ORCID Profile
0000-0003-4471-0509
Current Organisation
University of South Australia
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Publisher: Wiley
Date: 20-12-2012
Abstract: Following a stroke, in iduals' abilities may not match the demands of their environment and occupations, resulting in compromised occupational performance. The process of adaptation can enable adjustment of the way occupations are performed to achieve occupational mastery. The purpose of this honours study was to investigate and describe older adults' lived experience of occupational adaptation following a stroke. An interpretative phenomenological approach was used. Participants in the community were recruited through Domiciliary Care service co-ordinators. In-depth interviews were conducted with three men and two women, aged 68-78 years who had experienced a stroke up to 14 years ago. Data were analysed using the Colazzi's method to formulate themes. Experiencing a stroke is initially a 'shock to the system' and while 'your whole life changes', there are still ways to 'get on and do your best'. The theme 'your whole life changes' had three subthemes: 'apprehension and fear', 'problem solving' and 'stretching the limitations'. Resilience, motivation and effort are the required qualities for adaptive responses after stroke. Coping strategies identified to facilitate occupational mastery include the use of humour, touch, expressing anger, using self-talk, maintaining hope, having a sense of being fortunate and supportive friends and family. These findings support an empowering approach to therapy, facilitating clients to identify and utilise in idually appropriate coping strategies to negotiate negative emotions and apprehension and enable the required personal qualities for occupational adaptation.
Publisher: SAGE Publications
Date: 20-07-2015
Abstract: Information about challenges for occupational therapists is typically provided in small-scale studies from different perspectives. The purpose of this meta-synthesis was to synthesise and report about challenges in occupational therapy practice that appear to penetrate across the profession. Databases searched were Ovid Medline, EMBASE, AMED and CINAHL. Search terms were selected after gaining understanding of the topic: occupational therap* AND Exp burnout / OR Exp morals / OR retention OR clinical reasoning OR new graduate OR novice OR transition-to-practice. Studies were critically appraised using the criteria of credibility, transferability, confirmability and dependability. Findings, along with direct quotes, were extracted and data compared and contrasted through first, second and third order analysis. Twenty-four studies were included in the meta-synthesis and three constructs were identified: ‘challenges in context’ ‘personal challenges’ and ‘social and cultural challenges’. These findings inform knowledge about constraining factors on clinical reasoning and the alignment of practice with the occupational therapy philosophy, and give insight into satisfaction with practice, ethical and professional behaviours. These findings could inform provision of professional support, education for students and enhance agency to reform practice. More research is needed about professional socialisation, clinical reasoning and ethical issues.
Publisher: Wiley
Date: 04-10-2014
Abstract: Growth in the number of occupational therapy programmes in Australia has resulted in a critical shortage of academics. When experienced clinicians are recruited into academia, they may find the transition process difficult. The study aimed to explore clinicians' perspectives of what happens when they transition into academia. A constructivist grounded theory approach was used in this qualitative research project. Recruitment was conducted using purposive and theoretical s ling from occupational therapy programmes in Australia. Interview transcripts were analysed using constant comparative method through a process of open, axial, selective and theoretical coding. Sixteen participants engaged in semi-structured in-depth interviews. The theory of transition into academia included a process of 'weighing up the commitment' to academia and the core category of 'a good fit for me'. The transition was characterised by the taxing nature of the work, the need to learn multiple aspects of a new role, the different values and beliefs in an academic environment and the amount of time it took to achieve success. Participants underwent a shift in identity to adjust to the academic environment and eventually reached a point where they were able to judge if academia suited them. Australian universities have long-standing cultural practices which differ considerably from clinical settings. Transitioning from a clinical to an academic occupational therapy role requires complex adjustments to values, beliefs and identity. The process involved consideration by the new academics of their 'fit' for academia, and how committed they were to stay.
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.APMR.2019.01.011
Abstract: To systematically search the literature and construct a meta-synthesis of how choice and control are perceived by people with spinal cord injury (SCI). Medline, Academic Search Premier, CINAHL, Cochrane, EMBASE, HealthSource, ProQuest, PsychInfo, SAGE, and SCOPUS were searched from 1980 until September 2018 including all languages. Reference lists of selected studies were also reviewed. Eligible qualitative studies included perspectives about choice of control as reported by people with an SCI. Studies were excluded if they included perspectives from other stakeholder groups. A total of 6706 studies were screened for title and abstract and full text of 127 studies were reviewed resulting in a final selection of 29. Characteristics of the studies were extracted along with any data (author interpretations and quotes) relating to perspectives on choice and control. First-order analysis involved coding the data in each study and second-order analysis involved translating each segment of coded data into broader categories with third-order analysis condensing categories to 2 broad overarching themes. These themes were experiencing vulnerability or security and adapting to bounded abilities. Perspectives of choice and control are influenced by interrelated environmental, interpersonal, and personal contexts. From a personal perspective, participants reported a readiness for adaptation that included turning points where emotional and cognitive capacity to make choices and take control changed. Health professionals need to be responsive to this readiness, promote empowerment and foster, rather than remove, hope.
