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A discussão sobre a assistência ao estudante universitário brasileiro não é recente. Entretanto, há escassez de pesquisas com base na ocupação, centrada no estudante e no ambiente universitário. Objetiva-se refletir sobre o Cuidado Centrado no Estudante, como uma proposta de promoção da saúde e bem-estar de estudantes universitários brasileiros. O artigo deriva de pesquisa científica realizada em uma universidade pública brasileira, fruto de uma tese de doutoramento, com estudantes das áreas da saúde e exatas, sobre demandas psicossociais do ambiente acadêmico. O recorte apresentado neste texto é a elaboração da proposta, que considera os problemas ocupacionais dos universitários e o contexto em que se inserem, a partir dos referenciais teóricos dos estudos da ocupação à luz do Modelo de Ocupação Humana. Esta proposta entende o estudante como protagonista do seu cuidado e realça a necessidade de compreender os fatores internos e externos que influenciam estes estudantes. O Cuidado Centrado no Estudante perpassa pelo fortalecimento de espaços e propostas relacionados aos serviços de apoio estudantil, baseado na prática de Terapia Ocupacional centrada no cliente como um caminho possível para promover oportunidades, prevenção do sofrimento psíquico, promoção da saúde e participação ocupacional para estudantes universitários.
La discusión sobre la asistencia a universitarios brasileños no es nueva. Sin embargo, son escasas las investigaciones basadas en la ocupación y centradas en el estudiante y el ambiente universitario. Se busca reflexionar alrededor del Cuidado Centrado en el Estudiante, como propuesta de promoción de la salud y el bienestar de estudiantes universitarios brasileños. El artículo se deriva de una tesis doctoral realizada en una universidad pública brasileña con estudiantes de las áreas de salud y ciencias exactas, sobre las demandas psicosociales del entorno académico. Se aborda la elaboración de la propuesta, que considera la problemática ocupacional del estudiantado y el contexto en el que se inserta, a partir de referentes teóricos de los estudios en ocupación, a la luz del Modelo de la Ocupación Humana. El Cuidado Centrado en el Estudiante entiende al estudiante como protagonista de su atención y evidencia la necesidad de comprender los factores internos y externos que le afectan, e implica el fortalecimiento de espacios y propuestas de los servicios de apoyo estudiantil, a partir de la práctica de la Terapia Ocupacional centrada en el cliente como posibilidad para promover oportunidades, prevenir el sufrimiento psíquico, promover la salud y la participación ocupacional de estudiantes universitarios
The discussion about assistance to Brazilian university students is not new. However, there is a scarcity of occupation-based, student-centered, and university-centered research. The objective of this study is to reflect on Student-Centered Care, as a proposal to promote the health and well-being of Brazilian university students. This article -the result of a doctoral thesis- derives from scientific research on the psychosocial demands of the academic environment carried out at a Brazilian public university with students from the areas of health and exact sciences. The excerpt presented in this text is the elaboration of the proposal, which considers the occupational problems of university students and the context in which they are immersed, based on the theoretical references of occupation studies in the light of the Human Occupation Model. This proposal understands the student as the protagonist of Student-Centered Care and highlights the need to understand the internal and external factors that influence it. Student-Cente-red Care involves the strengthening of spaces and proposals related to student support services based on the practice of client-centered Occupational Therapy as a possible way to promote opportunities, prevent psychological distress, and promote the health and participation of university students.
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Universities , Health Promotion , Students , Environment , OccupationsABSTRACT
Background: Balance dysfunction seems to be a common complaint in the elderly making them vulnerable to increased risk of fall. The Otago exercise program (OEP) consists of strength training, exercises to improve balance and cardiovascular function. Fall prevention programs in the elderly are of recent growing research interest; however, limited studies have been done on interventions aiming at enhancing activities of daily living (ADL). The aim of this study was to see the efficacy of OEP in enhancing ADL performance and improving balance in the geriatric population. Aims and Objectives: To study the effect of OEP on ADL, balance, and fall risk in the elderly. Materials and Methods: A sample of 100 subjects was recruited from Navodaya Medical College Hospital and Lalitha-Home for the Aged, Raichur. Balance was assessed with the Berg balance scale, strength was assessed using 30 s sit-to-stand, confidence in ADL performances was evaluated by the activities-specific balance confidence scale, and fall risk assessed by the 7-item Falls Efficacy Scale International. The subjects practiced warm-up, strengthening, and balance exercises of the program thrice a week for 3 months with alternate periods of walking. Results: Statistical analysis showed significant improvements in balance, strength, ADL performances, and reduction of fall risks. Conclusion: The study concludes that OEP improved both static and dynamic balance with enhanced participation in ADL performances and also aids in the decrement of fall risks in the elderly.
