Factores predictores de la calidad de vida en ancianos que utilizan recursos asistenciales especializados

La calidad de vida es un concepto relativamente nuevo, tanto en la investigación como en la práctica clínica, que ha surgido con un gran empuje en los últimos años como objetivo prioritario de las políticas sociales y sanitarias en todos los países occidentales. Ahora bien, determinar qué elementos forman parte del concepto y evaluarlos de manera sistemática, no es una tarea fácil. Si a esto añadimos que en nuestro país mas de 7 millones de personas tienen 65 o más años, con una tendencia al alza, de las cuales, más del 32,0% presentan alguna limitación o discapacidad y el 4,2% algún tipo de trastorno depresivo, podemos imaginar que el colectivo de personas mayores y los problemas que les afectan, supone un área de gran interés investigador (sancho, 2005). Esta mayor supervivencia de la población, unida a una morbilidad elevada, nos conduce a pensar que, probablemente, además de un deterioro físico, también se produce un deterioro del estado de ánimo, influyendo ambos aspectos negativamente en el bienestar subjetivo. En esta tesis doctoral se pretenden identificar cuáles son los factores que se asocian a la calidad de vida de los ancianos que utilizan recursos asistenciales especializados en castilla-la mancha. Especialmente, hemos tenido en cuenta dos aspectos que, a priori, parecen influir de manera decisiva en la per-cepción de bienestar y calidad de vida: el estado de discapacidad y la situación emocional en los ancianos participantes, que se caracterizan por haber tenido contacto con el sistema formal de cuidados, a nivel sanitario o social. Se han estudiado las características de 450 ancianos que ingresaron consecutivamente durante un año en diversos dispositivos asistenciales geriátricos, tanto sanitarios (hospital de día, unidad de media estancia hospitalaria y consulta externa), como sociales (centro de día y resistencia) se analizaron diversos aspectos en todos los ancianos participantes, recogidos mediante un protocolo que incluía datos sobre la situación clínica y de discapacidad, la situación afectiva y social y la calidad de vida. Para facilitar la sistematización de la recogida de datos y del trabajo, se diseño un cuestionario con tal propósito y se utilizaron diversos instrumentos de evaluación estandarizados. El diseño de la investigación es transversal, prospectivo y de carácter aplicado, descriptivo en la primera fase y analítico en la segunda, y se llevo a cabo en un hospital monográfico de geriatría, un hospital general con servicio de geriatría, un centro de día y una residencia de ancianos. Entre las principales conclusiones que hemos obtenido, podemos destacar que se confirma que la discapacidad física, el estado de ánimo deprimido, la polifarmacia y el dolor, son factores que influyen de manera determinante en la percepción subjetiva de la calidad de vida del anciano. La calidad de vida relacionada con la salud, no ha mostrado asociaciones de interés, a excepción de la edad, que se ha asociado positivamente a la misma. Nos parece necesario incorporar este tipo de medidas a la valoración geriátrica integral, como información complementaria del resto de áreas que se contemplan habitualmente en ella, así como instrumento para el control y evaluación del estado del paciente, para seleccionar tratamientos y controlar sus efectos, para conocer la percepción de salud del sujeto y para la toma de de-cisiones respecto a las políticas sanitarias y sociales y a la provisión de recursos. Palabras clave: anciano/calidad de vida/estado de ánimo/discapacidad física/pgc/sf-36/gds/ib/ecr

Hand Rehabilitation after Chronic Brain Damage: Effectiveness, Usability and Acceptance of Technological Devices: A Pilot Study

Purpose: The aim is to present an overview of existing tools for hand rehabilitation after brain injury and a pilot study to test HandTutor® in patients with chronic brain damage (CBD)

La Inteligencia Emocional en la formación de estudiantes de Grado en Terapia Ocupacional

