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Vigorè M, Steccanella A, Maffoni M, Torlaschi V, Gorini A, La Rovere MT, Maestri R, Bussotti M, Masnaghetti S, Fanfulla F, Pierobon A. Patients' Clinical and Psychological Status in Different COVID-19 Waves in Italy: A Quanti-Qualitative Study. Healthcare (Basel) 2023; 11:2477. [PMID: 37761674 PMCID: PMC10531315 DOI: 10.3390/healthcare11182477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND COVID-19 waves have been characterized by different clinical manifestations, a decrease of functional abilities, and the presence of psychological symptoms. The aims of this study were to investigate differences in physical and psychological symptoms during the three Italian waves of the coronavirus pandemic. METHODS Patients undergoing a functional, cardiological and pneumological check-up follow-up at ICS Maugeri Institutes, 2-3 months after recovery from COVID-19 were consecutively recruited to participate in the study, completing a quanti-qualitative questionnaire about anxiety, depression, PTSD symptoms, and personal resources. RESULTS 104 patients were recruited: 44 and 60 during the first and second/third pandemic waves, respectively. Physical comorbidities were more present in the second/third waves compared to the first one, while no significant differences were found in anxious and depressive symptoms, which were significantly higher than normal during the three waves; PTSD symptoms were reported by 56.3% of patients. Family, social support, and a positive mindset were described as resources to cope with the COVID-19 burden. Negative affects arose during outbreaks (panic) and the disease (fear), while positive affect (joy) characterized only the follow-up period. CONCLUSION This study shows how psychophysical symptoms might change during the pandemic waves and highlights the importance of protective factors to balance the subjective distress.
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Affiliation(s)
- Martina Vigorè
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Andrea Steccanella
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Marina Maffoni
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Valeria Torlaschi
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Alessandra Gorini
- Istituti Clinici Scientifici Maugeri IRCCS, Milano-Camaldoli, 20138 Milan, Italy
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, 20122 Milan, Italy
| | - Maria Teresa La Rovere
- Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Roberto Maestri
- Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Maurizio Bussotti
- Cardiorespiratory Rehabilitation Unit of Milano Institute, Istituti Clinici Scientifici Maugeri IRCCS, 20138 Milan, Italy
| | - Sergio Masnaghetti
- Department of Medicine and Cardiopulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, 21049 Tradate, Italy
| | - Francesco Fanfulla
- Respiratory Function and Sleep Medicine Unit, Istituti Clinici Scientifici Maugeri IRCCS, 27010 Pavia, Italy
| | - Antonia Pierobon
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
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Baldassarre D, Iacoviello L, Baetta R, Roncaglioni MC, Condorelli G, Remuzzi G, Gensini G, Frati L, Ricciardi W, Conaldi PG, Uccelli A, Blandini F, Bosari S, Scambia G, Fini M, Di Malta A, Amato M, Veglia F, Bonomi A, Klersy C, Colazzo F, Pengo M, Gorini F, Auteri L, Ferrante G, Baviera M, Ambrosio G, Catapano A, Gialluisi A, Malavazos AE, Castelvecchio S, Corsi-Romanelli MM, Cardani R, La Rovere MT, Agnese V, Pane B, Prati D, Spinardi L, Liuzzo G, Arbustini E, Volterrani M, Visconti M, Werba JP, Genovese S, Bilo G, Invitti C, Di Blasio A, Lombardi C, Faini A, Rosa D, Ojeda-Fernández L, Foresta A, De Curtis A, Di Castelnuovo A, Scalvini S, Pierobon A, Gorini A, Valenti L, Luzi L, Racca A, Bandi M, Tremoli E, Menicanti L, Parati G, Pompilio G. Rationale and design of the CV-PREVITAL study: an Italian multiple cohort randomised controlled trial investigating innovative digital strategies in primary cardiovascular prevention. BMJ Open 2023; 13:e072040. [PMID: 37451717 PMCID: PMC10351259 DOI: 10.1136/bmjopen-2023-072040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/26/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Prevention of cardiovascular disease (CVD) is of key importance in reducing morbidity, disability and mortality worldwide. Observational studies suggest that digital health interventions can be an effective strategy to reduce cardiovascular (CV) risk. However, evidence from large randomised clinical trials is lacking. METHODS AND ANALYSIS The CV-PREVITAL study is a multicentre, prospective, randomised, controlled, open-label interventional trial designed to compare the effectiveness of an educational and motivational mobile health (mHealth) intervention versus usual care in reducing CV risk. The intervention aims at improving diet, physical activity, sleep quality, psycho-behavioural aspects, as well as promoting smoking cessation and adherence to pharmacological treatment for CV risk factors. The trial aims to enrol approximately 80 000 subjects without overt CVDs referring to general practitioners' offices, community pharmacies or clinics of Scientific Institute for Research, Hospitalization and Health Care (Italian acronym IRCCS) affiliated with the Italian Cardiology Network. All participants are evaluated at baseline and after 12 months to assess the effectiveness of the intervention on short-term endpoints, namely improvement in CV risk score and reduction of major CV risk factors. Beyond the funded life of the study, a long-term (7 years) follow-up is also planned to assess the effectiveness of the intervention on the incidence of major adverse CV events. A series of ancillary studies designed to evaluate the effect of the mHealth intervention on additional risk biomarkers are also performed. ETHICS AND DISSEMINATION This study received ethics approval from the ethics committee of the coordinating centre (Monzino Cardiology Center; R1256/20-CCM 1319) and from all other relevant IRBs and ethics committees. Findings are disseminated through scientific meetings and peer-reviewed journals and via social media. Partners are informed about the study's course and findings through regular meetings. TRIAL REGISTRATION NUMBER NCT05339841.
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Affiliation(s)
- Damiano Baldassarre
- Centro Cardiologico Monzino IRCCS, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
- Research Center in Epidemiology and Preventive Medicine (EPIMED), Varese, Italy
| | | | - Maria Carla Roncaglioni
- Laboratory of Cardiovascular Prevention, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Gianluigi Condorelli
- Department of Cardiovascular Medicine, IRCCS-Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Giuseppe Remuzzi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | | | - Luigi Frati
- IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Walter Ricciardi
- Istituti Clinici Scientifici Maugeri IRCCS Pavia, Pavia, Italy
- Università Cattolica del Sacro Cuore - Campus di Roma, Rome, Italy
| | - Pier Giulio Conaldi
- IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy
| | | | - Fabio Blandini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvano Bosari
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Scambia
- Università Cattolica del Sacro Cuore - Campus di Roma, Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | | | - Mauro Amato
- Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Fabrizio Veglia
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, Ravenna, Italy
| | | | - Catherine Klersy
- Unit of Clinical Epidemiology & Biostatistic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Martino Pengo
- Istituto Auxologico Italiano IRCCS, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | | | | | - Giuseppe Ferrante
- Department of Cardiovascular Medicine, IRCCS-Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Marta Baviera
- Laboratory of Cardiovascular Prevention, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Giuseppe Ambrosio
- Cardiology, University of Perugia School of Medicine, Perugia, Italy
| | - Alberico Catapano
- IRCCS Multimedica, Milan, Italy
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Alessandro Gialluisi
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
- Research Center in Epidemiology and Preventive Medicine (EPIMED), Varese, Italy
| | - Alexis Elias Malavazos
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Massimiliano Marco Corsi-Romanelli
- UOC SMEL-1, IRCCS POLICLINICO SAN DONATO, San Donato Milanese, Italy
- Department of Health and Biomedical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Rosanna Cardani
- BioCor Biobank, UOC SMEL-1 of Clinical Pathology, IRCCS-Policlinico San Donato, San Donato Milanese, Italy
| | | | - Valentina Agnese
- IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy
| | - Bianca Pane
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Università degli Studi di Genova, Genoa, Italy
| | - Daniele Prati
- Department of Transfusion Medicine and Haematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Spinardi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanna Liuzzo
- Università Cattolica del Sacro Cuore - Campus di Roma, Rome, Italy
- Dipartimento di Scienze Cardiovascolari, Fondazione Policlinico Gemelli IRCCS, Rome, Italy
| | - Eloisa Arbustini
- Centro Malattie Genetiche Cardiovascolari - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Maurizio Volterrani
- Cardio Pulmonary Department, IRCCS San Raffaele, Rome, Italy
- Exercise Science and Medicine, San Raffaele Open University, Rome, Italy
| | - Marco Visconti
- Co.S. (Consorzio Sanità) Study Center, Italy, Soresina, Italy
| | | | | | - Grzegorz Bilo
- Istituto Auxologico Italiano IRCCS, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | | | | | - Carolina Lombardi
- Istituto Auxologico Italiano IRCCS, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Andrea Faini
- Istituto Auxologico Italiano IRCCS, Milan, Italy
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Debora Rosa
- Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Luisa Ojeda-Fernández
- Laboratory of Cardiovascular Prevention, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Andreana Foresta
- Laboratory of Cardiovascular Prevention, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Amalia De Curtis
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | | | | | - Antonia Pierobon
- Istituti Clinici Scientifici Maugeri IRCCS Montescano, Montescano, Italy
| | - Alessandra Gorini
- Istituti Clinici Scientifici Maugeri IRCCS Milano, Milan, Italy
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milan, Italy
| | - Luca Valenti
- Department of Transfusion Medicine and Haematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dipartimento Fisiopatologia e Trapianti, Università degli Studi di Milano, Milan, Italy
| | - Livio Luzi
- IRCCS Multimedica, Milan, Italy
- Department of Health and Biomedical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Annarosa Racca
- Federfarma Lombardia & Fondazione Guido Muralti, Milan, Italy
| | - Manuela Bandi
- Federfarma Lombardia & Fondazione Guido Muralti, Milan, Italy
| | - Elena Tremoli
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, Ravenna, Italy
| | - Lorenzo Menicanti
- Department of Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Gianfranco Parati
- Istituto Auxologico Italiano IRCCS, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Giulio Pompilio
- Centro Cardiologico Monzino IRCCS, Milan, Italy
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
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Calabrese L, Maffoni M, Torlaschi V, Pierobon A. What Is Hidden behind Amputation? Quanti-Qualitative Systematic Review on Psychological Adjustment and Quality of Life in Lower Limb Amputees for Non-Traumatic Reasons. Healthcare (Basel) 2023; 11:healthcare11111661. [PMID: 37297801 DOI: 10.3390/healthcare11111661] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/10/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVE This systematic review aims to investigate Quality of Life (QoL)/Health Related Quality of Life (HRQoL) and psychological adjustment in non-traumatic lower limb amputees (LLA). METHODS PubMed, Scopus, and Web of Science databases were used for the literature search. Studies were read and analysed using the (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) PRISMA statement procedure. RESULTS The literature search retrieved 1268 studies, of which 52 were included in the systematic review. Overall, psychological adjustment, especially depression with or without anxiety symptoms, influences the QoL/HRQoL in this clinical population. Other factors influencing QoL/HRQoL include subjective characteristics, physical aspects, the cause and level of the amputation, relational aspects, social support, and the doctor-patient relationship. In addition, the patient's emotional-motivational status, depression and/or anxiety symptoms, and acceptance play a key role in the subsequent rehabilitation process. CONCLUSIONS In LLA patients, psychological adjustment is a complex and multifaceted process, and QoL/HRQoL may be influenced by various factors. Shedding light on these issues may provide useful suggestions for promoting clinical and rehabilitative interventions that may be tailored and effective in this clinical population.
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Affiliation(s)
- Laura Calabrese
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, 27040 Montescano, Italy
| | - Marina Maffoni
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, 27040 Montescano, Italy
| | - Valeria Torlaschi
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, 27040 Montescano, Italy
| | - Antonia Pierobon
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, 27040 Montescano, Italy
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Granata N, Torlaschi V, Zanatta F, Giardini A, Maestri R, Pavesi C, Sommaruga M, Gazzi L, Bertolotti G, Sarzi Braga S, Monelli M, Zanelli E, Pierobon A. Positive affect as a predictor of non-pharmacological adherence in older Chronic Heart Failure (CHF) patients undergoing cardiac rehabilitation. PSYCHOL HEALTH MED 2023; 28:606-620. [PMID: 35603663 DOI: 10.1080/13548506.2022.2077394] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In Chronic Heart Failure (CHF) patients, psychological and cognitive variables and their association with treatment adherence have been extensively reported in the literature, but few are the investigations in older people. The present study aimed to evaluate the psychological, cognitive, and adherence to treatment profile of older (>65 years) CHF patients, the interrelation between these variables, and identify possible independent predictors of self-reported treatment adherence. CHF inpatients undergoing cardiac rehabilitation were assessed for: anxiety, depression, cognitive impairment, positive and negative affect, and self-reported adherence (adherence antecedents, pharmacological adherence, and non-pharmacological adherence). 100 CHF inpatients (mean age: 74.9 ± 7.1 years) were recruited. 16% of patients showed anxiety and 24.5% depressive symptoms; 4% presented cognitive decline. Cognitive functioning negatively correlated to depression, anxiety, and negative affect (p < 0.01). The adherence antecedents (disease acceptance, adaptation, knowledge, and socio-familiar support) negatively correlated to anxiety (p < 0.05), depression (p < 0.001), and negative affect (p < 0.05), while they positively correlated to positive affect (p < 0.01). Pharmacological adherence negatively correlated to anxiety and negative affect (p < 0.05). Conversely, non-pharmacological adherence and positive affect positively correlated (p < 0.05). Furthermore, depression and anxiety negatively predicted adherence antecedents (β = -0.162, p = 0.037) and pharmacological adherence (β = -0.171, p = 0.036), respectively. Finally, positive affect was found as an independent predictor of non-pharmacological adherence (β = 0.133, p = 0.004). In cardiac rehabilitation, a specific psychological assessment focused on anxiety, depression, and affect can provide useful information to manage CHF older patients' care related to treatment adherence. In particular, positive affect should be targeted in future interventions to foster patients' non-pharmacological adherence.
