A Controlled Trial of Goal Setting for Long-Term Community Psychiatric Patients

1986 ◽  
Vol 49 (8) ◽  
pp. 264-268 ◽  
Author(s):  
Christine Howell

Clinical goal setting is a widely advocated, yet poorly documented technique. This paper describes a controlled trial which was carried out with long-term community psychiatric patients. The experimental group received goal setting in the form of goal attainment scaling (GAS), whilst the control group received social reinforcement. The experimental group had a higher goal score and a significantly higher sessional involvement (p<0.05). The goal categories decided by the clinicians as relevant, differed from those wished by the subjects; the latter subsequently attained only low goal scores. There were no significant differences between the two groups on the work performance or social interaction outcome measures. These differences between the two groups were obtained despite the fact that the subjects of the research were the most intransigent to treatment. It is suggested that goal setting is an independent treatment technique which requires further substantiation, particularly amongst occupational therapists who are covertly or overtly employing the technique. Further research must address the question of identifying the characteristics of patients most likely to benefit from goal setting.

2021 ◽  
Author(s):  
Jie Jia ◽  
Chong Li ◽  
Xinyu Song ◽  
Shugeng Chen ◽  
Chuankai Wang ◽  
...  

BACKGROUND A serious game-based Cellphone Augmented Reality System (CARS) was developed for rehabilitation of stroke patients, which is portable, convenient, and suitable for self-training. OBJECTIVE The present research aimed to study the effectiveness of CARS in improving upper limb motor function and cognition function of stroke patients via conducting a long-term randomized controlled trial and analyze the patient’s acceptance of the proposed system. METHODS A randomized, double-blind, controlled trial was performed with 30 post-stroke, sub-acute phase patients. All patients in both the experimental group (n=15) and the control group (n=15) performed a 1-hour session of therapy each day, 5 days per week, for 2 weeks. Patients in the experimental group received 30 minutes of rehabilitation training with CARS and 30 minutes of conventional occupational therapy (OT) each session, while patients in the control group received conventional OT for the full 1 hour each session. The Fugl-Meyer Assessment-Upper Extremity subscale (FMA-UE), Action Research Arm Test (ARAT), Manual Muscle Test (MMT), Brunnstrom Stage (BS), and Barthel Index (BI) were used to assess motor function, and the Mini-Mental State Examination (MMSE), Add VS Sub (AVS), and Stroop Game (SG) were used to assess cognitive function before and after the 2-week treatment period. In addition, the User Satisfaction Evaluation Questionnaire (USEQ) was used to reflect the patients’ acceptance of the system in the experimental group after the final intervention. RESULTS All the assessment scores of the experimental group and control group were significantly improved after intervention (p<0.05). The experimental group’s score of FMA-UE and ARAT increased by 11.47 and 5.86 respectively after intervention, which were both significantly higher than the increase of the control group (p<0.01). Similarly, the score of AVS and SG in the experimental group increased by 7.53 and 6.83 respectively after the intervention, which was also higher than the control group (p<0.01). The evaluation of the adoption of this system has three sub-dimensions. In terms of accessibility, the patients reported a mean score of 4.27±0.704 for the enjoyment of their experience with the system, 4.33±0.816 for success to use the system, 4.67±0.617 for the ability to control the system. In terms of comfort, the patients reported 4.40±0.737 for clear information provided by the system, 4.40±0.632 for comfort. In terms of acceptability, the patients reported 4.27±0.884 for usefulness in their rehabilitation, 4.67±0.617 for agreeing with CARS as a suitable tool for home-based rehabilitation. CONCLUSIONS CARS and conventional OT together-based rehabilitation were more effective in improving both upper limb motor function and cognition function as compared with conventional OT. Due to the low cost, and ease of use, CARS is also potentially suitable for home-based rehabilitation. CLINICALTRIAL The Chinese Clinical Trial Registry (ChiCTR1800017568).


2011 ◽  
Vol 14 (3) ◽  
pp. 294-301 ◽  
Author(s):  
Yu-Chu Chung ◽  
Hsing-Hsia Chen ◽  
Mei-Ling Yeh

Purpose: The purpose of this study was to evaluate the effect of rice vinegar administered via nasogastric feeding tube on catheter-associated bacteriuria in patients with long-term urinary catheterization. Method: The authors conducted a randomized controlled trial ( n = 60) to compare treatment with dilute vinegar and usual care. The authors recruited patients with chronic catheters from a long-term care facility in northern Taiwan. The experimental group received 100 ml of diluted rice vinegar each day for 4 weeks, whereas the control group received 100 ml of water. The authors analyzed urine weekly and cultured it on Day 28. Results: The generalized estimating equation results showed significant between-group differences in urinary pH, bacterial titer, and turbidity. No patient in the experimental group, but three in the control group, exhibited symptomatic urinary tract infection (UTI). Rice vinegar may decrease bacteriuria. Medicinal use of vinegar may decrease the risk of symptomatic UTI, but further study is needed to determine the effects of ingesting vinegar for a longer period and with a larger sample size.


