1
|
Chilman LB, Meredith PJ, Southon N, Kennedy-Behr A, Frakking T, Swanepoel L, Verdonck M. Occupational Performance Coaching for parents of picky eaters: A mixed methods study. Aust Occup Ther J 2024; 71:644-660. [PMID: 38538542 DOI: 10.1111/1440-1630.12947] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 03/04/2024] [Accepted: 03/08/2024] [Indexed: 10/03/2024]
Abstract
BACKGROUND/AIM Picky eating is a common childhood phenomenon that impacts many families' occupations surrounding mealtimes. Evidence of the effectiveness of Occupational Performance Coaching (OPC) for caregivers of children suggests it may represent a useful occupation-focused intervention for parents of picky eaters. Using an OPC-targeted intervention, this study aims to report preliminary effectiveness, explore the experience of parents' participation, and investigate factors that influence the OPC intervention. METHODS This study used an explanatory mixed-method design. Parent participants (n = 8) were recruited via purposive sampling and engaged in three sessions of OPC delivered via an online platform between October and December 2022. Standardised assessments were completed before and after OPC and a qualitative semi-structured interview two weeks after the final OPC session. Variables were analysed descriptively, and independent t tests were performed to compare scores on each standardised assessment pre- and post-intervention. Pearson's correlation analyses were conducted to consider associations between resistance to change and the extent of change in each outcome measure. Reflexive thematic analysis was conducted on postintervention interview transcripts. CONSUMER AND COMMUNITY INVOLVEMENT Consumer invovlement was limited to parents feedback on their experiences of the intervention. RESULTS Improvements in occupational performance as measured by the COPM change score were statistically significant (p = <0.001). Child eating behaviours, as measured by the CEBQ Food Fussiness subscale change score (p = 0.01) and BPFAS change score (p = 0.02), demonstrated significant improvements. The extent to which parents viewed these behaviours as problematic as measured by the BPFAS problem change score, showed a significant reduction (p = <0.001). Three themes emerged from interviews with parents: small changes beyond nutrition, parents supported as the experts, and what parents value within an intervention. CONCLUSION Targeted OPC intervention delivered online by an occupational therapist may be an effective intervention for parents of picky eaters. Future studies using randomised controls are required before OPC can be routinely recommended in a clinical setting for the management of picky eating in children.
Collapse
Affiliation(s)
- Laine B Chilman
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Pamela J Meredith
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Nicole Southon
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Ann Kennedy-Behr
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
- School of Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - Thuy Frakking
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
- Research Development Unit, Caboolture Hospital, Metro North Hospital and Health Service, Queensland Health, Herston, Australia
- Centre for Clinical Research, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Speech Pathology Department, Gold Coast University Hospital, Gold Coast Hospital and Health Service, Queensland Health, Southport, Australia
| | - Libby Swanepoel
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
- Australian Centre for Pacific Islands Research, School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Michèle Verdonck
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
| |
Collapse
|
2
|
Balikci A, May-Benson TA, Sirma GC, Kardas A, Demirbas D, Aracikul Balikci AF, Ilbay G, Sozen HG, Beaudry-Bellefeuille I. The Homeostasis-Enrichment-Plasticity (HEP ®) Approach for Premature Infants with Developmental Risks: A Pre-Post Feasibility Study. J Clin Med 2024; 13:5374. [PMID: 39336861 PMCID: PMC11432283 DOI: 10.3390/jcm13185374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Revised: 09/05/2024] [Accepted: 09/10/2024] [Indexed: 09/30/2024] Open
Abstract
Background: The environmental enrichment (EE) framework has inspired several early intervention (EI) approaches. This study evaluated the feasibility, safety, caregiver acceptance, and satisfaction of implementing the HEP Approach intervention, a novel EI model based on the EE paradigm. Outcome measures for motor development, individual functional goals, sensory functions, caregiver-provided environmental affordances, and motivation for movement were examined. Methods: A pre-post-study design examined 18 premature infants (<33 weeks six days gestation) with a corrected age of 4-10 months. A 21-item Likert scale survey assessed the feasibility, safety, acceptability, and satisfaction of implementing the HEP Approach intervention. The Peabody Developmental Motor Scales-2, Test of Sensory Functions in Infants, Affordances in the Home Environment for Motor Development, and Infant Movement Motivation Questionnaire were used for outcomes. The goal attainment scale measured progress toward parent goals. The HEP Approach consisted of 12 one-hour sessions implemented over three months. Results: Most participating parents found the HEP Approach intervention feasible, safe, acceptable, and satisfactory. GAS scores demonstrated significant gains with a mean t-score of 67.75 (SD = 2.00). Results found significant improvement (p ≤ 0.05) in all outcome measures. Conclusions: Results suggest that the HEP Approach intervention is safe, feasible, and acceptable to implement. Outcome measures were meaningful and sensitive in identifying improved motor development, individualized parental goals, sensory functions, caregivers' use of environmental opportunities, and movement motivation in premature at-risk infants. Results suggest further studies on the HEP Approach are feasible, and highlight the potential of this intervention to inspire and guide future research in this field.
Collapse
Affiliation(s)
| | | | - Gamze Cagla Sirma
- Department of Occupational Therapy, Faculty of Health Sciences, Fenerbahçe University, Istanbul 34758, Türkiye
| | - Ayten Kardas
- Department of Physiology, Faculty of Medicine, Yeditepe University, Istanbul 34755, Türkiye
| | - Duygu Demirbas
- Department of Occupational Therapy, Faculty of Health Sciences, İstanbul Sağlık ve Teknoloji University, Istanbul 34275, Türkiye
| | | | - Gul Ilbay
- Department of Physiology, Faculty of Medicine, Kocaeli University, Kocaeli 41001, Türkiye
| | - Hatice Gulhan Sozen
- Department of Child Health and Diseases, Faculty of Medicine, Bahcesehir University, Istanbul 34734, Türkiye
| | | |
Collapse
|
3
|
Arêas FZDS, Da Silva Filho WG, Arêas GPT, Jo HJ. Editorial: Neurorehabilitation in neurotrauma: treating traumatic brain and spinal cord injuries. Front Hum Neurosci 2024; 18:1484962. [PMID: 39318701 PMCID: PMC11421167 DOI: 10.3389/fnhum.2024.1484962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2024] [Accepted: 08/23/2024] [Indexed: 09/26/2024] Open
Affiliation(s)
- Fernando Zanela da Silva Arêas
- Baylor Scott and White Research Institute (BSWRI), Dallas, TX, United States
- Baylor Institute for Rehabilitation, Dallas, NC, United States
- Neurorehabilitation and Neuromodulation Laboratory, Universidade Federal do Espirito Santo, Vitoria, Brazil
| | | | | | - Hang Jin Jo
- Department of Rehabilitation Science, University at Buffalo, Buffalo, NY, United States
| |
Collapse
|
4
|
Sather TW, Strong KA. Supporting Participation Through Project-Based Intervention: A Tutorial for Working With People With Aphasia in Individual Sessions. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-14. [PMID: 39240835 DOI: 10.1044/2024_ajslp-24-00094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2024]
Abstract
PURPOSE Participation is an integral focus of services to people with aphasia and is considered best practice within the scope of practice for speech-language pathology. The Life Participation Approach to Aphasia encourages meaningful participation in life for people living with aphasia. In theory, providing participation-based services to people with aphasia seems logical; however, embedding these constructs of participation into practice can be challenging for speech-language pathologists (SLPs). Project-based intervention (PBI) provides an authentic opportunity to target participation and support identity reformulation in aphasia intervention. Historically, projects have been provided primarily in group-based settings, which may be difficult for the majority of SLPs who primarily offer individual sessions due to reimbursement. This tutorial provides a framework for using PBI in individual sessions for clients with aphasia using five evidence-based components: (a) shared decision making, (b) patient-reported outcomes, (c) goal setting, (d) the project, and (e) ongoing evaluation. Evidence-based tools and a case example are provided to support each component. CONCLUSIONS Projects and PBI provide tangible means of placing participation at the center of intervention while also providing opportunities to target language impairments, identity reconstruction, and various environments in a meaningful and personalized way. Projects can be scaled to the client's needs and abilities as well as to the constraints and options of the service delivery setting.
Collapse
Affiliation(s)
- Thomas W Sather
- Department of Communication Sciences and Disorders, University of Wisconsin-Eau Claire
| | - Katie A Strong
- Department of Communication Sciences and Disorders, Central Michigan University, Mount Pleasant
| |
Collapse
|
5
|
Fonseca AO, Gomes JS, Novaes RACB, Dias CL, Rodrigues MEDMA, Gadelha A, Noto C. Feuerstein Instrumental Enrichment Program for People With Schizophrenia After the First Episode of Psychosis: Protocol for an Open-Label Intervention Study. JMIR Res Protoc 2024; 13:e57031. [PMID: 39240685 PMCID: PMC11415717 DOI: 10.2196/57031] [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: 02/08/2024] [Revised: 05/22/2024] [Accepted: 07/18/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Schizophrenia is a disorder associated with neurocognitive deficits that adversely affect daily functioning and impose an economic burden. Cognitive rehabilitation interventions, particularly during the early phases of illness, have been shown to improve cognition, functionality, and quality of life. The Feuerstein Instrumental Enrichment (FIE) program, based on the Mediated Learning Experience and the Structural Cognitive Modifiability theory, has been applied in various disorders, but its applicability in schizophrenia has not yet been clarified. OBJECTIVE This study aims to investigate the effects of the FIE program on the functionality of patients with first-episode schizophrenia. METHODS In total, 17 patients will be recruited for an open-label intervention consisting of twice-weekly sessions for 10 weeks. The primary outcome measure will be changes in the Goal Achievement Scale score. Maze task performance from the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) battery will serve as a secondary outcome measure. At the same time, changes in Positive and Negative Syndrome Scale scores and other MATRICS domains will be analyzed as exploratory outcomes. Assessments will be administered before and after the intervention, with a follow-up period of 6 months. RESULTS This trial was preregistered in The Brazilian Registry of Clinical Trials (RBR-4gzhy4s). By February 2024, 11 participants were enrolled in the training. Recruitment is expected to be completed by May 2024. Data analysis will be conducted between May and September 2024. The results are expected to be published in January 2025. CONCLUSIONS This study may establish a protocol for the FIE program that uses mediation techniques for individuals in the early stages of schizophrenia. The results will add to the knowledge about strategies to promote cognitive skills and functional impairment in daily life. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/57031.
Collapse
Affiliation(s)
- Ana Olivia Fonseca
- First Episode Program, Psychiatric Department, Federal University of Sao Paulo, Sao Paulo, Brazil
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - July Silveira Gomes
- First Episode Program, Psychiatric Department, Federal University of Sao Paulo, Sao Paulo, Brazil
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Sao Paulo, Brazil
| | | | - Cíntia Lopes Dias
- First Episode Program, Psychiatric Department, Federal University of Sao Paulo, Sao Paulo, Brazil
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Federal University of Sao Paulo, Sao Paulo, Brazil
| | | | - Ary Gadelha
- First Episode Program, Psychiatric Department, Federal University of Sao Paulo, Sao Paulo, Brazil
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Cristiano Noto
- First Episode Program, Psychiatric Department, Federal University of Sao Paulo, Sao Paulo, Brazil
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Sao Paulo, Brazil
| |
Collapse
|
6
|
Silvera-Tawil D, Cameron J, Li J, Varnfield M, Allan LP, Harris M, Lannin NA, Redd C, Cadilhac DA. Multicomponent Support Program for Secondary Prevention of Stroke Using Digital Health Technology: Co-Design Study With People Living With Stroke or Transient Ischemic Attack. J Med Internet Res 2024; 26:e54604. [PMID: 39172512 PMCID: PMC11377903 DOI: 10.2196/54604] [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: 11/15/2023] [Revised: 04/23/2024] [Accepted: 06/14/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Few individuals (<2%) who experience a stroke or transient ischemic attack (TIA) participate in secondary prevention lifestyle programs. Novel approaches that leverage digital health technology may provide a viable alternative to traditional interventions that support secondary prevention in people living with stroke or TIA. To be successful, these strategies should focus on user needs and preferences and be acceptable to clinicians and people living with stroke or TIA. OBJECTIVE This study aims to co-design, with people with lived experience of stroke or TIA (referred to as consumers) and clinicians, a multicomponent digital technology support program for secondary prevention of stroke. METHODS A consumer user needs survey (108 items) was distributed through the Australian Stroke Clinical Registry and the Stroke Association of Victoria. An invitation to a user needs survey (135 items) for clinicians was circulated via web-based professional forums and national organizations (eg, the Stroke Telehealth Community of Practice Microsoft Teams Channel) and the authors' research networks using Twitter (subsequently rebranded X, X Corp) and LinkedIn (LinkedIn Corp). Following the surveys, 2 rounds of user experience workshops (design and usability testing workshops) were completed with representatives from each end user group (consumers and clinicians). Feedback gathered after each round informed the final design of the digital health program. RESULTS Overall, 112 consumers (male individuals: n=63, 56.3%) and 54 clinicians (female individuals: n=43, 80%) responded to the survey; all items were completed by 75.8% (n=85) of consumers and 78% (n=42) of clinicians. Most clinicians (46/49, 94%) indicated the importance of monitoring health and lifestyle measures more frequently than current practice, particularly physical activity, weight, and sleep. Most consumers (87/96, 90%) and clinicians (41/49, 84%) agreed that providing alerts about potential deterioration in an individual's condition were important functions for a digital program. Intention to use a digital program for stroke prevention and discussing the data collected during face-to-face consultations was high (consumers: 79/99, 80%; clinicians 36/42, 86%). In addition, 7 consumers (male individuals: n=5, 71%) and 9 clinicians (female individuals: n=6, 67%) took part in the user experience workshops. Participants endorsed using a digital health program to help consumers manage stroke or TIA and discussed preferred functions and health measures in a digital solution for secondary prevention of stroke. They also noted the need for a mobile app that is easy to use. Clinician feedback highlighted the need for a customizable clinician portal that captures individual consumer goals. CONCLUSIONS Following an iterative co-design process, supported by evidence from user needs surveys and user experience workshops, a consumer-facing app that integrates wearable activity trackers and a clinician web portal were designed and developed to support secondary prevention of stroke. Feasibility testing is currently in progress to assess acceptability and use.
Collapse
Affiliation(s)
- David Silvera-Tawil
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Sydney, Australia
| | - Jan Cameron
- Department of Medicine, Monash University, Melbourne, Australia
- Australian Centre for Heart Health, Melbourne, Australia
| | - Jane Li
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Sydney, Australia
| | - Marlien Varnfield
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Sydney, Australia
| | - Liam P Allan
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Sydney, Australia
- Department of Medicine, Monash University, Melbourne, Australia
| | - Mitch Harris
- Data 61, Commonwealth Scientific and Industrial Research Organisation, Melbourne, Australia
| | - Natasha A Lannin
- Australian Centre for Heart Health, Melbourne, Australia
- Department of Neuroscience, Monash University, Melbourne, Australia
| | - Christian Redd
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Sydney, Australia
| | - Dominique A Cadilhac
- Department of Medicine, Monash University, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| |
Collapse
|
7
|
Kraus B, Wolf TJ. The Spinal Cord Injury Self-Management Program: A Pilot. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024:15394492241271173. [PMID: 39155813 DOI: 10.1177/15394492241271173] [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: 08/20/2024]
Abstract
People with chronic spinal cord injury (SCI) experience a higher rate of secondary health conditions (SHCs) which affect their health and well-being. Self-management (SM) is a proven intervention approach, but formal programs may need to be tailored for the SCI population to reflect their needs and values. We sought to examine the feasibility and acceptability of the Spinal Cord Injury Self-Management (SCISM) Program and estimate its effect. A total of 32 individuals with SCI participated in the program. The primary outcomes were feasibility, acceptability, SHCs, and goal attainment. Participants were assessed at baseline, postintervention, and 3-month follow-up. Findings indicated that the SCISM Program was feasible and acceptable for use with moderate positive effects on SHCs and large positive effects in goal attainment. People with chronic SCI want to continue improving SM skills. The SCISM Program is feasible, acceptable, and should be examined further to reduce SHCs following SCI.
