bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychological impact of the SARS outbreak on a Singaporean rehabilitation department
Authors: Sin Sim So , Huak Chan Yiong 
Published: May 2014

Severe acute respiratory syndrome (SARS) developed in Singapore in March 2003. It started from three index cases and rapidly multiplied in the hospitals. The total number of probable SARS cases was 238, of which 42% was health-care workers. This article describes the psychological impact of the SARS outbreak on the staff of a rehabilitative services department in a general hospital in Singapore 2 months after the outbreak. In total, 55 rehabilitation staff were asked to participate in this voluntary survey, consisting of self-reported measures on demographics, the General Health Questionnaire (GHQ) and the Impact of Events Scale (IES). A questionnaire measuring changes in life priorities as a result of SARS and ways that people coped with SARS was also administered. A total of 23.4% of subjects had GHQ scores higher than 5, indicating presence of psychiatric symptoms, while 12.8% of them scored more than 30 for IES, indicating presence of post-traumatic stress symptoms. Support from colleagues, taking precautionary measures and getting clear directives and disease information had helped participants to cope with the psychological impact of the epidemic. Health-care facilities need to look into infection control, good information dissemination and emotional support structures for staff to help their employees cope with the psychological impact of epidemic outbreaks.
Impact of the introduction of a multidisciplinary weaning team on a general intensive care unit
Authors: Bruton A , McPherson K 
Published: May 2014

The majority of patients needing mechanical ventilation are weaned rapidly and easily, but a significant minority (20–30%) require more gradual withdrawal. Evidence suggests that a structured approach to this process, involving a multidisciplinary team, is likely to be the most successful. This article describes the process of setting up a multidisciplinary weaning team on a general intensive care unit in a regional hospital. A team drawn from nursing, physiotherapy and anaesthetic staff was created and a decision was made to introduce protocol-directed weaning. Change management theory and published evidence-based guidelines were used to make this introduction. Pre- and post-protocol introduction data were collected on staff perceptions and weaning outcomes. The team overcame a number of barriers to change and protocoldirected weaning was successfully embedded into routine practice. Protocol-directed weaning reduced the reintubation rate from 16% to 3.4% (P=0.015). The process of introducing the changes necessary to use protocols for weaning also altered the attitudes and perceptions of unit staff and improved interdisciplinary working relationships. Introducing changes to weaning practice required concerted efforts over a lengthy period of time, during which it was essential to support all the staff involved. However, the process has been an important step for the service, allowing the authors to develop new ways of working that are directed at improving patient care.
Reliability of marker placements and optoelectronic systems for analysing spinal movement
Authors: Chockalingam Nachiappan , Cochrane Tom , Dangerfield Peter 
Published: May 2014

While highlighting various investigations into anatomical landmarks that could be used in spinal and back surface measurement, this study indicates the usefulness of optoelectronic systems and marker placements for spine and back movement analysis. Earlier research has demonstrated the use of optoelectronic gait analysis systems to measure dynamic back movements and the potential to produce repeatable patterns of such back movements. These consistent patterns of movement suggest a relationship between spinal and back surface motion. However, these studies, mainly measuring the range of movement (ROM) of the spine, have not examined the effects of marker placements. This investigation examined the spine ROM and the movement of markers on the back using a three-dimensional optoelectronic system developed for gait and movement studies. Interobserver variability was assessed using three subjects and three investigators. While indicating the changes in various segmental lengths during right and left lateral flexion in different planes, this investigation reports the technical error of measurement (0.00–0.02 cm for differences in linear distances and 0.31–0.83° for angles) and the coefficient of reliability (83–98%) on marker placements. The results suggest the feasibility of application of this technique to investigate dynamic trunk and spinal movement.
Promoting continence in people with multiple sclerosis: A guide
Authors: Freeman Lynn 
Published: May 2014

Many multiple sclerosis (MS) sufferers will experience difficulty with urinary continence at some time during the course of their disease. Although certain types of problems are common in this population, they are not exclusive. Identification of underlying bladder pathologies can prove difficult, resulting in delayed diagnosis and inappropriate treatments being carried out. Recent literature suggests using specialist continence teams; however, common pathologies can be compounded by associated functional deficits in mobility and dexterity as well as other problems, making patient management more difficult. The multidisciplinary team can play a valuable role alongside the specialist continence team. This article describes the common bladder problems experienced by people with MS and gives practical advice on how health professionals can promote continence in this group.
Implementing a priority and waiting list system in an acute hospital setting
Authors: Lowe Deborah , Barber Lyndsey 
Published: May 2014

