Pre-test Phase Research Articles

Game On: A Journey into Computational Thinking with Modern Board Games in Portuguese Primary Education

Recent studies highlight the potential of modern board games (MBGs) to foster computational thinking (CT) skills in students. This research explored the impact of integrating MBGs into a primary education classroom through an embedded concurrent mixed-methods approach, with a pre-experimental design in its quantitative aspect and content analysis in its qualitative dimension, with 20 fourth-grade students from a school in Portugal. The students participated in 10 game sessions, each lasting 50 min, and their CT skills were assessed using Bebras tasks in both the pre-test and post-test phases. Statistical analysis, including the Shapiro–Wilk test for normality and paired sample t-tests, revealed significant improvements in key CT areas, particularly abstraction, algorithmic thinking, and decomposition. Descriptive statistics were also calculated, and content analysis using Nvivo software was conducted on field notes, corroborating the quantitative data. The results suggest that MBGs can serve as a valuable educational tool for developing CT skills in young learners. This study not only highlights the effectiveness of MBGs but also emphasises the need for further research using more robust experimental designs to enhance CT development in educational settings.

The Interplay of Knowledge Management, E-Governance, and Business Performance Efficiency: Insights from Saudi Public Sector Institutions

This study goes more deeply into the critical aspects of understanding knowledge management, e-governance, and performance efficiency in the Saudi public sector. Simultaneously, the main target is first to grasp how these aspects influence this kind of effectiveness, especially in light of this significant Vision 2030 of the State. By utilizing a technique, the research exploited determined it utilitarian of SMART PLS software to model Structural Equation Modeling (SEM) structure. The study involved 170 people, from the highest-level executives to entry-level employees and cross-section management, administration, and IT specialists. The given article will pursue the complexity of the characters’ interactions while revealing some of the book’s central lessons. T for this study tool, an elaborate questionnaire went through an extensive pretest phase where the content validity and reliability were verified through interviews with expert methods. In 2023, over a quarter of a year data collection period, the self-administered questionnaire was distributed to the representatives of different public institutions, which was done during the year 2023. We obtained some necessary information through the data found and processed using the SMART PLS and SEM. Outcomes highlighted the complex and multidimensional interrelationship of knowledge management, e-governance, and business performance efficiency, from which we make the knowledge of various factors facilitating the performance of the public sector offices in Saudi Arabia. Indeed, it is worth mentioning that the research endorses essential elements in line with Vision 2030, adding tangible directions to the policymakers, government leaders, and practitioners aiming to increase the productivity and effectiveness of public sector projects in the Kingdom.

Translation and cross-cultural adaptation of the Posthumous Dignity Therapy Schedule of Questions to Brazilian Portuguese.

Dignity Therapy (DT) is a brief form of psychotherapy that helps people with life-threatening illnesses and their loved ones cope with emotional pain and demoralization. Unfortunately, not everyone has the opportunity to receive DT during their lifetime. Posthumous Dignity Therapy (PDT) was then devised to be administered to bereaved family members. However, PDT has not yet been validated or studied in the specific cultural and linguistic context of Portuguese-Brazilians. This study aims to fill this gap by validating PDT for the Portuguese (Brazilian) context. Using Beaton's methodology, including the processes of translation, synthesis, back-translation, evaluation by an expert committee, and pre-testing, the PDT Schedule of Questions underwent validation and cultural adaptation. The research was conducted in a Palliative Care Unit at a tertiary cancer hospital in Brazil. The questionnaire was translated, back-translated, and evaluated by the panel of experts, obtaining a Content Validity Index of 0.97. During the pretest phase, it was observed that the participant's interview method needed to be changed from remote (telephone or videoconference) to in-person. Additionally, it was necessary to modify some terms related to death and dying, as they caused discomfort to the participants. As a result of this process, the PDT was modified, and adapted to the Brazilian cultural and linguistic reality. This validation study will be significant for future DT research from the caregivers' perspective and for projects aiming to implement this therapeutic modality in palliative care units, in addition to helping participants remember their loved ones better by providing a tangible legacy document that assists them emotionally and materially in coping with the grieving process.