Collapse
|
8
|
Maldonado P, Bessaguet H, Chol C, Giraux P, Lafaie L, Adham A, David R, Celarier T, Ojardias E. Treatment of Acquired Deforming Hypertonia with Botulinum Toxin in Older Population: A Retrospective Study. Toxins (Basel) 2024; 16:365. [PMID: 39195775 PMCID: PMC11359055 DOI: 10.3390/toxins16080365] [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: 07/15/2024] [Revised: 08/12/2024] [Accepted: 08/13/2024] [Indexed: 08/29/2024] Open
Abstract
Acquired deforming hypertonia (ADH) affects the daily care of numerous nursing home residents. The aim of this study was to analyze the practice, aims, and effectiveness of botulinum toxin injections (BTxis) in the treatment of older patients with contractures, an indication for which BTxis are still underused. Data were extracted retrospectively from medical records regarding population, contractures, and injections. A prospective analysis was conducted to evaluate treatment goals set by goal attainment scaling (GAS) at T0 and at T1, to evaluate the therapeutic effects. We also recorded the occurrence of side effects, using a telephone questionnaire. This study included 41 patients older than 70 years who had received one or more BTxis for the first time between January 2018 and December 2021. Most of the older people we included lived in an institution (66%), manifested severe dependence, and presented significant morbi-mortality (37% of the patients died in the year after the last injection). The main objectives of these injections were purely comfort, without any functional goals. The GAS scores suggested effectiveness for comfort GAS scores. No complications were recorded. This study highlights the BTxis potential to address the needs of a larger number of older patients with ADH.
Collapse
Affiliation(s)
- Pablo Maldonado
- Department of Medical Gerontology, Gier Hospital, 19 rue Laurent Charles, 42400 Saint-Chamond, France;
| | - Hugo Bessaguet
- Department of Physical Medicine and Rehabilitation, University Hospital of Saint Etienne (CHUSE), Bellevue Hospital, 25 Boulevard Pasteur, 42100 Saint-Etienne, France; (H.B.); (P.G.)
- Inter-University Laboratory of Human Movement Biology, “Physical Ability and Fatigue in Health and Disease” Team (F-42023), Saint-Etienne “Jean Monnet”, “Lyon 1”, “Savoie Mont-Blanc” Universities, 42000 Saint-Etienne, France
| | - Cédric Chol
- Department of Medical Gerontology University Hospital of Saint Etienne (CHUSE), Charité Hospital, 44 Rue Pointe Cadet, 42100 Saint-Etienne, France; (C.C.); (L.L.); (T.C.)
| | - Pascal Giraux
- Department of Physical Medicine and Rehabilitation, University Hospital of Saint Etienne (CHUSE), Bellevue Hospital, 25 Boulevard Pasteur, 42100 Saint-Etienne, France; (H.B.); (P.G.)
- Lyon Neuroscience Research Center, Trajectoires Team (Inserm UMR-S 1028, CNRS UMR 5292, Lyon 1 and Saint-Etienne Universities), 42270 Saint-Etienne, France
| | - Ludovic Lafaie
- Department of Medical Gerontology University Hospital of Saint Etienne (CHUSE), Charité Hospital, 44 Rue Pointe Cadet, 42100 Saint-Etienne, France; (C.C.); (L.L.); (T.C.)
| | - Ahmed Adham
- Department of Physical Medicine and Rehabilitation, University Hospital of Saint Etienne (CHUSE), Bellevue Hospital, 25 Boulevard Pasteur, 42100 Saint-Etienne, France; (H.B.); (P.G.)
- Lyon Neuroscience Research Center, Trajectoires Team (Inserm UMR-S 1028, CNRS UMR 5292, Lyon 1 and Saint-Etienne Universities), 42270 Saint-Etienne, France
| | - Romain David
- Physical and Rehabilitation Medicine Unit, Poitiers University Hospital, University of Poitiers, 86021 Poitiers, France;
- PRISMATICS Laboratory (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
| | - Thomas Celarier
- Department of Medical Gerontology University Hospital of Saint Etienne (CHUSE), Charité Hospital, 44 Rue Pointe Cadet, 42100 Saint-Etienne, France; (C.C.); (L.L.); (T.C.)
| | - Etienne Ojardias
- Department of Physical Medicine and Rehabilitation, University Hospital of Saint Etienne (CHUSE), Bellevue Hospital, 25 Boulevard Pasteur, 42100 Saint-Etienne, France; (H.B.); (P.G.)
- Lyon Neuroscience Research Center, Trajectoires Team (Inserm UMR-S 1028, CNRS UMR 5292, Lyon 1 and Saint-Etienne Universities), 42270 Saint-Etienne, France
| |
Collapse
|
9
|
Wyman D, Butler LT, Morgan-Trimmer S, Bright P, Barber J, Budgett J, Walters K, Lang I, Rapaport P, Banks S, Palomo M, Orgeta V, Livingston G, Rockwood K, Lord K, Manthorpe J, Dow B, Hoe J, Cooper C. Process evaluation of a New psychosocial goal-setting and manualised support intervention for Independence in Dementia (NIDUS-Family). Age Ageing 2024; 53:afae181. [PMID: 39171389 DOI: 10.1093/ageing/afae181] [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: 03/15/2024] [Indexed: 08/23/2024] Open
Abstract
INTRODUCTION We report a mixed-methods process evaluation embedded within a randomised controlled trial. We aimed to test and refine a theory of change model hypothesising key causal assumptions to understand how the New Interventions for Independence in Dementia Study (NIDUS)-Family (a manualised, multimodal psychosocial intervention), was effective relative to usual care, on the primary outcome of Goal Attainment Scaling (GAS) over 1 year. METHODS In 2021-2022, intervention-arm dyads completed an acceptability questionnaire developed to test causal assumptions. We conducted qualitative interviews with dyads and intervention facilitators, purposively selected for diverse follow-up GAS scores. We collected observational data from intervention session recordings. We thematically analysed data, then integrated qualitative and quantitative data. RESULTS 174/204 (85.3%) dyads allocated to NIDUS-Family, fully completed it, 18 partially completed, while 12 received no intervention. We interviewed 27/192 (14%) of dyads receiving any sessions, and 9/10 facilitators; and observed 12 sessions. 47/192 (24.5%) of carers completed the acceptability questionnaire. We identified four themes: (A) 'Someone to talk to helps dyads feel supported'; (B) 'NIDUS-Family helps carers change their perspective'; (C) 'Personalisation helps people living with dementia maintain their identity' and (D) 'Small steps help dyads move forward'. CONCLUSION Key causal pathway mechanisms were: a respectful, trusting and impartial relationship with the facilitator: supporting the development of meaningful goals and support to find manageable solutions. Core implementation factors were delivery of the modules from a consistent facilitator across regular sessions. Core contextual factors influencing these mechanisms were dyadic participation and understanding of abilities.
Collapse
Affiliation(s)
- Danielle Wyman
- Faculty of Science and Engineering, School of Psychology and Sport Science at Anglia Ruskin University, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK
| | - Laurie T Butler
- Faculty of Science and Engineering, School of Psychology and Sport Science at Anglia Ruskin University, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK
| | | | - Peter Bright
- Faculty of Science and Engineering, School of Psychology and Sport Science at Anglia Ruskin University, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK
| | - Julie Barber
- Division of Psychiatry, University College London, Wing B, Floor 6 Maple House, 149 Tottenham Court Road, London, UK
| | - Jessica Budgett
- Centre for Psychiatry and Mental Health, Queen Mary University of London Wolfson Institute of Population Health, Yvonne Carter Building, Turner Street, London E1 2AB, UK
| | - Kate Walters
- Division of Psychiatry, University College London, Wing B, Floor 6 Maple House, 149 Tottenham Court Road, London, UK
| | - Iain Lang
- University of Exeter, The Medical School, Exeter, UK
| | - Penny Rapaport
- Centre for Psychiatry and Mental Health, Queen Mary University of London Wolfson Institute of Population Health, Yvonne Carter Building, Turner Street, London E1 2AB, UK
| | - Sara Banks
- Centre for Psychiatry and Mental Health, Queen Mary University of London Wolfson Institute of Population Health, Yvonne Carter Building, Turner Street, London E1 2AB, UK
| | - Marina Palomo
- Camden and Islington NHS Foundation Trust, Department of Clinical Psychology, St. Pancras Hospital, 4 St. Pancras Way, London, NW1 0PE, UK
| | - Vasiliki Orgeta
- Division of Psychiatry, University College London, Wing B, Floor 6 Maple House, 149 Tottenham Court Road, London, UK
| | - Gill Livingston
- Division of Psychiatry, University College London, Wing B, Floor 6 Maple House, 149 Tottenham Court Road, London, UK
| | - Kenneth Rockwood
- Division of Geriatric Medicine, Department of Medicine, School of Health Administration, Dalhousie University, Suite 1421-5955 Veterans' Memorial Lane, Halifax, NS B3H 4R2, Canada
| | - Kathryn Lord
- Centre for Applied Dementia Studies, University of Bradford, Richmond Road, Bradford, West Yorkshire BD7 1DP, UK
| | - Jill Manthorpe
- Social Care Workforce Research Unit, Faculty of Social Science and Public Policy, King's College London, 150 Stamford Street, London SE1 9NN, UK
| | - Briony Dow
- National Ageing Research Institute Ltd, Parkville, VIC, Australia
| | - Juanita Hoe
- Gellar Institute of Ageing and Memory, School of Medicine, University of West London, London W5 5RF, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Queen Mary University of London Wolfson Institute of Population Health, Yvonne Carter Building, Turner Street, London E1 2AB, UK
| |
Collapse
|
10
|
Szabó M, Gárdián G, Szpisjak L, Salamon A, Gábor T, Klivényi P, Zádori D. The Application of Goal Attainment Scaling in Cervical Dystonia - An Exploratory Observational Pilot Study. Mov Disord Clin Pract 2024; 11:1013-1017. [PMID: 38828630 PMCID: PMC11329570 DOI: 10.1002/mdc3.14118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 03/29/2024] [Accepted: 05/13/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Due to its heterogeneous manifestation an individualized approach to reach therapeutic goals in cervical dystonia (CD) is advantageous. OBJECTIVES The aim of the current study was to adapt goal attainment scaling (GAS) to drive the management of CD. METHODS 38 patients with CD, regularly treated with botulinum neurotoxin (BoNT), were involved in the current exploratory observational pilot study. GAS, including domains of motor, pain, disability, and psychiatric features, was applied to set up individualized goals with the calculation of initial GAS T-scores. Following at least 4 BoNT injection cycles, patients were reassessed whether they reached the pre-set goals. RESULTS The initial GAS T-scores (median: 36.9, range: 22.8-40) significantly improved (P < 0.001) to the end of the study (the median of final GAS T-scores: 50, range: 25.5-63.6). CONCLUSIONS The applicability of GAS in CD patients was confirmed, but further large-scale studies are needed refining this innovative approach.
Collapse
Affiliation(s)
- Máté Szabó
- Department of Neurology, Albert Szent‐Györgyi Clinical Centre, Albert Szent‐Györgyi Faculty of MedicineUniversity of SzegedSzegedHungary
- Department of NeurologyElbe Klinik StadeStadeGermany
| | - Gabriella Gárdián
- Department of Neurology, Albert Szent‐Györgyi Clinical Centre, Albert Szent‐Györgyi Faculty of MedicineUniversity of SzegedSzegedHungary
| | - László Szpisjak
- Department of Neurology, Albert Szent‐Györgyi Clinical Centre, Albert Szent‐Györgyi Faculty of MedicineUniversity of SzegedSzegedHungary
| | - András Salamon
- Department of Neurology, Albert Szent‐Györgyi Clinical Centre, Albert Szent‐Györgyi Faculty of MedicineUniversity of SzegedSzegedHungary
| | - Tamás Gábor
- Department of Neurology, Albert Szent‐Györgyi Clinical Centre, Albert Szent‐Györgyi Faculty of MedicineUniversity of SzegedSzegedHungary
| | - Péter Klivényi
- Department of Neurology, Albert Szent‐Györgyi Clinical Centre, Albert Szent‐Györgyi Faculty of MedicineUniversity of SzegedSzegedHungary
| | - Dénes Zádori
- Department of Neurology, Albert Szent‐Györgyi Clinical Centre, Albert Szent‐Györgyi Faculty of MedicineUniversity of SzegedSzegedHungary
| |
Collapse
|
11
|
Balikci A, May-Benson TA, Sirma GC, Ilbay G. HEP ® (Homeostasis-Enrichment-Plasticity) Approach Changes Sensory-Motor Development Trajectory and Improves Parental Goals: A Single Subject Study of an Infant with Hemiparetic Cerebral Palsy and Twin Anemia Polycythemia Sequence (TAPS). CHILDREN (BASEL, SWITZERLAND) 2024; 11:876. [PMID: 39062325 PMCID: PMC11276252 DOI: 10.3390/children11070876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 07/16/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Early intervention (EI) for infants identified as being at high risk for cerebral palsy (CP), or who have been diagnosed with it, is critical for promotion of postnatal brain organization. The aim of this study was to explore the effectiveness of the Homeostasis-Enrichment-Plasticity (HEP) Approach, which is a contemporary EI model that applies the key principles of enriched environment paradigms and neuronal plasticity from experimental animal studies to ecological theories of human development on the motor development, sensory functions, and parental goals of an infant with twin anemia polycythemia sequence (TAPS) and CP. METHODS An AB phase with follow-up single case study design which consisted of multiple baseline assessments with the Peabody Developmental Motor Scales-2 (PDMS-2) and the Test of Sensory Functions in Infants (TSFI) was used. Non-overlapping confidence intervals analysis was used for pre-post PDMS-2 scores. The measurement of progress toward goals and objectives was conducted using the Goal Attainment Scale (GAS). The HEP Approach intervention consisted of 12 one-hour sessions implemented over a period of 3 months, where a physical therapist provided weekly clinic-based parental coaching. RESULTS Results found a stable baseline during Phase A and improvement in response to the HEP Approach intervention during Phase B in both the PDMS-2 and TSFI according to 2SD Band analysis. The confidence intervals for the PDMS-2 scores also indicated a significant improvement after HEP intervention. The scores for both the PDMS-2 and the TSFI were consistent or showed improvement throughout the Follow-Up phase. A GAS t-score of 77.14 indicated that the infant exceeded intervention goal expectations. CONCLUSIONS Although our findings suggest that the HEP Approach intervention has promise in enhancing sensory functions, motor skill outcomes, and parental goals in an infant with TAPS and CP, further research is required to validate and apply these results more broadly.
