Positive Psychosocial Impact Research Articles

Development of a mindfulness-based intervention for narcolepsy: a feasibility study.

Mindfulness-based interventions (MBI) have been shown to improve psychosocial functioning in medical populations but have not been studied in narcolepsy. This study examined the feasibility and acceptability of an MBI that was adapted for narcolepsy, including three variations in program length. Adults with narcolepsy (N = 60) were randomized to MBI groups of varying durations: brief (4 weeks), standard (8 weeks), or extended (12 weeks). Participants completed assessments at baseline, 4, 8, and 12 weeks. To assess feasibility and acceptability, primary outcomes included attendance, meditation practice, and data completeness. Additionally, participants completed measures of mindfulness, self-compassion, mood, sleep, psychosocial functioning, and cognition. An effect size of Cohen's d ≥ 0.5 was used as the prespecified benchmark for a minimal clinically important difference (MCID). The attendance, meditation, and data completeness benchmarks were met by 71.7%, 61.7%, and 78.3% of participants, respectively. Higher proportions of the brief and extended groups met these benchmarks compared to the standard group. All groups met the MCID for mindfulness, self-compassion, self-efficacy for managing emotions, positive psychosocial impact, global mental health, and fatigue. Standard and extended groups met the MCID for anxiety and depression, and extended groups met the MCID for additional measures including social and cognitive functioning, daytime sleepiness, hypersomnia symptoms, and hypersomnia-related functioning. Results suggest that the remote delivery and data collection methods are feasible to employ in future clinical trials, and it appears that the extended MBI provides the most favorable clinical impact while maintaining attendance and engagement in meditation practice. Awareness and Self-Compassion Enhancing Narcolepsy Treatment (ASCENT), NCT04306952, https://clinicaltrials.gov/ct2/show/NCT04306952.

The psychosocial impact of eye-gaze assistive technology on everyday life of children and adults

Purpose This study investigates the psychosocial impact of eye-gaze assistive technology (EGAT) in both children and adults with long-term experience using eye-gaze assistive technology in everyday life, as well as the psychosocial impact as related to duration of use. Methods In this descriptive comparative study, 34 adult and 27 child EGAT users participated in a structured individual interview using the Psychosocial Impact of Assistive Devices Scale (PIADS). Results The participants’ age ranged from 5–74 years, 50% were female and 52% had been diagnosed with cerebral palsy. The EGAT had a positive psychosocial impact on competence, adaptability, and self-esteem among adult and child users. Competence was the only subscale with a higher value for adults (p = 0.038), compared to children. The items with the highest impact for the psychosocial aspects were quality of life, ability to participate, and self-esteem. The adults had longer duration of use than children, but for high-, medium-, and low-duration users, the device showed a positive psychosocial impact. Conclusions Participants considered EGAT to have high positive impacts for participation and quality of life. The study adds new knowledge in that high positive psychosocial impact may be found even among low-duration users of EGAT, which is important to consider for service providers.

Assessment of the Psychosocial Impact of Pancreatic Cancer Surveillance in High-Risk Individuals.

Pancreatic cancer (PC) surveillance of high-risk individuals (HRIs) downstages PC and improves survival. However, it remains less clear whether PC surveillance has a positive psychosocial impact on HRIs. Herein, we aimed to define the attitudes and beliefs of HRIs undergoing PC surveillance, and the immediate and sustained psychosocial impact of PC surveillance in HRIs. 100 HRIs undergoing PC surveillance by endoscopic ultrasound (EUS) completed three surveys addressing different components of the psychosocial impact of PC surveillance. Logistic regression analyses were performed to identify predictive factors relating to these components. Most HRIs reported increased perceived benefits of PC surveillance, self-efficacy, and perceived severity of PC. HRIs reported few negative emotions prior to surveillance and frequent positive emotions after surveillance. Compared to prior to surveillance, there was a 53.5% decrease in the level of distress reported by HRIs after surveillance, which was sustained for 4-6 weeks post-surveillance. Family history of PC and lower self-reported mental health were identified as predictors for increased perceived susceptibility to PC (p < 0.01) and greater change in distress pre- to post-surveillance (p < 0.01), respectively. Our findings suggest that PC surveillance can lead to sustained psychosocial benefits in HRIs.