The effect of augmented reality storybooks on the story comprehension and retelling of preschool children.

This study aimed to compare the retelling and story comprehension performance of two groups of preschool children-an experimental and a control group-who experienced printed and augmented reality storybooks. The participant group consisted of 90 participants, with 45 in the experimental group (22 girls, 23 boys) and 45 in the control group (21 girls, 24 boys). The average age of the children was 54.2 months. In the study, the researcher evaluated children's story-retelling performance using the rubric and used a Story Comprehension Test to measure their story comprehension performance. The researchers utilized the ROAR application to incorporate augmented reality content into the books. In the pre-test phase, the teachers read the designated texts to the children in the experimental and control groups. After the eight-week break, the control group experienced the same texts with printed books, while the experimental group experienced them with augmented reality support. Each child participated individually in the reading process with the teacher. In the study, teachers asked the children to retell the story and asked the questions from the Story Comprehension Test at the end of each book reading section for pre-test and post-test measurements. The pre-test results revealed no significant difference in the two groups' story-retelling and Story Comprehension Test scores. The post-test results indicated a significant difference in the story-retelling performance and Story Comprehension Test scores between the experimental and control groups, favoring the experimental group. Based on these findings, the augmented reality content can potentially enhance children's retelling and story comprehension performances.

Impact of Basic Life Support Training on Knowledge and Performance Among Rural Intermediate Students: A Quasi-Experimental Study

Objectives: This study aimed to evaluate the effectiveness of Basic Life Support (BLS) training on the knowledge and performance of intermediate students from a rural area. Methodology: A quasi-experimental study with pretest, posttest, and follow-up phases was conducted at a private sector high school. Non-probability purposive sampling was used to select participants, consisting of 11th and 12th-grade students with low to moderate levels of BLS knowledge, as assessed by a structured questionnaire. The BLS training, lasting three hours, included a PowerPoint presentation and hands-on practice. Data were collected from 80 participants at three stages: pre-test, post-test, and a follow-up test three months after the intervention. Participant performance was evaluated using the American Heart Association checklist. Data analysis was performed using SPSS version 25, with Friedman’s ANOVA applied for inferential statistics. Results: Initially, 95% of participants had a low level of BLS knowledge, with a median score of 3. Post-intervention, knowledge significantly improved, with a median score of 6.5 and 37.5% of participants achieving a high level of knowledge, while 30% reached a moderate level (p-value <0.0001). However, knowledge retention declined after three months, with a median score of 4.0 (p-value <0.0001). Previous knowledge of CPR was significantly associated with improved post-intervention knowledge scores (p-value = 0.03). Conclusion: The BLS training significantly enhanced participants' knowledge and performance. Nonetheless, there was a notable decline in knowledge retention over time.

Emotional Working Memory Training Treatment for Young Adult Problem Online Sports Bettors: A Preliminary Randomized Controlled Trial.

One of the key features of gambling disorder (GD) is impairment in cognitive-emotional control. Considering the negative consequences of GD, the present study investigated the effectiveness of emotional working memory training (eWMT) in improving cognitive control, attention, working memory capacity, and cognitive emotion regulation strategies (CERS) among young adults with GD compared to a placebo group. Following the initial assessment in the pre-test phase, eligible participants were randomly assigned to one of two groups: experimental (n = 34) and placebo (n = 30). These groups completed eWMT and a feature matching task for 20 sessions respectively. The post-test and follow-up measures indicated that eWMT significantly improved cognitive control, attention, working memory capacity, and the use of maladaptive cognitive emotion regulation strategies, but it had no significant effect on adaptive CERS. The promising results of the present study suggest the use of eWMT as a new intervention to improve cognitive-emotional control among individuals with online gambling problems.

