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1.
Artículo en Inglés | MEDLINE | ID: mdl-39306826

RESUMEN

BACKGROUND: Young adults drink heavily and experience negative alcohol consequences. To capitalize on mornings after drinking as an optimal time to intervene, we developed a novel, theory-based personalized feedback intervention (PFI) called Alcohol Feedback, Reflection, and Morning Evaluation (A-FRAME), to reduce heavy drinking. An initial prototype was refined via feedback from college students who drink heavily. The goal of the present study was to conduct an open trial to establish feasibility and acceptability of the refined PFI. METHODS: The refined PFI was delivered for 4 weeks to 18 heavy-drinking young adults (Mage = 22.61, 44% women, 66.7% White, 27.8% Black, 16.7% Asian, 5.6% Native American/Alaskan Indian, 22.2% Hispanic/Latino). Participants completed a goal-setting procedure, followed by 28 daily surveys. Surveys indicating prior-day drinking were followed by the option to view personalized feedback (e.g., goal attainment, blood alcohol concentration [BAC], peer norms, protective behaviors). Aggregated feedback was also delivered at the 14- and 28-day marks. Participants completed a post-test acceptability survey and individual interviews to inform further refinement. RESULTS: The response rate to daily surveys was 93.8% and all participants completed study procedures, demonstrating feasibility. Daily feedback was reviewed about half (45.5%) of the time it was offered (i.e., following drinking days). Biweekly feedback was viewed 50% and 56% of the time at 14- and 28-day marks, respectively. Other benchmarks for acceptability were supported by survey and interview results. CONCLUSIONS: Open trial results support the feasibility and acceptability of this theory-based intervention for heavy-drinking young adults. A planned randomized controlled trial will evaluate efficacy.

2.
Digit Health ; 10: 20552076241277351, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39221090

RESUMEN

Objective: Goal setting is a behavior change technique associated with improved change in outcomes. Digital (eHealth, mHealth) behavior change interventions often prescribe all goals with no opportunity for participants to create and track their own; thus, little is known about the types of goals participants create for themselves and their impacts on behavioral outcomes. This analysis describes the goals created by participants using an optional personal goal-setting component and evaluates the association between participant goal creation and weight loss in an eHealth adult weight loss intervention. Methods: This represents a mixed methods QUANT-qual design to understand the types of goals users create for themselves and their impacts on behavior change outcomes. Qualitative codes were applied for the topic, behavior/outcome focus, adherence to SMART criteria, and repetition with count summaries. Quantitative analyses applied regression modeling to determine if the number of goals set was associated with the 6-month weight change, controlling for covariates. Results: Participants (n = 363) set an average of 23.4 goals (SD = 22.7) over 6 months. Those who reached at least 5% weight loss set significantly more goals than those who lost between 1% and 4.99% or who lost <1% or gained weight (p's < 0.0001). Setting more personal goals was associated with significant weight loss reduction at 6 months, controlling for covariates (p's < 0.05). Conclusions: Greater use of a personal goal-setting feature was associated with improved weight loss outcomes among active users. This can be a low-investment addition to digital behavior change interventions to contribute to improved outcomes.

