Acceptability and feasibility Dotaz Zobrazit nápovědu
Standard approaches to cognitive remediation can suffer from limited skill transferability to patients' life. Complex virtual environments (VEs) enable us to create ecologically valid remediation scenarios while preserving laboratory conditions. Nevertheless, the feasibility and efficacy of these programs in psychiatric patients are still unknown. Our aim was to compare the feasibility and efficacy of a novel rehabilitation program, designed in complex VEs, with standard paper-pencil treatment in patients with schizophrenia and major depressive disorder. We recruited 35 participants to complete a VE rehabilitation program and standard treatment in a crossover pilot study. Twenty-eight participants completed at least one program, 22 were diagnosed with schizophrenia and 6 with major depressive disorder. Participant's performance in the representative VE training task significantly improved in terms of maximum achieved difficulty (p ≤ 0.001), speed (p < 0.001) and efficacy (p ≤ 0.001) but not in item performance measure. Neither the standard treatment nor the VE program led to improvement in standardized cognitive measures. Participants perceived both programs as enjoyable and beneficial. The refusal rate was higher in the VE program (8.6%) than in the standard treatment (0%). But in general, the VE program was well-accepted by the psychiatric patients and it required minimal involvement of the clinician due to automatic difficulty level adjustment and performance recording. However, the VE program did not prove to be effective in improving cognitive performance in the standardized measures.
BACKGROUND: Loneliness, a major public health concern, could be alleviated through social interventions with nature contact as a primary component. "Friends in Nature" is a complex nature-based social intervention designed to be implemented as part of "Reimagining Environments for Connection and Engagement: Testing Actions for Social Prescribing in Natural Spaces" (RECETAS). This project aims to alleviate loneliness and promote health-related quality of life in six different geographic areas worldwide. Feasibility studies are crucial to assess the viability of complex interventions and study procedures before conducting definitive studies. This paper aims to describe the design, implementation, and evaluation of the six-related feasibility studies on the "Friends in Nature" intervention. These studies specifically evaluate feasibility of recruitment and study procedures, intervention implementation, and data collection and distribution. METHODS: We defined a comprehensive set of indicators to assess the feasibility of "Friends in Nature." For the first domain, recruitment procedures were assessed to determine their adequacy, while attrition rates were examined to assess participant retention. For the second domain, the implementation of interventions was evaluated, along with the study design's ability to adapt to unexpected situations and participant adherence to the intervention. Finally, for the third domain, completion rates and the acceptability of the study activities were also analyzed. The feasibility of using specific scales to assess loneliness and well-being was also explored. RESULTS: The feasibility indicators defined for this study were useful to assess the feasibility of "Friends in Nature." Recruitment procedures were generally found to be adequate, and the number of dropouts was low. Interventions were implemented with minor adjustments, and facilitators played a vital role in the well-functioning of the interventions. Although some unexpected situations occurred during the study, adaptations were made, and participants were generally satisfied with the activities proposed. Scales used to assess loneliness and quality of life showed potential for measuring the effects of nature-based social prescribing in the full trial. CONCLUSION: This paper offers valuable insights into the design and execution of feasibility studies for complex interventions like "Friends in Nature." Findings from these assessments explore the feasibility of "Friends in Nature" and will inform the main RECETAS studies, which are designed to strengthen the evidence base to support the use of nature-based social prescribing to reduce loneliness and promote quality of life. TRIAL REGISTRATION: Barcelona trial: NCT05488496, Prague trial: NCT05522140, and Helsinki trial: NCT05507684.
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Physical inactivity and unhealthy dietary habits are known to be disadvantageous for the development of late adverse effects in survivors of childhood, adolescent, and young adult cancer. To make interventions, aimed at improving lifestyle, fit into the daily life of survivors, interventions should be designed and delivered in a person-centred way with a limited time burden. As part of the European PanCareFollowUp project, an eHealth intervention was developed to support sustainable changes to physical activity levels and/or diet of childhood, adolescent, and young adult cancer survivors. This feasibility study aims to gain insight into the feasibility and potential effect sizes of the PanCareFollowUp lifestyle intervention. METHODS: The PanCareFollowUp lifestyle intervention consists of person-centred 3-6 screen-to-screen sessions with a certified lifestyle coach. The intervention will be evaluated with a single-arm pre-post feasibility study conducted at two survivorship care clinics in the Netherlands. A total of 60 participants who are (i) diagnosed with cancer <25 years, (ii) ≥ 5 years post-treatment, (iii) aged 16-55 years, and (iv) have a low physical activity level and/or unhealthy dietary intake manifested by overweight will be recruited. Using reports, hospital records, and questionnaires for survivors, coaches, and late effect doctors, feasibility will be based on (i) adherence to intervention, (ii) acceptability, (iii) practicality, (iv) integration/implementation, (v) demand, and (vi) attrition. The potential effect sizes of the intervention will be explored by determining the percentage of survivors that reach the personalized lifestyle goals that were set with the coach. Physical activity level, dietary intake, BMI, general self-efficacy, self-management, and motivation level will be assessed at three time points with questionnaires, reports, and/or an accelerometer. DISCUSSION: Data of this study will be gathered to assess the feasibility and potential effect sizes. This will allow for further intervention refinement as needed as well as to inform a future large-scale intervention study and a manual for implementation at other centres. TRIAL REGISTRATION: International Clinical Trial Registry Platform (ICTRP) number: NL8932 (ICTRP Search Portal (who.int)). Registered on September 29, 2020.
