Rehabilitation Hospital Research Articles

ІННОВАЦІЇ В СФЕРІ СПА-ПОСЛУГ ГОТЕЛЮ

The article provides an analysis of innovations in the SPA industry and implementation of the latest techniques and innovative procedures in Ukrainian hotels. The fast pace of life of a modern active person, the rapid development of technologies, the deterioration of the ecological state, anxiety and insomnia, psychological disorders associated with military aggression and many other factors encourage tourists to pay more attention to their health and rest, choose hotels that provide SPA services. SPA is a place where one can restore one’s emotional balance, improve mental and physical health, increase social activity and creativity using healing treasures provided by the nature, various types of massage, rejuvenating procedures. The research methodology was based on the application of a system analysis of innovations developed and implemented in international spa centers such as Palazzo Fiuggi, Italy; Soneva Jani, Maldives; Rakxa, Thailand; Park Eagles, Austria. An abstract-logical method was used to make theoretical generalizations and conclusions about the essence of innovations in the field of spa services. The main areas of innovative activity are analyzed and their characteristics are provided. The importance of innovations in the field of SPA industry is considered and important factors that must be taken into account when providing services are determined. The main approaches that the company needs to focus on when providing SPA procedures have been determined. Classic and innovative wellness services with an indication of the healing effect are given. The main types of massage are defined. The characteristics of non-invasive procedures during which modern equipment is used and at the same time hospitalization of the patient to a hospital and quick rehabilitation periods are not required (Ultherapy, CoolSculpting). The characteristics of innovative equipment for relaxation and recovery are considered. Based on the analysis and study of innovations in the field of SPA services, the authors have proposed modern innovative procedures, which take into account the needs of customers and expand the range of additional services.

Patient and multidisciplinary health professional perceptions of an Australian geriatric evaluation and management and rehabilitation hospital in the home service.

Hospital in the Home models are rapidly expanding in response to increasing bed pressures. This study examined patient and multidisciplinary health professional perceptions of a new geriatric evaluation and management and rehabilitation hospital in the home service in Australia. The service was unique, as adults of all ages with a variety of rehabilitation or geriatric evaluation and management needs were within scope. A qualitative descriptive approach was used with a consumer co-researcher and a consumer advisor being integral to decision-making. Patient feedback was collected via a paper-based patient satisfaction survey between August 2020 and February 2022. Additionally, interviews with current and past staff were conducted from July to November 2021. Reflexive thematic analysis was conducted for qualitative data and descriptive statistics used for quantitative data. Patient surveys were analysed (n = 199, 42.2% response rate) with 60.8% of participants aged 75years or over and 26.6% speaking a language other than English. High satisfaction was expressed. Feelings of comfort, familiarity, convenience, and reassurance were voiced. A person-centred approach enhanced involvement in care. Challenges included carer burden and clear communication. Sixteen staff (33% response rate) were interviewed. In general, staff said the service was inclusive and responsive, and the home environment beneficial, particularly for patients from culturally diverse backgrounds. A strong hospital partnership and comprehensive multidisciplinary approach were vital. Challenges included fragmentation due to part-time roles and combining with a pre-existing acute hospital in the home service. This qualitative exploration of staff and patients' perceptions of a geriatrician-led, multidisciplinary geriatric evaluation and management and rehabilitation hospital in the home service demonstrated that it was person-centred and optimised patients' control and ownership of care. The inclusive service parameters ensured responsiveness to diverse needs whilst allowing earlier return home from hospital, both of which are vital for quality patient care.

