Search Results (330)

Background: Fear of falling (FOF) is a significant concern among older adults, especially after total knee arthroplasty (TKA). FOF can limit daily activities, reduce quality of life, and hinder recovery. This study aimed to investigate the prevalence, severity, and impacts of FOF in patients undergoing TKA and identify factors contributing to increased FOF. Methods: A prospective observational study was conducted at King Abdulaziz Medical City in Riyadh, Saudi Arabia, from April 2024 to December 2024. This study included 52 participants aged 20 to 75 years who had undergone primary TKA. Data were collected at two time points: after TKA and at three months post-surgery. The Short Falls Efficacy Scale-International (SFES-I) was used to assess the severity of FOF, and the Short Form 36 (SF-36) was used to measure the quality of life. Descriptive statistics, t-tests, and logistic regression were used for analysis. Results: This study included 52 participants (mean age: 63.77 ± 6.65 years; 82.7% female). Post-TKA, all participants exhibited high FOF (mean SFES-I score: 56.75 ± 8.30). After three months, the mean SFES-I score decreased significantly to 49.04 ± 12.45 (t = 4.408, p < 0.05). Post-TKA, SF-36 showed significant improvements in the physical function, role of physical limitations, bodily pain, vitality, social function, role of emotional limitations, and mental health subdomains. Bilateral total knee arthroplasty, body mass index, and some SF-36 subcomponents—such as general health, vitality, and role of emotional limitations—were identified as factors leading to increased FOF. Conclusions: FOF remains prevalent and severe in TKA patients, even at three months post-surgery, affecting rehabilitation outcomes. Early identification and tailored interventions for FOF should be considered essential components of comprehensive TKA recovery programs. Full article

Background/Objectives: Collaboration in mental health care is essential for implementing a model oriented towards the psychosocial rehabilitation of people based on multifaceted interventions involving different actors and sectors of society to respond to demands. Despite the benefits presented by the scientific evidence, there are still many barriers to collaborative care, and professionals continue to struggle in reorienting their conduct. The current situation demands organization and the framing of well-founded action plans to overcome challenges, which in turn requires a detailed understanding of collaborative practices in mental health care and their conceptual boundaries. A concept analysis was undertaken to propose a working definition of collaborative practices in mental health care (CPMHC). Methods: This paper used the Walker and Avant concept analysis method. This includes identifying the defining concept attributes, antecedents, consequences, and empirical referents. A literature search was carried out from November 2024 to February 2025 in three databases (Medline, CINAHL, and LILACS), considering studies published between 2010 and 2024. Results: The final sample of literature investigated consisted of 30 studies. The key attributes were effective communication, building bonds, co-responsibility for care, hierarchical flexibility, articulation between services, providers and community, monitoring and evaluating of care processes, and attention to the plurality of sociocultural contexts. Conclusions: This comprehensive analysis contributes to guiding future research and policy development of collaborative practices in mental health, considering the individual, relational, institutional, and social levels. Further research is possible to deepen the understanding of the production of collaborative practices in mental health in the face of the complexity of social relations and structural inequities. Full article

Background/Objectives: Psychosocial (PS) factors and cognitive dysfunction (CD) in patients with atrial fibrillation (AF) may negatively impact treatment compliance. The PS profile covers multiple psychological and socio-economic factors, although research is mostly limited to depression, anxiety, and work stress. This study assessed the prevalence of a broad range of PS factors in patients with AF and their relationship with cognitive decline. Methods: We retrospectively analyzed data from patients referred to a cardiovascular rehabilitation clinic between March 2017 and April 2023 who underwent standardized assessments of PS factors, cognition, and quality of life. Results: Of the 798 included patients, 230 (28.8%) had AF, with a mean age of 68.07 years (SD 9.60 years). Six of nine PS factors were present in more than half of the overall sample. Compared to non-AF patients, those with AF showed significantly higher levels of social isolation, depression, and hostility, whereas low socioeconomic status, family and work-related stress, and other mental disorders were more frequent in the non-AF group. CD was present in 67.4% of the total cohort and was more prevalent in AF patients with a higher PS burden. Patients with permanent AF reported the poorest health status. Conclusions: Integrating assessments of PS factors and cognition in cardiac rehabilitation is feasible and supports a more comprehensive, patient-centred model of care in AF. Full article

