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Ottoboni G, Chirico I, Povolná P, Dostálová V, Holmerová I, Janssen N, Dassen F, de Vugt M, Sánchez-Gómez MC, García-Peñalvo F, Franco-Martin MA, Chattat R. Psychosocial care in dementia in European higher education: Evidence from the SiDECar ("Skills in DEmentia Care") project. Nurse Educ Today 2021; 103:104977. [PMID: 34051541 DOI: 10.1016/j.nedt.2021.104977] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 03/26/2021] [Accepted: 05/11/2021] [Indexed: 05/25/2023]
Abstract
In dementia care, psychosocial interventions can increase people's quality of life with dementia and their caregivers. Despite their effectiveness, their translation into practice lacks the desirable systematicity. Systematic educational programs on psychosocial interventions in dementia will improve this translation, as it prepares professionals to face the complexity of dementia care. This study aimed to systematically map out the extent to which higher education programs in Europe include teaching activities about psychosocial care of dementia. We collected quantitative and qualitative data about 303 higher education teaching activities on psychosocial care in dementia across Europe. The analysis revealed that the number of teaching activities focusing on psychosocial care in dementia was relative. Although the results reflected UNESCO indications, the teaching activities on psychosocial care in dementia appeared less systematized than optimal. As world health agencies recommend, international higher education systems should consider more psychosocial care topics because they can prepare professionals to respond timely and effectively to dementia patients and caregivers' needs.
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Affiliation(s)
- G Ottoboni
- Department of Psychology, University of Bologna, Bologna, Italy.
| | - I Chirico
- Department of Psychology, University of Bologna, Bologna, Italy.
| | - P Povolná
- Charles University, Faculty of Humanities, Czech Republic; Institute for Postgraduate Medical Education, Prague, Czech Republic.
| | - V Dostálová
- Charles University, Faculty of Humanities, Czech Republic; Institute for Postgraduate Medical Education, Prague, Czech Republic.
| | - I Holmerová
- Charles University, Faculty of Humanities, Czech Republic; Institute for Postgraduate Medical Education, Prague, Czech Republic.
| | - N Janssen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, the Netherlands.
| | - F Dassen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, the Netherlands.
| | - M de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, the Netherlands.
| | | | | | | | - R Chattat
- Department of Psychology, University of Bologna, Bologna, Italy.
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Lion K, Szcześniak D, Evans S, Evans S, Farina E, Brooker D, Chattat R, Meiland F, Droes RM, Rymaszewska J. Can we reduce the stigmatisation experience with psychosocial interventions? An investigation of the meeting centre support programme impact on people with cognitive impairments. Eur Psychiatry 2021. [PMCID: PMC9471906 DOI: 10.1192/j.eurpsy.2021.378] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionPeople living with dementia or mild cognitive impairment (MCI) experience stigmatisation and there are not many specific psychosocial interventions dedicated to help them coping with this issue, reducing its impact on their lives.ObjectivesThis study aimed to a) investigate the stigmatisation level among people with dementia and MCI in Poland, Italy and the United Kingdom and b) assess the role of the Meeting Centre Support Programme (MCSP) in decreasing stigmatisation.MethodsWe investigated outcomes for 114 people with dementia and MCI living in Italy, Poland and the UK who participated 6 months in MCSP or usual care (UC) using a pre/post-test control group study design. Level of stigmatisation was assessed with the Stigma Impact Scale: neurological impairment (SIS).ResultsStigmatisation level (SIS) among participants varied from 2 to 65 (median=33.5; Q1=27; Q3=41) with people from the UK experiencing a statistically significantly higher level of stigmatisation than people in Italy and Poland. In Italy, stigmatisation was lower (p=0.02) in the MCSP group following the intervention. In Poland, the social isolation level did not significantly change in MCSP, but increased (p=0.05) in UC. In the UK, the social rejection level raised (p=0.03) in MCSP. Overall, the combined data of the three countries did not show statistically significant differences in SIS between MCSP and UC.ConclusionsStigmatisation among people with dementia and MCI is complex and seems culturally dependent. There is a great opportunity in psychosocial interventions to reduce the burden of stigma among people with dementia which requires further investigation.DisclosureNo significant relationships.
