Religiosity and mental health as aspects of comprehensiveness in care

ABSTRACT Objective: to understand how religiosity can influence the health of individuals diagnosed with mental disorders, based on comprehensive care. Methods: this is an integrative literature review, with the inclusion of articles in Portuguese, English and Spanish, between 2010 and 2018. Results: the critical analysis and qualitative synthesis of the 24 selected studies were categorized into two subtopics: The influence of religiosity in promoting comprehensive mental health care; Mental health versus religiosity: influencing conditions for effective access to comprehensive care. Final considerations: a positive influence of religiosity was identified in the lives of individuals diagnosed with mental disorders; however, evidence shows that health teams do not feel comfortable and prepared to work with religiosity as an expression of spirituality. This being one of the dimensional aspects of health, it can be inferred, on the results, the existence of this gap in the comprehensive care approach.

Interventional Strategies Based on the Types of Family Characteristics for the Diabetes Educator

Family roles are important consideration in diabetes management. The various psychosocial contexts within families, especially those with a member with diabetes, are very complex and play a key role in comprehensive care. It is important that all diabetes educators are aware of such family characteristics when designing an intervention. Diabetes educators are required to understand diverse types of family characteristics and should be well trained regarding such roles to support families with a diabetic member.

Positionspapier Schlaganfallnachsorge der Deutschen Schlaganfall-Gesellschaft – Teil 2: Konzept für eine umfassende Schlaganfallnachsorge

ZusammenfassungDie Schlaganfallnachsorge ist im Gegensatz zur akuten und rehabilitativen Versorgung des Schlaganfalls wenig standardisiert. Der fragmentierte ambulante Sektor erlaubt hierbei ein hohes Maß an Flexibilität, leidet aber folglich an variabler Qualität der Nachsorge. Die Kommission Nachsorge der Deutschen Schlaganfall-Gesellschaft formuliert in diesem Positionspapier ein inhaltliches Konzept, um eine strukturierte Nachsorge mit multiprofessionellem Ansatz zu entwickeln. Diese soll im Sinne einer „Comprehensive-care“-Versorgung und patientenzentriert erfolgen. Dazu schlagen wir ein diagnostisches Stufenkonzept mit Screening und ggf. weitergehender Untersuchung vor, das in Absprache mit den Betroffenen zu einem standardisierten Therapieplan führt, der im Langzeitverlauf entsprechend angepasst werden muss. Inhaltlich sind sowohl internistische Domänen (Management von Risikofaktoren) als auch genuin neurologische Domänen (Spastik, kognitive Defizite etc.) zu berücksichtigen. Besondere Herausforderungen an dieses Konzept sind die sektorenübergreifende (inter- und intrasektorale) Kommunikation zwischen den Akteuren im Gesundheitswesen untereinander sowie mit den Patienten und Angehörigen, die Notwendigkeit zur Schaffung eines Vergütungsmodells für eine solche Nachsorge und letztlich die Etablierung eines entsprechenden Qualitätsmanagements. Digitale Lösungen erachten wir als hilfreiche Werkzeuge für Aspekte der Diagnose, Therapie und Kommunikation in der Schlaganfallnachsorge.

Factors Associated with Adherence to Antiretroviral Drugs among HIV Positive Patients Attending Selected Comprehensive Care Centers in Semi-Urban, Kenya

Management of Human Immunodeficiency Virus (HIV) is multipronged but its nerve centre is lifelong adequate and consistent use of antiretroviral drugs (ARVs). The overall objective of this study was to determine the factors associated with adherence to antiretroviral drugs among HIV positive patients attending selected Comprehensive Care Centres (CCC) in Kibwezi West Sub-county, Makueni County, Kenya. 385 respondents were recruited by systematic random sampling and interviewed. Three Focused Group Discussions (FGD) and two Key Informant Interviews (KII) were also conducted. Majority 364(94.5%) of the respondents were adherent to ARVs. There was a significant association between adherence to ARVs and gender {χ 2 (1) =4.636, p<0.05} with males likely to have poor adherence {OR 0.174 (95%CI 0.130, 0.233)}. Age was significantly associated with adherence {Likelihood Ratio G2 (4) =10.693, p<0.05} with older ages (above 65 years) likely to adhere. Living in the same house with someone on ARVs was significantly associated with adherence to ARVs {χ 2 (1) =3.997 p=<0.05} with respondents living in the same house with someone on ARVs likely to adhere {OR 0.144 (95%CI 0.103, 0.200)}. Majority of the respondents had adequate knowledge and positive attitude towards adherence to ARVs. FGDs and KIIs identified fear, stigma, not believing in oneself, participating in activities that hamper adherence such as drinking alcohol, ignorance, denial, lack of social support, busy work schedule poor attitude by health service providers, drug stock outs, distance and long waiting time as contributing to poor adherence to ARVs. In conclusion, constant education and awareness creation on importance of adherence to ARVs should be strengthened particularly during clinic appointments to maintain knowledge and enhance positive attitude towards adherence. Measures to improve adherence among the male and younger population should be strengthened. Key words: adherence, antiretrovirals age, gender, knowledge, attitude.

Disease, Disability, and Paternalism in the Fight for Medicare for All

The sick and disabled need true co-conspirators who hold politicians accountable, who value the sick and disabled as expert strategists speaking to the needs of the community; who understand and amplify our urgency and our anger. We need universal, single-payer health care—comprehensive care for all, regardless of income or health status—now.