Yes / Pain and delirium are common in people with dementia admitted to hospitals. These are often under-diagnosed and under-treated. Pain is implicated as a cause of delirium but this association has not been investigated in this setting. To investigate the relationship between pain and delirium in people with dementia, on admission and throughout a hospital admission. Design: Exploratory secondary analysis of observational prospective longitudinal cohort data. Setting: Two acute hospitals in the UK. Methodology: Two-hundred and thirty participants aged ≥70 years were assessed for dementia severity, delirium ((Confusion Assessment Method (CAM), pain (Pain Assessment in Advanced Dementia (PAINAD)) scale and prescription of analgesics. Logistic and linear regressions explored the relationship between pain and delirium using cross-sectional data. Results: Pain at rest developed in 49%, and pain during activity for 26% of participants during their inpatient stay. Incident delirium developed in 15%, of participants, and 42% remained delirious for at least two assessments. Of the 35% of participants who were delirious and unable to self-report pain, 33% of these participants experienced pain at rest, and 56 experienced pain during activity. The odds of being delirious were 3.26 times higher in participants experiencing pain at rest (95% Confidence Interval 1.03–10.25, P = 0.044). Conclusion: An association between pain at rest and delirium was found, suggesting pain may be a risk factor for delirium. Since pain and delirium were found to persist and develop during an inpatient stay, regular pain and delirium assessments are required to manage pain and delirium effectively. / The Impact of Acute Hospitalisation on People with Dementia: The Behaviour and Pain (BepAID Study (jointly funded by the Alzheimer’s Society and BUPA foundation (Grant reference number: 131). Dr Sampson’s, Dr White’s, Dr Kupeli’s and Miss Vickerstaff ’s posts are supported by Marie Curie core funding, grant (MCCC-FCO-16-U).

This study portrays the Social Service Department of the Vancouver General Hospital from the first days of its institution under the Women's Auxiliary, through the course of its growth to the present time. The history has been divided into three periods; the first, under the Women's Auxiliary; the second, after integration into the hospital administrative structure, and the introduction of trained workers; and finally, the present organization. An evaluation and comparison by standards has been included, together with suggestions for improvement of existing services. The Vancouver General Hospital has consistently maintained an "A" rating for medical service to patients. The Social Service Department is only one of the services offered by the hospital, and is not yet recognized as an essential component of the medical team. The study of its development explains the nature of the traditional ties from which the department is endeavoring to emancipate itself. The present policy is to build a gradually strengthening base upon which a truly professional service will be recognized, appreciated and sought. In order to obtain a picture as complete as possible, early documents, reports, records and files, both from the Hospital and from the Women’s Auxiliary, have been studied. Information was also secured from interviews with persons concerned with the department in the past and present. The existing department has been studied by personal observation and through contacts made while working in this setting. Inadequacies and problems which hamper the service have been revealed in the study, but also, there is indication that the department is healthily aware of these, and is planning its future with care. There is room for much interpretation of the profession of social work to the medical and administrative staff, and to the community, in order that full understanding and support may be obtained. Likewise, doubled staff will be required before the department will be able to operate as it would wish. There is a cumbersome involvement with administrative and clerical duties, particularly in Outpatients' Department, which will need to be eliminated before the staff may be free to perform its casework function. / Arts, Faculty of / Social Work, School of / Graduate