The Effect of Eight Weeks of Selected Vestibular Exercises on Functional Balance, Walking Speed and Quality of Life of Sedentary Elderly Men

Introduction: Aging and sedentary lifestyle are associated with a decrease in physical and mental abilities. The purpose of this study is to investigate the effect of eight weeks of selected vestibular exercises on functional balance, walking speed, and quality of life of sedentary elderly men. Methods: This semi-experimental research was conducted from the winter of 1402 to the summer of 1403 with the participation of 30 sedentary elderly men from Tawheed Golmkan Elderly Care Center in Mashhad. The samples were selected purposefully and based on previous studies (25) and were divided into two experimental and control groups of 15 people. The experimental group performed selected vestibular exercises three sessions a week for eight weeks, while the control group did not perform any exercises. Dynamic comparison test, 10-meter walking speed and short-term life questionnaire were used to evaluate the quality of life. Data analysis was performed using Shapiro-Wilk test, analysis of covariance, and t-test at a significance level of P<0/05. Results: The results of paired t test showed that dynamic balance (P=0/001), walking speed (P=0/001), and quality of life (P=0/001) of the experimental group improved significantly after the exercise program. This was while there was no improvement in the control group. The covariance results did not show a significant difference between the groups in the pre-test phase, but there was a significant increase in the scores of the experimental group in the post-test phase. Conclusion: It is recommended to use exercises to prevent the disabilities of the elderly and improve their quality of independent life.

Psychological capital educational program and its effect on nurse interns’ innovative behavior

BackgroundNurse interns’ capacity for innovative behavior is a key component of healthcare settings because of increasing demands and complexities. Thus, it is important to find strategies that promote their innovative behavior. The development of psychological capital (PsyCap) improves positive behaviors and attitudes, such as engagement, motivation, and satisfaction, in the work environment. Therefore, this study aimed to assess the effect of a PsyCap educational program on nurse interns’ innovative behavior.MethodsA quasi-experimental design was used in this study. This study was executed at Fayoum University hospitals. The study participants comprised all the available nurse interns (n = 223) registered in the internship year (2022–2023) in the aforementioned settings. The data were gathered using three instruments, namely, the PsyCap Knowledge Questionnaire, the PsyCap Questionnaire, and the Innovative Behavior Inventory.ResultsThe nurse interns’ mean scores regarding total knowledge about PsyCap, total perception of PsyCap, and total perception of innovative behavior significantly improved through the posttest phase (41.27 ± 9.31, 92.22 ± 6.26, 91.31 ± 9.06, respectively) and the follow-up phase (37.83 ± 8.83, 89.96 ± 6.31, 88.89 ± 8.33) in comparison with the pretest phase (14.39 ± 5.83, 69.04 ± 8.13, 60.55 ± 7.15).ConclusionThe PsyCap educational program was effective and beneficial for improving the nurse interns’ perceptions of innovative behavior. Therefore, PsyCap interventions should be implemented in hospitals through professional development programs and orientation programs.

Promoting theory of mind and emotion understanding in preschool settings: an exploratory training study.

This new exploratory study is part of a larger ongoing follow-up project. Its specific aim was to verify whether an innovative European Program, primarily designed to enhance children's social and emotional learning, led to gains in theory of mind and emotion understanding when implemented in preschool settings. Thirty-four children (mean age: 56.4 months; SD: 10.1; range: 40-70 months) participated in the study. They were randomly and equally divided into a training group and a control group. The training sample completed eight linguistic-conversational activities drawn from the Program, in groups of 5 to 6 children, over 8 weeks. The activities were based on listening to stories and/or watching videos and then thinking and talking about the inner world (thoughts and emotions) of the story characters as well as the participants' own inner states. During the training phase, the children in the control group engaged in drawing or free play activities. At both the pre-test and post-test phases of the study, all the children completed a language test, a battery of theory of mind (ToM) tasks (including 'change of location' and 'unexpected content' tasks), and the Test of Emotion Comprehension which evaluates nine components of emotion understanding (EU). The validated national versions of the tests were administered in all cases. Significant differences were identified between the training and control groups. Indeed, the participants in the Program training activities, which were based on conversational exchanges between an adult and a group of children, as well as among the children themselves, outperformed the control participants on both overall theory of mind and overall emotion understanding. A more detailed analysis showed that the training group outperformed the control group in relation to both specific components of EU and the 'change of location' ToM task. The results of this exploratory study suggest that the Program is effective at enhancing preschoolers' social understanding and thus merits implementation in preschool settings.

