Two recent studies showed that cognitive-behavioral treatment (CBT) is efficacious in treating in... more Two recent studies showed that cognitive-behavioral treatment (CBT) is efficacious in treating insomnia in older adults with comorbid medical conditions. The authors extended these findings by comparing 12 older adults with comorbid insomnia who received a home-based video CBT program to the authors' previously published data on 24 participants who received classroom CBT or no treatment. All 36 participants were initially randomized within the same protocol, but the video arm was conducted 7 months after completion of the other two study arms. Compared to controls, the video CBT group demonstrated significant changes in five of eight self-report measures of sleep at posttreatment, including sleep latency, time awake after sleep onset, total time in bed, overall sleep quality, and dysfunctional beliefs and attitudes about sleep. Compared to controls, the video CBT group also had posttreatment improvements in daytime functioning, including mood, pain perception, social functioning, and energy-vitality. Although video CBT was not significantly different from classroom CBT on self-report measures, the attrition rate was higher (27% vs. 19%) and the number of participants who achieved clinically significant change was lower (50% vs. 73%). These preliminary findings suggest that delivering CBT in a home-based video format has the potential to serve as a first-line, cost-effective treatment for comorbid insomnia.
... Developmental psychology for the health care professions. Post a Comment. CONTRIBUTORS: Autho... more ... Developmental psychology for the health care professions. Post a Comment. CONTRIBUTORS: Author: Billingham, Katherine A. Author: Feldman, Howard S. Author: Lopez, Martita A. PUBLISHER: Westview Press (Boulder, Colo.). SERIES TITLE: YEAR: 1982. ...
1. J Gerontol Nurs. 1989 May;15(5):8-15. Learned helplessness. LeSage J, Slimmer LW, Lopez M, Ell... more 1. J Gerontol Nurs. 1989 May;15(5):8-15. Learned helplessness. LeSage J, Slimmer LW, Lopez M, Ellor JR. 1. Nurses described learned helplessness solely in terms of residents not performing the daily activities they were capable of. ...
Hepatic hydatid cysts were seen in 79 patients between 1973 and 1980: 23 were treated by cystecto... more Hepatic hydatid cysts were seen in 79 patients between 1973 and 1980: 23 were treated by cystectomy, 33 by partial hepatectomy, and the remaining 23 by internal drainage. The indication for internal drainage was bacterial infection of the cyst, or the anatomical site of the cyst preventing excision. There were 3 deaths, 2 due to sepsis following internal drainage, and
In hemiparetic individuals, low endurance to exercise may compound the increased energy cost of m... more In hemiparetic individuals, low endurance to exercise may compound the increased energy cost of movement and contribute to poor rehabilitation outcomes. The purpose of this investigation was to describe how hemiparetic stroke patients responded to intense exercise and aerobic training. Forty-two subjects were randomly assigned to an exercise training group or to a control group. Treatments were given three times per week for 10 weeks in similar laboratory settings. Baseline and posttest measurements were made of maximal oxygen consumption, heart rate, workload, exercise time, resting and submaximal blood pressures, and sensorimotor function. Only experimental subjects showed significant improvement in maximal oxygen consumption, workload, and exercise time. Improvement in sensorimotor function was significantly related to the improvement in aerobic capacity. After treatment, experimental subjects showed significantly lower systolic blood pressure at submaximal workloads during the graded exercise test. We conclude that hemiparetic stroke patients may improve their aerobic capacity and submaximal exercise systolic blood pressure response with training. Sensorimotor improvement is related to the improvement in aerobic capacity.
Older adults with comorbid insomnia and medical illness have been excluded from behavioral treatm... more Older adults with comorbid insomnia and medical illness have been excluded from behavioral treatment research, but recent evidence suggested that such treatments would be effective with this population. In this study, 38 older adults with comorbid insomnia were randomized to 1 of 3 conditions: classroom cognitive-behavioral treatment (CBT), home-based audio relaxation treatment (HART), or delayed-treatment control. Compared to the control group, the CBT group had significant changes in 5 of 7 self-report measures of sleep at the 4-month follow-up. The HART group obtained significant outcomes on 3 of 7 measures. Wrist actigraphy measures and secondary-outcome measures did not yield significant findings for either treatment. Clinically significant changes at follow-up were obtained for 54% of patients in CBT, 35% in HART, and 6% in the control group when treatment dropouts were included. Although not as effective as in-person CBT, home interventions may have utility as a first-line, low-cost treatment.
... Developmental psychology for the health care professions. Post a Comment. CONTRIBUTORS: Autho... more ... Developmental psychology for the health care professions. Post a Comment. CONTRIBUTORS: Author: Billingham, Katherine A. Author: Feldman, Howard S. Author: Lopez, Martita A. PUBLISHER: Westview Press (Boulder, Colo.). SERIES TITLE: YEAR: 1982. ...
