scholarly journals Terapia Ocupacional em grupo de pacientes reumatológicos em serviço ambulatorial/ Occupational Therapy in a Group of Reumatological Patients in Ambulatory Service

Author(s):  
Lucas De Paiva Silva ◽  
Amanda Cavalcanti Belo ◽  
Kátia Magdala Lima Barreto

A presente análise da prática discute experiências de intervenções terapêuticas ocupacionais junto a grupo de seis pacientes com doenças reumatológicas, em Hospital Universitário de referência da Região Metropolitana do Recife, entre Abril e Maio de 2019, totalizando oito encontros de oficinas artesanais. A aplicação dos instrumentos Medida Canadense de Desempenho Ocupacional e Score for Assessment and Quantification of Chronic Rheumatic Affections of the Hands apontaram desde manutenções a diminuições das queixas de dificuldade de mobilidade funcional manual. Os atendimentos em grupo promoveram reabilitação funcional manual, a construção de um espaço de bem-estar, interação social e educação em saúde. Abstract: This practice analysis discusses experiences of occupational therapeutic interventions with a group of six patients with rheumatological diseases, at a referral University Hospital of the Recife Metropolitan Region, between April and May 2019, totaling eight artisan workshops meetings. The application of the instruments Canadian Ocupational Performance Measure and Score for Assessment and Quantification of Chronic Rheumatic Affections of the Hands pointed from maintenance to decreases of complaints of manual functional mobility. The group approach promoted manual functional rehabilitation, the construction of a space for well-being, social interaction and health education.Keywords: Ambulatory Care; Health Education; Occupational Therapy; Rheumatology. Resumen: Este análisis de práctica discute las experiencias de intervenciones terapéuticas ocupacionales con un grupo de seis pacientes con enfermedades reumatológicas, en un hospital universitario de la Región Metropolitana de Recife, entre abril y mayo de 2019, totalizando ocho reuniones de talleres de artesanos. La aplicación de los instrumentos Medida de Desempeño Ocupacional Canadiense y Puntaje para la Evaluación y Cuantificación de Afecciones Reumáticas Crónicas de las Manos señaló desde el mantenimiento a la disminución de quejas de movilidad funcional manual. El atención grupal promovió rehabilitación funcional manual, un espacio para el bienestar, interacción social y la educación para la salud.Palabras clave: Atención Ambulatoria; Educación en Salud; Reumatología; Terapia Ocupacional.

Author(s):  
Cinthia Raquel Ferreira Nascimento ◽  
Juliana Fonsêca de Queiroz Marcelino ◽  
Mariana Lima da Silva Lousada ◽  
Vera Lucia Dutra Facundes

