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Lindblom S, Flink M, von Koch L, Laska AC, Ytterberg C. Feasibility, Fidelity and Acceptability of a Person-Centred Care Transition Support Intervention for Stroke Survivors: A Non-Randomised Controlled Study. Health Expect 2024; 27:e70057. [PMID: 39373138 PMCID: PMC11456962 DOI: 10.1111/hex.70057] [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: 02/28/2024] [Revised: 09/17/2024] [Accepted: 09/24/2024] [Indexed: 10/08/2024] Open
Abstract
BACKGROUND Care transitions from hospital to home are a critical period for patients and their families, especially after a stroke. The aim of this study was to assess the feasibility, fidelity and acceptability of a co-designed care transition support for stroke survivors. METHODS A non-randomised controlled feasibility study recruiting patients who had had stroke and who were to be discharged home and referred to a neurorehabilitation team in primary healthcare was conducted. Data on the feasibility of recruitment and fidelity of the intervention were collected continuously during the study with screening lists and checklists. Data on the perceived quality of care transition were collected at 1-week post-discharge with the Care Transition Measure. Data on participant characteristics, disease-related data and outcomes were collected at baseline (hospitalisation), 1 week and 3 months post-discharge. Data on the acceptability of the intervention from the perspective of healthcare professionals were collected at 3 months using the Normalisation Measure Development Questionnaire. RESULTS Altogether, 49 stroke survivors were included in the study: 28 in the intervention group and 21 in the control group. The recruitment and data collection of patient characteristics, disease-related data, functioning and outcomes were feasible. The fidelity of the intervention differed in relation to the different components of the co-designed care transition support. The intervention was acceptable from the perspective of healthcare professionals. Concerns were raised about the fidelity of the intervention. A positive direction of effects of the intervention on the perceived quality of the care transition was found. CONCLUSION The study design, data collection, procedures and intervention were deemed feasible and acceptable. Modifications are needed to improve intervention fidelity by supporting healthcare professionals to apply the intervention. The feasibility study showed a positive direction of effect on perceived quality with the care transition, but a large-scale trial is needed to determine its effectiveness. PATIENT OR PUBLIC CONTRIBUTION Stroke survivors, significant others and healthcare professionals were involved in a co-design process, including the joint development of the intervention's components, contextual factors to consider, participant needs and important outcomes to target. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT0292587.
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Affiliation(s)
- Sebastian Lindblom
- Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Theme of Women's Health and Allied Health ProfessionalsKarolinska University HospitalStockholmSweden
| | - Maria Flink
- Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Research and Development Unit for Elderly Persons (FOU nu), Region StockholmJärfällaSweden
| | - Lena von Koch
- Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Theme of Heart and Vascular and NeuroKarolinska University HospitalStockholmSweden
| | - Ann Charlotte Laska
- Department of Clinical Sciences, Danderyd HospitalKarolinska InstitutetStockholmSweden
| | - Charlotte Ytterberg
- Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Theme of Women's Health and Allied Health ProfessionalsKarolinska University HospitalStockholmSweden
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Zike DM, Hansen MA, Arvinen-Barrow M. Psychosocial factors associated with athlete adaptation to spinal cord injury: a systematic review. Disabil Rehabil 2024:1-13. [PMID: 39329402 DOI: 10.1080/09638288.2024.2406981] [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: 07/29/2023] [Revised: 09/14/2024] [Accepted: 09/16/2024] [Indexed: 09/28/2024]
Abstract
PURPOSE To review existing research on psychosocial factors associated with athlete adaptation to acquired spinal cord injury (SCI). METHODS A systematic review was conducted in February 2023. MEDLINE (Pubmed), PsycINFO, and SPORTDiscus databases were used, and peer-reviewed academic journal entries fully retrievable from the researcher's institution library or online were considered for inclusion. Publications were identified according to predetermined eligibility criteria, and 18 publications were included in the review. RESULTS The results identified many psychosocial factors associated with adaptation to acquired SCI, including self-identity, emotions, coping strategies, sport involvement, social support, narratives, pain, participation, activity, self-efficacy, and sociability. CONCLUSIONS This review highlights the need for innovative methodologies and diverse perspectives and sampling in future investigations. Rehabilitation and sport and performance psychology practitioners working with athletes with acquired SCI are encouraged to gain a better understanding of the narratives framing and constraining athletes' life stories and rehabilitation experiences and consider using strategies such as narrative ambushing (Frank, 2010) to help athletes develop new ways of thinking about acquired SCI. Rehabilitation practitioners are also encouraged to discuss and facilitate opportunities to get involved in adaptive sports for athletes with acquired SCI as part of their rehabilitation plan.
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Affiliation(s)
- Derek M Zike
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Michael A Hansen
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Monna Arvinen-Barrow
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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3
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Stiekema APM, Rauwenhoff JCC, Bierlaagh D, Donkervoort M, Jansen N, Jurrius KHM, Zadoks J, van Heugten CM. Case management for people with acquired brain injury: feasibility and effectiveness of a two-year pragmatic randomized controlled trial. Brain Inj 2024:1-12. [PMID: 39245982 DOI: 10.1080/02699052.2024.2399070] [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: 07/19/2023] [Revised: 05/22/2024] [Accepted: 08/21/2024] [Indexed: 09/10/2024]
Abstract
BACKGROUND Case management (CM) aims to facilitate access to and integration of health care and social services. We investigated the feasibility and effectiveness of CM. METHODS Randomized controlled trial with 219 patients and 114 caregivers randomly allocated to CM (109/59) or care as usual (110/55). CM was based on early and continuous online monitoring of problems and needs. Outcomes were assessed every 6 months with the Hospital Anxiety and Depression Scale (HADS). Secondary outcome domains were participant restrictions, life satisfaction, self-efficacy, caregiver burden, and needs. Multilevel modeling was used. Feasibility aspects were protocol delivery, participants' and case managers' satisfaction, and factors affecting implementation. RESULTS There were no significant differences between groups. Participation restrictions and unmet needs decreased in both groups within 6 months. Monitoring was successful in 38, and 10 participants asked the CM for support. CM consisted mostly of providing information. DISCUSSION CM based on early and continuous online monitoring does not have benefit in identifying and addressing problems early after relatively mild injury. Unsuccessful monitoring may have hindered access to the case manager and prevented us from evaluating CM as a complex intervention. It remains a challenge to early identify those who could benefit from care coordination.
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Affiliation(s)
- Annemarie P M Stiekema
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands
| | - Johanne C C Rauwenhoff
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands
| | | | - Mireille Donkervoort
- Health Care and Social Work Division, Windesheim University of Applied Sciences, Almere, The Netherlands
- Mevrouw Slimmer Werken Social Innovation in Health Care and Well-Being, Drogteropslagen, Netherlands
| | - Natska Jansen
- Brain Injury Team, Brain Injury Network, Overijssel, Netherlands
| | | | - Judith Zadoks
- In-Tussen Foundation, Utrecht, the Netherlands
- BreinDok Innovation in Care, Utrecht, the Netherlands
| | - Caroline M van Heugten
- Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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4
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Miller LR, Divers R, Reed C, Cherry J, Patrick A, Calamia M. Value-consistent rehabilitation is associated with long-term psychological flexibility and quality of life after traumatic brain injury. Neuropsychol Rehabil 2024; 34:955-973. [PMID: 37708399 DOI: 10.1080/09602011.2023.2256964] [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: 02/22/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023]
Abstract
Meaningful steps have been taken toward using holistic approaches in outpatient rehabilitation for traumatic brain injury (TBI) (i.e., treating the whole individual); however, research and practice continue to disproportionately focus on adapting to physical and cognitive changes. Research suggests treatment focusing on individual values may be important for psychological adjustment after TBI. The current study sought to explore individual values across multiple life domains in those with TBI as well as what values outpatient rehabilitation was helpful for, and to examine discrepancies between these factors (i.e., value-consistent rehabilitation) in relation to important long-term treatment outcomes. 215 adults with a history of TBI who had participated in outpatient rehabilitation completed online surveys assessing how consistent outpatient rehabilitation was with individual values, psychological flexibility, and quality of life. The life domains with the greatest discrepancies between individual importance and rehabilitation helpfulness were spirituality, intimate relations, and family relations. Greater value-consistent rehabilitation was associated with higher levels of psychological flexibility and quality of life beyond demographics and injury characteristics. Our findings provide further support in favour of holistic, client-centred approaches that are facilitated by neurological rehabilitation programs.
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Affiliation(s)
- Luke R Miller
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Ross Divers
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Christopher Reed
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Jared Cherry
- Department of Neurology, Yale School of Medicine, New Haven, CT, United States
| | - Abihail Patrick
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Matthew Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
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Derrett S, Owen HE, Barson D, Maclennan B, Samaranayaka A, Harcombe H, Wyeth EH. New Zealand's Prospective Outcomes of Injury Study-10 years on (POIS-10): descriptive outcomes to 12 years post-injury. Inj Prev 2024; 30:251-255. [PMID: 38195656 DOI: 10.1136/ip-2023-045058] [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: 01/11/2024]
Abstract
BACKGROUND The 'Prospective Outcomes of Injury Study-10 years on' (POIS-10) aims to contribute to improving long-term disability, health and well-being outcomes for injured New Zealanders. This brief report describes recruitment, characteristics and key outcomes to 12 years post-injury. METHODS Between 2007 and 2009, the study recruited 2856 people, including 566 Māori, from New Zealand's Accident Compensation Corporation's entitlement claims register. People experienced a range of injury types, causes and settings; 25% had been hospitalised for their injury. POIS-10 data were primarily collected via interviewer-administered structured questionnaires. RESULTS Of the original participants, 2068 (92%) were eligible for follow-up in POIS-10. Of these, 1543 (75%) people participated between March 2020 and July 2021, including 240 Māori. Half of the participants (n=757; 50%) reported ongoing problems attributed to their injury 12 years earlier. Most reported difficulties with items assessing disability (WHO Disability Assessment Schedule II). For health-related quality of life (HRQoL), measured using the EQ-5D-5L, the prevalence of problems was higher 12 years post-injury compared with 12 months post-injury for four of five dimensions. Importantly, the prevalence of problems did not reduce to pre-injury levels for any HRQoL dimension. DISCUSSION POIS-10 highlights the importance of early post-injury interventions to improve health, disability and well-being outcomes of injured New Zealanders.
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Affiliation(s)
- Sarah Derrett
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, Otago, New Zealand
| | - Helen E Owen
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, Otago, New Zealand
| | - David Barson
- Preventive and Social Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Brett Maclennan
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, Otago, New Zealand
| | | | - Helen Harcombe
- Preventive and Social Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Emma H Wyeth
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, Otago, New Zealand
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Binks SNM, Veldsman M, Handel AE, Jacob S, Maddison P, Coebergh J, Michael S, Ramanathan S, Easton A, Nissen MS, Leite MI, Okai D, Blaabjerg M, Husain M, Irani SR. Fatigue predicts quality of life after leucine-rich glioma-inactivated 1-antibody encephalitis. Ann Clin Transl Neurol 2024; 11:1053-1058. [PMID: 38303486 PMCID: PMC11021603 DOI: 10.1002/acn3.52006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/20/2023] [Accepted: 01/15/2024] [Indexed: 02/03/2024] Open
Abstract
Patient-reported quality-of-life (QoL) and carer impacts are not reported after leucine-rich glioma-inactivated 1-antibody encephalitis (LGI1-Ab-E). From 60 patients, 85% (51 out of 60) showed one abnormal score across QoL assessments and 11 multimodal validated questionnaires. Compared to the premorbid state, QoL significantly deteriorated (p < 0.001) and, at a median of 41 months, fatigue was its most important predictor (p = 0.025). In total, 51% (26 out of 51) of carers reported significant burden. An abbreviated five-item battery explained most variance in QoL. Wide-ranging impacts post-LGI1-Ab-E include decreased QoL and high caregiver strain. We identify a rapid method to capture QoL in routine clinic or clinical trial settings.
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Affiliation(s)
- Sophie N. M. Binks
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical NeurosciencesOxfordUK
- Department of NeurologyOxford University Hospitals NHS Foundation TrustOxfordUK
| | - Michele Veldsman
- Department of Experimental PsychologyUniversity of OxfordOxfordUK
| | - Adam E. Handel
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical NeurosciencesOxfordUK
- Department of NeurologyOxford University Hospitals NHS Foundation TrustOxfordUK
| | - Saiju Jacob
- Department of Neurology, Queen Elizabeth HospitalUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - Paul Maddison
- Department of Neurology, Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK
| | - Jan Coebergh
- St Peter's HospitalAshford and St Peter's NHS Hospitals Foundation TrustChertseyUK
| | - Sophia Michael
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical NeurosciencesOxfordUK
- Department of Neurology, Queen Elizabeth HospitalUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - Sudarshini Ramanathan
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical NeurosciencesOxfordUK
- Translational Neuroimmunology Group, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- Department of NeurologyConcord HospitalSydneyNew South WalesAustralia
| | - Ava Easton
- The Encephalitis Society32 Castlegate, MaltonNorth YorkshireYO17 7DTUK
- Department of Clinical Infection, Microbiology and ImmunologyUniversity of LiverpoolLiverpoolUK
| | - Mette Scheller Nissen
- Department of NeurologyOdense University HospitalOdenseDenmark
- Department of Clinical ResearchUniversity of Southern DenmarkOdenseDK‐5000Denmark
| | - Maria Isabel Leite
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical NeurosciencesOxfordUK
- Department of NeurologyOxford University Hospitals NHS Foundation TrustOxfordUK
| | - David Okai
- Neuropsychiatry DepartmentMaudsley Outpatients, Maudsley HospitalDenmark HillLondonSE5 8AZUK
| | - Morten Blaabjerg
- Department of NeurologyOdense University HospitalOdenseDenmark
- Department of Clinical ResearchUniversity of Southern DenmarkOdenseDK‐5000Denmark
| | - Masud Husain
- Department of Experimental PsychologyUniversity of OxfordOxfordUK
- Nuffield Department of Clinical NeurosciencesOxfordUK
| | - Sarosh R. Irani
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical NeurosciencesOxfordUK
- Department of NeurologyOxford University Hospitals NHS Foundation TrustOxfordUK
- Departments of Neurology and NeurosciencesMayo ClinicJacksonvilleFloridaUSA
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7
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Stolwyk RJ, Mihaljcic T, Wong DK, Hernandez DR, Wolff B, Rogers JM. Post-stroke Cognition is Associated with Stroke Survivor Quality of Life and Caregiver Outcomes: A Systematic Review and Meta-analysis. Neuropsychol Rev 2024:10.1007/s11065-024-09635-5. [PMID: 38466357 DOI: 10.1007/s11065-024-09635-5] [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: 01/18/2022] [Accepted: 02/05/2024] [Indexed: 03/13/2024]
Abstract
Disability arising from post-stroke cognitive impairment is a likely contributor to the poor quality of life (QoL) stroke survivors and their carers frequently experience, but this has not been summarily quantified. A systematic literature review and meta-analysis was completed examining the association between general and domain-specific post-stroke cognitive functioning and adult stroke survivor QoL, caregiver QoL, and caregiver burden. Five databases were systematically searched, and eligibility for inclusion, data extraction, and study quality were evaluated by two reviewers using a standardised protocol. Effects sizes (r) were estimated using a random effects model. Thirty-eight studies were identified, generating a sample of 7365 stroke survivors (median age 63.02 years, range 25-93) followed for 3 to 132 months post-stroke. Overall cognition (all domains combined) demonstrated a significant small to medium association with QoL, r = 0.23 (95% CI 0.18-0.28), p < 0.001. The cognitive domains of speed, attention, visuospatial, memory, and executive skills, but not language, also demonstrated a significant relationship with QoL. Regarding caregiver outcomes, 15 studies were identified resulting in a sample of 2421 caregivers (median age 58.12 years, range 18-82) followed for 3 to 84 months post-stroke. Stroke survivor overall cognitive ability again demonstrated a significant small to medium association with caregiver outcomes (QoL and burden combined), r = 0.17 (95% CI 0.10-0.24), p < 0.001. In conclusion, lower post-stroke cognitive performance is associated with significant reductions in stroke survivor QoL and poorer caregiver outcomes. Cognitive assessment is recommended early to identify those at risk and implement timely interventions to support both stroke survivors and their caregivers.
