scholarly journals “Together We Stand”: A Pilot Study Exploring the Feasibility, Acceptability, and Preliminary Effects of a Family-Based Psychoeducational Intervention for Patients on Hemodialysis and Their Family Caregivers

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1585
Author(s):  
Helena Sousa ◽  
Oscar Ribeiro ◽  
Constança Paúl ◽  
Elísio Costa ◽  
Roberta Frontini ◽  
...  

This pilot study aimed to assess the feasibility, acceptability, and preliminary effects of a family-based psychoeducational intervention for patients undergoing hemodialysis (HD) and their family members. This was a single-group (six dyads), six-week, pre–post pilot study, delivered in a multifamily group format. Feasibility was based on screening, eligibility, content, retention, completion, and intervention adherence rates. Acceptability was assessed at post-intervention through a focus group interview. Self-reported anxiety and depression and patients’ inter-dialytic weight gain (IDWG) were also measured. The screening (93.5%), retention (85.7%), and completion (100%) rates were satisfactory, whereas eligibility (22.8%), consent (18.4%), and intervention adherence (range: 16.7–50%) rates were the most critical. Findings showed that participants appreciated the intervention and perceived several educational and emotional benefits. The results from the Wilcoxon Signed-Rank Test showed that a significant decrease in anxiety symptoms (p = 0.025, r = 0.646) was found, which was followed by medium to large within-group effect sizes for changes in depression symptoms (p = 0.261, r = 0.325) and patients’ IDWG (p = 0.248, r = 0.472), respectively. Overall, the results indicated that this family-based psychoeducational intervention is likely to be feasible, acceptable, and effective for patients undergoing HD and their family caregivers; nonetheless, further considerations are needed on how to make the intervention more practical and easily implemented in routine dialysis care before proceeding to large-scale trials.

2019 ◽  
Vol 29 (3) ◽  
pp. 7-11
Author(s):  
Simone A. Majetich ◽  
Michael W. Majetich ◽  
James M. Clegg ◽  
Susan M. Ratay

Abstract Context The use of osteopathic manipulative medicine (OMM) continues to decline in medical practice, despite an increasing number of osteopathic physicians. Objective This pilot study was designed to determine if a brochure created to increase knowledge about osteopathic medicine and OMM was read by patients, reviewed as being helpful, needed modifications and increased patient understanding of and willingness to receive OMM in preparation for a large scale trial that will assess this in both the hospital and ambulatory settings. Methods The study was performed using an educational brochure and 2 closed questionnaires. Twenty-seven patients of either inpatient or observation status aged 18 and above with English literacy were enrolled. Participants first completed a pre-questionnaire with questions regarding understanding of OMM and willingness to receive treatment. They then read the provided educational brochure, which contained a checkbox to verify the material was read in its entirety. Participants completed a post-questionnaire with similar questions. The results were analyzed with Wilcoxon signed rank test with 95% confidence to observe any changes in pre- and post-questionnaire responses. Results Of the participants, 48.1% provided verification that they read the brochure. A significant increase in patient willingness to receive OMM as part of their treatment regimen was observed for those who read the brochure (P=.008 ). No significant change was seen for those who didn’t read the brochure (P=.26). Additionally, 100% of participants indicated that the brochure was helpful, and 100% of participants indicated a better understanding of OMM. Cost remained a significant barrier to accepting or pursuing OMM treatment. Conclusion This pilot study demonstrated a statistically significant improvement in willingness to receive treatment after reviewing the designed brochure. It also identified a need to convey information regarding cost of OMM treatment to patients and a need to better emphasize the checkbox located within the brochure for verification purposes. The brochure and study design proved feasible and will provide the foundation for a larger scale trial looking to assess if a patient educational handout improves understanding of OMM and willingness to receive treatment in the hospital and ambulatory settings.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Shane Chanpimol ◽  
Kimberly Benson ◽  
Heidi Maloni ◽  
Susan Conroy ◽  
Mitchell Wallin

