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1.
Rev Saude Publica ; 54: 39, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32321056

RESUMO

OBJECTIVE: To examine and map the consequences of chronic pain in adulthood. METHOD: Documents addressing the impact of chronic pain on the psychological and social spheres of people suffering from chronic pain, published in Spanish and English between 2013 and 2018, were included. Those who addressed pharmacological treatments, chronic pain resulting from surgical interventions or who did not have access to the full text were excluded. Finally, 28 documents from the 485 reviewed were included. RESULTS: Studies show that pain is related to high rates of limitation in daily activities, sleep disorders and anxiety-depression spectrum disorders. People in pain have more problems to get the workday done and to maintain social relationships. Chronic pain is also associated with worse family functioning. CONCLUSIONS: This review shows that limitations in the ability to perform activities of daily living, sleep, psychological health, social and work resources and family functioning are lines of interest in published articles. However, knowledge gaps are detected in areas such as the influence of having suffered pain in childhood or adolescence, the consequences of non-fulfillment of working hours and gender inequalities.


Assuntos
Dor Crônica/psicologia , Atividades Cotidianas/psicologia , Adolescente , Adulto , Idoso , Ansiedade/psicologia , Depressão/psicologia , Relações Familiares/psicologia , Humanos , Pessoa de Meia-Idade , Transtornos do Sono-Vigília/psicologia , Adulto Jovem
4.
Health Qual Life Outcomes ; 18(1): 50, 2020 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-32127015

RESUMO

BACKGROUND: The provision of psychometrically valid patient reported outcomes (PROs) improves patient outcomes and reflects their quality of life. Consequently, ad hoc clinician-generated questionnaires of the past are being replaced by more rigorous instruments. This change, while beneficial, risks the loss/orphaning of decades-long information on difficult to capture/chronically ill populations. The goal of this study was to assess to the quality of data retrieved from these legacy questionnaires. METHODS: Participants included 8563 patients who generated a total of 12,626 hospital admissions over the 2004-2014 study period. Items used to screen for issues related to function, mood, symptoms, and social support among patients with chronic disease were identified in our medical center's patient information questionnaire. Cluster and exploratory factor analyses (EFA) followed by multidimensional item response theory (MIRT) analyses were used to select items that defined factors. Scores were derived with summation and MIRT approaches; inter-factor relationships and relationships of factor scores to assigned diagnostic codes were assessed. Rasch analyses assessed the constructs' measurement properties. RESULTS: Literature review and clinician interviews yielded four hypothesized constructs: psychological distress/wellbeing, symptom burden, social support, and physical function. Rasch analyses showed that, while all had good measurement properties, only one, function, separated individuals well. In exploratory factor analyses (EFA), 11 factors representing depression, respiratory symptoms, musculoskeletal pain, family support, mobility, activities of daily living, alcohol consumption, weight loss, fatigue, neurological disorders, and fear at home were identified. Based on the agreement between EFA and cluster analyses as well as Cronbach's alpha, six domains were retained for analyses. Correlations were strong between activities of daily living and mobility (.84), and moderate between pain and mobility (.37) and psychological distress (.59) Known-group validity was supported from the relationships between factor scores and the relevant diagnostic code assignments (.12 to .20). CONCLUSIONS AND DISCUSSION: Items from ad hoc clinician-generated patient information questionnaires can be aggregated into valid factors that assess supportive care domains among chronically ill patients. However, the binary response options offered by many screening items limit their information content and consequently, as highlighted by Rasch analyses, their ability to meaningfully discriminate trait levels in these populations.


Assuntos
Atividades Cotidianas/psicologia , Qualidade de Vida , Inquéritos e Questionários/normas , Idoso , Idoso de 80 Anos ou mais , Doença Crônica/psicologia , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/métodos
5.
Arq Neuropsiquiatr ; 78(1): 2-8, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-32074186

RESUMO

OBJECTIVE: The association between cognitive impairment and physical frailty has been studied in older adults. The criteria degree of frailty may be keys to associated cognitive impairment. To analyze the association between cognitive impairment and the criteria for frailty. METHODS: We cross-sectionally examined data from 667 older adults (≥60 years of age) from a study entitled 'Variables associated to cognition in elderly caregivers' involving patients in an urban and rural primary healthcare center. We defined cognitive impairment based on different groups of scores on the Mini Mental State Examination, and defined frailty and prefrailty using the criteria by the Cardiovascular Health Study. We performed multinomial regression models to analyze the association between levels of frailty and cognitive impairment. RESULTS: Similar proportions of women (54.8%) and men (45.2%) participated in the study (mean age: 71 years old). We found cognitive impairment, prefrailty and frailty in 34, 54, and 24% of the participants, respectively. Concomitant cognitive impairment and frailty was found in 13% of them. The chances of cognitive impairment increased up to 330% (Odds Ratio [OR]: 4.3; 95% confidence interval [95%CI] 2.4‒7.7; p<0.001) among frail individuals, and 70% (OR: 1.7; 95%CI 1.0‒2.8; p=0.033) among prefrail individuals compared to robust/non-frail individuals. After controlling for age, education, place of residence and functional dependence, slowness and fatigue criteria were significantly associated with cognitive impairment. CONCLUSION: Older adults with frailty have a greater likelihood of concomitant cognitive impairment than prefrail and robust older adults. The prevalence of cognitive impairment and frailty is consistent with data reported in literature. The present findings contribute to the investigation of cognitive frailty.


Assuntos
Disfunção Cognitiva/etiologia , Idoso Fragilizado/psicologia , Fragilidade/complicações , Fragilidade/psicologia , Atividades Cotidianas/psicologia , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Brasil/epidemiologia , Disfunção Cognitiva/epidemiologia , Estudos Transversais , Feminino , Fragilidade/epidemiologia , Avaliação Geriátrica , Humanos , Vida Independente , Masculino , Testes de Estado Mental e Demência , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Distribuição por Sexo
6.
Am J Occup Ther ; 74(1): 7401170010p1-7401170010p2, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32078505

RESUMO

The special section in this issue advances research for occupational therapy interventions for people with low vision. Three systematic reviews provide evidence for occupational therapy interventions in the areas of activities of daily living, instrumental activities of daily living, leisure and social participation, and reading. In addition, the special section addresses oculomotor treatment in traumatic brain injury, normative data for the Dynavision, and properties of a ScanCourse.


Assuntos
Terapia Ocupacional , Baixa Visão , Atividades Cotidianas/psicologia , Humanos , Atividades de Lazer/psicologia , Participação Social/psicologia
7.
Medicine (Baltimore) ; 99(6): e19062, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32028426

RESUMO

BACKGROUND: The efficacy and safety of selective serotonin reuptake inhibitors (SSRIs) for functional independence and depression prevention in early stage of post-stroke (within 1 month after stroke onset) are still unclear. METHODS: Relevant randomized controlled trials (RCTs) comparing early SSRIs therapy with placebo were sought from PubMed, Cochrane Library, Medline, and Embase. Primary outcomes were functional independence and depression occurrence. Secondary outcomes contained the improvement of Fugl-Meyer motor scale (FMMS) score and adverse events. We used fixed or random effects model to pooled effect estimates. And we chose risk ratio (RR) or mean differences (MDs) with the 95% confidence intervals (CIs) for data analysis. RESULTS: We included 10 RCTs with total 5370 patients. The outcome of functional independence showed no significant difference between SSRIs and placebo group (RR, 1.28; 95% CI, 0.96-1.72; P = .10; I = 92%). However, depression occurrence differed significantly between these 2 groups, which favored SSRIs group (RR, 0.78; 95% CI, 0.67-0.90; P = .001; I = 23%). In addition, we observed that the side effects of SSRIs were seizure and nausea. Except psychiatric disorders/insanity rate was less in SSRIs group than placebo group (RR, 0.66; 95% CI, 0.48-0.90; P = .009) (I = 0%), other adverse events were revealed non-significant in our meta-analysis. CONCLUSIONS: Our meta-analysis revealed that early SSRIs therapy were effective to prevent post-stroke depression. However, SSRIs did not improve patient's post-stroke functional independence. In addition to increase the occurrence of seizure and nausea, SSRIs were relatively safe.


