Research has demonstrated that everyday functional abilities are compromised in mild cognitive impairment (MCI), a transitional stage between normal cognitive aging and dementia, as well as in healthy aging. These functional changes have been shown to be strong predictors of future decline, highlighting their importance. However, early changes in everyday functioning remain poorly characterized, largely due to a scarcity of sensitive measures capable of detecting subtle disruption. Recent research suggests that eye-tracking methodology may be effective in addressing this gap. Fifty-two participants (27 younger adults and 25 non-demented older adults) completed a novel eye-tracking task involving passive viewing of a naturalistic scene and verbalization of a task goal (e.g., make coffee, pack a lunch). Participants also completed a performance-based measure of everyday action that required them to enact the same tasks (e.g., coffee, lunch) that were included in the eye-tracking paradigm, self-report measures of functional ability, and neuropsychological measures. Mixed ANOVAs were conducted to examine group (young, old) and condition (passive viewing, verbalization)/task (simple, complex) effects on eye-tracking and everyday action performance. Independent samples t-tests/Mann-Whitney U tests were conducted to examine group differences in eye-tracking and everyday action performance. Correlation analyses across all measures were conducted to evaluate the potential mechanisms of eye-tracking and everyday action results. Results showed no significant group differences in the primary eye-tracking variables, but both groups made a lower proportion of fixations to distractor (i.e., non-target) objects during task verbalization compared to passive scene viewing. Older adults made more inefficient actions during performance-based everyday task completion, particularly when task demands were high. Eye tracking and everyday action variables were related to different measures of self-reported functional ability. Finally, eye-tracking variables were primarily related to neuropsychological measures of executive functions/working memory, whereas everyday action performance was most strongly related to measures of verbal learning and memory. These findings suggest that age-related functional changes at the level of eye movements may occur after changes in behavioral performance of everyday tasks. Importantly, performance-based assessment of everyday action appears sensitive to age-related decline. Additionally, naturalistic eye movements and everyday task performance may reflect distinct components of self-reported functioning and may be driven by distinct cognitive processes. Future research with refined naturalistic eye-tracking tasks and samples with a wider range of impairment is necessary to further explore these findings and improve characterization and detection of risk for dementia. / Psychology

Syftet för föreliggande studie var att undersöka olika sätt att organisera primärvårdens om- händertagande av patienter med psykisk ohälsa och hur det påverkar patienters nöjdhet med vården. Studiens frågeställningar syftade att undersöka 1) skillnader i nöjdhet mellan patienter som erbjuds sedvanlig Integrerad Beteendehälsa (IBH) med Brief Interventions (BI) och de som får utökad bedömning med vägledd självhjälp 2) om patienters vardagliga funktion förbättras och om förbättringen har ett samband med deras upplevelse av nöjdhet 3) hur vanligt negativa upplevelser är inom behandlingsmetoderna. Av 41 randomiserade primärvårdspatienter kunde 30 analyseras utifrån deras upplevda nöjdhet inom vården. Båda grupperna var i genomsnitt nöjda med vården och skattade besöken som hjälpsamma. Patienter som efter utökad bedömning fick vägledd självhjälp skattade tidigt i behandlingen högre grad av nöjdhet och den skillnaden kvarstod. Det fanns en signifikant förändring av vardaglig funktion till det bättre för patientgruppen som helhet, men förändringen korrelerade inte signifikant med nöjdhet. Det fanns en tydlig skillnad i antal rapporterade negativa upplevelser. 14 negativa upplevelser rapporterades av patienter som fått Brief Interventions, medan en negativ upplevelse rapporterades av patienterna som fått vägledd självhjälp. Slutsatser från föreliggande studie bekräftar tidigare forskning kring att nöjdhet går att uppfylla med kortare behandlingsinterventioner samt strukturerade behandlingar. / The purpose of the present study was to examine different ways of organizing primary care for patients with general mental disorders, and how the treatment affects the patient’s satisfaction with the care. The study aimed to examine 1) if there is a difference in patient satisfaction between patients offered brief interventions within the primary care behavior health model, and patients offered an extended assessment with guided self help 2) if the patients everyday function improves and correlates with their experience of satisfaction 3) how common adverse events are within the two treatment methods. Out of 41randomized primary care patients, 30 could be analyzed based on their perceived satisfaction in health care. The result showed that both treatment groups were overall satisfied with the care and estimated the care visits as helpful. Patients who received guided self-help estimated a higher degree of satisfaction earlier in the treatment, and the level of satisfaction remained high throughout the treatment. Regarding the patient group as a whole, there was a significant change in everyday function; the patients improved their everyday function although it did not correlate with satisfaction. There was a significant difference in the number of adverse events between the two treatment groups. 14 adverse events were reported from patients who received Brief Interventions and 1 adverse event was reported from a patient who received guided self-help. Conclusions from the present study confirm findings from previous research that it is possible to achieve patient satisfaction with brief treatment interventions and structured treatment plans.