Biomedical subjects

Ieke Winkens

Publications and source records attributed to Ieke Winkens.

4 recordsLinked to original sources

PubMed2006

Manifestations of mental slowness in the daily life of patients with stroke: A qualitative study.

OBJECTIVE: To explore the consequences of mental slowness in the daily life of patients with stroke. DESIGN: In a cross-sectional survey semi-structured interviews were completed. Interviews were transcribed and coded by two independent reviewers. Qualitative analysis was done by means of the 'constant comparison method'. SETTING: Three rehabilitation centres in the Netherlands. PARTICIPANTS: A convenience sample of 13 patients with stroke, suffering from mental slowness, was derived from December 2003 to May 2004. MAIN OUTCOME MEASURES: Interview descriptions of the everyday consequences of mental slowness. RESULTS: Patients experienced many problems in daily life due to mental slowness. These could be divided into two main groups: (1) problems in cognitive functioning; (2) psychological and somatic complaints. In response to these problems, some patients mentioned the use of compensation strategies in order to reduce the demands on their information processing capacity. CONCLUSIONS: Mental slowness in cognitive functioning affects a wide range of activities, causing emotional symptoms in many patients and stimulating the spontaneous use of compensation strategies in some patients.

Activities of Daily Living↗

PubMed2004

Cognitive functioning after stroke: a one-year follow-up study.

Cognitive disorders after stroke are one of the main causes of disability in daily activities. The main aim of this study was to investigate the frequency of post-stroke dementia, post-stroke mild cognitive impairment (MCI) and post-stroke amnestic MCI at different times after first-ever stroke; 196 patients were included in the study. In addition, cognitive disorders and their clinical course were studied. Frequency of post-stroke dementia was about 10% at all evaluation times; most patients had post-stroke MCI. Of the cognitive functions investigated, mental speed and calculation were most frequently affected. Performance on almost all cognitive tests was improved 6 and 12 months after stroke. Thus, while the frequency of post-stroke dementia is low, the frequency of post-stroke MCI is high, but improvement of cognitive function is possible.

Activities of Daily Living↗

PubMed2004

Do caregiver management strategies influence patient behaviour in dementia?

OBJECTIVES: Little is known about the effectiveness of caregiver management strategies on the functioning of the demented patient. However, identification of specific caregiver strategies may provide useful information on the management and manifestation of behavioural problems in dementia. METHODS: Ninety-nine patients with dementia and their informal caregivers were followed up for one year. Interviews were used to assess differences in caregiver management strategies. Behavioural disturbances in the patient were measured with the Neuropsychiatric Inventory (NPI). Repeated measures analysis were carried out to investigate the relationship between caregiver management strategies and patient behaviour. RESULTS: Three caregiver management strategies were identified, based on whether caregivers accepted, or not, the caregiving situation and dementia related problems. Caregivers characterized by non-acceptance were typified as 'Non-adapters'; caregivers characterized by acceptance were further subdivided into two groups typified as 'Nurturers' and 'Supporters'. Caregiver characteristics such as sex, education and personality were important determinants of management strategies. MANOVA showed that non-adapters reported significantly more hyperactivity symptoms in patients and felt less competent than did supporters. CONCLUSIONS: Caregiver management strategies would appear to be associated with behavioural problems in dementia, and are important in predicting patient behaviour and caregiver burden. Intervention programmes should aim at teaching caregivers adequate management strategies.

Adaptation, Psychological↗

PubMed2003

Behavioural disturbances in dementia patients and quality of the marital relationship.

OBJECTIVES: To investigate the relationship between behavioural problems in patients with dementia and changes in the marital relationship. METHODS: Fifty-three spouse caregivers of patients with dementia participated in the study. Questionnaires and interviews were used to examine caregiver perception of changes in the quality of their relationship. Behavioural disturbances in the patient were measured with the NeuroPsychiatric Inventory (NPI). RESULTS: Caregivers experienced a deterioration of their relationship, yet at the same time most felt closer to their spouse now than in the past. Regression analysis revealed that patient behavioural problems were, independent of patient cognitive status or functional impairment, associated with deterioration in the quality of the relationship between patient and caregiver. Patient apathy rather than depressive mood was associated with this deterioration. Apathy diminished the amount and reciprocity of interactions between partners. CONCLUSIONS: These results show that passive behaviour rather than excessive behaviour has most impact on the deterioration of the marital relationship. Intervention programmes should target relationship problems when problem behaviour, especially apathy, is present in patients with dementia.

Aged↗