RESUMO
PURPOSE: This study aimed to explore how peer mentors experience their role and practice in Active Rehabilitation camps for individuals with acquired brain injury. METHODS: Sixteen peer mentors with acquired brain injury were interviewed, and the data were analysed using Systematic text condensation. Self-determination theory was used to interpret the results. RESULTS: Six themes were constructed: "Altruistic motives drive peer mentors" engagement", "What does it mean to be a peer mentor?", "Peer mentors question their qualifications", "Camp is tough-Nothing can compare", "Being a peer mentor-A part of one's rehabilitation process", and "Closeness and trust-A bubble of understanding". The peer mentors reported personal benefits, such as increased knowledge about brain injury, self-esteem, motivation, physical activity, community participation, and social networks. They perceived that mutual understanding among peer mentors and mentees created a safe camp atmosphere, which led to positive experiences. CONCLUSION: The peer mentors benefitted from their role and described it as part of their rehabilitation journey. We recommend that peer mentors receive training before entering this position, feedback on their performance, and camp schedules that accommodate time for rest and informal meetings between mentees and peer mentors.
Peer mentorship interventions for individuals with acquired neurological injury are becoming more popular. Because peer mentors are vital in such interventions, learning more about their perspectives is essential.Peer mentors with acquired brain injury (ABI) who engage in Active Rehabilitation camps report various personal benefits, such as heightened self-esteem, increased community participation, and establishment of a broader support network.To address challenges that peer mentors may perceive, we recommend that the organisers of these interventions ensure mentors receive adequate training before taking on their roles and receive ongoing feedback on their performance.Individuals with ABI who are interested in peer mentoring and fulfil the organisers' criteria should be encouraged to apply for this role, as it can become a natural extension of their rehabilitation process.
RESUMO
PURPOSE: To determine the characteristics and outcomes of structured, time-limited peer mentorship activity programmes for individuals with acquired brain or spinal cord injury. MATERIALS AND METHODS: A mixed methods systematic review with an advanced convergent qualitative meta-integration synthesis design was adopted. Seven databases were searched, with two reviewers independently screening, selecting, and extracting data and evaluating the methodological quality of the included studies. RESULTS: The review included ten original studies: five qualitative, four quantitative, and one mixed methods. The peer mentorship programmes were conducted in Europe, Oceania, the United States, and Africa, lasting from two days to 2.5 weeks. The programmes had diverse focuses, but all addressed mentees' independence, health, or quality of life in some way. None was based on a theoretical framework. Programme participation positively impacted cognition, emotions, independence, and social life. The safe and supportive environments the mentees and peer mentors created facilitated the outcomes. The evidence of programme participation on life satisfaction and community participation was inconclusive. CONCLUSION: Despite their short duration, structured, time-limited peer mentorship activity programmes can strengthen community rehabilitation of individuals with acquired brain or spinal cord injury. It is recommended that peer mentorship programmes are grounded on a theoretical framework.
Structured, time-limited peer mentorship activity programmes impact mentees' thoughts and emotions, social lives, and independence in daily lives.Being able to challenge oneself in a safe and supportive environment created by mentees and peer mentors is essential for achieving positive outcomes.Peer mentorship programme organisers should establish clearly defined programme aims and base their rationale on how to reach these aims on relevant theoretical frameworks.
RESUMO
Emotion regulation is proposed to have a salient role in optimal aging. However, currently used measures of emotion regulation have not been validated for older adults. Therefore, we evaluated the psychometric properties of the Difficulties in Emotion Regulation Scale-short form (DERS-16) in a large Norwegian sample consisting of individuals between 70 and 95 years (n = 2525). Tests of internal consistency, reliability, assessment of intra-domain correlations, and confirmatory factor analyses were performed. Construct validity was further investigated by assessing concurrent associations between DERS-16 and well-established measures of psychological disorders, psychological health, and well-being (five-item version of Geriatric Depression Scale, Geriatric Anxiety Inventory-short form, and OECD guidelines on measuring subjective well-being). All subscales derived from the instrument showed adequate internal consistency. Furthermore, we obtained a theoretically consistent factor structure, in which a bifactor model combining a general emotion regulation factor and five additional domain-specific facet-factors had superior model fit. As expected, difficulties in emotion regulation correlated positively with symptoms of depression and anxiety, and negatively with psychological health and well-being. Associations were generally of moderate strength. We can thus conclude that the DERS-16 demonstrates excellent psychometric properties when used in samples with older adults and may safely be employed in studies of emotion regulation difficulties in the older segment of our population.
