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OBJECTIVE: Impaired self-awareness (SA) after acquired brain injury (ABI) has traditionally been linked to deficits in executive functions. However, conflicting findings about this relationship have been reported in the literature. This inconsistency is probably due to the multicomponent nature of both constructs, as not all aspects of executive functions may be equally relevant to all components of self-awareness. This study explored whether offline SA (i.e. metacognitive knowledge) and online SA (i.e. error detection) relate to a less studied executive component, conflict monitoring/resolution. METHOD: Twenty-six patients with ABI performed the Three-Conflict Cognitive Control Task (3CCT), an experimental task that allowed to measure the ability to monitor and solve three different types of conflicts (Distractors-filtering, Spatial Stroop and Simon). Measures of SA were collected: offline SA was based on self-informant discrepancy about patient's everyday functional difficulties, and online SA was based on error detection abilities during a performance-based naturalistic task (The Breakfast Conflict Task). RESULTS: After controlling for global cognition, the conflict monitoring measure of 3CCT demonstarted incremental validity in predicting offline and online SA measured in naturalistic tasks. CONCLUSIONS: Conflict monitoring/resolution seems to be an important component of SA. This finding contributes to further understand the relationship between executive functions and SA. In addition, conflict monitoring/resolution is an executive component that should be considered when designing assessment and intervention strategies to deal with ISA.
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TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03958487.
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AIMS: To analyse the measurement properties of the Spanish version of the COPM (Canadian Occupational Performance Measure) in older adult rehabilitation inpatients. METHOD: A sample of 172 users from 17 inpatient care facilities for older adults (47% nursing homes) participated in a quantitative prospective study. We examined validity by correlating the COPM with the Barthel Index (BI), the Lawton Instrumental Activities of Daily Living scale (IADL), the EuroQol-five domains-three level questionnaire (EQ-5D-3L), and the Client-Centred Rehabilitation Questionnaire (CCRQ) and by examining associations with demographic variables. Reliability was evaluated through test-retest and responsiveness through differences in change scores in two types of care facilities. RESULTS: Participants prioritised 637 occupational performance problems, mainly in the area of self-care (70.5%). The COPM scale scores were significantly correlated with BI, IADL, EQ-5D-3L (except the pain dimension), and CCRQ (except the family involvement and continuity dimensions). COPM scores did not show statistically significant differences concerning educational level. Regarding reliability, high test-retest correlations were obtained (>.80). Nursing home users showed less responsiveness to rehabilitation than other users (change score < 2 vs. > 2 points). CONCLUSION AND SIGNIFICANCE: The Spanish COPM provides satisfactory measurement properties as a client-centred instrument in older adult rehabilitation inpatient.
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Atividades Cotidianas , Pacientes Internados , Terapia Ocupacional , Humanos , Masculino , Feminino , Idoso , Estudos Prospectivos , Reprodutibilidade dos Testes , Idoso de 80 Anos ou mais , Inquéritos e Questionários , Casas de Saúde , Espanha , Psicometria , Avaliação da DeficiênciaRESUMO
The main objective of this protocol is to understand the effectiveness of the use of a mobile application (OcupApp) to generate a personal self-analysis about meaningful activities in a population of adults aged between 50 and 70 years with low or moderate depression/anxiety. A randomised study will be carried out comparing the effects of the use of the OcupApp application with a control intervention on health-related quality of life, mental health, frequency of participation on meaningful activities, and perceived occupational balance. This is the first study to use occupational self-analysis in m-health to improve occupational balance, mental health, frequency of participation in meaningful activities and health-related quality of life. The app was co-created with a population whose characteristics are similar to those of the target users, and it was tested in both the intervention itself and the presentation, thus it is expected to be effective.Trial Registration Number: Clinical Trial B1-2020_25.
This is the first study to evaluate the impact of an app on occupational participation in people older than 50 years with mild-moderate anxiety and/or depressionIntroducing an occupational self-analysis app that helps people become aware of their occupations can improve health-related quality of life, mental health, frequency of participation on meaningful activities, and perceived occupational balance.OcupApp will allow people to go under occupational self-analysis process from home or any other place, maintaining the principles of the original programme.
