Search Results (10)

Background and Objectives: Diabetes is a rapidly increasing global health challenge compounded by a critical shortage of diabetes care and education specialists. Robot-assisted diabetes care offers a cost-effective and scalable alternative to traditional methods such as training and dispatching human experts. This pilot study aimed to evaluate the feasibility of using robots for diabetes care consultations by examining their ability to elicit meaningful patient feedback, identify therapeutic issues, and assess their potential as substitutes for human specialists. Materials and Methods: A robot-assisted consultation programme was developed by selecting an appropriate robot, designing the programme content, and tailoring back-channel communication elements. Experienced diabetes care nurses operated the robot during the consultations. Patient feedback was collected through a 17-item questionnaire using a five-point Likert scale (evaluating functionality, impressions, and effects). Additionally, a five-item questionnaire was used to assess whether the programme helped patients reflect on the key therapeutic domains of diabetes knowledge, diet, exercise, medications, and blood glucose control. Results: This study included 32 participants (22 males; mean age, 69.7 ± 12.6 years; mean HbA1c, 7.2 ± 1.0%). None of the participants reported any discomfort during the consultation. Sixteen of the seventeen feedback items scored above the median of 3, as did all five therapeutic reflection items. The interview content analysis revealed the programme’s ability to differentiate patients facing issues in treatment compliance from those effectively managing their condition. Robots can elicit valuable patient narratives like human specialists. Conclusions: The results of this pilot study support the feasibility of robot-assisted diabetes care to assist human experts. Future research should explore the programme’s application with healthcare professionals with limited experience in diabetes care, further demonstrating its scalability and utility in diverse healthcare settings. Full article

Background: The oral health of people with schizophrenia (PWS) is very poor, suggesting a need for oral health promotion programmes with a high level of evidence. The aim of the EBENE study (Clinicaltrials.gov: NCT02512367) was to develop and evaluate the effectiveness of a multidisciplinary therapeutic educational programme in oral health (TEPOH) for PWS. Methods: A multicentre cluster randomised controlled trial, with outpatient psychiatry centres as the unit of randomisation, was designed to compare the effectiveness of TEPOH (intervention group) versus standard care (control group). The trial was conducted in 26 outpatient psychiatry centres in France (14 in the intervention group, 12 in the control group). Eligible patients with a diagnosis of schizophrenia were enroled between 2016 and 2020 and followed for 6 months. The TEPOH group received a multicomponent intervention (comprising an introductory session, three educational sessions, and a debriefing session). The primary endpoint was the evaluation of periodontal disease as a community periodontal index (CPI) score ≥ 3 at Month 6. The trial was completed using a qualitative approach based on semi-structured interviews with caregivers conducted between July 2018 and December 2019. The trial was stopped early due to difficulties in recruiting patients. Results: Overall, 81 patients (of 250 planned) were included, and 54 patients completed the trial: 40 in the TEPOH group and 14 in the control group. At baseline, the percentage of CPI ≥ 3 was 42.5% in the TEPOH group and 9.1% in the control group. At Month 6, the percentage of CPI ≥ 3 was 20% in the TEPOH group and 14.3% in the control group. The qualitative evaluation underlined that the professionals emphasised the “seriousness” and “assiduity” of the patients’ participation in this programme and that the TEPOH reinforced carers’ investment in oral hygiene. It also highlighted structural factors (lack of resources for professionals, lack of teeth in PWS, COVID-19 pandemic) that may have exacerbated the difficulties with enrolment and follow-up. Conclusions: The effectiveness of this TEPOH, developed for PWS as part of the EBENE study, has not been demonstrated. Certain aspects of the programme’s content and implementation need to be reconsidered. In particular, an adapted subjective measurement scale should be developed. Full article

Background: Mental health is an ever-increasing concern for UK Universities and is underreported. Creative and dynamic approaches to tackle student wellbeing are important. In 2018, Sheffield Hallam University (SHU) Student Wellbeing Service initiated a pilot study of a therapeutic running programme ‘MINDFIT’ that combined physical activity, led by a counsellor, alongside a psychoeducation approach to support student mental health. Methods: Mixed methods were used which included the Patient Health Questionnaire-9 (PHQ-9), evaluating low mood and depression, and Generalized Anxiety Disorder Scale-7 (GAD-7), evaluating levels of anxiety. Results: A total of 28 students were triaged onto a weekly programme over three semesters. Overall, 86% of the participants completed the programme. A promising reduction in the scores for PHQ-9 and GAD-7 was found at the end of the programme. Focus groups, with student participants, were held to gather qualitative data for analysis. After thematic analysis, three main themes emerged: “Creating a safe community”, “Making progress” and “Pathways to success”. Conclusions: MINDFIT was an effective and engaging multi-layered therapeutic approach. Recommendations identified the importance and effectiveness of the triage process in recruiting students and sustainability of the programme through the continued engagement of students post programme. More research is required to identify the long-term effects of the MINDFIT approach and how applicable it is to higher education contexts. Full article

