bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of intermediate care: The carer's perspective
Authors: Reid Gaynor Ann , Hulme Claire 
Published: May 2014

Aims: The worldwide phenomenon of an ageing population has considerable consequences for health and health care; leading to greater demand for long-term care and support from families for older relatives. In the UK this, together with the preference for dependent older people to be cared for in the community, has led to the growth of intermediate care services (ICS) that bridge hospital and home offering rehabilitation and care. However, there has been limited in-depth exploration of carer perspectives of these services. This study therefore aimed to explore the impact of ICS on informal carers. Methods: An overview of UK Government policy on carers is provided to set the context. Qualitative semi-structured interviews, which explored participants’ lives as carers, their daily routine and what caring meant to them, were conducted with 19 informal carers within one ICS in north-west England. Findings: The ICS was not viewed in isolation; the impact of the ICS on the carer depended on previous experience and quality of health care, involvement in the decision making process, expectations and communication. Conclusions: A whole systems approach should be encouraged to increase awareness of carers’ experiences and the lasting impact negative experiences can have.
The assistant practitioner: A professional project
Authors: Adams Caroline 
Published: May 2014

Background: Since the beginning of the 20th century, there has been much academic interest in the subject of the professional. Newly emerging professions or those belonging to emerging tiers of professional status—;such as the assistant practitioner—;may be unaware of the current rhetoric concerning de-professionalization or re-professionalization of health-care practitioners. In the case of radiography, the additional project of professionalizing the assistant practitioner has been troublesome in regard to its scope of practice. The supervising practitioners (radiographers) may have regarded their emergence only as a labour market strategy, which in turn would have caused assistant practitioners to feel disempowered. Content: This article takes the role of the assistant practitioner as a case study to highlight issues of hegemony within the profession of radiography in the UK. The history of radiography, through which the role of the assistant practitioner and its scope of practice evolved, is fi rst examined. Concepts of professionalization, and issues of knowledge, control and division of labour are then explored. Conclusions: It is suggested that the protected title of Radiographer may need to be explored in light of the reconsideration of values and movement of tasks. The author suggests that the title should be subdivided to incorporate both Practitioner and Assistant Practitioner in Radiography; in order to empower the assistant practitioner in their role.
Motivational interviewing in vocational rehabilitation for people living with mental ill health
Authors: Lloyd Chris , Tse Samson , Waghorn Geoff , Hennessy Nicole 
Published: May 2014

Background: People living with mental ill health are among the most socially and economically marginalized members of the community. Unemployment rates are high and suitable support to return to work may not always be available. Motivational interviewing (MI) is a focused method of communication that was originally developed to assist counsellors in the treatment of problem drinking. However, more recent applications have demonstrated success with a variety of health conditions and problem behaviours. MI helps clients identify and change behaviours that may be preventing them from achieving optimal life goals, for instance, returning to paid employment. Content: This article gives an overview of the MI approach and highlights key research to date in the field. The vocational expectations of mental health service users and barriers to achieving them are examined. The potential for using MI in vocational rehabilitation with people living with mental ill health is then explored. Conclusions: A successful return to work can help people regain a lost sense of purpose and identity, which is crucial to achieving optimal life goals. It is proposed that motivation for work can be clarified and enhanced by the skilled application of a MI technique. Further work and research in this area is needed.
Review of upper limb ability assessments in acute stroke care, from a practice perspective
Authors: Rowland Tennille J , Gustafsson Louise , Henderson Robert D , Turpin Merrill , Read Stephen J 
Published: May 2014

Aims: The purpose of this study was to compare three upper limb ability assessments - the Action Research Arm Test (ARAT), Arm Motor Ability Test (AMAT), and Chedoke Arm and Hand Activity Inventory (CAHAI) - in acute stroke occupational therapy practice during a 6-month period, to identify whether any or all were appropriate for use in acute stroke care. Methods: Medical records of clients with stroke admitted to an acute stroke unit were reviewed retrospectively. Inclusion criteria were: (a) admission between March and August 2006, (b) new diagnosis of stroke, (c) upper limb involvement, and (d) assessed by an occupational therapist with ARAT, AMAT or CAHAI. Included records were reviewed and the following noted: diagnosis, upper limb weakness, gender, age, assessment score, when assessed, time to administer, test items completed, and qualitative notations. Findings: Thirty three records satisfied the inclusion criteria. A range of stroke subtypes were assessed. The mean ARAT score was 21.4/45, CAHAI was 66.5/91 and AMAT was 3.0/5. The median number of days post-stroke when assessed was 9 days. Conclusions: Overall, ARAT, CAHAI and AMAT were useful for assessment of upper limb ability. The results cannot specifically identify which assessment is most suited to the acute stroke setting. The findings do support the inclusion of ARAT, CAHAI and AMAT in standard clinical care.
The evolution of a state-wide continuing education programme for allied health professionals
Authors: MM Schoo Adrian , E Stagnitti Karen , P McNamara Kevin 
Published: May 2014

