psychosocial intervention

心理社会干预
  • 文章类型: Journal Article
    目的:关于拉丁美洲工作场所心理暴力(PVW)的研究集中在发生率上。相比之下,关于卫生部门预防性干预措施(PIs)的研究非常有限。我们的目标是确定在秘鲁卫生机构中预防PVW的心理社会干预措施的最相关特征达成共识的程度。为此,在国家一级招募了具有PVW知识和经验的卫生专业人员,并应用了德尔菲共识技术。
    结果:共识研究分为四个阶段,包括三个阶段的德尔菲会诊。在第三个协商阶段,428名专家参加了来自该国66个卫生机构的25个分析小组。共有70.3%的参与者是女性,27.6%的参与者从事护理和急救服务。经过德尔菲共识分析,我们获得了在该国预防PVW的10种分级心理社会干预措施的列表.最值得注意的是基于先前解决职业间冲突的干预措施,事件的可见性以产生相反的效果,以及体验式培训以提高自信和共情的沟通技巧。
    OBJECTIVE: Studies on psychological violence in the workplace (PVW) in Latin America have focused on incidence values. In contrast, studies on preventive interventions (PIs) in the health sector are very limited. Our objective was to determine to what extent there is consensus on the most relevant characteristics of the psychosocial interventions applied in the prevention of PVW in health institutions in Peru. To that end, health professionals with knowledge and experience in PVW at the national level were recruited, and the Delphi consensus technique was applied.
    RESULTS: The consensus study was developed in four stages that included three phases of Delphi consultation. In the third consultation phase, 428 experts participated in 25 analysis groups from 66 health institutions in the country. A total of 70.3% of the participants were women, and 27.6% of the participants worked in nursing and emergency services. After the Delphi consensus analysis, we obtained a list of 10 hierarchical psychosocial interventions to prevent PVW in the country. Most notable were interventions based on the prior resolution of interprofessional conflicts, on the visibility of incidents to generate an inverse effect and on experiential training to improve assertive and empathic communication skills.
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  • 文章类型: Journal Article
    目的:开发一种减少和预防躁动的算法,旨在指导国际精神病学协会(IPA)制定的躁动定义的实施。
    方法:回顾有关治疗指南和推荐算法的文献;通过反复整合研究信息和专家意见进行算法开发。
    方法:IPA鼓动工作组。
    方法:IPA国际激越专家小组。
    方法:将可用信息整合到一个综合算法中。
    方法:无。
    结果:IPA鼓动工作组建议调查,计划,以及减少和预防躁动的行动(IPA)方法。对行为进行彻底调查后,进行计划和行动,重点是共同决策;根据需要评估和调整计划的成功。重复该过程,直到搅拌降低到可接受的水平,并优化复发的预防。心理社会干预是每个计划的一部分,并在整个过程中持续进行。药物干预分为夜间/昼夜节律躁动的选择小组;轻度-中度躁动或具有突出情绪特征的躁动;中度-重度躁动;严重躁动,对患者或其他人有危险伤害。每个小组都提供了治疗替代方案。在各种场所-家庭中发生的躁动,疗养院,急诊科,介绍了临终关怀和治疗方法的调整。
    结论:IPA对躁动的定义被实施为一种躁动管理算法,该算法强调社会心理和药物干预的整合,对治疗反应的反复评估,调整治疗方法以反映临床情况,共同决策。
    OBJECTIVE: To develop an agitation reduction and prevention algorithm is intended to guide implementation of the definition of agitation developed by the International Psychogeriatric Association (IPA).
    METHODS: Review of literature on treatment guidelines and recommended algorithms; algorithm development through reiterative integration of research information and expert opinion.
    METHODS: IPA Agitation Workgroup.
    METHODS: IPA panel of international experts on agitation.
    METHODS: Integration of available information into a comprehensive algorithm.
    METHODS: None.
