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Schorderet C, Bastiaenen CHG, de Bie RA, Maréchal M, Vuilleumier N, Allet L. Development of a tool to assess environmental factors to support home care - a Delphi study. BMC Geriatr 2023; 23:501. [PMID: 37605112 PMCID: PMC10441718 DOI: 10.1186/s12877-023-04207-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/30/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Living in an adequate environment suited to one's abilities and needs is an essential condition to function in daily life. However, no complete tool currently exists to provide a rapid overview of a person's environment, both material (accommodation and auxiliary means) and social (entourage and available services). Our aim was to develop a tool to identify potentially problematic environmental factors and to determine when an in-depth assessment is necessary. METHODS Health professionals experienced in home-based treatment participated in a three-round Delphi process. The first round aimed to define which items the tool should contain, the second to collect participants' opinions on a first version of the tool, and the third to collect the participants' opinions on the adapted version of the tool. RESULTS A total of 29 people participated in the first round, 21 in the second and 18 in the third. The final tool contains 205 items divided into four categories (basic information about the inhabitant and their home, inhabitant's level of independence and autonomy, home, tools and means at the inhabitant's disposition) and two annexes (stairs to access to the home, internal staircase to the dwelling). CONCLUSIONS A complete tool allowing professionals working in patients' homes to obtain an overview of the environmental factors that could represent obstacles to the independence of the inhabitant, or to the possibility of providing quality care could be developed. This tool is very complete but relatively long. To facilitate its usability, it would be relevant that a digital version to focus on individual relevant categories be elaborated.
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Affiliation(s)
- Chloé Schorderet
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, Sion, Switzerland.
- Department of Epidemiology, Care and Public Health Research Institute CAPHRI, Maastricht University, Maastricht, the Netherlands.
- The Sense Innovation & Research Center, Lausanne and Sion, Switzerland.
| | - Caroline H G Bastiaenen
- Department of Epidemiology, Care and Public Health Research Institute CAPHRI, Maastricht University, Maastricht, the Netherlands
| | - Robert A de Bie
- Department of Epidemiology, Care and Public Health Research Institute CAPHRI, Maastricht University, Maastricht, the Netherlands
| | | | | | - Lara Allet
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, Sion, Switzerland
- The Sense Innovation & Research Center, Lausanne and Sion, Switzerland
- Department of Community Medicine, University Hospitals and University of Geneva, Geneva, Switzerland
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Granados-Santiago M, Romero-Fernández R, Calvache-Mateo A, Heredia-Ciuro A, Martin-Nuñez J, López-López L, Valenza MC. Relationship between patient functionality impairment and caregiver burden: is there a cut off point for the severe COPD patient? Expert Rev Respir Med 2023; 17:247-253. [PMID: 36924330 DOI: 10.1080/17476348.2023.2190887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) patients experience a progressive limitation of their functionality accompanying their clinical evolution. Concretely, severe COPD patients usually require the figure of a caregiver. Caregiver burden has yet to be explored in other similar chronic diseases. The objective is to propose a cutoff point in different functional impairment aspects, to predict the presence of caregiver burden. METHODS Severe COPD patients were divided into two groups according to the caregiver burden, measured with the Zarit Burden Interview (ZBI). The patients were assessed with the London Chest Activity of Daily Living (LCADL) scale, the Functional Independence Measure (FIM), and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). RESULTS 70 COPD patients and their caregivers were included in this cross-sectional study. The ROC curve indicated a cutoff point of 19 in the LCADL scale (AUC = 0.722). Dependence in daily life activities had a cutoff point of 123 in the FIM (AUC = 0.776). Social participation in activities of daily living had a cutoff point of 37 in the WHODAS 2.0 (AUC = 0.739). CONCLUSION Dyspnea related to functional status, dependence in daily life activities, and social participation in activities of daily living of severe COPD patients can predict caretaker burden.
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Affiliation(s)
| | - Ramón Romero-Fernández
- Department of Physiotherapy. Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Andrés Calvache-Mateo
- Department of Physiotherapy. Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Alejandro Heredia-Ciuro
- Department of Physiotherapy. Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Javier Martin-Nuñez
- Department of Physiotherapy. Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Laura López-López
- Department of Physiotherapy. Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Marie Carmen Valenza
- Department of Physiotherapy. Faculty of Health Sciences, University of Granada, Granada, Spain
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Siira H, Kääriäinen M, Jämsä U. Experiences of implementation of the group-based adaptation training intervention for patients with chronic somatic illnesses or disabilities among multi-professional teams in specialized healthcare. Ann Med 2023; 55:2253725. [PMID: 37695695 PMCID: PMC10496520 DOI: 10.1080/07853890.2023.2253725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 08/12/2023] [Accepted: 08/26/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVE To describe the experiences of multi-professional teams of implementation of group-based adaptation training intervention for patients with chronic somatic illnesses or disabilities in specialized healthcare. MATERIALS AND METHODS Multi-professional teams (n = 7) implementing adaptation training courses for chronically ill patients in specialised healthcare were interviewed between 09/2020 and 12/2021. The themes for thematic group interviews were based on the standard protocol implementation of adaptation training in specialised healthcare, including planning, implementation and evaluation of the adaptation training courses. The interviews were audio-recorded and transcribed. The data were analysed using inductive content analysis. RESULTS The experiences of multi-professional teams involved using pedagogical methods, providing guidance and counselling to support the rehabilitation process, ensuring opportunities for peer support, and supporting the course participants' involvement and activities in everyday life. CONCLUSIONS Healthcare professionals should use pedagogical methods in reflective guidance and counselling to promote client-oriented approach in supporting adaptation. Their competence in pedagogy needs to be build and maintained by continuous education. Multi-professional teams need to ensure sufficient and versatile conditions for peer support and involvement of family members by creating open and trusting atmosphere, unhurried encounters, discussions, different and varying ways of working. Adaptation training can strengthen the self-efficacy of participants and help them shift their attention from illness and disability to thoughts of the future. Adaptation training can support active and meaningful daily life in a changed life situation.
