A stress management program: inpatient-to-outpatient continuity

Occupational therapy interventions in pulmonary rehabilitation – an update in the COVID-19 ERA

Background. As symptoms of COVID-19 infection are varying in severity and type, the long-term disability is yet to be established due to a short time-window since the pandemic started. Most survivors will have persistent pulmonary symptoms even after the infection, which raises the awareness of the importance of pulmonary rehabilitation in these patients, as they are mostly young, with severely diminished quality of life as they are unable to perform their basic activities of daily living as before. Occupational therapy is a form of rehabilitation treatment aimed at maximizing functionality and independence in performing activities of daily living, improvement of the patient’s autonomy and prevention of further functional decline. Objective. The purpose of the current work is to review the most important occupational therapy interventions applicable during a pulmonary rehabilitation program for chronic pulmonary pathologies, that can also be applied in COVID-19 survivors with persistent respiratory symptoms. Discussion. The main objectives of occupational therapy in pulmonary rehabilitation are training using breathing techniques at rest and during task performance, upper limbs training to increase exercise tolerance, programming and simplifying daily activities, informing patients of the importance of asking for help, planning the day/week, organizing the environment, educating the patient. All these objectives can be achieved in a simple way and at low-cost. Conclusions. Occupational therapy intervention during comprehensive pulmonary rehabilitation must be promoted to specifically evaluate and solve problems related to respiratory disability. Occupational tasks should be related to symptoms occurring during specific activities. Standardized protocols and definition of outcomes during occupational therapy intervention are lacking. Keywords: occupational therapy, pulmonary rehabilitation, COVID-19, activities of daily living, quality of life,

Determining the Effectiveness of a Short-Term Anxiety Management Course

The effectiveness of a 6-week anxiety management course at a mental health day hospital was researched. The author was motivated to research these sessions due to her own observations of the clients' progress in the groups. There was also an increasing demand for anxiety management groups with many clients being referred by general practitioners. The subjects were 37 clients. The diagnosis of the clients varied but anxiety must have been identified as a problem. Four of the 6-week courses were run over a period of 10 months.

The course was evaluated using three questionnaires: the Hospital Anxiety and Depression (HAD) Scale, the Spielberger Questionnaire (state and trait) and the Fear Questionnaire. The clients completed the questionnaires four times: pre-treatment, at the beginning and at the end of the course, and at 2 months post-treatment. A control group was used.

The data collected from the questionnaires were analysed using paired t-tests. The results showed that the anxiety management course was effective, with a statistically significant reduction in symptoms by the end of the course. The control group did not show significant change.

It was the HAD Scale that showed the statistically significant positive change. The state section of the Spielberger Questionnaire followed the same pattern as the HAD Scale and showed a reduction in symptoms, although it was not statistically significant. The results of the Fear Questionnaire suggested that the clients' phobias were not treated by the anxiety management course. A client satisfaction questionnaire was used and participants made positive comments about the value of the course.

Holistic health stress management program. Nursing student and client health outcomes

This descriptive study examines the application of stress management techniques by nursing students to their clients (i.e., patients, family members, friends) within a model holistic stress management nursing course. Out of 90 students, 88 completed a Client Teaching Relaxation Questionnaire during the course. Responses indicated a decrease in clients' perceived levels of discomfort following a stress reduction intervention (paired t = 18.7, df = 84, p < .0001). The students further reported that stress management skills were applicable to clients with a wide range of diagnoses in hospitals, homes, and other community settings. Imagery (52%) was documented as the predominant strategy taught to clients. Study results suggest that with teaching time allowed for self-mastery during the course, students can successfully apply these simple to complex stress management skills to many different clients, enhancing the caring aspect for both client and student. The course presented in this study provided students with essential foundational skills necessary to deal with client stress.