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1.
BMC Musculoskelet Disord ; 20(1): 439, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31597562

RESUMO

BACKGROUND: Chronic low back pain (LBP) is a leading cause of disability worldwide. Biopsychosocial rehabilitation programs have been advocated for its management, especially since the widespread acceptance of the biopsychosocial model of chronic pain. Despite extensive evidence of its short-term benefits, few studies have reported on its long-term effect and more specifically on indirect outcomes such as return to work and quality of life (QoL). The present study evaluated the long-term effect of a multidisciplinary biopsychosocial rehabilitation (MBR) program for patients with chronic LBP, for which short- and intermediate-term efficacy had been established, with an emphasis on recovering work capability. METHODS: This prospective cohort study enrolled 201 patients on a four-week MBR program incorporating physical and occupational therapies and psychological counselling. Assessments occurred at program admission and discharge and at 6 and 18 months. Work capability, Oswestry Disability Index, Tampa Scale for Kinesiophobia, Core Outcome Measures Index (COMI), and Hospital Anxiety and Depression Scale were assessed. Multiple mixed models were used to detect changes in each outcome. Logistic regressions were calculated to identify predictors of recovery of work capability. RESULTS: Of the 201 patients who fulfilled the eligibility criteria, 160 (79.8%) attended the discharge assessment, 127 (63.2%) attended the 6-month follow-up, and 107 (53.3%) continued to the 18-month follow-up. Initially, 128 patients (71.5%) had been on sick leave. At 6 and 18 months, 72 (56.7%) and 84 (78.5%) participants had recovered their work capability, respectively. There were significant improvements in pain, disability, kinesiophobia, and anxiety and depression scores over time. Patients who recovered work capability showed significantly greater improvements in their total COMI score, general QoL, and disability, which were the best three predictors of recovering work capability. CONCLUSIONS: This study extends previous results confirming the program's contribution to recovering work capability among chronic LBP patients.


Assuntos
Ansiedade/reabilitação , Dor Crônica/reabilitação , Depressão/reabilitação , Dor Lombar/reabilitação , Terapia Ocupacional/métodos , Reabilitação Psiquiátrica/métodos , Adulto , Ansiedade/diagnóstico , Ansiedade/etiologia , Dor Crônica/complicações , Dor Crônica/diagnóstico , Dor Crônica/psicologia , Terapia Combinada/métodos , Depressão/diagnóstico , Depressão/etiologia , Avaliação da Deficiência , Feminino , Seguimentos , Humanos , Dor Lombar/complicações , Dor Lombar/diagnóstico , Dor Lombar/psicologia , Masculino , Pessoa de Meia-Idade , Medição da Dor , Equipe de Assistência ao Paciente , Questionário de Saúde do Paciente , Estudos Prospectivos , Qualidade de Vida , Resultado do Tratamento
2.
Res Dev Disabil ; 94: 103495, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31499380

RESUMO

BACKGROUND: Research evidence from studies in North America on the relationships between family-centered practices, parents' self-efficacy beliefs, parenting confidence and competence beliefs, and parents' psychological well-being was used to confirm or disconfirm the same relationships in two studies in Spain. AIMS: The aim of Study 1 was to determine if results from studies in North America could be replicated in Spain and the aim of Study 2 was to determine if results from Study 1 could be replicated with a second sample of families in Spain. METHODS AND PROCEDURES: A survey including the study measures was used to obtain data needed to evaluate the relationships among the variables of interest. The participants were 105 family members in Study 1 and 310 family members in Study 2 recruited from nine early childhood intervention programs. Structural equation modeling was used to test the direct and indirect effects of the study variables on parents' well-being. OUTCOMES AND RESULTS: Results showed that family-centered practices were directly related to both self-efficacy beliefs and parenting beliefs, and indirectly related to parents' psychological well-being mediated by belief appraisals. CONCLUSION AND IMPLICATIONS: The pattern of results was similar to those reported in other studies of family-centered practices. Results indicated that the use of family-centered practices can have positive effects on parent well-being beyond that associated with different types of belief appraisals.