This article outlines the development and review of the implementation of a process of prioritization and allocation of referrals to the occupational therapy team covering the medical wards in a 550-bed acute hospital in Swindon, UK. Before the implementation of the system, occupational therapists were ward aligned. Owing to the differing referral rates between wards, therapists experienced unequal caseloads. This created an inequitable service for patients, as some had to wait longer than others for assessment. Because of the limited evidence base available, the system was developed based on practice rather than evidence. Local social services guidelines were adapted to establish levels of priority of referrals. Standards for length of wait for assessment were devised using existing criteria from the rapid assessment service, the previous system under which the occupational therapy service tried to see patients due for imminent discharge. Under the new system, referrals were prioritized daily and placed in a central folder. All occupational therapists on the medical wards assessed patients in order of priority, regardless of ward. At the time of the audit, 2–3 occupational therapists were responsible for the discharge planning role across the five medical wards and patients were transferred to another setting for rehabilitation if required. The audit showed a high percentage adherence to the standards. Implementation of the system resulted in an equitable service for patients and more manageable, balanced caseloads for therapists.
A review of standing frame features and their impact on user acceptability
Authors: Daniels Nikki , Clift Maxine , Armstrong Julie , Gopsill Catherine , Pinnington Lorraine , Ward Chris 
Published: May 2014

Over 70 standing frames are available in the UK. This equipment can be used by adults and children with a range of disabilities to help them achieve or maintain a standing posture. Variations exist between the styles of frames available and the features they offer. Factors such as positioning, comfort and personal acceptance can have a significant impact on duration and frequency of use. Practical issues, such as ease of use, adjustability, manoeuvrability and storage, can also affect the acceptance of such equipment. To meet the diverse needs of different clinical groups and the changing needs of individuals, it is essential that appropriate features are selected. Awareness and knowledge of individual features and their appropriateness for user needs can help with successful frame selection and optimize the benefits of this intervention. This article provides an overview of a selection of standing frame features and discusses their potential advantages and limitations in relation to the impact on user acceptability
Attitudes towards the diagnosis of Alzheimer's disease among carers and non-carers
Authors: Sullivan Karen , Muscat Tracey 
Published: May 2014

This article provides some preliminary data on preferences among non-carer older adults regarding disclosure of Alzheimer's disease (AD) diagnosis, and compares these preferences to those of carers of people with AD (AD carers). Reasons underlying disclosure preference among carers and non-AD carers are investigated. The authors then explore the level of AD knowledge among carer and non-carer samples and investigate its relationship with disclosure preferences. Participants were 20 elderly adults (aged 60–88 years) who were not caring for a relative with AD and 16 older adults (aged 51–79 years) who were caring for a relative with AD and who had attended a carer education programme. Participants completed a modified AD knowledge test and a test designed to measure the reasons for and against disclosure of an AD diagnosis. AD knowledge among AD carers was significantly higher than that among non-carers. Views about disclosure of AD diagnoses did not differ between groups and generally, opinions were for disclosure. No significant differences were found when preferences for disclosure for oneself vs a significant other were compared. Similar reasons for disclosure were given by carers and non-carers, and included factors such as the person's right to know his or her diagnosis.
Context of change in community mental health occupational therapy: Part one
Authors: Harrison Deborah 
Published: May 2014

Mental health services have experienced radical changes over the past 20 years. There has been a shift from institutional to community care and different professions have been brought together to work in teams. More recently, these teams have been aligned to geographical boundaries, not by profession, and have one manager from any professional background. The working relationships between the professional groups in the teams can be an area of difficulty and the individual clinician can experience role confusion and stress. This two-part study used focused ethnography to explore an occupational therapist's role in a community mental health team. It found that the occupational therapist was trying to develop her role both as a mental health worker and as an occupational therapist and that the context of organizational change was an important influence on these roles. This article describes the background literature, methodology and findings. Part two covers the data analysis, discussion and recommendations for further research and practice.
Driving to learn: Powered wheelchair training for those with cognitive disabilities
Authors: Nilsson Lisbeth M , Eklund Mona 
Published: May 2014

