Person-specific evidence has the ability to mobilize relational capacity: A four-step grounded theory developed in people with long-term health conditions

Person-specific evidence was developed as a grounded theory by analyzing 20 selected case descriptions from interventions using the guided self-determination method with people with various long-term health conditions. It explains the mechanisms of mobilizing relational capacity by including person-specific evidence in shared decision-making. Person-specific self-insight was the first step, achieved as individuals completed reflection sheets enabling them to clarify their personal values and identify actions or omissions related to self-management challenges. This step paved the way for sharing these insights and challenges in a relationship with a supportive health professional, who could then rely on person-specific evidence instead of assumptions or a narrow disease perspective for shared decision-making. Trust in the evidence encouraged the supportive health professional to transfer it to the interdisciplinary team. Person-specific evidence then enhanced the ability of team members to apply general evidence in a meaningful way. The increased openness achieved by individuals through these steps enabled them to eventually share their new self-insights in daily life with other people, decreasing loneliness they experienced in self-management. Relational capacity, the core of the theory, is mobilized in both people with long-term health conditions and healthcare professionals. Further research on person-specific evidence and relational capacity in healthcare is recommended.

Multivitamin use and risk of preeclampsia: A systematic review and meta-analysis

INTRODUCTION

Preeclampsia is associated with adverse maternal and neonatal outcomes. It is unclear whether multivitamin use reduces the risk of preeclampsia. This systematic review and meta-analysis aimed to evaluate the association between multivitamin use and the risk of preeclampsia.

MATERIAL AND METHODS

We searched PubMed, Embase and the Cochrane Library from database inception to July 2021. Randomized controlled trials (RCTs), case-control and cohort studies assessing the association between multivitamin use and risk of preeclampsia were eligible. Studies of treatment with a single micronutrient were excluded. Relative risks and 95% confidence intervals (95% CI) were calculated using random-effects models. RoB2, the Newcastle Ottawa Scale and GRADE were used to assess risk of bias and quality of evidence. The protocol was registered in PROSPERO (no. CRD42021214153).

RESULTS

Six studies were included (33 356 women). Only two RCTs were found, both showing a significantly decreased risk of preeclampsia in multivitamin users. These studies were not compatible for meta-analysis due to clinical heterogeneity. A meta-analysis of observational studies using a random-effects model showed an unchanged risk of preeclampsia following multivitamin use (relative risk 0.85, 95% CI 0.69-1.03). The quality of evidence according to GRADE was very low.

CONCLUSIONS

Very weak evidence suggests that multivitamin use might reduce the risk of preeclampsia; however, more research is needed. Large RCTs should be prioritized. The results of this review do not allow any final conclusions to be drawn regarding a preventive effect of multivitamin use in relation to preeclampsia.

Lifestyle Habits among Pregnant Women in Denmark during the First COVID-19 Lockdown Compared with a Historical Period-A Hospital-Based Cross-Sectional Study

The first national lockdown in Denmark due to the COVID-19 pandemic was declared on 11 March 2020. From this date, national restrictions were imposed. We aimed to assess the potential influence of this first nationwide lockdown on exercise, alcohol consumption, and smoking in early pregnancy. Using a cross-sectional study based on routinely collected patient-reported data, we compared the lifestyle habits of women who were pregnant during the first phase of the pandemic (COVID-19 group) (n = 685) with those of women who were pregnant the year before (Historical group) (n = 787). We found a reduction in any exercise (PR = 0.91, 95% CI (0.84 to 0.99), in adherence to national recommendations of exercise (PR = 0.89, 95% CI (0.80 to 0.99), in cycling (15% vs. 28%, p < 0.0001), and swimming (0.3% vs. 3%, p = 0.0002) in the COVID-19 group compared with the Historical group. The prevalence of binge drinking was reduced in the COVID-19 group compared with the Historical group (PR = 0.80, 95% CI (0.68 to 0.93). In contrast, the prevalence of any weekly alcohol consumption and smoking cessation during pregnancy was similar between groups. Our findings indicate that national restrictions due to the COVID-19 pandemic influenced the lifestyle habits of pregnant women and should be addressed in antenatal counseling.

Virtual reality in the assessment of selected cognitive function after brain injury

OBJECTIVE

To assess selected cognitive functions of persons with traumatic brain injury using a computer-simulated virtual reality environment.

STUDY DESIGN

A computer-simulated virtual kitchen was used to assess the ability of 30 patients with brain injury and 30 volunteers without brain injury to process and sequence information. The overall assessment score was based on the number of correct responses and the time needed to complete daily living tasks. Identical daily living tasks were tested and scored in participants with and without brain injury. Each subject was evaluated twice within 7 to 10 days. A total of 30 tasks were categorized as follows: information processing, problem solving, logical sequencing, and speed of responding.