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Affiliation(s)
- Heidi Siira
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Medical Rehabilitation, Wellbeing Services County of North Ostrobothnia, Oulu University Hospital, Oulu, Finland
| | - Ulla Jämsä
- Department of Medical Rehabilitation, Wellbeing Services County of North Ostrobothnia, Oulu University Hospital, Oulu, Finland
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D’Amore C, O’Hoski S, Griffith LE, Richardson J, Goldstein RS, Beauchamp MK. Factors associated with participation in life situations in people with COPD. Chron Respir Dis 2022; 19:14799731221079305. [PMID: 35253474 PMCID: PMC8902177 DOI: 10.1177/14799731221079305] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To examine potential determinants of participation frequency and limitations
in people with Chronic Obstructive Pulmonary Disease (COPD). Methods For this secondary analysis, we grouped the following factors using the
International Classification of Functioning, Disability and Health (ICF)
components: age, psychological distress (Hospital Anxiety and Depression
Scale (HADS)), gait aid use, supplemental oxygen use, grip strength,
modified Medical Research Council Dyspnea scale, Short Physical Performance
Battery, and Six-Minute Walk Test (6MWT). Participation was measured using
the frequency and limitation domains of the Late Life Disability Instrument
(LLDI). Relationships between factors and participation were examined using
linear regression. Results Ninety-six participants (age 68.7 ± 8.1 yrs; FEV1 %pred 34 IQR
25–54) were included in the analysis. Factors were linked to four ICF
components: activity, body functions, personal, and environmental factors.
The final model for LLDI-frequency contained HADS, use of gait aid, and 6MWT
(F (3, 81) = 27.69 (p < .001), R2 = 0.51),
and for LLDI-limitations, the final model included age, HADS, and 6MWT (F
(3, 82) = 19.74 (p < .001), R2 = 0.42). Discussion Participation in life situations in people with COPD is associated with
multiple ICF components. Psychological distress (i.e., anxiety and
depression symptoms) and mobility were important determinants of
participation frequency and limitations. Prospective studies are needed to
confirm these relationships.
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Affiliation(s)
- Cassandra D’Amore
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Sachi O’Hoski
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- West Park Healthcare Centre, Toronto, ON, Canada
| | - Lauren E Griffith
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Roger S Goldstein
- West Park Healthcare Centre, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Marla K Beauchamp
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- West Park Healthcare Centre, Toronto, ON, Canada
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Zacarias LC, Câmara KJDC, Alves BM, Morano MTAP, Viana CMS, Mont'Alverne DGB, Castro SS, Leite CF. Validation of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) for individuals with COPD. Disabil Rehabil 2021; 44:5663-5668. [PMID: 34261374 DOI: 10.1080/09638288.2021.1948117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE COPD fits the profile of disabling health conditions. This study aims to validate the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in individuals with COPD. MATERIAL AND METHODS 100 participants with COPD responded to the Brazilian 36-item version of the WHODAS 2.0, as well as the Saint George's Respiratory Questionnaire (SGRQ), and the COPD Assessment Test (CAT). Spirometric data was extracted from medical records. RESULTS The internal consistency analysis showed coefficients for all WHODAS 2.0 domains with a strong correlation (0.70-0.85) except for Life activities, which had a moderate correlation (coefficient = 0.60). In the construct analysis, the coefficients for the WHODAS and SGRQ domains presented a consistent correlation among them, varying from 0.40 to 0.69. No correlation was evidenced among the WHODAS domains and the spirometric data, highlighting that linear measures fail when associated with the functioning of an individual with COPD. Discriminative analysis revealed a capacity for the WHODAS 2.0 to distinguish among COPD different levels of clinical impact obtained from CAT excluding the Getting along domain. CONCLUSION The WHODAS 2.0 shows as a valid instrument that can sensibly assess functioning differences related to the clinical impact classification level in subjects with COPD.IMPLICATIONS FOR REHABILITATIONWHODAS 2.0 is a valid tool to assess functioning in subjects with COPD.WHODAS 2.0 is sensitive to functioning differences related to classification level and to clinical impact in individuals with COPD.As a Patient-Reported Outcome Measure (PROM), WHODAS 2.0 offers the opportunity to develop clinical patient-centered interventions, improving the health care.As a low-cost, easy-to-use tool, WHODAS can be a useful resource in the process of clinical assessment of patient functioning.
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Affiliation(s)
- Laíla Cândida Zacarias
- Graduate Program in Cardiovascular Sciences, Federal University of Ceara, Fortaleza, Brazil
| | | | | | | | | | | | - Shamyr Sulyvan Castro
- Master Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Brazil
| | - Camila Ferreira Leite
- Graduate Program in Cardiovascular Sciences, Federal University of Ceara, Fortaleza, Brazil.,Master Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Brazil
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