Introduction: The aim of the study was to assess the influence of the implemented therapeutic programme, which consisted of body posture correction and of change of habits, on the pelvic floor muscle function in women with stress urinary incontinence. Material and methods: The 60 women were randomly divided into two groups: the study population and the clinical control group (subjects received envelopes with numbers of the group: 1- study population aged 38.3 ± 5.54, 2- clinical control group aged 35.5 ± 4.7. We used the following research methods: A personal questionnaire with subjects’ demographics and with questions related to the type of work, physical activity, childbirths and any issues related to the pelvic floor (pre-test), Pelvic floor muscle assessment with the use of the PERFECT Scheme and the Oxford scale palpation examination, sEMG with intravaginal electrode and manometry with an intravaginal probe—pre-test and post-test. Subjective assessment of body posture in the sagittal plane according to the McKenzie methodology. Results: In both groups, VRP (resting vaginal pressure) and resting PFM tension were significantly reduced. The strength and endurance of PFM, tension during MVC and VSP (intravaginal pressure during contraction) increased, with no difference between the groups. SUI decreased significantly, and quality of life improved significantly in both groups. Conclusions: Education of the pelvic floor and changing habits significantly affected the activity of PFM and improved the quality of life in the group of patients with SUI. The posture correction therapy with manual therapy and stretching exercises did not increase this effect. Full article

Background: The traditional therapeutic approach has perceived the role of nutrition as a minor intervention in psychiatry. The microbiota–gut–brain axis theory evidences the influence of dietary and nutritional patterns on mental health. Aims: To evidence the impact of dietary advice on increasing symbiotic intake on nutritional status and dietary habits in individuals with schizophrenia spectrum disorders. Methods: Randomised clinical trial (two-arm, double-blind, balanced-block, six-month intervention) in 50 individuals diagnosed with schizophrenia spectrum disorders. The control group received conventional dietary advice on an individual basis. A personal nutritional education programme was established in the intervention group (IG) to increase prebiotic and probiotic intake through dietary advice (dairy and fermented foods, green leafy vegetables, high-fibre fruit, whole grains, etc.). Data on nutritional status and dietary habits were collected (baseline and six months). The degree of dietary adherence to the recommended patterns was recorded weekly. Anthropometric parameters were also analysed monthly. Results: Finally, 44 subjects completed the follow-up. All participants exceeded the dietary reference intakes. The overall and intra-group analysis showed a statistically significant (p < 0.05) reduction in macro and micronutrient intakes with a closer approximation to the recommended dietary intakes, except for polyunsaturated fatty acids, oligosaccharides, polysaccharides and dietary fibre. After six months of intervention, statistical differences (p < 0.001) were found in all variables of the anthropometric profile in the IG, as well as an increase in the consumption of foods with a high symbiotic content (at baseline and six months). Likewise, a reduction in eggs, meat, fish, sugars and ultra-processed foods was evident, leading to significant intra-group differences (p < 0.05). Conclusions: Implementing conventional nutritional education strategies and specific nutritional advice with a symbiotic effect improves the dietary-nutritional profile in patients with schizophrenia spectrum disorders. Furthermore, it highlights the nutritional impact on mental health, stating itself as adjuvant therapy for physical health and lifestyle improvement. Full article

Background: In France, there are two main types of psychosocial educational therapies for people with mental disorders: (1) therapeutic patient education (TPE) or “training”, and (2) psychoeducation. Both types of educational therapy aim to improve disease morbidity, treatment compliance and patient quality of life, but they have very different modes of application. The aim of this study was to interview mental health professionals in order to explore and identify the determinants (barriers and enablers) underlying their acceptance of therapeutic patient education (TPE) in order to facilitate the implementation of these programmes among people with severe mental illness such as schizophrenia. Methods: In this multicentre cross-sectional study, we opted for a qualitative approach based on individual semi-structured interviews with 21 mental health professionals trained in TPE, regardless of whether they had practiced it before or not. In accordance with the “Jardé” law (Decree no 2016-1537 dated 16 November 2016 published on 17 November 2016 in the Official Journal of the French Republic). No regulatory approval was required for this study. Results: The major themes that emerged from the analysis were grouped into the following conceptual framework: (1) mental health professionals (MHPs) highlight important organizational and institutional challenges that they feel are beyond their scope; (2) MHPs mention in parallel their own perceptions and representations of TPE in the context of mental health care; and (3) MHPs’ representations could hide a lack of knowledge or awareness that would prevent them from appropriating TPE programmes. For each major theme, the sub-themes identified are presented. Conclusions: Although TPE is of interest in the process of patient empowerment, we found that caregivers were reluctant to appropriate this approach to care. Efforts must be made in the initial and ongoing training of MHPs to move from a paternalistic model to a patient partnership model, which is made possible by TPE. These efforts must also be firmly supported by health care facilities, and proactive governance is required for the successful implementation of TPE. Full article