Multicentric investigation on the safety, feasibility and usability of the ABLE lower-limb robotic exoskeleton for individuals with spinal cord injury: a framework towards the standardisation of clinical evaluations

BackgroundRobotic lower-limb exoskeletons have the potential to provide additional clinical benefits for persons with spinal cord injury (SCI). However, high variability between protocols does not allow the comparison of study results on safety and feasibility between different exoskeletons. We therefore incorporated key aspects from previous studies into our study protocol and accordingly conducted a multicentre study investigating the safety, feasibility and usability of the ABLE Exoskeleton in clinical settings.MethodsIn this prospective pretest-posttest quasi-experimental study across two SCI centres in Germany and Spain, in- and outpatients with SCI were recruited into a 12-session training and assessment protocol, utilising the ABLE Exoskeleton. A follow-up visit after 4 weeks was included to assess after-training outcomes. Safety outcomes (device-related adverse events (AEs), number of drop-outs), feasibility and usability measures (level of assistance, donning/doffing-time) were recorded at every session together with changes in gait parameters and function. Patient-reported outcome measures including the rate of perceived exertion (RPE) and the psychosocial impact of the device were performed. Satisfaction with the device was evaluated in both participants and therapists.ResultsAll 24 participants (45 ± 12 years), with mainly subacute SCI (< 1 year after injury) from C5 to L3, (ASIA Impairment Scale A to D) completed the follow-up. In 242 training sessions, 8 device-related AEs (pain and skin lesions) were reported. Total time for don and doff was 6:50 ± 2:50 min. Improvements in level of assistance and gait parameters (time, steps, distance and speed, p < 0.05) were observed in all participants. Walking function and RPE improved in participants able to complete walking tests with (n = 9) and without (n = 6) the device at study start (p < 0.05). A positive psychosocial impact of the exoskeleton was reported and the satisfaction with the device was good, with best ratings in safety (participants), weight (therapists), durability and dimensions (both).ConclusionsOur study results prove the feasibility of safe gait training with the ABLE Exoskeleton in hospital settings for persons with SCI, with improved clinical outcomes after training. Our study protocol allowed for consistent comparison of the results with other exoskeleton trials and can serve as a future framework towards the standardisation of early clinical evaluations.Trial Registrationhttps://trialsearch.who.int/, DRKS00023503, retrospectively registered on November 18, 2020.

PCR109 Optimism, Social Support and Psychosocial Impact Among Breast Cancer Survivors: The Mediating Effect of Resilience

This study aimed to investigate the occurrence of positive and negative psychosocial impacts among breast cancer survivors in association with optimism, perceived social support, and resilience. Furthermore, study the mediating role of resilience in the relation between optimism, perceived social support, and positive and negative psychosocial impact.

Long-term efficacy of glycopyrrolate on sialorrhea in Goldenhar syndrome: a case report

BackgroundGoldenhar syndrome (GS) is a rare congenital disease characterized by impaired development of different facial structures and deformations of the teeth structures. Sialorrhea, which can cause difficulties in breathing and language impairment, is very common in GS and often difficult to treat. This case report highlights the short- and long-term importance of the therapeutic choice – glycopyrronium in oral solution - for the treatment of sialorrhea in children with poly-malformative syndrome, complicated by outcomes of post-hemorrhagic hydrocephalus.Case presentationWe report the case of a 6-year-old child with GS, carrying a percutaneous endoscopic gastrostomy after tracheostomy. The child also presented developmental dysfunction of oral motor skills of feeding, complicated by severe sialorrhea, related to the maxillo-facial dysmorphism. Sialorrhea caused several respiratory tract infections and led to an increase in the care burden. Both the inoculations of botulinum toxin and the treatment with scopolamine transdermal patch have shown mild and transient efficacy. The therapeutic choice of glycopyrronium in oral solution was the most suitable for this patient, leading to long-term sialorrhea control.ConclusionsThis clinical experience represents the first long-term efficacy and tolerability evaluation in using glycopyrrolate oral solution in treating drooling in children with GS. The reduction of drooling over time and the lack of clinically relevant adverse events have contributed to the decrease of respiratory tract infections, the development of oral motor skills, and determining a positive psycho-social impact on the patient's quality of life and her family.