Analyzing the trends in intervention studies of rehabilitation nursing: a literature review

The present study reviewed the literature to determine the trends in re-habilitation nursing intervention programs by systematically analyzing previous studies including rehabilitation nursing interventions, seeking insight to reconstruct future rehabilitation programs, and exploring re-search directions for future rehabilitation nursing intervention studies. About 94 intervention studies published from the inaugural issue of the <i>Journal of the Korean Society of Rehabilitation Nursing</i> to 2022 were analyzed. Among them, 33 studies were published between 2001 and 2005, followed by 25 studies between 2011 and 2015. All studies were authored by nurses. Concerning the types of rehabilitation nursing in-tervention programs, exercise interventions were more common than educational interventions. The exercise intervention programs im-proved performance in daily activities and decreased pain. The educa-tion intervention programs improved knowledge and increased the im-plementation of health behaviors. Based on these findings, we intend to ascertain the roles and functions of rehabilitation nurses in the mid-to-long-term and develop a specialized rehabilitation nurse system with expertise and science that meets the current trends of an increasing demand for rehabilitation nursing in various institutions such as rehabil-itation hospitals, homes, welfare rehabilitation centers, and long-term care facilities, taking the field of rehabilitation nursing to another level.

Families’ social security and benefit needs when a child is diagnosed with cancer

Abstract When a child is diagnosed with cancer, the need for health and social services and benefits increases significantly within the family. Illness changes everyday life due to medical treatments, worry and financial challenges due to parents’ absence from work. Previous research shows that higher socioeconomic status correlates with better survival for cancer patients in Finland and abroad. The purpose of the study is to reveal the factors behind the disparate cancer outcomes among children from different backgrounds. Our aim is to build a comprehensive understanding of how families utilize services and mobilize their own social capital. The research approach is qualitative. Parents, whose child was diagnosed with cancer within 4 years, were interviewed. The interviews were analyzed with a narrative approach. The interview data was utilised in conjubction with participants’ data from the benefit register of the Social Insurance Institution of Finland (KELA). Thus, both subjective experiences and register data provide a holistic picture of families’ needs and benefit use. All families utilized more than one social benefit provided by KELA. In addition, families utilized social services and benefits provided by the municipality and patient organizations. Parents reported advice received from hospital social workers and rehabilitation counsellors very important. Social benefits and services cover only part of the families’ needs. In addition, parents reported need for concrete support such as help in household duties. The results allow for comparison among families and their social capital, e.g. the support they received from their relatives and friends. The study shows that families have a wide array of service and benefit needs when a child is diagnosed with cancer. The study helps benefit and service providers understand how families differ in their service and benefit needs and in their ability to mobilize support from their own network. Key messages • Families have a wide array of service and benefit needs when a child gets cancer. • Families differ in how they mobilize support from relatives and friends during child's illness.

Which Patients gain more from short-term planned hospitalization?

Abstract Background The measurement of health-related quality of life (HRQoL) has become one of the most important components in the evaluation of healthcare outcomes. The EQ-5D-5L is an econometric tool to transform HRQoL into Quality Adjusted Life Year (QALY). The study aims to measure the health gain, expressed in QALY, provided by an Italian clinic. Methods A retrospective study was conducted on 137 geriatric patients admitted, for short-term planned rehabilitation hospitalization, from March 2018 to March 2020. Patients completed the EQ-5D-5L questionnaire at both admission and discharge. We calculated QALY from the difference between EQ-5D-5L at discharge and admission, assuming that health gains (discounted at the rate of 3.5%) accumulate up to one year after discharge. A risk adjustment has been done through the Cumulative Illness Rating Scale (CIRS). We stratified our sample by gender, age, BMI and clinical severity. Descriptive (median and interquartile range) and statistical (Mann-Whitney and Dunn's Test) analysis was carried out using STATA. Results In our sample (62.8% female) the median age was 82[15] years old. The median length of stay was 16[17] days. Patients gained 0.14[0.19] QALY: this was greater (p < 0.05) for female (0,15[0,14]) than males (0,12[0,14]). According to age groups, patients >75 years old had a lower QALY (0.12[0.26]) than both patients ≤65 years (0.16[0.15]) and those between 65 and 75 years (0.15[0.12]), while patients younger than 65 years had a higher QALY gain than the other two groups (p > 0.05). The obese class I (0.31[0.46]) gained more QALY than the other BMI classes (p < 0,05), except that obese class II. Patients with a Severity Index of CIRS higher than the median of our sample had a greater health gain (0.18[0.20] vs. 0.12[0.20]) (p > 0.05). Conclusions The EQ-5D-5L allowed us to quantify the ‘health gain’ obtained by patients through its transformation into QALY. The best results were obtained in female and obese class I patients. Key messages • The outcome assessment is essential when performing healthcare. • The QALY allows us to assess quantitative and qualitative life expectancy's increases provided by healthcare.

