Interaction of Socio-demographic Characteristics on Acceptance of Disability Among Individuals With Physical Disabilities

A smartphone-based supportive counseling on health anxiety and acceptance of disability in Systemic Lupus Erythematosus patients: A randomized clinical trial

OBJECTIVE

This study aimed to evaluate the effects of a supportive counseling via the smart phone on the health anxiety, and acceptance of disability in the patients with Systemic Lupus Erythematosus.

METHODS

The present study was a randomized clinical trial with pre-post design. Randomly dividing 124 patients into experimental and control groups. Before and after the intervention, all patients answered the health anxiety and disability acceptance questionnaires. For eight weeks, the trial group received remote counseling help using the WhatsApp platform.

RESULTS

All 124 patients randomized into groups, completed follow-up which were analyzed. By the end of 8th week, the level of health anxiety (MD=11.34, P < 0.001) of the experiment group was significantly lower than the control group, while the level of acceptance of disability (MD=91.42, P < 0.001) of experiment group was significantly higher than the control group.

CONCLUSION

Smartphone-based supportive counseling may help people with Systemic Lupus Erythematosus manage their symptoms better, and live better by reducing health worry and increasing acceptance of impairment.

PRACTICE IMPLICATIONS

Virtual supportive counseling can assist healthcare professionals to optimize the potential of education and support processes.

Decompressive Craniectomy for Hemispheric Infarction in a Low-Income Population

BACKGROUND

Stroke is a worldwide leading cause of mortality and disability, and there are substantial economic costs for poststroke care. Disadvantaged populations show increased incidence, severity, and unfavorable outcomes. This study aimed to report the survival, functional outcome, and caregiver satisfaction of low-income patients diagnosed with a large hemispheric infarction (LHI) who underwent decompressive craniectomy (DC).

METHODS

A retrospective analysis was conducted in consecutive adult patients with an LHI who underwent DC at a single center between October 2015 and September 2019. Demographic, clinical, and radiologic data were reviewed. The primary outcomes were 1-year survival and favorable functional outcome.

RESULTS

Forty-nine patients were included; those <60 years of age showed a higher proportion of favorable functional outcomes (76% vs. 33%; P = 0.031) but similar survival (52% vs. 56%; P = 0.645) than older patients, respectively. Performing the craniectomy in <48 hours from stroke onset compared with ≥48 hours showed no statistically significant differences in survival (59% vs. 46%; P = 0.352) and favorable functional outcomes (56% vs. 70%; P = 0.683), respectively. In retrospective thinking, 79% of caregivers would decide to perform the surgery again.

CONCLUSIONS

Age group and time from stroke onset to craniectomy were not associated with survival; notwithstanding, a higher proportion of patients <60 years of age were associated with a favorable functional outcome compared with older patients. Additionally, if given the option, most caregivers would decide to perform the surgery again, independently of the grade of disability of the patient.