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Brooker D, Dröes R, Chattat R, Farina E, Rymaszewska J, Meiland F, Evans S, Henderson C. ENABLING PARTICIPATION IN SOCIAL ACTIVITY: THE MEETING CENTRES SUPPORT PROGRAMME. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2166] [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: 11/13/2022] Open
Affiliation(s)
- D Brooker
- University of Worcester, UK, Worcester, England, United Kingdom
| | - R Dröes
- VU University Medical Center, Amsterdam, Netherlands
| | - R Chattat
- University of Bologna, Bologna, Italy
| | - E Farina
- Fondazione Don Gnocchi, Milan, Italy
| | | | - F Meiland
- VU University Medical Center, Amsterdam 1070 BB, Netherlands
| | | | - C Henderson
- London School of Economics, London, United Kingdom
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Vernooij-Dassen M, Mariani E, Engels Y, Chattat R. SHARED DECISION MAKING IN DEMENTIA CARE PLANNING: INVOLVING FAMILY CAREGIVERS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2369] [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: 11/13/2022] Open
Affiliation(s)
- M. Vernooij-Dassen
- IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands,
| | | | - Y. Engels
- IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands,
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Evans S, Brooker D, Droes R, Meiland F, Rymaszewska J, Szczesniak D, Chattat R, Farina E. EVALUATION OF THE MEETING CENTER SUPPORT PROGRAMME FOR PEOPLE WITH DEMENTIA AND THEIR FAMILY CARERS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1257] [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: 11/14/2022] Open
Affiliation(s)
- S. Evans
- University of Worcester, Worcester, United Kingdom
| | - D. Brooker
- University of Worcester, Worcester, United Kingdom
| | - R. Droes
- VU University Medical Center, Amsterdam, Netherlands,
| | - F. Meiland
- VU University Medical Center, Amsterdam, Netherlands,
| | | | | | | | - E. Farina
- Fondazione Don Carlo Gnocchi, Milan, Italy,
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Dröes RM, Meiland FJM, Evans S, Brooker D, Farina E, Szcześniak D, Van Mierlo LD, Orrell M, Rymaszewska J, Chattat R. Comparison of the adaptive implementation and evaluation of the Meeting Centers Support Program for people with dementia and their family carers in Europe; study protocol of the MEETINGDEM project. BMC Geriatr 2017; 17:79. [PMID: 28376895 PMCID: PMC5381019 DOI: 10.1186/s12877-017-0472-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 12/16/2016] [Accepted: 03/31/2017] [Indexed: 11/17/2022] Open
Abstract
Background The MEETINGDEM study aims to implement and evaluate an innovative, inclusive, approach to supporting community dwelling people with mild to moderate dementia and their family carers, called the Meeting Centers Support Program (MCSP), in three countries in the European Union (EU): Italy, Poland and United Kingdom. Demonstrated benefits of this person-centered approach, developed in The Netherlands, include high user satisfaction, reduced behavioral and mood problems, delayed admission to residential care, lower levels of caregiving-related stress, higher carer competence, and improved collaboration between care and welfare organizations. Methods The project will be carried out over a 36 month period. Project partners in the three countries will utilize, and adapt, strategies and tools developed in the Netherlands. In Phase One (month 1-18) activities will focus on establishing an initiative group of relevant organizations and user representatives in each country, exploring pathways to care and potential facilitators and barriers to implementing the program, and developing country specific implementation plans and materials. In Phase Two (month 19‑36) training will be provided to organizations and staff, after which the meeting centers will be established and evaluated for impact on behavior, mood and quality of life of people with dementia and carers, cost-effectiveness, changes in service use, user satisfaction and implementation process. Discussion An overall evaluation will draw together findings from the three countries to develop recommendations for successful implementation of MCSP across the EU. If the Meeting Centers approach can be widely implemented, this could lead to major improvements in dementia care across Europe and beyond. Trial registration The trial was retrospectively registered in May 2016: trial number: NTR5936.
