Browsing by Author "Bērziņa, Guna"
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Item Comparison of content and psychometric properties for assessment tools used for brain tumor patients : a scoping review(2021-10-09) Ģiga, Lelde; Pētersone, Anete; Čakstiņa, Silva; Bērziņa, Guna; Rīga Stradiņš University; Department of RehabilitationAims: To determine the most frequently utilized functional status assessment instruments for patients with brain tumors, compare their contents, using the International Classification of Functioning, Disability and Health (ICF), and their psychometric properties. Methods: A scoping review was conducted to explore possible assessment instruments and summarize the evidence. A systematic literature search was performed for identification of the frequently used functional assessment tool in clinical trials in PubMed, ScienceDirect, and ProQuest databases. The content of most used instruments was linked to the ICF categories. The psychometric qualities of these assessment tools were systematically searched and analyzed. Results: Nine most used assessment tools in clinical trials were identified. The most frequently used assessment instrument is the Karnofsky Performance Scale, which is developed for a general assessment of oncological patients. Out of four self-assessment tools, two were disease-specific (EORTC QLQ-BN20 and FACT-Br), EORTC QLQ-C30 has been shown good psychometric properties in patients with brain tumors as well as in patients with various oncological diseases, similar to the SF-36, it is used in patients with brain tumors as well as in patients with various diseases. The Functional Independence Measure and the Barthel Index were two objective assessment tools that described functioning, but two were neuropsychological tests (MMSE and Trial Making Test). Two hundred eighty-three meaningful concepts were identified and linked to 102 most relevant second-level categories covering all components of the ICF. Forty-nine studies reporting psychometric properties of those nine assessment tools were identified, indicating good reliability and validity for all the instruments. Conclusion: Nine most frequently utilized functional status assessment instruments for patients with brain tumors represent all components of the ICF and have good psychometric properties. However, the choice of the tool depends on the clinical question posed and the aim of its use.Item Comparison of Content and Psychometric Properties of Malnutrition Outcome Measures : A Systematic Review(2022-04-20) Savicka, Līga; Salaka, Santa; Bērziņa, Guna; Department of RehabilitationObjective: To determine the most-often used outcome measures for malnutrition risk and malnutrition, analyse outcome measure content, and assess psychometric properties. Methods: MEDLINE, SAGE Journals, Web of Science, SCOPUS, ProQuest and Science Direct databases were searched to identify outcome measures. Outcome measure content was compared using the International Classification of Functioning Disability and Health (ICF). Psychometric properties were also systematically searched and compared. This review was prepared according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: A total of 1,311 studies met the inclusion criteria. The most-often used outcome measures for detecting malnutrition or its risk overall were: body mass index (590), albumin (469), Mini Nutritional Assessment (312), haemoglobin (251), and Subjective Global Assessment (139). The most psychometrically sound outcome measure was Mini Nutritional Assessment, but the most comprehensive measure, covering the most ICF categories, was Patient-Generated Subjective Global Assessment, with a total of 58 meaningful concepts. Conclusion: The results provide an insight into the content and psychometric quality of malnutrition risk and malnutrition outcome measures. There was some variation between the way reviewers linked meaningful concepts to ICF, and literature gaps were identified regarding psychometric properties. These results can be used to help select the most appropriate malnutrition outcome measure. LAY ABSTRACT Malnutrition leads to a decline in physical and mental functioning, as well as activity limitations, which can result in poor disease outcomes and reduced quality of life. Early identification of malnutrition depends on choosing the most appropriate diagnostic method. This article systematically analyses the outcome measures most commonly used in research for detecting malnutrition risk and malnutrition in adults. The