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1.
Acta Myol ; 39(3): 121-129, 2020 Sep.
Article in English | MEDLINE | ID: mdl-33305168

ABSTRACT

OBJECTIVE: The aim of this study was to use a structured questionnaire in a large cohort of Duchenne Muscular Dystrophy (DMD) patients to assess caregivers and patients views on respiratory function and to establish if their responses were related to the patients' age or level of functional impairment. METHODS: Questionnaires were administered to caregivers in 205 DMD patients of age between 3 and 36 years (115 ambulant, 90 non-ambulant), and to 64 DMD patients (3 ambulant, 61 non-ambulant) older than 18 years, subdivided into groups according to age, FVC, ambulatory and ventilatory status. RESULTS: Some differences were found in relation to FVC % values (p = 0.014), ambulatory (p = 0.043) and ventilatory status (p = 0.014). Nearly half of the caregivers expected deterioration over the next years, with the perspective of deterioration more often reported by caregivers of non-ambulant (p = 0.018) and ventilated patients (p = 0.004). Caregivers appeared to be aware of the relevance of respiratory function on quality of life (84%) showing willingness to enter possible clinical trials if these were aiming to stabilize the progression of respiratory function with a very high number of positive responses across the spectrum of age, FVC, ambulatory and ventilatory status. The boys older than 18 years showed similar results. CONCLUSIONS: Our study showed that the concern for respiratory function increases with age and with the reduction of FVC or the need for ventilation, but the need for intervention was acknowledged across the whole spectrum of age and functional status.


Subject(s)
Caregivers/psychology , Disability Evaluation , Family Health , Muscular Dystrophy, Duchenne , Noninvasive Ventilation , Quality of Life , Respiration , Adult , Child , Dependent Ambulation/psychology , Disease Progression , Female , Functional Status , Humans , Male , Men/psychology , Muscular Dystrophy, Duchenne/physiopathology , Muscular Dystrophy, Duchenne/psychology , Muscular Dystrophy, Duchenne/therapy , Noninvasive Ventilation/methods , Noninvasive Ventilation/psychology , Patient Reported Outcome Measures , Respiratory Function Tests/methods , Respiratory Function Tests/psychology , Vital Capacity
2.
Mech Ageing Dev ; 192: 111384, 2020 12.
Article in English | MEDLINE | ID: mdl-33080280

ABSTRACT

This cross-sectional study was conducted among a rural elderly population of 725 individuals aged over 60 years from Eastern India to assess the association of multiple chronic diseases with frailty and dependence. Multimorbidity, frailty, and dependence were assessed using prevalidated tools. Regression models were used to assess the association between variables and adjust for confounders. The overall prevalence of multimorbidity was 48.8 % and that of frailty and dependence for activities of daily living was 58.6 % and 5.4 %, respectively. There was no statistically significant difference (p = 0.53) between the mean age of persons with and without multimorbidity. Frailty and dependency, however, showed a significant increasing trend with the mean age. Unadjusted bivariate analyses showed a significantly larger proportion of persons who were frail or at risk of frailty having multimorbidity as compared to those who were robust. Logistic regression models showed a significant association between risk of frailty and multimorbidity but failed to demonstrate a significant relationship between dependency and number of chronic diseases when adjusted for the interaction between frailty and chronic diseases. There was a significant association between dependence, frailty, and multimorbidity. Further research to determine the extent, direction, and nature of this complex relationship needs to be explored.


Subject(s)
Activities of Daily Living , Dependent Ambulation , Frailty , Multiple Chronic Conditions , Risk Assessment/methods , Aged , Cross-Sectional Studies , Dependency, Psychological , Dependent Ambulation/physiology , Dependent Ambulation/psychology , Disability Evaluation , Female , Frailty/diagnosis , Frailty/epidemiology , Frailty/physiopathology , Geriatric Assessment/methods , Humans , India/epidemiology , Male , Multiple Chronic Conditions/epidemiology , Multiple Chronic Conditions/therapy , Prevalence , Risk Factors , Rural Population/statistics & numerical data
3.
Disabil Rehabil ; 42(1): 137-146, 2020 01.
Article in English | MEDLINE | ID: mdl-30264598

