Pragulų profilaktika: mokslo įrodymais pagrįstos rekomendacijos

Pragula apibrėžiama kaip lokalus odos ir (arba) audinių pažeidimas, paprastai virš kaulo iškilumo vietos, kaip pasekmė spaudimo arba spaudimo ir šlyties jėgų kombinacijos. Pragulos yra problema, visų pirma susijusi su blogesne paciento gyvenimo kokybe (diskomfortą sukelia kvapas, skausmas, tvarstymas), sunkesne pacientų slauga (dažniausiai tai yra susiję su papildomo laiko sąnaudomis bei atitinkamų kompetencijų turėjimu), be to, pragulos siejamos su didesniu pacientų mirtingumu dėl įvykusių komplikacijų (vyrauja infekcijos sukeltos komplikacijos).Pragula apibrėžiama kaip lokalus odos ir (arba) audinių pažeidimas, paprastai virš kaulo iškilumo vietos, kaip pasekmė spaudimo arba spaudimo ir šlyties jėgų kombinacijos. Pragulos yra problema, visų pirma susijusi su blogesne paciento gyvenimo kokybe (diskomfortą sukelia kvapas, skausmas, tvarstymas), sunkesne pacientų slauga (dažniausiai tai yra susiję su papildomo laiko sąnaudomis bei atitinkamų kompetencijų turėjimu), be to, pragulos siejamos su didesniu pacientų mirtingumu dėl įvykusių komplikacijų (vyrauja infekcijos sukeltos komplikacijos)

Pirminės sveikatos priežiūros ir socialinių darbuotojų bendradarbiavimas. Praktiniai įgūdžiai

Lietuvos sveikatos mokslų universitetas. Medicinos akademijaSocialinio darbo katedraVytauto Didžiojo universiteta

Insights into the system of care of the elderly with mental disorders from the perspective of informal caregivers in Lithuania

Background: Changes in the demographics and respective growth of life expectancy and social needs make informal caregiving crucial component of comprehensive health and social care network, which substantially contributes to the health and well-being of the elderly. The purpose of this paper is to understand the system of care of elderly patients with mental disorders from the perspective of informal caregivers in Lithuania. Methods: We conducted five semi-structured focus group discussions with 31 informal caregivers attending to elderly patients with mental disorders. The data were audiotaped and transcribed verbatim. A thematic analysis was subsequently performed. Results: Five thematic categories were established: (1) the current state of care-receivers: representation of the complexity of patients' physical and mental condition. (2) The current state of caregivers: lack of formal caregivers' integration as a team; inadequate formal involvement of informal caregivers. (3) Basic care needs: the reflection of the group needs relating directly to the patient, care organisation and the caretaker. (4) The (non-) Readiness of the existing system to respond to the needs for care: long-term care reliance on institutional services, lack of distinction between acute/immediate care and nursing, lack of integration between the medical sector and the social care sector. (5) Potential trends for further improvement of long-term care for the elderly with mental disorders. Conclusions: Strengthening of the care network for elderly patients with mental disorders should cover more than a personalised and comprehensive assessment of the needs of patients and their caregivers. Comprehensive approaches, such as formalization of informal caregivers' role in the patient care management and planning, a more extensive range of available services and programs supported by diverse sources of funding, systemic developments and better integration of health and social care systems ar

Colloboration between social and health care institutions in primary health care (PHC) solving health care problems in social risk families : the ongoing research project

Lietuvos sveikatos mokslų universitetasSocialinio darbo katedraVytauto Didžiojo universiteta

Metodinės rekomendacijos dėl tarpsektorinio bendradarbiavimo stiprinimo pirminės sveikatos priežiūros sistemoje dirbant su socialinės rizikos šeimomis : metodinė mokymo priemonė