El desarrollo de habilidades emocionales es esencial en las funciones profesionales de los terapeutas ocupacionales, cuyo rol principal implica el trato directo con personas que están en situación desventajosa y/o solicitan ayuda así como la colaboración multidisciplinar con otros profesionales. Objetivo: conocer las habilidades emocionales basales de los estudiantes de Terapia Ocupacional, previo al inicio de la formación práctica. Material y método: Estudio multicéntrico observacional prospectivo (antes-después de las prácticas), con un seguimiento de 8 meses, y una duración de cuatro años. La muestra estuvo compuesta por los estudiantes del grado de Terapia Ocupacional de la UCLM, UMA, UMH y la USP de Costa Rica. Para evaluar la inteligencia emocional se utilizó el cuestionario TMMS-24 (Trait Meta-Mood Scale). Resultados: Muestra de 763 estudiantes, 13.2 % varones y 86.8 % mujeres. El 41,3 % de pertenecían a la UCLM, 42,3 % a la UMA y 16.4 % a la UMH. Se apreciaron diferencias importantes según el género en la dimensión de Atención del TMMS (presta poca atención el 20,4% (IC95% 12,8-29,7) de los Hombres frente al 38,2% (IC95% 34,4-42,1) de las Mujeres; p<0.001). Según la edad se observaron diferencias en la dimensión de Atención del TMMS: un 55% (IC95% 38,5-69,3) de los de 26 años o más prestan poca atención frente a 27 a 37% (IC95% 31,4-43,3)en las edades menores (p=0,022). Según el curso se observaron diferencias en Claridad: en primer curso 35,8% (IC95% 28,4-43,4) debe mejorar frente a solo 21 a 25% (IC95% 18,1-36,7) en segundo y tercero. Respecto al área de prácticas, disfunción física y geriatría mostraban escasa atención en un 38 a 40% (IC95% 30,6-49,9) frente a 27 a 29% (IC95% 23-36,7) en infancia o SM.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Efficacy of a videogame in the treatment of patients with schizophrenia

For some years there has been considerable interest in using virtual reality for rehabilitation in schizophrenia, although there is little evidence of its usefulness. Th e aim of this study was to evaluate the effi cacy of an intervention through Nintendo Wii® to improve cognitive domains, self-esteem and quality of life. 40 patients were randomized into two groups: experimental and control. A statistically signifi cant improvement in cognitive domains was found, especially in working memory. Results in quality of life and self-esteem have not obtained statistical signifi cance, though a large eff ect size appeared. Long-term studies are needed to test the effi cacy of virtual reality systems on quality of life and self-esteem, as changes in these constructs may develop in a relatively longer time

A data-globe and immersive virtual reality environment for upper limb rehabilitation after spinal cord injury

While a number of virtual data-gloves have been used in stroke, there is little evidence about their use in spinal cord injury (SCI). A pilot clinical experience with nine SCI subjects was performed comparing two groups: one carried out a virtual rehabilitation training based on the use of a data glove, CyberTouch combined with traditional rehabilitation, during 30 minutes a day twice a week along two weeks; while the other made only conventional rehabilitation. Furthermore, two functional indexes were developed in order to assess the patient’s performance of the sessions: normalized trajectory lengths and repeatability. While differences between groups were not statistically significant, the data-glove group seemed to obtain better results in the muscle balance and functional parameters, and in the dexterity, coordination and fine grip tests. Related to the indexes that we implemented, normalized trajectory lengths and repeatability, every patient showed an improvement in at least one of the indexes, either along Y-axis trajectory or Z-axis trajectory. This study might be a step in investigating new ways of treatments and objective measures in order to obtain more accurate data about the patient’s evolution, allowing the clinicians to develop rehabilitation treatments, adapted to the abilities and needs of the patients

How relevant is the place where first-year college students live in relation to the increase in body mass index?