Assuntos
Antidepressivos de Segunda Geração/uso terapêutico , Depressão/prevenção & controle , Inibidores de Captação de Serotonina/uso terapêutico , Acidente Vascular Cerebral/psicologia , Atividades Cotidianas/psicologia , Humanos , Acidente Vascular Cerebral/complicações , Reabilitação do Acidente Vascular Cerebral/métodos
8.
Medicine (Baltimore) ; 98(52): e18515, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31876742

RESUMO

Although functional impairment is very common among patients with major depressive disorder (MDD) and is a necessary diagnostic criterion for MDD, clinicians have not directed their attention beyond the mood symptoms of MDD. We aimed to multi-dimensionally assess the functional abilities of patients with MDD using a standardized scale of adaptive function reported by caregivers or parents to identify the nature and degree of functional impairment in patients with MDD.This study was conducted in 40 depressive patients aged 19 to 60 years. Patients were screened according to the DSM-IV-TR and a Hamilton Depression Rating Scale score ≥8. We administered the parent/caregiver rating form of the Korean Vineland Adaptive Behavior Scale to assess functional outcomes in the patients.Patients with MDD showed significant differences in both global and domain-specific functional abilities compared to those of the normal group (all t > -6.35, P < .05) and the patients' premorbid IQ (all t > 4.30, P < .001). The number of episodes among clinical factors was negatively correlated with overall adaptive functioning (r = -0.32, P < .05) and expressive communication (r = -0.42, P < .01).Our present study replicates existing evidence showing impairment in both broad and various functional areas in patients with MDD, suggesting the importance of quantitatively assessing functional outcomes and acquiring information about functioning from informants other than patients.


Assuntos
Atividades Cotidianas/psicologia , Transtorno Depressivo Maior/psicologia , Adaptação Psicológica , Adulto , Feminino , Humanos , Entrevista Psicológica , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Adulto Jovem
9.
Psychol Aging ; 34(7): 991-1004, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31647260

RESUMO

Facial expressions of emotion allow us to predict other people's intentions and behaviors. However, we often overextend these predictions to also make inferences about other people's underlying tendencies and dispositions. People with happy expressions are perceived to have stable positive traits whereas people with sad expressions are perceived to have stable negative traits. In these studies, we tested whether this extends to inferences about younger and older adults' abilities to complete fundamental activities of independent living, such as independently getting dressed, preparing food, and remembering directions. Our results showed that both younger and older adult targets were perceived to have greater everyday competence in completing activities of daily living (ADLs), instrumental activities of daily living (IADLs), and memory tasks when they displayed happy or neutral expressions rather than sad expressions. This pattern did not vary based upon either the target's gender or the participant's age. However, for the ADL and IADL ratings, the overgeneralization of emotions to ratings of everyday competence was greater for the older adult targets than for the younger adult targets. Drawing from the ecological approach to social perception, these results suggests that spontaneous trait inferences are most likely to occur when the age-trait association is strong. Given that perceptions of competence are also associated with behavioral ramifications, such as being subjected to patronizing behavior, having lower employment opportunities, and being seen as low in social status, our results also suggest that older adults whose facial expressions appear sad may be especially prone to these adverse outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Atividades Cotidianas/psicologia , Emoções/fisiologia , Expressão Facial , Percepção Social , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
10.
Occup Ther Int ; 2019: 4175184, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31558888

RESUMO

The Activity Card Sort (ACS) measures the level of participation, as perceived by each person which, unlike other scales, makes it both personal and significant. However, there is a limitation to applying the ACS to Spanish older adults as it is restricted to culturally relevant activities solely in the United States. Therefore, the aim of this study was to select activity items that reflected Spanish older adults' lifestyles in order to develop the Activity Card Sort-Spain Version (ACS-SP). Frequently, activities performed in Spain (n = 103) were listed in an initial draft. The Likert scale was administrated to a large group of Spanish nationals over the age of 60 years (n = 98) to establish which type of activities will be eventually included in the Spanish version. The final version was drawn up comprising 79 activities distributed between four performance areas. In addition, other activities that were not previously included by other assessment tools were considered and have been listed in this review, such as taking a nap, going out for a drink or "tapas," or searching for a job. The gradual adaptation to ACS for Spaniards will make it possible to measure the level of an individual's participation within a community. However, further work on psychometric properties is needed.