Author(s):  
Mohammad Zoladl ◽  
Solaiman Afroughi ◽  
Khairollah Nooryan ◽  
Shirali Kharamin ◽  
Amin Haghgoo ◽  
...  

Objective: Psychological education for families in the form of a model is one of the effective approaches in managing problems caused by mental health problems. The present study aimed to determine the effect of using the participatory care model on the caregiver burden and resilience of home caregivers of patients with mental disorders. Method: In this clinical trial, 66 households with psychiatric patients hospitalized at Shahid Rajaee Psychiatric Hospital in Yasuj during 2014-2015 were selected and assigned into 2 groups of experimental and intervention based on convenience and simple random sampling. The data of this study were gathered by Novak & Guest (1989) Caregiver burden and Sixbey (2005) Resilience Questionnaire before and after intervention. Participatory care model was performed for 12 ninety-minute sessions in the intervention group. No intervention was provided to the control group during the study period. SPSS software (version 21) was used to run the descriptive and inferential statistics. Results: Chi-squared test showed that the caregiver burden was significantly lower in the experimental group than in the control group after the intervention (P = 0.0001). Following the intervention, increased resilience and all its components were observed in the experimental group compared to the control group. According to the independent t test and Mann-Whitney U, the 2 groups were considerably different (P < 0.05). Conclusion: The application of the participatory care model efficiently increased resilience and decreased the intensity of the caregiver burden on the home caregivers of patients suffering from mental disorders.


10.2196/22659 ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. e22659
Author(s):  
Ann Van de Winckel ◽  
Tanjila Nawshin ◽  
Casey Byron

Background Patients with chronic diseases often need to adhere to long-term individualized home exercise programs (HEPs). Limited adherence to long-term exercise given during physical therapy (PT) visits reduces the capacity of exercise to manage or improve symptoms related to chronic disease. In addition, a lower socioeconomic status negatively impacts exercise adherence. To mitigate this, apps that motivate people to exercise could be a viable option. Using an app through telehealth may help adults with chronic diseases to achieve long-term HEP adherence. However, because apps for rehabilitation are an emerging field, the feasibility of the app needs to be evaluated. Objective To address HEP adherence in participants with chronic diseases who are experiencing financial distress, we aim to evaluate the feasibility of and satisfaction with the Hudl Technique app and telehealth and satisfaction with PT care and to monitor HEP adherence and compliance (ie, percentage of participant-recorded videos sent) in participants using the app with telehealth compared with those using standard HEPs on paper. Methods We recruited patients scheduled for outpatient PT. We performed a randomized controlled trial in which the experimental group received weekly HEP demonstrations through app videos on a tablet with feedback on their self-recorded HEP video performance from the telehealth physical therapist. The control group received HEPs on paper without feedback, as is customary in PT practice. Demographic, clinical, and health coverage information was collected for screening and baseline measurements. Adherence and compliance were evaluated. Both groups completed surveys at 8 and 24 weeks on their satisfaction with PT care, and the experimental group also completed a survey on their satisfaction with the app with telehealth use. Descriptive and nonparametric statistics were used for within-group and between-group comparisons and analyzed with JMP, version 13. Results Overall, 45 adults with chronic diseases who were experiencing financial distress were randomized into experimental (23/45, 51%) and control (22/45, 49%) groups, with 74% (17/23) and 86% (19/22) participants completing the 24-week HEP, respectively. The experimental group had an HEP adherence frequency of 4 (SD 2) to 5 (SD 2) times per week at 8 and 24 weeks (P=.14), whereas HEP adherence decreased in the control group from 4 (SD 2) to 3 (SD 2) times per week (P=.07), with a significant difference (P=.01) between groups at 24 weeks. Of the total participants, 68% (15/22) sent videos. They sent 68% (16/24) of the requested number of videos on average. The average score for PT care satisfaction was maintained at 87% in the experimental group (P=.99), whereas it decreased from 89% at 8 weeks to 74% at 24 weeks (P=.008) in the control group. App-related adverse events were not observed. Conclusions The Hudl app/telehealth platform is feasible for delivering HEPs and maintaining HEP adherence in participants with chronic diseases who are experiencing financial distress. Trial Registration ClinicalTrials.gov NCT02659280; https://clinicaltrials.gov/ct2/show/NCT02659280