content of the most common outcome measures was analysed using the International Classification of Functioning Disability and Health (ICF). Linking rules, and the psychometric properties of the measures were systematically searched, analysed according to an already established framework, and compared.Item Comparison of Rehabilitation Outcomes for Persons After Stroke in Latvia and Sweden. Doctoral Thesis(Rīga Stradiņš University, 2016) Bērziņa, Guna; Vētra, Anita; Stibranta Sunerhāgena, KatarīnaStroke is one of the most common causes of long-term disability that leads to substantial economic and social burden for individuals, families, communities and nations. Rehabilitation aims to improve person’s functioning and decrease adverse consequences of stroke in all levels. Therefore, defining an optimal model of stroke care is in the interests of patients, health professionals, researchers and policymakers. One of the ways towards it is by investigating and comparing the outcomes of the stroke care systems currently in use. The aim of this thesis was to explore the determinants of rehabilitation outcomes for persons after stroke and to compare them between those living in Latvia or in Sweden, using the bio-psycho-social model suggested by World Health Organization (WHO). This project was organized in four parts. Part 1 focused on comparison between two in-patient rehabilitation systems and the differences in level of independence at discharge from rehabilitation between two cohorts were compared in 1055 and 1748 persons after stroke, living in Latvia and Sweden, respectively. For all following parts of this research work, cross-sectional study design was used. In Part 2, the influence of dependence level at discharge from rehabilitation on self-perceived disability in chronic phase of stroke was investigated in 255 persons from Latvia. Part 3 explored personal factors’ (age, gender, place of residence and time since onset of stroke) role in perception of functional limitations, barriers and facilitators in 243 persons living in Sweden. The relevance of the same factors in persons after stroke living in Latvia was evaluated in Part 4. Functional Independence Measure, International Classification of Functioning, Disability and Health Core Set for stroke and World Health Organization Disability Assessment Schedule 2.0 were used for outcome assessment. Socio-demographic and medical data, as well as information on organisational aspects of rehabilitation were also used as variables. Both theoretical as well as statistical analyses were used to compare rehabilitation systems in Latvia and Sweden. Appropriate regression analyses were used in all parts of this work. It seems that the components of stroke care are similar in rehabilitation systems in Latvia and Sweden. However, both populations vary in their basic medical and sociodemographic characteristics, as well as in the level of independence at admittance and discharge. There are also potential differences in the content and organizational aspects of rehabilitation. The levels of independence in daily activities at discharge from rehabilitation are significant factors that influenced perception of disability in the chronic phase of stroke. Personal factors such as age, gender, place of residence and time since onset of stroke can influence self-perceived functioning and environmental factors, as defined in the framework of the ICF, in persons living in Sweden. Same factors were also significant in the model that evaluated problems in ‘Activities and Participation’ persons living in Latvia. However, the role of those factors where rather small in both populations. Thus, the results of this thesis shows that different aspects of WHO’s suggested biopsycho- social model influence rehabilitation outcomes for persons after stroke and results depends on the country of residence (Latvia or Sweden). Functional, organizational, social and personal factors are of importance. Some of the factors are modifiable by the healthcare system, but some are the responsibility of society as a whole.Item Comparison of Rehabilitation Outcomes for Persons After Stroke in Latvia and Sweden. Summary of the Doctoral Thesis(Rīga Stradiņš University, 2016) Bērziņa, Guna; Vētra, Anita; Stibranta Sunerhāgena, KatarīnaStroke is one of the most common causes of long-term disability that leads to substantial economic and social burden for individuals, families, communities and nations. Rehabilitation aims to improve person’s functioning and decrease adverse