130 Surgical Repair of Cleft Lip: Comparison of Neonatal and Standard Time Repair

Abstract Aim Cleft lip and palate (CLP) abnormalities are the most common congenital orofacial anomalies, affecting 1 in 700 live births per year in the United Kingdom. Cleft lip is present in approximately 55% of all CLP deformities. The aim of this study is to compare standard and neonatal cleft lip repair. Method Advanced literature searches were carried out using Medline ALL (1946 to date) and Embase (1974 to date), 11 articles were deemed relevant and included in this study. Results Aesthetic results showed excellent outcomes with neonatal repair with regards to the appearance of the scar, facial (lip and nasal) symmetry but those aesthetic results are no better than those achieved at standard time. Conclusions Early intervention can be beneficial as early repair takes place when the cleft is less severe and when the tissues are more malleable, making the surgery less challenging and when some aspects of foetal scar healing remain. Early repair has a positive impact on the development of the alveolar projections and can assist in reducing an alveolar cleft if present, improving the aesthetic outcome. Neonatal surgery carries with it no greater risk than surgery carried out at 6 months and will allow feeding to begin at an early stage promoting recovery. Early repair also brings with it a positive psychosocial impact where infants and mothers can build a normal relationship from an early stage. Later in life, children and adults will be less self-conscious following good aesthetic repair. In conclusion, neonatal repair may be recommended over standard time repair.

Generativity among persons providing or receiving peer or mutual support: A scoping review.

People with lived experience of mental illness or distress can help others recover through peer or mutual support. One way they may help others recover is by fostering generativity, which refers to one's concern for and contributions toward the betterment of others, including future generations (e.g., through caregiving, engaging in civics). Generativity may add purpose to one's life, benefit society, and improve areas which persons with lived experience feel are important for their recovery. Despite its importance, the state of knowledge on experiences and facilitators of generativity, as well as the impact that engaging in generativity has on the lives of persons engaged in peer or mutual support, is unclear. A librarian-assisted scoping review of the literature was conducted in five steps: identifying the research question and relevance; selecting studies; charting data; and coding and summarizing the results. Out of 11,862 articles that were screened, only 18 met eligibility criteria. Most studies were conducted in the United States and included White/Caucasian participants. Our synthesis produced themes related to generative actions, which included helping others, changing organizations and systems, and sharing personal stories. Themes describing facilitators of generativity included individual-level and organizational-level factors. One theme reflecting the positive psychosocial impact of engaging in generativity was produced. Findings from this study point to several knowledge gaps to be investigated in future research and can facilitate the implementation of peer support initiatives aimed at fostering generativity, which may in turn promote recovery. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

근육병 장애인의 Arm Support 사용에 따른 작업 부하의 변화와 심리·사회적 영향 : 사례연구

Objective : The purpose of this study was to investigate the change of workload and the psychosocial impact of arm support according to use in people with muscular disorders, who are restricted from performing activities of daily living due to the decrease in upper extremity muscle strength. Methods : The subjects were three people with muscular disabilities living in the community, all diagnosed with spinal muscular atrophy. Subjects performed eating, wearing a mask, brushing the hair before and after the active arm support was applied. After that, we measured and compared the workload of activities before and after using active arm support through NASA-TLX, and measured the psychosocial impact of arm support using the K-PIADS. Finally, we investigated the subjective feeling of the subjects after using the arm support through an interview. Results : As for the change in workload, the average score of all items decreased after using arm support, and the average score of the physical demand item decreased the most. The results of the psychosocial impact were 2.08 points ('positive impact ~ very positive effect') for competence, 2.06 points for adaptability ('positive effect ~ very positive effect'), and 1.71 points for self-esteem ('slightly positive effect ~ positive effect'). Through the interview, we confirmed that the subjects felt confidence, satisfaction, and comfort when performing the activity by using arm support, but also felt uncomfortable due to the arm support not being fixed correctly and the interference of wheelchair structure. Conclusions : Through this study, we found that arm support lowered the workload of the people with disabilities and had a positive psychosocial impact. In the future, we hope that a study based on the community will be conducted for various types of people with muscular disabilities. And also customized services should be conducted through systematic evaluation. we expected that the results of this study will be used as basic data for research and services that utilize arm support as an intervention strategy.