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Affiliation(s)
- Renerus J Stolwyk
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Monash Clayton Campus, Melbourne, VIC, 3800, Australia.
| | - Tijana Mihaljcic
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Monash Clayton Campus, Melbourne, VIC, 3800, Australia
| | - Dana K Wong
- School of Psychology & Public Health, La Trobe University, Bundoora, Australia
| | - Diana Ramirez Hernandez
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Monash Clayton Campus, Melbourne, VIC, 3800, Australia
| | - Brittany Wolff
- School of Psychological Science, The University of Western Australia, Perth, Australia
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Dong HJ, Brain K, Olsson M, Dragioti E, Gerdle B, Ghafouri B. Eating habits and the desire to eat healthier among patients with chronic pain: a registry-based study. Sci Rep 2024; 14:4705. [PMID: 38409442 PMCID: PMC10897138 DOI: 10.1038/s41598-024-55449-z] [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: 09/25/2023] [Accepted: 02/23/2024] [Indexed: 02/28/2024] Open
Abstract
Healthcare professionals often meet pain patients with a poor nutritional status such as obesity, unhealthy dietary behaviors, and a suboptimal dietary intake. A poor nutritional status may play a significant role in the occurrence, development, and prognosis of chronic pain. This study investigated eating habits in a specialized pain rehabilitation center using data (N = 2152) from the Swedish quality registry for pain rehabilitation during the period 2016-2021. Patients answered a lifestyle questionnaire regarding their eating habits and desire to modify their lifestyle. The mean (SD) patient age was 46.1 (14.6) years, with 24.8% classified as obese. Suboptimal eating habits included irregular mealtimes (27.2%), weekly consumption of fast-food (20.3%) and nearly daily consumption of confectionery (33.3%). Approximately 20% (n = 426) reported a desire to eat healthier. Frequent confectionery intake (Odds ratio [OR] 1.23, 95% Confidence Interval (CI) 1.04-1.47) and fast-food consumption (OR 1.58, 95% CI 1.24-2.02) increased the likelihood to desire healthier eating. Younger patients (18-29 years), those classified as obese, and those with more extended spatial pain were more likely to express a desire to eat healthier. Eating habits should be addressed in pain management and interdisciplinary pain rehabilitation teams are encouraged to provide nutritional care tailored to the patient's needs.
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Affiliation(s)
- Huan-Ji Dong
- Pain and Rehabilitation Center, and Department of Health, Medicine and Caring Sciences, Linköping University, 58185, Linköping, Sweden.
| | - Katherine Brain
- School of Health Science, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Integrated Pain Service, Newcastle, NSW, 2300, Australia
| | - Max Olsson
- Pain and Rehabilitation Center, and Department of Health, Medicine and Caring Sciences, Linköping University, 58185, Linköping, Sweden
| | - Elena Dragioti
- Pain and Rehabilitation Center, and Department of Health, Medicine and Caring Sciences, Linköping University, 58185, Linköping, Sweden
- Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, 45500, Ioannina, Greece
| | - Björn Gerdle
- Pain and Rehabilitation Center, and Department of Health, Medicine and Caring Sciences, Linköping University, 58185, Linköping, Sweden
- Department of Neurosurgery and Pain Rehabilitation, Skåne University Hospital, 22185, Lund, Sweden
| | - Bijar Ghafouri
- Pain and Rehabilitation Center, and Department of Health, Medicine and Caring Sciences, Linköping University, 58185, Linköping, Sweden
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9
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Jeawon M, Hase B, Miller S, Eng JJ, Bundon A, Chaudhury H, Maffin J, Clarkson R, Wright J, Mortenson WB. Understanding the experiences, needs, and strengths of people with incomplete spinal cord injury who can ambulate. Disabil Rehabil 2024; 46:546-555. [PMID: 36740758 DOI: 10.1080/09638288.2023.2171495] [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: 05/04/2022] [Accepted: 01/17/2023] [Indexed: 02/07/2023]
Abstract
PURPOSE To identify the experiences, needs, and strengths of people with incomplete spinal cord injury who can ambulate and to explore and discuss potential supports, services, and programs that would best assist them in the community. MATERIAL AND METHODS In this qualitative descriptive study, interviews were the primary means of data collection. These were supplemented with descriptive standardized measures of function and life satisfaction. Qualitative data were analyzed thematically. RESULTS Twenty-four participants were interviewed, their average age was 55 years and 46% were female. We identified three themes: 'I really couldn't go there', described the physical and social barriers experienced by participants, 'It'd be really nice to let the public know there are people out there like me' expressed the desire for greater social understanding of incomplete spinal cord injury, and 'I just don't quit', displayed the perseverance that participants demonstrated following their injury. CONCLUSION Findings indicate service providers to improve the inclusion of ambulatory individuals with incomplete spinal cord injury in their programs. Suggestions include designing programs (community, healthcare, return to work, peer support), environments using the principles of universal design for people with incomplete spinal cord injury who ambulate, and increasing consideration of their perspectives.Implication for rehabilitation:People with incomplete spinal cord injury who can ambulate live with invisible impairments, which are often not acknowledged by family, friends, health professionals, and people with complete spinal cord injuryThey may feel excluded from activities (organized by spinal cord injury associations) that were originally designed for people with complete spinal cord injuryGreater awareness among health professionals, friends, family, and people with complete spinal cord injury of the needs of people with incomplete spinal cord injury who can ambulate is needed to increase their inclusion.
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Affiliation(s)
- Murveena Jeawon
- Department of Occupational Sciences and Occupational Therapy, University of British Columbia, Vancouver, Canada
- GF Strong Rehabilitation Centre, Vancouver, Canada
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, Canada
| | - Bethany Hase
- Department of Occupational Sciences and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Susanna Miller
- Department of Occupational Sciences and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Janice J Eng
- GF Strong Rehabilitation Centre, Vancouver, Canada
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
| | - Andrea Bundon
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, Canada
- School of Kinesiology, University of British Columbia, Vancouver, Canada
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Vancouver, Canada
| | - Jocelyn Maffin
- Spinal Cord Injury - British Columbia, Vancouver, Canada
| | - Ryan Clarkson
- Spinal Cord Injury - British Columbia, Vancouver, Canada
| | - Jenna Wright
- Spinal Cord Injury - British Columbia, Vancouver, Canada
| | - W Ben Mortenson
- Department of Occupational Sciences and Occupational Therapy, University of British Columbia, Vancouver, Canada
- GF Strong Rehabilitation Centre, Vancouver, Canada
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, Canada
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10
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Kähler M, Nilsson HM, Lexell J. The Life After Stroke In Northern Sweden Study (LASINS): Methodology, cohort demographics and initial results. NeuroRehabilitation 2024; 54:319-329. [PMID: 38277309 DOI: 10.3233/nre-230278] [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: 01/28/2024]
Abstract
BACKGROUND To advance rehabilitation we need a comprehensive understanding of functioning and disability of people after stroke. OBJECTIVE To present an overview of the methodology of the Life After Stroke In Northern Sweden Study, compare participants and non-participants regarding gender and age, and describe baseline sociodemographics, stroke characteristics and the participants' self-rated degree of recovery. METHODS Data were collected through a study specific questionnaire, from the participants' medical records and with internationally established self-assessment tools focusing on sleep disturbances, depressive symptoms, fatigue, physical activity, and remaining physical and cognitive impairments, activity limitations, participation restrictions and life satisfaction. RESULTS Of 301 potential participants, 160 comprise the final sample (response rate 53%; 86 men and 74 women, mean age 73 years±11, mean time since stroke onset 35 months±11; 18- 61). Most participants had an ischemic stroke (87%), were retired (84%), cohabitant (63%) and walked independently (71%). The mean self-rated degree of recovery was 75 (SD±24; 0- 100). CONCLUSIONS These baseline data together with forthcoming studies will describe stroke-related impairments, activity limitations, participation restrictions and life satisfaction more than one year after stroke, and deepen our understanding of factors of importance for a healthy and successful life after stroke.
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Affiliation(s)
- Maria Kähler
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
- Department of Rehabilitation, Sunderby Hospital, Luleå, Sweden
| | - Hanna M Nilsson
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
- Department of Rehabilitation, Sunderby Hospital, Luleå, Sweden
| | - Jan Lexell
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
- Department of Rehabilitation, Ängelholm Hospital, Ängelholm, Sweden
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11
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Lenouvel E, Ullrich P, Siemens W, Dallmeier D, Denkinger M, Kienle G, Zijlstra GAR, Hauer K, Klöppel S. Cognitive behavioural therapy (CBT) with and without exercise to reduce fear of falling in older people living in the community. Cochrane Database Syst Rev 2023; 11:CD014666. [PMID: 37965937 PMCID: PMC10646947 DOI: 10.1002/14651858.cd014666.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
BACKGROUND Fear of falling (FoF) is a lasting concern about falling that leads to an individual avoiding activities that he/she remains capable of performing. It is a common condition amongst older adults and may occur independently of previous falls. Cognitive behavioural therapy (CBT), a talking therapy that helps change dysfunctional thoughts and behaviour, with and without exercise, may reduce FoF, for example, by reducing catastrophic thoughts related to falls, and modifying dysfunctional behaviour. OBJECTIVES To assess the benefits and harms of CBT for reducing FoF in older people living in the community, and to assess the effects of interventions where CBT is used in combination with exercise. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 1, 2023), MEDLINE Ovid (from 1946 to 11 January 2023), Embase Ovid (from 1980 to 11 January 2023), CINAHL Plus (Cumulative Index to Nursing and Allied Health Literature) (from 1982 to 11 January 2023), PsycINFO (from 1967 to 11 January 2023), and AMED (Allied and Complementary Medicine from 1985 to 11 January 2023). We handsearched reference lists and consulted experts for identifying additional studies. SELECTION CRITERIA This review included randomised controlled trials (RCTs), quasi-RCTs, and cluster-RCTs assessing CBT with and without exercise interventions compared to control groups with sham-treatment, or treatment as usual. We defined CBT as a collaborative, time-limited, goal-oriented, and structured form of speaking therapy. Included studies recruited community-dwelling older adults, with a mean population age of at least 60 years minus one standard deviation, and not defined by a specific medical condition. DATA COLLECTION AND ANALYSIS Two review authors used standard methodological procedures expected by Cochrane. For continuous data, as assessed by single- or multiple-item questionnaires, we report the mean difference (MD) with 95% confidence interval (CI) when studies used the same outcome measures, and standardised mean difference (SMD) when studies used different measures for the same clinical outcome. For dichotomous outcomes, we reported the treatment effects as risk ratios (RR) with 95% CIs. We measured the primary outcome, FoF, immediately, up to, and more than six months after the intervention. We analysed secondary outcomes of activity avoidance, occurrence of falls, depression, and quality of life when measured immediately after the intervention. We assessed risk of bias for each included study, using the GRADE approach to assess the certainty of evidence. MAIN RESULTS We selected 12 studies for this review, with 11 studies included for quantitative synthesis. One study could not be included due to missing information. Of the 11 individual studies, two studies provided two comparisons, which resulted in 13 comparisons. Eight studies were RCTs, and four studies were cluster-RCTs. Two studies had multiple arms (CBT only and CBT with exercise) that fulfilled the inclusion criteria. The primary aim of 10 studies was to reduce FoF. The 11 included studies for quantitative synthesis involved 2357 participants, with mean ages between 73 and 83 years. Study total sample sizes varied from 42 to 540 participants. Of the 13 comparisons, three investigated CBT-only interventions while 10 investigated CBT with exercise. Intervention duration varied between six and 156 hours, at a frequency between three times a week and monthly over an eight- to 48-week period. Most interventions were delivered in groups of between five and 10 participants, and, in one study, up to 25 participants. Included studies had considerable heterogeneity, used different questionnaires, and had high risks of bias. CBT interventions with and without exercise probably improve FoF immediately after the intervention (SMD -0.23, 95% CI -0.36 to -0.11; 11 studies, 2357 participants; moderate-certainty evidence). The sensitivity analyses did not change the intervention effect significantly. Effects of CBT with or without exercise on FoF may be sustained up to six months after the intervention (SMD -0.24, 95% CI -0.41 to -0.07; 8 studies, 1784 participants; very low-certainty evidence). CBT with or without exercise interventions for FoF probably sustains improvements beyond six months (SMD -0.28, 95% CI -0.40 to -0.15; 5 studies, 1185 participants; moderate-certainty of evidence). CBT interventions for reducing FoF may reduce activity avoidance (MD -2.57, 95% CI -4.67 to -0.47; 1 study, 312 participants; low-certainty evidence), and level of depression (SMD -0.41, 95% CI -0.60 to -0.21; 2 studies, 404 participants; low-certainty evidence). We are uncertain whether CBT interventions reduce the occurrence of falls (RR 0.96, 95% CI 0.66 to 1.39; 5 studies, 1119 participants; very low-certainty evidence). All studies had a serious risk of bias, due to performance bias, and at least an unclear risk of detection bias, as participants and assessors could not be blinded due to the nature of the intervention. Downgrading of certainty of evidence also occurred due to heterogeneity between studies, and imprecision, owing to limited sample size of some studies. There was no reporting bias suspected for any article. No studies reported adverse effects due to their interventions. AUTHORS' CONCLUSIONS CBT with and without exercise interventions probably reduces FoF in older people living in the community immediately after the intervention (moderate-certainty evidence). The improvements may be sustained during the period up to six months after intervention (low-certainty evidence), and probably are sustained beyond six months (moderate-certainty evidence). Further studies are needed to improve the certainty of evidence for sustainability of FoF effects up to six months. Of the secondary outcomes, we are uncertain whether CBT interventions for FoF reduce the occurrence of falls (very low-certainty evidence). However, CBT interventions for reducing FoF may reduce the level of activity avoidance, and may reduce depression (low-certainty evidence). No studies reported adverse effects. Future studies could investigate different populations (e.g. nursing home residents or people with comorbidities), intervention characteristics (e.g. duration), or comparisons (e.g. CBT versus exercise), investigate adverse effects of the interventions, and add outcomes (e.g. gait analysis). Future systematic reviews could search specifically for secondary outcomes.