Comparison of the Opinions of Adolescents With Different Orthodontic Treatment Needs.

The aim of this study was to compare oral health-related quality of life (OHRQoL) among adolescents granted (G) versus not granted (NG) publicly funded orthodontic treatment. Adolescents aged 15-20 years who were granted versus not granted publicly funded orthodontic treatment responded to a web-based survey, assessing OHRQoL in relation to functional impact, psychological impact, and motivators for orthodontic treatment. Before the survey, pretesting of the questionnaire was conducted to ensure its reliability. Differences between the groups were tested using the chi-squared and Mann-Whitney U-tests. Reliability was assessed using Cohen's κ and Pearson's correlation coefficient during the pretest phase. One hundred and forty patients, equally distributed between a G and an NG group, responded to the survey. Gender, age, and demographic distribution were comparable in both groups. All respondents expressed a high subjective treatment need and similar answers regarding functional aspects. Orthodontic treatment motivators (G: 86.2% and NG: 94.7%, p = 0.443) were primarily related to improved self-esteem, overall well-being, facial appearance, and being able to laugh without embarrassment. The NG group expressed a more negative OHRQoL impact due to the appearance of their teeth compared with the G group (p < 0.001) and a negative impact caused by the position of their teeth (p < 0.001). Orthodontic treatment need indices should aim to reinforce subjective measures as adolescents express similar motivators for orthodontic treatment, regardless of the clinician's objectively based decision about treatment need.

The Impact of an Educational Program on the Stages of Change for Mammography Screening Among Rural Women with Low Health Literacy

Background: The aim of the study was to investigate the effect of an educational program on the mammography screening stage of change among rural women with low health literacy. Methods: In general, 52 rural women participated in this experimental study. The samples were selected using a multi-stage cluster sampling method and divided into two intervention (n=26) and control (n=26) groups. An educational program was implemented for the intervention group for one month. The data collection tool was a valid questionnaire based on constructs of the transtheoretical model (TTM) related to mammography screening, which was completed in the pre-test phase and after three and six months. The data were analyzed using SPSS 16 at the significant level of 0.05. Results: There was no significant difference between the control and intervention groups at the pre-test phase (P&gt;0.05). The intervention group demonstrated considerable progress in the stage of change for mammography screening after three- and six-month follow-ups (P&lt;0.001, odds ratio [OR]=2.54). The odds ratio of progress in the stages of change in the intervention group compared to the control group significantly increased after three (P&lt;0.001, OR=4.29) and six (P&lt;0.001, OR=5.45) months of follow-up. In addition, the findings indicated a significant increase in the mean scores of decisional balance, processes of change, and self-efficacy in the intervention group compared to the control group three and six months after the educational intervention (P&lt;0.005). Conclusion: The educational program significantly advanced mammography screening stages among rural women with low health literacy. These results highlight the program’s effectiveness in enhancing screening behaviors in this underserved population.

