Abstract Objective: The aim of this study was to describe how patients in palliative care relate to occupation during hospitalization and to define the meaning it has for them. Method: Eight inpatients in palliative care with various cancer diagnoses were interviewed one time. These interviews were transcribed and analyzed using qualitative content analysis. Results: Patients experience occupations as meaningful when in hospital during the last period of their lives. They would like to be able to handle their own needs as much as possible. Staff behavior, the design of the environment, the lack of accessible occupations, and the degree to which patients can decide whether to receive or decline visits affect the possibility to make their wishes a reality. Our results also revealed that patients experience a sense of loss of their role, as well as a lack of control and participation. Significance of Results: Our results confirm the importance of occupation and of patients having the option to and being given opportunities to take care of themselves when in palliative care. Further studies are needed to enable us to understand how organized occupations might influence patients' experience of being in a hospital during the final period of life.
A total of 244 long-term survivors of subarachnoid haemorrhage (SAH) were examined at a follow-up concerning change in instrumental activities of daily living (IADL). A decrease from previous independence prevailed for 51 % of the sample. As expected, home-maintenance activities were more common pre-SAH for women than for men, and for these activities post-SAH disabilities were most frequently recorded for married/cohabiting women. Using factor analysis, IADL items could be grouped into three different factors characterizing: (a) domestic and social activities, (b) administrative chores and (c) handling money or the telephone. Two of these factors were logically associated with two or three impairments (language, motor, perception, long- and short-term memory). Since IADL disabilities are common among long- term survivors of SAH, the need for rehabilitation and occupational therapy is discussed briefly.
Objectives – To investigate eventual differences between women and men with Parkinson's disease (PD) before and after surgery, with respect to clinical status, disability and health-related quality of life (HRQoL). Material and methods – Twenty-four men and 14 women with PD received a total of 46 surgical procedures (pallidotomy, thalamotomy and deep brain stimulation of the thalamus, pallidum or subthalamic nucleus). The impact of PD on disability and other aspects of HRQoL was analysed separately in men and women before and at a mean of 11 months after surgery, using the following assessment tools: The Unified Parkinson's Disease Rating Scale (UPDRS), the ADL Taxonomy, the Nottingham Health Profile, the Life Satisfaction Questionnaire and a Visual Analogue Scale. Results – At surgery, women had a significantly longer duration of disease than men (mean: 15 vs. 10 years, P < 0.01). They had a higher stage on the Hoehn and Yahr scale and worse scores on UPDRS parts II (ADL) and IV (complications), as well as on the Schwab and England scale and on the ADL Taxonomy. Following surgery, both men and women showed improvement, but women experienced greater benefit than men in ADL, in emotions, and in social life. Conclusions – Perhaps women with PD should be offered surgery more often and earlier in the course of their disease.
The importance of engagement in meaningful occupations and participation in life situations of people with psychiatric disabilities is well known. Therefore, community care workers (CCWs) in shelte ...
This investigation addresses functions/impairments, abilities/disabilities and quality of life (QoL) in a consequtive series of non-hospitalized long-term survivors [2, 5–12 years] of subarachnoid haemorrhage (SAH). The investigated parameters of functions/impairments were: motor, language, perceptual and memory functions. Abilities/disabilities studied were: activities of daily living (ADL) including both personal- and instrumental ADL, working and leisure capacities. Quality of life was assessed using a double visual analogue scale. Occurrence of depression was registered using a self-rating scale.A questionnaire focusing motor and language impairments, personal ADL, work and leisure activities was initially mailed to 324 subjects. Most of them answered the questionnaire. Ten hospitalized subjects could not validly report their functions and abilities and for that reason were excluded.In a follow-up investigation up to 247 long-term non-hospitalized subjects were investigated by a physician and an occupational therapist. A total of 82% had at least one impairment. The majority (73%) had memory impairment and among these subjects equal proportions (about 50%) had impairments of long-and short-term memory. Forty-five percent were perceptually impaired, while motor impairment occurred for 25% and aphasia in 10%. Only a small minority (9%) were, according to self-reports, regarded as being to some extent disabled in personal ADL. The corresponding numbers of disabled in instrumental ADL, leisure and working-capacity were 52%, 48% and 40% respectively. Depression was found in 22%—among whom the majority had minimal or mild depression. Overall QoL was judged to be unchanged or increased in 62% of cases and, therefore, decreased in 38%.As expected, impairments to a significant degree caused disabilities. None of the five different categories of impairment were associated with mood (depressed/not depressed) and QoL (decreased/not decreased). Occurrence of depression was significantly associated with the different aspects of disabilities. In contrast, among a series of instrumental ADL-variables, leisure and working capacity, QoL was influenced negatively only by decreased ability to act sociably and, to a minor extent, by depressed mood.Judging from the extent of decreased quality of life, it appears that nearly 40% of all non-hospitalized former victims of SAH have not coped successfully with the impact of the SAH. A follow-up programme aiming at optimizing the coping process of SAH victims is, therefore, outlined
The study illuminated how persons with psychiatric disabilities experienced the processes of change in a residential context.Qualitative interviews with residents living in supported housing were conducted and analyzed using constant comparative analysis.Residential conditions appear to provide a complex structure that facilitates rehabilitative interactions, in which 'progressive tensions' arise between opposing values, such as authentic versus artificial, and independence versus dependence, both of which are important in the process of change.A client-centred approach could be taken further if clients are engaged in productive discussions about challenging these 'progressive tensions'. Awareness of the meaning of home also emerged as central.
This investigation focuses on the prevalence of motor, language, perceptual and memory impairments in long-term survivors of subarachnoid haemorrhage. The prevalence of different impairments was as follows: language 10%, motor 25%, perception 45% (a prevalence that may be age-dependent), and memory 73%. A total of 82% of the subjects had at least one impairment, and impairments of perception and long-term memory were particularly common with a ruptured anterior communicant artery. A factor analysis showed that perceptual function/impairment could be separated into two entities: lower- versus higher-order perception. Another factor analysis separated higher-order perception from memory, casting doubt upon assessment methods that aggregate these two entities.
The occurrence of intracranial aneurysms (IAs) in the families of 579 consecutive patients with subarachnoid hemorrhage (SAH), of whom 485 had verified IAs, was studied retrospectively. IAs occurred in the families of 6.7% of the IA patients, but only 0.4% of their siblings had IAs. However, there were differences between the familial and nonfamilial IA patients, indicating that the familial patients are a specific small subpopulation of IA patients. The familial patients were younger, often had multiple aneurysms, and had aneurysms frequently located on arteries other than those in the nonfamilial group. (Neurosurgery 20:236-239, 1987)
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