Collapse
Affiliation(s)
| | | | - Gamze Cagla Sirma
- Department of Occupational Therapy, Faculty of Health Sciences, Fenerbahçe University, Istanbul 34758, Türkiye;
| | - Gul Ilbay
- Department of Physiology, Faculty of Medicine, Kocaeli University, Kocaeli 41001, Türkiye;
| |
Collapse
|
12
|
Doig E, Teo A, Pick V, Libera M, New A, Turner B, Suleman S, Foster M, Hoyle M. Exploring the goals and outcomes of adults with severe acquired brain injury participating in an extended inpatient brain injury rehabilitation unit in Australia. Disabil Rehabil 2024:1-9. [PMID: 38988260 DOI: 10.1080/09638288.2024.2375058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 06/27/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE To explore the rehabilitation goals and evaluate goal attainment outcomes of people with severe acquired brain injury (ABI), and investigate the relationship between goal engagement and goal attainment. MATERIALS AND METHODS Mixed-methods cohort study with twenty-nine adults with severe ABI in Australia. Demographic data, goal statements and pre-post program Goal Attainment Scale scores as well as Goal Engagement Scale scores were collected. Goals were coded using inductive content analysis and categorised by ICF component and domain. Goal attainment within ICF categories was described and compared using descriptive statistics. Pre-post program change in goal attainment was evaluated using Wilcoxon signed rank tests and correlations between goal engagement and attainment was explored using Spearman's (rho). RESULTS 94% of 320 goals were categorised as ICF Activity and Participation. There was significant improvement in goal attainment between admission and discharge (z=-0.47, p < 0.01). There was no significant relationship between goal engagement and goal attainment however there was a positive association between engagement in goal setting at admission and discharge.Conclusions: This interdisciplinary, inpatient rehabilitation program underpinned by key-worker facilitated person-centred, role-based goal setting resulted in goal attainment in chosen goals, which were primarily activity and participation-focused.
Collapse
Affiliation(s)
- Emmah Doig
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Hospital Service, Brisbane, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Amos Teo
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Valerie Pick
- Brain Injury Rehabilitation Service, Metro South Health, Brisbane, Australia
| | - Marilia Libera
- Brain Injury Rehabilitation Service, Metro South Health, Brisbane, Australia
| | - Alison New
- Brain Injury Rehabilitation Service, Metro South Health, Brisbane, Australia
| | - Ben Turner
- Acquired Brain Injury Outreach Service, Metro South Health, Brisbane, Australia
| | - Sameera Suleman
- Brain Injury Rehabilitation Service, Metro South Health, Brisbane, Australia
| | - Michele Foster
- The Hopkins Centre, Griffith University, Brisbane, Australia
| | - Melanie Hoyle
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| |
Collapse
|
13
|
Al-Otaibi SL, Algabbani MF, Alboraih AM, AlAbdulwahab SS. Effectiveness of Family-Professional Collaboration on Functional Goals Achievement of Children with Cerebral Palsy and Caregivers' Quality of Life and Burden: A Randomized Comparative Study. J Clin Med 2024; 13:4057. [PMID: 39064097 PMCID: PMC11277485 DOI: 10.3390/jcm13144057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/29/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
Background: Family-professional collaboration is important to enhance the outcomes for children with cerebral palsy and their caregivers. Aims: This study examined the effect of implementing a family-professional collaboration practice model on children with cerebral palsy and their caregivers. Materials and methods: A randomized, single-blind comparative study included 28 physical therapists, 44 children with cerebral palsy between the ages of 2 and 12 years old, and their caregivers. Physical therapists in the experimental group received training in how to implement collaboration in their therapy sessions over the course of two sessions (3 h each). The children's achievement goal-range rate was measured using the Goal Attainment Scaling, the caregivers' quality of life was assessed using the World Health Organization Quality of Life-Brief, and the caregiver burden was evaluated using the Zarit Burden Interview. Results: All children showed improvement on the Goal Attainment Scaling change rate (p = 0.002), with no significant differences between groups (p < 0.44). However, a group × time interaction was observed. The Children Goal Attainment Scaling rate decreased between the two assessment sessions for children in the control group, while the Goal Attainment Scaling change rate was steady for the experimental group. There were no main effects of time and group or interaction of time × group reported on World Health Organization Quality of Life-Brief domains and no main effect of time on the Zarit Burden Interview, but there was a main effect between groups (p = 0.03), with partial eta square = 0.11 in favor of the experimental group. Conclusions: The family-professional collaboration practice model could be a potential practice to positively improve the outcomes in children with cerebral palsy and their caregivers.
Collapse
Affiliation(s)
- Sarah L. Al-Otaibi
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia (S.S.A.)
| | - Maha F. Algabbani
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia (S.S.A.)
| | - Azza M. Alboraih
- Research and Scientific Center, Sultan Bin Abdulaziz Humanitarian City, Riyadh 13571, Saudi Arabia
| | - Sami S. AlAbdulwahab
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia (S.S.A.)
| |
Collapse
|
14
|
Xu T, Soh SLH, Chua CP, Pearpilai J, Wee SL. Clinical effectiveness and cost-effectiveness of a multicomponent frailty management program "Say No To Frailty" in Singapore: A cluster-randomized controlled trial protocol. Contemp Clin Trials 2024; 142:107546. [PMID: 38697512 DOI: 10.1016/j.cct.2024.107546] [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: 02/07/2024] [Revised: 04/19/2024] [Accepted: 04/25/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND A 12-week multicomponent frailty management program - Say No To Frailty (SNTF) consisting of interactive talks and fitness exercises led by a trained program leader has shown feasibility and positive health outcomes in community-living older adults with frailty and pre-frailty in Singapore. This study aims to evaluate the clinical- and cost-effectiveness of SNTF on physical functions, self-confidence, community participation, quality of life and fall reduction in the local community setting. METHODS This study will use the cluster-randomization method to randomly allocate 12 participating centres into three arms. Centres under two intervention arms will conduct the same SNTF program but led by a program leader with different training backgrounds (an Allied Health Professional (AHP) v.s. a non-AHP), whereas centres under the control arm will continue their usual care without an additional intervention. Eligible participants at each participating centre will be recruited via the convenience sampling method in the community setting. Primary outcome measure (frailty level) and secondary outcome measures (e.g., physical functions, self-confidence, community participation, quality of life) will be conducted by the blinded assessors at baseline, immediate, 3 months and 9 months post-intervention. Fall data will be collected during the one-year study period. Outcomes between and within groups will be compared and analysed using STATA to evaluate the clinical effectiveness. Program costs and relevant healthcare costs during the follow-up phase will be recorded for cost-effectiveness analysis. CONCLUSION This study will provide significant insights into conducting SNTF for Singapore community-living older adults with frailty and pre-frailty on clinical- and cost-effectiveness. Australia New Zealand Clinical Trials Registry: ACTRN12621001673831.
Collapse
Affiliation(s)
- Tianma Xu
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore.
| | - Shawn Leng Hsien Soh
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Chern-Pin Chua
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | | | - Shiou Liang Wee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| |
Collapse
|
15
|
Wortley K, Carda S, Ganzert C, Farag J, Reebye R. Upper Limb Casting Application Post-Botulinum Toxin Injection for Elbow Spasticity: A Guided Casting Protocol. Am J Phys Med Rehabil 2024; 103:645-649. [PMID: 38630558 DOI: 10.1097/phm.0000000000002487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
ABSTRACT Casting is an effective adjunctive treatment, which increases the effects of botulinum toxin on patients with spasticity. The evidence for casting as an adjunctive therapy post-botulinum toxin has been well documented in the literature. However, standardized casting protocols are lacking, with no published descriptions of upper limb casting application post-botulinum toxin injection for spasticity. In this article, we will describe our experience regarding the application of upper limb casting as an adjunctive therapy for elbow spasticity, detailing indications, contraindications, and description of our protocol (materials required and technique).
Collapse
Affiliation(s)
- Kate Wortley
- From the Canadian Advances in Neuro-Orthopedics for Spasticity Congress, Study Location, New Westminster Rehabilitation Medicine, New Westminster, Canada (KW, SC, CG, RR); Division of Developmental Pediatrics, University of Alberta (KW), Alberta, Canada; Service of Neuropsychology & Neurorehabilitation, Lausanne University Hospital (CHUV), Lausanne, Switzerland (SC); Hodgson Orthopedic Group, Coquitlam, Canada (CG); Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Canada (JF); Toronto Rehab Institute, University Health Network, Toronto, Canada (JF); and Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, Canada (RR)
| | | | | | | | | |
Collapse
|
16
|
Shwayder E, Dodson JA, Tellez K, Johanek C, Adhikari S, Meng Y, Schoenthaler A, Jennings LA. Goal setting among older adults starting mobile health cardiac rehabilitation in the RESILIENT trial. J Am Geriatr Soc 2024; 72:2157-2166. [PMID: 38450759 PMCID: PMC11226380 DOI: 10.1111/jgs.18868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/12/2024] [Accepted: 02/14/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND There is growing recognition that healthcare should align with individuals' health priorities; however, these priorities remain undefined, especially among older adults. The Rehabilitation Using Mobile Health for Older Adults with Ischemic Heart Disease in the Home Setting (RESILIENT) trial, designed to test the efficacy of mobile health cardiac rehabilitation (mHealth-CR) in an older cohort, also measures the attainment of participant-defined health outcome goals as a prespecified secondary endpoint. This study aimed to characterize the health priorities of older adults with ischemic heart disease (IHD) using goal attainment scaling-a technique for measuring individualized goal achievement-in a sample of 100 RESILIENT participants. METHODS The ongoing RESILIENT trial randomizes patients aged ≥65 years with IHD (defined as hospitalization for acute coronary syndrome and/or coronary revascularization), to receive mHealth-CR or usual care. For the current study, we qualitatively coded baseline goal attainment scales from randomly selected batches of 20 participants to identify participants' cardiac rehabilitation outcome goals and their perceptions of barriers and action plans for goal attainment. We used a deductive framework (i.e., 4 value categories from Patient Priorities Care) and inductive approaches to code and analyze interviews until thematic saturation. RESULTS This sample of 100 older adults set diverse health outcome goals. Most (54.6%) prioritized physical activity, fewer (17.1%) identified symptom management, fewer still (13.7%) prioritized health metrics, mostly comprised of weight loss goals (10.3%), and the fewest (<4%) were related to clinical metrics such as reducing cholesterol or preventing hospital readmission. Participants anticipated extrinsic (access to places to exercise, time) and intrinsic (non-cardiac pain, motivation) barriers. Action plans detailed strategies for exercise, motivation, accountability, and overcoming time constraints. CONCLUSIONS Using goal attainment scaling, we elicited specific and measurable goals among older adults with IHD beginning cardiac rehabilitation. Priorities were predominantly functional, diverging from clinical metrics emphasized by clinicians and healthcare systems.
Collapse
Affiliation(s)
- Elianna Shwayder
- Leon H. Charney Division of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York, NY
| | - John A. Dodson
- Leon H. Charney Division of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York, NY
- Division of Healthcare Delivery Science, Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Kelly Tellez
- Division of Healthcare Delivery Science, Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Camila Johanek
- Division of Healthcare Delivery Science, Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Samrachana Adhikari
- Division of Biostatistics, New York University Grossman School of Medicine, New York, NY
| | - Yuchen Meng
- Division of Biostatistics, New York University Grossman School of Medicine, New York, NY
| | - Antoinette Schoenthaler
- Institute for Excellence in Health Equity, New York University Grossman School of Medicine, New York, NY
| | - Lee A. Jennings
- Section of Geriatric Medicine, University of Oklahoma Health Sciences Center
| |
Collapse
|
17
|
Leeson R, Collins M, Douglas J. Interventions that aim to increase social participation through recreation or leisure activity for adults with moderate to severe traumatic brain injury: a scoping review. Disabil Rehabil 2024; 46:3286-3302. [PMID: 37607065 DOI: 10.1080/09638288.2023.2246377] [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: 12/28/2021] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE Social isolation and reduced social participation are common after traumatic brain injury (TBI). Developing interventions that aim to increase social participation through recreation or leisure activities continues to be challenging. This scoping review was conducted to provide an overview of interventions used to increase social participation through in-person recreation or leisure activity for adults with moderate to severe TBI living in the community. METHODS Using the Arksey and O'Malley framework, a scoping review of the literature published from 2005 to 2023 was conducted across four databases: Medline, CINAHL, PsycINFO and Scopus. Quality appraisals were conducted for included studies. RESULTS Following the removal of duplicates, 10,056 studies were screened and 52 were retained for full-text screening. Seven papers were included in the final review. Studies varied with respect to the type of intervention and program outcomes. The interpretation was impeded by study quality, with only two studies providing higher levels of evidence. Barriers and facilitators to successful program outcomes were identified. CONCLUSIONS Few studies with interventions focused on increasing social participation in leisure or recreation activity were identified. Further research incorporating mixed methods and longitudinal design to evaluate effectiveness over time is needed to build the evidence base for increasing social participation through leisure activity.
Collapse
Affiliation(s)
- Rebecca Leeson
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Michelle Collins
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Jacinta Douglas
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Summer Foundation, Melbourne, Victoria, Australia
| |
Collapse
|
18
|
Darvishi S, Datta Gupta A, Hamilton-Bruce A, Koblar S, Baumert M, Abbott D. Enhancing poststroke hand movement recovery: Efficacy of RehabSwift, a personalized brain-computer interface system. PNAS NEXUS 2024; 3:pgae240. [PMID: 38984151 PMCID: PMC11232286 DOI: 10.1093/pnasnexus/pgae240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 06/06/2024] [Indexed: 07/11/2024]
Abstract
This study explores the efficacy of our novel and personalized brain-computer interface (BCI) therapy, in enhancing hand movement recovery among stroke survivors. Stroke often results in impaired motor function, posing significant challenges in daily activities and leading to considerable societal and economic burdens. Traditional physical and occupational therapies have shown limitations in facilitating satisfactory recovery for many patients. In response, our study investigates the potential of motor imagery-based BCIs (MI-BCIs) as an alternative intervention. In this study, MI-BCIs translate imagined hand movements into actions using a combination of scalp-recorded electrical brain activity and signal processing algorithms. Our prior research on MI-BCIs, which emphasizes the benefits of proprioceptive feedback over traditional visual feedback and the importance of customizing the delay between brain activation and passive hand movement, led to the development of RehabSwift therapy. In this study, we recruited 12 chronic-stage stroke survivors to assess the effectiveness of our solution. The primary outcome measure was the Fugl-Meyer upper extremity (FMA-UE) assessment, complemented by secondary measures including the action research arm test, reaction time, unilateral neglect, spasticity, grip and pinch strength, goal attainment scale, and FMA-UE sensation. Our findings indicate a remarkable improvement in hand movement and a clinically significant reduction in poststroke arm and hand impairment following 18 sessions of neurofeedback training. The effects persisted for at least 4 weeks posttreatment. These results underscore the potential of MI-BCIs, particularly our solution, as a prospective tool in stroke rehabilitation, offering a personalized and adaptable approach to neurofeedback training.
Collapse
Affiliation(s)
- Sam Darvishi
- RehabSwift Pty Ltd, 10 Pulteney Street, The University of Adelaide, Adelaide, SA 5000, Australia
- School of Electrical and Electronic Engineering, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Anupam Datta Gupta
- Department of Rehabilitation Medicine, The Queen Elizabeth Hospital, Woodville, SA 5011, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Anne Hamilton-Bruce
- Stroke Research Programme, Basil Hetzel Institute, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Woodville, SA 5011, Australia
| | - Simon Koblar
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Mathias Baumert
- School of Electrical and Electronic Engineering, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Derek Abbott
- School of Electrical and Electronic Engineering, The University of Adelaide, Adelaide, SA 5000, Australia
| |
Collapse
|
19
|
Pijarnvanit P, Sriphetcharawut S. The Effects of Telehealth Parent Coaching on Occupational Performance and Executive Function of Children with Attention-Deficit/Hyperactivity Disorders, and Parent Self-Efficacy: A Preliminary Study. Occup Ther Health Care 2024; 38:783-799. [PMID: 36708506 DOI: 10.1080/07380577.2023.2169976] [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: 05/03/2022] [Accepted: 01/15/2023] [Indexed: 01/29/2023]
Abstract
This study examined the effectiveness of telehealth parent coaching on occupational performance and executive functions of children with attention-deficit/hyperactivity disorders (ADHD) and executive function deficits and parent self-efficacy. A one group pretest-posttest design was implemented with nine parents of children with ADHD ages 7-12 years old. The intervention consisted of ten, 60-minute, individual sessions, one per week delivered via telehealth. The parent program had three coaching components: goal setting, education, and the problem-solving process. Using strategies from the Four-Quadrant Model of Facilitated Learning, the results showed statistical improvement in performance and satisfaction of occupational performance and all executive functions scores of children except for the Shift and Emotional Control. Parent self-efficacy was also improved. These preliminary results suggest that the telehealth parent coaching program may potentially support a family who has a child with ADHD and executive function deficits.