Background/Objectives: Cardiovascular diseases (CVDs) encompass a wide range of heart and vascular conditions and remain the leading cause of death worldwide. Acceptance and Commitment Therapy (ACT) is a psychotherapeutic approach that integrates acceptance, mindfulness, and commitment to value-based actions. This systematic review aims to explore the current evidence on the potential role of ACT interventions in supporting psychological well-being among individuals with CVDs. Methods: A systematic review was conducted in accordance with PRISMA guidelines. A search of the literature was conducted through Scopus, PubMed, Web of Science, Cochrane, and PsycINFO databases. Six studies met the inclusion criteria. Results: The reviewed studies suggest that ACT may promote psychological flexibility, emotion regulation, and self-care behaviors in patients with CVDs. Reported outcomes include improved mindfulness, reduced distress, and enhanced quality of life. However, the evidence base is limited in both size and methodological rigor, with included studies varying in design and population. Conclusions: While preliminary findings indicate that ACT shows promise in addressing psychological aspects of CVDs, the current evidence remains insufficient to draw definitive conclusions. Further high-quality, large-scale studies are needed to evaluate the effectiveness and clinical applicability of ACT in cardiovascular populations. Full article

This study presents a systematic review regarding the use of augmented reality and virtual reality in exergaming by analyzing studies published during 2010–2025. This study focuses on providing an overview of the field and on examining and synthesizing the findings of related studies to identify the contexts, applications, and domains in which extended reality exergames are being used and the related implications, benefits, and challenges. Based on the results, augmented reality and virtual reality exergames offer immersive, enjoyable, engaging, and personalized experiences that support physical, cognitive, and emotional well-being, while enhancing physical performance, cognitive functioning, psychological outcomes, and mental health. They promote motivation, active lifestyles, and sustainable health behaviors across diverse populations, including older adults, individuals with disabilities, and neurological groups, as well as the general adult and youth populations. Although emphasis is placed on their use in physical and cognitive rehabilitation and treatment, they also show great potential to be effectively used in different domains, including education. Among the technologies examined, the significant majority of studies focused on virtual reality exergames, a limited number of studies involved augmented reality, and only a few studies examined mixed reality, extended reality, and the metaverse. Finally, nine main topics were identified through topic modeling, providing a clear representation of the core themes within the literature. Full article

Background: Psychological problems post-stroke can negatively impact stroke survivors. Although general psychological services exist (e.g., NHS Talking Therapies), access remains limited, particularly for individuals with post-stroke communication and cognitive impairments. Stroke service staff report low confidence in managing psychological distress. This study is the first to explore the barriers and facilitators to implementing a novel intervention package comprising a cross-service care pathway and staff training to enhance post-stroke psychological provision. Methods: Staff from stroke and mental health services in four UK regions, recruited through purposive sampling to ensure diversity of services and professional roles, participated in semi-structured interviews or focus groups, guided by the Theoretical Domains Framework (TDF), before and after implementation of the intervention package. Pre-implementation interviews/groups identified anticipated barriers and facilitators to implementation and training needs, informing the development of site-specific intervention packages; post-implementation interviews/groups explored experienced barriers, facilitators and perceptions of the intervention. Interviews underwent thematic analysis using the TDF. Results: Fifty-five staff participated pre-implementation and seventeen post-implementation, representing stroke (e.g., nurse, physiotherapist, consultant) and psychology (e.g., counsellor, psychological therapist) roles across acute, rehabilitation, community, and voluntary services. Challenges anticipated pre-implementation included: limited specialist post-stroke psychological support; low staff confidence; and fragmented service pathways. Post-implementation findings indicated increased staff knowledge and confidence, enhanced screening and referral processes, and stronger inter-service collaboration. Implementation success varied across sites (with some sites showing greater ownership and sustainability of the intervention) and across staff roles (with therapy staff more likely than nursing staff to have received training). Conclusions: Effective implementation of an intervention package to increase psychological provision post-stroke requires staff engagement at all levels across all services. Staff investment influenced ownership of the intervention package, beliefs about priorities and overall enhancement of service capability. Full article