Revising and evaluating falls prevention education for older adults in hospital

Objective: Partnering with patients and staff to develop and evaluate falls prevention education could better enable patient learning and engagement. This study aimed to create a revised version of the Safe Recovery falls prevention education programme in partnership with older patients and hospital staff, to improve patient engagement in undertaking falls preventive strategies in hospital. Design: Two-phase sequential mixed methods participatory design. Setting: Hospital rehabilitation wards in Western Australia. Method: Phase 1: older patients ( n = 10) and staff ( n = 10) were surveyed before and after original programme delivery to ascertain their reaction and learning. Consumer-focused discussions were undertaken with staff and patients online to inform programme revision. A patient video and workbook were co-produced, and staff were trained to deliver the revised programme. Phase 2: older patients ( n = 10) and staff ( n = 10) were surveyed before and after receiving the revised programme to gain reactions and learning. Deductive content analysis and Wilcoxon signed-rank tests were used to analyse the qualitative and quantitative data. Results: Patients and staff perceived the original programme to be outdated and expressed low levels of satisfaction with the original resources. In contrast, both patients and staff were highly satisfied with the revised programme. Both original and revised Safe Recovery programme patient groups demonstrated significant improvements in knowledge and awareness to reduce their risk of falling after receiving the education ( p = .008, p = .005, respectively). However, patients receiving the revised programme were significantly more likely to intend to take action ( p = .024) and have a clear action plan ( p = .010). Staff perceived that the revised resources showed significant improvements in aesthetic appeal ( p = .007) and ability to engage patients in learning ( p = .007). Conclusion: Patients and staff contributed to successfully revising the Safe Recovery programme with positive reactions to the co-produced resources. Participating in falls education significantly improved older patients’ knowledge and attitudes regarding falls prevention.

Clinicians’ perspectives on motor learning strategy selection and application in occupational therapy and speech-language pathology interventions for children with acquired brain injury

Purpose Explore occupational therapists’ (OTs) and speech language pathologists’ (SLPs) process of selecting and applying motor learning strategies (MLS) in their interventions for children with acquired brain injury (ABI), and identify similarities and differences between OTs and SLPs in MLS selection and application. Methods This qualitative descriptive study involved individual semi-structured interviews with OTs and SLPs from the ABI program at Holland Bloorview Kids Rehabilitation Hospital (Toronto, Canada). Interviews were analyzed using thematic analysis. A modified constant comparison method permitted comparison within and between professions. Results Four OTs and three SLPs were interviewed. Four themes were developed: aligning MLS application with the child’s cognitive ability, using MLS to promote success within a single session, adjusting MLS across treatment sessions, and promoting generalization and transfer of motor skills beyond the therapy session. MLS application was predominately based on child-specific factors with task-specific considerations. OTs and SLPs used similar clinical reasoning processes for selecting and applying MLS. Conclusions This study provides a greater understanding of OTs’ and SLPs’ clinical reasoning process when applying MLS in pediatric ABI interventions. The similarities in MLS selection and application between disciplines suggest that an interprofessional approach to MLS is suitable for pediatric ABI rehabilitation.