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Introducción: El envejecimiento poblacional y el aumento de enfermedades crónicas han incrementado la prevalencia de discapacidad en adultos mayores. Evaluar la capacidad funcional en actividades básicas de la vida diaria (ABVD) es esencial para mantener la independencia y calidad de vida. Este estudio se enfocó en evaluar la capacidad funcional de adultos mayores en ABVD en el ámbito familiar de Asunción en el año 2023. Materiales y métodos: Se realizó un estudio observacional, descriptivo, de corte transversal, en noviembre del 2023, con 91 adultos mayores (≥65 años) de Asunción, en hogares familiares. Se aplicaron encuestas mediante Google Formulario y se utilizó el Índice de Barthel para medir la capacidad funcional. El muestreo fue no probabilístico por bola de nieve. Se empleó estadística descriptiva e inferencial, con un nivel de significancia de p≤0,05. Se respetaron los aspectos éticos de la investigación. Resultados: Participaron 91 adultos mayores, con una edad promedio de 79 años±8,2. El 62,6% fueron mujeres y 41,8% del grupo de edad de 75 a 84 años. Según el Índice de Barthel, el 59,3% necesita ayuda para cortar alimentos y el 34,1% depende de otra persona para la higiene personal. El 28,6% tiene incontinencia en deposiciones y el 30,8% en micción. La puntuación promedio del Índice de Barthel fue 68,5±33,9, indicando dependencia leve en el 61,5% de los participantes. El 77% de los adultos mayores reciben cuidados de un familiar. Conclusión: Un alto porcentaje de los adultos mayores mostró algún grado de dependencia, especialmente en actividades de alimentación e higiene. La edad avanzada y el sexo femenino se asociaron con mayores niveles de dependencia. La mayoría de los adultos mayores dependieron de familiares para su cuidado, destacando la necesidad de fortalecer las redes de apoyo y capacitar a los cuidadores informales.
Introduction: Population aging and the increase in chronic diseases have raised the prevalence of disability in older adults. Evaluating functional capacity in basic activities of daily living (BADL) is essential to maintaining independence and quality of life. This study focused on evaluating the functional capacity of older adults in BADL within the family setting of Asunción in 2023. Material and methods: An observational, descriptive, cross-sectional study was conducted in November 2023, with 91 older adults (≥65 years) from Asunción, in family homes. Surveys were administered via Google Forms, and the Barthel Index was used to measure functional capacity. The sampling was non-probabilistic snowball sampling. Descriptive and inferential statistics were employed, with a significance level of p≤0.05. Ethical aspects of the research were respected. Results: Ninety-one older adults participated, with an average age of 79 years±8.2. Of these, 62.6% were women and 41.8% were in the age group of 75 to 84 years. According to the Barthel Index, 59.3% needed help cutting food, and 34.1% depended on another person for personal hygiene. Additionally, 28.6% had bowel incontinence, and 30.8% had urinary incontinence. The average Barthel Index score was 68.5±3.9, indicating mild dependence in 61.5% of participants. Furthermore, 77% of older adults received care from a family member. Conclusion: A high percentage of older adults showed some degree of dependence, especially in activities related to feeding and hygiene. Advanced age and female sex were associated with higher levels of dependence. Most older adults relied on family members for care, highlighting the need to strengthen support networks and train informal caregivers.
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Introduction: Psychological distress among older adults in India is a concerning issue due to the aging population, the unique challenges they face, and limited access to mental health resources. Understanding and addressing this concern are crucial for promoting better mental health and overall quality of life. This study aims to estimate the prevalence of psychological distress among older adults in selected subcenters of Budge Budge II block, West Bengal; and to find out the factors associated with psychological distress among the study participants. Methods: A descriptive cross?sectional study was conducted among 180 persons aged ?60 years from different subcenters of the Budge Budge II block selected by multistage random sampling from May 2023 to July 2023 by face-to-face interview using a predesigned, pretested, structured schedule comprising the Kessler Psychological Distress Scale. Multivariable binary logistic regression was done to identify the sociodemographic factors associated with psychological distress. Results: In this study among 180 elderly individuals, the mean age was 67 (±6.34) years, with 65.5% in the 60–69 age group. Nearly two-thirds (70.5%) had no psychological distress, while 18.9%, 5%, and 5.6% had mild, moderate, and severe distress, respectively. Participants who were belonging to the age group 70–79 years [aOR (95% confidence interval [CI]) = 3.31 (1.27–8.63)], widowed or separated (aOR [95% CI] = 3.53 [1.33–9.31]), functionally dependent (aOR [95% CI]) = (8.89 [1.49–53.23]), and economically dependent (aOR [95% CI] = 7.81 [3.21–19.03]) were statistically significant covariates of psychological distress. Conclusion: Nearly one?third of the elderly were suffering from psychological distress. Preventive measures for psychological disorders should be integrated into public health at the local level by providing specialist outpatient services to diagnose and treat common psychological disorders at the primary health center level.
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ResumenObjetivos: comprender el cotidiano de familiar de niños y niñas de enseñanza prebásica y básica en una escuela del sector Barranco Amarillo, región de Magallanes y Antártica Chilena; conocer la experiencia de cuidados relacionados con la prevención de la obesidad infantil y la promoción de la salud de sus familias. Método: estudio cualitativo, descriptivo-exploratorio, basado en la sociología comprensiva y del cotidiano de Michel Maffesoli, con la participación de doce familias. Resultados: las familias tienen conocimientos sobre una buena salud, tratando de comer de forma sana, pero les resulta difícil aplicarlos porque no encuentran una rutina apropiada, por el mayor costo de los alimentos saludables, el sedentarismo y la preferencia por comidas rápidas, entre otros. Conclusión: es preciso instaurar estrategias de intervención en la prevención de la obesidad infantil, teniendo como foco la promoción de la salud para una vida digna y saludable.