2020 ◽  
Author(s):  
Ann Van de Winckel ◽  
Tanjila Nawshin ◽  
Casey Byron

BACKGROUND Patients with chronic diseases often must adhere to a long-term individualized home exercise program (HEP) to manage their symptoms, and improve or maintain their cardiovascular health, flexibility and/or strength. Those exercises are provided and updated during physical therapy (PT) visits. Limited adherence (ie, perform the required number of HEP/week) to long-term exercise reduces the capacity of exercise to improve or stabilize impairments related to chronic disease. Lower socio-economic status is an additional factor that negatively impacts exercise adherence. To mitigate this, online apps available to motivate people to exercise could be a viable option. Using an app through telehealth may benefit adults with chronic diseases achieve long-term home exercise program (HEP) adherence. However, because using apps for rehabilitation is an emerging field, the app’s feasibility needs to be evaluated. OBJECTIVE To address HEP adherence in participants with chronic diseases and in financial distress, defined by people being on Medicaid or similar programs, we evaluated HEP adherence, compliance (ie, percentage of participant-recorded videos sent), as well as satisfaction with the PT care and with the Hudl Technique® app and telehealth in terms of feasibility, compared to standard HEP on paper. METHODS We recruited patients scheduled for outpatient PT. We performed a randomized controlled trial where the experimental group received weekly HEP demonstrations through app videos on a tablet and received feedback on their self-recorded HEP video performance from the telehealth-physical therapist. The control group received HEP on paper without feedback as is custom in PT practice. The treating therapist and data analyst were blinded to the allocation. Demographic, clinical, and health coverage information was collected for screening and baseline measurements. Adherence and compliance were evaluated. Both groups completed surveys at 8 and 24 weeks on satisfaction with PT care and, for the experimental group, also satisfaction with the app/telehealth use. RESULTS Forty-five adults with chronic diseases and financial distress were randomized into an experimental (n=23) and a control group (n=22), with respectively 17 and 19 participants completing the 24-week HEP. The experimental group maintained a HEP adherence frequency of 4±2 times/week at 8 and 24 weeks (P=.29), whereas in the control group HEP adherence decreased from 4±2 to 3±2 times/week (P=.07), with a significant difference (P=.04) between groups at 24 weeks. Sixty-eight percent of participants sent videos. They sent on average 68% of the requested number of videos. The average score for satisfaction with PT care was maintained at 87% in the experimental group (P=1.00) whereas it dropped from 89% at 8 weeks to 74% at 24 weeks (P=.008) in the control group. There were no app-related adverse events. CONCLUSIONS The Hudl app/telehealth is feasible for delivering HEP and helps participants with chronic diseases and financial distress maintain HEP adherence. CLINICALTRIAL The full trial protocol is available at ClinicalTrials.gov (NCT02659280).


2021 ◽  
Author(s):  
Yurou Chen ◽  
Lin Xu ◽  
Di Huang ◽  
Dongping Chen ◽  
Feng Wu ◽  
...  

Abstract Background: We aim to study the clinical effect of moxibustion at Laogong interval with Panax notoginseng on the short-term maturation and long-term patency of arteriovenous fistula. Methods: Seventy-four pre-dialysis uremic patients who received radial artery-cephalic vein fistula creations were enrolled in this study and randomly assigned to the control group and experimental group. After arteriovenous fistula creations, the control group underwent handgrip exercise, and the experimental group received moxibustion at Laogong acupoint interval with Panax notoginseng. Patients were treated for 12 weeks and followed up for 24 weeks at the following time points: before creations and 2, 4, 8, 12, 24 weeks after creations. The diameter of anastomosis, the diameter of draining-veins, the blood flow of draining-veins, the diameter of arteria brachialis, and the blood flow of arteria brachialis evaluated the maturation and patency of arteriovenous fistula. ELISA determined serum levels of ET and NO levels.Results: The maturity rate in the experimental group was significantly higher than that in the control group at 4 weeks after arteriovenous fistula creations (P =0.048). The diameter of anastomosis, the diameter of draining veins, and the blood flow of draining veins increased in both groups during the whole 24 weeks. The diameter and blood flow of arteria brachialis ascended in both groups during the previous 12 weeks. Compared with the control group, moxibustion at Laogong interval with Panax notoginseng significantly improved the value of the diameter of draining-veins (P =0.016), the blood flow of draining-veins (P = 0.015), the diameter of arteria brachialis (P < 0.001), and the blood flow of arteria brachialis (P =0. 012) at 2 weeks, and enhanced the blood flow of draining-veins (P =0.029) and arteria brachialis (P < 0.001) at 12 weeks. Serum levels of ET were significantly lower (P =0.047), and serum levels of NO were markedly higher (P < 0.001) in the experimental group than that in the control group at 2 weeks after creations. Conclusion: Moxibustion at Laogong interval with Panax notoginseng was non-invasive and promoted the maturation of arteriovenous fistula at 4 weeks after creations. However, its long-term beneficial effect on patency after creations was not significant.Trial registration: Chinese Clinical Trial Registry, No.ChiCTR1900024042. Registered, http://www.chictr.org.cn/index.aspx.