Assuntos
Deficiências do Desenvolvimento , Crianças com Deficiência , Saúde da Família , Saúde Mental , Pais/psicologia , Reabilitação Psiquiátrica , Adulto , Pré-Escolar , Deficiências do Desenvolvimento/epidemiologia , Deficiências do Desenvolvimento/psicologia , Crianças com Deficiência/psicologia , Crianças com Deficiência/reabilitação , Feminino , Humanos , Masculino , Poder Familiar/psicologia , Reabilitação Psiquiátrica/métodos , Reabilitação Psiquiátrica/psicologia , Sistemas de Apoio Psicossocial , Autoeficácia , Espanha/epidemiologia
3.
Res Dev Disabil ; 94: 103477, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31494354

RESUMO

BACKGROUND: Disability support organisations have embraced Active Support, but it has proved difficult to embed in services. AIMS: This study aimed to identify the factors associated with increases over time in the quality of Active Support. METHOD: Data were collected on the predicted variable of the quality of Active Support, and predictor variables of service user, staff and service characteristics, including practice leadership, and composition and size of services from 51 services in 8 organisations over 2-7 time points. Data were analysed using multi-level modelling. RESULTS: There was significant linear change in Active Support scores (group mean centered at the organisational level) over time. Individuals with lower support needs received better Active Support and those with higher support needs experienced greater increases over time. Stronger practice leadership and more staff with training in Active Support were significant predictors of the quality of Active Support. Larger services with seven or more individuals and where there was a very heterogeneous mix of individuals were associated with lower quality of support. CONCLUSIONS: Ensuring strong practice leadership, and staff training in Active Support that emphasises the principle of adapting support to each individual's level of ability and preferences are key to delivering high levels of Active Support.


Assuntos
Deficiência Intelectual , Participação nas Decisões/normas , Reabilitação Psiquiátrica , Sistemas de Apoio Psicossocial , Melhoria de Qualidade/organização & administração , Serviço Social , Desenvolvimento de Pessoal/normas , Engajamento no Trabalho , Adulto , Austrália , Participação da Comunidade/métodos , Pessoas com Deficiência/psicologia , Feminino , Humanos , Deficiência Intelectual/psicologia , Deficiência Intelectual/reabilitação , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Reabilitação Psiquiátrica/métodos , Reabilitação Psiquiátrica/organização & administração , Reabilitação Psiquiátrica/normas , Qualidade da Assistência à Saúde , Serviço Social/métodos , Serviço Social/organização & administração , Serviço Social/normas
4.
Psychiatr Rehabil J ; 42(3): 329, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31464484

RESUMO

In our clinical work with veterans experiencing serious mental illness and substance use disorders, we noticed specific challenges not commonly addressed with traditional dual recovery group therapy-including having overactive threat systems and feelings of shame and self-criticism. For a program development project at our Veterans Affairs Psychosocial Rehabilitation and Recovery Center, we designed and implemented a group therapy program based on Compassion Focused Therapy (CFT), a therapeutic model that directly addresses the aforementioned challenges (Gilbert, 2009b). Results from pre- and post-intervention measures suggested veterans gained compassion and mindfulness skills and experienced reduced depressive symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Depressão/terapia , Empatia , Transtornos Mentais/terapia , Reabilitação Psiquiátrica/métodos , Psicoterapia de Grupo/métodos , Transtornos Relacionados ao Uso de Substâncias/terapia , Veteranos , Adulto , Diagnóstico Duplo (Psiquiatria) , Humanos , Estados Unidos , United States Department of Veterans Affairs
5.
Psychiatr Rehabil J ; 42(3): 296-304, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31070444

RESUMO

OBJECTIVE: A subset of military veterans who have experienced both traumatic brain injury and psychological trauma present with chronic neuropsychiatric symptoms and experience persistent obstacles to social reintegration. This project aimed to develop a novel treatment targeting the unmet social rehabilitation needs of these veterans. Initial intervention development, feasibility, and outcome data are explored. METHOD: Four treatment groups were conducted (n = 20). A treatment workbook was developed during Groups 1 and 2 (n = 10) and research data were collected from Groups 3 and 4 (n = 10). RESULTS: There was a 0% attrition rate across all groups with unanimous requests for additional sessions. T test effect sizes were analyzed with bias-corrected Hedges' g. Improvements were observed on measures of depression (p = .026, g = 0.73), empathic perspective taking (p = .007, g = 0.94), social cognition (p = .002-.678, g = 0.27-1.30 across multiple measures), social relationships (p = .007, g = 1.50), traumatic brain injury-related quality of life (social: p = .014, g = 0.68, emotional: p = .009, g = 1.28) and nonsocial executive functioning (p = .006, g = 0.54). CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Preliminary evidence from this exploratory study suggests that targeting multiple layers of social competence using a combined psychotherapy and cognitive rehabilitation approach holds promise. Larger, controlled studies are needed to further evaluate the feasibility and efficacy of this intervention. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Lesões Encefálicas Traumáticas/reabilitação , Reabilitação Psiquiátrica/métodos , Trauma Psicológico/reabilitação , Psicoterapia de Grupo/métodos , Participação Social , Percepção Social , Habilidades Sociais , Veteranos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos , Veteranos/psicologia
7.
Asian J Psychiatr ; 42: 67-73, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30974306