AbstractObjectives: to understand the daily life of families of boys and girls in pre-school and basic education in a school in the Barranco Amarillo sector, Magallanes and Chilean Antarctic Region; to know the experience of care related to the prevention of childhood obesity and the promotion of the health of their families. Method: qualitative, descriptive-exploratory study, based on the Comprehensive and Daily Sociology of Michel Maffesoli, with the participation of twelve families. Results: families have knowledge about good health, trying to eat healthy, but it is difficult for them to apply them because they do not find an appropriate routine, due to the higher cost of healthy foods, sedentary lifestyle, and the preference for fast foods, among others. Conclusion: it is necessary to establish intervention strategies in the prevention of childhood obesity, focusing on health promotion, for a dignified and healthy life
ResumoObjetivos: compreender o cotidiano das famílias de meninos e meninas na educação pré-escolar e básica em uma escola do setor Barranco Amarillo, Magalhães e Região Antártica Chilena; conhecer a experiência de cuidados relacionados à prevenção da obesidade infantil e à promoção da saúde de seus familiares. Método: estudo qualitativo, descritivo-exploratório, baseado na Sociologia Compreensiva e Cotidiana de Michel Maffesoli, com a participação de 12 famílias. Resultados: as famílias têm conhecimento sobre a boa saúde, procurando se alimentar de forma saudável, mas têm dificuldade em aplicá-los por não encontrarem uma rotina adequada devido ao maior custo dos alimentos saudáveis, sedentarismo e preferência por fast foods, entre outros. Conclusão:é necessário estabelecer estratégias de intervenção na prevenção da obesidade infantil, com foco na promoção da saúde para uma vida digna e saudável.
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Humans , Male , Female , Child, Preschool , Child , Primary Prevention , Activities of Daily Living , Family , Disease Prevention , Pediatric Obesity , Health PromotionABSTRACT
Introduction: The mental health issues faced by empty nesters deserve more attention. Studying self-perception of aging (SPA) and its influencing factors among empty nesters may help prevent negative SPA. Objective: To analyze situations and factors influencing SPA among elderly empty nesters, especially the mediating role of daily living ability and loneliness. Materials and Methods: A cross-sectional study was conducted in two communities in Binzhou City, Shandong Province of China. A total of 613 elderly empty nesters were studied using a self-designed general information questionnaire, the Brief Ageing Perception Questionnaire (B-APQ), the Activities of Daily Living (ADL) Scale, and the UCLA Loneliness Scale (ULS-6). Structural equation modeling (SEM) was used to analyze the relationships between variables. Results: Pathway analysis of SPA influencing factors shows that marital status, children's visits, and self-reported health had an indirect effect on SPA through loneliness. Chronic disease status had an indirect effect on SPA through daily living ability. Time outdoors had an indirect effect on SPA through activities of daily living and loneliness. Discussion: Daily life ability, chronic disease status, time outdoors, loneliness, self-reported health, marital status, and children's visits affected SPA among empty nesters. Conclusion: Empty nesters' SPA is relatively negative, and there are many influencing factors. It is important to improve empty nesters' abilities to manage healthcare tasks, increase outdoor activities and family members' care, and provide comprehensive interventions to help them navigate aging.
Introducción: Los problemas de salud mental que presentan las personas cuyos hijos ya no viven con ellas merecen mayor atención. El estudio de la autopercepción del envejecimiento y sus factores influyentes en esta población puede ayudar a la prevención de percepciones negativas del envejecimiento. Objetivo: Analizar las situaciones y factores influyentes en la autopercepción del envejecimiento de los adultos mayores cuyos hijos ya no viven con ellos, específicamente, el rol mediador de las actividades de la vida diaria y la soledad. Materiales y métodos: Se realizó un estudio transversal en 2 comunidades de la ciudad de Binzhou, provincia de Shandong, China. Se estudiaron 613 adultos mayores cuyos hijos ya no vivían con ellos, aplicando un cuestionario de información general, el Cuestionario Breve de Percepción del Envejecimiento (B-APQ), la Escala de Actividades de la Vida Diaria (ADL) y la Escala de Soledad de la Universidad de California (ULS-6). Se utilizaron modelos de ecuaciones estructurales para analizar las relaciones entre las variables. Resultados: El análisis de los factores influyentes en el envejecimiento autopercibido muestra que el estado civil, las visitas de los hijos y la soledad afectan de manera indirecta la autopercepción del envejecimiento. Asimismo, las enfermedades crónicas y la capacidad para realizar las actividades de la vida diaria afectan de manera indirecta la autopercepción del envejecimiento. Discusión: La capacidad para realizar actividades de la vida diaria, las enfermedades crónicas, salir, la soledad, el estado de salud autoreportado, el estado civil y las visitas de los hijos son algunos factores que influyen en la autopercepción del envejecimiento en esta población. Conclusión: La autopercepción del envejecimiento de las personas cuyos hijos ya no viven con ellas es relativamente negativa y hay muchos factores influyentes. Es importante mejorar el manejo que se le da a la salud de esta población, aumentando las actividades al aire libre y el cuidado de sus familiares e implementando intervenciones integrales para ayudarlos en el tratamiento del envejecimiento.
