智力和发展性残疾儿童青少年身体活动效益：基于ICF的系统综述

目的 基于《国际功能、残疾和健康分类》(ICF)构建智力和发展性残疾儿童青少年身体活动效益系统综述的范畴和PICO架构,探讨智力和发展性残疾儿童和青少年参加身体活动的健康效益。     

Brief report: Follow‐up outcomes of multisystemic therapy for adolescents with an intellectual disability and the relation with parental intellectual disability

Research on follow‐up outcomes of systemic interventions for family members with an intellectual disability is scarce. In this study, short‐term and long‐term follow‐up outcomes of multisystemic therapy for adolescents with antisocial or delinquent behaviour and an intellectual disability (MST‐ID) are reported. In addition, the role of parental intellectual disability was examined. Outcomes of 55 families who had received MST‐ID were assessed at the end of treatment and at 6‐month, 12‐month and 18‐month follow‐up. Parental intellectual disability was used as a predictor of treatment outcomes. Missing data were handled using multiple imputation. Rule‐breaking behaviour of adolescents declined during treatment and stabilized until 18 months post‐treatment. The presence or absence of parental intellectual disability did not predict treatment outcomes. This study was the first to report long‐term outcomes of MST‐ID. The intervention achieved similar results in families with and without parents with an intellectual disability.     

The influence of a health education programme on healthy lifestyles and practices among university students

Abu-Moghli FA, Khalaf IA, Barghoti FF. International Journal of Nursing Practice 2010; 16 : 35–42
The influence of a health education programme on healthy lifestyles and practices among university students
This study aimed at exploring the lifestyles of university students, the relationship between specific demographical variables and health practices and the role of training in improving these practices. An experimental and a comparison group were selected using the convenient sampling method. Two 5-day training programmes on healthy lifestyles were conducted. Self-reported behaviours of both groups were assessed before and after the programme. The results reflected slightly positive health practices related to the three behavioural categories with the type of diet being the highest and physical activity being the lowest. No significant differences were reflected in relation to the selected variables. A positive influence of training on improving health behaviours of university students related to the three behavioural categories was observed. Results suggest a similar course to be included as a university elective and students' involvement in available extra curricular activities be encouraged.     

Impact of nurse‐led behavioural counselling to improve metabolic health and physical activity among adults with mental illness

The life expectancy of adults with mental illness is significantly less than that of the general population, and this is largely due to poor physical health. Behavioural counselling can improve physical health indicators among people with non‐communicable disease. This repeated‐measures, single‐group intervention trial evaluated the effects of a 19‐week behavioural counselling programme on metabolic health indicators and physical activity levels of outpatient adults with mental illness. Sixteen participants completed the intervention that comprised individual face‐to‐face counselling sessions with a registered nurse every 3 weeks, and progress reviews with a medical practitioner every 6 weeks. Assessment included self‐report and objective measurement of physical activity, and measures of blood pressure and anthropometry. Statistically‐significant changes were demonstrated between baseline and post intervention for participants’ waist circumference (P = 0.035) and waist‐to‐height ratio (P = 0.037). Non‐significant improvements were demonstrated in weight and physical activity. The findings indicated that adults with mental illness can engage in a nurse‐led behavioural counselling intervention, with improvements in some metabolic health measures after 19 weeks. It is recommended that behavioural counselling programmes for adults with mental illness be sustained over time and have an ‘open door’ policy to allow for attendance interruptions, such as hospitalization.     

Attitudes towards people with physical or intellectual disabilities: nursing students and non‐nursing peers

Title. Attitudes towards people with physical or intellectual disabilities: nursing students and non‐nursing peers. Aim. This paper is a report of a study of the attitudes of Dutch nursing students towards people with physical or intellectual disabilities. Background. Attitudes of healthcare professionals are a major factor in the rehabilitation and self‐acceptance of persons with disabilities. Consequently, it is important that nurses develop or maintain positive attitudes towards people with disabilities during their education. However, more knowledge is needed about current attitudes of nursing students and factors influencing these attitudes. Methods. A sample of Dutch nursing students (n = 81) and an age‐matched group of non‐nursing peers (n = 48) completed standardized scales measuring attitudes about physically or intellectually disabled people. Data were collected in 2006. Findings. Nursing students were more positive towards physically disabled people than their peers, and more strongly endorsed empowerment and similarity of intellectually disabled people. These attitudinal differences generally remained statistically significant after multivariate adjustment for demographic variables and experience and contact with individuals with disabilities. An important independent determinant of a positive attitude towards physically disabled people in the total sample was having a relative or friend with a physical disability. This association, however, was not apparent in attitudes towards intellectually disabled persons. Conclusion. Educational interventions aimed at improving attitudes towards people with disabilities should include focus on forms of contact beyond the context of formal care relationships.     

