scholarly journals Determining the effect of tele-rehabilitation on patients with stutter using the goal attainment scaling (GAS)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maryam Eslami Jahromi ◽  
Leila Ahmadian

Abstract Background Lack of proper and timely patients' access to speech pathologists can affect the treatment and follow-up process; therefore, patients do not achieve the expected therapeutic goals. The aim of this study was to determine the effect of tele-rehabilitation on the stuttering patients using the goal attainment scaling (GAS). Methods This interventional study was carried out on patients who visited the rehabilitation centers affiliated to the Jahrom Welfare Office. They underwent remote speech therapy using Skype. To evaluate the treatment outcomes of the stuttering patients, GAS was used. Results The participants' speech and lingual skills improved using videoconferencing. The mean score of total GAS for patients was 53.08. Of 112 health goals, patients reached the expected or higher than expected levels in 78 goals. Conclusions Rehabilitation through video conferencing was effective for patients with stuttering, improved their speech, and decreased their stuttering. Since, application of remote rehabilitation services can provide regular access to healthcare services, it can lead to improving patient treatment provide more frequent and faster treatment follow-up.

2016 ◽  
Vol 5 (1) ◽  
pp. 44-57
Author(s):  
Anke Buschmann ◽  
Bettina Multhauf

Zusammenfassung. Das Ziel vorliegender Studie bestand in einer Überprüfung der Akzeptanz und Teilnehmerzufriedenheit eines Gruppentrainings für Eltern von Kindern mit Lese- und/oder Rechtschreibschwierigkeiten. Zudem sollten erste Indikatoren bezüglich der Wirksamkeit des Programmes untersucht werden. Dazu wurden Daten von 25 Müttern zu 2 Messzeitpunkten (Post-Test, 3-Monats-Follow-up) analysiert. Die Probandinnen nahmen über einen Zeitraum von 3 Monaten an 5 Sitzungen des Programms «Mein Kind mit Lese- und Rechtschreibschwierigkeiten verstehen, stärken und unterstützen: Heidelberger Elterntraining zum Umgang mit LRS» teil. Ein Paper-Pencil-Fragebogen diente zum Post-Test der Erhebung von Teilnahmeparametern, der Zufriedenheit mit dem Training, der Relevanz einzelner Themen und der wahrgenommenen Veränderungen in wichtigen Zielbereichen. Zusätzlich kam eine für das Gruppensetting adaptierte Form des Goal Attainment Scaling zum Einsatz, um das Erreichen persönlich relevanter Ziele unmittelbar nach dem Training sowie 3 Monate später zu erfassen. Die Analyse des Fragebogens zeigte eine hohe Partizipationsbereitschaft der Mütter. Die Rahmenbedingungen des Trainings (Gruppengröße, Dauer des Trainings und der Sitzungen) sowie die didaktischen Methoden wurden als ideal und die Themen als relevant eingeschätzt. Die Mütter sahen sich in der Lage, die Inhalte im Alltag anzuwenden und nahmen positive Veränderungen hinsichtlich Einfühlungsvermögen, Unterstützung des Kindes, Hausaufgabensituation und Beziehung zum Kind wahr. Das Ausmaß des Erreichens individueller Ziele zum Post-Test variierte je nach Zielbereich: Einfühlen und Verstehen (75 %), Optimierung der Hausaufgabensituation (76 %), Unterstützung psychosozialer Entwicklung (86 %), Lese-Rechtschreibförderung (60 %) und war auch 3 Monate später noch vergleichbar hoch. Die Überprüfung der Wirksamkeit hinsichtlich einer Belastungsreduktion und Kompetenzstärkung seitens der Eltern erfolgt aktuell im Vergleich zu einer unbehandelten Kontrollgruppe.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040819
Author(s):  
Pontus Rygh ◽  
Ina Asklund ◽  
Eva Samuelsson

