How to engage patients in computerized cognitive training: a cognitive rehabilitation expert's perspective.

PURPOSE: The relationship between a patient and their therapist plays a crucial role in patient engagement. While Computerized Cognitive Training (CCT) may assist in preserving cognitive skills in cases of aging, dementia or acquired brain injuries, its effectiveness has not been definitively proven. Improving user engagement, acceptance, and software usability could aid in addressing this issue. The present study aims to identify potential obstacles and facilitators by examining the perspectives of rehabilitation professionals on the current usage of CCT software. METHODS: Semi-structured interviews were conducted with 16 rehabilitation professionals, familiar with a CCT software. The data were transcribed and followed by an independent iterative thematic analysis. RESULTS: Two major themes were identified: (1) facilitating factors and (2) difficulties related to use. The main obstacles were difficulties related to the computerized nature of the exercises, technology use, understanding the software and general learning difficulties. The main facilitators were the ecological and novel nature of the exercises, and the adaptability of the difficulty levels. CONCLUSION: The complexity of the CCT presents challenges for its usage by rehabilitation professionals, which in turn can impede patient utilization as well. To address this issue and promote sustainable use of the software, providing instruction delivery to facilitate learning and understanding of the CCT is essential. Additionally, creating a standardized foundation that therapists can refer to for guidance may also aid in optimizing the software's usage. It is recommended to utilize a model for CCT acceptability and acceptance in developing these solutions to enhance patient engagement.

Computerized Cognitive Training (CCT) may help sustain cognitive skills or delay its decline due to causes such as aging, dementia or acquired brain injuries.User engagement, user acceptance and software usability could help address these issues.The relationship between a patient and their therapist plays a crucial role in patient engagement.Difficulties related to using and understanding a CCT software could affect behavioral intention/use.Rehabilitation professionals may face difficulties using CCT software, which could in turn, hinder patient utilization.Facilitating learning and understanding of the software through instruction delivery to increase acceptance could respond to the existing obstacles.A model for CCT acceptability/acceptance may be useful for improving the development of these solutions, to optimize patient engagement.Creating a standardized foundation for therapists to refer to could help optimize usage of CCT software.

Clustering patients and caregivers for technology design: A step prior to the design of an innovative technological device for the detection of epileptic seizures.

AIMS: Seizure detection using heart rate variability, from a detailed analysis by deep learning analysis system, may help patients with epilepsy to manage their symptoms. This exploratory study aims to identify patient and caregiver groups, according to acceptability factors. METHODS: Two versions of the same questionnaire were designed to survey quality of life, self-efficacy, and patients with epilepsy and caregivers on seizure detection acceptability using a patch, after watching a video that described a patch connected to a companion application. Participation was voluntary and anonymous. RESULTS: Responses from 68 patients with epilepsy and 33 caregivers were collected. Patients with epilepsy were grouped into three clusters: supportive, indeterminate, and reluctant to use the technology. Caregivers were also grouped into three clusters: supportive, reluctant to use the technology, either with sensitivity to their environment, or with hedonic motivation. The clusters enable the distinction between participants in self-efficacy. CONCLUSIONS: Clustering of patients with epilepsy and caregivers should be a prerequisite to the design of a technological device intended to promote self-management of seizure detection. These groupings distinguish those who are favorable, reluctant or undecided to use the technology. These can be based on an assessment of self-efficacy.

[A TPE programme for patients with neurodegenerative diseases and their carers]. / Un programme d'ETP pour les patients porteurs d'une maladie neurodégénérative et leurs aidants.

The team of the geriatric department of the Grenoble-Alpes (38) University Hospital Center has created the Accompagner therapeutic education program to meet the needs of patients suffering from neurocognitive disorders in the context of a neurodegenerative disease and their families. Presentation and current organization of the workshops.

A triadic approach to health and dependence in aging adults: incongruence in perception.

PURPOSE: Taking charge of dependent people is a major challenge. Numerous studies focus on the congruence of the dyadic perceptions of the actors. This study looks into the congruence of perceptions concerning dependence (i.e., physical and mental losses that prevent carrying out everyday tasks) and pathologies affecting older people within the triad: the aged person living at home, the informal caregiver, and the in-home professional caregiver. METHODS: A face-to-face questionnaire examining dependence and pathologies was administered separately to the three actors of 58 triads. This database has been analyzed mainly with techniques of data mining (MCA and AHC). RESULTS: The perception of pathologies and dependence are perceivably different depending on the actors. Within a same triad, perceptions of these two points-taken together or individually-turn out to be very dispersed. We bring to light three factors that structure 94% (with Benzécri's correction) of the congruence in perception within triads, and we propose a typology in four clusters of triads on this theme. CONCLUSIONS: The congruence analyses of the triads showed that incongruence in cross-perceptions of older people, formal, and informal caregivers on pathologies and dependence is clearly structured. Four quite distinct clusters have emerged, which could be exploited in the framework of public policies on the management of dependency in the home setting, to effectively alleviate the incongruence in the triads.

Perception of domestic risks among carers for dependent older persons.