GeroPsych ◽  
2011 ◽  
Vol 24 (3) ◽  
pp. 115-125 ◽  
Author(s):  
Gabriele Wilz ◽  
Denise Schinköthe ◽  
Renate Soellner

Introduction: The evaluation of effective interventions is still needed to prevent family caregivers of persons with dementia from becoming physically or mentally ill. However, in most existing intervention studies, primary outcomes are not well matched to the treatment goals. Method: A randomized controlled trial (N = 229) was conducted to compare a treatment group (CBT), a treated control group, and an untreated control group. In theses analyses we focused on the primary outcome measurement (GAS) as a perceived treatment success as well as treatment compliance and participants’ evaluation. Results: Results showed that 30.1% achieved complete goal attainment, 39.8% partial goal attainment, and 24.1% declared no change (overachievement 2.4%; deterioration 3.6%). Discussion: The intervention can be considered to have been successful.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Shamekh Mohamed El-Shamy ◽  
Ehab Mohamed Abd El Kafy

Abstract Background TheraTogs promotes proprioceptive sense of a child with cerebral palsy and improves abnormal muscle tone, posture alignment, balance, and gait. Therefore, the aim of this study was to investigate the efficacy of TheraTogs orthotic undergarment on gait pattern in children with dyskinetic cerebral palsy. Thirty children with dyskinetic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received TheraTogs orthotic undergarment (12 h/day, 3 days/week) plus traditional physical therapy for 3 successive months and (2) a control group that received only traditional physical therapy program for the same time period. Gait parameters were measured at baseline and after 3 months of intervention using Pro-Reflex motion analysis. Results Children in both groups showed significant improvements in the gait parameters (P < 0.05), with significantly greater improvements in the experimental group than in the control group. Conclusions The use of TheraTogs may have a positive effect to improve gait pattern in children with dyskinetic cerebral palsy. Trial registration This trial was registered in the ClinicalTrial.gov PRS (NCT03037697).


Author(s):  
Shibili Nuhmani

AbstractObjectivesObjective of the study is to investigate whether Soft tissue mobilization (STM) can assist with static stretching to improve hamstring flexibly.MethodsThe design of the study was repeated measure design. The study was conducted at the physical therapy laboratory of Jamia Hamdard University, New Delhi. Participants included 78 healthy males with hamstring tightness, randomly assigned to either the control group (static stretching) or the experimental group (STM and static stretching). The experimental group received five sets of four different STM techniques, followed by two sets of 30-s static stretches 3 days per week over the course of 12 weeks. The control group received 5 min of sham ultrasound with an inactive probe prior to static stretching. Active knee extension test (AKE) was the outcome measure.ResultsBoth groups showed significant improvement in AKE compared with the baseline measurements. With ingroup analysis showed a significant difference in AKE across all measured time periods (weeks 4, 8, and 12) with pre-test in both groups (p<0.05). No significant difference in AKE improvement was found between groups (p>0.05).ConclusionThe results of this study show that STM prior to static stretching does not significantly improve hamstring flexibility among healthy individuals. Although this study cannot be generalized, the results may be useful for evidence-based practice in the management of hamstring tightness.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anna-Lotta Irewall ◽  
Anders Ulvenstam ◽  
Anna Graipe ◽  
Joachim Ögren ◽  
Thomas Mooe

AbstractEnhanced follow-up is needed to improve the results of secondary preventive care in patients with established cardiovascular disease. We examined the effect of long-term, nurse-based, secondary preventive follow-up by telephone on the recurrence of cardiovascular events. Open, randomised, controlled trial with two parallel groups. Between 1 January 2010 and 31 December 2014, consecutive patients (n = 1890) admitted to hospital due to stroke, transient ischaemic attack (TIA), or acute coronary syndrome (ACS) were included. Participants were randomised (1:1) to nurse-based telephone follow-up (intervention, n = 944) or usual care (control, n = 946) and followed until 31 December 2017. The primary endpoint was a composite of stroke, myocardial infarction, cardiac revascularisation, and cardiovascular death. The individual components of the primary endpoint, TIA, and all-cause mortality were analysed as secondary endpoints. The assessment of outcome events was blinded to study group assignment. After a mean follow-up of 4.5 years, 22.7% (n = 214) of patients in the intervention group and 27.1% (n = 256) in the control group reached the primary composite endpoint (HR 0.81, 95% CI 0.68–0.97; ARR 4.4%, 95% CI 0.5–8.3). Secondary endpoints did not differ significantly between groups. Nurse-based secondary preventive follow-up by telephone reduced the recurrence of cardiovascular events during long-term follow-up.


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