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Affiliation(s)
- R M Dröes
- Department of Psychiatry, VU University medical center/GGZinGeest, Postbox 74077, 1070 BB, Amsterdam, The Netherlands.
| | - F J M Meiland
- Department of Psychiatry, VU University medical center/GGZinGeest, Postbox 74077, 1070 BB, Amsterdam, The Netherlands
| | - S Evans
- Association for Dementia Studies, University of Worcester, Henwick Grove, Worcester, WR26AJ, UK
| | - D Brooker
- Association for Dementia Studies, University of Worcester, Henwick Grove, Worcester, WR26AJ, UK
| | - E Farina
- Santa Maria Nascente IRCCS Clinical Research Center, Don Carlo Gnocchi Foundation, Via Alfonso Capecelatro 66, 20148, Milan, Italy
| | - D Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10, 50-367, Wroclaw, Poland
| | - L D Van Mierlo
- Department of Psychiatry, VU University medical center/GGZinGeest, Postbox 74077, 1070 BB, Amsterdam, The Netherlands
| | - M Orrell
- Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK
| | - J Rymaszewska
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10, 50-367, Wroclaw, Poland
| | - R Chattat
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, Bologna, Italy
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Dröes RM, Chattat R, Diaz A, Gove D, Graff M, Murphy K, Verbeek H, Vernooij-Dassen M, Clare L, Johannessen A, Roes M, Verhey F, Charras K. Social health and dementia: a European consensus on the operationalization of the concept and directions for research and practice. Aging Ment Health 2017; 21:4-17. [PMID: 27869503 DOI: 10.1080/13607863.2016.1254596] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [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: 10/20/2022]
Abstract
BACKGROUND Because the pattern of illnesses changes in an aging population and many people manage to live well with chronic diseases, a group of health care professionals recently proposed reformulating the static WHO definition of health towards a dynamic one based on the ability to physically, mentally and socially adapt and self-manage. This paper is the result of a collaborative action of the INTERDEM Social Health Taskforce to operationalize this new health concept for people with dementia, more specifically the social domain, and to formulate directions for research and practice to promote social health in dementia. METHOD Based on the expertise of the Social Health Taskforce members (N = 54) three groups were formed that worked on operationalizing the three social health dimensions described by Huber et al.: (1) capacity to fulfil potential and obligations; (2) ability to manage life with some degree of independence; (3) participation in social activities. For each dimension also influencing factors, effective interventions and knowledge gaps were inventoried. After a consensus meeting, the operationalizations of the dimensions were reviewed by the European Working Group of People with Dementia (EWGPWD). RESULTS The social health dimensions could be well operationalized for people with dementia and are assessed as very relevant according to the Social Health Taskforce and EWGPWD. Personal (e.g. sense of coherence, competencies), disease-related (e.g. severity of cognitive impairments, comorbidity), social (support from network, stigma) and environmental factors (e.g. enabling design, accessibility) that can influence the person with dementia's social health and many interventions promoting social health were identified. CONCLUSION A consensus-based operationalization of social health in dementia is proposed, and factors that can influence, and interventions that improve, social health in dementia identified. Recommendations are made for research and practice.