Introdução: Os problemas de saúde mental dos ninhos vazios merecem maior atenção. Estudar a autopercepção do envelhecimento da situação e os fatores de influência entre os ninhos vazios ajudaria os ninhos vazios a prevenirem a autopercepção negativa do envelhecimento. Objetivo: Analisar a situação e os fatores de influência da autopercepção do envelhecimento entre idosos de ninhos vazios, explicitando o papel mediador da capacidade de vida diária e da solidão nos fatores de influência da autopercepção do envelhecimento. Materiais e Métodos: Um estudo transversal foi realizado em 2 comunidades na cidade de Binzhou, na província de Shandong. 613 idosos de ninhos vazios foram pesquisados usando um questionário de informações gerais auto elaborado, Brief Aging Perceptions Questionnaire (B-APQ), Activities of Daily Living (ADL), Loneliness Scale-6 (ULS-6) e modelagem de equações estruturais foram usadas para analisar as relações entre as variáveis. Resultados: A análise do caminho da autopercepção do envelhecimento dos fatores que influenciam mostra: estado civil, filhos para visitar, autorrelato de saúde por meio da solidão tiveram efeito indireto na autopercepção do envelhecimento. O status de doenças crônicas através da capacidade de vida diária teve efeito indireto na autopercepção do envelhecimento. Sair de casa devido à capacidade de vida diária e à solidão teve efeito indireto na autopercepção do envelhecimento. Discussão: O efeito da capacidade de vida diária, doenças crônicas, saídas, solidão, autorrelato de saúde, estado civil e visita de crianças na autopercepção do envelhecimento entre pessoas com o ninho vazio. Conclusão: A autopercepção do envelhecimento dos ninhos vazios é relativamente negativa e há muitos fatores que influenciam. É importante melhorar a capacidade de gestão da saúde dos ninhos vazios, aumentar as atividades ao ar livre e o cuidado dos familiares, e adotar medidas de intervenção abrangentes para ajudá-los a tratar o envelhecimento.
Subject(s)
Self Concept , Activities of Daily Living , Aging , Factor Analysis, Statistical , LonelinessABSTRACT
O processo de envelhecimento pode levar a diminuição de habilidades motoras, o que pode comprometer a independência nas atividades diárias. A impressão 3D oferece possibilidades para a confecção de produtos assistivos personalizados e que auxiliam as atividades de vida diárias, melhorando o desempenho e promovendo maior independência. Este estudo relata uma experiência de avaliação de desempenho em uma tarefa simulada como parte do processo de alimentação, com o objetivo de explorar a influência do design de dispositivos assistivos na realização da atividade. Os resultados são discutidos de forma a explorar de que forma as avaliações de protótipos podem contribuir para o aprimoramento e proposição de soluções em design com vistas a promover a independência e satisfação dos usuários no desempenho de atividades diárias.(AU)
The aging process can lead to a decrease in motor skills, which can compromise independence in daily activities. 3D printing offers possibilities for the production of personalized assistive products that help with activities of daily living, improving performance and promoting greater independence. This study reports an experience of evaluating performance in a simulated task as part of the feeding process, with the aim of exploring the influence of the design of assistive devices on the performance of the activity. The results are discussed in order to explore how prototype evaluations can contribute to the improvement and proposal of design solutions with a view to promoting users' independence and satisfaction in the performance of daily activities.(AU)
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Male , Female , Aged , Aged, 80 and over , Self-Help Devices , Diet , Printing, Three-DimensionalABSTRACT
Background: Heart valve disease is a signi?cant and increasing global problem in the developing world. Valve surgery plays a central role in the management of acquired valvular heart disease. The optimal diagnostic evaluation, surgical treatment and post-operative care of these patients are only possible through a cooperative effort of the primary care physician, the cardiologist and the cardiac surgeon. The aim of this study is to evaluate the effectiveness of cardiac rehabilitation on depression, appetite and activities of daily living in post-operative valve replacement individuals. (21) This study evaluated the depression levels, appetite levels and activities of daily living levels to see the effect ofObjectives: cardiac rehabilitation in post-operative valve replacement individuals. An Experimental study of 30 participants of both genders,Methodology: male and female adults between the age group 25-45 years were included in the study. The study was done by direct markings with the help of 3 questionnaires respectively. Depression is assessed by using Hamilton Depression Rating Questionnaire (HDRQ), Appetite by using Simpli?ed Nutritional Appetite Appearance Questionnaire (SNAQ) and Activities of daily living is assessed by using Functional Independence Measure Questionnaire (FIM) on the post-operative Day-3 and at the Time of discharge respectively. The Individuals showed a signi?cant bene?cialResult: effect regarding depression, appetite and activities of daily living that is shown by the HDRQ, SNAQ & FIM Questionnaires. EarlyConclusion: cardiac rehabilitation appears to be an effective approach to improve the activities of daily living, mental health and appetite levels in post- operative valve replacement individuals.
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INTRODUCTION: Chronic neck pain (CNP) is a common musculoskeletal problem that affects a large proportion of the population and lasts longer than three months. It has a high cost in terms of life, disability, and healthcare. Several modalities have effectively provided immediate and long-term relief for CNP; however, the comparative clinical effectiveness of these modalities is limited. OBJECTIVES: The study aimed to determine the clinical effectiveness of Class IV Laser therapy and Therapeutic Ultrasound (TUS) in patients with CNP. METHODS AND MATERIALS: Forty-four patients with CNP of both genders were recruited from an age range of 2045 years from the Department of Musculoskeletal Physiotherapy of Maharishi Markandeshwar Institute of Physiotherapy, MM(DU), Ambala, India. They were divided into two groups at random: the LASER group A (n = 22) and the TUS group B (n = 22). The intervention duration was 2 weeks with 6 treatment sessions. Pre- and post-treatment outcome measures were assessed with the Visual Analog Scale (VAS), Algometer, Goniometer, and Neck Disability Index (NDI) questionnaires at baseline and after 2 weeks of intervention. The LASER group received a target dose of 10 joules per cm2 at a power of 10 watts, with a continuous dosage frequency. The TUS group underwent a continuous mode ultrasound (3 MHz, 1 W/cm2) for 6 minutes. The Shapiro-Wilk test was used to assess the normality of the data. For parametric and non-parametric data analysis within the group, the paired t-test and Wilcoxon signed rank were used. The independente t-test and Mann-U Whitney test were used for the group comparison of parametric and non-parametric data, respectively. RESULTS: In both groups, there was a significant improvement in all the outcome measures (p<0.001). There was a statistically significant difference between the two interventions in VAS, Pain Pressure Threshold (PPT), and NDI (p<0.05). CONCLUSION: Class IV Laser therapy is clinically more effective than therapeutic ultrasound in treating patients with chronic neck pain.
