bluuebunny/crossref_metadata_2025_split huggingface dataset:
A review of paediatric occupational therapy university curricula in South Africa: Part one
Authors: Brown G Ted , Brown Anita , Roever Carsten 
Published: May 2014

The paediatric content of the eight undergraduate and entry-level postgraduate occupational therapy programmes in South Africa was examined through a survey of the faculties. In the first of a two-part article documenting the study, current best practices in paediatric occupational therapy are reviewed by means of a literature review. Part two will identify and discuss the current status of the paediatric content of occupational therapy education programmes in South Africa, including theoretical frameworks, assessments and intervention strategies.The literature suggests that there is a degree of commonality in paediatric occupational therapy practice between Canada, the US, the UK and Australia in terms of theoretical frameworks, assessment tools and intervention strategies used. Teaching staff must not only include current best practices based on sound research evidence in paediatrics in curricula, but teach in the context of the diverse client diagnostic groups that students will encounter upon graduation.
Sources of stress in undergraduate podiatry students in the UK and Australia
Authors: Mandy A , Tucker B , Tinley P 
Published: May 2014

High sources of stress have been reported in health-care students, including physiotherapy students. However, there are no studies investigating stress in podiatry students. This study was undertaken to examine the sources of stress in undergraduate podiatry students in universities in both the UK and Australia. The Undergraduate Sources of Stress (USOS) questionnaire, comprising 18 items in three subscales (academic demands, financial issues, personal issues), was administered to students in all years of the bachelor programmes in the UK (n=54/97, response rate=56%) and Australia (n=56/94, response rate=60%). Academic concerns were rated highest for all students, particularly the amount to learn, time demands and intellectual demands of the course. UK levels of academic stress are greatest when students are in their first year, when academic demands are combined with clinical education placements. The university fees were significantly higher for Australian students (P=0.001). In total, 64% of podiatry students in Australia worked in paid employment while studying, compared with 41% of the UK podiatry students. Mean hours of paid employment were 5.3hours for UK students and 7.0hours for Australian students. However, there was no correlation between any of the stress subscales on number of hours worked. High levels of academic stress reported by podiatry students are consistent with other student health-care professions.
Vocational rehabilitation in the UK: Opportunities for health-care professionals
Authors: Frank Andrew O , Thurgood Judy 
Published: May 2014

Many therapists have had little training in vocational rehabilitation, which is increasingly seen to be important because of demographic change and the need for people to work longer, including those with ill health or disabilities. This article reviews the interface between those with physical disabilities or chronic ill health, health professionals, employers and various government schemes in the UK. Although concentrating on physical ill health, many of the themes will also be applicable to people with mental health problems. All health professionals concerned with the care of people of working age will increasingly need to advise on the implications of ill health on employment and rehabilitation professionals will be expected to provide a lead. This article covers definitions of vocational rehabilitation and its importance for the current delivery of health care in the context of recent government legislation. It introduces readers to schemes that support and encourage individuals back into work and their interrelationships with the benefits system. It includes innate factors that may influence return to work (job retention), or finding new employment. A further section covers the responsibility of employers to their employees, including a section on work-related ill health.
Encouraging the use of reflexivity in the writing up of qualitative research
Authors: Smith Susan 
Published: May 2014

There is no set formula to guide researchers in writing up qualitative research projects. Much writing up of any research tends to eliminate the self-analysis of the researcher. This article analyses the author's position in relation to the qualitative research process. Reflexive research is defined as a method that fully embraces and exploits the subjectivity of the researcher. Increasing reflexivity of research can increase the credibility and trustworthiness of qualitative data. In this article, examples from a qualitative study are used to illustrate how much of the reflexive self-analysis undertaken as part of the original design was lost in the study's formal scientific write-up. The reasons why writers are reluctant to write about the ‘self’ in published journals are explored. Two different approaches to qualitative writing up are discussed: the ‘realist’ and the ‘confessional’ approaches. The confessional approaches that were lost in the design and process of this study are described, taking power relationships as a theme for the examples cited. The need for both confessional and realist tales in the writing up of qualitative research is considered in relation to participant visibility and service user empowerment.
Cauda equina syndrome: The development of a citywide physiotherapy pathway of care
Authors: Ferguson Fraser 
Published: May 2014

