Disability Prevention Program Improves Life-Space and Falls Efficacy: A Randomized Controlled Trial.

OBJECTIVES: To evaluate the effects of a home-based disability prevention program on life-space and falls efficacy among low-income older adults. DESIGN: Single-blind two-arm randomized controlled trial. SETTING: Participants' homes. PARTICIPANTS: Participants were low-income cognitively intact older adults (≥65 years old) with restricted daily activities. Our analytic sample for life-space (n = 194) and falls efficacy (n = 233) varied as the life-space measure was introduced 4 months after the trial began. INTERVENTION: Up to six 1-hour home visits with an occupational therapist; up to four 1-hour home visits with a registered nurse; and up to $1,300 worth of home repairs, modifications, and assistive devices with a handyman, during a course of 4 months. MEASUREMENTS: Life-space was measured by the Homebound Mobility Assessment; falls efficacy was measured using the 10-item Tinetti Falls Efficacy Scale at baseline and 5 months. RESULTS: Participants were on average 75 years old, predominantly Black (86%) and female (85%-86%). Compared with participants in the control group, participants receiving the intervention were more likely to have improved versus decreased life-space in areas of bathroom (adjusted odds ratio (OR) = 3.95; 95% confidence interval (CI) = 1.20-12.97), front or back porch, patio, or deck (adjusted OR = 2.67; 95% CI = 1.05-6.79), stairs (adjusted OR = 4.09; 95% CI = 1.34-12.48), leaving the house for any reason other than for health care (adjusted OR = 2.40; 95% CI = 1.01-5.73), and overall life-space (adjusted OR = 2.15; 95% CI = 1.10-4.19). Participants who received the intervention also had an 11% improvement in falls efficacy in performing daily activities (exponentiated coefficient = 1.12; 95% CI = 1.04-1.21). CONCLUSION: Life-space and falls efficacy were improved through a multicomponent, person-directed, home-based disability prevention intervention. Findings suggest that this intervention should be translated into different settings to promote independent aging.

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60 años de la aprobación del título de fisioterapia y de la primera escuela de fisioterapia reconocida, la de Salus Infirmorum en el centro infantil "Casa del Niño" de Madrid / 60 years since approval of the physiotherapy degree and the first recognized physiotherapy school, Salus Infirmorum ubicated in the children's center "Casa del Niño" in Madrid

Se acaban de cumplir 60 años de la aprobación de la especialidad de Fisioterapia para los Ayudantes Técnicos Sanitarios, así como la creación de las primeras escuelas de Fisioterapia. El presente artículo justificará cómo el conjunto de brotes epidémicos de poliomielitis en España, influyeron de forma decisiva en el nacimiento de profesiones sanitarias como la Fisioterapia. Por otro lado, se reconstruirá el proceso de institucionalización, nacimiento y desarrollo en sus primeros años de la Escuela de Fisioterapia Salus Infirmorum, la primera en ser aprobada por el Ministerio de Educación. Salus Infirmorum, con la creación del centro infantil "Casa del Niño" consiguió aunar la formación de fisioterapeutas y el tratamiento de niños con problemas motóricos como consecuencia de la poliomielitis. En el centro se atendió a más de 680 niños y se formaron en ella 373 enfermeras fisioterapeutas, siendo reconocido como Obra de interés social, por la Comisaría de Asistencia Social del Ministerio de Educación Nacional, en orden 6 de junio de 1958

Sixty years have passed since approval of the Physiotherapy specialty for licensed practical nurses, as well as the establishment of the first Physiotherapy Schools. This paper will explain how the set of epidemic outbreaks of poliomyelitis in Spain, had a decisive influence on the birth of health professions such as Physiotherapy. On the other hand, throughout it, the process of institutionalization of Salus Infirmorum, the first Physiotherapy College recognized by the Ministry of Education, its birth and its first year’s early development will be reconstructed. Salus Infirmorum, with the creation of the children’s center "Casa del Niño" managed to combine the physiotherapists training with the treatment of children with motor disorders as a result of poliomyelitis. In the healthcare center, more than 680 children were attended and 373 physiotherapist-nurses were trained, being recognized as a Social Interest Group, by the Social Assistance Commission of the Ministry of National Education, in order June 6, 1958

[Occupational therapy and eating disorders, a care case study]. / Ergothérapie et troubles du comportement alimentaire, récit d'une prise en charge.

Occupational therapy offers support through actuation via a suggested activity. It opens up a differentiated space, a space of experiences where patients can contemplate themselves through play. The therapeutic relationship, assured by the occupational therapist, offers flexibility and malleability to welcome, contain and support the person with an eating disorder. It aims to be compassionate without judgement to favour the experience of movement. 'Making do with oneself' to 'be with oneself' while respecting the temporality of the patient's possibilities.

Effects of Physical Limitations on Daily Activities Among Adults With Mental Health Disorders: Opportunities for Nursing and Occupational Therapy Interventions.