3.
Int J Behav Med ; 2024 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-39266910

RESUMEN

BACKGROUND: Co-occurring chronic pain and posttraumatic stress disorder (PTSD) is associated with poorer physical and mental functioning and well-being. Treatments often incorporate goal-setting around personally meaningful behaviors; however, it is unclear whether intentionally focusing on improving meaning and purpose in life (i.e., meaning-as-goal) may also serve as a helpful treatment target. The objective of the current study is to determine whether reported progress toward meaning-as-goal at 6 months is associated with pain severity and interference, physical and mental health functioning, and global meaning and purpose at 6- and 12-months. METHODS: Data were collected as part of an evaluation effort focused on VA's Whole Health System implementation efforts. VA electronic health records were linked to survey data across three time points (baseline, 6 months, and 12 months) from Veterans with both chronic pain and PTSD across 18 VA sites. A total of 1341 Veterans met inclusion criteria (mean age = 62, SD = 11.7). RESULTS: Regression analyses showed that progress toward meaning-as-goal was significantly associated with all 6-month variables, with standardized coefficients ranging from - 0.14 (pain severity and interference) to .37 (global meaning and purpose), in addition to all 12-month variables, with standardized coefficients ranging from - .13 (pain severity and interference) to .31 (global meaning and purpose). CONCLUSIONS: Efforts to intentionally promote meaning and purpose as part of evidence-based treatment for chronic pain and PTSD may lead to decreased pain and improved physical and mental health functioning and global meaning and purpose. With coefficients ranging from small to moderate effect sizes, more work is needed to better understand how best to maximize meaning-related goals.

4.
Disabil Rehabil ; : 1-9, 2024 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-39158140

RESUMEN

PURPOSE: In the BigMove intervention, people with physical and mental health conditions assess their functioning, set goals, and define action plans to achieve their goals recorded in an e-health application using all categories of the International Classification of Functioning, Disability, and Health (ICF). This study investigates whether data from this application can provide insight into participants' self-perceived functioning, goals and action plans and observe changes over time. METHODS: Data from 446 participants were analysed with descriptive statistics to describe self-perceived functioning and the ICF categories related to the 15 most frequently chosen goals. Action plans were analysed using inductive analysis. Changes over time were investigated by comparing assessments before and after at least 4 months in the intervention. RESULTS: The data provided insight into the self-perceived functioning, goals and action plans. Also, changes over time were observed. Self-perceived functioning changed from being mainly negative before, to mainly positive after the intervention. While goals were mostly related to the same ICF categories, the action plans changed from more specific short-term to more general long-term plans. CONCLUSIONS: Our study demonstrates that all categories of the ICF can be used to record self-perceived functioning, goals and action plans and monitor changes over time.


The complete International Classification of Functioning, Disability, and Health (ICF) can provide a useful tool to record self-perceived functioning, goals, and action plans.Setting goals by using all ICF categories shows what is relevant to people themselves and can stimulate activities that foster functioning according to what people value.Assessments of self-perceived functioning, related goals, and action plans offer a novel approach to assessing health and comparing healthcare outcomes.

5.
Front Cardiovasc Med ; 11: 1441336, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39193500

RESUMEN

Introduction: Frailty is common among patients entering cardiac rehabilitation (CR). Frailty is associated with poor health outcomes; however, it is unclear if frailty influences achieving goals in CR. Methods: We report a secondary analysis of participants who were referred to an exercise and education-based CR program from 2005 to 2015. Frailty was measured by a 25-item accumulation of deficits frailty index (FI) ranging from 0 to 1; higher scores indicate higher frailty. Participants were categorized by admission frailty levels (FI scores: < 0.20, 0.20-0.29, 0.30-0.39, > 0.40). CR goals were determined with shared decision-making between CR staff and the patients. We conducted logistic regression analyses to examine the odds of goal attainment by CR completion, adjusting for age, sex, education, marital status, and referring diagnosis. Analyses were performed using baseline frailty as a categorical and continuous outcome, and frailty change as a continuous outcome in separate models. Results: Of 759 eligible participants (age: 59.5 ± 9.8, 24% female), 607 (80%) participants achieved a CR goal at graduation. CR goals were categorized into similar themes: control or lose weight (n = 381, 50%), improve physical activity behaviour and fitness (n = 228, 30%), and improve cardiovascular profile (n = 150, 20%). Compared to the most severe frailty group (FI >0.40), lower levels of frailty at baseline were associated with achieving a goal at CR completion [FI < 0.20: OR = 4.733 (95% CI: 2.197, 10.194), p < .001; FI 0.20-0.29: OR = 2.116 (1.269-3.528), p = .004]. Every 1% increase in the FI was associated with a 3.5% reduction in the odds of achieving a CR goal [OR = 0.965 (0.95, 0.979), p < .001]. Participants who reduced their frailty by a minimally clinically important difference of at least 0.03 (n = 209, 27.5%) were twice as likely to achieve their CR goal [OR = 2.111 (1.262, 3.532), p = .004] than participants who increased their frailty by at least 0.03 (n = 82, 10.8%). Every 1% improvement in the FI from baseline to follow up was associated with a 2.7% increase in the likelihood of CR goal achievement [OR = 1.027 (1.005, 1.048), p = .014]. Conclusion: Lower admission frailty was associated with a greater likelihood of achieving CR goals. Frailty improvements were associated with CR goal achievement, highlighting the influence of frailty on goal attainment.

