bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Evaluation of the Consumer Recovery Satisfaction Survey
Authors: Henderson Anthony , Coall David , Lillee Alyssa , Isaac Mohan , Janca Aleksandar 
Published: May 2014

Objective: The purpose of this study was to develop and evaluate a consumer satisfaction instrument for its psychometric properties and utility as part of a mental health rehabilitation service's quality improvement strategy. Methods: The instrument was developed and evaluated qualitatively using the Nominal Group Technique and quantitatively using factor analysis and Structural Equation Modelling. Findings: The study resulted in the development of Consumer Recovery Satisfaction Survey (CRSS), an instrument with strong psychometric properties. Discussion: Satisfaction survey instruments tend to be biased towards identifying what is important to an organization. Consumers, however, have different priorities and this was evidenced through their significant contribution to the development and evaluation of the CRSS. Conclusion: The CRSS is a standardized instrument that can be used with confidence as part of a mental health rehabilitation service's internal quality improvement programme as well as benchmarking against other organizations.
Perceptions of a client-centred approach among Slovenian occupational therapists
Authors: Krizaj Tanja , Hurst Jenni 
Published: May 2014

Aims: The aim of the study was to explore how Slovenian occupational therapists use a client-centred approach in their current clinical practice. Method: A generic qualitative approach was selected and twelve semi-structured interviews were completed to gain a deeper understanding of the use of a client-centred approach used by occupational therapists in the Slovenian health care system. A thematic analysis was used to analyse the data and identify the participants’ experiences. Findings: The majority of the participants perceived that the use of a client-centred approach was beneficial to the occupational therapy process. While they experienced factors that would facilitate the use of this approach they also identified challenges to implementation in their own practice settings. Their experience of the Slovenian health care system was that it was still strongly influenced by the medical model. Conclusions: All the participants expressed a willingness to incorporate a client-centred approach in their practice. They all identified the motivation of the individual occupational therapist and their willingness to undertake further education as essential. This study will inform and influence the development of this approach in occupational therapy practice in Slovenia.
Factors affecting myofascial pain pattern recognition in musculoskeletal therapists: an exploratory study
Authors: Kyte Derek , Rushton Alison , Eveleigh Gill 
Published: May 2014

Aims: To evaluate the ability of experienced musculoskeletal physiotherapists to recall and identify myofascial trigger point (MTrP) pain referral patterns associated with the cervical spine, and to determine the factors affecting myofascial pain pattern recognition in experienced musculoskeletal physiotherapists. Methodology: A questionnaire-based descriptive survey using mixed methods was employed. A specially constructed questionnaire was used in the study. Responses were subjected to descriptive, statistical, and thematic analysis. Results: Twenty-five experienced musculoskeletal (MSK) physiotherapists (mean qualification period=10.3 years, mean specialist MSK experience=7.52 years) took part in the study. 100% completed the questionnaire. The MTrP pattern recognition rate was 23.33%. Thematic analysis of the qualitative data revealed a number of factors that may help to explain this low rate within the study sample. Conclusions: This exploratory study highlights deficiencies in the ability of experienced musculoskeletal physiotherapists to recall and identify MTrP pain referral patterns associated with the cervical spine. Several factors were identified that may have contributed to the observed deficiencies in this area including: lack of education, knowledge and experience, difficulty with clinical recall, and notions surrounding clinical relevance.
Effects of Speech Therapy on Voice and Speech in Parkinson's After a 15-day Rehabilitation Course: A Pilot Study
Authors: Simberg Susanna , Rae Johanna , Kallvik Emma , Salo Benny , Martikainen Kirsti 
Published: May 2014

Background/Aims: Speech and voice symptoms appear in approximately 65-74% of patients with Parkinson's disease (PD), however, only a limited part of these patients seems to be referred to speech therapy. The purpose of the present study was to evaluate the effects of a two-part, 15-day rehabilitation course on speech and voice function in PD. Methods: Daily speech therapy sessions were provided both individually and in groups. Six participants with PD, and their spouses, participated in the study. Speech samples were recorded and they were analysed perceptually and acoustically. Additionally, the participants completed the Voice Activity and Participation Profile (VAPP). The spouses filled in a version of the questionnaire where they evaluated their spouses’ voice limitations and activity and participation restrictions. Findings: The results of perceptual assessment showed that the voice quality improved significantly both in the reading and the spontaneous speech samples. Also, acoustic analysis showed that average fundamental frequency and vocal range increased in the measurements made three months postonset of treatment. In addition, the results from the VAPP showed that the quality of life improved. Conclusions: This study provides indications that the participants benefit from the rehabilitation course and further studies are needed to evaluate the effects of this type of rehabilitation.
Application of a hermeneutic phenomenologically orientated approach to a qualitative study
Authors: Jones Fiona , Rodger Sylvia , Ziviani Jenny , Boyd Roslyn 
Published: May 2014

