A Prospective Observational Study of Frailty in Geriatric Revitalization Aimed at Community-Dwelling Elderly.

(1) Background: The increasing life expectancy brings an increase in geriatric syndromes, specifically frailty. The literature shows that exercise is a key to preventing, or even reversing, frailty in community-dwelling populations. The main objective is to demonstrate how an intervention based on multicomponent exercise produces an improvement in frailty and pre-frailty in a community-dwelling population. (2) Methods: a prospective observational study of a multicomponent exercise program for geriatric revitalization with people aged over 65 holding Barthel Index scores equal to, or beyond, 90. The program was developed over 30 weeks, three times a week, in sessions lasting 45-50 min each. Frailty levels were registered by the Short Physical Performance Battery, FRAIL Questionnaire Screening Tool, and Timed "Up & Go" at the beginning of the program, 30 weeks later (at the end of the program), and following 13 weeks without training; (3) Results: 360 participants completed the program; a greater risk of frailty was found before the program started among older women living in urban areas, with a more elevated fat percentage, more baseline pathologies, and wider baseline medication use. Furthermore, heterogeneous results were observed both in training periods and in periods without physical activity. However, they are consistent over time and show improvement after training. They show a good correlation between TUG and SPPB; (4) Conclusions: A thirty-week multicomponent exercise program improves frailty and pre-frailty status in a community-dwelling population with no functional decline. Nevertheless, a lack of homogeneity is evident among the various tools used for measuring frailty over training periods and inactivity periods.

Life Domains and Lifestyle of Older Adults Living in a Nursing Home: A Pilot Study.

Although the preventive occupational therapy intervention program Lifestyle Redesign® has proven to be effective in maintaining and improving the health and quality of life of older adults, a similar program has not yet been culturally adapted to the Spanish population. As a preliminary step in developing a lifestyle intervention tailored to healthy Spanish older adults living in a nursing home (Lifestyle Choice; originally in Spanish "Elección de Estilo de Vida"), we aimed to identify and describe the life domains of this population and determine overlap with content areas addressed in the Lifestyle Redesign® program. An observational cross-sectional study was carried out using quantitative methods, including 30 healthy older adult residents in the "Virgen del Prado" nursing home in Talavera de la Reina (Toledo), based on the development of a questionnaire and a survey. Six life domains were identified: self-care, sleep and rest, mobility, personal safety, health maintenance, spirituality, and free time usage. The results of this study reveal important overlaps with content areas of Lifestyle Redesign®, suggesting that it may be feasible to develop a lifestyle intervention ("Elección de Estilo de Vida") tailored to the sociocultural features of the healthy Spanish population over 65 years old living in nursing homes.

Psychosocial Interventions for the Treatment of Cancer-Related Fatigue: An Umbrella Review.

Cancer-related fatigue is one of the most common symptoms of cancer and one of those referred by patients as the most disabling. However, we still do not have enough evidence to allow us to recommend effective and personalized approaches. GOAL: To provide evidence on the efficacy of ASCO-recommended psychosocial interventions for reducing cancer-related fatigue. METHODOLOGY: A general quantitative systematic review for nonprimary clinical interventions that allows the collection, synthesis and analysis of already published reviews. Systematic reviews of RTCs were selected as these make up the body of knowledge that provides the most evidence in an umbrella format. The results do not provide clear or comparable evidence regarding the different interventions, with moderate evidence standing out for cognitive interventions and mindfulness. CONCLUSIONS: Research gaps, study biases and the need for further research to ask more precise questions and to make reliable recommendations to mitigate the impact of cancer-related fatigue are evident.

Occupational Therapy Interventions for the Improvement of the Quality of Life of Healthy Older Adults Living in Nursing Homes: A Systematic Review.

