Therapeutic Team Research Articles

The development of the Sensory Emotional Engagement Checklist (SEE-C): Preliminary reliability and validity

ABSTRACT The Sensory Emotional Engagement Checklist (SEE-C) was developed to assess social emotional challenges in children whose sensory integration and sensory processing differences impact daily life. Thus, the purpose of this study was to assess the validity and reliability of the SEE-C for identifying social emotional patterns. Retrospective data were used from parent interviews and consultations at a pediatric clinic in the northeast with occupational therapists that produced items representative of hypothesized social-emotional behavioral subtypes. Factor analysis was conducted to explore construct validity, followed by internal consistency reliability of factor groupings. Correlational analyses were computed for factors within the SEE-C as well as between the SEE-C and the Sensory Processing 3 Dimensions Checklist (SP3D-C). Data were collected from 167 individuals’ charts of children ranging from 4.5 to 13.5 years who were evaluated for sensory integration and sensory processing differences. Factor analysis revealed a four-factor solution that explained the proposed structure of the SEE-C. Internal reliability for SEE-C factors ranged from α = .7 to .8. Correlations were weak but significant within the SEE-C, as well as between factors of the SEE-C and the SP3D-C subscales. Evidence supports the preliminary reliability and validity of the SEE-C as well as suggesting a link between children’s social emotional styles and sensory-related behaviors. The proposed social emotional behavior patterns of the SEE-C also suggest behaviors commonly considered in the mental health field may be reflective of sensory integration and sensory processing differences. These sensory-emotional patterns can further justify the inclusion of pediatric Occupational Therapists as part of the therapeutic intervention team for social emotional challenges in children.

Arts Therapy in the Education System at a Time of a National Disaster

Roughly 4,000 arts therapists are employed by the Israeli education system, which enabled a rapid response in the school setting when Israel awoke on October 7, 2023 to the Hamas attacks and the national disaster that ensued. This participatory research presents the perspectives of 14 female arts therapist coordinators of therapeutic service teams working in educational settings with special needs children. In semi-structured interviews, the coordinators discussed their initial feelings, how they organized interventions over time since October 7, the challenges they faced, multicultural issues and recommendations for the future. The interviews were analyzed according to the principles of thematic analysis. Despite the collective trauma and the challenges, the findings show that the arts therapists found creative ways in the education system to provide a therapeutic response both online and through different modes of intervention. These interventions contributed to supporting the clients’ broader circles of classmates, school staff and parents.

Association between Symptoms of Depression and Generalised Anxiety Disorder Evaluated through PHQ-9 and GAD-7 and Anti-Obesity Treatment in Polish Adult Women.

Obesity impacts mental health greatly. Psychological factors may influence the effectiveness of its treatment. This study aimed to compare symptoms of generalised anxiety disorder and depression among adult women across different weight categories. The study sample comprised 1105 adult women. The computer-assisted web interview (CAWI) utilising the seven-item Generalised Anxiety Disorders Scale (GAD-7) and the nine-item Patient Health Questionnaire (PHQ-9) was used. Both GAD-7 and PHQ-9 scores correlated positively with BMI (r = 0.121, p < 0.001 and r = 0.173, p < 0.001, respectively) and negatively with age (r = -0.106, p < 0.001 and r = -0.103, p < 0.001, respectively). Patients undergoing treatment with semaglutide scored lower for both anxiety symptoms (8.71 ± 6.16, p = 0.013) and depression symptoms (9.76 ± 6.37, p = 0.013). Women who underwent bariatric surgery screened less frequently for anxiety (8.03 ± 6.27, p = 0.002) but not for depression. An interdisciplinary approach involving mental health professionals within the therapeutic team can comprehensively address factors contributing to obesity development and treatment outcomes. Further investigation of semaglutide's use is needed due to the promising evidence suggesting a positive effect on decreasing the severity of depression and anxiety symptoms to assess the direct or indirect character of this influence.