Journal of Consulting and Clinical Psychology, 2005
The present study tested cognitive-behavioral therapy (CBT) for insomnia in older adults with ost... more The present study tested cognitive-behavioral therapy (CBT) for insomnia in older adults with osteoarthritis, coronary artery disease, or pulmonary disease. Ninety-two participants (mean age = 69 years) were randomly assigned to classroom CBT or stress management and wellness (SMW) training, which served as a placebo condition. Compared with SMW, CBT participants had larger improvements on 8 out of 10 self-report measures of sleep. The type of chronic disease had no impact on these outcomes. The hypothesis that CBT would improve daytime functioning more than SMW was only supported by a global rating measure. These results add to findings that challenge the dichotomy between primary and secondary insomnia and suggest that psychological factors are likely involved in insomnias that are presumed to be secondary to medical conditions.
A program of cognitive-behavioral interventions was applied on a hospital geriatric rehabilitatio... more A program of cognitive-behavioral interventions was applied on a hospital geriatric rehabilitation unit. Unique features were the tailoring of the program to the population and each participant, and the immediate application of the program with distressed patients in a proactive manner designed to maximize rehabilitation outcome. The program was successful in that initially distressed participants achieved rehabilitation goals to the same extent as the nondistressed comparison group, and participant scores on measures of distress and coping, except for anxiety, matched those of comparison patients at discharge.
Forty-five elderly subjects performed a modified paired-associate learning task under two conditi... more Forty-five elderly subjects performed a modified paired-associate learning task under two conditions designed to enhance their perception of control. Subjects in enhanced control conditions chose their own response items ("choice" subjects) or were allowed to manually control response interval duration ("self-paced"). Yoked controls learned the same items selected by choice subjects, or experienced pacing conditions under which they were allowed comparable amounts of response time. The design was an incomplete 2 x 3 x 6 factorial with two types of item selection (choice vs. force), three types of pacing (self-paced, yoked item-by-item, yoke by trial median time), and six trials. There was no "choice" group in the "item yoked" pacing condition. As predicted, subjects experiencing either or both of the control-enhancing conditions performed better than yoked controls. Experiencing both item choice and self-pacing did not result in performance which was significantly better than that of subjects experiencing only one or the other. Results are discussed in light of previous work with young persons, and recommendations are offered to researchers.
Two recent studies showed that cognitive-behavioral treatment (CBT) is efficacious in treating in... more Two recent studies showed that cognitive-behavioral treatment (CBT) is efficacious in treating insomnia in older adults with comorbid medical conditions. The authors extended these findings by comparing 12 older adults with comorbid insomnia who received a home-based video CBT program to the authors' previously published data on 24 participants who received classroom CBT or no treatment. All 36 participants were initially randomized within the same protocol, but the video arm was conducted 7 months after completion of the other two study arms. Compared to controls, the video CBT group demonstrated significant changes in five of eight self-report measures of sleep at posttreatment, including sleep latency, time awake after sleep onset, total time in bed, overall sleep quality, and dysfunctional beliefs and attitudes about sleep. Compared to controls, the video CBT group also had posttreatment improvements in daytime functioning, including mood, pain perception, social functioning, and energy-vitality. Although video CBT was not significantly different from classroom CBT on self-report measures, the attrition rate was higher (27% vs. 19%) and the number of participants who achieved clinically significant change was lower (50% vs. 73%). These preliminary findings suggest that delivering CBT in a home-based video format has the potential to serve as a first-line, cost-effective treatment for comorbid insomnia.
... Developmental psychology for the health care professions. Post a Comment. CONTRIBUTORS: Autho... more ... Developmental psychology for the health care professions. Post a Comment. CONTRIBUTORS: Author: Billingham, Katherine A. Author: Feldman, Howard S. Author: Lopez, Martita A. PUBLISHER: Westview Press (Boulder, Colo.). SERIES TITLE: YEAR: 1982. ...
1. J Gerontol Nurs. 1989 May;15(5):8-15. Learned helplessness. LeSage J, Slimmer LW, Lopez M, Ell... more 1. J Gerontol Nurs. 1989 May;15(5):8-15. Learned helplessness. LeSage J, Slimmer LW, Lopez M, Ellor JR. 1. Nurses described learned helplessness solely in terms of residents not performing the daily activities they were capable of. ...