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IMPORTANCE: Impaired self-awareness (SA) of deficits after an acquired brain injury (ABI) severely affects patients' independence in activities of daily living (ADLs). However, any assessment tool permits an exhaustive evaluation of SA in the context of ADLs. OBJECTIVE: To study the validity of the Breakfast and Dressing Conflict Task (BD Conflict Task) to assess online SA (awareness of performance in the context of a given task) in patients with ABI; to study its interactions with offline SA (general awareness); and to test the validity of a simplified measure of performance monitoring, the ADL Conflict-Monitoring Index. DESIGN: Convergent validity and correlational study. SETTING: Research laboratory, hospitals, and homes. PARTICIPANTS: Thirty patients with ABI and 28 neurologically healthy controls. OUTCOMES AND MEASURES: Using the BD Conflict Task, measures of emergent awareness, self-regulation, anticipatory awareness, and self-evaluation were assessed and their convergent validity and relationship with offline SA were analyzed. The ADL Conflict-Monitoring Index was calculated, and its convergent validity was tested. RESULTS: The online SA variables of the BD Conflict Task showed convergent validity with traditional online SA measures. Offline SA correlated with emergent and anticipatory awareness in the Breakfast Task. The ADL Conflict-Monitoring Index proved to be a valid measure of patients' performance monitoring. CONCLUSIONS AND RELEVANCE: These preliminary findings suggest that the BD Conflict Task is a valid tool to assess online SA in patients with ABI and provide further understanding of the online SA-offline SA interaction. Furthermore, the ADL Conflict-Monitoring Index may be a valid and easy-to-use monitoring measure in clinical settings. Plain-Language Summary: Patients with acquired brain injury (ABI) and reduced awareness of their cognitive deficits face problems performing activities of daily living (ADLs) and may show signs of unsafe behaviors. Being aware of one's own abilities involves anticipating problems before starting a task, detecting and correcting errors during the task, and evaluating performance afterward. This study provides preliminary validity for the Breakfast and Dressing Conflict Task, a new tool that assesses aspects of self-awareness simultaneously in the context of familiar and significant ADLs. Furthermore, the tool simplifies the assessment of detecting and correcting errors with an easy-to-use index, making it suitable for use in clinical settings.
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Atividades Cotidianas , Lesões Encefálicas , Humanos , Desjejum , Percepção , BandagensRESUMO
OBJECTIVES: The Self-Management Analysis in Chronic Conditions (SMACC) checklist was developed as a guidance tool to support the development, comparison and evaluation of self-management support programmes for persons with a chronic condition. The checklist was based on a previously performed concept analysis of self-management. The aim of this study was to validate its content using an international Delphi study and to deliver a final version. DESIGN: A two-round Delphi study was conducted between October 2022 and January 2023. Using the researchers' networks, professionals with research or clinical expertise in self-management support and chronic conditions were recruited via online purposive snowball sampling. Participants were asked to score each item of the checklist (16 items total) on 3 content validity indicators: (1) clarity and comprehensibility, (2) relevance and importance and (3) degree of alignment with the overall goal of the checklist to promote adequate and comprehensive self-management support programmes. A consensus threshold of 75% agreement was used. The participants were also asked general questions about the checklist as a whole and were asked to provide feedback considering its refinement. RESULTS: Fifty-four professionals with an average 14.5 years of experience participated in round 1, 48 with an average 12.5 years of experience participated in round 2. The majority of professionals were from Western Europe. For the majority of items consensus was reached after round 1. In round 2, 3 of the 4 remaining items reached consensus, 1 last item was retained based on highly recurring feedback. CONCLUSIONS: The SMACC checklist was considered a valid and comprehensive tool to aid the development, evaluation and comparison of self-management support programmes. It was acknowledged as a useful instrument to supplement existing frameworks and was seen as feasible to implement in both research and clinical settings. Further validation in the field, with input from patients and peer experts, will be valuable.