Undernutrition risk is independently associated with worsened indicators of hospital rehabilitation in COVID-19 patients

ABSTRACT Objective This study was designed to analyze the association between the risk of undernutrition and indicators of hospital rehabilitation in patients with COVID-19 while controlling for confounding variables. Methods This was an analytical study conducted by analyzing the medical records of patients with COVID-19. A total of 562 adult patients were eligible for the study. In addition to the risk of undernutrition (independent variable), indicators of hospital rehabilitation (dependent variables) were evaluated. These indicators included the length of hospital stay, clinical outcome (discharge or death), food intake, mobility (bedridden status), the use of mechanical ventilation, and the need for enteral nutrition. Pre-existing comorbidities (confounding/control variables) were grouped into cardiovascular, metabolic/endocrine, neurological, chronic obstructive pulmonary disease, and other categories (neoplasms, multiple sclerosis, and kidney disease). A dichotomization model was applied for data analysis. The Chi-Square test was used to verify the association between the risk of undernutrition and the dependent variables. Associations with a significance level of P < 0.05 were subjected to Poisson regression to identify the prevalence ratio. Results Patients at risk of undernutrition had a 90% higher chance of being bedridden and were 35 times more likely to experience a decrease in food intake. They also had an 89% higher chance of using invasive mechanical ventilation and a 91% higher chance of requiring enteral nutrition. Additionally, individuals at risk of undernutrition had a 73% higher chance of death. Adjustment for comorbidities did not alter these associations, demonstrating that the risk of undernutrition is independently associated with indicators of hospital rehabilitation. Conclusion The risk of undernutrition is independently associated with worsened indicators of hospital rehabilitation in patients with COVID-19, including higher prevalence of mortality.

Diaphragmatic breathing combined with abdominal drawing-in maneuver for walking function in post-stroke patients: a randomized controlled study protocol

BackgroundPatients with stroke frequently experience walking dysfunction. Core training can help improve balance and walking function in patients with stroke. However, core training movements in clinical practice are numerous and differently targeted. Therefore, this study will investigate the improvement of walking function in patients with combined diaphragmatic breathing maneuver (DBM) and draw-in breathing technique (ADIM) training.MethodsThis single-blind, randomized controlled preliminary will analyze the viability of DBM combined ADIM training versus routine rehabilitation therapy in patients with stroke with early to mid-stroke. Patients will be randomly assigned to either the DBM and ADIM training or the routine rehabilitation training. We will recruit 42 stroke inpatients from the Second Rehabilitation Hospital of Shanghai who meet the trial criteria and measure the balance and walking functions and improvement of that after 4 weeks of intervention. The primary outcome is the 10 m maximum walking test (10MWT). The secondary outcomes indices include the limits of stability test (LOS), Berg balance scale test (BBS), Functional Ambulation Categories test (FAC), Timed Up and Go test (TUG), trunk impairment scale test (TIS), ultrasound indicators of the diaphragm and transversus abdominis (UI), rhythmic weight shift test (RWS), walk across test (WA), Fugl-Meyer assessment of lower extremity (FMA-LE), and Barthel index of ADL test.DiscussionThe primary objective of this project was to investigate the effects of DBM combined with ADIM on balance capacity and walking function for patients with early to mid-stroke. The outcomes of this study will hold significant implications for future clinical applications in rehabilitation.Trial registrationChinese Clinical Trial Registry (ChiCTR), ID: ChiCTR2100054897. Registered on 28 December 2021.

Evolution of Cardiovascular Risk Factors in Post-COVID Patients.