Professionalisation and Autonomy of the Occupational Therapist Profession in Poland

Abstract Occupational therapy has been practised for several decades across various medical entities. However, it was only since 2012 that opportunities for professional development in this area began to be created. It can be considered that with the establishment of higher education training in occupational therapy, the perception of this profession has changed and is becoming increasingly important among professionals and the Polish society. Various measures are being taken to regulate the profession (including a law on certain health professions currently under procedure in the Sejm), but the topic of professionalisation and autonomy is still not sufficiently explored and addressed in Polish literature. The aim of this article is to present occupational therapists’ opinions on the professionalisation and autonomy of their profession. A questionnaire was used to survey 188 middle-aged people (35.18±9.72 years). The results show a need to regulate the occupational therapist profession, to guarantee assistance for therapists in improving their qualifications and to increase their remuneration. According to a significant number of respondents, therapists are undervalued and treated unequally in their work environment. The prestige of the occupational therapist profession was rated at a low level. The main conclusion of the study indicates that in the process of professionalisation and autonomy of the profession in Poland, more attention should be paid to the promotion of the contemporary model of occupational therapy in order to increase its recognition and raise awareness of the essence and importance of the role of an occupational therapist in both the medical (therapeutic team) and social environment.

Switching Vancomycin Monitoring From Trough Concentration to Area Under the Curve Estimation by Bayesian Forecasting: A Short Communication on a Cost-Benefit Study in Resource-Limited Settings.

This study was conducted to evaluate the cost-benefit indicators of a vancomycin monitoring protocol based on area under the curve estimation using commercial Bayesian software. This quasi-experimental study included patients who were aged >18 years with a vancomycin prescription for >24 hours. Patients who were terminally ill or those with acute kidney injury (AKI) ≤24 hours were excluded. During the preintervention period, doses were adjusted based on the trough concentration target of 15-20 mg/L, whereas the postintervention period target was 400-500 mg × h/L for the area under the curve. The medical team was responsible for deciding to stop the antimicrobial prescription without influence from the therapeutic drug monitoring team. The main outcomes were the incidence of AKI and length of stay. Cost-benefit simulation was performed after statistical analysis. There were 96 patients in the preintervention group and 110 in the postintervention group. The AKI rate decreased from 20% (n = 19) to 6% (n = 6; P = 0.003), whereas the number of vancomycin serum samples decreased from 5 (interquartile range: 2-7) to 2 (interquartile range: 1-3) examinations per patient ( P < 0.001). The mean length of hospital stay for patients was 26.19 days after vancomycin prescription, compared with 17.13 days for those without AKI ( P = 0.003). At our institution, the decrease in AKI rate and reduced length of stay boosted yearly savings of up to US$ 369,000 for 300 patients receiving vancomycin therapy. Even in resource-limited settings, a commercial Bayesian forecasting-based protocol for vancomycin is important for determining cost-benefit outcomes.

COMPARISON OF PSYCHOTHERAPY APPROACHES IN ADOLESCENTS AND CHILDREN WITH ANOREXIA NERVOSA

INTRODUCTION: Anorexia nervosa (AN) is a serious eating disorder characterized by an intense fear of gaining weight and obsessive calorie restriction, often starting during adolescence. It can lead to severe somatic complications such as hormonal imbalances and heart arrhythmias. Treatment typically involves a multidimensional approach addressing somatic and psychological aspects, primarily relying on psychotherapy. Family support is crucial, providing emotional support, motivation, and of a healthy lifestyle maintenance. Individual or group therapy helps patients understand their behavior, change negative thoughts, and develop healthier coping strategies. Family therapy, often using Cognitive Behavioral Therapy (CBT) or Adolescent-Focused Therapy (AFT), is common. Treatment is prolonged and requires patient commitment and collaboration with a therapeutic team. MATERIALS AND METHODS: This review of studies is based on articles from PubMed and Google Scholar databases, focusing on eating disorders in adolescents, including treatment, psychotherapy, family-based therapy, and anorexia nervosa. RESULTS: Studies and guidelines indicate that family therapy is the preferred method for treating anorexia in children and adolescents, leading to significant improvements in body weight and eating disorder symptoms, with long-term positive effects. Behavioral therapy and AFT also yield promising results in adolescents. CONCLUSION: Further research is needed to tailor therapy to each patient, as there is limited research comparing the effectiveness of individual methods, especially in the long term, despite their widespread clinical use.

