bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sharing the care: the key-working experiences of professionals and the parents of life-limited children
Authors: Rodriguez Alison , King Nigel 
Published: May 2014

Aims: To explore the lived experience of caring and care planning for a child with a life-limiting condition (LLC). Method: Using van Manen's conceptualisation of hermeneutic phenomenology, three focus groups were conducted with 21 paediatric palliative care professionals, and interviews were conducted with 20 parents of children with LLCs. Findings: Parents' expectations for support were raised by the diagnosis, but the reality could disappoint, which put pressures on professionals. Current service designs with respect to key working did not always coincide with family preferences. Both parents and professionals found that the care journey required them to shift personas to respond to different contexts. Conclusions: The findings are limited by the sample characteristics, but they provide insight for current policy and practice initiatives. The key worker needs to be mindful of historical care arrangements and be prepared to step into the family ‘team’ arrangements.
Preoperative education: empowering patients with confidence
Authors: Spalding Nicola J 
Published: May 2014

Preoperative education is widely used by health-care professionals all over the world to help patients to prepare for their impending surgery and postoperative needs. The focus of this research was a multidisciplinary preoperative education programme provided in one UK NHS trust for patients awaiting a total hip replacement. The purpose of this research was to gain an understanding of how the preoperative education process achieves beneficial health and wellbeing outcomes proven in previous research. This article reports on one of the themes which arose from the data; namely the beneficial outcome of empowering patients. A case study enabled the researcher and the health-care professionals who provided preoperative education to understand the role of the educational process in empowering patients. It appeared that the educational product and processes enabled patients to gain confidence, which empowered them to prepare for a total hip replacement.
Rehabilitation goals identified by inpatients with cancer using the COPM
Authors: Watterson Julie , Lowrie Daniel , Vockins Helen , Ewer-Smith Charlie , Cooper Jill 
Published: May 2014

The purpose of this study was to investigate the rehabilitation goals of inpatients with cancer. The Canadian Occupational Performance Measure (COPM) was used with 90 inpatients in a cancer rehabilitation centre to identify rehabilitation goals and their level of importance. These goals were divided into the occupational performance categories of self-care, productivity and leisure. Results showed that 65% of goals were related to self-care, 20% to leisure and 15% to productivity. Self-care, leisure and productivity goals were attributed similar importance ratings by the study subjects, with average scores being 8.66, 8.21 and 8.81 respectively (on a scale of 1–10, with 10 being of highest importance). The authors conclude that these findings have important implications for therapists and managers working in cancer rehabilitation who are responsible for the provision of a holistic, client-led service.
Occupational therapy for people with osteoarthritis: Scope of practice and evidence base
Authors: Grant Mary 
Published: May 2014

Literature linking osteoarthritis and occupational therapy is limited and largely descriptive in nature. Existing research studies tend to focus on splinting the arthritic hand, rehabilitation following joint replacement and the provision of assistive devices. The purpose of this study was to explore the scope of occupational therapy practice for people who have osteoarthritis and the nature and source of evidence for its effectiveness. A small-scale exploratory study, using qualitative interviews as a method of data collection, was carried out with ten occupational therapists working in rheumatology, orthopaedics, hand therapy, primary care and social services settings. Interviews were transcribed verbatim and content analysis performed on the data generated. Findings indicated a broader, more holistic scope of practice than the existing literature suggests and a limited evidence base to support effectiveness. Specific ideas for future research in the area evolved from the data, which provide a springboard for much needed evaluation research in this field.
Effect of two seating positions on upper limb function in normal subjects
Authors: Gandavadi Amar , Ramsay Jill 
Published: May 2014

Many upper limb functions are performed in a sitting position. However, if seating is inadequate and poorly designed, back pain and reduced upper limb control may result. This study investigates pelvic posture and performance in an upper limb task. In total, 15 normal healthy volunteers (aged 18–30 years) were seated in posterior and anterior pelvic tilt positions and performed a simple upper limb task. The parameters measured were electromyography of the lumbar paravertebral muscles, time taken to complete the task and the task error rate. The data were analysed by repeated measures analysis of variance (ANOVA) and post-hoc t tests. The results indicate that, when seated in an anterior pelvic tilt position, the error rate decreased (P=0.013) and the electrical activity increased (P=0.008). The time taken to complete the task was not significantly different. Since the error rate decreased when seated in the anterior pelvic tilt position, it might be concluded that this posture facilitated task skill. It is suggested that the increase in electrical activity is related to the increased load on the lumbar muscles in maintaining the posture. This study's generalizability is limited, with small subject numbers and the use of a non-functional task. It is, however, a beginning in addressing the interrelationship between the seated posture and skilled upper limb performance.
Assistant practitioners: Issues of accountability, delegation and competence
Authors: Mackey Hazel , Nancarrow Susan 
Published: May 2014

