a comunicação como intervenção terapêutica de enfermagem

Mestrado, Enfermagem de Saúde Infantil e Pediatria, 2015, Escola Superior de Enfermagem de LisboaOs cuidados centrados na família (CCF) garantem a saúde e o bem-estar da criança e família numa relação de respeito e parceria. Assim, o apoio da família torna-se essencial para que a sua participação nos cuidados à criança seja uma realidade dentro dos CCF. As competências comunicacionais dos Enfermeiros são uma componente essencial dos CCF, como elemento de ligação numa equipa multidisciplinar e cuidadora da criança/família. À medida que a sua intervenção se desenvolve com novas competências, é importante que seja dada também relevância crescente à comunicação. Assim sendo, pretende-se aprofundar a temática das vivências e respostas dos pais perante a doença aguda do filho, tendo como objeto de estudo a comunicação como intervenção terapêutica de Enfermagem. Para tal, foi utilizado como metodologia a reflexão sobre e na prática, numa abordagem do Cuidar de Jean Watson, inserido no paradigma da transformação. Ao longo da experiência de estágio em diferentes contextos pediátricos foram desenvolvidas diversas atividades relacionadas com a problemática, destacando-se a criação de um Manual de Promoção de Saúde: Estratégia de Comunicação para a Saúde, Dossier Temático: A Comunicação Terapêutica com a Família da Criança Hospitalizada, uma norma de Guia Orientador de Boas Práticas no Processo de Comunicação Terapêutica com a Criança/Família que recorre ao Serviço de Urgência, inserida no Manual de Acolhimento do mesmo. Pode-se concluir que os Enfermeiros desenvolvem a comunicação como instrumento terapêutico na relação de parceria e de ajuda com a criança/família, na relação com grupos de ajuda mútua, nos momentos de educação para a saúde a ainda na formação das equipas de saúde, sendo o binómio gestão das emoções/gestão da informação transversal no cuidado humano

Anti–hypercholesterolemic effect of kenaf (Hibiscus cannabinus L.) seed on high–fat diet Sprague dawley rats

AbstractObjectiveTo determine the antihypercholesterolemic effects of kenaf seed samples and compare with the commercial hypocholesterolemic drug on serum lipids profiles and malondialdehyde (MDA) level in the rat.MethodsKenaf seed oil (KSO), microencapsulated kenaf seed oil (MKSO), kenaf seed extract (KSE) and defatted kenaf seed meal (DKSM) were prepared and phytochemicals screening on these samples were done prior in vivo study. Phenolic compounds in KSE were quantified using high performance liquid chromatography. There were 40 (divided in eight diet groups of 5) male Sprague dawley rats adapted to normal standard diet or hypercholesterolemic diet (HD) with or without the treatment of these kenaf samples for 32 days.ResultsAll the kenaf samples exhibited to contain most of the major phytochemicals. KSE possessed gallic acid, tannic acid, catechin, benzaldehyde, benzoic acid, syringic acid, sinapic acid, ferulic acid, naringin acid, and protocatechuic acid. The significant higher (P<0.05) serum total cholesterol, low density lipoprotein cholesterol and MDA levels in HD group without treatment than the normal control group suggested the hypercholesterolemia was induced by the incorporation of cholesterol into diet. KSE exhibited higher cholesterol–lowering properties due to the significant lower (P<0.05) in serum triglycerides, total cholesterol and MDA levels. KSE showed the highest efficiency of cholesterol–lowering activity, followed by KSO, MKSO and DKSM.ConclusionsDKSM, MKSO, KSO and KSE appeared to have comparable anti–hypercholesterolemic effect with the commercial hypocholesterolemic drug. Hence, kenaf seed could be used as an alternative natural source to replace the synthetic hypocholesterolemic drugs

4-Thioxo-3,5-dithia-1,7-hepta­nedioic acid

The complete molecule of the title compound, C5H6O4S3, is generated by crystallographic twofold symmetry with the C=S group lying on the rotation axis. The molecules are linked through weak hydrogen-bond contacts by glide-plane operations to form R 2 2(20) rings and ladder-like C(4) chains along the c axis

Doctors' approaches to decision support in counseling patients with localized prostate cancer: an Asian perspective