The Driving to Learn project was an exploration of how those with significant cognitive disabilities could benefit from training in a joystick-operated powered wheelchair. This study focuses on a particular part of the wider Driving to Learn project, mainly looking at the relationship between characteristics connected to powered wheelchair-use and the trainees' success or failure in developing a consciousness of joystick-use. Forty-five people, aged 12 months to 52 years, were included in the project one by one over a period of 12 years. Forty people from this group had profound cognitive disabilities and multivariate additional disabilities, the other five, aged below 2 years, were at high risk of developing this condition. Data sources consisted of video-recordings, field notes, and open interviews with trainers and others acquainted with the participants. The project had a grounded theory approach, using concomitant analysis and collection of data together with constant comparisons and repeated analyses' of changes in the participants' approaches and attitudes connected to powered wheelchairuse. The findings showed that high predictability and usability of powered wheelchair-use, facilitated successful achievements in the earlier identified process of growing consciousness of joystick-use (Nilsson et al, 2006). The relevance of the gained knowledge and the implications for rehabilitation and occupational therapy practice are discussed.
Choosing a powered wheelchair: The options
Authors: Fernandes Tanya 
Published: May 2014

Powered wheelchairs allow those with mobility problems to move around independently and participate in day-to-day activities, thus becoming active members of society. This article will look at the importance of a thorough assessment of the user's needs in order to select the most appropriate piece of equipment to suit the individual's requirements. There is a wide variety of powered wheelchairs on the market and this article will help those considering purchasing such equipment to navigate through the many choices and options available.
The effect of exercise training on balance in adult patients with post-stroke hemiplegia
Authors: Olawale OA , Ogunmakin OS 
Published: May 2014

Stroke patients with balance problems are prone to falls. The objective of this study was to evaluate the effects of exercise training on balance and incidence of falls in adult patients with post-stroke hemiplegia. The study was conducted with 23patients with first episode, single stroke (14men, 9women; mean age=57.56±10.40years, range 43–78). Ten of the participants had right-sided hemiplegia and 13 had left-sided hemiplegia; mean time since stroke was 28.88±21.64months (range 3–60). The patients underwent balance-specific exercise training for 8weeks. Participants were assessed for balance before and after the intervention using the Berg Balance Scale (BBS). In addition, reports of falls among the patients were tracked for the period of intervention and compared with the history of falls in the 8weeks preceding the start of exercise training. Wilcoxon signed-rank test was used to evaluate the significance of the difference between the pre-training and post-training balance scores on the BBS, and to determine whether significant difference existed between the mean values of history of falls and incidence of falls (P<0.05). Exercise training resulted in significant improvement in balance and non-significant reduction in incidence of falls of adult stroke patients. It was concluded that balance deficits should be addressed with individualized balance training programmes in order to reduce the incidence of falls in stroke patients.
Independent mobility for children with disabilities
Authors: Fernandes Tanya 
Published: May 2014

It is essential that children with disabling conditions such as cerebral palsy or muscular dystrophy are helped to be independently mobile from an early age. If not, they can develop ‘learned helplessness’, where the child will become passive and dependent upon others, and will not grow and develop to his or her potential. Independent mobility can be achieved through the provision of customized vehicles such as wheelchairs or tricycles. The UK charity Whizz-Kidz provides this equipment, which is often not available through the NHS, to help children to ‘realize their true potential’. This article aims to describe the different types of mobility equipment available to help children with disabilities to move around and develop their skills, and offers some examples of different products on the market.
A phenomenological study of patients' experiences of an orthopaedic preadmission clinic
Authors: Gillespie Beryl , Spalding Nicola J 
Published: May 2014

Preadmission clinics are seen by healthcare professionals as an important part of patients' preoperative experience. Economic benefits, through reducing length of stay postoperatively, have been realized. Relatively little research exists which informs healthcare professionals of the patients view of such clinics. Such feedback from the patients has the potential to provide important evaluative data which can be used to inform future preadmission clinics. This paper presents the findings from a small qualitative study conducted in a total hip replacement preadmission clinic in an independent hospital. Phenomenological interviews were undertaken with ten patients who attended a preadmission clinic. The findings were used by the multidisciplinary team comprising of senior clinicians within the preadmission clinic, and a number of recommendations were made and implemented to improve the clinic. Further analysis of the data also led to the team appreciating the value of the clinic for boosting patients' confidence so that they could make informed choices about their care.
Response and completion rates for postal outcomes booklets in stroke rehabilitation
Authors: Murray Jenni , Forster Anne , Young John 
Published: May 2014

