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La enfermedad de cáncer es uno de los principales problemas sociosanitarios en el mundo. El envejecimiento de la población española unido a las altas tasas de supervivencia de pacientes con cáncer hacen que el número de cententarios en nuestro país aumente. El diagnóstico y el proceso evolutivo de la enfermedad genera situaciones de discapacidad y dependencia en el paciente enfermo que afectan a este mismo, pero también a la dinámica familiar. La familia es uno de los principales sustentadores de cuidado del paciente enfermo, el rol del cuidador principal recae comúnmente en género femenino en primer grado de consanguinidad como así lo avala la presente investigación. Estos cuidadores pueden presentar carga obejtiva y subjetiva en el cuidado del paciente enfermo. La Ley de Dependencia resulta insuficiente en su aplicación y tardía en la concesión de ayudas. La disciplina de Trabajo Social debe ser garante de dignidad en el paciente enfermo y en el cuidador principal, adelantándose a futuros acontecimietnos de necesidades sociales derivadas de la enfermedad oncológica.

Abstract Background Everyday cognition is the application of basic cognitive skills and knowledge of the specific cognitive domain for the resolution of problems that are integrated within the instrumental domains of functioning. The main objective is to evaluate the effectiveness of a Training Programme in Everyday Cognition in order to improve the levels of everyday cognition and global cognitive performance in older adults. Methods A randomised controlled trial of two groups. The sample was composed of healthy older adults. The intervention of the experimental group consisted of an Everyday Cognition Training Programme, and the intervention of the control group consisted of a Conventional Cognitive Training Programme. The Rapid Assessment of Cognitive Functions test (ERFC) and the Everyday Cognition Battery test (ECB) were used to assess the intervention. Results Total sample (n = 237) composed of 44 men and 223 women, with a mean age of 73.45 years. Statistically significant differences (p

RESUMEN La cognición cotidiana consiste en la aplicación de las habilidades cognitivas básicas y el conocimiento del dominio específico para la resolución de problemas que se integran dentro de los dominios instrumentales de funcionamiento. Para valorar la cognición cotidiana, existen evaluaciones que presentan problemas cotidianos cognitivamente desafiantes, pertenecientes a actividades instrumentales, cuyo objetivo es evaluar el funcionamiento cognitivo dentro de estos dominios en el mundo real. Objetivo principal: Analizar la diferencia existente entre la realización de programas de estimulación cognitiva tradicionales y programas de intervención directa en cognición cotidiana. Metodología: Estudio experimental, aleatorizado, estratificado, prospectivo, longitudinal mediante un esquema de asignación fija con grupo experimental y grupo control. La población a estudio fueron adultos mayores sanos de la ciudad de Salamanca que participaron en los programas de terapia ocupacional. La intervención constó de un programa específico de estimulación en cognición cotidiana. Para la evaluación se utilizó la ERFC (evaluación rápida de las funciones cognitivas) para medir la función cognitiva global y la ECB (Everyday Cognition Battery) para medir la cognición cotidiana. Resultados: Muestra total de pacientes (n = 147) compuesta por 19 hombres y 128 mujeres, con una edad media de 75 años. Se observaron diferencias estadísticamente significativas (p < 0,001) en la variable ECB, así como diferencias estadísticamente significativas (p < 0,05) en los ítems “total”, “cálculo”, “razonamiento”, “comprensión” y “reconocimiento visual”. Conclusiones: La utilización combinada de estimulación cognitiva tradicional y entrenamiento en cognición cotidiana presenta mayores beneficios en términos de cognición cotidiana que la utilización exclusiva de estimulación cognitiva en adultos mayores.