Patient-authored medical record II: A not-knowing approach to psychiatric nursing

A patient-authored medical record (PAMR) is a narrative-based prescription that is written by a psychiatric patient with help from a nurse. It is a tool specifically designed and developed for psychiatric nursing. We have reported its notable therapeutic effects for Japanese patients and found that the patients had accurate views of how to improve their illness. The present paper, which broadens the scope of this examination, includes the entire process of using this tool, including both patient-authored medical records and follow-up dialogue. We aim to demonstrate how a patient's potentials are leveraged and expanded through the interpretation of such texts through dialogue, in which interpretation takes the form of a conversational question based on not-knowing. Follow-up meetings facilitate the therapeutic process and team collaboration for patients, medical staff, and families. We also reaffirm the soundness and legitimacy of psychiatric patients writing their own prescription with help from a nurse.

Implementation of an Open Door Policy on Two Acute Care Units

Since the amendments to the Baden-Württemberg Psychiatric Assistance Act, psychiatric patients who are treated involuntarily can be admitted to open wards. As a result, a comprehensive research project was carried out to implement an open-door policy. This work evaluates the attitudes of patients and therapeutic teams. Over the course of a year, 8 focus groups with 6 to 11 participants were conducted with patients and staff before and at the end of the intervention phase and analyzed qualitatively. The concept of open doors was received positively. The staff raised safety concerns whereas on the patient side the door status seemed to be of limited relevance regarding the experience of autonomy or stigmatization. The elaboration of conflict issues allows a further development of specific concepts towards the implementation of open doors on psychiatric acute wards.

Psychodiabetology: The Challenge of the Future?

The number of people suffering from diabetes, including type 1, is constantly increasing both in Poland and worldwide. Type 1 diabetes is a chronic disease characterized by uncertain prognosis and relapses, as well as permanent, irreversible, and progressive changes in health status. The ongoing disease results in dysfunction or disability, and the patient requires specialized supervision, care, and rehabilitation. However, the success of therapy does not depend solely on the perfection of treatment, but also on the patient's readiness to change their lifestyle and cooperate with the therapeutic team. The patient's constant alertness in making therapeutic decisions does not always lead to expected treatment results, and the risk of hypoglycemia associated with intensive insulin treatment depletes the patient's motivation for treatment, leading over time to the development of 'therapeutic burnout' and psychiatric disorders. This narrative review is an attempt to summarize the knowledge and possible future solutions in diabetes type 1 in Poland as well as highlight the importance of comprehensive care, including psychological care, which appears fundamental in a chronic disease such as type 1 diabetes. Therefore, the aim of the study was to present generational changes and psychosocial problems of patients with type 1 diabetes and to identify urgent challenges in diabetic care. Attention should be paid to the deteriorating mental condition of the young generations, who, in the course of diabetes, are exposed to additional psychological and psychiatric health problems. The next generation of patients will require more psychological care, which is why the challenge of the future is to create psychodiabetology centers.

The awareness of treatment plans of craniosynostosis: guideline for patient and family version

BackgroundFunctional and structural complexities associated with craniosynostosis present challenges for families of affected individuals. Additionally, these patients undergo childhood surgeries that significantly impact the role of the family/caregiver. Consequently, multiple therapeutic teams have provided various guidelines, with the most recent version in 2023 introducing the patient/family guide. The objective of this study was to evaluate the level of awareness among the patient’s family/caregiver regarding the treatment plan.MethodsThe descriptive-analytical study sample consisted of 117 caregivers (parents) of children diagnosed with craniosynostosis between 2013 and 2023, who were conveniently selected for participation. The self-designed questionnaire was based on the 2023 guidelines and underwent reliability and validity testing. It comprised 14 chapters derived from the literature, with a total of 55 yes/no questions.ResultsBased on the results obtained from this study, the total correct response rate is 62.3%. The highest level of respondent awareness was associated with Chapter 12, with a correct response rate of 69%. The lowest level of awareness, at 41.8%, was related to Chapter 10.ConclusionIt is better to use appropriate educational aids such as educational podcasts based on the latest guidelines for craniosynostosis to educate parents.

