bluuebunny/crossref_metadata_2025_split huggingface dataset:
The development of the Grip on Challenging Behaviour dementia care programme
Authors: Zwijsen Sandra A , Gerritsen Debby L , Eefsting Jan A , Hertogh Cees MPM , Pot Anne Margriet , Smalbrugge Martin 
Published: May 2014

Background: Current guidelines and theories on the origin of challenging behaviour in dementia indicate that a structured multidisciplinary approach to its management is necessary. In the Grip on Challenging Behaviour study, a care programme was developed to improve the management of challenging behaviour. Method: In developing the care programme, the overlapping parts of dementia care guidelines were supplemented with discipline-specific parts. Three meetings with experts were arranged to further develop the structure of the care programme and to ensure a good fit with practice. Results: The care programme consists of four steps: detection, analysis, treatment, and evaluation. For each step, forms were developed to guide and structure the process and assign responsibilities for each discipline. As well as a description of the development and the content of the care programme, this paper presents two case studies in which the programme was used. Conclusion: The Grip on Challenging Behaviour care programme provides a way for dementia special care units to manage challenging behaviour in a structured way and with a multidisciplinary approach making use of their own resources.
Psychosocial functioning of Chinese older people with chronic physical illness
Authors: Tsang Hector WH , Cheang Callas TK , Tong Betsey YM , Tse Shirley SL 
Published: May 2014

Using the Chinese Geriatric Depression Scale, The World Health Organization Quality of Life (WHOQoL) scale and the Self-concept Questionnaire, this article examined the relationship between depression and psychosocial functioning among 80 older people with chronic physical illness in Hong Kong. It aimed to test the hypothesis that people with chronic physical illness are prone to depression, which in turn leads to lower quality of life and negative self-esteem.The group with chronic physical illness scored higher on the Geriatric Depression Scale than the control group. The control group had higher scores than the illness group in the physical health and psychological health domains of the WHO-QoL scale and had better functioning in activities of daily living and leisure. Despite some contradictory findings, the results of this study support the proposed hypothetical framework relating chronic physical illness to depression and support findings of previous research. Data from this study highlight the negative impact of chronic physical illness on the physical and psychological status of older people. Implications for rehabilitation services are discussed.
Encouraging the development of team working skills in physiotherapy students
Authors: Smith Sue 
Published: May 2014

This research report provides an overview of the main findings from the student focus groups at the beginning and end of a module, undertaken on 50 first-year students on a BSc (Hons) Physiotherapy course. One of the module's learning outcomes was to ensure the development of team working skills. This module and this research project echoed the aims of the Department of Health's Meeting the Challenge, reflecting the government's commitment to modernizing education for allied health professionals. An understanding of the roles of other health workers and developing team working skills is integral to educational culture in terms of preparing physiotherapy students to be effective practitioners who can work well with others. Students discussed their experiences, challenges and coping strategies used while working together in a small group (n=5) on a group assessment of a case study. Qualitative data were supplemented by the Team Reflexivity Questionnaire and consideration of the principles underpinning Belbin's work on team roles. The main findings focussed on group members' poor assertiveness and listening skills. This in turn led to difficulties in planning, negotiating for a leader and delegating and organizing work. Discussion of the implications of these findings on educational practice is undertaken, looking particularly at the development of assertiveness skills early in the undergraduate course, observational monitoring of ‘early’ group interactions and allowing time for new groups to socialize before allocating the formal assessment task. Recommendations for tutor practice are made.
Circulatory response to hydrotherapy and dry heat in individuals with type 2 diabetes
Authors: Scott Petrofsky Jerrold , Besonis Chris , Rivera David 
Published: May 2014

In total, 33 subjects aged 23–74 years were examined to observe the effect of exposure to warm water hydrotherapy (40ºC), local heating (40ºC) and global (whole body) dry heat at 30ºC and 40ºC on their circulation. Data from patients with type 2 diabetes (n=16, mean age=58.3±11.5 years, mean weight=88.1±16.4 kg) were compared to data from control subjects (n=17, mean age=52±14.2 years, mean weight=80.4±12.3 kg). Vascular occlusion was used to assess endothelial damage. Subjects with type 2 diabetes had an impaired circulatory response to warm water immersion, dry heat and the application of local heat to increase skin temperature. Blood flow, in general, was diminished in diabetics by at least 50% when comparing resting blood flow in diabetics to that in control subjects. The response to heat under any condition studied here was also severely impaired in subjects with diabetes. These findings suggest that the application of warmth to increase circulation in patients with diabetes may not be as beneficial as once thought. In addition, the diminished sensation seen in diabetic patients with sensory neuropathies may make prolonged heating of their limbs potentially dangerous. For these reasons, therapists should use heat with caution in patients with diabetes.
Influence of occupation and home environment on the wellbeing of European elders
Authors: Green Sharon , Sixsmith Judith , Dahlin Ivanoff Synneve , Sixsmith Andrew 
Published: May 2014