Psychosocial Impact of Assistive Devices and Other Technologies on Deaf and Hard of Hearing People.

Deaf and hard of hearing people use a variety of assistive devices and technologies as a strategy to mitigate, counter or compensate for life difficulties resulting from hearing loss. Although outcome measures are commonly used with hearing aids, few studies have explored the perceived psychosocial impact of other assistive devices and technologies or the factors leading to their abandonment or lack of use. Therefore, the main aim of this study was to assess the psychosocial impact of different assistive devices on deaf and hard of hearing people using the Psychosocial Impact of Assistive Devices Scale. The sample was made up of 291 individuals, 176 women and 115 men, with an average age of 56.12 years (standard deviation (SD) = 25.11), who were all users of different assistive devices. Overall, the results of the study showed that the use of assistive devices had a positive psychosocial impact, although this impact varied slightly depending on the specific type of device. Moreover, a relationship was identified between the psychosocial impact and the probability of future abandonment of a hearing aid or a cochlear implant. The results point to the importance of considering the psychosocial impact derived from the use of a device as a relevant variable in the adoption process of assistive technologies for deaf and hard of hearing people.

Trekking Poles to Aid Multiple Sclerosis Walking Impairment: An Exploratory Comparison of the Effects of Assistive Devices on Psychosocial Impact and Walking.

Walking dysfunction is reported by two-thirds of persons with multiple sclerosis (MS). Assistive devices are frequently recommended to improve walking; however, it is uncommon to consider their psychosocial impact, although many users abandon their assistive devices. The psychosocial impact, walking, balance, and fatigue associated with three assistive devices were compared to guide clinical decision making. Twenty-five persons with MS (median Expanded Disability Status Scale score, 4.0; range, 2.5-6.0) who reported walking difficulty were trained in the use of three assistive devices-a single-point cane (SPC), a four-point cane (FPC), and a trekking pole (TP)-at 1- to 2-week intervals, then used the assistive device for their usual activities. Outcome measures included the Psychosocial Impact of Assistive Devices Scale (PIADS), the 6-Minute Walk Test (6MWT), walking speed, cadence, stride length, stride time, the 12-item Multiple Sclerosis Walking Scale (MSWS-12), the Activities-specific Balance Confidence (ABC) scale, the 5-item Modified Fatigue Impact Scale (MFIS-5), and a visual analogue scale of fatigue (VAS-F). The SPC and TP were more positive in the PIADS adaptability, competence, and self-esteem subscales. The SPC and TP resulted in higher 6MWT, walking speed, cadence, stride length, stride time, and MSWS-12 scores compared with the FPC. No differences were found in ABC scale, MFIS-5, or VAS-F scores. Participants reported more positive psychosocial impact, and walked faster and with higher quality, with the SPC and TP than with the FPC. Clinicians should consider suggesting an SPC or TP to patients who may benefit from assistive device use and for whom psychosocial impact is an important consideration.

Assistive technologies, educational engagement and psychosocial outcomes among students with disabilities in higher education

Purpose Increasing numbers of students with disabilities are accessing higher education each year, yet little is known about their assistive technology (AT) needs and its influence on relevant outcomes. The aim of this study was to examine met/unmet AT needs on educational engagement, academic self-efficacy and well-being and the impact of AT use in the areas of competence, adaptability and self-esteem for students with disabilities in higher education in Ireland. Methods One hundred and eleven students with disabilities completed a cross-sectional online survey comprising the College Learning Effectiveness Inventory, the Student Course Engagement Questionnaire, the Self-Efficacy for Learning Form Abridged, the Psychosocial Impact of Assistive Devices Scale, and the Warwick-Edinburgh Mental Well-Being Scale. Results AT use was found to have a positive psychosocial impact in the areas of competence, adaptability and self-esteem. Those whose AT needs were fully met scored significantly higher on academic self-efficacy, well-being, and on 4 of the 10 educational engagement subscales compared to those who had unmet AT needs. Met/unmet AT needs were not predictive of educational engagement. Conclusion These findings highlight the importance of AT from both educational engagement and psychosocial perspectives for students with a wide variety of disability diagnoses. The wide-reaching benefits of AT must be considered by governmental departments when making funding allocations to disability services within higher education institutions. Implications for rehabilitation Students with disabilities can face many additional challenges within the higher education environment. Findings from this research show that access to appropriate assistive technology can support students’ educational engagement, increase well-being and academic self-efficacy and have a positive impact in the areas of competence, adaptability and self-esteem. Disability and Assistive Technology Officers in higher education should be cognizant of both the educational and psychological benefits of assistive technology across diverse students with various disability diagnoses. Policy makers should consider the wide-reaching benefits of assistive technology when making funding allocations to higher education institutions.