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Affiliation(s)
- R M Dröes
- a Department of Psychiatry, Alzheimer Centre , EMGO Institute for Health and Care Research, VU University Medical Centre , Amsterdam , The Netherlands
| | - R Chattat
- b Department of Psychology , University of Bologna , Bologna , Italy
| | - A Diaz
- c Alzheimer Europe , Luxembourg , Luxembourg
| | - D Gove
- c Alzheimer Europe , Luxembourg , Luxembourg
| | - M Graff
- d Radboud University Medical Centre, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Radboud Alzheimer Centre , Nijmegen , The Netherlands
| | - K Murphy
- e School of Nursing and Midwifery, Aras Loyola, National University of Irelands , Galway , Ireland
| | - H Verbeek
- f Research School CAPHRI, Department of Health Services Research , Maastricht University , Maastricht , The Netherlands
| | - M Vernooij-Dassen
- d Radboud University Medical Centre, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Radboud Alzheimer Centre , Nijmegen , The Netherlands
| | - L Clare
- g Centre for Research in Ageing and Cognitive Health (REACH) , School of Psychology, University of Exeter, and PenCLAHRC, University of Exeter Medical School , Exeter , United Kingdom
| | - A Johannessen
- h Norwegian National Advisory Unit on Ageing and Health , VID Specialized University , Oslo , Norway
| | - M Roes
- i German Center for Neurodegenerative Diseases, Department of Nursing Science, Faculty of Health , University of Witten/Herdecke , Witten , Germany
| | - F Verhey
- j Department of Psychiatry and Neuropsychology , Maastricht University , Maastricht , The Netherlands
| | - K Charras
- k Fondation Médéric Alzheimer , Psychosocial Interventions Department , Paris , France
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Mangiaracina F, Chattat R, Farina E, Saibene FL, Gamberini G, Brooker D, Evans SC, Evans SB, Szcześniak D, Urbanska K, Rymaszewska J, Hendriks I, Dröes RM, Meiland FJM. Not re-inventing the wheel: the adaptive implementation of the meeting centres support programme in four European countries. Aging Ment Health 2017; 21:40-48. [PMID: 27982713 DOI: 10.1080/13607863.2016.1258540] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 02/04/2023]
Abstract
OBJECTIVES The implementation of new health services is a complex process. This study investigated the first phase of the adaptive implementation of the Dutch Meeting Centres Support Programme (MCSP) for people with dementia and their carers in three European countries (Italy, Poland, the UK) within the JPND-MEETINGDEM project. Anticipated and experienced factors influencing the implementation, and the efficacy of the implementation process, were investigated. Findings were compared with previous research in the Netherlands. METHOD A qualitative multiple case study design was applied. Checklist on anticipated facilitators and barriers to the implementation and semi-structured interview were completed by stakeholders, respectively at the end and at the beginning of the preparation phase. RESULTS Overall, few differences between countries were founded. Facilitators for all countries were: added value of MCSP matching needs of the target group, evidence of effectiveness of MCSP, enthusiasm of stakeholders. General barriers were: competition with existing care and welfare organizations and scarce funding. Some countries experienced improved collaborations, others had difficulties finding a socially integrated location for MCSP. The step-by-step implementation method proved efficacious. CONCLUSION These insights into factors influencing the implementation of MCSP in three European countries and the efficacy of the step-by-step preparation may aid further implementation of MCSP in Europe.