ABSTRACT

Purpose: This Australian study piloted a new measure of Orientation and Mobility to better understand the functional mobility of guide dog handlers with low vision or blindness. It is expected that this measure can be used to better match guide dogs to their handlers.Materials and methods: The new Orientation and Mobility Outcomes tool scores a client in Stable/Familiar and Dynamic/Unfamiliar conditions, also considering Travel-Related Wellbeing. Semi-structured interviews were conducted with 51 guide dog handlers, during which travel skills were co-rated with an interviewer.Results: A cluster analysis of the Orientation and Mobility Outcomes data identified four mobility styles: intrepid explorers, social navigators, independent roamers and homebodies. The differences between these clusters had more to do with mental mapping skills than level of vision, and different guide dog characteristics were needed to support the travel styles identified for each cluster.Conclusions: The results confirm the importance of the Orientation and Mobility Outcomes tool as a sensitive, person-centred measure of the impact of Orientation and Mobility and guide dog training. In particular, the four mobility clusters provide a new perspective on matching guide dogs with clients, also suggesting the need for a more personalised look at the guide dog training process.Implications for RehabilitationOrientation and Mobility Outcomes data seem precise enough to support and inform the process of matching guide dogs to handlers.Uniform results cannot be expected from guide dog mobility in handlers - age, stage of life, health and spatial cognition impact the competence and travel style of guide dog handlers, whereas vision is less important.Sharing the work of visual interpretation and decision making with a guide dog makes independent travel more possible.Valuable dog characteristics that are specific to handler requirements might be bred or trained from puppy raising onwards, creating a more diverse pool of dogs to draw upon.


Subject(s)
Blindness/rehabilitation , Dependent Ambulation , Orientation, Spatial , Rehabilitation , Service Animals/psychology , Animals , Australia , Blindness/physiopathology , Blindness/psychology , Dependent Ambulation/physiology , Dependent Ambulation/psychology , Dogs , Humans , Rehabilitation/methods , Rehabilitation/organization & administration , Rehabilitation/standards
4.
BMC Geriatr ; 19(1): 255, 2019 09 18.
Article in English | MEDLINE | ID: mdl-31533637

ABSTRACT

BACKGROUND: The world is facing many socio-demographic changes, such as an increased average life expectancy and the presence of chronic and non-communicable diseases, which in turn, leads to an enhanced dependency on others. Consequently, the demand for informal caregivers has significantly increased during the past few years. Caring for a dependent person is linked to a series of burdens that often leads to physical, psychological and emotional difficulties. Taking into consideration the difficulties faced by informal caregivers, knowing in which areas of functioning they need more guidance may help to relieve their burden. Therefore, the main goal of this study is to better understand the needs and competencies of the informal caregiver when caring for a dependent person in the different self-care domains. METHODS: This cross-sectional study used a questionnaire administered on a single occasion by face-to-face interview. Descriptive and inferential statistics alongside non-parametric statistical techniques such as the Mann-Whitney test and Spearman's correlation were used. RESULTS: The average age of the 143 informal caregivers is 58 years old, with the youngest in our sample being 21 years of age. Most of them are female, and 50% of them are children taking care of one of their parents. Most of the dependent people are completely dependent in the areas of comfort and hygiene (53.8%) and medication management (55.9%). The female informal caregivers see themselves as having more competencies in sanitary hygiene than the male ones, with no significant differences in their competencies' perception in the other areas of self-care. Older caregivers see themselves as less competent in certain areas of self-care such as feeding, mobility, transfers, medication and symptoms management and communication. Most of the information given to the informal caregiver is about the disease (82.3%) and the medication management (80.4%). There are still a lot of areas of self-care, where no information, or almost none, is given to the informal caregivers. CONCLUSIONS: Before home discharge of a dependent person, it is important to acknowledge the needs and competencies of the informal caregiver, to capacitate them in looking after their relatives, to help decrease their burden and consequently, decrease the number of hospital readmissions.


Subject(s)
Caregivers/psychology , Caregivers/standards , Clinical Competence/standards , Health Services Needs and Demand/standards , Self Care/psychology , Self Care/standards , Adult , Aged , Communication , Cross-Sectional Studies , Dependent Ambulation/psychology , Dependent Ambulation/standards , Female , Humans , Male , Middle Aged , Surveys and Questionnaires , Young Adult
5.
Disabil Health J ; 11(4): 562-567, 2018 10.
Article in English | MEDLINE | ID: mdl-30301538

ABSTRACT

BACKGROUND: Emergent disability studies research is interested in the community's views on how disability, including self-directed mobility, influences social and environmental policies. We anticipate that individuals' alignment with disability models, or sets of assumptions about the cause, nature, and treatment of disability, will influence attitudes about self-directed mobility. Self-directed mobility is defined as mobility that is controlled by an individual and may include walking or assisted ambulation through the use of mobility technology such as prosthetics, walking aids, manual wheelchairs, or motorized wheelchairs. OBJECTIVE: The purpose of this study was to explore how demographic factors, contact with people with disabilities, attitudes toward people with disabilities, and alignment with social or medical models of disability predict attitudes toward self-directed mobility. METHODS: 1545 students at a public university completed demographic questions, and measures of disability attitudes, disability model orientation, and self-directed mobility. RESULTS: The predictors explained 16.60% of the variance in participants' attitudes toward self-directed mobility (R2 = 0.166, F(7,1537) = 43.9, p < .001). Significant predictors included: female gender (ß = -0.14, p < .01), more positive attitudes toward people with disabilities (ß = -0.30, p < .001), and social model orientation (ß = 0.59, p < .001). CONCLUSIONS: Participants who more strongly agreed with disability as a social construct (social model) were in stronger agreement that self-directed mobility is a fundamental right. Future research extending to rehabilitation professionals is warranted.