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Affiliation(s)
- Eric Lenouvel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern (UPD), Bern, Switzerland
- Graduate School for Health Science, University of Bern, Bern, Switzerland
| | - Phoebe Ullrich
- Geriatrisches Zentrum am Universitätsklinikum Heidelberg, AGAPLESION Bethanien Krankenhaus, Heidelberg, Germany
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Heidelberg University Hospital, Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), Röntgenstraße 1, D-69126, Heidelberg, Germany
| | - Waldemar Siemens
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
| | - Dhayana Dallmeier
- AGAPLESION Bethesda Clinic Ulm, Research Unit on Ageing, Ulm, Germany
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Michael Denkinger
- Institute for Geriatric Research, University of Ulm Medical Center, Ulm, Germany
- AGAPLESION Bethesda Clinic Ulm, Geriatric Centre Ulm/Alb-Donau, Ulm, Germany
| | - Gunver Kienle
- Department of Medicine II, Medical Center, University of Freiburg, Freiburg, Germany, Freiburg, Germany
| | - G A Rixt Zijlstra
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, Netherlands
- Public Health Service Flevoland (GGD Flevoland), Department of Health Policy & Research, Lelystad, Netherlands, Netherlands
- Health Care and Social Work Division, Windesheim University of Applied Sciences, Almere The Netherlands, Netherlands
| | - Klaus Hauer
- Geriatrisches Zentrum am Universitätsklinikum Heidelberg, AGAPLESION Bethanien Krankenhaus, Heidelberg, Germany
- Robert Bosch Gesellschaft für Medizinische Forschung mbH, Stuttgart, Germany
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern (UPD), Bern, Switzerland
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12
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Grunert KG, Chimisso C, Lähteenmäki L, Leardini D, Sandell MA, Vainio A, Vranken L. Food-related consumer behaviours in times of crisis: Changes in the wake of the Ukraine war, rising prices and the aftermath of the COVID-19 pandemic. Food Res Int 2023; 173:113451. [PMID: 37803775 DOI: 10.1016/j.foodres.2023.113451] [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: 04/17/2023] [Revised: 09/01/2023] [Accepted: 09/10/2023] [Indexed: 10/08/2023]
Abstract
When the COVID-19 pandemic subsided, the war in Ukraine led to further disruptions in consumers' daily behaviours, with rising prices for food and energy. We conducted a survey study on self-reported changes in food-related consumer behaviour in ten European countries and compared the results to a similar study conducted two years ago. A latent class cluster analysis distinguished five clusters and showed that different types of consumers can be distinguished based on how they react to the crisis as regards their eating habits. 19% of survey participants reported no major changes, and 32% reported changes mostly in terms of more price sensitivity. Among those that reported changes beyond reacting to higher prices, there are indications of more mindful eating and more deliberate choices. The changes already found earlier in response to the COVID-19 pandemic therefore seem to have been strengthened and supplemented by reactions to price increases. The results present a challenge to the food industry in terms of supplying healthy and sustainable food at affordable prices.
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Affiliation(s)
- Klaus G Grunert
- MAPP Centre, Aarhus University, Denmark; School of Marketing and Communication, University of Vaasa, Finland.
| | | | | | | | - Mari A Sandell
- Department of Food and Nutrition, University of Helsinki, Finland
| | - Annukka Vainio
- Helsinki Institute of Sustainability Science, Department of Forest Sciences, University of Helsinki, Finland
| | - Liesbet Vranken
- Department of Earth and Environmental Sciences, KU Leuven, Belgium
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Tsirmpas C, Nikolakopoulou M, Kaplow S, Andrikopoulos D, Fatouros P, Kontoangelos K, Papageorgiou C. A Digital Mental Health Support Program for Depression and Anxiety in Populations With Attention-Deficit/Hyperactivity Disorder: Feasibility and Usability Study. JMIR Form Res 2023; 7:e48362. [PMID: 37819688 PMCID: PMC10600652 DOI: 10.2196/48362] [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: 04/20/2023] [Revised: 07/27/2023] [Accepted: 08/20/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND A total of 1 in 2 adults with attention-deficit/hyperactivity disorder (ADHD) struggles with major depressive or anxiety disorders. The co-occurrence of these disorders adds to the complexity of finding utility in as well as adherence to a treatment option. Digital therapeutic solutions may present a promising alternative treatment option that could mitigate these challenges and alleviate symptoms. OBJECTIVE This study aims to investigate (1) the feasibility and acceptance of a digital mental health intervention, (2) participants' engagement and retention levels, and (3) the potential efficacy with respect to anxiety and depression symptoms in a population with ADHD. Our main hypothesis was that a digital, data-driven, and personalized intervention for adults with coexisting ADHD and depressive or anxiety symptoms would show high engagement and adherence, which would be accompanied by a decrease in depressive and anxiety symptoms along with an increase in quality of life and life satisfaction levels. METHODS This real-world data, single-arm study included 30 adult participants with ADHD symptomatology and coexisting depressive or anxiety symptoms who joined a 16-week digital, data-driven mental health support program. This intervention is based on a combination of evidence-based approaches such as cognitive behavioral therapy, mindfulness, and positive psychology techniques. The targeted symptomatology was evaluated using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Barkley Adult ADHD Rating Scale-IV. Quality of life aspects were evaluated using the Satisfaction With Life Scale and the Life Satisfaction Questionnaire, and user feedback surveys were used to assess user experience and acceptability. RESULTS The study retention rate was 97% (29/30), and high engagement levels were observed, as depicted by the 69 minutes spent on the app per week, 5 emotion logs per week, and 11.5 mental health actions per week. An average decrease of 46.2% (P<.001; r=0.89) in depressive symptoms and 46.4% (P<.001; r=0.86) in anxiety symptoms was observed, with clinically significant improvement for more than half (17/30, 57% and 18/30, 60%, respectively) of the participants. This was followed by an average increase of 23% (P<.001; r=0.78) and 20% (P=.003; r=0.8) in Satisfaction With Life Scale and Life Satisfaction Questionnaire scores, respectively. The overall participant satisfaction level was 4.3 out of 5. CONCLUSIONS The findings support the feasibility, acceptability, and value of the examined digital program for adults with ADHD symptomatology to address the coexisting depressive or anxiety symptoms. However, controlled trials with larger sample sizes and more diverse participant profiles are required to provide further evidence of clinical efficacy.
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Affiliation(s)
| | | | - Sharon Kaplow
- Feel Therapeutics Inc., San Francisco, CA, United States
| | | | | | - Konstantinos Kontoangelos
- First Department of Psychiatry, Eginition Hospital, Medical School National and Kapodistrian University of Athens, Athens, Greece
- Neurosciences and Precision Medicine Research Institute "Costas Stefanis", University Mental Health, Athens, Greece
| | - Charalabos Papageorgiou
- Neurosciences and Precision Medicine Research Institute "Costas Stefanis", University Mental Health, Athens, Greece
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14
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Mälstam E, Asaba E, Åkesson E, Guidetti S, Patomella AH. The Feasibility of Make My Day-A Randomized Controlled Pilot Trial of a Stroke Prevention Program in Primary Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6828. [PMID: 37835098 PMCID: PMC10572257 DOI: 10.3390/ijerph20196828] [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: 06/09/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023]
Abstract
Incorporating and sustaining engaging everyday activities (EEAs) in everyday life holds potential for improving health and wellbeing; thus, there is reason to explore EEAs as a behavioral change technique in stroke prevention. The aim of this study was to evaluate the feasibility of the stroke prevention program Make My Day (MMD) for people with moderate-to-high risk for stroke in a primary healthcare setting, where EEAs are utilized to promote healthy activity patterns. A randomized controlled pilot trial was designed to evaluate the feasibility of MMD. Twenty-nine persons at risk for stroke were recruited and randomized into either an intervention group (n = 14) receiving MMD or a control group (n = 15) receiving brief health advice and support with goal setting. The results suggest that MMD is feasible, with timely recruitment, overall high response rates and study completion, and sensitivity to change in key outcome measures. Moreover, the results demonstrate that the application of EEAs can be useful for promoting behavioral change in stroke prevention. Recommendations for improvements for a full-scale trial include recruiting a relevant sample, using reliability- and validity-tested outcome measures, and implementing strategies to limit missing data.
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Affiliation(s)
- Emelie Mälstam
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, 141-52 Stockholm, Sweden; (E.A.); (S.G.); (A.-H.P.)
- Department of Occupational and Public Health Sciences, Faculty of Health and Occupational Studies, University of Gävle, 801-76 Gävle, Sweden
| | - Eric Asaba
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, 141-52 Stockholm, Sweden; (E.A.); (S.G.); (A.-H.P.)
- Unit for Research, Development, and Education, Stockholm’s Sjukhem Foundation, 112-19 Stockholm, Sweden;
| | - Elisabet Åkesson
- Unit for Research, Development, and Education, Stockholm’s Sjukhem Foundation, 112-19 Stockholm, Sweden;
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, 141-52 Stockholm, Sweden
| | - Susanne Guidetti
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, 141-52 Stockholm, Sweden; (E.A.); (S.G.); (A.-H.P.)
- Women’s Health and Allied Health Professionals Theme Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, 171-76 Stockholm, Sweden
| | - Ann-Helen Patomella
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, 141-52 Stockholm, Sweden; (E.A.); (S.G.); (A.-H.P.)
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15
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Brännmark C, Klasson S, Stanne TM, Samuelsson H, Alt Murphy M, Sunnerhagen KS, Åberg ND, Jalnefjord O, Björkman-Burtscher I, Jood K, Tatlisumak T, Jern C. FIND Stroke Recovery Study (FIND): rationale and protocol for a longitudinal observational cohort study of trajectories of recovery and biomarkers poststroke. BMJ Open 2023; 13:e072493. [PMID: 37164469 PMCID: PMC10173956 DOI: 10.1136/bmjopen-2023-072493] [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: 05/12/2023] Open
Abstract
INTRODUCTION Comprehensive studies mapping domain-specific trajectories of recovery after stroke and biomarkers reflecting these processes are scarce. We, therefore, initiated an exploratory prospective observational study of stroke cases with repeated evaluation, the FIND Stroke Recovery Study. We aim to capture trajectories of recovery from different impairments, including cognition, in combination with broad profiling of blood and imaging biomarkers of the recovery. METHODS AND ANALYSIS We recruit individuals with first-ever stroke at the stroke unit at the Sahlgrenska University Hospital, Sweden, to FIND. The inclusion started early 2018 and we aim to enrol minimum 500 patients. Neurological and cognitive impairments across multiple domains are assessed using validated clinical assessment methods, advanced neuroimaging is performed and blood samples for biomarker measuring (protein, RNA and DNA) at inclusion and follow-up visits at 3 months, 6 months, 1 year, 2 years and 5 years poststroke. At baseline and at each follow-up visit, we also register clinical variables known to influence outcomes such as prestroke functioning, stroke severity, acute interventions, rehabilitation, other treatments, socioeconomic status, infections (including COVID-19) and other comorbidities. Recurrent stroke and other major vascular events are identified continuously in national registers. ETHICS AND DISSEMINATION FIND composes a unique stroke cohort with detailed phenotyping, repetitive assessments of outcomes across multiple neurological and cognitive domains and patient-reported outcomes as well as blood and imaging biomarker profiling. Ethical approval for the FIND study has been obtained from the Regional Ethics Review Board in Gothenburg and the Swedish Ethics Review Board. The results of this exploratory study will provide novel data on the time course of recovery and biomarkers after stroke. The description of this protocol will inform the stroke research community of our ongoing study and facilitate comparisons with other data sets. TRIAL REGISTRATION NUMBER The protocol is registered at http://www. CLINICALTRIALS gov, Study ID: NCT05708807.
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Affiliation(s)
- Cecilia Brännmark
- Department of Laboratory Medicine, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Research, Development, Education and Innovation, Gothenburg, Sweden
| | - Sofia Klasson
- Department of Laboratory Medicine, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tara M Stanne
- Department of Laboratory Medicine, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Clinical Genetics and Genomics, Gothenburg, Sweden
| | - Hans Samuelsson
- Institute of Psychology, Faculty of Social Sciences, University of Gothenburg, Gothenburg, Sweden
- Region Västra Göraland, Sahlgrenska University Hospital, Department of Rehabilitation Medicin, Gothenburg, Sweden
| | - Margit Alt Murphy
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Occupational Therapy and Physiotherapy, Gothenburg, Sweden
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Katharina S Sunnerhagen
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - N David Åberg
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Acute Medicine and Geriatrics, Gothenburg, Sweden
- Institute of Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Oscar Jalnefjord
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Medical Physics and Biomedical Engineering, Gothenburg, Sweden
| | - Isabella Björkman-Burtscher
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Radiology, Gothenburg, Sweden
| | - Katarina Jood
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Neurology, Gothenburg, Sweden
| | - Turgut Tatlisumak
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Neurology, Gothenburg, Sweden
| | - Christina Jern
- Department of Laboratory Medicine, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Clinical Genetics and Genomics, Gothenburg, Sweden
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Dixon R, Derrett S, Samaranayaka A, Harcombe H, Wyeth EH, Beaver C, Sullivan M. Life satisfaction 18 months and 10 years following spinal cord injury: results from a New Zealand prospective cohort study. Qual Life Res 2023; 32:1015-1030. [PMID: 36701016 PMCID: PMC10063493 DOI: 10.1007/s11136-022-03313-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] [Accepted: 11/29/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE To examine the life satisfaction outcomes after spinal cord injury (SCI) and to identify the factors associated with life satisfaction at 18 months and 10 years post-SCI in New Zealand (NZ). METHODS Adults (16-64 years) were recruited between 2007 and 2009 from NZ's two spinal units following first admission for SCI. Interviews at 6 months, 18 months, and 10 years post-SCI examined demographic, physical, psychosocial, economic, and environmental characteristics. Multivariable regression models were used to identify predictors of life satisfaction at each timepoint. RESULTS Overall, 118 people participated at 6 months, 103 at 18 months, and 63 at 10 years post-SCI. Pre-SCI, 90% of participants were satisfied with life, 67% were satisfied at 18 months, and 78% at 10 years. At 18 months post-SCI, participants who reported: never or sometimes using a wheelchair, no problems with self-care, no problems with anxiety or depression, no/lesser disability, or fewer secondary health conditions (SHCs) at 6 months post-SCI were more likely to be satisfied (p < 0.05), compared to those without these characteristics. Participants who experienced considerable disability at 6 months post-SCI were 22% less likely to be satisfied 10 years post-SCI compared to those experiencing no/lesser disability (p = 0.028). CONCLUSIONS A higher proportion of participants were satisfied at both 18 months and 10 years post-SCI than not satisfied. To improve the likelihood of satisfaction with life, increased focus on reducing disability and providing supports for those using wheelchairs, experiencing anxiety/depression or problems with self-care, and effects of SHCs are promising for future potential interventions.