Cauda Equina Syndrome (CES) is a very rare condition in patients with low back pain (LBP), however, the discovery of CES is seen as a surgical emergency. With the rapid rolling out of patient self-referral to outpatient physiotherapy, there is an increased likelihood of physiotherapists being exposed to this condition. However, the literature to date has focused on CES from a medical perspective and clear physiotherapy guidelines have not been reviewed. To improve and standardize the citywide management of such patients a pathway of care was developed. Clinical specialist physiotherapists oversaw the development guided by orthopaedic and neurosurgery consultants. The results of a three-cycle audit suggest this evidence-based pathway of care is an effective tool in identifying patients with CES.
Interdisciplinary circuit class therapy: Increasing therapy time on an acute stroke unit
Authors: Zanker Kate , English Coralie , Prideaux Nicole , Luker Julie 
Published: May 2014

The purpose of this study was to evaluate whether the implementation of interdisciplinary circuit class therapy is a feasible and sustainable means of increasing activity-based therapy time for patients in an acute stroke unit. Thirty participants (15 with stroke as a primary diagnosis) participated in twice weekly circuit class therapy for 3 weeks. Measures included therapy time, attendance rate and patient levels. Circuit class therapy signifi cantly increased the time spent engaged in activity-based therapy (circuit class therapy days: 86 ± 28; non-circuit class therapy days: 32 ± 26, P < 0.001). Circuit class therapy was feasible; operating within existing staffi ng levels with an attendance rate of 78%. It was sustainable over a 12-month period and it was also associated with high patient satisfaction. Circuit class therapy is a feasible and sustainable way of increasing activity-based therapy time for patients in an acute care setting. Further research should examine the impact of circuit class therapy provided in an acute care setting on recovery of functional abilities and length of hospital stay.
Peer observation: A tool for continuing professional development
Authors: Davys Deborah , Jones Vivienne 
Published: May 2014

Peer observation has been advocated as a means of monitoring and improving the quality of teaching in higher education, while peer support and review have been used to provide feedback and monitoring in the clinical context. The process of peer observation of practice in educational, managerial and clinical settings could facilitate improvements in all aspects of practice, have relevance as a tool for continuing professional development and help improve the quality of care for service users. This article presents a background to peer observation and highlights its relevance to health-care professionals. A practical process to assist in the implementation of peer observation is outlined, with consideration to relevant contextual issues.
Supervising assistant practitioners: Evaluating a reflective diary approach
Authors: Mackey Hazel , Whitfield Louisa 
Published: May 2014

This study examined the use of a reflective diary approach to the supervision of assistant practitioners, a new breed of higher level support workers who complement the work of professionally registered practitioners. A qualitative methodology was used to understand the experiences and insight of assistant practitioners and their supervising therapists. The evaluation took place in a single healthcare trust and involved focus groups with two groups of stake holders: assistant practitioners and their supervising therapists. This study demonstrated that the reflective diary has the potential to be a valuable tool in the supervision of assistant practitioners who are attempting to learn new skills, and balance expectations and performance as they define and clarify new working practices. Findings indicate that a reflective diary approach to supervision is useful to assistant practitioners in developing clinical decision-making skills and confidence. It is also a useful tool for supervising therapists to use, explore and reflect on competence and delegation issues. However, for the reflective diary to be used effectively in supervision, a clear and explicit rationale for the purpose of the reflective diary must be given to assistant practitioners and their supervisors to increase motivation and engagement with using reflective diaries.
A comparison of the evidence of two interventions for self-care with stroke patients
Authors: Haslam Toni-Marie , Beaulieu Karen 
Published: May 2014

Current healthcare demands the use of evidence-based practise (EBP) through national standards, such as National Service Frameworks (Department of Health, 2004) and as part of professional registration (Health Professions Council (HPC), 2004) when justifying treatment. This study, completed as undergraduate research, compared the evidence base for functional and remedial intervention in self-care rehabilitation for stroke patients in order to establish the most effective treatment. A literature review searched electronic databases and identified 11 articles, which covered ten different interventions within the functional and remedial approaches. Literature was critiqued using Taylor's (2000) tool for EBP in occupational therapy. Themes were identified through critique, and evidence for both treatment approaches was compared and contrasted. The results were inconclusive, forming tentative suggestions rather than conclusive evidence on which to base interventions. Functional intervention was favoured, as this had the strongest evidence-base. Evidence supported and rejected interventions in both approaches, highlighting the need to research specific interventions as part of EBP, rather than treatment approaches. Results also highlighted lack of rigour in current research. There is a need to develop outcome measures that go beyond physical and cognitive improvement to establish occupational outcomes in addition to further research.
A study into the employment trends of individuals treated at a spinal cord injury centre
Authors: Hills Lynne , Cullen Emma 
Published: May 2014

