Criterion validity of a new measure of self-actualization

Adjusted Indirect and Mixed Comparisons of Interventions for the Patient-Reported Outcomes Measures (PROMs) of Disabled Adults: A Systematic Review and Network Meta-Analysis

This systematic review adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA) guidelines and used the method of network meta-analysis to compare the effects of different types of interventions from different perspectives which were abilities of daily life activity, psychological health, social functioning, and overall life quality. The eligibility criteria were: (1) Participants were adults above 18 years old with disabilities; (2) Interventions could be classified into active exercise, passive therapy, psychological education, psychosocial support program, multi-disciplinary program, and usual care; (3) Outcomes should be the patient-reported outcome measures (PROMs) that could be classified into abilities of daily life activity, psychological health, social functioning, and overall life quality; (4) Randomized designed and published in English. The keywords and their search field were: (1) “people with disabilities/disability”, “disabled”, “handicapped”, or “disable people” in titles or abstracts; (2) AND “randomized” or “randomised” in titles or abstracts; (3) NOT “design”, “protocol”, or “review” in titles. After searching in databases of Medline (EBSCO), PubMed, CINAHL, and Ovid, 16 studies were included. As a result, active exercise and passive therapy are most likely to be the best interventions for overall life quality, psychological education and passive therapy are most likely to be the best interventions for abilities of daily life activity, and psychosocial support programs are most likely to be the best intervention for psychological health and social functioning.

Perceived Autonomy and Activity Choices Among Physically Disabled Older People in Nursing Home Settings: A Randomized Trial

Objectives: To evaluate the effect of individually tailored programs on perceived autonomy in institutionalized physically disabled older people and to describe participants’ activity wishes and content of the programs. Method: This blinded randomized trial with follow up included a total of nine nursing homes and 50 nursing home residents who were randomized into either a control group or an intervention group. Perceived autonomy was measured at baseline (T1), after 12 weeks (T2) of intervention and after 24 weeks (T3) Wishes for daily activities was identified at T1. Weekly reports of individual programs were drawn up. Results: Both groups perceived autonomy as average at baseline and increased their mean score at T2 to high or close to high. At T3, both groups scored average but exceeded the level of T1. Activity wishes and the content of the programs indicate incoherence. Discussion: Although the correspondence between the individual wishes for activities and the concrete content of the programs was not obvious, results indicate potential for enabling the perception of autonomy among physically disabled older nursing home residents. The clinical consequences may suggest a focus on existing traditions, methods, and tools in the nursing home practice.

Autonomy among physically frail older people in nursing home settings: a study protocol for an intervention study

BACKGROUND

Experiencing autonomy is recognised to promote health and well-being for all age groups. Perceived lack of control has been found to be detrimental to physical and mental health. There is a lack of evidence-based knowledge elucidating how frail older people in nursing home settings themselves perceive autonomy in daily life. Further, there are no studies on the extent to which this perception can be influenced positively by participating in an individually tailored programme based on residents' own wishes for daily activities.

METHODS AND DESIGN

A total of 9 nursing homes and 55 participants aged 65 years or older were included in the study. All the participants were restricted in performing at least one P-ADL activity unassisted and had a Mini Mental State Examination-score above 16. Perceived autonomy was measured at baseline, after 12 weeks and after 24 weeks by The Autonomy Sub-dimension in the Measure of Actualisation of Potential test. Programmes were based on participants' individual assessment of their most important daily activities. Staff at all nursing homes who usually organize physical training, social or creative activities carried out individually tailored programmes using their usual methods and equipment. Participants in each nursing home were divided by lot into either a control group or an intervention group. The control groups received their usual care and treatment.

DISCUSSION

This study is designed to assess the status of perceived autonomy at baseline and to provide information about the effectiveness of individually tailored programmes according to perceptions of autonomy registered in institutionalised physically frail older people. This will add knowledge to assist response to present and future challenges in relation to health promotion initiatives for this group.

Mystical-type experiences occasioned by psilocybin mediate the attribution of personal meaning and spiritual significance 14 months later

Psilocybin has been used for centuries for religious purposes; however, little is known scientifically about its long-term effects. We previously reported the effects of a double-blind study evaluating the psychological effects of a high psilocybin dose. This report presents the 14-month follow-up and examines the relationship of the follow-up results to data obtained at screening and on drug session days. Participants were 36 hallucinogen-naïve adults reporting regular participation in religious/ spiritual activities. Oral psilocybin (30 mg/70 kg) was administered on one of two or three sessions, with methylphenidate (40 mg/70 kg) administered on the other session(s). During sessions, volunteers were encouraged to close their eyes and direct their attention inward. At the 14-month follow-up, 58% and 67%, respectively, of volunteers rated the psilocybin-occasioned experience as being among the five most personally meaningful and among the five most spiritually significant experiences of their lives; 64% indicated that the experience increased well-being or life satisfaction; 58% met criteria for having had a 'complete' mystical experience. Correlation and regression analyses indicated a central role of the mystical experience assessed on the session day in the high ratings of personal meaning and spiritual significance at follow-up. Of the measures of personality, affect, quality of life and spirituality assessed across the study, only a scale measuring mystical experience showed a difference from screening. When administered under supportive conditions, psilocybin occasioned experiences similar to spontaneously occurring mystical experiences that, at 14-month follow-up, were considered by volunteers to be among the most personally meaningful and spiritually significant of their lives.

Self-actualization and poststroke rehabilitation

Rehabilitation is influenced by the individual's abilities and resources and extent to which they are used. This study explored self-actualization (capacity to maximize use of one's abilities and resources) in 37 individuals attending in-patient rehabilitation following a stroke by (1) comparing the level of self-actualization of the participants to the level of self-actualization of 562 healthy community-dwelling individuals without stroke; (2) assessing changes in the level of self-actualization during rehabilitation (admission vs. discharge); and (3) exploring the relationships between self-actualization and changes in functional independence during rehabilitation, length of stay in the rehabilitation unit and change in living environment at discharge. Self-actualization was assessed with the measure of actualization of potential. The results showed that individuals with stroke had significantly lower self-actualization levels (P<0.001) than community-dwelling individuals without stroke. Self-actualization levels remained stable during rehabilitation (P=0.07). No significant relationships were found between self-actualization and changes in functional independence (P=0.36), length of stay (P=0.82) or change in living environment (P=0.65). This study suggests that many individuals with stroke are poorly actualized and self-actualization levels do not improve during rehabilitation. Further studies are needed to explore the relationship between self-actualization and other outcome measures in poststroke rehabilitation such as depressive symptoms or social participation.