OBJECTIVE: To evaluate current scientific evidence on the effectiveness of occupational therapy interventions for the improvement of the quality of life of healthy adults over 65 years old living in nursing homes. DATA SOURCE: PubMed, Web of Science, Dialnet, Scopus, Cochrane, Cinahl and SciELO databases searched between 2012 and 2022. STUDY INCLUSION AND EXCLUSION CRITERIA: a) Studies involving occupational therapy interventions in residential settings (nursing homes or community residential settings), b) Studies conducted on a population of healthy adults over 65 years old, c) Studies with a level of evidence 1a-1b to 3a-3b, d) Studies containing the MeSH descriptors in the keyword list. DATA EXTRACTION: For each study included in the review, key information was collected and entered into a data extraction form based on Cochrane recommendations, using Microsoft Excel v.16.16.21 software. DATA SYNTHESIS: Descriptive summary of study characteristics and summarized methodological quality of the studies. RESULTS: Six of the articles met the inclusion criteria and were categorised into "promotion of active ageing" and "meaningful activities and quality of life". Overall, the strength of evidence was moderate, and the risk of bias was low. CONCLUSION: Occupational therapy intervention programmes structured around the opportunity to choose meaningful activities can improve the perceived quality of life of healthy older adults living in nursing homes.

Validation of the Spanish Versions of FACIT-PAL and FACIT-PAL-14 in Palliative Patients.

Palliative patients require several types of care to improve their quality of life as much as possible, and valid and reliable assessment instruments are essential. The objective of this study is the Spanish validation of the Functional Assessment Chronic Illness Therapy-Palliative Care (FACIT-PAL) and its abbreviated version, FACIT-PAL-14, in palliative care patients. FACIT-PAL and FACIT-PAL-14 were translated into Spanish and administered to 131 terminal oncology patients in home palliative care units, hospital palliative care units, health center teams, and social health centers. The European Organization for Research and Treatment of Cancer questionnaire, EORTC-QLQ-C15-PAL version, was used to evaluate the criterion validity. The EORTC-QLQ-C15-PAL was employed as a "gold standard", and it obtained significant results with FACIT scales. FACIT-PAL-14, FACIT-PAL, and its subscales reported high internal consistency, from 0.640 to 0.816. The exploratory factor analysis for FACIT-PAL-14 found a structure in three factors that explained the 70.10% variance, and the FACIT-PAL scale found a structure of five factors. Physical wellbeing from FACIT-PAL highly correlated to the EORTC-QLQ-C15-PAL (r = 0.700), but social and family wellbeing was correlated to a lesser extent (r = -0.323). FACIT-PAL and the TOI (Toi Outcome Index) were also highly correlated with the EORTC-QLQ-C15-PAL, with values of r = -0.708 and r = -0.709, respectively. The Spanish versions of FACIT-PAL and FACIT-PAL-14 were demonstrated to be valid and reliable scales in palliative care patients.

Quo Vadis, Amadeo Hand Robot? A Randomized Study with a Hand Recovery Predictive Model in Subacute Stroke.

BACKGROUND: Early identification of hand-prognosis-factors at patient's admission could help to select optimal synergistic rehabilitation programs based on conventional (COHT) or robot-assisted (RAT) therapies. METHODS: In this bi-phase cross-over prospective study, 58 stroke patients were enrolled in two randomized groups. Both groups received same treatments A + B (A = 36 COHT sessions for 10 weeks; B = 36 RAT sessions for 10 weeks; 45 min/session; 3 to 5 times per week). Outcome repeated measures by blinded assessors included FMUL, BBT, NHPT, Amadeo Robot (AHR) and AMPS. Statistical comparisons by Pearson's rank correlations and one-way analyses of variance (ANOVA) with Bonferroni posthoc tests, with size effects and statistic power, were reported. Multiple backward linear regression models were used to predict the variability of sensorimotor and functional outcomes. RESULTS: Isolated COHT or RAT treatments improved hand function at 3 months. While "higher hand paresis at admission" affected to sensorimotor and functional outcomes, "laterality of injury" did not seem to affect the recovery of the hand. Kinetic-kinematic parameters of robot allowed creating a predictive model of hand recovery at 3 and 6 months from 1st session. CONCLUSIONS: Hand impairment is an important factor in define sensorimotor and functional outcomes, but not lesion laterality, to predict hand recovery.