Introdução: A gestação na adolescência é considerada um problema de saúde pública. Neste contexto, o terapeuta ocupacional pode desenvolver sua abordagem com foco no desempenho ocupacional desta população, que se depara com um novo papel e na modificação de suas ocupações. Objetivo: Descrever as ações de terapia ocupacional com adolescentes gestantes sobre o desempenho em ocupações na rotina diária. Métodos: Estudo do tipo pesquisa-ação com abordagem qualitativa. Foi desenvolvido no ambulatório da Saúde da Mulher de um Hospital Universitário da cidade do Recife -- PE, entre março e julho de 2016, com 10 adolescentes gestantes. Os dados foram obtidos por meio de entrevista semiestruturada, consulta a prontuários e observação participante dos grupos, que gerou registros em diário de campo e gravações. Os princípios éticos da Resolução 466/12 do Conselho Nacional de Saúde, foram respeitados. Resultados: As ações foram iniciadas com o levantamento, junto às gestantes, de dificuldades no desempenho ocupacional, problematização esta que favoreceu as discussões posteriores, em direção à construção compartilhada de estratégias. As ocupações indicadas como problemáticas foram: calçar o sapato, depilar-se, atividade sexual, descanso e sono e mobilidade funcional. A partir daí, o grupo elaborou estratégias para melhorar sua performance nestas atividades, bem como qualidade de vida, respaldadas por orientações da terapeuta ocupacional.  Conclusões: No estudo, foi possível identificar as dificuldades no desempenho ocupacional na rotina diária das gestantes, bem como favorecer a reflexão das mesmas sobre as estratégias de enfrentamento, para contribuir com a redução de agravos à saúde, promoção da autonomia e independência funcional.  Abstract Introduction: Gestation in adolescence is considered a public health problem. In this context, the occupational therapist can develop his approach focusing on the occupational performance of this population, which faces a new role and on the modification of their occupations. Objective: To describe the actions of occupational therapy with pregnant adolescents, on the performance in occupations in the daily routine. Methods: A research-action study with a qualitative approach. It was developed at the Women's Health outpatient clinic of a University Hospital of the city of Recife - PE, between March and July 2016, with 10 pregnant adolescents. The data were obtained through a semi-structured interview, consultation of medical records and participant observation of the groups, which generated records in field diaries and recordings. The ethical principles of Resolution 466/12 have been respected. Results: The actions were initiated with the survey, along with pregnant adolescents, of difficulties in occupational performance, problematization that favored the later discussions, towards the shared construction of strategies. The occupations indicated as problematic were: wear shoes, depilation, sexual activity, rest and sleep, and functional mobility. From there, the group developed strategies to improve their performance in these activities, as well as quality of life, backed by occupational therapist guidelines. Conclusions: In the study, it was possible to identify the difficulties in occupational performance in the daily routine of pregnant women, as well as to favor their reflection on coping strategies, to contribute to the reduction of health problems, promotion of autonomy and functional independence.Key words: occupational therapy, pregnancy in adolescence, role playing, activities of daily living.  Resumen Este artículo tiene como proposito analizar y debater lasposibilidades de laactuación de la terapia ocupacional enel âmbito de la Cultura, desde las reflexiones docentes generado por losestudiantes graduados enla Terapia Ocupacional enel centro de enseñanza superior (IES) publica. Hoy, laspoliticapublicasbrasileñaspresentanla cultura como derecho. Cultura, en neste caso, no sólo entendida como manifestaciones artísticas y estéticas, sino como uma cuestión de la identidade, protegiendotambiénsu diversidade. Para esta investigación, elegimosel enfoque cualitativo a partir de un enfoque analítico descriptivo, teniendo como base el método documentaldeldiario de campo de lasclases de los dos semestres consecutivos de la disciplina de Terapia Ocupacional Social de uncurso de una Universidad Publica. Los resultados obtenidos se dividieranentres categorias de análisis: (1) Cultura atravesandolapráctica, (2) Cultura como recurso y (3) Cultura como um campo de acción de la Terapia Ocupacional. Se entiende que la Cultura puede definir como campo específico de acción, con una finalidade determinada, lo que apunta para lanecesidad de los estúdios y uma formacción dirigida enparticular  aaquellas políticas, servicios y prácticas. Los datos de este estudio especialmente sumado a las diversas experienciasde la Terapia Ocupacional enelámbito de la Cultura han demonstrado lanecesidad de replantearlaformaciónprofesional. Una pista importante llevaría a uma revisión de lasdirectrices curriculares nacionales, teniendo em cuentaelámbito de la Cultura como locus de produccióndelconociento y laintervencióndel terapeuta ocupacional. Se apunta que és necesarioinvertiren neste tipo de formación para laconsolidación de lasprácticas de el terapeuta ocupacional enelámbito de la Cultura.Palalvras claves: Terapia Ocupacional, Cultura, Ciudadanía Cultural, Formación Profesional. 


Author(s):  
Tanja Laukkala ◽  
Jaana Suvisaari ◽  
Tom Rosenström ◽  
Eero Pukkala ◽  
Kristiina Junttila ◽  
...  

The COVID-19 pandemic has caused an unequally distributed extra workload to hospital personnel and first reports have indicated that especially front-line health care personnel are psychologically challenged. A majority of the Finnish COVID-19 patients are cared for in the Helsinki University Hospital district. The psychological distress of the Helsinki University Hospital personnel has been followed via an electronic survey monthly since June 2020. We report six-month follow-up results of a prospective 18-month cohort study. Individual variation explained much more of the total variance in psychological distress (68.5%, 95% CI 65.2–71.9%) and negative changes in sleep (75.6%, 95% CI 72.2–79.2%) than the study survey wave (1.6%, CI 0.5–5.5%; and 0.3%, CI 0.1–1.2%). Regional COVID-19 incidence rates correlated with the personnel’s psychological distress. In adjusted multilevel generalized linear multiple regression models, potentially traumatic COVID-19 pandemic-related events (OR 6.54, 95% CI 5.00–8.56) and front-line COVID-19 work (OR 1.81, 95% CI 1.37–2.39) was associated with personnel psychological distress but age and gender was not. While vaccinations have been initiated, creating hope, continuous follow-up and psychosocial support is still needed for all hospital personnel.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 703-703
Author(s):  
Jessica Finlay ◽  
Philippa Clarke ◽  
Lisa Barnes

