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Promoting Psychological Health in Women with SCI: A Pilot Study of a Virtual-Reality Intervention Program
e78 Health Questionnaire (PHQ-9) assessed depression severity. These scales were administered in a retrospective pre-test with a traditional post-test. At the conclusion of the 8-week interview, individual semistructured interviews with caregivers were conducted to illuminate the perceived impacts following a therapeutic yoga intervention for people with PD. Results: Following the 8-week intervention, the PHQ-9 revealed a 59% improvement in depressive symptoms and the PAC displayed a reduction of 4% over time. The qualitative data supports this finding, as the themes included enjoying the yoga intervention, increased motivation and patience, and decreased stress levels. All caregivers identified that they would like to continue with some type of yoga. Conclusions: Preliminary data from a therapeutic yoga intervention for PD indicated perceived benefits in depression levels for caregivers, and the qualitative data supported this finding as well. Although PAC scores minimally decreased during the intervention, caregivers reported feeling more patience and motivation in dealing with their care recipient. Key Words: Caregiver, Parkinson’s Disease, Yoga Disclosures: None disclosed. Research Poster 503 The Relationship Between Apathy and Healthrelated Quality of Life in Individuals with Traumatic Brain Injury (TBI) Jean Lengenfelder (Kessler Foundation), Yael Govover, Christopher Cagna, Angela Smith, Nancy Chiaravalloti Research Objectives: To investigate the relationship between apathy and health-related quality of life in individuals with traumatic brain injury (TBI). Design: Individuals were measured on apathy using the Apathy Evaluation Scale (AES). Quality of life was measured using the 36-item Short Form Health Survey (SF-36) and the Functional Behavioral Profile (FBP), self and significant other forms. These measures were given as part of a larger cross-sectional research study. Setting: Individuals were recruited from the general brain injury community including local support groups and previous research participants. Participants: Participants were 50 individuals with moderate-severe traumatic brain injury who were at least 1 year post-injury. Interventions: Not applicable. Main Outcome Measure(s): Data for this poster was taken from a larger study examining the relationship between apathy and executive functioning. The hypothesis for this poster was not one of the main planned outcomes of the study but rather formulated after data collection. Results: Apathy was present in 38% (NZ19) of the individuals using the AES. There were no differences between the apathy and non apathy groups in age, education, gender, time since injury, or premorbid IQ. The two groups also did not differ on current activity levels as measured by the Activity Card Sort (ACS). There was a significant difference between the groups in depression (pZ.001) on the CMDI. After controlling for depression, the apathy group demonstrated significantly lower scores on the SF-36 mental component summary score (MCS; pZ.000) but not the physical component summary (PCS). The apathy group also demonstrated significantly different performance on several measure of the FBP, self total (pZ.000), FBP self self social interaction (pZ.000), self problem solving (pZ.000), significant other total (pZ.03), and FBP significant other social interaction (pZ.05). Conclusions: Apathy was present in a subset of individuals with moderatesevere TBI. Individuals with apathy also exhibited greater levels of depression. Persons with apathy demonstrated significant differences in quality of life, particularly in regard to mental health, compared to those without apathy. In addition, persons with apathy showed significantly more difficulties with functional behaviors, including social integration and problem solving. Understanding the prevalence of apathy after brain injury, its relation to depression and impact on individuals’ quality of life is important for targeted potential interventions. Key Words: Apathy, quality of life, traumatic brain injury Disclosures: None disclosed.
Research Posters Research Poster 504 Promoting Psychological Health in Women with SCI: A Pilot Study of a Virtual-Reality Intervention Program Susan Robinson-Whelen (TIRR-Memorial Hermann), Rosemary B. Hughes, Heather B. Taylor, Margaret A. Nosek Research Objectives: Test the feasibility of offering a group self-esteem enhancement intervention for women with spinal cord injury (SCI) in an online virtual world. Design: Pre-post test. Setting: Second Life (SL), a free online virtual world. Participants: Twelve predominantly white (75%), middle-aged (range 3463), well-educated (92% college graduates) women with SCI (6 paraplegia, 6 tetraplegia). Interventions: With community input, we tailored a cross-disability selfesteem program for women with SCI. The intervention, which consisted of seven weekly 2-hour sessions, focused on connecting to self, connecting with others, and engaging in self-care and consisted of content presentations, group discussion, relaxation training, and weekly action planning/review. Study staff trained participants how to create their avatar, navigate, and communicate in SL prior to the intervention. Main Outcome Measure(s): Feasibility: Attendance, feedback (openended, rating scales), self-reported program impact. Results: Session attendance was good; only one woman attended fewer than half the sessions due to serious family illness. All rated the SL training as excellent/good, but some found SL somewhat difficult to learn (20%) and at least somewhat stressful (25%). Participants described SL as somewhat (8%) or