Subject(s)
Attitude to Health , Dependent Ambulation/psychology , Disabled Persons/psychology , Disabled Persons/rehabilitation , Empathy , Students/psychology , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult
6.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 53(5): 285-292, sept.-oct. 2018. tab, graf
Article in Spanish | IBECS | ID: ibc-178091

ABSTRACT

Introducción: La mayoría de las personas de elevada edad o con discapacidad desea permanecer viviendo en su propio hogar frente a cualquier otra opción residencial, incluso cuando se requieren cuidados de larga duración. La adaptación funcional de la vivienda constituye una de las claves para hacerlo con seguridad y calidad de vida. Este trabajo investiga si las personas con discapacidades -derivadas fundamentalmente de su avanzada edad- desarrollan comportamientos adaptativos dirigidos a compensar la pérdida funcional mediante mejoras en su vivienda y entorno; también investiga cuáles son las covariables que lo explican. Material y métodos: Se parte de la llamada ecuación de Lewin, que relaciona las conductas individuales con las características personales y del entorno. En este caso la conducta adaptativa sería la realización de gastos en la vivienda para su adaptación o mejora. Se utilizan los microdatos de la Encuesta EDAD2008 (INE 2010), a los que se aplica un modelo logit bivariante para estimar la relación entre ese gasto adaptativo y distintas covariables explicativas. Resultados: Se verifica que se cumple el modelo de Lewin. Los coeficientes y odds ratios resultantes muestran que las características funcionales, económicas y de entorno son las que determinan, por encima de otras de tipo personal o socioeconómico, el gasto adaptativo. Conclusiones: La adaptación funcional de la vivienda es un comportamiento de ajuste voluntario justificado por las condiciones de la persona y del entorno de su vivienda y edificio. Dada la importancia de promover mejores condiciones para el «envejecimiento en casa», se plantea la necesidad de estimular el gasto privado en adaptaciones como fórmula complementaria al necesario aumento de los programas de subvenciones públicas existentes


Introduction: Most elderly people or those with disabilities wish to stay in their own home rather than any other residential option, even when long-term care is required. The functional adaptation of homes is one of the key factors in doing this with safety and quality of life. This paper investigates whether people with disabilities (arising mainly from their advanced age) develop adaptive behaviours aimed at compensating for their functional loss through improvements in their home and environment, as well as knowing the covariables that explain it. Material and methods: It starts from the so-called Lewin equation, which relates individual behaviours to personal and environmental characteristics. In this case the adaptive behaviour would be the economic expenditure on the home for its adaptation or improvement. The microdata of the Spanish EDAD 2008 survey are used, to which a bivariate logit model is applied to estimate the relationship between this adaptive expenditure and different explanatory covariates. Results: The results show that the Lewin model is fulfilled. The resulting coefficients and odds ratios show that the functional, economic, and environmental characteristics are what determine, above others of a personal or socioeconomic type, the adaptive expenditure. Conclusions: Housing adaptation is a voluntary adjustment behaviour justified by the functional conditions of the person and those of the housing and building environment. Given the importance of promoting better conditions for «ageing at home», there is a need to stimulate private expenditure on adaptation as a complementary formula to the necessary increase in existing public subsidy programs


Subject(s)
Humans , Adaptation, Psychological , Mobility Limitation , Architectural Accessibility , Disabled Persons/psychology , Dependent Ambulation/psychology , Housing for the Elderly/organization & administration , Frail Elderly/statistics & numerical data , Quality of Life , Spain
8.
Respir Med ; 115: 78-82, 2016 06.
Article in English | MEDLINE | ID: mdl-27215508

