La influencia de la institucionalización sobre la percepción de la autonomía y la calidad de vida en ancianos

Objetivo Evaluar la influencia de la institucionalización en la autonomía y la calidad de vida percibida entre ancianos institucionalizados. Método Estudio casi-experimental (serie temporal interrumpida) y longitudinal. La muestra estuvo compuesta de 104 añosos de tres centros residenciales de Santander, España. A fin de evaluar la calidad de vida y la dependencia fueron utilizadas dos escalas: el Índice de Barthel y el Índice de Lawton. Resultados Se observó una relación significativa entre la autonomía y la independencia y su declinio en virtud de la institucionalización, como los aspectos físicos y sociales. Conclusión La dependencia de las personas mayores es un fenómeno complejo, que demanda distintos tipos de intervención, incluyéndose las acciones de apoyo común, que tienden a cubrir la ausencia de autonomía en la vida cuotidiana, sin recurrir a la institucionalización.Objective To evaluate the influence exercised by institutionalization on the autonomy and perception of quality of life among the institutionalized elderly. Method The study is quasi-experimental (interrupted time series) and longitudinal. The sample is composed for 104 elderly people who went into a three nursing home in Santander, Spain. To assess the quality of life and dependence two scales were used: the Barthel Index and Lawton Index. Results There was an important relationship between autonomy and independence and their deterioration due to their institutionalisation, such as the physical and social aspects. Conclusion It´s important to point out that the dependence of the elderly is a complex phenomenon, which admits many types of intervention, including the customary ones referring to more classic welfare actions which tend to supplant the absence of autonomy in everyday life by facilitating services and attention to make up for this need, without having to resort to institutionalization.Objetivo Avaliar a influência da institucionalização na autonomia e na qualidade de vida percebida entre idosos institucionalizados. Método Estudo quase-experimental (série temporal interrompida) e longitudinal. A amostra foi composta de 104 idosos de três centros residenciais de Santander na Espanha. Para avaliar a qualidade de vida e a dependência foram utilizadas duas escalas: o Índice de Barthel e o Índice de Lawton. Resultados Observou-se uma relação significativa entre autonomia e independência e seu declínio devido à institucionalização, como os aspectos físicos e sociais. Conclusão A dependência dos idosos é um fenômeno complexo, que demanda vários tipos de intervenção, incluindo as ações de apoio comum, que tendem a cobrir a ausência de autonomia na vida cotidiana, sem recorrer a institucionalização

Satisfaction with caregiving among informal caregivers of elderly people with dementia based on the salutogenic model of health

Objectives: The main objective was to analyze the variables Sense of Coherence, Resilience and Emotional Regulation as predictors of satisfaction with care in caregivers of older adults people with dementia. Methods: An ex post facto cross-sectional study design with a single group. The data were collected between June and October 2020.63 caregivers of older adults people with severe dementia participated, by responding to questionnaires concerning the study variables during a telephone interview. Information was also collected regarding the characteristics of the care provided (years of evolution, degree of dementia, index of independence) and regarding the caregiver (age and years of caregiving) which will be analyzed as control variables. The data were analyzed using correlation analysis and multiple linear regression analysis. Results: The participants presented average levels for Sense of Coherence, Resilience, Emotional Regulation (M = 16.93) and a high degree of Satisfaction with care. Sense of Coherence was the main predictor of Satisfaction with care, explaining up to 67% of the variance, through its Significance and Comprehensibility dimensions. Although the Resilience variable presented a significant association with Satisfaction, its role in the predictive model was displaced by Sense of Coherence. Conclusions: Sense of Coherence and Resilience are relevant psychological variables because of their positive relationship with satisfaction with care among caregivers of older adults people with dementia. The caregivers' perception of the significance and comprehensibility of the situation are important positive predictors of their satisfaction with the care of older people with dementia. These results are suggestive to guide the follow-up and psychological support of caregivers

Retirement or no Retirement? The Decision´s Effects on Cognitive Functioning, Well-Being, and Quality of Life

This study addressed the psychological effects on personal well-being and reported quality of life of staying professionally active in late adulthood, and to what extent years of professional inactivity modulates cognitive abilities. Design and Methods: We collected data on 262 elderly adults, 129 of whom were professionally active elderly adults (who voluntarily maintained their professional activity after the age of retirement) and 133 of whom were retired adults, in a set of experimental tasks to measure basic cognitive resources. The study took place during the first quarter of 2020. Results: Active elderly people performed better on cognitive tasks that assessed attention, memory, and solving abilities and also reported more satisfaction with life and their current work. Multiple linear regressions analyses revealed that years of inactivity were associated with lower cognitive performance. Mentally demanding jobs were significantly associated with memory performance, but not with attention and planning. Conclusions: An involuntary separation from professional activity in the beginning of late adulthood may cause a deeper decline of cognitive functions, poorer adaptive adjustment to the aging process, and higher dissatisfaction with the period of life the individual is going through

Apathy and Leukoaraiosis in Mild Cognitive Impairment and Alzheimer's Disease: Multicenter Diagnostic Criteria according to the Latest Studies

AIMS: The aim is to study the prevalence and possible relationship of apathy and leukoaraiosis in cases of cognitive impairment of varying severity in Spain. METHODS: We conducted a cross-sectional, descriptive, multicenter study involving 109 patients with Alzheimer's disease (AD) and 59 with mild cognitive impairment (MCI). RESULTS: The older group with AD had a higher prevalence of leukoaraiosis and apathy, with significant differences compared to the MCI group. CONCLUSIONS: To our knowledge, this is the first multicenter study in our country that jointly analyzes the presence of apathy and leukoaraiosis in the institutionalized elderly with varying degrees of cognitive impairment according to the most recent criteria for detecting apathy in dementia

Acceptance and commitment therapy for well-being at worksites: charting the field for enhancing Its applicability

The advent of the "New Era for Mental Health" has made the management of this intangible asset one of the hottest topics in the workplace. It is the leading cause of disability today. Organizations are encouraged to use psychological interventions to promote and prevent more sustainable and productive workplaces. The aim of this article is to develop an exploratory and systematic mixed review that combines quantitative and narrative analysis to synthesize the available literature on the use of Acceptance and Commitment Therapy (ACT) interventions in the workplace—an increasingly popular therapy to address this challenge. This review provides a comprehensive reflection of the existing state of the art, gaps in current research, and future directions on the topic. The analysis of 59 articles collected from Web of Science (WoS), Scopus, and PubMed databases from 2000 to 2023 reveals, firstly, that the use of ACT interventions in the workplace is increasing significantly, with an upward trend over the last 5years and a presence in high-impact journals. Secondly, the research themes identified reveal that ACT intervention is still focused on clinical settings with limited presence in other sectors or organizational settings—such as education, business management, or return-to-work programs. Based on these results, this research underscores the growing importance of ACT in the workplace, revealing seven research opportunities to extend its application across various sectors and accelerate its effective implementation in industry and academia, thereby enhancing mental health and productivity

Impact of the pandemic on dementia care and caregivers: a qualitative study

Physical distancing measures to limit contagion in the COVID-19 pandemic made it difficult to care for older persons with dementia. Non-essential home visits were prevented and family caregivers took over most of their care. The aim of our study was to describe the lived experience of peoples living with dementia caregivers during the pandemic regarding the care provided and the person cared for. A qualitative phenomenological design was used. Participants were recruited using purposeful sampling. Informants were selected from primary healthcare centers, day centers, and a community mental health unit. The study participants comprised 21 caregivers. Semi-structured in-depth interviews by telephone were used, and field notes were collected from the researchers. A thematic analysis was conducted. The criteria used to control trustworthiness were credibility, transferability, dependability, and confirmability. Three main themes and six related sub-themes were identified: (1) care for the person with dementia during the pandemic, including lockdown, associated with difficulties in coping with restrictions, deterioration in health, and the impact of the closure of health and social resources; (2) health and social care provided to people with dementia after the disruptions and the care received from primary care prior to hospital or residential admission; and (3) the caregiver's perspective on the effects of the psycho-emotional impact, and coping strategies adopted in caring. Interventions for people with dementia should be planned in order to prevent the worsening of their health and cognitive status, while also developing programs to prevent stress and alleviate caregiver burden in case of health crises.This project was funded by the Instituto de Investigación Marqués de Valdecilla (IDIVAL), Spain (Grant number: INNVAL 2020/12). The authors gratefully acknowledge the participation of the caregivers and thank them for their availability, time, and contribution to our study. The authors would also like to thank the participating centers for facilitating access to the sample of the study

Cross-cultural evaluation of the Michigan Hand Outcomes Questionnaire: a systematic review

This systematic review aims to provide a comprehensive synthesis and in-depth analysis of the quality of the different cross-cultural versions of the MHQ. This study was conducted using Pubmed, Web of Science, CINAHL and SCOPUS databases to identify cross-cultural validation studies of the MHQ. Methodological quality, quality of evidence and criteria for good measurement properties of these studies were applied for each psychometric property. Quality assessment and data extraction were performed independently by two reviewers according to the COnsensus-based Standards for selection of health Measurement INstruments (COSMIN) guidelines. A total of 493 articles were identified, of which 22 were included and 20 were analysed.Of the six properties analysed, responsiveness and hypothesis testing for construct validity had the highest methodological quality and quality of evidence, and met the criteria for good measurement properties. The lowest quality properties were measurement error and internal consistency. The different cross-cultural versions of the MHQ were found to be reliable, valid and able to detect clinical change. The lack of development of measurement error, formulation of an a priori hypothesis or structural validity affects the detection of small clinical changes and their discriminative capacity

Effectiveness of a telephone intervention based on motivational health coaching for improving the mental health of caregivers of people with dementia: A randomised controlled trial

Objectives: Caring for a family member with dementia is considered one of the activities with the greatest negative impact on a person's mental health. Developing long-lasting and effective strategies is a challenge for caregivers. This study sought to evaluate the impact of an intervention based on a programme of motivational coaching delivered by telephone in a group of caregivers of patients with dementia compared to a control group. Methods: A randomised controlled trial with a control group and an intervention group. (CONSORT guidelines were used). Telephone calls were made during six weeks, involving a process of coaching and motivational interviews. The following variables were measured in caregivers: self-efficacy of caring, depression, perceived stress, frequency of problematic behaviours and dysfunctional thoughts. Assessments were conducted at three time points: baseline, post-intervention and three months? post-intervention. Results: In total, 106 caregivers participated (53 subjects in the control group and 53 in the intervention group). Statistically significant differences (ANCOVA) were found between both groups for the self-efficacy and stress variables, with improved results in the intervention group (p < .01). Furthermore, statistically significant differences were found in the intervention group between the baseline and post-intervention assessments, with improvements in self-efficacy, decreased stress and decreased dysfunctional thoughts (p < .05). The results were maintained over time for both groups. Conclusions: An intervention based on telephone calls using a health coaching approach with motivational interviewing appears to be effective for the improvement of self-efficacy and mental health of caregivers of people with moderate dementia. Furthermore, these effects appear to be maintained over time

Experiences of caregiving and quality of healthcare among caregivers of patients with complex chronic processes: a qualitative study

Aim: To explore the perceptions of main caregivers regarding caring for chronic complex patients in two different regions of Spain. Background: Spain is a country with an ageing population and a high number of people with chronic diseases. It is well known that the role of the caregiver is important to ensure quality of life and appropriate care. Methods: Qualitative design using focus groups. Five focus groups, from two different regions, were conducted with 22 caregivers of people with chronic complex diseases to explore their personal experience, examine the quality of care received by the patient and their family and to develop strategies for the improvement of the quality of health care. The focus groups were audio and video recorded. The transcriptions of the focus group sessions were exported to qualitative software analysis MAXQDA 2018.2. The qualitative content analysis was based on different analytical cycles. Results:In general terms, caregivers would refer to accepting the care of their family members, but they highlight many negative aspects such as tiredness, lack of help and overload of care. They indicated general satisfaction with the health system but indicated that help was insufficient and that strategies to better address the situations of the complex chronic patient should be improved. The main categories observed were: Conclusions. Complex chronic illnesses are increasingly common at present, generating important consequences on the lives of patients and that of their caregivers. The design of any health strategy for facing the dilemma of chronic illnesses, must necessarily include the vision of the caregivers

Sense of coherence, academic performance and professional vocation in Certified Nursing Assistant students

BACKGROUND: The sense of coherence (SOC) of the salutogenic health model explains why people in stressful situations are able to maintain or even improve their health. There are some studies on which measures are more effective to reduce stress in Nursing assistant students. There are no studies that link SOC with the two key aspects in the prevention of stress in Nursing assistant students: the motivation of pursuing this profession and the academic level. OBJECTIVES: To explore the salutogenic paradigm among Nursing assistant students in a region of Spain (Comunitat Valenciana). DESIGN: Cross-sectional, analytical and exploratory study carried out in 2016. METHODS: Students of the first year of Nursing Assistant certification. Self-administered questionnaire to collect the variables: Sense of Coherence (SOC-13 instrument); professional vocation; Self-reported grades of the academic record. RESULTS: The mean score for the total SOC measurement was M?=?56.38 (SD?=?12.236; 71). Regarding the SOC components, the average score was for Manageability M?=?16.45 (SD?=?4.53; 24); Comprehensibility M?=?19.27 (SD?=?5.642; 30) and Meaningfulness M?=?20.65 (SD?=?4.48; 23). Students who lived in rural environments presented a weaker SOC (M?=?54.05), compared to those who were located in urban environments (M?=?56.83) and large cities (M?=?56.15). The students who reported a choice of studies motivated by professional vocation presented a stronger SOC, scoring also a remarkable academic performance (p?<?0.05). CONCLUSIONS: Strong levels of SOC in Nursing assistant students, are related to a greater motivation to study something desirable, and to obtaining high academic performance, despite being a demanding and high-stress profession. Therefore, a strong SOC seems to contribute to being more resistant to stress. The environments that provide and facilitate greater external resources such as health, education, culture, association, leisure and recreation, for the community, have higher global levels of sense of coherence