There are many treatment options for localized prostate cancer, and there is clinical equipoise in relation to the treatment outcomes. This study aimed to explore doctors’ approaches to decision support in counselling patients with localized prostate cancer in a country with a less established system of support and care delivery for cancer treatment. Four in-depth interviews and three focus group discussions were conducted with seven government policy makers/consultant urologists, three oncologists, four private urologists and six urology trainees in Malaysia between 2012 and 2013. Doctors facilitated the treatment decision by explaining about the disease and the treatment options, which included monitoring, side effects and complications of each treatment option. Paper-based (charts and diagram drawings) or electronic (ipad apps and websites) illustrations and physical models were used as patient education aids. Further reading materials and websites links were often provided to patients. Patients were given time till subsequent follow up to decide on the treatment and family involvement was encouraged. Referral to other healthcare professionals (oncologist, radiotherapist or other urologist) for second opinion was offered to the patients. The doctors would recommend patients to speak to prostate cancer survivors for peer support but official support groups were not easily accessible. This study highlighted a multi-faceted approach to support patients with localized prostate cancer in making a treatment decision. It not only involved the doctors (urologist or oncologist) themselves, but also empowered the patients and their social network to support the decision making process

Assessing catastrophic health expenditure and impoverishment in adult asthma care:a cross-sectional study of patients attending six public health clinics in Klang District, Malaysia

BackgroundIn Malaysia, asthma is a common chronic respiratory illness. Poor asthma control may increase out-of-pocket payment for asthma care, leading to financial hardships Malaysia provides Universal Health Coverage for the population with low user fees in the public health system to reduce financial hardship. We aimed to determine out-of-pocket expenditure on outpatient care for adult patients with asthma visiting government-funded public health clinics. We examined the catastrophic impact and medical impoverishment of these expenses on patients and households in Klang District, Malaysia.MethodsThis is a cross-sectional face-to-face questionnaire survey carried out in six government-funded public health clinics in Klang District, Malaysia. We collected demographic, socio-economic profile, and outpatient asthma-related out-of-pocket payments from 1003 adult patients between July 2019 and January 2020. Incidence of catastrophic health expenditure was estimated as the proportion of patients whose monthly out-of-pocket payments exceeded 10% of their monthly household income. Incidence of poverty was calculated as the proportion of patients whose monthly household income fell below the poverty line stratified for the population of the Klang District. The incidence of medical impoverishment was estimated by the change in the incidence of poverty after out-of-pocket payments were deducted from household income. Predictors of catastrophic health expenditure were determined using multivariate regression analysis.ResultsWe found the majority (80%) of the public health clinic attendees were from low-income groups, with 41.6% of households living below the poverty line. About two-thirds of the attendees reported personal savings as the main source of health payment. The cost of transportation and complementary-alternative medicine for asthma were the main costs incurred. The incidences of catastrophic expenditure and impoverishment were 1.69% and 0.34% respectively. The only significant predictor of catastrophic health expenditure was household income. Patients in the higher income quintiles (Q2, Q3, Q4) had lower odds of catastrophic risk than the lowest quintile (Q1). Age, gender, ethnicity, and poor asthma control were not significant predictors.ConclusionThe public health system in Malaysia provides financial risk protection for adult patients with asthma. Although patients benefited from the heavily subsidised public health services, this study highlighted those in the lowest income quintile still experienced financial catastrophe and impoverishment, and the risk of financial catastrophe was significantly greater in this group. It is crucial to ensure health equity and protect patients of low socio-economic groups from financial hardship.<br/

Android malware detection technique via feature analysis

The rapidly increasing popularity of the Android platform has resulted in a significant increase in the number of malware compared to previous years. Since Android offers an open market model, it is an ideal target to launch malware attacks. Due to this problem, a lot of research work has been proposed to protect users from attacks. However, such protection cannot last long as attackers will usually find ways to defeat protection mechanism. As a result, this paper aims to develop an effective malware detection technique. The proposed method focuses on static analysis approach, which utilizes features from permissions, intents and API calls of an Android application. In order to create a sensitive and representative feature set, the proposed method also uses the correlation-based feature selection method. The final feature set will be fed into the support vector machine to perform the classification. Experimental results have shown that the proposed method achieved reliable detection accuracy at 95% and outperformed the benchmark metho

Who makes the decision? Malaysian healthcare professionals' views on prostate cancer treatment