Abstract Does the world shrink as we age? The neighborhood captures a spatial area someone inhabits and moves through on a daily basis. It reflects a balance between internal perceptions and abilities, and the external environment which may enable or restrict participation in everyday life. We frequently hear that older adults have shrinking neighborhoods given declining functional mobility. This is associated with declines in physical and cognitive functioning, depression, poorer quality of life, and mortality. Knowledge of the interplay between objective and subjective neighborhood measurement remains limited. This symposium will explore these linked yet distinct constructs based on secondary data analyses of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a racially diverse sample of 30,000+ aging Americans. Finlay investigates how someone’s perceived neighborhood size (in number of blocks) varies by individual and geographic characteristics including age, cognitive function, self-rated health, and urban/rural context. Esposito’s analyses focus on neighborhood size in relation to race and residential segregation. Clarke compares subjective perceptions of neighborhood parks and safety from crime to objective indicators, and examines variations by health and cognitive status. Barnes will critically consider implications for how older adults interpret and engage with their surrounding environments. The symposium questions the validity of neighborhood-based metrics to reflect the perspectives and experiences of older residents, particularly those navigating cognitive decline. It informs policy-making efforts to improve physical neighborhood environments and social community contexts, which are critical to the health and well-being of older adults aging in place.


Pharmaceutics ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 239
Author(s):  
Marios Spanakis ◽  
Maria Melissourgaki ◽  
George Lazopoulos ◽  
Athina E. Patelarou ◽  
Evridiki Patelarou

Background: Drug interactions represent a major issue in clinical settings, especially for critically ill patients such as those with cardiovascular disease (CVD) who require cardiothoracic surgery (CTS) and receive a high number of different medications. Methods: A cross-sectional study aimed at evaluating the exposure and clinical significance of drug–drug (DDIs) and drug–dietary supplement interactions (DDSIs) in patients admitted for CTS in the University Hospital of Crete Greece. DDIs were evaluated regarding underlying pharmacological mechanisms upon admission, preoperation, postoperation, and discharge from CTS clinic. Additionally, upon admission, the use of dietary supplements (DSs) and if patients had informed their treating physician that they were using these were recorded with subsequent analysis of potential DDSIs with prescribed medications. Results: The study employed 76 patients who were admitted for CTS and accepted to participate. Overall, 166 unique DDIs were identified, with 32% of them being related to pharmacokinetic (PK) processes and the rest (68%) were related to possible alterations of pharmacodynamic (PD) action. CVD medications and drugs for central nervous system disorders were the most frequently interacting medications. In total, 12% of the identified DDIs were of serious clinical significance. The frequency of PK-DDIs was higher during admission and discharge, whereas PD-DDIs were mainly recorded during pre- and postoperation periods. Regarding DS usage, 60% of patients were using DSs and perceived them as safe, and the majority had not informed their treating physician of this or sought out medical advice. Analysis of medical records showed 30 potential combinations with prescribed medications that could lead in DDSIs due to modulation of PK or PD processes, and grapefruit juice consumption was involved in 38% of them. Conclusions: An increased burden of DDIs and DDSIs was identified mostly upon admission for patients in CTS clinics in Greece. Healthcare providers, especially prescribing physicians in Greece, should always take into consideration the possibility of DDIs and the likely use of DS products by patients to promote their well-being; this should only be undertaken after receiving medical advice and an evidenced-based evaluation.


2021 ◽  
pp. 030802262110002
Author(s):  
Joanne Inman ◽  
Katrina Bannigan ◽  
Jacqueline Akhurst

Introduction The dearth of clinical trials of individualised occupational therapy with people with a diagnosis of psychosis limits the evidence base globally for occupational therapy practice. This study evaluated the feasibility of conducting a pragmatic clinical trial. Method Mixed methods design using a pragmatic perspective; two-centre, one-group pretest-posttest study, at six months. POINTER Occupational Intervention Specification captured routine individualised occupational therapy. Process evaluation included recruitment, retention, intervention delivery, fidelity, adherence and outcome measurement. The primary outcome was participation in activities of everyday life, measured by Time Use Survey, Participation Scale and Utrecht Scale for Evaluation of Rehabilitation-Participation. The Canadian Occupational Performance Measure measured self-reported experience of and satisfaction with occupational performance. The Short Form-36v2 Health Survey measured health-related quality of life, a secondary outcome. Participants’ experiences were explored using a questionnaire. Intervention providers’ perspectives were investigated via the POINTER occupational intervention log and focus groups. Results Recruitment was (20/36) and drop-out 20% (4/20). Fidelity was 77%, and adherence was good; POINTER had validity and utility. Outcome measurement was acceptable to participants, indicating increased participation in activities of everyday life. Conclusion A larger clinical trial is merited; recruitment processes need further exploration, and outcome measurement needs refining.