ABSTRACT

BACKGROUND: There is little information worldwide about the impact of health literacy (HL) on clinical outcomes of COPD. Our aim was to quantify inadequate HL in Spain, as measured by the Short Assessment of Health Literacy for Spanish Adults questionnaire, and to examine the associations between HL and both COPD outcomes and health status. METHODS: 296 COPD patients of 68(SD = 9) years and a FEV1%predicted of 53%(SD = 18%) were enrolled and followed-up for one year. 59% showed "inadequate" HL. RESULTS: Individuals with inadequate HL were older (70[SD = 9] vs 65[SD = 8] years; p < 0.001) and had less knowledge of their disease, as measured by the low HL-COPD questionnaire, (6.9[SD = 2.3] vs 7.5[SD = 1.9]; p < 0.001). While their lung function was no different, they reported significant differences in mMRC (1.6[SD = 1] vs 1.4[SD = 1]; p < 0.001), CAT (19.2[SD = 8.1] vs 18.3[SD = 7.5]; p = 0.049), and EQ-5 (3.1[SD = 2.2] vs 2.3[SD = 1.9]; p < 0.00). Those with inadequate HL had also higher risk of having ≥2 comorbidities (OR = 1.87; 95%CI = 1.14-3.08), need of assistance (OR = 2.5; 95%CI = 1.5-4.2), anxiety/depression (OR = 1.9; 95%CI = 1.2-3.0), admissions or visits to the emergency department (OR = 1.70; 95%CI = 1.1-2.7), and all-cause deaths in the following year (3.8% (SE = 1.1%) vs 0%; p = 0.051). CONCLUSIONS: Inadequate HL is prevalent among COPD patients and it is related to health status and relevant clinical outcomes of the disease. HL needs to be considered when planning the care for COPD patients.


Subject(s)
Health Literacy/statistics & numerical data , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/physiopathology , Activities of Daily Living/psychology , Aged , Comorbidity , Cross-Sectional Studies , Dependent Ambulation/psychology , Depression/epidemiology , Emergency Service, Hospital/statistics & numerical data , Female , Forced Expiratory Volume/physiology , Health Knowledge, Attitudes, Practice , Health Literacy/trends , Health Status , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Mortality , Outcome Assessment, Health Care , Quality of Life , Respiratory Function Tests/methods , Spain/epidemiology , Surveys and Questionnaires
9.
Presse Med ; 44(7-8): 700-6, 2015.
Article in French | MEDLINE | ID: mdl-25964157

ABSTRACT

Non-use of the walker may be secondary to an initial inappropriate prescribing, a lack of adequate training, a lack of monitoring and side effects of using. Improving both stability and mobility in users is due to several biomechanical mechanisms. The benefits of walker are: general physiological effects, more confidence, better social life and decrease in the burden of care. The disadvantages of walker are: technical or practical aspects criticized by users, musculoskeletal disorders, delayed reaction time, fall risk and stigma. Few scientific data evaluating the interest of the walker concerning mobility exist, thus recommendations are low grade and are often taken from professional clinical experiences. The choice of technical walking assistance depends on the pathology and biomechanical mechanism. The walker robots are few distributed.


Subject(s)
Dependent Ambulation , Health Services Needs and Demand , Mobility Limitation , Walkers/statistics & numerical data , Aged , Aged, 80 and over , Dependent Ambulation/psychology , Dependent Ambulation/statistics & numerical data , Health Knowledge, Attitudes, Practice , Health Services Needs and Demand/statistics & numerical data , Humans , Perception , Personal Autonomy , Practice Patterns, Physicians'/statistics & numerical data , Risk Assessment , Walkers/supply & distribution
10.
Disabil Rehabil Assist Technol ; 9(4): 299-306, 2014 Jul.
Article in English | MEDLINE | ID: mdl-23782225

ABSTRACT

PURPOSE: The aim of this study was to explore the psychosocial impact of standing devices as experienced by users. METHOD: This is the second part of a comprehensive survey in five counties in Sweden where all the subjects with standing devices were invited to participate. The impact of standing devices on functional independence, quality of life and wellbeing was assessed using a questionnaire, Psychosocial Impact of Assistive Devices Scale (PIADS). RESULTS: The psychosocial impact of the standing devices was perceived as positive. The highest PIADS scores in relation to age were found in the oldest group, aged 65 years and older. The ability to walk and independence in ambulation resulted in higher scores than the use of a wheelchair and/or dependence on others. Those who stood often awarded higher scores in the PIADS questionnaire compared to those who used the device less frequently. When standing was integrated in various activities, its psychosocial impact received high scores. CONCLUSION: The psychosocial impact of standing devices was generally experienced positively. The main results indicated that standing in a standing device had a value and we as professionals should ask the users about the intended purpose of their standing in order to prescribe the optimal device. IMPLICATIONS FOR REHABILITATION: Standing in standing devices has positive psychosocial impact for the user. As professionals we should broaden our view of the use of standing devices, i.e. to see the standing device as an aid that not only treats the body's structures or improves the user's abilities in activities, but also provides a psychosocial impact on the user's daily life, and to find meaningful goals for the user from a psychosocial perspective.