Effects of providing a nutrition education program for teenagers: Dietary and physical activity patterns

This study enhanced nutritional knowledge in an education program and encouraged healthy dietary habits and regular physical activity among teenagers. A total of 203 adolescents from a secondary school in Hong Kong took part in the study. Their Body Mass Index, dietary habits, and physical exercise pattern were recorded and examined before and after the health education program. The prevalence of overweight and obesity, together with the fat composition, were high among the participants before the nutrition education program. There was a marked gain in knowledge upon its completion. A follow-up action conducted 3 months later revealed positive outcomes in relation to the diet and physical activity level. The teenagers were able to take control of their health and requested the tuck shop to sell more healthy food and reduce the supply of unhealthy items. The educational initiatives in dietary habits and physical activities proved to be effective in encouraging the teenagers to eat more healthily and to adopt an active lifestyle.     

A community-based exercise program to increase participation in physical activities among youth with disability: a feasibility study

Purpose: To evaluate the feasibility of a student-mentored community-based exercise program for youth with disability.

Method: Nineteen youth (nine female; mean age 18 years) with disability (seven cerebral palsy, six Down syndrome, three spina bifida, two autism spectrum disorder, one spinal cord injury) were recruited. Each participant was matched with a student mentor and exercised twice a week for 12?weeks at their local gymnasium. Five domains of feasibility were assessed: demand, implementation, practicality, limited efficacy testing, and acceptability.

Results: Demand comprised 55 expressions of interest. Demonstrating evidence of implementation, 91% of scheduled sessions were attended and training fidelity (comparing training load in weeks 1 and 12) showed exercise intensity significantly increased for strength and aerobic exercises. The program was practical with no major and 17 minor adverse events (e.g., muscle soreness). Limited efficacy testing was demonstrated by increased arm (4?kg, 95% CI: 1–7) and leg strength (43?kg, 95% CI: 24–62), walking endurance (80?m, 95% CI: 24–137), and improvement in three dimensions of health-related quality of life (autonomy, physical, and psychological well-being). The program was accepted very positively by participants.

Conclusions: A student-mentored community-based exercise program feasibly engages youth with disability in community-based exercise.

• Implications for Rehabilitation

• A 12-week community-based student-mentored exercise program for youth with disability is feasible.

• Exercising in a real-world setting with a student mentor has a positive effect on physical and psychological well-being of youth with disability.

     

Exploring physical activity behaviour of persons with multiple sclerosis: a qualitative pilot study

Purpose. Identify facilitators and barriers to physical activity (PA), and explore the utility of Social Cognitive Theory (SCT) and Transactional Model of Stress and Coping (TMSC) in understanding PA behaviour among persons with multiple sclerosis (MS).

Methods. Thirteen participants from a clinical trial were interviewed and classified as physically active, sometimes active or inactive based on the Health-Promoting Lifestyle Profile-II. Interviews were analysed using analytical induction, which consisted of coding data into pre-established categories and then exploring similarities and differences between groups. Pre-established coding categories were constructs from SCT (i.e. environment, expectations, self-efficacy and self-regulation) and TMSC (i.e. stress appraisal and coping style).

Results. Inactive and active participants differed in their self-regulation skills, self-efficacy and coping styles. Common barriers to PA included symptoms and the physical and social environment. Facilitators of PA included strong self-regulation skills, confidence to overcome symptoms to engage in PA (i.e. barrier self-efficacy) and positive coping styles.

Conclusion. Results from this pilot study suggest that PA interventions will need to implement multiple strategies that target self-efficacy, social environment and coping styles. We found SCT and TMSC useful in understanding PA behaviour among persons with MS; however, a limitation to these theories is that they are not explicit in the relationship between health and cognitions. Future research will need to explore how to incorporate models of health and function into existing behaviour change theories.