Collapse
Affiliation(s)
- Pongsapak Pijarnvanit
- Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sarinya Sriphetcharawut
- Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| |
Collapse
|
20
|
Büttiker J, Marks D, Hanke M, Ludyga S, Marsico P, Eggimann B, Giannouli E. Cognitive-motor exergame training on a labile surface in stroke inpatients: study protocol for a randomized controlled trial. Front Neurol 2024; 15:1402145. [PMID: 38966081 PMCID: PMC11223001 DOI: 10.3389/fneur.2024.1402145] [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] [Received: 03/16/2024] [Accepted: 05/29/2024] [Indexed: 07/06/2024] Open
Abstract
Background Cognitive-motor training in form of exergames has been found to be feasible and effective for the improvement of motor and cognitive functioning in older adults and several patient populations. Exergame training under unstable conditions might increase the proprioceptive resources needed and thus might be a superior training approach compared to exergame training on stable ground for stroke patients, who often have proprioceptive deficits. Objective Aim of this study is to assess the feasibility and effects of exergame-based cognitive-motor training on a labile platform on physical and cognitive functioning in stroke inpatients. Methods This is two-armed pilot randomized controlled trial taking place in an inpatient neurologic rehabilitation clinic. A total of 30 persons that are undergoing inpatient rehabilitation due to a stroke will be randomly assigned to either the intervention group (IG) or the control group (CG). Participants of the IG will receive exergame-based motor-cognitive training on a labile surface, whereas participants of the CG will train on a stable surface. Primary outcome is feasibility comprising measures of adherence, attrition, safety and usability. Secondary outcomes will be measures of cognitive (psychomotor speed, inhibition, selective attention, cognitive flexibility, brain activity) and motor (functional mobility, gait speed, balance, proprioception) functioning. Results Data collection started in February 2024 and is expected to be completed by August 2024. Conclusion This is the first study looking into exergame training on labile surface in stroke patients. It will give valuable insights into the feasibility and potential added value of this type of training and thus inform further implementation efforts in the context of inpatient rehabilitation. Clinical trial registration ClinicalTrials.gov, NCT06296069.
Collapse
Affiliation(s)
- Joel Büttiker
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Detlef Marks
- Rehaklinik Zihlschlacht, Centre for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | - Manuel Hanke
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Petra Marsico
- Research Department, Swiss Children’s Rehab, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Benjamin Eggimann
- OST – Eastern Switzerland University of Applied Sciences, Rapperswil, Switzerland
| | | |
Collapse
|
21
|
Tur Segura M, Gimeno Esteve F, Biedermann Villagra T, Jiménez Redondo J, García Rodríguez N, Milà Villarroel R. Radial extracorporeal shock wave therapy for the management of spasticity in cerebral palsy: study protocol for a randomized controlled trial. Front Neurol 2024; 15:1402452. [PMID: 38957349 PMCID: PMC11218758 DOI: 10.3389/fneur.2024.1402452] [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] [Received: 03/17/2024] [Accepted: 06/04/2024] [Indexed: 07/04/2024] Open
Abstract
Background Spasticity is the most common motor disorder in cerebral palsy (CP), and its management is complex, posing a significant challenge for the rehabilitation team. Radial extracorporeal shock wave therapy (rESWT) has emerged in recent years as an effective, non-invasive, and low-risk alternative for the management of spasticity in CP patients, with only minor side effects such as small bruises or discomfort during application. There is great variability in rESWT administration protocols, ranging from a single session up to the 12 sessions. The most extensively studied protocol involves 3 rESWT sessions with a one-week interval between session. According to current literature, the effect of rESWT has not been investigated by extending the time interval between sessions beyond 1 week to determine if therapeutic effects on spasticity can be prolonged over time. Methods Following a power calculation using the minimal clinical important difference of our primary outcome (R2 of Modified Tardieu Scale), 72 patients will be included in the study. Enrolment is based upon inclusion/exclusion criteria outlined in the Methods section. Participants will be randomized in 3 groups. Each patient will receive 2000 impulses in the Triceps Sural muscle (distributed by all the plantar flexor muscles: soleus and gastrocnemius), at a 2.2 Bars pressure and a frequency of 8 Hz. The Control Group will receive 3 rESWT sessions with a time interval of 1 week between each session. The Experimental Group A will receive 3 rESTW sessions with a time interval of 2 weeks between each session and the Experimental Group B will receive 3 rESTW sessions with a time interval of 4 weeks between each session. Discussion This study will provide further information regarding the effect of rESWT on spasticity in patients with CP. If an increase in the time interval between rESWT sessions allows for the prolongation of therapeutic benefits on spasticity, it will be clinically relevant fact. With the same treatment dosage, patients will be able to benefit from its effects for a longer period of time. Clinical trial registration ClinicalTrials.gov, identifier NCT05702606.
Collapse
Affiliation(s)
- Míriam Tur Segura
- Fundació Aspace Catalunya, Barcelona, Spain
- School of Health Sciences Blanquerna, Ramon Llull University, Barcelona, Spain
| | | | | | | | | | | |
Collapse
|
22
|
Otero-Villaverde S, Formigo-Couceiro J, Martin-Mourelle R, Montoto-Marques A. Safety and effectiveness of thermal radiofrequency applied to the musculocutaneous nerve for patients with spasticity. Front Neurol 2024; 15:1369947. [PMID: 38915804 PMCID: PMC11194366 DOI: 10.3389/fneur.2024.1369947] [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] [Received: 01/13/2024] [Accepted: 05/20/2024] [Indexed: 06/26/2024] Open
Abstract
Objective Evaluate safety and effectiveness of thermal radiofrequency in the musculocutaneous nerve in patients with focal elbow flexor spasticity. Design Ambispective observational follow-up study. Patients with focal spasticity secondary to central nervous system injury with elbow flexor pattern who received thermal radiofrequency treatment in the musculocutaneous nerve between 2021 and 2023 were included. Subjects 12 patients. Methods Ultrasound-guided thermal radiofrequency was applied to the musculocutaneous nerve at 80°C for 90 s. Effectiveness was assessed prior to thermal radiofrequency and at 6 months using scales to measure pain (VAS), spasticity (MAS), disability (DAS), quality of life (SQol-6D), patient-perceived and physician-perceived satisfaction (PIG-C, PGA), and goal attainment (GAS). Elbow joint range of motion was evaluated via goniometry. Safety was evaluated by assessing side effects. Results Patients had statistically significant improvements in spasticity (p = 0.003), severe elbow flexion (p = 0.02), pain (p = 0.046), functioning (p < 0.05), and spasticity-related quality of life (p < 0.05 in three sections). Furthermore, treatment goals were attained. Patient- and physician-perceived clinical improvement was achieved. Regarding side effects, two patients had dysesthesia that was self-limiting, with maximum duration of 1 month. Conclusion Thermal radiofrequency in the musculocutaneous nerve can be a safe, effective treatment for patients with severe spasticity with an elbow flexor pattern.
Collapse
Affiliation(s)
- Sergio Otero-Villaverde
- Physical Medicine and Rehabilitation Department, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | | | | | | |
Collapse
|
23
|
Appleton J, Stockton DA, Dickinson M, Debono D. Improving Outcomes for Regional Families in the Early Years: Increasing Access to Child and Family Health Services for Regional Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:728. [PMID: 38928974 PMCID: PMC11203508 DOI: 10.3390/ijerph21060728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/24/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024]
Abstract
Providing child and family health (CFH) services that meet the needs of young children and their families is important for a child's early experiences, development and lifelong health and well-being. In Australia, families living in regional and rural areas have historically had limited access to specialist CFH services. In 2019, five new specialist CFH services were established in regional areas of New South Wales, Australia. The purpose of this study is to understand the regional families' perceptions and experiences of these new CFH services. A convergent mixed-methods design involving a survey and semi-structured interviews with parents who had used the service was used for this study. Data collected include demographics, reasons for engaging with the service, perception, and experience of the service, including if the service provided was family centred. Triangulation of the quantitative and qualitative analysis uncovered three main findings: (i) The regional location of the service reduced the burden on families to access support for their needs; (ii) providing a service that is family-centred is important to achieve positive outcomes; and (iii) providing a service that is family-centred advances the local reputation of the service, enabling a greater reach into the community. Providing local specialist CFH services reduces the burden on families and has positive outcomes; however, providing services that are family-centred is key.
Collapse
Affiliation(s)
- Jessica Appleton
- Tresillian Family Care Centres, Mackenzie St., Belmore, NSW 2192, Australia
- Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia (D.D.)
| | - Deborah A. Stockton
- Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia (D.D.)
| | - Marie Dickinson
- Tresillian Family Care Centres, Mackenzie St., Belmore, NSW 2192, Australia
- Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia (D.D.)
| | - Deborah Debono
- Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia (D.D.)
| |
Collapse
|
24
|
Pham VM, Hoang TL, Hoang KC, Nguyen NM, DeLuca SC, Coker-Bolt P. The effect of constraint-induced movement therapy for children with hemiplegic cerebral palsy in Vietnam. Disabil Rehabil 2024:1-7. [PMID: 38828697 DOI: 10.1080/09638288.2024.2360060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 05/21/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE Pediatric constraint-induced movement therapy (CIMT) is an evidence-based treatment that has a long history of demonstrating efficacy for children with hemiparesis. The purpose of this study is to determine the effectiveness of a culturally responsive CIMT program for children with hemiplegic cerebral palsy (CP) developed for the Vietnam healthcare system. METHODS Thirty children with hemiplegic CP (mean age = 2.88 years, age range: 1 to 8 yrs, 60% male) were recruited to a CIMT program (7.5 h/week, 4 weeks) developed for the cultural context of Vietnam. Motor abilities of the affected arm and participation in daily activities were evaluated at 3 time points (one-week prior to CIMT (baseline), one-week before (pre) and after (post) CIMT) using the Quality of Upper Extremity Skill Test (QUEST) and Pediatric Motor Activity Log-Revised (PMAL-R). Individual goals were measured using the Goal Attainment Scale (GAS). RESULTS There were significant increases in the "How often scale" and "How Well" scales of the PMAL-R (0.75 and 0.75, p < 0.00)). Score of Grasp and Dissociated Movement items on the QUEST increased significantly (6.47 and 7.63, p < 0.001). Group GAS T-Scores were 52.19 indicating that children met individual goals. CONCLUSIONS A model of CIMT was successfully developed and delivered within the Vietnamese healthcare system. Future studies should explore the optimal model for CIMT in various regions of world where the delivery of rehabilitation services may vary.
Collapse
Affiliation(s)
- Van Minh Pham
- Rehabilitation Department, Ha Noi Medical University, Hanoi, Vietnam
- Ha Noi Rehabilitation Hospital, Hanoi, Vietnam
| | - Thi Lien Hoang
- Rehabilitation Department, Ha Noi Medical University, Hanoi, Vietnam
- Ha Noi Rehabilitation Hospital, Hanoi, Vietnam
| | - Khanh Chi Hoang
- Rehabilitation Department, Ha Noi Medical University, Hanoi, Vietnam
- Ha Noi Rehabilitation Hospital, Hanoi, Vietnam
| | - Ngoc-Minh Nguyen
- Rehabilitation Department, Nursing and Medical Technology Faculty, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Institut de recherche expérimentale et clinique (IREC), pôle de Pneumologie, ORL et Dermatologie, Université Catholique de Louvain, Brussels, Belgium
| | | | | |
Collapse
|
25
|
Zerbinati P, Mazzoli D, Galletti M, Basini G, Rambelli C, Mascioli F, Bò MC, Delia C, Petroselli L, Vulpiani MC, Prati P, Bemporad J, Merlo A. A survey on the short to medium-term satisfaction of neurological patients treated by functional surgery for the correction of limb deformities. Curr Med Res Opin 2024:1-10. [PMID: 38756086 DOI: 10.1080/03007995.2024.2352855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/05/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES Functional surgery (FS) is often used to correct congenital or acquired deformities in neurological patients. Along with functional results, short- and medium-term patient satisfaction should always be considered a key goal of surgery and rehabilitation. The aim of this study is to assess the short to medium-term satisfaction of patients who underwent FS and its correlation with perceived improvements. METHODS Invitation to an anonymous online survey was sent via e-mail to all neurological adult patients or caregivers of children who underwent lower or upper limb FS over the 2018-2020 period. The survey investigated patients' satisfaction with the surgery and the variation in pain, ADLs, level of independence, body image, self-esteem, social interaction skills, participation in social events, leisure activities and sports, and use of orthoses or walking aids. Descriptive data analysis was performed. Correlations were assessed using Kendall's tau. RESULTS 122 out of 324 adults and 53 out of 163 children's caregivers filled out the questionnaire, with a response rate approaching 40%. Eighty-three percent of adult respondents and 87% of the children's caregivers were satisfied or very satisfied in the short and medium terms and reported their expectations had been met. Satisfaction was significantly correlated (p < 0.01) with improvements in functional abilities, social participation, self-esteem, and pain reduction. Half of the adults and 40% of children stopped using their orthoses or replaced them with lighter ones. Dissatisfaction and worsened conditions were reported by <10% of the respondents. CONCLUSION According to patients and caregivers, FS was satisfactory in the short and medium terms, following improvements in all the ICF domains for most patients.
Collapse
Affiliation(s)
- Paolo Zerbinati
- Neuro-Orthopedic Surgery Unit, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Davide Mazzoli
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Martina Galletti
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Giacomo Basini
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Chiara Rambelli
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Francesca Mascioli
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Maria Chiara Bò
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Caterina Delia
- Azienda Ospedaliero-Universitaria Sant'Andrea, Roma, Italy
| | | | | | - Paolo Prati
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Jonathan Bemporad
- Neurologic Rehabilitation Unit, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Andrea Merlo
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| |
Collapse
|
26
|
Werk LP, Muschalla B. Effects and Side Effects in a Short Work Coaching for Participants with and without Mental Illness. Behav Sci (Basel) 2024; 14:462. [PMID: 38920794 PMCID: PMC11201230 DOI: 10.3390/bs14060462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/17/2024] [Accepted: 05/27/2024] [Indexed: 06/27/2024] Open
Abstract
Employees with mental illness are often the first to be unable to cope with increasingly complex psychosocial work demands. But people without mental illness can also suffer from, for example, high workload. This study compares a short coaching to stabilize work ability for employees with and without mental illness regarding coaching topics, effects on work-related resources, goal attainment, and unwanted events. Individual coaching of three sessions (problem exploration by behavior analysis, practice of new behavior, reflection) was conducted with employees from different professional fields. A medical history was taken to determine whether participants are affected by a mental disorder. All coaching was conducted by the same behavior therapist in training (L.P.W.) under the supervision of an experienced behavior therapist (B.M.). Two hundred and three coachings with three sessions were completed. In total, 103 participants did not have a mental illness (51%), and 100 participants reported a mental disorder (49%). The coaching participants with mental illness had lower initial levels of work-related capacities (more severe impairments) and coping behavior as compared to the participants without mental illness. In the pre-post comparisons, both groups achieved significant improvements in work-related coping after the coaching. There were no differences in goal attainment between both groups. While participants without mental illness reported more unwanted events in parallel to the coaching (30% reported negative developments in life), participants with mental illness reported coaching-related unwanted events (20% felt to be dependent on the coach). Coaching with an individual focus on one topic can improve work-related resources in participants with and without mental disorders. Since participants with and without mental illness experience different unwanted events in coaching, psychotherapeutic expertise is needed in order to set the right focus.