Publisher: Public Library of Science (PLoS)
Date: 29-09-2023
Publisher: Wiley
Date: 07-02-2023
Abstract: Occupational therapists working in community aged care play a key role in service provision because of their expertise in considering the person, their occupations, and environmental context. To further understand occupational therapy practice in community aged care, this study aimed to explore the approaches, models, frames of reference, assessments, interventions, and outcome evaluation methods being used by Australian occupational therapists in aged care. An online questionnaire was developed, piloted, and delivered to occupational therapists working in community aged care in Australia. Responses to closed‐ended questions were analysed using descriptive statistics, and a summative approach to content analysis was applied to open‐ended questions. Seventy‐one occupational therapists employed in community aged care across Australia participated in the questionnaire. Almost half of the respondents were employed in private practice. All respondents used a compensatory approach to practice, whereas just over three‐quarters used a restorative approach. The Person‐Environment‐Occupation (PEO) model was the most frequently used occupation‐focused model ( n = 45). The biomechanical and rehabilitative frames of reference were each used by over two thirds of respondents. Cognitive assessments were most common, followed by functional and environmental assessments. The interventions of equipment and home modifications were very common followed by remedial therapy. Community aged care occupational therapists show coherence in theory‐to‐practice application, but there is wide ersity in practice decisions and possibly gaps in practice. Occupational therapists remain firmly client centred but apply compensatory approaches more than reablement approaches. This trend may be due to the influence of aged care funding models and limits on time. In addition to reacting to crisis, there is scope for occupational therapists to have a greater focus on early intervention to support dementia care and prevent falls.
Publisher: Science Publishing Group
Date: 2016
Publisher: Wiley
Date: 14-09-2023
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.NEDT.2013.06.010
Abstract: The meta-synthesis provides a collective qualitative understanding of the transition experience from nursing and allied health clinician to academic. This understanding assists the preparation for those making the transition as well as giving guidance to those who have recently commenced in academia. Published qualitative studies about the transition from clinician to academic were systematically selected in order to integrate their findings in a meta-synthesis. Databases searched were CINAHL, EMBASE, MEDLINE, SCOPUS, 'Education Research Complete', and 'Academic Search Premier'. The search terms used were academ* OR facult* AND transition. The search was further refined by adding the terms qualitative AND clinic* OR practit* OR profession*. Studies were appraised for credibility, neutrality and relevance. Findings along with direct quotes were extracted from the studies and thematic analysis was used within an interpretative framework. Seven studies were included in the meta-synthesis. The included studies were from nursing, physiotherapy, health and social care. The central theme was a shift in identity from clinician to academic which involved a progression through 4 phases over a period of 1- 3years. These phases were 'feeling new and vulnerable' 'encountering the unexpected' 'doing things differently' and 'evolving into an academic'. New academics felt unsettled and uncertain in the initial phases of transition. It is proposed that these challenges are related to difficulty extracting tacit knowledge and immersion in a new culture. The change of values and beliefs to adapt to the new culture require a concurrent identity shift which can take up to three years. Newcomers need collegial and institutional guidance with prioritization of tasks to address the multiplicity of the academic role and avoid frustration and disillusionment.
Publisher: Springer Science and Business Media LLC
Date: 16-03-2023
DOI: 10.1007/S11136-023-03387-0
Abstract: This study analysed data from a national survey of people living in Australian Residential Aged Care Facilities (RACFs) reporting on what is the best thing about where they live and suggestions for improvement. Data from prior to the Covid-19 pandemic were compared with data during the Covid-19 pandemic. Qualitative data from the Happy Life Index Survey were analysed using summative content analysis to code the responses in the data sets and then organise them into categories. Once categorised, the pre-Covid-19 and mid-Covid-19 data sets were compared using descriptive statistics. A total of 4745 residents, from over 100 RACFs, provided 8512 open-text responses to at least one of the two survey questions. Pre-Covid-19 responses were compared with mid-Covid-19 responses and those trending towards relevance (5–10% change) were identified. There were both positive and negative relevant percent changes for staff number, food (general comments), and friendliness. A trending positive percentage change was observed for staff quality and the internal environment. There was a trending negative relevant percentage change for lifestyle activities, staff generally, level of contentedness, the general environment, general choice, and general views about the service. People living in RACFs notice the changes in staffing levels and visitors during restrictions imposed during infectious outbreaks. During these times, they appreciate the quality of the staff attending to their needs and the quality of their food. Further exploration is needed of the value of lifestyle activities and strategies to promote feelings of contentedness and general wellbeing during times of restriction.