The NHS Modernisation Agenda, alongside workforce shortages in health-care professions, has led to increasing interest in the role of assistant practitioners in the delivery of health and social care. This article describes the introduction and evaluation of assistant practitioners in occupational therapy who were empowered to work independently in a limited number of interventions and services within an NHS trust. The evaluation involved focus groups with four groups of key stakeholders: the assistant practitioners, their supervisors, managers and service users. Key themes included ambiguity about who takes responsibility for the outcomes of care and uncertainty about challenging the role of the ‘professional’ staff. There was a lack of clarity about how work is ‘delegated’ to the assistant practitioners and it was difficult to determine levels of competence in the new workers, because the existing staff did not recognize their qualifications. These issues need to be addressed in order to optimize the relationships between staff, clarify the roles of team members and ensure that service users receive the most appropriate care from the most appropriate practitioner. The evaluation involved focus groups with four groups of key stakeholders: the assistant practitioners, their supervisors, managers and service users. Key themes included ambiguity about who takes responsibility for the outcomes of care and uncertainty about challenging the role of the ‘professional’ staff. There was a lack of clarity about how work is ‘delegated’ to the assistant practitioners and it was difficult to determine levels of competence in the new workers, because the existing staff did not recognize their qualifications. These issues need to be addressed in order to optimize the relationships between staff, clarify the roles of team members and ensure that service users receive the most appropriate care from the most appropriate practitioner
Health professionals' views on services for patients with cancer-related palliative care needs
Authors: Thomson Margaret , Hourston Paula , Ladley Jo , Findlay Leigh , Kelly Aileen 
Published: May 2014

The purpose of this article is to describe the work undertaken by a multiprofessional palliative care research team. The team explored the views of allied health professionals (AHPs) on issues, barriers, good practice and options in achieving quality, equity and appropriate access to AHP services for patients with cancer-related palliative care needs. Three workshops were carried out in the west of Scotland to ascertain views of AHPs. These were followed by a postal questionnaire to validate the analysis of the workshops content. To improve the quality, equity and access to AHP services for patients with cancer-related palliative care needs, participants suggested that perceived barriers in awareness, communication, resources, education and service delivery need to be addressed. AHPs currently are working on developing practice and guidelines; however, a review of levels of staffing is perceived as essential to allow AHPs to achieve strategic goals.
A review of Days Healthcare wheelchair seating products and their application
Authors: Turner Christine 
Published: May 2014

This article aims to help readers to make the right choices when prescribing seating products. While it is possible to learn about the evaluation process from a theoretical perspective, there is never a substitute for hands-on experience. When evaluating the suitability of a product for a client, detailed assessment should consider his or her postural management needs as well as the risk of tissue breakdown. There are many risk factors and while some people suffer tissue trauma principally as a result of pressure, others may suffer as a consequence of shear or moisture-induced maceration. Therefore, there is no one cushion that is likely to be appropriate for all high-risk situations and it is very challenging to successfully categorize seating products as ‘high risk, medium risk or low risk’. The assessment of postural management needs is also very complex and a user's functional independence can be significantly affected by his or her ergonomic position in relation to the wheelchair. Days Healthcare offers a range of pressure-relieving wheelchair cushions for people at risk of developing pressure sores. The products also improve postural positioning, thus providing for enhanced comfort and ergonomic functioning.
Therapeutic standing for people with multiple sclerosis:
Authors: Baker Karen , Cassidy Elizabeth , Rone-Adams Shari 
Published: May 2014

The purpose of this pilot study was to assess the feasibility and efficacy of a daily standing programme in the community for subjects with multiple sclerosis (MS).A single blind randomized crossover design was used. There were two interventions; daily standing in a standing frame for 30 minutes and a daily exercise programme. Interventions were sequential and crossed after 3 weeks. The primary outcome measures were the Ashworth scale, spasm frequency scale and range of movement. Subjects consisted of six individuals with a diagnosis of secondary progressive MS.Statistically significant improvements were demonstrated in hip and ankle range of movement with standing when compared to the exercise phase for both groups. No significant differences in spasticity or spasm were found although a downward trend was seen.All subjects achieved 30 minutes of therapeutic standing. Three subjects achieved 30 minutes standing after building up tolerance over the 3-week intervention period.In conclusion therapeutic standing increased range of movement in wheelchair dependent subjects. Further examination of the immediate and long-term effects of standing on spasm and spasticity is warranted.
Developing clinical expertise for healthcare professionals through masters courses
Authors: Rushton Alison , Lindsay Geoff 
Published: May 2014