O objetivo deste estudo foi caracterizar os pacientes que foram encaminhados por profissionais do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP) ao Ambulatório de Psicologia, localizado dentro do Serviço de Psicologia da instituição. Durante o período de 2013 a 2016 o Ambulatório de Psicologia recebeu o total de 189 pacientes, que passaram pelo atendimento de triagem psicológica para a avaliação da elegibilidade do caso, ou seja, se a demanda apresentada pelo paciente e os sintomas psicológicos estavam de acordo com os critérios de inclusão estabelecidos pelo Ambulatório. Dos 110 pacientes que foram aceitos no Ambulatório, 58 estavam de acordo com os critérios de inclusão desta pesquisa. Para a caracterização sóciodemográfica utilizou-se a Entrevista de Anamnese Padrão do Ambulatório de Psicologia. Para a avaliação dos aspectos psicológicos e comportamentais utilizou-se o Inventário de Ansiedade de Beck (BAI), o Inventário de Depressão de Beck (BDI), Inventário de Sintomas de Estresse para Adultos de Lipp (ISSL), Inventário de Habilidades Sociais (IHS) e para avaliar a qualidade de vida utilizou-se o World Health Organization Quality of Life (WHOQoL-Bref). As análises foram conduzidas no software Statistical Package for the Social Science 20.0 (SPSS 20.0), foram realizados testes para verificar a existência de associação entre as variáveis sociodemográficas e os resultados obtidos nos instrumentos. A caracterização sociodemográfica identificou que 81% dos pacientes são mulheres, 46,6% possuem de 18 a 58 anos, 58,6% são procedentes de Ribeirão Preto, 58% possuem companheiro, 39,7% possuem de 10 a 14 anos de estudo e 62,% trabalham. As principais fontes de encaminhamento foram da Psicologia (22%) e das especialidades voltadas ao cuidado da saúde da mulher (19%). Em relação ao desfecho do atendimento psicológico, 54% ocorreram devido à alta por falta ou desistência do paciente. Quanto aos aspectos psicológicos e comportamentais, 46,6% apresentaram sintomas de ansiedade moderado e grave e 55,2% sintomas de depressão moderado e grave 55,2% e 89,7% possuem estresse. Houve o predomínio de déficit nas habilidades sociais nos fatores avaliados no IHS e a autossatisfação com a qualidade de vida foi avaliada como ruim por 43% dos pacientes. Esta pesquisa obteve dados relevantes para a melhoria no funcionamento do Ambulatório de Psicologia do HCFMRP/USP e por se tratar de um centro de atendimento de grande porte, que forma profissionais especializados, torna-se importante a produção e divulgação de conhecimentos na área. / The purpose of this study was to characterize those who were referred by professionals from the Clinic Hospital of the Medical School of Ribeirão Preto of the University of São Paulo (HCFMRP-USP) to the Ambulatory of Psychology, located within the Psychology Department of the institution. During the period from 2013 to 2016, the Ambulatory of Psychology received a total of 189 patients, who underwent psychological screening to assess the eligibility of the case, in other words, whether the patient\'s demand and the psychological symptoms were in agreement with the inclusion criteria established by the Ambulatory. Out of the 110 patients who were admitted to the outpatient clinic, 58 were in agreement with the inclusion criteria of this study. For the sociodemographic characterization the Interview of Standard Anamnesis of the Ambulatory of Psychology was used. For the evaluation of the psychological and behavioral aspects the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Lipp´s Inventory of Stress Symptoms for Adults (ISSL), Social Skills Inventory (IHS) were used, and to evaluate the quality of life the World Health Organization of Life (WHOQoL-Bref) was used. The analyzes were conducted in the Statistical Package for Social Science 20.0 (SPSS 20.0) software, and tests were carried out to verify the existence of an association between sociodemographic variables and the results obtained in the instruments. The sociodemographic characterization identified that 81% of the patients are women, 46.6% are 18 to 58 years old, 58.6% are from Ribeirão Preto, 58% have a partner, 39.7% have 10 to 14 years of study and 62,% work. The main sources of referrals were from Psychology (22%) and specialties focused on women\'s healthcare (19%). Regarding to the outcome of psychological care, 54% occurred because of discharge due to lacks or patient\'s abandonment. Concerning the psychological and behavioral factors, 46.6% had symptoms of moderate and severe anxiety and 55.2% had moderate and severe depression symptoms, 55.2% and 89.7% had stress. There was an absolute predominance of deficit in social skills factors evaluated in the IHS, and self-satisfaction with quality of life was evaluated as \'poor\' by 43% of the patients. This research obtained relevant data for the improvement in the functioning of the Ambulatory of Psychology of HCFMRP/USP and because it is a large service center, which forms specialized professionals, it becomes important to produce and disseminate knowledge in the area.

No description available.