RESUMEN La cognición cotidiana consiste en la aplicación de las habilidades cognitivas básicas y el conocimiento del dominio específico para la resolución de problemas que se integran dentro de los dominios instrumentales de funcionamiento. Para valorar la cognición cotidiana, existen evaluaciones que presentan problemas cotidianos cognitivamente desafiantes, pertenecientes a actividades instrumentales, cuyo objetivo es evaluar el funcionamiento cognitivo dentro de estos dominios en el mundo real. Objetivo principal: Analizar la diferencia existente entre la realización de programas de estimulación cognitiva tradicionales y programas de intervención directa en cognición cotidiana. Metodología: Estudio experimental, aleatorizado, estratificado, prospectivo, longitudinal mediante un esquema de asignación fija con grupo experimental y grupo control. La población a estudio fueron adultos mayores sanos de la ciudad de Salamanca que participaron en los programas de terapia ocupacional. La intervención constó de un programa específico de estimulación en cognición cotidiana. Para la evaluación se utilizó la ERFC (evaluación rápida de las funciones cognitivas) para medir la función cognitiva global y la ECB (Everyday Cognition Battery) para medir la cognición cotidiana. Resultados: Muestra total de pacientes (n = 147) compuesta por 19 hombres y 128 mujeres, con una edad media de 75 años. Se observaron diferencias estadísticamente significativas (p < 0,001) en la variable ECB, así como diferencias estadísticamente significativas (p < 0,05) en los ítems “total”, “cálculo”, “razonamiento”, “comprensión” y “reconocimiento visual”. Conclusiones: La utilización combinada de estimulación cognitiva tradicional y entrenamiento en cognición cotidiana presenta mayores beneficios en términos de cognición cotidiana que la utilización exclusiva de estimulación cognitiva en adultos mayores.

Abstract Introduction Ageing entails a series of neuroanatomical and neurophysiological changes in some cognitive processes that directly affect the daily life and autonomy of a person. We believe it is necessary to have tools that assess the cognitive functions that are essential for carrying out daily activities in an independent manner. The aim of this study was to translate the Everyday Cognition Battery (ECB) into Spanish, adapt it to the sociocultural context of Spain, and validate it by testing the psychometric properties, i.e., the reliability and validity of the translated version. Methods The translation and adaptation of the ECB into Spanish was carried out following the method recommended by Beaton et al., the process concluding with a pilot test to ensure that subjects were able to understand the scale correctly. Between March and October 2019, the study population voluntarily completed the translated version of each of the four subscales that make up the battery of tests. The translated version was validated by analysing its psychometric properties, using reliability or internal consistency tests assessed with Cronbach’s alpha coefficient and validity tests analysed using correlation tables and Spearman’s correlation coefficient. The scale considered to represent the gold standard in the assessment of cognition was the Rapid Assessment of Cognitive Functions (RACF), and to assess Instrumental Activities of Daily Living (IADL) this was the Lawton and Brody Index. Results The total study population included 226 subjects, of which 52 participants were excluded, resulting in a study sample size of 174 older adults. The recognition, inductive reasoning and computation span tests showed good reliability (Cronbach’s alpha coefficient of > 0.827, > 0.836, and > 0.823, respectively), while the knowledge test showed questionable reliability with a Cronbach’s alpha coefficient of > 0.615. The validity analysis demonstrated that all the combinations of correlations of the different scales were significantly and positively related to one another. Conclusions The Spanish version of the ECB tool is socially and culturally equivalent to the original version, and both its validity and reliability for assessing everyday cognition in older adults have been demonstrated.

BackgroundAgeing entails changes in complex cognitive functions that lead to a decrease in autonomy and quality of life. Everyday cognition is the ability to solve cognitively complex problems in the everyday world, enabling instrumental activities of life. Benefits have been found in studies using everyday cognition-based assessment and intervention, as the results predict improvements in everyday performance, not just in specific cognitive functions. A study protocol is presented based on assessment and training in everyday cognition versus traditional cognitive stimulation for the improvement of functionality, emotional state, frailty and cognitive function.MethodsA parallel randomised controlled clinical trial with two arms will be conducted. It will be carried out by the University of Salamanca (Spain) in eleven centres and associations for the elderly of the City Council of Salamanca. People aged 60 years or older without cognitive impairment will be recruited. Participants will be randomly distributed into two groups: the experimental group will undergo a training programme in everyday cognition and the control group a programme of traditional cognitive stimulation, completing 25 sessions over 7 months. All participants will be assessed at the beginning and at the end of the intervention, where socio-demographic data and the following scales will be collected: The Medical Outcomes Study (MOS), Questionnaire ARMS-e, Everyday Cognition Test (PECC), Scale Yesavage, Test Montreal Cognitive Assessment (MoCA), The Functional Independence Measure (FIM), Fragility Index and Lawton y Brody Scale.DiscussionThe present study aims to improve conventional clinical practice on cognitive function training by proposing a specific assessment and intervention of everyday cognition based on the importance of actual cognitive functioning during the resolution of complex tasks of daily life, giving priority to the improvement of autonomy.Trial registrationClinicalTrials.gov; ID: NCT05688163. Registered on: January 18, 2023.