Individuals living with mental health disorders served by the public mental health system often face comorbid medical conditions that affect their quality of life and lifespan. The effect of physical limitations on the engagement in daily activities among individuals living with mental health disorders has not been extensively researched. Adults attending community wellness centers (N = 53) in a northeastern United State were included in a descriptive study exploring the impact of physical limitations on daily activities. The activities most frequently affected were: walking or moving around, sleeping, and finding a job. The physical limitations affecting these three activities were lack of energy and pain. Health care professionals, including mental health nurses and occupational therapy practitioners, are in an ideal position to collaborate by evaluating and offering treatment interventions that address physical limitations to positively affect occupational functioning and recovery. [Journal of Psychosocial Nursing and Mental Health Services, 55(10), 45-51.].

[Beyond suffering, schizophrenic improvisation and therapeutic challenges]. / Au-delà des maux, improvisation schizophrénique et (en)jeux thérapeutiques.

Led jointly by an actress and an occupational therapist, an 'improvisation' activity has been set up within the Sainte-Anne University Hospital SHU Sector 14 for hospitalised patients, on medical prescription. This containing environment provides psychological support and encourages patients with schizophrenia to explore their creativity and to 'let go' so as to discover new physical possibilities. The group thereby becomes a support for the relationship and the development of verbal and non-verbal communication.

Propuesta de enfermería con terapias complementarias para el abordaje de riesgos psicosociales a nivel laboral / Proposal to nursing with complementary therapies for the approach psychosocial risk factors at work

ResumenIntroducción: Es reconocido que el trabajo genera efectos positivos en las personas como seguridad económica, bienestar y satisfacción, aspectos que ofrecen beneficios en todo ámbito, inclusive en la salud. A pesar de lo anterior, el mundo laboral en la actualidad exige tomar decisiones, pensar críticamente, liderar, además de poseer conocimientos para ejecutar las labores en forma eficiente y eficaz, lo cual puede producir sobrecarga y disconfort que afectan física, psicológica y socialmente a un individuo.Desarrollo: El propósito de este trabajo es aportar al enfrentamiento de los riesgos psicosociales en el ámbito laboral, por medio de la utilización de terapias complementarias y/o alternativas desde la disciplina de Enfermería. Se postula que la enfermería posee un campo de saberes, ligados al cuidado holístico y a la promoción en salud, por ello se toma el marco legal actual y las bases disciplinares de Enfermería, las cuales dan soporte a la implementación de terapias complementarias o alternativas en salud laboral.Conclusión: Como consideraciones finales, se destaca que las bases disciplinares de la enfermería abogan por el cuidado de los trabajadores a través del uso de terapias complementaria, de modo que otorgue fundamentos teóricos y científicos al área de salud laboral para enfrentar los riesgos psicosociales en el trabajo desde una mirada trasformadora.

AbstractIntroduction: It is recognized that the work generates positive effects on people and economic security, wellbeing and satisfaction, both of which offer benefits in all areas, including health. Despite this, the world of work now requires decisions, think critically, lead, besides having expertise to perform tasks efficiently and effectively, which may result in overload and discomfort affecting physically, psychologically and socially an individual.Developing: This article is a theoretical reflection conducted with the purpose of contributing from the discipline of nursing, facing the psychosocial risk factors at work through the usage of complementary and/or alternative therapies. This is proposed since nursing possesses knowledge linked to holistic care and healthcare promotion. For that purpose, the current legal framework globally and nationally, and the disciplinary bases for nursing, are presented, which contribute to the implementation of complementary or alternative therapies on occupational health.Conclusion: As closing remarks, it is proposed that nursing possesses disciplinary bases which advocate for the workers healthcare through the usage of complementary therapies. Therefore, that profession might present theoretical and scientific fundamentals to the occupational healthcare in order to face psychosocial risk factors at work with a transforming perspective.

Health-Related Quality-of-Life Outcomes: Comparing Patients With Aneurysmal and Nonaneurysmal Subarachnoid Hemorrhage.

Subarachnoid hemorrhage (SAH) is divided into two major types (aneurysmal [ASAH] and nonaneurysmal [NASAH]) because, in approximately 15% of the patients who experience SAH, no source of hemorrhage can be identified. Anecdotal evidence and contradictory research suggest that patients with NASAH experience some of the same health-related quality of life (HRQOL) issues as patients with ASAH. This quantitative survey design study compared 1-3 years after hemorrhage the HRQOL in patients who had experienced an NASAH with those who had experienced an ASAH. This is the first U.S. study to specifically investigate HRQOL in NASAH and the second to compare HRQOL outcomes between patients with ASAH and NASAH. These study results corroborate those of the first-that the two groups are much more similar than different. It confirms that the impact on employment for both hemorrhage groups is significant, and it also finds an even greater inability to return to work for the patients with NASAH. Physical symptom complaints were more common in the group with NASAH, whereas the group with ASAH experienced more emotional symptoms. Both groups had low levels of posttraumatic stress disorder (PTSD), with those levels not differing significantly between groups. However, PTSD and social support were shown to impact HRQOL for both groups. The authors recommend that clinicians assess all patients with SAH for PTSD and institute treatment early. This may include offering psychological services or social work early in the hospital course. Further research and policy changes are needed to assist in interventions that improve vocational reintegration after SAH. Patients with NASAH should no longer be described as having experienced a "benign hemorrhage." They have had a life-changing hemorrhage that may forever change their lives and impact their HRQOL.

