Evaluation of Cognitive Performance in Patients with Fibromyalgia Syndrome: A Case-Control Study.

Patients with fibromyalgia syndrome tend to report deficits in cognitive functions; however, there is no clear consensus on which cognitive domains are impaired. The aim of this study was to compare the differences in cognitive performance between a group of patients with fibromyalgia syndrome and a group of pain-free subjects controlling for the covariables anxiety, depression, and sleep quality. In total, 130 patients with fibromyalgia syndrome and 111 pain-free subjects with an average age of 54.96 years completed the evaluation protocol consisting of sociodemographic data, psychological data, and neurocognitive tests. All data were collected from May 2022 to May 2023. Multivariate analyses of covariance (MANCOVAs) were conducted to assess intergroup differences in all neurocognitive tests. MANCOVA analyses showed that the group of patients with fibromyalgia showed a worse cognitive performance than the group of pain-free subjects after controlling for anxiety, depression, and sleep quality. This study found that fibromyalgia patients exhibited worse cognitive performance and executive function than pain-free subjects. Thus, cognitive performance seems to not be related with anxiety, depression, or sleep quality in our sample of women with FMS.

Association of OPRM1 rs1799971, HTR1B rs6296 and COMT rs4680 polymorphisms with clinical phenotype among women with fibromyalgia.

To investigate the association between three selected pain polymorphisms and clinical, functional, sensory-related, psychophysical, psychological or cognitive variables in a sample of women with fibromyalgia (FMS). One hundred twenty-three (n = 123) women with FMS completed demographic (age, height, weight), clinical (years with pain, intensity of pain at rest and during daily living activities), functional (quality of life, physical function), sensory-related (sensitization-associated and neuropathic-associated symptoms), psychophysical (pressure pain thresholds), psychological (sleep quality, depressive and anxiety level) and cognitive (pain catastrophizing, kinesiophobia) variables. Those three genotypes of the OPRM1 rs1799971, HTR1B rs6296 and COMT rs4680 single nucleotide polymorphisms were obtained by polymerase chain reactions from no-stimulated whole saliva collection. No significant differences in demographic, clinical, functional, sensory-related, psychophysical, psychological and cognitive variables according to OPRM1 rs1799971, HTR1B rs6296 or COMT rs4680 genotype were identified in our sample of women with FMS. A multilevel analysis did not either reveal any significant gene-to-gene interaction between OPRM1 rs1799971 x HTR1B rs6296, OPRM1 rs1799971 x COMT rs4680 and HTR1B rs6296 x COMT rs4680 for any of the investigated outcomes. This study revealed that three single nucleotide polymorphisms, OPRM1 rs1799971, HTR1B rs6296 or COMT rs4680, mostly associated with chronic pain were not involved in phenotyping features of FMS. Potential gene-to-gene interaction and their association with clinical phenotype in women with FMS should be further investigated in future studies including large sample sizes.

Effects of a Game-Based Virtual Reality Video Capture Training Program Plus Occupational Therapy on Manual Dexterity in Patients with Multiple Sclerosis: A Randomized Controlled Trial.

Neurorehabilitation is a fundamental aspect in the treatment approach for multiple sclerosis (MS), in which new technologies have gained popularity, especially the use of virtual reality (VR). The aim of this paper is to analyze an occupational therapy (OT) intervention compared with OT + VR (OT + VR) on the manual dexterity of patients with MS. 26 MS subjects were initially recruited from an MS patient association and randomized into two groups. The OT group received 20 conventional OT sessions distributed in two sessions per week. The OT + VR group received 20 sessions of VR interventions, twice weekly and lasting 30 minutes, consisting of VR games accessed via the online web page motiongamingconsole.com, in addition to the conventional OT sessions. Pre- and postintervention assessments were based on the Purdue Pegboard Test, the Jebsen-Taylor Hand Function Test, and the Grooved Pegboard Test. Clinical improvements were found regarding the precision of movements, the execution times, and the efficiency of certain functional tasks in the Purdue Pegboard Test and Jebsen-Taylor Hand Function Test tests in the OT + VR group. Although significant differences were not found in the manual dexterity between the OT and OT + VR groups, improvements were found regarding the precision and effectiveness of certain functional tasks.

Is the experience of meaningful activities understood in nursing homes? A qualitative study.

Lack of occupation can lead to boredom, apathy, social exclusion and solitude. Occupation should incorporate meaningful activities. The aim of this study is to describe how Spanish Nursing Home residents experienced and made sense of meaningful activities. A qualitative phenomenological approach was followed. Data were collected over an 18-month period between 2012 and 2014. Purposeful sampling was conducted with Spanish residents in nursing homes in Madrid. Data were collected using unstructured and semi-structured interviews. The data were analyzed using the Giorgi proposal. Thirty-eight residents (20 female and 18 male) participated. Three main themes describing the significance of meaningful activity in nursing homes emerged from the data: Feeling the passage of time, Seeking an occupation, and Living with restrictions. Nursing homes should strive to develop diverse and meaningful activity programs for residents in order to occupy their time and provide them with a greater sense of purpose.

Non-capable residents: is the experience of dependence understood in nursing homes? A qualitative study.