Assuntos
Atividades Cotidianas/psicologia , Características Culturais , Estilo de Vida/etnologia , Inquéritos e Questionários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Ocupacional/instrumentação , Psicometria , Espanha
11.
Pan Afr Med J ; 33: 115, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31489093

RESUMO

Prader Willi syndrome is a rare genetic disease. Symptoms include binge eating disorder associated with the risk of morbid obesity, learning difficulties and behavioral problems or even major psychiatric disorders. The purpose of this case study is to conduct a literature review on Prader Willi syndrome and to highlight its impact on daily life, both on physical and mental health, as well as its management. We report the case of an 11-year old Moroccan girl presenting with Prader Willi syndrome. She was assisted in performing activities of daily living by using a comprehensive biopsychosocial approach which improved her quality of life. We here emphasize the primary and central role of the psychotherapist in the treatment of patients with Prader Willi syndrome which is based on counselling, motivational interviewing and cognitive behaviour therapy techniques. Prader Willi syndrome is a disease with severe psychiatric symptoms. Patient's care requires multidisciplinary team approach involving psychologist or psychiatrist.


Assuntos
Atividades Cotidianas/psicologia , Síndrome de Prader-Willi/terapia , Qualidade de Vida , Criança , Terapia Cognitivo-Comportamental/métodos , Feminino , Humanos , Marrocos , Entrevista Motivacional/métodos , Síndrome de Prader-Willi/psicologia
12.
Estud. interdiscip. envelhec ; 24(2): 45-60, set. 2019. tab
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-1096117

RESUMO

Objetivo: identificar os fatores sociodemográficos e econômicos associados a diferentes níveis de dependência funcional em idosos restritos ao lar assistidos por uma Unidade de Saúde da Família de Vitória (ES). Métodos: Pesquisa transversal de 101 idosos com dependência funcional e restritos ao lar. Perfil sociodemográfico e econômico foi obtido através de questionário; dependência funcional foi aferida através da Escala Medida de Independência Funcional. Foram realizados os testes Chi-quadrado de Pearson ou Exato de Fisher e Razão de Prevalência. Resultados: Verificou-se que 43,5% dos idosos apresentaram dependência leve e 56,4% dependência moderada/grave. A maioria dos idosos era do sexo feminino, com idade ≥ 80 anos, brancos, viúvos, baixa escolaridade, aposentados, baixa renda, contribuíam para renda familiar, com filhos, com cuidador, relataram ter passado a maior parte da vida na cidade, residindo em bairro nobre e em residências multigeracionais. Verificou-se como variáveis associadas aos diferentes níveis de dependência funcional idade ≥ 80 anos (p = 0,018), ocupação (p = 0,033) e renda (p = 0,036). Conclusão: Se comportaram com fatores associados aos diferentes níveis de dependência funcional: idade ≥ 80 anos, ocupação e renda. (AU)


Objective: to identify sociodemographic and economic factors associated with different levels of functional dependency in older adults restricted to the home, assisted by a Family Health Unit of Vitória, ES. Methods: A cross-sectional survey of 101 older people with functional dependency and restricted to the home. Sociodemographic and economic profiles were obtained through questionnaire; Functional dependency was measured through the Functional Independence Measure scale. Pearson's Chi-square or Fisher's Exact and Prevalence Ratio tests were performed. Results: It was found that 43.5% of the older adults had mild dependency and 56.4% had moderate/severe dependency. The majority of the older adults were female, aged 80 and over, white, widowers, low schooling, retirees, low income, contributed to family income, with children, with caregiver, reported having spent most of their lives in the city residing in middle-class neighborhoods and multigenerational residences. The variables associated with the different levels of functional dependency were the fourth age (p = 0.018), occupation (p = 0.033) and income (p = 0.036). Conclusion: Behaved with factors associated with different levels of functional dependency age ≥ 80 years, occupation and income. (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Fatores Socioeconômicos , Atividades Cotidianas/psicologia , Saúde do Idoso , Idoso Fragilizado/estatística & dados numéricos , Brasil , Estudos Transversais , Estratégia Saúde da Família
13.
Cancer Invest ; 37(7): 299-310, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31379217