(1) Background: SARS-CoV-2 infection has been a subject of extensive discussion in the medical field, particularly in relation to the risk factors and effective treatment strategies for reducing the negative health outcomes associated with the virus. However, researchers indicate that individuals in the recovery phase after COVID-19 experience a range of symptoms that significantly impact their overall well-being and quality of life. At present, there is insufficient evidence to substantiate the claim that patients in the post-acute phase of COVID-19 are at an elevated risk of developing new-onset hypertension or even metabolic syndrome. The current study aimed to assess the risk of cardiovascular diseases after COVID-19 and the optimal treatment of these conditions. (2) Methods: This research was conducted at the Cardiovascular Rehabilitation Clinic of the Iasi Clinical Rehabilitation Hospital (Romania) between the 1st of September and 31st of December 2022. From a total of 551 patients hospitalized in that period, 70 patients with multiple comorbidities were selected. This study included patients over 18 years old who were diagnosed with COVID-19 within the past 30 days. (3) Results: The included patients were mostly women (62.9%) from the urban area (61.4%). Comparing the post-COVID-19 period to the pre-COVID-19 one, it was observed that the risk of hypertension increased from 69.57% to 90% among the subjects (p = 0.005). Risk factors for the new onset of hypertension were identified as age, female gender, and an elevated body mass index. Moreover, the number of patients with dyslipidemia doubled, and a higher body mass index was noted. (4) Conclusions: Our findings suggest that patients affected by COVID-19 are at an increased risk of developing hypertension and related disorders.

Current status of rehabilitation services and problems in Yunnan Province, Southwest China: a general doctors’ questionnaire-based study

Objectives Community-based hospitals in China lack physicians, especially rehabilitation physicians. Recently, several financial resources have been developed to prepare general doctors for community-based hospitals. These doctors seem to be the best choices for assuming the role of a rehabilitation physician. However, their willingness and in-depth information from their perspectives have not been previously investigated. Materials and methods We conducted a general investigation of rehabilitation resources in Yunnan, a province located in Southwest China with a population of more than 40 million. Our investigation covered the entire Yunnan Province from December 2020 to May 2022. The questionnaire was administered to 670 general doctors in 112 community hospitals randomly selected in Yunnan Province based on their willingness to assume the role of rehabilitation physicians and obstructive factors to process the rehabilitation services. The reliability and validity of the questionnaire were evaluated, and items regarding their general condition were analyzed. Results Cronbach’s alpha and Kaiser–Meyer–Olkin values were 0.748 and 0.729, respectively. The measure comprises four factors: common disease, demand for training to improve skills, subjective/objective factors, and proactivity to recommend rehabilitation therapy. More than 20% of general doctors were unwilling to take on the role of rehabilitation physicians, and their willingness was related to satisfaction with their current job, comprehension of community-based rehabilitation, and comprehension of government support (p < .05). Conclusions From the perspective of general doctors, the reimbursement rate for medical insurance, which burdens patients, is the greatest problem in the process of developing community-based hospital rehabilitation services. Offering professional training to increase their capacity and developing common practices to increase doctors’ proactivity to recommend rehabilitation therapy may help increase the future support of medical insurance and increase general doctors’ willingness to take on the role of a rehabilitation physician.

Elderly surgical hospitalizations in the municipality of Rio de Janeiro, 2020

It is estimated that, by 2025, around 14% of the country's population will be aged over 60. The increase in the population's life expectancy has encouraged scientific work in healthcare for the elderly. The profile of illness generates greater demand for hospital admissions, drug treatments and rehabilitation. The study sought a comprehensive assessment of the current state of health of the elderly, especially those undergoing surgical interventions. Objective: To analyze the recorded hospitalizations of elderly surgical patients in the municipality of Rio de Janeiro in 2020. Methods: Quantitative, cross-sectional, retrospective, and analytical with a focus on secondary data from the SUS Hospital Information System (SIH). Results: Of the total number of hospitalizations, 28,318 (48.9%) were female and 29,535 (51.1%) were male. The average age was 70.4 years (± 7.9) among elderly hospitalizations, and this average was higher in women 71.2 (± 8.4) compared to men 69.5 (± 7.4). Conclusion: The results show the importance of the health information system in the state of Rio de Janeiro as a tool for drawing up, planning, and monitoring diagnostic, preventive and health promotion actions aimed at the elderly population.