OBJECTIVE: The aim of the present study was to describe how dependence was experienced by Spanish nursing home residents with functional limitations. METHODS: A qualitative phenomenological approach was followed. An initial purposeful sampling of Spanish residents in for-profit nursing homes in the southern area of Madrid was carried out. Theoretical sampling was also implemented in order to gain a more in-depth understanding of dependence. The inclusion criteria for nursing home residents were: aged 60 years old or older, having a functional impairment (Barthel Index <90), and lack of any cognitive impairment (Mini-Mental State Examination-Folstein >19) and able to communicate verbally in Spanish. Data were collected using unstructured and semi-structured interviews. The interviews were tape recorded and fully transcribed. Data collection was concluded once theoretical saturation was reached, and the data were analyzed using the Giorgi proposal. RESULTS: A total of 30 residents (15 female and 15 male) with a mean age of 83 years were included. Two main themes that describe the significance of dependence in nursing homes emerged from the data: (i) remaining "capable", with one subtheme named "building the difference", where residents described their own dependence classification of "non-capable" residents; and (ii) "sharing life", with two subthemes named "living together with non-capable residents" and "sharing the environment". Being considered as "non-capable" is labelling the resident forever. CONCLUSIONS: The dependence experience of Spanish nursing home residents might help us gain a deeper insight into their expectations about functional limitations, as well as to understand the change in the relationship between residents considered "non-capable", caregivers and the other residents.

A qualitative study of the relationships between residents and nursing homes nurses.

AIMS AND OBJECTIVES: To explore the relationships between residents and nurses in Spanish nursing homes. BACKGROUND: The nurses are one of the elements conditioning the life of the nursing home resident, influencing sense of security and mediating the relationships among residents. DESIGN: A qualitative phenomenological approach was applied. METHODS: An initial purposeful sampling of Spanish residents from nursing homes in the southern area of Madrid was conducted. The study included nursing home residents, aged 60 and over, with no cognitive impairment and who were able to communicate verbally in Spanish. Data were collected using unstructured and semi-structured interviews, researcher field notes, and personal diaries and letters from the residents. Data collection was concluded once theoretical saturation was reached, and data were analysed using the Giorgi proposal. RESULTS: Two main themes emerged: (1) 'meeting the nursing home nurses,' residents interact with nurses and establish relationships with them. The relationship is perceived as positive yet distant, and at times it is difficult to establish a closer relationship; and (2) 'managing relationships with the nursing home nurses,' residents learn to manage their relationships with the nurses, acquiring new behaviours to get closer to them, avoiding confrontations and helping each other. CONCLUSIONS: Residents manage their relationships with nurses using multiple behavioural strategies. They perceive these adjustments as necessary to facilitate daily life or avoid problems and/or confrontations. Deepening the relationships between residents and nurses could improve the management of nursing homes. RELEVANCE TO CLINICAL PRACTICE: Dialogue and active listening with residents must be incorporated into the daily nursing care. It should be given the same attention to all residents, with special attention to residents with cognitive and functional difficulties.

Is the influence of nurse care practices and nursing home organization understood? A qualitative study.

AIM: To describe residents' experience of nursing home organization and nursing care practices in a region of Spain. BACKGROUND: Nursing home organization, nursing practices and rules within the institution may all influence residents' daily living and their perception on the quality of care provided. DESIGN: A qualitative approach was conducted, using purposeful and theoretical sampling. Data were collected from nursing home residents, following unstructured and semi-structured interviews, researcher field notes and residents' personal diaries and letters. Giorgi analysis was conducted. RESULTS: Two main themes emerged. (1) 'Following nursing home rules'. Norms may be seen as boundaries, especially for those residents who were independent before admission. (2) 'Prioritizing nursing care in residents'. Prioritizing the nursing care may limit the autonomy of residents because it does not meet their preferences and needs. CONCLUSION: Understanding the meaning of nursing home organization and nursing care practices with nursing home residents might provide deeper insight into their expectations. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing staff should have greater involvement in the nursing home organization, as well as in prioritizing the care provision based on resident's needs and preferences.

Is the mealtime experience in nursing homes understood? A qualitative study.

AIM: The aim of the present study was to explore the significance of the mealtime experience among residents of nursing homes in Spain. METHODS: A qualitative phenomenological approach was followed. An initial purposeful sampling of Spanish residents in for-profit nursing homes in the southern area of Madrid was carried out. A theoretical sampling was also implemented in order to gain a more in-depth understanding of dependence. Inclusion criteria for nursing home residents were: age (60 years or older) and lack of any cognitive impairment. Data were collected using unstructured and semistructured interviews. Data collection was concluded once theoretical saturation was reached, and the data were analysed using the Giorgi proposal. RESULTS: A total of 26 residents with a mean age of 83 years were included. Three main themes that describe the significance of meals in nursing homes emerged from the data: (i) timing of the meals - mealtimes serve as a point of reference for organizing activities in the nursing home and orient the residents during the day; (ii) table allocation - table allocation depends on the judgment of the personnel, the behavior of each resident and on the input from the residents that use a table; and (iii) the meals themselves - food is experienced as a privilege, as a sign of autonomy and normality, and as an indicator of personal identity. CONCLUSION: Understanding the social significance of meals for residents in nursing homes would provide deeper insight into resident expectations. This will in turn help to improve service and quality of life for residents.