Publisher: Frontiers Media SA
Date: 20-12-2021
DOI: 10.3389/FPUBH.2021.768778
Abstract: Intergenerational programs have long been identified as a way of promoting health and well-being for participants. Continuing such programs during pandemic restrictions is challenging and requires a novel approach. This community case study describes the use of co-design to create a high-level intergenerational program model, adapt it to specific community needs, and deliver it virtually with the aid of modern communication technology. Interviews conducted after the program had finished indicated that despite the challenges and limitations of the virtual environment, meaningful connections were achieved across three generations. The high-level program model may serve as a basis for other programs wanting to explore this area.
Publisher: Wiley
Date: 11-12-2018
Abstract: Professionals in health and social care have high workloads and are working with erse populations in hierarchical and complicated service delivery systems. There is increasing pressure on new graduates because they are expected to be immediately work ready and may not receive adequate support or supervision. It is well known that there can be issues with satisfaction and retention rates of new graduates due to the challenges they experience. Ethical tensions are an unavoidable part of occupational therapy practice and may contribute to unique challenges for new graduates who may not yet have the personal resources to make sense of these independently. New graduate occupational therapy perceptions of ethical tensions have not yet been explored and this study sought to fill this gap. Exploring the ethical tensions experienced by new graduates can inform appropriate policies, procedures, preparedness and standards. A qualitative study using narrative enquiry was undertaken in which stories were gathered from eight new graduate occupational therapists who had been working for 6-24 months. Semi-structured in-depth interviews were used to gather data. Transcripts were analysed following narrative analysis guidelines. Member checking, reflexivity and keeping an audit trail of methodological and analytical decisions were employed to strengthen the rigour of the study. Analysis revealed six predominant themes: working in a business model, respecting client choice, dealing with aggression and death, mandatory reporting is hard to do, differing team values, and feeling devalued and unsupported. The findings highlight the importance of understanding the ethical tensions faced by new graduates and of exploring ways to assist new graduates to respond constructively to ethical dilemmas, distress and uncertainties. To address the risk of attrition, graduates need systems in place for accessing support to increase preparedness to respond to ethical tensions when they do arise.
Publisher: SAGE Publications
Date: 28-04-2021
DOI: 10.1177/02692155211012324
Abstract: To capture qualitative research about the perspectives and reasoning of allied health professionals about variability in the use of clinical guidelines in stroke rehabilitation. Ovid Medline, Psychinfo, Cochrane, Ovid Emcare, Scopus and Web of Science. The review protocol followed the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. Qualitative or mixed methods research that provided qualitative data about use of clinical guidelines delivered by allied health professionals in stroke rehabilitation was included. Clinical guidelines included any evidence-based documents that guided allied health stroke rehabilitation practice. All studies were screened in duplicate at title and abstract and then at full text. Included studies were appraised using the McMaster Critical Appraisal Tool. Data from 850 allied health professionals in 22 qualitative research studies from seven different countries were analysed and synthesised. Four themes were developed including: context necessitates strategy, all clients are different, systemic changes are needed and need a good reason to change something. The findings aligned with the four arms of evidence-base practice. Allied health professionals use clinical guidelines when they align with their reasoning and match the 'sweet spot' for client goals and circumstance. Clinical guideline use is attributed to sufficient resourcing, time and motivation and a strong research culture within health systems. Variabilities in clinical guideline use by allied health professionals are due to their clinical reasoning, contextual factors, client characteristics and enabling health systems.
Publisher: Informa UK Limited
Date: 08-10-2022
DOI: 10.1080/09638288.2021.1984592
Abstract: Following a brain injury survivors may have physical, or cognitive changes or behaviours which bring safety risks into play when engaging in activities. Therapists experience tensions in enabling the dignity of participation in the context of managing risk. Ten occupational therapists and seven physiotherapists participated in a grounded theory study utilising semi-structured in-depth interviews to explore the tensions between dignity and management of safety risks. Data were analysed using constant comparative method and a process of moving from open coding to categories to theory development. The process of weighing up was central to the therapists' approach to supporting dignity while managing risk. Respecting dignity itself is placed at risk when preventing harm is weighted higher than living a full life. Therapists who use weighing up as a process that respects dignity place greater value on the principles of respecting autonomy and promotion of justice for people with a brain injury. Rather than taking control and attempting to minimise risk therapists who privilege the perspective of the client, and provide opportunities for learning through failure or success, enable clients to live a full life.IMPLICATIONS FOR REHABILITATIONEnsuring that clients with brain injury are safe often requires therapists to exercise control and remove agency thus removing the rights of the client to the dignity of risk and living a full life.Providing opportunities within rehabilitation for clients to experience failure and success enables learning and thereby support dignity.Privileging the client perspective provides clients the dignity of living a normal life.
Publisher: Wiley
Date: 03-04-2011
DOI: 10.1111/J.1440-1630.2011.00927.X
Abstract: In common with other health professionals, occupational therapists have a growing ethical and legal obligation to maintain competence and currency in their area of practice. Despite this context of increasing demands for professional accountability, there is little known about how occupational therapists perceive the role and meaning of professional currency in their day-to-day practice. This qualitative study sought to explore this further. Four focus group interviews were conducted, with 17 South Australian occupational therapists. Participants worked in a variety of practice areas. They covered both metropolitan and rural settings and ranged from being recent graduates to experienced therapists. The interviews involved facilitating small group discussion around a series of open-ended semi-structured questions. The resulting discussions were recorded and transcribed. Thematic analysis was utilised to explore participants' perspectives. Thematic analysis of the transcripts revealed five themes. These included: self-determination perceived capacity workplace impact you need to have people around and looking after yourself. These themes were conceptualised as incorporating dynamic foundational and constructional aspects. Foundational aspects facilitate or hinder the pursuit of professional currency, and constructional aspects encompass the meaning and value ascribed to professional currency. These findings yield some interesting insights into the way therapists think about and structure their professional learning, and provide direction to plan professional development activities based on self-identified need and preference.
Publisher: Public Library of Science (PLoS)
Date: 21-06-2022
DOI: 10.1371/JOURNAL.PONE.0270051
Abstract: Practice-integrated education and professional development programs (also known as residencies), have been available to pharmacists in America and the United Kingdom for many years. In 2016, the Society of Hospital Pharmacists of Australia launched Australia’s novel Foundation Residency Program to support the development of early-career pharmacists, and has been implemented across many hospitals nationally. This model was adopted by the South Australian (SA) public hospital pharmacy statewide service and was granted full accreditation. The study aimed to explore key stakeholders’ expectations and early perceptions of the structure, role and impact of the SA program and in that process, to identify key influencing factors and strategies informing future program planning and design. Purposeful s ling was adopted to recruit participants who oversee preceptors and residents, across all employment levels and pharmacy service sites. Stakeholders participated in in idual semi-structured interviews. Each interview was audio-recorded and transcribed verbatim. The transcribed dataset was managed using NVivo software TM (version 10) and analysed using reflexive thematic analysis through the lens of the PRECEDE-PROCEED logic model framework. Thirty-three staff consented to participate. Participants were de-identified with a randomly assigned code number. Three key themes were identified using reflexive thematic analysis alignment of program goals and visions, culture shift to prioritising workforce development as core business, program structure supports focused workforce development. Participants view the residency as beneficial for development of the residents, preceptors, and the hospital pharmacy workforce. The multisite structure was a strength of the program. Whilst it was acknowledged that the rotations, cross-site rotations, and research project presented challenges, they were deemed worth the investment. Overall, it was felt that incremental increases in program capacity will occur over time, as culture changes, and as investing in workforce development becomes core business. The findings have led to several key recommendations to guide program expansion.