2020 ◽  
pp. 000841742097112
Author(s):  
Eleonore H. Koolen ◽  
Martijn A. Spruit ◽  
Marianne de Man ◽  
Jeanine C. Antons ◽  
Elieke Nijhuis ◽  
...  

Background. Occupational therapy (OT) may be an important intervention in patients with COPD, but studies show conflicting results. Purpose. To evaluate the effectiveness of home-based monodisciplinary OT in COPD patients Method. We conducted an observational clinical study. Main outcomes were the mean differences in the Canadian Occupational Performance Measure (COPM) performance and satisfaction scores, pre and post intervention. Findings. Pre- and postintervention data were obtained from 41 patients. Statistically significant increases were observed in COPM performance (5.0 ± 1.1 versus 6.9 ± 0.9; P<0.001) and satisfaction (4.6 ± 1.3 versus 6.9 ± 1.0; P<0.001). The most frequently reported occupational performance problems were found in the domains of productivity (47%) and mobility (40%), fewer in self-care (10%) and the least in leisure (3%). Implications. Home-based monodisciplinary OT can contribute significantly to the improvement of daily functioning of patients with COPD. OT should therefore be considered more often as part of the integrated management of these patients.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Agnes Langer ◽  
Lucia Gassner ◽  
Anna Flotz ◽  
Sebastian Hasenauer ◽  
Jakob Gruber ◽  
...  

AbstractThe lack of physical exercise during the COVID-19 pandemic-related quarantine measures is challenging, especially for patients with Parkinson’s disease (PD). Without regular exercise not only patients, but also nursing staff and physicians soon noticed a deterioration of motor and non-motor symptoms. Reduced functional mobility, increased falls, increased frailty, and decreased quality of life were identified as consequences of increased sedentary behavior. This work overviews the current literature on problems of supplying conventional physiotherapy and the potential of telerehabilitation, allied health services, and patient-initiated exercise for PD patients during the COVID-19 period. We discuss recent studies on approaches that can improve remote provision of exercise to patients, including telerehabilitation, motivational tools, apps, exergaming, and virtual reality (VR) exercise. Additionally, we provide a case report about a 69-year-old PD patient who took part in a 12-week guided climbing course for PD patients prior to the pandemic and found a solution to continue her climbing training independently with an outdoor rope ladder. This case can serve as a best practice example for non-instructed, creative, and patient-initiated exercise in the domestic environment in difficult times, as are the current. Overall, many recent studies on telemedicine, telerehabilitation, and patient-initiated exercises have been published, giving rise to optimism that facilitating remote exercise can help PD patients maintain physical mobility and emotional well-being, even in phases such as the COVID-19 pandemic. The pandemic itself may even boost the need to establish comprehensive and easy-to-do telerehabilitation programs.


2019 ◽  
Vol 48 (7) ◽  
pp. 479-483 ◽  
Author(s):  
Dan Goldhaber ◽  
Umut Özek

The use of test scores as a performance measure in high-stakes educational accountability has become increasingly popular since the enactment of the No Child Left Behind Act of 2001 (NCLB), which imposed sanctions such as the threat of losing federal funds unless a state implemented a school accountability system that measures student progress continuously. Since then, many in the education community have questioned whether differences in student test scores reflect actual discrepancies in the long-term well-being of individuals. In this review, we try to address this question in the light of the extant literature that examines the relationship between test scores and later life outcomes. We show that while there are certainly studies that contradict the causality of this relationship, there is also abundant evidence suggesting a causal link between test scores and later life outcomes. We conclude that any debate about the use of test scores in educational accountability (1) should be framed by use of all relevant empirical evidence, (2) should also consider the predictive validity of nontest measures of student success, and (3) should keep in mind that the predictive validity of test scores could be stronger in some contexts than others.


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