bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changing practice speciality in occupational therapy: Exploring the experience. Part two
Authors: Richardson Jennifer , Rugg Sue 
Published: May 2014

Despite an ongoing shortage of occupational therapists in the UK, the career behaviours of senior occupational therapists are under-researched. This article explores Senior occupational therapists' experience of changing practice specialities as a potential retention strategy. The background to this area was considered in part one of this article. In the second part of this article, the authors detail an interview-based qualitative study conducted with 10 Senior I/II occupational therapists who had changed practice specialities within the previous decade. Thematic analysis of the study data led to the emergence of five inter-related study categories. These reflected participants' reasons for changing practice speciality, the practical steps taken, the elements that made changing easier or more difficult and the resulting effects. A model of the process of changing practice speciality was derived from these data. This saw participants as influenced by a range of personal, professional and organizational elements. These, in turn, influenced the practical steps taken to effect change. Reported outcomes included increased job satisfaction and retention within the profession. These findings suggest that changing practice speciality can improve recruitment and retention among Senior occupational therapists, to the benefit of all concerned.
A review of paediatric occupational therapy university curricula in South Africa: Part two
Authors: Brown G Ted , Brown Anita , Roever Carsten 
Published: May 2014

This is the second article of a study of the paediatric content of undergraduate and entry-level postgraduate occupational therapy university programmes in South Africa. Current best practices in paediatric occupational therapy were examined through a literature review, which is presented in part one. This second article reports the results of the survey that examined the paediatric theoretical models, assessment tools and interventions taught by the eight universities in South Africa that offer occupational therapy programmes. Six faculties responded to the electronic survey, yielding a response rate of 75%.On average, paediatrics constituted 21.5% of the total South African occupational therapy curricula. The most commonly taught theoretical models were Erikson's Eight Stages of Psychosocial Development, neurodevelopmental therapy and the Model of Human Occupation. There was a deficit in curricular programming with regard to perceptual motor theory. The Developmental Test of Visual-Motor Integration, Goodenough-Harris Drawing Test and the Test of Visual Perceptual Skills (non-motor) were among the most widely taught assessments. All six university programmes incorporated health promotion and disease prevention into their syllabuses. Therefore, occupational therapy students in South Africa receive a broad and varied education with regard to paediatrics.
Long-term effects of static positional stretches of the patient's stroke-affected shoulder
Authors: Gustafsson Louise , McKenna Kryss 
Published: May 2014

The purpose of this randomized controlled trial was to investigate the 6-month follow-up effects of an inpatient management programme for the stroke-affected shoulder. The programme included twice daily 30-min static positional stretches of the stroke-affected shoulder and positioning of the stroke-affected upper limb using an armrest support at all other times. In total, 32 participants (17 treatment group and 15 comparison group) were recruited from an inpatient stroke rehabilitation unit. Dependent variables, including pain-free range of motion into external rotation, hemiplegic shoulder pain, motor recovery and functional independence, were measured at admission to rehabilitation, discharge from rehabilitation and at 6 months after discharge. Analysis of data was completed using linear mixed models. There were no statistically significant differences between the two groups from discharge to follow-up. Clinically important differences were identified in favour of the comparison group with respect to all dependent variables. The results of this study question the effectiveness of the inpatient management programme and highlight adverse long-term effects. Further research is required to investigate how soft tissue length of the stroke-affected shoulder can be maintained and to investigate possible explanations for the results.
Ankle joint dorsiflexion: Assessment of true values necessary for normal gait
Authors: Weir John , Chockalingam Nachiappan 
Published: May 2014

Motion of a reduced quantity has been referred to as 'equinus' and the widely accepted theory is that when equinus is present, an abnormal foot function occurs. For normal foot function and human ambulation the amount of ankle joint dorsiflexion required is claimed to be 10 degrees. The main purpose of this study was to determine and investigate this arbitrary figure of 10 degrees. Fourteen normal adult subjects with a normal range of motion at the ankle joint and no known gait abnormalities took part in the study. Predetermined suitable anatomical landmarks were marked by reflective skin markers. Data was collected at a frequency of 120Hz using a three-dimensional opto electronic motion analysis system and the three-dimensional co-ordinates were smoothed using a Butterworth filter (Fc = 7Hz) and analysed. All foot angles were expressed relative to the sub talar neutral position and were expressed as joint co-ordinate system (JCS) angles. Results indicated a ankle joint dorsiflexion value of between 12 and 22 degrees with a wide variation between subjects (Coefficient of Multiple correlation (CMC) values 0.723–0.992). The results appear to show ankle joint dorsiflexion in normal subjects is greater than the value traditionally espoused by clinicians for walking. This is as a result of the anatomical basis on which measurements are currently made. Although, this may have clinical implications in terms of orthotic prescriptions, more research is needed to determine the effect of terrain, footwear and muscle length on the measurements.
Intermediate care: An occupational therapy perspective
Authors: Grant Mary , Ward Gill , Dring Paula , Booth Julie , Jacob-Lloyd Hilary , Steed Anita , Hibberd Jane 
Published: May 2014