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Affiliation(s)
- Nicolò Granata
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Montescano, Pavia, Italy
| | - Valeria Torlaschi
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Montescano, Pavia, Italy
| | - Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
| | - Anna Giardini
- Information Technology Department, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Roberto Maestri
- Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Montescano, Pavia, Italy
| | - Claudia Pavesi
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Montescano, Pavia, Italy
| | - Marinella Sommaruga
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Camaldoli, Milano, Italy
| | - Lidia Gazzi
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto di Lumezzane, Brescia, Italy
| | - Giorgio Bertolotti
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto di Tradate, Varese, Italy
| | - Simona Sarzi Braga
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCSS, Istituto di Tradate, Varese, Italy
| | - Mauro Monelli
- Subacute Care, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Camaldoli, Milano, Italy
| | - Emanuela Zanelli
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCSS, Istituto di Lumezzane, Brescia, Italy
| | - Antonia Pierobon
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Montescano, Pavia, Italy
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Zanatta F, Farhane-Medina NZ, Adorni R, Steca P, Giardini A, D'Addario M, Pierobon A. Combining robot-assisted therapy with virtual reality or using it alone? A systematic review on health-related quality of life in neurological patients. Health Qual Life Outcomes 2023; 21:18. [PMID: 36810124 PMCID: PMC9942343 DOI: 10.1186/s12955-023-02097-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/07/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND In the field of neurorehabilitation, robot-assisted therapy (RAT) and virtual reality (VR) have so far shown promising evidence on multiple motor and functional outcomes. The related effectiveness on patients' health-related quality of life (HRQoL) has been investigated across neurological populations but still remains unclear. The present study aimed to systematically review the studies investigating the effects of RAT alone and with VR on HRQoL in patients with different neurological diseases. METHODS A systematic review of the studies evaluating the impact of RAT alone and combined with VR on HRQoL in patients affected by neurological diseases (i.e., stroke, multiple sclerosis, spinal cord injury, Parkinson's Disease) was conducted according to PRISMA guidelines. Electronic searches of PubMed, Web of Science, Cochrane Library, CINAHL, Embase, and PsychINFO (2000-2022) were performed. Risk of bias was evaluated through the National Institute of Health Quality Assessment Tool. Descriptive data regarding the study design, participants, intervention, rehabilitation outcomes, robotic device typology, HRQoL measures, non-motor factors concurrently investigated, and main results were extracted and meta-synthetized. RESULTS The searches identified 3025 studies, of which 70 met the inclusion criteria. An overall heterogeneous configuration was found regarding the study design adopted, intervention procedures and technological devices implemented, rehabilitation outcomes (i.e., related to both upper and lower limb impairment), HRQoL measures administered, and main evidence. Most of the studies reported significant effects of both RAT and RAT plus VR on patients HRQoL, whether they adopted generic or disease-specific HRQoL measures. Significant post-intervention within-group changes were mainly found across neurological populations, while fewer studies reported significant between-group comparisons, and then, mostly in patients with stroke. Longitudinal investigations were also observed (up to 36 months), but significant longitudinal effects were exclusively found in patients with stroke or multiple sclerosis. Finally, concurrent evaluations on non-motor outcomes beside HRQoL included cognitive (i.e., memory, attention, executive functions) and psychological (i.e., mood, satisfaction with the treatment, device usability, fear of falling, motivation, self-efficacy, coping, and well-being) variables. CONCLUSIONS Despite the heterogeneity observed among the studies included, promising evidence was found on the effectiveness of RAT and RAT plus VR on HRQoL. However, further targeted short- and long-term investigations, are strongly recommended for specific HRQoL subcomponents and neurological populations, through the adoption of defined intervention procedures and disease-specific assessment methodology.
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Affiliation(s)
- Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Naima Z Farhane-Medina
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
- Department of Psychology, University of Córdoba, Córdoba, Spain
| | - Roberta Adorni
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Anna Giardini
- Information Technology Department, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Marco D'Addario
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Antonia Pierobon
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy
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Zanatta F, Steca P, Fundarò C, Giardini A, Felicetti G, Panigazzi M, Arbasi G, Grilli C, D’Addario M, Pierobon A. Biopsychosocial effects and experience of use of robotic and virtual reality devices in neuromotor rehabilitation: A study protocol. PLoS One 2023; 18:e0282925. [PMID: 36897863 PMCID: PMC10004562 DOI: 10.1371/journal.pone.0282925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/18/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Robot-assisted therapy (RAT) and virtual reality (VR)-based neuromotor rehabilitation have shown promising evidence in terms of patient's neuromotor recovery, so far. However, still little is known on the perceived experience of use of robotic and VR devices and the related psychosocial impact. The present study outlines a study protocol aiming to investigate the biopsychosocial effects and the experience of use of robotic and non-immersive VR devices in patients undergoing neuromotor rehabilitation. METHODS Adopting a prospective, two-arm, non-randomized study design, patients with different neuromotor diseases (i.e., acquired brain injury, Parkinson's Disease, and total knee/hip arthroplasty) undergoing rehabilitation will be included. In a real-world clinical setting, short- (4 weeks) and long-term (6 months) changes in multiple patient's health domains will be investigated, including the functional status (i.e., motor functioning, ADLs, risk of falls), cognitive functioning (i.e., attention and executive functions), physical and mental health-related quality of life (HRQoL), and the psychological status (i.e., anxiety and depression, quality of life satisfaction). At post-intervention, the overall rehabilitation experience, the psychosocial impact of the robotic and VR devices will be assessed, and technology perceived usability and experience of use will be evaluated through a mixed-methods approach, including both patients' and physiotherapists' perspectives. Repeated measures within-between interaction effects will be estimated, and association analyses will be performed to explore the inter-relationships among the variables investigated. Data collection is currently ongoing. IMPLICATIONS The biopsychosocial framework adopted will contribute to expanding the perspective on patient's recovery within the technology-based rehabilitation field beyond motor improvement. Moreover, the investigation of devices experience of use and usability will provide further insight into technology deployment in neuromotor rehabilitation programs, thereby maximising therapy engagement and effectiveness. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT05399043.
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Affiliation(s)
- Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Cira Fundarò
- Istituti Clinici Scientifici Maugeri IRCCS, Neurophysiopathology Unit of Montescano Institute, Montescano, Italy
- * E-mail:
| | - Anna Giardini
- Istituti Clinici Scientifici Maugeri IRCCS, Information Technology Department of Pavia Institute, Pavia, Italy
| | - Guido Felicetti
- Istituti Clinici Scientifici Maugeri IRCCS, Neuromotor Rehabilitation Unit of Montescano Institute, Montescano, Italy
| | - Monica Panigazzi
- Istituti Clinici Scientifici Maugeri IRCCS, Occupational Physiatry and Ergonomics Unit of Montescano Institute, Montescano, Italy
| | - Giovanni Arbasi
- Istituti Clinici Scientifici Maugeri IRCCS, Neuromotor Rehabilitation Unit of Montescano Institute, Montescano, Italy
| | - Cesare Grilli
- Istituti Clinici Scientifici Maugeri IRCCS, Occupational Physiatry and Ergonomics Unit of Montescano Institute, Montescano, Italy
| | - Marco D’Addario
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Antonia Pierobon
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano, Italy
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7
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Vigorè M, Granata N, Callegari G, Vaninetti R, Conti S, Maestri R, Piaggi G, Cremonese G, Pierobon A. Frailty and rehabilitation outcome in older patients with cardiorespiratory disease: preliminary multidimensional data. Monaldi Arch Chest Dis 2022; 93. [PMID: 36458416 DOI: 10.4081/monaldi.2022.2447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022] Open
Abstract
Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are two clinical conditions often associated with cognitive dysfunctions, psychological distress, poor quality of life (QoL), and functional worsening. In addition, since patients suffering from these conditions are often older adults, frailty syndrome represents a further and important issue to be investigated. The present preliminary study aimed to perform a multidimensional assessment of CHF and/or COPD older patients (age ≥65) undergoing cardiac or pulmonary rehabilitation. The characteristics of the included patients (30 CHF and 30 COPD) resulted almost similar, except for the COPD patients' longer duration of illness and better performances in Addenbrooke's cognitive examination III subtests and short physical performance battery (SPPB). No significant differences were found in the frailty evaluation, but a consistent number of patients resulted to be frail (CHF=36.7% vs COPD=26.6%). After the rehabilitation program, a significant improvement was found in the whole sample concerning the executive functions (14.34±2.49 vs 15.62±2.22, p=0.001), quality of life (58.77±18.87 vs 65.82±18.45, p=0.003), depressive and anxious symptoms (6.27±4.21 vs 3.77±3.39, p=0.001 and 5.17±3.40 vs 3.38±3.21, p=0.001), frailty status [4.00 (3.00,5.00) vs 3.00 (3.00,5.00) p=0.035] and functional exercise abilities [SPPB, 7.40±3.10 vs 9.51±3.67, p=0.0002; timed up and go test, 14.62±4.90 vs 11.97±4.51, p<0.0001; 6-minute walking test, 353.85±127.62 vs 392.59±123.14, p=0.0002]. Preliminary results showed a substantial homogeneity of CHF and COPD older patients' cognitive, psychosocial, frailty, and functional characteristics. Nevertheless, the specific rehabilitation intervention appears promising in both clinical populations. This trial has been registered with the ClinicalTrials.gov, NCT05230927 registration number (clinicaltrials.gov/ct2/show/NCT05230927).
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Affiliation(s)
- Martina Vigorè
- Psychology Unit, ICS Maugeri IRCCS Institute of Montescano.
| | - Nicolo Granata
- Department of Cardiac Respiratory Rehabilitation, ICS Maugeri IRCCS Institute of Tradate (VA).
| | | | - Raffaella Vaninetti
- Department of Cardiac Respiratory Rehabilitation, ICS Maugeri IRCCS Institute of Tradate (VA).
| | - Simona Conti
- Department of Cardiac Respiratory Rehabilitation, ICS Maugeri IRCCS Institute of Tradate (VA).
| | - Roberto Maestri
- Department of Biomedical Engineering, ICS Maugeri IRCCS Institute of Montescano.
| | - Giancarlo Piaggi
- Pulmonary Rehabilitation, ICS Maugeri IRCCS Institute of Montescano.
| | - Gioele Cremonese
- Department of Cardiac Respiratory Rehabilitation, ICS Maugeri IRCCS Institute of Tradate (VA).
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8
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Maffoni M, Pierobon A, Fundarò C. MASCoD-Multidimensional Assessment of Subjective Cognitive Decline. Front Psychol 2022; 13:921062. [PMID: 36533024 PMCID: PMC9748696 DOI: 10.3389/fpsyg.2022.921062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/30/2022] [Indexed: 09/19/2023] Open
Abstract
Subjective cognitive decline (SCD) is a subclinical cognitive impairment that is complained by the individual without being objectively supported at clinical, diagnostic, and neuropsychological levels. It can negatively impact on patient's frailty and quality of life, as well as on the caregiver's burden. Moreover, it can be prodromal to Mild Cognitive Impairment or dementia. Although the clinical manifestations of SCD can differ along with several cognitive domains, to date there are only screening tools to investigate subjective memory complaints. Thus, the first aim of this paper is to propose a preliminary English and Italian version of a new screening tool called MASCoD (Multidimensional Assessment of Subjective Cognitive Decline); the second aim is to propose its preliminary adoption on a pilot sample. This schedule is a brief test derived from the review of the literature and the clinical experience provided by an experts panelist. From pilot tests, it seems promising as it can help the professional to make differential diagnosis and to predict the risk of developing severe cognitive impairment over time, developing a personalized care path. This screening tool is brief, easily embeddable in usual clinical assessment, and administrable by different professionals. Furthermore, following validation, it will allow to collect manifold cognitive manifestations of SCD, addressing the shortage of previous validated instruments globally assessing cognition affected by this condition.
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Affiliation(s)
- Marina Maffoni
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Montescano, Italy
| | - Antonia Pierobon
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Montescano, Italy
| | - Cira Fundarò
- Neurophysiopatology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Montescano, Italy
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9
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Gorini A, Giuliani M, Fiabane E, Bonomi A, Gabanelli P, Pierobon A, Moretta P, Pagliarulo G, Spaccavento S, Vaudo G, Pirro M, Mannarino MR, Milani L, Caruso MP, Baiardi P, Dalla Vecchia LA, La Rovere MT, Pistarini C, Baldassarre D. Prevalence of Psychopathological Symptoms and Their Determinants in Four Healthcare Workers' Categories during the Second Year of COVID-19 Pandemic. Int J Environ Res Public Health 2022; 19:13712. [PMID: 36294291 PMCID: PMC9602535 DOI: 10.3390/ijerph192013712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/03/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Highly stressful situations, such as the current COVID-19 pandemic, induce constant changes in the mental state of people who experience them. In the present study, we analyzed the prevalence of some psychological symptoms and their determinants in four different categories of healthcare workers during the second year of the pandemic. A total of 265 physicians, 176 nurses, 184 other healthcare professionals, and 48 administrative employees, working in different Italian healthcare contexts, answered a questionnaire including variables about their mental status and experience with the pandemic. The mean scores for anxiety and depressive symptoms measured more than one year after the onset of the pandemic did not reach the pathological threshold. In contrast, post-traumatic and burnout symptoms tended toward the critical threshold, especially in physicians. The main determinant of psychological distress was perceived stress, followed by job satisfaction, the impact of COVID-19 on daily work, and a lack of recreational activities. These results increase the knowledge of which determinants of mental distress would be important to act on when particularly stressful conditions exist in the workplace that persist over time. If well-implemented, specific interventions focused on these determinants could lead to an improvement in employee well-being and in the quality of care provided.
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Affiliation(s)
- Alessandra Gorini
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Milano-Camaldoli, 64, 20138 Milan, Italy
| | | | - Elena Fiabane
- Department of Physical and Rehabilitation Medicine, Istituti Clinici Scientifici Maugeri IRCCS, 16167 Genoa, Italy
| | - Alice Bonomi
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy
| | - Paola Gabanelli
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Pavia Institute, 27100 Pavia, Italy
| | - Antonia Pierobon
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, 27040 Montescano, Italy
| | - Pasquale Moretta
- Istituti Clinici Scientifici Maugeri IRCCS, Neurological Rehabilitation Unit of Teleselezioni Terme Institute, 82037 Telese Terme, Italy
| | - Giovanna Pagliarulo
- Istituti Clinici Scientifici Maugeri IRCCS, Neurological Rehabilitation Unit of Teleselezioni Terme Institute, 82037 Telese Terme, Italy
| | - Simona Spaccavento
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Bari Institute, 70124 Bari, Italy
| | - Gaetano Vaudo
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
- Unit of Internal Medicine, “Santa Maria” Terni University Hospital, 05100 Terni, Italy
| | - Matteo Pirro
- Unit of Internal Medicine, Department of Medicine, University of Perugia, 06132 Perugia, Italy
| | - Massimo R. Mannarino
- Unit of Internal Medicine, Department of Medicine, University of Perugia, 06132 Perugia, Italy
| | | | | | - Paola Baiardi
- Istituti Clinici Scientifici Maugeri IRCCS, Direzione Scientifica Centrale of Pavia Institute, 27100 Pavia, Italy
| | | | - Maria Teresa La Rovere
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Cardiology of Montescano Institute, 27040 Montescano, Italy
| | - Caterina Pistarini
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation of Pavia Institute, 27100 Pavia, Italy
| | - Damiano Baldassarre
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, 20122 Milan, Italy
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Raglio A, Maestri R, Robbi E, Pierobon A, La Rovere MT, Pinna GD. Effect of Algorithmic Music Listening on Cardiac Autonomic Nervous System Activity: An Exploratory, Randomized Crossover Study. J Clin Med 2022; 11:jcm11195738. [PMID: 36233606 PMCID: PMC9571939 DOI: 10.3390/jcm11195738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/21/2022] [Accepted: 09/25/2022] [Indexed: 11/16/2022] Open
Abstract
It is proven that music listening can have a therapeutic impact in many clinical fields. However, to assume a curative value, musical stimuli should have a therapeutic logic. This study aimed at assessing short-term effects of algorithmic music on cardiac autonomic nervous system activity. Twenty-two healthy subjects underwent a crossover study including random listening to relaxing and activating algorithmic music. Electrocardiogram (ECG) and non-invasive arterial blood pressure were continuously recorded and were later analyzed to measure Heart Rate (HR) mean, HR variability and baroreflex sensitivity (BRS). Statistical analysis was performed using a general linear model, testing for carryover, period and treatment effects. Relaxing tracks decreased HR and increased root mean square of successive squared differences of normal-to-normal (NN) intervals, proportion of interval differences of successive NN intervals greater than 50 ms, low-frequency (LF) and high-frequency (HF) power and BRS. Activating tracks caused almost no change or an opposite effect in the same variables. The difference between the effects of the two stimuli was statistically significant in all these variables. No difference was found in the standard deviation of normal-to-normal RR intervals, LFpower in normalized units and LFpower/HFpower variables. The study suggests that algorithmic relaxing music increases cardiac vagal modulation and tone. These results open interesting perspectives in various clinical areas.
