IntroductionAffective disorders are associated with impaired overall functioning and quality of l... more IntroductionAffective disorders are associated with impaired overall functioning and quality of life (QoL). Despite different medical and psychological treatment options, the prognosis remains largely unchanged. Consequently, the field needs new intervention strategies especially targeting patient groups with impaired functioning. This study aims to improve functioning and QoL in patients with affective disorders using a comprehensive 360° intervention.Methods and analysisAffective disorders: eliminate WArning signs And REstore (AWARE) functioning is a randomised, controlled, parallel-group design study. Participants will be 120 outpatients, men or women, aged 18–65 years, with a diagnosis of bipolar disorder or major depressive disorder. Inclusion requires an objectively rated impaired functioning defined as a score ≥11 according to the Functioning Assessment Short Test. Participants will be randomised to 6-month AWARE intervention or treatment as usual (TAU). The AWARE interventio...
Baggrund Bipolar lidelse (mani og depression) er ifølge World Health Organisation (WHO) blandt de... more Baggrund Bipolar lidelse (mani og depression) er ifølge World Health Organisation (WHO) blandt de 10 primære årsager til nedsat funktionsevne i verden (1). Prævalensen af bipolar sindslidelse i Danmark er ca. 1 % svarende til ca. 40.000 patienter. På trods af såvel medicinsk som psykologisk behandling oplever op til 50 % af patienter med bipolar sindslidelse, selv når de er velbehandlede, ofte vedvarende og invaliderende funktionsevnenedsættelse i form af kognitive vanskeligheder samt vanskeligheder i forhold til at udføre aktiviteter (2-4). Disse gener vanskeliggør patienternes uddannelse, fastholdelse på arbejdsmarkedet og sociale relationer (5,6). Det er ikke undersøgt, hvorledes de kognitive vanskeligheder påvirker den del af funktionsevnen på aktivitetsog deltagelsesniveau, som omhandler evnen til at udføre Activities of Daily Living (ADL). Derfor er formålet med aktuelle studie at beskrive ADL evnen hos patienter med bipolar sindslidelse samt sammenhængen mellem kognitive vans...
... REFERENCES Note: OCR errors may be found in this Reference List extracted from the full text ... more ... REFERENCES Note: OCR errors may be found in this Reference List extracted from the full text article. ACM has opted to expose the complete List rather than only correct and linked references. ... The ACM Portal is published by the Association for Computing Machinery. ...
Intentional Relationship Model (IRM) er en begrebsmaessig model, som redegor for terapeutisk anve... more Intentional Relationship Model (IRM) er en begrebsmaessig model, som redegor for terapeutisk anvendelse af selvet i en ergoterapeutisk intervention. Som ergoterapeut far man via modellen anvisninger pa, hvilke handlemuligheder og konkrete interpersonelle faerdigheder, der kan anvendes til at fremme klienters aktivitetsengagement. I artiklen bliver modellens elementer gennemgaet, og forfatterne af artiklen har suppleret med forslag til psykologisk litteratur, som kan understotte de enkelte dele i modellen.
Background: A large proportion of persons with bipolar disorder (BD) experience cognitive impairm... more Background: A large proportion of persons with bipolar disorder (BD) experience cognitive impairments and activity limitations even when in remission (1). While most research concerning functioning has focused on cognitive impairments, the aim of this study is to describe the ability to perform Activities of Daily Living (ADL) among persons with BD reporting cognitive impairments and compare their ADL ability to healthy persons of similar age. Method: Participants (n = 43) with BD (based on ICD-10 diagnostic criteria), aged 18-60 years, in full remission defined by Hamilton Depression Rating Scale (HDRS-17) and the Young Mania Rating Scale (YMRS) scores ≤ 7 and with complaints of subjective cognitive difficulties of moderate to severe degree by scores ≥ 13 on the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) questionnaire. The ADL ability was assessed with Assessment of Motor and Process Skills (AMPS). Results and conclusion: The preliminary results indicate tha...
Background: Worldwide, occupational therapy has emphasized the importance of a positive client-th... more Background: Worldwide, occupational therapy has emphasized the importance of a positive client-therapist relationship for the outcomes of therapy. A consistent theoretical framework for addressing the relational aspects of occupational therapy practice was published with Taylor’s Intentional Relationship Model (IRM) (1). Educational Philosophy or theory: The IRM acknowledges that all occupational therapists prefer certain types of therapeutic responding, whereas other ways of responding is less developed and may feel uncomfortable. However, the therapist’s therapeutic responding needs to be in accordance with the client’s current needs. Thus, occupational therapists and students are challenged to develop their skills in therapeutic responding to be able to provide better assistance to more clients. Pedagogy/educational approach(-es) used: During the last years, the IRM has been taught to occupational therapy students in Oslo and Copenhagen. Furthermore the students complete the Self...