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Affiliation(s)
- Ruby Dixon
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Sarah Derrett
- Division of Health Sciences, Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, New Zealand.
| | - Ari Samaranayaka
- Division of Health Sciences, Biostatistics Centre, University of Otago, Dunedin, New Zealand
| | - Helen Harcombe
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Emma H Wyeth
- Division of Health Sciences, Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, New Zealand
| | - Carolyn Beaver
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Martin Sullivan
- School of Social Work, Massey University, Palmerston North, New Zealand
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Shwartz-Asher D, Grabarski M, Tziner A, Shkoler O. Career Don’t Stop Believing: Career Empowerment as a Mediator between Hope and Organizational Outcomes. REVISTA DE PSICOLOGÍA DEL TRABAJO Y DE LAS ORGANIZACIONES 2023. [DOI: 10.5093/jwop2023a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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Aili K, Hellman T, Svartengren M, Danielsson K. Including a Three-Party Meeting Using the Demand and Ability Protocol in an Interdisciplinary Pain Rehabilitation Programme for a Successful Return to Work Process. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16614. [PMID: 36554495 PMCID: PMC9778674 DOI: 10.3390/ijerph192416614] [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: 10/26/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
The Demand and Ability Protocol (DAP) is used in three-party meetings involving an employee, an employer, and a representative from the rehabilitation team. The aim of this study is to investigate the inclusion of an intervention using the DAP in an interdisciplinary pain rehabilitation programme (IPRP) compared to usual care. This non-randomised controlled trial included patients assigned to an IPRP in Sweden. The intervention group received a DAP intervention targeting their work situation in addition to the usual care provided by the IPRP. The control group received IPRP only. Outcome measures were collected from the Swedish Quality Registry for Pain Rehabilitation. Results demonstrated improvements in both groups regarding self-reported anxiety, depression and EQ5D. Sleep was improved in the intervention group but not in the control group. No statistical differences in outcomes were observed between the groups. In conclusion, adding the DAP intervention to IPRP seemed to have the potential to improve sleep among the patients, which may indicate an overall improvement regarding health outcomes from a longer perspective. The results were less clear, however, regarding the work-related outcomes of sickness absence and workability.
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Affiliation(s)
- Katarina Aili
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, 751 85 Uppsala, Sweden
- Department of Health and Sport, School of Health and Welfare, Halmstad University, 301 18 Halmstad, Sweden
| | - Therese Hellman
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, 751 85 Uppsala, Sweden
- Department of Occupational and Environmental Medicine, Uppsala University Hospital, 751 85 Uppsala, Sweden
| | - Magnus Svartengren
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, 751 85 Uppsala, Sweden
- Department of Occupational and Environmental Medicine, Uppsala University Hospital, 751 85 Uppsala, Sweden
| | - Katarina Danielsson
- Department of Medical Sciences, Psychiatry, Uppsala University, 751 85 Uppsala, Sweden
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Ekstrand E, Brogårdh C, Axen I, Fänge AM, Stigmar K, Hansson EE. Perceived Consequences of Post-COVID-19 and Factors Associated with Low Life Satisfaction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15309. [PMID: 36430026 PMCID: PMC9690380 DOI: 10.3390/ijerph192215309] [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: 10/13/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
A significant number of individuals experience post-COVID-19 symptoms, but knowledge of perceived consequences and life satisfaction is lacking. Here, we investigate perceived consequences regarding everyday life, health, physical activity and work post-COVID-19 and factors associated with low life satisfaction. A total of 766 people (mean age 48; 672 women) experiencing post-COVID-19 symptoms at least two months after infection (mean 13 months) responded to an online survey. A majority (≥77%) perceived physical fatigue, mental fatigue, dizziness, reduced work ability, low life satisfaction and a reduced level of aerobic capacity. In the final logistic regression model (Nagelkerke R Square 0.296, p < 0.001), poor work ability was the most important factor for perceiving low satisfaction with life (Odds ratio 3.369, 95% CI 2.040-5.565, p < 0.001, Nagelkerke R Square 0.177). Reduced aerobic capacity, fatigue and living in a city also increased the odds of low life satisfaction. As people with post-COVID-19 report several long-term consequences, this suggests that there is a need for targeted care for this group. The results of this study can serve as guidance for healthcare authorities regarding important long-term consequences that should be considered in rehabilitation programs directed toward post-COVID-19.
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Affiliation(s)
- Elisabeth Ekstrand
- Department of Health Sciences, Lund University, 221 85 Lund, Sweden
- Department of Hand Surgery, Skåne University Hospital, 205 02 Malmö, Sweden
| | - Christina Brogårdh
- Department of Health Sciences, Lund University, 221 85 Lund, Sweden
- Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, 221 40 Lund, Sweden
| | - Iben Axen
- Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Nobels v. 13, 171 77 Stockholm, Sweden
| | | | - Kjerstin Stigmar
- Department of Health Sciences, Lund University, 221 85 Lund, Sweden
| | - Eva Ekvall Hansson
- Department of Health Sciences, Lund University, 221 85 Lund, Sweden
- Ear-Nose- and Throat Department, Skåne University Hospital, 221 40 Lund, Sweden
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20
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Wenneberg SB, Block L, Sörbo A, Naredi S, Oras J, Hendén PL, Ljungqvist J, Liljencrantz J, Hergès HO. Long-term outcomes after aneurysmal subarachnoid hemorrhage: A prospective observational cohort study. Acta Neurol Scand 2022; 146:525-536. [PMID: 35852005 PMCID: PMC9796482 DOI: 10.1111/ane.13674] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/27/2022] [Accepted: 07/10/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The survival rates for patients affected by aneurysmal subarachnoid hemorrhage (aSAH) have increased in recent years; however, many patients continue to develop cognitive dysfunctions that affect their quality of life. The commonly used outcome measures often fail to identify these cognitive dysfunctions. This study aimed to evaluate the long-term outcomes at 1 and 3 years after aSAH to assess changes over time and relate outcomes to patient characteristics and events during the acute phase. MATERIALS AND METHODS This prospective observational study included patients that experienced aSAH. Patients were assessed according to the extended Glasgow Outcome Scale, Life Satisfaction Questionnaire, Mayo-Portland Adaptability inventory-4, and Mental Fatigue scale. RESULTS Patients were assessed after 1 year (n = 62) and 3 years (n = 54). At 3 years, the extended Glasgow Outcome Scale score improved in 15% and worsened in 12% of the patients. Mental fatigue was observed in 57% of the patients at 1 year. Patients <60 years of age at the time of aSAH had more self-assessed problems, including pain/headache (p < .01), than patients >60 years of age. Patients with delayed cerebral ischemia during the acute phase reported more dissatisfaction at 3 years, whereas no significant result was seen at 1 year. CONCLUSIONS Cognitive dysfunction, especially mental fatigue, is common in patients with aSAH, which affects quality of life and recovery. Patient outcome is a dynamic process developing throughout years after aSAH, involving both improvement and deterioration. This study indicates the importance of longer follow-up periods with broad outcome assessments.
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Affiliation(s)
- Sandra Bjerkne Wenneberg
- Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Anaesthesiology and Intensive Care, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
| | - Linda Block
- Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Anaesthesiology and Intensive Care, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
| | - Ann Sörbo
- Department of Neurology and Rehabilitation and Department of Research, Education and InnovationSödra Älvsborg HospitalBoråsSweden,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Silvana Naredi
- Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Anaesthesiology and Intensive Care, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
| | - Jonatan Oras
- Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Anaesthesiology and Intensive Care, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
| | - Pia Löwhagen Hendén
- Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Anaesthesiology and Intensive Care, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
| | - Johan Ljungqvist
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of NeurosurgerySahlgrenska University HospitalGothenburgSweden
| | - Jaquette Liljencrantz
- Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Anaesthesiology and Intensive Care, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
| | - Helena Odenstedt Hergès
- Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Anaesthesiology and Intensive Care, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
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21
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The impact of comorbid spinal pain in depression on work participation and clinical remission following brief or short psychotherapy. Secondary analysis of a randomized controlled trial with two-year follow-up. PLoS One 2022; 17:e0273216. [PMID: 35994437 PMCID: PMC9394798 DOI: 10.1371/journal.pone.0273216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 07/08/2022] [Indexed: 11/27/2022] Open
Abstract
Objectives This explorative study analyses the influence of baseline comorbid long-lasting spinal pain (CSP) on improvement of long term work participation and clinical remission of mental health illness following either brief coping-focussed or short-term psychotherapy for depression. Whether type of treatment modifies outcome with or without CSP is also analysed. Design A secondary post hoc subgroup analysis of a pragmatic randomised controlled trial. Interventions Brief or standard short psychotherapy. Methods Based on baseline assessment, the sample was subdivided into a subgroup with and a subgroup without CSP. Work participation and clinical remission of depression and anxiety were assessed as treatment outcome at two-year follow-up. Simple and multivariate logistic regression analyses, across the intervention arms, were applied to evaluate the impact of CSP on treatment outcome. Selected baseline variables were considered as potential confounders and included as variates if relevant. The modifying effect of CSP on treatment outcome was evaluated by including intervention modality as an interaction term. Main results Among the 236 participants with depressive symptoms, 83 participants (35%) were identified with CSP. In simple logistic regression analysis, CSP reduced improvements on both work participation and clinical remission rate. In the multivariate analysis however, the impact of CSP on work participation and on clinical remission were not significant after adjusting for confounding variables. Reduction of work participation was mainly explained by the higher age of the CSP participants and the reduced clinical remission by the additional co-occurrence of anxiety symptoms at baseline. The occurrence of CSP at baseline did not modify long term outcome of brief compared to short psychotherapy. Conclusions CSP at baseline reduced work participation and worsened remission of mental health symptoms two-year following psychotherapy. Older age and more severe baseline anxiety are associated to reduced effectiveness. Type of psychotherapy received did not contribute to differences.
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22
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Comprehensive geriatric assessment is associated with increased antidepressant treatment in frail older people with unplanned hospital admissions-results from the randomised controlled study CGA-Swed. BMC Geriatr 2022; 22:645. [PMID: 35931975 PMCID: PMC9354437 DOI: 10.1186/s12877-022-03324-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Frail older people are at higher risk of further deterioration if their needs are not acknowledged when they are acutely ill and admitted to hospital. Mental health comprises one area of needs assessment. AIMS The aims of this study were threefold: to investigate the prevalence of depression in frail hospital patients, to identify factors associated with depression, and to compare depression management in patients receiving and not receiving Comprehensive Geriatric Assessment (CGA). METHODS This secondary analysis from the CGA-Swed randomized control trial included 155 frail older people aged 75 years and above. Instruments included Montgomery Åsberg Depression Rating Scale (MADRS), the ICE Capability measure for older people (ICECAP-O) and the Fugl-Meyer Life Satisfaction scale (Fugl-Meyer Lisat). Depression was broadly defined as MADRS score ≥ 7. Regression models were used to identify variables associated with depression and to compare groups with and without the CGA intervention. RESULTS The prevalence of a MADRS score indicating depression at baseline was 60.7%. The inability to do things that make one feel valued (ICECAP-O) was associated with a fourfold increase in depression (OR 4.37, CI 1.50-12.75, p = 0.007). There was a two-fold increase in odds of receiving antidepressant medication in the CGA intervention group (OR 2.33, CI 1.15-4.71, p = 0.019) compared to patients in the control group who received regular medical care. CONCLUSION Symptoms of depression were common among frail older people with unplanned hospital admission. Being unable to do things that make one feel valued was associated with depression. People who received CGA intervention had higher odds of receiving antidepressant treatment, suggesting that CGA improves recognition of mental health needs during unplanned hospital admissions in frail older people. TRIAL REGISTRATION ClinicalTrials.gov, NCT02773914. Retrospectively registered 16 May 2016.