INTRODUÇÃO: A dor cervical crônica (DCC) é um problema musculoesquelético comum que afeta uma grande proporção da população e dura mais de três meses. Ela tem um alto custo em termos de vida, incapacidade e assistência médica. Várias modalidades têm proporcionado alívio imediato e de longo prazo para a dor cervical crônica; entretanto, a eficácia clínica comparativa dessas modalidades é limitada. OBJETIVOS: O objetivo do estudo foi determinar a eficácia clínica da terapia a laser de classe IV e do ultrassom terapêutico (UST) em pacientes com DCC. MÉTODOS E MATERIAIS: Quarenta e quatro pacientes com DCC de ambos os sexos, em uma faixa etária de 20 a 45 anos, foram recrutados do Departamento de fisioterapia musculoesquelética do Instituto de Fisioterapia Maharishi Markandeshwar, MM (DU), Ambala, Índia. Eles foram divididos em dois grupos de forma aleatória: o grupo LASER A (n = 22) e o grupo UST B (n = 22). A duração da intervenção foi de 2 semanas com 6 sessões de tratamento. As medidas de resultado pré e pós-tratamento foram avaliadas com os questionários Escala Visual Analógica (EVA), Algometer, Goniometer e Índice de Incapacidade do Pescoço (IIP) na linha de base e após 2 semanas de intervenção. O grupo LASER recebeu dose alvo de 10 joules por cm2 na potência de 10 watts, com frequência de dosagem contínua. O grupo UST foi submetido a ultrassom em modo contínuo (3 MHz, 1 W/cm2) por 6 minutos. O teste de Shapiro-Wilk foi utilizado para avaliar a normalidade dos dados. Para análise dos dados paramétricos e não paramétricos dentro do grupo, foram utilizados o teste t pareado e o posto sinalizado de Wilcoxon. O teste t independente e o teste Mann-U Whitney foram utilizados para comparação de grupos para dados paramétricos e não paramétricos, respectivamente. RESULTADOS: Em ambos os grupos, houve uma melhora significativa em todas as medidas de resultado (p<0,001). Houve uma diferença estatisticamente significativa entre as duas intervenções na EVA, Limiar de pressão de dor (PPT) e IIP (p<0,05). CONCLUSÕES: A terapia a laser de classe IV é clinicamente mais eficaz do que o ultrassom terapêutico no tratamento de pacientes com dor cervical crônica.
Subject(s)
Neck Pain , Laser Therapy , Chronic PainABSTRACT
Background: Elderly populations with co-morbidities and sensory impairments are more likely to be functionally dependent on their activities of daily living. Objectives of the study were to determine functional dependency among the elderly population residing in a rural area of Ernakulam district, and also to determine the factors associated with functional dependency in the study population. Methods: A community-based cross-sectional study was conducted among 200 elderly people from rural area of Ernakulam district, Kerala. A non-probability convenient sampling method was used for the study participants. A semi-structured questionnaire was used to collect information about the socio-demographic questions, medical history and history of comorbidities. Barthel’s scale assessed activities of daily living and independent activities of daily living were assessed by Lawton’s scale. The statistical test was done using statistical package for the social sciences (SPSS) version 21 and a chi-square test of significance was used to find the association of various factors with functional dependency. Results: In Barthel’s scale using ADL score, fully dependent was found to be 2.5%. In the IADL score using Lawton’s scale fully dependent was found to be 0.5% among the study participants. Among the study participants, 57.9% of females and 42.1% of males have a visual impairment, 60% of females and 40% of males have a hearing impairment, 45.5% of females and 54.5% of males have a cognitive impairment. Conclusions: Comorbidities such as diabetes mellitus, cardiovascular diseases, osteoporosis, osteoarthritis, and cognitive impairment contribute to a decline in functional abilities among older adults.
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Objective To investigate the frailty status and influencing factors of the elderly stroke pa-tients in community to provide a basis for its prevention and treatment.Methods The convenience sampling was used to select 200 elderly stroke patients as the study subjects in a community hospital in Guangzhou City from October 2020 to January 2022.The general information questionnaire,Chinese version of Tilburg frailty indicator scale,Modified Rankin Index Scale,Barthel index scale,short version of Geriatric Depression Scale and Social Support Rating Scale were used to collect the data.Results The incidence rate of frailty in 200 ca-ses of community elderly stroke was 86.0%.The results of multiple linear regression analysis showed that the degree of disability,ability of daily living,depression and social support were the influencing factors of frailty of the elderly stroke patients in community(F=71.813,P<0.001).Conclusion The incidence rate of frailty is higher in community elderly stroke patients,the higher the degree of disability,the lower the ability of daily living,the higher the level of depression and the lower the level of social support,the higher the frailty level of community elderly stroke patients.