Collapse
Affiliation(s)
- Lilly Paulin Werk
- Department of Psychotherapy & Diagnostics, Institute of Psychology, Technische Universität Braunschweig, Humboldtstraße 33, 38106 Braunschweig, Germany;
| | | |
Collapse
|
27
|
Pradeau C, Estival S, Postal V, Laurier V, Maugard C, Isner-Horobeti ME, Mourre F, Krasny-Pacini A. A pilot rating system to evaluate the quality of goal attainment scales used as outcome measures in rehabilitation. Neuropsychol Rehabil 2024:1-32. [PMID: 38805592 DOI: 10.1080/09602011.2024.2343150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/01/2024] [Indexed: 05/30/2024]
Abstract
Goal Attainment Scaling (GAS) is a method for writing person-centred approach evaluation scales that can be used as an outcome measure in clinical or research settings in rehabilitation. To be used in a research setting, it requires a high methodological quality approach. The aim of this study was to explore the feasibility and reliability of the GAS quality rating system, to ensure that GAS scales used as outcome measures are valid and reliable. Secondary objectives were: (1) to compare goal attainment scores' reliability according to how many GAS levels are described in the scale; and (2) to explore if GAS scorings are influenced by who scores goal attainment. The GAS scales analysed here were set collaboratively by 57 cognitively impaired adults clients and their occupational therapist. Goals had to be achieved within an inpatient one-month stay, during which clients participated in an intervention aimed at improving planning skills in daily life. The GAS quality rating system proved to be feasible and reliable. Regarding GAS scores, interrater reliability was higher when only three of the five GAS levels were described, i.e., "three milestone GAS" (0.74-0.92), than when all five levels were described (0.5-0.88), especially when scored by the clients (0.5 -0.88).
Collapse
Affiliation(s)
- Charles Pradeau
- Pôle de Médecine Physique et de Réadaptation, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut Universitaire de Réadaptation Clemenceau (IURC) Strasbourg, Strasbourg cedex, France
| | - Severine Estival
- Laboratoire Interdisciplinaire des Sciences du Numérique, CNRS, Université Paris-Saclay, Orsay, France
| | - Virginie Postal
- Laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
| | | | | | - Marie-Eve Isner-Horobeti
- Pôle de Médecine Physique et de Réadaptation, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut Universitaire de Réadaptation Clemenceau (IURC) Strasbourg, Strasbourg cedex, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg University"Mitochondrie, stress oxydant et protection musculaire", Bordeaux, France
| | - Fabien Mourre
- Hôpital Marin APHP, Unité Prader-Willi, Hendaye, France
| | - Agata Krasny-Pacini
- Pôle de Médecine Physique et de Réadaptation, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut Universitaire de Réadaptation Clemenceau (IURC) Strasbourg, Strasbourg cedex, France
- Strasbourg Translational Neuroscience and Psychiatry, Inserm, Université de Strasbourg, Strasbourg, France
| |
Collapse
|
28
|
Tan RES, Ng LJH, Chew E, Lim AYT. Outcomes of complete neurotomy and immediate repair of the musculocutaneous nerve for treatment of elbow spasticity. J Hand Surg Eur Vol 2024:17531934241251667. [PMID: 38780056 DOI: 10.1177/17531934241251667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Neurotomy interrupts the stretch reflex and can be used for the treatment of spasticity. We hypothesized that neurotomy with nerve repair reduces spasticity while preserving motor function due to the preferential recovery of efferent over afferent fibres. This study reports the 1-year outcomes of neurotomy and immediate repair of the musculocutaneous nerve in the proximal arm for treatment of elbow flexor spasticity, comparing these to outcomes in the literature for neurectomy without nerve repair. A total of 10 adult patients with spasticity of the elbow flexors from stroke or traumatic brain injury who had undergone neurotomy and immediate repair of the musculocutaneous nerve were prospectively studied. The results suggest that this procedure effectively reduces elbow flexor spasticity, improves elbow resting position, active elbow extension and is useful for achieving patient goals with effects lasting at least 12 months.Level of evidence: IV (therapeutic).
Collapse
Affiliation(s)
- Ruth En Si Tan
- Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore
| | - Lloyd Jee Hean Ng
- Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore
| | - Effie Chew
- Division of Rehabilitation Medicine, Department of Medicine, National University Hospital, Singapore
| | - Aymeric Yu Tang Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| |
Collapse
|
29
|
Ryan AK, Miller L, Rose TA, Johnston LM. Child-led goal setting and evaluation tools for children with a disability: A scoping review. Dev Med Child Neurol 2024. [PMID: 38760984 DOI: 10.1111/dmcn.15959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/25/2024] [Accepted: 04/22/2024] [Indexed: 05/20/2024]
Abstract
AIM To examine child-led goal setting and evaluation tools and approaches for children with a disability or developmental delay. METHOD Six databases were searched for studies that included population (children aged less than 18 years with disability or developmental delay); construct (child-led goal setting tool or approach); and context (developmental therapy or rehabilitation). The utility of tools and approaches across the goal setting and evaluation process was investigated using abductive content analysis. RESULTS Fifty articles met the inclusion criteria. Three approaches and four tools for child-led goal setting and evaluation were identified. No studies reported the clinimetric properties of tools specifically for child self-respondents. Qualitative analysis revealed six distinct goal phases in which tools and approaches were used, which were synthesized into a new framework for child-led goal setting and evaluation titled DECIDE: Direct children to goal setting; Elicit goal topics and priorities; Construct a goal statement; Indicate baseline goal performance; Develop an action plan to address the goal; and Evaluate goal progress after the intervention. INTERPRETATION Children actively participated in goal setting and evaluation across six DECIDE goal phases. Further clinimetric information is required to support use of goal setting and evaluation tools with child self-respondents. Future research should emphasize the development of multi-phase goal setting tools and approaches for diverse populations of children.
Collapse
Affiliation(s)
- Aisling K Ryan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Laura Miller
- School of Allied Health, Australian Catholic University, Brisbane, Queensland, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Leanne M Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Children's Health Queensland Hospital and Health Services, Brisbane, Queensland, Australia
| |
Collapse
|
30
|
Ohno K, Oi R, Harada A, Tomori K, Sawada T. Response Shifts in the Canadian Occupational Performance Measure: A Convergent Mixed-Methods Study. Am J Occup Ther 2024; 78:7803205100. [PMID: 38709675 DOI: 10.5014/ajot.2024.050487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024] Open
Abstract
IMPORTANCE A response shift (RS) is a phenomenon in which there is an individual perceptual gap between pre and post assessments. RS effects were not considered in the Canadian Occupational Performance Measure (COPM) development process. OBJECTIVE To detect the effects of RS on the COPM. DESIGN Convergent mixed-methods research. SETTING Subacute rehabilitation hospital in Japan. PARTICIPANTS Nineteen adult patients with a range of neurological and musculoskeletal conditions recruited from a subacute rehabilitation hospital. OUTCOMES AND MEASURES In the qualitative analysis, patients' perceptions regarding occupation identified by the COPM were compared between the initial assessment (Time 1 [T1]) and a reassessment (Time 2 [T2]). In the quantitative study, patients were asked to re-rate the occupations in which the RS had occurred, giving feedback on their perceptions at T1 (T2'). The difference between T2 and T2' was calculated to clarify the magnitude of the RS. RESULTS Of the 19 patients, 18 had an RS in at least one occupation. The RS effects were classified into five categories: Replacing, Adding, Reducing, Unspecified, and Embodiment. Ninety occupations were extracted from all the patients, and 46 (51.1%) were affected by RS. The percentages of occupations for which the change in score due to RS exceeded the minimal clinically important difference (±2 points) was 26.1% (12 of 46) for COPM-Performance scores and 30.4% (14 of 46) for COPM-Satisfaction scores. CONCLUSIONS AND RELEVANCE Diverse RS effects have been identified in the COPM, which also affect score interpretation. Plain-Language Summary: The Canadian Occupational Performance Measure has a potential measurement bias that is due to a response shift in which there is an individual perceptual gap between pre and post assessments. The results of this study reveal a need to establish more accurate measurement methods to reduce the impact of response shifts on COPM scores.
Collapse
Affiliation(s)
- Kanta Ohno
- Kanta Ohno, PhD, is Assistant Professor, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, Tokyo, Japan;
| | - Riho Oi
- Riho Oi, BOT, is Occupational Therapist, Department of Occupational Therapy, Gotanda Rehabilitation Hospital, Tokyo, Japan
| | - Ai Harada
- Ai Harada, BOT, is Occupational Therapist, Department of Occupational Therapy, Shizuoka Tokushukai Hospital, Shizuoka, Japan
| | - Kounosuke Tomori
- Kounosuke Tomori, PhD, is Professor, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, Tokyo, Japan
| | - Tatsunori Sawada
- Tatsunori Sawada, PhD, is Professor, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, Tokyo, Japan
| |
Collapse
|
31
|
Tilton-Bolowsky VE, Hillis AE. A Review of Poststroke Aphasia Recovery and Treatment Options. Phys Med Rehabil Clin N Am 2024; 35:419-431. [PMID: 38514227 DOI: 10.1016/j.pmr.2023.06.010] [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] [Indexed: 03/23/2024]
Abstract
Poststroke aphasia, which impacts expressive and receptive communication, can have detrimental effects on the psychosocial well-being and the quality of life of those affected. Aphasia recovery is multidimensional and can be influenced by several baseline, stroke-related, and treatment-related factors, including preexisting cerebrovascular conditions, stroke size and location, and amount of therapy received. Importantly, aphasia recovery can continue for many years after aphasia onset. Behavioral speech and language therapy with a speech-language pathologist is the most common form of aphasia therapy. In this review, the authors also discuss augmentative treatment methodologies, collaborative goal setting frameworks, and recommendations for future research.
Collapse
Affiliation(s)
- Victoria E Tilton-Bolowsky
- Department of Neurology, Johns Hopkins School of Medicine, 600 North Wolfe Street, Phipps 446F, Baltimore, MD 21287, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins School of Medicine, 600 North Wolfe Street, Phipps 446F, Baltimore, MD 21287, USA.
| |
Collapse
|
32
|
Pickering A, Tucker P, Limond J. Single-case experimental design intervention for inappropriate sexualised behaviour in adolescent traumatic brain injury. Disabil Rehabil 2024:1-12. [PMID: 38688476 DOI: 10.1080/09638288.2024.2338188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/28/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE This study develops the evidence-base of interventions for inappropriate sexualised behaviour following brain injury involving adolescents. MATERIALS AND METHODS We describe a Single-Case Multiple Baseline Design intervention of Positive Behavioural Support (PBS) across settings. It involves a 16 year old adolescent who had a severe Traumatic Brain Injury (TBI) and presented with sexualised talk and touch. PBS may potentially be a successful intervention to remediate this. The aim of the article was to determine whether PBS could reduce the frequency and impact of the sexualised behaviour in a variety of his key daily settings. Visual and quantitative analyses were completed before and after the introduction of the PBS intervention within home and school settings. RESULTS Findings showed reduction in the frequency of sexualised talk and touch alongside subjective impact ratings in the home. Downward trends were encouraging in the school settings, but demonstrated smaller effects than home. The Overt Behaviour Scale showed a reduction in overall severity and the impact on others. CONCLUSIONS This study shows the promising impact on behaviour of introducing the PBS intervention within the home and school settings to support positive clinical change evidenced in the reduction in target behaviours and subjective response for caregivers.
Collapse
Affiliation(s)
- Andrea Pickering
- Department of Psychology, Recolo Ltd, London, UK
- Department of Clinical Psychology, Canterbury Christchurch University, Canterbury, UK
| | - Peter Tucker
- Department of Psychology, Recolo Ltd, London, UK
| | - Jennifer Limond
- Department of Clinical Psychology, University of Exeter, Exeter, UK
| |
Collapse
|
33
|
Furlanetto K, Khopade R, Phutane V, Bhat R, Stolee P. From not knowing to doing: An interprofessional approach to clinician training in use of Goal Attainment Scaling (GAS) as a recovery-oriented outcome measure in a rural mental health service. Int J Ment Health Nurs 2024. [PMID: 38685694 DOI: 10.1111/inm.13340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/21/2024] [Accepted: 04/08/2024] [Indexed: 05/02/2024]
Abstract
Outcome measurement and feedback are key to quality improvement in healthcare. Goal attainment scaling (GAS) is a tool that could be used to measure outcomes of mental health services delivering recovery-oriented care. The objective of this prospective study was to evaluate the effectiveness of tailored, interprofessional, multilevel and adaptable GAS training on clinician views, learning, competence, performance and confidence in the use of GAS. Thematic analysis of eight clinician participant views was done using the method proposed by Braun and Clarke (Thematic analysis: a practical guide to understanding and doing, 2022). Four main themes were generated: clinicians found that this type of training is useful, GAS influenced the way they thought about their roles in goal setting and recovery-oriented care and COVID-19 pandemic impacts. Furthermore, clinicians' skills to set scalable GAS goals with consumers and clinician confidence in using GAS improved. The results of this study show a positive impact of tailored, interprofessional, multilevel and adaptable training supporting development of clinician skills in the GAS process. The training design had a favourable effect on clinician views, learning, competence, performance and confidence of GAS as a recovery-oriented outcome measure. The approach to GAS training and use of GAS as a recovery-oriented outcome measure should be considered in response to mental health service reform.
Collapse
Affiliation(s)
| | | | - Vivek Phutane
- Goulburn Valley Health, Shepparton, Victoria, Australia
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Ravi Bhat
- Goulburn Valley Health, Shepparton, Victoria, Australia
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| |
Collapse
|
34
|
McCusker C, Quinn C, Smyth B, Irwin M, McCavert ME, Raleigh N, McCrudden E. 'Family first' - feasibility and pilot outcomes of a community intervention for families of children in recovery following brain injury. Brain Inj 2024; 38:368-376. [PMID: 38317303 DOI: 10.1080/02699052.2024.2311347] [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: 03/10/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE Feasibility and pilot outcomes of a new community-based program for families of children with acquired brain injury (ABI) are presented. Interventions, delivered by home-visiting and teletherapy, were underpinned by problem-solving therapy, narrative meaning making, goal-directed interventions and community system psychoeducation. METHODS Eighty-three families of children, who had sustained an ABI before 12 years of age, had an average of 13 sessions of the 'Family First' (FF) intervention. A mixed-methods prospective design was employed. Feasibility was evaluated through measures of accessibility and acceptability. Goal attainment scaling and pre-post changes on standardized questionnaires assessed changes in psychosocial adjustment and quality of life. RESULTS Feasibility analyses suggested engagement and retention of often hard to reach families and children with high psychosocial needs. Qualitative analyses suggested themes related to the accessibility of a unique service ('Nothing else like this out there' and 'Accessible and flexible') which facilitated 'Empowerment' within a family context ('A family affair'). Promising changes on standardized scales of behavior problems, competencies and child and family quality of life were discerned. Increased goal attainment scores were observed. CONCLUSION The FF program showed feasibility and promise. It impacted positively on the lives of children and families and improved capacity in supporting systems.