RESUMO

OBJECTIVE: The persistent disability and low Quality of Life (QoL) are the impacts of schizophrenia. Community-Based Rehabilitation (CBR) is recommended for people with schizophrenia. The objective of this study is to analyze the effectiveness of CBR to improve the quality of life of people with schizophrenia. METHODS: It was a quasi-experimental study, conducted in February-December 2017, in Yogyakarta, Indonesia. Subjectwere people with schizophrenia, 18-56 years old, with their caregiver. CBRintervention using psychoeducation module and social skill module during 12 weeks. It was conducted by local health workers, sub district social welfare workers, community health workers (called Kader in Indonesia) and supervised by a psychiatrist. The QoL was assessed using a validated measuring instrument at the baseline and at the week 16. Hypothesis test using Wilcoxon test RESULTS: There were 100 people with schizophrenia involved in the study. They were divided into intervention group and control group. Every group consists of 50 subjects. Both groups had similar characteristics at the baseline. The intervention group received CBR, whereas the control group didn't. Thirty-four people (68%) of intervention group increased their QoL, whereas in the control group there were twenty-three people (46%) increased their QoL. The QoL decrease occurred in one subject (4%) from the control group. Other subjects had constant QoL. Improvement of QoL in the intervention group is higher than the control group (p < 0.05). CONCLUSIONS: CBR is effective for improving the QoL of people with schizophrenia in the community. CBR is conducted by the health worker and sub-district social welfare worker.


Assuntos
Serviços de Saúde Comunitária/métodos , Educação de Pacientes como Assunto/métodos , Reabilitação Psiquiátrica/métodos , Psicoterapia/métodos , Qualidade de Vida , Esquizofrenia/reabilitação , Habilidades Sociais , Adolescente , Adulto , Feminino , Humanos , Indonésia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
8.
BMC Med Res Methodol ; 19(1): 59, 2019 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-30876403

RESUMO

BACKGROUND: Evaluation of complex interventions should include a process evaluation to give evaluators, researchers, and policy makers greater confidence in the outcomes reported from RCTs. Implementation fidelity can be part of a process evaluation and refers to the degree to which an intervention is delivered according to protocol. The aim of this implementation fidelity study was to evaluate to what extent a dialogue-based psychosocial intervention was delivered according to protocol. A modified conceptual framework for implementation fidelity was used to guide the analysis. METHODS: This study has an explanatory, sequential two-phase mixed methods design. Quantitative process data were collected longitudinally along with data collection in the RCT. Qualitative process data were collected after the last data collection point of the RCT. Descriptive statistical analyses were conducted to describe the sample, the intervention trajectories, and the adherence measures. A scoring system to clarify quantitative measurement of the levels of implementation was constructed. The qualitative data sources were analyzed separately with a theory-driven content analysis using categories of adherence and potential moderating factors identified in the conceptual framework of implementation fidelity. The quantitative adherence results were extended with the results from the qualitative analysis to assess which potential moderators may have influenced implementation fidelity and in what way. RESULTS: The results show that the core components of the intervention were delivered although the intervention trajectories were individualized. Based on the composite score of adherence, results show that 80.1% of the interventions in the RCT were implemented with high fidelity. Although it is challenging to assess the importance of each of the moderating factors in relation to the other factors and to their influence on the adherence measures, participant responsiveness, comprehensiveness of policy description, context, and recruitment appeared to be the most prominent moderating factors of implementation fidelity in this study. CONCLUSIONS: This evaluation of implementation fidelity and the discussion of what constitutes high fidelity implementation of this intervention are crucial in understanding the factors influencing the trial outcome. The study also highlights important methodological considerations for researchers planning process evaluations and studies of implementation fidelity. TRIAL REGISTRATION: ClinicalTrials.gov , NCT02338869; registered 10/04/2014.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Cooperação do Paciente/estatística & dados numéricos , Reabilitação Psiquiátrica/métodos , Reabilitação Psiquiátrica/estatística & dados numéricos , Acidente Vascular Cerebral/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , /estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde/métodos , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Projetos de Pesquisa/normas
9.
J Adv Nurs ; 75(8): 1702-1712, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30883846

