552 - Humanitude Care on Patients with Dementia and Delirium in Acute Hospital Improves Outcomes

Background/ Objectives:Older patients with dementia and/or delirium often have challenging behaviours such as refusal of care and aggression. These cause much distress to both healthcare staff and patients, increase burden of care and put older patients at risk of functional decline. Humanitude, a methodology of care developed by Gineste and Marescotti, is a relationship- centred and compassionate care approach that aims to enable patients. The aim of this study is to investigate the effectiveness of Humanitude on older patients’ well-being, mobility and activities of daily living (ADLs).Design:Quasi-experimental, non-equivalent controlled trial design.Setting:Acute care hospitalParticipants:Twenty patients diagnosed with dementia and/ or delirium were recruited from two geriatric wards. Ten were in the Humanitude ward and the other ten in a conventional ward received usual care for older patients served as concurrent controls.Intervention:Patients in Humanitude ward received Humanitude care by trained healthcare workers during day-to-day care, which is based on the 4 pillars of gaze, speech, touch and verticality (maintaining an upright position). Every patient encounter utilizing Humanitude techniques follow a structured care sequence that helps draw the patient into the care relationship.Measurements:The outcome measures include Modified Perme ICU Mobility Score, Bradford Well- being Profile and Modified Barthel Index (MBI).Results:There was significant improvement of median score within the Humanitude group from admission to discharge in mobility (admission: 9.0 [0-27] vs discharge 19.5 [1-36], p=0.002**), MBI (admission: 20 [0.0-46] vs discharge: 54.3 [3-81], p = 0.002**) and well-being (admission: 7.0 [1-15] vs discharge 20.0 [8-26], p=0.002**). The median increase in the score of Humanitude group was also significantly higher than usual care group in mobility (Humanitude: 8 [1-24] vs usual care 0 [-9-16], p= 0.02*), MBI (Humanitude: 17.5 [3-64] vs usual care 0 [-3-17], p= <0.001***), and well-being (Humanitude: 11 [6-20] vs usual care 0 [-5-4], p= <0.001 ***).Conclusion:Humanitude care improves outcomes in mobility, ADL function and well-being for patients with dementia and/ or delirium in the acute hospital.(Word count: 329)

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Communication behavior of cognitively impaired older inpatients

Zeitschrift für Gerontologie und Geriatrie ◽

10.1007/s00391-019-01623-2 ◽

2019 ◽

Vol 52 (S4) ◽

pp. 264-272

Author(s):

Eva-Luisa Schnabel ◽

Hans-Werner Wahl ◽

Susanne Penger ◽

Julia Haberstroh

Keyword(s):

Cognitive Impairment ◽

Psychometric Properties ◽

Acute Care ◽

Older Patients ◽

Hospital Setting ◽

Acute Care Hospital ◽

Acute Care Hospitals ◽

Well Being ◽

Communication Behavior ◽

Care Hospital

Abstract Background and objective Acutely ill older patients with cognitive impairment represent a major subgroup in acute care hospitals. In this context, communication plays a crucial role for patients’ well-being, healthcare decisions, and medical outcomes. As validated measures are lacking, we tested the psychometric properties of an observational instrument to assess Communication Behavior in Dementia (CODEM) in the acute care hospital setting. As a novel feature, we were also able to incorporate linguistic and social-contextual measures. Material and methods Data were drawn from a cross-sectional mixed methods study that focused on the occurrence of elderspeak during care interactions in two German acute care hospitals. A total of 43 acutely ill older patients with severe cognitive impairment (CI group, Mage ± SD = 83.6 ± 5.7 years) and 50 without cognitive impairment (CU group, Mage ± SD = 82.1 ± 6.3 years) were observed by trained research assistants during a standardized interview situation and rated afterwards by use of CODEM. Results Factor analysis supported the expected two-factor solution for the CI group, i.e., a verbal content and a nonverbal relationship aspect. Findings of the current study indicated sound psychometric properties of the CODEM instrument including internal consistency, convergent, divergent, and criterion validity. Conclusion CODEM represents a reliable and valid tool to examine the communication behavior of older patients with CI in the acute care hospital setting. Thus, CODEM might serve as an important instrument for researcher and healthcare professionals to describe and improve communication patterns in this environment.

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Preadmission Functional Decline Predicts Functional Improvement Among Older Patients Admitted to Acute Care Hospital

The Journals of Gerontology Series A ◽

10.1093/gerona/glx211 ◽

2017 ◽

Vol 73 (10) ◽

pp. 1363-1369 ◽

Cited By ~ 4

Author(s):

Cristina Gagliardi ◽

Andrea Corsonello ◽

Mirko Di Rosa ◽

Paolo Fabbietti ◽

Antonio Cherubini ◽

...