Nature-Adventure based experiential methods for enhancing psychotherapeutic efficacy

IntroductionA complex, Nature-, and Adventure Therapy - integrated Schema Therapeutic program (N-ABST) and a related efficacy study was launched in 2022 April at the Psychotherapy Department, at Semmelweis University. The participants had the opportunity of having outdoor, experience based group processes – seven full days in a month - in addition to the classic Schema Therapy (ST) sessions. According to the study design, 4-week long traditional thematic ST programs and 4-week long N-ABST programs were taken place alternately.ObjectivesOur aim was to compare the efficacy in a randomized, controlled design, short and medium terms. The participants of the programs and thus the target group of the research were adults, diagnosed mainly with Borderline Personality Disorder, inpatients in psychiatry.MethodsThis methodological innovation also meant the integration of two therapeutic teams in practice. When establishing the collaboration, we put emphasis on finding common points and understanding how N-AT contributes to schema therapy goals. During our joint work, it became clear that the elemental need for contact with nature enriched the schema therapy approach with a new basic need that was not included in it before. Measurements were taken before the start of the entire program and at the end of the 4-week cycle. Preliminary results are presented based on the Personality Inventory for DSM-5 - Hungarian Short Form (PID-5-HSF), and the Derogatis Symptom Checklist (SCL90).ResultsIn the N-ABST group (n=23) the PID5 “Dysinhibition” scale (p &lt; .01, Cohen’s d = .636), and the “Negative Affectivity” scale (p &lt; .05, Cohen’s d = .388) showed significantly lower scores after therapy. In the case of the “Detachment” we have found a tendency to decrease after the therapy. Regarding the comparison of the effectiveness of N-ABST and classical Schema Therapy - with the current state of analysis - there was a significant difference in the PID5 values for “Suspiciousness” and “Manipulativeness”. The former characteristic was reduced to a greater extent by the schema therapy, and the latter by the N-ABST therapy. Based on the SCL90, the N-ABST program resulted in a significant symptom reduction measured by the following subscales: somatization, obsessive compulsive, interpersonal sensitivity, depression, phobia. Global symptom severity also decreased significantly (p &lt; .05, Cohen’s d = .588).ConclusionsAccording to our results, Nature- Adventure Therapy enhanced Schema Therapy seems to be an innovative and efficient method in the psychotherapy of personality disorders. Besides the effectiveness, there is a great challenge to design programs that are sustainable and therefore serves therapy long term as well.This study was supported by the National Research, Development and Innovation Office grant K 129195.Disclosure of InterestNone Declared

A Therapeutic Team’s Interventions and Their Perception of Parental Reactions Towards Them: A Child’s Psychiatric Inpatient Treatment of Anorexia Nervosa

This article explores the family consultations during the inpatient treatment of children and adolescents with anorexia nervosa. There were three study goals: to explore the therapeutic team’s interventions, to study the team’s perception of parental reactions toward the interventions, and to compare two groups of parents. Medical records of 32 were analyzed using Consensual Qualitative Research. There were eight categories of interventions discussed. Parents with better cooperation were more concentrated on their personal experiences (p = 0.005), whereas parents with poorer cooperation had more work on marital conflict (p = 0.004). Bereavement also appeared to be a particularly important theme.

Optimization of the stroke hospital selection strategy and the distribution of endovascular thrombectomy resources.

