RESUMEN
The prevalence of behavioural problems in nursing home residents with dementia is high. Knowledge based on practical experiences suggests that problems diminish when caregivers are better able to recognize and acknowledge the individual psychosocial needs of residents. Dementia Care Mapping (DCM) is a method designed to support caregivers in providing person centered care. After implementing two DCM-cycli in a Dutch care facility changes in behaviour and level of agitation of clients with dementia and changes in job satisfaction of caregivers were evaluated in a One-Group Pretest-Posttest design. The GIP-28 (Dutch Behavioral Rating Scale for Psychogeriatric Inpatients) and the CMAI (Cohen Mansfield Agitation Inventory) were used to measure potential changes in behaviour and level of agitation of the clients. The MAS-GZ (Maastricht Scale of Satisfaction with Labour in Health Care) was used to measure potential changes in job satisfaction of caregivers. The data of 45 clients with dementia and 27 caregivers were analyzed. They stayed and worked in seven different wards of the care facility including day-care for clients who were still living at home, group care and small-scale-living care for residential clients. The results of this pilot study show that problems related to affective behaviour (subscale GIP-28: emotions of anxiety, mistrust and melancholy) as well as verbal agitation (subscale CMAI: excessively asking for attention, complaining and negativism) decreased in the group clients with dementia. No changes occurred in the other subscales and in the total score of the GIP-28 and CMAI. The overall job satisfaction of caregivers did not change, but their contentment with the extent to which they feel connected with clients improved. In conclusion, the results of this pilot study indicate that implementing DCM in care facilities for persons with dementia could have some positive consequences for both clients and caregivers. A large-scale controlled trial including diagnosis and stage of dementia as baseline measures, is recommended.
Asunto(s)
Demencia/psicología , Hogares para Ancianos , Satisfacción en el Trabajo , Casas de Salud , Personal de Enfermería/psicología , Atención Dirigida al Paciente/normas , Adulto , Anciano , Anciano de 80 o más Años , Conducta , Cuidadores/psicología , Femenino , Humanos , Masculino , Países Bajos , Proyectos Piloto , Calidad de la Atención de Salud , Índice de Severidad de la EnfermedadRESUMEN
The objective of this study was to examine whether it is through their low control beliefs that low socio-economic status groups have higher risks of heart disease, and to examine whether this mechanism is more substantial than and independent of the mechanism via classical coronary risk factors. In a population-based prospective cohort study, participants were selected from 27 general practices in the north-eastern part of The Netherlands. In 1993, there were 3888 men and women, 57 years and older, who were without prevalent heart disease. During the 5-year follow-up period, 287 cases of incident heart disease (acute myocardial infarction and/or congestive heart failure) were registered (7%). Persons with a low socio-economic status had higher risks of heart disease (RR = 1.45 (95% CI: 1.06 - 1.99)) compared with their high status counterparts. On average, 4 percent of the socio-economic differences were accounted for by the classical coronary risk factors (e.g. smoking, hypertension) compared with 30 percent by the control beliefs. The contribution of the latter was largely independent of the former. Our findings support the hypothesis that socio-economic inequalities in heart disease-at least in middle-aged and older persons-may be based upon differences in control beliefs, more than upon differences in smoking rates and other classical risk factors.
Asunto(s)
Cardiopatías/epidemiología , Cardiopatías/psicología , Control Interno-Externo , Factores de Edad , Escolaridad , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Estudios Prospectivos , Factores de Riesgo , Factores Sexuales , Fumar/epidemiología , Factores Socioeconómicos , Encuestas y CuestionariosRESUMEN
This paper describes self-reported health problems among 2616 Slovak adolescents (52.4% boys, 47.6% girls). Adolescents consider their health as very good in general. They often feel 'vital', and rarely feel depressed or irritated. However, the psychological health of more than 20% of the boys and 40% of the girls was unsatisfactory. Furthermore, a sizeable number suffered from separate physical complaints, chronic diseases or used medical services. Findings are more unfavourable for girls in comparison with boys. Our findings indicate that adolescence is not such a healthy period in human life as is often considered. The Slovak Republic, a Central European country, does not differ in this respect from Western European countries.
Asunto(s)
Estado de Salud , Trastornos Mentales/epidemiología , Psicología del Adolescente , Adolescente , Conducta del Adolescente , Distribución de Chi-Cuadrado , Femenino , Servicios de Salud/estadística & datos numéricos , Indicadores de Salud , Humanos , Estudios Longitudinales , Masculino , Prevalencia , Escalas de Valoración Psiquiátrica , Psicometría , Autoevaluación (Psicología) , Eslovaquia/epidemiologíaRESUMEN
Socio-economic differences in risk behaviors in adolescence can be seen as a prelude to the re-emergence of socio economic health differences in adulthood. We studied whether or not socio-economic differences in health risk behaviors are present in male and female adolescents in The Netherlands. The relation between socio-economic status (SES) and health risk behaviors was examined, by testing both the main and interaction effects of SES and gender on separate health risk behaviors on one hand, and on the behaviors cumulatively on the other. The data were derived from 1984 adolescents in the four northern provinces of The Netherlands. SES was measured by means of the educational level and the occupational status of both parents. Four health risk behaviors were included in this study: smoking, alcohol consumption, soft drug use, and (no) physical exercise. We found that the relationships between SES and health risk behaviors are not as linear as is often found in adulthood. Our findings can be characterised overall by an absence of relationship between SES and health risk behaviors. The only exception applies to sport, which is linearly related to SES. Adolescents in the lower SES groups engage in sport less than adolescents in the higher SES groups. There was an irregular relationship between the father's occupational status and the adolescents' smoking and drinking. Adolescents in the highest, lowest and middle of the six SES groups have the highest rates of health risk behaviors. All observed relationships are similar for both male and female adolescents. A relationship between gender and the separate health risk behaviors was found only for alcohol consumption and drug use. For both male adolescents showed higher rates of risk behavior. Males also scored higher on the cumulative health risk behaviors than their female counterparts. The findings of this study do not support the hypothesis of latent differences in adolescence.