O objetivo deste estudo foi caracterizar os pacientes que foram encaminhados por profissionais do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP) ao Ambulatório de Psicologia, localizado dentro do Serviço de Psicologia da instituição. Durante o período de 2013 a 2016 o Ambulatório de Psicologia recebeu o total de 189 pacientes, que passaram pelo atendimento de triagem psicológica para a avaliação da elegibilidade do caso, ou seja, se a demanda apresentada pelo paciente e os sintomas psicológicos estavam de acordo com os critérios de inclusão estabelecidos pelo Ambulatório. Dos 110 pacientes que foram aceitos no Ambulatório, 58 estavam de acordo com os critérios de inclusão desta pesquisa. Para a caracterização sóciodemográfica utilizou-se a Entrevista de Anamnese Padrão do Ambulatório de Psicologia. Para a avaliação dos aspectos psicológicos e comportamentais utilizou-se o Inventário de Ansiedade de Beck (BAI), o Inventário de Depressão de Beck (BDI), Inventário de Sintomas de Estresse para Adultos de Lipp (ISSL), Inventário de Habilidades Sociais (IHS) e para avaliar a qualidade de vida utilizou-se o World Health Organization Quality of Life (WHOQoL-Bref). As análises foram conduzidas no software Statistical Package for the Social Science 20.0 (SPSS 20.0), foram realizados testes para verificar a existência de associação entre as variáveis sociodemográficas e os resultados obtidos nos instrumentos. A caracterização sociodemográfica identificou que 81% dos pacientes são mulheres, 46,6% possuem de 18 a 58 anos, 58,6% são procedentes de Ribeirão Preto, 58% possuem companheiro, 39,7% possuem de 10 a 14 anos de estudo e 62,% trabalham. As principais fontes de encaminhamento foram da Psicologia (22%) e das especialidades voltadas ao cuidado da saúde da mulher (19%). Em relação ao desfecho do atendimento psicológico, 54% ocorreram devido à alta por falta ou desistência do paciente. Quanto aos aspectos psicológicos e comportamentais, 46,6% apresentaram sintomas de ansiedade moderado e grave e 55,2% sintomas de depressão moderado e grave 55,2% e 89,7% possuem estresse. Houve o predomínio de déficit nas habilidades sociais nos fatores avaliados no IHS e a autossatisfação com a qualidade de vida foi avaliada como ruim por 43% dos pacientes. Esta pesquisa obteve dados relevantes para a melhoria no funcionamento do Ambulatório de Psicologia do HCFMRP/USP e por se tratar de um centro de atendimento de grande porte, que forma profissionais especializados, torna-se importante a produção e divulgação de conhecimentos na área. / The purpose of this study was to characterize those who were referred by professionals from the Clinic Hospital of the Medical School of Ribeirão Preto of the University of São Paulo (HCFMRP-USP) to the Ambulatory of Psychology, located within the Psychology Department of the institution. During the period from 2013 to 2016, the Ambulatory of Psychology received a total of 189 patients, who underwent psychological screening to assess the eligibility of the case, in other words, whether the patient\'s demand and the psychological symptoms were in agreement with the inclusion criteria established by the Ambulatory. Out of the 110 patients who were admitted to the outpatient clinic, 58 were in agreement with the inclusion criteria of this study. For the sociodemographic characterization the Interview of Standard Anamnesis of the Ambulatory of Psychology was used. For the evaluation of the psychological and behavioral aspects the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Lipp´s Inventory of Stress Symptoms for Adults (ISSL), Social Skills Inventory (IHS) were used, and to evaluate the quality of life the World Health Organization of Life (WHOQoL-Bref) was used. The analyzes were conducted in the Statistical Package for Social Science 20.0 (SPSS 20.0) software, and tests were carried out to verify the existence of an association between sociodemographic variables and the results obtained in the instruments. The sociodemographic characterization identified that 81% of the patients are women, 46.6% are 18 to 58 years old, 58.6% are from Ribeirão Preto, 58% have a partner, 39.7% have 10 to 14 years of study and 62,% work. The main sources of referrals were from Psychology (22%) and specialties focused on women\'s healthcare (19%). Regarding to the outcome of psychological care, 54% occurred because of discharge due to lacks or patient\'s abandonment. Concerning the psychological and behavioral factors, 46.6% had symptoms of moderate and severe anxiety and 55.2% had moderate and severe depression symptoms, 55.2% and 89.7% had stress. There was an absolute predominance of deficit in social skills factors evaluated in the IHS, and self-satisfaction with quality of life was evaluated as \'poor\' by 43% of the patients. This research obtained relevant data for the improvement in the functioning of the Ambulatory of Psychology of HCFMRP/USP and because it is a large service center, which forms specialized professionals, it becomes important to produce and disseminate knowledge in the area.