This study aimed to examine the involvement of occupational therapists in the development of intermediate care services in England. A non-experimental survey design was employed and a postal questionnaire was sent to 414 members of the specialist section of the College of Occupational Therapists: Older People. Quantitative and qualitative data from the 159 respondents was analysed using descriptive statistics and content analysis respectively. Results indicate that the occupational therapists in this study were heavily involved in the development of intermediate care services. This included the creation and monitoring of integrated equipment stores and in the extension of their role to include intermediate care coordination. Intermediate care provision for older people with mental health problems was seen to be an area requiring further development. The National Service Framework for older people continues to provide opportunities for occupational therapists working to further develop and shape services for this growing sector of society.
Assessment of dependence on assistive ambulatory devices among older adults: A new tool
Authors: Liu Hao , Zabel Reta , Prati Victor 
Published: May 2014

The use of an assistive ambulatory device (AAD) such as a cane or walker may potentially be linked to a greater risk of falling. This study examined the test and re-test reliability of an instrument developed by the authors: the Ambulatory Device Dependence Efficacy Scale (ADDES), which assesses older institutionalized adults’ level of dependence on an AAD, with the aim of determining the relationship (if any) between AAD dependence and falling. Thirty-five AAD users from two assistive living facilities qualified to participate in this study. The validity of the ADDES was evaluated by three experienced physical therapists working in geriatric settings. The test reliability of the ADDES and how it related to history of falling were also assessed and analysed. This study found the ADDES scale to be highly reliable in testing how dependent an AAD user is on his/her AAD during walking. Findings showed that dependence on an AAD is positively correlated with the length of time it has been used. ADDES scores may indicate the level of falls risk, although a follow-up study is suggested to explore this relationship further.
Introduction to the use of Rasch analysis to assess patient performance
Authors: McAllister Sue 
Published: May 2014

Background: Rasch analysis is a statistical model used to develop assessment tools to effectively measure change in human attributes. It has a number of advantages compared to other statistical approaches; the most important of these is that it enables the development of assessments that more accurately quantify patient performance. Content: This article will discuss issues of measurement in rehabilitation, describe the advantages of Rasch analysis and illustrate these with examples from the rehabilitation literature. Discussion and conclusions: An understanding of Rasch analysis will assist clinicians to make informed decisions about selection of assessment tools that will provide the most accurate measurement of their patient’s performance and better support decision making regarding patient eligibility, progress and discharge. This information will also assist clinicians in critically analysing research evidence where assessment tools are used to generate data for comparative analysis.
Developing a self-management and exercise model for people with multiple sclerosis
Authors: Hartley S 
Published: May 2014

Aims The recognition of lack of support for people with multiple sclerosis (MS) with minimal to moderate disability, and growing evidence to support the benefits of exercise, initiated the development of an interdisciplinary self-management model. This article describes the development and components of the model, and the evaluation of the programme to date. Methods The service model was developed to include four programmes over a 2-year time frame. The study group comprised 33 people with MS. The group programme consisted of 6 weeks of information and exercise in the hospital setting, followed by 8 weeks of supervised exercise sessions in a leisure centre setting. Measures of gait, quality of life, fatigue levels and mood were obtained at baseline and following programme completion and the perceived benefits were recorded using a patient satisfaction questionnaire. Findings The evaluation demonstrated significant improvements in walking speed and quality of life and the participants reported a range of perceived physical and psychological benefits. It was identified that tighter selection criteria is required, with consideration of the time since diagnosis and how participants have adapted to their condition. The need for guidelines for other therapists setting up similar programmes was also identified. Conclusions This model provides evidence of the potential benefits of earlier intervention for people with MS and encouraging exercise through self-management programmes. It can therefore, with further refinement, meet a perceived shortfall in service provision both now and in the future.
Head posture assessment for patients with neck pain: Is it useful?
Authors: Silva Anabela Gonalves , Punt T David , Sharples Paul , Vilas-Boas João Paulo , Johnson Mark I 
Published: May 2014