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Affiliation(s)
- Alfredo Raglio
- Music Therapy Research Laboratory, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
- Correspondence: ; Tel.: +39-03825901
| | - Roberto Maestri
- Laboratory for the Study of Ventilatory Instability, Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Elena Robbi
- Laboratory for the Study of the Autonomic Nervous System and Cardiorespiratory Activity, Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Antonia Pierobon
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Maria Teresa La Rovere
- Laboratory for the Study of the Autonomic Nervous System and Cardiorespiratory Activity, Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Gian Domenico Pinna
- Laboratory for the Study of Ventilatory Instability, Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
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Perrone C, Fiabane E, Maffoni M, Pierobon A, Setti I, Sommovigo V, Gabanelli P. Vaccination hesitancy: To be vaccinated, or not to be vaccinated, that is the question in the era of COVID-19. Public Health Nurs 2022; 40:90-96. [PMID: 36168152 PMCID: PMC9538072 DOI: 10.1111/phn.13134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/22/2022] [Accepted: 09/01/2022] [Indexed: 01/14/2023]
Abstract
COVID-19 vaccine hesitancy poses serious challenges in achieving adequate vaccine coverage in the general population. While most studies on vaccine hesitance determinants during the COVID-19 pandemic were quantitative, qualitative research on the reasons for vaccine resistance is still lacking. To fill this gap, this study aims to qualitatively investigate cognitive and emotional factors associated with COVID-19 vaccine hesitancy. This qualitative pilot study was conducted between October and November 2021 in Italy. A total of 40 COVID-19 vaccine-hesitant ("hesitant not vaccinated" or "hesitant but vaccinated") individuals completed anonymous questionnaires with open-ended questions. Data were analysed using the Interpretive Description approach. The central theme that emerged about vaccine hesitancy was the lack of control. This construct included four different sub-categories: distrust of the government, infodemic, influence of family, and general anti-vaccine opinions. The results also showed that the most important emotional and cognitive factors associated with hesitancy were anger related to a perceived sense of oppression; emotional avoidance to minimize risk; anxiety related to potential vaccine side effects. Identifying and understanding factors influencing COVID-19 vaccination hesitancy is crucial to improving communication strategies that will ultimately result in increased confidence and vaccine acceptance.
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Affiliation(s)
- Cecilia Perrone
- Istituti Clinici Scientifici Maugeri IRCCSPsychology Unit of Pavia InstitutePaviaItaly
| | - Elena Fiabane
- Istituti Clinici Scientifici MaugeriDepartment of Physical and Rehabilitation Medicine of Nervi InstituteGenovaItaly
| | - Marina Maffoni
- Istituti Clinici Scientifici Maugeri IRCCSPsychology Unit of MontescanoMontescanoItaly
| | - Antonia Pierobon
- Istituti Clinici Scientifici Maugeri IRCCSPsychology Unit of MontescanoMontescanoItaly
| | - Ilaria Setti
- Department of Brain and Behavioural SciencesUnit of Applied PsychologyUniversity of PaviaPaviaItaly
| | - Valentina Sommovigo
- Department of PsychologyFaculty of Medicine and PsychologySapienza University of RomeRomaItaly
| | - Paola Gabanelli
- Istituti Clinici Scientifici Maugeri IRCCSPsychology Unit of Pavia InstitutePaviaItaly
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12
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Granata N, Vigoré M, Steccanella A, Ranucci L, Sarzi Braga S, Baiardi P, Pierobon A. The Clinical Frailty Scale (CFS) employment in the frailty assessment of patients suffering from Non-Communicable Diseases (NCDs): A systematic review. Front Med (Lausanne) 2022; 9:967952. [PMID: 36052327 PMCID: PMC9425100 DOI: 10.3389/fmed.2022.967952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background The Clinical Frailty Scale (CFS) is a well-established tool that has been widely employed to assess patients' frailty status and to predict clinical outcomes in the acute phase of a disease, but more information is needed to define the implications that this tool have when dealing with Non-Communicable Diseases (NCDs). Methods An electronic literature search was performed on PubMed, Scopus, EMBASE, Web of Science, and EBSCO databases to identify studies employing the CFS to assess frailty in patients with NCDs. Findings After database searching, article suitability evaluation, and studies' quality assessment, 43 studies were included in the systematic review. Researches were conducted mostly in Japan (37.5%), and half of the studies were focused on cardiovascular diseases (46.42%), followed by cancer (25.00%), and diabetes (10.71%). Simplicity (39.29%), efficacy (37.5%), and rapidity (16.07%) were the CFS characteristics mostly appreciated by the authors of the studies. The CFS-related results indicated that its scores were associated with patients' clinical outcomes (33.92%), with the presence of the disease (12.5%) and, with clinical decision making (10.71%). Furthermore, CFS resulted as a predictor of life expectancy in 23 studies (41.07%), clinical outcomes in 12 studies (21.43%), and hospital admissions/readmissions in 6 studies (10.71%). Discussion CFS was found to be a well-established and useful tool to assess frailty in NCDs, too. It resulted to be related to the most important disease-related clinical characteristics and, thus, it should be always considered as an important step in the multidisciplinary evaluation of frail and chronic patients. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.asp? PROSPERO 2021, ID: CRD42021224214.
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Affiliation(s)
- Nicolò Granata
- Department of Cardiac Respiratory Rehabilitation of Tradate Institute, Istituti Clinici Scientifici Maugeri IRCCS, Varese, Italy
| | - Martina Vigoré
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano, Italy
- *Correspondence: Martina Vigoré
| | - Andrea Steccanella
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano, Italy
| | - Luca Ranucci
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano, Italy
| | - Simona Sarzi Braga
- Cardio-vascular Department, MultiMedica IRCCS, Sesto San Giovanni, Italy
| | - Paola Baiardi
- Central Scientific Direction, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Antonia Pierobon
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano, Italy
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13
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Vigorè M, Granata N, Braga SS, Piaggi G, Audifreddi S, Ferrari M, La Rovere MT, Pierobon A. Cognitive impairment, frailty and rehabilitation outcome in older cardiorespiratory patients. DEC_FRAinRIAB: Study protocol. PLoS One 2022; 17:e0272132. [PMID: 35925981 PMCID: PMC9351997 DOI: 10.1371/journal.pone.0272132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/08/2022] [Indexed: 11/19/2022] Open
Abstract
Background Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are two clinical conditions often associated with functional worsening, cognitive dysfunctions, treatment non-adherence, psychological distress and poor quality of life (QoL). In addition, since patients suffering from these conditions are often older adults, the presence of frailty syndrome could worsen the clinical situation. Methods and design This study protocol of a prospective multi-center clinical trial, will be conducted at two hospitals of the Istituti Clinici Scientifici Maugeri IRCCS group, from July 2020 until December 2022. CHF and COPD older patients (age ≥65) will undergo a multidisciplinary assessment at admission, discharge and at 6 months follow-up, from an inpatient rehabilitation program: disease-related clinical characteristics, functional variables, cognitive screening, treatment adherence, anxiety, depression, QoL and frailty. The estimated sample size will consist of 300 patients Discussion The expected results are related to the possibility of an improvement in the areas of intervention after the rehabilitative program and the maintenance of these improvements over time. The assessment of clinical and functional status, cognitive impairment, treatment adherence, psychosocial characteristics, and frailty could provide more specific and useful information about the main features to be considered in the evaluation and treatment of older patients suffering from CHF and COPD undergoing a rehabilitative pathway. Trial registration The study has been registered on January 28, 2022 with the ClinicalTrials.gov NCT05230927 registration number (clinicaltrials.gov/ct2/show/NCT05230927).
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Affiliation(s)
- Martina Vigorè
- Istituti Clinici Scientifici Maugeri, IRCCS, Psychology Unit of Montescano Institute, Pavia, Italy
| | - Nicolò Granata
- Istituti Clinici Scientifici Maugeri, IRCCS, Cardiac Rehabilitation Division of Tradate Institute, Varese, Italy
- * E-mail:
| | - Simona Sarzi Braga
- Istituti Clinici Scientifici Maugeri, IRCCS, Cardiac Rehabilitation Division of Tradate Institute, Varese, Italy
| | - Giancarlo Piaggi
- Istituti Clinici Scientifici Maugeri, IRCCS, Respiratory Rehabilitation Division of Montescano Institute, Pavia, Italy
| | - Silvia Audifreddi
- Istituti Clinici Scientifici Maugeri, IRCCS, Health Direction of Tradate Institute, Varese, Italy
| | - Marina Ferrari
- Istituti Clinici Scientifici Maugeri, IRCCS, Cardiac Rehabilitation Division of Montescano Institute, Pavia, Italy
| | - Maria Teresa La Rovere
- Istituti Clinici Scientifici Maugeri, IRCCS, Cardiac Rehabilitation Division of Montescano Institute, Pavia, Italy
| | - Antonia Pierobon
- Istituti Clinici Scientifici Maugeri, IRCCS, Psychology Unit of Montescano Institute, Pavia, Italy
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14
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Zanatta F, Giardini A, Pierobon A, D'Addario M, Steca P. A systematic review on the usability of robotic and virtual reality devices in neuromotor rehabilitation: patients' and healthcare professionals' perspective. BMC Health Serv Res 2022; 22:523. [PMID: 35443710 PMCID: PMC9020115 DOI: 10.1186/s12913-022-07821-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 03/14/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The application of virtual reality (VR) and robotic devices in neuromotor rehabilitation has provided promising evidence in terms of efficacy, so far. Usability evaluations of these technologies have been conducted extensively, but no overviews on this topic have been reported yet. METHODS A systematic review of the studies on patients' and healthcare professionals' perspective through searching of PubMed, Medline, Scopus, Web of Science, CINAHL, and PsychINFO (2000 to 2021) was conducted. Descriptive data regarding the study design, participants, technological devices, interventions, and quantitative and qualitative usability evaluations were extracted and meta-synthetized. RESULTS Sixty-eight studies were included. VR devices were perceived as having good usability and as a tool promoting patients' engagement and motivation during the treatment, as well as providing strong potential for customized rehabilitation sessions. By contrast, they suffered from the effect of learnability and were judged as potentially requiring more mental effort. Robotics implementation received positive feedback along with high satisfaction and perceived safety throughout the treatment. Robot-assisted rehabilitation was considered useful as it supported increased treatment intensity and contributed to improved patients' physical independence and psychosocial well-being. Technical and design-related issues may limit the applicability making the treatment difficult and physically straining. Moreover, cognitive and communication deficits were remarked as potential barriers. CONCLUSIONS Overall, VR and robotic devices have been perceived usable so far, reflecting good acceptance in neuromotor rehabilitation programs. The limitations raised by the participants should be considered to further improve devices applicability and maximise technological rehabilitation effectiveness. TRIAL REGISTRATION PROSPERO registration ref. CRD42021224141 .
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Affiliation(s)
- Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Anna Giardini
- Information Technology Department, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Antonia Pierobon
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy.
| | - Marco D'Addario
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
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Ferraris M, Maffoni M, DE Marzo V, Pierobon A, Sommaruga M, Barbara C, Porcile A, Russo C, Ghio L, Clavario P, Porto I. Post-traumatic stress disorder, depression and anxiety symptoms in COVID-19 outpatients with different levels of respiratory and ventilatory support in the acute phase undergoing three months follow up. Minerva Med 2022; 114:169-177. [PMID: 35266658 DOI: 10.23736/s0026-4806.22.07847-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The well-known COVID-19 pandemic totally transformed people's lives, paving the way to various psychopathological symptoms. In particular, patients may experience a short- and long-term decreasing in their wellbeing. In this vein, the aim of this paper is to assess the COVID-19 patients' psychopathological profile (Post Traumatic Stress Disorder, distress, anxiety and depression symptoms), detecting possible differences linked to the ventilatory treatments. METHODS Outpatients who recovered from COVID-19 were asked to provide socio-demographic and clinical information, and to complete a brief psychological screening evaluation (Impact of Event Scale-Revised - IES-R, Depression Anxiety Stress Scale - DASS-21). RESULTS Overall, after informed consent, 163 Italian patients took part in this research. Of them, 31,9% did not undergo any ventilatory therapy, 27,6% undertook oxygen therapy; 28,2% underwent noninvasive mechanical ventilation and 12.3% received invasive mechanical ventilation. Although no statistically significant differences were revealed among patients stratified by spontaneous breathing or ventilatory therapies, they reported statistically significant more depression (4.5+5.2 vs 3.5+3.2; p=.017) and anxiety (4.3+4.5 vs 2.4+2.6; p<.00001) symptoms than normative groups. Moreover, patients experiencing COVID-19 disease as a trauma, complained statistically significant higher levels of depression, anxiety and stress symptoms than who did not describe a clinically relevant traumatic experience (p<0.001). CONCLUSIONS Thus, this study suggests to healthcare professionals to consider COVID-19 experience as a potential real trauma for patients and underlines the necessity to define patients' psychopathological profile in order to propose tailored and effective preventive and supportive psychological interventions.
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Affiliation(s)
- Marta Ferraris
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Marina Maffoni
- Istituti Clinici Scientifici Maugeri, IRCCS, Psychology Unit of Montescano Institute, Pavia, Italy -
| | - Vincenzo DE Marzo
- Cardiology Unit, DICATOV - Cardiothoracic and Vascular Department, IRCCS San Martino Hospital, Genoa, Italy
| | - Antonia Pierobon
- Istituti Clinici Scientifici Maugeri, IRCCS, Psychology Unit of Montescano Institute, Pavia, Italy
| | - Marinella Sommaruga
- Istituti Clinici Scientifici Maugeri IRCSS, Psychology Unit of Camaldoli Institute, Milano, Italy
| | - Cristina Barbara
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Annalisa Porcile
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Carmelo Russo
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Lucio Ghio
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Piero Clavario
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Italo Porto
- Cardiology Unit, DICATOV - Cardiothoracic and Vascular Department, IRCCS San Martino Hospital, Genoa, Italy
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Maffoni M, Abelli P, Laganga Senzio G, Pierobon A. The Montescano effect: Being resilient through challenges and changes. Eur J Psychol 2022; 18:1-5. [PMID: 35330851 PMCID: PMC8895700 DOI: 10.5964/ejop.8119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/11/2022] [Indexed: 11/28/2022]
Abstract
Hospitals are places where you live a piece of your life, no matter you are healthcare professional, patient or caregiver. This editorial describes the humanistic approach to medicine adopted by the Montescano Institute, an Italian research and clinical hospital dedicated to the rehabilitation of neurological and cardiopulmonary diseases according to updated international guidelines. The aim of these “notes from the field” is to provide a sound example of humanistic clinical practice before, during and after the challenges posed by the COVID-19 pandemic. In this environmental each individual is indeed engaged in relationships, which trigger mutual empowerment and growth.
