RESUMEN
Parents Plus (PP) programs are systemic, solution-focused, group-based interventions. They are designed for delivery in clinical and community settings as treatment programs for families with child-focused problems, such as behavioral difficulties, disruptive behavior disorders, and emotional disorders in young people with and without developmental disabilities. PP programs have been developed for families of preschoolers, preadolescent children, and teenagers, as well as for separated or divorced families. Seventeen evaluation studies involving over 1,000 families have shown that PP programs have a significant impact on child behavior problems, goal attainment, and parental satisfaction and stress. The effect size of 0.57 (p < .001) from a meta-analysis of 10 controlled studies for child behavior problems compares favorably with those of meta-analyses of other well-established parent training programs with large evidence bases. In controlled studies, PP programs yielded significant (p < .001) effect sizes for goal attainment (d = 1.51), parental satisfaction (d = 0.78), and parental stress reduction (d = 0.54). PP programs may be facilitated by trained front-line mental health and educational professionals.
Asunto(s)
Trastornos de la Conducta Infantil , Responsabilidad Parental , Padres/educación , Adolescente , Niño , Preescolar , Femenino , Humanos , MasculinoRESUMEN
UNLABELLED: This study is a first-level evaluation of a family intervention targeted at adolescents with social, emotional and behavioural difficulties (SEBD) attending Child and Adolescent Mental Health Services (CAMHS) in Ireland. It is a combined implementation of the Working Things Out adolescent programme and the Parents Plus Adolescent Programme (WTOPPAP). METHOD: A total of 93 adolescents aged 11-17 years (M = 14.64, SD = 1.31; 39% male) and their parents took part in the study. The study used a quasi-experimental One-Group Pretest-Posttest design to assess change from pre- to post-intervention using the Strengths and Difficulties Questionnaire, the McMaster General Functioning Scale, Goal Attainment, Parent Stress Scale and the Kansas Parenting Satisfaction Scale. Both parent- and adolescent-rated goal attainment and general family functioning improved from pre- to post-intervention. Parents also rated their satisfaction with parenting as having significantly improved. Adolescent-rated emotional difficulties significantly improved for the overall sample and parent-rated child total difficulties for female adolescents significantly improved from pre-test to post-test. Parents of female adolescents also reported a significant drop in parental stress. These findings indicate that the WTOPPAP may be an effective intervention for adolescents with SEBD, particularly females, and their parents. Further implications are discussed.
Asunto(s)
Ansiedad/terapia , Trastornos de la Conducta Infantil/terapia , Depresión/terapia , Terapia Familiar/métodos , Padres/psicología , Adolescente , Servicios de Salud del Adolescente , Ansiedad/psicología , Niño , Trastornos de la Conducta Infantil/psicología , Servicios de Salud del Niño , Depresión/psicología , Emociones , Femenino , Objetivos , Humanos , Masculino , Servicios de Salud Mental , Satisfacción Personal , Problema de Conducta/psicología , Estrés Psicológico/psicología , Estrés Psicológico/terapiaRESUMEN
This study is a first-level evaluation of an intervention targeted at adolescents with social, emotional and behavioural difficulties in Irish post-primary schools. It is a combined implementation of the Working Things Out adolescent programme and the Parents Plus Adolescent Programme (WTOPPAP). Overall, 47 parents and their children (mean age: 13.81 years) took part in the study. The study used a repeated measures design to assess change at pre- and post-intervention and 5-month follow-up using the Strengths and Difficulties Questionnaire, McMaster General Functioning Scale, Goal Attainment (parent- and adolescent-rated), Parent Stress Scale and Kansas Parenting Satisfaction Scale (parent-rated) as assessment measures. This study found that parent-rated child total difficulties and adolescent-rated emotional difficulties significantly improved from pre-test to 5-month follow-up. Parent- and adolescent-rated goals, and parent-rated child conduct difficulties, parental stress and satisfaction with parenting also significantly improved from pre- to post-test. These gains were largely maintained at 5-month follow-up. These findings indicate that the WTOPPAP may be an effective intervention for adolescents with emotional and behavioural difficulties and their parents. It was demonstrated that a manualised family intervention could be effectively rolled out at a number of school locations, with delivery and evaluation being conducted by school staff. Further implications are also discussed.
