scholarly journals Depressive Symptoms in Individuals after Stroke in a Home-Based Rehabilitation Setting

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Julianne Vermeer ◽  
Amanda McIntyre ◽  
Shannon Janzen ◽  
Danielle Rice ◽  
Laura Allen ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Poststroke Depression ◽  
Rehabilitation Team ◽  
Care Access ◽  
Home Based ◽  
Patient Health ◽  
The Impact

Poststroke depression has been shown to affect rehabilitation progress. This study evaluated patients after stroke who actively participated in a home-based rehabilitation program to determine variables that correlated with depressive symptoms in this population. A retrospective review of patients who were provided rehabilitation by Community Stroke Rehabilitation Team clinicians between January 1, 2009, and September 30, 2015, was completed. Logistic regression analysis was conducted to determine which demographic and outcome variables (Functional Independence Measure [FIM™] and Reintegration to Normal Living Index [RNLI]) were independently associated with depressive symptoms, as defined by Patient Health Questionnaire (PHQ-9) scores. 889 patients (53.2% male, mean age = 69.8 years) were included. Based on PHQ-9 scores, 89.7% of patients presented with no or mild depressive symptoms (PHQ-9 < 10) and 10.3% were considered to have moderate to severe depressive symptoms (PHQ-9 ≥ 10). The regression demonstrated that referral from outpatient, community care access centre, or community settings (OR = 1.89, p=0.04), low RNLI scores (OR = 0.92; p=0.001), and younger age (OR = 0.96; p<0.001) predicted patients having moderate to severe depressive symptoms. Given the impact of poststroke depression on rehabilitation, clinicians should consider the potential impact of referral source, community reintegration, and age when monitoring and treating depressive symptoms.

scholarly journals Impact of COVID-19 Pandemic on Inpatient Rehabilitation and the Original Infection Control Measures for Rehabilitation Team

2021 ◽  
Author(s):  
Yukimasa Igawa ◽  
Takahiro Sugimoto ◽  
Hiromasa Horimoto ◽  
Yusuke Moriya ◽  
Masaki Okada ◽  
...  
Keyword(s):  
Infection Control ◽  
Functional Independence Measure ◽  
Qualitative Evaluation ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Control Measures ◽  
Rehabilitation Team ◽  
Training Time ◽  
Infection Control Measures ◽  
The Impact

AbstractObjectiveThis study aimed to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on inpatient rehabilitation, and to determine the effectiveness of the original infection control measures implemented for the rehabilitation team.MethodsIn this single-center, retrospective, observational study, we calculated multiple rehabilitation indices of patients discharged from our rehabilitation ward between February 28 and May 25, 2020 when Hokkaido was initially affected by COVID-19, and compared them with those calculated during the same period in 2019. Fisher’s exact test and the Mann-Whitney U test were used for statistical analysis. We also verified the impact of implementing the original infection control measures for the rehabilitation team on preventing nosocomial infections.ResultsA total of 93 patients (47 of 2020 group, 46 of 2019 group) were included. The median age was 87 and 88 years, respectively, with no differences in age, sex, and main disease between the groups. Training time per day in the ward in 2020 was significantly lower than that in 2019 (p = 0.013). No significant differences were found in the qualitative evaluation indices of Functional Independence Measure (FIM) score at admission, FIM gain, length of ward stay, FIM efficiency, and rate of discharge to home. None of the patients or staff members had confirmed COVID-19 during the study period.ConclusionsEarly COVID-19 pandemic in Hokkaido affected the quantitative index for inpatient rehabilitation but not the qualitative indices. No symptomatic nosocomial COVID-19 infections were observed with our infection control measures.

scholarly journals Effects of Tele-Rehabilitation Compared with Home-Based in-Person Rehabilitation for Older Adult’s Function after Hip Fracture

2021 ◽  
Vol 18 (10) ◽  
pp. 5493
Author(s):  
Mariana Ortiz-Piña ◽  
Pablo Molina-Garcia ◽  
Pedro Femia ◽  
Maureen C. Ashe ◽  
Lydia Martín-Martín ◽  
...  
Keyword(s):  
Older Adults ◽  
Hip Fracture ◽  
Functional Recovery ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Control Group ◽  
Control Groups ◽  
Timed Up And Go ◽  
Home Based

This study aimed to examine the effect of a multidisciplinary tele-rehabilitation program on functional recovery of older adults with hip fracture compared with home-based in-person rehabilitation. In this single-blinded, non-randomized clinical trial, we included older with hip fracture. The tele-rehabilitation group received a 12-week tele-rehabilitation program (supervised by their family caregivers). The control group received the usual postoperative rehabilitation provided by the Andalusian health system (Spain). The primary outcome was the patient-reported functional status assessed with the Functional Independence Measure. We also measured performance-based functional recovery using the Timed Up and Go Test and Short Physical Performance Battery. We performed both a per-protocol (62 participants; 28 tele-rehabilitation and 34 control groups) and an intention-to-treat analysis (71 participants; 35 tele-rehabilitation and 36 control groups). Participants who used the tele-rehabilitation program had higher Functional Independence Measure scores (high effect size: 0.98 Cohen’s d; p < 0.001) and better performance in the Timed Up and Go Test (medium effect size: 0.63 Cohen’s d; p = 0.025) compared with the control group. Differences between groups post-intervention were not statistically significant in the Short Physical Performance Battery. The tele-rehabilitation intervention proposed in this study is a valuable treatment option in the recovery process for older adults with hip fracture. ClinicalTrials.gov Identifier: NCT02968589.

A neuropsychological group rehabilitation program with institutionalized elderly

2016 ◽  
Vol 33 (S1) ◽  
pp. s235-s235
Author(s):  
L. Lemos ◽  
H. Espírito-Santo ◽  
S. Simões ◽  
F. Silva ◽  
J. Galhardo ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Depressive Symptomatology ◽  
Randomized Study ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Rehabilitation Program ◽  
Post Intervention ◽  
Institutionalized Elderly ◽  
Group Rehabilitation ◽  
The Impact

IntroductionElderly institutionalization involves an emotional adaptation and the research shows that the risk of depression increases.ObjectivesEvaluate the impact of a neuropsychological group rehabilitation program (NGRP) on depressive symptomatology of institutionalized elderly.AimsNGRP influences the decrease of depressive symptoms.MethodsElderly were assessed pre- and post-intervention with the Geriatric Depression Scale (GDS) and divided into a Rehabilitated Group (RG), a Waiting List Group (WLG), and a Neutral Task Group (NTG).ResultsIn this randomized study, before rehabilitation, 60 elderly people (RG; 80.31 ± 8.98 years of age; 74.2% women) had a mean GDS score of 13.33 (SD = 9.21). Five elderly included in the NTG (80.13 ± 10.84 years; 75.0% women) had a mean GDS score of 10.60 (SD = 4.72). Finally, 29 elderly in the WLG (81.32 ± 6.68 years; 69.0% women) had a mean GDS score of 14.93 (SD = 6.02). The groups were not different in GDS baseline scores (F = 0.74; P = 0.478). ANCOVA has shown significant differences (P < 0.05) in GDS scores between the three groups after 10 weeks. Sidak adjustment for multiple comparisons revealed that elderly in the WLG got worse scores in GDS, comparing with elderly in RG (P < 0.01), and with elderly in NTG (P < 0.05).ConclusionsElderly that are not involved in a task get worse in depressive symptomatology. Being involved in a structured group task means lower depressive symptoms and being in a NGRP means even greater results.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Determining Stroke Rehabilitation Inpatients' Level of Nursing Care

2001 ◽  
Vol 10 (1) ◽  
pp. 40-51 ◽  
Author(s):  
Jan Coleman Gross ◽  
Stacey W. Goodrich ◽  
Mary E. Kain ◽  
Elizabeth A. Faulkner
Keyword(s):  
Nursing Care ◽  
Stroke Rehabilitation ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Two Factors ◽  
Staffing Needs ◽  
Care Index ◽  
Strong Inverse Relationship

The purpose of this study was to evaluate the feasibility of using the Functional Independence Measure (FIM) to predict staffing needs of stroke patients in an acute inpatient rehabilitation program. The Patient Care Index (PCI) was concurrently administered with the FIM on all stroke admissions to a stroke rehabilitation unit over a 3-month period. One hundred fourteen patients 18 years of age or older admitted to the unit with a medical diagnosis of stroke were included in the sample. Total FIM score had a strong inverse relationship to the level of care indicated by the PCI at Days 1, 5, 7, 10, 15, and 20 of rehabilitation (rs = —.76 to —.87). Total FIM score and the need for staff supervision for safety were the two factors predictive of the level of nursing care. The FIM has potential to guide nurse-staffing decisions.

scholarly journals The Impact of Nutritional Status and Body Mass Index on Rehabilitation Outcomes in Patients Receiving Home-Based Medical Care

2020 ◽  
Vol 3 (2) ◽  
pp. 15
Author(s):  
Kanako Eiwa ◽  
Naomi Nakayama ◽  
Yumi Takami ◽  
Shuko Iwasaki ◽  
Yoshinori Hino ◽  
...  
Keyword(s):  
Body Mass Index ◽  
At Risk ◽  
Nutritional Status ◽  
Medical Care ◽  
Body Mass ◽  
Functional Independence ◽  
The Body ◽  
Rehabilitation Outcomes ◽  
Home Based ◽  
The Impact

