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Tijsen LMJ, Derksen EWC, Achterberg WP, Buijck BI. A Qualitative Study Exploring Rehabilitant and Informal Caregiver Perspectives of a Challenging Rehabilitation Environment for Geriatric Rehabilitation. J Patient Exp 2023; 10:23743735231151532. [PMID: 36687166 PMCID: PMC9850128 DOI: 10.1177/23743735231151532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
There is a trend toward formalization of the rehabilitation process for older rehabilitants in a Challenging Rehabilitation Environment (CRE). This concept involves the comprehensive organization of care, support, and environment in rehabilitation wards. So far, literature about the principles of CRE is scarce. This study aims to explore the opinions of rehabilitants and informal caregivers regarding CRE, through a qualitative study between 2019 and 2020. Three telephone interviews were conducted with informal caregivers, and also 3 focus groups with 15 rehabilitants and 3 informal caregivers, all with recent experience in rehabilitation. Nine themes emerged regarding the rehabilitation process: (1) rehabilitant (attention for resilience, motivation, cognitive and emotional aspects), (2) rehabilitant centered (goal setting, physical and cognitive functioning and coping), (3) informal caregivers (involving and attention for resilience and relation), (4) communication (aligning the rehabilitation process), (5) exercise (increasing intensity by using task-oriented exercise, patient-regulated exercise, and group training), (6) peer support (learning experiences and recognition), (7) daily schedule (influence on the planning and activities outside therapy), (8) nutrition (energy for rehabilitation), and (9) eHealth (makes rehabilitation more challenging and fun). Regarding organizational processes, 4 themes were identified: (1) environmental aspects (single bedrooms, shared room for activities and therapy options on the ward), (2) staff aspects (small team with an emphatic supportive and motivating attitude), (3) organizational aspects (organized in an efficient way), and (4) return home (the discharge process should be well prepared for instance with home visits). Organizing excellent rehabilitation care requires a thorough understanding of the concept of CRE, as it is a complex and comprehensive concept that concerns the whole rehabilitation process. Its effectiveness and efficiency should be researched in prospective studies.
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Affiliation(s)
- Lian M J Tijsen
- Department of Public Health and Primary Care, Leiden University
Medical Center, Leiden, The Netherlands,Oktober, Bladel, The Netherlands,De Zorgboog, Bakel, The Netherlands,Lian M J Tijsen, LUMC, Department Public
Health and Primary Care, Postzone V0-P, Postbus 9600, 2300 RC Leiden, The
Netherlands.
| | - Els W C Derksen
- Department of Primary and Community Care, Radboud University Medical
Center, Nijmegen, The Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University
Medical Center, Leiden, The Netherlands
| | - Bianca I Buijck
- Oktober, Bladel, The Netherlands,De Zorgboog, Bakel, The Netherlands
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Benavent JV, Tenías JM, Pellin A, Casaña Mohedo J, Cabellos-García AC, Gea-Caballero V. Sociodemographic Determinants for the Health-Related Quality of Life of Patients with Vascular Amputations as Determined with the Prosthesis Evaluation Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082691. [PMID: 32295274 PMCID: PMC7216231 DOI: 10.3390/ijerph17082691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 03/19/2020] [Accepted: 04/07/2020] [Indexed: 11/16/2022]
Abstract
Background: To identify the sociodemographic variables independently related to the different dimensions of the Prosthesis Evaluation Questionnaire (PEQ). Methods: An observational, cross-sectional study was conducted, with a sample of 61 Spanish vascular amputees (Valencia, Spain). Included in this study are the results of the PEQ and explanatory-sociodemographic variables, as well as a descriptive and analytic analysis. Results: Gender differences were observed in “appearance” and “perception of appearance” (significantly higher levels for men). Older patients tended to have worse scores in “utility”, “frustration”, “social burden” and “deambulation”. More favorable scores were obtained for those residing in rural areas in “social burden” and “deambulation”. Educational level had a positive correlation with scores. Conclusion: Gender, age, place of residence, and educational level could be considered determinants of the quality of health related to prosthesis adaptation in vascular amputees. Clinical relevance: Knowing the influential variables in the process of prosthetization will allow better adaptation and an improvement in the quality of life.