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23
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Assander S, Bergström A, Eriksson C, Meijer S, Guidetti S. ASSIST: a reablement program for older adults in Sweden - a feasibility study. BMC Geriatr 2022; 22:618. [PMID: 35879678 PMCID: PMC9316332 DOI: 10.1186/s12877-022-03185-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 06/01/2022] [Indexed: 12/03/2022] Open
Abstract
Background Western countries emphasise the provision of assistive home care by implementing reablement services. Reablement services are offered to a limited degree in Sweden, and systematic research regarding outcomes and how reablement can be tailored to maximize benefits for older adults has been lacking. This study aimed to evaluate the feasibility of a novel reablement program (ASSIST 1.0) regarding study design and outcome measures, as well as fidelity, adherence, and acceptability of the program in a Swedish context. Method A non-randomised, quasi-experimental, mixed-method, pre/post-test design was applied with an intervention group receiving ASSIST 1.0 (n = 7) and a control group receiving regular home care (n = 10). ASSIST 1.0 was developed to empower older adults to increase their perceived performance and satisfaction of performing activities in everyday life as well as increase their perceived health, self-efficacy, and well-being. ASSIST 1.0 was founded on the concept of reablement and included three components: i) goal setting with The Canadian Occupational Performance Measure (COPM), ii) provided support to home care staff to enhance their provision of reablement, and iii) explored the incorporation and use of an information- and communication technology (ICT) to facilitate information transfer. Results Using COPM for goal setting with older adults and providing support to the staff via workshops were valuable components in the delivery of ASSIST 1.0. The ICT product encountered several challenges and could not be evaluated. COPM and EQ-5D were deemed the most important instruments. Organisational and political barriers affected the feasibility. Although, the fidelity and adherence were complied the staff perceived the program to be acceptable. Conclusion The ASSIST 1.0 program was feasible in regard of study design, delivering the intervention, and evaluating instruments that detected a change. A logical progression would be to conduct a full-scale trial. In addition, a usability study to evaluate the technological component is also recommended. With minor improvements, the ASSIST 1.0 program has the potential to contribute to the development of a home care organisation that could enhance older adults possibility to age in place at home. Trial registration number NCT03505619
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Affiliation(s)
- Susanne Assander
- Department of Neurobiology, Caring Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
| | - Aileen Bergström
- Department of Neurobiology, Caring Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Christina Eriksson
- Department of Neurobiology, Caring Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.,Academic Primary Health Care Centre, Stockholm, Sweden
| | - Sebastiaan Meijer
- Department of Biomedical Engineering and Health Systems, Kungliga Tekniska Högskolan, Stockholm, Sweden
| | - Susanne Guidetti
- Department of Neurobiology, Caring Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.,Medical Unit Occupational Therapy and Physiotherapy, Theme Women´S Health and Allied Health Professionals, Karolinska University Hospital, Stockholm, Sweden
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24
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Grenawalt TA, Tansey TN, Phillips BN, Strauser DR, Rosenthal DA, Wagner S. Effectiveness of internet-based behavioral activation on quality of life among young adult survivors of childhood brain tumor: a randomized controlled trial. Disabil Rehabil 2022:1-8. [PMID: 35798680 DOI: 10.1080/09638288.2022.2094478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Diagnosis and treatment of childhood brain tumor have detrimental effects on physical, neurocognitive, psychological, and social functioning that lasts into adulthood and effects quality of life (QOL). To address diminished QOL, an Internet-based behavioral activation (BA) intervention was developed. Behavioral activation aims to increase activities and behaviors likely to improve thoughts, mood, and QOL. METHODS Participants included 127 young adult survivors of childhood brain tumor (SCBT) randomized into the experimental group (n= 64) or the waitlist control group (n= 63). The dependent variables included: life satisfaction, stress, and activation and were assessed with a two-way mixed analysis of variance (ANOVA). RESULTS Results revealed a significant interaction between the intervention and time on life satisfaction, F(1, 125)=4.793, p = 0.03. There were no significant main effects over time for perceived stress and activation. CONCLUSIONS Findings offer initial evidence that BA can be delivered over the internet and that Internet-delivered BA can have a positive effect on the QOL of young adult SCBT. Internet-based BA interventions can serve as a resource for young adult SCBT who desire to boost their mood and QOL.Implications for rehabilitationBehavioral activation (BA) is aimed at increasing positively reinforcing overt behaviors that are likely to promote improved thoughts, mood, and quality of life (QOL).Results indicated study participants in the experimental group demonstrated a significant gain in life satisfaction compared to the control group after receiving the Internet-based BA intervention; and provides support that the intervention was associated with positive changes across time.Findings offer initial evidence that BA can be delivered over the internet and that Internet-delivered BA can have a positive effect on the QOL of young adult survivors of childhood brain tumor (SCBT).Internet-based BA interventions can serve as a resource for young adult SCBT who desire to boost their mood and QOL.
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Affiliation(s)
- Teresa Ann Grenawalt
- Department of Educational Studies in Psychology, Research Methodology, and Counseling, University of Alabama, Tuscaloosa, AL, USA
| | - Timothy N Tansey
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, Madison, WI, USA
| | - Brian N Phillips
- Department of Special Education and Rehabilitation Counseling, Utah State University, Logan, UT, USA
| | - David R Strauser
- Department of Kinesiology and Community Health, Work and Disability Lab, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - David A Rosenthal
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, Madison, WI, USA
| | - Stacia Wagner
- Children's Brain Tumor Foundation, New York, NY, USA
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25
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Carlsson-Lalloo E, Berg M, Rusner M, Svedhem V, Mellgren Å. Sexual satisfaction and its associations with patient-reported outcomes in a cohort of women living with human immunodeficiency virus in Sweden. Int J STD AIDS 2022; 33:751-760. [PMID: 35622448 DOI: 10.1177/09564624221100056] [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: 11/16/2022]
Abstract
Background: Sexual satisfaction is an important dimension of health-related quality of life that needs to be addressed. Various factors may influence sexual satisfaction in women living with HIV (WLHIV); however, research in this area is limited. The aim of this study was to investigate patients' self-reported sexual satisfaction and its associations with patient-reported outcomes in WLHIV in Sweden. Methods: Data was retrieved from the InfCareHIV registry for the years 2011-2016. The registry includes a self-reported validated 9-item health questionnaire to assess patient-reported outcomes, side effects and adherence. In total, 1292 WLHIV aged ≥18 years were included, corresponding to 42.8% of the female Swedish InfCareHIV cohort 2011-2016. A total of 2444 questionnaires were included in the study. The patient-reported outcomes used were satisfaction with physical health and psychological health, sexual satisfaction, and experiencing side effects from HIV-medication. Associations were tested in univariable and multivariable models. Results: The study shows that there was a significant association between sexual satisfaction and satisfaction with psychological health (p ≤ 0.0001). There was a lower probability of reporting sexual satisfaction in women who were of an older age when they received an HIV-diagnosis (p = 0.033), who had lived for more years with HIV (p = 0.0004), or who had experienced side effects (p = 0.028). Conclusions: This national register-based study identified that sexual satisfaction in WLHIV is associated with psychological health and with having experienced side-effects. Patient-reported outcomes can provide valuable information so that the care of WLHIV covers all aspects of health and supports sexual satisfaction, which is an important part of quality of life.
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Affiliation(s)
- Ewa Carlsson-Lalloo
- Institute of Health and Care Sciences, 70712Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Faculty of Caring Science, Work Life and Social Welfare, 101066University of Borås, Borås, Sweden
| | - Marie Berg
- Institute of Health and Care Sciences, 70712Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Faculty of Medicine and Community Health, 485354Evangelical University of Africa, Bukavu, Democratic Republic of Congo
| | - Marie Rusner
- Institute of Health and Care Sciences, 70712Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Research, Education and Innovation, 531534Södra Älvsborg Hospital, Borås, Sweden
| | - Veronica Svedhem
- Department of Infectious Diseases, 59562Karolinska University Hospital, Stockholm, Sweden.,Unit of Infectious Diseases, Department of Medicine, 27106Karolinska Institute, Huddinge, Stockholm, Sweden
| | - Åsa Mellgren
- Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, 3570University of Gothenburg, Gothenburg, Sweden
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26
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Turesson C, Liedberg G, Vixner L, Lofgren M, Björk M. Evidence-based digital support during 1 year after an Interdisciplinary Pain Rehabilitation Programme for persons with chronic musculoskeletal pain to facilitate a sustainable return to work: a study protocol for a registry-based multicentre randomised controlled trial. BMJ Open 2022; 12:e060452. [PMID: 35470201 PMCID: PMC9039404 DOI: 10.1136/bmjopen-2021-060452] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/06/2022] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Chronic musculoskeletal pain (CMSP) severely affects the individual's quality of life, functioning and ability to work, and comes with significant societal costs for sick leave and productivity loss. After rehabilitation, patients with CMSP often experience lack of support when responsibility for the return-to-work process is taken over by the employer. Therefore, we aim to evaluate the effectiveness of a digital support (Sustainable WorkEr digital support for Persons with chronic Pain and their Employers (SWEPPE)) for promoting a sustainable return-to-work for persons with CMSP and to facilitate the employers' supportive role and responsibilities in the process. METHODS AND ANALYSIS In this registry-based multicentre randomised controlled trial, 360 patients with CMSP will be randomised to either receive the smartphone application SWEPPE (n=180) or to a control group (n=180). The intervention group will use SWEPPE for 1 year and the control group will not receive any intervention for return to work (RTW). Participants will be recruited from approximately 10 specialist and primary care level units connected to the Swedish National Quality Registry for Pain Rehabilitation providing Interdisciplinary Pain Rehabilitation Programmes (IPRP) for CMSP. Eligibility criteria are age 18-65 years and a need for support in RTW or continued support at work for creating a sustainable work situation. Baseline data will be collected when the participants have completed the IPRP. Final assessment will be performed after 12 months. The primary outcome will be a number of days with sickness cash benefit. Secondary outcomes and explanatory variables including important domains affected by CMSP such as health-related quality of life, functioning and work ability will be collected. ETHICS AND DISSEMINATION The Swedish Ethics Review Board approved the study (Dnr 2020-01593, Dnr 2021-01854). The study findings will be disseminated through publication, national and international conferences, and meetings to be available for patients, healthcare providers or stakeholders. TRIAL REGISTRATION NUMBER NCT05058547.
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Affiliation(s)
- Christina Turesson
- Department of Health Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Gunilla Liedberg
- Department of Health Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Linda Vixner
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Monika Lofgren
- Department of Clinical Sciences and Department of Rehabilitation Medicine Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Mathilda Björk
- Department of Health Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
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27
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Esposito C, Di Napoli I, Di Martino S, Prilleltensky I, Arcidiacono C. The I COPPE Scale Short Form for measuring multidimensional well-being: Construct validity and reliability from US, Argentinian, and Italian large samples. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:696-711. [PMID: 34223645 PMCID: PMC9292542 DOI: 10.1002/jcop.22659] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 04/20/2021] [Accepted: 06/07/2021] [Indexed: 06/13/2023]
Abstract
The aim of this study is to present a short form of the I COPPE scale of multidimensional well-being. We conducted two studies, which include four samples collected across three countries, namely United States, Argentina, and Italy. In the pilot study we tested during the data analysis phase whether it was feasible to reduce the full I COPPE scale by omitting the items dealing with past well-being. Prompted by the positive results of the pilot study, we launched a final validation study with a sample of 2682 Italian people who completed the I COPPE scale short form, which is designed without items referring to past well-being. Results from a series of confirmatory factor analyses show that the I COPPE scale short form presents acceptable levels of construct validity and reliability. Moreover, the 7-factor correlated-trait model proved to be the best fit for the data. We discuss advantaged of using the I COPPE scale short form along with limitations and future recommendations.
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Affiliation(s)
- Ciro Esposito
- Department of HumanitiesUniversity of Naples Federico IINaplesItaly
| | | | | | - Isaac Prilleltensky
- Department of Educational and Psychological StudiesUniversity of Miami's School of Education & Human DevelopmentMiamiFloridaUSA
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28
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Nilsson Schönnesson L, Ross MW, Garcia-Huidobro D, Eriksson LE, Andersson G, Williams ML, Ekström AM. Hopelessness and HIV infection: an exploratory study with a gender-specific perspective. BMC Psychol 2022; 10:46. [PMID: 35227317 PMCID: PMC8887031 DOI: 10.1186/s40359-022-00755-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 02/16/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND An understudied psychological response to HIV-related stressors among people living with HIV is hopelessness. Hopelessness is the expectation that things will not improve and feeling helpless to change one's current situation. The aim of this study was to assess prevalence and levels of hopelessness and its direct and indirect contributors in people living with HIV in Sweden. METHODS Participants included 967 women and men from the "Living with HIV in Sweden" cross-sectional study with available data regarding hopelessness measured by the Beck Hopelessness Scale. Binary and multiple logistic regression analyses were used to determine direct and indirect factors that may contribute to feelings of hopelessness. Path analyses were used to assess the underlying structure of hopelessness. All analyses were conducted by gender. RESULTS Almost half the participants reported moderate to severe hopelessness. There were no differences in frequency of feeling hopeless or level of hopelessness by gender or sexual orientation. Dissatisfaction with finances, dissatisfaction with physical health, and low HIV-related emotional support were found to be directly associated with hopelessness for both women and men. Although having some indirect factors in common, unemployment and HIV stigmatization, women and men had different underlying structures of hopelessness. CONCLUSIONS Our findings are important to HIV clinicians in identifying those at risk of hopelessness from a gender perspective in order to reduce preventable psychological distress among people living with HIV.
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Affiliation(s)
- Lena Nilsson Schönnesson
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden.
- Kolstan, Övre Kolstan, 671 98, Gunnarskog, Sweden.
| | - Michael W Ross
- Joycelyn Elders Professor and Chair of Sexual Health Education, Department of Family Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Diego Garcia-Huidobro
- Departamento de Medicina Familiar, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Lars E Eriksson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83, Huddinge, Sweden
- School of Health Sciences, City, University of London, London, EC1V 0HB, UK
- Medical Unit Infectious Diseases, Karolinska University Hospital, 141 86, Stockholm, Sweden
| | - Galit Andersson
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Mark L Williams
- Joycelyn Elders Professor and Dean, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Anna-Mia Ekström
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
- Medical Unit Infectious Diseases, Karolinska University Hospital, 141 86, Stockholm, Sweden
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29
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van der Velde MY, Aerden LAM, van Oort A, Bodde K, Rambaran Mishre R, Oosterveer DM. Caregiver strain and fatigue are independent determinants of anxiety among patients early after stroke. Neuropsychol Rehabil 2022; 33:428-439. [PMID: 35019819 DOI: 10.1080/09602011.2021.2023583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Anxiety and depression are common mental health disorders in stroke patients, and often co-occur. However, in contrast to depression, there is limited research about anxiety after stroke, although impact of anxiety can be substantial. Therefore, this cross-sectional observational study investigated determinants of anxiety after stroke and compared them with determinants of depression after stroke. Stroke surviving patients (n = 284) were seen six weeks after discharge from the hospital or rehabilitation setting. Of these, 238 patients answered all questions of the Hospital Anxiety and Depression Scale measuring anxiety (HADS-a) and 239 patients answered all questions measuring depression (HADS-d). Step-wise regression was used to identify independent determinants of anxiety and depression after stroke. Higher levels of anxiety were associated with a higher caregiver strain (p < 0.01) and more fatigue (p < 0.05). In contrast, higher levels of depression were associated with lower life satisfaction (p < 0.001) and less daily activities (p < 0.05), but also more fatigue (p < 0.001). Hence, our results show that both fatigue and caregiver strain are associated with higher levels of anxiety, but of these only fatigue is also associated with higher levels of depression. Practitioners should therefore ask for both anxiety and depression symptoms in stroke patients.
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Affiliation(s)
- Mark Y van der Velde
- Department of Clinical Geriatrics, Maasstad Hospital, Rotterdam, The Netherlands
| | - Leo A M Aerden
- Department of Neurology, Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - Andrea van Oort
- Department of Psychiatry and Medical Psychology, Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - Karin Bodde
- Department of Neurology, Reinier de Graaf Gasthuis, Delft, The Netherlands
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30
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VanderWeele TJ. Constructed Measures and Causal Inference: Towards a New Model of Measurement for Psychosocial Constructs. Epidemiology 2022; 33:141-151. [PMID: 34669630 PMCID: PMC8614532 DOI: 10.1097/ede.0000000000001434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/05/2021] [Indexed: 11/25/2022]
Abstract
Psychosocial constructs can only be assessed indirectly, and measures are typically formed by a combination of indicators that are thought to relate to the construct. Reflective and formative measurement models offer different conceptualizations of the relation between the indicators and what is sometimes conceived of as a univariate latent variable supposed to correspond in some way to the construct. I argue that the empirical implications of reflective and formative models will often be violated by data since the causally relevant constituents will generally be multivariate, not univariate. These empirical implications can be formally tested but factor analysis is not adequate to do so. I argue that formative models misconstrue the relation between the constructed measures and the underlying reality by which causal processes operate, but that reflective models misconstrue the nature of the underlying reality itself by typically presuming that the constituents of it that are causally efficacious are unidimensional. I discuss the ensuing problems arising from these misconstruals. I propose a causal interpretation of associations between constructed measures and various outcomes that is applicable to both reflective and formative models and is applicable even if the usual assumptions of these models are violated. I put forward an outline for a new model of the process of measure construction and discuss the practical implications of these observations and proposals for the provision of definitions, the selection of items, item-by-item analyses, the construction of measures, and the interpretation of the associations of these measures with subsequent outcomes.