Producción Científica1) Objective: This study analyzes the evolution of the body mass index (BMI) throughout the academic year associated with changes in the lifestyle associated with the place where students live during the course, lifestyle design, and health strategies for the university community. (2) Methods: A total of 93 first-year nursing students participated in this study. Data were collected throughout the course by administering self-reported questionnaires about eating habits and lifestyles, weight, and height to calculate their BMI and place of residence throughout the course. Data were analyzed using statistical analysis (Mann–Whitney, chi-square, Student’s t-test, repeated-measures analysis of variance, and least significant difference tests). (3) Results: We found that the mean BMI increases significantly throughout the course among all students regardless of sex, age, eating habits, or where they live during the course. At the beginning of the course, the mean BMI was 22.10 ± 3.64. The mean difference between the beginning of the course and the middle has a value of p-value < 0.015 and between the middle of the course and the end a p-value < 0.009. The group that increased the most is found among students who continue to live in the family nucleus rather than those who live alone or in residence. Students significantly changed their eating and health habits, especially those who live alone or in residence. (4) Conclusions: There is an increase in BMI among students. It is necessary to carry out seminars or talks that can help students understand the importance of good eating practices and healthy habits to maintain their weight and, therefore, their health, in the short, medium, and long term and acquire a good quality of life.Este trabajo fue apoyado por subvenciones (Grants 2019-GRIN-26896, 2020-GRIN-29192

Gender differences in anxiety, attitudes, and fear among nursing undergraduates coping with CPR training with PPE kit for COVID

Producción CientíficaBackground: The aim of this study was to examine the attitudes, fears, and anxiety level of nursing students faced with a critical clinical simulation (cardiopulmonary reanimation) with and without personal protective equipment (PPE). Methods: A pilot before–after study as conducted from 21 to 25 June 2021, with 24 students registered in the nursing degree of the Faculty of Health Sciences of the Castilla-La Mancha University (UCLM) in the city of Talavera de la Reina (Toledo, Spain). From 520 possible participants, only 24 were selected according to the exclusion and inclusion criteria. The STAI Manual for the State-Trait Anxiety Inventory, a self-evaluation questionnaire, was used to study trait STAI (basal anxiety), trait STAI before CPR, state STAI after CPR, total STAI before CPR, and total STAI after CPR as the main variables. A t-test was used to study the STAI variables according to sex and the physiological values related to the anxiety level of participants. An ANOVA statistical test was used to perform a data analysis of the STAI variables. Results: A total of 54.2% of participants (IC 95% 35.1–72.1) suffered from global anxiety before the cardiopulmonary reanimation maneuvers (CPR). The results of the STAI before CPR maneuvers showed significant differences according to gender in state anxiety (p = 0.04), with a higher level of anxiety in women (22.38 ± 7.69 vs. 15.82 ± 7.18). Conclusions: This study demonstrates different levels of anxiety in terms of gender suffered by nursing students in high-pressure environments, such as a CPR situation

Changes in resilience in students of occupational therapy after their first exposure to practice placement education

Introduction: Resilience is a multidimensional and dynamic construct associated with positive growth and the capacity to transform stressful and negative factors into opportunities of personal development and self-improvement when faced with difficult experiences. The resilience process of each individual integrates multiple analysis levels, which range from genetic-environmental interactions to a complex process of adaptation between the individual and his/her family, friends, co-workers, society, and culture. Objective: To determine whether resilience improves in students of occupational therapy when exposed for the first time to practice placement education. Methodology: Quasi-experimental, prospective, observational, multi-center study with a sample composed of students from the Degree of Occupational Therapy of the public universities of Málaga (UMA) and Castilla-La Mancha (UCLM) (Spain). Two weeks prior to the beginning of the practice education period, the participants completed a questionnaire that included sociodemographic data and the area of their internships. They were also given the Spanish version of the Connor-Davidson's resilience scale (CD-RISC). All these instruments were also completed 1 week after the end of the clinical practice. Results: There were statistically significant differences between the variables that make up resilience and the different internship areas. On the other hand, there was a significant improvement of global resilience after the clinical practice period, in both women (13.85 points; p < 0.001) and men (7.72 points; p < 0.035), when the internship area was not considered. Conclusions: The results show that resilient students are more optimistic and work to improve a situation beyond doing simply what is expected of them, knowing how to control their feelings. This is beneficial for students in practice education, since, during these, they face difficult situations that require a resilient pattern, which helps reduce stress and the burnout syndrome