consequences of stroke in all levels. Therefore, defining an optimal model of stroke care is in the interests of patients, health professionals, researchers and policymakers. One of the ways towards it is by investigating and comparing the outcomes of the stroke care systems currently in use. The aim of this thesis was to explore the determinants of rehabilitation outcomes for persons after stroke and to compare them between those living in Latvia or in Sweden, using the bio-psycho-social model suggested by World Health Organization (WHO). This project was organized in four parts. Part 1 focused on comparison between two in-patient rehabilitation systems and the differences in level of independence at discharge from rehabilitation between two cohorts were compared in 1055 and 1748 persons after stroke, living in Latvia and Sweden, respectively. For all following parts of this research work, cross-sectional study design was used. In Part 2, the influence of dependence level at discharge from rehabilitation on self-perceived disability in chronic phase of stroke was investigated in 255 persons from Latvia. Part 3 explored personal factors’ (age, gender, place of residence and time since onset of stroke) role in perception of functional limitations, barriers and facilitators in 243 persons living in Sweden. The relevance of the same factors in persons after stroke living in Latvia was evaluated in Part 4. Functional Independence Measure, International Classification of Functioning, Disability and Health Core Set for stroke and World Health Organization Disability Assessment Schedule 2.0 were used for outcome assessment. Socio-demographic and medical data, as well as information on organisational aspects of rehabilitation were also used as variables. Both theoretical as well as statistical analyses were used to compare rehabilitation systems in Latvia and Sweden. Appropriate regression analyses were used in all parts of this work. It seems that the components of stroke care are similar in rehabilitation systems in Latvia and Sweden. However, both populations vary in their basic medical and sociodemographic characteristics, as well as in the level of independence at admittance and discharge. There are also potential differences in the content and organizational aspects of rehabilitation. The levels of independence in daily activities at discharge from rehabilitation are significant factors that influenced perception of disability in the chronic phase of stroke. Personal factors such as age, gender, place of residence and time since onset of stroke can influence self-perceived functioning and environmental factors, as defined in the framework of the ICF, in persons living in Sweden. Same factors were also significant in the model that evaluated problems in ‘Activities and Participation’ persons living in Latvia. However, the role of those factors where rather small in both populations. Thus, the results of this thesis shows that different aspects of WHO’s suggested biopsycho- social model influence rehabilitation outcomes for persons after stroke and results depends on the country of residence (Latvia or Sweden). Functional, organizational, social and personal factors are of importance. Some of the factors are modifiable by the healthcare system, but some are the responsibility of society as a whole.Item Factors associated with long-term mortality for stroke unit patients in Latvia(2018-12) Mihejeva, Illa; Vētra, Anita; Bērziņa, Guna; Rīga Stradiņš UniversityAim: The aim of this study was to evaluate how pre-stroke risk factors, neurological symptoms, and the level of disability shortly after stroke are associated with poststroke mortality during a 7-year period after stroke, for persons treated in a stroke unit. Methods: The data of 231 patients were included in the study. Patients who were treated in the stroke unit at the Riga East University Hospital between February 1, 2009, and July 20, 2009, were included in this study. Three stepwise Cox proportional hazard analyses were performed to analyze mortality in the 7 years following stroke. Pre-stroke risk factors (type of stroke, arterial hypertension, diabetes mellitus, atrial fibrillation, smoking, alcohol abuse, obesity, recurrent stroke, age, gender), neurological symptoms (motor deficit, sensory disturbance, aphasia, poststroke urinary incontinence (PSUI), mental status), and limitations of activity (feeding, bathing, grooming, dressing, toilet use, transfers, mobility, stairs) were evaluated as factors associated with mortality