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Affiliation(s)
- Tyler J. VanderWeele
- From the Departments of Epidemiology and Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
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Singh H, Chan K, Cheung L, Hitzig SL, Musselman KE. The impact of falls and fear of falling on participation, autonomy, and life satisfaction among individuals with spinal cord injury: A brief report. J Spinal Cord Med 2021; 44:S234-S239. [PMID: 34779724 PMCID: PMC8604446 DOI: 10.1080/10790268.2021.1943251] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
CONTEXT Qualitative research suggests that falls can have a negative psychosocial impact on the lives of individuals with spinal cord injury (SCI). However, it is unclear whether these qualitative findings are supported by quantitative psychosocial metrics. This paper examines whether falling and/or having a fear of falling impacts participation, autonomy, and life satisfaction among individuals with SCI. METHODS Falls and fear of falling were tracked over six months using a survey and phone check-ins conducted approximately every three to four weeks. The Life Satisfaction 9 and Impact on Participation and Autonomy Questionnaires were administered at baseline and after six months. Responses on the questionnaires were statistically compared between fallers and non-fallers as well as participants with and without a fear of falling during the tracking period. FINDINGS Of the 65 community-dwelling adults with chronic SCI, 38 were categorized as fallers (aged 54.29 ± 13.73, 19.55 ± 14.20 years post-SCI, AIS A-D) and 27 were non-fallers (aged 57.78 ± 12.21, 17.93 ± 17.24 years post-SCI, AIS A-D). Our results revealed no significant differences between fallers and non-fallers in their perceived participation, autonomy, or life satisfaction at baseline or after six months. At the last check-in, 34 participants denied a fear of falling, while 31 had a fear of falling. Perceived autonomy outdoors (P=0.02), total life satisfaction (P=0.04), satisfaction with life as a whole (P=0.00) and self-care (P=0.01) differed between participants with and without a fear of falling after six months. CONCLUSION Fear of falling, rather than falls, may impact participation, autonomy, and life satisfaction in the SCI population.
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Affiliation(s)
- Hardeep Singh
- KITE, Toronto Rehab-University Health Network, Toronto, Canada,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada,Bridgepoint Collaboratory for Research & Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System
| | - Katherine Chan
- KITE, Toronto Rehab-University Health Network, Toronto, Canada
| | - Lovisa Cheung
- KITE, Toronto Rehab-University Health Network, Toronto, Canada,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sander L. Hitzig
- KITE, Toronto Rehab-University Health Network, Toronto, Canada,St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Kristin E. Musselman
- KITE, Toronto Rehab-University Health Network, Toronto, Canada,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada,Correspondence to: Kristin E. Musselman, SCI Mobility Lab, KITE, Toronto Rehab-University Health Network, 520 Sutherland Drive, Toronto, M4G 3V9, Canada.
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Abstract
Nowadays, companies must be concerned with the levels of satisfaction and happiness of employees. Hence, this paper proposes to investigate the links between salary and happiness through an exploratory study with a quasi-experimental design. The sample included 376 respondents, and we employed structured equation modeling (SEM) in ADANCO. Prior to evaluating the structural model, the goodness of fit shows moderate/excellent values. Our empirical results show a positive relationship between salary and happiness, salary and life satisfaction, salary and financial satisfaction, financial satisfaction and life satisfaction, and financial satisfaction and happiness. Thus, we consider that our research contributes to the literature by analyzing the relationship between income and happiness in a developing country such as Romania. Congruent with previous findings, we consider that our results provide evidence of the road from salary to happiness in developing countries.
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Ekstrand E, Brogårdh C. Life satisfaction after stroke and the association with upper extremity disability, sociodemographics, and participation. PM R 2021; 14:922-930. [PMID: 34541828 DOI: 10.1002/pmrj.12712] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/25/2021] [Accepted: 09/09/2021] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Remaining disability after stroke can reduce a person's life satisfaction. Because previous studies of life satisfaction show inconsistent results, there is a need for more knowledge regarding perceived life satisfaction after stroke and associated factors. OBJECTIVE To assess perceived life satisfaction after stroke in relation to Swedish reference values; and the association with upper extremity disability, sociodemographics, and participation. DESIGN Cross-sectional study. SETTING University hospital. PARTICIPANTS Seventy-five persons (72% male) with mild to moderate disability in a stable phase after stroke. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Life satisfaction was assessed with the Life Satisfaction Questionnaire (LiSat-11), which includes one global item Life as a whole and 10 domain-specific items. Global life satisfaction and explanatory factors were evaluated in two multivariate logistic regression models. RESULTS Fifty-three percent of the participants were satisfied with Life as a whole. Highest satisfaction was found for Family life (78%) and Partner relationship (77%) and lowest satisfaction for Vocational situation (32%), Sexual life (25%), and Physical health (23%). Life as a whole and most domain-specific items showed a significantly lower proportion of satisfied persons compared to Swedish reference values. In the first regression model with factors of upper extremity disability, manual ability was the strongest explanatory variable for Life as a whole (p value = .032, Nagelkerke R Square 0.117). In the second regression model, participation, social, and working status were the final explanatory variables (p value = .006, Nagelkerke R Square = 0.207). CONCLUSION Our findings indicate that persons with mild to moderate disability after stroke perceive overall less satisfaction with Life as a whole and domain-specific items than the general Swedish population. To increase a person's life satisfaction after stroke, rehabilitation interventions should target a variety of aspects including enhancing functioning of upper extremity, reducing participation restrictions, and providing support regarding social and vocational situation.
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Affiliation(s)
- Elisabeth Ekstrand
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden
| | - Christina Brogårdh
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, Lund, Sweden
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Grenawalt TA, Umucu E, Reyes A, Baylin A, Strauser DR, Tansey TN, Wagner S. Psychometric Validation of the PERMA-Profiler as a Well-Being Measure for Young Adult Survivors of Pediatric Central Nervous System Tumor. REHABILITATION COUNSELING BULLETIN 2021. [DOI: 10.1177/00343552211025509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aims to validate a measure of well-being, the PERMA-Profiler, among a sample of young adult survivors of pediatric central nervous system (CNS) tumor. Measurement structure of the PERMA-Profiler was evaluated using exploratory factor analysis and confirmatory factor analysis using pretest–posttest data. Reliability and concurrent validity of the PERMA-Profiler were examined. This study included 127 young adult survivors of pediatric CNS tumor between the ages of 18 and 30 ( M = 23.83, SD = 3.00) years. The results of factor analyses yielded a single-factor solution for well-being. Significant relationships between well-being and happiness, life satisfaction, perceived stress, and physical health were observed, providing support for the concurrent validity of the PERMA-Profiler. The PERMA-Profiler displayed good internal consistency and test–retest reliability. The PERMA-Profiler can help rehabilitation researchers and counselors better evaluate well-being in young adult survivors of pediatric CNS tumor, which provides opportunity for more targeted psychosocial interventions.
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Affiliation(s)
| | | | | | | | | | | | - Stacia Wagner
- Children’s Brain Tumor Foundation, New York, NY, USA
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Long-term follow-up of patients with chronic musculoskeletal pain attending interdisciplinary pain rehabilitation: outcomes and predictive factors. Int J Rehabil Res 2021; 44:110-117. [PMID: 33859116 DOI: 10.1097/mrr.0000000000000467] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The long-term outcomes of interdisciplinary pain rehabilitation (IPR) in patients with chronic musculoskeletal pain (CMP) and its predictors has been studied to a limited extent. In this historical cohort study, functioning, satisfaction with life domains, and pain were assessed at baseline, discharge, and at 6-15 years follow-up. At follow-up, most patients (77%) rated the effects of the IPR as temporarily or persistently positive. The gains in functioning, satisfaction with life domains, and pain made during IPR remained for 6-15 years after the IPR. Patients who were single, retired, or not in work, and those having higher pain and lower functioning at baseline, had lower functioning at follow-up, while patients with traumatic pain disorders had higher functioning at follow-up. Gains made during IPR, particularly gains in social and mental functioning and in pain predicted functioning at follow-up. Treatments and events between discharge and follow-up also influenced the long-term outcome. In conclusion, on average, outcomes achieved during IPR persisted at long-term follow-up. Predictors of a better long-term outcome were mainly baseline characteristics.
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Brogårdh C, Hammarlund CS, Eek F, Stigmar K, Lindgren I, Schouenborg AT, Hansson EE. Self-Perceived Life Satisfaction during the First Wave of the COVID-19 Pandemic in Sweden: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6234. [PMID: 34207621 PMCID: PMC8296066 DOI: 10.3390/ijerph18126234] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/02/2021] [Accepted: 06/07/2021] [Indexed: 01/01/2023]
Abstract
Currently, there is limited knowledge on how the Swedish strategy with more lenient public health restrictions during the COVID-19 pandemic has influenced people's life satisfaction. Here, we investigated self-reported life satisfaction during the first wave of the pandemic in Sweden, and perceived changes in life satisfaction in relation to various sociodemographic factors. A total of 1082 people (mean age 48 (SD 12.2); 82% women) responded to an online survey during autumn 2020 including the "Life Satisfaction Questionnaire-11". A majority (69%) were satisfied with life as a whole, and with other important life domains, with the exception of contact with friends and sexual life. An equal share reported that life as a whole had either deteriorated (28%) or improved (29%). Of those that perceived a deterioration, 95% considered it to be due to the pandemic. Regarding deteriorated satisfaction with life as a whole, higher odds were found in the following groups: having no children living at home; being middle aged; having other sources of income than being employed; and having a chronic disease. The Swedish strategy might have contributed to the high proportion of satisfied people. Those who perceived a deterioration in life satisfaction may, however, need attention from Swedish Welfare Authorities.
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Affiliation(s)
- Christina Brogårdh
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden; (C.S.H.); (F.E.); (K.S.); (I.L.); (A.T.S.); (E.E.H.)
- Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, 222 41 Lund, Sweden
| | - Catharina Sjödahl Hammarlund
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden; (C.S.H.); (F.E.); (K.S.); (I.L.); (A.T.S.); (E.E.H.)
- The PRO-CARE Group, School of Health and Society, Kristianstad University, 291 39 Kristianstad, Sweden
| | - Frida Eek
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden; (C.S.H.); (F.E.); (K.S.); (I.L.); (A.T.S.); (E.E.H.)
| | - Kjerstin Stigmar
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden; (C.S.H.); (F.E.); (K.S.); (I.L.); (A.T.S.); (E.E.H.)
- Department of Research and Development, Skåne University Hospital, 222 41 Lund, Sweden
| | - Ingrid Lindgren
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden; (C.S.H.); (F.E.); (K.S.); (I.L.); (A.T.S.); (E.E.H.)
- Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, 222 41 Lund, Sweden
| | - Anna Trulsson Schouenborg
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden; (C.S.H.); (F.E.); (K.S.); (I.L.); (A.T.S.); (E.E.H.)
- Department of Neurosurgery and Pain Rehabilitation, Skåne University Hospital, 222 41 Lund, Sweden
| | - Eva Ekvall Hansson
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden; (C.S.H.); (F.E.); (K.S.); (I.L.); (A.T.S.); (E.E.H.)
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Wyeth EH, Derrett S, Nelson V, Bourke J, Crengle S, Davie G, Harcombe H. POIS-10 Māori: Outcomes and Experiences in the Decade Following Injury. Methods Protoc 2021; 4:37. [PMID: 34065208 PMCID: PMC8163162 DOI: 10.3390/mps4020037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 11/16/2022] Open
Abstract
Injury-related disability burden extends well beyond two years post-injury, especially for Māori (Indigenous) New Zealanders. Māori also experience greater difficulty accessing health services. This prospective cohort study extension uses mixed-methods and aims to understand and identify factors contributing to long-term experiences and outcomes (positive and negative) at 12 years post-injury for injured Māori and their whānau (families), and explore the barriers and facilitators to whānau flourishing, and access to health and rehabilitation services. Five hundred and sixty-six Māori, who were injured between 2007-2009, participated in the Prospective Outcomes of Injury Study (POIS). Of these, 544 consented to long-term follow up, and will be invited to participate in a POIS-10 Māori interview at 12 years post-injury. We anticipate a 65% follow-up rate (~n = 350). Aligned with the Meihana Model, interviews will collect information about multiple inter-related dimensions. Administrative injury and hospitalisation data up to 12 years post-injury will also be collected. Regression models will be developed to examine predictors of long-term health and disability outcomes, after adjusting for a range of confounders. POIS-10 Māori will identify key points in the injury and rehabilitation pathway to inform future interventions to improve post-injury outcomes for Māori and whānau, and will highlight the support required for Māori flourishing post-injury.
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Affiliation(s)
- Emma H. Wyeth
- Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (V.N.); (J.B.); (S.C.)
| | - Sarah Derrett
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (S.D.); (G.D.); (H.H.)
| | - Vicky Nelson
- Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (V.N.); (J.B.); (S.C.)
| | - John Bourke
- Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (V.N.); (J.B.); (S.C.)
- Burwood Academy Trust, Private Bag 4708, Christchurch 8140, New Zealand
- Menzies Health Institute, Griffith University, Brisbane, QLD 4222, Australia
| | - Sue Crengle
- Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (V.N.); (J.B.); (S.C.)
| | - Gabrielle Davie
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (S.D.); (G.D.); (H.H.)
| | - Helen Harcombe
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (S.D.); (G.D.); (H.H.)