Keyword(s):

Acute Care ◽

Older Patients ◽

Functional Decline ◽

Acute Care Hospital ◽

Functional Improvement ◽

Care Hospital

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Feasibility and acceptability of hypnosis-derived communication administered by trained nurses to improve patient well-being during outpatient chemotherapy: a pilot-controlled trial

Supportive Care in Cancer ◽

10.1007/s00520-021-06481-6 ◽

2021 ◽

Author(s):

Caroline Arbour ◽

Marjorie Tremblay ◽

David Ogez ◽

Chloé Martineau-Lessard ◽

Gilles Lavigne ◽

...

Keyword(s):

Usual Care ◽

Emotional Support ◽

Symptom Management ◽

Controlled Trial ◽

Well Being ◽

Physical Symptoms ◽

Intervention Site ◽

Outpatient Chemotherapy ◽

Edmonton Symptom Assessment Scale ◽

Contrast Perception

Abstract Purpose This pilot-controlled trial aimed to examine the feasibility and acceptability of hypnosis-derived communication (HC) administered by trained nurses during outpatient chemotherapy to optimize symptom management and emotional support — two important aspects of patient well-being in oncology. Methods The trial was conducted in two outpatient oncology units: (1) intervention site (usual care with HC), and (2) control site (usual care). Nurses at the intervention site were invited to take part in an 8-h training in HC. Participants’ self-ratings of symptoms and emotional support were gathered at predetermined time points during three consecutive outpatient visits using the Edmonton Symptom Assessment Scale and the Emotional Support Scale. Results Forty-nine patients (24 in the intervention group, 25 in the control group) with different cancer types/stages were recruited over a period of 3 weeks and completed the study. All nurses (N = 10) at the intervention site volunteered to complete the training and were able to include HC into their chemotherapy protocols (about ± 5 min/intervention). Compared to usual care, patients exposed to HC showed a significant reduction in physical symptoms during chemotherapy. In contrast, perception of emotional support did not show any significant effect of the intervention. Participants exposed to HC report that the intervention helped them relax and connect on a more personal level with the nurse during chemotherapy infusion. Conclusions Our results suggest that HC is feasible, acceptable, and beneficial for symptom management during outpatient chemotherapy. While future studies are needed, hypnosis techniques could facilitate meaningful contacts between cancer patients and clinicians in oncology. Trial registration Clinical Trial Identifier: NCT04173195, first posted on November 19, 2019

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Rice farming care as a novel method of green care farm in East Asian context: an implementation research

BMC Geriatrics ◽

10.1186/s12877-021-02181-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chiaki Ura ◽

Tsuyoshi Okamura ◽

Sachiko Yamazaki ◽

Masaya Shimmei ◽

Keisuke Torishima ◽

...

Keyword(s):

East Asia ◽

Usual Care ◽

Usual Care Group ◽

Well Being ◽

Care Group ◽

Rice Farming ◽

People With Dementia ◽

Significant Difference ◽

Positive Experiences ◽

Green Care Farms

Abstract Background Green care farms, which offer care for people with dementia in a farm setting, have been emerging in the Netherlands. The aim of this study was to 1) implement green care farms which use rice farming in Japan, 2) explore the positive experiences of rice farming care, and 3) compare the effect of rice farming care to that of usual care on well-being and cognitive ability. Methods We developed a new method of green care farm in Japan which uses rice farming, a farming that is practiced all over East Asia. The participants were 15 people with dementia (mean age = 75.6 ± 9.8 years) who participated in a one-hour rice farming care program once a week for 25 weeks. We also collected qualitative data on the positive experiences of study participants after the program. As a reference data, we also collected the corresponding data of the usual care group which included 14 people with dementia (mean age = 79.9 ± 5.8 years) who were attending the near-by day-care. Results The mean participation rate on the rice farming care group was 72.1%. After the intervention, participants reported experiencing enjoyment and connection during the program. It also changed the staff’s view on dementia. The green care farm group showed a significant improvement in well-being but no significant difference in cognitive function compared to the usual care group. Conclusions Green care farms by using rice farming is promising care method which is evidence-based, empowerment-oriented, strengths-based, community-based dementia service, which also delivers meaningful experience for the people with dementia in East Asia. Trial registration UMIN, UMIN000025020, Registered 1 April 2017.

