1,903 research outputs found
Psychoeducational Program for Breast Cancer Patients: A Pilot Study
Cancer treatments adversely affect cognition in general and memory in particular. The current study focused on developing and investigating the feasibility and effectiveness of a group program for breast cancer survivors suffering from cognitive problems post cancer treatment. This intervention was designed to provide participants with specific memory and stress-reducing strategies. Three breast cancer survivors participated in this program, which included five 2-hour weekly sessions and one 1-hour follow-up session 1 month later. Assessment included self-report and objective measures. No statistical analyses were performed: all presented results are descriptive. The data hint that the intervention is associated with enhanced quality of life, satisfaction with memory abilities, and some increases in both the quality and quantity of effective memory and stress-reducing strategies of participants. Although the intervention is feasible, there were challenges to recruitment. Further research regarding content and delivery methods for cognitive interventions for breast cancer survivors is warranted
Prospective Memory Impairment in Parkinson Disease without Dementia: Cognitive Mechanisms and Intervention
Cognitive impairment among non-demented individuals with Parkinson disease (PD) produces significant disability, reduced quality of life, and restricted participation. This dissertation will cover PD-related impairment in prospective memory, or the ability to remember to execute delayed intentions at the appropriate moment in the future. Prospective memory impairment in PD is increasingly recognized as a functionally and clinically relevant problem and viable target for cognitive intervention. To lay the groundwork for the development of effective interventions for prospective memory in PD, this dissertation examines the cognitive mechanisms underlying prospective memory impairment in PD and the potential of training in a targeted strategy to improve prospective memory in PD. Specifically, it focuses on the efficacy of an associative encoding strategy called implementation intentions for addressing PD-related deficits in prospective memory in a laboratory setting and as reported in everyday life. Results indicate that implementation intentions training holds promise for improving prospective memory in PD. A synthesis and analysis of the dissertation studies reveals avenues for future research that will bolster the scientific and clinical impact of this line of work
The ‘frontal lobe’ project: A double-blind, randomized controlled study of the effectiveness of higher level driving skills training to improve frontal lobe (executive) function related driving performance in young drivers
The current study was undertaken in order to evaluate the effectiveness of higher level skills training on safe driving behaviour of 36 teenage drivers. The participants, who attended the Driver Training Research camp in Taupo (NZ) over a two week period, were 16 to 17 years old and had a valid restricted driver licence. The study focused on four main aims. Firstly, the behavioural characteristics of the sample and their attitudes to risk taking and driving were examined. Results showed that speeding was the most anticipated driving violation, and high levels of confidence were associated with a higher number of crashes and a greater propensity for risk taking. Many, often male participants, also rated their driving skills as superior to others and thought they would be less likely than others to be involved in an accident. Secondly, the relationship between driving performance and executive functioning, general ability and sustained attention was evaluated. Overall, better driving performance and more accurate self-evaluation of driving performance was related to higher levels of executive functions, in particular, working memory, and
cognitive switching. In addition, higher general ability and greater ability to sustain attention were also linked to better performance on the driving related assessments. The third focus of this study was to compare the effects of both, higher level and vehicle handling skills training on driving performance, confidence levels and
attitudes to risk. While both types of training improved direction control, speed
choice and visual search, along with number of hazards detected and actions in relation to hazards, statistically significant improvement on visual search was seen only after higher level skills training. Vehicle handling skills training significantly improved direction control and speed choice. In addition, confidence levels in their driving skills were significantly lowered and attitudes to speeding, overtaking and
close following had improved significantly in the participants after the higher level
driving skills training. The final aspect to this study was to examine the effects of the
training over the following 6 month period based on self-reported driving behaviour.