Aims Neck pain is a common complaint and accounts for a significant proportion of individuals seeking physiotherapy. Assessment for patients with neck pain normally involves a judgment of head posture. Head posture is considered important as deviations from ‘normal’ may have detrimental biomechanical and physiological implications and provide clues as to optimal interventions. However, studies comparing head posture between patients with neck pain and asymptomatic individuals have shown conflicting results. This article critically appraises the role of head posture assessment for patients with neck pain. Methods The rationale for a relationship between head posture and neck pain is discussed; clinical assessment of head posture—including issues around surrogate measures, validity and reliability—is explored, and studies comparing patients with neck pain and asymptomatic individuals are examined. Finally, studies investigating techniques to correct head posture are appraised. Findings and conclusions It is unclear whether the assessment of head posture through observation is valid and/or reliable and whether therapeutic interventions to improve head posture result in gains for the patient. There is a need for further research exploring the links between these factors, and practitioners should be encouraged to re-appraise the value of assessing head posture for patients with neck pain.
Exploring the impact of rheumatoid arthritis on patients' lives
Authors: Hughes John G 
Published: May 2014

Aims A limited number of published studies have explored the perceptions and experiences of people living with rheumatoid arthritis (RA). Qualitative research of this kind is essential for the design and development of patient-centred outcome indices. This study aimed to explore the experiences of those patients with RA, to improve understanding of the impact of the condition on a person's life. Methods A grounded theory qualitative study was conducted with a convenience sample of 13 persons from the North West of England. The issues to be discussed during interviews were dictated by emerging categories and themes. Findings Those persons who participated in the study identified a range of symptoms and consequences of RA, including intractable pain, reduced mobility, systemic fatigue, sleeplessness, eating difficulties, and emotional disturbances. RA also negatively impacted on participants' ability to perform everyday tasks, reduced freedom and independence, and resulted in persons becoming more sedentary and socially reclusive. Conclusions The study showed that RA has a huge impact on every aspect of a sufferer's life. Most outcome tools do not adequately reflect this. This highlights the need for the development of new patient-centred outcome indices capable of incorporating the symptoms and consequences identified here.
Long-term stroke survivors' needs and perceptions of an exercise maintenance model of care
Authors: Patterson Sarah , Ross-Edwards Benjamin 
Published: May 2014

Aims Stroke is a leading cause of disability in Australia, having an associated decline in functional activities and socialization over time. This article discusses an exploration of stroke survivors' views on a stroke maintenance exercise group, and aims to provide insight into the long-term needs of this clinical group. Methods A qualitative study using open-ended, in-depth interviews was completed with a purposive sample of 10 long-term stroke survivors from two stroke maintenance exercise groups. Findings Thematic analysis of survivor's responses identified three common themes: further insight into difficulties post-stroke; group provision of exercise opportunity, information and social support; and outcomes of increased confidence, motivation and participation. Conclusions This study highlights the challenges faced by long-term stroke survivors and the value of programmes, such as this stroke maintenance exercise group, in facilitating community participation.
Hip precautions following hemiarthroplasty: A UK study of occupational therapists
Authors: McQueen Jean , Nivison Catherine , Clyde Deborah , Ballance Fiona , Fairbairn Pamela , Murray Elaine 
Published: May 2014

Aims One intervention that occupational therapists may undertake with patients following hip fracture is the promotion of hip precautions. These hip precautions focus on advising patients to avoid certain movements and/or the provision of aids to independence, for up to 12 weeks post surgery. A systematic search of published literature identified limited evidence on which to base practice in this field. A national survey was therefore undertaken to establish whether hip precautions are used uniformly throughout the United Kingdom. Methods This study aimed to capture occupational therapy current practice in hip precautions following hemiarthroplasty surgery. Questionnaires were sent to members of the College of Occupational Therapists Specialist Section - Trauma and Orthopaedics, and to therapists who responded to an article in Occupational Therapy News. A total of 198 questionnaires were distributed. Findings 100 questionnaires were returned. The majority of occupational therapists who responded encouraged their patients to adhere to hip precautions post surgery, however, there was concern at the lack of robust evidence to support practice. A small number of therapists who did not encourage their patients to adhere to hip precautions reported no detrimental consequences. Conclusions This study discusses concern that focusing on hip precautions following hemiarthroplasty surgery may unnecessarily impair function, and highlights the need for further research to investigate whether post surgery hip precautions are necessary.
An analysis of the ‘Six disabled lives’ report in the UK: Important or impotent?
Authors: Scullion Philip 
Published: May 2014