Subject(s)
Dependent Ambulation/psychology , Disabled Persons/psychology , Orthopedic Equipment , Quality of Life/psychology , Self Concept , Self-Help Devices/psychology , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Posture , Surveys and Questionnaires , Sweden , Young Adult
11.
Enferm. glob ; 12(32): 211-221, oct. 2013. tab, ilus
Article in Spanish | IBECS | ID: ibc-115712

ABSTRACT

Objetivo: Estudiar la relación entre los problemas de salud de los mayores dependientes y la formación de los cuidadores informales. Material y métodos: Se presenta un estudio exploratorio, descriptivo, de corte transversal, seleccionando a 41 cuidadores mediante muestreo no probabilístico intencional. Se ha diseñado un cuestionario basado en la bibliografía existente y cuya validez de contenido ha sido consensuada por expertos. Para el análisis de datos se ha utilizado SPSS versión 18.0. Resultados: Un 41,5% de los cuidadores informales recibieron algún tipo de formación; un 92,7% de cuidadores plantean que necesitan formación en relación con los problemas de salud de las personas cuidadas y un 58,5% de mayores han sido cuidadas por cuidadores que no han recibido formación. Conclusiones: Es significativo, que en nuestro estudio hay más cuidadores sin formación cuidando personas con problemas de salud, que con formación específica; siendo necesario que los cuidadores informales principales puedan asistir a los programas formativos sobre los problemas de salud y sobre los cuidados que requieran las personas mayores que cuidan, por lo que se plantea como estrategia de mejora, que desde la gestión sanitaria se proporcionen los recursos y medios que necesiten los cuidadores, y se potencie el uso de herramientas formativas (foros, chats, correos electrónicos, tuenti, facebook, blog, twitter, Skype, entre otros), que pueden plantearse como alternativa a las sesiones presenciales (AU)


Aim: To study the relationship between the health problems of elderly dependent and training of informal caregivers. Methods: We present an exploratory, descriptive cross-sectional, selecting 41 caregivers through intentional non-probability sampling. He has designed a questionnaire based on the literature and content validity has been agreed upon by experts. For data analysis has been used SPSS version 18.0. Results: 41.5% of informal caregivers received some training, 92.7% of caregivers state that need training regarding the health problems of people cared and 58.5% of seniors have been maintained for caregivers who are not trained. Conclusions: It is significant that in our study there are more untrained caregivers caring for people with health problems than with specific training, being necessary to the main informal cares to attend training programs on issues of health care and requiring older people who care for what is proposed as a strategy for improvement, health management since they provide the resources and facilities needed by caregivers, and enhance the use of training tools (forums, chats, emails, Tuenti, facebook, blog, twitter, Skype, etc.), which can arise as an alternative to face sessions (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , 16054/psychology , Caregivers/education , Caregivers/psychology , Caregivers , Mobility Limitation , Alzheimer Disease/epidemiology , Alzheimer Disease/nursing , Quality of Life , Cross-Sectional Studies/methods , Cross-Sectional Studies , Clinical Governance/organization & administration , Clinical Governance/standards , Primary Health Care/methods , Primary Health Care , Nurse Clinicians/organization & administration , Surveys and Questionnaires , Dependent Ambulation/psychology
12.
Physiother Theory Pract ; 29(1): 19-30, 2013 Jan.
Article in English | MEDLINE | ID: mdl-22765020

ABSTRACT

The hospitals' outpatient clinics for people with multiple sclerosis (PwMS) are important in the health care. Research regarding physiotherapy in such clinics is limited. The purpose was to investigate how PwMS perceive movement during single sessions of physiotherapy in a hospital's outpatient clinic, and what do these experiences mean for the patient's insight into their movement disturbances? Qualitative research interviews were performed with a purposive sample of 12 PwMS and supplemented with seven videotaped sessions. Content analysis was performed. The results indicate that contextualized perceptions of movement appear to be an essential source for PwMS to gain expanded insight with regard to their individual movement disturbances regardless of their ambulatory status. The contextualization implies that perceptions of movement are integrated with the physiotherapist's explanations regarding optimizing gait and balance or other activities of daily life. Perceptions of improvement in body part movement and/or functional activities are vital to enhancing their understanding of their individual movement disorders, and they may provide expanded insight regarding future possibilities and limitations involving everyday tasks. The implementation of movements, which transforms the perceived improvement into self-assisted exercises, appeared to be meaningful. Contextualized perceptions of improvements in movement may strengthen the person's sense of ownership and sense of agency and thus promote autonomy and self-encouragement. The findings underpin the importance of contextualized perceptions of movement based on exploration of potential for change, as an integrated part of information and communication in the health care for PwMS. Further investigations are necessary to deepen our knowledge.