“Giving yourself some breathing room…”: an exploration of group meditation for people with aphasia

ABSTRACT Background Meditation practices have been found to improve both cognitive and psychological functions related, in particular, to attention and well-being in both healthy people and those with chronic health conditions, including stroke. Considering the range of cognitive and psychosocial consequences in people with post-stroke aphasia, meditation has been identified as a potential rehabilitative tool to target these areas, investigating also, in some studies, any potential impact on language abilities. Even with growing numbers of studies exploring the effectiveness of meditation techniques in the stroke population, no study to date has sought to explore the impact of meditation from the perspective of the lived experience of people with aphasia. Aim This preliminary study explored the perceived impact of meditation on a range of activities and areas of participation for people with chronic aphasia who, with the exception of one participant, learned how to meditate after the onset of their stroke. Methods Five participants who regularly attended a meditation group for people with aphasia agreed to an individual semi-structured interview, followed by participation in two subsequent focus groups to member-check data. Interviews were thematically analysed using an Interpretative Phenomenological Analysis approach in order to capture the lived experience of meditation. Results A consistent and positive psychosocial impact was reported by all participants related to the development of acceptance and resilience post-stroke. As with healthy meditators, individual variation was seen in how people learn meditation, and in their preferences and success with different meditation techniques. The reduced focus on the language impairment itself was a strong motivator to attend the meditation group; however, the benefit of regular practice on self-acceptance and building resilience, and a sense of calm, were also prominent themes. The positive experience of meditating in a group was a further motivator to participate regularly in the meditation practice. Conclusion Meditation can have psychosocial benefits for people with aphasia and may offer a positive and complementary approach when living with aphasia following stroke. Individual variation in responsiveness to meditation techniques highlighted the importance of monitoring participant preferences when delivering and interpreting meditation outcomes with people with aphasia. The role of meditation in language rehabilitation with people with chronic aphasia as a complementary treatment tool remains an area of future enquiry.

The change of teeth color, whiteness variations and its psychosocial and self-perception effects when using low vs. high concentration bleaching gels: a one-year follow-up

BackgroundDental bleaching in traditional concentrations generates greater sensitivity. In this respect, new systems of lower concentration of hydrogen peroxide for tooth bleaching appeared, with color stability unknown over time. The aim of this study was to compare the change and stability of color with low-concentration (6%) hydrogen peroxide gel in an in-office bleaching setting relative to conventional 37.5% gel, including their effects on psychosocial and esthetic self-perception, after 1 year.MethodsPatients (n = 25) were assessed at 12 months post bleaching treatment (whitening with 6% chemo-activated alkaline formula gel versus 37.5% traditional concentration gel). Color changes were measured objectively using total variation in color (ΔE), and subjectively using Vita Classical and Vita Bleached scale (ΔSGU) by calibrated evaluators (Kappa = 0.85). The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and Oral Health Impact Profile (OHIP-14) aesthetic questionnaires were used to measure the self-perception and the psychosocial impact of the bleaching protocols.ResultsThe effect (ΔE) of 37.5% HP (8.37 ± 2.73) was significantly better than that of 6% HP (5.27 ± 2.53) in terms of color rebound after 1 year of follow-up. There were significant differences in psychosocial impact and esthetic self-perception measurements prior to bleaching versus one-year post-whitening time points; positive effects were maintained.ConclusionsLow concentration (6%) achieved effective bleaching with good stability after 1 year, accompanied by a positive psychosocial impact and enhanced self-perception at follow-up.Trial registrationNCT03217994 (before enrollment of the first participant). Data register: July 14, 2017.

