health Questionnaire 9 (PHQ-9) indicating moderately severe to severe depression from ten primary health centres in Goa, India. Pregnant women or patients who needed urgent medical attention or were unable to communicate clearly were not eligible. Participants were randomly allocated (1:1) to enhanced usual care (EUC) alone or EUC combined with HAP in randomly sized blocks (block size four to six [two to four for men]), stratified by primary health centre and sex, and allocation was concealed with use of sequential numbered opaque envelopes. Physicians providing EUC were masked. Primary outcomes were depression symptom severity on the Beck Depression Inventory version II and remission from depression (PHQ-9 score of <10) at 3 months in the intention-to-treat population, assessed by masked field researchers. Secondary outcomes were disability, days unable to work, behavioural activation, suicidal thoughts or attempts, intimate partner violence, and resource use and costs of illness. We assessed serious adverse events in the per-protocol population. This trial is registered with the ISRCTN registry, number ISRCTN95149997. FINDINGS: Between Oct 28, 2013, and July 29, 2015, we enrolled and randomly allocated 495 participants (247 [50%] to the EUC plus HAP group [two of whom were subsequently excluded because of protocol violations] and 248 [50%] to the EUC alone group), of whom 466 (95%) completed the 3 month primary outcome assessment (230 [49%] in the EUC plus HAP group and 236 [51%] in the EUC alone group). Participants in the EUC plus HAP group had significantly lower symptom severity (Beck Depression Inventory version II in EUC plus HAP group 19·99 [SD 15·70] vs 27·52 [13·26] in EUC alone group; adjusted mean difference -7·57 [95% CI -10·27 to -4·86]; p<0·0001) and higher remission (147 [64%] of 230 had a PHQ-9 score of <10 in the HAP plus EUC group vs 91 [39%] of 236 in the EUC alone group; adjusted prevalence ratio 1·61 [1·34-1·93]) than did those in the EUC alone group. EUC plus HAP showed better results than did EUC alone for the secondary outcomes of disability (adjusted mean difference -2·73 [-4·39 to -1·06]; p=0·001), days out of work (-2·29 [-3·84 to -0·73]; p=0·004), intimate partner physical violence in women (0·53 [0·29-0·96]; p=0·04), behavioural activation (2·17 [1·34-3·00]; p<0·0001), and suicidal thoughts or attempts (0·61 [0·45-0·83]; p=0·001). The incremental cost per quality-adjusted life-year gained was $9333 (95% CI 3862-28 169; 2015 international dollars), with an 87% chance of being cost-effective in the study setting. Serious adverse events were infrequent and similar between groups (nine [4%] in the EUC plus HAP group vs ten [4%] in the EUC alone group; p=1·00). INTERPRETATION: HAP delivered by lay counsellors plus EUC was better than EUC alone was for patients with moderately severe to severe depression in routine primary care in Goa, India. HAP was readily accepted by this previously untreated population and was cost-effective in this setting. HAP could be a key strategy to reduce the treatment gap for depressive disorders, the leading mental health disorder worldwide. FUNDING: Wellcome Trust.
[Mh] Termos MeSH primário: Conselheiros
Transtorno Depressivo Maior/terapia
Atenção Primária à Saúde/métodos
Psicoterapia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Feminino
Seres Humanos
Índia
Masculino
Meia-Idade
Atenção Primária à Saúde/economia
Escalas de Graduação Psiquiátrica
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170410
[Lr] Data última revisão:
170410
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161219
[St] Status:MEDLINE


  9 / 58 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27722995
[Au] Autor:Eisler I; Flinter F; Grey J; Hutchison S; Jackson C; Longworth L; MacLeod R; McAllister M; Metcalfe A; Patch C; Cope B; Robert G; Rowland E; Ulph F
[Ad] Endereço:South London & Maudsley NHS Foundation Trust, London, UK.
[Ti] Título:Training Genetic Counsellors to Deliver an Innovative Therapeutic Intervention: their Views and Experience of Facilitating Multi-Family Discussion Groups.
[So] Source:J Genet Couns;26(2):199-214, 2017 Apr.
[Is] ISSN:1573-3599
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Innovations in clinical genetics have increased diagnosis, treatment and prognosis of inherited genetic conditions (IGCs). This has led to an increased number of families seeking genetic testing and / or genetic counselling and increased the clinical load for genetic counsellors (GCs). Keeping pace with biomedical discoveries, interventions are required to support families to understand, communicate and cope with their Inherited Genetic Condition. The Socio-Psychological Research in Genomics (SPRinG) collaborative have developed a new intervention, based on multi-family discussion groups (MFDGs), to support families affected by IGCs and train GCs in its delivery. A potential challenge to implementing the intervention was whether GCs were willing and able to undergo the training to deliver the MFDG. In analysing three multi-perspective interviews with GCs, this paper evaluates the training received. Findings suggests that MFDGs are a potential valuable resource in supporting families to communicate genetic risk information and can enhance family function and emotional well-being. Furthermore, we demonstrate that it is feasible to train GCs in the delivery of the intervention and that it has the potential to be integrated into clinical practice. Its longer term implementation into routine clinical practice however relies on changes in both organisation of clinical genetics services and genetic counsellors' professional development.
[Mh] Termos MeSH primário: Conselheiros/educação
Educação Médica/normas
Família
Aconselhamento Genético/métodos
Doenças Genéticas Inatas
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161011
[St] Status:MEDLINE
[do] DOI:10.1007/s10897-016-0008-0


  10 / 58 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27507247
[Au] Autor:Kim K
[Ad] Endereço:School of Theology, The Southern Baptist Theological Seminary, 2825 Lexington Rd., Louisville, KY, 40280, USA. kyukim01@gmail.com.
[Ti] Título:The Power of Being Vulnerable in Christian Soul Care: Common Humanity and Humility.
[So] Source:J Relig Health;56(1):355-369, 2017 Feb.
[Is] ISSN:1573-6571
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Soul caregivers often hesitate to be vulnerable in their pastoral practices. Jesus, however, embraced his vulnerabilities as a human to redeem humanity even though he was the Son of God. This paper first explores the dynamics of shame and power that make soul caregivers reluctant to accept their vulnerabilities and then describes the contributions of sharing caregiver's vulnerabilities in a soul care practice. This article argues that being vulnerable allows a soul caregiver to imitate Jesus by sharing in the client's common humanity, initiating an authentic relationship between the client and the soul caregiver; it is also a practice of humility, inviting God's cure in soul care. This study proposes the necessity of embracing vulnerability in soul care ministry, instead of hiding it.
[Mh] Termos MeSH primário: Atitude
Clero/psicologia
Conselheiros/psicologia
Assistência Religiosa
Poder (Psicologia)
[Mh] Termos MeSH secundário: Seres Humanos
Vergonha
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171027
[Lr] Data última revisão:
171027
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160811
[St] Status:MEDLINE
[do] DOI:10.1007/s10943-016-0294-8



página 1 de 6 ir para página                
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde