Responsiveness of the Canadian occupational performance measure

This study evaluated the responsiveness of the Canadian Occupational Performance Measure (COPM), an individualized, client-centered outcome measure for the identification and evaluation of self-perceived occupational performance problems. We recruited 152 consecutive patients with various diagnoses, admitted to the outpatient clinic of two occupational therapy departments, to complete a COPM interview and three self-reported health status questionnaires on two occasions: prior to the start of occupational therapy treatment and 3 months later. The three questionnaires were the Sickness Impact Profile (SIP68), the Disability and Impact Profile (DIP), and the Impact on Participation and Autonomy (IPA). We assessed criterion responsiveness by calculating the area under the curve (AUC) for the receiver operating characteristic curve and the optimal cutoff values for the COPM scores. To determine construct responsiveness, we calculated correlations between the change in COPM scores and the change in the SIP68, DIP, and IPA scores. The AUC ranged from 0.79 to 0.85, and the optimal cut-off values for the performance scores and satisfaction scores ranged from 0.9 to 1.9. We found significant positive correlations between the COPM scores and the SIP68, DIP, and IPA scores. The capability of the COPM to detect changes in perceived occupational performance issues is supporte

Attitudes towards medication non-adherence in elderly kidney transplant patients: A Q methodology study

Background. Non-adherence to the post-transplant regime is a common problem in kidney transplant patients and may lead to rejection or even graft failure. This study investigated attitudes towards the post-transplant regime of immunosuppressive medication among the ever growing population of elderly kidney recipients.Methods. Q methodology was used to explore attitude profiles. Participants (> 65 years) were asked to rank-order opinion statements on issues associated with (non-)adherence. The rankings were subject to by-person factor analysis, and the resulting factors were interpreted and described as attitudes.Results. Twenty-six elderly renal transplant recipients participated in the study. All passed the Mini-Mental

Long-Term Kidney and Maternal Outcomes After Pregnancy in Living Kidney Donors

For counseling it is important to know if pregnancy after Living Kidney Donation (LKD) affects long-term outcomes of the mono-kidney and the mother. Therefore, we performed a retrospective multicenter study in women ≤45 years who donated their kidney between 1981 and 2017. Data was collected via questionnaires and medical records. eGFR of women with post-LKD pregnancies were compared to women with pre-LKD pregnancies or nulliparous. eGFR before and after pregnancy were compared in women with post-LKD pregnancies. Pregnancy outcomes post-LKD were compared with pre-LKD pregnancy outcomes. 234 women (499 pregnancies) were included, of which 20 with pre- and post-LKD pregnancies (68) and 26 with only post-LKD pregnancies (59). Multilevel analysis demonstrated that eGFR was not different between women with and without post-LKD pregnancies (p = 0.23). Furthermore, eGFR was not different before and after post-LKD pregnancy (p = 0.13). More hypertensive disorders of pregnancy (HDP) occurred in post-LKD pregnancies (p = 0.002). Adverse fetal outcomes did not differ. We conclude that, despite a higher incidence of HDP, eGFR was not affected by post-LKD pregnancy. In line with previous studies, we found an increased risk for HDP after LKD without affecting fetal outcome. Therefore, a pregnancy wish alone should not be a reason to exclude women for LKD.</p

Interprofessional Practice and Education Primary Care Transitional Care Module

Interprofessional Practice and Education Primary Care Transitional Care Module 2018 e-learning module provides an interactive learning experience for interprofessional primary care graduate professional students and skilled nursing facility team members. The purpose of the e-learning module is to educate graduate professional students and skilled nursing facility team members interested in working with interprofessional teams to care for older adults transitioning across the healthcare system. Transitional care from acute care to a skilled nursing facility is a crucial aspect of the care of older adults which can be costly and dangerous to older adults. The e-learning module provides a safe space to help learners critically think to improve their performance before being in a live transitional care setting. The module guides learners on several safe, high-quality transitional care behaviors such as communication skills and teamwork in collaborating across providers and health systems, using critical thinking based on patient-centered goals, ethical decision making, and assuring resources necessary in the discharge plan of care when caring for an older adult. This module includes learning objectives and competencies to successfully transition an older adult from acute care to primary care. The module takes about 15-20 minutes to complete.https://digitalcommons.unmc.edu/con_module/1000/thumbnail.jp

Self-management challenges and support needs among kidney transplant recipients: A qualitative study

This study investigated self‐management challenges and support needs experienced by kidney transplant recipients. After kidney transplantation, recipients are expected to take an active role in self‐management. However, evidence suggests that nurses experience difficulties operationalizing self‐management support. Greater insight into the recipients’ perspective could help to improve the adequacy and efficacy of nurse‐led self‐management support