Background: Home-based medical care is expanding rapidly in Japan.Objectives: We aimed to identify the factors associated with outcomes of therapy in patients receiving home-visit rehabilitation.Methods: One hundred twenty-one patients receiving home-based rehabilitation were investigated. Nutritional status was assessed by the Mini Nutritional Assessment Short Form (MNA-SF). The Functional Independence Measure (FIM) was employed to assess the activities of daily living (ADL). The body mass index (BMI), medical history, and orthopedic disease-related pain were also recorded. The primary outcome was the improvement in FIM scores in one year.Results: A total of 19 (17%) patients were malnourished and 58 (48%) were at risk of malnutrition. Malnourished patients had a lower FIM score at initiation than those at risk of malnutrition or with normal nutritional status. Only changes in patients’ BMI and MNA-SF scores over one year were significantly associated with improved FIM scores (p = 0.0079 and p = 0.0049, respectively). No association was noted with the other factors.Conclusions: This is the first report to demonstrate that changes in MNA-SF scores and BMI are significantly associated with rehabilitation outcomes in home-based care. Nutritional management is essential along with rehabilitation to improve ADL in the long-term home care setting.

Depressive Symptoms in Dialysis: Prevalence and Relationship with Uremia-Related Biochemical Parameters

2018 ◽  
Vol 46 (4) ◽  
pp. 286-291 ◽  
Author(s):  
Luigi Cirillo ◽  
Roberta Cutruzzulà ◽  
Chiara Somma ◽  
Marco Gregori ◽  
Giuseppe Cestone ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Functional Impairment ◽  
Biochemical Parameter ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Dialysis Patients ◽  
Cross Sectional ◽  
Patient Health ◽  
Laboratory Variables ◽  
The Impact

Background: Depression is the most common psychiatric disorder in long-term dialysis patients and a risk factor for morbidity and mortality. Although there is a relevance of the issue in the dialysis setting, we still know little about possible relationships between depression and uraemia-related biochemical abnormalities. Our aims were to evaluate (1) the prevalence of depression in our haemodialysis (HD) and peritoneal dialysis (PD) population using a validated and easy-to-implement screening tool and (2) the association between depression and the main uraemia-related clinical and biochemical parameter changes. Methods: In this monocentric cross-sectional study, all patients of our centre with at least 3 months of dialysis were screened by Patient Health Questionnaire-9 (PHQ-9), a self-administered depression-screening questionnaire validated in dialysis setting. The impact of depressive symptoms on daily life was also assessed. We then analysed relationships between the PHQ-9-derived depressive score, functional impairment score, demographic, clinical and laboratory variables. Results: In our cohort of 145 patients, depressive symptoms were found in 69 patients (46%). Stratifying for severity, mild, moderate and severe grade accounted for 31, 13 and 2% respectively. Depressive symptoms affected 36% of patients on PD versus 52% of patients on HD. Moreover, the PD patients had significantly less functional impairment derived from depressive symptoms than the HD patients. Simple and multiple regression analysis identified serum phosphorus as the only uraemia-related laboratory parameter that was high statistically associated with depressive score. Conclusions: Using a reliable, simple and fast tool, we found that depressive symptoms affect almost half of dialysis patients, particularly so the HD cohort. Severity of depressive symptoms seems related to serum levels of phosphorus possibly because depression affects compliance to therapy.

Use of the functional independence measure in Japanese rehabilitation team interaction

2019 ◽  
Vol 21 (6) ◽  
pp. 660-689
Author(s):  
Hiroaki Izumi
Keyword(s):  
Clinical Decision Making ◽  
Collaborative Work ◽  
Functional Independence Measure ◽  
Clinical Decision ◽  
Functional Independence ◽  
Disabled Persons ◽  
Rehabilitation Team ◽  
Team Members ◽  
Team Interaction ◽  
Team Meetings

The functional independence measure (FIM) is a clinical scale which is used to evaluate the amount of assistance disabled persons need to conduct their daily living activities. Drawing on 65 video-recorded rehabilitation team meetings and medical records collected from a Japanese hospital, this article utilizes ethnomethodology and conversation analysis to uncover how Japanese rehabilitation team members use the FIM to track changes in the functional status of patients and decide the length of stay in ongoing interactional sequences. Analysis shows that a series of the FIM scores assembled and arranged in situ provide a sequential framework for members to understand the progress of rehabilitation and predict the plateau phase. Moreover, a particular expert is asked about patients’ capacity for further improvements and his or her opinions are treated as a basis for clinical decisions. In this way, diagnostic and clinical decision-making is produced through the ongoing collaborative work of various specialists.

