Zoekresultaten

The Implications for Nursing Care of Frail Elderly with Limited Self-Management Abilities

Abstract Aim: To gain insight into the relationship between self-management abilities (taking initiatives, investment behaviour, variety, multifunctionality, self-efficacy, positive frame of mind) and physical, psychological and social frailty. Design: A cross-sectional study. Methods: 145 community-dwelling older people receiving home-care completed a questionnaire on sociodemographic factors, the Self-Management-Ability-Scale and the Tilburg Frailty Indicator. After determining correlations, sequential multiple linear regression analyses were executed. Results: All self-management abilities are negatively associated with physical frailty; five (except multifunctionality) are negatively associated with psychological frailty. Variety in resources and positive frame of mind are negatively associated with social frailty. Sociodemographic characteristics, chronic diseases and self-management abilities together significantly explain participants’physical (34.9%), psychological (21.4%) and social (43.9%) frailty. After controlling for sociodemographic characteristics and chronic diseases, the self-management abilities together significantly explain 11 per cent of psychological and 6.8 per cent of social frailty. Having a positive frame of mind significantly negatively influences social frailty.

Environmental influences on induction of itching and scratching using immersive virtual reality

Chronic itching is a serious and uncomfortable condition. The scratch response might result in a vicious cycle of alternating itching and scratching. To develop psychological interventions for people suffering from chronic itching and to break the vicious itch-scratching-itch cycle, it is important to elucidate which environmental factors trigger itch sensations. Virtual reality (VR) techniques provide a useful tool to examine specific content characteristics in a three-dimensional (3D VR) environment and their influences on itch sensations and scratching behaviour. This article describes two experiments in which we focused on the effects of environmental information on itching and scratching behaviour. Additionally, in the second experiment, we examined the influence of having a chronic skin condition on sensitivity to itch induction. We found evidence for the importance of the content of audio–visual materials for the effectiveness in inducing feelings of itch in the observers. In both experiments, we observed significantly higher levels of perceived itch in the itch-inducing conditions than in the control condition. Moreover, the results showed that elevated levels of perceived itch were associated with an increase in scratching behaviours, which was especially salient in the contagious itch condition, in which perceived itch was accompanied by a significant increase in the number of scratches. Experiment 2 additionally showed increased perceived itch levels in participants who reported having a chronic skin condition, reflecting higher sensitivity to itch-inducing audio–visual stimuli in this group than in participants without a chronic skin condition. Based on the results we concluded that directing attention towards itch- or scratch aspects of related information in the environment and to the consequences for one’s own skin are effective tools to induce itch sensations and scratching behaviour. This knowledge provides tools for developing novel strategies in advising and treating people suffering from chronic itching and breaking the vicious itch-scratching-itch cycle.

Blended interventions to change behavior in Patients with Chronic Somatic Disorders

Blended behavior change interventions combine therapeutic guidance with online care. This new way of delivering health care is supposed to stimulate patients with chronic somatic disorders in taking an active role in their disease management. However, knowledge about the effectiveness of blended behavior change interventions and how they should be composed is scattered. This comprehensive systematic review aimed to provide an overview of characteristics and effectiveness of blended behavior change interventions for patients with chronic somatic disorders.

Blended interventions to change behavior in patients with chronic somatic disorders

The association between physical activity and cardiorespiratory fitness in patients with rheumatoid artahrtis and high cardiovascular risk

Background: Rheumatoid arthritis (RA) is associated with increased risk of cardiovascular disease (CVD) disease and CV mortality1. High values of cardiorespiratory fitness (CRF) are protective against CVD and CV mortality2. Physical activity levels in patients with RA are low. Knowledge on whether physical activity is associated with CRF in patients with RA and high CV risk is scarce. This knowledge is important because improving the level of physical activity could improve CRF and lower CV risk in this group of patients with RA and high CV risk. However, it is unclear whether physical activity is associated with CRF in this group of patients. This study presents the preliminary results at baseline of the association of physical activity with CRF from an ongoing pilot study aimed at improving CRF through exercise therapy in patients with RA and high CV risk.Objectives: To determine (i) the level of physical activity in patients with RA and high CV risk and (ii) whether physical activity is associated with CRF in patients with RA and high CV risk.Methods: Patients with RA and high CV risk participated in this pilot study. Increased 10-year risk of CV mortality was determined by using the Dutch SCORE-table. Anthropometrics and disease characteristics were collected. Physical activity was assessed with an Actigraph accelerometer to determine the number of steps and intensity of physical activity expressed in terms of sedentary, light, and moderate-to-vigorous time per day. Participants wore the accelerometer for seven days. A minimum of four measurement days with a wear time of at least 10 hours was required. The VO2 max measured with a graded maximal exercise test was used to determine the CRF. Pearson correlation coefficients were calculated for the associations between the different measures of physical activity and VO2max. For the variables that were associated, linear regression analysis was carried out, with pain and disease activity as possible confounders.Results: Thirteen females and five males were included in the study. The mean age was 66.5 (± 15.0) years. Only 22% of the patients met public health physical activity guidelines for the minimal amount of 150 minutes a week. The mean step count was 6237 (± 2297) steps per day and mean moderate-to-vigorous physical activity time was 16.50 (± 23.56) minutes per day. The median VO2max was 16.23 [4.63] ml·kg-1·min-1, which is under the standard. Pearson correlations showed a significant positive association for step count with VO2max. No associations were found for sedentary, light, and moderate-to-vigorous physical activity with VO2max. The significant association between step count and VO2max(p = 0.01) was not confounded by disease severity and pain.Discussion: Since better CRF protects against CVD, increasing daily step count may be a simple way to reduce the risk of CVD in patients with RA and high CV risk. However, these results need to be confirmed in a larger study group. Future research should investigate if improving daily step count will lead to better CRF levels and ultimately will lead to a reduction in CV risk in patients with RA and high CV risk.Conclusion: Physical activity levels of patients with RA and high CV risk do not meet public health requirements for physical activity criteria and the VO2max was under the standard. Step count is positively associated with CRF.

Relationships between HRV, sleep and physical activity in personal data

In this blogpost, I share five insights that I uncovered after analyzing my personal Oura ring data to explore possible relationships between my resting HRV, sleep and physical activity.