The effect of reminiscence therapy on quality of life,attitudes to ageing,and depressive symptoms in institutionalized elderly adults with cognitive impairment: A quasi‐experimental study

The aim of this study was to analyse the effect of group narrative reminiscence therapy on cognition, quality of life, attitudes towards ageing, and depressive symptoms in a group of older adults with cognitive impairment in institutional care. A quasi‐experimental pretest/post‐test control group design was employed. Interventions involving reminiscence therapy with a narrative approach were included in the care plan and implemented in groups of between five and ten respondents once a week for 8 weeks (total 59 participants). The members of the control group (n = 57) received standard care. A study questionnaire was designed to measure demographic characteristics, quality of life (WOHQOL‐BREF, WHOQOL‐OLD), depressive symptoms (GDS), cognition (MMSE), and attitudes towards ageing (AAQ). Reminiscence therapy positively affected older adults’ quality of life (mostly the areas of mental health and social participation), and also their attitudes to ageing and old age. It reduced symptoms of depression, but had no discernible effect on cognitive function. Reminiscence therapy can positively affect selected aspects of quality of life, attitudes towards old age, and symptoms of depression in the elderly in long‐term healthcare facilities. Group reminiscence therapy can be used as a nursing intervention.     

The Relationship Between Fatigue and Quality of Life in Children With Chronic Health Problems: A Systematic Review

PURPOSE: This systematic review synthesized the literature regarding fatigue in children with chronic health problems and examined the relationship to quality of life. CONCLUSIONS: Most studies that have examined fatigue and its relationship to quality of life in children with chronic health problems have focused on children with cancer. Studies found that children often reported fatigue and that it decreased quality of life. PRACTICE IMPLICATIONS: Quantifying fatigue in children with chronic illnesses and disabilities is critical for pediatric nursing assessment. Understanding the impact of fatigue on children with chronic health problems is a first step in improving their quality of life.     

Individuals' perception of their quality of life following a liver transplant: an exploratory study

This study explores individuals' perceptions of the effect of a liver transplant on their quality of life, focusing on the progression from dependence to independence physically, socially and psychologically. A phenomenological design using taped semi-structured interviews was used. The sample consisted of five patients attending the out-patients clinic at least 1 year following a liver transplant for chronic liver disease. The data were analysed using cluster analysis of transcribed interviews. Categories were identified as physical, social and psychological factors affecting their progression from dependence to independence pre- and post-transplant and specific factors were identified as significant in overcoming the stressors affecting this progression. The findings reflected Maslow's Hierarchy of Needs. Pre-transplant their physical problems prevented them fulfilling personal goals and addressing psychological issues, e.g. dying. Post-transplant any physical problems identified were insignificant to the participant. They were keen to socially integrate and be treated as normal; however, family and friends restricted their independence by continuing to 'wrap them in cotton wool' as they had before their transplant. Personality, incentives and Unit support were identified as imperative in their progression from dependence to independence. The findings demonstrate a need to impress on family and friends of patients following a liver transplant, their role in assisting the patient's progression from dependence to independence.     

Outpatient-based physical rehabilitation for survivors of prolonged critical illness: A randomized controlled trial

Introduction: The physical and psychological impact of critical illness is well documented. Recovery may take many months and is often incomplete. The optimal way of addressing these important sequelae following hospital discharge remains unclear. Methods: Single center, randomized controlled trial in patients invasively ventilated for ≥5 days. The treatment group (TG) underwent a 7-week, outpatient-based exercise and education program, with the control group (CG) receiving no intervention during the study period. Primary outcome measures were changes in functional capacity assessed using the cardiopulmonary exercise testing parameters, peak VO₂, and anaerobic threshold (AT). Secondary outcome measures were changes in and health-related quality of life assessed using the Short Form 36 version 2 questionnaire. Assessors remained blinded to group allocation. Results: Sixty-three patients completed the study (target n = 90). Improvements in both peak VO₂ and AT were seen in both TG and CG but no significant difference between groups was evident. AT improved by 11.7% in CG (baseline 10.3 ml O₂ kg^?1 min^?1, follow-up 11.5 ml O₂ kg^?1 min^?1), and by 14.6% in TG (baseline 10.3 ml O₂ kg^?1 min^?1, follow-up 11.8 ml O₂ kg^?1 min^?1; ANCOVA p = 0.74). Peak VO₂ improved by 14.0% in CG (baseline 13.6 ml O₂ kg^?1 min^?1, follow-up 15.5 ml O₂ kg^?1 min^?1), and by 18.8% in TG (baseline 13.8 ml O₂ kg^?1 min^?1, follow-up 16.4 ml O₂ kg^?1 min^?1; ANCOVA p = 0.68). Significant improvements were seen in both groups for physical component summary scores (PCS) (TG 39.6 versus 31.0; CG 36.1 versus 32.6) and mental component summary scores (MCS) (TG 48.6 versus 38.4; CG 41.3 versus 37.0). The degree of improvement was significantly higher in the treatment group in comparison to control subjects (PCS p = 0.048; MCS p = 0.017). This improvement was most marked in the subgroup ventilated for >14 days. Conclusions: A 7-week, outpatient-based exercise and education program resulted in improved health-related quality of life scores but not improved exercise capacity.     

Determinants of 1‐year changes in disease‐specific health status in patients with advanced chronic obstructive pulmonary disease: A 1‐year observational study

We aimed to identify baseline and longitudinal determinants of change in disease‐specific health status in patients with advanced chronic obstructive pulmonary disease (COPD). Demographic and clinical characteristics as well as disease‐specific health status (St George's Respiratory Questionnaire, SGRQ) were assessed in 105 outpatients with advanced COPD at baseline and at 4, 8 and 12 months. Eighty‐five patients (81.0%) had complete SGRQ data at baseline and 12 months and were included in analyses. Stepwise multiple regression analysis revealed that lower SGRQ total score, higher depression scores and longer time needed to complete the Timed Up and Go (TUG) test at baseline, as well as increase in time needed to complete the TUG test and increase in dyspnoea during the 1‐year follow‐up period, were predictors of deterioration in disease‐specific health status. The current study reinforces the stimulation of physical mobility and the targeting of dyspnoea as components for treatment programs to optimize disease‐specific health status in patients with advanced COPD.