Subject(s)
Movement Disorders/psychology , Movement Disorders/rehabilitation , Multiple Sclerosis/psychology , Multiple Sclerosis/rehabilitation , Perception , Physical Therapy Modalities/psychology , Activities of Daily Living/psychology , Adult , Aged , Aged, 80 and over , Cohort Studies , Dependent Ambulation/psychology , Female , Humans , Male , Middle Aged , Movement Disorders/etiology , Multiple Sclerosis/complications , Patient Satisfaction , Qualitative Research , Self Report
13.
Pediatr. aten. prim ; 14(56): 317-321, oct.-dic. 2012.
Article in Spanish | IBECS | ID: ibc-108026

ABSTRACT

Los trastornos del control de esfínteres son uno de los problemas más comunes en la consulta del pediatra de Atención Primaria. Se expone un caso clínico de un niño de cuatro años que presenta encopresis funcional por rechazo a utilizar el inodoro, así como la intervención llevada a cabo en conjunto por Pediatría y Psicología Clínica. La exposición de este caso muestra cómo la misma manifestación puede esconder distintos problemas que requerirán diferentes abordajes terapéuticos. Asimismo, se pone de manifiesto la necesidad de prestar atención a los diversos contextos que rodean al niño (familia, escuela, profesionales), así como valorar la interacción y la influencia mutua de los síntomas de este con la actitud de los padres y con otros factores externos para entender y abordar el problema de forma más precisa y global (AU)


Toilet training disorders are commonly treated problems in Primary Health Care Pediatrician practice. A case study of a four year-old boy with functional encopresis and stool toileting refusal is presented; the interdisciplinary intervention conducted by specialized Pediatrics and Clinical Psychology is also discussed. This clinical case presentation shows that the same symptoms may underlie different problems which would require different therapeutic interventions. The need to pay attention to the contexts surrounding the child (family, school, professionals) is also highlighted; as well as assessing the interaction and reciprocal influence between the child’s symptoms, the parents’ attitudes and other external factors, in order to understand and approach to the problem in a more comprehensive way (AU)


Subject(s)
Humans , Male , Child , Toilet Training , Elimination Disorders/diagnosis , Elimination Disorders/psychology , Elimination Disorders/rehabilitation , Encopresis/complications , Encopresis/diagnosis , Object Attachment , Language Development , Primary Health Care/methods , Primary Health Care/trends , Encopresis/physiopathology , Encopresis/psychology , Mobility Limitation , Dependent Ambulation/education , Dependent Ambulation/psychology
14.
Int Psychogeriatr ; 24(11): 1836-45, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22874772

ABSTRACT

BACKGROUND: Out-of-home mobility refers to the realization of trips outside the home, by foot or by other means of transportation. Although out-of-home mobility is important for the well-being of older people with cognitive impairment, its importance for their caregivers is not clear. This study aims to clarify the relationship between caregiving burden and out-of-home mobility of care-recipients using Global Positioning Systems (GPS) technology. METHODS: Seventy-six dyads (care-recipients and caregivers) were recruited from a psychogeriatric center, where they underwent cognitive assessment, followed by psychosocial interviews at home. Care-recipients received GPS tracking kits to carry for a period of four weeks, whenever they left home. Mobility data and diagnostic and psychosocial data were examined in relation to caregiver burden. RESULTS: The strongest predictors of burden were care-recipients' lower cognitive status and more time spent walking out-of-home. An interaction was found between cognitive status and time spent walking in relation to caregiver burden. The relationship between walking and burden was stronger among caregivers of care-recipients with dementia than caregivers of care-recipients with no cognitive impairment or mild cognitive impairment. Care-recipients' behavioral and emotional states were also positively related to caregiver burden. CONCLUSIONS: The findings stress the importance of maintaining older persons' out-of-home mobility during cognitive decline.


Subject(s)
Caregivers/psychology , Cognition Disorders , Dementia , Dependent Ambulation/psychology , Mental Competency , Transportation of Patients/methods , Activities of Daily Living/psychology , Adult , Aged , Aged, 80 and over , Cognition Disorders/diagnosis , Cognition Disorders/etiology , Cognition Disorders/psychology , Dementia/complications , Dementia/diagnosis , Dementia/physiopathology , Dementia/psychology , Female , Geographic Information Systems , Geriatric Assessment/methods , Humans , Interview, Psychological , Male , Middle Aged , Mobility Limitation , Outcome and Process Assessment, Health Care , Psychiatric Status Rating Scales
15.
Rehabilitación (Madr., Ed. impr.) ; 45(1): 61-66, ene.-mar. 2011.
Article in Spanish | IBECS | ID: ibc-86083

ABSTRACT

Objetivo. El objetivo principal es revisar las herramientas disponibles para valorar la movilidad del paciente amputado de miembro inferior con el fin de identificar las más útiles en cuanto a información clínica, sencillez técnica y tiempo de realización para poder aplicarlas en la práctica clínica diaria. Los individuos que sufren una amputación de miembro inferior presentan un deterioro funcional que afecta a múltiples facetas de la vida, como la movilidad. La movilidad es una necesidad básica física, vital y social y su recuperación óptima es uno de los principales objetivos de los programas de rehabilitación del paciente amputado. Método. Se realizó una búsqueda sistemática de los estudios relevantes publicados desde enero de 2003 hasta enero de 2010 en MEDLINE, EMBASE, Cochrane Database y PEDro, incluyendo ensayos clínicos aleatorizados, metaanálisis, revisiones sistemáticas y artículos de revisión; también se revisaron diversas guías de práctica clínica. Resultados y conclusiones. A pesar de encontrar referencias de múltiples escalas genéricas, específicas, cuestionarios y tests de ejecución, no se encuentra en la literatura evidencia de consenso respecto a cuáles son las herramientas más adecuadas para valorar la movilidad del paciente amputado de extremidad inferior. Los tests de marcha se han demostrado fiables y sensibles a los cambios producidos por la rehabilitación, y su resultado se correlaciona con medidas de función física y con el uso de la prótesis, son prácticos y simples, por lo que pueden ser incluidos en la práctica clínica habitual, dejando los cuestionarios y tests específicos para el ámbito de la investigación(AU)