Purpose: This study aimed to explore the views of Malaysian healthcare professionals (HCPs) on the roles of various stakeholders who were involved in making decisions about prostate cancer treatment. Method: Four in-depth interviews and three focus group discussions were conducted with HCPs from government and private hospitals in Malaysia between December 2012 and March 2013. HCPs consisted of private urologists (n=4), government urologists (n=6), urology trainees (n=5), government policy maker (n=1) and oncologists (n=3). There were 16 male and three female participants. Trained researchers used a topic guide to guide the interviews which were audio-recorded, transcribed verbatim, checked and managed with Nvivo 10 software. Thematic approach was used to analyse the data. Result: Three parties were involved in the decision making process: HCPs, patients and family. Patients who did not understand prostate cancer and its treatment had difficulty in making decisions. These patients tended to leave the decision to the HCPs. Some patients made their own treatment decision. Some patients avoid asking too many questions to avoid the possibility of being influenced towards one option by their HCP. HCPs would leave the final say to the patient because of three reasons: to avoid patients’ regret (“patient will not be happy at the end of the day”); wanting the patient to “balance what they wanted and what was the reality of each option”; and knowing there was no single best treatment option. The family members, especially children, made the decision for some patients. This may be due to Malaysia’s close-knit family culture where patients were concerned about their children’s emotions. While some patients were able to make their own decisions for non-invasive treatment (e.g. hormonal treatment), they would like to involve their family if they were considering surgery. HCPs observed that patients rarely involved their wives in decision making. Conclusion: Decision making during prostate cancer treatment involves three parties; HCP, patient and family. The decisional roles depend on the patients personal preferences, understanding of the illness, and the family dynamics

Development of high resolution melting analysis for the diagnosis of human malaria

Molecular detection has overcome limitations of microscopic examination by providing greater sensitivity and specificity in Plasmodium species detection. The objective of the present study was to develop a quantitative real-time polymerase chain reaction coupled with high-resolution melting (qRT-PCR-HRM) assay for rapid, accurate and simultaneous detection of all five human Plasmodium spp. A pair of primers targeted the 18S SSU rRNA gene of the Plasmodium spp. was designed for qRT-PCR-HRM assay development. Analytical sensitivity and specificity of the assay were evaluated. Samples collected from 229 malaria suspected patients recruited from Sabah, Malaysia were screened using the assay and results were compared with data obtained using PlasmoNexTM, a hexaplex PCR system. The qRT-PCR-HRM assay was able to detect and discriminate the five Plasmodium spp. with lowest detection limits of 1–100 copy numbers without nonspecific amplifications. The detection of Plasmodium spp. in clinical samples using this assay also achieved 100% concordance with that obtained using PlasmoNexTM. This indicated that the diagnostic sensitivity and specificity of this assay in Plasmodium spp. detection is comparable with those of PlasmoNexTM. The qRT-PCR-HRM assay is simple, produces results in two hours and enables high-throughput screening. Thus, it is an alternative method for rapid and accurate malaria diagnosis

Feasibility of supported self-management with a pictorial action plan to improve asthma control

Supported self-management reduces asthma-related morbidity and mortality. This paper is on a feasibility study, and observing the change in clinical and cost outcomes of pictorial action plan use is part of assessing feasibility as it will help us decide on outcome measures for a fully powered RCT. We conducted a pre–post feasibility study among adults with physician-diagnosed asthma on inhaled corticosteroids at a public primary-care clinic in Malaysia. We adapted an existing pictorial asthma action plan. The primary outcome was asthma control, assessed at 1, 3 and 6 months. Secondary outcomes included reliever use, controller medication adherence, asthma exacerbations, emergency visits, hospitalisations, days lost from work/daily activities and action plan use. We estimated potential cost savings on asthma-related care following plan use. About 84% (n = 59/70) completed the 6-months follow-up. The proportion achieving good asthma control increased from 18 (30.4%) at baseline to 38 (64.4%) at 6-month follow-up. The proportion of at least one acute exacerbation (3 months: % difference −19.7; 95% CI −34.7 to −3.1; 6 months: % difference −20.3; 95% CI −5.8 to −3.2), one or more emergency visit (1 month: % difference −28.6; 95% CI −41.2 to −15.5; 3 months: % difference −18.0; 95% CI −32.2 to −3.0; 6 months: % difference −20.3; 95% CI −34.9 to −4.6), and one or more asthma admission (1 month: % difference −14.3; 95% CI −25.2 to −5.3; 6 months: % difference −11.9; 95% CI −23.2 to −1.8) improved over time. Estimated savings for the 59 patients at 6-months follow-up and for each patient over the 6 months were RM 15,866.22 (USD3755.36) and RM268.92 (USD63.65), respectively. Supported self-management with a pictorial asthma action plan was associated with an improvement in asthma control and potential cost savings in Malaysian primary-care patients. Trial registration number: ISRCTN87128530; prospectively registered: September 5, 2019, http://www.isrctn.com/ISRCTN87128530