This paper identifies a gap in the existing literature surrounding the role of masters postgraduate courses in developing clinical expertise, and through use of survey methodology describes the characteristics of existing courses. Quantitative and qualitative data were combined through the 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, greatest emphasis was placed on the theoretical components of a course (90%, n=120), with a similar emphasis on clinical placement (38.6%, n=51) and mentorship (46.2%, n=61). Approaches were similar across professions except for the use of placements where a significant difference existed (x2 [132,2] = 25.173, P<0.05) with more allied health professional courses using placements compared to nursing or interprofessional courses. Saturation of the qualitative data was achieved highlighting themes reflective of the different means of developing expertise. The study had good external validity and can therefore be used as the basis for future work.
Suitable moving and handling equipment: A guide
Authors: Fernandes Tanya 
Published: May 2014

Carers and nursing staff involved in manual handling activities are more likely to suffer from workrelated injuries, such as back pain. The employment of assistive equipment such as hoists, profiling beds and transfer boards can, however, minimize these risks and create a safer working environment for the carer and the cared for. This article will focus on guidance and legislation related to the minimization of work-related injuries and will highlight some of the different products available on the market to assist with activities involving the lifting and/or transferring of patients.
Physiotherapy for chronic rhinosinusitis: The use of continuous ultrasound
Authors: Nakhostin Ansari Noureddin , Naghdi Soofia , Farhadi Mohammad 
Published: May 2014

Chronic rhinosinusitis (CRS) is the most common chronic disease in the field of ear, nose and throat and is often very difficult to treat. The aim of this pilot study was to determine the effects of continuous ultrasound (US) on CRS. In a randomized, single-blind, placebo-controlled study, 20 patients were treated with either continuous US (n = 10) or mock-US (n = 10), 3 days a week for 10 treatment sessions. All patients improved after treatment with US. Excellent and good improvements were observed in nine patients. Between-group comparisons of ‘percent improvement’ showed a significantly higher improvement in the US group than in the control group. The total scores of rhinosinusitis symptoms were significantly improved after treatment in both the groups. At one-month follow-up, eight patients in the US group reported no recurrence of the disease and the CRS had recurred in all patients of the control group. This trial demonstrates that continuous US may be an effective tool in the treatment of patients with CRS, although further study is needed.
Physiotherapists' perceptions of problematic musculoskeletal soft tissue disorders
Authors: Poltawski Leon , Watson Tim , Byrne Geraldine 
Published: May 2014

Aims: Many common musculoskeletal disorders are resistant to existing management strategies, causing long-term pain and disability. While arthritic and spinal problems have been prioritized for research, several soft tissue disorders may be equally burdensome for individuals and difficult to treat successfully. Identifying those that are least responsive to treatment may help focus the limited resources available for research and treatment provision. This study aimed to rank the most problematic disorders, and identify contributory factors, to inform the debate on research and service priorities in the management of musculoskeletal disorders. Methods: The views of practising physiotherapists on the most problematic soft tissue disorders were sought using a postal questionnaire survey and telephone interviews. The questionnaire was sent to 193 experienced musculoskeletal physiotherapists working in National Health Service and private clinics in south-east England. Findings: The response rate was 48%. The top three problematic disorders were identified as frozen shoulder, plantar fasciitis and tennis elbow. Subsequent interviews with 20 respondents indicated that inadequate differential diagnosis, triaging and differences in therapeutic practice may account for some of the observed variation in outcomes. Conclusions: A greater focus on these particular disorders and issues by both clinicians and the research community is warranted.
Qualitative research: Part three - Methods
Authors: Nicholls David 
Published: May 2014

Background: There are still many practitioners, academics and researchers who are bemused by the principles and practices of qualitative research. In the third and final article in this three part series, I look at sampling in qualitative studies, methods of data collection and analysis. Content: Building on the previous two articles, I highlight the importance of rigour and explore some of the different criteria used by researchers to demonstrate that their research is trustworthy. I include a brief discussion of some of the more recent trends in mixed-method or post-positivist research. Conclusions: Qualitative research is different in many ways to quantitative, and it cannot be approached with the same mind-set. It seeks to explore different aspects to quantitative research, focusing on the individual experience, rather than conclusions that can be drawn from large groups. Because of these differences, the two approaches to research should not be seen as alternatives, but complementary.
Predictors of fitness improvements in phase III cardiac rehabilitation exercise
Authors: McKee Gabrielle 
Published: May 2014