This study was undertaken to identify the employment status of individuals before and after spinal cord injury (SCI), the factors influencing return to work and the reasons why return to previous employment status were difficult, delayed or not achieved. The study identified when individuals were ready to address return to employment issues as well as the resources that may be required to support return to work. Postal questionnaires were sent to 242 individuals, aged 16 years and above, who were admitted to the Stanmore spinal cord injury centre (SCIC) with acute, traumatic SCI between 1998 and 2003. Forty-two percent of respondents returned to paid employment however, only 26% actually remained in employment. Reasons for non-return to or cessation of employment were primarily related to respondents' health, access to transport and training. Twenty-five percent of respondents described themselves as long-term sick, particularly those with cervical injuries. Physical intensity of work activities altered after injury. For those returning to paid employment, family and employer support was reported to be most commonly available and beneficial . Those respondents who had more structured support schemes had found them beneficial. Approximately half of respondents stated they were ready to address return to work during their admission. Findings suggest that vocational advice and education should be available following a SCI, particularly for those with a cervical injury or those working in heavy or strenuous jobs before injury.
The conventional care of therapists as acute stroke specialists: A case study
Authors: Hubbard Isobel , Parsons Mark 
Published: May 2014

There has been an increase in the number of stroke units in Australia owing to evidence proving their clinical effectiveness. This study aimed to explore the conventional care provided by an occupational therapist and physiotherapist employed in the acute stroke unit of an Australian hospital and then compare the findings to national stroke guidelines. Mixed methodologies were used in a case study format. Results showed that conventional care was based primarily on an efficient initial investigative process which occurred in a work place under pressure. Other findings highlighted patient-centered care and hypothesis-driven clinical reasoning. The study revealed that, in general, the conventional care provided by the two therapists met the national stroke guidelines. This case study has explored the use of combined methodologies for studying complex packages of care and has also provided a basis on which to propose a model of practice.
The efficacy of community-based rehabilitation programmes for adults with TBI
Authors: Evans Lizzie , Brewis Claire 
Published: May 2014

Aims: The aim of this systematic review was to investigate the factors that infl uence the efficacy of community-based rehabilitation programmes in improving the quality of life and daily functioning of adults with severe traumatic brain injury. Methods: A systematic review of the literature was conducted. In keeping with the principles of best evidence synthesis, the findings from the studies were analysed according to their methodological quality. Findings: Eleven studies were included in the review; synthesis of these studies revealed that the outcomes of community rehabilitation programmes are mediated by a complex interaction between programme characteristics, participant characteristics and the methods used to assess outcomes. Variations in study methodology and quality further impact the extent to which treatment effectiveness can be demonstrated. There was evidence to support the use of telephone counselling nd interdisciplinary team rehabilitation. There was moderate strength evidence indicating the psychosocial benefits of engaging in group rehabilitation programme Conclusions: Outcome measures designed specifically for use with traumatic brain injury clients in community settings need to be validated. The clinical and cost benefits of telephone counselling, peer support groups and interdisciplinary team rehabilitation programmes warrant further research.
Goal setting and outcome measurement in a wheelchair service: A client-centred approach
Authors: Pimentel Sue 
Published: May 2014

Aims: There is increasing recognition of the need for a client-centred approach to health-care provision, which takes into account how people live with their health condition in all domains of life. This study aimed to explore assessment practices for clients requiring standard wheelchairs in one wheelchair service in the UK, and develop a framework for setting client-centred goals and measuring outcomes that uses this approach. Methods: An action research approach was adopted within the normal parameters of the wheelchair service. A brief review of relevant literature was undertaken, and an assessment and prescription form incorporating client-centred goals was then developed and implemented. Outcomes were collected from clients using a telephone questionnaire. A focus group was used to elicit the views, beliefs and working practices of therapists. Findings: The data gave an insight into the type of functional mobility goals that clients set. Goal setting was an unfamiliar concept for most clients, and therapists stated that they needed to guide them through the process. Formulating goals at the start of the assessment process helped both therapist and client focus on the outcomes the client wanted to achieve. Conclusions: This project demonstrates how a conceptual change to services can be achieved. The process for setting client-centred goals and measuring outcomes was quick to implement and has orked effectively in practice; crucially by ensuring clients' own goals are achieved.
Pressure ulcers and deep tissue injury in wheelchair users: A bioengineering perspective
Authors: Agam L , Gefen A 
Published: May 2014