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Affiliation(s)
| | - José María Tenías
- Dirección General de Investigación, Innovación, Tecnología y Calidad, Conselleria de Sanitat Universal i Salut Pública, 46010 Valencia, Spain;
| | - Ana Pellin
- Valencia International University, 46002 Valencia, Spain;
| | - Jorge Casaña Mohedo
- Universidad Europea, 46010 Valencia, Spain
- Correspondence: (J.C.M.); (A.C.C.-G.); Tel.: +34-670-634-579 (J.C.M.)
| | - Ana Cristina Cabellos-García
- Hospital Universitari i Politècnic La Fe, Grupo de Investigaciόn Enfermero en Arte y Ciencia del Cuidado GREIACC, Health Research Institute La Fe, 46026 Valencia, Spain
- Correspondence: (J.C.M.); (A.C.C.-G.); Tel.: +34-670-634-579 (J.C.M.)
| | - Vicente Gea-Caballero
- Nursing School La Fe, Adscript Center of Universitat de Valencia, Grupo de Investigaciόn en Arte y Ciencia del Cuidado GREIACC, Health Research Institute La Fe, 46026 Valencia, Spain;
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Em S, Karakoc M, Sariyildiz MA, Bozkurt M, Aydin A, Cevik R, Nas K. Assessment of sexual function and quality of life in patients with lower limb amputations. J Back Musculoskelet Rehabil 2019; 32:277-285. [PMID: 30347588 DOI: 10.3233/bmr-170873] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Diseases causing disabilities lead to sexual dysfunction. However, studies that evaluate sexual functions in patients with traumatic lower limb amputations (LLA) are limited and controversial. OBJECTIVE The objective is to evaluate sexual functions in male patients with LLA and to identify factors that might contribute to sexual dysfunction. The hypothesis is that male patients with LLA would experience worse sexual and emotional functioning and consequently emotional impairment that consequently influenced the sexual function. METHODS Sixty men with traumatic LLA and 60 healthy men were assessed according to the International Index of Erectile Function (IIEF) scoring system. Emotional state was assessed by the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), and the quality of life by the Short Form-36 Health Survey (SF-36). RESULTS Patients had significantly lower scores in the IIEF total score and subscores in comparison with the controls. Intercourse satisfaction scores were significantly higher (p< 0.05) in patients with trans-tibial amputation than in those with trans-femoral amputation. BDI and BAI scores negatively correlated with erectile function, sexual desire, intercourse satisfaction, overall satisfaction and total IIEF scores. The mental and physical scores of SF-36 significantly correlated with some of the sub scores and IIEF total scores. The power of statistical analysis for study population was 100% according to the given effect size (α= 0.01). CONCLUSION The present study suggests that the LLA leads to impairments in the sexual function and quality of life in male patients. Also, sexual dysfunction in patients is strongly associated with emotional state, pain, level of amputation and quality of life.
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Affiliation(s)
- Serda Em
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Mehmet Karakoc
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Mustafa Akif Sariyildiz
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Mehtap Bozkurt
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Abdulkadir Aydin
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Remzi Cevik
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Kemal Nas
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Sakarya University, Adapazarı, Turkey
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Davie-Smith F, Coulter E, Kennon B, Wyke S, Paul L. Factors influencing quality of life following lower limb amputation for peripheral arterial occlusive disease: A systematic review of the literature. Prosthet Orthot Int 2017; 41:537-547. [PMID: 28147898 DOI: 10.1177/0309364617690394] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The majority of lower limb amputations are undertaken in people with peripheral arterial occlusive disease, and approximately 50% have diabetes. Quality of life is an important outcome in lower limb amputations; little is known about what influences it, and therefore how to improve it. OBJECTIVES The aim of this systematic review was to identify the factors that influence quality of life after lower limb amputation for peripheral arterial occlusive disease. METHODS MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science and Cochrane databases were searched to identify articles that quantitatively measured quality of life in those with a lower limb amputation for peripheral arterial occlusive disease. Articles were quality assessed by two assessors, evidence tables summarised each article and a narrative synthesis was performed. STUDY DESIGN Systematic review. RESULTS Twelve articles were included. Study designs and outcome measures used varied. Quality assessment scores ranged from 36% to 92%. The ability to walk successfully with a prosthesis had the greatest positive impact on quality of life. A trans-femoral amputation was negatively associated with quality of life due to increased difficulty in walking with a prosthesis. Other factors such as older age, being male, longer time since amputation, level of social support and presence of diabetes also negatively affected quality of life. CONCLUSION Being able to walk with a prosthesis is of primary importance to improve quality of life for people with lower limb amputation due to peripheral arterial occlusive disease. To further understand and improve the quality of life of this population, there is a need for more prospective longitudinal studies, with a standardised outcome measure. Clinical relevance This is of clinical relevance to those who are involved in the rehabilitation of persons with lower limb amputations. Improved quality of life is associated with successful prosthetic use and focus should be directed toward achieving this.