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Objective To explore the relationship and internal path between activities of daily living(ADL),sleep quality and mental health of community elderly people in Shanghai.Methods A questionnaire survey was conducted among community residents aged 60 years and older seeing doctors in community health care center of five streets in Shanghai during Sept to Dec,2021 using convenience sampling.Activities of Daily Living(ADL),Pittsburgh Sleep Quality Index(PSQI)and 10-item Kessler Psychological Distress Scale(K10)were adopted in the survey.Single factor analysis,correlation analysis and multiple linear regression were used to analyze the data.The effect relationship between the variables was tested using Bootstrap's mediated effects test.Results A total of 1 864 participants were included in the study.The average score was 15.53±4.47 for ADL,5.60±3.71 for PSQI and 15.50±6.28 for K10.The rate of ADL impairment,poor sleep quality,poor and very poor mental health of the elderly were 23.6%,27.3%,11.9%and 4.9%,respectively.ADL and sleep quality were all positively correlated with mental health(r=0.321,P<0.001;r=0.466,P<0.001);ADL was positively correlated with sleep quality(r=0.294,P<0.001).Multiple linear results of factors influencing mental health showed that ADL(β= 0.457,95%CI:0.341-0.573),sleep quality(β =0.667,95%CI:0.598-0.737)and mental health were positively correlated(P<0.001).Sleep quality partially mediated the relationship between ADL and mental health(95%CI:0.078-0.124)with an effect size of 33.0%.Conclusion Sleep quality is a mediator between ADL and mental health among community elderly people.Improving ADL and sleep quality may improve mental health in the population.
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Objective:To investigate the therapeutic effect of sequential therapy with butylphthalein on acute cerebral infarction and mild-to-moderate increases in middle cerebral artery blood flow in patients.Methods:The clinical data of 92 patients with acute cerebral infarction and mild-to-moderate increases in middle cerebral artery blood flow who received treatment at the Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from January 2018 to October 2021 were retrospectively analyzed. These patients were divided into a study group and a control group using a random number table method. The control group was given an intravenous infusion of butylphthalein sodium chloride injection, while the study group took oral butylphthalein soft capsules after intravenous infusion of butylphthalein sodium chloride injection. The baseline data, hemodynamics, neurological function, and clinical outcomes were compared between the two groups. At 90 days after treatment, the National Institutes of Health Stroke Scale (NIHSS), the Activity of Daily Living Scale (ADL), and the modified Rankin Scale (mRS) were used to evaluate clinical outcomes. Transcranial Doppler ultrasound (TCD) examination was performed to evaluate hemodynamic changes.Results:A total of 92 patients completed all the observation indices as required, including 48 patients in the study group and 44 patients in the control group. There were no significant differences in demographics, vascular risk factors, laboratory results, NIHSS score, ADL score, or arterial hemodynamics of the diseased brain between the two groups (all P > 0.05). At 90 days after treatment, the NIHSS score in the study group was significantly lower than that in the control group [(4.00 ± 1.95) points vs. (4.91 ± 2.08) points; t =-2.16, P = 0.033]. The ADL score in the study group was significantly higher than that in the control group [(82.71 ± 9.56) points vs. (76.25 ± 11.47) points; t = 2.94, P = 0.004]. The good rate of outcomes in the study group was significantly higher than that in the control group [70.83% (34/48) vs. 50.00% (22/44); χ2 = 4.18, P = 0.041]. There were significant differences in the peak systolic velocity [(152.33 ± 9.58) cm/s vs. (157.41 ± 11.77) cm/s; t = 2.27, P = 0.025] and the mean velocity [(90.00 ± 8.30) cm/s vs. (94.45 ± 9.07) cm/s; t = -2.46, P = 0.016] of the middle cerebral artery between the study and control groups. The difference in pulsitility index between the two groups was not statistically significant [(0.97 ± 1.06) vs. (1.01 ± 1.21); t = 1.69, P = 0.093]. Compared with the poor outcome group, patients in the good outcome group had lower NIHSS and ADL scores after discharge (both P < 0.001), and the proportion of patients who received sequential therapy with butylphthalein in the good outcome group was higher [(60.70% (34/56) vs. 38.90% (14/36); χ2 = 4.18, P = 0.041]. Conclusion:Sequential therapy with butylphthalein can reduce neurological deficits, promote neurological function recovery, improve the hemodynamics of diseased blood vessels, and greatly improve daily living activities in patients with acute cerebral infarction complicated by mild to moderate increases in middle cerebral artery blood flow.