Therapeutic patient education (TPE) aims to help people with chronic disease strengthen their empowerment and psychosocial skills to better manage their condition. Although TPE has great potential for addiction medicine, studies on its benefits for reducing alcohol-related harms and increasing empowerment are sparse. We conducted a qualitative study of people with alcohol use disorder (AUD) who participated in the community-based TPE programme Choizitaconso to assess their perceptions and experiences of it. Semi-structured interviews were conducted with 16 participants who had completed the TPE programme at least six months previously. The interviews were transcribed and analysed using a sequential thematic analysis. We identified four general themes: (1) the context of participation: the TPE programme could be a strategy to facilitate engagement in AUD care; (2) representations and experiences: the programme helped to “normalize” participants’ relationship with alcohol use by increasing empowerment; (3) TPE strengths: improved knowledge about alcohol use, self-image, weight loss, self-stigma reduction; (4) TPE limitations: difficulty putting learning into practice after the programme ended. The Choizitaconso programme met participants’ health and psychosocial expectations, strengthening their empowerment and reducing self-stigma, thereby facilitating engagement in AUD care. Full article

Bariatric surgery is the most efficacious treatment for obesity, though it is not free from complications. Preoperative conditioning has proved beneficial in various clinical contexts, but the evidence is scarce on the role of prehabilitation in bariatric surgery. We describe the protocol and pilot study of a randomized (ratio 1:1), parallel, controlled trial assessing the effect of a physical conditioning and respiratory muscle training programme, added to a standard 8-week group intervention based on therapeutical education and cognitive-behavioural therapy, in patients awaiting bariatric surgery. The primary outcome is preoperative weight-loss. Secondary outcomes include associated comorbidity, eating behaviour, physical activity, quality of life, and short-term postoperative complications. A pilot sample of 15 participants has been randomized to the intervention or control groups and their baseline features and results are described. Only 5 patients completed the group programme and returned for assessment. Measures to improve adherence will be implemented and once the COVID-19 pandemic allows, the clinical trial will start. This is the first randomized, clinical trial assessing the effect of physical and respiratory prehabilitation, added to standard group education and cognitive-behavioural intervention in obese patients on the waiting list for bariatric surgery. Clinical Trial Registration: NCT0404636. Full article

Pre-emptive kidney transplantation (PEKT) is considered one of the most effective types of kidney replacement therapies to improve the quality of life (QOL) and physical prognosis of patients with end-stage renal disease (ESRD). In Japan, living-donor kidney transplantation is a common therapeutic option for patients undergoing dialyses (PDKT). Moreover, during shared decision-making in kidney replacement therapy, the medical staff of the multidisciplinary kidney team often provide educational consultation programmes according to the QOL and sociopsychological status of the ESRD patient. In Japan, the majority of kidney donations are provided by living family members. However, neither the psychosocial status of donors associated with the decision-making of kidney donations nor the interactions of the psychosocial status between donors and recipients have been clarified in the literature. In response to this gap, the present study determined the QOL, mood and anxiety status of donors and recipients at kidney transplantation decision-making between PEKT and PDKT. Deterioration of the recipient’s QOL associated with “role physical” shifted the decision-making to PEKT, whereas deterioration of QOL associated with “role emotional” and “social functioning” of the recipients shifted the decision-making to PDKT. Furthermore, increased tension/anxiety and depressive mood contributed to choosing PDKT, but increased confusion was dominantly observed in PEKT recipients. These direct impact factors for decision-making were secondarily regulated by the trait anxiety of the recipients. Unlike the recipients, the donors’ QOL associated with vitality contributed to choosing PDKT, whereas the physical and mental health of the donors shifted the decision-making to PEKT. Interestingly, we also detected the typical features of PEKT donors, who showed higher tolerability against the trait anxiety of reactive tension/anxiety than PDKT donors. These results suggest that choosing between either PEKT or PDKT is likely achieved through the proactive support of family members as candidate donors, rather than the recipients. Furthermore, PDKT is possibly facilitated by an enrichment of the life–work–family balance of the donors. Therefore, multidisciplinary kidney teams should be aware of the familial psychodynamics between patients with ESRD and their family members during the shared decision-making process by continuing the educational consultation programmes for the kidney-replacement-therapy decision-making process. Full article

Lifelong learning among healthcare practitioners is crucial to keep abreast of advances in therapeutic and service delivery approaches. In South Africa, continuous professional development (CPD) was mandated (2019) for re-registration of pharmacists to illustrate their learning according to the South African Pharmacy Council’s (SAPC) competency standards. This paper uses a preceptor programme linked to the University of the Western Cape School of Pharmacy’s service learning programme to map the competencies employed by pharmacist preceptors in primary care public healthcare facilities in Cape Town in an attempt to encourage completion of their annual CPDs and strengthening the academic-service partnership. Competencies identified were divided into input competencies related to the preceptor’s role in designing and implementing the educational programme in their facilities and assisting students to complete their prescribed learning activities, and output/outcome competencies that emerged from preceptors identifying the facility needs and employing their input competencies. Input competencies pertained to education, leadership, patient counselling, collaborative practice and human resources management. Output competencies related to pharmaceutical infrastructure, quality assurance, professional and health advocacy, primary healthcare, self-management and patient-centred care. The preceptor programme enabled pharmacist preceptors to employ several competencies that are aligned with the SAPC’s competency framework. Full article