RESUMO

Age-related decreases in Quality of Life (QoL) are often compounded by comorbidities, including cancer. This study aimed to examine QoL changes before and after a new cancer diagnosis using data from the National Health and Aging Trend Study (NHATS), linked to Medicare claims (N = 136). There was a significant increase in the relative odds of fair/poor self-reported health and needing help with Activities of Daily Living. There was also a marginal increase in depression, but no change in anxiety or pain scores. Results underscore importance of considering pre-cancer QoL when making treatment decisions for older adult cancer patients.


Assuntos
Atividades Cotidianas/psicologia , Neoplasias/diagnóstico , Qualidade de Vida/psicologia , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Ansiedade/etiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Neoplasias/psicologia , Autorrelato , Estados Unidos
14.
Qual Life Res ; 28(12): 3293-3301, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31414348

RESUMO

PURPOSE: The purpose of this study was to evaluate whether an educational palliative care intervention improved the quality of life for next of kin to older persons in nursing homes. METHODS: Altogether, 90 next of kin in the intervention group and 105 next of kin in the control group were included. Data were collected using the WHOQOL-BREF questionnaire, answered before and 3 months after the intervention was completed. Descriptive and comparative analyses were performed. RESULTS: This study found a statistically significant increase in the Physical health subscale in the intervention group but not in the control group. In contrast, the General health score decreased in the control group but not in the implementation group. Furthermore, we found an increase in the item able to perform activities of daily living in the intervention group and a decrease in the item energy and fatigue in the control group. CONCLUSION: The results indicated small statistical changes regarding next of kins' QoL in favour of the intervention. Lessons learned from the study for future research are to include next of kin as participants at meetings about next of kin and to include more meetings about the theme next of kin. Both approaches would bring a stronger focus on the family-centred care aspect of the intervention into the education component, which this study indicates the need for. TRIAL REGISTRY: Trial registration NCT02708498. Date of registration 26 February 2016.


Assuntos
Atividades Cotidianas/psicologia , Família/psicologia , Cuidados Paliativos/métodos , Qualidade de Vida/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Previsões , Humanos , Masculino , Casas de Saúde , Inquéritos e Questionários
15.
J Autism Dev Disord ; 49(11): 4390-4399, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31372802

RESUMO

Preschool children with autism spectrum disorder (ASD) experience slower development of daily living skills (DLS) that are essential for independent functioning compared to typically developing children. Few studies have examined the trajectories of DLS in preschoolers with ASD and the existing literature has reported conflicting results. This study examined DLS trajectories and potential covariates for preschoolers with ASD from a multi-site longitudinal study following children from diagnosis to the end of grade 1. Multi-level modeling was conducted with DLS domain scores from the Vineland Adaptive Behavior Scales-2. The results demonstrated a positive trajectory of increasing scores over time, associations of age of diagnosis, developmental level, stereotypy, and language skills with the mean score at T4 or age 6 years, whereas rate of change was only associated with ASD symptom severity, such that an improvement in DLS trajectory was associated with lower and improving ASD symptom severity.