Background/Objectives: The scientific literature shows that new scientific and social priorities regarding social impacts and co-creation are leading to profound transformations in all scientific and social contexts. In the field of mental health, one dimension of this transformation is the increasing visibility of dialogic models that support the improvement of mental health. While this is very positive, it carries a risk of deformations that can lead to negative outcomes for both society and science. There is a lack of scientific research about the errors related to the new visibility of the Successful Dialogues in Mental Health (SDMH) model. The objective of this research is to clarify a certain type of error, namely when the excellent results obtained through the use of this model in particular contexts are attributed to a supposed dialogic approach of psychiatric rehabilitation, made by researchers without a degree in medicine. Methods: In order to clarify this error, we use a communicative methodology through a qualitative research design, oriented to unveil the main steps in the original development of the model. Results: The results show that the SDMH model has never presented itself as psychiatric, but instead as a social–dialogic collaboration with psychiatrists with the aim of helping individuals to overcome mental health problems. Conclusions: This study clarifies the purpose of the SDMH model which contributes to benefiting citizens, particularly those with mental health conditions. Full article

Introduction: Home-based cardiac telerehabilitation (HBCTR) is a multidisciplinary intervention aimed at optimizing functional, psychological, and social recovery in patients undergoing percutaneous coronary intervention (PCI). This rehabilitation model serves as an effective alternative to traditional center-based rehabilitation, providing a cost-effective and clinically advantageous approach. Methods: Following PRISMA guidelines, we conducted a systematic literature search across multiple databases (PubMed, CINAHL, Cochrane, Scopus, Web of Science). We included randomized controlled trials (RCTs), cohort, and observational studies assessing telerehabilitation in post-PCI patients. Primary outcomes focused on health-related quality of life (HRQoL) and adherence, while secondary outcomes included functional capacity (6 min walk test, VO₂max), cardiovascular risk factor control, and psychological well-being. Risk of bias was assessed using the Cochrane RoB 2.0 and ROBINS-I tools. Results: A total of 3575 articles were identified after removing duplicates, of which 877 were selected based on title and abstract, and 17 met the inclusion criteria, with strong RCT representation ensuring robust evidence synthesis. HBCTR was associated with significant improvements in exercise capacity, with increases in VO₂max ranging from +1.6 to +3.5 mL/kg/min and in 6 min walk distance from +34.7 to +116.6 m. HRQoL scores improved significantly, with physical and mental component scores increasing by +6.75 to +14.18 and +4.27 to +11.39 points, respectively. Adherence to telerehabilitation programs was consistently high, often exceeding 80%, and some studies reported reductions in hospital readmissions of up to 40%. Wearable devices and smartphone applications facilitated self-monitoring, enhancing adherence and reducing readmissions. Several studies also highlighted improvements in anxiety and depression scores ranging from 10% to 35%. Conclusions: HBCTR is a promising strategy for rehabilitation and quality-of-life improvement after PCI. It offers a patient-centered solution that leverages technology to enhance long-term outcomes. By integrating structured telerehabilitation programs, healthcare systems can expand accessibility, promote adherence, and improve equity in cardiovascular care. Full article

Laryngeal cancer significantly affects not only survival but also core functions such as speech, swallowing, and breathing. These impairments often result in substantial psychological distress and reduced health-related quality of life (HRQoL). This review aims to synthesize current evidence regarding the psychological impact, quality of life outcomes, and system-level challenges faced by laryngeal cancer patients while identifying strategies for integrated survivorship care. Anxiety and depressive symptoms are highly prevalent among laryngeal cancer patients, particularly those undergoing total laryngectomy or chemoradiotherapy. HRQoL outcomes vary significantly depending on treatment modality, with long-term deficits noted in domains such as voice, swallowing, and emotional well-being. Access to psychological support and rehabilitation remains inconsistent, hindered by institutional, socioeconomic, and cultural barriers. Structured survivorship models, psychological screening, and patient-centered rehabilitation have demonstrated benefits but are not universally implemented. Comprehensive care for laryngeal cancer must extend beyond tumor control to address persistent functional and psychological sequelae. A multidisciplinary, anticipatory, and personalized approach—centered on integrated rehabilitation and mental health support—is essential to optimize survivorship outcomes and improve long-term quality of life. Full article