RESUMO
BACKGROUND: Persons with cerebral palsy (CP) walk with reduced ankle plantar flexor power compared to typically developing. In this study, we investigated whether a ballistic strength-training programme targeting ankle plantar flexors could improve muscle strength, muscle architecture and walking function in adults with CP. METHODS: Eight adults (mildly affected CP) underwent eight weeks of ballistic strength training, with two sessions per week. Before and after the intervention preferred walking speed, ankle plantar flexion rate of force development (RFD), maximal voluntary contraction (MVC), muscle thickness, pennation angle and fascicle length were measured. Data are presented for individuals, as well as for groups. Group changes were analysed using the Wilcoxon signed-rank test. RESULTS: Data were analysed for eight participants (five women, mean age 37.9 years; six GMFCS I and two GMFCS II). Two participants increased their walking speed, but there were no significant group changes. In terms of muscle strength, there were significant group changes for RFD at 100 ms and MVC. In the case of muscle architecture, there were no group changes. CONCLUSION: In this study, we found that eight weeks of ballistic strength training improved ankle plantar flexor muscle strength but walking function and muscle architecture were unchanged. Larger studies will be needed to obtain conclusive evidence of the efficacy of this training method.
RESUMO
To examine the psychometric properties of the Norwegian version of the Fear of COVID-19 Scale (FCV-19S), randomly selected individuals from a larger registry study were invited. We assessed the reliability and validity of the instrument in a sample of 1089 adults in Norway (response rate 73%). Internal consistency measured by Cronbach's alpha (0.88) was acceptable. Omega alphaHierarchical (ωt = 0.69) was lower indicating that the general factor is less reliable, explaining 69% of the total variance. Confirmatory factor analysis indicated that the FCV-19S is not strictly unidimensional. Exploratory graph analysis and confirmatory factor analysis supported a two-factor model (cognitive and somatic fear), which were highly correlated (r = 0.84). The Norwegian version of the FCV-19S showed an underlying two-factor structure. However, the high correlation means the two latent factors (cognitive and somatic fear) act as indicators for a second-order general factor and support use of the FCV-19S sum score. The FCV-19S appears to be a valid instrument to assess fear of COVID-19 with good psychometric properties. Supplementary Information: The online version contains supplementary material available at 10.1007/s11469-020-00454-2.
RESUMO
BACKGROUND: Dizziness is a common complaint, and the symptom often persists, together with additional complaints. A treatment combining Vestibular Rehabilitation (VR) and Cognitive Behaviour Therapy (CBT) is suggested. However, further research is necessary to evaluate the efficacy of such an intervention. The objective of this paper is to present the design of a randomised controlled trial aiming at evaluating the efficacy of an integrated treatment of VR and CBT on dizziness, physical function, psychological complaints and quality of life in persons with persistent dizziness. METHODS/DESIGN: The randomised controlled trial is an assessor-blinded, block-randomised, parallel-group design, with a 6- and 12-month follow-up. The study includes 125 participants from Bergen (Norway) and surrounding areas. Included participants present with persistent dizziness lasting for at least 3 months, triggered or exacerbated by movement. All participants receive a one-session treatment (Brief Intervention Vestibular Rehabilitation; BI-VR) with VR before being randomised into a control group or an intervention group. The intervention group will further be offered an eight-session treatment integrating VR and CBT. The primary outcomes in the study are the Dizziness Handicap Inventory and preferred gait velocity. DISCUSSION: Previous studies combining these treatments have been of varying methodological quality, with small samples, and long-term effects have not been maintained. In addition, only the CBT has been administered in supervised sessions, with VR offered as home exercises. The current study focusses on the integrated treatment, a sufficiently powered sample size, and a standardised treatment programme evaluated by validated outcomes using a standardised assessment protocol. TRIAL REGISTRATION: www.clinicaltrials.gov, ID: NCT02655575 . Registered on 14 January 2016.
Assuntos
Terapia Cognitivo-Comportamental , Tontura/terapia , Modalidades de Fisioterapia , Atenção Primária à Saúde , Vestíbulo do Labirinto/fisiopatologia , Adolescente , Adulto , Idoso , Terapia Combinada , Tontura/diagnóstico , Tontura/fisiopatologia , Tontura/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
PURPOSE: To evaluate the feasibility of integrating vestibular rehabilitation and cognitive behaviour therapy (VR-CBT) for people with persistent dizziness in primary care. DESIGN: Prospective single-group pre- and post-test study. PARTICIPANTS: Adults (aged 18-70) with acute onset of dizziness and symptoms lasting a minimum 3 months, recruited from Bergen municipality. METHODS: Participants attended eight weekly group sessions of VR-CBT intervention. Feasibility outcomes consisted of recruitment and testing procedures, intervention adherence, and participant feedback, besides change in primary outcomes. The primary outcomes were Dizziness Handicap Inventory (DHI) and preferred gait velocity. RESULTS: Seven participants were recruited for the study. All participants completed the pre-treatment tests, five participants completed the intervention and answered post-treatment questionnaires, and three completed post-treatment testing. Of the five participants, three attended at least 75% of the VR-CBT sessions, and two 50% of the sessions. Participants reported that the VR-CBT was relevant and led to improvement in function. DHI scores improved beyond minimal important change in two out of five participants, and preferred gait velocity increased beyond minimal important change in two out of three participants. CONCLUSION: The current tests and VR-CBT treatment protocols were feasible. Some changes are suggested to optimise the protocols, before conducting a randomised controlled trial. TRIAL REGISTRATION: NCT02655575. Registered 14 January 2016-retrospectively registered.