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Lista de Checagem , Autogestão , Humanos , Consenso , Técnica Delphi , Doença CrônicaRESUMO
Objective: There is a crucial need for reliable tools to measure impaired self-awareness (ISA) in patients with acquired brain injury (ABI) across cognitive-functional domains. The aim of this study was to assess the psychometric properties of the Cog-Awareness ADL Scale, which is a novel self-proxy discrepancy method for measuring ISA in both basic and instrumental activities of daily living. Methods: This multicenter study included 54 patients (no-low ISA n = 33; severe ISA, n = 21) from four outpatient rehabilitation units in Málaga-Granada, Spain, and 51 healthy controls. The participants and proxy raters completed the Cog-Awareness ADL Scale and the Patient Competency Rating Scale (PCRS). Agreement between both scales was assessed using Spearman's correlations and the Bland-Altman plot. Group comparisons were made on measures of SA, cognitive abilities and demographic variables. Sensitivity and specificity were analysed by ROC curve analysis. Results: Convergent validity was supported by strong correlations with the PCRS and its subscales (rho's ranging from 0.51 to 0.80, p < 0.01 for all). The Bland-Altman plot confirmed measurement agreement (only 3.70% of the scores were outside the 95% limits). External validity was demonstrated by effectively discriminating between healthy controls and ABI patients with no-low and severe ISA on each discrepancy index while controlling for cognitive/demographic variables. The Cog-Awareness ADL Scale showed optimal diagnostic accuracy (AUC = 0.95, sensitivity = 0.90, specificity = 0.90). Conclusions: The Cog-Awareness ADL Scale proved to be a feasible, valid, and clinical tool to assess ISA across different cognitive-functional domains, in Spanish ABI-patients.
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Introduction: During the lockdown caused by COVID-19 in Spain, citizens had to stop performing activities in the usual way, which could have had an impact on mental health. The aim of this study was to determine the contribution of participating in meaningful activitieson mental health in the Spanish population during the COVID-19 lockdown. Method:A cross-sectional online survey was developed and administered, where mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), participation in meaningful activities (Engage-ment in Meaningful Activities Survey) and socio-demographic data were assessed. A hierarchical-linear-regression was used to identify key correla-tions. Results:The participants (N= 311) reported low mental health (M= 16.12/36) and a lower level of resilience (M = 25.48). The results of the re-gression revealed that 32.6% of the variance of the GHQ was significantly explained by the living space, including an outdoor space, resilience and participation in meaningful activities. The loss of meaningful activities was significantly related to mental health, with a significant contribution when controlling for the other variables (β = -.12). Conclusion:Although experi-mental studies are needed to determine causality, this study highlights the relationship between participation in meaningful activities and mental health during the lockdown.(AU)
Introduction: During the lockdown caused by COVID-19 in Spain, citizens had to stop performing activities in the usual way, which could have had an impact on mental health. The aim of this study was to determine the contribution of participating in meaningful activities on mental health in the Spanish population during the COVID-19 lockdown. Method: A cross-sectional online survey was developed and administered, where mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), participation in meaningful activities (Engagement in Meaningful Activities Survey) and socio-demographic data were assessed. A hierarchical-linear-regression was used to identify key correlations. Results: The participants (N = 311) reported low mental health (M = 16.12/36) and a lower level of resilience (M = 25.48). The results of the regression revealed that 32.6% of the variance of the GHQ was significantly explained by the living space, including an outdoor space, resilience and participation in meaningful activities. The loss of meaningful activities was significantly related to mental health, with a significant contribution when controlling for the other variables (β = -.12). Conclusion: Although experimental studies are needed to determine causality, this study highlights the relationship between participation in meaningful activities and mental health during the lockdown.(AU)
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Humanos , Saúde Mental , Pandemias , Infecções por Coronavirus/epidemiologia , Isolamento Social , Resiliência Psicológica , Espanha , Psicologia Social , Terapia OcupacionalRESUMO
We present the process of translation, adaptation, and validation in the Spanish context of the 10-item version of the Weekly Calendar Planning Activity (WCPA-10), a performance-based measure of cognitive instrumental activities of daily living (C-IADL). The study consisted of two phases: I) translation/cultural adaptation of the WCPA, conducted by professional bilingual translators, a panel of experts, and a pilot study, and II) validation in a sample of 42 acquired brain injury patients (ABI) and 42 healthy participants (HC). WCPA primary outcomes showed expected convergent/discriminant validity patterns with socio-demographical and clinical variables and cognitive processes identifying those WCPA outcomes that best predicted executive and memory deficits measured with a battery of traditional neuropsychological tests. In addition, performance on the WCPA was a significant predictor of everyday functioning over variables such as socio-demographics or global cognition when measured with traditional tests. External validity was established by the WCPA's ability to identify everyday cognitive deficits in ABI patients compared to HC, even in those with subtle cognitive impairment based on neuropsychological tests. The Spanish WCPA-10 seems an appropriate and sensitive assessment tool to identify cognitive-functional impairment in ABI-patients, even those with subtle cognitive impairment. The results also highlight the relevance of this kind of test, as they indicate a better prediction of patients' real-world functioning than traditional neuropsychological tests.