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Affiliation(s)
- Marina Maffoni
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri, IRCCS, Montescano (PV), Italy
- Istituti Clinici Scientifici Maugeri, IRCCS, Via S. Maugeri, 4 27100 Pavia, Italy. +39 385 247212.
| | - Paola Abelli
- Health Management of Montescano Institute, Istituti Clinici Scientifici Maugeri, IRCCS, Montescano (PV), Italy
| | - Giuseppe Laganga Senzio
- Hospital Management of Pavia and Montescano Institutes, Istituti Clinici Scientifici Maugeri, IRCCS, Montescano (PV), Italy
| | - Antonia Pierobon
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri, IRCCS, Montescano (PV), Italy
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17
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Maffoni M, Torlaschi V, Pierobon A, Zanatta F, Grasso R, Bagliani S, Govoni L, Biglieri M, Cerri L, Geraci L, Salvaneschi G, Piaggi G. Video calls during the COVID-19 pandemic: A bridge for patients, families, and respiratory therapists. Fam Syst Health 2021; 39:650-658. [PMID: 34723568 DOI: 10.1037/fsh0000661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND In response to COVID-19 pandemic outbreak, healthcare procedures and modalities have changed considerably. Video calls may supply valid support for health care professionals, contributing to maintaining the communication between hospitalized patients and their families. The present study aimed to observe the experience of a group of respiratory therapists who conducted video calls between patients and their families in a COVID-19 unit. METHOD Semistructured interviews (20-30 minutes duration) with the respiratory therapists who conducted the video calls in a COVID-19 unit in the North of Italy were performed. Participants joined the study voluntarily and, after receiving the informed consent, the interviews were audio-recorded. To better understand healthcare professionals' experience, the Interpretive Description methodology was adopted. RESULTS Seven respiratory therapists (three males, four females; mean age 45.1 ± 14.4) were recruited. Sixteen codes emerged from the analysis, constituting five primary themes: Contact, Impact, Challenges, Centering, and Future. CONCLUSIONS The findings shed light on the usability of video calls during this emergency period and their potential for future implementation. Specifically, this type of call may bridge the distances in such periods of care and help professionals to emotionally support patients and caregivers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Marina Maffoni
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri, IRCCS
| | - Valeria Torlaschi
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri, IRCCS
| | - Antonia Pierobon
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri, IRCCS
| | | | - Roberta Grasso
- Respiratory Rehabilitation Division of Montescano Institute, Istituti Clinici Scientifici Maugeri, IRCCS
| | - Stefania Bagliani
- Respiratory Rehabilitation Division of Montescano Institute, Istituti Clinici Scientifici Maugeri, IRCCS
| | - Luca Govoni
- Respiratory Rehabilitation Division of Montescano Institute, Istituti Clinici Scientifici Maugeri, IRCCS
| | - Milena Biglieri
- Respiratory Rehabilitation Division of Montescano Institute, Istituti Clinici Scientifici Maugeri, IRCCS
| | - Luca Cerri
- Respiratory Rehabilitation Division of Montescano Institute, Istituti Clinici Scientifici Maugeri, IRCCS
| | - Luca Geraci
- Respiratory Rehabilitation Division of Montescano Institute, Istituti Clinici Scientifici Maugeri, IRCCS
| | - Giulia Salvaneschi
- Department of Cardiac Rehabilitation of Montescano Institute, Istituti Clinici Scientifici Maugeri
| | - Giancarlo Piaggi
- Respiratory Rehabilitation Division of Montescano Institute, Istituti Clinici Scientifici Maugeri, IRCCS
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18
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Maffoni M, Torlaschi V, Gabanelli P, Abelli P, Pierobon A. The CO-MAsk Approach: Tips for Fostering Mask Use Among Older Adults During the COVID-19 Pandemic. Eur J Psychol 2021; 17:257-263. [PMID: 35136445 PMCID: PMC8768468 DOI: 10.5964/ejop.6815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Face masks are effective at limiting contagion of the coronavirus. However, adherence to face mask use among the older adult population is often unsatisfactory due to cognitive impairment, misconceptions, and difficulty in retrieving face masks. This brief note provides healthcare professionals with simple suggestions about how to improve face mask adoption in the older adults, in particular if they suffer from mild cognitive impairment. Thus, clinical reflections and psychoeducational suggestions are summarized into a simple mental roadmap. Specifically, the CO-MAsk approach underlines the necessity to consider the following factors: Cognition (possible cognitive impairment), Occasions (real chances to access correct information and proper protection equipment), Motivation (individual motivation towards sanitary prescriptions) and Assumptions (personal beliefs and understandings). Possible obstacles and practical suggestions for are also discussed. It is of paramount importance that healthcare professionals pay attention to emotional, cognitive and psychological aspects to effectively improve the face masks adherence among older adults, specifically when cognitive decline is present.
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Affiliation(s)
- Marina Maffoni
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano (PV), Italy
| | - Valeria Torlaschi
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano (PV), Italy
| | - Paola Gabanelli
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Pavia Institute, Pavia (PV), Italy
| | - Paola Abelli
- Istituti Clinici Scientifici Maugeri, Health Administration of Montescano Institute, Montescano (PV), Italy
| | - Antonia Pierobon
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano (PV), Italy
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Vigorè M, Granata N, Ranzini L, Mussino R, Guccione A, Scola I, Poggi P, Armenio S, Contardi A, Gabetta M, Pierobon A. ICF model implementation in an interdisciplinary intervention for intraparenchymal hemorrhage (IPH) with focus on neuropsychological functioning: a case report. G Ital Med Lav Ergon 2021; 43:150-155. [PMID: 34370926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 06/13/2023]
Abstract
Spontaneous intraparenchymal hemorrhage (IPH) is relatively common and has a very important impact on clinical outcomes, motor and functional abilities and it may affect different cognitive domains. A 60-year-old male was admitted in post-acute phase, at Istituti Clinici Scientifici Maugeri IRCCS, to undertake neuro-motor treatment for a period of 4 months. The patient was affected by IPH. The clinical presentation revealed left hemiparesis, mild dysphagia, cognitive deficits (attention, visuospatial abilities and executive functions), psychiatric symptoms, emotional dysregulation and previous difficulties in medication management. The patient received an intensive cognitive, motor, speech and occupational rehabilitative intervention. Neuropsychological, motor, speech and occupational assessment and computerized tomography were performed before and after rehabilitative training to evaluate changes after the interdisciplinary intervention. The patient showed an improvement in cognitive, motor, speech and functional performances as well as in emotional aspects. After 1 year at home, the patient performed an outpatient visit that shown the substantial maintenance of the performances reached after the rehabilitative intervention. Rehabilitative interventions after IPH should always be provided by interdisciplinary teams in order to reach the best possible clinical outcomes and to maintain them over time.
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Affiliation(s)
- Martina Vigorè
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Pavia, Italy
| | - Nicolò Granata
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Pavia, Italy
| | - Laura Ranzini
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Pavia, Italy
| | - Riccardo Mussino
- Neuromotor Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Pavia, Italy
| | - Alessandro Guccione
- Occupational Physiatry and Ergonomics Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Pavia, Italy
| | - Ilaria Scola
- Neuromotor Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Pavia, Italy
| | - Paolo Poggi
- Diagnostic Imaging Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Pavia, Italy
| | - Simona Armenio
- Department of Public health and Infectious diseases, Sapienza University of Rome, Italy
| | - Antonella Contardi
- Neuromotor Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Pavia, Italy
| | - Monica Gabetta
- Neuromotor Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Pavia, Italy
| | - Antonia Pierobon
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Pavia, Italy
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20
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Vigorè M, Taurino E, Maestroni R, Torlaschi V, Maffoni M, Maestri R, Pierobon A, Fanfulla F. Neuropsychological and executive screening in obstructive sleep apnea: early effect of ventilatory therapy. Minerva Med 2021; 112:346-353. [PMID: 34015910 DOI: 10.23736/s0026-4806.20.07254-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is often associated with clinical, psychological and neuropsychological comorbidities such as Mild Cognitive Impairment (MCI). This study evaluated changes in clinical, psychosocial, Health Related Quality of Life (HRQoL) and neuropsychological profile in OSA subjects after ventilatory therapy, making comparison with normative data. The aim of the study was to verify the suitability of the HRQoL and neuropsychological screening tests in detecting variations in OSA subjects. METHODS At baseline, 32 OSA subjects underwent the following assessment: EuroQol (EQ-5D-3L) and EQ VAS, Hospital Anxiety and Depression Scale (HADS), Montreal Cognitive Assessment (MoCA) and Frontal Assessment Battery (FAB). After the ventilatory titration, 31 OSA subjects repeated the EQ VAS, MoCA and FAB assessment. RESULTS The analyzed subjects (77% male, 58.97±10.06 years old and 47.34±26.67 AHI [ev*hr-1]) showed low emotive distress, a lower perception of HRQoL than normative data and 35.48% of them exhibited executive deficits, too. MCI was detected in 3.2% and 48.4% of subjects after normative Italian and international correction, respectively. Subsequently the ventilatory therapy and the rehabilitative interdisciplinary treatment, subjects improved in EQ VAS (68.23±18.73 vs. 87.13±10.80, P=0.0001), FAB scores (15,30±2.03 vs. 16,65±1,40, P=0.007) and MoCA memory subtest scores (2.16±1.34 vs. 3.06±1.63, P=0.008). CONCLUSIONS Ventilatory therapy provided during a rehabilitative and interdisciplinary program increased subjects' HRQoL, executive functions and verbal memory.
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Affiliation(s)
- Martina Vigorè
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Montescano, Montescano, Pavia, Italy
| | - Eugenia Taurino
- Unit of Respiratory Function and Sleep Medicine, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Montescano, Pavia, Italy
| | - Rita Maestroni
- Unit of Respiratory Function and Sleep Medicine, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Montescano, Pavia, Italy
| | - Valeria Torlaschi
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Montescano, Montescano, Pavia, Italy
| | - Marina Maffoni
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Montescano, Montescano, Pavia, Italy
| | - Roberto Maestri
- Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Montescano, Pavia, Italy
| | - Antonia Pierobon
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Montescano, Montescano, Pavia, Italy -
| | - Francesco Fanfulla
- Unit of Respiratory Function and Sleep Medicine, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Montescano, Pavia, Italy
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21
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Moretta P, Lanzillo A, Lo Sapio MD, Spaccavento S, Cellamare F, Nisoli F, Ianni A, Pain D, Feroldi S, Forlani CA, Boccola S, Madonia F, Volanti P, Pierobon A, Scola I, Manera M, Bertolotti G, Trojano L. Correction to: The Italian validation of the communicative effectiveness index questionnaire: a multicentric study. Neurol Sci 2021; 42:2601. [PMID: 33856583 DOI: 10.1007/s10072-021-05256-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Pasquale Moretta
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Telese Terme, Benevento, Italy.
| | - Anna Lanzillo
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Telese Terme, Benevento, Italy
| | - Maria Daniela Lo Sapio
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Telese Terme, Benevento, Italy
| | - Simona Spaccavento
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Bari, Bari, Italy
| | - Fara Cellamare
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Bari, Bari, Italy
| | - Francesca Nisoli
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Tradate, Milan, Italy
| | - Alessandra Ianni
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Tradate, Milan, Italy
| | - Debora Pain
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Milano, Milan, Italy
| | - Sarah Feroldi
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Milano, Milan, Italy
| | - Chiara Angela Forlani
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Castel Goffredo, Mantova, Italy
| | - Sara Boccola
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Castel Goffredo, Mantova, Italy
| | - Francesca Madonia
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Mistretta, Messina, Italy
| | - Paolo Volanti
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Mistretta, Messina, Italy
| | - Antonia Pierobon
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Montescano, Pavia, Italy
| | - Ilaria Scola
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Montescano, Pavia, Italy
| | - Marina Manera
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Pavia, Pavia, Italy
| | - Giorgio Bertolotti
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Tradate, Milan, Italy
| | - Luigi Trojano
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
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22
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Abstract
One of the most precious values of the modern age is time. Despite the increasing life expectancy achieved
by medicine and by the time-saving automation technologies, for most of us, time is never enough.
Beside manifold upheavals and psychological consequences (1), the COVID-19 pandemic and the consequent
quarantine have impacted on our subjective perception of “time”, opening a frightening Pandora’s
box. The healthcare emergency has thrown the population into a surreal novel where the time perception
may be shrunk and, simultaneously, expanded or suddenly frozen without control and full awareness.
Individuals are waved by events like leaves lashed out by an unexpected wind which brings unpredictable
changes. Thus, our existence is no more like before: the rhythm of our days has changed, and nothing could
be the same in our next future as the pandemic has left indelible marks in habits and perspectives.
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Affiliation(s)
- M Maffoni
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano (PV), Italy
| | - V Torlaschi
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano (PV), Italy
| | - A Pierobon
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano (PV), Italy
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23
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Stefanati A, Pierobon A, Baccello V, DeStefani E, Gamberoni D, Furlan P, Sandri F, Stano A, Coin P, Baldo V, Gabutti G. Travellers' risk behaviors and health problems: Post-travel follow up in two travel medicine centers in Italy. Infect Dis Now 2020; 51:279-284. [PMID: 33069841 DOI: 10.1016/j.medmal.2020.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/15/2020] [Accepted: 10/08/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES We examined the association between travellers' characteristics, compliance with pre-travel recommendations and health problems. METHODS Volunteer travellers were enrolled and data collected using a questionnaire between 30-60 days after returning home. We analyzed the associations through bivariate and multivariate models. RESULTS Of the 468 enrolled travelers, 68% consumed raw food and 81% food containing milk and/or eggs. 32% consumed street vendor food and 30% drinks containing ice. 24% used the recommended mechanical prophylaxis measures. 46% got sick during and/or after travel (gastrointestinal symptoms most frequently). Factors predisposing to health problems were female gender, youth/middle age, intermediate travel duration and profession. The American continent and staying in hostels and tents were significantly associated with febrile illness. Street vendor food was significantly associated with skin reactions. CONCLUSIONS Adherence to behavioral recommendations remains low. Travellers must be informed of health risks during and after travel.