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Effect of Artificial Intelligence on Nutritional Status of children post cardiac surgery; A Randomized Controlled Trial (Preprint)

10.2196/preprints.36480 ◽

2022 ◽

Author(s):

Maryam Zahid ◽

Ume Sughra

Keyword(s):

Nutritional Status ◽

Usual Care ◽

Usual Care Group ◽

Mobile Application ◽

Controlled Trial ◽

Intervention Group ◽

Care Group ◽

Randomized Controlled ◽

Nutritional Status Of Children ◽

Post Cardiac Surgery

BACKGROUND Malnutrition is the most common problem in congenital heart diseases patients. Health based mobile applications play an important role in planning and tracking of diet for better nutritional status OBJECTIVE To assess the effect of artificial intelligence on nutritional status of children post cardiac surgery in comparison to usual care group. To assess usefulness of diet related mobile application in comparison to usual care group. METHODS This is a two arm randomized controlled trial that was conducted at a Tertiary Care Hospital, Rawalpindi. The study duration was 6 months from February 2021 till July 2021. Sample size was calculated to be 88. Intervention group was given a diet related mobile application and usual care group was handed a pamphlet with diet instructions on discharge. RESULTS Mean weight of all participants was 15 ± 5.7 kg at the time of discharge whereas at the end of 8th week mean weight of the participants in usual care group was 16.5 ± 7.2 kg and intervention group was 17.1 ± 5 kg. Average calories consumed by usual care group was 972 ± 252 kcal and 1000.75 ± 210 kcal by intervention group after 8 weeks of discharge. Average proteins consumed by the usual care group was 34.3 ± 12.5 grams and 39± 6.4 grams by intervention group after 8 weeks of discharge. At the end of intervention preferred diet planning tool for 79% of the participants was mobile application. At 8th week 93% of the participants considered the visual cues useful, 80% think that the mobile application language was understandable, 79% of the participants think nutritional goal setting is a useful feature in mobile application and 55% of the participants think the recipes in the application were useful. CONCLUSIONS The study showed strength for the future of scalable modern technology for self-nutrition monitoring. There was slight increase in the weight and nutritional intake of both groups as interventions period was limited. CLINICALTRIAL Study was registered on clinicaltrial.gov website with trial identity number NCT04782635.

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Sensory Integration Therapy Versus Usual Care for Sensory Processing Difficulties in Autism Spectrum Disorder in Children: Study Protocol for a Pragmatic Randomised Controlled Trial

10.21203/rs.2.95/v2 ◽

2019 ◽

Author(s):

Elizabeth Randell ◽

Rachel McNamara ◽

Sue Delport ◽

Monica Busse ◽

Richard Hastings ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Usual Care ◽

Sensory Processing ◽

Sensory Integration ◽

Controlled Trial ◽

Well Being ◽

Autism Spectrum ◽

Face To Face ◽

Sensory Integration Therapy ◽

Randomised Controlled

Abstract Background: Autism Spectrum Disorder (ASD) is a common lifelong condition affecting 1 in 100 people. ASD affects how a person relates to others and the world around them. Difficulty responding to sensory information (noise, touch, movement, taste, sight) is common, and might include feeling overwhelmed or distressed by loud or constant low-level noise (e.g. in the classroom). Affected children may also show little or no response to these sensory cues. These ‘sensory processing difficulties’ are associated with behaviour and socialisation problems, and affect education, relationships, and participation in daily life. Sensory Integration Therapy (SIT) is a face-to-face therapy or treatment, provided by trained occupational therapists who use play -based sensory-motor activities and the just-right challenge to influence the way the child responds to sensation, reducing distress, and improving motor skills, adaptive responses, concentration and interaction with others. With limited research into SIT, this protocol describes in detail how the intervention will be defined and evaluated. Methods: Two-arm pragmatic individually 1:1 Randomised Controlled Trial (RCT) with internal pilot of SIT versus Usual Care (UC) for primary school aged children (4 to 11 years) with ASD and Sensory Processing (SP) difficulties. 216 children will be recruited from multiple sources. Therapy will be delivered in clinics meeting full fidelity criteria for manualised SIT over 26 weeks (face-to-face sessions: 2 per week for 10 weeks, 2 per month for 2 months; Telephone call: 1 per month for 2 months). Follow up assessments will be completed at 6 and 12 months post randomisation. Prior to recruitment: therapists will be invited to participate in focus groups/interviews to explore what is delivered as usual care in trial regions; carers will be invited to complete an online survey to map out their experience of services. Following recruitment: carers will be given diaries to record their contact with services. Following intervention, carer and therapist interviews will be completed. Discussion: Results of this trial will provide high quality evidence on the clinical and cost-effectiveness of SIT aimed at improving behavioural, functional, social, educational and well-being outcomes for children and well-being outcomes for carers and families. Trial registration: ISRCTN14716440. Registered 08/11/2016. http://www.isrctn.com/ISRCTN14716440