RESULTS

Persons with brain injuries consistently demonstrated a significant decrease in the ability to process information (P = 0.04-0.01), identify logical sequencing (P = 0.04-0.01), and complete the overall assessment (P < 0.01), compared with volunteers without brain injury. The time needed to process tasks, representing speed of cognitive responding, was also significantly different between the two groups (P < 0.01).

CONCLUSION

A computer-generated virtual reality environment represents a reproducible tool to assess selected cognitive functions and can be used as a supplement to traditional rehabilitation assessment in persons with acquired brain injury.

The 1999 Eleanor Clarke Slagle Lecture. Defining lives: occupation as identity: an essay on competence, coherence, and the creation of meaning

This article presents a view of occupation as the principal means through which people develop and express their personal identities. Based on a review of theory and research, it proposes that identity is instrumental to social life because it provides a context for deriving meaning from daily experiences and interpreting lives over time. The article proposes that identity also provides a framework for goal-setting and motivation. It is asserted that competence in the performance of tasks and occupations contributes to identity-shaping and that the realization of an acceptable identity contributes to coherence and well-being. Within this framework, it is postulated that performance limitations and disfigurement that sometimes result from illness or injury have identity implications that should be recognized by occupational therapy practitioners. By virtue of their expertise in daily living skills, occupational therapy practitioners are well positioned to help address the identity challenges of those whom they serve. In so doing, they make an important contribution to meaning and well-being.

Occupations and well-being: a study of personal projects

OBJECTIVE

The purpose of this study was to explore the relationship between occupation and subjective well-being (SWB).

METHOD

A convenience sample of 120 adults completed a personal projects analysis, a method of rating their current goal-directed pursuits. They also completed measures of SWB (Affect Balance Scale, Life Satisfaction Index Form A) and personality traits (Myers-Briggs Personality Inventory). Characteristics of personal projects were correlated with SWB scores. Multiple regression analysis was used to investigate possible predictors of well-being from among the characteristics of personal projects, personality traits, and demographic variables.

RESULTS

The stress associated with personal projects was significantly and inversely correlated with well-being, as was project difficulty. Perceived progress in completing projects was significantly positively correlated with well-being. The strongest predictors for well-being were the composite project factors of stress and efficacy. Two personality traits, sensing and extraversion, interacted with the project dimension of stress to emerge as significant predictors of well-being. Together, these four variables explained 42% of the variance in well-being scores.

CONCLUSION

These findings are consistent with assumptions that attributes of meaningful occupations are significantly related to people's perceived well-being.

Personal projects: a useful approach to the study of occupation

A comprehensive and useful understanding of human occupation requires research methods that capture its individual dimensions while permitting analyses within and across groups. In this article we describe the construct of personal projects and the research method of personal projects analysis. Both have their origins in studies of personality and have been used successfully to link individual traits and context-based, goal-directed behavior to well-being and other variables. The appropriateness and relevance of this approach for studies of occupation and occupational therapy are considered.

The scholarly productivity of occupational therapy faculty members: results of a regional study

A study of the scholarly activities of 66 occupational therapy faculty members at selected academic health centers was conducted through a mailed survey. An analysis of the responses showed that (a) the respondents' primary scholarly activities were reporting research findings in refereed journal articles and presenting papers at professional meetings and (b) only a small percentage of the respondents had directed extramurally funded projects. In addition, the level of scholarly productivity of the occupational therapists was significantly lower than that of their allied health colleagues. The majority of the respondents indicated that their own academic preparation was the primary factor that encouraged their scholarly pursuits and that heavy teaching responsibility was the primary discouraging factor. The respondents indicated also that faculty scholarly activities are, and will continue to be, important considerations in academic promotion decisions.

Measuring empathy in occupational therapy students

Empathy is one interpersonal skill dimension that contributes to the occupational therapy process. This paper explores the concept of empathy and briefly recapitulates some of the assessment devices used in an attempt to measure the skill. It further describes an investigation involving 23 occupational therapy students in a basic master's program. The students were administered the Hogan Empathy Scale, and scores were correlated with peer and faculty empathy ratings. The results revealed a significant correlation between measured empathy and perceived ability to empathize. Possibilities are discussed for using the Hogan Empathy Scale in occupational therapy education.

Attitudes of graduates toward occupational therapy education

Recently graduated occupational therapists were surveyed to determine their perceptions of the adequacy of their professional training. Through a mailed questionnaire, therapists evaluated their undergraduate professional preparation based upon their clinical experiences since graduation. Additional suggestions were solicited regarding possible areas of curriculum change, and the survey gave special attention to the area of interpersonal skill development. Responses were examined for areas of commonality and possible use in curriculum planning and modification. Results indicated that recent graduates see a need for more and earlier patient contact, increased attention to the development of administrative and managerial skills, and courses designed to facilitate skills necessary for effective interpersonal relationships.