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Objetivos: diseñar y llevar a cabo una intervención para aumentar la conciencia durante el desempeño de la actividad de conducir un simulador, en un caso de una persona con un accidente cerebrovascular. Métodos: basándose en el modelo de conciencia dinámica, la intervención se centró en la propia experiencia y en el feedback visual a través de vídeos sobre el desempeño. Resultados: el usuario obtuvo una mejoría en la conciencia inmediatamente después del desempeño (autoevaluación posterior), pero no en la conciencia anticipatoria antes de la actividad. Conclusiones: la autoevaluación posterior mejora tras la experiencia y el feedback, pero no lo hace la conciencia anticipatoria, quizás debido a alteraciones en la memoria. Estudios futuros deberán abordar cómo conseguir efectos sobre la anticipación del desempeño de la actividad.(AU)
Objective: An intervention was designed and carried out to increase awareness during the activity of simulated driving, in a case of a person with a stroke. Methods: based on the dynamic awareness model, the intervention was based on self-experience and visual feedback through performance videos. Results: An improvement in awareness immediately after the performance (subsequent self-assessment) was achieved by the user, but not in anticipatory awareness before the activity. Conclusions: subsequent self-assessment improves after the experience and feedback, but anticipatory awareness does not, perhaps because of memory disorders. Future studies should address how to achieve effects on the advance of the activity performance.(AU)
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Humanos , Masculino , Pessoa de Meia-Idade , Estado de Consciência , Acidente Vascular Cerebral , Reabilitação do Acidente Vascular Cerebral , Terapia Ocupacional , Conscientização , Condução de Veículo/psicologia , Pacientes Internados , Exame Físico , Avaliação de Sintomas , Retroalimentação PsicológicaRESUMO
PURPOSE: The aim of the study is to present the process of translation, adaptation and validation of the Client-Centred Rehabilitation Questionnaire (CCRQ) in the Spanish context. METHODS: The process integrates two sequential phases. Phase 1 consists of a questionnaire translation and back-translation process conducted by a panel of experts, and a pilot study. In phase 2, CCRQ-e (Spanish version) was administered to 305 rehabilitation inpatients to collect evidence on the reliability and validity of the instrument. RESULTS: The exploratory and confirmatory analysis confirmed seven original domains, eliminating four items from the original scale. CCRQ-e has a good internal consistency. Discriminative construct validity distinguished significant differences based on age, educational level, and severity of diagnosis. Criterion validity of the CCRQ and EQ-5D showed negative significant correlations between CCRQ-e and the general perception of health EQ-VAS, and a positive correlation between CCRQ-e and EQ pain and EQ anxiety (higher scores in CCRQ-e mean lower client-centered practice perceived). CONCLUSIONS: The Spanish version of the CCRQ is suitable for evaluating person-centered rehabilitation from the person's perspective. It includes aspects related to the comfort, decision-making, and participation of the client, as well as questions about the provision of service and the environment.Implications for rehabilitationThe original seven domains of the CCRQ could be replicated in the sample of patients from Spanish rehabilitation services.By eliminating four items from the original scale, the validated scale, known as the CCRQ-e (Spanish version), was obtained.The CCRQ-e allows a reliable and valid evaluation of the perception of the person-centeredness of the Spanish rehabilitation services.The CCRQ-e is the first self-reported measure in Spanish of an individual's experience during the rehabilitation service.