RESUMO

AIMS: This study examined (a) psychosocial health care needs of people with type 2 diabetes from the perspective of patients and diabetes healthcare providers in primary care, in terms of topics, attention in diabetes care and preferences and (b) factors associated with a positive attitude towards specialized psychosocial health care. DESIGN: Qualitative focus group study. METHODS: Using purposive sampling, participants were selected from general practices. In 2012-2013, three focus groups were conducted in people with type 2 diabetes (N = 20) and three with healthcare providers (N = 18). RESULTS: Opinions differed considerably on whether there was a need for psychosocial health care. Topics focused mainly on diabetes-specific issues ranging from a need for additional diabetes education to attention and support in regular diabetes care. However, not all healthcare providers felt competent enough to address psychosocial problems. Some participants reported a need for specialized psychosocial help. A positive attitude towards specialized psychosocial health care appeared to be influenced by care setting (e.g., in the primary care practice or 'outside' mental health care), care accessibility, proactive discussion of psychosocial issues with and referral by healthcare providers and previous experiences with psychosocial health care. CONCLUSION: Although only few participants expressed a need for specialized psychosocial care, attention for psychosocial well-being in regular diabetes care was generally appreciated. IMPACT: People with type 2 diabetes generally felt psychosocial care could be provided as part of regular diabetes care. Suggestions for healthcare providers to meet psychosocial health care needs include training and discussion tools.


Assuntos
Atitude do Pessoal de Saúde , Diabetes Mellitus Tipo 2/psicologia , Diabetes Mellitus Tipo 2/reabilitação , Pessoal de Saúde/psicologia , Pacientes/psicologia , Atenção Primária à Saúde , Reabilitação Psiquiátrica/métodos , Adulto , Idoso , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
10.
J Clin Psychiatry ; 80(1)2019.
Artigo em Inglês | MEDLINE | ID: mdl-30865789

RESUMO

Despite the availability of effective treatments for MDD, many individuals have difficulty achieving remission. Residual symptoms can be difficult to differentiate from treatment side effects. Through 2 comic-based case presentations, this CME activity depicts common clinical scenarios and provides evidence-based strategies for effectively identifying and managing residual symptoms of MDD.


Assuntos
Transtorno Bipolar , Educação em Saúde/métodos , Pais/educação , Educação de Pacientes como Assunto/métodos , Reabilitação Psiquiátrica/métodos , Psicotrópicos/uso terapêutico , Adulto , Transtorno Bipolar/psicologia , Transtorno Bipolar/terapia , Criança , Saúde da Família , Humanos , Pais/psicologia
11.
Psychiatr Rehabil J ; 42(3): 268-276, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30907609

RESUMO

OBJECTIVE: The objective of this study was to test effectiveness and feasibility of equine-facilitated cognitive processing therapy (EF-CPT), a manualized adaptation of the cognitive processing therapy model for veterans with posttraumatic stress disorder (PTSD) championed by the Department of Veterans Affairs, in which equine-facilitated activities are integrated into face-to-face sessions. METHOD: Twenty-seven veterans with a diagnosis of PTSD participated (Mage = 51; 78% male) in a pretest-posttest design. Veterans were seen by a single psychologist for 12 sessions of individual EF-CPT. Instruments included: PTSD Checklist (PCL), Trauma Related Guilt Inventory (TRGI), Working Alliance Inventory (WAI), and the Human Animal Bond Scale (HABS). We hypothesized improvement on all measures, low attrition, and good model fidelity. Paired sample t tests were conducted using SPSS. RESULTS: PCL scores improved significantly (M1 = 68.25, M2 = 35.96, p ≤ .001), as did TRGI scores (p ≤ .001 on all scales). HABS and WAI indicated good working relationship. Two individuals attended one session and did not return (both under the age of 50); there was no other attrition (7% rate). Audio of sessions was reviewed for fidelity; there were variations in temporal order of session plans, which is within the acceptable flexibility of the manual. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This manualized intervention has promise as an effective and well-tolerated treatment for veterans with PTSD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Terapia Assistida por Animais/métodos , Terapia Cognitivo-Comportamental/métodos , Reabilitação Psiquiátrica/métodos , Transtornos de Estresse Pós-Traumáticos/reabilitação , Veteranos , Adulto , Idoso , Animais , Estudos de Viabilidade , Feminino , Cavalos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estados Unidos , United States Department of Veterans Affairs
12.
BMC Psychiatry ; 19(1): 55, 2019 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-30717713