6.
Langenbecks Arch Surg ; 409(1): 266, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39215842

RESUMEN

PURPOSE: Despite mobilization is highly recommended in the ERAS® colorectal guideline, studies suggest that more than half of patients don't reach the daily goal of 360 min out of bed. However, data used to quantify mobilization are predominantly based on self-assessments, for which the accuracy is uncertain. This study aims to accurately measure postoperative mobilization in ERAS®-patients by validated motion data from body sensors. METHODS: ERAS®-patients with elective bowel resections were eligible. Self-assessments and motion sensors (movisens: ECG-Move 4 and Move 4; Garmin: Vivosmart4) were used to record mobilization parameter from surgery to postoperative day 3 (POD3): Time out of bed, time on feet and step count. RESULTS: 97 patients were screened and 60 included for study participation. Self-assessment showed a median out of bed duration of 215 min/day (POD1: 135 min, POD2: 225 min, POD3: 225 min). The goal of 360 min was achieved by 16.67% at POD1, 21.28% at POD2 and 20.45% at POD3. Median time on feet objectively measured by Move 4 was 109 min/day. During self-assessment, patients significantly underestimated their "time on feet"-duration with 85 min/day (p = 0.008). Median number of steps was 933/day (Move 4). CONCLUSION: This study confirmed with objectively supported data, that most patients don't reach the daily mobilization goal of 360 min despite being treated by an ERAS®-pathway with ERAS®-nurse. Even considering an empirically approximated underestimation, the ERAS®-target isn't achieved by more than 75% of patients. Therefore, we propose an adjustment of the general ERAS®-goals into more patient-centered, individualized and achievable goals. REGISTRATION: This study is part of the MINT-ERAS-project and was registered prospectively in the German Clinical Trials Register on 25.02.2022. Trial registration number is "DRKS00027863".


Asunto(s)
Vías Clínicas , Ambulación Precoz , Procedimientos Quirúrgicos Electivos , Recuperación Mejorada Después de la Cirugía , Estudios de Factibilidad , Humanos , Femenino , Masculino , Anciano , Persona de Mediana Edad , Anciano de 80 o más Años , Autoevaluación (Psicología)
7.
BMC Sports Sci Med Rehabil ; 16(1): 183, 2024 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-39198888

RESUMEN

BACKGROUND: Studies examining post-race emotional experiences in the context of endurance races among recreational athletes are scarce. The purpose of this study was to describe how recreational athletes experience the time after completing an endurance race. METHODS: In this study, a qualitative study design was used, and data collection was carried out with semi-structured interviews. The selection of subjects was completed systematically through criterion selection. The selection criteria were men and women, aged 18 years or older, who had completed an endurance race, and finished, lasting at least 180 min within the past 12 months. The interviews were analyzed using conventional qualitative content analysis. RESULTS: Sixteen recreational endurance athletes who, within six months, had completed an endurance race of running, cycling, cross-country skiing or Ironman, participated and were interviewed. Four overarching themes emerged from the analysis: "High on life", "Loss of energy, Ambivalence and Melancholy", "Activity-charged emotions", and "Dimensions of emotions over time and new goals", describing the content of the interviews. CONCLUSIONS: Endurance athletes experienced varied post-race emotions that were both physically and mentally challenging, suggesting a holistic approach to managing post-race emotions would be beneficial. From the athletes' perspectives, post-race feelings were dependent on many factors, including time spent training for a specific race, and perceived inability to set new goals for an upcoming training period. Setting future goals prior to an event may be a tool for reducing the risk of negative post-race emotions, including post-race blues.