Hepatic hydatid cysts were seen in 79 patients between 1973 and 1980: 23 were treated by cystecto... more Hepatic hydatid cysts were seen in 79 patients between 1973 and 1980: 23 were treated by cystectomy, 33 by partial hepatectomy, and the remaining 23 by internal drainage. The indication for internal drainage was bacterial infection of the cyst, or the anatomical site of the cyst preventing excision. There were 3 deaths, 2 due to sepsis following internal drainage, and
In hemiparetic individuals, low endurance to exercise may compound the increased energy cost of m... more In hemiparetic individuals, low endurance to exercise may compound the increased energy cost of movement and contribute to poor rehabilitation outcomes. The purpose of this investigation was to describe how hemiparetic stroke patients responded to intense exercise and aerobic training. Forty-two subjects were randomly assigned to an exercise training group or to a control group. Treatments were given three times per week for 10 weeks in similar laboratory settings. Baseline and posttest measurements were made of maximal oxygen consumption, heart rate, workload, exercise time, resting and submaximal blood pressures, and sensorimotor function. Only experimental subjects showed significant improvement in maximal oxygen consumption, workload, and exercise time. Improvement in sensorimotor function was significantly related to the improvement in aerobic capacity. After treatment, experimental subjects showed significantly lower systolic blood pressure at submaximal workloads during the graded exercise test. We conclude that hemiparetic stroke patients may improve their aerobic capacity and submaximal exercise systolic blood pressure response with training. Sensorimotor improvement is related to the improvement in aerobic capacity.
Older adults with comorbid insomnia and medical illness have been excluded from behavioral treatm... more Older adults with comorbid insomnia and medical illness have been excluded from behavioral treatment research, but recent evidence suggested that such treatments would be effective with this population. In this study, 38 older adults with comorbid insomnia were randomized to 1 of 3 conditions: classroom cognitive-behavioral treatment (CBT), home-based audio relaxation treatment (HART), or delayed-treatment control. Compared to the control group, the CBT group had significant changes in 5 of 7 self-report measures of sleep at the 4-month follow-up. The HART group obtained significant outcomes on 3 of 7 measures. Wrist actigraphy measures and secondary-outcome measures did not yield significant findings for either treatment. Clinically significant changes at follow-up were obtained for 54% of patients in CBT, 35% in HART, and 6% in the control group when treatment dropouts were included. Although not as effective as in-person CBT, home interventions may have utility as a first-line, low-cost treatment.
... Developmental psychology for the health care professions. Post a Comment. CONTRIBUTORS: Autho... more ... Developmental psychology for the health care professions. Post a Comment. CONTRIBUTORS: Author: Billingham, Katherine A. Author: Feldman, Howard S. Author: Lopez, Martita A. PUBLISHER: Westview Press (Boulder, Colo.). SERIES TITLE: YEAR: 1982. ...
Journal of Consulting and Clinical Psychology, 2005
The present study tested cognitive-behavioral therapy (CBT) for insomnia in older adults with ost... more The present study tested cognitive-behavioral therapy (CBT) for insomnia in older adults with osteoarthritis, coronary artery disease, or pulmonary disease. Ninety-two participants (mean age = 69 years) were randomly assigned to classroom CBT or stress management and wellness (SMW) training, which served as a placebo condition. Compared with SMW, CBT participants had larger improvements on 8 out of 10 self-report measures of sleep. The type of chronic disease had no impact on these outcomes. The hypothesis that CBT would improve daytime functioning more than SMW was only supported by a global rating measure. These results add to findings that challenge the dichotomy between primary and secondary insomnia and suggest that psychological factors are likely involved in insomnias that are presumed to be secondary to medical conditions.
A program of cognitive-behavioral interventions was applied on a hospital geriatric rehabilitatio... more A program of cognitive-behavioral interventions was applied on a hospital geriatric rehabilitation unit. Unique features were the tailoring of the program to the population and each participant, and the immediate application of the program with distressed patients in a proactive manner designed to maximize rehabilitation outcome. The program was successful in that initially distressed participants achieved rehabilitation goals to the same extent as the nondistressed comparison group, and participant scores on measures of distress and coping, except for anxiety, matched those of comparison patients at discharge.
Forty-five elderly subjects performed a modified paired-associate learning task under two conditi... more Forty-five elderly subjects performed a modified paired-associate learning task under two conditions designed to enhance their perception of control. Subjects in enhanced control conditions chose their own response items ("choice" subjects) or were allowed to manually control response interval duration ("self-paced"). Yoked controls learned the same items selected by choice subjects, or experienced pacing conditions under which they were allowed comparable amounts of response time. The design was an incomplete 2 x 3 x 6 factorial with two types of item selection (choice vs. force), three types of pacing (self-paced, yoked item-by-item, yoke by trial median time), and six trials. There was no "choice" group in the "item yoked" pacing condition. As predicted, subjects experiencing either or both of the control-enhancing conditions performed better than yoked controls. Experiencing both item choice and self-pacing did not result in performance which was significantly better than that of subjects experiencing only one or the other. Results are discussed in light of previous work with young persons, and recommendations are offered to researchers.
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