Strain waves on additively manufactured plates for an on-orbit impact detector concept

Orbital debris impacts on spacecraft are an emerging threat to space missions due to the exponential increase in the number of satellites orbiting the Earth. Debris characteristics (size, material, velocity, etc.) are not well known for the size range of 10 mm or less that is undetectable using Earth telescopes or radar observation. The objective of this research was to determine wether a concept designed to detect impact of particles in the ∼1 to 5 mm range, find the location of the impact, and characterize the impacting projectile (velocity, size, angle, density), is feasible.The paper describes the design, fabrication, and tests performed on “witness plates” (the concept) made of two parallel layers of additively manufactured aluminum and instrumented with sixteen gages, eight on each layer. Laboratory experiments have shown that the waves can be recorded and properly interpreted to find location of impact, sound speed in the plate, and to estimate impact velocity. It was shown analytically that the amplitude of the first strain wave that propagates from the impact point is expected to decay as 1/r. This was observed as well in the signals recorded in the experiments. CTH computations were performed during the pre-test design phase and the post-test analysis phase. In fact, the numerical simulations have been key and pervasive in this research effort as they provided invaluable insight for the initial design and the correct interpretation of signal anomalies seen during the tests. Additionally, the computations confirmed the 1/r law derived analytically, i.e. that the assumptions for the derivation were justified. The main conclusions of the research are that, for a normal impact, the 1/r law for front gages can be easily used to determine the diameter of the impactor. It is possible that the back gages could be used to determine the density of the impactor as well. Finally, it was shown that oblique impacts generate an expected assymetry in the signals recorded. Though this aspect should be investigated further, the assymetry is probably uniquely related to the impact angle, which could provide the angle information.

Translation and Cross-Cultural Adaptation of the Questionnaire on Stress in Diabetic Patients (QSD-R) to Brazilian Portuguese.

Diabetes mellitus is a chronic disease that can cause psychological stress. This study was conducted to perform the translation and cross-cultural adaptation of the QSD-R for diabetic patients into Portuguese (Brazil). This study was a cross-cultural adaptation process carried out in a public university in São Paulo, Brazil, in three stages: translation and backtranslation by two native-speaking independent professionals, analysis by a committee of specialists, and a pre-test phase. The final version was created by seven experts after making semantic, idiomatic, and cultural changes to eighteen items. The results indicated a satisfactory content validation index (CVI ≥ 0.80). This version was applied to 30 patients. No item was excluded from the instrument. The translated version of the QSD-R was considered adequate and culturally adapted for use in Brazil to enable the psychometric validation of the instrument.

Effectiveness of cognitive reappraisal and distraction for induced acute pain: A laboratory study.

Cognitive reappraisal and distraction modulate pain; however, little is known about their effectiveness at different levels of pain intensity. Thus, the aim of this study has been to analyze the differential efficacy of both strategies to reduce perceived pain intensity and pain unpleasantness in low and moderate pain levels. 3 (emotion regulation strategy: cognitive reappraisal, distraction, and control) × 2 (intensity of the painful stimuli: low and moderate intensity) × 2 (time: pretest and posttest) mixed factorial design. Ninety healthy adults were randomly assigned to one of six experimental conditions. Pain-heat stimuli were administered with an advanced thermal stimulator. All participants completed the experimental pretest and posttest phases; in each phase, 12 pain stimuli were administered. Participants received brief training on how to apply cognitive reappraisal, distraction, and the control condition for the posttest phase. Data were collected from May 2022 to November 2022. Analyses of repeated-measure analysis of variance showed that at posttest cognitive reappraisal and distraction were equally effective in reducing perceived pain intensity in low pain levels, while distraction was more effective than cognitive reappraisal in decreasing perceived pain intensity in moderate pain levels. Both distraction and cognitive reappraisal were effective in decreasing pain unpleasantness regardless of the intensity of the painful stimuli. These findings highlighted the beneficial use of both strategies in the short term for pain relief, distraction being more effective in moderate pain levels. Applying both strategies to everyday situations that may cause short-term acute pain could be of great clinical relevance. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Effectiveness of Role-Playing Training on Emotional Self-disclosure and Sense of Coherence in Students with Hearing Loss