Collapse
Affiliation(s)
- Chris McCusker
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Catherine Quinn
- Brain Injury Matters (NI) Castlereagh Business Park, Belfast, Northern Ireland
| | - Bridget Smyth
- Brain Injury Matters (NI) Castlereagh Business Park, Belfast, Northern Ireland
| | - Meg Irwin
- Brain Injury Matters (NI) Castlereagh Business Park, Belfast, Northern Ireland
| | | | - Niamh Raleigh
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Eunan McCrudden
- Department of Clinical Psychology, Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland
| |
Collapse
|
35
|
Manolov R, Lebrault H, Krasny-Pacini A. How to assess and take into account trend in single-case experimental design data. Neuropsychol Rehabil 2024; 34:388-429. [PMID: 36961228 DOI: 10.1080/09602011.2023.2190129] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 03/07/2023] [Indexed: 03/25/2023]
Abstract
One of the data features that are expected to be assessed when analyzing single-case experimental designs (SCED) data is trend. The current text deals with four different questions that applied researchers can ask themselves when assessing trend and especially when dealing with improving baseline trend: (a) What options exist for assessing the presence of trend?; (b) Once assessed, what criterion can be followed for deciding whether it is necessary to control for baseline trend?; (c) What strategy can be followed for controlling for baseline trend?; and (d) How to proceed in case there is baseline trend only in some A-B comparisons? Several options are reviewed for each of these questions in the context of real data, and tentative recommendations are provided. A new user-friendly website is developed to implement the options for fitting a trend line and a criterion for selecting a specific technique for that purpose. Trend-related and more general data analytical recommendations are provided for applied researchers.Trial registration: ClinicalTrials.gov identifier: NCT04560777.
Collapse
Affiliation(s)
- Rumen Manolov
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology Barcelona, Spain
| | - Hélène Lebrault
- Rehabilitation department for children with congenital neurological injury, Saint Maurice Hospitals Saint Maurice, France
- Sorbonne Université, Laboratoire d'Imagerie Biomédicale, LIB Paris, France
- GRC 24, Handicap Moteur et Cognitif et Réadaptation (HaMCRe); Sorbonne Université Paris, France
| | - Agata Krasny-Pacini
- Pôle de Médecine Physique et de Réadaptation, Institut Universitaire de réadaptation Clemenceau StrasbourgHôpitaux Universitaires de Strasbourg, UF 4372, Strasbourg, France
- Unité INSERM 1114 Neuropsychologie Cognitive et Physiopathologie De La Schizophrénie, Département de Psychiatrie, Hôpital Civil de Strasbourg, Strasbourg, France
- Université de Strasbourg, Faculté de Médecine Strasbourg
| |
Collapse
|
36
|
Arthanat S, Wilcox J, LaRoche D. Smart home automation technology to support caring of individuals with Alzheimer's disease and related dementia: an early intervention framework. Disabil Rehabil Assist Technol 2024; 19:779-789. [PMID: 36136955 DOI: 10.1080/17483107.2022.2125088] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/25/2022] [Accepted: 09/11/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Home automation technology comprising of Internet of Things and Smart gadgets is a rapidly growing industry that is projected to have a major scope for ageing-in-place and caregiving. This study examined the feasibility and cost-benefits of a personalized home automation intervention for care of individuals with Alzheimer's disease and related dementia (ADRD) with emphasis on their safety and independence, and reduction of care burden. METHODS A mixed method intervention study was conducted with five dyads each comprising of a caregiver and care recipient with ADRD. Each dyad received personalized home automation intervention with individualized goals centred on home safety, activity engagement, and caregiver-recipient connectivity. The goals were created and monitored using goal attainment scaling (GAS). The dyads were followed up after three months with a home visit and interview. Goal attainment scoring and thematic analysis of the interviews were conducted to examine the findings from the study. RESULTS All dyads indicated positive goal attainment between pre and post intervention. Goals that were met were complimented by the categories of peace of mind, self-efficacy, and care recipient engagement, while unmet goals as well as complexities with the technology were elucidated under challenges. Overarching and conceptually linked themes from the study were unfamiliarity, value, and timing. CONCLUSION Home automation technology has the potential to be adapted to promote independence and safety of individuals with ADRD while relieving care burden. Nonetheless, we propose an early intervention framework to overcome identified challenges and optimize the technology's usability and sustainability.IMPLICATIONS FOR REHABILITATIONHome automation involving Internet of Things and Smart gadgets has gained rapid popularity owing to the comfort and connectivity they provide to mainstream consumers.The technology has an emerging significance to ageing-in-place and care of individuals with Alzheimer's Disease and Related Dementia (ADRD) as it can be adapted and implemented to enhance home safety and activity engagement of the care recipients while also strengthening their connectivity with the caregivers.Unfamiliarity with the technology compounded by the progression of ADRD can, however, be detrimental to its adoption.Individualized focus and early integration of the technology for caregiver-care recipient dyads can mitigate these challenges and optimize its usability and long-term value in relation to ageing-in-place and caregiver wellbeing.
Collapse
Affiliation(s)
- Sajay Arthanat
- Department of Occupational Therapy, University of New Hampshire, Durham, NH, USA
| | - John Wilcox
- Department of Occupational Therapy, University of New Hampshire, Durham, NH, USA
| | - Dain LaRoche
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
| |
Collapse
|
37
|
Cheema K, Dunn T, Chapman C, Rockwood K, Howlett SE, Sevinc G. A systematic review of goal attainment scaling implementation practices by caregivers in randomized controlled trials. J Patient Rep Outcomes 2024; 8:37. [PMID: 38530578 PMCID: PMC10965877 DOI: 10.1186/s41687-024-00716-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 03/18/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Goal attainment scaling (GAS), an established individualized, patient-centred outcome measure, is used to capture the patient's voice. Although first introduced ~60 years ago, there are few published guidelines for implementing GAS, and almost none for its use when caregivers GAS is implemented with caregiver input. We conducted a systematic review of studies that implemented GAS with caregiver input; and examined variations in GAS implementation, analysis, and reporting. METHODS Literature was retrieved from Medline, Embase, Cochrane, PsycInfo and CINAHL databases. We included randomized controlled trials (published between 1968 and November 2022) that used GAS as an outcome measure and involved caregiver input during goal setting. RESULTS Of the 2610 studies imported for screening, 21 met the inclusion criteria. Most studies employed GAS as a primary outcome. The majority (76%) had children as study participants. The most common disorders represented were cerebral palsy, developmental disorders, and dementia/Alzheimer's disease. The traditional five-point GAS scale, with levels from -2 to +2, was most often implemented, with -1 level typically being the baseline. However, most studies omitted essential GAS details from their reports including the number of goals set, number of attainment levels and whether any training was given to GAS facilitators. CONCLUSIONS GAS with caregiver input has been used in a limited number of randomized controlled trials, primarily in pediatric patients and adults with dementia. There is a variability in GAS implementation and many crucial details related to the specifics of GAS implementation are omitted from reports, which may limit reproducibility. Here we propose catalog that may be utilized when reporting research results pertaining to GAS with caregivers to enhance the application of this patient-centered outcome measure.
Collapse
Affiliation(s)
- Kulpreet Cheema
- Ardea Outcomes, Halifax, NS, Canada
- Neuroscience and Mental Health Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | | | | | - Kenneth Rockwood
- Ardea Outcomes, Halifax, NS, Canada
- Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
- Geriatric Medicine Research Unit, Nova Scotia Health Authority, Halifax, NS, Canada
| | - Susan E Howlett
- Ardea Outcomes, Halifax, NS, Canada
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
- Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
| | | |
Collapse
|
38
|
Thibaudeau E, Peyroux E, Franck N, Carling H, Lepage M. Navigating Social Cognitive Impairments in Schizophrenia Spectrum Disorders: Protocol for a Pilot Pre-Post Quasi-Experimental Study for Remote Avatar-Assisted Cognitive Remediation Therapy. JMIR Res Protoc 2024; 13:e54251. [PMID: 38477975 DOI: 10.2196/54251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Social cognitive impairments are prevalent in schizophrenia spectrum disorder (SSD) and have detrimental effects on functioning. Cognitive remediation (CR) has shown its efficacy in improving social cognitive impairments, although the transfer of these skills to daily life and the personalization of these interventions remain challenging. RC2S (Remédiation Cognitive de la Cognition Sociale dans la Schizophrénie; Cognitive remediation of social cognition in Schizophrenia) is a French CR that combines the learning of strategies and practice using paper-and-pencil exercises and digital relational simulations. This French program was designed as an in-person intervention. OBJECTIVE This project aims to culturally adapt the RC2S program, in French-Canadian and North American English and to assess the feasibility, acceptability, safety, and implementation of a remote version in people with SSD. An exploratory objective is to assess the preliminary effect of remote RC2S on goal attainment, social cognition, and psychosocial outcomes. METHODS We will use a pre-post quasi-experimental design. First, the translation and cultural adaptation in North American English and French-Canadian of RC2S is presented. Then, 20 participants aged ≥18 years with a diagnosis of SSD, presenting with a subjective or an objective impairment in social cognition, will be included to receive RC2S. In addition, 5 therapists will be included as research participants to assess their perspective on RC2S. Participants with SSD will undergo a baseline remote assessment of their social cognition, clinical symptoms, and functioning. They will then start remote RC2S for 24 biweekly individual 1-hour sessions with a therapist. Following the case formulation and goal setting, participants will complete personalized paper-and-pencil exercises to develop strategies and integrative digital relational simulations, during which they will help an avatar navigate through a variety of social contexts and relationships. The last 2 sessions are dedicated to the transfer to daily life. All participants will complete in-session questionnaires assessing therapeutic alliance, motivation, acceptability, feasibility, and implementation. Following RC2S, the participants with SSD will repeat the same assessment as the baseline. Descriptive statistics will be used to summarize the data about acceptability, feasibility, safety, and implementation. To assess the preliminary effect of RC2S, an intention-to-treat approach will be used with linear mixed models for repeated measures with fixed effects of time. RESULTS So far, 45% (9/20) of participants with SSD (mean age 37.9, SD 9.3 years) have completed the project. They received a mean of 20.5 out of 24 (SD 3.5) sessions of RC2S. A total of 5 therapists also completed the project. CONCLUSIONS Improving social cognitive impairments is an important target in SSD to promote functional recovery. Using digital technologies to address these impairments and deliver the intervention is a promising approach to increase the ecological validity of CR and access to the intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT05017532; https://classic.clinicaltrials.gov/ct2/show/NCT05017532. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54251.
Collapse
Affiliation(s)
- Elisabeth Thibaudeau
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Research Center, Montreal, QC, Canada
| | | | - Nicolas Franck
- Centre Hospitalier Le Vinatier, Lyon, France
- Université Claude-Bernard-Lyon-I, Lyon, France
| | - Hannah Carling
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Research Center, Montreal, QC, Canada
| | - Martin Lepage
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Research Center, Montreal, QC, Canada
| |
Collapse
|
39
|
Hoffman R, Spencer E, Steel J. A qualitative exploration of speech-language pathologists' approaches in treating spoken discourse post-traumatic brain injury. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:608-622. [PMID: 36918757 DOI: 10.1111/1460-6984.12866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Spoken discourse impairments post-traumatic brain injury (TBI) are well-documented and heterogeneous in nature. These impairments have chronic implications for adults in terms of employment, socializing and community involvement. Intervention delivered by a speech-language pathologist (SLP) is recommended for adults with discourse impairments post-TBI, with an emphasis on context-sensitive treatment. The developing evidence base indicates a wide array of treatment components for SLPs to evaluate and implement within their clinical practice. However, there is limited insight into how SLPs are currently treating discourse impairments and the rationales informing clinical practice. AIMS To explore the under-researched area of clinical practice for spoken discourse interventions with adults post-TBI, including treatment components and clinician rationales, and to contribute towards a shared knowledge base. METHODS & PROCEDURES Participants were recruited via purposeful sampling strategies. Six SLPs participated from Australia, the United Kingdom (UK) and the United States (US). Semi-structured interviews were conducted via Zoom. Interviews were manually transcribed, coded and analysed via a qualitative content analysis approach. OUTCOMES & RESULTS Participants described discourse treatment practices across various settings and TBI recovery stages. Results indicated that SLPs used numerous treatment activities, resources and outcome measures. Intervention approaches primarily targeted social communication skills, strategy development/utilization and insight-building. Clinical practice conformed to available guidelines where possible, reflected best practice and incorporated components of the research literature. Participants reported using individualized treatment activities aimed at addressing client-specific factors and rationales prioritized tailored, context-sensitive and goal-directed treatment. CONCLUSIONS & IMPLICATIONS This study provided insight into a previously under-researched area. It highlighted a wide range of treatment activities and factors informing current SLPs' treatment of spoken discourse impairment post-TBI. Overall, clinical practice and rationales discussed in this study were aligned with best practice and emphasized a contextualized, individualized approach to discourse treatment across service settings and stages of recovery. Participants identified areas requiring further support, including access to training, resources and research, and the challenge of finding suitable outcome measures. Further investigation into discourse management post-TBI, from initial assessment to outcome measurement, may help inform clinical decision-making and the transfer of research to practice. WHAT THIS PAPER ADDS What is already known on the subject Spoken discourse impairments occur in dialogic and monologic productions post-TBI. Interventions targeting both genres are detailed within the research literature; however, studies exploring clinical practice and decision-making for discourse interventions post-TBI are limited. What this paper adds to existing knowledge This study provides new insight into the current treatment targets, activities, resources and outcome measures employed by clinicians supporting adults with discourse impairment post-TBI. It details the factors that influence clinical decision-making for this caseload and identifies an emphasis on client priorities and the value of clinician experience. What are the potential or actual clinical implications of this work? This study identifies the broad and complex considerations required to deliver context-sensitive discourse intervention post-TBI. It indicates the need for an in-depth review from assessment to treatment outcomes to better understand and support this area of practice and to direct future research. This study also highlighted the role of clinician experience in discourse intervention and the value of sharing clinical knowledge and resources within and across the profession to support all levels of clinician experience.
Collapse
Affiliation(s)
| | | | - Joanne Steel
- University of Newcastle, Callaghan, NSW, Australia
| |
Collapse
|
40
|
Skoumal M, Honegger M, Roller-Wirnsberger R. Frailty and innovative participatory rehabilitation. J Nutr Health Aging 2024; 28:100012. [PMID: 38492946 DOI: 10.1016/j.jnha.2023.100012] [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: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 03/18/2024]
Abstract
This Mini-Review showcases the latest evidence on rehabilitation opportunities for older people with multimorbidity and frailty. There is growing evidence, that a person-centered and contextualized rehabilitation approach may offer benefits, not only in the context of preserving mobility, but especially targeting social participation. Modern rehabilitation aligns with the bio-psycho-social model of the International Classification of Functioning, Disability and Health (ICF), emphasizing the individual and collaboratively determined definition of personalized rehabilitation goals at the activity and participation level. Further studies are warranted to evaluate objective outcome-measurement tools within the domains of activity and participation.
Collapse
Affiliation(s)
- Martin Skoumal
- Austrian Pension Insurance, Department for Scientific Research in Rehabilitation, Friedrich-Hillegeist-Straße 1, 1021 Vienna, Austria
| | - Martina Honegger
- Austrian Pension Insurance, Department for Scientific Research in Rehabilitation, Friedrich-Hillegeist-Straße 1, 1021 Vienna, Austria
| | - Regina Roller-Wirnsberger
- Medical University of Graz, Department of Internal Medicine, Research Unit Old Age Medicine and Lifelong Health, Auenbruggerplatz 15, 8036 Graz, Austria.
| |
Collapse
|
41
|
Baldwin DS, Adair M, Micheelsen A, Åstrøm DO, Reines EH. Goal setting and goal attainment in patients with major depressive disorder: a narrative review on shared decision making in clinical practice. Curr Med Res Opin 2024; 40:483-491. [PMID: 38294154 DOI: 10.1080/03007995.2024.2313108] [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: 11/01/2023] [Accepted: 01/29/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVE Narrative review of the processes of goal setting and goal attainment scaling, as practical approaches to operationalizing and implementing the principles of shared decision making (SDM) in the routine care of people living with major depressive disorder (MDD). METHODS We searched electronic databases for clinical studies published in English using key terms related to MDD and goal setting or goal attainment scaling. Two clinical studies of goal setting in MDD are considered in detail to exemplify the practicalities of the goal setting approach. RESULTS While SDM is widely recommended for people living with mental health problems, there is general agreement that it has thus far been implemented variably. In other areas of medicine, the process of goal setting is an established way to engage the patient, facilitate motivation, and assist the recovery process. For people living with MDD, the concept of goal setting is in its infancy, and only few studies have evaluated its clinical utility. Two clinical studies of vortioxetine for MDD demonstrate the utility of goal attainment scaling as an appropriate outcome for assessing functional improvement in ways that matter to the patient. CONCLUSIONS Goal setting is a pragmatic approach to turning the principles of SDM into realities of clinical practice and aligns with the principles of recovery that encompasses the notions of self-determination, self-management, personal growth, empowerment, and choice. Accumulating evidence supports the use of goal attainment scaling as an appropriate personalized outcome measure for use in clinical trials.