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Affiliation(s)
- A Stefanati
- University of Ferrara, Department of Medical Sciences, Ferrara, Italy.
| | - A Pierobon
- Local Health Unit 7 Pedemontana, Veneto Regione, Departiment of Prevention, Bassano del Grappa, Italy
| | - V Baccello
- University of Ferrara, Department of Medical Sciences, Ferrara, Italy
| | - E DeStefani
- Local Health Unit 7 Pedemontana, Veneto Regione, Departiment of Prevention, Bassano del Grappa, Italy
| | - D Gamberoni
- University of Ferrara, Department of Medical Sciences, Ferrara, Italy
| | - P Furlan
- University of Padua, Department of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - F Sandri
- University of Ferrara, Department of Medical Sciences, Ferrara, Italy
| | - A Stano
- Local Health Unit 7 Pedemontana, Veneto Regione, Departiment of Prevention, Bassano del Grappa, Italy
| | - P Coin
- Local Health Unit 7 Pedemontana, Veneto Regione, Departiment of Prevention, Bassano del Grappa, Italy
| | - V Baldo
- University of Padua, Department of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - G Gabutti
- University of Ferrara, Department of Medical Sciences, Ferrara, Italy
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24
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Moretta P, Lanzillo A, Sapio MDL, Spaccavento S, Cellamare F, Nisoli F, Ianni A, Pain D, Feroldi S, Forlani CA, Boccola S, Madonia F, Volanti P, Pierobon A, Scola I, Manera M, Bertolotti G, Trojano L. The Italian validation of the Communicative Effectiveness Index Questionnaire: a multicentric study. Neurol Sci 2020; 42:2283-2290. [PMID: 33006055 DOI: 10.1007/s10072-020-04781-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 09/26/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Common assessment tools for aphasia evaluate single language impairments but not their functional impact on patient's communication skills in daily life. The lack of tools focused on ecological aspects might affect the choice of rehabilitative trainings. The Communicative Effectiveness Index (CETI) represents an attempt to assess the communicative abilities in "ecologic" context. This study aimed to explore psychometrics properties of the Italian translation and adaptation of CETI (I-CETI). METHODS Sixty-eight patients with aphasia due to left hemispheric stroke admitted to post-acute rehabilitation units and their relatives were included in the study. Data were collected in three different sessions. At study entry, patients were assessed for language, depression, and functional abilities, while their caregivers and speech therapists independently completed the I-CETI to assess inter-rater agreement (baseline). One week later, caregivers and speech therapists completed again I-CETI, to assess test-retest reliability (T1). Last, at discharge, patients completed again the evaluation protocol, and caregivers and speech therapists completed I-CETI (T2). RESULTS I-CETI showed high internal validity, excellent reliability, and good correlation between scores obtained by speech therapists and caregivers. Moreover, scores of I-CETI had quite good correlations with a traditional tool to assess language, and with measures of functional independence both at study entry and at discharge. DISCUSSION I-CETI showed good psychometric proprieties. These results allowed considering I-CETI as a reliable tool to assess effects of speech treatments on the communicative abilities in patients with aphasia. Furthermore, I-CETI might help clinicians to develop treatments more tailored on the "ecologic" difficulties of patients.
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Affiliation(s)
- Pasquale Moretta
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Telese Terme, Benevento, Italy.
| | - Anna Lanzillo
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Telese Terme, Benevento, Italy
| | - Maria Daniela Lo Sapio
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Telese Terme, Benevento, Italy
| | - Simona Spaccavento
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Bari, Bari, Italy
| | - Fara Cellamare
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Bari, Bari, Italy
| | - Francesca Nisoli
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Tradate, Milan, Italy
| | - Alessandra Ianni
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Tradate, Milan, Italy
| | - Debora Pain
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Milano, Milan, Italy
| | - Sarah Feroldi
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Milano, Milan, Italy
| | - Chiara Angela Forlani
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Castel Goffredo, Mantova, Italy
| | - Sara Boccola
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Castel Goffredo, Mantova, Italy
| | - Francesca Madonia
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Mistretta, Messina, Italy
| | - Paolo Volanti
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Mistretta, Messina, Italy
| | - Antonia Pierobon
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Montescano, Pavia, Italy
| | - Ilaria Scola
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Montescano, Pavia, Italy
| | - Marina Manera
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Pavia, Pavia, Italy
| | - Giorgio Bertolotti
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation, Institute of Tradate, Milan, Italy
| | - Luigi Trojano
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
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25
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Granata N, Nissanova E, Torlaschi V, Ferrari M, Vigorè M, Sommaruga M, Angelino E, Rizza C, Caprino A, Pierobon A. Psychosocial Cardiological Schedule-Revised (PCS-R) in a Cardiac Rehabilitation Unit: Reflections Upon Data Collection (2010-2017) and New Challenges. Front Psychol 2020; 11:1720. [PMID: 32765382 PMCID: PMC7381208 DOI: 10.3389/fpsyg.2020.01720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 06/23/2020] [Indexed: 01/04/2023] Open
Abstract
Introduction The Psychosocial Cardiological Schedule (PCS) was developed as a screening tool for patients undergoing cardiac rehabilitation (CR) to detect clinically relevant psychosocial/cognitive problems requiring psychological assessment/intervention. Filled out by a trained nurse, it classifies patients according to their need or not for a psychological interview and intervention provided by the psychologist (PCS-Yes vs. PCS-No). Aims The main aim was to compare PCS data collected, respectively, in 2010 and 2017, regarding patients’ socio-demographic characteristics, clinical variables, and the inclusion criteria for psychological counseling. Subsequently, the original Italian PCS was revised and an English version of the schedule was provided [PCS-Revised (PCS-R)]. Results 28 patients (aged 53.5 + 12.6 years, M = 20) of the 87 recruited in 2010 vs. 35 (aged 64.9 + 12.7 years, M = 28) of the 83 recruited in 2017 met the criteria for PCS-Yes: age < 55 years, social problems (living alone, no social support), manifest psychological/behavioral problems, suspected neuropsychological disorders, low prescription adherence, inadequate disease awareness. Comparing the two samples (2010 vs. 2017), clinical variables were similar, and the need for a psychological interview did not differ substantially (32.2 vs. 42.2%), but age increased significantly (PCS-Yes: 53.5 ± 12.6 vs. 64.9 ± 12.7 years, p = 0.001; PCS-No: 68.3 ± 8.0 vs. 75.0 ± 7.7 years, p = 0.0001). A significant increase was observed in the recommendation for neuropsychological assessment (3.6 vs. 25.7%, p = 0.02) to confirm eventual cognitive deficits. These results, the clinical experience, and the recent evidences from literature led to the PCS-R, incorporating a psychosocial screening, a psychological/neuropsychological deeper assessment, and a recommendation for a specific intervention to be carried out either during rehabilitation or in outpatient services. Conclusion The data comparison highlight changes in the cardiac population, which is aging and more frequently requires neuropsychological assessment. The PCS-R could be considered in clinical practice as a useful screening tool to implement a timely coordinated interdisciplinary intervention, comprehensive of specific and tailored psychotherapeutic techniques.
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Affiliation(s)
- Nicolò Granata
- Psychology Unit, Istituto di Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Ekaterina Nissanova
- Psychology Unit, Istituto di Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Valeria Torlaschi
- Psychology Unit, Istituto di Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Marina Ferrari
- Department of Cardiac Rehabilitation, Istituto di Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Martina Vigorè
- Psychology Unit, Istituto di Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Marinella Sommaruga
- Psychology Unit, Istituto di Camaldoli, Istituti Clinici Scientifici Maugeri IRCCS, Milan, Italy
| | - Elisabetta Angelino
- Psychology Unit, Istituto di Torino, Istituti Clinici Scientifici Maugeri IRCCS, Turin, Italy
| | | | - Alessandra Caprino
- Department of Cardiac Rehabilitation, Istituto di Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Antonia Pierobon
- Psychology Unit, Istituto di Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
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Ranzini L, Schiavi M, Pierobon A, Granata N, Giardini A. From Mild Cognitive Impairment (MCI) to Dementia in Chronic Obstructive Pulmonary Disease. Implications for Clinical Practice and Disease Management: A Mini-Review. Front Psychol 2020; 11:337. [PMID: 32184750 PMCID: PMC7058664 DOI: 10.3389/fpsyg.2020.00337] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/12/2020] [Indexed: 12/21/2022] Open
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease characterized by partially irreversible chronic airflow limitation. Current literature highlights that COPD patients also have an increased risk to develop Mild Cognitive Impairment (MCI) and dementia. Chronic patients with cognitive impairment experience a worsening of health-related quality of life, mainly because it could affect treatment self-management, medication adherence and personal independence. Moreover, they also report high levels of anxiety and depression, which are associated with disease severity, poor quality of life, poor adherence to rehabilitation programs and difficulties in self-management. In current literature, there is a lack of studies describing simultaneously the associations between cognitive impairment, dysfunctional psychosocial factors, self-management abilities and their impact on pharmacological/non-pharmacological adherence. Therefore, the aim of the present short review is to describe the implications of cognitive impairment and psychosocial factors for clinical practice and disease management in COPD patients. Due to the interaction of these factors on adherence to rehabilitation programs, self-management and rehabilitation completion, future research should investigate simultaneously the role of all these different aspects to individuate a specific clinical approach that might include specific screening tools to evaluate cognitive impairment and psychosocial difficulties. A timely specific evaluation, within an interdisciplinary approach, could help to implement a more individualized and personalized treatment.
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Affiliation(s)
- Laura Ranzini
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano, Italy
| | - Mara Schiavi
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano, Italy
| | - Antonia Pierobon
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano, Italy
| | - Nicolò Granata
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano, Italy
| | - Anna Giardini
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano, Italy
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Zanatta F, Nissanova E, Świątoniowska-Lonc N, Pierobon A, Callegari G, Olmetti F, Felicetti G, Karniej P, Polański J, Giardini A, Jankowska-Polańska B. Psychosocial Predictors of Self-Efficacy Related to Self-Reported Adherence in Older Chronic Patients Dealing with Hypertension: A European Study. Patient Prefer Adherence 2020; 14:1709-1718. [PMID: 33061314 PMCID: PMC7524841 DOI: 10.2147/ppa.s258999] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/04/2020] [Indexed: 12/04/2022] Open
Abstract
PURPOSE Non-adherence to clinical prescriptions is widely recognized as the most common cause of uncontrolled hypertension, contributing to develop acute and chronic cardiovascular diseases. Specifically, patients' unintentional non-adherence is related to psychosocial factors as beliefs about medications, perceived physician's communication effectiveness and medication-specific social support. The aim of this study was to observe the impact of these factors on self-efficacy in relation to pharmacological and non-pharmacological self-reported adherence among older chronic patients with hypertension. PATIENTS AND METHODS This research had a cross-sectional, observational and multicentre study design. Italian inpatients under rehabilitation, and Polish inpatients/outpatients were recruited. Following a cognitive screening, socio-demographic and clinical characteristics were obtained. Data on clinical and behavioral adherence (i.e., pharmacological adherence, adherence to refill medicines, intentional non-adherence) and psychosocial factors related to treatment adherence (i.e., beliefs about medicines, physician's communication skills, medication-specific social support, psychological antecedents and self-efficacy) were collected with self-report questionnaires. RESULTS A total of 458 patients were recruited. Fischer's LSD post hoc test revealed significant differences between Italian and Polish samples in all measures (p<0.001). Multiple linear regression analysis showed low self-reported intentional non-adherence (β = -.02, p=0.031), high self-reported adherence to refill medications (β=-.05, p=0.017), high levels of perceived physician's communication effectiveness (β=0.11, p<0.001), positive beliefs about medications (β=0.13, p<0.001), and high perceived medication-specific social support (β=0.05, p<0.001) to predict significantly high patients' self-efficacy in relation to pharmacological and non-pharmacological self-reported adherence. CONCLUSION The observed psychosocial and behavioral factors revealed to positively impact on self-efficacy in relation to treatment adherence among older chronic patients dealing with hypertension. In a prevention framework, future studies and clinical practice may consider these factors in order to improve assessment and intervention on adherence in this population.
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Affiliation(s)
- Francesco Zanatta
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano (PV), Italy
| | - Ekaterina Nissanova
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano (PV), Italy
| | | | - Antonia Pierobon
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano (PV), Italy
- Correspondence: Antonia Pierobon Istituti Clinici Scientifici Maugeri IRCCS, Via S. Maugeri, 4, Pavia27100, ItalyTel +39 385 247255Fax +39 385 61386 Email
| | - Giovanna Callegari
- Respiratory Rehabilitation Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano (PV), Italy
| | - Francesca Olmetti
- Cardiological Rehabilitation Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano (PV), Italy
| | - Guido Felicetti
- Neuromotor Rehabilitation Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano (PV), Italy
| | - Piotr Karniej
- Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | - Jacek Polański
- Department of Internal Diseases, Occupational Medicine, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Anna Giardini
- Information Technology Department, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Beata Jankowska-Polańska
- Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
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Baldovin T, Pierobon A, Bertoncello C, Destefani E, Gennari M, Stano A, Baldo V. May car washing represent a risk for Legionella infection? Ann Ig 2019; 30:57-65. [PMID: 29215132 DOI: 10.7416/ai.2018.2196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Legionella is a ubiquitous Gram-negative bacterium naturally found in aquatic environments. It can pose a health problem when it grows and spreads in man-made water systems. Legionella pneumophila is the most common cause of Legionnaires' disease nowadays, a community-acquired pneumonia with pulmonary symptoms and chest radiography no different from any other form of infectious pneumonia. Legionella monitoring is important for public health reasons, including the identification of unusual environmental sources of Legionella. METHODS We report two cases of Legionnaires' disease associated with two different car wash installations in the province of Vicenza, in the Veneto region, northeastern Italy. Patients were not employees of the car wash installations, but users of the service. In both cases, Legionella antigen was detected in urine using the Alere BinaxNOW® Legionella Urinary Antigen, and Legionella antibodies were detected in serum using SERION ELISA classic Legionella pneumophila 1-7 IgG and IgM. Water samples were also analyzed as part of the surveillance program for Legionella prevention and control in compliance with the Italian guidelines. RESULTS Both patients had clinical symptoms and chest radiography compatible with pneumonia, and only one of them had diabetes as a risk factor. Legionella urinary antigen and serological test on serum samples were positive for Legionella in both patients, even if much slighter in the case A due to the retrospective serological investigation performed a year later the episode and after the second clinical case occurred in the same district. The environmental investigations highlighted two different car wash plants as potential source of infection. A certified company using shock hyperchlorination was asked to disinfect the two plants and, subsequently, control samples resulted negative for Legionella pneumophila. CONCLUSION Any water source producing aerosols should be considered at risk for the transmission of Legionella bacteria, including car wash installations frequently used by a large number of customers and where poor maintenance probably creates favorable conditions for Legionella overgrowth and spreading. Additional research is needed to ascertain optimal strategies for Legionella monitoring and control, but environmental surveillance, paying careful attention to possible unconventional sources, should remain an important component of any Legionnaires' disease prevention program. Additionally, all available diagnostic methods would be recommended for the confirmation of all cases even in the event of non-serogroup 1 Legionella pneumophila infection, probably underestimated at this time.