Background: Phenomenology enables researchers and clinicians to understand the lived experience of those affected by situations that are not easily measurable. This paper presents an example of the decision making undertaken to investigate the lived experience of adolescents with cerebral palsy in their transition to secondary school. The process engaged in undertaking this research is used as a means of highlighting key decision points when undertaking qualitative investigation of this kind. Study design: Hermeneutic phenomenologically orientated study Study participants/setting: Eleven parent-adolescent dyads of youth with cerebral palsy (8 males, 2 females, ages 12-14 years; Gross Motor Function Classification System (GMFCS) I=3, II=4, III=3, IV=1; Manual Abilities Classification System (MACS) I=5, II=2, III=4, IV=1, V=5; spasticity=10, dystonia=1; rural=1, regional=3, metropolitan=7). Methods: A step-by-step qualitative decision making pathway, including Colaizzi's methods, to facilitate investigation of the lived experience of adolescents with cerebral palsy was developed. Results: The paper presents four main phases in the decision making process required when designing or interpreting a qualitative research study, namely philosophy, methodology, research methods, and confirmation. Conclusions: A clear process in the construction of qualitative research has been developed. This should support researchers working in various fields of allied health and rehabilitation to investigate the experiences of service recipients where there is insufficient research to formulate hypotheses.
The development of media-driven clinical skills through using the ‘e-skills portfolio’
Authors: Stephens John , Parr Mike 
Published: May 2014

Background: The‘e-skills portfolio’ has been developed to give students the opportunity to engage in a creative approach to learning the distinctive core skills of: electrotherapy, manual therapy and therapeutic exercise. This paper aims to review the development and implementation of this e-skills portfolio within a pre-registration MSc physiotherapy programme. Content: Students work in small groups, and capture (through film or images) practice of clinical skills through simulation in the university setting. The analysis of the e-skills portfolio involved a pluralistic approach to: analysing data collected from two student discussion groups (n=21); reviewing submitted portfolio content; and teaching team reflections. Findings were then coded, and the emergent themes identified. Emergent themes from the data included assessment of skills and feedback, reflective practice, employment, continuing professional development through peer and self-coaching, and resource access. Conclusions: Engagement in compiling the e-skills portfolio appears to promote students' continuing professional development through a critical process of peer- and self-coaching and deliberate practice. This practice of using the e-skills portfolio is based within an adapted action research model, and appropriate learning support, particularly in IT, is a crucial element in this process.
Orthopaedic patient outcomes following interdisciplinary inpatient rehabilitation
Authors: Yan Kun , Pogoda Terri 
Published: May 2014

Aims: This study's primary aim was to identify factors associated with discharge disposition and length of stay (LOS) at an interdisciplinary inpatient rehabilitation unit for patients who underwent total knee arthroplasty/unilateral or bilateral knee surgery (TKA/KS) or total hip arthroplasty (THA). Methods: This was a retrospective medical chart review of 119 veterans receiving post joint replacement rehabilitation at a United States Department of Veterans Affairs Medical Center at an interdisciplinary inpatient rehabilitation unit between December 2008 and May 2010 following joint replacement surgery. Patient demographic, health/function, and outcome factors were abstracted. Findings: Approximately 96% of patients who received post joint replacement rehabilitation were discharged to a home setting. For every 1 point score increase on the Functional Independence Measurement (FIM) scale at discharge, patients were 1.29 times more likely to be discharged to home (95% CI=1.02–1.63; P<0.04), but this effect diminished after accounting for age. Older veterans had longer LOS. Discharge to a non-home setting following inpatient rehabilitation was associated with older age, lower functional independence at admission, and poorer functional gain between admission and discharge. Conclusions: Interdisciplinary inpatient rehabilitation is an effective transitional step from the surgical intervention to the home setting for veterans undergoing TKA/KS or THA.
Correlation between obesity and balance in school children
Authors: Sasidharan Abishek , Vijayappan Vijesh , Pillai Sithara , Khan Fayaz 
Published: May 2014

Background This study aimed to find out whether there is any relationship between obesity and balance among school-going children. Methods Five hundred school-going children, who were randomly selected, and had a mean age of 10.20 ± 1.51 years were recruited for the study. Obesity levels were assessed using Body Mass Index (BMI) and balance was quantified using the Paediatric Reach Test (PRT). Results The results showed a negative correlation between BMI and balance impairments in school children (R=0.45) and this correlation was significantly evident above the threshold level of BMI >22 kg/m2. The mean BMI was 19.94 ± 3.98 kg/m2 and the mean PRT score was 20.91 ± 4.30 points. Conclusion A high BMI above a certain threshold is correlated with balance impairment in school children; therefore, regular physical training is essential to maintaining the BMI within normal limits.
Raynaud's phenomenon
Authors: Mawdsley Anne 
Published: May 2014