ObjectivesThe efficacy of app-based treatment for stress urinary incontinence (SUI) has been demonstrated in a randomised controlled trial (RCT). In this study, we investigate the user characteristics and the effectiveness of the same app when freely available, and compare these results with the RCT.DesignProspective cohort study.ParticipantsDuring a 17-month period, 24 602 non-pregnant, non-postpartum women older than 18 years downloaded the app and responded anonymously to a questionnaire. Of these, 2672 (11%) responded to the 3-month follow-up.InterventionThree months’ use of the app Tät, containing information, a pelvic floor muscle training programme and lifestyle advice.Main outcome measuresChange in symptom severity (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF)) and subjective improvement (Patient Global Impression of Improvement (PGI-I)).ResultsOf the respondents, 88% lived in Sweden and 75% (18 384/24 602) were incontinent with a mean age of 45.5 (SD 14.1) years. The UI types, based on symptoms, were SUI (53%), urgency UI (12%), mixed UI (31%) and undefined (4%). The mean ICIQ-UI SF score was 8.2 (SD 4.0) at baseline. The mean ICIQ-UI SF score reduction at follow-up was 1.31 (95% CI: 1.19 to 1.44) with a larger reduction in those with more severe incontinence at baseline (severe/very severe 3.23 (95% CI: 2.85 to 3.61), moderate 1.41 (95% CI: 1.24 to 1.59) and slight 0.24 (95% CI 0.06 to 0.42). When the results were weighted to match the distribution of severity in the RCT, the ICIQ-UI SF score reduction was 2.2 compared with 3.9 in the RCT. Regarding PGI-I, 65% experienced improvement compared with 92% in the RCT.ConclusionsThe app Tät was effective for self-management of UI even in the real world. Although the reduction in incontinence symptoms was less than in the RCT, two-thirds of the users improved. App-based treatment reaches many women without requiring resources from ordinary healthcare services.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Lopez-Villegas ◽  
D Catalan-Matamoros ◽  
K T Lappegard ◽  
S Peiro ◽  
R Lopez-Liria

Abstract Background the concept of 'patient experience' has become central to how to improve healthcare. Remote communication with patients is today a frequent practice in healthcare services, showing similar outcomes to conventional monitoring at the hospital (CM) while enabling cost reduction in both formal and informal care. The purpose of this study was to analyse the experiences of people with remote monitoring (RM) of pacemakers. Methods Patients were randomly allocated to either the RM or CM. Using the 'Generic Short Patient Experiences Questionnaire' (GS-PEQ), as well as an ad-hoc survey from the 'telehealth patient satisfaction survey' and 'costs survey', patients' experiences were measured six months after the pacemaker implant in a cohort of 50 consecutive patients. The mean age was 74.8 (±11.75) years and 26 (52%) patients were male of which 1 was lost in follow-up. Differences in baseline characteristics between groups were not found. Results Findings showed overall positive and similar experiences in patients in both groups. Significant differences were found in GS-PEQ concerning how RM patients received less information about their diagnosis/ afflictions (p = 0.046). We did not find significant differences in other items such as 'confidence in the clinicians' professional skills', 'treatment perception adapted to their situation', 'involvement in decisions regarding the treatment', 'perception of hospital organisation', waiting before admission', 'satisfaction of help and treatment received', 'benefit received', and 'incorrect treatment'. Conclusions The remote communication of pacemakers was met with positive levels of patients' experiences similarly to patients in the CM group. However, patients included in RM group received less information. Thus, improving the quality and timing of information is required in RM group in the planning and organisation of future remote communication healthcare services for people living with a pacemaker implant. Key messages Patients included in both groups of follow-up showed similar levels in their experiences with the use of the pacemakers. It is necessary improving the quality and timing of information required in remote monitoring of users in the planning of future remote communication healthcare services for people with pacemaker.


2019 ◽  
Vol 10 ◽  
pp. 204201881882220 ◽  
Author(s):  
Zohar Landau ◽  
Galit Kowen-Sandbank ◽  
Daniela Jakubowicz ◽  
Asnat Raziel ◽  
Nasser Sakran ◽  
...  