Effect of preoperative cluster care nursing on patient compliance during preoperative isolation of pediatric patients before cochlear implant surgery

ObjectiveThis study investigates the effect of pre-operative cluster care nursing on patient compliance during preoperative isolation of pediatric patients from their family members before cochlear implant surgery. Study methodsA total of 350 pediatric patients who underwent cochlear implant surgery at Sichuan Rehabilitation Hospital from January 2021 to December 2022 were enrolled. The children were divided into two groups:Experimental group (group E) consisted of 182 children who received pre-operative cluster care nursing, and control group (group C) consisted of 168 children who received pre-operative routine nursing. The compliance scores of the two groups of patients when separated from their families before entering the operating room and the number of patients requiring intravenous injection of midazolam were recorded. ResultsThe compliance scores of group E were significantly lower than those of group C (t = 4.141, P < 0.001). The percentage of patients requiring intravenous injection of midazolam was recorded: it was 21.98% (40/182) in group E and 42.26% (71/168) in group C. Notably, the injection rate of midazolam in group E was significantly lower than that in group C (χ2 = 16.597, P < 0.001). ConclusionPre-operative cluster care nursing can improve patient compliance and reduce the use of sedative drugs during preoperative isolation of pediatric patients from their family members for cochlear implant surgery.

A - 99 Older Adult Male with Idiopathic Normal Pressure Hydrocephalus (iNPH): Neuropsychological Case Study.

Idiopathic normal pressure hydrocephalous (iNPH) is a potentially reversible syndrome characterized by ventriculomegaly. Parkinsonism is an often-overlooked clinical feature of iNPH. Mostile et al. (2022) argued that the diagnostic iNPH "triad" should be reconsidered as a "tetrad" including parkinsonism. This case will discuss iNPH presenting with parkinsonism. Patient is an 81-year-old male with a history of iNPH with Hakim's triad. His medical history includes hyperlipidemia, hypertension, deep vein thrombosis, benign prostatic hyperplasia, total knee replacement, and chronic depression. Presenting concerns were continued cognitive and gait impairments. Patient was referred from his physiatrist for evaluation of his cognitive functioning and assistance with discharge planning in an acute inpatient rehabilitation hospital. Patient was neuropsychologically evaluated to clarify the etiology of his cognitive presentation. Patient's cognitive profile was impaired in areas of attention, executive functioning, processing speed, visuoperception, and displayed a subcortical memory profile. Patient had intact functioning in areas of oral reading, naming, and working memory. Motor examination was evident for apraxia, task-specific tremor, and micrographia. This case report provides additive findings for common presentation of iNPH including parkinsonism presenting with comorbid psychiatric and medical confounders, highlighting the need for further research on neuropsychological profile of iNPH post shunt procedure. It also accentuates the need to accept parkinsonism as one of the common presentations of iNPH. Akinesia has been reported in nearly 70% of iNPH cases (Krauss et al, 1997), with bradykinesia and postural instability being the main parkinsonian features. Asymmetry and resting tremor were seen to be uncommon (Molde et al., 2017).

Evolution and characteristics of speech and language therapist services in a high complexity Chilean hospital according to monthly statistical records (REM)

Introduction: speech and language therapist services has been extensively described. However, in Chile the evolution and characteristics of these services at hospital level and especially during the last years (pre and post COVID-19) are unknown. The exploration of these data could contribute to the development of strategies and decision making at the local level. Objective: to determine the evolution and characteristics of speech and language therapist services between the years 2015-2022 in a Chilean high complexity hospital. Methods: by means of a quantitative, transectional and descriptive design, 96 databases corresponding to the Monthly Statistical Records (REM) between January 2015 and December 2022 were reviewed. The variables analyzed were: number of initial and intermediate evaluations, hospital rehabilitation sessions, home rehabilitation and procedures-activities performed. Results: an oscillating increase in the number of speech and language therapist services performed between 2015-2022 was observed. Preference is given to hospital rehabilitation sessions (95,626 services) followed by initial evaluations (11,550). By specific area, the highest number of benefits was obtained by swallowing rehabilitation (22,594), while individual and group auditory rehabilitation only presented 7 and 11 records respectively. Conclusions: the analysis of the REM exhibits an incremental evolution of the registry of speech and language therapist services, especially since the last three years (2020 onwards), this despite the fluctuations observed during the previous years (2015-2019). This increase would be directly related to the increase in the hiring of professionals, improvement of supplies and equipment, incorporation of the speech therapist to pathologies with explicit health guarantees (GES) and the need for professional staffing due to the COVID-19 contingency