RESUMO
BACKGROUND: The objective of this study was to explore occupational rehabilitation clinicians' experiences on how to approach their participants on long-term sick leave in order to facilitate return to work (RTW). METHODS: An exploratory qualitative design was used. Four focus groups were conducted with 29 clinicians working on interdisciplinary inpatient and outpatient occupational rehabilitation teams in Norway. The clinicians shared narratives from clinical practice. Transcripts were analysed, and results were reported by use of systematic text condensation. RESULTS: The clinicians used several approaches to facilitate RTW among individuals on sick leave. Three themes emerged as especially important in order to succeed: 1) To get a basic understanding of the participant's life-world through a mapping process; 2) To build a therapeutic alliance through communication characterised by sensitivity to the participants' needs and emotional concerns; and 3) To initiate processes of change that increase the possibilities for RTW. Four main areas targetable for change were identified, three directed at the individual and one encompassing the participants' surroundings. These approaches were: a) To increase feelings of confidence and coping; b) To increase the participants' awareness of their own limits; c) To challenge inefficient and negative attitudes and thoughts related to the sick-role; and d) Close and immediate dialogue with key stakeholders. CONCLUSIONS: To increase the possibilities for RTW among individuals on long-term sick leave, a thorough mapping process and the construction of a therapeutic alliance are seen as crucial elements in approaches by occupational rehabilitation clinicians. By gaining the participants' trust and identifying their barriers and possibilities for work, the clinicians can target modifiable factors, especially at the individual level, and obstacles for RTW in their individual surroundings. This study elucidates what occupational rehabilitation clinicians do, say and provide to increase their participants' abilities and possibilities to RTW.
Assuntos
Grupos Focais , Saúde Ocupacional , Padrões de Prática Médica , Retorno ao Trabalho , Licença Médica/estatística & dados numéricos , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Pesquisa Qualitativa , Melhoria de QualidadeRESUMO
OBJECTIVE: Comparing assessments of incapacity to work in patients with subjective health complaints (SHC) by physicians from 5 different European countries. DESIGN: Cross-sectional study. METHOD: General practitioners from Norway (n=56), Sweden (n=29), Denmark (n=41), France (n=46) and occupational and insurance physicians from the Netherlands (n=93) watched and assessed incapacity to work in nine video vignettes of patients with SHC. We subsequently analysed differences between assessments (whether or not there was incapacity to work) by country, with Norway as a reference, as well as differences between general practitioners from the four countries and occupational and insurance physicians using a generalised linear mixed model. RESULTS: Assessments of incapacity to work by physicians from the 5 countries were generally very similar. However, compared to Norwegian general practitioners, Swedish general practitioners (odds ratio (OR) of 0.43 with 95% confidence interval (CI) of 0.23-0.79) and Dutch occupational and insurance physicians (OR of 0.55 with 95% CI of 0.36-0.86) concluded less often that the patients in the videos were unable to work. There were no differences between general practitioners from the other 2 European countries and those from Norway. The Dutch occupational and insurance physicians also concluded less often that there was an incapacity to work compared to all general practitioners from the other 4 European countries (OR of 0.67 with 95% CI of 0.49-0.93). CONCLUSION: There are significant differences between assessments of incapacity to work in patients with SHC between countries and professional groups, but these differences are generally small. Potential explanations for these differences could be found in occupational and insurance medicine specialist training and in the existence of professional guidelines.
Assuntos
Clínicos Gerais/psicologia , Médicos do Trabalho/psicologia , Avaliação da Capacidade de Trabalho , Comparação Transcultural , Estudos Transversais , Europa (Continente) , França , Humanos , Países Baixos , Noruega , SuéciaRESUMO
BACKGROUND: The workplace is used as a setting for interventions to prevent and reduce sickness absence, regardless of the specific medical conditions and diagnoses. AIMS: To give an overview of the general effectiveness of active workplace interventions aimed at preventing and reducing sickness absence. METHODS: We systematically searched PubMed, Embase, Psych-info, and ISI web of knowledge on 27 December 2011. Inclusion criteria were (i) participants over 18 years old with an active role in the intervention, (ii) intervention done partly or fully at the workplace or at the initiative of the workplace and (iii) sickness absence reported. Two reviewers independently screened articles, extracted data and assessed risk of bias. A narrative synthesis was used. RESULTS: We identified 2036 articles of which, 93 were assessed in full text. Seventeen articles were included (2 with low and 15 with medium risk of bias), with a total of 24 comparisons. Five interventions from four articles significantly reduced sickness absence. We found moderate evidence that graded activity reduced sickness absence and limited evidence that the Sheerbrooke model (a comprehensive multidisciplinary intervention) and cognitive behavioural therapy (CBT) reduced sickness absence. There was moderate evidence that workplace education and physical exercise did not reduce sickness absence. For other interventions, the evidence was insufficient to draw conclusions. CONCLUSIONS: The review found limited evidence that active workplace interventions were not generally effective in reducing sickness absence, but there was moderate evidence of effect for graded activity and limited evidence for the effectiveness of the Sheerbrooke model and CBT.