Rehab Centers: Beyond Cognition: A Longitudinal Investigation of the Role of Motivation During a Vocational Rehabilitation Program.
Beyond Cognition: A Longitudinal Investigation of the Role of Motivation During a Vocational Rehabilitation Program.
Filed under: Rehab Centers
J Nerv Ment Dis. 2013 Feb 14;
Choi KH, Fiszdon JM, Bell MD
ABSTRACT: Studies that have specifically examined the effects of motivation on work have been limited to evaluations of baseline motivation and have not accounted for cognition. These have also not examined whether motivation changes over time. In the current analyses, we examined how baseline motivation and longitudinal changes in motivation, along with the effects of baseline cognition, related to work function in a sample of 123 individuals with schizophrenia or schizoaffective disorder participating in a 26-week vocational rehabilitation program. Our results indicate that cognition at baseline was a significant predictor of work outcomes over time. Baseline motivation and changes in motivation were significantly linked to work outcomes. The impact of motivation remained significant even after accounting for baseline cognition. These findings provide evidence that motivation is malleable during vocational rehabilitation and has an important impact on vocational function above and beyond the impact of cognition.
HubMed – rehab
COMMENTARY: Improving Cardiac Rehabilitation Referral and Use Through Value-Based Payment Models: A Closer Look.
Filed under: Rehab Centers
J Cardiovasc Nurs. 2013 Feb 14;
Bean G
Improving Cardiovascular Care Through Outpatient Cardiac Rehabilitation: An Analysis of Payment Models That Would Improve Quality and Promote Use.
Filed under: Rehab Centers
J Cardiovasc Nurs. 2013 Feb 14;
Mead H, Grantham S, Siegel B
BACKGROUND:: Much attention has been paid to improving the care of patients with cardiovascular disease by focusing attention on delivery system redesign and payment reforms that encompass the healthcare spectrum, from an acute episode to maintenance of care. However, 1 area of cardiovascular disease care that has received little attention in the advancement of quality is cardiac rehabilitation (CR), a comprehensive secondary prevention program that is significantly underused despite evidence-based guidelines that recommending its use. PURPOSE:: The purpose of this article was to analyze the applicability of 2 payment and reimbursement models-pay-for-performance and bundled payments for episodes of care – that can promote the use of CR. CONCLUSIONS:: We conclude that a payment model combining elements of both pay-for-performance and episodes of care would increase the use of CR, which would both improve quality and increase efficiency in cardiac care. Specific elements would need to be clearly defined, however, including: (a) how an episode is defined, (b) how to hold providers accountable for the care they provider, (c) how to encourage participation among CR providers, and (d) how to determine an equitable distribution of payment. CLINICAL IMPLICATIONS:: Demonstrations testing new payment models must be implemented to generate empirical evidence that a melded pay-for-performance and episode-based care payment model will improve quality and efficiency.
HubMed – rehab
Exercise Self-efficacy and Symptoms of Depression After Cardiac Rehabilitation: Predicting Changes Over Time Using a Piecewise Growth Curve Analysis.
Filed under: Rehab Centers
J Cardiovasc Nurs. 2013 Feb 14;
Howarter AD, Bennett KK, Barber CE, Gessner SN, Clark JM
BACKGROUND:: Cardiac rehabilitation is often recommended after experiencing a cardiac event and has been shown to significantly improve health outcomes among patients. Several psychosocial variables have been linked with cardiac rehabilitation program success, including exercise self-efficacy. However, little is known about temporal patterns in patients’ exercise self-efficacy after program completion. OBJECTIVE:: This study examined changes in exercise self-efficacy among 133 cardiac rehabilitation patients and whether symptoms of depression impacted the rate of change in exercise self-efficacy. METHOD:: Participants completed questionnaires at the beginning and end of cardiac rehabilitation and at 6-month intervals for 2 years. RESULTS:: Growth curve analyses showed that exercise self-efficacy levels were highest at the beginning of cardiac rehabilitation, significantly declined 6 months after cardiac rehabilitation, and leveled off over the next 18 months. Results also showed that baseline depressive symptoms interacted with time: Compared with participants with fewer symptoms, participants high in depressive symptoms began cardiac rehabilitation with lower levels of exercise self-efficacy and evidenced significant declines 6 months after cardiac rehabilitation. At no time were they equal to their counterparts in exercise self-efficacy, and their means were lower 2 years after cardiac rehabilitation than before cardiac rehabilitation. CONCLUSIONS:: Our findings imply that patients show unrealistic optimism surrounding the ease of initiating and maintaining an exercise program and that integrating efficacy-building activities into cardiac rehabilitation, especially for patients who show signs of distress, is advisable.
HubMed – rehab
Comparative Study of Outcome of the Endoscopic Sinus Surgery and Conventional Surgery for Nasal Polyposis.
Filed under: Rehab Centers
Mymensingh Med J. 2013 Jan; 22(1): 84-92
Humayun MP, Alam MM, Ahmed S, Salam S, Tarafder KH, Biswas AK
This is a cross-sectional study done in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College & Hospital (DMCH) & Bangladesh Institute of Research and Rehabilitation of Diabetic Endocrine and Metabolic Disorder (BIRDEM), Dhaka during the period of January 2009 to August 2010. This study included 60 cases of nasal polyposis, among them in 30 cases Functional Endoscopic Sinus Surgery (FESS) was done and in 30 cases conventional surgical procedure was done as treatment procedure. Here mean age of patient in FESS was 45.43 years and in conventional surgery was 45.13 years and male female ratio was 3.3:1. In this study postoperative complication of FESS were found in 07(23.33%) cases whereas in conventional surgery it were in 16 (53.33%) cases (p = <0.01, df = 1, Chi-squire = 7.65). In case of outcome, complete relief of symptoms occur in 22(73.33%) cases by FESS and 14(46.66%) cases by conventional procedure (p = <0.05 df = 2, Chi-squire = 9.29). In FESS 22(73.33%) cases and in conventional technique 14(46.67%) cases discharged within 24-48 hours (p = <0.05, df = 1, Chi-squire = 4.44). Recurrence after FESS was 6.67% cases and conventional surgery was 30% cases. The results of this series reveled that FESS had the combined advantages of precise removal of the disease with minimal complication. HubMed – rehab
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