ABSTRACT
BACKGROUND: Disability affects a significant portion of the global population nowadays, necessitating innovative approaches to access rehabilitation processes. Home-based rehabilitation has emerged as a beneficial approach, offering comfort and context-specific therapy. OBJECTIVE: This study aims to evaluate the impact of a multidisciplinary home-based rehabilitation program for individuals with moderate neuromusculoskeletal disabilities in terms of motor function and mood. METHODS: A total of 270 participants with median age of 66 (IQR 20-98) years were recruited from the National Disability Registry of Chile. The intervention involved a multidisciplinary team composed of 49 health care professionals providing personalized treatment plans over 4 months (32 sessions for physical therapy, 8 sessions for occupational therapy, 4 sessions for nutrition, 8 sessions for psychology, and 4 sessions for nursing and podiatry). This program also included 2 medical evaluations (at the beginning and the end) to monitor clinical progress in terms of motor function and mental health, using the Berg Balance Scale and Beck Depression Inventory, respectively. RESULTS: The home-based rehabilitation program showed significant improvements (P<.001) in motor function and balance with a reduction in fall risk. Specifically, the Berg Balance Scale score decreased close to 15% after the home-based rehabilitation program for all enrolled participants. On the other hand, depression levels showed no significant changes (P=.27), with percentages of variation less than 8% between the 2 assessed conditions. In this sense, participants remained with the same mild depression level (14 of 63) concerning the Beck Depression Inventory score. CONCLUSIONS: This study concludes that personalized home-based rehabilitation programs are effective in enhancing motor function and balance, particularly in individuals with neurological conditions. On the other hand, the findings in terms of mood advocate for further exploration of psychological support within such programs to enhance overall patient well-being. TRIAL REGISTRATION: ClinicalTrials.gov NCT06537791; https://clinicaltrials.gov/study/NCT06537791.
ABSTRACT
Globally, there are around 1.3 billion cigarette consumers, indicating it to be the second highest risk factor for early death and morbidity. Meanwhile, psychological therapy offers tools based on its different models and techniques, which can contribute to smoking cessation. In this context, this study gathers scientific evidence to identify psychological therapies that can be used to reduce cigarette consumption. A systematic review of controlled clinical studies was conducted, implementing the PRISMA methodology. Search queries were performed with terms extracted from MESH (Medical Subject Headings) and DECS (Descriptors in Health Sciences). Subsequently, the search was queried in the scientific databases of Medline/PubMed, Cochrane, Scopus, Science Direct, ProQuest, and PsycNet, with subsequent verification of methodological quality using the Joanna Briggs Institute checklists. The selected documents revealed that cognitive behavioral therapy prevails due to its use and effectiveness in seven publications (25%). The cognitive approach with mindfulness therapy is found in 4 publications (14%), the transtheoretical model with motivational therapy in 4 publications (14%), brief psychological therapy in 3 publications (10%), and the remaining 10 documents (37%) correspond with others. Intervention studies refer to cognitive behavioral therapy as the most used in reducing cigarette consumption; in terms of the duration of abstinence, scientific evidence shows beneficial effects with short-term reduction.
Subject(s)
Cigarette Smoking , Smoking Cessation , Humans , Smoking Cessation/psychology , Smoking Cessation/methods , Cigarette Smoking/psychology , Cognitive Behavioral Therapy , Psychotherapy/methodsABSTRACT
The prevalence of autism spectrum conditions has been increasing in recent decades. However, this has not been reflected in an increase in clinical research, so there is insufficient evidence on the supports and adaptations that psychological treatments require for this population. Evidence-based psychological therapies are frequently goal-focused, usually short-term, such as cognitive behavioral therapy, which integrates cognitive and behavioral modalities. Due to the high rates of comorbidity in people with autism, various psychological therapies are in the process of adapting their delivery. This review explores research-suggested adaptations to implement psychological therapies in adults with autism without intellectual disability. Both formal and intervention techniques adaptations are required. Adaptations at each stage of psychological therapies are important to support the differences, needs, and preferences of the adult with autism. Professional training aimed at working with this particular population, and research on how to optimize the access of this population to mental health services are essential for its correct implementation.
La prevalencia de las condiciones del espectro autista ha ido en aumento en las últimas décadas, aunque esto no se ha reflejado en un aumento de la investigación clínica, por lo que se cuenta con evidencia insuficiente sobre los apoyos y adaptaciones que requieren los tratamientos psicológicos para esta población. Las terapias psicológicas basadas en evidencia frecuentemente están centradas en objetivos, generalmente a corto plazo, como la terapia cognitivo conductual, que integra modalidades cognitivas y conductuales. Debido a las altas tasas de comorbilidad en las personas con autismo, diversas terapias psicológicas se encuentran en el proceso de adaptar su implementación. Esta revisión explora las adaptaciones sugeridas en la investigación para la implementación de las terapias psicológicas en adultos con autismo sin discapacidad intelectual. Se requieren tanto adaptaciones en el encuadre como en las técnicas de intervención. Las adaptaciones en cada etapa de las terapias psicológicas son importantes para apoyar las diferencias, necesidades y preferencias del adulto con autismo. Para su correcta implementación son esenciales la formación profesional orientada al trabajo con esta población particular, e investigaciones sobre cómo optimizar el acceso de esta población a los servicios de salud mental.