ENABLE-AGE was a EU-funded project involving research teams in Germany, Hungary, Latvia, Sweden and the UK. A main aim was to study the relationship between home and healthy ageing for very old people living alone at home. In all, 1918 older people from the five EU countries were surveyed.This article addresses results from a sub-set of in-depth interviews, conducted with 80 octogenarians in Sweden and the UK. The impact of the home environments and patterns of occupational engagement on individual wellbeing is presented. Findings indicate that occupational pursuits are diverse, and not dictated by chronological age. Social activities outside the immediate home environment are particularly valued, as is easy access to favourite local venues. Additionally, being able to leave the home to pursue chosen activities is enjoyed and nurtured. House-bound elders find their occupational satisfaction increasingly dependent upon both their own ingenuity and the accessibility of the interior home.
Usefulness of digital gait analysis for assessing patients with Guillain-Barré syndrome
Authors: Walton Timothy , Vincent Mary , Richards Jim , Davidson Ian 
Published: May 2014

This study aimed to investigate the usefulness of laboratory-based digitized gait analysis as an outcome measure to identify improvement in a mildly affected patient with Guillain-Barré syndrome 10 and 20 months post-nadir. Data are presented in the form of a single case study. Considerable improvements were found within ground reaction forces and lower limb kinematics, indicating a markedly improved functional gait pattern. This improvement was reinforced by positive subjective feedback. Initially, this assessment intended to identify the extent to which sensitive measurements using digitized gait analysis could provide a means of examining patient improvement following Guillain-Barré syndrome. As a serendipitous finding, it was noted that it can also provide a focus to therapy sessions.
The appropriate use of equipment for moving and handling patients
Authors: Hampton Sylvie 
Published: May 2014

A case study reported on BBC Radio 4 highlighted the lack of knowledge and understanding that is associated with lifting patients in and out of bed and onto chairs. A lady remained seated in her wheelchair for 22 months because the local authority did not allow her carers to lift her and never considered supplying appropriate equipment that would have allowed them to lift her in safety. The authority had a responsibility to care for this lady and, as there is a vast range of equipment available, to allow someone to develop a life-threatening pressure ulcer is both unnecessary and disgraceful. It is important to learn about the available equipment and to understand how it can be applied in practice to offer quality of life to the patient and to prevent pressure damage occurring. This article describes the case study and offers some suggestions for the type of equipment that could have been provided in this case.
Suitable moving and handling equipment: A guide
Authors: Fernandes Tanya 
Published: May 2014

The regular transfer and lifting of patients can place added stresses on carers. The high incidence of injury among care staff has resulted in an increase in the use of mechanical devices, designed to reduce musculoskeletal strain. This article looks at the various mobility aids, options and hoists available to aid carers involved in the essential task of moving and handling people. Contact details for the manufacturers and suppliers of such mechanical aids will be provided.
Exploring social and leisure participation among stroke survivors: Part one
Authors: Amarshi Farah , Artero Lisa , Reid Denise 
Published: May 2014

Older adults who live in the community often report decreased levels of social and leisure participation following stroke. A qualitative study using open-ended, focused interviews was conducted with a sample of 12 older adult stroke survivors. This study aimed to explore how often older adult stroke survivors participate in social and leisure activities, the meaning(s) associated with this participation and the factors felt to hinder or contribute to this participation. The first part of the article provides the background and methodology to the study. Part two, published in the following issue, details the findings from the interviews and provides discussion.
An investigation into the use of a journal club for evidence-based practice
Authors: McQueen Jean , Nivison Catherine , Husband Vicki , Miller Claire 
Published: May 2014