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Affiliation(s)
- T Baldovin
- Department of Cardiac, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padua, Italy
| | - A Pierobon
- Specialization School of Hygiene and Preventive Medicine, University of Padua, Padua, Italy
| | - C Bertoncello
- Department of Cardiac, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padua, Italy
| | - E Destefani
- Dipartimento di Prevenzione AULSS 3, Bassano del Grappa (VI), Veneto Region, Italy
| | - M Gennari
- Dipartimento di Prevenzione AULSS 3, Bassano del Grappa (VI), Veneto Region, Italy
| | - A Stano
- Dipartimento di Prevenzione AULSS 3, Bassano del Grappa (VI), Veneto Region, Italy
| | - V Baldo
- Department of Cardiac, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padua, Italy
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Maffoni M, Pierobon A, Frazzitta G, Callegari S, Giardini A. Living with Parkinson's—past, present and future: a qualitative study of the subjective perspective. ACTA ACUST UNITED AC 2019; 28:764-771. [DOI: 10.12968/bjon.2019.28.12.764] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: the social impact of Parkinson's is difficult to capture in quantitative research given the condition's variable presentation, so qualitative research is needed to support a person-centred approach. Aims: to describe how people with Parkinson's experience living with their condition over time. Methods: 27 audio-recorded verbatim-transcribed interviews were analysed through the grounded theory method. Findings: past, present and future were the core categories that emerged. Past is the dimension of regretted memories of past life overturned by the communication of diagnosis. Present is the time dimension in which patients concretely experience the hindrances associated with the condition (loss of autonomy, submissive acceptance and social embarrassment), and the resources (search for autonomy, serene or in-progress acceptance, and social support). Future is characterised by both positive visions of tomorrow and negative ones (worry, resignation, denial). Conclusion: these results, highlighting what living with Parkinson's means over time, may contribute to a better tailoring of nursing practice to the person's needs and rhythm, in a perspective of continuous adaptation.
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Affiliation(s)
- Marina Maffoni
- PhD Student, Department of Brain and Behavioral Sciences, University of Pavia, Italy
| | - Antonia Pierobon
- Psychologist/Psychotherapist, Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit Institute of Montescano, Pavia, Italy
| | | | - Simona Callegari
- Psychologist/Psychotherapist, Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit Institute of Montescano, Pavia, Italy
| | - Anna Giardini
- Psychologist/Psychotherapist, Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit Institute of Montescano, Pavia, Italy
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Pierobon A, Ranzini L, Torlaschi V, Sini Bottelli E, Giardini A, Bruschi C, Maestri R, Callegari S, Raccanelli R, Sommaruga M. Screening for neuropsychological impairment in COPD patients undergoing rehabilitation. PLoS One 2018; 13:e0199736. [PMID: 30067787 PMCID: PMC6070177 DOI: 10.1371/journal.pone.0199736] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 06/13/2018] [Indexed: 01/26/2023] Open
Abstract
Introduction Chronic obstructive pulmonary disease (COPD) is a complex multi-component disorder characterized by progressive irreversible respiratory symptoms and extrapulmonary comorbidities, including anxiety-depression and mild cognitive impairment (MCI). However, the prevalence of these impairments is still uncertain, due to non-optimal screening methods. This observational cross-sectional multicentre study aimed to evaluate the prevalence of anxiety-depressive symptoms and MCI in COPD patients, identify the most appropriate cognitive tests to screen MCI, and investigate specific cognitive deficits in these patients and possible predictive factors. Materials and methods Sixty-five stable COPD inpatients (n = 65, aged 69.9±7.6 years, mainly stage III–IV GOLD) underwent the following assessments: Hospital Anxiety and Depression Scale (HADS), Geriatric Depression Scale (GDS) or Beck Depression Inventory-II (BDI-II), Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and a complete neuropsychological battery (ENB-2) including different cognitive domains (attention, memory, executive functions, and perceptive and praxis abilities). Results Moderate-severe anxiety was present in 18.5% of patients and depressive symptoms in 30.7%. The prevalence of MCI varied according to the test: 6.2% (MMSE), 18.5% (MoCA) and 50.8% (ENB-2). In ENB-2, patients performed significantly worse compared to Italian normative data on digit span (5.11±0.9 vs. 5.52±1.0, p = 0.0004), trail making test-B (TMT-B) (176.31±99.5 vs. 135.93±58.0, p = 0.004), overlapping pictures (26.03±8.9 vs. 28.75±8.2, p = 0.018) and copy drawing (1.370.6 vs. 1.61±0.5, p = 0.002). At logistic regression analysis, only COPD severity (p = 0.012, odds ratio, OR, 4.4 [95% CI: 1.4–14.0]) and anxiety symptoms (p = 0.026, OR 4.6 [1.2–17.7]) were significant and independent predictors of the deficit in copy drawing, which assesses visuospatial and praxis skills. Conclusion Given the prevalence of neuropsychological impairments in COPD patients, the routine adoption in rehabilitation of screening tools for mood and cognitive function, including digit span, TMT-B and copy drawing, may be useful to detect psychosocial comorbidities and personalize the rehabilitative program.
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Affiliation(s)
- Antonia Pierobon
- Psychology Unit, Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Montescano (PV), Italy
- * E-mail:
| | - Laura Ranzini
- Psychology Unit, Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Montescano (PV), Italy
| | - Valeria Torlaschi
- Psychology Unit, Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Montescano (PV), Italy
| | - Elisa Sini Bottelli
- Psychology Unit, Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Montescano (PV), Italy
| | - Anna Giardini
- Psychology Unit, Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Montescano (PV), Italy
| | - Claudio Bruschi
- Department of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Montescano (PV), Italy
| | - Roberto Maestri
- Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Montescano (PV), Italy
| | - Simona Callegari
- Psychology Unit, Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Montescano (PV), Italy
| | - Rita Raccanelli
- Cardiorespiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Camaldoli (MI), Italy
| | - Marinella Sommaruga
- Clinical Psychology and Social Support Unit, Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Camaldoli (MI), Italy
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Fattirolli F, Bettinardi O, Angelino E, da Vico L, Ferrari M, Pierobon A, Temporelli D, Agostini S, Ambrosetti M, Biffi B, Borghi S, Brazzo S, Faggiano P, Iannucci M, Maffezzoni B, Masini ML, Mazza A, Pedretti R, Sommaruga M, Barro S, Griffo R, Piepoli M. What constitutes the ‘Minimal Care’ interventions of the nurse, physiotherapist, dietician and psychologist in Cardiovascular Rehabilitation and secondary prevention: A position paper from the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology. Eur J Prev Cardiol 2018; 25:1799-1810. [DOI: 10.1177/2047487318789497] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background In cardiovascular prevention and rehabilitation, care activities are carried out by different professionals in coordination, each with their own specific competence. This GICR–IACPR position paper has analysed the interventions performed by the nurse, physiotherapist, dietician and psychologist in order to identify what constitutes minimal care, and it lists the activities that are fundamental and indispensable for each team member to perform in clinical practice. Results In analysing each type of intervention, the following dimensions were considered: the level of clinical care complexity, determined both by the disease and by environmental factors; the ‘area’ complexity, i.e. the specific level of competence required of the professional in each professional section; organisational factors, i.e. whether the care is performed in an inpatient or outpatient setting; duration of the rehabilitation intervention. The specific contents of minimal care have been identified for each professional area together with the specific goals, the assessment tools and the main essential interventions. For the assessments, only a few validated tools have been indicated, leaving the choice of which instrument to use to the individual professional based on experience and usual practice. Conclusion For the interventions, attention has been focused on conditions of major complexity requiring special care, taking into account the different care settings, the clinical conditions secondary to the disease event, and the distinct tasks of each area according to the operator's specific role. The final report performed by each professional has also been included.
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Affiliation(s)
| | - Ornella Bettinardi
- Psychiatric Emergency and Urgency Service, Department of Mental Health, Italy
| | | | - Letizia da Vico
- Department of Health Professions, Azienda Ospedaliero Universitaria Careggi, Italy
| | - Marina Ferrari
- Cardiovascular Rehabilitation Unit, Istituti Clinici Scientifici Maugeri, Italy
| | | | - Daniele Temporelli
- Cardiovascular Rehabilitation, Istituti Clinici Scientifici Maugeri, Italy
| | | | | | - Barbara Biffi
- Dietology and Clinical Nutrition Service, Don Carlo Gnocchi Foundation, Italy
| | | | - Silvia Brazzo
- Dietology and Clinical Nutrition, Istituti Clinici Scientifici Maugeri, Italy
| | | | - Manuela Iannucci
- Cardiac Rehabilitation Unit, S Filippo Neri Hospital Salus Infirmorum, Italy
| | | | - Maria Luisa Masini
- Department of Health Professions, Azienda Ospedaliero Universitaria Careggi, Italy
| | - Antonio Mazza
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Italy
| | - Roberto Pedretti
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Italy
| | - Marinella Sommaruga
- Clinical Psychology and Social Support, Istituti Clinici Scientifici Maugeri, Italy
| | | | - Raffaele Griffo
- Italian Association for Cardiovascular Prevention and Rehabilitation (GICR-IACPR), Research and Educational Centre, Italy
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Sommaruga M, Angelino E, Della Porta P, Abatello M, Baiardo G, Balestroni G, Bettinardi O, Callus E, Ciracì C, Omodeo O, Rizza C, Michielin P, Ambrosetti M, Griffo R, Pedretti RF, Pierobon A. Best practice in psychological activities in cardiovascular prevention and rehabilitation: Position Paper. Monaldi Arch Chest Dis 2018; 88:966. [DOI: 10.4081/monaldi.2018.966] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 06/10/2018] [Indexed: 11/23/2022] Open
Abstract
Recent guidelines on cardiovascular disease prevention suggest multimodal behavioral interventions for psychosocial risk factors and referral for psychotherapy in the case of clinically significant symptoms of depression and anxiety overall. Accordingly, psychologists of the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (GICR-IACPR) have reviewed the key components of psychological activities in cardiovascular prevention and rehabilitation (CPR). The aim of this study was to elaborate a position paper on the best practice in routine psychological activities in CPR based on efficacy, effectiveness and sustainability. The steps followed were: i) a review of the latest international guidelines and position papers; ii) analysis of the evidence-based literature; iii) a qualitative analysis of the psychological services operating in some reference Italian cardiac rehabilitation facilities; iv) classification of the psychological activities in CPR as low or high intensity based on the NICE Guidelines on psychological interventions on anxiety and depression. We confirm the existence of an association between depression, anxiety, social factors, stress, personality and illness onset/outcome and coronary heart disease. Evidence for an association between depression, social factors and disease outcome emerges particularly for chronic heart failure. Some positive psychological variables (e.g., optimism) are associated to illness outcome. Evidence is reported on the impact of psychological activities on ‘new’ conditions which are now indicated for cardiac rehabilitation: pulmonary hypertension, grown-up congenital heart, end-stage heart failure, implantable cardioverter-defribrillator and mechanical ventricular assist devices, frail and oldest-old patients, and end-of-life care. We also report evidence related to caregivers. The Panel divided evidence-based psychological interventions into: i) low intensity (counseling, psycho-education, self-care, self-management, telemedicine, self-help); or ii) high intensity (individual, couples and/or family and group psychotherapy, such as stress management). The results show that psychotherapy is mainly consisting of cognitive-behavior therapy, interpersonal therapy, and short-term psycho-dynamic therapy. The current data further refine the working tools available for psychological activities in CPR, giving clear directions about the choice of interventions, which should be evidence-based and have at least a minimum standard. This document provides a comprehensive update on new knowledge and new paths for psychologists working in the CPR settings.
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Pierobon A, Sini Bottelli E, Ranzini L, Bruschi C, Maestri R, Bertolotti G, Sommaruga M, Torlaschi V, Callegari S, Giardini A. COPD patients' self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation. Int J Chron Obstruct Pulmon Dis 2017; 12:2059-2067. [PMID: 28790808 PMCID: PMC5529298 DOI: 10.2147/copd.s133586] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In addition to clinical comorbidities, psychological and neuropsychological problems are frequent in COPD and may affect pulmonary rehabilitation delivery and outcome. The aims of the study were to describe a COPD population in a rehabilitative setting as regards the patients depressive symptoms, anxiety, mild cognitive impairment (MCI) and self-reported adherence and to analyze their relationships; to compare the COPD sample MCI scores with normative data; and to investigate which factors might predict adherence to prescribed physical exercise. This was a multicenter observational cross-sectional study. Of the 117 eligible stable COPD inpatients, 84 were enrolled according to Global initiative for chronic Obstructive Lung Disease (GOLD) criteria (mainly in Stage III–IV). The assessment included Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), anxiety, depression and self-reported pharmacological and nonpharmacological adherence. From the MMSE, 3.6% of patients were found to be impaired, whereas from the MoCA 9.5% had a likely MCI. Patients referred had mild-severe depression (46.7%), anxiety (40.5%), good pharmacological adherence (80.3%) and difficulties in following prescribed diet (24.1%) and exercise (51.8%); they struggled with disease acceptance (30.9%) and disease limitations acceptance (28.6%). Most of them received good family (89%) or social (53%) support. Nonpharmacological adherence, depression, anxiety and MCI showed significant relations with 6-minute walking test, body mass index (BMI) and GOLD. Depression was related to autonomous long-term oxygen therapy modifications, disease perception, family support and MCI. In the multivariate logistic regression analysis, higher BMI, higher depression and lower anxiety predicted lower adherence to exercise prescriptions (P=0.0004, odds ratio =0.796, 95% CI =0.701, 0.903; P=0.009, odds ratio =0.356, 95% CI =0.165, 0.770; and P=0.05, odds ratio =2.361, 95% CI =0.995, 5.627 respectively). In COPD patients, focusing on pharmacological and nonpharmacological adherence enhance the possibility of tailored pulmonary rehabilitation programs.
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Affiliation(s)
| | | | | | | | - Roberto Maestri
- Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri, IRCCS, Montescano
| | | | - Marinella Sommaruga
- Clinical Psychology and Social Support Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Camaldoli, Italy
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Steca P, Monzani D, Pierobon A, Avvenuti G, Greco A, Giardini A. Measuring dispositional optimism in patients with chronic heart failure and their healthcare providers: the validity of the Life Orientation Test-Revised. Patient Prefer Adherence 2017; 11:1497-1503. [PMID: 28919722 PMCID: PMC5593410 DOI: 10.2147/ppa.s139522] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The Life Orientation Test-Revised (LOT-R) measures dispositional optimism (DO) - an individual difference promoting physical and psychological well-being in healthy adults (HAs) as well as in patients with chronic heart failure (CHF) and healthcare providers (HPs). Controversy has arisen regarding the dimensionality of the LOT-R. Whereas DO was originally defined as a one-dimensional construct, empirical evidence suggests two correlated factors in the LOT-R. This study was the first attempt to identify the best factor structure of the LOT-R in patients with CHF and HPs and to evaluate its measurement invariance among subsamples of patients with CHF, HPs, and a normative sample of HAs. Its validity was also evaluated in patients with CHF. The sample comprised 543 participants (34% HAs; 34% HPs; and 32% CHF patients). Congeneric, two correlated factor, and two orthogonal factor models for the LOT-R were compared by performing confirmatory factor analysis (CFA). Measurement invariance was evaluated by considering differential item functioning (DIF) among subsamples of HPs, patients with CHF, and HAs. In patients with CHF, validity was assessed by considering associations with anxiety and depression. The CFA demonstrated the superior fit of the two orthogonal factor model. Moreover, across patients with CHF, HPs, and HAs, the results highlighted a minimal DIF with only trivial consequences. Finally, negative but weak correlations of DO with anxiety and depression confirmed the validity of the LOT-R in patients with CHF. In summary, these findings supported the validity and suitability of the LOT-R for the assessment of DO in patients with CHF, HPs, and HAs.