This study aimed to determine if age, gender, body mass index and pre-programme fitness were predictors of fitness improvements in phase III cardiac rehabilitation programmes. The main objective was to propose how this information could be used to further tailor exercise intervention to individual needs. A sample of 119 patients were included in this single site, practice-based, longitudinal observational investigation of patients before and after attending a structured cardiac rehabilitation programme. Patient fitness was measured both before and after participation in a phase III cardiac rehabilitation programme, using a Bruce protocol sub-maximal exercise stress test. Significant increases in fitness occurred after participation in the cardiac rehabilitation programme. The factor that significantly influenced pre-programme fitness was age. The factors that significantly influenced fitness improvements were pre-programme fitness and gender, with the least fit participants and males improving fitness most. Findings suggest potential methods of further individualizing the exercise component of cardiac rehabilitation and highlight areas for further exploration.
Reliability of hand function testing instruments in patients with muscular dystrophies
Authors: Aldehag Anna S , Jonsson Hans , Littorin Susanne , Ansved Tor 
Published: May 2014

Aims Welander distal myopathy (WDM) and myotonic dystrophy type 1 (DM1) are conditions characterized by gradually impaired hand function. Measurement of hand function is therefore important in therapy for patients. However, to date reliability of common hand function test instruments for these patients has not been evaluated. The aim of the study was to test intra-rater reliability (test-retest) of the hand function testing instruments: the Grippit®, Grip Ability Test (GAT), hand-held myometer (Microfet2TM) and Purdue Pegboard in patients with WDM and DM1. In addition, inter-rater reliability of these instruments was tested in DM1 patients. Methods For test-retest, the two patient groups (16 patients in each group) were tested on 2 consecutive weeks, on the same day of the week and at the same time of day. During the second week, the DM1 patients were randomly tested either before or after retest for inter-rater reliability. Results Mainly good–very good (intra-class correlation coefficient≥0.61) intra-rater and inter-rater reliability were found in three out of four instruments tested: the Purdue Pegboard, Grippit and the hand-held myometer for both WDM and DM1 patients. Conclusions The instruments are thus considered reliable for evaluating hand function in patients with WDM and DM1. However, the GAT and pinch grip measured with the Grippit® need to be interpreted with caution, as the reliability of these instruments varied from fair to good.
Caregiver stress in traumatic brain injury
Authors: Blake Holly 
Published: May 2014

Aims Many patients experience physical, behavioural, cognitive and emotional problems following traumatic brain injury (TBI). They may require continuing care for many years, most of which is provided by informal caregivers, such as spouses, parents, or other family members. The caregiving role is associated with a range of adverse effects including anxiety, depression, poor physical health and lowered quality of life. This article explores issues around caregiver stress; highlighting interventions for this group and areas for further research. Methods Literature exploring the impact of caregiving, its influencing and alleviating factors and interventions for caregivers of people with TBI is discussed, with brief critical analysis of key studies. Findings Research suggests that caregiver characteristics, coping strategies, their appraisal of the situation and social networks may be associated with the amount of distress experienced. Many caregivers have unmet needs such as respite care and information provision on TBI. Providing information may help to alleviate strain. Community-based family therapies providing education, support and counselling can help to decrease distress and improve aspects of family functioning, although evidence for these is lacking. Conclusions There is a need for more well-designed, controlled studies evaluating the impact of interventions to alleviate caregiver strain.
Qualitative research: Part three – Methods
Authors: Nicholls David 
Published: May 2014

Background There are still many practitioners, academics and researchers who are bemused by the principles and practices of qualitative research. In the third and final article in this three part series, I look at sampling in qualitative studies, methods of data collection and analysis. Content Building on the previous two articles, I highlight the importance of rigour and explore some of the different criteria used by researchers to demonstrate that their research is trustworthy. I include a brief discussion of some of the more recent trends in mixed-method or post-positivist research. Conclusions: Qualitative research is different in many ways to quantitative, and it cannot be approached with the same mind-set. It seeks to explore different aspects to quantitative research, focusing on the individual experience, rather than conclusions that can be drawn from large groups. Because of these differences, the two approaches to research should not be seen as alternatives, but complementary.