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Affiliation(s)
- F Mangiaracina
- a Department of Psychology , University of Bologna , Bologna , Italy.,e Department of Psychiatry , EMGO Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands
| | - R Chattat
- a Department of Psychology , University of Bologna , Bologna , Italy
| | - E Farina
- b Don Gnocchi Foundation , IRCCS Santa Maria Nascente , Milan , Italy
| | - F L Saibene
- b Don Gnocchi Foundation , IRCCS Santa Maria Nascente , Milan , Italy
| | - G Gamberini
- b Don Gnocchi Foundation , IRCCS Santa Maria Nascente , Milan , Italy
| | - D Brooker
- c Association for Dementia Studies , University of Worcester , Worcester , UK
| | - S C Evans
- c Association for Dementia Studies , University of Worcester , Worcester , UK
| | - S B Evans
- c Association for Dementia Studies , University of Worcester , Worcester , UK
| | - D Szcześniak
- d Division of consulation Psychiatry and Neuroscience, Department of Psychiatry , Wroclaw Medical University , Wroclaw , Poland
| | - K Urbanska
- d Division of consulation Psychiatry and Neuroscience, Department of Psychiatry , Wroclaw Medical University , Wroclaw , Poland
| | - J Rymaszewska
- d Division of consulation Psychiatry and Neuroscience, Department of Psychiatry , Wroclaw Medical University , Wroclaw , Poland
| | - I Hendriks
- e Department of Psychiatry , EMGO Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands
| | - R M Dröes
- e Department of Psychiatry , EMGO Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands
| | - F J M Meiland
- e Department of Psychiatry , EMGO Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands
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Ansaloni L, Catena F, Chattat R, Fortuna D, Franceschi C, Mascitti P, Melotti RM. Risk factors and incidence of postoperative delirium in elderly patients after elective and emergency surgery. Br J Surg 2010; 97:273-80. [PMID: 20069607 DOI: 10.1002/bjs.6843] [Citation(s) in RCA: 199] [Impact Index Per Article: 14.2] [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 : This study evaluated the incidence of postoperative delirium (POD) in elderly patients undergoing general surgery, the risk factors associated with POD, and its impact on hospital stay and mortality. METHODS : Patients aged over 65 years who had emergency or elective operations were eligible for this case-control study. Risk factors significantly associated with POD using univariable analysis were entered into multivariable analysis, to establish those independently associated with POD. RESULTS : A total of 351 patients (357 admissions) were enrolled in the study. The incidence of POD was 13.2 per cent (17.9 per cent for emergency operations). Independent variables associated with POD were: age above 75 years, co-morbidity, preoperative cognitive impairment, psychopathological symptoms and abnormal glycaemic control. Median length of hospital stay was 21 (range 1-75) days for patients with POD versus 8 (range 1-79) days for control patients (P < 0.001). The hospital mortality rate was 19 and 8.4 per cent respectively (P = 0.021). CONCLUSION : The incidence of POD is high in elderly patients for both emergency and elective surgery, leading to an increase in hospital stay and perioperative mortality. To minimize POD, associated risk factors of co-morbidity, cognitive impairment, psychopathology and abnormal glycaemic control must be identified and treated.
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Affiliation(s)
- L Ansaloni
- Unit of General, Emergency and Transplant Surgery, St Orsola-Malpighi University Hospital, Italy.
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Moniz-Cook E, Vernooij-Dassen M, Woods R, Verhey F, Chattat R, De Vugt M, Mountain G, O'Connell M, Harrison J, Vasse E, Dröes RM, Orrell M. A European consensus on outcome measures for psychosocial intervention research in dementia care. Aging Ment Health 2008; 12:14-29. [PMID: 18297476 DOI: 10.1080/13607860801919850] [Citation(s) in RCA: 264] [Impact Index Per Article: 16.5] [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: 01/07/2023]
Abstract
Psychosocial intervention makes a vital contribution to dementia care. However, the lack of consensus about which outcome measures to use to evaluate effectiveness prevents meaningful comparisons between different studies and interventions. This study used an iterative collaborative, evidence-based approach to identify the best of currently available outcome measures for European psychosocial intervention research. This included consensus workshops, a web-based pan-European consultation and a systematic literature review and a rigorous evaluation against agreed criteria looking at utility across Europe, feasibility and psychometric properties. For people with dementia the measures covered the domains of quality of life, mood, global function, behaviour and daily living skills. Family carer domains included mood and burden, which incorporated coping with behaviour and quality of life. The only specific staff domain identified was morale, but this included satisfaction and coping with behaviour. In conclusion twenty-two measures across nine domains were recommended in order to improve the comparability of intervention studies in Europe. Areas were identified where improved outcome measures for psychosocial intervention research studies are required.
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Affiliation(s)
- E Moniz-Cook
- Institute of Rehabilitation, University of Hull & Humber Mental Health Teaching NHS Trust, Hull, UK.