[The world of the oldest old: is the effectiveness of an intervention measurable? Geriatric occupational therapy program created by a group of nurses as described by Paola D'Ovidio and Francesca Perego]. / Il mondo degli AmA (Anziani molto Anziani): si può misurare l'efficacia di un intervento?

A group of women who assumed the role of providing an integration of the routine care of a nursing home through the activation of various laboratories (from writing, to painting, to manual activities, to music), report on the criteria and the methodologies of their intervention, as well as the results obtained, over a period of three years, by giving a central place to the testimony of the "oldest old" population. The narrative of this experience is proposed not only as a strategy which can be reproduced but also as a methodology of evaluation for a setting which could be hardly assessed with standardized instruments based on quantitative rules and scores.

Analysis of a silent voice: a qualitative inquiry of embroidery created by a patient with schizophrenia.

A poster-sized piece of embroidery, completed in the 1960s, hangs in the Glore Psychiatric Museum, a testament to the daily experience of a woman who rarely spoke and was diagnosed with schizophrenia. The embroidery document was analyzed by three researchers who came to agreement on themes via triangulation and constant comparison. The woman's lived experience was considered. The analysis found that although the patient was silent, she was connected in interesting ways to the environment around her. Implications for nursing care include awareness of the importance of milieu to patients, that silence should not be inferred to be detachment, and nurses should continue to develop creative ways to engage patients who may communicate in nontraditional ways.

Neonatal nurses' and therapists' perceptions of positioning for preterm infants in the neonatal intensive care unit.

PURPOSE: Determine perceptions about positioning for preterm infants in the neonatal intensive care unit (NI CU). DESIGN: Twenty-item survey. SAMPLE: Neonatal nurses (n = 68) and speech, physical, and occupational therapists (n = 8). MAIN OUTCOME VARIABLE: Perceptions about positioning were obtained, and differences in perceptions between nurses and therapists were explored. RESULTS: Ninety-nine percent of respondents agreed that positioning is important for the well-being of the infant. Sixty-two percent of nurses and 86 percent of therapists identified the Dandle ROO as the ideal method of neonatal positioning. Forty-four percent of nurses and 57 percent of therapists reported that the Dandle ROO is the easiest positioning method to use in the NICU. Some perceptions differed: Therapists were more likely to report that the SleepSack does not hold the infant in good alignment. Nurses were more likely to report that the infant does not sleep well in traditional positioning.

Developmentally supportive care in the neonatal intensive care unit: an occupational therapist's role.

The role of a pediatric occupational therapist (OT) in the NICU is to provide comprehensive services, including evaluation, treatment, education, decision making, family support, and discharge planning. It may also include early intervention services or outpatient pediatric rehabilitation services. This article will address the need for developmentally supportive care in the NICU, and specifically addresses the role of an OT in this setting. It will explain how crucial collaboration between team members can be in providing quality, comprehensive care for these neonates. In addition, it will address the important role of the parent in this setting for developmentally supportive care while in the NICU and follow-up intervention upon discharge.

[Self-images and perceptions of other professions among students of nursing, physiotherapy, and occupational therapy and their importance for interprofessional cooperation]. / Das Selbst- und Fremdbild von Auszubildenden in der Pflege, Physiotherapie und Ergotherapie und seine Be- deutung für die interprofessionelle Kooperation.

INTRODUCTION: Interdisciplinary cooperation is necessary to provide effective and high quality treatment for clients of the health care system. Interaction between professional groups depends on how their members perceive their self-image and the image of other professions. METHOD: Within the framework of the project "Quality in the education of health-professionals" a qualitative study with 23 nurses, 24 physiotherapists and 15 occupational therapists in the second or third year of training was conducted. Participants were asked to report their self-image and the image of the other two professions. A qualitative content analysis according to Mayring was used for data analysis. RESULTS: Four categories emerged that allowed describing the self image and the image of the other professions: roles of the respective health professions, relation of the health professionals to their clients, attributes that typically characterized members of a particular profession, and relationship between the health professions. DISCUSSION: Latent conflicts between professional groups became apparent. Contradicting perceptions are due to subjective bias in favour of the own professional group. Interdisciplinary collaboration requires a new culture of co-operation.

Vital signs: a nurse-led education initiative for occupational therapists.

This article describes a collaborative development between a critical care outreach team and occupational therapists to improve the therapists' awareness of vital signs. Occupational therapists are increasingly involved in patient discharge from acute care areas; traditionally, their role focused on rehabilitation of patients who had recovered from acute crises. In accordance with improving patient safety, occupational therapists need to be able to recognise the early warning signs of acute deterioration and understand the significance of vital signs to be able to raise concerns with nursing and medical staff.