BACKGROUND: Despite growing interest for home care, little evidence exists on the perception of domestic risk among carers for dependent older persons. This study aims to characterize the risks to which carers of aging dependent individuals are exposed, and to determine whether these risk dimensions are predictive for effective support, for burden, and for psychological distress. METHODS: Seventy care partners were questioned about the risk situations identified at the homes of the old people they care for, about the burden they felt in their role, and about their feelings of psychological distress. Securing was evaluated by means of sensibility measures, and overprotection was evaluated by means of specificity measures. RESULTS: Risk rates were high for loneliness of the old people, wandering, burns, and unsatisfactory health monitoring. There was very little overlap between identification of the risks and implementation of solutions by the caregiver, except for the risks that involved heat. The distinction between accurate securing and overprotection is especially important, because the burden of care partners was linked to uncontrolled domestic risks. CONCLUSION: Typologies of reactions to risk, characterized by a signal detection approach, could contribute to a better understanding of the situations experienced by care partners, especially situations of neglect and of overprotection.

Special issue on technology and neuropsychological rehabilitation: Overview and reflections on ways to conduct future studies and support clinical practice.

In this editorial, we wish to highlight and reflect on research advances presented in the articles comprising this special issue on technology and neuropsychological rehabilitation, which happens to be published more than a decade after the first special issue on the subject. In 2004, the journal recognised the great potential of information technology for increasing the support provided to people with cognitive deficits, and published emerging state-of-the art practices in the field. Since that time, research and technology have made tremendous progress, and the influence of information technology on research methods has transformed the field of neurorehabilitation. The aim of this editorial is thus to shed light on methodological and conceptual issues requiring further attention from researchers and clinicians in the fields of neuropsychological rehabilitation and technology, and to stimulate debate on promising avenues in clinical research.

Evaluation of a therapeutic education program for French family caregivers of elderly people suffering from major neurocognitive disorders: Preliminary study.

The pertinence of a therapeutic program of education has been studied with regard to carers of patients suffering from major neurocognitive disorders. The program, adapted to the needs expressed by the carers, consisted of three workshops with a view to supplying general information about the pathologies, specific information on behavioral disorders, and specific aids to identify and manage their emotional reactions. The results of this preliminary study show a moderate significant benefit to the level of anxiety in the participants, taking into account the specific expectations of the carers and bringing to light further needs.

Vocally disruptive behaviors management in older people with dementia.

Although shouting is a common psycho-behavioral symptom in geriatric institutions, the question of its assessment and treatment remains seldom studied and has rarely been the subject of specific recommendations. The combination of the focus group method and brainstorming has emerged as a methodology both relevant and feasible in geriatric facility to identify the coping strategies used by professionals and generalize guidelines for clinical observation and vocally disruptive behaviors management (shouting). The standardized gathering of professional experiences in nursing homes and their analysis with reference to results of the literature enabled the development of an analytical and clinical decision making diagram that can be an operational tool to cope with the occurrence of shouting in older people with dementia. Five types of triggers/aggravating shoutings emerged: 1) physical or moral pain and emotional reactions, 2) presence of sensory loss, 3) social isolation, under-stimulation or hyper sensitivity to stimulation and care, 4) reminiscences and 5) re-emergence of painful memories and loss of language skills. These factors have been associated with five methods of intervention : 1) pharmacological treatments, 2) animations, such as listening to music, physical activity and workshops using therapeutic mediation, 3) family or animal support and use of interventions to provide relaxation or stimulation, 4) interventions to deal with sensory deficits and 5) interventions modifying the environment.

Traumatic stress symptoms after the November 13th 2015 Terrorist Attacks among Young Adults: The relation to media and emotion regulation.

OBJECTIVE: A major terror attack occurred in the Paris region on 13th November 2015. This event was widely showed, described, and commented in the media. Media consumption may lead to a widespread diffusion of trauma-related symptoms following a collective trauma. These effects may depend on the type of media and emotion regulation strategies used by the media consumer. METHOD: Trauma history, traumatic symptoms, media consumption, psychological distress, and emotion regulation strategies of 451 young adults were assessed by an online survey. RESULTS: Findings reveal the joint role of social networks use and dysfunctional emotion regulation strategies on anxiety, depression, and somatization symptoms and also on cognitive and emotional alteration among traumatic symptoms. DISCUSSION: Consistent with the emotional contagion hypothesis, individuals who reported spending more time on social networks were also those who were experiencing more psychological distress.

[Contribution of pictorial help to the understanding of medical prescriptions in elderly adults and in patients with Alzheimer's disease]. / Apport d'une aide imagée à la compréhension de prescriptions médicales chez des sujets âgés et des patients atteints de maladie d'Alzheimer.

The effects on comprehension of presenting medical prescription information in a pictorial format were compared to a verbal format in healthy old adults and in patients suffering from Alzheimer disease (AD). Participants received medical prescription instructions in one of two formats: with verbal instructions only, or with verbal instructions associated with pictorial representations. The results indicated that comprehension for prescription information of healthy old subjects and AD patients was facilitated by the combined presentation. Furthermore, the pictorial instructions appeared acting on the capacity to work out a specific medication schemata, that is to say on their real, operational, understanding. These results suggest that analogical pictorial format leads more directly to the medical prescriptions' situation model and alleviates the particularization deficiency of the therapeutic schemata, independently of global cognitive functioning, visual perception, space perception and visual semantic analysis in AD. The presentation of illustrations representing medical prescriptions would allow to decrease doubts and errors, which are frequent in normal aging and even more in Alzheimer's disease, and contribute to a better medical compliency.