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Derrett S, Wyeth EH, Richardson A, Davie G, Samaranayaka A, Lilley R, Harcombe H. Prospective Outcomes of Injury Study 10 Years on (POIS-10): An Observational Cohort Study. Methods Protoc 2021; 4:mps4020035. [PMID: 34067618 PMCID: PMC8163161 DOI: 10.3390/mps4020035] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/12/2021] [Accepted: 05/12/2021] [Indexed: 11/16/2022] Open
Abstract
Injury is a leading cause of disability and is costly. This prospective cohort study extension aims to improve disability, health, and wellbeing outcomes for injured New Zealanders, including for Māori. We will identify predictors and modifiable risk factors of long-term outcomes (positive and negative), and develop an Injury Early Care Tool (INJECT) to inform the implementation of effective interventions to improve outcomes. In the Prospective Outcomes of Injury Study (POIS), 2856 people participated following an injury (occurring between 2007 and 2009) registered with New Zealand's no-fault accident compensation scheme (ACC). POIS-10 will invite 2121 people (including 358 Māori) who completed a 24-month POIS interview and agreed to follow-up, anticipating 75% participation (n = 1591). Interviews will collect sociodemographic characteristics, life events, comorbidities, and new injuries since participants' 24-month interview, as well as key disability, health, and wellbeing outcomes 12 years post-injury. Injury-related data will be collected from ACC and hospitalisation records 12 years post-injury. Regression models for the main outcomes will examine the direct effects of predictor variables after adjustment for a wide range of confounders. POIS-10 is enhanced by our partnership with ACC, and expert advisors and will benefit injured people, including Māori, through increased understanding of mechanisms and interventions to improve long-term post-injury outcomes.
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Affiliation(s)
- Sarah Derrett
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (A.R.); (G.D.); (R.L.); (H.H.)
- Correspondence:
| | - Emma H. Wyeth
- Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand;
| | - Amy Richardson
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (A.R.); (G.D.); (R.L.); (H.H.)
| | - Gabrielle Davie
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (A.R.); (G.D.); (R.L.); (H.H.)
| | - Ari Samaranayaka
- Biostatistics Centre, Division of Health Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand;
| | - Rebbecca Lilley
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (A.R.); (G.D.); (R.L.); (H.H.)
| | - Helen Harcombe
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (A.R.); (G.D.); (R.L.); (H.H.)
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Garcia D, Nima AA, Kazemitabar M, Amato C, Lucchese F, Mihailovic M, Kijima N. Psychometric properties of the Swedish version of the satisfaction with life scale in a sample of individuals with mental illness. PeerJ 2021; 9:e11432. [PMID: 34026367 PMCID: PMC8123228 DOI: 10.7717/peerj.11432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/20/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Health assessment among individuals with mental health problems often involves measures of ill-being (e.g., anxiety, depression). Health is, however, defined as a state of physical, mental and social well-being and not merely the absence of disease (WHO, 1948, 2001). Hence, in order to address mental illness during the 21st century, we need to develop methods for the prevention, identification and treatment of mental illness; but also, for the promotion, identification, and maintenance of well-being. In this context, over three decades of subjective well-being research have resulted in the development of measures of positive aspects of human life, such as the Satisfaction with Life Scale (Diener et al., 1985). Our aim was to investigate the psychometric properties of the Satisfaction with Life Scale in a Swedish population of individuals with mental illness using both Classical Test Theory (CTT) and Item Response Theory (IRT). METHOD A total of 264 participants (age mean = 43.46, SD = 13.31) diagnosed with different types of mental illness answered to the Swedish version of the Satisfaction with Life Scale (five items, 7-point scale: 1 = strongly disagree, 7 = strongly agree). RESULTS We found positive and significant relationships between the five items of the scale (r ranging from 0.37 to 0.75), good reliability (Cronbach's alpha = 0.86), and that the one-factor solution had best goodness of fit (loadings between 0.52-0.88, p < 0.001). Additionally, there were no significant differences in comparative fit indexes regarding gender and occupation status. All items had high discrimination values (between 1.95-3.81), but item 5 ("If I could live my life over, I would change almost nothing"); which had a moderate discrimination value (1.17) and the highest estimated difficulty on response 7 (3.06). Moreover, item 2 ("The conditions of my life are excellent") had less discrimination and redundant difficulty with both item 1 ("In most ways my life is close to my ideal"; 2.03) on response 7 and with item 3 ("I am satisfied with my life"; -1.21) on response 1. The five items together provided good information, with especial good reliability and small standard error within -1.00 up to about 2.00 and the highest amount of test information at 0.00 of the level of life satisfaction within this population. CONCLUSIONS Consistent with previous research, the scale had good reliability and provided good information across most of the latent trait range. In addition, within this population, sociodemographic factors such as gender and occupation status do not influence how individuals respond to the items in the scale. However, the items couldn't measure extreme levels of low/high life satisfaction. We suggest replication of these findings, the test of additional items, and the modification of items 2 and 5 in order to use the scale among individuals with mental illness.
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Affiliation(s)
- Danilo Garcia
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
- Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
- Promotion of Health and Innovation (PHI) Lab, Network for Well-Being, Sweden
- Blekinge Centre of Competence, Region Blekinge, Karlskrona, Sweden
| | - Ali Al Nima
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
- Promotion of Health and Innovation (PHI) Lab, Network for Well-Being, Sweden
- Blekinge Centre of Competence, Region Blekinge, Karlskrona, Sweden
| | - Maryam Kazemitabar
- Department of Psychology, University of Tehran, Tehran, Iran
- Promotion of Health and Innovation (PHI) Lab, Network for Well-Being, Iran
| | - Clara Amato
- Blekinge Centre of Competence, Region Blekinge, Karlskrona, Sweden
- Promotion of Health and Innovation (PHI) Lab, Network for Well-Being, Italy
| | - Franco Lucchese
- Promotion of Health and Innovation (PHI) Lab, Network for Well-Being, Italy
- Department of Dynamic and Clinical Psychology, University of Rome “La Sapienza”, Rome, Italy
| | - Marko Mihailovic
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, United States
- Promotion of Health and Innovation (PHI) Lab, Network for Well-Being, United States
| | - Nobuhiko Kijima
- Promotion of Health and Innovation (PHI) Lab, Network for Well-Being, Japan
- Faculty of Business and Commerce, Keio University, Tokyo, Japan
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Abualait TS, Alzahrani MA, Ibrahim AI, Bashir S, Abuoliat ZA. Determinants of life satisfaction among stroke survivors 1 year post stroke. Medicine (Baltimore) 2021; 100:e25550. [PMID: 33879705 PMCID: PMC8078317 DOI: 10.1097/md.0000000000025550] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/08/2021] [Accepted: 03/25/2021] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT Stroke is the major leading cause of death and severe long-term disability worldwide. The consequences of stroke, aside from diminished survival, have a significant impact on an individual's capability in maintaining self-autonomy and life satisfaction (LS). Thus, this study aimed to assess LS and other specific domains of LS in stroke survivors following their first-ever stroke, and to describe the relationship using socio-demographic and stroke-related variables.This study recruited 376 stroke survivors (244 men and 132 women, mean age: 57 years) 1 year following stroke. Data on participants' LS (measured using the Life Satisfaction Questionnaire [LiSat-11]), socio-demographics, and stroke-related variables were collected.Univariate analysis showed that LS and the 10 specific domains were not associated with the patients' gender or stroke type; however, age at onset, marital status, and vocational situation were significantly associated with some domains in LiSat-11 (Spearman's rho = 0.42-0.87; all P < 0.05). Logistic regression revealed that verbal and cognitive dysfunction were the most negative predictors of LS (odds ratio 4.1 and 3.7, respectively).LS is negatively affected in stroke survivors 1 year post onset. The results indicate that recovering social engagement is a positive predictor of higher LS in stroke survivors. More importantly, the findings revealed that cognitive and verbal dysfunctions were the most prominent negative predictors of the overall gross level of LS. Multidisciplinary rehabilitation for stroke survivors is therefore critical.
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Affiliation(s)
- Turki S. Abualait
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University
| | - Matar A. Alzahrani
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University
| | - Alaa I. Ibrahim
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University
| | - Shahid Bashir
- Neuroscience Center, King Fahad Specialist Hospital, Dammam
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41
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Carlsson-Lalloo E, Rusner M, Berg M, Svedhem V, Mellgren Å. People living with HIV in Sweden report high levels of sexual satisfaction in a registry-based cohort study. AIDS Care 2021; 34:559-567. [PMID: 33793361 DOI: 10.1080/09540121.2021.1909698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Sexual satisfaction can be challenging for people living with HIV (PLWH). To investigate self-reported sexual satisfaction in PLWH and its association with HIV-related biomarkers, a retrospective observational cohort study with data on sociodemographic characteristics and changes in PLWH's assessment of their sexual satisfaction over time were retrieved from the Swedish National Quality Assurance Registry (InfCareHIV) where patient-related outcomes are reported annually. PLWH who had assessed self-reported sexual satisfaction 2011-2016 were included. Sexual satisfaction was dichotomized into sexual "satisfaction and dissatisfaction" and associations were analysed. In total, 3798 patients (66% men) answered 8202 questionnaires. Overall, 67% reported sexual satisfaction, with women more satisfied than men (72% vs 64%, p < 0.0001). Sexual satisfaction did not differ between patients on antiretroviral treatment (ART) >6 months whether the viral load was suppressed or not. Overall, the probability of reporting sexual satisfaction increased by 4% annually (p < 0.001). This increase may be explained by evolving knowledge about the minimal risks of sexual HIV transmission when on ART together with Sweden's concomitant revision of legal restrictions. The use of patient-related outcomes in clinical practice is an important tool for facilitating conversations about sexuality in order to promote the health and well-being of PLWH.
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Affiliation(s)
- Ewa Carlsson-Lalloo
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Regional Cancer Center West, Gothenburg, Sweden
| | - Marie Rusner
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Research, Södra Älvsborg Hospital, Borås, Sweden
| | - Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Obstetrics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Veronica Svedhem
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine, Unit of Infectious Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Åsa Mellgren
- Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden
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Auger LP, Aubertin M, Grondin M, Auger C, Filiatrault J, Rochette A. Assessment methods in sexual rehabilitation after stroke: a scoping review for rehabilitation professionals. Disabil Rehabil 2021; 44:4126-4148. [PMID: 33689511 DOI: 10.1080/09638288.2021.1889047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim was to identify and describe the assessment methods used by rehabilitation professionals to evaluate sexuality for individuals post-stroke, as well as the domains of sexuality addressed. METHODS Seven databases were selected for this scoping review. Articles needed to meet these inclusion criteria: published studies with a sample of ≥ 50% stroke clients and describing a quantitative or qualitative assessment method that could be used by rehabilitation professionals. This study was conducted following the PRISMA guidelines and domains of sexuality were categorized using the ICF core set for stroke. RESULTS Of the 2447 articles reviewed, the 96 that met the selection criteria identified a total of 116 assessment methods classified as standardized assessment tools (n = 62), original questionnaires (n = 28), semi-structured interviews (n = 16) or structured interviews (n = 10). Sexual functions were predominantly assessed using standardized tools, while intimate relationships and partner's perspective were generally addressed more by original questionnaires and qualitative methods. A stepwise approach combining relevant assessment methods is presented. CONCLUSIONS Individually, these diverse assessment methods addressed a limited scope of relevant domains. Future research should combine quantitative and qualitative methods to encompass most domains of sexuality of concern to post-stroke individuals.IMPLICATIONS FOR REHABILITATIONMost of the studies reviewed here used quantitative methods to assess sexuality, rather than qualitative methods, and mostly used standardized assessment tools.Few assessment methods covered all domains related to sexuality.Qualitative methods and standardized assessment tools were shown to be complementary, therefore emphasizing the added value of mixed methods in assessing sexuality after a stroke.Among the methods that were reviewed, certain would be more suitable for the identification of the need to address sexuality (e.g., Life Satisfaction Checklist-11) and others to assess more thoroughly sexuality (e.g., Change in Sexual Functioning Questionnaire (CSFQ-14)).
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Affiliation(s)
- Louis-Pierre Auger
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Mélanie Aubertin
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
| | - Myrian Grondin
- Marguerite-d'Youville Library, Université de Montréal, Montreal, Canada
| | - Claudine Auger
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Johanne Filiatrault
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Montreal Geriatric University Institute Research Center, Montreal, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
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Eek F, Larsson C, Wisén A, Ekvall Hansson E. Self-Perceived Changes in Physical Activity and the Relation to Life Satisfaction and Rated Physical Capacity in Swedish Adults during the COVID-19 Pandemic-A Cross Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E671. [PMID: 33466860 PMCID: PMC7829747 DOI: 10.3390/ijerph18020671] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/07/2021] [Accepted: 01/12/2021] [Indexed: 12/11/2022]
Abstract
COVID-19 restrictions may prevent people from reaching recommended levels of physical activity (PA). This study examines self-perceived changes in the extent and intensity of PA during the COVID-19 pandemic, and the relation between perceived changes in PA and general life satisfaction and perceived physical capacity. A total of 1318 participants (mean age 47.8 SD12.6; 82.1% women) were recruited through social media in Sweden during autumn 2020. The survey included questions regarding perceived changes in PA compared to the previous year, the "Rating of Perceived Capacity" scale and "Life Satisfaction Questionnaire-11". A change in PA was reported by 65% of participants. More participants reported an increase (36%) than a decrease (29%), however a decrease in PA was significantly more often considered to be due to the pandemic. The highest odds of decreased PA was found in the oldest age group (70+ years) (OR 2.8; 95% CI 1.4-5.7). Those who reported decreased levels of PA reported lower life satisfaction and aerobic capacity than the other groups (p > 0.001). Decreased physical activity was reported by many, but an equal share reported increased activity during the pandemic. The highest odds for decreased activity was found in the oldest group-the group that has been subjected to the strictest recommended COVID-19 restrictions in Sweden.
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Affiliation(s)
- Frida Eek
- Division of Physiotherapy, Department of Health Sciences, Lund University, 22240 Lund, Sweden; (C.L.); (A.W.); (E.E.H.)
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Hitzig SL, Jeyathevan G, Farahani F, Noonan VK, Linassi G, Routhier F, Jetha A, McCauley D, Alavinia SM, Omidvar M, Craven BC. Development of community participation indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project. J Spinal Cord Med 2021; 44:S79-S93. [PMID: 34779731 PMCID: PMC8604477 DOI: 10.1080/10790268.2021.1955204] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Community participation following spinal cord injury/disease (SCI/D) can be challenging due to associated primary impairments and secondary health conditions as well as difficulties navigating both the built and social-emotional environment. To improve the quality of SCI/D rehabilitation care to optimize community participation, the SCI-High Project developed a set of structure, process and outcome indicators for adults with SCI/D in the first 18 months after rehabilitation admission. A pan-Canadian Working Group of diverse stakeholders: (1) defined the community participation construct; (2) conducted a systematic review of available outcomes and their psychometric properties; (3) constructed a Driver diagram summarizing available evidence associated with community participation; and (4) prepared a process map. Facilitated meetings allowed selection and review of a set of structure, process and outcome indicators. The structure indicator is the proportion of SCI/D rehabilitation programs with availability of transition living setting/independent living unit. The process indicators are the proportion of SCI/D rehabilitation inpatients who experienced: (a) a therapeutic community outing prior to rehabilitation discharge; and, (b) those who received a pass to go home for the weekend. The intermediary and final outcome measures are the Moorong Self-Efficacy Scale and the Reintegration to Normal Living Index. The proposed indicators have the potential to inform whether inpatient rehabilitation for persons with SCI/D can improve self-efficacy and lead to high levels of community participation post-rehabilitation discharge.