Literature linking journal clubs with evidence-based practice is plentiful but largely descriptive in nature. Existing research has tended to focus on how journal clubs are run with limited evidence presented to demonstrate that evidence found has been incorporated into practice. The purpose of this study was to explore the potential impact participation in a specific journal club had on knowledge of evidence for practice and actual clinical practice. A small-scale exploratory study using pre- and post-questionnaires as a method of data collection was undertaken with seven occupational therapists involved in the journal club. Questionnaire results were analysed qualitatively through content analysis to identify key themes in the data generated. Findings appear indicative of some changes in professional practice and staffs attitude following participation in the journal club with staff reporting an increased awareness of the evidence base for interventions. Specific ideas for future research have evolved from this exploratory study. This may act as a catalyst for much needed evaluation in this field.
Impairment of muscle performance before and following total hip replacement
Authors: McMeeken Joan M , Galea Mary P 
Published: May 2014

The aim of this preliminary descriptive study was to investigate the presurgical condition and medium term postsurgical outcomes of pain, function and muscle performance in patients with total hip replacements who do not receive specific perioperative exercise. The 17 participants in this within-subject study were acute tertiary hospital patients scheduled for total hip replacement. The main outcome measures were pain (visual analogue scale), function (timed up and go test and stair climbing), and muscle performance (isokinetic testing of quadriceps and hamstrings). These measures were collected by a physiotherapist blinded to the purpose of the study, at three time periods, twice before surgery to establish stability of measurement and at 8–12 weeks post surgery. Following total hip replacement pain decreased and function generally improved. Concentric and eccentric performance of the tested muscles on the operated side returned to the preoperative state, but remained significantly weaker than the unoperated side 8–12 weeks following surgery. Poor muscle performance was correlated with poor function indicating that appropriate and targeted strengthening exercises to the muscles controlling the knee and hip joints on the operated side may be required to achieve maximum functional outcome.
Developing clinical expertise through clinical placement at masters level
Authors: Rushton Alison , Lindsay Geoff 
Published: May 2014

This paper reports further on a descriptive survey that explored the characteristics of existing masters courses that aimed to develop clinical expertise. The focus of the paper is the clinical placement component of masters courses. Quantitative and qualitative data were combined through use of a questionnaire to a total population sample (n=171) of course tutors of masters courses in healthcare. A very good response rate (n=148, 86.5%) found 89% (n=132) of courses aiming to develop clinical expertise. As a means of developing expertise, emphasis was placed on clinical placement by 38.6% of participants (n=51). The data illustrate the features of clinical placement and raise key issues, such as the emphasis placed on part-time models of placement. Distinct differences between physiotherapy and other courses were highlighted, including physiotherapy's preference for two placements, the 2:1 model, placement of students outside of their place of work, and the use of placements at the end of the theoretical course components. The study has good external validity and can therefore be used as the basis for future work.
Use of simulated patients in development of physiotherapy students' interpersonal skills
Authors: Lewis Mark , Bell Jamie , Asghar Amanda 
Published: May 2014

Aims Research into the effect of using simulated patients on the self-perceived interpersonal skills of physiotherapy students is limited. This study sought to address this by investigating if such an approach is beneficial. Methods A cohort of 2nd year physiotherapy students (n = 35) completed a validated questionnaire that measured interpersonal (communication) skills at baseline (3 weeks before simulated patient interaction), and at follow-up (1 week following interaction). Paired t-tests were used to identify statistically significant shifts in perceived interpersonal skills. Findings Mean (baseline) anxiety and confidence scores were 11.9 (SD) and 13.8 (SD) respectively. Following interaction with simulated patients there was a significant improvement in mean anxiety (11) and confidence scores (15) (P<0.05). Conclusions Interaction with simulated patients appears to reduce student anxiety and increase confidence in communicating with patients.
A simple guide to the interpretation of clinical trial results
Authors: Morrow Brenda M 
Published: May 2014

Introduction The understanding and appropriate interpretation of results of clinical trials are fundamental to critical analysis and clinical decision-making. Reports should differentiate between statistically and clinically signifi cant results. Content This article will provide a guide to interpreting clinical trial results; by exploring the importance of ‘P’ values, the size and precision of a treatment effect and the incorporation of confi dence intervals into the description of the treatment effect, for both dichotomous and continuous variables. Discussion and Conclusions The results of clinical trials should only be used clinically after applying a combination of critical analysis, clinical acumen and common sense. The decision on whether the treatment would be clinically worthwhile must be judged according to the size of the treatment effect, the potential for harm, fi nancial cost, and the patient's likely experience of the intervention.
Qualitative research: Part one – Philosophies
Authors: Nicholls David 
Published: May 2014