Assuntos
Atividades Cotidianas/psicologia , Transtorno do Espectro Autista/psicologia , Criança , Desenvolvimento Infantil , Linguagem Infantil , Pré-Escolar , Feminino , Humanos , Estudos Longitudinais , Masculino , Análise Multinível , Índice de Gravidade de Doença , Fatores de Tempo
16.
Acta Clin Croat ; 58(1): 3-12, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31363319

RESUMO

Pulmonary hypertension (PH) is a chronic disease which severely impairs quality of life (QoL). The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) is the first disease-specific tool to assess patient-reported symptoms, functioning and QoL in PH patients. The aim of this study was to adapt and validate the CAMPHOR for use in Croatia. The adaptation process involved three stages: translation (bilingual and lay panel), cognitive debriefing interviews with patients and psychometric validation. For the latter stage, a postal survey was conducted with 50 patients to examine the reliability and validity of the adapted scale. All three scales of the Croatian CAMPHOR demonstrated excellent internal consistency (Symptoms = 0.93; Activity limitations = 0.94; QoL = 0.92) and test-retest reliability correlations (Symptoms = 0.90; Activity limitations = 0.95; QoL = 0.90). Predicted correlations with the SF-36 scales provided evidence for construct validity of the CAMPHOR scales. Evidence for known group validity was shown by the ability of the scales to distinguish between participants based on patient-perceived general health and disease severity. The Croatian version of the CAMPHOR is a valid and reliable tool for use in clinical routine and clinical research.


Assuntos
Hipertensão Pulmonar/psicologia , Qualidade de Vida/psicologia , Índice de Gravidade de Doença , Inquéritos e Questionários/normas , Atividades Cotidianas/psicologia , Adaptação Fisiológica , Adulto , Idoso , Croácia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Tradução
17.
Acta Clin Croat ; 58(1): 157-166, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31363338

RESUMO

The most severe effects of rheumatoid arthritis (RA) are loss of physical function and chronic pain, which may have a major impact on different areas of the person's existence. The aim of this study was to get an insight into the quality of life (QOL) in subjects with RA in connection with pain perception and functional ability. The following instruments were used: the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), Short Form Health Survey (SF-36), Health Assessment Questionnaire Disability Index (HAQ-DI) and Visual Analog Scale for Pain (VAS Pain). The results indicated that there was no statistical difference in the QOL between subjects with RA and healthy population according to SF-36 Croatian norms. Also, the results showed that stronger pain experience was significantly associated with poorer social functioning assessment (SF36SF, Spearman's rho=-0.463, p<0.05), poorer general health perception (SF36GH, Spearman's rho=-0.432, p<0.05) and poorer physical functioning (WHOPH, Spearman's rho=-0.688, p<0.01). Furthermore, the subjects evaluating their general functional state worse were found to have worse physical functioning (SF36PF, Spearman's rho=-0.699 and WHOPH, Spearman's rho=-0.769), poorer social functioning (SF36SF, Spearman's rho=-0.580) and experienced greater pain intensity (SF36BP, Spearman's rho=-0.652). Therefore, additional efforts should be invested to define a holistic and integrative model of treatment and rehabilitation of people with RA, focused on pain relief, improvement of functional ability, encouraging social interaction and supporting positive emotional responses.


Assuntos
Atividades Cotidianas/psicologia , Artrite Reumatoide/psicologia , Nível de Saúde , Qualidade de Vida/psicologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/psicologia , Autoimagem , Inquéritos e Questionários
18.
Int J Qual Stud Health Well-being ; 14(1): 1658843, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31451104

RESUMO

Purpose: The aim of this study is to describe young women's (16-25 years old) experiences of living with existential concerns for which they have sought support from healthcare professionals, teachers, family, or friends, among others. Methods: This phenomenological study is based on a reflective lifeworld research (RLR) approach. Nine young women were interviewed about their experience of living with existential concerns. Results: The results show the essential meaning of the phenomenon of "existential concerns" that can be described as living a life that is marked in a profound way by a feeling of being lost in an unknown terrain. To further understand the essential meaning, four constituents are described: the unpredictable body, longing for comprehension, playing a game, and longing to share one's vulnerability. Conclusions: Young women with existential concerns are vulnerable, as they are profoundly influenced by these concerns. They have to navigate through daily life while trying to fit in and to make their situation comprehensible. These young women have a longing to share their existential concerns with a trustworthy person, while at the same time they fear revealing their existential concerns and risking being rejected by others. A lifeworld-led, caring science approach, intertwined with the results of the present study, has the potential to direct caring practice.