    RESULTS: The IPA Agitation Work Group recommends the Investigate, Plan, and Act (IPA) approach to agitation reduction and prevention. A thorough investigation of the behavior is followed by planning and acting with an emphasis on shared decision-making; the success of the plan is evaluated and adjusted as needed. The process is repeated until agitation is reduced to an acceptable level and prevention of recurrence is optimized. Psychosocial interventions are part of every plan and are continued throughout the process. Pharmacologic interventions are organized into panels of choices for nocturnal/circadian agitation; mild-moderate agitation or agitation with prominent mood features; moderate-severe agitation; and severe agitation with threatened harm to the patient or others. Therapeutic alternatives are presented for each panel. The occurrence of agitation in a variety of venues-home, nursing home, emergency department, hospice-and adjustments to the therapeutic approach are presented.
    CONCLUSIONS: The IPA definition of agitation is operationalized into an agitation management algorithm that emphasizes the integration of psychosocial and pharmacologic interventions, reiterative assessment of response to treatment, adjustment of therapeutic approaches to reflect the clinical situation, and shared decision-making.
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  • 文章类型: Letter
    自从COVID-19大流行开始以来,在爱尔兰和国外很少有指导,围绕研究的开展,尤其是随机对照试验(RCT)。这导致对医院进行研究的公共卫生指南的解释不一致。因此,进行RCT的研究人员面临挑战,在招聘和保留方面。这些挑战在心理社会干预的随机对照试验中得到了放大,沟通和身体接触在RCT管理中起着重要作用。因此,从其他研究中学习是很重要的。这项研究解决了在都柏林爱尔兰的两个儿科门诊糖尿病诊所中进行心理社会干预的RCT所面临的挑战,包括克服这些问题的建议。建议包括:(1)承认研究是一项必不可少的服务;(2)医院管理应实施指导方针,以确保在大流行期间采取一致的研究方法;(3)确保在与患者进行临床就诊之前有一个明确有效的沟通机制,让他们放心并获得他们的信任;(4)试验经理应该每天抽出时间与他们的团队进行检查,就像他们在办公室一样。
    Since the beginning of the COVID-19 pandemic, there has been very little guidance in Ireland and abroad, around the conduct of research, and randomised controlled trials (RCTs) in particular. This has led to inconsistent interpretations of public health guidelines for the conduct of research in hospitals. Consequently, challenges have arisen for researchers conducting RCTs, in relation to recruitment and retention. These challenges are amplified for RCTs of psychosocial interventions, where communication and physical contact play a major role in administering the RCT. Therefore, learning from other research studies is important. This study addresses the challenges in administering an RCT of a psychosocial intervention in two paediatric outpatient diabetes clinics in Dublin Ireland, including recommendations to overcome these. Recommendations include the following: (1) recognise research as an essential service; (2) hospital management should implement guidelines to ensure a consistent approach to the conduct of research during pandemics; (3) ensure that there is a mechanism for the provision of clear and effective communication before the clinic visit with patients, to reassure them and gain their trust; and (4) trial managers should make time to check in with their team every day, as they would do if they were in the office.
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    文章类型: Journal Article
    大约30%的精神分裂症患者对一线抗精神病药物治疗没有反应,这影响了疾病的负担。抗治疗精神分裂症(TRS)表示患者对至少两个不同抗精神病药的适当试验没有反应。氯氮平是一种被批准用于治疗难治性精神分裂症的独特药物,然而,1/3的患者对氯氮平无效。尽管已经提出了不同的策略来治疗氯氮平耐药的精神分裂症,证据非常有限,不清楚,质量差。进行了正式的文献检索,然后,小组成员被要求完成35个问题,涉及TRS的不同方面。采用改进的德尔菲法统一专家意见,达成共识。TRS诊断和治疗方面的专家共识是阿根廷生物精神病学协会(AAPB)组织下主要国家科学协会的专家的结果。共识声明旨在指导诊断和治疗。
    Approximately 30% of people with schizophrenia fail to respond to first-line antipsychotic treatment which impacts the burden of the disease. Treatment-resistant schizophrenia (TRS) denotes patients with failure to respond to at least two adequate trials of different antipsychotics. Clozapine is a unique drug approved for treating treatment-resistant schizophrenia, however 1/3 of patients fail to respond to clozapine. Even though different strategies have been proposed for treating clozapine-resistant schizophrenia, the evidence is very limited, unclear, and of poor quality. A formal literature search was conducted and then, panel members were asked to complete 35 questions addressing different aspects of TRS. A modified Delphi method was used to unify expert opinion and achieve consensus. The expert consensus in diagnostic and treatment of TRS is the result of experts from the main national scientific societies under the organization of the Argentine Association of Biological Psychiatric (AAPB). The consensus statement aims to guide on diagnosis and treatment.