Patient perspectives of ankle-foot orthoses for walking ability in peripheral artery disease: A qualitative study

Calf claudication associated with peripheral artery disease results in limited walking ability and diminished quality of life. Ankle-foot orthoses (AFO) have been used to mitigate calf pain during community-based walking exercise, yet little is known about patients' perspectives of this novel device. The purpose of this qualitative study was to determine the personal impact AFO had on patients who used them. Ten patients with calf claudication who previously completed a 12-week unstructured community-based walking program supplemented by AFO participated in a semi-structured recorded focus group. After data saturation was achieved, transcripts were coded and analyzed, and 2 primary themes emerged from the focus groups: 1) positive functional impact of AFO on walking ability and quality of life and 2) self-selected AFO usage patterns. Six subthemes included 1) positive ambulatory changes from using AFO, 2) sustained ambulatory improvements without AFO, 3) positive psychosocial impact, 4) optimal conditions for AFO usage, 5) optimal ambulatory surfaces when using AFO, and 6) challenges with comorbidities. The AFO were influential in decreasing claudication symptoms, improving walking capacity, and enhancing participation in meaningful daily and recreational activities. This study explores experiential knowledge of patients with calf claudication describing AFO as an effective tool to enhance unstructured walking programs. Further trials are needed to optimize device design and effectiveness in varying walking environments.

Surgical cancellation rates due to peri‐operative hypertension: implementation of multidisciplinary guidelines across primary and secondary care

Patients with uncontrolled hypertension are at increased risk of complications during general anaesthesia but the number of patients whose surgery is delayed or cancelled due to hypertension remains unknown. Prospective, regional multicentre service evaluations were performed on consecutive patients undergoing elective surgery before and after the publication of new guidelines from the Association of Anaesthetists and the British Hypertensive Society. The aim was to quantify the number of operations cancelled due to hypertension alone and to assess impact of the guidelines on cancellation rates. In October 2013 (before the publication of the guidelines), 1.37% (95%CI 0.69-2.11%) of patients listed for elective surgery were cancelled solely due to raised blood pressure. This reduced significantly to 0.54% (95%CI 0.20-0.92%, p<0.001) in 2018. There was a significant reduction in inappropriate cancellations for stage 1 or 2 hypertension from 2013 to 2018 (72 vs. 14, respectively, p<0.001) in keeping with the recommendations in the guidelines. Furthermore, the number of patients being referred back to primary care for the management of hypertension reduced from 2013 to 2018 (85 vs. 30, respectively, p<0.001). Our data suggest achievement of three major outcomes: reduced surgical cancellations due to hypertension alone; improved detection of significant hypertension before elective surgery; and reduced referral back to primary care from hospital for hypertension management. To the best of our knowledge, this is the first time the successful implementation of guidelines from the Association of Anaesthetists has been assessed on such a broad scale. Our data indicate that these guidelines have been effectively implemented in both primary and secondary care, which is likely to have made a positive psychosocial, physical and economic impact on patients and the NHS.

Patient-Centered Satisfaction After Secondary Correction of the Cleft Lip and Nasal Defect

To evaluate patient-reported aesthetic and psychosocial outcomes of secondary cleft lip and nose revision procedures. Single-center cohort study. Tertiary care pediatric hospital. Patients who underwent secondary revision procedures for cleft lip and nasal defect (N = 42). Patients were administered a survey during a routine postoperative clinic visit. Outcome measures were planned prior to data collection and included improvement in appearance seen in lip and nose, satisfaction with revision procedure, changes in self-confidence, likelihood to participate in social activities, and effect on teasing by peers. Patients agreed that an improvement was seen in the appearance of their lip (1.93) and nose (1.98) following surgery. Overall, patients felt satisfied with the results of their revision procedure (1.76). An improvement in confidence and decrease in feelings of self-consciousness was reported. Patients were teased less by their peers and more likely to participate in social activities. Secondary revision procedures of the cleft lip and nasal defect provide a patient-reported improvement in appearance and a positive psychosocial impact on patient's lives.

