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- Effectiveness of a combined intervention on psychological and physical capacities of frail older adults: a cluster randomized controlled trialPublication . Apóstolo, João Luís Alves; Dixe, Maria dos Anjos; Bobrowicz-Campos, Elzbieta Malgorzata; Areosa, Timóteo; Santos-Rocha, Rita; Braúna, Mónica; Ribeiro, Jaime; Marques, Isabel; Freitas, Joana; Almeida, Maria de Lurdes; Couto, FilipaBackground: Older adults experience physical and psychological declines affecting independency. Adapted and structured combined interventions composed of cognitive stimulation and physical exercise contribute to comorbidities’ reduction. Methods: Multicenter single-blinded two-arm cluster randomized controlled trial conducted to assess effectiveness of a combined intervention (CI), composed of a cognitive stimulation program (CSP) and a physical exercise program (PEP), on psychological and physical capacities of frail older adults as to on their activities of daily living. Were recruited 50 subjects from two elderly end-user organizations. Of these, 44 (65.9% females, mean age of 80.5 8.47 years) were considered eligible, being randomly allocated in experimental (EG) or control group (CG). Data collected at baseline and post-intervention. EG received CI three times a week during 12 weeks. CG received standard care. Non-parametric measures were considered. Results: At baseline, groups were equivalent for study outcomes. The comparison of pre- and post-intervention data revealed that subjects receiving CI reduced depressive symptomatology and risk of fall based on gait and balance, and improved gait speed. Simultaneously, in the CG a significant decline on activities of daily living was observed. Significant results were found among biomechanical parameters of gait (BPG). EG’ effect size revealed to be small (0.2 r < 0.5). CG’ effect size was also small; but for activities of daily living there was an evident decrease. Conclusion: The CI is effective on managing older adults’ psychological and physical capacities.
- Development of a guided imagery program for patients admitted to palliative care unitsPublication . Coelho, Adriana; Parola, Vítor; Fernandes, Olga; Querido, Ana; Apóstolo, JoãoBackground: Guided imagery (GI) is being increasingly used as a non-pharmacological intervention in different clinical settings. However, GI intervention programs have not yet been developed and adapted to patients admitted to palliative care units, which impedes their implementation. Thus, the need emerges to develop and validate a GI program. Objective: To develop and validate a GI program. Methodology: A descriptive study was conducted following the guidelines of the Medical Research Council for the development of complex interventions in 3 phases: identifying the evidence base, identifying/developing appropriate theory, modelling process and outcomes. Results: The development process resulted in a program consisting of 2 GI sessions to be implemented in the same week. Preliminary results on the implementation of a GI session suggest that the intervention is effective in increasing comfort. Conclusion: The characteristics of the GI program proved to be adjusted to the context and target population. The effectiveness of the GI program will be tested in a quasi-experimental study.