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  • 文章类型: Journal Article
    运动损伤已成为真正的健康问题。尤其值得注意的是,年轻人中严重的运动损伤越来越多。运动损伤(SI)是一个多因素的事件,许多内部和外部,近端和远端因素以递归的方式发挥作用,包括生理和心理变量。因此,许多声音表示需要解决这个问题,一些预防方案已经出现。然而,不同的障碍和限制阻止了控制良好的程序的广泛扩展,由普通体育基层组织中高度专业化的专业人员密切监测。这些有助于繁荣不同的低强度(LI)干预和电子健康应用程序,专注于身体热身,训练和健身,和旨在减少运动员对SI的脆弱性的心理技能。这种干预通常使用自我管理的技术和/或非专业人员,可以有效地监控程序。事实上,LI干预已显示出有效应对不同的健康和心理问题。然而,这些干预措施面临着一个重要的挑战:人们通常表现出缺乏参与。本文提出了游戏化如何有助于参与此类干预措施。基于力学-动力学-美学框架分析游戏设计,本文建议一套旨在预防SIs的应用和网络LI干预措施指南应包括培养动机和减少减员。
    Sports injuries have become a real health concern. Particularly noticeable is the increasing number of severe sports injuries among young people. Sports injury (SI) is a multifactorial event where many internal and external, proximal and remote factors play a role in a recursive way, including physical and psychological variables. Accordingly, many voices expressing the need of tackling that and several prevention programs have arisen. Nevertheless, different barriers and limitations prevent a wide extension of well-controlled programs, closely monitored by highly specialized professionals in ordinary sports grass-root organizations. These have helped flourishing different low intensity (LI)-interventions and e-Health apps focusing on both physical warmup, training and fitness, and mental skills aimed at reducing athlete\'s vulnerability to SIs. This kind of intervention usually uses self-administered techniques and/or non-specialized staff that can effectively monitoring the program. In fact, LI-interventions have shown to be effective coping with different health and psychological issues. However, these interventions face an important challenge: the lack of engagement people usually show. The current paper proposes how gamification can contribute to the engagement to such interventions. Based on the mechanics-dynamics-aesthetics framework to analyze game design, the paper suggests a set of guidelines app- and web-LI interventions aimed at preventing SIs should include to foster motivation and reduce attrition.
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  • 文章类型: Journal Article
    Schizophrenia is a lifelong condition with acute exacerbations and varying degrees of functional disability. Acute and long-term treatments are based on antipsychotic drugs, even if some domains of personal and social functioning are not addressed by psychopharmacotherapy. In fact, psychosocial interventions show a positive impact on patient\'s functioning and clinical outcome. In addition, psychosocial interventions are significantly associated with a lower number of relapses and hospitalizations in schizophrenia.
    An analytical review of the International Guidelines on Psychosocial Interventions in Schizophrenia has been performed; we included the National Institute for Health and Care Excellence (NICE) guidelines, the Scottish Intercollegiate Guidelines Network (SIGN) guidelines, the Royal Australian and New Zealand College of Psychiatrists (RANZCP) guidelines, the Schizophrenia Patient Outcomes Research Team (PORT) guidelines and the American Psychiatric Association (APA) guidelines.
    The international guidelines recommend psychosocial interventions as supportive treatments alongside pharmaceutical or psychotherapeutic ones.