Nowadays, emergency medical technicians (EMTs) decide to send a suspected stroke patient to a primary stroke center (PSC) or to an endovascular thrombectomy (EVT)-capable hospital, based on the Cincinnati Prehospital Stroke Scale (CPSS) and the number of symptoms a patient presents at the scene. Based on existing studies, the patient is likely to have a better functional outcome after three months if the time between the onset of symptoms and receiving EVT treatment is shorter. However, if an acute ischemic stroke (AIS) patient with large vessel occlusion (LVO) is first sent to a PSC, and then needs to be transferred to an EVT-capable hospital, the time to get definitive treatment is significantly increased. For this purpose, We formulate an integer programming model to minimize the expected time to receive a definitive treatment for stroke patients. We then use real-world data to verify the validity of the model. Also, we expand our model to find the optimal redistribution and centralization of EVT resources. It will enable therapeutic teams to increase their experience and skills more efficiently within a short period of time.

Interpersonal patient-therapeutic team communication during COVID-19 pandemic – selected problems

Introduction. Interpersonal communication is an important element of effective cooperationbetween a patient and therapeutic team. Patients ill with COVID-19 during the pandemicespecially needed a direct contact with medical staff. Introduction of modern technologiesduring COVID-19 pandemic enabled interpersonal communication between a patient andtherapeutic team.Objective: The aim of the study was presentation of the selected elements of interpersonalcommunication in the work of a nurse between a patient and therapeutic team during COVID-19 pandemic.Material and Methods. The problem of interpersonal communication between a patient andtherapeutic team during COVID-19 pandemic was analyzed based on the results of scientificstudies and perceptual experiences.Results. COVID-19 pandemic was a new challenge for therapeutic teams in patient care intreatment facilities, to provide an effective interpersonal communication. In order to improvethe quality of interpersonal communication alternative forms of communication with patientswere applied. During the COVID-19 pandemic social media played a special role in primaryhealth care. Efforts undertaken by medical staff also had to be focused on safe environment ofcare and safe work conditions.Conclusions. Interpersonal communication between a patient and therapeutic team should beimproved during the pandemic considering the provision of a high quality services for patientsin a state of threat to health and life. An improvement of the effectiveness of interpersonalcommunication is conditioned by the implementation of alternative forms of communicationwith a patient, efficient functioning of social media, provision of safe environment of patientcare and safe work conditions for medical staff.

Towards improving the quality of internships in medicine and allied health professions

Introduction: One of the important elements influencing the well-being of society is a highly educated, professional staff of the entire therapeutic team. Physiotherapists play a significant role in this team, which is why the higher education system is expected to make efforts to develop optimal education programs, including the development of practical skills. The purpose of this article is to present the Healint4All project, whose mission is to facilitate international internships for students of physiotherapy and other medical professions, which will allow high-class professionals in the healthcare sector to enter the job market.Material and methods: A step-by-step process of creating a protocol for auditing places of clinical practice was prepared. Virtual, interactive teaching resources were developed to prepare auditors. A literature analysis, focus interviews in groups of academic teachers, practitioners, and students. A pilot study of the protocol in live environments was conducted.Results: Both potential auditees (medical institutions) and auditors (universities) positively assessed the newly created tool. The recommendations included paying attention to transparency, simplicity, and linguistic correctness in all language versions of the protocol. It was suggested that the protocol, containing everything useful, should not be too long and would not burden the user with time. Conclusions: In the opinion of students and experts who evaluated the Healint4All protocol, it will contribute to increasing the supply and quality of international placements offered by healthcare organizations throughout Europe, as well as simplifying the processes involved in organizing these for students, educational institutions, and healthcare organizations.

