People with voice problems can seek advice and therapy from a speech-language pathologist. Besides having problems with the speaking voice, a number of them are also amateur choristers. In addition to her standard examination, the speech-language pathologist has to specifically describe the use of the singing voice during choral singing and to assess the amount of mutual influence of speaking and singing voice. In therapy, a healthy phonation is learned. In today's practice, the therapist tends to confine herself to training the sepaking voice. It is known that pitch variation influences phonation. As pitch is a complicating factor in singing, the therapist could make the client aware of this influence by using exercises that alternate speaking and singing voice. Reference to and cooperation with singing teachers is essential. A network of speech-language pathologists 'with an ear for singers' and singing teachers should be built up.
Background: Osteoarthritis is a major public health concern. Despite existing evidence-based treatment options, the health care situation remains unsatisfactory. Digital care options, especially when combined with in-person sessions, seem to be promising. Objective: The aim of this study was to investigate the needs, preconditions, barriers, and facilitators of blended physical therapy for osteoarthritis. Methods: This Delphi study consisted of interviews, an online questionnaire, and focus groups. Participants were physical therapists, patients with hip and/or knee osteoarthritis with or without experience in digital care, and stakeholders of the health care system. In the first phase, interviews were conducted with patients and physical therapists. The interview guide was based on the Consolidated Framework For Implementation Research. The interviews focused on experiences with digital and blended care. Furthermore, needs, facilitators, and barriers were discussed. In the second phase, an online questionnaire and focus groups served the process to confirm the needs and collect preconditions. The online questionnaire contained statements drawn by the results of the interviews. Patients and physical therapists were invited to complete the questionnaire and participate in one of the three focus groups including (1) patients; (2) physical therapists; and (3) a patient, a physical therapist, and stakeholders from the health care system. The focus groups were used to determine concordance with the results of the interviews and the online questionnaire. Results: Nine physical therapists, seven patients, and six stakeholders confirmed that an increase of acceptance of the digital care part by physical therapists and patients is crucial. One of the most frequently mentioned facilitators was conducting regular in-person sessions. Physical therapists and patients concluded that blended physical therapy must be tailored to the patients' needs. Participants of the last focus group stated that the reimbursement of blended physical therapy needs to be clarified. Conclusions: Most importantly, it is necessary to strengthen the acceptance of patients and physical therapists toward digital care. Overall, fo
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INTRODUCTION: The aim of this study was to investigate reasons why people consulted an occupational therapist following cancer treatment, and to examine the outcome of occupational therapy interventions, in the context of multidisciplinary rehabilitation.METHODS: Data from 181 patients were collected retrospectively. The International Classification of Human Functioning and Health (ICF) was used to describe the reasons for occupational therapy consultation. Patients had completed the Canadian Occupational Performance Measurement (COPM) before and after the occupational therapy intervention. Change scores were calculated with a 95% confidence interval and a two-sided p-value obtained from a paired t-test.RESULTS: The reasons for occupational therapy consultation were predominantly within the ICF domain "Activities and Participation". On average, patients improved 3.0 points (95% CI 2.8-3.2) on the performance scale of the COPM, and 3.4 points (95% CI 3.2-3.7) on the satisfaction scale (both: p = <.001).CONCLUSION: The result of this study supports the added value of occupational therapy to cancer rehabilitation, and emphasise the positive effect of occupational therapy on everyday functioning. Controlled clinical studies are needed to strengthen the evidence.