8.
J Clin Med ; 13(14)2024 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-39064173

RESUMEN

As chronic illness is common among older people, self-care practices for older people are needed to control health status, to prevent possible complications and to ensure optimal quality of life. The literature has demonstrated that integrated care approaches are one key success factor for delivering person-centered and sustainable care for older people, with rehabilitation being a cornerstone in tertiary care prevention for older citizens. The current paper addresses the state of the literature for person-centered geriatric rehabilitation (GR) and the importance of personalized and participatory goal setting. In accordance with the bio-psycho-social model of the International Classification of Functioning, Disability and Health (ICF), social participation and the related goals are of particular importance for the entire rehabilitation process. The social participation of individuals enrolled into GR is therefore one of the milestones to be achieved during GR. Personalized goal setting during the entire rehabilitation process, Comprehensive Geriatric Assessment (CGA) and shared decision making allow a comprehensive care approach separate from solely function-based rehabilitation. The review also focusses on recent developments in digitalization in healthcare and delivers insights into how healthcare professionals' collaborative practice supports sustainable rehabilitation results in patients of advanced chronological age.

9.
Disabil Rehabil ; : 1-9, 2024 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-38988260

RESUMEN

PURPOSE: To explore the rehabilitation goals and evaluate goal attainment outcomes of people with severe acquired brain injury (ABI), and investigate the relationship between goal engagement and goal attainment. MATERIALS AND METHODS: Mixed-methods cohort study with twenty-nine adults with severe ABI in Australia. Demographic data, goal statements and pre-post program Goal Attainment Scale scores as well as Goal Engagement Scale scores were collected. Goals were coded using inductive content analysis and categorised by ICF component and domain. Goal attainment within ICF categories was described and compared using descriptive statistics. Pre-post program change in goal attainment was evaluated using Wilcoxon signed rank tests and correlations between goal engagement and attainment was explored using Spearman's (rho). RESULTS: 94% of 320 goals were categorised as ICF Activity and Participation. There was significant improvement in goal attainment between admission and discharge (z=-0.47, p < 0.01). There was no significant relationship between goal engagement and goal attainment however there was a positive association between engagement in goal setting at admission and discharge.Conclusions: This interdisciplinary, inpatient rehabilitation program underpinned by key-worker facilitated person-centred, role-based goal setting resulted in goal attainment in chosen goals, which were primarily activity and participation-focused.


Goal setting is a core rehabilitation practice and service delivery models that facilitate collaborative goal setting which engages patients, their significant others and health professionals as a team are necessary to enable person-centred care.Role-based goal setting effectively engaged patients with acquired brain injury and their families, facilitating goal setting and the formation of activity and participation-focused rehabilitation goals in this extended rehabilitation setting.