Allied health professionals require continuing education (CE) to maintain and improve competencies and standards of care. Research suggests that professional access to CE in rural areas can be difficult. This article uses an action research framework to describe the development and implementation of a CE programme for allied health professionals in a rural area in Australia, and its subsequent evolution into a state-wide programme. To evaluate programme relevance, attendance and perceived clinical relevance, physiotherapists (n = 75) in southwest Victoria were surveyed 1 year after commencement of a CE programme. A secondary outcome was the perceived effect on clinical practice. More than two-thirds (68.6%) of physiotherapists attended at least one workshop, 57.2% attended four or more sessions and 22.9% attended at least one of the two conducted courses over the period. In addition, 20% of the physiotherapists perceived that attending the programme had a large positive effect on their therapeutic skills, whereas 68.6% reported some effect. From a regional CE programme for physiotherapists the programme evolved into a state-wide programme for 22 allied health professions.
Information provision during stroke rehabilitation: The health professional's perspective
Authors: Gustafsson Louise 
Published: May 2014

Education in chronic conditions such as stroke aims to improve self-management skills. Previous research has informed health professionals about the information needs of clients with stroke and their carers, and suggested methods for information provision. This article will briefly review the evidence in this area and present findings from a study which investigated the clinical practice and views on information provision of stroke rehabilitation team members. Sixty-seven health professionals working in the inpatient or outpatient stroke rehabilitation settings of six major hospitals completed a questionnaire on information provision. Information topics that were conveyed by the majority of participants to both clients and their carers included what to expect in rehabilitation, recovery after stroke, treatment after stroke, and community services. Participant responses were similar for clients with stroke and their carers during both inpatient and outpatient rehabilitation. The participants were aware of the ideal methods of information provision but cited factors relevant to the team and organization as barriers to effective practice. Health professionals are finding it difficult to achieve ideal practice for information provision in stroke rehabilitation. The identification of key team members who are responsible for identifying individual information needs and coordinating delivery of the education programme may be beneficial and requires further evaluation.
Qualitative research: Part two - Methodologies
Authors: Nicholls David 
Published: May 2014

Background There are still many practitioners, academics and researchers who are bemused by the principles and practices of qualitative research. The second paper in this three part series on qualitative research explores the important question of research methodologies. Content Focusing on four of the more common methodologies – phenomenology, grounded theory, ethnography and discourse analysis – the article shows how each represents a distinctively different view of reality (a feature of qualitative research that was unpacked in the first article in the series). Conclusions These methodologies are then used to highlight some of the fundamental methodological differences between quantitative and qualitative research. Having set down these principles, I move on, in the third article, to discuss qualitative methods of data collection and analysis.
Pilot study evaluating fear of falling and falls among older rolling walker users
Authors: Liu Hao , Grando Victoria , Zabel Reta , Nolen Jeff 
Published: May 2014

Aims Fear of falling is considered a risk factor for falls. Walkers are commonly used by older adults for enhancing mobility. This study aimed to investigate the level of fear of falling in terms of the Falls Efficacy Scale, how that level is associated with fall frequency, and how walkers were used among older walker users. Methods Forty two qualified older adults completed the Falls Efficacy Scale and a questionnaire concerning walker use and history of falls in the last 12 months. Their walkers were assessed for appropriate use and maintenance. Findings Fifteen subjects (36%) fell at least once after beginning to use a walker, but the number of falls did not correlate to the duration of walker use. A moderate positive correlation existed between Falls Efficacy Scale scores and the number of falls. Assessments of the walkers showed that the most common misuse was lack of medical consultation in obtaining a walker, followed by incorrect walker height, forward-leaning posture during ambulation. However, the most significant difference (P<0.05) between the fallers and the non-fallers was only identified in poor posture problems. Conclusions Inappropriate use of a walker, especially the forward-leaning posture, may be associated with the falls. Falls may increase the fear of falling in older walker users. Clinicians including physicians, therapists, and nurses should possess knowledge to instruct older adults on appropriate walker use.
Upfront and enabling: Delivering specialist multidisciplinary neurological rehabilitation
Authors: Ross Denise , Heward Kate , Salawu Yomi , Chamberlain M Anne , Bhakta Bipin 
Published: May 2014