after stroke. Results: A total of 145 (62.8%) patients died during the study period. The final model for each group of factors included only one of the factors used for the analysis. Patients who had alcohol abuse were 40% more likely to die earlier. The hazard for those with PSUI is 1.72 times higher than those without PSUI. The independence in grooming showed a 39% lower likelihood of dying earlier. Conclusion: Alcohol abuse as a pre-stroke risk factor, poststroke urinary incontinence as a neurological symptom, and dependence in grooming as a factor of disability were associated with earlier mortality in the first seven years after stroke.Item Mākslu terapija dažādām klientu / pacientu grupām(Rīgas Stradiņa universitāte, 2014) Mārtinsone, Kristīne; Krevica, Edīte; Bērziņa, Guna; Vētra, Aivars; Puķīte, Margarita; Paiča, Inese; Karkuva (Karkou), Vikija (Vicky); Akmane, Elīna; Hartmane, Sandra; Mihailovs, Ivans Jānis; Mihailova, Sandra; Vilka, Evija; Veitnere, Zane; Grīnberga, Ingrida; Mazkalne, M.; Kušnareva, Z.; Silniece, Sanita; Ķince, Liene; Šuriņa, Sanita; Eglīte, Džoanna; Meluškāne, Sindija; Lindiša, Daiga; Dzene, Daiga; Dakse, Evita; Ciganovska, Sanita; Veide-Nedviga, Līga; Šķone, Naira; Dzilna-Silova, Ilze; Upmale, Anda; Visnola, Dace; Duhovska, Jana; Barsineviča, Sandra; Beļska, Anžela; Denisjuka, J.; Enģele, Līga; Paipare, Mirdza; Garnaka, Rita; Šteina, AnnaŠis rakstu krājums ir izveidots un publicēts Erasmus Mūžizglītības intensīvās programmas projektā “Mākslu terapija dažādām klientu / pacientu grupām” (2014) Rīgas Stradiņa universitātes Rehabilitācijas fakultātē, profesionālā maģistra studiju programmā “Mākslas terapija” sadarbībā ar projekta partneriem. Raksti ir balstīti uz teorētisko prezentāciju un autoru semināru saturu intensīvās programmas laikā. Rakstu krājumā aprakstīts teorētiskais un praktiskais darbs ar veselības aprūpes disciplīnu - mākslas terapijas specializācijām - mākslas terapijas, deju kustību terapijas, mūzikas terapijas iespējas ar dažādām klientu / pacientu grupām veselības aprūpē, sociālajā aprūpē un izglītības vidē. Rakstu krājumā ir dažādi mākslas terapeiti no Igaunijas, Latvijas, Lietuvas, Vācijas un Lielbritānijas, kā arī viņu praktiskās pieredzes kopsavilkums. Gadījumu izpēte ir neseno pētījumu rezultāti mākslas terapijas jomā. Raksti akcentē un raksturo mākslas terapijas specializācijas specifiku un piedāvā iespējas darbā ar dažādām klientu / pacientu grupām. Kolekcijā tiek piedāvāti daudzdimensionāli skati uz mākslas terapijas praktisko daļu. Tas arī demonstrē dažādus terapeitiskos ietvarus, medicīnisko, psiholoģisko teoriju integrāciju, kas tiek izmantota mākslas terapijas pielietojamības pamatā, piedāvā dažus uz mākslu balstīta novērtējuma aspektus un dalās noderīgā pieredzē. Autori piedāvā mūsdienu pieejas mākslas terapijas darbos. Projekta galvenie mērķi bija nodrošināt pieredzes apmaiņu, izmantojot aktivitātes starp projekta partneriem; iegūt un attīstīt jaunas zināšanas un prasmes; izveidot norādes materiālus mākslas terapijas darbiem dažādām klientu / pacientu grupām; un veicināt turpmāku mākslas terapijas attīstību projektā iesaistītajās valstīs.Item Patients' physical activity in stroke units in Latvia and Sweden(2021-03-23) Kārkliņa, Agnese; Chen, Erik; Bērziņa, Guna; Stibrant Sunnerhagen, Katharina; Faculty of RehabilitationObjective: A prospective, observational study to describe levels of physical activity in patients with stroke in a comprehensive stroke unit in Sweden and Latvia, comparing data between countries. Methods: The study was performed at stroke units in one hospital in Sweden (data were acquired over a 2-month period in 2017) and two hospitals in Latvia (data were acquired over a 3-month period between 2016 and 2017). Patients with stroke were observed for 1 min every 10 min. The level of physical activity, location, and the people present were noted at each time-point. Results: A total of 27 patients were observed in Latvia and 25 patients in Sweden. Patients from both countries were in bed half of the time and spent the majority of the day in their bedroom and alone. Patients in Sweden had higher physical activity levels, spent more time outside their bedroom and spent more time with rehabilitation specialists and visitors. Conclusion: Patients are inactive and alone for a majority of the time during hospitalization at a comprehensive stroke unit in both countries. There are differences in environment in the stroke unit between countries.Item Patients' physical activity in stroke units in Latvia and