Publisher: Wiley
Date: 31-10-2022
DOI: 10.1111/HEX.13636
Abstract: Acquired brain injury (ABI) can result in considerable life changes. Having choice and control over daily life is valued by people following ABI. This meta‐synthesis will analyse and integrate international research exploring perspectives of choice and control in daily life following ABI. Databases were searched from 1980 to 13 January 2022 for eligible qualitative studies. After duplicates were removed, 22,768 studies were screened by title and abstract, and 241 studies received full‐text assessment with 56 studies included after pearling. Study characteristics and findings were extracted that related to personal perspectives on choice and control by people with an ABI (including author interpretation and quotes). Data from each study were coded and then segments of coded data across the studies were compared to create multiple broad categories. Findings were then reduced from categories into 3 overarching themes with 12 subthemes. These themes were: (1) feeling like a second‐class citizen (2) reordering life and (3) choosing a path. Participants with an ABI tussled between their feelings of loss following brain injury and their thinking about how they start to regain control and become agents of their own choices. The themes describe their sense of self, their changed self and their empowered self in relation to ‘choice and control’. Re‐engaging with choice and control after ABI is dynamic and can be challenging. Health professionals and supporters need to facilitate a gradual and negotiated return to agency for people following ABI. A sensitive and person‐centred approach is needed that considers the readiness of the person with ABI to reclaim choice and control at each stage of their recovery. Clear service or process indicators that are built on lived experience research are needed to facilitate changes in service delivery that are collaborative and inclusive. This review included the voices of 765 people living with ABI and was conducted by a erse team of allied health professionals with practice knowledge and research experience with people following ABI. Twenty‐nine of the 56 included studies had participants contributing to their design or analysis.
Publisher: Public Library of Science (PLoS)
Date: 31-05-2017
Publisher: SAGE Publications
Date: 02-2022
DOI: 10.1177/03080226211064475
Abstract: Consumer involvement in occupational therapy programmes is one of the accreditation requirements of the Occupational Therapy Council in Australia. Consumers are direct recipients of occupational therapy services. Current knowledge about consumer involvement within occupational therapy education is minimal and mostly in mental health. This study identifies the trends for involvement and methods for recruitment and retention of consumers in Australian occupational therapy university education programmes. Twenty-one occupational therapy programme directors in Australian universities were directly invited by email to participate in an online questionnaire. Prior to distribution, the questionnaire was piloted and the content validity tested. Analysis of closed-ended questions occurred using frequencies and percentages and content analysis occurred with open-text responses. Nine programme directors completed the questionnaire. Consumers were mainly involved in delivering lectures, sharing stories and having discussions in small groups. Consumers were recruited to programmes through collaboration with organisations and/or by direct approach. The main retention strategies included employing consumers as university educators and providing support before/during involvement. Consumer involvement in curricula addresses university programme requirements and aims to prepare students for consumer-focussed practice. The findings inform educators about erse ways of recruiting, retaining and involving consumers in their programmes.
Publisher: Wiley
Date: 18-07-2022
Publisher: Elsevier BV
Date: 09-2020
Publisher: Informa UK Limited
Date: 28-08-2020
Publisher: Wiley
Date: 08-11-2018
Abstract: Curriculum mapping involves systematic charting of programme content against professional competencies. This process can reveal strengths, gaps and redundancies within educational programmes. Curriculum mapping occurred using intended learning (ILOs) as documented in in idual courses and linking them to units and elements within the occupational therapy minimum competency standards (ACSOT) and Miller's Framework of competency. Five occupational therapy academics and two impartial research assistants identified links between ILOs and units and elements of the ACSOT. Analysis of each course in the curriculum was completed by two reviewers. A systematic protocol was developed that enabled a transparent process and resolution of discrepancies between reviewers. There were many links (47% of total) between the documented curriculum and ACSOT Unit 1 Professional attitudes and behaviours. The other six units of the ACSOT had between 5% (Unit 7) and 16% links (Unit 3). No links were made between ILOs and the elements of evaluation (4.4), cessation (3.7) and quality assurance of services (7.3). Difficulties mapping ILOs to units and elements revealed inconsistencies in specificity and language in the ILOs and also ambiguities and gaps within the standards themselves. Mapping against Miller's framework showed a steady increase in performance expectations of students across the four years levels. Curriculum mapping is recommended for critical reflection about content of occupational therapy programmes and to review pedagogical approaches. This process revealed strengths and weaknesses of the occupational therapy curriculum being mapped but also revealed insight into the current ACSOT that may inform future iterations.