Background Qualitative research has made great strides in recent years and it now makes an important contribution to our understanding of health and illness. But there are still many practitioners, academics and researchers who are totally bemused by its principles and practices. Content In the first of a series of three articles exploring qualitative research philosophies, methodologies and methods, I attempt to unravel some of its complexities and peculiarities, in the hope that those readers new to qualitative research will study it further and consider using it in the future. This article deals with broad questions of philosophy; most especially the fundamental difference between a quantitative and qualitative worldview. Conclusions This article explores the difference between a belief in a single objective reality and multiple realities, and relates these to quantitative and qualitative research methods. It also considers the role of theory, focusing on the difference between inductive and deductive reasoning. These concepts are the basis for the second article in the series on qualitative methodologies, to appear in the next issue.
Patient satisfaction with botulinum toxin therapy in adult spasticity
Authors: Sakel Mohamed , Mackenzie Robin 
Published: May 2014

AimsHealth-care authorities in the UK are legally required to consult patients and public on optimizing service delivery. Yet to the authors knowledge, only one audit of patient satisfaction with botulinum toxin (BTX) treatment of spasticity have been published, and no surveys have been conducted in this area. This survey aimed to gain insights into patient perceptions of performance of one service delivering BTX therapy for patients with spasticity in one UK setting, to improve service delivery.MethodsA questionnaire to explore patient satisfaction was developed and piloted by the authors, and sent to a convenience sample of 100 patients seen by the service.FindingsQuestionnaire findings suggest that centralized vs peripatetic services, patient and treatment team characteristics, patients expectations and the treatment setting are influential factors in patient satisfaction. The majority of patients felt that the service met their expectations. Patient dissatisfaction centred on lengthy waiting times.ConclusionsPatient satisfaction is an essential part of the evidence base necessary to evaluate or change a clinical service. This survey revealed dissatisfaction with waiting times for BTX therapy; finding a new therapeutic role for physiotherapists as physio-injectorsrather than BTX injections being provided solely by consultantsis suggested as a potential solution to this. Advantages and disadvantages of potential implications of this are assessed. There is a need for a validated questionnaire and carefully refined multidisciplinary research to build on these service evaluation findings.
An exploration of clients' goals during inpatient and outpatient stroke rehabilitation
Authors: Gustafsson Louise , McLaughlin Kate 
Published: May 2014

Aims The purpose of this pilot study was to explore the goal setting of clients with stroke during inpatient and outpatient rehabilitation. Methods Sixteen participants were recruited from an inpatient (n=6) and outpatient (n=10) stroke rehabilitation programme. A semi-structured interview was conducted to determine participant's goals for rehabilitation and the goals of therapy sessions. Responses were coded according to the International Classification of Functioning, Disability and Health and thematic analysis undertaken to further summarize the responses. Findings Thematic analysis identified a difference in the types of goals identified by the two participant groups. Goals for the inpatient group were focused on activities and participation (n=18, 78%), whereas a more even distribution between activities and participation (n=23, 56%) or body functions and structures (n=18, 44%) was observed with the outpatient group. When asked to identify the perceived goals of therapy session, participants from both groups stated goals primarily related to body functions and structures (74–86%). Conclusions This study has highlighted an apparent shift in clients' goals during the inpatient and outpatient phases of stroke rehabilitation. In addition, a clear discrepancy between the clients' goals and their perceived goals of therapy sessions during both phases of rehabilitation was evident. These findings suggest a need for an improved process of collaborative goal setting during stroke rehabilitation.
Using qualitative observational methods in rehabilitation research: Part two
Authors: Clarke David J 
Published: May 2014

Background Qualitative observational methods are an effective means of detailing social processes and phenomena that constitute the day-to-day reality of practice in rehabilitation units. Of vital importance in this approach is the need to record and analyse fieldnotes in sufficient detail, to ensure the researchers' explanations of particular processes or events are an accurate and credible representation of those phenomena. Content In this second article, the process of participant observation is discussed, and the approaches to recording fieldnotes and working with qualitative observational data are described with illustrative examples. These examples also serve to highlight three principles that researchers should pay attention to when developing fieldnote records. Conclusions Participant observation allows the researcher to gain access to and develop understanding of what the social and occupational world feels and looks like to those who work in rehabilitation. For observational data to be comprehensive and address the research questions posed, the context and organization of social settings as well as phenomena of particular interest should be captured as fully as possible. A considered and rigorous approach to recording and analysing fieldnotes will ensure this is achieved.