RESUMO

BACKGROUND: Clinically operated community-based residential rehabilitation units (Community Rehabilitation Units) are resource intensive services supporting a small proportion of the people with severe and persisting mental illness who experience difficulties living in the community. Most consumers who engage with these services will be diagnosed with schizophrenia or a related disorder. This review seeks to: generate a typology of service models, describe the characteristics of the consumers accessing these services, and synthesise available evidence about consumers' service experiences and outcomes. METHOD: A systematic review was undertaken to identify studies describing Community Rehabilitation Units in Australia, consumer characteristics, and evidence about consumer experiences and outcomes. Search strings were applied to multiple databases; additional records were identified through snowballing. Records presenting unique empirical research were subject to quality appraisal. RESULTS: The typology defined two service types, Community-Based Residential Care (C-BRC), which emerged in the context of de-institutionalisation, and the more recent Transitional Residential Rehabilitation (TRR) approach. Key differentiating features were the focus on transitional care and 'recovery' under TRR. Schizophrenia spectrum disorders were the most common primary diagnosis under both service types. TRR consumers were more likely to be male, referred from community settings, and less likely to be subject to involuntary treatment. Regarding outcomes, the limited quantitative evidence (4 records, 2 poor quality) indicated C-BRC was successful in supporting the majority of consumers transferred from long-term inpatient care to remain out of hospital. All qualitative research conducted in C-BRC settings was assessed to be of poor quality (3 records). No methodologically sound quantitative evidence on the outcomes of TRR was identified. Qualitative research undertaken in these settings was of mixed quality (9 records), and the four records exploring consumer perspectives identified them as valuing the service provided. CONCLUSIONS: While there is qualitative evidence to suggest consumers value the support provided by Community Rehabilitation Units, there is an absence of methodologically sound quantitative research about the consumer outcomes achieved by these services. Given the ongoing and increasing investment in these facilities within the Australian context, there is an urgent need for high-quality research examining their efficiency and effectiveness. TRIAL REGISTRATION: PROSPERO ( CRD42018097326 ).


Assuntos
Serviços Comunitários de Saúde Mental/métodos , Transtornos Mentais/terapia , Reabilitação Psiquiátrica/métodos , Tratamento Domiciliar/métodos , Índice de Gravidade de Doença , Adulto , Austrália/epidemiologia , Serviços Comunitários de Saúde Mental/tendências , Humanos , Pacientes Internados/psicologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Reabilitação Psiquiátrica/tendências , Tratamento Domiciliar/tendências
13.
Psychiatr Rehabil J ; 42(2): 201-205, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30688476

RESUMO

OBJECTIVE: Our goal was to develop and pilot a methodology that could reliably identify therapeutic homework tasks that are coherent with the goals of individuals receiving mental health recovery support. METHOD: The content of goals and therapeutic homework tasks of 66 clients were classified using the Camberwell Assessment of Need Goal-Action Plan (CAN-GAP) taxonomy. Goal-homework pairs were considered coherent if the content of the homework and goal were both independently assigned the same content domain. RESULTS: The content of the goals and homework tasks were found to be highly coherent, with a 75% match in categories. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: It is possible to simply, and reliably, determine whether the content of goals and homework tasks are coherent. Lower coherence would require support workers to spend more time making the connection between homework and goals more explicit. Future research should determine whether higher coherence leads to greater goal attainment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Metas , Transtornos Mentais/reabilitação , Serviços de Saúde Mental/normas , Reabilitação Psiquiátrica/métodos , Reabilitação Psiquiátrica/normas , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Projetos Piloto , Adulto Jovem
14.
J Psychosoc Nurs Ment Health Serv ; 57(6): 39-44, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-30602052

RESUMO

The current study investigated the effectiveness of a state-wide Community Support Services training grounded in work-based learning to improve knowledge about psychiatric rehabilitation principles and skills. Supervisory staff and direct care staff in supported housing settings completed a 17-item, multiple choice, preand posttest after attending a 48-hour training series. Results indicated that participants gained psychiatric rehabilitation knowledge. These findings support the effectiveness of the training series grounded in work-based learning. [Journal of Psychosocial Nursing and Mental Health Services, 57(6), 39-44.].