Subject(s)
Autism Spectrum Disorder , Intellectual Disability , HumansABSTRACT
Resumen El cáncer avanzado está asociado a numerosos desafíos incluyendo el deterioro físico progresivo que gatilla miedos referentes a la dependencia y pérdida de autonomía, mortalidad y sentido de la vida. El continuo aumento de la sobrevida en los pacientes oncológicos ha llevado a que estos vivan en un proceso de adaptación y cambios continuos, lo que conlleva una gran carga emocional tanto para el paciente como para su familia. Muchos pacientes oncológicos en fase terminal cumplen criterios para un diagnóstico psiquiátrico y signos de distrés, siendo los síntomas depresivos muy frecuentes. Esto nos hace pensar en la necesidad imperiosa de intervenciones adecuadas para personas en esta situación, en donde las cuestiones existenciales, reestructuración del propósito, relaciones interpersonales, sentido de la vida, proceso de morir y muerte, cumplen un rol fundamental. El objetivo de este trabajo es describir la experiencia canadiense de una terapia psicológica individual breve denominada Managing Cancer And Living Meaningfully (CALM), que ha sido realizada y evaluada durante los últimos 10 años en Toronto, Canadá, con el objetivo de reducir el malestar emocional y promover el bienestar psicológico en pacientes con cáncer avanzado. Este artículo describe sus principales componentes, características y evidencia de su beneficio para esta población.
Advanced cancer is associated with numerous challenges including progressive physical deterioration that triggers fears regarding dependence and loss of autonomy, mortality and meaning of life. The continuous increase in survival in oncology patients has led them to live in a process of adaptation and continuous changes, which carries a great emotional burden for both the patient and his or her family. Many terminal cancer patients meet criteria for a psychiatric diagnosis or sign distress, with depressive symptoms being very frequent. This makes us think of the imperative need for appropriate interventions for people in this situation, where existential issues, restructuring of purpose, interpersonal relationships, meaning of life and the process of dying and death play a fundamental role. The aim of this work is to describe a Canadian experience of a brief individual psychological therapy called Managing Cancer and Living Meaningfully (CALM), which was developed and evaluated over the last 10 years in Toronto. CALM Therapy was designed to reduce distress and promote psychological well-being in patients with advanced cancer; this article will describe its main components, characteristics and evidence of its benefit for this population.
Subject(s)
Humans , Bereavement , Death , Fear , Psycho-Oncology , Neoplasms/psychology , CanadaABSTRACT
Los pacientes con trastornos temporomandibulares (TTM) presentan trastornos psicológicos y psiquiátricos frecuentemente. Estos pacientes frecuentemente muestran somatización, depresión, ansiedad, reacción al estrés y catastrofismo, lo que juega un rol en la predisposición, iniciación y perpetuación de los TTM y en la respuesta al tratamiento. Esta revisión presenta opciones terapéuticas que comprometen al eje psicológico de los pacientes con TTM, las cuales buscan principalmente reducir la ansiedad y la tensión emocional presentes, modificar las distintas percepciones del dolor y cómo afrontarlo. Existen diversas posibilidades, dentro de las cuales se encuentran: educación del paciente, identificación de las situaciones que incrementan esa tensión para evitarlas, enseñanza de técnicas de relajación como biofeedback, hipnosis y yoga. En cuanto al tratamiento psicológico, la que presenta mejor resultado para los TTM, es la terapia cognitiva conductual (TCC). La intervención psicológica adecuada y eficaz puede reducir el dolor de los TTM, disminuyendo la probabilidad de que el cuadro se haga más complejo. Dentro de las alternativas de tratamiento psicológico para los TTM, un tratamiento estándar conservador (educación, instrucción de autocuidado, evitación de movimientos dolorosos, dieta blanda), incluso el más breve, puede ser suficiente a corto plazo para la mayoría de los pacientes que presentan TTM, sobretodo en los casos de cuadros agudos. La adición de una TCC, por parte de un especialista, entrega habilidades de afrontamiento que se sumarán a la eficacia, especialmente en los casos crónicos, obteniendo mejores resultados a largo plazo.
Patients with temporomandibular disorders (TMD) frecuently present psychological and psychiatric problems. These patients often show increased somatization, depression, anxiety, stress reaction and catastrophism, wich plays a role in the predisposition, initiation and perpetuation of TMD and treatment response. This review presents thaerapeutic options that compromise the psychological axis of patients with TMD, wich primarily seek to reduce the anxiety and the emotional stress present, modify different perceptions of pain and coping. There are different posibilities, within wich are: patient education, identifying situations that increase the tension to avoid them, teaching relaxation techniques such as biofeedback, hipnosis and yoga. As for psychological treatment, the most common for chronic orofacial pain is cognitive behavioral therapy (CBT). The appropriate and effective psychological intervention can reduce TMD pain, decreasing the probability that the symptoms become more complex. Within psychological treatment options for TMD, conservative standard treatment (education, self-instruction, avoidance of painful movements, soft diet), even the shortest, may be sufficient in the short term for most patients with TMD, especially in cases of acute conditions. The addition of CBT, by a specialist, gives coping skills that will add to the effectiveness, especially in chronic cases, obtaining better results in the long term.