Objective: We examined short and long-term outcomes of bariatric surgery in patients with obesity and type 1 diabetes mellitus (T1DM). Methods: We reviewed the records of all adults insured by Maccabi Healthcare Services during 2010 -2015, with body mass index (BMI) ⩾30 kg/m2 and T1DM; and compared weight reduction and glucose control according to the performance of bariatric surgery. BMI and glycated hemoglobin (HbA1c) levels were extracted for baseline and every 6 months, for a mean 3.5 years. Results: Of 52 patients, 26(50%) underwent bariatric surgery. Those who underwent surgery were more often female and with a longer duration of diabetes. Immediately postoperative, 4(15%) developed diabetic ketoacidosis, while 6(23%) experienced severe hypoglycemic episodes. The mean BMI decreased among surgery patients: from 39.5±4.4 to 30.1±5.0 kg/m2 ( p < 0.0001); and increased among those who did not undergo surgery: from 33.6±3.9 to 35.1±4.4 kg/m2 ( p = 0.49). The mean HbA1c level decreased during the first 6 months postoperative: from 8.5±0.9% to 7.9±0.9%; however, at the end of follow-up, was similar to baseline, 8.6±2.0% (p = 0.87). For patients who did not undergo surgery, the mean HbA1c increased from 7.9±1.9% to 8.6±1.5% ( p = 0.09). Conclusions: Among individuals with obesity and T1DM, weight loss was successful after bariatric surgery, but glucose control did not improve. The postoperative risks of diabetic ketoacidosis and severe hypoglycemic episodes should be considering when performing bariatric surgery in this population.


2005 ◽  
Vol 114 (3) ◽  
pp. 198-201 ◽  
Author(s):  
Stephen B. Clyne ◽  
Jamie A. Koufman ◽  
Stacey L. Halum ◽  
Gregory N. Postma

Laryngeal granulomas are effectively treated with antireflux therapy and speech therapy. Failure to respond leads to treatment with Botox or surgical excision. We report on the use of the pulsed dye laser for treating chronic granulomas that do not respond to standard therapy. We performed a retrospective review from September 2002 to September 2003. Patients identified with chronic granulomas that were not responding to standard therapy were treated in our office with the pulsed dye laser. Ten patients were identified; the mean age was 58 years. Two patients underwent more than one pulsed dye laser treatment. Five of the 10 had resolution of their lesions, and 3 had a partial response. Two were unchanged. The average follow-up was 6 months, and there were no complications. We conclude that in-office use of the pulsed dye laser is a relatively safe and effective method for treating laryngeal granulomas that do not respond to antireflux therapy and speech therapy.


2015 ◽  
Vol 122 (3) ◽  
pp. 610-615 ◽  
Author(s):  
William W. Scott ◽  
Steven Sharp ◽  
Stephen A. Figueroa ◽  
Alexander L. Eastman ◽  
Charles V. Hatchette ◽  
...  