Background Rights of disabled people are enshrined in an international convention mediated by the United Nations (UN). However, a recent Ombudsman's Report in the UK: ‘Six lives: the provision of public services to people with learning disabilities’, adds to a long line of similar reports showing evidence that such citizens are denied equitable treatment from health and social care organizations. Content This article offers an analysis of the Ombudsman's Report in the context of current disability legislation and the work of other bodies which have an obligation to ensure equitable treatment in UK health and social care settings. The report found that many vulnerable groups have suffered extreme injustices in their encounters with health and social care professionals, which have resulted in avoidable deaths and unnecessary distress and suffering. These findings, and how these injustices may be avoided and overcome in the future, are discussed. Conclusions Despite a plethora of official commitments to good practice to ensure that the rights of disabled people are upheld, these vulnerable citizens are still not being protected. Mencap, a UK disability-related charity has labelled this ‘institutional discrimination’. It is suggested here that individual professionals, in practice, education and research, must take on the responsibility to challenge and change underlying attitudes and behaviours in relation to disabled people.
Qigong as a mindful exercise intervention for people living with mental ill health
Authors: Lloyd Chris , Tsang Hector , Deane Frank 
Published: May 2014

Background Individuals with schizophrenia are more likely to be overweight or obese than the general population, and the associated health problems put them at a higher risk of death. Exercise is therefore an important non-pharmacological intervention that mental health workers can assist clients to engage in, and mindful exercise approaches may be particularly well-suited to this population. Content This article describes the concept of qigong as a mindful exercise and looks at preliminary evidence suggesting that mindful exercise is of physical and emotional benefit to people with mental ill health. The authors propose an easy, standardized exercise protocol which clinicians can use and teach patient, and call for further research to explore its efficacy. Conclusions It is suggested that mindful exercise may be used as an intervention to assist people living with mental ill health to improve their community functioning and hence their recovery.
Concept analysis in healthcare research
Authors: Cronin Patricia , Ryan F , Coughlan M 
Published: May 2014

Background In recent years there has been an increasing interest in concept analysis as a means of establishing conceptual clarity about phenomena of interest within healthcare disciplines. This emergence is associated primarily with the recognition that a set of well developed key concepts pertaining to a discipline's domain of interest is an essential pre-requisite to building its scientific research base. Concept analysis focuses on concepts that are abstract and about which there is some ambiguity of meaning. Within healthcare disciplines these are mainly behavioural concepts that are concerned with understanding health and illness experiences. Content There are a number of approaches to concept analysis that appear to have some similarities but which possess essential philosophical differences. This article examines the ontological and epistemological underpinnings of concepts and concept analysis. Methods of concept analysis that represent the various philosophical positions are presented and a critique of their limitations is offered. Conclusions Concept analysis, using a structured framework, is means of identifying characteristics and attributes of abstract or ill-defined concepts with the purpose of achieving clarity. However, it can be a difficult and time consuming process that requires rigorous attention at all stages if the outcome is to be meaningful for knowledge and theory development and ultimately, practice.
Long-term follow-up of persons with spinal cord injury integrated in the community
Authors: Martin Priya , Cherian Binu , John Judy , Tharion George , Bhattacharjee Suranjan 
Published: May 2014

AimsThe main aim of this study was to identify the changes over time on the functional status of people with spinal cord injury in a sample of the South Indian population, integrated in the community, following rehabilitation. It also aimed at evaluating the adaptations that occurred in that time period, in order to facilitate planning of services based on patient requirementsMethodsData was gathered from medical records and through structured interviews from 85 individuals with traumatic paraplegia who were rehabilitated from the Christian Medical College, Vellore. The Functional Independence Measure was used to assess activities of daily living. Thirteen variables were analysed using Chi-square and Pearson's Correlation Coefficient tests.FindingsThe mean age of the patients at the time of study was 38.95±10.19. Out of the 85 patients, 89.4% were male, 43.5% were between 19 to 50 years of age and 61.2% were married. The most common site of spinal lesion (84.7%) was between T10 and T12. The majority, 64.7%, of the patients were ambulant with orthoses and appliances such as walker, crutches and canes. Most of the patients were independent in activies of daily living with some assistive devices (90.6%). The majority of the patients (76.5%) were over 5 years post injury.ConclusionsAdjustments and adaptations occurred in a time period within 5 years post injury, after which the gains were stabilized. Rehabilitation and intervention measures should focus on the initial time frame after SCI.The results may provide better understanding to plan and co-ordinate rehabilitation measures for people with SCI.