Assuntos
Atividades Cotidianas/psicologia , Adaptação Psicológica , Existencialismo/psicologia , Qualidade de Vida/psicologia , Adolescente , Adulto , Feminino , Humanos , Pesquisa Qualitativa , Suécia , Adulto Jovem
19.
Neuropsychology ; 33(8): 1121-1135, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31448941

RESUMO

OBJECTIVE: Compensatory strategies such as assistive technology, external reminders, and environmental cues may help support instrumental activities of daily living (IADLs) and independence. However, functional ability is most often evaluated in clinical settings where everyday compensation cannot be readily observed. The present study used a novel, real-world evaluation of everyday activities (prospective memory, household chores, complex IADLs, and planning tasks) to examine the impact of compensation. METHOD: Fifty community dwelling older adults were recruited with cognitive status ranging from healthy to mildly impaired. Participants completed a battery of validated performance-based and cognitive tasks, an IADL questionnaire (also completed by an informant), and real-world activities carried out in their own homes. RESULTS: The real-world evaluation demonstrated adequate interrater reliability (intraclass coefficient = 0.92) and construct validity (r = 0.55). Compensation improved real-world task outcome on prospective memory and household chores tasks. Further, cognition emerged as a moderator between compensation and prospective memory task outcome. Participants' ratings on an IADL questionnaire were related to real-world and performance-based functioning whereas informants' ratings were related to performance-based tasks and cognition. CONCLUSIONS: Our results suggest that proxy measures of functional ability (i.e., performance-based, cognitive, and IADL questionnaire measures) do not fully capture the complexity of real-world performance for nondemented community dwelling older adults. Compensation appeared to improve prospective memory performance, particularly for individuals with average to low average cognitive abilities. A difference in IADL questionnaire ratings suggest that participants may be better able to judge their real-world performance than informants. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Atividades Cotidianas , Adaptação Psicológica/fisiologia , Envelhecimento/fisiologia , Disfunção Cognitiva/fisiopatologia , Testes Neuropsicológicos/normas , Atividades Cotidianas/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Vida Independente , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
20.
Qual Life Res ; 28(12): 3177-3185, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31352570

RESUMO

PURPOSE: To map the Shah-modified Barthel Index (SBI) to the Health Utility Index Mark III (HUI-3) in stroke patients, and to compare the performance of a recently developed method called the Mean Rank Method (MRM) against a popular method, the Ordinary Least Squares (OLS) method. METHODS: A cohort of 473 patients who had their first clinical stroke diagnosis and hospital admission and were assessed using the SBI and HUI-3 at 3 months and/or 12 months post-admission. Observations were split to form a training dataset (N = 473) and a validation dataset (N = 245). RESULTS: In the training dataset, the MRM using SBI total score as the predictor produced a mapped utility distribution that closely resembled the observed utility distribution. It had almost no shrinkage of the standard deviation (P = 0.542), whereas the OLS using SBI total score and SBI item scores under-estimated the standard deviation by 28% and 26%, respectively (each P < 0.001). The MRM mapping gave better fit in terms of smaller mean absolute error and larger intra-class correlation than the two versions of OLS mapping, whereas the OLS gave smaller mean-squared errors than the MRM. Multivariate regression analysis showed that the use of OLS-mapped utilities tended to under-estimate both the mean utility of people who had no comorbidity and the utility-comorbidity association as compared to the observed utility-comorbidity pattern although the differences did not reach statistical significance (each P > 0.05). The MRM-mapped utility showed utility-comorbidity pattern more similar to the observed. Similar findings were obtained from the validation dataset. CONCLUSIONS: The MRM performed well. Mapping functions are available to map the SBI to the HUI-3 Utility Index.


Assuntos
Atividades Cotidianas/psicologia , Nível de Saúde , Qualidade de Vida/psicologia , Acidente Vascular Cerebral/psicologia , Inquéritos e Questionários , Feminino , Humanos , Análise dos Mínimos Quadrados , Masculino , Pessoa de Meia-Idade
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