Publisher: Wiley
Date: 28-07-2021
Abstract: The manual wheelchair skills training programme is used to structure teaching manual wheelchair use for people following injury or disability. This pilot study aimed to explore the outcomes of introducing a group wheelchair skills training programme on skill performance, confidence and frequency of wheelchair use for people with lower limb utation in a rehabilitation setting from the perspective of participants and group facilitators. This pilot study used a two‐phase mixed methods nested design. Eleven people with lower limb utations received a minimum of two 45‐min wheelchair skills sessions, using the Wheelchair Skills Training Program, delivered in a mix of group and one‐to‐one sessions. In phase one, wheelchair skill performance, confidence and frequency were measured using the Wheelchair Skills Test Questionnaire‐Version 5.0, goal achievement was measured through the Functional Independence Measure and Goal Attainment Scale. These measures were repeated in phase two. Nested within phase two was qualitative data collection. Interviews were conducted with eight participants and a focus group held with three programme facilitators, to gather their perceptions of the training process. Descriptive statistics were used to analyse and report quantitative data and thematic analysis was used to combine qualitative data from the two participant groups. Post intervention, the mean Wheelchair Skills Test Questionnaire score increased in performance (42.3 ± 13.4), confidence (33.9 ± 20.7) and frequency (33.9 ± 27.3). Goal Attainment was achieved or exceeded by 91% of all participants. Four themes were developed from qualitative data including, “motivators driving learning,” “delivery methods, structure and profile of the Wheelchair Skills Training Program,” “managing risk and safety” and “confidence in wheelchair use.” The pilot study found that The Wheelchair Skills Training Program can improve wheelchair performance, confidence and frequency to support enhanced safety, independence and quality of life for people with lower limb utations.
Publisher: Public Library of Science (PLoS)
Date: 13-12-2021
DOI: 10.1371/JOURNAL.PONE.0261389
Abstract: Podiatrists regularly use scalpels in the management of foot pathologies, yet the teaching and learning of these skills can be challenging. The use of 3D printed foot models presents an opportunity for podiatry students to practice their scalpel skills in a relatively safe, controlled risk setting, potentially increasing confidence and reducing associated anxiety. This study evaluated the use of 3D printed foot models on podiatry students’ anxiety and confidence levels and explored the fidelity of using 3D foot models as a teaching methodology. Multiple study designs were used. A repeated measure trial evaluated the effects of a 3D printed foot model on anxiety and confidence in two student groups: novice users in their second year of podiatry studies (n = 24), and more experienced fourth year students completing a workshop on ulcer management (n = 15). A randomised controlled trial compared the use of the 3D printed foot models (n = 12) to standard teaching methods (n = 15) on students’ anxiety and confidence in second year students. Finally, a focus group was conducted (n = 5) to explore final year student’s perceptions of the fidelity of the foot ulcer models in their studies. The use of 3D printed foot models increased both novice and more experienced users’ self-confidence and task self-efficacy however, cognitive and somatic anxiety was only reduced in the experienced users. All changes were considered large effects. In comparison to standard teaching methods, the use of 3D printed foot models had similar decreases in anxiety and increases in confidence measures. Students also identified the use of 3D foot models for the learning of scalpel skills as ‘authentic’ and ‘lifelike’ and led to enhanced confidence prior to assessment of skills in more high-risk situations. Podiatry undergraduate programs should consider using 3D printed foot models as a teaching method to improve students’ confidence and reduce their anxiety when using scalpels, especially in instances where face-to-face teaching is not possible (e.g., pandemic related restrictions on face-to-face teaching).
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.APMR.2017.02.024
Abstract: To report and synthesize the experiences, needs, and preferences of carers of stroke survivors undergoing inpatient rehabilitation. MEDLINE, CINAHL, Embase, PsycINFO, and Web of Science were searched to March 2016. Reference lists of relevant publications were searched. No language restrictions were applied. Eligible qualitative studies reported the experiences of carers of stroke survivors who underwent inpatient rehabilitation. The search yielded 3532 records 93 full-text publications were assessed for eligibility, and 34 documents (33 studies) were included. Comprehensiveness of reporting was assessed using the Consolidated Criteria for Reporting Qualitative Health Research framework. Data on the characteristics of included studies were independently extracted by 2 authors. Differences in data extraction between authors were resolved through discussion or by a third author. All text in studies' results and discussion sections were extracted for analysis. Extracted texts were analyzed inductively using thematic synthesis. Seven analytical themes were developed that related to the carers' experiences, needs, and preferences: (1) overwhelmed with emotions (2) recognition as a stakeholder in recovery (3) desire to be heard and informed (4) persisting for action and outcomes (5) being legitimate clients (6) navigating an alien culture and environment and (7) managing the transition home. This systematic review provides new insights into the experiences, needs, and preferences of carers of stroke survivors undergoing inpatient rehabilitation. Carers experienced distress as they navigated a foreign culture and environment without adequate communication and processes in place for their inclusion. We recommend deliberate efforts to provide a more inclusive environment that better supports and prepares carers for their new role.