Background: Today, 160,000 people with dementia live in Sweden. With increasing age, the risk of suffering from dementia is higher. Many of those who seek hospital care and other healthcare facilities have dementia in addition to other disorders. Caring for people with dementia demands that the nurse has the knowledge and skills required to be able to provide adequate and safe care. Aim: The aim of this study is to describe nurse´s experiences in taking care of patients with dementia disease. Method: A literature-based study was performed, analyzing ten qualitative articles Results: The results consist of two main themes with four subthemes each. The first theme is nurses experience of barriers to good dementia care with four subthemes, the organization as an obstacle, lack of time, lack of knowledge, education and experience, non-adapted care environment. The second main theme was nurse's experience with conditions to good dementia care with four sub-themes, working in teams, working person-centered, knowledge of dementia diseases and caring environment. These highlight nurses experience to care for people with dementia. Conclusion: To care for patients with dementia, according to the result, time and knowledge are mainly required. Working person-centered gives the patient quality of care. Building a relationship with the patient and learning how to interpret signals takes time but is necessary for good care and good working environment. Resources are needed from management in form of time, staffing and knowledge development

No description available.

Este trabalho intenta tematizar a questão da crise através da prática de Plantão Psicológico, tendo como cenário o hospital geral universitário (HU) da Universidade de São Paulo (USP). Acompanhando pacientes e equipe de saúde do hospital, os psicólogos experienciaram muitas situações de crise, tais como aquelas expressas pelo gênero dramático. Suas experiências levaram a compreender tal prática por meio de uma analogia. Escolhe-se a tragédia grega como fio condutor para esta pesquisa, uma vez que este gênero literário do século V a. C. possui um caráter de transcendência histórica, trazendo em seu bojo a possibilidade de traduzir e desvelar aspectos da experiência humana nas situações críticas. Artisticamente, o drama se reporta a uma situação em que o protagonista encontra-se em uma encruzilhada do destino, submetido a uma circunstância de perda de liberdade por um advento imponderável e convocado a empunhar sua responsabilidade na direção do sentido de sua existência. A metodologia de pesquisa se assenta no olhar da fenomenologia existencial. Sendo assim, afasta-se de procedimentos ou instrumentais pré-definidos, partindo, como propõe M. Heidegger, do questionamento do ser. Elege-se a narrativa de atendimentos realizados por psicólogos plantonistas nos vários espaços do HU, apresentada através de diários de bordo, como matéria-prima para este interrogar e interpretar. Desvelou-se a crise como ruptura ocasionada por um acontecimento que irrompe na cotidianidade, levando à situação de alheamento e ocultamento de sentido pelo aniquilamento temporário da malha representacional que dá sustentação a existência. Estando lançado neste hiato, inaugura-se outra temporalidade que convoca à metaforização da crise, considerando-se o Plantão Psicológico como utensílio pertinente para possibilitar este trânsito / This present work intends to explore crisis phenomenon as a question through the Psychological Attendance practice, which scenario is the University General Hospital at the University of São Paulo. The psychologists experience many crisis situations such those expressed by drama theme, while accompanying hospital patients and health staff. Their experiences lead to comprehend such praxis by the means of an analogy. Greek tragedy is the guideline chosen for this research, because this literary style from the V b. C. century, by its historical transcendental characteristic, carries forward possibilities to translate and unveil relevant aspects of human experience when passing by critical situations. Artistically, drama conveys a situation where the protagonist finds himself in a destiny crossroads, under loss of freedom circumstances by an unexpected event, which convocates him to handle his own responsibility toward the sense of his existence. Existential phenomenology is the methodological path for this research. Departing from the questioning of being, as Heideggers proposal, it goes apart from predefined procedures. Psychologists attendances narratives at many hospital wards, as board diaries, are the main resource for the interrogation and interpretation