Overall key points Raynaud's phenomenon is very common and can be associated with pain and loss of hand function. Some more serious cases are associated with an underlying disease, such as scleroderma. Raynaud's phenomenon may be the first symptom of another disease, and specialist assessment is required if there are concerns about another condition or if the case is severe. Lifestyle changes can make a difference in the management of this condition.
Gout
Authors: Greener Mark 
Published: May 2014

Overall key points Up to 90 per cent of cases of gout arise from under-excretion of urate. Acute gout usually develops rapidly, often beginning at night in the first metatarsophalangeal joint. If drug and lifestyle changes do not adequately treat the underlying hyperuricaemia, patients can develop recurrences and chronic tophaceous gout. Cardiovascular and other comorbidities are common.
What did they say? How children, families and nurses experience ‘care’
Authors: Lewis Peter , Kelly Margaret , Wilson Val , Jones Susan 
Published: May 2014

The degree to which family-centred care is achieved in paediatric practice varies and is subject to multiple complex influences. As part of a strategy to improve patient care, one paediatric ward participated in a study to elicit how care was experienced by three stakeholder groups. This paper aims to discuss the experiences of care of children, parents and nurses in an acute care setting, highlighting the gap between espoused values of family-centred care and those realized in practice. Semi-structured interviews were used to capture the experiences of the three stakeholder groups in relation to care planning and delivery. Data analysis was managed by means of cognitive mapping. Integration of data from each group on a single cognitive map enabled construction of a community narrative. Three themes emerged from the data: Relationships Decision-making So, what about the nurses? An overarching theme of communication was found to be an integral part of all the themes. The research team are now working in collaboration with the ward nurses to feed back findings and develop ways of using the data to inform clinical practice. Determination of what was real for children, parents and nurses in this setting is enabling staff to improve the way in which care is delivered. Nurses are using the findings in conjunction with continuing opportunities for development to bridge the gap between espoused values of family-centred care and the actual experience of caring and being cared for.
Assessing emergency theatre start times
Authors: Kearsey Christopher , Barnes Thomas , North Rebecca , Toh Eugene 
Published: May 2014

Introduction: Orthopaedic trauma lists have become increasingly long. In 2010, it was estimated that there were approximately 20 000 cases of major trauma in the UK, with a further 28 000 cases of trauma that did not meet the criteria of major trauma. This observational study aimed to assess the efficiency of theatre start times and identify the areas where time is lost and the potential financial implications of this. Materials and methods: A retrospective observational study, conducted from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) theatre database at this unit, was included, with 275 individual surgical cases. This was undertaken over the last 2 years—including 97 weekends in total. The outcomes measured were: 1) number of orthopaedic cases, 2) number of other speciality cases, 3) the average transit, anaesthetic and procedure time of both orthopaedic and other speciality cases, 4) the number of lists which started with orthopaedic cases and 5) the average start time of orthopaedic and other speciality cases. Results: There were a total of 275 cases carried out over the prescribed time period on the emergency theatre list. The majority of these were orthopaedic (54%). The other speciality cases (46%) consisted mainly of general surgery, gynaecology, urology, anaesthetic, general medicine, plastic surgery and paediatrics. Average transit times for orthopaedic cases were 15 minutes (0–52), compared with 14 minutes (0–38) for other specialities. Discussion and conclusion: Theatres on Sunday were not starting at 09:00, when they are supposed to. For orthopaedic cases on the emergency list, on average start times were 1.5 hours (maximum of 2.5 hours) late. With anaesthetic time added on, it may be 12:30 before the patient is on the table. As a result, there is a potential loss of approximately £1500–£2000 every weekend and £78 000–£130 000 every year.
research roundup
Authors: Ellis Peter 
Published: May 2014

Peter Ellis presents a synopsis of a selection of recently published research of interest to renal nurses. The aim of this roundup is to provide a brief overview, rather than a detailed critique, of the papers selected. A reference is provided for those who wish to look at the research in more detail. In line with the theme of this issue of JRN, primary care and renal disease, three of the articles are of equal interest to nurses working outside of renal nursing. Their messages translate to areas of nursing where the detection and management of early chronic kidney disease (CKD) takes place.
Can Traumacel be used in the treatment of chronic wounds?
Authors: Hofman D. , Wilson J. , Poore S. , Cherry G. , Ryan T. 
Published: May 2014