Sweden(2021-05) Kārkliņa, Agnese; Chen, Erik; Bērziņa, Guna; Stibrant Sunnerhagen, Katharina; Rehabilitācijas fakultāteObjective: A prospective, observational study to describe levels of physical activity in patients with stroke in a comprehensive stroke unit in Sweden and Latvia, comparing data between countries. Methods: The study was performed at stroke units in one hospital in Sweden (data were acquired over a 2-month period in 2017) and two hospitals in Latvia (data were acquired over a 3-month period between 2016 and 2017). Patients with stroke were observed for 1 min every 10 min. The level of physical activity, location, and the people present were noted at each time-point. Results: A total of 27 patients were observed in Latvia and 25 patients in Sweden. Patients from both countries were in bed half of the time and spent the majority of the day in their bedroom and alone. Patients in Sweden had higher physical activity levels, spent more time outside their bedroom and spent more time with rehabilitation specialists and visitors. Conclusion: Patients are inactive and alone for a majority of the time during hospitalization at a comprehensive stroke unit in both countries. There are differences in environment in the stroke unit between countries.Item Pragmatic solutions to reduce the global burden of stroke : a World Stroke Organization-Lancet Neurology Commission(2023-12) World Stroke Organization–Lancet Neurology Commission Stroke Collaboration Group; Feigin, Valery L; Owolabi, Mayowa O; Mihejeva, I.; Bērziņa, Guna; Jurjāns, K.; Miglāne, E.; Department of Rehabilitation; Department of Neurology and NeurosurgeryItem Rehabilitācijas rezultātu salīdzinājums personām pēc insulta Latvijā un Zviedrijā. Promocijas darba kopsavilkums(Rīgas Stradiņa universitāte, 2016) Bērziņa, Guna; Vētra, Anita; Stibranta Sunerhāgena, KatarīnaInsults ir viens no visbiežāk sastopamiem ilgstošas invaliditātes iemesliem pieaugušo populācijā. Tas rada ievērojamas ekonomiskas un sociālas problēmas indivīdiem, viņu ģimenēm, sabiedrībām un nācijām. Rehabilitācijas mērķis ir uzlabot personas funkcionēšanu un mazināt insulta nelabvēlīgās sekas jebkurā aprūpes līmenī. Šī iemesla dēļ gan pacientu, gan veselības aprūpes profesionāļu, kā arī pētnieku un politiķu interesēs ir atrast optimālu insulta aprūpes modeli. Viens no veidiem, kā šim modelim tuvoties, ir izpētīt un salīdzināt insulta aprūpes iznākumus, kas tiek izmantoti šobrīd. Šī darba mērķis bija salīdzināt rehabilitācijas rezultātus personām pēc insulta Latvijā un Zviedrijā, izmantojot Pasaules Veselības organizācijas ieteikto biopsihosociālo modeli. Šis darbs sastāv no četrām daļām. Pirmajā pētījuma daļā ir veikts divu stacionārās rehabilitācijas sistēmu (Latvijas un Zviedrijas) salīdzinājums, kā arī salīdzinātas neatkarības līmeņa atšķirības rehabilitācijas beigās starp divām grupām – 1055 Latvijā dzīvojošām un 1784 Zviedrijā dzīvojošām personām pēc insulta. Pārējām pētījuma daļām tika izmantots šķērsgriezuma pētījuma dizains. Otrajā daļā tika pētīta neatkarības līmeņa – rehabilitācijas kursa beigās – ietekme uz personu vērtējumu par viņu invaliditātes pakāpi hroniskā insulta fāzē 255 personām no Latvijas. Trešajā daļā tika pētīta personālo faktoru (vecuma, dzimuma, dzīvesvietas un laika kopš insulta) loma, nosakot 243 Zviedrijā dzīvojošu personu vērtējumu par funkcionēšanas ierobežojumiem, kā arī vides faktoru kavētājiem un veicinātājiem. Šo pašu faktoru nozīme Latvijā dzīvojošām personām pēc insulta tika vērtēta pētījuma ceturtajā daļā. Kā iznākuma novērtēšanas instrumenti tika izmantoti: Funkcionālās neatkarības mērījums, Starptautiskās funkcionēšanas, nespējas un veselības klasifikācijas (SFK) insulta pamatkopa un Pasaules Veselības organizācijas Invaliditātes novērtēšanas saraksta 2. versija. Kā mainīgie tika izmantoti sociodemogrāfiskie un medicīniskie dati, kā arī informācija par rehabilitācijas organizatoriskajiem aspektiem. Tika veikts gan teorētisks, gan statistisks salīdzinājums starp Latvijas un Zviedrijas rehabilitācijas sistēmām. Atbilstošas regresijas analīzes tika veiktas visās šī pētījuma daļās. Latvijas un Zviedrijas sistēmās insulta aprūpes komponenti šķiet līdzīgi. Tomēr abas populācijas atšķiras ar pamata medicīniskajiem rādītājiem, sociodemogrāfisko raksturojumu un neatkarības līmeni rehabilitācijas sākumā un beigās. Iespējams, ka tās savā starpā atšķiras arī ar rehabilitācijas saturu un organizatoriskajiem aspektiem. Neatkarības līmenis ikdienas aktivitāšu veikšanā rehabilitācijas kursa beigās ir nozīmīgs faktors, kas ietekmē