Publisher: SAGE Publications
Date: 08-2013
DOI: 10.4276/030802213X13757040168351
Abstract: A meta-synthesis is a means of extracting data from multiple qualitative studies about the same topic, re-analysing the findings and bringing them together as a collective whole. Data from six qualitative studies that investigated the experience of engaging in occupation following a stroke were extracted and reanalysed with the purpose of gaining a greater understanding of the subjective experience to inform occupational therapy practice. Six databases were systematically searched for literature published in English during 1990–2011. Seven studies were appraised using the Critical Appraisal Skills Programme tool six of these were included in the meta-synthesis. Five conceptual themes regarding occupational engagement emerged from the review: an emotional response, impact on identity, role of significant others, community access and the process of occupational adaptation. Engagement in occupation following a stroke is linked to self-identity and an emotional response both of these, in turn, have an impact on capacity for occupational adaptation. In iduals are situated within a context of significant others and community. These findings give occupational therapists greater insight into the experience of older people following stroke in community settings.
Publisher: Informa UK Limited
Date: 10-11-2016
DOI: 10.1080/09638288.2016.1247470
Abstract: Older people living in the community need to plan for getting help quickly if they have a fall. In this paper planning for falls is referred to as contingency planning and is not a falls prevention strategy but rather a falls management strategy. This research explored the perspectives of older people and community workers (CWs) about contingency planning for a fall. Using a qualitative descriptive approach, participants were recruited through a community agency that supports older people. In-depth interviews were conducted with seven older people (67-89 years of age) and a focus group was held with seven workers of mixed disciplines from the same agency. Older people who hadn't fallen were included but were assumed to be at risk of falls because they were in receipt of services. Thematic analysis and concept mapping combined the data from the two participant groups. Four themes including preconceptions about planning ahead for falling, a fall changes perception, giving, and receiving advice about contingency plans and what to do about falling. Both CWs and older people agree contingency planning requires understanding of in idual identity and circumstances. CWs have limited knowledge about contingency planning and may be directive, informative, or conservative. Implications for Rehabilitation Falls can result in serious consequences for older people. There is an evidence-practice gap as availability of and access to contingency planning does not necessarily mean older people will use it in a falls emergency. Older people prefer community workers to be directive or informative about contingency planning options but they do want choice and control. Increased community workers knowledge of, and collaborative decision-making about, contingency planning may promote patient-centered services and assist in closing the evidence-practice gap.
Publisher: SAGE Publications
Date: 20-07-2016
Abstract: Dementia can affect participation and engagement due to deprivation of cognitive, social and sensory stimulation. To meet this need, educators and a service provider collaborated for occupational therapy students to provide cognitive stimulation therapy for people with dementia. We used a published, evidence-based cognitive stimulation therapy programme called ‘Making a Difference’. However, due to student availability, we adapted the programme to be conducted once weekly for 12 weeks by students in pairs. These services occurred in both community and residential settings. Following completion of the programme in 2012, perspectives of staff ( n = 8), family carers ( n = 5) and three people with dementia were sought about their involvement. Semi-structured interviews were recorded, transcribed and analysed using thematic analysis. We found three themes of ‘something to talk about’, ‘it was a new relationship’ and ‘wanting to have a go’. Despite some initial concerns about people with dementia becoming stressed, the programme promoted social interactions, participation and engagement. The students adopted a relationship-centred approach with empathy and deliberate planning of sessions being important. Through provision of the adapted Making a Difference programme, occupational therapy students were able to fulfil an unmet need while learning from their experience.
Publisher: Elsevier BV
Date: 09-2023
Publisher: Informa UK Limited
Date: 10-08-2020
Publisher: Springer Science and Business Media LLC
Date: 12-07-2017
Publisher: Routledge
Date: 14-09-2023
Publisher: SAGE Publications
Date: 09-10-2020
Abstract: Early career occupational therapists experience considerable learning. This research sought to develop a theory of how they learn once practising. The research employed a constructivist grounded theory methodology. Interviews were conducted with 20 participants who were either experienced ( n = 8), early career occupational therapists ( n = 10) or in supporting roles for early career occupational therapists ( n = 2). Participants were asked their views about what early career occupational therapists find troublesome and how they respond. Data were collected and analysed concurrently. Open, focused and theoretical coding were used to develop a theory. The theory of learning-to-practise occupational therapy included four learning thresholds: consolidating professional reasoning navigating into the workplace building competence and confidence and developing a personal theory and practise style. There were 11 strategies identified that early career occupational therapists use to cross the learning thresholds. Early career occupational therapists’ understanding and value of knowledge shifted, which culminated in them ‘realising’ their personal theory and practice style. They refined their values and beliefs and learned to be more deliberate and reflective in their thinking and actions. Early career occupational therapists were challenged, which promoted learning. This research extends understanding of the learning needs, thinking and actions taken by early career occupational therapists to cross learning thresholds and to develop their personal theory and practice style.
