Psychological health of caregivers of people with dementia is a major public concern. This study sought to determine the relationship between caregiver burden, psychological distress, frailty and functional dependency of a relative with advanced dementia. Persons with dementia and their caregivers (102 dyads) participated in this Portuguese community based cross-sectional study. Data were collected using the Clinical Dementia Rating Scale, a sociodemographic questionnaire, the Zarit Burden Interview, the Brief Symptoms Inventory and the Edmonton Frail Scale. Alzheimer's disease was the most common type of dementia among the recipients of care, who showed moderate (42.2%) to severe (52.9%) dementia. Among them 35.3% exhibited moderate and 45.1% severe frailty. Family caregivers reported moderate (76.5%) to severe burden (18.6%). Psychological distress was very high among family caregivers. Results show that people with dementia exhibited moderate (35.3%) or severe frailty (45.1%) and that a severe frailty was found in people with moderate dementia. A one-way ANOVA was conducted between the Global Severity Index and some sociodemographic variables. ANOVA reached p < .01 for employment status of the caregiver, assistance and professional support, and psychiatric history; and p = 0.01 for caregiver age and years of caregiving. Although caregivers reported benefit from the supportive approach offered by the multidisciplinary home care team, high levels of distress and associated burden were found, which might decrease their capacity to care for the person with dementia and their own health and well-being.
This paper examines the healthcare needs of community‐dwelling older people living in Porto, Portugal, diagnosed with moderate or severe dementia, linked to functional dependency, cognitive decline, limitations in the activities of daily life, and frailty levels. A sample of 83 participants was recruited. Data were collected between 2013 and 2017. A sociodemographic questionnaire, the Clinical Dementia Rating (CDR), the Barthel Index (BI), the Lawton and Brody Instrumental Activities of Daily Living (IADL) Scale, and the Edmonton Frail Scale (EFS) were used. A set of 26 healthcare needs was defined to support the assessment. The Pearson chi‐square or Fisher's exact test (as appropriate) was used to examine the association of the needs (unmet and met) with the levels of dementia and frailty. Participants were diagnosed previously with moderate or severe dementia and benefited from a structured home‐care program. There was a high number rated as “severe dementia,” “fully dependent,” “severely or fully dependent in the activities of daily living (ADL),” and “severe frailty.” There were statistically significant differences among needs identified in people with moderate or severe dementia and moderate or severe frailty. The most prevalent healthcare needs in the sample were food preparation, medication/taking pills, looking after their home, toilet use, sensory problems, communication/interaction, bladder, bowels, eating and drinking, memory, sleeping, and falls prevention. In particular, the study identifies a set of needs that are present simultaneously in both frailty and dementia stages. This study underlines that despite well‐structured home‐care programs for people with dementia, unmet health needs remain. Timely healthcare needs assessment may help professionals to avoid fragmented care and to tailor quality‐integrated interventions, including the emotional and psychological balance of the caregiver.