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Savorani G, Chattat R, Capelli E, Vaienti F, Giannini R, Bacci M, Anselmo R, Paletti P, Maioli F, Forti P, Sciumbata A, Ravaglia G. IMMEDIATE EFFECTIVENESS OF THE “NEW IDENTITY” REALITY ORIENTATION THERAPY (ROT) FOR PEOPLE WITH DEMENTIA IN A GERIATRIC DAY HOSPITAL. Arch Gerontol Geriatr 2004:359-64. [PMID: 15207434 DOI: 10.1016/j.archger.2004.04.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Techniques of reality orientation in dementia are widely used around the world and indifferent settings. Nevertheless, after the controversies for adverse effects and frustration,by the new millennium "a new era" is coming on where cognitive rehabilitation "has come of age" and a series of positive results appeared until the fulfillment in the global and person-centered approach. This renewed technique may no more be based only on cognitive psychology but it is necessary to apply a more complete psychosocial approach taking into account also emotional, behavioral and functional domains of the globally considered person. The aims of our study are: (1) To assess the global efficacy on cognitive and affective functions. (2) To detect cognitive subsystems more sensible to our three-phase stimulation program. We studied 34 outpatients, 13 men and 21 women, age range 67-88 years, referred to our Expertise Center, all but one affected by mild cognitive impairment(MCI), suffering from mild dementia (clinical dementia rating, CDR <1). After 20 sessions of formal and complementary activities, a comprehensive improvement of cognition, language,memory and affective functions was observed. Semantic fluency improved with high statistically significant difference. The immediate recall, free or cued, appeared more sensible to stimulation than the delayed one. A correlation between a mini mental state examination (MMSE) low basal score and higher performance after the program was also obtained.
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Affiliation(s)
- G Savorani
- Department of Internal Medicine and Aging, Dementia Expertise Center, S. Orsola-Malpighi University Hospital, I-40138 Bologna, Italy.
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Chattat R, Ellena L, Cucinotta D, Savorani G, Mucciarelli G. A study on the validity of different short versions of the geriatric depression scale. Arch Gerontol Geriatr Suppl 2001; 7:81-6. [PMID: 11431049 DOI: 10.1016/s0167-4943(01)00124-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- R Chattat
- Department of Psychology, Bologna University, Italy
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Usai A, Chattat R, Cucinotta D, Savorani G, Ellena L, Mucciarelli G. Cognitive style, cognitive impairment and health status in elderly. Arch Gerontol Geriatr Suppl 2001; 7:413-8. [PMID: 11431093 DOI: 10.1016/s0167-4943(01)00168-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- A Usai
- Department of Psychology, Bologna University, Italy
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Chattat R, Bazzocchi G, Balloni M, Conti E, Ercolani M, Zaccaroni S, Grilli T, Trombini G. Illness behavior, affective disturbance and intestinal transit time in idiopathic constipation. J Psychosom Res 1997; 42:95-100. [PMID: 9055217 DOI: 10.1016/s0022-3999(96)00217-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Patients with constipation differ not only from healthy subjects but can also be categorized into two groups: slow transit constipation (STC) and normal transit constipation (NTC) using measures of total intestinal transit time (TITT). We investigated the role of illness behavior and affective state in 45 NTC and 29 STC patients as compared with 20 healthy subjects. All subjects completed the Illness Behavior Questionnaire (IBQ), the Symptom Questionnaire (SQ), and the CES-D to assess illness behavior, psychological distress, and depression. The constipated patients reported more psychological distress than healthy subjects. Within the constipated group, the NTC subjects had significantly higher scores on the IBQ dimensions of hypochondriasis and disease affirmation. Our results suggest that even among constipated patients psychological distress is prominent and that measures of illness behavior help to discriminate among different pathophysiological groups.