10.
Alzheimers Dement (N Y) ; 10(3): e12493, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39011459

RESUMEN

Introduction: Person-centered goals capture individual priorities in personal contexts. Goal Attainment Scaling (GAS) has been used in drug trials involving people living with dementia (PLWD) but GAS has been characterized as difficult to incorporate into trials and clinical practice. We used GAS in a trial of New Interventions for Independence in Dementia Study (NIDUS)-family, a manualized care and support intervention, as the primary outcome and to tailor the interventions to goals set. We aimed to assess the feasibility and content of baseline goal-setting. Methods: We developed training for nonclinical facilitators to set individualized GAS goals remotely with PLWD and family carer dyads, or carers alone, in the intervention trial, during the COVID-19 pandemic. A qualitative content analysis of the goals set explored participants' priorities and unmet needs, to consider how existing GAS goal domains might be extended in a psychosocial intervention trial context. Results: Eleven facilitators were successfully trained to set and score GAS goals. A total of 313/328 (95%) participants were able to collaboratively set three to five goals with the facilitators. Of these, 302 randomized participating dyads set 1043 (mean 3.5, range 3 to 5) goals. We deductively coded 719 (69%) goals into five existing GAS domains (mood, behavior, self-care, cognition, and instrumental activities of daily living); 324 (31%) goals were inductively coded into four new domains: carer break, carer mood, carer behavior, and carer sleep. The most frequently set goals pertained to social support. There was little variation in types of goals set based on the context of who set them or level of pandemic restrictions in place. Discussion: It is feasible for people without clinical training to set GAS holistic goals for PLWD and family carers in the community. GAS has potential to facilitate personalization of care and support interventions, such as NIDUS-family, and facilitate the roll out of more personalized care. Highlights: Goal Attainment Scaling (GAS) can capture meaningful priorities of people with dementia and their family carers.A psychosocial intervention RCT used GAS as the primary outcome measure and goals were set collaboratively by non-clinically trained facilitators.The findings underscore the feasibility of using GAS as an outcome measure with this population.The content analysis findings unveiled the diversity in experiences and priorities of the study participants.GAS has the potential to support the implementation of more person-centred approaches to dementia care.

11.
BMC Palliat Care ; 23(1): 179, 2024 Jul 19.
Artículo en Inglés | MEDLINE | ID: mdl-39030499

RESUMEN

BACKGROUND: Palliative rehabilitation amalgamates the principles of palliative care and rehabilitation to enhance patients' quality of life by optimizing physical function and maximizing autonomy despite advancing illness. Alongside providing non-pharmacological symptom management, it emphasizes personalized goal-setting tailored to individual needs. This case illustrates the transformative impact targeted physiotherapy interventions can have on patients' physical function, morale and motivation in spite of their expected deterioration. CASE PRESENTATION: An 85-year-old male with angioimmunoblastic T cell lymphoma was admitted to home hospice care. He was referred for physiotherapy to optimize his function and mobility despite his short prognosis. A conversation guide was used throughout the duration of therapy to identify personal goals, prescribe and review the use of appropriate interventions, and discuss future therapeutic plans. Within a month he achieved his functional goals, experienced reduced physical dependency, and had increased satisfaction in his ability to participate more actively in self-care. This also resulted in significant improvements in his confidence, mood, and overall well-being. Engaging the patient actively in his care and management journey provided him with significant motivation and hope. CONCLUSION: The case study highlights the vital role of physiotherapists in facilitating transparent communication among patients, healthcare providers, and caregivers throughout palliative rehabilitation. Through open dialogue and utilizing conversation guides, physiotherapists help understand patient preferences, goals, and motivation. This patient-centred approach ensures that therapeutic interventions align with individual needs, enhancing overall patient care and the provision of holistic palliative care.


Asunto(s)
Cuidados Paliativos , Humanos , Masculino , Anciano de 80 o más Años , Cuidados Paliativos/métodos , Objetivos , Modalidades de Fisioterapia , Calidad de Vida/psicología
12.
BMC Psychol ; 12(1): 411, 2024 Jul 27.
Artículo en Inglés | MEDLINE | ID: mdl-39068493