scholarly journals Mental Distress in the United States at the Beginning of the COVID-19 Pandemic

2020 ◽  
Vol 110 (11) ◽  
pp. 1628-1634 ◽  
Author(s):  
Calliope Holingue ◽  
Luther G. Kalb ◽  
Kira E. Riehm ◽  
Daniel Bennett ◽  
Arie Kapteyn ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Odds Ratio ◽  
Mental Distress ◽  
Adult Population ◽  
The United States ◽  
The Us ◽  
Patient Health ◽  
Completion Date ◽  
History Of ◽  
The Impact

Objectives. To assess the impact of the COVID-19 pandemic on mental distress in US adults. Methods. Participants were 5065 adults from the Understanding America Study, a probability-based Internet panel representative of the US adult population. The main exposure was survey completion date (March 10–16, 2020). The outcome was mental distress measured via the 4-item version of the Patient Health Questionnaire. Results. Among states with 50 or more COVID-19 cases as of March 10, each additional day was significantly associated with an 11% increase in the odds of moving up a category of distress (odds ratio = 1.11; 95% confidence interval = 1.01, 1.21; P = .02). Perceptions about the likelihood of getting infected, death from the virus, and steps taken to avoid infecting others were associated with increased mental distress in the model that included all states. Individuals with higher consumption of alcohol or cannabis or with history of depressive symptoms were at significantly higher risk for mental distress. Conclusions. These data suggest that as the COVID-19 pandemic continues, mental distress may continue to increase and should be regularly monitored. Specific populations are at high risk for mental distress, particularly those with preexisting depressive symptoms.

scholarly journals High Prevalence of Poststroke Depression in Ischemic Stroke Patients in Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Fikru Tsehayneh ◽  
Abenet Tafesse
Keyword(s):  
Depressive Symptoms ◽  
Negative Impact ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
Screening Tools ◽  
Limited Information ◽  
Poststroke Depression ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Patient Health

Background. There is limited information and research carried out regarding the prevalence of poststroke depression (PSD) in the study area. Psychiatric disorders complicate a significant proportion of patients suffering from stroke. This of course have a great negative impact on our knowledge about poststroke depression in Ethiopia, and poststroke depression complicates a significant number of stroke patients and their rehabilitation. Methods. A cross-sectional study on all patients aged above 18 years and diagnosed with stroke in the past two years who attended the neurology follow-up clinics of Tikur Anbessa Specialized Hospital (TASH) and Zewditu Memorial Hospital (ZMH) was done by using a structured questionnaire containing Patient Health Questionnaire-9 (PHQ-9) depression screening tool. Result. Of 84 patients who were eligible for the study, 32.2% of patients have depressive symptoms. Women (OR 0.001, 95% CI 0.12–0.87) and aphasic patients (OR 0.034, 95% CI 0.19–1.27) were more likely to have depressive symptoms. Conclusion. Depressive symptoms after stroke are common in Ethiopian patients. Our study demonstrates female and aphasic patients are more likely to screen positive for PSD. Hence, screening all poststroke patients with different screening tools is practical, and further studies are needed to assess the validity of these screening tools and also to assess PSD as a predictor of stroke outcome.

scholarly journals Interdisciplinary Therapy for patients with dementia

2014 ◽  
Vol 8 (3) ◽  
pp. 285-290
Author(s):  
Maysa Luchesi Cera ◽  
Daniela Cristina Carvalho de Abreu ◽  
Rosângela de Abreu Venancio Tamanini ◽  
Amanda Carla Arnaut ◽  
Patrícia Pupin Mandrá ◽  
...  
Keyword(s):  
Intervention Program ◽  
Functional Performance ◽  
Functional Dependence ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Clinical Dementia Rating ◽  
Interdisciplinary Intervention

Patients with dementia require rehabilitation involving several health professionals, where interdisciplinary care can further enhance the routine of patients and their families.OBJECTIVE:To compare the functional performance of elderly with dementia before and after an interdisciplinary intervention program provided by a healthcare service of medium complexity.METHODS: Three cases with clinically-confirmed dementia enrolled on an interdisciplinary rehabilitation program were reported. The following instruments were applied: Mini Mental-State Exam, Clinical Dementia Rating, Geriatric Depression Scale, Lawton & Brody Index, and the Functional Independence Measure for adults (FIM). The therapeutic strategies were individualized and designed based on patient performance on the FIM, according to the criteria of the Classification of Functionality, Disability and Health, implemented at the house of therapy of the Center for Integrated Rehabilitation together with provision of guidance.RESULTS: A reduction in functional dependence was observed after intervention, evidenced by less supervision needed to carry out Activities of Daily Living. Conclusion: The three patients benefited from the interdisciplinary intervention.

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