Collapse
Affiliation(s)
- David S Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- University Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Mood Disorders Service, Southern Health NHS Foundation Trust, Southampton, UK
| | | | | | | | | |
Collapse
|
42
|
Tinch-Taylor R, Pickles A, Stringer D, Csipke E, Cella M, McCrone P, Reeder C, Birchwood M, Fowler D, Greenwood K, Johnson S, Perez J, Ritunnano R, Thompson A, Upthegrove R, Wilson J, Kenny A, Isok I, Joyce EM, Wykes T. Understanding the Mechanisms of Cognitive Remediation on Recovery in People With Early Psychosis: A Mediation and Moderation Analysis. Schizophr Bull 2024:sbae021. [PMID: 38428943 DOI: 10.1093/schbul/sbae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
BACKGROUND To provide precision cognitive remediation therapy (CR) for schizophrenia, we need to understand whether the mechanism for improved functioning is via cognition improvements. This mechanism has not been rigorously tested for potential moderator effects. STUDY DESIGN We used data (n = 377) from a randomized controlled trial using CIRCuiTS, a therapist-supported CR, with participants from first-episode psychosis services. We applied structured equation modeling to test whether: (1) CR hours explain the goal attainment functional outcome (GAS) at posttreatment, (2) global cognitive improvement mediates GAS, and if (3) total symptoms moderate the CR hours to cognitive improvement pathway, and/or negative symptoms moderate the cognition to functioning pathway, testing moderator effects via the mediator or directly on CR hours to functioning path. STUDY RESULTS CR produced significant functioning benefit for each therapy hour (Coeff = 0.203, 95% CI 0.101-0.304, P < .001). The mediated path from CR hours to cognition and cognition to functioning was small and nonsignificant (Coeff = 0.014, 95% CI = -0.010, 0.037, P = .256). Total symptoms did not moderate the path to cognition (P = .211) or the direct path to outcome (P = .896). However, negative symptoms significantly moderated the effect of cognitive improvements on functioning (P = .015) with high negative symptoms reducing the functional gains of improved cognition. CONCLUSIONS Although cognitive improvements were correlated with functioning benefit, they did not fully explain the positive effect of increased therapy hours on functioning, suggesting additional CR factors also contribute to therapy benefit. Negative symptoms interfere with the translation of cognitive improvements into functional gains so need consideration.
Collapse
Affiliation(s)
- Rose Tinch-Taylor
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Andrew Pickles
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Dominic Stringer
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emese Csipke
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Matteo Cella
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Paul McCrone
- School of Health Sciences, University of Greenwich, London, UK
| | - Clare Reeder
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Max Birchwood
- Warwick Medical School, University of Warwick, Coventry, UK
| | - David Fowler
- School of Psychology, University of Sussex, Brighton, UK
| | | | - Sonia Johnson
- Faculty of Brain Sciences, University College London, London, UK
| | - Jesus Perez
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Rosa Ritunnano
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | | | - Jon Wilson
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Alex Kenny
- Patient Advisory Board, King's College London, London, UK
| | - Iris Isok
- Patient Advisory Board, King's College London, London, UK
| | - Eileen M Joyce
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Til Wykes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| |
Collapse
|
43
|
Lin YN, Hung TH, Rodakowski J, Kang JH, Han DS, Liou TH, Wu YH, Chang FH. Development of a Dyad-Focused Intervention for Stroke Survivors and Their Family Caregivers: A Feasibility Study. Am J Occup Ther 2024; 78:7802180230. [PMID: 38422433 DOI: 10.5014/ajot.2024.050571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
IMPORTANCE Transitioning from the hospital to the community poses significant challenges for stroke survivors and their caregivers. OBJECTIVE To examine the feasibility and preliminary effects of a dyad-focused strategy training intervention. DESIGN Single-arm trial with data collection at baseline, postintervention, and 3-mo follow-up. SETTING Rehabilitation settings in Taiwan. PARTICIPANTS Sixteen stroke survivor-caregiver dyads. INTERVENTIONS Dyad-focused strategy training was provided to stroke survivor-caregiver dyads twice a week over 6 wk. The training included shared decision-making, goal setting, performance evaluation, strategy development and implementation, and therapeutic guided discovery. OUTCOMES AND MEASURES Feasibility indicators were Goal Attainment Scaling, Dyadic Relationship Scale, Participation Measure-3 Domains, 4 Dimensions, Activity Measure for Post-Acute Care, Montreal Cognitive Assessment, Trail Making Test, Stroop Color and Word Test, Preparedness for Caregiving Scale, and Zarit Burden Interview. RESULTS In total, 15 dyads completed all intervention sessions with full attendance. Both stroke survivors and their caregivers demonstrated high engagement and comprehension and reported moderate to high satisfaction with the intervention. From baseline to postintervention, the effects on goal attainment, frequency and perceived difficulty of community participation, executive function, mobility function, and caregiver preparedness were significant and positive. CONCLUSIONS AND RELEVANCE Our study supports the feasibility and preliminary efficacy of dyad-focused strategy training for stroke survivor-caregiver dyads transitioning from the hospital to the community in Taiwan. Our preliminary evidence indicates that dyads who receive strategy training exhibit advancement toward their goals and experience considerable enhancements in their individual outcomes. Plain-Language Summary: This study addresses the scarcity of interventions catering to both stroke survivors and their caregivers. By demonstrating the feasibility of our dyad-focused intervention, the research offers preliminary evidence that supports the potential advantages of involving both stroke survivors and their caregivers in the intervention process.
Collapse
Affiliation(s)
- Yen-Nung Lin
- Yen-Nung Lin, MD, MS, is Professor, Graduate Institute of Injury Prevention and Control, College of Public Health, and Director and Visiting Staff, Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Te-Hsun Hung
- Te-Hsun Hung, BS, is Master's Student, Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Juleen Rodakowski
- Juleen Rodakowski, OTD, MS, OTR/L, FAOTA, is Associate Professor and Chair, Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA
| | - Jiunn-Horng Kang
- Jiunn-Horng Kang, MD, PhD, is Dean, College of Biomedical Engineering, and Professor, Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, and Visiting Staff, Taipei Medical University Hospital, Taipei, Taiwan
| | - Der-Sheng Han
- Der-Sheng Han, MD, PhD, is Professor, Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan, and Director and Visiting Staff, National Taiwan University Hospital, Beihu Branch, Taipei, Taiwan
| | - Tsan-Hon Liou
- Tsan-Hon Liou, MD, PhD, is Superintendent, Wan Fang Hospital, Taipei, Taiwan, and Professor, Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei, Taiwan
| | - Yi-Hsuan Wu
- Yi-Hsuan Wu, MS, OTR/L, is Occupational Therapist, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Feng-Hang Chang
- Feng-Hang Chang, ScD, OTR/L, is Professor, Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei, Taiwan, and Occupational Therapist, Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan;
| |
Collapse
|
44
|
Logan B, Viecelli AK, Pascoe EM, Pimm B, Hickey LE, Johnson DW, Hubbard RE. Training healthcare professionals to administer Goal Attainment Scaling as an outcome measure. J Patient Rep Outcomes 2024; 8:22. [PMID: 38407666 PMCID: PMC10897066 DOI: 10.1186/s41687-024-00704-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 02/18/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Goals generated by Goal Attainment Scaling (GAS) can be used as an outcome measure to promote person-centred research and care. There are no training packages which support its use outside of the rehabilitation discipline. This paper describes the development and evaluation of a training package to support the implementation of GAS as an outcome measure in healthcare research. The training package consisted of classroom teaching, a training manual for self-directed learning, one-on-one simulation and hot reviews. It was developed for the GOAL Trial, a randomised controlled trial assessing a Comprehensive Geriatric Assessment's effectiveness in enabling frail older people living with chronic kidney disease to attain their goals. Training participants were invited to complete pre- and post-training online evaluation surveys. RESULTS Forty-two healthcare professionals attended an initial online classroom teaching, with 27 proceeding to administer GAS to GOAL Trial patients. Response rates for the online pre- and post-training surveys were 95% and 72%, respectively. Prior to training, only 15% of participants reported being able to appropriately scale and troubleshoot GAS goals. Post-training this was 92%. There was 100% participant satisfaction for the training manual, one-on-one simulation, and hot reviews. CONCLUSIONS This training package helps ensure healthcare professionals administering GAS have adequate knowledge and skills. It has the potential for adoption as a guide to support the implementation of GAS by other researchers seeking to embrace persont-centred principles in their work.
Collapse
Affiliation(s)
- Benignus Logan
- Centre for Health Services Research, University of Queensland, 34 Cornwall St, Woolloongabba, Brisbane, QLD, 4102, Australia.
| | - Andrea K Viecelli
- Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, Brisbane, QLD, 4102, Australia
| | - Elaine M Pascoe
- Centre for Health Services Research, University of Queensland, 34 Cornwall St, Woolloongabba, Brisbane, QLD, 4102, Australia
| | - Bonnie Pimm
- Centre for Health Services Research, University of Queensland, 34 Cornwall St, Woolloongabba, Brisbane, QLD, 4102, Australia
| | - Laura E Hickey
- Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia
| | - David W Johnson
- Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, Brisbane, QLD, 4102, Australia
- Centre for Kidney Disease Research, Translational Research Institute, Brisbane, Australia
| | - Ruth E Hubbard
- Centre for Health Services Research, University of Queensland, 34 Cornwall St, Woolloongabba, Brisbane, QLD, 4102, Australia
- Department of Geriatric Medicine, Princess Alexandra Hospital, Brisbane, Australia
| |
Collapse
|
45
|
Cyr EM, Palisano RJ, Chiarello LA, Fragala-Pinkham M. Promoting Cycling Skills and Participation with Two-Wheel Bike Riding for Children with Neurodevelopmental Disorders. Phys Occup Ther Pediatr 2024; 44:690-703. [PMID: 38314608 DOI: 10.1080/01942638.2024.2309669] [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: 09/18/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 02/06/2024]
Abstract
AIMS Evaluate changes in two-wheel cycling skills and biking participation goals for children with neurodevelopmental disorders (ND) receiving a home visit and email following iCan Bike camp. METHODS Participants: 11 children with ND, 9-16 years, and one of their parents. A cycling skills checklist, two-wheel riding Goal Attainment Scaling (GAS), and biking participation GAS were completed before camp (T1), at support visit after camp (T2), and three months following camp (T3). Parents completed biking practice logs. Participants received a support visit to provide instruction, coaching, and address questions, and an email to check progress. RESULTS Significant changes were made in two-wheel riding GAS T1 to T2 (p = 0.01), biking participation GAS T2 to T3 (p = 0.02), and cycling skills T1 to T2 (p = 0.01) and T2 to T3 (p = 0.02). Practice frequency was related to cycling skills (0.72, p = 0.01) and biking participation (0.86, p < 0.001); cycling skills were related to biking participation (0.81, p = 0.003). CONCLUSION Children improved cycling skills and biking participation following camp, support visit, and email check-in. Children who practiced more had greater cycling skills and biking participation. Encouraging weekly bicycling and providing support may promote cycling skills and participation following camp.
Collapse
Affiliation(s)
- Elizabeth M Cyr
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA, USA
- Department of Physical Therapy, University of New England, Portland Campus, Portland, ME, USA
| | - Robert J Palisano
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA, USA
| | - Lisa A Chiarello
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA, USA
| | - Maria Fragala-Pinkham
- Department of Physical and Occupational Therapy, Boston Children's Hospital, Boston, MA, USA
| |
Collapse
|
46
|
Pellichero A, Best KL, Sorita É, Archambault PS, Demers L, Rouault L, Routhier F. Feasibility and clinical applicability of a novel power wheelchair training approach. Disabil Rehabil Assist Technol 2024; 19:516-524. [PMID: 35895011 DOI: 10.1080/17483107.2022.2103189] [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: 04/08/2022] [Accepted: 07/13/2022] [Indexed: 10/16/2022]
Abstract
PURPOSE To evaluate the feasibility and the clinical applicability of administering the COMET (cognition, occupation, mobility, evaluation and training) intervention. MATERIALS AND METHODS A pilot research was conducted with adults who were being considered for power wheelchair (PWC) provision, or who were recently provided a PWC, and who had been identified to benefit from a PWC training. The COMET intervention applies a goal directed, client-centred and occupation-based approach. Feasibility and applicability indicators were collected for: process, resources, management and treatment. Indicators were evaluated as "successful/unsuccessful". Clinical outcomes included the Goal Attainment Scale (GAS), the Canadian Occupational Performance Measure (COPM), the Power mobility Indoor Driving Assessment (PIDA) and the Wheelchair Skills Test (WST). RESULTS Four females (62.5 ± 3.5 years) with cognitive impairment participated in the study. Among the 13 indicators, 10 were successfully achieved. Indicators that did not meet the criteria for success were adherence rate, safety and treatment for the PIDA. Two adverse events were reported, with one minor injury. Participants demonstrated better than expected results on the GAS, the COPM scores and the WST. However, only two reported an improvement beyond 4% of the PIDA. CONCLUSIONS With few modifications, the COMET intervention and the study protocol will be feasible and applicable in clinical practice. Individuals with complex cognitive and mobility impairment demonstrated abilities to learn PWC use. Further investigation of the COMET intervention is required to evaluate its efficacy.Implications for rehabilitationA novel power wheelchair (PWC) training approach adapted to individual with complex mobility and cognitive impairments was developed: the COMET (cognition, occupation, mobility, evaluation and training) intervention.The COMET intervention applies a goal directed, client-centred and occupation-based approach.With minor modifications, the COMET intervention may be feasible and clinically applicable to train individuals with complex motor and cognitive impairments how to use a PWC.Further evaluation of the COMET intervention and lager control trialsare suggested.
Collapse
Affiliation(s)
- Alice Pellichero
- Department of Rehabilitation, Université Laval, Québec City, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
| | - Krista L Best
- Department of Rehabilitation, Université Laval, Québec City, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
| | - Éric Sorita
- Université de Bordeaux - Handicap Activité Cognition Santé (EA 4136 HACS), Bordeaux, France
| | - Philippe S Archambault
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montréal, Canada
| | - Louise Demers
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, Canada
| | - Lucas Rouault
- Dispositif d'expertise et de la liaison pour les troubles d'apprentissage - ADIMC, La Couronne, France
- Association Nationale Française des Ergothérapeutes, Paris, France
| | - François Routhier
- Department of Rehabilitation, Université Laval, Québec City, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
| |
Collapse
|
47
|
Okita Y, Kawaguchi Y, Inoue Y, Ohno K, Sawada T, Levack W, Tomori K. Characteristics of goal-setting tools in adult rehabilitation: A scoping review. Clin Rehabil 2024; 38:234-250. [PMID: 37644842 PMCID: PMC10725121 DOI: 10.1177/02692155231197383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 08/09/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVES This scoping review aims to map the literature on goal-setting tools in adult rehabilitation, exploring their characteristics, target users and supporting evidence to inform practice and future research in this area. METHODS We completed a comprehensive search of four databases to identify relevant articles on tools for goal setting in rehabilitation. We followed Arkey and O'Malley's scoping review process to guide article selection, data extraction and data analysis. RESULTS We identified a total of 165 studies that reported on 55 different goal-setting tools, including tools for goal selection and goal documentation (n = 31), goal setting and intervention planning (n = 15), and for measuring the quality of the goal-setting process (n = 9). Over half of the tools were primarily designed for use in rehabilitation of physical disabilities (n = 32). Some tools fell under multiple sub-categories based on their characteristics as follows: 22 framework tools, 12 interview tools, 9 outcome measurement tools for goal achievement, 6 outcome measurement tools for goal quality and 25 documentation tools. The majority of goal-setting instruments targeted goals at the level of activity and participation (n = 51) and aimed to facilitate a client-centred or shared decision-making approach to rehabilitation planning (n = 46). CONCLUSIONS This study provides a comprehensive overview of existing goal-setting tools, highlighting their characteristics, target users and identified needs. These findings can enhance practitioners' awareness of the range of goal-setting tools available and can enable more effective utilization of these tools in clinical practice. Further research should investigate how clinicians can combine multiple tools to deliver goal setting.
