Evaluating illness representations in heart transplant patients.

The aim was to see whether qualitative analysis improved quantitative measurement of illness perception after heart transplant. Two methods of evaluating illness representations were compared: one quantitative (administration of the Illness Perception Questionnaire-Revised) and one qualitative (phenomenological reduction). The qualitative analysis provided greater insight into the idiosyncratic and dynamic nature of the concept of illness representations. Adjustments to the Illness Perception Questionnaire-Revised are suggested to improve the evaluation of illness perception in terms of dispersion of scores, emotional impact, coping strategies and treatment, and social support, and ultimately to enhance interventions designed to promote treatment compliance.

The use of a trained dog as a gait aid for clients with ataxia: a case report.

PURPOSE: To illustrate the use of a trained dog as a therapeutic tool to optimize physical and psychosocial adaptation of clients with ataxia. METHOD: The gait pattern and gait speed of two people with cerebellar ataxia using different gait aids, including a trained intervention dog and an assistance dog, were compared. Participants' experience of working with the dogs was documented via semi-structured interviews. RESULTS: The use of an intervention dog as part of rehabilitation allowed clients to explore the benefits of an assistance dog and to optimize their physical functioning. The assistance dog had a less destabilizing effect than other walking aids on the clients' self-image. CONCLUSION: Trained dogs may represent an innovative and positive alternative for mobility for people with ataxia, improving both physical and psychosocial parameters. Assistance dogs seem to be a suitable gait aid, since they facilitate ambulation, promoting independent mobility.

Objectif :  Illustrer l'utilisation d'un chien dressé comme outil thérapeutique pour optimiser l'adaptation physique et psychosociale des clients vivant avec l'ataxie. Méthode :  On a comparé la démarche et la vitesse de marche chez deux personnes atteintes d'ataxie cérébelleuse en utilisant différentes aides à la marche, y compris un chien de réadaptation et un chien d'assistance. Des entrevues semi-structurées ont permis de documenter l'expérience des clients avec les chiens. Résultats :  L'utilisation d'un chien comme élément de la réadaptation a permis aux clients d'explorer les bienfaits d'un chien d'assistance et d'optimiser leur fonctionnement physique. Le chien d'assistance semble moins dommageable pour l'image de soi que les autres aides à la marche. Conclusion :  Les chiens dressés peuvent représenter une solution innovatrice et positive sur le plan de la mobilité pour les personnes vivant avec l'ataxie ; améliorant les paramètres tant physiques que psychosociaux. Les chiens d'assistance semblent améliorer le patron de marche puisqu'ils facilitent les déplacements et favorisent la mobilité autonome.

Randomized controlled trial on the long-term efficacy of a multifaceted, interdisciplinary lifestyle intervention in reducing cardiovascular risk and improving lifestyle in patients at risk of cardiovascular disease.

The objective of the study was to evaluate the efficacy of an interdisciplinary intervention known as Educoeur in reducing cardiovascular risk and improving health behaviors in people without evidence of cardiovascular disease and to compare the Educoeur program to interventions in a specialized clinic and in usual care family practice. In a parallel, randomized, controlled trial of 185 adults with at least two modifiable cardiovascular risk factors, patients were randomly assigned to either Educoeur, specialized clinic or usual care. Cardiovascular risk, biological and lifestyle measures were assessed at baseline and at 2 years. In Educoeur, measurements were also taken before and after the lifestyle group treatment program. In 12 weeks, patients in Educoeur significantly lowered their cardiovascular risk, weight, body mass index, waist circumference, systolic blood pressure, kilocalories intake and improved their VO2 Max and mental health. Changes remained significant at 2 years. Between group comparisons at 2 years demonstrated that Educoeur was significantly better in reducing cardiovascular risk than interventions in usual care. Together, these results highlight the importance of providing interdisciplinary programs that optimize cardiovascular risk reduction and promote active lifestyles in patients at risk of cardiovascular disease.