Wheelchair users are highly susceptible to deep tissue injury. Interface pressures are unlikely to predict this, and an alternative assessment approach is needed that can easily monitor internal mechanical stresses and deformations. This review aims to provide clinicians with a comprehensive perspective of the biomechanical aspects of pressure ulceration in wheelchair users.
The role of patient education in the rehabilitation of people with spinal cord injuries
Authors: Williams Sue 
Published: May 2014

Individuals with newly acquired spinal cord injuries need to be educated to manage the consequences of their neurological impairment and disability. However, to enable individuals with long-term conditions to manage their own care, they need to be provided with more than simply information about their condition. Critical to independence and self-management are empowerment and self-efficacy. As part of the process of rehabilitation, patient education programmes need to incorporate teaching strategies that develop these key skills to facilitate a successful outcome of rehabilitation for the patient.This article will explore these strategies, and the theories behind them, from a nursing perspective; highlighting how the rehabilitation professional can use these to improve patient outcomes.
Smart Homes: Intelligent buildings
Authors: I Swann Julie 
Published: May 2014

Throughout the world advances in technology have enabled the development of products and systems to improve the quality of our lives. Many modern appliances are sensor-operated or remote-controlled, and many items originally designed for the general market have enhanced the lives of people who have problems coping with the complexities of life or physical management of their environment. Telecare products and the advent of smart technology incorporated into smart homes enables some people who would otherwise have struggled in their own homes to continue to live in the community safely, with the support of good social care networks. This article describes smart homes and outlines some of the constituent telecare products and monitoring systems that can be set according to the needs of the household. Case scenarios are provided that demonstrate how levels of independence can be enhanced, particularly for people with disabilities and cognitive impairment. The future of the smart home, and the therapist's role with clients who have or require this type of housing is discussed.
Prevention and management of aggression in mental health: An interdisciplinary discussion
Authors: Stubbs Brendon , Dickens Geoff 
Published: May 2014

Aims Health-care professionals working in mental health settings are at risk of encountering violent and aggressive behaviour from patients, which can have a detrimental effect on their physical, psychological, emotional and spiritual well-being. Prevention and management of aggression and violence is therefore a priority. However, unlike their nursing colleagues, allied health professionals are not routinely taught such strategies in their pre-registration training. Methods This article describes and critically explores violence prevention and management strategies under three headings: psychological, physical and pharmacological interventions. This is intended as a discussion article to introduce and update allied health-care professions in this area, assist them in identifying their own training needs, and allow them to have a greater role in multidisciplinary planning and discussion relating to aggression and violence in mental health settings. Conclusions Focused and consistent training during pre-registration programmes, particularly in psychological interventions to de-escalate potentially violent scenarios could benefi t allied health professionals who go on to work in mental health settings. Future research should address the effi cacy of all types of interventions aimed at reducing aggression.
Assessing student nurses' clinical skills: The ethical competence of mentors
Authors: Gopee Neil 
Published: May 2014

Aims Various issues related to assessment of student nurses’ clinical skills have been documented in the literature. The assessment of these skills is performed by designated qualifi ed health-care professionals, referred to here as mentors. Research suggests that during clinical placements, some mentors may be signing students’ practice competencies as pass without full evidence of their competence. If the student is not competent in those skills, they could unknowingly harm patients, which amounts to unethical practice on the part of the mentor. Content This article describes the reasons for exploring ethical practice in relation to assessments of clinical skills. It examines what ethical practice and ethical competence are, the importance of detecting student underachievement early, and the support available to mentors for resolving problems with assessment of clinical skills. Discussion and Conclusions It is suggested that education for ethical competence should be more emphatically incorporated in the educational preparation programmes for mentors and similar roles.