A Q-method approach to perceptions of professional reasoning in occupational therapy undergraduates.

BACKGROUND: Professional reasoning provides a firm basis for the development of teaching and assessment strategies to support the acquisition of skills by healthcare students. Nevertheless, occupational therapy educators should use diverse methods of learning assessment to examine student learning outcomes more fully with an evaluation that supports the overall complexity of the process, particularly learners' subjective experience. The aim of this article is to identify the range of perspectives among occupational therapy undergraduates regarding terms or concepts that are key for improving their professional reasoning. METHODS: Q-methodology was used to address the aim of the study. A concourse relating to a series of ideas, phrases, terminology, and concepts associated with various studies on professional reasoning in occupational therapy, specifically on students in this field, was generated. The terms that had the clearest evidence, the most relevance or the greatest number of citations in the literature were collected (n = 37). The P-set was assembled by non-probabilistic sampling for convenience. It comprised undergraduate university students in occupational therapy. Factor analysis was conducted using Ken-Q Analysis v.1.0.6, reducing the number of Q-sets to smaller groups of factors representing a common perspective. RESULTS: Through statistical analysis of the Q-sorts of 37 occupational therapy students, 8 default factors were identified. The four factors in accordance with the selection criteria were rotated by varimax rotation to identify variables that could be grouped together. Each viewpoint was interpreted, discussed and liked to different aspects of professional reasoning in occupational therapy. CONCLUSIONS: The observed perceptions were linked to the various aspects of professional reasoning that have been widely discussed in the occupational therapy literature. For most of the students, there was a strong correspondence between the narrative, interactive and conditional aspects of the various components.

Et Itinerantur / Et Itinerantur

Desde mi interés sobre la vertiente social de la Medicina y desde el punto de vista de la Rehabilitación mi trabajo profesional, docente e investigador se ha proyectado sobre la discapacidad y su entorno. Fue por el año 1983 cuando conocí a Dª. Ana Vicente por aquel entonces Terapeuta Ocupacional en la Residencia Asistida de Cáceres; desde entonces y hasta ahora, bueno hasta hace un año he mantenido contacto con las y los terapeutas ocupacionales, desde lo profesional y desde lo docente-investigador. Creo que siempre les he trasmitido mi afición por conocer que es lo que nos impulsa, en la certeza de que somos un todo donde las partes están tan íntimamente relacionadas que lo que ocurre en una de ellas tiene repercusión en las otras

The social aspects of medicine and the perspective of rehabilitation in my work as a physician, professor and researcher have focused on disability and its circumstances. It was the year 1983 when I firstmet Ana Vicente, at that time occupational therapist at a nursing home in Cáceres; since then and until now, well strictly speaking until last year, I've been in contact with occupational therapists, in my role as a physician as well as a professor and researcher. I hope I have always made them clear my interest in knowing what drives them, with the certainty that we are all part of the same thing and that all parts are intimately related, and what happens in one of them has an effect upon the others

Professional Reasoning in Occupational Therapy: A Scoping Review.

BACKGROUND/AIM: Professional reasoning in occupational therapy is the process used by practitioners to plan, direct, perform, and reflect on client care. The professional's ability to manage the process of the intervention is structured around it, thereby influencing the effectiveness of the work carried out. The objectives of this research were to identify and describe (a) the historical development of this area of research from 1982 to 2017 and (b) the nature and volume of the scientific literature on professional reasoning in occupational therapy and the evidence that exists today. METHODS: A scoping review method was used to carry out an historical mapping of research on professional reasoning and to summarise the lines of research explored to date. The review was conducted in five stages following the PRISMA guidelines. After applying the selection criteria, the search identified 303 references. RESULTS: The results are presented under three headings: (a) nature and volume of publications on professional reasoning in occupational therapy according to number and year of publications, journal, country, author, and line of research; (b) historical trends in the scientific literature on professional reasoning in occupational therapy since 1982; and (c) methodological aspects of the research. Each of them is discussed through statistical analysis. CONCLUSIONS: The research about professional reasoning in occupational therapy is a field of empirical nature, in which qualitative studies predominate. Principal lines of research are focused on specific fields of practice, undergraduates, and theoretical aspects of professional reasoning. There were identified three historical phases with common features in terms of objectives and research methods.