Abstract Background Physical rehabilitation services are an important component of treatment for persons with multiple sclerosis (PwMS) to improve and maintain physical mobility. However, PwMS often have significant barriers to outpatient physical therapy (PT) services including mobility deficits and lack of transportation. The integration of exercise gaming (exergaming) and telehealth into clinical PT practices may overcome these barriers. The overarching purpose of this pilot study was to evaluate the acceptability and effects of an individualized telePT intervention using exergaming. Methods Ten individuals with multiple sclerosis (MS) completed a 12-week exergaming (Jintronix®) telerehabilitation intervention. In order to measure the acceptability of the telerehabilitation intervention, adherence was measured through the tablet-based rehabilitation software and each participant completed a satisfaction questionnaire. Clinical outcome measures were assessed at baseline and post-intervention. To evaluate the efficacy of this intervention, the following measures of physical function and fatigue were included; the Short Physical Performance Battery (SPPB), 25-Foot Walk (25FW), Modified Fatigue Impact Scale (MFIS), Multiple Sclerosis Walking Scale-12 (MSWS), and the 2-Minute Walk Test (2MWT). Clinical outcomes were analyzed using the Sign test and Wilcoxon signed rank test. All other data were evaluated using descriptive statistics. Results After the intervention, participants demonstrated significant improvements in ambulation speed during the 25FW (p = 0.04) and ambulation distance during the 2MWT (p = 0.002). Statistically significant increases of SPPB total score (p = .04) and sub-scores were also found. Participants did not demonstrate significant changes in the MFIS (p = 0.31) or MSWS-12 (p = 0.06) after the intervention. Participants had a 58.3% adherence rate during the intervention and performed their exercise program an average of 2.5 times per week. All participants reported that they were either ‘satisfied or ‘very satisfied’ with their telerehabilitation experience, would use telerehabilitation again, and would recommend telerehabilitation to others. Conclusion This individualized telerehabilitation intervention which integrates exergaming and clinical video teleconferencing is acceptable to patients and may offer a viable alternative to traditional PT for PwMS. Trial registration NCT03655431, retrospectively registered on August 31st, 2018.


BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Clemens Wiesinger ◽  
Dominik Stefan Schoeb ◽  
Mathias Stockhammer ◽  
Emir Mirtezani ◽  
Lukas Mitterschiffthaler ◽  
...  

Abstract Background Within the last decade, robotically-assisted laparoscopic prostatectomy (RALP) has become the standard for treating localized prostate cancer, causing a revival of the 45° Trendelenburg position. In this pilot study we investigated effects of Trendelenburg position on hemodynamics and cerebral oxygenation in patients undergoing RALP. Methods We enrolled 58 patients undergoing RALP and 22 patients undergoing robot-assisted partial nephrectomy (RAPN) (control group) in our study. Demographic patient data and intraoperative parameters including cerebral oxygenation and cerebral hemodynamics were recorded for all patients. Cerebral function was also assessed pre- and postoperatively via the Mini Mental Status (MMS) exam. Changes in parameters during surgery were modelled by a mixed effects model; changes in the MMS result were evaluated using the Wilcoxon signed rank test. Results Preoperative assessment of patient characteristics, standard blood values and vital parameters revealed no difference between the two groups. Conclusions Applying a 45° Trendelenburg position causes no difference in postoperative brain function, and does not alter cerebral oxygenation during a surgical procedure lasting up to 5 h. Further studies in larger patient cohorts will have to confirm these findings. Trial registration German Clinical Trial Registry; DRKS00005094; Registered 12th December 2013—Retrospectively registered; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005094.


2020 ◽  
Vol 5 (04) ◽  
pp. 68-72
Author(s):  
Vijayakumar PS ◽  
Sahana AU ◽  
Anusha Rajanna

Background: Special educators face unprecedented work conditions and expectations that affect their psychological wellbeing and professional outcome as well. This study examines the growing evidence that even a short-term Integrated yoga practice enhance psychological wellbeing among special educators by reducing their stress, anxiety and depression levels. Materials and Methods: Special educators were recruited based on inclusion and exclusion criteria (n=20) age ranging between 25-50 years (Mean35±6.3) for a single group interventional pre-post study design: Integrated yoga module (included postures, breathing practices, relaxation and mediation) was given for a period of 8 weeks. The subjects were assessed on day 1 pre and post intervention on day 60 on perceived stress scale (PSS), Beck’s depression inventory (BDI-II) and Beck’s Anxiety Inventory (BAI). Results: After 8 weeks of Integrated yoga practice there was asignificant reduction in anxiety scores (P less than 0.000), depression scores (P less than 0.000) and perceived stress levels (P less than 0.000) respectively compared to baseline by wilcoxon signed rank test. Conclusions: The results of this study suggest that even a short-term integrated yoga intervention that can enhance psychological wellbeing of the special educators.


1996 ◽  
Vol 11 (S2) ◽  
pp. S39-S39
Author(s):  
Juan March ◽  
Kathleen Dunn ◽  
Lawrence Brown ◽  
Johnny Farrow ◽  
Phillip Perkins

Purpose: The wide spread use of orotracheal intubation with rapid sequence induction has made it difficult for EMS professionals to gain experience in nasotracheal intubation (NTI) in a controlled supervised setting. The purpose of this study was to determine if a training session on NTI with a breathing manikin can be used to improve skill and comfort of EMS professionals.Methods: A prospective trial was conducted with a convenience sample of 16 emergency medical service professionals, previously trained in nasotracheal intubation techniques. For the training session a Laerdal airway manikin was modified by replacing the lungs with a bag-valve mask device, to simulate breathing with an inspiratory and expiratory phase. Following verbal instruction, and with direct supervision, each participant practiced NTI using the breathing manikin. Each participant completed a questionnaire, both before and after the training session, to determine self assessed comfort and skill level for both oral and nasal intubations (0 = lowest, 10 = highest). The pre and post intervention scores were compared using the Wilcoxon signed-rank test, £ = 0.01.


Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1245 ◽  
Author(s):  
Jiada Zhan ◽  
Taylor C. Wallace ◽  
Sarah J. Butts ◽  
Sisi Cao ◽  
Velarie Ansu ◽  
...  

Oral supplementation may improve the dietary intake of magnesium, which has been identified as a shortfall nutrient. We conducted a pilot study to evaluate appropriate methods for assessing responses to the ingestion of oral magnesium supplements, including ionized magnesium in whole blood (iMg2+) concentration, serum total magnesium concentration, and total urinary magnesium content. In a single-blinded crossover study, 17 healthy adults were randomly assigned to consume 300 mg of magnesium from MgCl2 (ReMag®, a picosized magnesium formulation) or placebo, while having a low-magnesium breakfast. Blood and urine samples were obtained for the measurement of iMg2+, serum total magnesium, and total urine magnesium, during 24 h following the magnesium supplement or placebo dosing. Bioavailability was assessed using area-under-the-curve (AUC) as well as maximum (Cmax) and time-to-maximum (Tmax) concentration. Depending on normality, data were expressed as the mean ± standard deviation or median (range), and differences between responses to MgCl2 or placebo were measured using the paired t-test or Wilcoxon signed-rank test. Following MgCl2 administration versus placebo administration, we observed significantly greater increases in iMg2+ concentrations (AUC = 1.51 ± 0.96 vs. 0.84 ± 0.82 mg/dL•24h; Cmax = 1.38 ± 0.13 vs. 1.32 ± 0.07 mg/dL, respectively; both p < 0.05) but not in serum total magnesium (AUC = 27.00 [0, 172.93] vs. 14.55 [0, 91.18] mg/dL•24h; Cmax = 2.38 [1.97, 4.01] vs. 2.24 [1.98, 4.31] mg/dL) or in urinary magnesium (AUC = 201.74 ± 161.63 vs. 139.30 ± 92.84 mg•24h; Cmax = 26.12 [12.91, 88.63] vs. 24.38 [13.51, 81.51] mg/dL; p > 0.05). Whole blood iMg2+ may be a more sensitive measure of acute oral intake of magnesium compared to serum and urinary magnesium and may be preferred for assessing supplement bioavailability.


2020 ◽  
Vol 20 (3) ◽  
pp. 134-139
Author(s):  
Deepak Thazhakkattu Vasu ◽  
Nor Azlin Mohd Nordin ◽  
See Xiao Xu ◽  
Shazli Ezzat Ghazali ◽  
Siti Norfadilah Abu Zarim

A significant percentage of stroke survivors are reported to have anxiety and depression.  Autogenic Relaxation Training (ART), a psychophysiological self-control therapy which aims to induce relaxation proved to be effective in reducing the anxiety and depression in some health conditions. However, there is lack of studies which evaluated the effects of ART in the rehabilitation of stroke survivors. The aim of this experimental pilot study is to evaluate the feasibility and outcomes of ART in addition to usual physiotherapy for stroke survivors. A total of 14 sub-acute stroke survivors from a teaching hospital were enrolled in this study. All participants received 20 minutes ART followed by 40 minutes usual physiotherapy once a week and they were requested to carry out the intervention at home for twice per week, for six weeks. Intervention outcomes were assessed using Hospital Anxiety and Depression Scale (HADS-A and HADS-D), Barthel Index (BI), Timed Up and Go (TUG) and EuroQol 5-Dimension 5 Levels (EQ5D5L). Changes in all outcome measures were analysed using paired t-test and Wilcoxon signed rank test, with level of significance set at p<0.05. Post-intervention, there is statistically significant reduction of the HADS-A (p=0.04), HADS-D (p=0.02), TUG (p=0.004) and EQ5D5L (p=0.03) scores of the participants. Although not statistically significant, the mean score ± SD of BI increased from 95 ± 12.5 to 100 ± 6.25. The intervention is feasible and acceptable by the stroke survivors with no adverse events reported. In conclusion, ART in addition to usual physiotherapy is feasible and beneficial in reducing anxiety and depression, and improving functional ability, mobility and quality of life among stroke survivors.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Dawidziuk ◽  
C Ngadimin ◽  
R Kwasnicki ◽  
N Jallali