Aims In the acute hospital setting, rehabilitation issues arising from neurological complications in patients on the medical and surgical wards are common. This article describes the work of one multidisciplinary, highly expert neurological rehabilitation team, which is available to advise and treat patients in a large teaching hospital in the UK, during one calendar year. Methods The development of the service, its staff and the interventions that the team employs are described. A review of the data from medical records of all patients referred to the team in the period 1st January to 31st December 2006 is then presented. These data were anonymised and extracted from patient notes using a standardized proforma, and include information on referral, initial diagnosis, rehabilitation interventions and subsequent discharge/transfer. Findings Sixty-one patients were seen. Their age ranged from 15 to 87 years with equal gender distribution. The dominant users of the team were surgery, respiratory medicine, intensive care and infectious diseases. Fifteen patients presented with new neurological conditions and 17 patients developed neurological conditions during their inpatient stay (stroke, critical care illness and other rare diagnoses). Twenty-nine patients had established neurological disabilities, and the enforced inactivity of admission threatened their precarious independence. Conclusions The team was instrumental in addressing key quality requirements of the UK National Service Framework for people with Long Term Neurological Conditions. Their contribution to better discharges, earlier discharges and the patients' ‘quality of life’ was viewed by staff involved with the patients as significant. Further rigorous research is required to quantify these improvements further.
Improving practice through involvement in action research
Authors: Spalding Nicola J 
Published: May 2014

Background This article presents an action research project as a case study to highlight the attributes of this approach in evaluating a health-care intervention, for the purpose of improving it. The action research was undertaken with a group of health-care professionals who wanted to improve a preoperative education programme for patients awaiting a total hip replacement. Content Descriptive detail is provided on the process and justification for action research in this context. The findings and discussion focus on the author's reflections on using action research, rather than the findings in respect of preoperative education. Integral to the action research was the involvement of the health-care professionals. Challenges arose during the research planning which had the potential to undermine the research purpose, but these were addressed to ensure the healthcare professionals were fully involved. Being involved in the action research enabled the health-care professionals to work together for a collective goal of improving their service. Significantly, the action research facilitated their reflections as a means of evaluating and improving their practice. Conclusions Many improvements were made as a result of the action research. These improvements were seen to have three dimensions: improvement in the health-care professionals' theoretical understanding, improvement in their own teaching practices, and improvement in their service outcomes.
Moving and handling rehabilitation patients: A survey of nurses' views
Authors: Kneafsey Rosie , Haigh Carol 
Published: May 2014

Aims This article reports on a UK national questionnaire survey to explore nurses' views in relation to the handling of rehabilitation patients. Methods 3205 questionnaires were distributed via the Royal College of Nursing Rehabilitation and Intermediate Care Nurses Forum and the UK Stroke Nurses Network national conference. Findings Questionnaires were returned by 501 nurses (a response rate of 15.6%); 83.6% of respondents were confident in their patient handling skills. Respondents valued physiotherapy knowledge and were committed to teamwork in relation to patient handling. ‘No lifting’ policies were reported to be in use in the workplaces of 77.6% of respondents, and 33.4% of these respondents felt the policies interfered with rehabilitation. There was an equal number of respondents who agreed that manually helping patients to stand or transfer helps them to regain more mobility than if an aid were used (40.2%), and who disagreed (40.2%). The majority of nurses (64.9%) stated that manual handling was more physically tiring than using a mechanical aid, and 60.9% of nurses reported that they had put themselves at risk to promote rehabilitation. Conclusions Nurses in this study valued their role in supporting patients with mobility and movement problems and were positive about teamworking as a way to facilitate this. However, further observational research is needed to explore the actual nature of multiprofessional teamworking in relation to patient handling. Nurses should view all patient handling activities as a rehabilitation opportunity and managers should ensure that nurses have access to the full range of patient handling equipment needed to facilitate rehabilitation.
Guillain-Barré syndrome: An update in rehabilitation
Authors: Khan Fary , Ng Louisa 
Published: May 2014