personas vērtējumu par viņa invaliditātes līmeni hroniskā insulta fāzē. Tādi personālie faktori kā vecums, dzimums, dzīvesvieta un laiks kopš insulta ietekmē Zviedrijā dzīvojošu personu vērtējumu par funkcionēšanu un vides faktoriem atbilstoši SFK konceptam. Šie paši faktori, novērtēti “aktivitāšu un līdzdalības” domēnā, bija nozīmīgi arī Latvijas populācijā. Tomēr šo faktoru loma abās populācijās bija diezgan maza. Šī darba rezultāti apstiprina, ka dažādi Pasaules Veselības organizācijas ieteiktā biopsihosociālā modeļa aspekti ietekmē rehabilitācijas rezultātus personām pēc insulta, turklāt tie atšķiras atkarībā no valsts, kurā persona dzīvo (Latvijā vai Zviedrijā). Svarīgi ir gan funkcionālie, gan sociālie, gan personālie faktori. Dažus no šiem faktoriem var ietekmēt, izmantojot veselības aprūpes sistēmu, bet citi ir visas sabiedrības atbildība.Item Systematization of rehabilitation interventions for neuro-oncological patients using international classification of health interventions : a scoping review(2024-01-12) Pētersone, Anete; Kārkliņa, Agnese; Bērziņa, Guna; Rehabilitācijas fakultāteBACKGROUND: To ensure equitable and effective rehabilitation for neuro-oncological patients the development of an effective treatment strategy is necessary. OBJECTIVE: To identify evidence for interventions used in acute rehabilitation for patients with neuro-oncological conditions and to systematize them according to the International Classification of Health Interventions (ICHI) classification Methods: A scoping review was conducted, comprising 3 parts: identification of interventions in publications; linking the interventions to ICHI classification; and identifying problems targeted by these interventions and linking them to International Classification of Functioning, Disability and Health (ICF) categories. RESULTS: The search strategy selected a total of 6,128 articles. Of these, 58 publications were included in the review. A total of 150 interventions were identified, 47 of which were unique interventions. Forty-three of the interventions were linked to the ICHI classification; 4 of these interventions were evidence level I, 18 evidence level II, 23 evidence level III, and 2 evidence level IV. Five interventions were linked to the ICF One-Level Classification, and the remaining 42 interventions were linked to the ICF Two-Level Classification. All interventions regarding the Body Systems and Functions were linked to the ICF Two-Level Classification. Only 5 interventions in the Activities and Participation domain, 3 interventions in the Health-related Behaviors domain, and 1 intervention in the Environment domain were linked to the ICF Two-Level Classification. Two identified problems (inpatient nursing and comprehensive inpatient rehabilitation) were not classified according to the ICF. DISCUSSION: A total of 47 unique interventions were identified, revealing a significant focus on addressing issues related to bodily functions and structures. The study also highlighted the challenge of linking specific interventions to ICHI codes, particularly when the source documentation lacked adequate detail. While this review offers valuable insights into rehabilitation for neuro-oncological patients and lays the groundwork for standardized coding and data exchange, it also emphasizes the need for further refinement and validation of the ICHI classification to better align with the multifaceted interventions used in rehabilitation. CONCLUSION: There is evidence in the literature of 47 interventions used by various rehabilitation professionals in the acute rehabilitation of neuro-oncological patients. However, most of these interventions are evidence level II and III. Four interventions (virtual reality, mirror therapy, robotic upper extremity training to improve function, and cognitive group therapy) are not included in the ICHI. The problems analysed in the literature that are targeted by interventions often do not coincide with the purpose of the specific intervention or are too broadly defined and not specific. These findings emphasize the need for greater precision in describing and documenting interventions, as well as the importance of aligning interventions more closely with ICF categories, particularly in the domains of Activities and Participation. This work highlights the heterogeneity in the reporting of rehabilitation interventions, and the challenges in mapping them to standardized classifications, emphasizing the ongoing need for refining and updating these classification systems.