Aprobavo Vytauto Didžiojo universiteto Socialinių mokslų fakulteto taryba 2013-10-09. Protokolas Nr. 17.Leidinys parengtas įgyvendinant projektą "Tarpsektorinis bendradarbiavimas sprendžiant sveikatos problemas socialinės rizikos šeimose" (TABESORI), kurį finansuoja Lietuvos mokslo taryba, paraiškos registracijos Nr. SIN-12015, finansavimo sutarties Nr. SIN-13/2012. Recenzentai : Nijolė LiobikienėBibliogr.: p. 31Sveikatos priežiūros ir socialinio sektoriaus bendradarbiavimas yra svarbus, tačiau vis dar nepakankamai naudojamas bendruomenės sveikatos stiprinimo išteklius mūsų šalyje. Glaudesnis tarpsektorinis bendradarbiavimas yra naudingas sprendžiant tiek sveikatos, tiek socialines problemas, ypač dirbant su socialinėje atskirtyje esančiais asmenimis. Tarpsektorinio lygmens iniciatyvų bei gairių, leidžiančių veiksmingiau mobilizuoti turimus išteklius bendrai sveikatos stiprinimo veiklai, stoka trukdo sudaryti plankias sąlygas šeimų labui. Vytauto Didžiojo universiteto (VDU) mokslininkai, bendradarbiaudami su kolegomis iš Lietuvos sveikatos mosklų universiteto (LSMU) Šeimos medicinos klinikos, 2012-2013 metais vykdo mokslinį projektą "Tarpsektorinis bendradarbiavimas sprendžiant sveikatos problemas socialinės rizikos šeimose" (tyrimą finansuoja Lietuvos mokslo taryba, paraiškos registracijos Nr. SIN-12015, finansavimo sutarties Nr. SIN-13/2012), kurio tikslas – įvertinti tarpsektorinį bendradarbiavimą ir jo galimybes, sprendžiant sveikatos ir socialines problemas socialinės rizikos šeimose. Išanagrinėję situaciją pastebėjome, kad pirminės sveikatos priežiūros darbuotojai dažnai neturi pakankamai informacijos apie egzistuojančias socialinės pagalbos priemones mieste, stokoja žinių apie tarpsektorinio bendradarbiavimo galimybes. [...]Lietuvos sveikatos mokslų universitetas. Medicinos akademijaSocialinio darbo katedraVytauto Didžiojo universiteta

Evaluation of Satisfaction with Healthcare Services in Multimorbid Patients Using PACIC+ Questionnaire: A Cross-Sectional Study

Background and Objectives: Although multimorbidity poses many challenges for both individuals and healthcare systems, information on how these patients assess the quality of their healthcare is lacking. This study assessed the multimorbid patients’ satisfaction with their healthcare. Materials and Methods: This cross-sectional study was a part of a project Joint Action—Chronic Diseases and Promoting Healthy Ageing across the Life Cycle and its implementation. The study included 400 patients with arterial hypertension and at least one concomitant chronic disease. Patients completed The Patient Assessment of Care for Chronic Conditions Plus (PACIC+) questionnaire, EuroQol Five-Dimensions—Three-Level Quality of Life questionnaire, and Hospital Anxiety and Depression scale. Results: The mean age of the participants was 65.38 years; there were 52.5% women. The mean PACIC+ 5As summary score was 3.60. With increasing age, participants rated worse on most PACIC+ subscales. Participants who assessed their quality of life as worse were also less satisfied with their healthcare. The presence of three or more concomitant diseases negatively affected PACIC+ scores. Patients with ischemic heart disease and heart failure had lower PACIC+ scores on most subscales, whereas patients with atrial fibrillation had lower scores only on the Agree subscale. The presence of diabetes was not associated with worse PACIC+ scores; moreover, the scores in Assist and Arrange subscales were even better in diabetic patients (3.36 vs. 2.80, p = 0.000 and 3.69 vs. 3.13, p = 0.008, respectively). Patients with chronic obstructive pulmonary disease, asthma, and musculoskeletal disorders showed lower PACIC+ scores. Conclusions: Older age, worse self-assessed health state, presence of three or more diseases, and certain chronic diseases were associated with lower patients’ satisfaction with their healthcare. Personalized healthcare, increasing competencies of primary healthcare teams, healthcare services accessibility, and financial motivation of healthcare providers may increase multimorbid patients’ satisfaction with their healthcare

The Impact of the Emotional Disposition of Healthcare Workers on the Expression of Adverse Events after Primary Vaccination against SARS-CoV-2