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Comparação Transcultural , Centros de Reabilitação , Humanos , Reprodutibilidade dos Testes , Projetos Piloto , Inquéritos e Questionários , PsicometriaRESUMO
El creciente interés de aplicar una práctica centrada en la persona en los servicios de terapia ocupacional y rehabilitación, implican disponer de herramientas para que la persona del servicio pueda evaluar las diferentes dimensiones que engloba el concepto. Después de un proceso de traducción, adaptación cultural y validación el Client-Centred Rehabilitation Questionaire o Cuestionario de Rehabilitación Centrado en el Cliente versión española (CCRQ-e) es una medida de autoevaluación diseñada para evaluar la experiencia centrada en la persona en los servicios de rehabilitación. Engloba tanto aspectos relacionados con el confort, decisión o participación del cliente, como aspectos relacionados con la provisión de servicio o el entorno. El instrumento consta de 29 ítems específicamente desarrollados para representar las características de rehabilitación en 7 subescalas: Toma de decisiones, educación, evaluación de resultados, implicación de la familia, soporte emocional, confort físico y continuidad/coordinación. Las 7 subescalas muestran una buena consistencia interna. Asimismo, la validez de constructo del instrumento mostró una buena capacidad discriminante entre programas y centros, en las diferentes subescalas, resultando un instrumento adecuado para evaluar la atención centrada en la persona en los servicios de rehabilitación. (AU)
The growing interest in applying a person-centered practice in occupational therapy and rehabilitation services, implies having tools so that the person in the service can evaluate the different dimensions that the concept encompasses. After a process of translation, cultural adaptation and validation, the Client-Centred Rehabilitation Questionnaire or Cuestionario de Rehabilitación Centrado en el Cliente in its Spanish version (CCRQ-e), is a self-assessment measure designed to assess the person-centered experience in rehabilitation services. It encompasses both aspects related to customer comfort, decision or participation, as well as aspects related to the provision of service or the environment. The instrument consists of 29 items, specifically developed to represent rehabilitation characteristics, in 7 subscales: decision making, education, outcome evaluation, family involvement, emotional support, physical comfort, and continuity/coordination. The 7 subscales show good internal consistency. Likewise, the construct validity of the instrument showed a good discriminating capacity between programs and centers, in the different subscales, resulting in an adequate instrument to evaluate person- centered care in rehabilitation services. (AU)
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Humanos , Terapia Ocupacional , Serviços de Reabilitação , Autoavaliação (Psicologia) , Inquéritos e Questionários , Espanha , TraduçãoRESUMO
INTRODUCTION: The sequelae of moderate-severe acquired brain injury (ABI) encompass motor, cognitive, sensory, emotional and behavioural areas that affect meaningful occupational participation and quality of life, with a high prevalence of associated mental disorders. When the patient returns to community life after discharge from the hospital, specialised care is generally insufficient due to the lack of consideration of the dual condition of mental disorder and ABI. Since there is a negative impact on competence and thus on occupational participation, occupational therapy represents a convenient way of intervention. On these assumptions, a community-based occupational therapy protocol on mental health for people with moderate/severe acquired brain injury (COT-MHABI) is presented. It is focused on meaningful occupational participation and looks for improvement in the quality of life. METHODS AND ANALYSIS: This study aims: (i) to design a protocol to evaluate the effectiveness of a community occupational therapy intervention based on MOHO for patients with a dual (mental health/ABI) for improving quality of life and self-perceived occupational performance; (ii) to analyse the outcomes of occupational and social variables (occupational balance, participation level, satisfaction with occupation and performed roles and community integration) after the COT-MHABI process; (iii) to analyse the impact of quality of life on satisfaction with occupations performed by this population. A non-randomised controlled clinical trial will be performed. Patients assigned to the experimental group will receive over one year of on-site and telematic occupational therapy sessions, 16 sessions on average. Variables such as quality of life, community integration or satisfaction with occupational performance will be collected at baseline, 6, and 12 months. DISCUSSION: The needs for the dual mental/ABI population in their reintegration into the community are related to the associated deficits and to the absence of specialised services for the complexity of this patient profile. Few studies consider the coexistence of mental health and ABI issues. The COT-MHABI protocol is proposed to provide continuity to the community needs of this population, conceptualised from occupational participation, person-centred and focused on meaningful activities. CLINICAL TRIAL REGISTRATION: Trial identifier and registry name ClinicalTrials.gov ID: NCT04586842 https://clinicaltrials.gov/ct2/show/NCT04586842?term=252136&draw=2&rank=1; Pre-results; Community-based Occupational Therapy Intervention on Mental Health for People With Acquired Brain Injury (COT-MHABI).