Many patients with bipolar disorder (BD) experience debilitating cognitive deficits, with risk of... more Many patients with bipolar disorder (BD) experience debilitating cognitive deficits, with risk of impaired occupational and psychosocial functioning. However, knowledge of how these deficits impact the patients' ability to perform Activities of Daily Living (ADL), tasks related to self-care and domestic life is limited. We explored the relation between impaired cognitive function and the ability to perform ADL in patients with BD. A total of 42 outpatients (mean age 36 years (range 19.0-58.0 years), 69% women) with BD in remission and with subjective cognitive complaints (≥ 13 on the Cognitive Complaints in Bipolar Disorder Rating Assessment questionnaire (COBRA)) were included. Objective neurocognitive function was evaluated with a short comprehensive cognitive test battery and ADL ability was evaluated with the performance-based Assessment of Motor and Process Skills (AMPS) in the homes of the patients. Our findings indicate that low processing speed correlated with decreased ...
Aims: Patients with bipolar disorder often experience disability in terms of cognitive impairment... more Aims: Patients with bipolar disorder often experience disability in terms of cognitive impairments and activity limitations even in remission. However, knowledge is sparse concerning the ability to perform Activities of Daily Living (ADL) during remission. The aim of this study was to (1) investigate the observed and self-reported ability to perform ADL tasks and (2) examine the association between observed and self-reported ability to perform ADL in patients with bipolar disorder in remission. Methods: The observed ADL ability was assessed with the Assessment of Motor and Process Skills, a standardized assessment providing interpretation of ADL ability in relation to competence, independence, and normative age expectations. Self-reported ADL ability was assessed with the standardized ADL-Questionnaire. Results: Forty-three patients with bipolar disorder in remission (median age 35 years, range 19–58 years) were assessed and overall, they displayed decreased observed ADL motor and ADL process ability relative to normative age. They exhibited increased physical effort, clumsiness or fatigue and/or inefficiency, there was concern for safe task performance and one-third may need assistance to live in the community. While participants reported decreased ADL ability, especially within instrumental ADL, they had a tendency towards evaluating themselves as more competent than what was observed. No relationships between measures of observed and self-reported ADL ability were found. Conclusion: Overall, patients with bipolar disorder in remission showed decreased ability to perform ADL. Clinical practice and future studies are recommended to use both observation-based and self-reported assessments of the ability to perform ADL tasks to fully capture disability in bipolar disorder.
IntroductionAffective disorders are associated with impaired overall functioning and quality of l... more IntroductionAffective disorders are associated with impaired overall functioning and quality of life (QoL). Despite different medical and psychological treatment options, the prognosis remains largely unchanged. Consequently, the field needs new intervention strategies especially targeting patient groups with impaired functioning. This study aims to improve functioning and QoL in patients with affective disorders using a comprehensive 360° intervention.Methods and analysisAffective disorders: eliminate WArning signs And REstore (AWARE) functioning is a randomised, controlled, parallel-group design study. Participants will be 120 outpatients, men or women, aged 18–65 years, with a diagnosis of bipolar disorder or major depressive disorder. Inclusion requires an objectively rated impaired functioning defined as a score ≥11 according to the Functioning Assessment Short Test. Participants will be randomised to 6-month AWARE intervention or treatment as usual (TAU). The AWARE interventio...
Baggrund Bipolar lidelse (mani og depression) er ifølge World Health Organisation (WHO) blandt de... more Baggrund Bipolar lidelse (mani og depression) er ifølge World Health Organisation (WHO) blandt de 10 primære årsager til nedsat funktionsevne i verden (1). Prævalensen af bipolar sindslidelse i Danmark er ca. 1 % svarende til ca. 40.000 patienter. På trods af såvel medicinsk som psykologisk behandling oplever op til 50 % af patienter med bipolar sindslidelse, selv når de er velbehandlede, ofte vedvarende og invaliderende funktionsevnenedsættelse i form af kognitive vanskeligheder samt vanskeligheder i forhold til at udføre aktiviteter (2-4). Disse gener vanskeliggør patienternes uddannelse, fastholdelse på arbejdsmarkedet og sociale relationer (5,6). Det er ikke undersøgt, hvorledes de kognitive vanskeligheder påvirker den del af funktionsevnen på aktivitetsog deltagelsesniveau, som omhandler evnen til at udføre Activities of Daily Living (ADL). Derfor er formålet med aktuelle studie at beskrive ADL evnen hos patienter med bipolar sindslidelse samt sammenhængen mellem kognitive vans...
... REFERENCES Note: OCR errors may be found in this Reference List extracted from the full text ... more ... REFERENCES Note: OCR errors may be found in this Reference List extracted from the full text article. ACM has opted to expose the complete List rather than only correct and linked references. ... The ACM Portal is published by the Association for Computing Machinery. ...