ResumoA competência digital dos cidadãos europeus continua longe do desejável para as necessidades de uma economia e sociedade altamente digitalizadas, sendo assim premente a necessidade de se estabelecer uma resposta global ao défice digital. A criação, em 2013, de um quadro europeu de referência para a compreensão e desenvolvimento da competência digital foi um passo nessa direção, mas os esforços para a sua aplicação continuam a ser de difícil concretização, em particular em Portugal. A importância do quadro consubstancia-se no contributo para a clarificação das principais componentes da competência digital, bem como para o estabelecimento de uma linguagem sólida e partilhada sobre a mesma. Porém, o seu principal objetivo é promover o desenvolvimento de iniciativas, para já nas áreas da educação, formação e emprego, que melhorem os níveis de competência digital dos cidadãos europeus. Este artigo tem um duplo objetivo: apresentar, fundamentadamente, o quadro europeu de referência para a competência digital e mapear iniciativas que têm surgido como consequência da sua existência. Estas, assim como o défice de outras, serão discutidas neste artigo na medida em que poderão servir de base para o desenvolvimento futuro de ações que valorizem a relevância da competência digital de qualquer cidadão e sugerir áreas de trabalho a serem desenvolvidas.Palavras-chave: DigComp, tecnologias digitais, sociedade digital, educação, formação, emprego, certificação Abstract The level of European citizens' digital competence remains far from desirable for the needs of a highly digitized economy and society and the need for the EU to establish a comprehensive response to the digital skills deficit is rising. The creation of a common framework for the development and understanding of digital competence in 2013 was a step in the right direction, but the efforts towards its application continue to prove slow in its realization in Portugal. This article has a double objective. The first is to present the European framework for the development and understanding of digital competence. The second is to map initiatives that have emerged as a consequence of its existence. These, as well as the deficit of others, can help develop actions that value a relevance of the digital competence of any citizen and suggest areas of work to be developed, particularly in the Portuguese context. The importance of the framework is to clarify the main components of digital competence, as well as to establish a solid and shared language on the same. However, its main objective is to promote the development of initiatives in the areas of education, training and employment that can improve the digital competence of European citizens. A competência digital no contexto europeuEm 2006, o Parlamento Europeu e o Conselho apresentaram uma recomendação que inclui oito competências-chave a desenvolver através da aprendizagem ao longo da vida, enquanto medida
National education policies are increasingly regulated by international agendas, for example the Agenda 2030 for Sustainable Development (SD). However, in order to put such policies into practice, social actors like teachers and teacher educators must include them in their practices. In this context, this study stems from the following research question: how does initial teacher education (ITE) promote the SD Agendas (2030 and 2063 for Africa)? The approach to this question is carried out through a case study focused on an Angolan teacher education higher education institution, in its graduate course for future secondary school biology teachers. The main aims of this study are (i) to characterize how ITE includes SD and (ii) to suggest ways to improve SD, particularly focusing on students’ future professional needs. Data were gathered from document analysis (the pedagogical curriculum plan of the course; titles and abstracts of final-year future biology teachers’ essays) and an interview with the course director of the biology teaching program of the Angolan institution. Content analysis of the gathered evidence was based on a three-dimensional framework: (a) SD goals (SDG) and the curriculum; (b) teacher education principles; and (c) current Angolan curricular perspectives. Results show that although the Pedagogical curriculum plan and the formative path, from the interviewee’s point of view, do not explicitly integrate SDG and its challenges for biology ITE, the majority of essays analyzed are locally contextualized and in a number of cases articulated with some of the 17 SDG. Suggestions for inclusion of SDG in ITE and for teacher education research are put forward.
Background Family caregivers’ empowerment can assume strategic importance in palliative care. Healthcare professionals and volunteers have been showing significant gaps in this field. Hence, education has been advocated as an effective strategy to fill this gap. While several educational initiatives exist, a comprehensive evidence synthesis on the effectiveness of educational training on healthcare professionals and volunteers is lacking. Aims An integrative review was conducted to explore worldwide initiatives, aiming to improve healthcare professionals and volunteers’ competence in a palliative care setting especially in relation to the family caregiver. Method A scoping literature review was conducted with systematic searches in multiple databases – REDALYC, CINAHL, SCIELO, EBSCO, ERIC and MEDLINE since January 2012. Studies were selected based on programmes content and its impact evaluation. Four researchers assessed the studies regarding their eligibility with reference to the inclusion and exclusion criteria. Findings Twenty‐two studies met the eligibility criteria. Multi‐professional learning was reported, emphasising nurses and physician's enrolment. Only few studies showed participants’ learning outcomes. Inconsistencies in delivery mode and duration were identified. Impact evaluations were heterogeneous and relied on no validated instruments. Family caregiver's content was addressed only in three initiatives. Conclusions Further research is needed using a more reliable design, mode of delivery and impact measurement of educational training. In addition, more initiatives associated with cost‐effectiveness, shorter‐ and longer‐term clinical impact are needed. Despite the strides already made towards the establishment of an evidence base for healthcare professionals in the field of palliative care, either greater consideration is required for family care providers in the education of healthcare professionals and respect for the cultural diversity.
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