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Lesões Encefálicas , Terapia Ocupacional , Lesões Encefálicas/complicações , Lesões Encefálicas/terapia , Humanos , Saúde Mental , Satisfação Pessoal , Qualidade de VidaRESUMO
Objetivos:explorar la contribución al bienestar psicológico de tejer en grupo frente a tejer individualmente y profundizar en las causas que llevan a las personas a tejer en grupo.Método: Se trata de un estudio observacional, descriptivo y retrospectivo. Un comité experto diseñó un cuestionario ad hoc para este estudio.Resultados:El cuestionario lo respondieron 644 personas tejedoras. Los resultados mostraron que la mayoría de las variables de bienestar psicológico fueron significativamente mayores en las personas que, además de tejer solas, tejían en grupo, en comparación con las que solo tejían de manera individual. Las principales causas de tejer en grupo fueron la oportunidad de obtener ideas del grupo y de enseñar y aprender de las demás personas. Conclusiones: Respaldando los beneficios de la prescripción social, tejer en grupo parece ser una fuente adicional de bienestar psicológico. (AU)
Objective: The aim of the study was to explore the contribution to psychological well-being of knitting in a group versus doing it alone. Likewise looking into the different reasons why people knit in a group.Method: It is a retrospective descriptive observational study. A questionnaire ad hoc was designed by a group of experts.Results: the questionnaire was answered by 644 knitters. The results showed that most of the psychological well-being variables were significantly higher in people who were knitting alone as well as they knitted in a group, compared to those who only knitted alone. The opportunity to share ideas as to teach and learn from others were been the main causes for group knitting.Conclusions: Supporting the benefits of social prescribing, group knitting seems to be additional sources of psychological well-being. (AU)
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Humanos , Terapia Recreacional , Terapia Ocupacional , Saúde Mental , Arteterapia , Inquéritos e Questionários , Redes Sociais OnlineRESUMO
INTRODUCTION: Competence-based learning must be integrated into the practical development of Physiotherapy. Teamwork, interpersonal relations, analytical skills or critical/clinical thinking are some examples of internationally recommended competences in this kind of university studies. Therefore, there is a need to evaluate this learning in Physiotherapy through valid tools that facilitate this task. OBJECTIVE: To analyze the psychometric properties according to competences in Clinical Practices (RECOPC-FIS II) in order to assess 14 transversal or universal competences of under-graduate students in the Physiotherapy degree. METHODS: A validation study was conducted with 197 students in the 3rd and 4th year of the Physiotherapy degree and 202 clinical tutors who assessed these students using the RECOPC-FIS II. Different psychometric properties were analyzed: factor structure, internal consistency and sensitivity to change. RESULTS: The RECOPC-FIS II has a high internal consistency. Its 14 items saturate in a single factor. Regarding the sensitivity to change, the rubric showed higher scores in the Practicum of the 4th year with respect to that of the 3rd year, reaching significant differences in all of them. CONCLUSION: The RECOPC-FIS II is a valid and reliable instrument to assess the transversal competencies of undergraduate students of Physiotherapy during their clinical practice. Therefore, it is intended to facilitate the acquisition of essential skills for the development of their professional career. The flexibility of this tool would allow its adaptation to other health science courses.
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Competência Clínica , Bacharelado em Enfermagem , Aprendizagem , Modalidades de Fisioterapia/educação , Estudantes de Enfermagem , Pensamento , Adulto , Feminino , Humanos , Masculino , PsicometriaRESUMO
Background: Client-centred practice aims to involve the person in making decisions during the therapeutic intervention process, giving him or her a central and active role.Objectives: To analyze the effects of client-centred practice in occupational therapy on issues related to occupational performance and participation among people with stroke and traumatic brain injury.Material and methods: A systematic review of randomized clinical trials examining the effects of a client-centred practice carried out by occupational therapists in patients with stroke or traumatic brain injury aged over 18 years was conducted. PubMed, Web of Science, Scopus, OT Seeker, PsycINFO and EBSCO were used to retrieve potentially eligible publications.Results: Eight studies, from 294 identified, were included. The extracted data showed that the application of client-centred practice in occupational therapy improved satisfaction with occupational performance compared to conventional interventions. However, client-centred practice and conventional intervention had similar effects on functionality (Activities of Daily Living), life satisfaction and burden on caregivers.Conclusions and significance: Client-centred practice has the effect of achieving greater satisfaction with occupational performance. This suggests that client-centred practice in occupational therapy helps patients to accept the new limitations on their occupational performance. Further studies are needed to determine the effects of client-centred practice on other aspects.