This study aimed to assess the response and completion rates for patient and caregiver stroke outcome booklets administered by post. The study also investigated whether the inclusion of a sixty-item, multiple domain outcome measure; the stroke impact scale (SIS) in the booklets affected response and completion rates. A consumer group informed the development of two patient booklets: one with four outcomes (without the SIS) and one with five (including the SIS). A caregiver booklet comprising four outcomes was also prepared. The booklets were posted to the homes of 51 stroke patients and 33 caregivers. The response rate was 84% and 79% for patients and their caregivers, respectively. Completion rates for individual outcomes were 85% and above for all outcomes except the EuroQol (79%) and the SIS (41%). For the EuroQol, 60% of uncompleted items were accounted for by one item: the selfrating health scale. Uncompleted items for the SIS were randomly distributed. The completion rate for patient booklets without the SIS was double that of booklets that included the SIS. The patient and carer stroke outcomes booklets developed in this study produced high response and (excluding the SIS) high completion rates. The booklets may offer a standardized approach to postal-administered outcome measurement in stroke rehabilitation trials.
Multi-disciplinary perceptions of music therapy in complex neuro-rehabilitation
Authors: Magee Wendy L , Andrews Keith 
Published: May 2014

Although there is growing evidence that music therapy has a significant role to play in rehabilitation of patients with complex neuro-disabilities, its provision in rehabilitation units varies widely internationally. Understanding the role it plays in therapeutic outcomes appears to be one of the barriers in developing music therapy service provision in the UK, where it remains under-resourced in rehabilitation units. This paper reports on a retrospective study of referral patterns to an established music therapy service in a multidisciplinary (MDT) neuro-rehabilitation setting in England. Referrals over a 2-year period were analysed to examine the reasons for referral to music therapy both in terms of priority and frequency, as well as which members of the multidisciplinary team were referring. The results indicate that where music therapy is integrated into MDT programmes it is perceived by the team to have a particular role in the rehabilitation of communication and emotional health needs.
Mind the gap: rethinking community neurological rehabilitation services
Authors: Jones Diana , Plant Rowena , Crawford Alison , Bearn Sue 
Published: May 2014

Recognition that there was a lack of knowledge about what services existed for adults aged 18– 65 years with an acquired neurological condition in North Cumbria, and how they were accessed and co-ordinated, led to a project to identify community rehabilitation provision and explore potential service models. Interviews were undertaken with service providers, and focus groups, interviews and a questionnaire were undertaken with services users and carers. The five areas of concern to emerge from a thematic analysis of the data related to service provision; respite care and day time occupation, transport and geography, co-ordination of services, and information. There were differences in perspectives and priorities. Having one point of contact for access to all services emerged as the preferred model, although this would not address the gaps in service provision. Despite the recognition that the National Service Framework for Long-term Conditions (Department of Health (DH), 2005b) has promoted service development for the target group, there is still a need to work towards greater coherence in service provision across a plurality of providers.
Integrating spirituality into mental health rehabilitation
Authors: Lloyd Chris , O’Connor Courtney 
Published: May 2014

Spiritualty gives meaning to people's lives. In this article, the authors discuss how spirituality is defined in occupational therapy practice, how it enhances client-centred practice, and explore how spiritualty can be incorporated into mental health practice. The Psychospiritual frame of reference provides a definition of spirituality and a framework. There is an emphasis on the spiritual dimension of connectedness, which is particularly salient for people with a severe mental illness living in community care units and undergoing the process of transition to community living.
An investigation of therapy student's perceptions of cultural awareness
Authors: Kale Swati , Swee Hong Chia 
Published: May 2014

Cultural awareness is recognized as an essential skill for the effective practice of physiotherapy and occupational therapy. The aim of this study was to investigate the perceptions of cultural awareness of 274undergraduate physiotherapy and occupational therapy students. A self administered questionnaire adapted and modified from Cheung et al (2002) was used. More than half of the students recognized the influence of cultural factors on the assessment and intervention process and the functional ability of the client. The majority of the students believed that the level of cultural awareness could be influenced by education (92%, 104/113) and placement experience (98%, 110/113). Students rated themselves to be ignorant or to having limited awareness of the sources of information and access to language translation services. This study highlights the need to address the challenges of working in a multicultural society within the curriculum and equip the students with the skills required to work in a multicultural society.