Alcohol Use Disorder (AUD) involves uncontrollable drinking despite negative consequences, a challenge amplified in festivals. ARise is a project using Augmented Reality (AR) to prevent AUD by helping festival visitors refuse alcohol and other substances. Based on the first Augmented Reality Exposure Therapy (ARET) for clinical AUD treatment, ARise uses a smartphone app with AR glasses to project virtual humans that tempt visitors to drink alcohol. Users interact in a safe and personalized way with these virtual humans through phone, voice, and gesture interactions. The project gathers festival feedback on user experience, awareness, usability, and potential expansion to other substances.Societal issueHelping treatment of addiction and stimulate social inclusion.Benefit to societyMore people less patients: decrease health cost and increase in inclusion and social happiness.Collaborative partnersNovadic-Kentron, Thalamusa
Alcohol use disorder (AUD) is a pattern of alcohol use that involves having trouble controlling drinking behaviour, even when it causes health issues (addiction) or problems functioning in daily (social and professional) life. Moreover, festivals are a common place where large crowds of festival-goers experience challenges refusing or controlling alcohol and substance use. Studies have shown that interventions at festivals are still very problematic. ARise is the first project that wants to help prevent AUD at festivals using Augmented Reality (AR) as a tool to help people, particular festival visitors, to say no to alcohol (and other substances). ARise is based on the on the first Augmented Reality Exposure Therapy (ARET) in the world that we developed for clinical treatment of AUD. It is an AR smartphone driven application in which (potential) visitors are confronted with virtual humans that will try to seduce the user to accept an alcoholic beverage. These virtual humans are projected in the real physical context (of a festival), using innovative AR glasses. Using intuitive phone, voice and gesture interactions, it allows users to personalize the safe experience by choosing different drinks and virtual humans with different looks and levels of realism. ARET has been successfully developed and tested on (former) AUD patients within a clinical setting. Research with patients and healthcare specialists revealed the wish to further develop ARET as a prevention tool to reach people before being diagnosed with AUD and to extend the application for other substances (smoking and pills). In this project, festival visitors will experience ARise and provide feedback on the following topics: (a) experience, (b) awareness and confidence to refuse alcohol drinks, (c) intention to use ARise, (d) usability & efficiency (the level of realism needed), and (e) ideas on how to extend ARise with new substances.
communicative participation, language disordersOBJECTIVE(S)/RESEARCH QUESTION(S) Speech and language therapists (SLTs) are the primary care professionals to treat language and communication disorders. Their treatment is informed by a variety of outcome measures. At present, diagnosis, monitoring of progress and evaluation are often based on performance-based and clinician-reported outcomes such as results of standardized speech, language, voice, or communication tests. These tests typically aim to capture how well the person can produce or understand language in a controlled situation, and therefore only provide limited insight in the person’s challenges in life. Performance measures do not incorporate the unobservable feelings such as a patient's effort, social embarrassment, difficulty, or confidence in communication. Nor do they address language and communication difficulties experienced by the person themselves, the impact on daily life or allow patients to set goals related to their own needs and wishes. The aim of our study is give our patients a voice and empower SLTs to incorporate their patient's perspective in planning therapy. We will Aangemaakt door ProjectNet / Generated by ProjectNet: 08-12-2020 12:072Subsidieaanvraag_digitaal / Grant Application_digitaalDossier nummer / Dossier number: 80-86900-98-041DEFINITIEFdevelop a valid and reliable patient-reported outcome measure that provides information on communicative participation of people with communication disorders and integrate this item bank in patient specific goal setting in speech and language therapy. Both the item bank and the goal setting method will be adapted in cocreation with patients to enable access for people with communication difficulties.STUDY DESIGN Mixed methods research design following the MRC guidance for process evaluation of complex interventions, using PROMIS methodology including psychometric evaluation and an iterative user-centered design with qualitative co-creation methods to develop accessible items and the goal setting method.RESEARCH POPULATION Children, adolescents and adults with speech, language, hearing, and voice disorders.OUTCOME MEASURES An online patient-reported outcome measure on communicative participation, the Communicative Participation Item Bank (CPIB), CPIB items that are accessible for people with language understanding difficulties, a communicative-participation person-specific goal setting method developed with speech and language therapists and patients and tested on usability and feasibility in clinical practice, and a course for SLTs explaining the use of the goal-setting method in their clinical reasoning process.RELEVANCE This study answers one of the prioritized questions in the call for SLTs to systematically and reliably incorporate the clients’ perspective in their daily practice to improve the quality of SLT services. At present patient reported outcomes play only a small role in speech and language therapy because 1) measures (PROMS) are often invalid, not implemented and unsuitable for clinical practice and 2) there is a knowledge gap in how to capture and interpret outcomes from persons with language disorders.