Estudio aleatorizado de un programa de entrenamiento de cognición cotidiana frente a estimulación cognitiva tradicional en adultos mayores / Randomized study of a everyday cognition training program versus traditional cognitive stimulation in elderly adults

La cognición cotidiana consiste en la aplicación de las habilidades cognitivas básicas y el conocimiento del dominio específico para la resolución de problemas que se integran dentro de los dominios instrumentales de funcionamiento. Para valorar la cognición cotidiana, existen evaluaciones que presentan problemas cotidianos cognitivamente desafiantes, pertenecientes a actividades instrumentales, cuyo objetivo es evaluar el funcionamiento cognitivo dentro de estos dominios en el mundo real. Objetivo principal: Analizar la diferencia existente entre la realización de programas de estimulación cognitiva tradicionales y programas de intervención directa en cognición cotidiana. Metodología: Estudio experimental, aleatorizado, estratificado, prospectivo, longitudinal mediante un esquema de asignación fija con grupo experimental y grupo control. La población a estudio fueron adultos mayores sanos de la ciudad de Salamanca que participaron en los programas de terapia ocupacional. La intervención constó de un programa específico de estimulación en cognición cotidiana. Para la evaluación se utilizó la ERFC (evaluación rápida de las funciones cognitivas) para medir la función cognitiva global y la ECB (Everyday Cognition Battery) para medir la cognición cotidiana. Resultados: Muestra total de pacientes (n = 147) compuesta por 19 hombres y 128 mujeres, con una edad media de 75 años. Se observaron diferencias estadísticamente significativas (p < 0,001) en la variable ECB, así como diferencias estadísticamente significativas (p < 0,05) en los ítems "total", "cálculo", "razonamiento", "comprensión" y "reconocimiento visual". Conclusiones: La utilización combinada de estimulación cognitiva tradicional y entrenamiento en cognición cotidiana presenta mayores beneficios en términos de cognición cotidiana que la utilización exclusiva de estimulación cognitiva en adultos mayores

Everyday cognition consists in the application of basic cognitive skills and the knowledge about a specific domain in problem solving which are integrated within the functional instrumental domains. In order to assess everyday cognition, there are assessments which include challenging cognitive tasks which are categorized as instrumental domains. The aim of these assessments is to assess cognition in the real world. Main objective: To analyze the difference among the implementation conventional of cognitive stimulation programs and the implementation of everyday cognition programs. Methods: Longitudinal prospective stratified randomized control trial. The population study will be older adults living in Salamanca who will participate in occupational therapy programs. The intervention will consist of a specific everyday cognition stimulation program. For the evaluation we used the ERFC (rapid assessment of cognitive functions) to measure global cognitive function and the ECB (everyday cognition battery) to measure daily cognition. Results: Sample size (n=147) composed of 19 males and 128 females with an average age of 75. Statistically significant difference is observed (p<0.001) in ECB variable (Everyday Cognition Battery), and in "total", "calculation", "reasoning", "comprehension" and "visual recognition" items as well (p<0.05). Conclusions: The combination of conventional cognitive stimulation and everyday cognition training has more benefits in terms of everyday cognition than the administration of cognitive stimulation by itself in older adults

Ansiedad del paciente hospitalizado en una Unidad de Observación de Urgencias de un hospital comarcal / Anxiety in the patient hospitalized in the ER Observation Unit of a regional hospital