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The Natural History of Back Pain after a Randomised Controlled Trial of Acupuncture Vs Usual Care – Long Term Outcomes

Acupuncture in Medicine ◽

10.1136/aim.25.4.121 ◽

2007 ◽

Vol 25 (4) ◽

pp. 121-129 ◽

Cited By ~ 6

Author(s):

Stephanie L Prady ◽

Kate Thomas ◽

Lisa Esmonde ◽

Simon Crouch ◽

Hugh MacPherson

Keyword(s):

Back Pain ◽

Randomised Controlled Trial ◽

Usual Care ◽

Controlled Trial ◽

Bodily Pain ◽

Care Group ◽

Long Term Outcomes ◽

Short Term Treatment ◽

Randomised Controlled

Introduction There is growing evidence about the effectiveness of acupuncture in the short term treatment of chronic low back pain but little is known about long term outcomes. To address this question we followed up participants of a past randomised controlled trial of acupuncture to assess outcomes after 5.5 to 7 years. Methods A postal questionnaire assessing pain, quality of life, disability, experience with back pain and healthcare resource use was sent to all 239 participants of the York Acupuncture for Back Pain trial. Results Response to the survey was low at 43.9%. Pain measured by the SF-36 Bodily Pain dimension was maintained in the acupuncture group since the last follow up 3.5 to 5 years previously. The usual care group had improved over the intervening years and there was now no evidence of a difference between the groups (difference −0.4 points, 95% confidence interval −10.1 to 9.7). The results were unchanged on sensitivity analysis using multiple imputation. In both groups back pain had not completely resolved and worry about back health was moderate. Physiotherapy and acupuncture were used at similar rates for continuing treatment. Discussion We theorise that exposure to a short course of acupuncture speeds natural recovery from a back pain episode, but improvements plateau after two years. Acupuncture is often accessed privately for long term management of back pain but is rarely available within the health service. While our study methods were robust, the low response rate means that our findings should be interpreted with caution.

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Using Moxibustion in Primary Healthcare to Correct Non-Vertex Presentation: A Multicentre Randomised Controlled Trial

Acupuncture in Medicine ◽

10.1136/acupmed-2012-010261 ◽

2013 ◽

Vol 31 (1) ◽

pp. 31-38 ◽

Cited By ~ 36

Author(s):

Jorge Vas ◽

José Manuel Aranda-Regules ◽

Manuela Modesto ◽

María Ramos-Monserrat ◽

Mercedes Barón ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Usual Care ◽

Primary Healthcare ◽

Primary Outcome ◽

Controlled Trial ◽

Acupuncture Point ◽

Care Group ◽

Moxibustion Group ◽

Vertex Presentation ◽

Randomised Controlled

Objective To compare the effectiveness of additional moxibustion at point BL67 with moxibustion at a non-specific acupuncture point and with usual care alone to correct non-vertex presentation. Methods This was a multicentre randomised controlled trial in which 406 low-risk pregnant women with a fetus in ultrasound breech presentation, with a gestational age of 33–35 weeks, were assigned to (1) true moxibustion at point BL67 plus usual care; (2) moxibustion at SP1, a non-specific acupuncture point (sham moxibustion) plus usual care; or (3) usual care alone. The primary outcome was cephalic presentation at birth. Women were recruited at health centres in primary healthcare. Results In the true moxibustion group, 58.1% of the full-term presentations were cephalic compared with 43.4% in the sham moxibustion group (RR 1.34, 95% CI 1.05 to 1.70) and 44.8% of those in the usual care group (RR 1.29, 95% CI 1.02 to 1.64). The reduction in RR of the primary outcome in women allocated to the true moxibustion group compared with the usual care group was 29.7% (95% CI 3.1% to 55.2%) and the number needed to treat was 8 (95% CI 4 to 72). There were no severe adverse effects during the treatment. Conclusions Moxibustion at acupuncture point BL67 is effective and safe to correct non-vertex presentation when used between 33 and 35 weeks of gestation. We believe that moxibustion represents a treatment option that should be considered to achieve version of the non-vertex fetus. Trial Registration Current Controlled Trials ISRCTN10634508.

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