Assuntos
Habitação , Transtornos Mentais/reabilitação , Enfermagem Psiquiátrica/educação , Reabilitação Psiquiátrica/educação , Adulto , Avaliação Educacional/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reabilitação Psiquiátrica/métodos
15.
Disabil Rehabil ; 41(8): 896-903, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-29228834

RESUMO

PURPOSE: Improved quality of life is an important outcome for adults with autism spectrum disorder. However, little research has examined factors associated with quality of life among adults with autism spectrum disorder. METHOD: This study comparing 66 adults with autism spectrum disorder (intelligence quotient > 70) aged 20-38 years with neuro-typical adults investigated their quality of life and related factors. All the participants were interviewed with questionnaires by a registered occupational therapist. RESULTS: Participants with autism spectrum disorder scored significantly lower in all domains of quality of life than did the controls. Adults with autism spectrum disorder reported higher anxiety level, more loneliness, and higher scores on four sensory quadrants than neuro-typical adults. The predictors of the physical health domain were anxiety and sensation-sensitivity behaviors. Loneliness and sensation-sensitivity behaviors were predictive of the psychological health domain. Comorbid psychiatric disorders and loneliness were predictive of the social relationship domain. CONCLUSIONS: Adults with autism spectrum disorder need more supportive social contexts and interventions to improve their quality of life. Social relationships, psychological health, and sensory processing difficulty must be considered when designing treatment programs for adults with autism spectrum disorder. Implications for Rehabilitation Adults with autism spectrum disorder scored significantly lower in all domains of quality of life than did the neuro-typical adults. Occupational therapy can provide more supportive social contexts and interventions on social relationship and sensory processing difficulty to improve their quality of life. Understanding factors associated with quality of life among adults with autism spectrum disorder can contribute to address their needs. Occupational therapy can facilitate health promotion through working with adults with autism spectrum disorder. Social relationships, psychological health, and sensory processing difficulty must be considered when designing treatment programs for adults with autism spectrum disorder.


Assuntos
Ansiedade , Transtorno do Espectro Autista , Testes de Inteligência , Solidão , Terapia Ocupacional , Qualidade de Vida , Apoio Social , Adulto , Ansiedade/etiologia , Ansiedade/psicologia , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/psicologia , Transtorno do Espectro Autista/reabilitação , Feminino , Humanos , Masculino , Determinação de Necessidades de Cuidados de Saúde , Terapia Ocupacional/psicologia , Terapia Ocupacional/normas , Reabilitação Psiquiátrica/métodos , Inquéritos e Questionários
16.
Disabil Rehabil ; 41(8): 879-886, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-29233002