Publisher: Elsevier
Date: 2021
Publisher: Mark Allen Group
Date: 04-2011
DOI: 10.12968/IJTR.2011.18.4.198
Abstract: Linda Schouten, Carolyn Murray, Kobie Boshoff Aims: This article describes a study evaluating a stroke rehabilitation group programme from multiple perspectives, at a community based day therapy centre in South Australia. The group programme involved goal directed exercise and functional/cognitive activities for one hour a week, over eight weeks. Methods: The study used an interpretive qualitative approach aimed to explore group member and facilitator perceptions about their involvement in the programme. In depth interviews were used for four group members with stroke, and three staff clinicians involved in the programme facilitation. The interview questions used for both types of participants were the same. In-depth thematic analysis was undertaken to interpret and combine the data from the interviews. Findings: Six themes emerged: ‘a place to go’, ‘ ersity of the group’, ‘the art of group design’, ‘awareness of abilities through doing’, ‘it's about relationships’, and ‘over and above’. Conclusions: These findings support the use of a group approach to rehabilitation aiming to address the long-term effects of stroke. Psychosocial benefits emerged which were beyond the expected functional aims of the programme. Some recommendations are made about group structure and design based on the evaluation.
Publisher: SAGE Publications
Date: 14-09-2017
Abstract: New graduate transition into the workforce is challenging and can involve managing ethical tensions. Ethical tensions cause new graduates to doubt their capabilities due to their lack of experience. To support new graduates, we need to know what these ethical tensions are. To explore the ethical tensions perceived to occur in practice for new graduate health professionals. This qualitative systematic review involved a search of five databases (Medline, EMBASE, AMED, CINAHL and Scopus) which resulted in the retrieval of 3554 papers. After the two-phased screening process, eight studies were identified that met the inclusion criteria and had rich data on the review question. Articles were read several times, critically appraised and analysed through thematic analysis. No ethical approval was required for the systematic review. The review was conducted following well-established reporting guidelines enabling transparency and rigour. Studies originated from Australia, United States, Iran and China. One study included speech pathologists and seven were with nurses. Four themes included the following: (1) enduring an unknown workplace culture that generates uncertainty without support for new graduates (2) being vulnerable because of distress from bullying, exclusion and being a scapegoat (3) constraining systems and institutional restrictions that cause dilemmas and (4) experiencing disillusionment from lost ideals about ethical practice. This review has brought to light the vulnerability of new graduates to negative workplace culture and collegial incivility. In addition, new graduates are subjected to ethical tensions created by institutional constraints which can create dilemmas and uncertainties through practice that does not align with what they anticipated. Understanding ethical tensions experienced by new graduates enables provision of informed support. There needs to be considerable cultural change for orientation and socialisation of new graduates to enable them to learn and manage ethical tensions.
Publisher: Hindawi Limited
Date: 27-08-2020
DOI: 10.1111/HSC.13149
Abstract: Intergenerational programs are emerging within the aged-care context as they provide a unique opportunity for older adults living with or without cognitive impairments to connect with children. One type of intergenerational program is an 'intergenerational playgroup' which creates opportunities for children to develop their skills, parents to create a local peer support network and provides older adults at risk of isolation with vital community interaction. The objective of this research was to evaluate an intergenerational playgroup taking place weekly within a residential aged-care setting. A qualitative case study research design was used to perform five observation sessions and semi-structured in-depth interviews. All members of the group (older adults and caregivers) as well as involved staff were invited to participate. Consent from any older adults with known cognitive impairment was sought from next of kin. Consent for children was provided by caregivers. A total of 12 clients (n = 8 diagnosis of dementia, 4 without dementia 11 females, 1 male), three staff members, and 10 caregivers and their children (0-5 years) provided consent to be observed. Of these, five older adults (all female, 1 with diagnosis of dementia), three staff and five caregivers participated in interviews. Data were analysed thematically. Four key themes: Learning from each other Appreciating experience in the moment Connecting through play and A sense of home and belonging were identified. These themes suggest that older adults play an active role in the dynamics of the playgroup, often being 'in the moment' during play, but also actively reminiscing on their past experiences of childhood. The sense of an inclusive and supportive community with a culture of being open to learning and to different perspectives was strong. The findings support the role of intergenerational playgroups for promoting community engagement with benefits of building relationships and connectivity for all stakeholders.
No related grants have been discovered for Carolyn Murray.