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Affiliation(s)
- Patrizia Steca
- Department of Psychology, University of Milano – Bicocca, Milan
| | - Dario Monzani
- Department of Psychology, University of Milano – Bicocca, Milan
- Correspondence: Dario Monzani, Department of Psychology, University of Milano – Bicocca, Piazza dell’Ateneo Nuovo, 1, 20126 Milano, Italy, Tel +39 02 6448 3803, Fax +39 02 6448 3706, Email
| | - Antonia Pierobon
- Psychology Unit, Istituti Clinici Scientifici Maugeri Spa SB, IRCCS Montescano, Montescano, Italy
| | - Giulia Avvenuti
- Psychology Unit, Istituti Clinici Scientifici Maugeri Spa SB, IRCCS Montescano, Montescano, Italy
| | - Andrea Greco
- Department of Psychology, University of Milano – Bicocca, Milan
| | - Anna Giardini
- Psychology Unit, Istituti Clinici Scientifici Maugeri Spa SB, IRCCS Montescano, Montescano, Italy
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Giardini A, Pierobon A, Callegari S, Bertotti G, Maffoni M, Ferrazzoli D, Frazzitta G. Towards proactive active living: patients with Parkinson's disease experience of a multidisciplinary intensive rehabilitation treatment. Eur J Phys Rehabil Med 2016; 53:114-124. [PMID: 27249420 DOI: 10.23736/s1973-9087.16.04213-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Non-pharmacological approaches to PD disease management seem to be a growing and promising field of investigation. Indeed interesting new perspectives are forthcoming from studies on physical rehabilitation and on physical exercise. AIM To qualitatively describe the rehabilitation experience of Parkinson Disease patients taking part in a multidisciplinary intensive rehabilitation treatment (MIRT) consisting of four weeks of physical therapy and exercise, with three daily sessions, five days a week. DESIGN Data from a qualitative observational study with patients' interviews were analyzed. SETTING PD inpatients of a Neurorehabilitation Department. POPULATION Convenient sample of 27 PD patients (13 male, 14 female), mean age 70.3±8.5 and mean disease duration 8.25±6.9 years; Hoehn-Yahr stage 3, hospitalized for the 4-week MIRT. METHODS Verbatim transcriptions of 27 semi-structured interviews were analysed using the Grounded Theory methodology. RESULTS Depressive symptoms were present in 55.5% of the patients measured by Geriatric Depression Scale: mild (N.=8; 30.0%), moderate (N.=6; 22.2%), severe (N.=1; 3.7%). The core category Efficacy of active living identified the becoming conscious of the usefulness of a proactive lifestyle to counterattack disease degeneration. The category Satisfaction described patients' satisfaction upon MIRT, resulting in a perceived enhanced functionality (coherently with quantitative functional parameters improvement at discharge) and a rediscovered autonomy. The category Future described the intention to continue the rehabilitation prescription at home embracing a more dynamic lifestyle. Of interest is that the majority in the interview used body related terms and described perceived changes through the body itself. Verbs of perception (to see, to feel, to perceive) were used in a spontaneous way by all inpatients. The inpatients experienced not only through their mind but also by means of body perceptions how a proactive lifestyle could become a means of disease control. CONCLUSIONS The positive subjective response to rehabilitation described qualitatively in this study, opens perspectives for tailoring interventions focusing also on patients' self, self-efficacy and perceived efficacy of active living. CLINICAL REHABILITATION IMPACT Patients' proactive disposition may widen the perspective on patients' motivation to rehabilitation. A multidisciplinary intervention may act both on physical and subjective disease aspects; paying attention to patients' subjective feedbacks could contribute reliably to guide for medical decisions in managing tailored and detailed interventions.
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Affiliation(s)
- Anna Giardini
- Psychology Unit, Istituti Clinici e Scientifici Maugeri, IRCCS Montescano, Montescano, Pavia, Italy -
| | - Antonia Pierobon
- Psychology Unit, Istituti Clinici e Scientifici Maugeri, IRCCS Montescano, Montescano, Pavia, Italy
| | - Simona Callegari
- Psychology Unit, Istituti Clinici e Scientifici Maugeri, IRCCS Montescano, Montescano, Pavia, Italy
| | - Gabriella Bertotti
- Department of Neurorehabilitation, Istituti Clinici e Scientifici Maugeri, IRCCS Montescano, Montescano, Pavia, Italy
| | - Marina Maffoni
- Psychology Unit, Istituti Clinici e Scientifici Maugeri, IRCCS Montescano, Montescano, Pavia, Italy
| | - Davide Ferrazzoli
- Moriggia-Pelascini Hospital, Gravedona ed Uniti, Como, Italy.,European Foundation for Biomedical Research, S. Isidoro Hospital, Trescore Balneario, Bergamo, Italy
| | - Giuseppe Frazzitta
- Moriggia-Pelascini Hospital, Gravedona ed Uniti, Como, Italy.,European Foundation for Biomedical Research, S. Isidoro Hospital, Trescore Balneario, Bergamo, Italy
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Sommaruga M, Tramarin R, Balestroni G, Bettinardi O, Miglioretti M, Omodeo O, Pierobon A. Organization of psychological activities in italian cardiac rehabilitation and prevention Survey on the implementation of guidelines for psychological activities in cardiac rehabilitation and prevention. Monaldi Arch Chest Dis 2016; 70:6-14. [DOI: 10.4081/monaldi.2008.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The present study was developed as part of a comprehensive evaluation of the state of the art of knowledge and implementation of the Italian Guidelines for psychological activities in Cardiac Rehabilitation, published in 2003 by the Working Group of Psychology of the Italian Society of Cardiac Rehabilitation (GICR). Methods. A questionnaire was designed to collect detailed information on facilities, organization, staffing level, professional background and activities carried out by psychologists working in Italian Cardiac Rehabilitation Units (CRU). Out of 144 Italian CRU (inventory 2004), 107 reported structured psychological programmes. The questionnaires were sent by conventional mail to the referring psychologist of these 107 CRU; they were invited to participate in the survey on a purely voluntary basis. Results. Responses were received from 70 (65.4%) of 107 CRU. 55 CRU (79.8%) report a good knowledge of the published GL; 10.1% declare that the psychologists did not know the current GL. 84.5% consider the GL to be fully applicable, while 15.5% believe that they are only partly applicable. Psychological assessment is performed through clinical interview (94.3%) and psychometric tests (81.4%). 92.8% of the CRU use screening instruments in order to evaluate psychosocial risk factors, in particular anxiety and depression (64.3%). Quality of life (22.8%) and cognitive impairment (17.1%) are not routinely assessed. Educational interventions are planned in 87.1% of the CR programme and are extended to the family members (51%) as well as counselling (57%). Psychological programme includes smoking (56%) and eating behaviour (55%) group interventions. Stress management is routinely planned in 69% of the CRU. Psychological intervention tailored to individual needs of the patients is performed in 62.9% CRU. Written final reports are available in 88.6% cases. The follow-up is carried out by 48.6% of the CRU, 15.7% in a structured way. Conclusions. The survey shows wide discrepancies in the provision of psychological activities in Italian CRU. Nevertheless psychological assessment and interventions seem acceptably coherent with current national GL on CR.
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Pierobon A, Giardini A, Majani G, Callegari S, Lenta F, La Rovere MT, Febo O. Into the cognitive constructs related to adherence to treatment in CHD outpatients: the importance of accepting the disease limitations. Monaldi Arch Chest Dis 2016. [DOI: 10.4081/monaldi.2009.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background and aims: Poor adherence to clinical prescriptions has been recognized as a major problem in management of chronic diseases. Only few studies tried to identify which factors could be considered predictive of low adherence to pharmacological and non pharmacological prescriptions in Coronary Heart Disease (CHD) patients. The aims of our observational-longitudinal study were to assess in CHD outpatients admitted to a Cardiological Day Hospital (DH): self-reported knowledge and acceptance about illness, perceived self-efficacy in disease management and emotional status, and the possible relationships among these variables. Methods: Patients were assessed at baseline during the first days of DH and few days before discharge (follow-up) by the Adherence Schedule in Ischemic Heart Disease (ASIHD) and by the Anxiety and Depression Scale (AD). The ASIHD is a tool specifically aimed at evaluating the cognitive, relational and behavioural antecedents of adherence to treatment of patients suffering CHD. The rehabilitation programme comprised: individualized physical training, nutrition monitoring, psychological assessment and psychoeducational interventions, when indicated. Baseline and follow- up clinical data, ASHID and AD scores were analysed both considering the whole sample (n=117) and the subgroup which met the clinical criteria for psychological counselling (n=35, psychologically treated group). Intracorrelation and intercorrelation coefficients of the whole sample baseline data were calculated among ASIHD, AD scores and socio-demographic data. Results: Our CHD outpatients (62.6±9.3 years) were mainly male, married and retired. They had 5,2 years of illness on the average, and only 9% of them were still smokers, whereas 62% had smoked in the past. Total and LDL cholesterol levels showed a significant reduction at follow up evaluation. Among ASIHD baseline item scores, many statistically significant intracorrelations emerged, in particular: disease limitations acceptance showed significant positive correlations with disease knowledge (r=.34, p=.0001), family/friend support (r=.27, p=.003), following dietary prescriptions (r=.38, p=.0001), exercise (r=.35, p=.0001), taking medicines punctually (r=.35, p=.0001), identifying physical/ psychological fatigue (r=.45, p=.0001), monitoring clinical parameters (r=.42, p=.0001), management of stressful situations (r=.26, p=.006), and reducing stress sources (r=.34, p=.0001). Concerning the significant intercorrelations between AD and ASIHD scores, disease acceptance showed negative correlations with anxiety and depression (r=-.27, p=.004; r=-.26, p=.004 respectively). Conclusions: The pathway stemmed from our data enlights that in the area of cognitive and relational antecedents of adeherence, accepting the disease limitations can be considered a central issue in CHD patient’s illness adjustment and prescriptions adherence. Moreover, the ASHID resulted a useful synthetic schedule of psychological/behavioural variables regarding perceived self-efficacy in disease management. This may facilitate a synergic team work on common priorities that respect the point of view of the patient and the clinical-rehabilitation purposes.
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Majani G, Callegari S, Pierobon A, Giardini A, Viola L, Baiardini I, Sommaruga M. A New Instrument in Quality-of-Life Assessment. International Journal of Mental Health 2015. [DOI: 10.1080/00207411.1999.11449463] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bettinardi O, da Vico L, Pierobon A, Iannucci M, Maffezzoni B, Borghi S, Ferrari M, Brazzo S, Mazza A, Sommaruga M, Angelino E, Biffi B, Agostini S, Masini ML, Ambrosetti M, Faggiano P, Griffo R. [First definition of minimal care model: the role of nurses, physiotherapists, dietitians and psychologists in preventive and rehabilitative cardiology]. Monaldi Arch Chest Dis 2015; 82:122-52. [PMID: 26058266 DOI: 10.4081/monaldi.2014.55] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Rehabilitative and preventive cardiology (CRP) is configured as intervention prevention to "gain health" through a process of multifactorial care that reduces disability and the risk of subsequent cardiovascular events. It makes use of an interdisciplinary team in which every professional needs to have multiple intervention paths because of the different levels of clinical and functional complexity of cardiac patients who currently have access to the rehabilitation. The document refers to the use of interventions by nurses, physiotherapists, dietitians and psychologists that are part of the rehabilitation team of CRP. Interventions of which have been documented, on scientific bases and clinical practice, empirical effectiveness and organizational efficiency. The methodological approach of this paper is a first attempt to define, through the model of consensus, the minimum standards for a CRP evidence based characterized by clearly defined criteria that can be used by operators of CRP. The document describes the activities to be carried out in each of the phases included in the pathways of care by nurses, physiotherapists, dietitians and psychologists. The routes identified were divided, according to the type of patients who have access to the CRP and to the phases of care, including the initial assessment, intervention, evaluation and final reporting, in high medium and low complexity. Examples of models of reporting, used by the operators of the team according to the principles of good clinical practice, are provided. This is made to allow traceability of operations, encourage communication inside the working group and within the patient and the caregiver. Also to give any possible indication for the post-rehabilitation.
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Pierobon A, Giardini A, Callegari S, Farina C, Torlaschi V, Bernini S, Frazzitta G, Majani G. [Neuropsychological evaluation and psychological intervention on patients with Parkinson's disease in physical rehabilitation]. G Ital Med Lav Ergon 2013; 35:183-191. [PMID: 24734326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Parkinson's Disease (PD) is characterized by a wide range of motor and non-motor symptoms. In the last years the evaluation of cognitive functioning, emotional aspects and health status of PD patients has became ever-growing important. METHODS In this article a neuropsychological and psychological assessment model, by means of tests and interviews, and a clinical approach to the narrative themes are described. Areas of clinical investigation: cognitive processing, emotional acceptance and behavioural adaptation to the disease, motivation to rehabilitation treatment, expectations regarding functional recovery, adherence, social and family perceived support, mood, awareness of possible cognitive deficits. Tests assessment (based on specific cognitive deficits related to PD): MMSE, FAB, TMTA-B, Phonological verbal fluency test, Stroop test, Geriatric Depression Scale (GDS) or Beck Depression Inventory- BDI-II and Parkinson's Disease Questionnaire-8 (PDQ-8). The psychological approach, which is part of an interdisciplinary rehabilitative intervention, is based on Cognitive Behavioural Therapy and it is focused on disease management even in the absence, sometimes, of a significant general emotional status modification and it is aimed at improving patient's adaptability, self-management and empowerment. In order to describe the model, the clinical and test data of two PD patients are illustrated. CONCLUSIONS The added value of this psychological approach lies in the clinical data integration of the test evaluation, the narrative aspects and the information mediated by the inter-professional team. This model allows a deeper and more personalized identification of the patient's subjective adjustment process according to his/her personal needs and resources.