RESUMO

OBJECTIVE: Evaluate, code and qualify the participation of Brazilian stroke survivors based on the international classification of functioning, disability and health (ICF) and identify predictors of post-stroke participation. METHODS: An exploratory, observational, cross-sectional study was conducted involving 78 individuals with hemiparesis stemming from a stroke. The stroke specific quality of life (SS-QOL) was used to evaluate the participation component of the ICF. The geriatric depression scale was used to screen depressive symptoms; the functional independence measure (FIM) was used to measure the degree of dependence; grip strength was determined using a dynamometer; and cognitive status was evaluated using the mini mental state examination. The one-way analysis of variance followed by the Bonferroni test was used for the comparison the participation scores of different groups (age and marital status). The independent t-test was used for the comparisons of the other groups (sex, time since the occurrence of stroke (<12 months or >12 months) and degree of functional independence). Multiple linear regression was employed to identify measures capable of predicting participation. RESULTS: Based on the classification and qualifiers of the ICF, the individuals analyzed exhibited a moderate level of participation. Participation was significantly associated with time since the occurrence of stroke (F = 2.46; 95% confidence interval (CI) = -23.67-0.34; p = 0.05), degree of functional independence (F = 2.40; 95% CI = -33.0 to -18.93; p < 0.001) and marital status (married or widowed) (F = 2.6; p = 0.05). No statistically significant associations were found with regard to age, sex or affected side of the body. Functional independence was the main predictor of participation (F = 99.2; r2 = 0.57; p <0.001) and the occurrence of depressive symptoms was a moderate predictor (F =12.78; r2 = 0.40; p = 0.001). CONCLUSIONS: Twenty-four ICF categories were coded and qualified with the use of the SS-QOL, enabling the participation component of the ICF biopsychosocial model to be easily evaluated in clinical practice. Overall, the sample in the present study demonstrated a moderate decline in participation following a stroke and only the "social roles" domain was severely affected. The FIM was the main predictor of participation and the depression was a moderate predictor. Therefore, health professionals involved in the rehabilitation of these patients should focus on the promotion of functional independence and improvements in emotional health to optimize social participation following a stroke. Implications for Rehabilitation The Brazilian stroke individuals analyzed exhibited a moderate level of participation. Functional independence was the main predictor of participation and the occurrence of depressive symptoms was a moderate predictor. Age, sex and affected side of the body were not predictors of participation. Our findings support that twenty-four International classification of functioning, disability and health categories were coded and qualified with the use of the stroke specific quality of life. Rehabilitation of social functioning post stroke patients should be focused on the promotion of functional independence and improvement in emotional health. This study offers a participation assessment model that can facilitate the incorporation of the ICF in the clinical practice.


Assuntos
Reabilitação Psiquiátrica/métodos , Qualidade de Vida , Participação Social/psicologia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Atividades Cotidianas , Adulto , Idoso , Brasil/epidemiologia , Estudos Transversais , Avaliação da Deficiência , Feminino , Humanos , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/psicologia , Reabilitação do Acidente Vascular Cerebral/métodos , Reabilitação do Acidente Vascular Cerebral/psicologia
17.
Psychiatr Rehabil J ; 42(1): 57-63, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30010355

RESUMO

OBJECTIVE: To identify the strategies peer specialists use to provide illness self-management support for older adults with serious mental illness (SMI) through text messaging. METHOD: Transcripts of text message exchanges between 8 older adult participants with SMI who completed the PeerTECH intervention and 3 older adult certified peer specialists who delivered the 12-week program were analyzed. Text message analyses explored themes relevant to peer support and health behavior change. Quantitative data comprised frequency of text messages by either the peer or consumer. RESULTS: Consumers (N = 8) had a mean age of 68.8 years (SD = 4.9) and were mainly women (88%), White (100%), and married (75%). Certified peer specialists (N = 3) were all 55 or older; 100% were female, 66% identified as White, and 33% identified as African American. Overall, peers sent 215 text messages whereas consumers sent 141 text messages. In the peer specialist-consumer text message exchanges, we identified 4 themes on different aspects of illness self-management, including health behavior change, self-management therapeutic techniques, engagement in health technology, and peer support. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This exploratory qualitative study offers preliminary support that peers are able to use text messages to support the delivery of a peer-delivered home-based medical and psychiatric self-management intervention. Certified peer specialists can potentially provide a range of illness self-management support to older adults with SMI via text messaging. These findings will inform the development of standardized peer text-messaging services to augment evidence-based illness self-management interventions for older adults with SMI. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Pessoal Técnico de Saúde , Transtornos Mentais/reabilitação , Grupo Associado , Relações Profissional-Paciente , Reabilitação Psiquiátrica/métodos , Autogestão/métodos , Mensagem de Texto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Smartphone
18.
Psychiatr Rehabil J ; 42(1): 41-47, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30221966