Background: Hearing loss can lead to various complications, including difficulties in language and speech development, as well as cognitive, psychological, social, occupational, educational, and learning impairments. Objectives: This study aimed to determine the effectiveness of role-playing training on emotional self-disclosure (ESDS) and sense of coherence in students with hearing loss. Methods: The study was a quasi-experimental design with a pretest-posttest approach and a control group. The statistical population included all students with hearing loss in the first and second high schools for the exceptional in Ahvaz City in 2023. A sample of 30 individuals was selected using the convenience sampling method and randomly assigned to either the experimental or control group (15 participants each). Students completed the Emotional Self-disclosure Scale and Sense of Coherence Questionnaire in both pretest and posttest phases. The experimental group received role-playing training in ten 90-minute sessions. Data were analyzed using analysis of covariance. Results: Role-playing training had a significant positive effect on both emotional self-disclosure and sense of coherence in students with hearing loss (P = 0.001). The post-test results showed that the experimental group scored significantly higher than the control group in emotional self-disclosure (147.73 ± 15.11 vs. 102.60 ± 16.18) and sense of coherence (97.40 ± 13.86 vs. 67.80 ± 8.14) (P = 0.001). Conclusions: Role-playing training can be a valuable intervention for enhancing the emotional well-being of students with hearing loss. This study contributes to the growing body of knowledge on interventions aimed at improving emotional well-being in students with hearing loss. Role-playing training emerges as a promising approach with the potential for implementation in educational and therapeutic settings.

The Effectiveness of Mindfulness-Based Stress Reduction on Quality of Life, Emotional Distress, and Pain Intensity among Women with Breast Cancer

Background: The purpose of this study was to investigate the effectiveness of mindfulness-based stress reduction training on improving quality of life, emotional distress, and pain intensity among women with breast cancer. Methods: In this semi-experimental research, a pretest-post-test design with a control group (unequal) was used. Its statistical population included all women with breast cancer in Sirjan city in 2021. Forty women with breast cancer in Sirjan city in 2021 were selected using the convenience sampling method and randomly assigned to either the experimental or control group. At first, a pre-test was taken from both groups. Then, mindfulness-based stress reduction training was implemented for the experimental group, and no intervention was performed for the control group. To collect data, the quality-of-life questionnaire of the World Health Organization and the emotional distress questionnaire were used. The research data were analyzed using covariance analysis. Results: The quality-of-life scores in the experimental group increased from 20.54 in the pre-test phase to 85.97 in the post-test phase and decreased from 48.85 to 39.05 in the control group. The emotional distress score in the experimental group decreased from 100.05 in the pre-test to 51.40 in the post-test stage. In the control group, the emotional distress decreased from 107.1 in the pretest to 103.7 in the post-test stage. Also, in the experimental group, the pain intensity scores decreased from 8.60 in the pre-test to 4.35 in the post-test. In the control group, the pain intensity decreased from 7.20 in the pre-test to 7.80 in the post-test. Conclusion: Stress reduction methods based on mindfulness can be effective in the quality of life, emotional distress, and pain intensity in women with breast cancer. According to the results, it seems necessary for nurses, doctors, and patients to cooperate with psychologists to carry out interventions.

Training Health Professional Students as Social Risk Advocates

Recognizing the intersection of cultural competency and social determinants of health is a pivotal aspect of enhancing health outcomes. In this retrospective cohort study, we sought to assess the influence of a 2-year leadership program on participants’ knowledge and self-confidence in utilizing social risk-targeted care to advocate for individual health and well-being. From 2018 to 2022, 318 health profession students completed the comprehensive 2-year program, and completed the program evaluation, which gauged the program’s impact on their knowledge and confidence to utilize social risk advocacy for those they serve. The data analysis revealed a statistically significant positive change between the pre-test and post-test phases regarding students’ self-reported comprehension of how an individual’s culture or background can impact their overall health and healthcare choices. There was a notable improvement in self-efficacy related to catering to the unique needs of individuals in rural and underserved settings as well as an increased intent to practice in underserved communities. The findings underscore the affirmative influence of affording students the opportunity to engage in tailored didactic training and community-based learning designed to cultivate the self-confidence necessary to advocate for health equity within their communities.