The response rate of participants however, was not sufficient to reach any meaningful conclusion on any long-term training effects. A pilot study using GPSbased data trackers to assess post-training driving behaviour revealed some promising results for future driver training evaluation studies. The overall implications of the results are discussed in relation to improving the safety of young
drivers in New Zealand
Mammography Screening Behaviors in Relation to the Expanded Health Belief Model in a Sample of Homebound Women with Multiple Sclerosis
MAMMOGRAPHY BEHAVIORS IN MULTIPLE SCLEROSISMammography Screening Behaviors in Relation to the Expanded Health Belief Model in a Sample of Homebound Women with Multiple SclerosisKaren K. Paraska, PhD, RNUniversity of Pittsburgh, 2005The purpose of this study was to determine the relationship between variables of the Expanded Health Belief Model (EHBM) including: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy, and modifying factors; and adherence to mammography screening in homebound women with Multiple Sclerosis (MS). The sample was derived from the National Multiple Sclerosis Society from a group of women in Allegheny County who received an intervention program titled "Home-based Health Maintenance Program for Women with MS." The program provided home visits by a nurse midwife who educated women with MS and their partners about breast cancer, as well as provided an appointment for a mammogram.The correlational, descriptive design used a telephone interview for data collection. Due to the lack of subject accrual, the study was subsequently divided into two phases. Phase One was an analysis of 149 women who were approached to complete the intervention program through de-identified data sent by the National Multiple Sclerosis Society (NMSS). Phase Two was the dissertation study of homebound women consisting of a telephone interview measuring EHBM variables with the instruments chosen. The battery included the Breast Cancer Knowledge Test, the Benefits and Barriers Mammography Scale, Short Form-36, Beck Depression Inventory-II edition, Mini-Mental State Examination, the Mammography Screening Self-Efficacy Scale, and physician recommendation for mammogram.The de-identified data in Phase One revealed that out of 149 women approached, 108 women received the intervention program. None of these women had a mammogram in the last year. Only 7 (6%) women had a mammogram, none were diagnosed with breast cancer, and no correlation was found between smoking and mammography screening adherence. In Phase Two, out of all the EHBM variables analyzed, the data suggests bivariate association between perceived susceptibility, severity, benefits, and self-efficacy with mammography screening adherence. Due to the small sample size and sparse cell sizes, binary logistic regression was not able to investigate the joint associations of EHBM predictors. Mammography is the primary method used for breast cancer screening, yet in the sample of women with MS, adherence remains well below recommended levels. Women who did not adhere tended not to participate in the health care system, perceived themselves less susceptible to breast cancer, and valued mammography less. It was also evident that physician referral was not important in this study. The study had several limitations including a small sample size, the minimal data obtained from the NMSS, and the short study duration. Future recommendations include a longitudinal study design, incorporation of family caregivers, and an increase in recruitment strategies
An Investigation into the Impact of Parkinson's Disease upon Decision Making Ability and Driving Performance
Diagnostics and Rehabilitation of Parkinson's Disease presents the most current information pertaining to news-making topics relating to this disease, including etiology, early biomarkers for the diagnostics, novel methods to evaluate symptoms, research, multidisciplinary rehabilitation, new applications of brain imaging and invasive methods to the study of Parkinson's disease. Researchers have only recently begun to focus on the non-motor symptoms of Parkinson's disease, which are poorly recognized and inadequately treated by clinicians. The non-motor symptoms of Parkinson's disease have a significant impact on patient quality of life and mortality and include cognitive impairments, autonomic, gastrointestinal, and sensory symptoms. In-depth discussion of the use of imaging tools to study disease mechanisms is also provided, with emphasis on the abnormal network organization in parkinsonism. Deep brain stimulation management is a paradigm-shifting therapy for Parkinson's disease, essential tremor, and dystonia. In the recent years, new approaches of early diagnostics, training programmes and treatments have vastly improved the lives of people with Parkinson's disease, substantially reducing symptoms and significantly delaying disability. Written by leading scientists on movement and neurological disorders, this comprehensive book should appeal to a multidisciplinary audience and help people cope with medical, emotional, and practical challenges
Navigating Occupation and Identity in Parkinson\u27s Disease: A Qualitative Exploration of Lived Experience
Evidence-based practice requires that health care providers interpret the best research evidence in the context of their clinical experience, while at the same time considering client knowledge and experiences. Although health care providers are becoming increasingly skilled at the evaluation of research evidence, client values and self-identified health issues are often neglected within the evidence-based practice process. Ignoring these key aspects of person-centered practice may lead to interventions that fail to target implications of a client’s disease that are important to occupational participation and quality of life. A focus on person-centeredness is particularly important in progressive neurodegenerative disorders such as Parkinson’s disease where there are no known curative treatments, and interventions must instead focus on symptom management. The purpose of this research therefore was to deepen the current understanding of the experience of life with Parkinson’s disease, and to use these understandings to inform health care practices for this group. Following a review of the lived experience literature, a primary study was conducted wherein six individuals with Parkinson’s disease were asked to take photographs and share verbal narrative accounts to illustrate their experience of living with Parkinson’s disease. Results highlight the interrelationship between occupation and identity, as many of the participants’ stories were interpreted as foregrounding the negotiation of occupation, and how such negotiation shaped their sense of identity. Overall, three major themes were identified: (1) Framing the meaning of Parkinson’s disease; (2) Negotiating engagement in occupation; (3) Being ready to accept changes that impact personal or social identity. These findings were used to make suggestions on how health care providers can enhance the level of person-centredness in their care
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