RESUMO

OBJECTIVE: Despite the increase in arts-based programs in community rehabilitation services in many countries, little is known about how these programs are perceived by health professionals who can refer individuals with mental health conditions to community-based psychiatric rehabilitation services. This study examined how senior professionals with key positions in the public health system perceive the integration of the arts in community-based psychiatric rehabilitation services in Israel. METHOD: Semistructured interviews were conducted with 10 professionals. RESULTS: The thematic analysis revealed 2 main themes. The first reflected "the perceived position of arts-based programs among other rehabilitation services," and had 2 subthemes: arts as a legitimate supplemental service, and arts as a motivating rehabilitation. The second theme reflected "the unique contribution of the arts to recovery processes," and had 3 subthemes: art-making facilitates self-expression and communication and bypasses resistance, art-making facilitates socialization, and art-making shapes and enhances personal identity. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Because most of the professionals were exposed to the creative arts in their workplace, they valued their contribution to the rehabilitation process. Thus, direct contact can provide more information, more accurate perceptions, and a better understanding of the benefits of arts-based services, which may in turn encourage service managers and policymakers to include these services. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Terapia pela Arte , Atitude do Pessoal de Saúde , Serviços Comunitários de Saúde Mental , Transtornos Mentais/reabilitação , Reabilitação Psiquiátrica , Adulto , Terapia pela Arte/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reabilitação Psiquiátrica/métodos , Pesquisa Qualitativa
19.
Int Psychogeriatr ; 31(4): 527-535, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30277193

RESUMO

ABSTRACTObjectives:To explore the acceptance and effects of life review on older adults. DESIGN: A mixed-method study design was utilized in this study. SETTING: Four nursing homes located in Fuzhou, China. PARTICIPANTS: Sixty-two older adults from four nursing homes were selected according to the criteria set for this study. METHOD: Sixty-two older adults were randomly assigned to either the life review group or the control group, and 55 of them completed the study. Twenty-four participants took part in qualitative interviews after the life review program concluded. The Geriatric Depression Scale-15, Rosenberg Self-Esteem Scale, and Purpose in Life Test were adopted to measure depression, self-esteem, and meaning in life, respectively. RESULTS: The findings indicated that life review can reduce depressive symptoms and may be effective at improving self-esteem and meaning in life among Chinese elderly people. More importantly, it revealed that cultural factors such as values, beliefs, and attitudes could interfere with participation in a life review. CONCLUSIONS: A culturally sensitive life review program could be an alternative approach to psychotherapy for promoting mental health in older adults.


Assuntos
Depressão , Acontecimentos que Mudam a Vida , Reabilitação Psiquiátrica/métodos , Qualidade de Vida , Autoimagem , Idoso , China , Depressão/diagnóstico , Depressão/psicologia , Depressão/terapia , Feminino , Avaliação Geriátrica/métodos , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Humanos , Masculino , Casas de Saúde/estatística & dados numéricos , Técnicas Psicológicas , Sistemas de Apoio Psicossocial
20.
Dementia (London) ; 18(1): 8-35, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27380931

RESUMO

An influential review in 2010 concluded that non-pharmacological multi-component interventions have positive effects on cognitive functioning, activities of daily living, behaviour and mood of people with dementia. Our aim here is to provide an up-to-date overview of research into psychosocial interventions and their impact on psychosocial outcomes. We focused on randomised controlled trials, controlled studies and reviews published between October 2008 and August 2015, since the earlier review. The search of PsychInfo, Medline and the Cochrane database of systematic reviews yielded 61 relevant articles, organised into four themes echoing key phases of the care pathway: Living at home with dementia (five reviews, eight studies), carer interventions (three reviews, four studies), interventions in residential care (16 reviews, 12 studies) and end-of-life care (three reviews, two studies), along with an additional group spanning community and institutional settings (six reviews, two studies). Community findings suggested that appointment of dementia specialists and attention to case management can produce positive outcomes; physical therapies, cognitive training and modified cognitive behaviour therapy also had a range of benefits. There was more limited evidence of positive benefits for people with dementia through interventions with family carers. Thirty-two articles focused on the management of 'behavioural symptoms' through a range of interventions all of which had some evidence of benefit. Also a range of multi-component and specific interventions had benefits for cognitive, emotional and behavioural well-being of people with dementia in residential settings, as well as for quality of life. Overall, interventions tended to be short term with impact only measured in the short term. We recommend further research on interventions to promote living well in the community post-diagnosis and to address end-of-life care. Development of psychosocial interventions would benefit from moving beyond the focus on control of behaviours to focus on wider aspects of life for people with dementia.


Assuntos
Demência/reabilitação , Reabilitação Psiquiátrica/métodos , Sistemas de Apoio Psicossocial , Cuidadores , Demência/psicologia , Serviços de Assistência Domiciliar , Humanos , Serviços de Saúde Mental , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Instituições Residenciais , Assistência Terminal , Resultado do Tratamento
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