    More research studies need to be conducted and included in the updated version of the international guidelines to confirm the effectiveness of psychosocial interventions in the long-term outcome of schizophrenia.
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  • 文章类型: Journal Article
    Advanced cystic fibrosis lung disease (ACFLD) is common, is associated with reduced quality of life, and remains the most frequent cause of death in individuals with cystic fibrosis (CF). These consensus guidelines provide recommendations to the CF community on management of both common and unique issues that arise when individuals reach a state of ACFLD.
    The CF Foundation assembled a multidisciplinary expert panel consisting of three workgroups: Pulmonary management; Management of comorbid conditions; Symptom management and psychosocial issues. Topics were excluded if the management considerations did not differ in ACFLD from in the overall CF population or if already addressed in other published guidelines. Recommendations were based on a systematic literature review combined with expert opinion when appropriate.
    The committee formulated twenty-three recommendation statements specific to ACFLD that address the definition of ACFLD, pulmonary and intensive care unit management, management of selected comorbidities, symptom control, and psychosocial issues.
    These recommendations are intended to be paired with previously published management guidelines for the overall CF population, with the objective of reducing practice variability and improving overall care, quality of life, and survival in those with ACFLD.
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  • 文章类型: Journal Article
    Purpose: We aimed to develop evidence-based practice guidelines that can support decision-making in individual cases and be used by a multidisciplinary team in stroke rehabilitation.Materials and methods: We conducted a literature search (step 1), and a survey of all neurological rehabilitation facilities in Germany concerning their structural working conditions and current practices (step 2). Based on this information, we drafted a first version of the practice guidelines, and discussed them with a group of experts (step 3). We also consulted concurrently with senior psychologists, head physicians (step 4), and patients after stroke (step 5). We revised the guidelines until consensus on the final version was reached (step 6).Results: Referring to the ICF for guidance, the practice guidelines comprise of psychological recommendations in five problem areas (\"Participation - Major Aims of Rehabilitation\", \"Cognition\", \"Affect & Behavior\", \"Risk Factors\", and \"Specific Problems & Aspects\"), and provide preliminary remarks on general frame conditions and procedural requirements. The practice guidelines were widely accepted by head psychologists and physicians of in- and outpatient neurological rehabilitation with an average agreement of 97% (range: 88-100%).Conclusions: Our practice guidelines include detailed recommendations for psychological interventions that can guide individual decision-making by a multidisciplinary team. Specific aspects to foster implementation were considered, and attempts were made to promote their dissemination.Implications for RehabilitationWe developed practice guidelines for psychological interventions in rehabilitation after stroke based on the best available evidence.The practice guidelines include detailed recommendations for psychological interventions that can guide individual decisions by a multidisciplinary team.The practice guidelines are highly specific, and have been widely agreed upon by a group of experts from different professions as well as by researchers, patients, and clinicians (average agreement: 97%).The practice guidelines offer knowledge on different areas of psychological impairment, can help guide diagnostic and therapeutic procedures for individual patients, and thus, improve standard care in neurological rehabilitation.
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  • 文章类型: Journal Article
    It is generally recognised that psychosocial interventions are essential components of the effective treatment of schizophrenia in adults. A considerable body of research is being published regarding the effectiveness of such interventions. In the current article, we derive recommendations reflecting the current state of evidence for their effectiveness.
    Recommendations were formulated on the basis of a review of relevant guidelines, particularly those formulated by the Scottish Intercollegiate Guideline Network (SIGN) and National Institute for Health and Care Excellence (NICE).
    There is evidence strongly supporting the use of family interventions, supported employment programs, and cognitive-behavioural therapy. There are also reasons to recommend the use of cognitive remediation, social skills training, and life skills training under specified circumstances. It is important that all patients and families be provided with education about the nature of schizophrenia and its treatment. Several recent innovative psychosocial approaches to treatment are awaiting more thorough evaluation.
    There continues to be strong evidence for the effectiveness of several psychosocial interventions in improving outcomes for adults with schizophrenia. In the past decade, innovative interventions have been described, several of which are the subject of ongoing evaluative research.
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