Objective. The principal objective was to review the available tools to measure mobility in lower limb amputees and to identify the most useful tools in terms of clinical information, technical simplicity and time to performance so that it can be used in the daily clinical practice. Individuals who have suffered a lower limb amputation have a functional deterioration that affects many aspects of life, including mobility. Mobility is a basic physical, vital and social need and its optimal recovery is one of the main objectives of the Rehabilitation programs for amputee patients. Methods. We conducted a systematic search for relevant studies published from January 2003 to January 2010 in MEDLINE, EMBASE, Cochrane and PEDro Database, including randomized clinical trials, review articles, systematic reviews and meta-analysis. Several clinical practice guidelines were also reviewed. Results and conclusions. Despite finding references of many generic scales, specific questionnaires and performance tests, no evidence of consensus was found in literature for the most appropriate tools to assess lower limb amputee's mobility. The Walking Tests have been found to be reliable and sensitive to changes related to the rehabilitation treatment and their outcomes are correlated with measures of physical function and the use of the prosthesis. They are practical and easy-to-use tests so that they can be included in the routine clinical practice, reserving the questionnaires and specific tests for research(AU)


Subject(s)
Humans , Male , Female , Mobility Limitation , Amputation, Traumatic/rehabilitation , Amputation, Surgical/rehabilitation , Relative Value Scales , Dependent Ambulation/physiology , Dependent Ambulation/psychology , Dependent Ambulation/statistics & numerical data , Surveys and Questionnaires
16.
J Gerontol Soc Work ; 54(1): 29-52, 2011 Jan.
Article in English | MEDLINE | ID: mdl-21170778

ABSTRACT

The subjective responses associated with personal life space and mobility status were explored. Thirty individuals participated in focus groups based on self-rated disability status, current places visited, and availability. Qualitative analyses revealed that most participants equated personal mobility with driving a vehicle. Attitudes concerning mobility status and preparedness for change varied based on disability level and personal experience. Fear of dependence from future mobility loss was prominent in all groups. Few participants acknowledged significant planning for future retirement from driving or other mobility challenges. An understanding of common attitudes, perceptions and meanings can inform professionals who intervene and support older adults experiencing mobility changes.


Subject(s)
Dependent Ambulation/psychology , Disabled Persons , Mobility Limitation , Aged , Aged, 80 and over , Automobile Driving/psychology , Disability Evaluation , Disabled Persons/psychology , Disabled Persons/rehabilitation , Emotions , Female , Focus Groups , Humans , Intention , Male , Middle Aged , Sickness Impact Profile , Socioeconomic Factors
17.
Spinal Cord ; 48(5): 393-9, 2010 May.
Article in English | MEDLINE | ID: mdl-19841634

ABSTRACT

STUDY DESIGN: Retrospective cross-sectional study with anonymous postal data collection. OBJECTIVE: Regaining the best possible mobility and independence is not only the focus of the rehabilitation process for individuals with spinal cord injury (SCI), but also represents an important criterion for the individual's quality of life (QoL). Therefore, if and to what extent physical exercise (PE) influences the QoL of individuals with SCI was investigated. SETTING: The period of investigation extended from September 2007 to January 2008. Data were acquired from the BG Trauma Hospital Hamburg database and the German Wheelchair Sport Federation databases. METHODS: Analysis of 277 questionnaires of individuals with acquired SCI between the age of 16 and 65 years with complete wheelchair dependency in everyday life and lesion level lower C5. RESULTS: In all, 51.5% of all individuals were reported being actively involved in sports as opposed to 48.5% individuals not participating in sports. Individuals actively involved in sports have higher employment rate than physically inactive individuals with SCI. PE was identified as the main influencing determinant of QoL. This was particularly within the physical and psychological dimensions. CONCLUSION: In discovering the potential of individuals with SCI for getting involved in PE, the improvement of physical and coordinative skills with interaction between individuals with SCI and external sport groups should be an inherent part of the rehabilitation process. Individuals not having access to PE should be given the opportunity to participate in wheelchair mobility courses. This may improve the adherence to PE of individuals with SCI in post-clinical settings.