Asunto(s)
Conducta del Adolescente/psicología , Conducta Infantil/psicología , Terapia Familiar/métodos , Evaluación de Resultado en la Atención de Salud , Problema de Conducta/psicología , Adolescente , Adulto , Niño , Femenino , Estudios de Seguimiento , Humanos , Masculino , Servicios de Salud EscolarRESUMEN
BACKGROUND: Malignant bowel obstruction (MBO) is a common condition among palliative patients and has limited management options. There is a paucity of widely accepted national and international evidence-based guidelines to direct the management of MBO in palliative patients. OBJECTIVE: The aim of this study was to survey current practice in New Zealand of nonopioid pharmacological management of MBO and compare it with the available literature. METHODS: The study utilized a survey consisting of three scenarios: probable incomplete malignant bowel obstruction (PIMBO), incomplete malignant bowel obstruction (IMBO), and complete malignant bowel obstruction (CMBO). An online survey was conducted over 2 months targeting palliative medicine practitioners working in a hospital, hospice inpatient unit, or community setting in New Zealand. RESULTS: Forty-eight doctors responded. Of the respondents, 56.3% used guidelines to manage MBO; however, 88.9% of the guidelines used were locally generated at the doctor's institution. Metoclopramide was the drug of choice in treating PIMBO, whereas haloperidol and hyoscine butylbromide (HB) were the preferred drugs as the severity of bowel obstruction increased. Dexamethasone was accepted as standard practice for managing all severities of MBO. A variation in the preferred starting and maximum dose of all the drugs was seen. There was a decrease in the use of laxatives and enemas as the severity of MBO increased. CONCLUSION: Variation in practice for managing MBO was evident among doctors in New Zealand. There is a need for national and international evidence-based guidelines to help define best management for the differing severities of this problematic condition.
Asunto(s)
Neoplasias Gastrointestinales/tratamiento farmacológico , Obstrucción Intestinal/tratamiento farmacológico , Cuidados Paliativos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Antieméticos/uso terapéutico , Antagonistas Colinérgicos/uso terapéutico , Dexametasona/uso terapéutico , Enema/estadística & datos numéricos , Femenino , Adhesión a Directriz , Haloperidol/uso terapéutico , Humanos , Laxativos/uso terapéutico , Masculino , Metoclopramida/uso terapéutico , Persona de Mediana Edad , Nueva Zelanda , Escopolamina/uso terapéutico , Encuestas y CuestionariosRESUMEN
This paper presents findings from a research study of two objective structured clinical skills evaluation (OSCE) processes that were used in the new BSc. in General and Psychiatric Nursing Registration programmes offered in an Institute of Technology in the south west of Ireland. OSCEs, which have gained widespread acceptance throughout the western world as valid academic measures of nursing competence has yet to be established in this country. This research aimed to evaluate the process and outcomes of OSCE from the perspective of the major stakeholder groups: first and second year nursing students, lecturers, clinical placement coordinators and assessors. A utilisation focussed evaluation approach was adopted which values the opinions and experiences of stakeholders. It is intended to use the findings to develop the validity and quality of the OSCE assessment. The OSCE process was found to have a positive impact on all stakeholders. OSCEs were perceived to be a meaningful and fair form of assessment. Students identified that they felt more prepared for and more confident about forthcoming placements. The OSCE process was, however, perceived to be a stressful experience and requires considerable preparation effort by students and academic staff. Mature students claimed that more practice effort was required but also felt more prepared for placements and achieved higher OSCE scores.