Abstract Background The increase in the survival of oncology patients include multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. An implementation of the conventional clinical practice, developed through multimodal physical exercise and functional rehabilitation program intervention, may be useful in controlling dyspnoea. This study aims to evaluate the effects of a multimodal exercise and functional rehabilitation program on fatigue, pain, functional capacity, and quality of life in cancer patients with cancer-related asthenia. Methods This is a protocol for an experimental, prospective, randomised study using a parallel, fixed assignment scheme, with an experimental group and a control group in patients from the oncology hospitalisation unit at the Salamanca University Hospital Complex in Spain, using consecutive sampling to select 50 participants with oncological asthenia who are hospitalised at the time of inclusion. After the baseline evaluation, the participants will be randomised into two groups. Both groups will receive standard clinical practice care and the normal health education program at discharge, but in addition, the participants assigned to the experimental group will also complete a multimodal exercise and functional rehabilitation program lasting one month. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of asthenia (FACT-An scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the attention and executive functions (Trail-Making Test), fear/avoidance of movement (TAMPA scale), pain (VAS scale), and body composition (waist, hip, brachial, thigh, wrist, and ankle circumferences). Discussion The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with asthenia. The current study addresses to improve the conventional clinical practice by proposing a multimodal physical exercise and functional rehabilitation program intervention, which will be implemented by an interdisciplinary team, to try to improve the autonomy of cancer patients with cancer-related asthenia. Trial registration ClinicalTrials.gov; ID: NCT04761289. (February 18, 2021). https://clinicaltrials.gov/ct2/show/ NCT04761289.

Abstract Background Survival in cancer patients has increased exponentially in recent years, with multiple side effects caused by treatments. Cancer-related asthenia and dyspnea are among them, which represent a serious health problem, with considerable limitations and reduced quality of life. An implementation of the conventional clinical practice, developed through physical exercise, may be useful in controlling dyspnoea. This study aims to compare the effects of a comprehensive rehabilitation implementing a programme of multimodal physical exercise with a specific autonomy recovery programme, versus an isolated intervention using the physical exercise programme alone, on the functionality, physical performance and respiratory parameters in oncologycal patients with dyspnea. Methods This is a protocol por an experimental, prospective, randomized, parallel-controlled clinical trial, with two arms design of fixed assignment with an experimental and control groups. It will conduct in the Oncology Hospitalisation Unit at the University Hospital Complex of Salamanca, using consecutive sampling to select 50 participants with oncological dyspnoea who are hospitalised at the time of inclusion. After baseline assessment, participants will be randomised into the groups. Experimental group will complete Comprehensive Rehabilitation with the autonomy recovery and the multimodal exercise programmes, and in the control group, only the multimodal exercise programme will be carried out. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of dyspnoea (MRC scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the oxygen saturation in the blood using pulse oximetry, fear/avoidance of movement with the Tampa Scale of Kinesiophobia (TSK), and the quality of life of the oncology patient (ECOG performance scale). Discussion The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with dyspnoea. Increase in the survival of patients with cancer includes multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. The current study addresses to improve the conventional clinical practice by proposing an integral, rehabilitative approach, to implement education and training for oncology patients with dyspnea to increase their quality of life. Trial registration ClinicalTrials.gov; ID: NCT04766593 . (February 23, 2021).