Effectiveness of a palliative care education program for caregivers of cancer patients receiving chemotherapy in Port Said City: A pre-post quasi-experimental study.

Emphasizing the pivotal role of caregivers in the cancer care continuum, a program designed to educate caregivers of cancer patients undergoing chemotherapy underscores their significance. The palliative care education initiative strives to cultivate a compassionate and effective care environment, benefiting both patients and caregivers. By imparting education, fostering positive attitudes, offering support, encouraging appropriate behaviors, and providing essential resources, the program aims to enhance the overall caregiving experience and contribute to the well-being of those navigating the challenges of cancer treatment. To evaluate the effectiveness of a palliative care education program for caregivers of cancer patients receiving chemotherapy. The research employed a purposive sample comprising 155 caregivers who were actively present with their cancer patients throughout the pre- and post-test phases within a quasi-experimental research design. The study took place at the outpatient oncology center of Al-Shifa Medical Complex in Port Said City, Egypt. To gather comprehensive data, 4 instruments were utilized: a demographic questionnaire, a nurse knowledge questionnaire, a scale measuring attitudes toward palliative care, and an assessment of reported practices in palliative care. This methodological approach allowed for a thorough exploration of caregiver perspectives, knowledge, attitudes, and practices within the context of a palliative care education program. Before the palliative care education program, only 1.3% of caregivers had a good overall level of knowledge about cancer and palliative care; this increased to 40.6% after the program. Similarly, before the palliative care education program, 32.9% of caregivers had a positive overall attitude, which increased to 72.3% after the program. Similarly, 27.1% of caregivers had an overall appropriate palliative care practice during the pre-test phase, which increased to 93.5% after the palliative care education program. The palliative care education program significantly improved caregivers' knowledge, attitudes, and practice scores. It is strongly recommended that caregivers of cancer patients receive continuing education in palliative care. In addition, it is crucial to conduct further research with a larger sample size in different situations in Egypt.

Impact of a comprehensive rehabilitation palliative care program on the quality of life of patients with terminal cancer and their informal caregivers: a quasi-experimental study

BackgroundPalliative care schemes, which include pain management, symptom control, psychosocial support and rehabilitation, aim to boost patients’ quality of life, ease the burden and anxiety of informal caregivers, and ultimately provide a comprehensive approach to enhance well-being during this challenging and sensitive period. This study aims to evaluate the impact of a comprehensive rehabilitation palliative care program on the quality of life of patients with terminal cancer and their informal caregivers.MethodsThis quasi-experimental study, conducted from August 2023 to January 2024 at outpatient clinics affiliated with the Oncology Center at Mansoura University, Egypt, focused on cancer patients and their caregivers in the palliative care department. Employing pre- and post-test phases, data were gathered using a questionnaire, EORTC QLQ C30, Hospital Anxiety and Depression Scale, Short Form Health Survey, Caregiver Burden Inventory, and Beck Anxiety Inventory. The investigation evaluated a 16-week rehabilitation program comprising exercise, psychoeducation, individual counselling, and spiritual support. Exercises, led by a physiotherapist, targeted fatigue and stress through tailored aerobic and resistance training. Psychoeducation sessions aimed to bolster coping abilities, covering fatigue management and nutrition. Trained counsellors addressed spiritual and existential concerns. Personal advisory sessions were available for individual support. Caregivers received education on rehabilitation and palliative care protocols, ensuring comprehensive patient care.ResultsThe mean age for cancer patients was 65.79 ± 13.85. In contrast, the mean age for primary carers was 42.05 ± 11.15. The QOL for cancer patients during the pre-test phase was 77.8 ± 7.16 and rose to 87.34 ± 14.56 during the post-test phase. Additionally, the total anxiety level of patients before the rehabilitation palliative care program was conducted was 15.45 ± 3.05 compared to 6.12 ± 3.21 after the post test phase. Furthermore, the total depression levels of the patients during the pre-test phase were 20.89 ± 9.21. However, after implementing the rehabilitation palliative care program, it decreased to 15.5 ± 6.86. In regards to the total quality of life of informal caregivers, it was measured at 67.28 ± 32.09 before conducting the program. Nevertheless, it increased to 25.95 ± 40.29 after conducting it. Additionally, the total Caregiver Burden Inventory before implementing the program was 37.45 ± 25.7, and it decreased to 29.36 ± 16.4 after conducting it. Additionally, the total score on the Beck Anxiety Inventory decreased from 45.7 ± 4.3 during the initial testing phase to 17.35 ± 23.67.ConclusionThe program for rehabilitation palliative care successfully achieved its goals by enhancing the overall quality of life for cancer patients and their caregivers. Additionally, it reduced the anxiety and depression levels among the patients, as well as the anxiety and caregiver burden among the caregivers. Continue research into the effectiveness of rehabilitation palliative care programs to identify best practices, improve existing programs, and expand access to these services.