Introduction: Few applications worldwide focus on psychosocial rehabilitation, and none specifically address psychosocial rehabilitation projects. This justifies the need for an application to assist mental health professionals in constructing and managing such projects in the Brazilian mental health scenario. Objective: This study aimed to present a web application, the “Psychosocial Rehabilitation Application” (Psychosocial Rehab App), and describe its development in detail through a technological survey conducted between May 2024 and February 2025. Method: The development process of the web app was carried out in the following four stages, adapted from the Novak method: theoretical basis, requirements survey, prototyping, and development with alpha testing. The active and collaborative participation of the main researcher (a psychiatric nurse) and two undergraduate software engineers, supervised by a software engineer and a professor of nursing and psychology, was essential for producing a suitable operational product available to mental health professionals. Interactions were conducted via video calls, WhatsApp, and email. These interactions were transcribed using the Transkriptor software and inserted into the ATLAS.ti software for thematic analysis. Results: The web app “Psychosocial Rehabilitation Application” displays a home screen for registration and other screens structured into the stages of the psychosocial rehabilitation project (assessment, diagnosis, goals, intervention, agreements, and re-assessment). It also has a home screen, a resource screen, and a function screen with options to add a new project, search for a project, or search for mental health support services. These features facilitate the operation and streamline psychosocial rehabilitation projects by mental health professionals. Thematic analysis revealed three themes and seven codes describing the entire development process and interactions among participants in collaborative, interrelational work. A collaborative approach between researchers and developers was essential for translating the complexity of the psychosocial rehabilitation project into practical and usable functionalities for future users, who will be mental health professionals. Discussion: The Psychosocial Rehab App was developed collaboratively by mental health professionals and developers. It supports the creation of structured rehabilitation projects, improving decision-making and documentation. Designed for clinical use, the app promotes autonomy and recovery by aligning technology with psychosocial rehabilitation theory and the actual needs of mental health services. Conclusions: The Psychosocial Rehab App was developed through collaborative work between mental health and technology professionals. The lead researcher mediated this process to ensure that the app’s functionalities reflected both technical feasibility and therapeutic goals. Empathy and dialog were key to translating complex clinical needs into usable and context-appropriate technological solutions. Full article

Augmented reality (AR) and virtual reality (VR) technologies have rapidly expanded within healthcare due to their innovative capabilities for enhancing patient care, medical training, and health outcomes. This systematic review synthesizes quantitative studies published post-2020, explicitly investigating AR and VR healthcare interventions. The review identifies, evaluates, and summarizes the effectiveness of these interventions, highlighting their clinical implications, outcomes, and implementation challenges. Twenty eligible studies were included, examining various health conditions such as cardiopulmonary resuscitation training, mental health disorders, stroke rehabilitation, and orthopedic recovery. Findings indicate generally positive outcomes from AR and VR interventions; however, issues including technology usability, adherence, and methodological limitations are noted. This review underscores the significant potential of AR and VR interventions in healthcare, but emphasizes the need for more rigorous research to address current gaps in the clinical effectiveness and application. Full article

Survivors of intensive care unit (ICU) hospitalization often face persistent health challenges after discharge, collectively referred to as post-intensive care syndrome (PICS). This condition affects physical, cognitive, and mental health, significantly impacting patients’ quality of life and increasing their healthcare utilization. Additionally, caregivers may develop PICS-F (PICS family), experiencing stress-related health burdens. Despite the growing awareness of these issues, structured post-ICU follow-up remains inconsistent, leaving a gap in care that general practitioners (GPs) must often fill. This review examines the role of GPs in managing post-ICU patients, outlining common complications, screening tools, rehabilitation strategies, and potential areas for improved collaboration between primary care and ICU teams. Emphasizing a multidisciplinary and proactive approach, we propose practical interventions that GPs can adopt to enhance long-term recovery outcomes for ICU survivors. Full article