Risk factors for readmission of patients with amputation to acute care from inpatient rehabilitation: A retrospective cohort study.

Amputation is a major condition that requires inpatient rehabilitation. Some research has been conducted to explore the risk factors for readmission of patients from inpatient rehabilitation facilities to acute care hospitals. However, few studies have included patients with amputation in the study population. To identify the risk factors for readmission of patients with amputation to acute care hospitals from an inpatient rehabilitation facility. Retrospective cohort study. An acute rehabilitation hospital associated with a community-based tertiary medical center. A retrospective review of 156 independent admissions of 145 patients from June 2019 to July 2022. The study outcome measure was readmission to acute care from an acute rehabilitation unit. Of the 156 independent admissions, the readmission rate was 19% (29/156). The most common cause of transfer was incision-site complications (9/29, 31%), including wound infection and wound dehiscence. Patients with amputation readmitted to acute care are more likely to be receivingdialysis (p < .001), have a longer length of stay in acute care before admission to the rehabilitation facility (p = .039), and have a lower Section GG score on admission (p < .001). Age, sex, ethnicity, amputation level, and history of diabetes mellitus were not associated with acute care hospital readmission. The logistic regression model revealed that patients being on dialysis was the only significant risk factor predictive of readmission to acute care (odds ratio [OR] 4.82, p = .006). This study showed that incision-site complications were the most common cause of disruption in inpatient rehabilitation via acute hospital readmission in patients with amputation. Being on dialysis was associated with a higher risk of readmission to acute care hospitals. Based on the results of this study, specific rehabilitation plans might be required for patients with amputation who carry certain risk factors to reduce rehospitalization to the acute care unit.

Impact of Caring for Mentally Ill Patient on Caregivers

Mentally ill person needs caretakers during hospitalization for severe conditions, continuing care, and rehabilitation. Caretakers experience mental illness when providing care for their mentally ill patients in Nepal. About 24.5% of caretakers had anxiety and 19.6% had depression. The financial, social, and psychological health of caregivers may all impact. The objective was to examine the psychological, financial and social impact on caregivers. A descriptive study was conducted on 207 caregivers’ of mentally ill patients at mental hospital, Nepal. Purposive sampling technique was used. Semi-structured questionnaires were developed to assess psychological and financial impacts and Likert scale questions were included to assess social impact. Information was gathered using a structured face-to-face interview. Impacts on caregivers’ psychological, economic and social were associated to their sociodemographic characteristics. Education, religion, and the patient's length of mental illness were all associated with psychological impact (χ2=54.37; df=5; p= &lt;0.001). Education and the duration of their mental illness are also related to the financial impact (χ2=31.95; df=7; p= &lt;0.001). The social impact experienced by caregivers is similarly associated with education, occupation, and the length of mental illness (χ2=61.03; df=5; p= &lt;0.001). The association between caregivers' sociodemographic factors and the psychological, financial, and social impacts on them was observed. This justifies encouraging caregivers to be a part of the support group in order to increase the information and emotional support they get from other caregivers who have similar experiences. Keywords: Impact, psychological, financial, social, mentally ill patient, caregiver

Amplitude training in occupational therapy for the treatment of Parkinson's disease: a feasibility study