OBJETIVO: evaluar el nivel de ansiedad del paciente hospitalizado en la Unidad de Observación del Servicio de Urgencias del Hospital de Medina del Campo (UOSU) (Valladolid), así como determinar la ocurrencia de los acontecimientos estresantes hospitalarios y cuantificar el grado de ansiedad que genera cada estresor hospitalario. MÉTODO: se realizó un estudio observacional, descriptivo y transversal a pacientes ingresados de forma no programada, durante seis y 24 horas y una edad comprendida entre los 18 y 80 años. Se utilizó un cuestionario validado que sigue la escala Likert y elaborado a partir de la escala de estresores hospitalarios de Volicer y Bohanon (6). RESULTADOS: participaron en el estudio 212 pacientes, 129 hombres y 83 mujeres. El 40% presentó una patología asociada a Medicina Interna. El 84% conocía en qué consistía su enfermedad, el 87% sabía los resultados de pruebas y un 35% pensaba que les podía ocurrir algo grave. Al 67% el hecho de desconocer el momento del alta, al 91% ingresar de forma repentina y al 72% obtener alivio para el dolor, les generaban los niveles más alto de estrés durante su ingreso. CONCLUSIONES: el dolor es el estresor hospitalario por excelencia, y en los pacientes ingresados el dolor torácico era lo que les generaba mayor nivel de ansiedad, junto con las posibles consecuencias de la enfermedad y la falta de información sobre la misma. Por el contrario, los inconvenientes derivados de la hospitalización (dormir con extraños, vestir ropa de hospital, etc.) son los acontecimientos que les producían menores niveles de ansiedad

OBJECTIVE: to assess the anxiety level of patients hospitalized in the ER Observation Unit of the Hospital de Medina del Campo (UOSU), as well as to determine the occurrence of hospital stressful events, and to quantify the level of anxiety generated by each of them. METHOD: an observational, descriptive and transversal study was conducted on 18-to-80-year old patients with non-scheduled hospital admission, during six and 24 hours. A validated questionnaire following the Likert scale was used; this was prepared on the basis of the Hospital Stress Rating Scale by Volicer and Bohanon. RESULTS: the study included 212 patients: 129 men and 83 women. From these, 40% presented a condition associated to Internal Medicine; 84% were aware of what their disease entailed, 87% knew their test results, and 35% thought that something serious could be happening to them. The highest levels of stress during hospitalization were caused by: the fact of not knowing the time of hospital discharge (67% of patients), sudden admission to hospital (91% of patients), and obtaining pain relief (72% of patients). CONCLUSIONS: pain is the hospital stressful event par excellence; and among hospitalized patients, chest pain generated the highest level of anxiety, as well as the potential consequences of the disease and the lack of information about it. On the contrary, the drawbacks associated with hospitalization (sleeping with strangers, wearing hospital clothes) were the events that caused the lowest levels of anxiety

Reliability and Validity of the Spanish Version of the Memorial Symptom Assessment Scale in Oncology Patients.

CONTEXT: Memorial Symptom Assessment Scale (MSAS) is a multidimensional tool developed to evaluate frequency, severity, and distress of common symptoms present in cancer patients. OBJECTIVE: To translate the original English version of MSAS and prove the reliability and validity of the Spanish version. METHODS: MSAS scale was translated into Spanish and administered to 246 cancer patients aged between 18 and 85 years. They attended the Day Hospital to receive chemotherapy. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 and Rotterdam Symptom Checklist were used to test criterion validity. RESULTS: TOTAL MSAS, Physical Symptom Subscale (PHYS), Psychological Symptom Subscale (PSYCH), and Global Distress Index (GDI) reported high internal consistency: 0.891, 0.801, 0.825, 0.813, respectively. Exploratory factor analysis identified two-factors structure and confirmatory factor analysis showed good adjustment rates. The emotional functioning subscale of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 highly correlated with PSYCH (r = -0.868; P < 0.001) and GDI (r = -0.810; P < 0.001), whereas social functioning subscale correlated with PSYCH (r = -0.704; P < 0.001) and GDI (r = -0.624; P < 0.001). The PHYS of Rotterdam Symptom Checklist correlated with PHYS (r = 0.876; P < 0.001) and the PSYCH with PSYCH (r = 0.872; P < 0.001). CONCLUSION: The Spanish version of MSAS was determined to be a valid and reliable scale in cancer patients.