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Pierobon A, Callegari S, Giardini A, Ferrari M, Olmetti F, Corbellini D, Febo O, Majani G. [Presentation of the Psycho-Cardiological schedule and convergence levels analyses among the psycho-cardiological screening and the psychological assessment]. Monaldi Arch Chest Dis 2012; 78:89-96. [PMID: 23167151 DOI: 10.4081/monaldi.2012.129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
UNLABELLED In Cardiovascular Rehabilitation the increasing inpatients complexity suggests the necessity to develop screening methods which allow to identify those patients that require a psychological intervention. MATERIAL AND METHODS A Psycho-Cardiological Schedule (PCS) was developed with the aim of detecting the critical situation indicators or the presence of psychological, social and cognitive problems. The PCS, compiled by a nurse or cardiologist in collaboration with a psychologist, allows to assess the need for a deeper psychological examination, clinical and/or with tests. Aim of the present study is to identify the convergence levels among the observational and anamnestic data of the PCS collected by a nurse and the clinical and/or test data of the psychological deeper assessment. RESULTS Among the 87 patients recruited in January-February 2010, 28 (aged 53.5 +/- 12.6, M = 20, F = 8) fulfilled the criteria for a deeper psychological examination: age < or = 50, manifestation of psychological/behavioural problems, neuropsychological disorders, low adherence to prescriptions, inadequate disease knowledge/representation. From data comparisons emerged convergence levels with 100% concordance as to smoke habits and problems in social-family support. High convergence levels also resulted as to emotional and/or behavioural problems (92.8%) and inadequate adherence to prescriptions (89.3%). Lower levels of concordance (82.1%) emerged when considering disease knowledge/representation, issues specifically linked to cognition and subjective illness experience, not directly detectable from behaviour. CONCLUSIONS our data confirm the synergic efficacy of the two evaluations: the Psycho-Cardiological Schedule reliably identifies the problematic macro-categories, mainly if they are characterized by behavioural indicators, which facilitate the detection. The psychological approach appears more suitable for better specifing macro-categories characteristics and for detecting critical aspects not overt but not less important, providing therefore advice for a therapeutic psychological management.
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Affiliation(s)
- Antonia Pierobon
- Servizio di Psicologia, Fondazione Salvatore Maugeri, IRCCS, Istituto Scientifico di Montescano, 27040 Montescano, PV, Italy.
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Giardini A, Pierobon A, Majani G, Bernocchi M, Corbellini D, Febo O. [Perception of illness and dispositional optimism in a sample of patients with chronic heart failure]. G Ital Med Lav Ergon 2012; 34:B38-B44. [PMID: 23326938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED INTRODUCTION. Psychological research on Chronic Heart Failure has mainly focused on the patient's emotional status, particularly on anxiety and depression. AIM To describe the psychological characteristics of a sample of hospitalized CHF inpatients and to assess their illness perception and their dispositional optimism and pessimism, and the mutual relations among these variables. METHOD 77 CHF inpatients of a Department of Cardiovascular Rehabilitation (aged 57.4 +/- 10.0) were consecutively enrolled. The following psychological constructs were assessed: anxiety (HADS-A), depression (BDI-II: total score, Cognitive and Affective Factors), illness perception (Brief IPQ) and dispositional optimism and pessimism (LOT-R). Correlations between Brief IPQ and LOT-R data were calculated and subsequently ANOVAs were performed on Brief IPQ and LOT-R data divided by sex, anxiety and depression. RESULTS. As to anxiety, 57 (74.0%) patients resulted not anxious, whereas 10 (13.0%) reported light anxious symptomatology, 8 (10.4%) moderate and 2 (2.6%) severe. Thirty nine patients (50.7%) resulted not depressed, whereas 19 (24.7%) resulted severely depressed. Significant correlations emerged among dispositional pessimism (LOT-R) and the following Brief IPQ variables: Treatment Control (r = - 0.40 p < 0.0001) and Coherence (r = -0.35 p = 0.002). Anxiety and depression differentiated the sample considering illness perception but not dispositional optimism and pessimism. CONCLUSIONS. As to anxiety and depression our data enlighten the presence of emotional disorders in CHF patients. Moreover illness perception differentiates the sample when analysed considering the emotional status. Interesting are the relationships among illness representations and dispositional pessimism, which deserve further studies. In our sample pessimism seems not to be opposed, in a bipolar construct, to optimism and results not related to depression; besides pessimism might have a predictive role in patient's disease management in a not yet explored direction. Finally our data confirm what usually qualitatively observed in clinical practice during the psychological intervention in rehabilitation cardiology. They also provide scientific information on the utility of an accurate psychological screening and a consequent specific intervention aimed at both providing psychological support and cognitive restructuring.
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Affiliation(s)
- Anna Giardini
- Servizio di Psicologia, Fondazione Salvatore Maugeri - IRCCS, Istituto Scientifico di Montescano (PV), Italy.
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Majani G, Pierobon A, Pinna GD, Giardini A, Maestri R, La Rovere MT. Additive prognostic value of subjective assessment with respect to clinical cardiological data in patients with chronic heart failure. ACTA ACUST UNITED AC 2011; 18:836-42. [PMID: 21450593 DOI: 10.1177/1741826711398804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Health-related quality of life tools that better reflect the unique subjective perception of heart failure (HF) are needed for patients with this disorder. The aim of this study was to explore whether subjective satisfaction of HF patients about daily life may provide additional prognostic information with respect to clinical cardiological data. METHODS One hundred and seventy-eight patients (age 51 ± 9 years) with moderate to severe HF [New York Heart Association (NYHA) class 2.0 ± 0.7; left ventricular ejection fraction (LVEF) 29 ± 8%] in stable clinical condition underwent a standard clinical evaluation and compiled the Satisfaction Profile (SAT-P) questionnaire focusing on subjective satisfaction with daily life. Cox regression analysis was used to assess whether SAT-P factors (psychological functioning, physical functioning, work, sleep/eating/leisure, social functioning) had any prognostic value. RESULTS Forty-six cardiac deaths occurred during a median of 30 months. Patients who died had higher NYHA class, more depressed left ventricular function, reduced systolic blood pressure (SBP), increased heart rate (HR), and worse biochemistry (all p < 0.05). Among the SAT-P factors, only physical functioning (PF) was significantly reduced in the patients who died (p = 0.003). Using the best subset selection procedure, resistance to physical fatigue (RPF) was selected from among the items of the PF factor. RPF showed independent predictive value when entered into a prognostic model including NYHA class, LVEF, SBP, and HR with an adjusted hazard ratio of 0.86 per 10 units increase (95% CI 0.75-0.98, p = 0.02). CONCLUSIONS Patients' dissatisfaction with physical functioning is associated with reduced long-term survival, after adjustment for known risk factors in HF. Given its user-friendly structure, simplicity, and significant prognostic value, the RPF score may represent a useful instrument in clinical practice.
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Affiliation(s)
- Giuseppina Majani
- Psychology Unit, Scientific Institute of Montescano, Salvatore Maugeri Foundation IRCCS, Pavia, Italy.
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Pierobon A, Giardini A, Callegari S, Majani G. Psychological adjustment to a chronic illness: the contribution from cognitive behavioural treatment in a rehabilitation setting. G Ital Med Lav Ergon 2011; 33:A11-A18. [PMID: 21488478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Patients with a chronic illness must continuously revise their lifestyle, adapting it to the behavioural limitations imposed by their state of health. These incessant adjustments of behaviour dictated by the patients' need to adapt to their clinical condition also cause profound psychological changes. The experience of a patient with a chronic illness often leads to a reformulation of self, which the patient may or may not be aware of, but which helps to facilitate successful behavioural adaptation. During the course of their disease, which spans from diagnosis to treatment, some patients have the opportunity to meet a psychologist, who has various tasks: understanding what stage of adaptation the chronically ill patients have reached, evaluating the patients' emotional state, facilitating their acceptance of their clinical condition, stimulating them to redefine their aims, if there are the presuppositions, and supporting their coping capacities and internal and external resources. This article is neither a review nor original research, but rather a "clinical exposition" with educational suggestions. The purpose of this article is to give a voice to the patients' internal dialogue, to what they say to themselves, to their narration of the illness, but also to explain the typical components of cognitive behavioural treatment in the setting of cardiological, respiratory and neuromotor rehabilitation.
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Affiliation(s)
- Antonia Pierobon
- Servizio di Psicologia, Fondazione Salvatore Maugeri, IRCCS, Istituto Scientifico di Montescano (PV), Italy.
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Pierobon A. Redefining self to continue living: cognitive behavioural treatments in patients with chronic illnesses. G Ital Med Lav Ergon 2011; 33:A7-A10. [PMID: 21488477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Giardini A, Pierobon A, Majani G, Biffa G, Volpe B, Sala A, Gangeri L, Aurelio MT, Ferri F, Colombo EM, Fontana L, Trabucco G, Travaglini C, Zoncheddu P, Nobili R, Bellapi S, Masolo LS, Sacchi AM. Adherence self report assessment in solid-organ pre and post transplant recipients. G Ital Med Lav Ergon 2011; 33:A69-A76. [PMID: 21488486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE There is strong evidence that many patients with chronic diseases have difficulties to adhere to the medical regimens. As to transplantation, nonadherence to the prescribed medical regimen has repeatedly been found to predict morbidity and mortality, both in adults and in children. Many instruments are available in order to assess nonadherence to immunosuppressive medication, whereas only few are available on behavioural components. Aim of the study was to present the Adherence Schedule in Transplantation (ASiT, in its three versions: ASiT-A, Adults; ASiT-PA, Proxy Adult and ASiT-PC, Proxy Child) that evaluates the Cognitive Relational Antecedents of adherence to treatment and the Self-efficacy in disease management in patients before and after transplantation. METHOD (1) Review and construct analysis of the already existing adherence Schedules, on the basis of literature review and clinical experience; (2) Construction of the ASiT in its three versions from an adaptation of the already existing adherence Schedules; (3) Administration of the ASiT to pre and post transplant recipients followed by a semi-structured interview in order to discuss with the patients pros and cons; (4) ASiT correction on the basis of patients' comments; (5) Translation in English by a bilingual English mother tongue. RESULTS On the whole 56 Schedules were administered to pre and post transplant (liver, heart, lung and kidney) recipients and their proxy and resulted to have good construct validity, were easily administered and were well accepted by patients. CONCLUSIONS As to research the ASiT could cover a wide range of nonadherence sources. Within a clinical context our Schedule could be a not time consuming tool useful in favouring the communication about adherence and able to enhance patients' personal limits and resources.
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Affiliation(s)
- Anna Giardini
- Servizio di Psicologia, Fondazione Salvatore Maugeri, IRCCS, Istituto Scientifico di Montescano (PV), Italy.
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Pierobon A, Giardini A, Fanfulla F, Callegari S, Majani G. A multidimensional assessment of obese patients with obstructive sleep apnoea syndrome (OSAS): A study of psychological, neuropsychological and clinical relationships in a disabling multifaceted disease. Sleep Med 2008; 9:882-9. [DOI: 10.1016/j.sleep.2007.10.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2007] [Revised: 10/10/2007] [Accepted: 10/28/2007] [Indexed: 10/22/2022]
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Mioni R, Xamin N, Zuliani L, Belligoli A, Pierobon A, Bleve L, Granzotto M, Maffei P, Sicolo N, Vettor R, Fallo F. 9.7 Insulin-Resistance and Altered Circadian Blood Pressure Profile in Normotensive Young Women with Polycystic Ovary Syndrome. High Blood Press Cardiovasc Prev 2008. [DOI: 10.1007/bf03263679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Giardini A, Majani G, Pierobon A, Gremigni P, Catapano I. [Contribution to the Italian validation of the IPQ-R]. G Ital Med Lav Ergon 2007; 29:A64-74. [PMID: 17650745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Knowledge of patients' opinions and beliefs about their illness is fundamental in interdisciplinary health care interventions. The IPQ and its revised version (IPQ-R) are questionnaires designed to assess components of the mental representation of illness described in Leventhal's self-regulation model. To validate the IPQ-R in the Italian population, verifying its psychometric properties and focusing on Part II of the instrument (opinions about disease), we enrolled 277 inpatients (216 males and 61 females) affected by myocardial infarction (n=70), coronary artery by-pass graft surgery (n=52), chronic heart failure (n=47), valve replacement (n=20), obstructive sleep apnoea syndrome associated to obesity (n=53) and respiratory failure (n=35). All patients completed the Italian version of the IPQ-R obtained by means of 3 translations and a back version. IPQ-R scores were compared to patients' scores on the SF-36 and AD schedule (on anxiety and depression). Structural validity and reliability (both internal and test-retest) of the Italian IPQ-R were assessed. The validity of Part II of the IPQ-R was confirmed. As in the original version, 7 factors were extracted. ANOVA revealed statistically significant differences between the different diseases. Correlations between IPQ-R and, respectively, the SF-36 and AD schedule were statistically significant and coherent with the constructs analyzed. Finally statistically significant correlations emerged between the IPQ-R factors. The test-retest reliability and internal consistency of the questionnaire were confirmed. The psychometric properties of the Italian version of the IPQ-R were demonstrated to be robust. Hence, the Italian version of the IPQ-R, which resulted homogeneous with the original version, could be useful in assessing the cognitive factors involved in patients' adjustment to various chronic illnesses.
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Affiliation(s)
- A Giardini
- Fondazione Salvatore Maugeri, Clinica del Lavoro e della Riabilitazione, IRCCS, Istituto Scientifico di Montescano (PV), Servizio di Psicologia.
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Pierobon A, Callegari S, Mastretta E. [A traumatic brain injury patient: from rehabilitation to social-familial re-integration. Case report focusing on quality of life aspects]. G Ital Med Lav Ergon 2006; 28:119-122. [PMID: 18924302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
WHO recommends that the biopsychosocial model be adopted in the rehabilitation and, particularly, in the multidisciplinary care of Traumatic Brain Injury (TBI) patients. The neuropsychological, psychological, and Quality of Life (QoL) assessment of TBI patients follows the evolution of their clinical conditions. The following evaluation battery is administered in our Unit: Specific Neuropsicological Tests, Wechsler Adult Intelligence Scales Revised (WAIS-R), and the Short Form-36 (SF-36) and Satisfaction Profile (SAT-P), two generic questionnaires measuring respectively health status and subjective aspects of QoL. Mauro is an 18-year old patient with TBI, complicated after one and a half years by epilepsy. The clinical report is divided into three phases (3, 5 and 18 months post-TBI)--ranging from the first psychological-neuropsychological assessment to the patient's socio-educational re-integration--and includes self-reports by the patient and/or his mother, a discussion of the QoL and neuropsychological data, and a presentation of the work carried out in the cognitive behavioural rehabilitation. The psychological topics that emerged are: memories of the traumatic event and the hospitalization period, enthusiasm about the "return to life", and difficulties and suffering due to the fact of "being different". This paper offers an example of both the assessment and treatment of TBI patients--following its course from where it begins in the Rehabilitation Center to its continuation in the patient's social environment. The purpose of such a global clinical management is to effectuate a psychosocial re-integration that is adequate in terms of the patient's cognitive resources and residual behavioural abilities.
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Affiliation(s)
- A Pierobon
- Servizio di Psicologia, Fondazione Salvatore Maugeri, Clinica del Lavoro e della Riabilitazione, IRCCS, Istituto Scientifico di Montescano (PV) Pavia, Italy.
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