The Effect of Brain Anodal and Cathodal Transcranial Direct Current Stimulation on Psychological Refractory Period at Different Stimulus-Onset Asynchrony in Non-Fatigue and Mental Fatigue Conditions.

The psychological refractory period (PRP) effect occurs when two stimuli that require separate responses are presented sequentially, particularly with a short and variable time interval between them. Fatigue is a suboptimal psycho-physiological state that leads to changes in strategies. In recent years, numerous studies have investigated the effects of transcranial direct current stimulation (tDCS) on motor control. The present study aimed to investigate the effects of two tDCS methods, anodal and cathodal, on PRP in ten different conditions of stimulus-onset asynchronies (SOAs) under non-fatigue and mental fatigue conditions. The participants involved 39 male university students aged 19 to 25 years. In the pre-test, they were assessed using the PRP measurement tool under both non-fatigue and mental fatigue conditions. The mental fatigue was induced by a 30-min Stroop task. The test consisted of two stimuli with different SOAs (50, 75, 100, 150, 300, 400, 600, 900, 1200, and 1500 ms). The first was a visual stimulus with three choices (letters A, B, and C). After a random SOA, the second stimulus, a visual stimulus with three choices (colors red, yellow, and blue), was presented. Subsequently, participants were randomly assigned to the anodal, cathodal, and sham stimulation groups and underwent four consecutive sessions of tDCS stimulation. In the anodal and cathodal stimulation groups, 20 min of tDCS stimulation were applied to the PLPFC area in each session, while in the sham group, the stimulation was artificially applied. All participants were assessed using the same measurement tools as in the pre-test phase, in a post-test phase one day after the last stimulation session, and in a follow-up phase four days after that. Inferential statistics include mixed ANOVA, one-way ANOVA, independent, and dependent t-tests. The findings indicated that the response time to the second stimulus was longer at lower SOAs. However, there was no significant difference between the groups in this regard. Additionally, there was no significant difference in response time to the second stimulus between the fatigue and non-fatigue conditions, or between the groups. Therefore, tDCS had no significant effect. There was a significant difference between mental fatigue and non-fatigue conditions in the psychological refractory period. Moreover, at lower SOAs, the PRP was longer than at higher SOAs. In conditions of fatigue, the active stimulation groups (anodal and cathodal) performed better than the sham stimulation group at higher SOAs. Considering the difference in response to both stimuli at different SOAs, some central aspects of the response can be simultaneously parallel. Fatigue also affects parallel processing. This study supports the response integration phenomenon in PRP, which predicts that there will be an increase in response time to the first stimulus as the interval between the presentation of the two stimuli increases. This finding contradicts the bottleneck model. In this study, the effectiveness of cathodal and anodal tDCS on response time to the second stimulus and PRP was found to be very small.