Background/Aims Parkinson Wellness Recovery Moves is a functional, large-amplitude exercise programme aimed at reducing the symptoms of Parkinson's disease. To date, evidence supports the use of amplitude training to reduce the symptoms of Parkinson's disease; however, evidence is lacking in the feasibility of using Parkinson Wellness Recovery Moves as an adjunct to occupational therapy within inpatient rehabilitation. The aim of this study was to evaluate the feasibility of implementing the Parkinson Wellness Recovery Moves intervention into the treatment of patients with Parkinson's disease, within an inpatient rehabilitation hospital. Methods A total of five adults with Parkinson's disease participated in this 11-week quasi-experimental feasibility trial. The use of Parkinson Wellness Recovery Moves was standardised, requiring each participant to engage in at least two occupational therapy sessions that included Parkinson Wellness Recovery Moves. Outcomes collected included fidelity of intervention implementation, and participant-centred outcomes of quality of life satisfaction and function via the Parkinson's Disease Questionnaire-39 and Section GG respectively. Results Each participant had a positive change in Section GG scores and completed between eight and 13 occupational therapy sessions that included Parkinson Wellness Recovery Moves. Four out of five participants reported higher quality of life at the time of discharge. Conclusions The use of Parkinson Wellness Recovery Moves was found to be feasible to implement within an inpatient rehabilitation hospital, with increased functional performance and improved quality of life.

Influence of Daily Aerobic Exercise Duration on Phase 2 Cardiac Rehabilitation at a Rehabilitation Hospital and Health-Related Quality of Life After Discharge.

Phase 2 in-patient cardiac rehabilitation (CR) at a rehabilitation hospital is now added the medical service fees in Japan and in light of the recent reimbursement for CR, a study needed to be performed to determine exertional exercise on its effectiveness and benefits to patients. We examined the effects of daily aerobic exercise duration on health-related quality of life (HR-QoL) at 6 months after discharge from phase 2 CR. Of the 54 consecutive cardiovascular disease patients admitted to a rehabilitation hospital after acute care, 43 were considered acceptable candidates for enrollment according to predetermined inclusion and exclusion criteria. Of these, 40 patients completed study requirements, including return of a questionnaire on HR-QoL survey 6 months after discharge. The primary outcome was HR-QoL as evaluated using the EuroQol five-dimension five-level (EQ-5D-5L). Two multiple regression models were constructed to assess the influences of daily aerobic exercise duration (content of rehabilitation) and other clinicodemographic variables assessed during acute care (model 1) or at transfer from acute care to a rehabilitation hospital (model 2). Both model 1, which included age, Barthel index of daily function before hospitalization, and daily aerobic exercise duration in the rehabilitation hospital (R2 = 0.553, P < 0.001), and model 2, which included New York Heart Association functional classification at transfer, Charlson comorbidity index at transfer, and daily aerobic exercise duration (R2 = 0.336, P = 0.002) identified aerobic exercise duration as a significant independent factor influencing HR-QoL at 6 months post-discharge (model 1: P = 0.041; model 2: P = 0.010). Enhanced daily aerobic exercise content during phase 2 in-hospital CR can significantly improve longer-term HR-QoL among cardiovascular disease patients independently of other clinicodemographic factors, including age, activities of daily living before treatment, and baseline condition at rehabilitation onset. These findings, that in the small sample size, support the continued expansion of phase 2 CR at a rehabilitation hospital in Japan.

A Case Study Implementing a Social Needs Screening Process and a Family Navigation Hub at Holland Bloorview Kids Rehabilitation Hospital.

Identifying and addressing clients' and families' most pressing social determinants of health needs are integral to quality healthcare. Healthcare leaders and front-line clinicians have long recognized the connection between unmet essential resource needs, such as food, housing and transportation and health outcomes. As a component of broader organizational efforts to improve equitable access to services, a social needs screening (SNS) initiative was introduced, along with a Family Navigation Hub providing navigation interventions. This paper describes the systematic approach taken to support the SNS initiative implementation and highlights evaluation results of the first year of activity.