Este trabalho intenta tematizar a questão da crise através da prática de Plantão Psicológico, tendo como cenário o hospital geral universitário (HU) da Universidade de São Paulo (USP). Acompanhando pacientes e equipe de saúde do hospital, os psicólogos experienciaram muitas situações de crise, tais como aquelas expressas pelo gênero dramático. Suas experiências levaram a compreender tal prática por meio de uma analogia. Escolhe-se a tragédia grega como fio condutor para esta pesquisa, uma vez que este gênero literário do século V a. C. possui um caráter de transcendência histórica, trazendo em seu bojo a possibilidade de traduzir e desvelar aspectos da experiência humana nas situações críticas. Artisticamente, o drama se reporta a uma situação em que o protagonista encontra-se em uma encruzilhada do destino, submetido a uma circunstância de perda de liberdade por um advento imponderável e convocado a empunhar sua responsabilidade na direção do sentido de sua existência. A metodologia de pesquisa se assenta no olhar da fenomenologia existencial. Sendo assim, afasta-se de procedimentos ou instrumentais pré-definidos, partindo, como propõe M. Heidegger, do questionamento do ser. Elege-se a narrativa de atendimentos realizados por psicólogos plantonistas nos vários espaços do HU, apresentada através de diários de bordo, como matéria-prima para este interrogar e interpretar. Desvelou-se a crise como ruptura ocasionada por um acontecimento que irrompe na cotidianidade, levando à situação de alheamento e ocultamento de sentido pelo aniquilamento temporário da malha representacional que dá sustentação a existência. Estando lançado neste hiato, inaugura-se outra temporalidade que convoca à metaforização da crise, considerando-se o Plantão Psicológico como utensílio pertinente para possibilitar este trânsito / This present work intends to explore crisis phenomenon as a question through the Psychological Attendance practice, which scenario is the University General Hospital at the University of São Paulo. The psychologists experience many crisis situations such those expressed by drama theme, while accompanying hospital patients and health staff. Their experiences lead to comprehend such praxis by the means of an analogy. Greek tragedy is the guideline chosen for this research, because this literary style from the V b. C. century, by its historical transcendental characteristic, carries forward possibilities to translate and unveil relevant aspects of human experience when passing by critical situations. Artistically, drama conveys a situation where the protagonist finds himself in a destiny crossroads, under loss of freedom circumstances by an unexpected event, which convocates him to handle his own responsibility toward the sense of his existence. Existential phenomenology is the methodological path for this research. Departing from the questioning of being, as Heideggers proposal, it goes apart from predefined procedures. Psychologists attendances narratives at many hospital wards, as board diaries, are the main resource for the interrogation and interpretation

Syfte: Var att beskriva sjuksköterskors upplevelser av att vårda patienter med psykisk sjukdom inom den somatiska sjukvården.Design: Studien genomfördes som en litteraturstudie.Metod: Litteratur som publicerats mellan 2003-2013 söktes i databaser PubMed CINAHL, PsykInfo, PsykArticles och ERIC. Tolv vetenskapliga artiklar utgjorde grunden för resultatet, dessa artiklar blev kvalitetsgranskade innan de användes.Resultat: Sjuksköterskor kände rädsla, oförutsägbarhet, osäkerhet samt frustation och hopplöshet i vården av psykiskt sjuka patienter då de saknade kunskap. Bristen av kunskap upplevdes som det största hindret i vården av denna patientgrupp. De upplevde osäkerhet till en följd av egna värderingar och fördomar till dessa patienter, vilket ledde till att sjuksköterskor undvek denna patientgrupp. Sjuksköterskor beskrev avsaknad av handledning och samarbete med psykiatriska kliniker då denna patientgrupp vårdades på somatiska avdelningar.Slutsats: Med en utökad kunskap inom psykiatri kan sjuksköterskor få möjlighet att minimera fördomar och rädsla i mötet med psykiskt sjuka patienter.