Gut-directed hypnotherapy is an effective treatment alternative for patients with refractory IBS, but the effectiveness is lower when the therapy is given outside the highly specialized research centers.
The results from secondary analyses provide preliminary support for the use of a third qualifier measuring subjective experience of involvement to facilitate the split between activity and participation in the International Classification of Functioning, Disability and Health, Children and Youth version, activity and participation domain.
Background Self-rated participation is a clinically relevant intervention outcome for people with mild intellectual disability. The aim of this systematic review was to analyse empirical studies that explored relationships between either environmental factors or individual characteristics and aspects of participation in young adults with mild intellectual disability. Method Four databases were used, 756 abstracts examined and 24 studies were evaluated in-depth. Results Four aspects of participation were found: involvement, perceptions of self, self-determination and psychological well-being. Reported environmental factors were: social support, choice opportunity, living conditions, school, work and leisure, attitudes, physical availability and society. Reported individual characteristics were adaptive and social skills. Conclusions There is a relative lack of studies of factors influencing self-rated participation and existing studies are difficult to compare because of disparity regarding approaches, conceptual frameworks, etc. For adequate interventions, it seems important to study how profiles of participation are influenced by different patterns of environmental factors and individual characteristics.
The concepts of participation and participation restriction are highly relevant in people with a mild intellectual disability. Self-rated performance might be sufficient to assess participation at a group level. In clinical practices, the relationship between the perceived importance and the actual performance of an activity is essential to assess.
Background: Intervention in severe aphasia often means aiming for access to meaningful social interaction in spite of linguistic barriers that might not be treatable. This demands knowledge about the different factors that influence functional communication. Apart from linguistic ability, executive functions are thought to play an important role. Aims: To expand the understanding of the relations of executive functions and linguistic ability to functional communication in severe aphasia. Methods and Procedures: Executive functions, linguistic ability, and functional communication were assessed in 47 participants with severe aphasia. The results were analysed for the total sample and for a verbal and a nonverbal subgroup. Outcomes and Results: Impairment of executive function was found in 79% of the participants. There were moderate to strong correlations between all subtests of executive functions and linguistic ability. In the total sample, significant partial correlation was found between functional communication and verbal output. In the nonverbal subgroup, there was a significant partial correlation between executive function and functional communication, when controlling for linguistic ability. In the verbal subgroup, no relations were found between executive functions or language and functional communication. Conclusions: Impairments of executive functions are common in people with severe aphasia, and executive function and linguistic ability are closely related. The ability to produce verbal output is strongly related to functional communication, but in people with extreme limitation or total absence of verbal output, executive functions seem to be an important factor for functional communication. There is a large variation of executive functions and functional communication in people with severe aphasia, especially in the nonverbal subgroup. It is important that people with severe aphasia are given a complete and proper evaluation of their abilities, and that the possible importance of executive function to communication is considered in communication intervention.
This study explores the potential of the health assessment questionnaire (HAQ) score as a clinical indicator that can be used to suggest comprehensive multidisciplinary assessments, by relating it to more general aspects of disability. In a cohort of 132 patients with early RA (mean age 55, 68% women), 28 joint count Disease Activity Scores (DAS-28), HAQ, and Short Form 36 (SF-36) scores were registered at annual follow-up visits 8 years after diagnosis. The patients were tentatively sub-grouped into a high-HAQ group (HAQ ≥ 1 at the 8-year follow-up) and a low-HAQ group. The high-HAQ group, comprising 36% of the cohort, had a higher mean HAQ score at inclusion and beyond at all visits compared to the low-HAQ group, and 24% of all individual patients in the high-HAQ group had a HAQ score ≥ 1 at inclusion. Although the DAS-28 improved in both groups, patients in the high-HAQ group also had significantly more persistent disability according to the SF-36: five scales at each follow-up visit and all eight scales at the majority of the visits. Individual RA patients with HAQ ≥ 1 probably have considerable persistent disabilities according to the SF-36. The HAQ score could be used as a clinical indicator suggesting comprehensive multidisciplinary assessments of the components of disability and corresponding interventions, in addition to the established use of HAQ at group levels and in parallel with the medication strategy based on DAS-28.
Importance: There is a need for evidence-based occupational therapy interventions to enhance time management in people with time management difficulties.
Objective: To pilot test the first part of the Let’s Get Organized (LGO) occupational therapy intervention in a Swedish context by exploring enhancements of time management skills, aspects of executive functioning, and satisfaction with daily occupations in people with time management difficulties because of neurodevelopmental or mental disorders.
Design: One-group pretest–posttest design with 3-mo follow-up.
Setting: Outpatient psychiatric and habilitation settings.
Participants: Fifty-five people with confirmed or suspected mental or neurodevelopmental disorder and self-reported difficulties with time management in daily life.
Intervention: Swedish version of Let’s Get Organized (LGO–S) Part 1, with structured training in the use of cognitive assistive techniques and strategies using trial-and-error learning strategies in 10 weekly group sessions of 1.5 hr.
Outcomes and Measures: Time management, organization and planning, and emotional regulation were measured with the Swedish version of the Assessment of Time Management Skills (ATMS–S). Executive functioning was measured with the Swedish version of the Weekly Calendar Planning Activity, and satisfaction with daily occupations was assessed with the Satisfaction With Daily Occupations measure.
Results: Participants displayed significantly improved time management, organization and planning skills, and emotional regulation, as well as satisfaction with daily occupations. Aspects of executive functioning were partly improved. ATMS–S results were sustained at 3-mo follow-up.
Conclusion and Relevance: LGO–S Part 1 is a promising intervention for improving time management skills and satisfaction with daily occupations and should be investigated further.
What This Article Adds: This study shows that LGO–S Part 1 is feasible for use in psychiatric and habilitation outpatient services. The results are promising for improved time management skills, organization and planning skills, and satisfaction with daily occupations and need to be confirmed in further studies.
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