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Affiliation(s)
- R Chattat
- Department of Internal Medicine, Bellaria Hospital, Bologna, Italy
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Pasquali R, Anconetani B, Chattat R, Biscotti M, Spinucci G, Casimirri F, Vicennati V, Carcello A, Labate AM. Hypothalamic-pituitary-adrenal axis activity and its relationship to the autonomic nervous system in women with visceral and subcutaneous obesity: effects of the corticotropin-releasing factor/arginine-vasopressin test and of stress. Metabolism 1996; 45:351-6. [PMID: 8606643 DOI: 10.1016/s0026-0495(96)90290-5] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In a previous study, we demonstrated that premenopausal women with visceral obesity have hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis, characterized by an exaggerated hormone response to corticotropin-releasing factor (CRF) and corticotropin (ACTH) stimulation. The hypothalamic peptide flow that stimulates the pituitary, particularly after a physiological stress challenge, involves not only CRF, but also arginine-vasopressin (AVP), which synergizes the CRF capacity to stimulate pituitary hormone secretion. Previous studies in humans have demonstrated that combining AVP with CRF permits maximal stimulation of the pituitary, providing a more appropriate method of assessing pituitary hormone reserve. We therefore investigated the response of the HPA axis to combined CRF and AVP stimuli in obese women with different obesity phenotypes. Moreover, we examined hormonal and cardiovascular responses to several mental stress tasks, according to previously standardized procedures. Two groups of age-matched premenopausal eumenorrheic obese women with visceral (V-BFD) or subcutaneous (S-BFD) body fat distribution and a group of normal-weight healthy controls were investigated. All women randomly underwent the following protocol: (1) a combined CRF/AVP test (100 micrograms plus 0.3 IU intravenously [IV], respectively); (2) a standardized stress test, which consisted of completing two puzzles and a mental arithmetic test; and (3) a control saline test. Blood samples for ACTH and cortisol determinations were obtained before and during each test, and measurements of arterial blood pressure and pulse rate were made at regular intervals during the stress test. After combined CRF/AVP administration, ACTH and cortisol were significantly higher in V-BFD than in the other two groups. In contrast, no significant hormonal variation was found in either group during stress tasks. During the stress test, pulse rate (but not arterial blood pressure) significantly increased after 8 and 15 minutes in the V-BFD group, whereas no significant variation was found in S-BFD and control women. A significant correlation was present between the pulse rate and change in cortisol level during the stress test at minutes 8 (r=.54, P<.05) and 15 (r=.57, p<.01) in all women considered together. Subjective emotional involvement during stressful tasks was measured by a two-dimensional short verbal scale, which revealed that the stress section had a more significant impact in obese V-BFD than in S-BFD and control women. These data therefore confirm that women with visceral obesity have hyperactivity of the HPA axis, and that the combined CRF/AVP stimulation may offer a good tool for investigating pituitary reserve in this obesity phenotype. Moreover, the results indicate that these women probably have a hyperreactive sympathetic response to acute stress that seems interrelated to that of the HPA axis.
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Affiliation(s)
- R Pasquali
- Institute of Clinical Medicine 1, University Alma Mater, Bologna, Italy
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Ercolani M, Trombini G, Chattat R, Cervini C, Piergiacomi G, Salaffi F, Zeni S, Marcolongo R. Fibromyalgic syndrome: depression and abnormal illness behavior. Multicenter investigation. Psychother Psychosom 1994; 61:178-86. [PMID: 8066155 DOI: 10.1159/000288887] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This study reports psychological symptoms assessed in 327 patients with fibromyalgia (FS) in a multicenter investigation. Two self-report scales, in their validated Italian translations, were used for screening: the CES-D (the Center of Epidemiologic Studies-Depression) developed at the NIMH for measuring depression and the Illness Behavior Questionnaire (IBQ) developed by Pilowsky and Spence. The cutoff point of 23 in the CES-D scores revealed about 49% of the fibromyalgic patients as depressed. In analyzing patterns of illness behavior patients with FS showed a high score on IBQ scales of disease conviction, psychological versus somatic focusing and denial. CES-D scores showed significant correlations with illness behavior scales. These results and their implications for the treatment of fibromyalgic patients are discussed.
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Affiliation(s)
- M Ercolani
- Dipartimento di Psicologia, Università di Bologna, Italia
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