Collapse
Affiliation(s)
- Yuho Okita
- School of Health Science, Swinburne University of Technology, Melbourne, Australia
| | - Yuko Kawaguchi
- Department of Rehabilitation, Kaikoukai Rehabilitation Hospital, Aichi, Japan
| | - Yuki Inoue
- Central Rehabilitation Department, Yokohama Rousai Hospital, Kanagawa, Japan
| | - Kanta Ohno
- Major of Occupational Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| | - Tatsunori Sawada
- Major of Occupational Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| | - William Levack
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Kounosuke Tomori
- Major of Occupational Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| |
Collapse
|
48
|
Salort-Campana E, Solé G, Magot A, Tard C, Noury JB, Behin A, De La Cruz E, Boyer F, Lefeuvre C, Masingue M, Debergé L, Finet A, Brison M, Spinazzi M, Pegat A, Sacconi S, Malfatti E, Choumert A, Bellance R, Bedat-Millet AL, Feasson L, Vuillerot C, Jacquin-Piques A, Michaud M, Pereon Y, Stojkovic T, Laforêt P, Attarian S, Cintas P. Multidisciplinary team meetings in treatment of spinal muscular atrophy adult patients: a real-life observatory for innovative treatments. Orphanet J Rare Dis 2024; 19:24. [PMID: 38268028 PMCID: PMC10809505 DOI: 10.1186/s13023-023-03008-6] [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: 08/13/2023] [Accepted: 12/19/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND In 2017, a new treatment by nusinersen, an antisense oligonucleotide delivered by repeated intrathecal injections, became available for patients with spinal muscular atrophy (SMA), whereas clinical trials had mainly involved children. Since 2020, the oral, selective SMN2-splicing modifier risdiplam has been available with restrictions evolving with time. In this peculiar context of lack of data regarding adult patients, many questions were raised to define the indications of treatment and the appropriate follow-up in this population. To homogenize access to treatment in France, a national multidisciplinary team meeting dedicated to adult SMA patients, named SMA multidisciplinary team meeting, (SMDTs) was created in 2018. Our objective was to analyze the value of SMDTs in the decision-making process in SMA adult patients and to provide guidelines about treatment. METHODS From October 2020 to September 2021, data extracted from the SMDT reports were collected. The primary outcome was the percentage of cases in which recommendations on validating treatment plans were given. The secondary outcomes were type of treatment requested, description of expectations regarding treatment and description of recommendations or follow-up and discontinuation. Data were analyzed using descriptive statistics. Comparisons between the type of treatment requested were performed using Mann-Whitney test or the Student t test for quantitative data and the Fisher's exact test or the χ2 test for qualitative data. RESULTS Cases of 107 patients were discussed at the SMDTs with a mean age of 35.3 (16-62). Forty-seven were SMA type 2, and 57 SMA type 3. Twelve cases were presented twice. Out of 122 presentations to the SMDTs, most of requests related to the initiation of a treatment (nusinersen (n = 46), risdiplam (n = 54), treatment without mentioning preferred choice (n = 5)) or a switch of treatment (n = 12). Risdiplam requests concerned significantly older patients (p = 0.002), mostly SMA type 2 (p < 0.0001), with greater disease severity in terms of motor and respiratory function compared to requests for nusinersen. In the year prior to presentation to the SMDTs, most of the patients experienced worsening of motor weakness assessed by functional tests as MFM32 or other meaningful scales for the most severe patients. Only 12% of the patients discussed had a stable condition. Only 49/122 patients (40.1%) expressed clear expectations regarding treatment. The treatment requested was approved by the SMDTs in 72 patients (67.2%). The most common reasons to decline treatment were lack of objective data on the disease course prior discussion to the SMDTs or inappropriate patient's expectations. Treatment requests were more likely to be validated by the SMDTs if sufficient pre-therapeutic functional assessment had been performed to assess the natural history (55% vs. 32%) and if the patient had worsening rather than stable motor function (p = 0.029). In patients with approved treatment, a-priori criteria to define a further ineffectiveness of treatment (usually after 14 months of treatment) were proposed for 67/72 patients. CONCLUSIONS In the context of costly treatments with few controlled studies in adults with SMA, in whom assessment of efficacy can be complex, SMDTs are 'real-world observatories' of great interest to establish national recommendations about indications of treatment and follow-up.
Collapse
Affiliation(s)
- Emmanuelle Salort-Campana
- Service de Neurologie du Pr Attarian, Centre de Référence des Maladies Neuromusculaires PACA Réunion Rhône Alpes, Timone University Hospital, Aix-Marseille University, 264 Rue Saint-Pierre, 13385, Marseille Cedex 05, France.
- Inserm UMR_S 910 Medical Genetics and Functional Genomics, Aix Marseille Université, Marseille, France.
- FILNEMUS, Marseille, France.
| | - Guilhem Solé
- Centre de Référence des Maladies Neuromusculaires AOC, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
- FILNEMUS, Marseille, France
| | - Armelle Magot
- Laboratoire d'Explorations Fonctionnelles, Hôtel-Dieu, Centre de Référence des Maladies Neuromusculaires AOC, CHU de Nantes, Nantes, France
- FILNEMUS, Marseille, France
| | - Céline Tard
- Centre de Référence des Maladies Neuromusculaires Nord Est Ile de France, Lille, France
- FILNEMUS, Marseille, France
| | - Jean-Baptiste Noury
- Reference Centre for Neuromuscular Diseases AOC, University Hospital of Brest, Brest, France
- FILNEMUS, Marseille, France
| | - Anthony Behin
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Île-de-France, Institut de Myologie, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
- FILNEMUS, Marseille, France
| | - Elisa De La Cruz
- Centre de Référence des Maladies Neuromusculaires AOC, CHU et Université de Montpellier, Montpellier, France
- UVSQ, Paris-Saclay University, Paris, France
| | - François Boyer
- Pôle de Médecine Physique et de Réadaptation, Hôpital Universitaire Reims-Champagne-Ardenne, CHU Sébastopol, Centre de Référence des Maladies Neuromusculaires Nord Est Ile de France, Reims, France
- FILNEMUS, Marseille, France
| | - Claire Lefeuvre
- Nord-Est-Ile-de-France, Service de Neurologie, FHU Phenix, Centre de Référence de Pathologie Neuromusculaire, Raymond Poincaré University Hospital, Garches, APHP, Garches, France
- FILNEMUS, Marseille, France
| | - Marion Masingue
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Île-de-France, Institut de Myologie, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
- FILNEMUS, Marseille, France
| | - Louise Debergé
- Centre de Référence des Maladies Neuromusculaires AOC, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
- FILNEMUS, Marseille, France
| | - Armelle Finet
- Service de Neurologie du Pr Attarian, Centre de Référence des Maladies Neuromusculaires PACA Réunion Rhône Alpes, Timone University Hospital, Aix-Marseille University, 264 Rue Saint-Pierre, 13385, Marseille Cedex 05, France
- FILNEMUS, Marseille, France
| | - Mélanie Brison
- Centre de Réference des Maladies Neuromusculaires PACA Réunion Rhône Alpes Service de Neurologie, CHU de Saint-Etienne, Saint-Étienne, France
- FILNEMUS, Marseille, France
| | - Marco Spinazzi
- Department of Neurology, Centre Hospitalier Universitaire d'Angers, Angers, France
- FILNEMUS, Marseille, France
| | - Antoine Pegat
- Service de Neurologie C, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 69500, Bron, France
- Service d'Explorations Fonctionnelles Neurologiques, Hôpital Neurologique Pierre Wertheimer, 69500, Bron, France
- FILNEMUS, Marseille, France
| | - Sabrina Sacconi
- Service Système Nerveux Périphérique & Muscle, Centre de Référence des Maladies Neuromusculaires PACA Réunion Rhône Alpes, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
- FILNEMUS, Marseille, France
| | - Edoardo Malfatti
- APHP, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, Henri Mondor Hospital, University Paris-Est, Créteil, France
- FILNEMUS, Marseille, France
| | - Ariane Choumert
- Department of Rare Neurological Diseases, Centre de Référence des Maladies Neuromusculaires PACA Réunion Rhône Alpes, CHU de la Réunion, Saint-Pierre, France
- FILNEMUS, Marseille, France
| | - Rémi Bellance
- CeRCa, Site Constitutif de Centre de Référence Caribéen des Maladies Neuromusculaires Rares, CHU de Martinique, Hôpital P. Zobda-Quitman, Fort-de-France, France
- FILNEMUS, Marseille, France
| | | | - Léonard Feasson
- Physiology and Exercise Laboratory EA4338, Centre de Référence des Maladies Neuromusculaires PACA Réunion Rhône Alpes, Rhône-Alpes Bellevue Hospital, University Hospital Center of Saint-Étienne, Saint-Étienne, France
- FILNEMUS, Marseille, France
| | - Carole Vuillerot
- Service de Médecine Physique et Réadaptation Pédiatrique, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69677, Bron Cedex, France
- FILNEMUS, Marseille, France
| | - Agnès Jacquin-Piques
- Department of Clinical Neurophysiology, CHU Dijon Bourgogne, Dijon, France
- FILNEMUS, Marseille, France
| | - Maud Michaud
- Department of Neurology, Nancy University Hospital, Nancy, France
- FILNEMUS, Marseille, France
| | - Yann Pereon
- Laboratoire d'Explorations Fonctionnelles, Hôtel-Dieu, Centre de Référence des Maladies Neuromusculaires AOC, CHU de Nantes, Nantes, France
- FILNEMUS, Marseille, France
| | - Tanya Stojkovic
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Île-de-France, Institut de Myologie, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
- FILNEMUS, Marseille, France
| | - Pascal Laforêt
- Nord-Est-Ile-de-France, Service de Neurologie, FHU Phenix, Centre de Référence de Pathologie Neuromusculaire, Raymond Poincaré University Hospital, Garches, APHP, Garches, France
- UVSQ, Paris-Saclay University, Paris, France
- FILNEMUS, Marseille, France
| | - Shahram Attarian
- Service de Neurologie du Pr Attarian, Centre de Référence des Maladies Neuromusculaires PACA Réunion Rhône Alpes, Timone University Hospital, Aix-Marseille University, 264 Rue Saint-Pierre, 13385, Marseille Cedex 05, France
- Inserm UMR_S 910 Medical Genetics and Functional Genomics, Aix Marseille Université, Marseille, France
- FILNEMUS, Marseille, France
| | - Pascal Cintas
- Service de Neurologie, CHU de Toulouse Purpan, Place du Docteur Baylac TSA 40031, 8. Centre de Référence des Maladies Neuromusculaires AOC, 31059, Toulouse Cedex 9, France
- FILNEMUS, Marseille, France
| |
Collapse
|
49
|
Kawanaka M, Iwanaga Y, Tokunaga A, Higashi T, Tanaka G, Imamura A, Iwanaga R. Changes in Challenging Behaviors Accompanying Transition to a New Facility in Individuals with Intellectual Disabilities. Healthcare (Basel) 2024; 12:288. [PMID: 38338171 PMCID: PMC10855692 DOI: 10.3390/healthcare12030288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/08/2024] [Accepted: 01/16/2024] [Indexed: 02/12/2024] Open
Abstract
Challenging behavior (CB), the most common example being extreme self-injurious or aggressive/destructive behavior, is often observed as a major behavior issue in individuals with severe intellectual disabilities. This study investigated how CB changed among residents of a facility for people with disabilities before and after it was restructured from a traditional format single room shared by two to three individuals with approximately 20 residents lived together to a format featuring private areas with two rooms per resident and a unitcare system. Twenty-one residents of Care Home A, which was rebuilt in the new care format, were selected. Care staff completed a questionnaire one month before, one month after, and six months after residents moved to the new facility. Scores were compared among each time point. The results revealed significant reductions in residents' aggressive, stereotyped, and targeted behaviors, such as hitting their own head and fecal smearing. The major features of the restructured facility were a living space consisting of two private rooms per resident and a shift to unit care for the entire ward. These new features enabled residents to reduce destructive stimuli and made it easier to understand what to do in each private room.
Collapse
Affiliation(s)
- Mizuho Kawanaka
- Department of Occupational Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan (R.I.)
- Service Promotion Section Business Support Division, Nanko Airinkai Social Welfare Corporation, Fukudamachi, Isahaya 854-0001, Japan
| | - Yuto Iwanaga
- Department of Occupational Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan (R.I.)
- Nagasaki City Disability Welfare Center, 2-41 Morimachi, Nagasaki 852-8104, Japan
| | - Akiko Tokunaga
- Department of Occupational Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan (R.I.)
| | - Toshio Higashi
- Department of Occupational Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan (R.I.)
| | - Goro Tanaka
- Department of Occupational Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan (R.I.)
| | - Akira Imamura
- Department of Occupational Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan (R.I.)
| | - Ryoichiro Iwanaga
- Department of Occupational Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan (R.I.)
| |
Collapse
|
50
|
Kato M, Kikuchi T, Watanabe K, Sumiyoshi T, Moriguchi Y, Oudin Åström D, Christensen MC. Goal Attainment Scaling for Depression: Validation of the Japanese GAS-D Tool in Patients with Major Depressive Disorder. Neuropsychiatr Dis Treat 2024; 20:49-60. [PMID: 38239870 PMCID: PMC10796153 DOI: 10.2147/ndt.s441382] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/11/2024] [Indexed: 01/22/2024] Open
Abstract
Purpose Goal attainment scaling (GAS) has been proposed as a person-centric, semi-quantitative measure that assimilates achievement of individually set goals into a single standardized "goal attainment score" that can be compared at the population level. We aimed to examine the reliability and validity of the Japanese version of the GAS for depression (GAS-D) tool in assessing goal attainment in people living with major depressive disorder (MDD). Patients and Methods This was a prespecified analysis of a prospective, 24-week, multicenter, observational cohort study of employed Japanese outpatients with MDD initiating treatment with vortioxetine according to the Japanese label (JRCT1031210200). Participants were assessed using the Japanese version of the GAS-D and other clinical rating scales at baseline and Weeks 8, 12 and 24. Results Goal attainment was significantly associated with symptom severity as assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS) scale, confirming convergent validity. In particular, GAS-D scores were significantly related to MADRS total score at Weeks 12 and 24, indicating that improvements in overall symptom severity with vortioxetine treatment were likely to be reflected in the achievement of individualized treatment goals. With an intraclass correlation coefficient of 0.67 (95% CI 0.45-0.82), the GAS-D also showed moderate test-retest reliability between Weeks 8 and 12 while proving independent of demographic characteristics. Conclusion The results of this open-label study support the use of the GAS-D as a valid and sensitive outcome measure in the assessment of treatment response in MDD.
Collapse
Affiliation(s)
- Masaki Kato
- Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
| | - Toshiaki Kikuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan
| | - Koichiro Watanabe
- Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | | | | | | |
Collapse
|