RESUMEN

PURPOSE: To explore the impact of mobile social media on the psychological well-being of Chinese international students and analyze the mechanisms of influence to enhance their overall psychological health and social interactions in a foreign environment. METHODS: Convenience sampling was employed, using questionnaires on Mobile Social Media, Psychological Resilience, Body Image, Health Goal Setting, Physical Activity Level, and Mental Health Status as measurement tools. Data were gathered from 378 Chinese international students across 33 universities in South Korea, including Kangwon National University, Myongji University, Kunsan National University, Seoul National University, and Chonbuk National University. Confirmatory factor analysis, correlation analysis, common method bias testing, and chain mediation effect analysis were conducted using SPSS and AMOS 23.0. RESULTS: Mobile social media has significant indirect effects on the mental health of international students through various factors: psychological resilience and physical activity level (effect 'adg' = 0.080, 95% CI [0.029, 0.144]), body image and physical activity level (effect 'beg' = 0.122, 95% CI [0.044, 0.247]), and health goal setting and physical activity level (effect 'cfg' = 0.255, 95% CI [0.123, 0.428]). CONCLUSION: The study shows that mobile social media benefits the mental health of Chinese international students by enhancing psychological resilience, physical activity, body image perception, and health goal setting. Collaboration between educational institutions and social media platforms is recommended to promote physical activity among international students. This collaboration can involve sharing encouraging messages, joining health communities, setting goals, and providing accessible exercise resources. Utilizing mobile apps or social media for tracking progress and goal-setting can also improve self-management skills.


Asunto(s)
Salud Mental , Medios de Comunicación Sociales , Estudiantes , Humanos , Medios de Comunicación Sociales/estadística & datos numéricos , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Femenino , Masculino , Adulto Joven , República de Corea , Adulto , Resiliencia Psicológica , Universidades , China , Ejercicio Físico/psicología , Imagen Corporal/psicología , Encuestas y Cuestionarios , Adolescente , Pueblos del Este de Asia
14.
J Appl Behav Anal ; 2024 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-38922863

RESUMEN

We discuss the use of two empirically validated behavior-change methods-checklists and goal setting-and designed a checklist to assist behavior analysts in improving their behavioral services to be more culturally responsive and trauma informed. We also present pilot data evaluating the use of the checklist and goal setting on the inclusion of culturally responsive and trauma-informed practices in behavior support plans designed for students in a public school. The training package was effective for both participants, and the participants' weekly goals corresponded to the observed changes in their behavior plans. Moreover, both participants strongly agreed that the checklist was valuable and easy to use and reported increases in their perceived abilities to implement culturally responsive and trauma-informed practices posttraining.

15.
Health Sci Rep ; 7(6): e2208, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38915356

RESUMEN

Background and Aims: Multiple diabetes care guidelines have called for the personalization of risk factor goals, medication management, and self-care plans among older patients. Study of the implementation of these recommendations is needed. This study aimed to test whether a patient survey embedded in the Electronic Healthcare Record (EHR), coupled with telephonic nurse care management, could engage patients in personalized goal setting and chronic disease management. Methods: We conducted a single-center equal-randomization delayed comparator trial at the primary care clinics of the University of Chicago Medicine from 2018.6 to 2019.12. Patients over the age of 65 years with type 2 diabetes with an active patient portal account were recruited and randomized to receive an EHR embedded goal setting and preference survey immediately in the intervention arm or after 6 months in the delayed intervention control arm. In the intervention arm, nurses reviewed American Diabetes Association recommendations for A1C goals based on health status class, established personalized goals, and provided monthly telephonic care management phone calls for a maximum of 6 months. Our primary outcome was the documentation of a personalized A1C goal in the EHR. Results: A total of 100 patients completed the trial (mean age, 72.51 [SD, 5.22] years; mean baseline A1C, 7.14% [SD, 1.06%]; 68% women). The majority were in the Healthy (59%) followed by Complex (30%) and Very Complex (11%) health status classes. Documentation of an A1C goal in the EHR increased from 42% to 90% (p < 0.001) at 6 months in the intervention group and from 54% to 56% in the control group. Across health status classes, patients set similar A1C goals. Conclusions: Older patients can be engaged in personalized goal setting and disease management through an embedded EHR intervention. The clinical impact of the intervention may differ if deployed among older patients with more complex health needs and higher glucose levels. Trial Registration: ClinicalTrials.gov Identifier: NCT03692208.