Traumacel (calcium salt of oxidised cellulose) has previously only been used in the treatment of acute wounds. To assess its safety and effectiveness in the management of chronic wounds a 12-week pilot study was undertaken which involved 11 patients with 15 non-healing leg ulcers and assessed ulcer size, ulcer pain and degree of exudate. Five ulcers healed within the study period. Significant pain relief was experienced by three patients. Use of the dressing did not appear to be related to a reduction in exudate. No patients experienced sensitisation to the product or had to be withdrawn because of adverse effects. Traumacel was found to be safe in the management of chronic ulceration, and appeared to promote healing in some recalcitrant ulcers.
The use of polarised polychromatic non-coherent light alone as a therapy for venous leg ulceration
Authors: Medenica L. , Lens M. 
Published: May 2014

Objective: This study assessed the effectiveness of polarised, polychromatic, non-coherent light therapy in the treatment of venous leg ulcers. Investigators in previous studies have advocated the use of light as an adjunct to other proven therapies or on its own. Method: This was a pilot prospective case-series study. We enrolled 25 patients with venous leg ulcers. All were treated with light only. Phototherapy (light therapy) treatments were given once a day over four weeks. Results: All ulcers except one (99%) had a positive value for the change in healing area at the end of the four weeks. The total number of 73 leg ulcers recorded at the beginning of the study was reduced to 51 at the end of the four weeks (p<0.01). The decrease in wound surface area following the treatment was statistically significant (mean: 57.15%; SD: 31.87%; p<0.01). Conclusion: Polarised, polychromatic light therapy applied as a monotherapy was associated with positive healing rates in patients with venous leg ulcers. It is a simple and non-invasive treatment. However, a well-designed randomised controlled study is needed to confirm the efficacy of this form of phototherapy and to objectively evaluate recommendations for its routine use in clinical practice. Declaration of interest: This research was supported by Bioptron AG, Switzerland, which supplied the Bioptron 2 light therapy system used.
The prevalence of pressure ulcers in hospitalised patients in a university hospital in India
Authors: Chauhan V.S. , Goel S. , Kumar P. , Srivastava S. , Shukla V.K. 
Published: May 2014

Objective: To estimate the prevalence of pressure ulcers in hospitalised patients and any underlying or predisposing factors to ulceration. Method: This cross-sectional study took place in a university hospital in Varanasi, India. A total of 445 patients hospitalised in medical and surgical wards were examined in a single day for the number, site and grade of pressure ulcers. Haemoglobin, serum albumin and blood sugar levels of patients with pressure ulcers were recorded. Results: The prevalence of pressure ulcers was high (4.94%). Anaemia, malnutrition and diabetes were important risk factors, while morbidity due to pressure ulcers in long-stay wards, such as neurology, was exceptionally high (40.9%). Conclusion: Pressure ulcers remain one of the most neglected aspects of health-care provision in India and identifying their associated risk factors at an early stage may go a long way in preventing their occurrence. Declaration of interest: None.
Silver absorption and antibacterial efficacy of silver dressings
Authors: Lansdown A.B.G. , Williams A. , Chandler S. , Benfield S. 
Published: May 2014

Objective: To evaluate the patterns of silver release from selected sustained silver-release dressings and the protective role of proteins in wound exudate and wound scale. The bactericidal action of silver in chronic wound therapy is also examined. Method: Sequential microbiological examination of wound swabs from seven patients with chronic wounds and sampling of wound exudate and wound scale. Silver content was measured using atomic absorption spectrometry. The ability of Contreet Foam to absorb exudate and release silver was studied in punch biopsy wounds in a rodent model. Results: Silver accumulation in wound exudate correlated well with its viscosity and protein content. Silver bound to wound scale and debris was approximately proportional to the silver ion release from dressings. Bacterial burden was controlled, but not eliminated, following chronic silver therapy. Conclusion: Silver dressings (Acticoat-7, Actisorb Silver, Contreet Foam, Aquacel Ag and Flamazine) were found to be safe for use in chronic wound therapy. Excess silver ion is bound by wound exudate and wound scale as a protective mechanism. Silver-release dressings are not likely to result in germ-free wounds. Further studies are needed to examine potential silver resistance. Declaration of interest: Coloplast A/S supplied dressings and met the laboratory costs.
Developing an accurate system of measuring colour in a venous leg ulcer in order to assess healing
Authors: McGuiness W. , Dunn S.V. , Neild T. , Jones M.J. 
Published: May 2014

Objective: To develop a standardised method of assessing venous ulceration, based on the colour of an ulcer bed and the surrounding skin. Method: This pilot study involved taking three sequential digital photographs during an episode of care and measuring the colour using image analysis software. Ten episodes of care were used for data collection. Results: Based on previous research, a threshold of ≤3° of colour and 3% of saturation was selected to indicate the reliability of the system. The mean of the colour measurements was inside the reliability threshold when measuring an ulcer bed, but outside the threshold for measuring the surrounding skin. Conclusion: The results indicate that the system provides consistent visual representation of a venous leg ulcer. Declaration of interest: None.