RESUMEN
BACKGROUND: We aimed to: (1) examine relationships between the Functional Oral Intake Scale (FOIS), Eating Assessment Tool-10 (EAT-10), and objective measures of swallowing (Modified Barium Swallow Impairment Profile [MBSImP©] and penetration-aspiration scale [PAS]) in patients with head and neck cancer, (2) compare outcomes between oral intake vs tube-dependent patients, and (3) compare outcomes across time points. METHODS: A total of 58 patients with head and neck cancer completed the FOIS, EAT-10, and underwent a standardized videofluoroscopy (VFSS). VFSS were analyzed using the PAS and MBSImP©. Nonparametric analyses were performed. RESULTS: A relationship between the FOIS and EAT-10 (r = -0.46; P < .001) was revealed. No other associations were observed (P < .05). Feeding status did not impact PAS or MBSImP©; however, patients with head and neck cancer who were tube dependent demonstrated higher (worse) EAT-10 scores (P = .01). CONCLUSIONS: In this cohort, a relationship between patient-perceived swallowing impairment and functional oral intake was revealed; however, no associations were observed between the FOIS and objective measures of swallowing impairment or swallowing safety.
Asunto(s)
Trastornos de Deglución/diagnóstico por imagen , Trastornos de Deglución/etiología , Ingestión de Alimentos/fisiología , Neoplasias de Cabeza y Cuello/cirugía , Carcinoma de Células Escamosas de Cabeza y Cuello/cirugía , Grabación en Video/métodos , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Bases de Datos Factuales , Deglución/fisiología , Femenino , Fluoroscopía/métodos , Neoplasias de Cabeza y Cuello/mortalidad , Neoplasias de Cabeza y Cuello/patología , Humanos , Masculino , Persona de Mediana Edad , Medición de Resultados Informados por el Paciente , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Índice de Severidad de la Enfermedad , Carcinoma de Células Escamosas de Cabeza y Cuello/mortalidad , Carcinoma de Células Escamosas de Cabeza y Cuello/patología , Estados UnidosRESUMEN
The present study examined how different patterns of coping influence psychological distress for staff members in programs serving individuals with intellectual disabilities. With a series of path models, we examined the relative usefulness of constructs (i.e., wishful thinking and psychological inflexibility) from two distinct models of coping (i.e., the transactional model and the psychological flexibility models, respectively) as mediators to explain how workplace stressors lead to psychological distress in staff serving individuals with intellectual disabilities. Analyses involved self-report questionnaires from 128 staff members (84% female; 71% African American) from a large, state-funded residential program for individuals with intellectual and physical disabilities in the southern United States of America. Cross-sectional path models using bootstrapped standard errors and confidence intervals revealed both wishful thinking and psychological inflexibility mediated the relation between workplace stressors and psychological distress when they were included in separate models. However, when both variables were included in a multiple mediator model, only psychological inflexibility remained a significant mediator. The results suggest psychological inflexibility and the psychological flexibility model may be particularly useful for further investigation on the causes and amelioration of workplace-related stress in ID settings.
Asunto(s)
Adaptación Psicológica , Cuidadores/psicología , Discapacidad Intelectual/enfermería , Estrés Psicológico/psicología , Adulto , Ansiedad/psicología , Estudios Transversales , Depresión/psicología , Femenino , Humanos , Satisfacción en el Trabajo , Masculino , Persona de Mediana Edad , Modelos Psicológicos , Encuestas y Cuestionarios , Estados Unidos , Lugar de Trabajo , Adulto JovenRESUMEN
INTRODUCTION: Viral gastroenteritis with dehydration is one of the most frequent reasons for visits to pediatric emergency departments (ED). Parental intervention before presentation to the ED can make a significant difference in the course of a child's illness. There is a discrepancy between medical knowledge of dehydration and parental fears and understanding. This project is part of a larger program of research developing an educational tool for parents of preschoolers with diarrhea, vomiting, and dehydration. The primary objective was to develop an interview guide. From initial data, the researchers explored parental motivations for bringing their children to the ED. METHODS: Ten families were recruited after their visit to a pediatric ED in the fall of 2007. Included were families of children younger than 4 years who experienced vomiting, diarrhea, and dehydration. Interviews were conducted over the telephone and were transcribed. The interview guide was edited in an iterative process. RESULTS: Thematic analysis focused on parents' decision to take their child to the ED. Making the decision to take a child to the ED is a complex process for parents. This decision involves expectations developed from community-level, family-level, and child factors. Issues of access to care affect parents' decision, including perceived level of urgency, travel time, and modes of transport available. CONCLUSIONS: A framework is proposed, which outlines the most important factors our sample of parents reported when deciding whether to take their ill child to the ED. The interview guide developed will facilitate collection of further information.