16.
Artículo en Inglés | MEDLINE | ID: mdl-38919830

RESUMEN

Mental health activities conducted by patients between therapy sessions (or "therapy homework") are a component of addressing anxiety and depression. However, to be effective, therapy homework must be tailored to the client's needs to address the numerous barriers they encounter in everyday life. In this study, we analyze how therapists and clients tailor therapy homework to their client's needs. We interviewed 13 therapists and 14 clients about their experiences tailoring and engaging in therapy homework. We identify criteria for tailoring homework, such as client skills, discomfort, and external barriers. We present how homework gets adapted, such as through changes in difficulty or by identifying alternatives. We discuss how technologies can better use client information for personalizing mental health interventions, such as adapting to client barriers, adjusting homework to these barriers, and creating a safer environment to support discomfort.

17.
Toxins (Basel) ; 16(6)2024 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-38922151

RESUMEN

The goal-setting process is pivotal in managing patients with disabling spasticity. This case-control study assessed the role of diagnostic nerve blocks in guiding the goal-setting process within goal-targeted treatment of spasticity with botulinum neurotoxin-A. In this case-control study, patients with disabling spasticity underwent either a goal-setting process based on the patient's needs and clinical evaluation (control group) or additional diagnostic nerve block procedures (case group). All enrolled patients underwent a focal treatment with botulinum neurotoxin-A injection and a 1-month follow-up evaluation during which goal achievement was quantified using the goal attainment scaling-light score system. Data showed a higher goal achievement rate in the case group (70%) than in the control group (40%). In conclusion, diagnostic nerve blocks may help guide the goal-setting process within goal-targeted treatment of spasticity with botulinum neurotoxin-A towards more realistic and achievable goals, thereby improving the outcomes of botulinum neurotoxin-A injection. Future studies should better explore the role of diagnostic nerve blocks to further personalize botulinum neurotoxin-A according to individual patients' preferences and requirements.


Asunto(s)
Toxinas Botulínicas Tipo A , Espasticidad Muscular , Bloqueo Nervioso , Rehabilitación Neurológica , Humanos , Masculino , Adulto , Persona de Mediana Edad , Anciano , Estudios de Casos y Controles , Toxinas Botulínicas Tipo A/uso terapéutico , Espasticidad Muscular/diagnóstico , Espasticidad Muscular/terapia , Rehabilitación Neurológica/métodos , Objetivos
18.
Pers Individ Dif ; 2242024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38882675

RESUMEN

It is well established that people scoring high in narcissism fantasize about a grandiose future. However, little research has examined whether narcissism is actually associated with setting unrealistic, grandiose future goals for oneself. In the present study, we pool three independent adult samples (total N = 482) to evaluate the relationship between three dimensions of narcissism (agentic extraversion, antagonism, and narcissistic neuroticism) and self-reported likelihood of setting statistically unlikely goals (e.g., creating world peace). Through a series of bootstrapped correlation and regression analyses, we find that participants scoring higher in agentic extraversion and antagonism are more likely to set unrealistic goals, whereas participants scoring higher in narcissistic neuroticism are less likely to set unrealistic goals. When controlling for covariance between these narcissism dimensions as well as self-esteem and history of manic/hypomanic symptoms, agentic extraversion emerges as the strongest correlate of setting unrealistic goals. Overall, this study demonstrates that narcissism, and particularly agentic extraversion, is associated with intending to set grandiose future goals.