Anatomical prosection practices in the Occupational Therapy degree. Student anxiety levels and academic effectiveness

CONTEXT. The practice of anatomical dissection and/or prosection on human cadavers is an essential component of human anatomy training programmes. However, this activity can be stressful for inexperienced students when exposed to cadavers for the first time, and it may generate high anxiety levels. The aims of this study are threefold: 1) To analyse the thoughts and feelings of firstyear students of the Occupational Therapy degree about prosection practices; 2) to examine their anxiety levels in relation to these practices; and 3) to evaluate how useful and effective they are as an educational tool for anatomy training. METHODS. This is a before-and-after cross-sectional study of first-year students of the Occupational Therapy degree at the Universidad de Castilla-La Mancha, Spain. These students had not previously participated in prosection practices. An anonymous questionnaire was distributed among the students before and after the practice, in order to examine their feelings and perceptions during the practice. To examine their anxiety levels we used a State-Trait Anxiety Inventory (STAI) questionnaire. To assess their learning outcomes the students had to complete two practical tests of recognition of anatomical structures, one before attending the practice and one immediately after. RESULTS. Basal anxiety levels, measured as trait anxiety (TA), remained stable and did not show significant differences during the practice (p>0.05). Their emotional anxiety, measured as state anxiety (SA), dropped after the practice from 14.7 to 10 points (p<0.05). Before the start of the practice 11 students (19%) showed signs of anxiety, and these remained so at the end of the practical session (p>0.05). As for their academic performance, we observed that the number of students able to pass the test after attending the prosection practice increased notably (by more than 60%). Additionally, 100% of the students recommended that the practice be retained for future courses, giving it an approval rate of 9.1 out of 10. CONCLUSION. Although anatomy is usually an attractive subject for Occupational Therapy students and they value prosection practices positively, they remain a potentially complex and stressful experience. Some students find that their experiences in the dissecting room can upset their emotional balance, however the implementation of coping mechanisms could be a very effective strategy to reduce their anxiety and also to improve their learning outcomes, helping to strengthen their practical 3 knowledge of anatomy as we have observed in this study. The students not only value positively these practices, they also believe that they are an extremely useful tool for both teaching and learning anatomy, and they recommend their routine use as part of the training process

Tendencias en terapia ocupacional en un mundo cambiante: mirar hacia atrás para seguir hacia delante Reflexiones desde la Conferencia Nacional de Decanas y Decanos de Terapia Ocupacional

There have been many changes that we have faced in recent decades in the practice of Occupational Therapy in Spain. All of them have contributed to shaping a young discipline, such as ours, but with deep roots based on values, knowledge and development of occupational science over time, at an academic and professional level. We have learned from all this, and it has helped us to grow and develop, relying on those solid foundations; but if the progress has been great, the challenges facing us for the next few years are even more so. In these lines we briefly outline some proposals, with the purpose of inviting reflection to readers interested in building a vision of the future of Occupational Therapy.Muchos han sido los cambios a los que nos hemos enfrentado en las últimas décadas en la práctica de la Terapia Ocupacional en España. Todos ellos han contribuido a perfilar una diciplina joven, como es la nuestra, pero con profundas raíces basadas en los valores, el conocimiento y el desarrollo de la ciencia ocupacional a través de los tiempos, a nivel académico y profesional. De todo ello hemos aprendido, y nos ha servido para crecer y desarrollarnos, apoyándonos en esos sólidos cimientos; pero si grandes han sido los avances, más aún lo son los desafíos que se nos presentan para los próximos años. En estas líneas esbozamos someramente algunas propuestas, con el propósito de invitar a la reflexión a los y las lectoras interesadas en construir una visión del futuro de la Terapia Ocupacional