Subject(s)
Activities of Daily Living/psychology , Exercise Therapy/psychology , Physical Fitness/psychology , Quality of Life/psychology , Spinal Cord Injuries/psychology , Spinal Cord Injuries/rehabilitation , Adult , Athletic Performance/psychology , Athletic Performance/statistics & numerical data , Cross-Sectional Studies , Dependent Ambulation/psychology , Dependent Ambulation/statistics & numerical data , Employment/psychology , Employment/statistics & numerical data , Exercise Therapy/statistics & numerical data , Female , Health Status , Health Surveys , Humans , Male , Middle Aged , Outcome Assessment, Health Care/methods , Retrospective Studies , Social Support , Spinal Cord Injuries/physiopathology , Sports/psychology , Sports/statistics & numerical data , Surveys and Questionnaires , Wheelchairs/psychology , Wheelchairs/statistics & numerical data
19.
Pediatr Blood Cancer ; 49(2): 183-9, 2007 Aug.
Article in English | MEDLINE | ID: mdl-16779807

ABSTRACT

BACKGROUND: Reliability and validity of a new tool, Functional Mobility Assessment (FMA), were examined in patients with lower-extremity sarcoma. FMA requires the patients to physically perform the functional mobility measures, unlike patient self-report or clinician administered measures. PROCEDURE: A sample of 114 subjects participated, 20 healthy volunteers and 94 patients with lower-extremity sarcoma after amputation, limb-sparing, or rotationplasty surgery. Reliability of the FMA was examined by three raters testing 20 healthy volunteers and 23 subjects with lower-extremity sarcoma. Concurrent validity was examined using data from 94 subjects with lower-extremity sarcoma who completed the FMA, Musculoskeletal Tumor Society (MSTS), Short-Form 36 (SF-36v2), and Toronto Extremity Salvage Scale (TESS) scores. Construct validity was measured by the ability of the FMA to discriminate between subjects with and without functional mobility deficits. RESULTS: FMA demonstrated excellent reliability (ICC [2,1] >or=0.97). Moderate correlations were found between FMA and SF-36v2 (r = 0.60, P < 0.01), FMA and MSTS (r = 0.68, P < 0.01), and FMA and TESS (r = 0.62, P < 0.01). The patients with lower-extremity sarcoma scored lower on the FMA as compared to healthy controls (P < 0.01). CONCLUSION: The FMA is a reliable and valid functional outcome measure for patients with lower-extremity sarcoma. This study supports the ability of the FMA to discriminate between patients with varying functional abilities and supports the need to include measures of objective functional mobility in examination of patients with lower-extremity sarcoma.


Subject(s)
Leg/surgery , Mobility Limitation , Postoperative Complications/epidemiology , Sarcoma/surgery , Severity of Illness Index , Survivors/psychology , Amputation, Surgical , Bone Neoplasms/drug therapy , Bone Neoplasms/radiotherapy , Bone Neoplasms/surgery , Canes/statistics & numerical data , Combined Modality Therapy , Crutches/statistics & numerical data , Dependent Ambulation/psychology , Dependent Ambulation/statistics & numerical data , Humans , Leg/physiopathology , Observer Variation , Pain/epidemiology , Pain/etiology , Personal Satisfaction , Physical Endurance , Physical Exertion , Postoperative Complications/physiopathology , Postoperative Complications/psychology , Reproducibility of Results , Running , Sarcoma/drug therapy , Sarcoma/radiotherapy , Social Adjustment , Sports , Walking , Wheelchairs/statistics & numerical data
20.
Int J Rehabil Res ; 28(4): 349-50, 2005 Dec.
Article in English | MEDLINE | ID: mdl-16319560

ABSTRACT

A follow-up study was conducted with 20 patients after the rehabilitation process at six Health Centres at the University Hospital in Umeå, Sweden. The study was conducted at the Accident Analysis Group, University Hospital in Umeå. None of the patients with physical impairments had self-experiences of injury events in the traffic environment. Sixty percent of the respondents reported feeling safe in the traffic environments. Eighty percent of the respondents were satisfied with the degree of safety and the advantage of roundabouts in traffic environments. The respondents who had personal assistance reported travel anxiety and fear. With respect to dealing with personal assistance and help, risk-taking behaviour and poor knowledge of patients with physical impairment, as a vulnerable road-user group, were important risk factors.


Subject(s)
Accidents, Traffic/statistics & numerical data , Dependent Ambulation/injuries , Disabled Persons , Mobility Limitation , Safety , Wheelchairs , Adult , Aged , Aged, 80 and over , Dependent Ambulation/psychology , Dependent Ambulation/statistics & numerical data , Disabled Persons/psychology , Disabled Persons/rehabilitation , Female , Follow-Up Studies , Home Health Aides/education , Humans , Male , Middle Aged , Sweden
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