Background and Objectives: Vaccination is one means of SARS-CoV-2 prevention and control. However, despite the effectiveness of vaccination, adverse reactions continue to require vigilance and monitoring. The researchers emphasize the possibility that some of the reported side effects may be psychological in origin. Based on this hypothesis, the main goal of this study was to evaluate the emotional dispositions of healthcare workers who experienced emotions before vaccination and adverse reactions after vaccination. Materials and Methods: This study was conducted between February and May 2021 in the Kaunas Clinics of the University of Health Sciences. A total of 2117 employees of the clinic departments who were vaccinated with two doses of the Pfizer–BioNTech vaccine participated in this study. Statistical analysis was performed on the data using IBM SPSS Statistics®. Results: Most participants (74.5%) experienced systemic (including local) adverse events; 16.5% experienced only local adverse events, and 9.1% experienced no adverse events. The frequency of systemic (including local) adverse events reduced with increasing age (p p p Conclusions: The information about vaccination and potential adverse events should be targeted at younger persons. It is recommended that women, more than men, should receive professional counseling from psychologists or psychotherapists. The public dissemination of positive messages about the benefits and safety of vaccines prior to a vaccination campaign may alleviate the tension or anxiety felt regarding potential adverse events. Healthcare specialists—both those who work directly with vaccines and those who do not—should maintain a positive psychological attitude towards vaccination, as this can increase patient satisfaction with the benefits of vaccines

Adverse Events and Immunogenicity of mRNA-Based COVID-19 Vaccine among Healthcare Workers: A Single-Centre Experience

Background and Objectives: The safety and effectiveness of vaccines are among the key priorities in COVID-19 pandemic management. Moreover, evidence-based data regarding vaccine safety and immunogenicity can play an important role in building the trust of the community regarding vaccination. The aim of this study was to investigate the safety and immunogenicity of Pfizer-BioNTech vaccine among healthcare workers in one hospital, 21 days after first dose. Materials and Methods: This study was conducted in the Hospital of the Lithuanian University of Health Sciences between February and March 2021. Hospital employees who arrived to receive the second dose of the Pfizer-BioNTech vaccine 21 days after the first one were invited to participate in the study: they were asked to complete an anonymous adverse events questionnaire and were offered a SARS-CoV-2 IgG/IgM rapid test. The study was performed at a single point, 21 days after the first dose of the vaccine. Results: Data of 4181 vaccine recipients were analysed. The first vaccine dose was associated with a 53.6% incidence of adverse events, mainly local reactions. Adverse events occurred more frequently in younger participants and women. Moderate adverse events were experienced by 1.4% of the vaccine recipients; 6.2% were incapacitated. Of the 3439 participants who performed a rapid IgG test, 94.5% were positive for IgG antibodies after the first vaccine dose. Seroconversion rates were lower in participants older than 47 years. Conclusions: Despite 1.4% moderate adverse events, no safety concerns or anaphylaxis were identified. The Pfizer-BioNTech vaccine induced an immune response in the overwhelming majority of recipients after a single dose. Younger participants experienced adverse events and were positive for IgG antibodies more frequently than older counterparts. It is important to mention that this study specifically considered short-term safety and reactions following vaccination and that long-term adverse effects were not investigated in the study. Thus, future research into both long-term adverse reactions and immune system programming is essential

Assessing the Pilot Implementation of the Integrated Multimorbidity Care Model in Five European Settings: Results from the Joint Action CHRODIS-PLUS

Multimorbidity, the coexistence of several chronic conditions in a patient, represents a great challenge for healthcare systems and society. The Integrated Multimorbidity Care Model (IMCM) was recently designed within the Joint Action on chronic diseases and promoting healthy ageing across the life cycle (CHRODIS) to ensure the continuity of care for patients with multimorbidity. The IMCM was implemented in five European pilot sites in Spain, Italy, and Lithuania, within the Joint Action CHRODIS-PLUS. The effect of these pilot interventions was assessed pre- and post-implementation by 17 healthcare managers, using the Assessment of Chronic Illness Care (ACIC) measure, and by 226 patients with the Patient Assessment of Care for Chronic Conditions (PACIC+) survey. The ACIC total score significantly increased (5.23 to 6.71, p = 0.022) after the intervention, with differences across sites. A significant increase in the PACIC+ summary score was found ranging from 3.25 at baseline to 4.03 after the intervention (p < 0.001), and 58% of the sample perceived an improvement in care. Higher PACIC+ scores after the intervention were associated to lower baseline values in the respective PACIC+ dimension and to greater changes in ACIC Part 1 (delivery system organization). The IMCM implementation can help improve the quality of care for patients with multimorbidity