Abstract Introduction Reconstructing the Stereotype is a student-led conference organised by Imperial College Plastic, Reconstructive and Aesthetic Surgery Society providing holistic outlook on plastic surgery with lectures, tutorials, and practical workshops. The aim of this event-evaluation study was to assess the effectiveness of the conference in improving reported knowledge, skills and awareness of the specialty. Method 25 delegates (21 medical students, 4 junior doctors; mean age 23.2 years; 14 women) volunteered to complete pre- and post-intervention online questionnaires comprising 26 five-step Likert scale questions on knowledge, skills, and career in plastic surgery. Significance of comparisons was established with Wilcoxon signed-rank test using IBM SPSS V26 (p &lt; 0.05). Results Post-conference, there was a significant increase in participants’ self-ratings across all domains investigated (p-values 0.000-0.001). Understanding of the reconstructive ladder showed largest improvement in knowledge (mean±SD: 1.96±1.27 vs 3.80±1.08), performing Z-pasty in skills (1.72±1.17 vs 3.72±1.06) and portfolio development in career category (2.28±1.17 vs 4.08±1.04). Two more participants declared considering career in plastic surgery after the conference. Conclusions A two-day student-organised conference significantly improved plastic surgery knowledge and skills of medical students and junior doctors. It also provided them with a realistic idea of what a career in the specialty entails.


2021 ◽  
pp. 1-12
Author(s):  
Joel Sadavoy ◽  
Sima Sajedinejad ◽  
Mary Chiu

ABSTRACT Objectives: While family caregivers (CGs) of persons with dementia are cost-effective for the health system, this form of caregiving leads to disproportionate vulnerability to physical, mental, and social adverse health consequences among CGs. The study goal was to determine the effect of the Reitman Centre CARERS program on key outcomes in family CGs of people with dementia. The Reitman Centre CARERS program is an innovative, group psychotherapeutic skills training intervention based on integrated problem-solving techniques (PST), simulation learning, and group psychotherapy designed to address each CGs’ unique situation. Design: A quasi-experimental, non-randomized, pre–post evaluation, multiple groups, multisite trial. Setting: Multisite group intervention provided in community agencies and hospital-based locations. Participants: Spousal or adult child family CGs (n = 264) living in the community and providing care to community-dwelling family members with dementia. Measurement: CGs were assessed for depression (CES-D); stress (PSS); burden (12-item SZBI); role overload, mastery, caregiving competence, and role captivity (Perlin scales), coping (CISS – Coping Inventory for Stressful Situations), CG reactions to CR’s memory and behavioral symptoms (RMBPC). Care recipients (CRs) were assessed on basic and complex activities of daily living (Katz and Lawton). Paired t-tests and Wilcoxon signed-rank test were used for statistical analysis of both the whole group and a more compromised subgroup of CGs. Results: For the group as a whole, CGs showed significant positive change on post-intervention outcome measures of stress, depression, burden, competence, role captivity, overload, mastery, coping, and reaction to memory issues. The intervention showed especially robust effect sizes (ES) in more compromised CGs. These positive outcomes emerged despite a significant measured deterioration in CRs’ function. Conclusion: The CARERS program may be an effective multicomponent intervention to improve the well-being, functioning, and coping skills of dementia CGs.


2020 ◽  
Author(s):  
Steve Durante ◽  
Vincent Dunet ◽  
François Gorostidi ◽  
Periklis Mitsakis ◽  
Niklaus Schaefer ◽  
...  

Abstract Background : Angiogenesis plays an important role in head and neck squamous cell carcinomas (HNSCC) progression. This pilot study was designed to compare the distribution of 68 Ga-NODAGA-RGD PET/CT for imaging α v β 3 integrins involved in tumor angiogenesis to 18 F-FDG PET/CT in patients with HNSCC. Material and methods : Ten patients (aged: 58.4 ± 8.3 years [range: 44–73 years], 6 males, 4 females) with a total of 11 HNSCC were prospectively enrolled. Activity mapping and standard uptake values (SUV) from both 68 Ga -NODAGA-RGD and 18 F-FDG PET/CT scans were recorded for primary tumor and compared with the Wilcoxon signed-rank test. The relation between the SUV of both tracers was assessed using the Spearman correlation. Results : All HNSCC tumors were visible with both tracers. Quantitative analysis showed higher 18 F-FDG SUV max in comparison to 68 Ga-NODAGA-RGD (14.0 ± 6.1 versus 3.9 ± 1.1 g/mL, p=0.0017) and SUV mean (8.2 ± 3.1 versus 2.0 ± 0.8 g/mL, p=0.0017). Both 18 F-FDG and 68 Ga-NODAGA-RGD uptake were neither correlated with grade, HPV nor p16 protein expression (p≥0.17). Conclusion : All HNSCC tumors were detected with both tracers with higher uptake with 18 F-FDG, however. 68 Ga-NODAGA-RGD has a different spatial distribution than 18 F-FDG bringing different tumor information.


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