Intentional Relationship Model (IRM) er en begrebsmaessig model, som redegor for terapeutisk anve... more Intentional Relationship Model (IRM) er en begrebsmaessig model, som redegor for terapeutisk anvendelse af selvet i en ergoterapeutisk intervention. Som ergoterapeut far man via modellen anvisninger pa, hvilke handlemuligheder og konkrete interpersonelle faerdigheder, der kan anvendes til at fremme klienters aktivitetsengagement. I artiklen bliver modellens elementer gennemgaet, og forfatterne af artiklen har suppleret med forslag til psykologisk litteratur, som kan understotte de enkelte dele i modellen.
Background: A large proportion of persons with bipolar disorder (BD) experience cognitive impairm... more Background: A large proportion of persons with bipolar disorder (BD) experience cognitive impairments and activity limitations even when in remission (1). While most research concerning functioning has focused on cognitive impairments, the aim of this study is to describe the ability to perform Activities of Daily Living (ADL) among persons with BD reporting cognitive impairments and compare their ADL ability to healthy persons of similar age. Method: Participants (n = 43) with BD (based on ICD-10 diagnostic criteria), aged 18-60 years, in full remission defined by Hamilton Depression Rating Scale (HDRS-17) and the Young Mania Rating Scale (YMRS) scores ≤ 7 and with complaints of subjective cognitive difficulties of moderate to severe degree by scores ≥ 13 on the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) questionnaire. The ADL ability was assessed with Assessment of Motor and Process Skills (AMPS). Results and conclusion: The preliminary results indicate tha...
Background: Worldwide, occupational therapy has emphasized the importance of a positive client-th... more Background: Worldwide, occupational therapy has emphasized the importance of a positive client-therapist relationship for the outcomes of therapy. A consistent theoretical framework for addressing the relational aspects of occupational therapy practice was published with Taylor’s Intentional Relationship Model (IRM) (1). Educational Philosophy or theory: The IRM acknowledges that all occupational therapists prefer certain types of therapeutic responding, whereas other ways of responding is less developed and may feel uncomfortable. However, the therapist’s therapeutic responding needs to be in accordance with the client’s current needs. Thus, occupational therapists and students are challenged to develop their skills in therapeutic responding to be able to provide better assistance to more clients. Pedagogy/educational approach(-es) used: During the last years, the IRM has been taught to occupational therapy students in Oslo and Copenhagen. Furthermore the students complete the Self...
Many patients with bipolar disorder (BD) experience debilitating cognitive deficits, with risk of... more Many patients with bipolar disorder (BD) experience debilitating cognitive deficits, with risk of impaired occupational and psychosocial functioning. However, knowledge of how these deficits impact the patients' ability to perform Activities of Daily Living (ADL), tasks related to self-care and domestic life is limited. We explored the relation between impaired cognitive function and the ability to perform ADL in patients with BD. A total of 42 outpatients (mean age 36 years (range 19.0-58.0 years), 69% women) with BD in remission and with subjective cognitive complaints (≥ 13 on the Cognitive Complaints in Bipolar Disorder Rating Assessment questionnaire (COBRA)) were included. Objective neurocognitive function was evaluated with a short comprehensive cognitive test battery and ADL ability was evaluated with the performance-based Assessment of Motor and Process Skills (AMPS) in the homes of the patients. Our findings indicate that low processing speed correlated with decreased ...
Aims: Patients with bipolar disorder often experience disability in terms of cognitive impairment... more Aims: Patients with bipolar disorder often experience disability in terms of cognitive impairments and activity limitations even in remission. However, knowledge is sparse concerning the ability to perform Activities of Daily Living (ADL) during remission. The aim of this study was to (1) investigate the observed and self-reported ability to perform ADL tasks and (2) examine the association between observed and self-reported ability to perform ADL in patients with bipolar disorder in remission. Methods: The observed ADL ability was assessed with the Assessment of Motor and Process Skills, a standardized assessment providing interpretation of ADL ability in relation to competence, independence, and normative age expectations. Self-reported ADL ability was assessed with the standardized ADL-Questionnaire. Results: Forty-three patients with bipolar disorder in remission (median age 35 years, range 19–58 years) were assessed and overall, they displayed decreased observed ADL motor and ADL process ability relative to normative age. They exhibited increased physical effort, clumsiness or fatigue and/or inefficiency, there was concern for safe task performance and one-third may need assistance to live in the community. While participants reported decreased ADL ability, especially within instrumental ADL, they had a tendency towards evaluating themselves as more competent than what was observed. No relationships between measures of observed and self-reported ADL ability were found. Conclusion: Overall, patients with bipolar disorder in remission showed decreased ability to perform ADL. Clinical practice and future studies are recommended to use both observation-based and self-reported assessments of the ability to perform ADL tasks to fully capture disability in bipolar disorder.
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