19.
Trials ; 25(1): 304, 2024 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-38711048

RESUMEN

BACKGROUND: Demographic changes, with an increasing number and proportion of older people with multimorbidity and frailty, will put more pressure on home care services in municipalities. Frail multimorbid people receiving home care services are at high risk of developing crises, defined as critical challenges and symptoms, which demand immediate and new actions. The crises often result in adverse events, coercive measures, and acute institutionalisation. There is a lack of evidence-based interventions to prevent and resolve crises in community settings. METHODS: This is a participatory action research design (PAR) in a 6-month cluster randomised controlled trial (RCT). The trial will be conducted in 30 municipalities, including 150 frail community-dwelling participants receiving home care services judged by the services to be at risk of developing crisis. Each municipality (cluster) will be randomised to receive either the locally adapted TIME intervention (the intervention group) or care as usual (the control group). The Targeted Interdisciplinary Model for Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) is a manual-based, multicomponent programme that includes a rigorous assessment of the crisis, one or more interdisciplinary case conferences, and the testing and evaluation of customised treatment measures. PAR in combination with an RCT will enhance adaptations of the intervention to the local context and needs. The primary outcome is as follows: difference in change between the intervention and control groups in individual goal achievement to resolve or reduce the challenges of the crises between baseline and 3 months using the PRACTIC Goal Setting Interview (PGSI). Among the secondary outcomes are the difference in change in the PGSI scale at 6 months and in neuropsychiatric symptoms (NPSs), quality of life, distress perceived by professional carers and next of kin, and institutionalisation at 3 and 6 months. DISCUSSION: Through customised interventions that involve patients, the next of kin, the social context, and health care services, crises may be prevented and resolved. The PReventing and Approaching Crises for frail community-dwelling patients Through Innovative Care (PRACTIC) study will enhance innovation for health professionals, management, and users in the development of new knowledge and a new adapted approach towards crises. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05651659. Registered 15.12.22.


Asunto(s)
Anciano Frágil , Servicios de Atención de Salud a Domicilio , Vida Independiente , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Anciano , Multimorbilidad , Fragilidad/diagnóstico , Fragilidad/terapia , Factores de Tiempo , Investigación Participativa Basada en la Comunidad , Resultado del Tratamiento , Intervención en la Crisis (Psiquiatría)/métodos , Calidad de Vida
20.
J Nutr Educ Behav ; 56(8): 521-531, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38691079

RESUMEN

OBJECTIVE: To explore the goals, barriers, and facilitators set by caregivers of preschool-aged children to improve food parenting practices and household food environments. DESIGN: Secondary qualitative analysis of collaborative goal sheets completed during in-home and telephone visits as part of a home-based pilot intervention. PARTICIPANTS: Thirty-three Hispanic/Latinx caregivers, predominantly of low income. PHENOMENON OF INTEREST: Patterns in goal content and anticipated barriers and facilitators. ANALYSIS: Thematic analysis of goal sheets with a mixed inductive-deductive approach. RESULTS: Almost half of the goals were to support a healthy environment (40.7%) by increasing the availability of healthy foods through food shopping and meal planning. Other goals were to increase structure (33.7%) by establishing food-related routines and decreasing distractions. Goals related to autonomy support (25.4%) included involving their children (eg, cooking together). Caregivers' perceived barriers encompass individual (eg, stress, lack of time), interpersonal (eg, other family members' eating behaviors), and environmental-level (eg, food availability) factors. Caregivers only identified facilitators at the individual and interpersonal levels (eg, motivation). CONCLUSIONS AND IMPLICATIONS: Understanding goals, barriers, and facilitators can be used to tailor key messages to improve food parenting practices and children's diets. Future interventions can target broader environmental barriers while increasing awareness of individual, interpersonal, and environmental-level facilitators.


Asunto(s)
Cuidadores , Responsabilidad Parental , Humanos , Responsabilidad Parental/psicología , Preescolar , Femenino , Cuidadores/psicología , Masculino , Adulto , Objetivos , Hispánicos o Latinos , Dieta , Dieta Saludable , Persona de Mediana Edad , Promoción de la Salud/métodos , Conducta Alimentaria
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