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Objective:To analyze the effect of donepezil hydrochloride combined with memantine on cognitive function in patients with Alzheimer's disease (AD).Methods:A randomized controlled trial was conducted among 90 patients with AD who were treated at the Zaozhuang Mental Health Center from January 2021 to March 2023. The patients were divided into a donepezil group and a combination group using a random number table grouping method, with 45 patients in each group. The donepezil hydrochloride group received only oral administration of donepezil hydrochloride tablets, while the combination group received oral administration of both donepezil hydrochloride tablets and memantine tablets. The two groups were continuously treated for 12 weeks. Before and after treatment, the Activities of Daily Living scale (ADL) score, the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD) score, the Mini-Mental State Scale (MMSE) score, and biochemical indicators (homocysteine, neuron-specific enolase, and S100 β) were compared between the two groups. Adverse drug reactions were observed in each group.Results:After treatment, the ADL, BEHAVE-AD, and MMSE scores in the combination group were (78.9 ± 6.1) points, (5.2 ± 0.5) points, and (22.8 ± 2.2) points, respectively, and they were (65.2 ± 5.9) points, (9.6 ± 0.9) points, and (19.4 ± 2.4) points, respectively, in the donepezil hydrochloride group. The ADL and MMSE scores in the combination group were significantly higher than those in the donepezil hydrochloride group ( t = 10.83, 7.01, both P < 0.001). The BEHAVE-AD score in the combination group was significantly lower than that in the donepezil hydrochloride group ( t = -28.67, P < 0.001). After treatment, serum levels of homocysteine, neuron-specific enolase, and S100 β in the combination group were (17.8 ± 3.6) μmol/L, (16.8 ± 2.7) μg/L, and (17.4 ± 7.5) μg/L, respectively, which were significantly lower than (21.5 ± 3.3) μmol/L, (20.4 ± 3.7) μg/L, and (23.5 ± 5.1) μg/L in the donepezil hydrochloride group ( t = -5.08, -5.27, -4.51, all P < 0.001). The incidence of adverse drug reactions in the combination group was 13.3% (6/45), which was slightly, but not significantly, higher than 8.9% (4/45) in the donepezil group ( χ2 = 0.45, P = 0.502). Conclusion:The combination of donepezil hydrochloride and memantine can effectively improve the mental and behavioral symptoms and cognitive function of patients with AD, improve daily living ability, and do not increase adverse reactions. The combined therapy has high clinical application value.
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Objective To systematically review whether mirror therapy(MT)intervention can effectively improve upper extremity motor function and activities of daily living(ADL)in stroke patients;whether its improvement is affected by pa-tients'age and disease course;and whether MT's influencing factors,such as intervention period,time,and fre-quency,have a dosage effect on upper extremity motor function and ADL. Methods Seven databases were searched,including Embase,Web of Science,PubMed,Cochrane Library,Wanfang data,VIP and CNKI from establishment to April,2023,and randomized controlled trials of MT for upper extremity motor function and ADL in stroke patients were screened.Quality assessment was performed using Physiothera-py Evidence Database(PEDro).Meta-analysis was performed using RevMan 5.4.1,and network meta-analysis was performed using R software,reticulated meta-analysis tables and cumulative probability tables were drawn for ranked comparisons,and funnel plots were drawn to test for publication bias of the outcome indicators using Stata 17.0 software.GRADE was used to evaluate the quality of evidence for the outcome indicators. Results A total of 13 papers(532 patients)were included.The PEDro score ranged from 6 to 8.Most of the literature did not report the blinding completely or did not implement allocation concealment,which might have some limita-tions.MT could improve the scores of Fugl-Meyer Assessment-Upper Extremities(n = 466,MD = 6.05,95%CI 3.44~8.66,P<0.001),Barthel index(n = 230,MD = 9.95,95%CI 6.23~13.68,P<0.001)and Functional Inde-pendence Measure(n = 147,MD = 4.17,95%CI 2.61~5.72,P<0.001)in stroke patients.Network meta-analysis showed that MT was more effective in upper limb motor function intervention for stroke patients aged 40 to 59 years with a disease course less than three months;and an intervention period less than four weeks,single inter-vention time less than 30 minutes,intervention duration daily more than 30 minutes and intervention twice daily might optimize the effects on upper limb motor function. Conclusion MT is effective on upper limb motor function and ADL in stroke patients,and the effect on upper limb mo-tor function is affected by the age and disease course of the patients,as well as the period,time and frequency of intervention.
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Objective:To explore the application effect of 5A self-management support method in the management of patients with stroke.Methods:A 5A self-management support program for stroke patients was developed from the five dimensions of Ask,Advice,Assess,Assist and Arrange.A total of 75 stroke patients admitted to the Neurology Department of Beijing Shijitan Hospital from November 2020 to April 2021 were randomly selected and divided into a control group(38 cases)and an observation group(37 cases)according to different intervention methods.The control group adopted routine intervention method,the observation group adopted 5A self-management support method.The intervention time expired 3 months after the patient was discharged.The intervention effects of the two groups were evaluated from the scores of self-management behavior,self-efficacy,activities of daily living and depression and anxiety situation.Results:At the end of the third month after discharge,the self-management behavior and self-efficacy scores for weekly exercise time,cognitive symptom management,communication with doctors,symptom management self-efficacy and disease common management self-efficacy scores of patients in the observation group scored(180.92±102.38),(3.68±1.32),(3.29±1.41),(7.15±3.44)and(6.82±2.10),respectively,which were significantly higher than those of the control group,the differences were statistically significant(t=5.63,4.10,4.37,6.40,7.60,P<0.05).At the end of the third month after discharge,the modified Barthel index(MBI)score of the patients in the observation group was(68.06±12.80),which was significantly higher than that of control group,the difference was statistically significant(t=7.27,P<0.05);the depression and anxiety scores of patients in the observation group were lower than those of the control group,the difference was statistically significant(t=2.38,2.64,P<0.05).Conclusion:The 5A self-management support method can significantly improve the self-management behavior and the ability of daily living activities of stroke patients after discharge,and effectively improve the anxiety and depression of patients,and improve the self-management effect of stroke patients after discharge.
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Objective:To use structural equation modeling to identify the indicator variables of intrinsic ability vitality among the elderly population.Methods:The study collected data on seven variables commonly used to measure vitality and mobility, including body mass index, weight loss, calf circumference, grip strength, gait speed at 4 m, up and go, and up and sit, from the comprehensive geriatric assessment(CGA)of patients admitted to the Department of Geriatrics of Beijing Hospital between May 2020 and May 2022.The study used a structural equation model to explore and verify the indicator variables of activity, utilizing exploratory factor analysis, confirmatory factor analysis, and correlation analysis.Results:The study conducted an exploratory factor analysis on seven variables, which resulted in two latent variables named vitality and locomotion.Body mass index, weight loss, and calf circumference were found to reflect vitality, while grip strength, 4 m-walking speed, time up and go test, and standing up and down test were found to reflect locomotion.Confirmatory factor analysis indicated that the measurement model was well-constructed and the indicator variables of vitality and locomotion were reasonably assigned[ χ2/ df=35/13, CFI=0.96, RMSEA(95% CI)=0.06(0.04, 0.08)].Correlation analysis showed that grip strength had a stronger correlation with locomotion-related variables than vitality-related variables( for grip strength and locomotion=0.33, for grip strength and vitality=0.21). Conclusions:The intrinsic ability and vitality of elderly individuals can be assessed through various means, including body mass index, weight loss, and calf circumference.However, grip strength is considered a more appropriate measure for reflecting locomotion rather than overall vitality.
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Objective:To examine the impact of intrinsic capacity(IC), comorbidity, and their interaction on the occurrence of adverse outcomes in community-dwelling older adults.Methods:This 2-year observational cohort study included 230 residents aged 75 and above who lived in the Beijing Taikang Yanyaun community active area from June to August 2018.The study evaluated the IC scale, Charlson comorbidity index(CCI), and activity of daily living(ADL).In September 2020, adverse outcomes such as functional decline(defined as a decline of at least one point on the ADL scores at 2-year follow-up compared with baseline)and falls were assessed.The structure equation model(SEM)path analysis was employed to examine the direct and indirect effects of IC and CCI on adverse outcomes.Results:Among the 212 older adults who completed a 2-year follow-up, aged 75-93(mean age 83.8±4.4)years, 59.4%(126 cases)were female.Out of these participants, 51.4%(109 cases)experienced functional decline and 33.5%(71 cases)had falls.Path analysis revealed that the direct effects of IC on functional decline and falls were significantly positive, with standardized coefficients of 0.430 and 0.369, respectively.However, the effect of CCI was not found to be significant.The multi-variable Logistic regression model showed that the total effect of IC on functional decline and falls remained significantly positive, with values of 1.184 and 0.915, respectively.CCI acted as a mediating factor, with indirect effects on functional decline and falls accounting for 5.4% and 0.8%, respectively.In terms of the relationship between age and adverse outcomes, the indirect effect of IC was significantly higher than that of CCI(functional decline: 0.192 vs.0.037; falls: 0.158 vs.0.017). Conclusions:The maintenance of IC in the health management of community-dwelling older adults should be given more attention as it can significantly affect the incidence of functional decline and falls.Comorbidity, on the other hand, has a weaker influence.
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Objective:To explore any effect of combining robot-assisted virtual scenario training of the upper limbs with scalp acupuncture on post-stroke cognitive impairment.Methods:Ninety patients with post-stroke cognitive impairment (PSCI) were divided at random into a control group, a scalp acupuncture group and a comprehensive group, each of 30. In addition to routine health education and rehabilitation training, the scalp acupuncture group was given scalp acupuncture, while the comprehensive group was treated with scalp acupuncture and virtual scenario training with an upper limb robot. Before and after 4 weeks of the treatment, the subjects′ cognitive functioning was assessed using the Mini-mental State Examination (MMSE) and the Montreal Cognitive Assessment scale (MoCA). Ability in the activities of daily living (ADL) was quantified using the Modified Barthel Index (MBI).Results:After the intervention, significant improvement was observed in the average MMSE, MoCA and MBI scores of all three groups. The average MMSE and MBI scores of the scalp acupuncture group were then significantly higher than the control group′s averages, while the average MMSE, MoCA and MBI scores of the comprehensive group were all significantly better than those of the other two groups.Conclusion:Robot-assisted virtual scenario upper limb training combined with scalp acupuncture can significantly improve the cognition and ADL ability of PSCI patients.
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@#Introduction: This systematic review aimed to investigate the level of participation, obstacles, and facilitator factors that influence activities of daily living among persons with spinal cord injury (SCI). Methods: A comprehensive search was conducted in four online databases, namely Google Scholar, PubMed, OT Seeker, and Cochrane Library covering the ten-years period from January 2012 to December 2022. Inclusion criteria encompassed original published studies in English focusing on daily activities, work, participation, obstacles, and facilitators in persons with SCI. Non-peer review sources (e.g., abstracts, grey literature, preprints), and studies unrelated to occupational therapy were excluded. The selected studies were assessed for quality using McMaster University Occupational Therapy Evidence-Based Practice critical review form. Results: Out of the 678 articles identified, ten studies were included after the screening, exploring participation in daily living activities, employment, return to work, leisure activities, family tasks, and community mobility among persons with SCI. Obstacles and facilitators influencing participation in activities of daily living were classified using the International Classification of Functioning, Disability, and Health (ICF) framework. This review highlighted that long-term participation is challenging for persons with SCI, affected by obstacles such as body functions, pain, low self-esteem, and environmental and social factors. Conclusion: The findings underscore the importance of adopting a multidisciplinary rehabilitation approach to enhance participation in daily activities for persons with SCI. Occupational therapy plays a significant role in improving participation levels among persons with SCI.