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Affiliation(s)
- Sander L. Hitzig
- St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Gaya Jeyathevan
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Farnoosh Farahani
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | | | - Gary Linassi
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - François Routhier
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Québec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Québec, Canada
| | - Arif Jetha
- Institute for Work & Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - S. Mohammad Alavinia
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Maryam Omidvar
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - B. Catharine Craven
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
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Wang R, Hu X, Zhang T, Fugl-Meyer KS, Langhammer B. Cross-cultural adaptation of Life Satisfaction Checklist-11 among persons with stroke in China: A reliability and validity study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2020; 26:e1887. [PMID: 33305872 DOI: 10.1002/pri.1887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/11/2020] [Accepted: 11/21/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The aim of the present study was to develop a cross-cultural adaptation and to evaluate the validity and reliability of a Chinese version of the LiSat-11 test. METHODS LiSat-11 was translated into Chinese according to standardized procedures. A cross-sectional descriptive study was conducted to examine its reliability and validity, in accordance to COnsensus-based Standards for the election of health Measurements Instruments guidelines, among persons with stroke approximately 3 years after their discharge from rehabilitation. Participants completed the LiSat-11, 36-Item Short-Form Health Survey (SF-36), National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Barthel Index (BI) and Hospital Anxiety and Depression Scale (HADS). To examine the test-retest reliability, thirty of these participants completed LiSat-11 again after 2 weeks. RESULTS In total, 60 persons with stroke were recruited. The Chinese version of LiSat-11 demonstrated good internal consistency with Cronbach's alphas at 0.82. Ceiling effects were found in five of the eleven items of LiSat-11, and there was a floor effect in one item. LiSat-11 had moderate to high correlations with SF-36 with Spearman's correlation coefficient (rho) ranging from 0.44 to 0.73 (p < 0.01) in a concurrent validity test, and high correlations were also found between LiSat-11 and HADS-A/D in a convergent validity test with rho = -0.63/-0.67 (p < 0.01). Low correlations with NIHSS, BI and mRS were found in a divergent validity test, rho = -0.25, 0.17 and -0.26, respectively. CONCLUSION The current study verified that the translated Chinese version of the Life Satisfaction Checklist-11 is a reliable and valid tool for measuring the life satisfaction of persons with chronic stroke.
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Affiliation(s)
- Rongrong Wang
- Neurorehabilitation Department, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China.,School of Rehabilitation, Capital Medical University, Beijing, China
| | - Xiaolei Hu
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Tong Zhang
- Neurorehabilitation Department, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China.,School of Rehabilitation, Capital Medical University, Beijing, China
| | - Kerstin Sjögren Fugl-Meyer
- Uppsala University Hospital, Uppsala, Sweden.,Department of Neurobiology, Karolinska Institute, Solna, Sweden.,Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Birgitta Langhammer
- Sunnaas Rehabilitation Hospital, Nesodden, Norway.,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Westgård T, Andersson Hammar I, Dahlin-Ivanoff S, Wilhelmson K. Can Comprehensive Geriatric Assessment Meet Frail Older People's Needs? Results from the Randomized Controlled Study CGA-Swed. Geriatrics (Basel) 2020; 5:E101. [PMID: 33291834 PMCID: PMC7768486 DOI: 10.3390/geriatrics5040101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The comprehensive geriatric assessment (CGA) designed to manage frail older people requiring acute medical care, is responsible for diagnostics, assessment, treatment, and planning while addressing a person's medical, psychological, social, and functional capabilities. The aim was to investigate if CGA had an impact on frail older people's activities of daily living (ADL) status, self-rated health, and satisfaction with hospital care. METHODS A two-armed design with frail people aged 75 or older who required an unplanned hospital admission were randomized to either the CGA ward or to an acute medical ward. Analyses were made based on the intention-to-treat principle (ITT). The primary outcome was ADL. Data were analyzed using Chi-square and odds ratio. A subgroup analysis was performed due to non-adherence and contamination. RESULTS One-hundred and fifty-five people participated in the study; 78 in the intervention and 77 in the control. Participants in the intervention group had a higher odds ratio of reporting having received written information and felt that care met their needs during their hospital stay. No additional statistically significant results for the primary or secondary outcomes in the ITT analysis were achieved. CONCLUSION Participants felt that the care they received with the CGA ward met their needs. The lack of additional results supporting the CGA could be due to difficulties performing pragmatic intervention trials in clinical hospital settings, and because a CGA during one hospital stay is probably not enough to have long-term effects.
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Affiliation(s)
- Theresa Westgård
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden; (I.A.H.); (K.W.)
- Centre of Aging and Health-AGECAP, University of Gothenburg, 405 30 Gothenburg, Sweden;
| | - Isabelle Andersson Hammar
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden; (I.A.H.); (K.W.)
- Centre of Aging and Health-AGECAP, University of Gothenburg, 405 30 Gothenburg, Sweden;
| | - Synneve Dahlin-Ivanoff
- Centre of Aging and Health-AGECAP, University of Gothenburg, 405 30 Gothenburg, Sweden;
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Katarina Wilhelmson
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden; (I.A.H.); (K.W.)
- Centre of Aging and Health-AGECAP, University of Gothenburg, 405 30 Gothenburg, Sweden;
- Department of Geriatrics, The Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
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Rajapuram N, Langness S, Marshall MR, Sammann A. Medical students in distress: The impact of gender, race, debt, and disability. PLoS One 2020; 15:e0243250. [PMID: 33270759 PMCID: PMC7714351 DOI: 10.1371/journal.pone.0243250] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/17/2020] [Indexed: 11/18/2022] Open
Abstract
Background In 2012, over half of US medical students experienced burnout and depression. Since that time, there have been many changes to student demographics, school resources and awareness of burnout in the medical field altogether. New tools are also available to screen for student distress, a condition that correlates with low mental quality-of-life, suicidal ideation and serious thoughts of dropping out. Despite increased attention on wellbeing and improved screening methods, no large-scale studies have evaluated student distress in the modern era of medical education. The objective of this study was to determine the current prevalence of medical student distress and contributing risk factors. Methods Student wellbeing from a national cohort of US medical students was measured with an electronic survey in a prospective, observational survey study from 2019–2020. Medical student distress was defined as a Medical Student Wellbeing Index (MS-WBI) of ≥4. Demographic details including age, race, gender, marital status, disability, desired specialty, and debt burden were evaluated in a multivariate logistic regression model to determine possible risk factors for the development of distress. Results A total of 3,162 students responded to the survey, representing 110 unique medical schools. Of these respondents, 52.9% met criteria for distress and 22% had either taken or considered taking a leave of absence for personal wellbeing. Independent risk factors for distress included involvement in the clinical phase of medical school (OR 1.37); non-male gender (OR 1.6); debt burden >$20,000 (OR 1.37), >$100,000 (OR 1.81), and >$300,000 (OR 1.96); and disability status (OR 1.84). Conclusions Medical student wellbeing remains poor in the modern era of medical education despite increased attention to wellbeing and increased availability of wellbeing resources. Disability status is a novel risk factor for distress identified in this study. The persistence of previously identified risk factors such as non-male gender, debt burden and clinical phase of school suggest that efforts to curb medical student distress have been inadequate to date.
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Affiliation(s)
- Nikhil Rajapuram
- Department of Surgery, University of California, San Francisco, San Francisco, CA, United States of America
- * E-mail:
| | - Simone Langness
- Department of Surgery, University of California, San Francisco, San Francisco, CA, United States of America
| | - Megan R. Marshall
- New York University School of Medicine, New York, NY, United States of America
| | - Amanda Sammann
- Department of Surgery, University of California, San Francisco, San Francisco, CA, United States of America
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Stiekema APM, Resch C, Donkervoort M, Jansen N, Jurrius KHM, Zadoks JM, van Heugten CM. Case management after acquired brain injury compared to care as usual: study protocol for a 2-year pragmatic randomized controlled superiority trial with two parallel groups. Trials 2020; 21:928. [PMID: 33203462 PMCID: PMC7672813 DOI: 10.1186/s13063-020-04804-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 10/12/2020] [Indexed: 12/19/2022] Open
Abstract
Background People with acquired brain injury may suffer from cognitive, emotional and behavioural changes in the long term. Continuity of care is often lacking, leading to a variety of unmet needs and hindering psychosocial functioning from the occurrence of brain injury up to years thereafter. Case management aims to prevent (escalation of) problems and to facilitate timely access to appropriate services. In other populations, case management has shown to improve psychosocial well-being. In this study, we aim to evaluate the feasibility of case management after acquired brain injury and its effectiveness and cost-effectiveness, compared to care as usual. Methods This is a pragmatic randomized controlled superiority trial with two parallel groups and repeated measures in adults with ABI and their family, taking place between November 2019 and December 2021 in three provinces in the Netherlands. Participants will be randomly allocated to either the case management group, receiving case management from hospital discharge up to 2 years thereafter, or the control group, receiving care as usual. Effectiveness will be evaluated every 6 months for 18–24 months by patient-reported psychosocial well-being (Hospital Anxiety and Depression Scale (HADS), Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P) restriction subscale and the Life Satisfaction Questionnaire (LiSat)), self-management (Patient Activation Measure (PAM)) and care needs (Longer-term Unmet Needs after Stroke (LUNS)). Family outcomes include self-efficacy (Carer Self-Efficacy Scale (CSES)), caregiver burden (Caregiver Strain Index (CSI)), psychosocial well-being (LiSat, HADS), family needs (Family Needs Questionnaire (FNQ)). Feasibility will be evaluated using qualitative methods, assessing fidelity, dose delivered, dose received, reach, recruitment and context. Cost-effectiveness will be determined by the EQ-5D-3L and service use. Discussion At the moment, there is no integrated health care service for people with acquired brain injury and their family members in the long term. If case management is shown to be feasible and (cost)-effective, it could bridge the gap between patients’ and families’ needs and the available services. Trial registration Netherlands Trial Register NL8104. Registered on 22 October 2019.
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Affiliation(s)
- Annemarie P M Stiekema
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands
| | - Christine Resch
- Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands.,Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Mireille Donkervoort
- Health Care and Social Work Division, Windesheim University of Applied Sciences, Almere, The Netherlands
| | - Natska Jansen
- Mevrouw Slimmer Werken Social Innovation in Health Care and Well-Being, Drogteropslagen, Netherlands.,Brain Injury Team, Overijssel, Netherlands
| | - Kitty H M Jurrius
- Health Care and Social Work Division, Windesheim University of Applied Sciences, Almere, The Netherlands
| | - Judith M Zadoks
- In-Tussen Foundation, Utrecht, the Netherlands.,BreinDok Innovation in Care, Utrecht, the Netherlands
| | - Caroline M van Heugten
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands. .,Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands. .,Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands.
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Life satisfaction in persons with spinal cord injury across the seasons. Spinal Cord 2020; 59:193-200. [PMID: 32792655 DOI: 10.1038/s41393-020-0532-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 07/15/2020] [Accepted: 07/20/2020] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Longitudinal study. OBJECTIVES This study aimed to examine level and variations of life satisfaction (LS) across the seasons in persons with spinal cord injury (SCI). SETTING Polish sample of persons with SCI. METHODS The study included 56 persons with SCI, who repeatedly completed the Life Satisfaction Questionnaire (LiSaT-9), and a study-specific questionnaire across the four seasons in a calendar year. Mixed model analyses were performed to: (1) examine seasonal changes in LS; (2) explore the possible moderating factors on seasonal changes in LS. RESULTS There were significant seasonal trends in overall and domain-specific LS scores; yet, these changes differed in terms of shape (i.e. linear vs. quadratic). In general, the highest LS scores occurred in spring across all domains, followed by a significant reduction in summer; yet, there were u-shape trends in LS domain scores for life as a whole, vocational, and financial situation and partner relations (P-for-quadratic trends ≤0.05). Five individual characteristics, i.e. place of living, education, gender, physical activity, and time since injury significantly moderated seasonal trends in LS scores (P's for interaction ≤ 0.05). CONCLUSION Life satisfaction in persons with SCI differs significantly in relation to different seasons throughout a year. The season of the year should be considered in future studies on LS and included in evaluating and projecting healthcare interventions or programs for persons with SCI.
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Stenberg G, Enthoven P, Molander P, Gerdle B, Stålnacke BM. Patients selected to participate in multimodal pain rehabilitation programmes in primary care-a multivariate cross-sectional study focusing on gender and sick leave. Scand J Pain 2020; 20:511-524. [PMID: 32246755 DOI: 10.1515/sjpain-2019-0149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/13/2020] [Indexed: 11/15/2022]
Abstract
Background and aims A multimodal rehabilitation programme (MMRP) is an evidence-based treatment of chronic pain conditions. The complexity involved in chronic pain needs to be identified and evaluated in order to adapt the rehabilitation to patients' needs. The aim was to investigate the multivariate relationships between self-reported variables in patients with chronic pain before taking part in MMRP in primary care, with a special focus on gender and degree of sick leave. Methods Prior to MMRP, 397 patients (339 women and 58 men) filled in a questionnaire about pain, healthcare aspects, health-related quality of life, anxiety and depression, coping, physical function, and work-related variables e.g. sick leave. Data were analysed by principal component analysis (PCA) and partial least square analysis. Results The PCA identified four components that explained 47% of the variation in the investigated data set. The first component showed the largest variation and was primarily explained by anxiety and depression, quality of life, acceptance (activity engagement), and pain-related disability. Gender differences were only seen in one component with the pain variables having the highest loadings. Degree of sick leave was not well explained by the variables in the questionnaire. Conclusions The questionnaire filled out by the patients prior to participation in MMRP in primary care identified much of the complexity of chronic pain conditions but there is room for improvement, e.g. regarding explanation of work-related factors. In the multivariate analysis, gender did not fall out as an important factor for how most patients answered the questions. Implications There are not many studies that describe patients who undergo MMRP in primary care since previously such patients were treated mostly in specialist care. More knowledge is needed about these patients in order to improve rehabilitation plans and interventions. The results suggest that the questionnaire identifies the complexity among chronic pain patients in primary care. The identified components could improve assessment before MMRP and contribute to better tailored programmes.
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Affiliation(s)
- Gunilla Stenberg
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Paul Enthoven
- Pain and Rehabilitation Centre and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Department of Medical and Health Sciences, Faculty of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Peter Molander
- Pain and Rehabilitation Centre and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Britt-Marie Stålnacke
- Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden
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