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Terapia Ocupacional , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Atividades Cotidianas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Assistência Centrada no Paciente , Acidente Vascular Cerebral/terapiaRESUMO
OBJECTIVE: To validate an informant-based tool - the extended version of the Cognitive Scale of Basic and Instrumental Activities of Daily Living (BADL and IADL) or Ext. Cog-ADL Scale - in a larger sample and with a broader range of cognitive-functional items related to activities of daily living (ADL). METHOD: The Ext. Cog-ADL Scale was administered to family informants of 42 patients with dementia, 43 patients with multidomain mild cognitive impairment (mdMCI), and 23 healthy control participants. We analyzed the convergent and concurrent validity and external validity of this scale. RESULTS: The Ext. Cog-ADL Scale demonstrated good psychometric properties. Episodic and working memory tests were the main predictors of most cognitive-functional items of the scale. While patients with dementia obtained lower scores in most error categories of the scale, affecting both BADL and IADL, mdMCI patients showed a more specific pattern of difficulties. Apart from the typical alterations in IADL, mdMCI patients also showed difficulties in several error categories related to BADL (i.e., error detection, problem solving, task self-initiation, distraction inhibition, and restore). CONCLUSIONS: The Ext. Cog-ADL Scale seems to be an adequate tool to capture the specific pattern of cognitive alterations related to IADL and BADL that differentiates dementia from mdMCI and healthy aging; it shows that mdMCI can involve specific cognitive difficulties that affect even BADL.
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Disfunção Cognitiva , Demência , Atividades Cotidianas/psicologia , Cognição , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/psicologia , Demência/diagnóstico , Demência/psicologia , Humanos , Testes NeuropsicológicosRESUMO
Case-based learning enables the application of theory to practice using real-life patient cases. The present study aims to compare the effect between video cases and paper cases on motivation for learning and knowledge acquisition to perform a clinical reasoning case exercise by occupational therapy students. A mixed-methods design was used with 120 students randomized into two groups. All students conducted a clinical reasoning case exercise on the same case, although in different presentation formats: paper case and video case. The quantitative measures of this study were the scores of motivation for learning from the Instructional Material Motivation Survey and the grades of a clinical reasoning case exercise. The qualitative part was based on the positive and negative aspects perceived by the participants. The results showed that the motivation for learning was significantly higher for the video case compared to the paper case, although there were no differences in the grades of the clinical reasoning case exercise between the two groups. The video cases were perceived as more relevant to professional practice and more informative in terms of non-verbal communication and context. In light of the results, teachers could use these two formats of presentation of cases with different objectives.
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Motivação , Terapia Ocupacional , Competência Clínica , Raciocínio Clínico , Exercício Físico , Humanos , EstudantesRESUMO
BACKGROUND: The spread of COVID-19 has affected people's daily lives, and the lockdown may have led to a disruption of daily activities and a decrease of people's mental health. AIM: To identify correlates of adults' mental health during the COVID-19 lockdown in Belgium and to assess the role of meaningful activities in particular. METHODS: A cross-sectional web survey for assessing mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), meaning in activities (Engagement in Meaningful Activities Survey), and demographics was conducted during the first Belgian lockdown between April 24 and May 4, 2020. The lockdown consisted of closing schools, non-essential shops, and recreational settings, employees worked from home or were technically unemployed, and it was forbidden to undertake social activities. Every adult who had access to the internet and lived in Belgium could participate in the survey; respondents were recruited online through social media and e-mails. Hierarchical linear regression was used to identify key correlates. RESULTS: Participants (N = 1781) reported low mental health (M = 14.85/36). In total, 42.4% of the variance in mental health could be explained by variables such as gender, having children, living space, marital status, health condition, and resilience (ß = -.33). Loss of meaningful activities was strongly related to mental health (ß = -.36) and explained 9% incremental variance (R2 change = .092, p < .001) above control variables. CONCLUSIONS: The extent of performing meaningful activities during the COVID-19 lockdown in Belgium was positively related to adults' mental health. Insights from this study can be taken into account during future lockdown measures in case of pandemics.