- Publikační typ
- časopisecké články MeSH
Background: Falls risk becomes more common with age and is associated with higher rates of disability, mortality, and healthcare costs. Exergames have shown to elicit improvements in prefrontal cortex activity, balance, and postural control of seniors, all of which are associated with fall risk, but it is unknown whether virtual reality (VR) exergames, played using a three-dimensional headset can enhance the effects of cognitive and physiological functioning. Objective: Evaluation of the effects of a co-produced VR exergame "Falling diamonds" on physical performance, trunk stability and cognition, three attributes linked to falls risk in seniors. Methods: A total of 44 physically active participants aged 60-85 years were randomized to either the immersive VR exergame (n = 14), non-immersive exergame (n = 15), or control (n = 15). Static balance, leg strength, and gait speed were measured by the Short Physical Performance Battery, trunk stability was assessed using the Prone test and cognition was evaluated by the RehaCom screening software at baseline and follow-up at 9 weeks. Results: The VR exergame group experienced greater improvements in the cognition measures of selective attention control and speed (p = .009, p = .033) more than the exergame group (p = .010) and control (p = .049, p = .004). Conclusions: The evaluation and delivery methods of VR exergame Falling diamonds are feasible, and trial measures, procedures, and intervention are deemed acceptable by participants. Our findings indicate that using a VR exergame to exercise could improve cognition in seniors.
- MeSH
- exergaming * MeSH
- kognice MeSH
- lidé středního věku MeSH
- lidé MeSH
- posturální rovnováha MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- studie proveditelnosti MeSH
- úrazy pádem prevence a kontrola MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- hodnotící studie MeSH
BACKGROUND: Globally, the World Health Organization reports that the chances of a child dying is highest in the first month of life, the neonatal period. The neonatal mortality rate in Cambodia is 18 per 1000 live births. In the province of Kampong Chhnang, that rate is the fifth highest among the 24 provinces of Cambodia at 27 per 1000 live births. We piloted a project to determine the feasibility of using a mHealth intervention (the use of mobile devices to improve health outcomes) to increase mothers' awareness about neonatal care and promote the government policy 'Safe Motherhood Protocols for Health Centres' which are in line with WHO recommendations for neonatal care. METHODS: Between September and December 2013, we piloted an Interactive Voice Response system that sent pre-recorded messages to mothers of newborns using the theme 'It takes a village to raise a baby'. Four hundred fifty-five mothers were registered onto this program and the intervention involved delivering seven periodic 60 to 90 s voice messages directly to the mobile phones of these mothers from day three of their neonate's life to day 28. An evaluation of the pilot was conducted in December 2013. One hundred twenty-nine mothers were randomly selected from the 455 registered mothers and interviewed using a quantitative questionnaire. We also held two focus group discussions with three mothers and seven health workers. RESULTS: Quantitative and qualitative results of 126 respondents were included for analysis. They indicate that the intervention was well accepted. Seventy-one percent of respondents reported that they would recommend the intervention to other mothers, and 83% reported that they would be willing to pay for the service. CONCLUSIONS: This type of mHealth intervention is an acceptable and feasible way of promoting the awareness of newborn care to rural Cambodian mothers.