OBJECT Screening, management, and follow-up of Grade 3 and 4 blunt carotid artery injuries (BCAIs) remain controversial. These high-grade BCAIs were analyzed to define their natural history and establish a rational management plan based on lesion progression and cerebral infarction. METHODS A retrospective review of a prospectively maintained database of all blunt traumatic carotid and vertebral artery injuries from August 2003 to April 2013 was performed, and Grade 3 and 4 BCAIs were identified. The authors define Grade 3 injuries as stenosis of the vessel greater than 50%, or the development of a pseudoaneurysm, and Grade 4 injuries as complete vessel occlusion. Demographic information, imaging findings, number of images obtained per individual, length of radiographic follow-up examination, radiographic outcome at end of follow-up period, treatment(s), and documentation of ischemic stroke or transient ischemic attack (TIA) were recorded. RESULTS Fifty-three Grade 3 BCAIs in 44 patients and 5 Grade 4 BCAIs in 5 patients were identified and had available follow-up information. The mean follow-up duration for Grade 3 BCAIs was 113 days, and the mean follow-up for Grade 4 BCAIs was 78 days. Final imaging of Grade 3 BCAIs showed that 53% of cases were radiographically stable, 11% had resolved, and 11% were improved, whereas 25% had radiographically worsened. In terms of treatment, 75% of patients received aspirin (ASA) alone, 5% received various medications, and 2% received no treatment. Eighteen percent of the patients in the Grade 3 BCAI group underwent endovascular intervention, and in all of these cases, treatment with ASA was continued after the procedure. Final imaging of the Grade 4 BCAIs showed that 60% remained stable (with persistent occlusion), whereas the remaining arteries improved (with recanalization of the vessel). All patients in the Grade 4 BCAI follow-up group were treated with ASA, although in 1 patient treatment was transitioned to Coumadin. There were 3 cases of cerebral infarction that appeared to be related to Grade 3 BCAIs (7% of 44 patients in the Grade 3 group), and 1 case of stroke that appeared to be related to a Grade 4 BCAI. All identified cases of stroke developed soon after hospital admission. CONCLUSIONS Although the posttraumatic cerebral infarction rate may be overestimated, the results of this study suggest that the Grade 3 and 4 BCAIs carry the highest stroke risk of the blunt cerebrovascular injuries, and those infarctions were identified on or shortly after hospital admission. Despite a 40% recanalization rate in the Grade 4 BCAI group and an 89% rate of persistent pseudoaneurysm in the Grade 3 BCAI group, follow-up imaging showed progressive worsening without radiographic improvement in only a small number of patients, and these findings alone did not correlate with adverse clinical outcome. Follow-up protocols may require amending; however, further prospective studies are needed to make conclusive changes as they relate to management.


1983 ◽  
Vol 97 (12) ◽  
pp. 1145-1148 ◽  
Author(s):  
M. W. M. Bridger ◽  
Ruth Epstein

AbstractThe records of 109 patients, presenting with functional voice disorder during the years 1977–1981, have been reviewed. The mean age was 45 years and the F: M ratio is 2: 1. Excess voice use was not obviously an aetiological factor. Sixty-one of the 109 patients (56 per cent) were cured by speech therapy, in that their voices returned to their pre-morbid state, and a further 28 (26 per cent) were improved by therapy; seven patients (6 per cent) did not improve and 13 (12 per cent) were lost to follow-up. Of the patients that were ‘cured’, 54 per cent were discharged after three months' treatment and 72 per cent after six months' treatment. Eight per cent required treatment for more than a year.


1974 ◽  
Vol 5 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Don L. Goodyear ◽  
James A. Bitter

To date, Goal Attainment Scaling procedures have been used primarily in mental health settings. This study was to investigate the value of Goal Attainment Scaling as a method for program evaluation in rehabilitation. This was assessed by the procedure's capability for measuring rehabilitation client change, the rehabilitation counselor's ability to predict client outcome using the procedure, and interrater reliability among follow-up raters in a rehabilitation setting. It was found that Goal Attainment Scaling is applicable in rehabilitation agencies and demonstrates promise for meeting current public program requirements for evaluation of rehabilitation service impact.


1997 ◽  
Vol 60 (3) ◽  
pp. 111-114 ◽  
Author(s):  
Anita Young ◽  
Rosemary Chesson

In this article, one approach to measuring therapeutic impact — Goal Attainment Scaling (GAS) — is discussed. The authors forward the case for GAS based on their own research regarding occupational therapy with children with learning disabilities. GAS is described and the factors relating to the setting of goals are examined. The main advantages are identified and GAS is seen to have benefits beyond those relating specifically to occupational therapy. The implications for multidisciplinary teamworking are examined and, in particular, it is asserted that co-workers may acquire, through the goal-setting process, realistic expectations of clients. The audit of therapeutic goals is seen to have the potential to inform decision making regarding treatment options. In conclusion, GAS is advocated as a particularly appropriate evaluative tool for the 1990s.


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