very (92%) enjoyable, and 91% said SL was more convenient than face-to-face programs. SL did not hinder connections, as 100% of the women reported feeling supported by group members and 50% thought SL offered more social interaction than face-to-face programs. Open-ended responses provided compelling evidence for the value of connecting with other women with SCI. All participants rated the program as good/very good overall, and all described making positive life changes over the course of the program. Conclusions: SL is a promising platform on which to offer group programming for women with SCI. Key Words: Spinal cord injury, women, intervention study, self-esteem Disclosures: None disclosed. Research Poster 505 Collaborative Care for Pain, Depression and Physical Inactivity in an Outpatient SCI Clinic: the SCI-CARE Study Charles Bombardier (University of Washington), Jesse R. Fann, Dawn Ehde, Maria R. Reyes, Jeanne M. Hoffman Research Objectives: To test the effectiveness of patient-centered collaborative care (CC) versus usual care (UC) to improve quality of life, pain, physical inactivity and depression in a spinal cord injury (SCI) clinic population. Design: Single blind randomized controlled trial. Setting: Outpatient SCI rehabilitation clinic. Participants: 174 outpatients (UCZ85; CCZ89) who were on average 47.7 years old, 76% male, 69% white, 8% Hispanic, 47% tetraplegic, 45% on Medicare, 95% more than one year after SCI. Interventions: A masters level collaborative care manager, integrated into the SCI clinic and supervised by content experts, provided assessment, coordination and treatment decision support to the primary team, adherence support and brief psychosocial interventions (cognitive behavioral therapy, motivational interviewing) to the patients in up to 12 in-person or telephone sessions. Main Outcome Measure(s): Quality of life (WHOQOL-BREF-primary outcome), pain intensity (NRS), pain interference (NRS), physical activity (PARA-SCI SF), sedentary hours, and depression severity (SCL-20) at 4 months after randomization.
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Research Posters Research Poster 504 Promoting Psychological Health in Women with SCI: A Pilot Study of a Virtual-Reality Intervention Program Susan Robinson-Whelen (TIRR-Memorial Hermann), Rosemary B. Hughes, Heather B. Taylor, Margaret A. Nosek Research Objectives: Test the feasibility of offering a group self-esteem enhancement intervention for women with spinal cord injury (SCI) in an online virtual world. Design: Pre-post test. Setting: Second Life (SL), a free online virtual world. Participants: Twelve predominantly white (75%), middle-aged (range 3463), well-educated (92% college graduates) women with SCI (6 paraplegia, 6 tetraplegia). Interventions: With community input, we tailored a cross-disability selfesteem program for women with SCI. The intervention, which consisted of seven weekly 2-hour sessions, focused on connecting to self, connecting with others, and engaging in self-care and consisted of content presentations, group discussion, relaxation training, and weekly action planning/review. Study staff trained participants how to create their avatar, navigate, and communicate in SL prior to the intervention. Main Outcome Measure(s): Feasibility: Attendance, feedback (openended, rating scales), self-reported program impact. Results: Session attendance was good; only one woman attended fewer than half the sessions due to serious family illness. All rated the SL training as excellent/good, but some found SL somewhat difficult to learn (20%) and at least somewhat stressful (25%). Participants described SL as somewhat (8%) or very (92%) enjoyable, and 91% said SL was more convenient than face-to-face programs. SL did not hinder connections, as 100% of the women reported feeling supported by group members and 50% thought SL offered more social interaction than face-to-face programs. Open-ended responses provided compelling evidence for the value of connecting with other women with SCI. All participants rated the program as good/very good overall, and all described making positive life changes over the course of the program. Conclusions: SL is a promising platform on which to offer group programming for women with SCI. Key Words: Spinal cord injury, women, intervention study, self-esteem Disclosures: None disclosed. Research Poster 505 Collaborative Care for Pain, Depression and Physical Inactivity in an Outpatient SCI Clinic: the SCI-CARE Study Charles Bombardier (University of Washington), Jesse R. Fann, Dawn Ehde, Maria R. Reyes, Jeanne M. Hoffman Research Objectives: To test the effectiveness of patient-centered collaborative care (CC) versus usual care (UC) to improve quality of life, pain, physical inactivity and depression in a spinal cord injury (SCI) clinic population. Design: Single blind randomized controlled trial. Setting: Outpatient SCI rehabilitation clinic. Participants: 174 outpatients (UCZ85; CCZ89) who were on average 47.7 years old, 76% male, 69% white, 8% Hispanic, 47% tetraplegic, 45% on Medicare, 95% more than one year after SCI. Interventions: A masters level collaborative care manager, integrated into the SCI clinic and supervised by content experts, provided assessment, coordination and treatment decision support to the primary team, adherence support and brief psychosocial interventions (cognitive behavioral therapy, motivational interviewing) to the patients in up to 12 in-person or telephone sessions. Main Outcome Measure(s): Quality of life (WHOQOL-BREF-primary outcome), pain intensity (NRS), pain interference (NRS), physical activity (PARA-SCI SF), sedentary hours, and depression severity (SCL-20) at 4 months after randomization.
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