Diabetic retinopathy (DR) is a leading cause of vision loss in patients with diabetes. While medical treatments like retinal laser photocoagulation, anti-VEGF therapy, and vitrectomy are primary, complementary therapies are gaining increasing attention. Based on the existing literature, a healthy lifestyle, including a balanced diet, stress management techniques, and regular physical activity targeting DR, can help regulate blood sugar levels and improve overall physical and mental health to reduce complications. This article explores physical activities and visual training methods related to DR, emphasizing complementary therapies, even though some of these practices are currently not fully integrated into evidence-based ophthalmology. Low vision exercises and aids help patients make the most of their remaining vision, improving their ability to perform everyday tasks, reducing the impact of vision loss, and promoting independence. There is some evidence that eye-related physiotherapy can improve the quality of life for patients with DR, although selection bias cannot be excluded in the presented studies. Consistent physical activity promotes holistic health, and therapies should be regularly monitored by ophthalmologists. This review further helps integrative healthcare professionals in offering appropriate therapies for rehabilitation purposes in the treatment of ophthalmic diseases, particularly DR. Full article

Background: Anorexia nervosa is an eating disorder characterised by distorted eating behaviour, physical and mental health problems, and the highest mortality rate among psychiatric disorders. Although anorexia nervosa appears to be associated with alterations in the spine, studies investigating the characteristics of spinal postures and mobility in individuals with anorexia nervosa are scarce to date. The present study aims to examine the relationship between anorexia nervosa and spinal posture and mobility by comparing people with anorexia nervosa to age-matched, normal-weight controls. Methods: Spinal posture and mobility were evaluated using a radiation-free back scan, the Idiag M360 (Idiag, Fehraltorf, Switzerland). Between-group differences were assessed using a two-way analysis of variance. Results: Adult females suffering from anorexia nervosa exhibited reduced lumbar [difference between groups (Δ) = 10.5°, 95% CI 4.6°–16.5°, p < 0.001] and thoracic (Δ = 8.8°, 95% CI 2.4°–15.2°, p = 0.007) curvatures compared to normal-weight controls. The only difference observed in spinal movements between the two groups was thoracic flexion, which was greater in individuals with anorexia nervosa (Δ = 8.4°, 95% CI 2.1°–14.4°, p = 0.009). Conclusions: These findings emphasise the need to consider spinal posture and thoracic mobility in the musculoskeletal assessment of anorexia nervosa. Interventions aimed at improving spinal postures may help to develop effective rehabilitative strategies for addressing spinal problems associated with anorexia nervosa and thus contributing to counteract the possible further worsening with advancing age. Full article

Background/Objectives: Most survivors of out-of-hospital cardiac arrest (OHCA) may suffer from cognitive, mental difficulties, and fatigue, which negatively impact their quality of life, despite a good physical recovery. However, no definitive data are available on this topic, so this study aims to assess the feasibility and acceptability of a centralized, sub-regional screening system for OHCA survivors in Italy and the prevalence of these disorders. Methods: OHCA survivors discharged with good neurological outcomes (Cerebral Performance Category (CPC) ≤ 2 and modified Ranking Scale (mRS) ≤ 3) from hospitals in the “Lombardia CARe” registry will be evaluated by a clinical psychologist using the Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS), EQ-5D-5L for quality of life, and the Impact of Event Scale-Revised (IES-R) at pre-discharge or within 15 days and then at 1, 3, 6, and 12 months. Patients with clinical issues will be referred for psychological support or to a community rehabilitation program. Feasibility will be defined as a recruitment rate ≥ 80% and acceptability as a retention rate ≥ 50% over 12 months. Results: Based on historical data from the Lombardia CARe, an estimated 350 eligible survivors are expected, which will allow estimation of a prevalence ranging between 20% and 30% with 5% precision and 95% confidence. Conclusions: This study will be the first in Italy to evaluate the feasibility and acceptability of a centralized, sub-regional system for pre-/post-discharge evaluation of cognitive impairment, mental health, and quality of life in a large cohort of OHCA survivors, documenting the prevalence of these disorders. Full article