A Review of the Nutritional Approach and the Role of Dietary Components in Children with Autism Spectrum Disorders in Light of the Latest Scientific Research

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects several areas of mental development. The onset of ASD occurs in the first few years of life, usually before the age of 3 years. Proper nutrition is important to ensure that an individual’s nutrient and energy requirements are met, and it can also have a moderating effect on the progression of the disorder. A systematic database search was conducted as a narrative review to determine whether nutrition and specific diets can potentially alter gastrointestinal symptoms and neurobehavioral disorders. Databases such as Science Direct, PubMed, Scopus, Web of Science (WoS), and Google Scholar were searched to find studies published between 2000 and September 2023 on the relationship between ASD, dietary approaches, and the role of dietary components. The review may indicate that despite extensive research into dietary interventions, there is a general lack of conclusive scientific data about the effect of therapeutic diets on ASD; therefore, no definitive recommendation can be made for any specific nutritional therapy as a standard treatment for ASD. An individualized dietary approach and the dietician’s role in the therapeutic team are very important elements of every therapy. Parents and caregivers should work with nutrition specialists, such as registered dietitians or healthcare providers, to design meal plans for autistic individuals, especially those who would like to implement an elimination diet.

Critical Challenges in Pluvicto Therapy: Incontinent and Anticoagulated Patients.

As molecular therapy continues to grow, unanticipated challenges may arise, requiring the institution's therapeutic team to reevaluate its therapeutic protocol to identify and address potential situations and challenges that may occur. This practical pointer will focus on the novel prostate cancer therapy Pluvicto (177Lu-vipivotide tetraxetan) and 2 unique situations and challenges of treating patients at the Theranostic Center at Carilion Clinic, an outpatient facility dedicated to targeted molecular therapy.

Independence of midwives in a therapeutic team - a midwife as a coordinator of the patient's stay at St. Sophia Hospital in Warsaw, Poland

Independence of midwives in a therapeutic team - a midwife as a coordinator of the patient's stay at St. Sophia Hospital in Warsaw, Poland

Physical activity of patients with chronic kidney disease

Introduction: The main causes of chronic kidney disease (CKD) are diabetic and hypertensive nephropathy. The incidence of civilization diseases is increasing, which also indirectly affects the increase in the incidence of CKD. The patient's therapy after the diagnosis should include the care of a multi-specialist therapeutic team that will remove as many restrictions as possible in everyday functioning and ensure a high quality of life. In addition to the selection of individual renal replacement therapy, i.a. physical rehabilitation. Despite the fact that in the course of chronic kidney disease physical activity is impaired by numerous pathophysiological processes, the patient should be encouraged to undertake physical activity in order to reduce the risk of death due to cardiovascular diseases, as well as to eliminate many other adverse health effects of the disease. The following paper aims to analyze the impact of physical activity on CKD patients and the pathophysiological causes of low physical activity in this group of patients and the possibility of implementing rehabilitation as an element of comprehensive therapy.&#x0D; Aim of the study: To review the current literature on the physical activity of patients with chronic kidney disease&#x0D; Materials and Methods: A review of the publications available in PubMed, using the key words „chronic kidney disease”, „psychical activity in chronic kidney disease”, physical activity”, „kidney failure”, „dialysis”, „renal rehabilitation”, „quality of life”

Quelles installations et appareillages pour les jeunes enfants en situation de handicap moteur sévère ? Pour quels objectifs ? Avec quel partenariat ?

The multidisciplinary therapeutic and educational team at the Ramdam Inclusive child care centre welcomes 30% of children with cerebral palsy among able-bodied children in the neighbourhood. The facilities of these young children with severe motor disabilities are essential they aim to preserve their orthopedic capital, to avoid choking spells, and to optimize their functional possibilities (motor, visual, communicational and relational) in their environment, at home as well as at their child care centre. They thus participate in their early social inclusion. From the multifactorial assessment of children's disorders and capacities, their occupations and their environment, to the co-construction of relevant objectives, partnership with the different actors is essential. We will emphasize the importance of this transdisciplinary work (and more specifically between the occupational therapist, the physiotherapist and the orthoprothesist, in close partnership with families and doctors), from the first “foam homemade installations” by the occupational therapist in the Ramdam child-care centre, to the orthopedic equipments made by the orthoprothesist. We will illustrate our constructive approach with some clinical vignettes of young children with severe motor disabilities, with the gradual introduction of facilities depending on the child's evolution, the parents’ requests and their progress in discovering their “different” child, proposals from the multidisciplinary team, while taking into account the specific and personalized goals for each child.