The development of an augmented reality device for the autonomous management of the electric bed and the electric wheelchair for patients with amyotrophic lateral sclerosis: a pilot study

Purpose The main aim of this Human Centred Design project was to develop the Environment COntrol in Amyotrophic Lateral Sclerosis (ECO-ALS) System, a new device which could improve ALS patient’s autonomy in controlling the environment. Moreover, we verified the feasibility and usability of this technology in ALS patients in advanced stages of the disease. Material and methods Twelve ALS patients in advanced disease stage were recruited, two patients for the development phase and ten patients and their caregivers for the two weeks’ trial phase. We evaluated the impact of the ECOALS system by administering the Psychosocial Impact of Assistive Devices Scale (PIADS), the Individual Prioritised Problem Assessment (IPPA), the McGill Quality of Life Questionnaire (MQOL) and the Caregiver Burden Inventory (CBI). Results In the trial phase, patients were very satisfied for having recovered their autonomy in the management of the EAB, that enabled patients to reduce calls to their caregivers to change their bed position. The IPPA questionnaire showed a significant improvement in patients’ participation and management of the system. Moreover, the PIADS questionnaire showed that patients perceived a progress in competence, adaptability and areas of self-esteem, confirming a positive psychosocial impact of the patients’ assistance device. Conclusion The project has collected some useful information for technological system development to face the need for autonomy ALS patients. Patients were satisfied with the tested aids and were interested in the future developments. Further studies are needed to improve the system and overcome some technical problems that occurred during the project. IMPLICATIONS FOR REHABILIATION The ECO-ALS system seems to improve the patients' perceived autonomy. The ECO-ALS system seems to improve the patients' perceived progress in competence, adaptability and areas of self-esteem, confirming a positive psychosocial impact of the assistance device. The ECO-ALS system seems to improve the patients' perceived quality of life. Patients were satisfied with the tested aids and were interested in the future developments.

Psychosocial Impact of Powered Wheelchair, Users’ Satisfaction and Their Relation to Social Participation

Several studies showed positive effects of assistive technologies on psychosocial impact and participation of adults with mobility impairments. The purpose of this study was to assess the psychosocial and participation impact of powered wheelchairs. Participants were thirty persons with disabilities who use powered wheelchairs with diverse medical conditions. The Quebec User Evaluation of Satisfaction with Assistive Technology, the Psychosocial Impact of Assistive Devices Scale and the Activities and Participation Profile Related to Mobility were used, in addition to demographic, clinical and wheelchair related questions. The participants were satisfied with both the assistive technology and related services, with the lowest satisfaction scores belonging to those who had been using their wheelchairs for a longer period of time. We noticed significant restrictions in participation mostly among persons with longer wheelchair utilization. The most satisfied were the ones with better performance in terms of social participation. Psychosocial scores showed a positive impact with higher adaptability among persons who transitioned from a manual compared to those who already had a powered wheelchair. There was a positive psychosocial impact and therefore an increase in quality of life of its users.

Insights Into Patients' Experience With Type 1 Diabetes: Exit Interviews From Phase III Studies of Sotagliflozin

PurposeThe purpose of this study was to conduct qualitative participant interviews to provide context to the meaningfulness of improvements in end points seen in 2 large-scale Phase III sotagliflozin trials in participants with type 1 diabetes. MethodsParticipants were eligible for an interview if they had exited one of the clinical trials within the previous 12 months. Participants were recruited by investigators at the clinical trial sites, and interviews were conducted by independent interviewers by telephone in accordance with a semistructured interview guide. Both interviewers and participants were blinded to treatment assignment. Qualitative analysis was conducted using ATLAS-ti version 7.5, and descriptive statistics were computed and summarized. FindingsAcross 3 countries, 41 participants were interviewed. Difficulty maintaining blood glucose within a desired range, described by participants as lack of blood glucose “stability,” was the most concerning symptom that they reported, wanting to see it improved during the clinical trial because it negatively impacted their physical, mental, and emotional lives. Participants who reported symptom improvement also reported a positive psychosocial impact while taking the clinical trial medication. All participants who monitored ketones described themselves as being “pretty confident” to “very confident” that they could avoid diabetic ketoacidosis by monitoring both ketone levels and understanding the physical signs and symptoms of hyperglycemia. ImplicationsImprovements in glucose stability and control were important to participants with type 1 diabetes, as these improvements were correlated with improvements in the participants' lives. ClinicalTrials.gov identifiers: NCT02384941; NCT02421510.