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Affiliation(s)
| | | | - Brian Kennon
- 2 Queen Elizabeth University Hospital, Diabetes Centre, NHSGGC, Glasgow, UK
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Ebrahimzadeh MH, Golhasani-Keshtan F, Shojaee BS. Correlation between health-related quality of life in veterans with chronic spinal cord injury and their caregiving spouses. ARCHIVES OF TRAUMA RESEARCH 2014; 3:e16720. [PMID: 25738130 PMCID: PMC4329229 DOI: 10.5812/atr.16720] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 10/25/2014] [Accepted: 11/10/2014] [Indexed: 11/16/2022]
Abstract
Background: Recently, investigations have indicated that caring of a chronically ill family member strongly influences the health status and the quality of life (QOL) of the caregiving family members. Objectives: The purpose of this study was to examine the relationship between health-related QOL of veterans with chronic spinal cord injury and their caregiving spouses. Patients and Methods: We designed a cross-sectional study including two groups; veterans with chronic spinal cord injury and their caregiving wives who were living in the city of Mashhad, Iran. The patients with spinal cord injury were veterans from the Iran-Iraq war (1980-1988). All the participants filled out the short form 36 (SF-36) health survey questionnaire. A Pearson correlation coefficient was calculated for the scales of the two groups. Results: The mean age and standard deviation of veterans and their spouses were 48.5 ± 5.9 and 44.8 ± 7.2, respectively and their number of children ranged between 0-6. Our data analysis showed that there was a significant difference between the two groups in some domains of the SF-36, including PF, MH, PCS, MCS, BP and GH (P < 0.05), but there was no significant difference in RP, VT, SF and RE between the two groups. Conclusions: The results indicate that a decrease in health status level of veterans, physically and mentally, can affect the health-related QOL of their caregiving spouses.
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Affiliation(s)
- Mohammad Hosein Ebrahimzadeh
- Orthopedic Research Center, Qhaem Hospital Medical School, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Farideh Golhasani-Keshtan
- Orthopedic Research Center, Qhaem Hospital Medical School, Mashhad University of Medical Sciences, Mashhad, IR Iran
- Corresponding author: Farideh Golhasani-Keshtan, Orthopedic Research Center, Qhaem Hospital Medical School, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-9153024084, E-mail:
| | - Bibi Soheila Shojaee
- Orthopedic Research Center, Qhaem Hospital Medical School, Mashhad University of Medical Sciences, Mashhad, IR Iran
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Global position sensing and step activity as outcome measures of community mobility and social interaction for an individual with a transfemoral amputation due to dysvascular disease. Phys Ther 2014; 94:401-10. [PMID: 24092905 DOI: 10.2522/ptj.20120527] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND AND PURPOSE Community mobility of individuals following lower limb amputation is highly variable and has a great impact on their quality of life. Currently, clinical assessments of ambulatory ability and motivation influence prosthetic prescription. However, these outcome measures do not effectively quantify community mobility (ie, mobility outside of the clinic) of individuals with an amputation. Advances in global positioning systems (GPSs) and other wearable step-monitoring devices allow for objective, quantifiable measurement of community mobility. This case report will examine the combined use of a GPS unit and a step activity monitor to quantify community mobility and social interaction of an individual with transfemoral amputation due to dysvascular disease. CASE DESCRIPTION A 76-year-old woman with a unilateral transfemoral amputation due to vascular disease carried a commercial GPS unit and step activity monitor to quantify her community mobility and social interaction every day over a period of 1 month. The step activity monitor was affixed to her prosthesis. The patient used a wheelchair as well as her prosthesis for everyday mobility. OUTCOME Information from the GPS unit and step activity monitor provided quantitative details on the patient's steps taken in and out of the home, wheelchair use, prosthesis use, driving trips, and time spent on social and community trips. DISCUSSION This case report describes a potential clinical measurement procedure for quantifying community mobility and social interaction of an individual with lower limb amputation. Future efforts are needed to validate this measurement tool on large sample sizes and in individuals with different mobility levels. Additionally, automatization of data analysis and technological approaches to reduce compromised GPS signals may eventually lead to a practical, clinically useful tool.
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Fortington LV, Dijkstra PU, Geertzen JHB. Determinants of Discharge to Long-Term Care After a Lower Limb Amputation. J Am Geriatr Soc 2013; 61:298-9. [DOI: 10.1111/jgs.12114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Lauren V. Fortington
- Department of Rehabilitation Medicine; University Medical Center Groningen; Groningen the Netherlands
| | - Pieter U. Dijkstra
- Department of Rehabilitation Medicine; University Medical Center Groningen; Groningen the Netherlands
- Department of Oral and Maxillofacial Surgery; University Medical Center Groningen; Groningen the Netherlands
| | - Jan H. B. Geertzen
- Department of Rehabilitation Medicine; University Medical Center Groningen; Groningen the Netherlands
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