- MeSH
- dospělí MeSH
- kvalitativní výzkum MeSH
- lidé MeSH
- matky psychologie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mobilní telefon MeSH
- novorozenec MeSH
- péče o kojence metody psychologie MeSH
- pilotní projekty MeSH
- spokojenost pacientů MeSH
- studie proveditelnosti MeSH
- těhotenství MeSH
- telemedicína metody MeSH
- venkovské obyvatelstvo MeSH
- vzdělávání pacientů jako téma metody MeSH
- zdravotnické služby pro venkov * MeSH
- zjišťování skupinových postojů MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- Geografické názvy
- Kambodža MeSH
Background: Mindfulness-based programs have shown a promising effect on several health factors associated with increased risk of dementia and the conversion from mild cognitive impairment (MCI) to dementia such as depression, stress, cognitive decline, immune system and brain structural and functional changes. Studies on mindfulness in MCI subjects are sparse and frequently lack control intervention groups. Objective: To determine the feasibility and the effect of mindfulness-based stress reduction (MBSR) practice on depression, cognition and immunity in MCI compared to cognitive training. Methods: Twenty-eight MCI subjects were randomly assigned to two groups. MBSR group underwent 8-week MBSR program. Control group underwent 8-week cognitive training. Their cognitive and immunological profiles and level of depressive symptoms were examined at baseline, after each 8-week intervention (visit 2, V2) and six months after each intervention (visit 3, V3). MBSR participants completed feasibility questionnaire at V2. Results: Twenty MCI patients completed the study (MBSR group n=12, control group n=8). MBSR group showed significant reduction in depressive symptoms at both V2 (p=0.03) and V3 (p=0.0461) compared to the baseline. There was a minimal effect on cognition - a group comparison analysis showed better psychomotor speed in the MBSR group compared to the control group at V2 (p=0.0493) but not at V3. There was a detectable change in immunological profiles in both groups, more pronounced in the MBSR group. Participants checked only positive/neutral answers concerning the attractivity/length of MBSR intervention. More severe cognitive decline (PVLT≤36) was associated with the lower adherence to home practice. Conclusion: MBSR is well-accepted potentially promising intervention with positive effect on cognition, depressive symptoms and immunological profile.
- MeSH
- deprese psychologie terapie MeSH
- hodnocení výsledků zdravotní péče MeSH
- kognitivní dysfunkce psychologie terapie MeSH
- lidé MeSH
- metafyzické vztahy mezi duší a tělem * MeSH
- pilotní projekty MeSH
- průzkumy a dotazníky MeSH
- psychický stres terapie MeSH
- studie proveditelnosti MeSH
- úzkost psychologie MeSH
- všímavost metody MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
- MeSH
- diabetes mellitus diagnóza MeSH
- lidé MeSH
- plošný screening MeSH
- průzkumy a dotazníky MeSH
- rodinní lékaři MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- kongresy MeSH
INTRODUCTION: Lumbar puncture (LP) is increasingly performed in memory clinics. We investigated patient-acceptance of LP, incidence of and risk factors for post-LP complications in memory clinic populations. METHODS: We prospectively enrolled 3868 patients (50% women, age 66 ± 11 years, mini mental state examination 25 ± 5) at 23 memory clinics. We used logistic regression analysis using generalized estimated equations to investigate risk factors for post-LP complications, such as typical postlumbar puncture headache (PLPH) and back pain. RESULTS: A total of 1065 patients (31%) reported post-LP complaints; 589 patients (17%) reported back pain, 649 (19%) headache, of which 296 (9%) reported typical PLPH. Only few patients needed medical intervention: 11 (0.3%) received a blood patch, 23 (0.7%) were hospitalized. The most important risk factor for PLPH was medical history of headache. An atraumatic needle and age >65 years were preventive. Gender, rest after LP, or volume of cerebrospinal fluid had no effect. DISCUSSIONS: The overall risk of complications is relatively low. If risk factors shown in this study are taken into account, LPs can be safely performed in memory clinics.
- MeSH
- ambulantní zařízení * MeSH
- bolest hlavy po spinální punkci epidemiologie etiologie MeSH
- demence MeSH
- incidence MeSH
- kognitivní poruchy MeSH
- lidé středního věku MeSH
- lidé MeSH
- paměť fyziologie MeSH
- prospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- spinální punkce škodlivé účinky metody MeSH
- studie proveditelnosti MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
BACKGROUND AND AIMS: Prehabilitation combines exercise, nutritional, and psychological interventions administered before surgery to improve patient outcomes. This comprehensive review and meta-analysis examined the feasibility, adherence, and effectiveness of prehabilitation in frail, high-risk individuals undergoing major abdominal surgery. METHODS: We searched the Cochrane Central Register of Controlled Trials, Web of Science, MEDLINE, Embase, and Cumulative Index to Nursing & Allied Health Literature (CINAHL) databases to identify relevant studies evaluating prehabilitation programs published between 2010 and 2023, either as observational studies or randomized clinical trials (RCTs). RESULTS: The 23 articles (13 RCTs and 10 observational studies) included 1849 older male and female patients aged 68.7 ± 7.2 years. Nineteen of the included studies reported on adherence to prehabilitation programmes, which was generally good (>75%) over different models, settings, and durations. Factors such as patients' desire for expedited surgery, self-assessment of fitness, personal and professional obligations, health issues, holidays, and advancement of surgery dates negatively affected adherence to prehabilitation programmes. When compared with rehabilitation or standard pre- and post-surgical care, prehabilitation was associated with a 25%, albeit not statistically significant reduction in postoperative complications, according to data from 14 studies reporting on postoperative complications (OR 0.75, 95% CI 0.48 to 1.17, P = 0.43; I2 = 65%). Prehabilitation has been found to improve the 6-min walk test significantly by 29.4 m (MD +29.4 m, 95% CI 5.6 to 53.3, P = 0.02; I2 = 39%), compared with rehabilitation or standard pre- and post-surgical care. CONCLUSION: Prehabilitation was acceptable to patients, with good adherence, and improved physical function.
- MeSH
- adherence pacienta * MeSH
- břicho chirurgie MeSH
- fyzioterapie v předoperační přípravě * MeSH
- lidé MeSH
- pooperační komplikace prevence a kontrola MeSH
- předoperační péče metody MeSH
- randomizované kontrolované studie jako téma MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- systematický přehled MeSH
Význam pohybové aktivity se v průběhu života zvyšuje, a to nejen z pohledu osobního, ale i společenského. Přesto se většina osob v pokročilém věku hýbe nedostatečně. Důsledky se projevují ve všech oblastech života a ovlivňují jeho kvalitu. Cílem této studie bylo posoudit přijatelnost, zvládnutelnost a účinnost inovativního pohybově-vzdělávacího programu inspirovaného principy vývojové kineziologie pro podporu funkční zdatnosti osob nad 70 let. Studie se zúčastnilo 82 seniorů žijících v domácím prostředí (průměrný věk 73,7 ± 3,4; 77 % žen), kteří byli náhodně rozděleni do intervenční (n = 45) a kontrolní (n = 37) skupiny. Účastníci v intervenční skupině cvičili 15 minut minimálně 6 dní v týdnu po dobu 12 týdnů z domova podle video sestav. Přijatelnost a zvládnutelnost byla vyhodnocena na základě záznamů z deníků a dotazníků. Účinnost byla hodnocena terénními objektivními a subjektivními testy vybraných komponent funkční zdatnosti. Data byla analyzována v SPSS pomocí deskriptivní statistiky, t-testů, chí-kvadrátu a ANOVA. Výsledky potvrdily nejen přijatelnost a zvládnutelnost, ale i účinnost. Míra dodržování programu byla 99,9 %. Program byl hodnocen jako srozumitelný, smysluplný a zvládnutelný. Všichni účastníci v intervenční skupině by program doporučili svým vrstevníkům a 91 % vyjádřilo záměr pokračovat. Účastníci se po intervenci cítili více fit (T = 4,96, p < ,001; F = 4,83, p < ,05) a zlepšili se v parametrech statické rovnováhy (T = –3,45, p = ,001) i dynamické rovnováhy (ES = ,05). Síla stisku ruky nebyla ovlivněna. Domácí online cvičení má potenciál se stát vítanou součástí každodenního života seniorů a přispívat tak ke zlepšení nebo zachování výchozích komponent funkční zdatnosti nezbytných pro aktivní život v pozdním věku.
The importance of physical activity increases throughout life, not only from a personal but also from a social perspective. Yet most people in old age do not move enough. The consequences are felt in all areas of life and affect the quality of life. The aim of this study was to assess the acceptability, manageability and effectiveness of an innovative movement-education programme inspired by the principles of developmental kinesiology to promote functional fitness in people over 70 years of age. Participants in the study included 82 home-dwelling older adults (mean age 73.7 ± 3.4; 77 % female) who were randomly assigned to intervention (n = 45) and control (n = 37) groups. Participants in the intervention group exercised for 15 minutes at least 6 days per week for 12 weeks from home according to video reports. Acceptability and manageability were assessed by diary entries and questionnaires. Efficacy was assessed by field objective and subjective tests of selected components of functional fitness. Data were analyzed in SPSS using descriptive statistics, t-tests, chi-square and ANOVA. The results confirmed not only acceptability and manageability but also efficacy. The compliance rate was 99.9%. The program was rated as understandable, meaningful and manageable. All participants in the intervention group would recommend the program to their peers and 91% expressed an intention to continue. Participants felt more fit after the intervention (T = 4.96, p < .001; F = 4.83, p < .05) and improved in both static balance (T = −3.45, p = .001) and dynamic balance (ES = .05) parameters. Handshake strength was not affected. Home-based online exercise has the potential to become a welcome part of seniors‘ daily lives, contributing to improving or maintaining baseline components of functional fitness necessary for active living in late life.
- MeSH
- adherence a compliance při léčbě statistika a číselné údaje MeSH
- audiovizuální záznam MeSH
- lidé MeSH
- podpora zdraví metody statistika a číselné údaje MeSH
- sběr dat metody statistika a číselné údaje MeSH
- senioři MeSH
- statistika jako téma MeSH
- tělesná a funkční výkonnost MeSH
- terapie cvičením * metody statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH