Peer Mentoring to Enhance Parent Coping with Child\u27s New Chronic Kidney Disease Diagnosis

Pediatric kidney disease diagnoses are stressful for the entire family and many parents lack social outlets that understand the associated lifestyle changes and stressors. There is a variety of evidence in the literature supporting the use of peer mentoring to promote positive coping among patients with chronic disease and their family members. This paper describes the development and implementation of a peer mentoring program among parents of children newly diagnosed with kidney disease to determine the impact on parent coping with their child’s diagnosis, as assessed through the Coping Health Inventory for Parents (CHIP-16). Results are discussed, as well as lessons learned and recommendations that may guide future peer mentoring programs among this population

TCP over High Speed Variable Capacity Links: A Simulation Study for Bandwidth Allocation

New optical network technologies provide opportunities for fast, controllable bandwidth management. These technologies can now explicitly provide resources to data paths, creating demand driven bandwidth reservation across networks where an applications bandwidth needs can be meet almost exactly. Dynamic synchronous Transfer Mode (DTM) is a gigabit network technology that provides channels with dynamically adjustable capacity. TCP is a reliable end-to-end transport protocol that adapts its rate to the available capacity. Both TCP and the DTM bandwidth can react to changes in the network load, creating a complex system with inter-dependent feedback mechanisms. The contribution of this work is an assessment of a bandwidth allocation scheme for TCP flows on variable capacity technologies. We have created a simulation environment using ns-2 and our results indicate that the allocation of bandwidth maximises TCP throughput for most flows, thus saving valuable capacity when compared to a scheme such as link over-provisioning. We highlight one situation where the allocation scheme might have some deficiencies against the static reservation of resources, and describe its causes. This type of situation warrants further investigation to understand how the algorithm can be modified to achieve performance similar to that of the fixed bandwidth case

PROFESSIONAL ACTIVITY IN THE CONTEXT OF HEALTH EDUCATION: A SYSTEMATIC REVIEW

Describe educational practices performed by health professionals with reference to the paradigm of health promotion. It is systematic review the search for articles in databases: Medline, Lilacs and SciELO, published during the period from 2003 to 2013. The search was performed using the integrated method, using the terms: health promotion, health education and experiences. Given the results, was possible to demonstrate the importance of conducting health education experiences in different contexts: primary care, hospitals and schools with various themes and methodologies adopted. However, although these experiences implemented primarily with a view to promoting health, highlighting elements such as autonomy, empowerment and decision-making, it was found that even if educational actions on normative health are carried out they weaken the process of the empowerment of the individuals involved

Patients’ perception of their involvement in shared treatment decision making : key factors in the treatment of inflammatory bowel disease

Objectives This study aims to characterize the relationships between the quality of the information given by the physician, the involvement of the patient in shared decision making (SDM), and outcomes in terms of satisfaction and anxiety pertaining to the treatment of inflammatory bowel disease (IBD). Methods A Web survey was conducted among 200 Canadian patients affected with IBD. The theoretical model of SDM was adjusted using path analysis. SAS software was used for all statistical analyses. Results The quality of the knowledge transfer between the physician and the patient is significantly associated with the components of SDM: information comprehension, patient involvement and decision certainty about the chosen treatment. In return, patient involvement in SDM is significantly associated with higher satisfaction and, as a result, lower anxiety as regards treatment selection. Conclusions This study demonstrates the importance of involving patients in shared treatment decision making in the context of IBD. Practice implications Understanding shared decision making may motivate patients to be more active in understanding the relevant information for treatment selection, as it is related to their level of satisfaction, anxiety and adherence to treatment. This relationship should encourage physicians to promote shared decision making

Social Support to Reduce Uncertainty in Childhood Cancer in South Texas: A Case Study

Parents of children with cancer are faced with the complicated situation of not only learning their child is critically ill, but also of learning how to adapt to life with childhood cancer. For parents of a child with cancer uncertainty can lead to increased levels of stress, anxiety, fear, loss of control and depression. Successful psychosocial and educational interventions in reducing uncertainty in adult populations have been reported. However, these have not been well documented in families dealing with childhood cancer. Discovering how to best provide these interventions in south Texas will provide a foundation for future research interventions in this population. This case study research utilized extensive interviews, as described by Yin (2013), to identify strengths and barriers for implementation of psychosocial and educational interventions in addressing uncertainty in parents of children diagnosed with cancer

An exploratory study of patient distress and participation in treatment decision-making for cancer

Background: There is a growing expectation that medical patients should be more involved in decisions about their health and treatment. However, often decisions about treatments are required at times of stress, such as foll owing a diagnosis of cancer.Objectives: The purpose of this study was to investigate the relationship between distress, emotion regulation and patient participation in treatment decision-ma king for cancer, and whether patient participation affects psychosocial outcomesMethod: The study was an observational, longitudinal design. Participants were 26 patients with cancer, recruited at their initial oncology appointment, who completed a questionnaire at the time of the ir consultation, a second questionnaire following their consultation and a third at three months follow up. Univariate analyses were used for confirmatory data analysis.Results: Participants who took a passive or active role in treatment decision-making had significantly higher levels of distress, compared to those who reported shared decision-making. Higher levels of distress and greater difficulties with emotion regulation were also significantly associated with participants not attaining their preferred role. No significant relationship was found between participation in treatment decision-making and psycho logical adjustment or satisfaction with the decision made.Conclusions: Greater awareness of patients' emotional well-being, at key points in their care pathway, would be valuable, to ensure patients' psychological needs a re met and to avoid detrimental consequences for their health care

Application of Symphonology Theory in Patient Decision-Making: Triangulation of Quantitative and Qualitative Methods

This study tested the theory of Symphonology in two ways: 1) by determining if concepts in Symphonology were expressed in the experience of patients involved in health care decision-making, and 2) by testing the effect of an education/counseling intervention based on Symphonology, designed to facilitate decision-making. The study design was a pre-test post-test quasi-experimental design. Demographic and disease-related variables, decision-making role preference and the Bioethical Decision Making Preference Scale for Patients/Families (BDMPSP) (Husted, 2001) were measured prior to the intervention. Demographic variables that were measured included age, gender, race, marital status, years and type of education and time since diagnosis. Verbatim transcripts of semi-structured subject interviews were analyzed. The intervention provided was designed to assist subjects through the decision-making process using Symphonology. After the intervention subjects were again interviewed and they completed a post-test BDMPSP. Subject responses from post-test interviews were triangulated with results of statistical analysis testing the difference between pre and post-intervention BDMPSP scores. Relationships between demographic variables and decision-making role preference and BDMPSP scores were statistically analyzed. The sample consisted of 30 subjects involved in a variety of decisions about health care and treatment during hospitalization in an acute care setting. Median age was 63, 75.7% were female (n = 23) and 53.3% (n = 16) had greater than a high school education. The distribution of decision-making role preferences was 40% active, 53.3% collaborative, and 6.7% passive. There were no significant relationships between demographic variables and decision-making role preference. Qualitative analysis demonstrated that patients expressed all of the concepts of Symphonology in interviews. Statistical analysis of differences in pre and post BDMPSP scores demonstrated that subjects had a more positive experience of being involved in decision-making (p = .02), felt more sufficiency of knowledge (p = .013), less frustration (p = .014) and more powerful (p = .009) after the intervention. Quantitative results were supported by qualitative findings. Findings support the validity of Symphonology theory. The theory can be used to describe the experience of being involved in decision-making and Symphonology has utility as a model for assisting patients through the decision-making process