Background Guillain-Barré syndrome (GBS) is an autoimmune mediated polyradiculoneuropathy which causes acute neuromuscular paralysis and ventilatory failure. It mainly affects young adults, and most patients (80%) make a good recovery; being ambulant again at 6 months post-onset. However, residual deficits can cause significant long-term disability, which impacts on activities of daily living, work, social activities, and health-related quality of life. Content This article provides an overview of the aetiology, pathogenesis and clinical presentation of GBS. Current evidence regarding use of outcome measures and the symptomatic and rehabilitation treatment for adult GBS survivors is outlined. Issues impacting on rehabilitation are also discussed, including complications as a result of immobility, autonomic dysfunction and deafferent pain syndromes. Conclusions GBS is a complex and challenging condition that requires integrated and coordinated health-care delivery and services. Rehabilitation is aimed at improving a person's functional ability in daily living tasks and social reintegration. However, evidence for many rehabilitation treatments is currently lacking. Outcome measurement for disability in this group is also limited and not well quantified. The longer term impact of disability in GBS survivors and ‘aging’ effects are not well understood. Further research in these areas is therefore required.
An overview of cohort study designs and their advantages and disadvantages
Authors: Morrow Brenda 
Published: May 2014

Background Cohort studies are analytical observational research studies which follow groups (cohorts) of subjects forward in time from an exposure to an outcome/s. Rigorous cohort studies provide the best scientific evidence of all the observational research designs. Contents This paper provides an overview of the definition, design, analysis, interpretation, advantages and disadvantages of cohort studies. Readers should appreciate the strengths, weaknesses and potential pitfalls of cohort studies when interpreting and applying results to clinical practice. Conclusions Cohort study designs should be considered when RCT are not possible or practical for ethical, logistical, or financial reasons. When properly designed and interpreted, links between exposures and outcomes (including an indication of causality) can be made.
The use of interactive formative assessments with first-year occupational therapy students
Authors: Mui Lim Sok , Rodger Sylvia 
Published: May 2014

Aims The literature suggests that the effective use of formative assessments enables timely and constructive feedback to be provided to students, leading to enhanced learning. In this article, the effect of the combined use of different interactive formative assessments during large group tutorials was investigated. Methods This study was carried out in 2009, and involved 115 first-year occupational therapy university students. Game-show quizzes involving the use of audience response system took place during the tutorials to enhance student engagement. Collaborative group testing where quizzes were presented individually, then in groups, was also used. Each student involved was asked to generate questions and answers that contributed to the quizzes and their exam. To examine the influence of interactive formative assessments, two methods of data analysis were used. First, a comparison of the 2009 cohort's exam results with those of the previous year's equivalent students and second, a qualitative analysis of students' completed evaluation questionnaires. Findings When compared to the previous year's cohort, there was a significant difference in the students' exam results (p<0.001). Qualitative descriptive analysis of evaluation questionnaires suggested that students perceived the interactive formative assessments as engaging, and assisted them in identifying knowledge gaps and focusing their exam revision. Conclusions Interactive formative assessments presented in this study led to enhanced learning and were viewed by the students as being fun and engaging, as well as providing immediate feedback.
Training characteristics important for growing consciousness of joystick-use in people with profound cognitive disabilities
Authors: Nilsson Lisbeth , Nyberg Per , Eklund Mona 
Published: May 2014

Aim The Driving to Learn project focused on people with profound cognitive disabilities and their possible achievements from practicing joystick-use in a powered wheelchair. The aim of this study within the project was to statistically analyse the participants' outcomes, and to explore factors, in terms of participant and training characteristics, associated with a favourable outcome of training joystick-use. Methods In this study, previously collected and analysed data and findings from 45 participants (aged 12 months to 52 years) were used to extract participant and training characteristics. Associations between participant and training characteristics and the participant's outcome of joystick-use were calculated. Results The results showed that training characteristics were decisive for reaching steering control, whereas participant characteristics were not. Factors significantly associated with participant's reaching ‘control of steering’ were: taking part in more than 30 training sessions (p=0.004), training at two or more training venues (p=0.007), undergoing a training period longer than two years (p=0.016), and a high degree of training with professional trainers (p=0.045). Conclusions Appropriate training characteristics assisted growing consciousness of joystick-use in people with profound cognitive disabilities. Findings from the project also include the identification of an eight-phase process of growing consciousness of joystick-use and the development of a tool for assessment of phases, which were used to measure the participants outcome.