ORCID Profile
0000-0003-0340-2286
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James Cook University
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RRED Rehabilitation Research Education Development
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Publisher: Cambridge University Press (CUP)
Date: 05-2004
DOI: 10.1375/BRIM.5.1.30.35404
Abstract: Community-based rehabilitation for people with acquired brain injury (ABI) is largely driven by goals set in the course of rehabilitation by clients and service providers. A preliminary study investigating the perspectives and practice of experienced rehabilitation coordinators was undertaken to explore issues that influence goal-setting in community rehabilitation settings. Detailed interviews and subsequent rounds of clarification were conducted with six experienced rehabilitation coordinators. Key themes identified through inductive analysis include cognitive influences, other client influences, service provider influences and the client-service provider relationship in the goal-setting process. Based on the findings, a preliminary descriptive schema of goal-setting in a community-based rehabilitation service for people with acquired brain injury is suggested. Factors such as training, experience, and values of the rehabilitation coordinators are also discussed in terms of their influence on goal-setting. Some strategies to assist a person with ABI to identify and work towards achieving realistic goals are identified. Suggestions for enhancing community-based rehabilitation practices with people with ABI, and scope for future research are noted. This paper constitutes a general overview of goal-setting in community-based ABI rehabilitation.
Publisher: Springer Science and Business Media LLC
Date: 08-10-2014
Publisher: CSIRO Publishing
Date: 2003
DOI: 10.1071/PY03028
Abstract: Despite the expense associated with rehabilitation following stroke, dissatisfaction with psychosocial outcomes is common (Thomas & Parry, 1996). The rehabilitation system has been critiqued as lacking a theoretical base for psychosocial interventions (Goldberg, Segal, Berk, Schall, & Gershkoff, 1997). The current paper examines the possible role of the Chronic Disease Self-Management Program ([CDSMP] Lorig, 1996) in contributing to the psychosocial rehabilitation of people with stroke. This paper focuses on the analysis of incidental comments made by participants about a version of the CDSMP, tailored for people with stroke. These comments, collected over an 18-month follow-up period, provide interesting insights into the key aspects of the program. Six informative themes emerged from the more specific comments, namely (1) the importance of social contact and comparison, (2) increased awareness and knowledge about stroke, (3) motivation to pursue goals and activities, (4) a sense of achievement, (5) maintenance of gains, and (6) the paradoxical nature of social support. According to participants, the program was associated with enhanced self-efficacy. Other reported benefits (such as social support and enhanced knowledge) were indirectly associated with the program and appeared to reflect social aspects of the group and its stroke-specific focus. Maintenance of gains made by participants was seen as a crucial issue.
Publisher: Informa UK Limited
Date: 04-2003
Abstract: In health and disability arenas, it is increasingly being recognized that removing or modifying environmental factors can have a greater influence over outcomes than many in idually focused interventions. In 2001, the World Health Organization endorsed a major revision of its framework for assessing and classifying health, disability and handicap, conceptualizing intervention and assessing outcome. This framework, the International Classification of Functioning, Disability and Health (ICF), is now defined by its recognition of the impact of environmental and personal factors on body function and structure, activities and participation in disablement. The ICF offers the potential to advance the understanding and integration of environmental dimensions into outcome research and measurement in health and disability. This paper proposes that a key future challenge for outcomes research is to understand and document environmental dimensions of health and disability using the precedent of the ICF. Potential steps and obstacles to this development are suggested, and the direct practice and broader policy applications gained by linking an international conceptual framework with clinical outcome research and practice are discussed.
Publisher: Lepra
Date: 06-2018
DOI: 10.47276/LR.89.2.124
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2011
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2000
DOI: 10.1097/00001199-200012000-00007
Abstract: To develop a service-relevant, suicide prevention strategy based on the perspectives of people with brain injuries and their family members. Structured interview-based, qualitative case design. Interviews were conducted in the context of community-based brain injury rehabilitation service delivery. Ten persons with moderate to severe brain injuries who exhibited suicidal orientations and four family member/carers of these participants. Qualitative analysis of interview transcripts revealed a number of relevant themes. The primary theme was that informal relationships play a key role in preventing suicide. Secondary themes included the potential role of specialist brain injury rehabilitation services in suicide prevention and the need for provision of more information about brain injury to family and friends to promote understanding. Some discrepancy was noted between the perspectives of people with brain injuries and family members. The need for multiple strategies to respond to suicide risk was reinforced. Service-relevant resources (suicide risk screen, contract, and brochure) have been developed and included in service delivery.
Publisher: SAGE Publications
Date: 2016
DOI: 10.4137/RPO.S40455
Abstract: The World Health Organization's International Classification of Functioning, Disability and Health identifies environmental and personal factors as contextually relevant to functioning following disability. Goal setting is also central to rehabilitation practice and enhances functioning. No current assessment exists that recognizes the interaction of environmental factors as they relate to goal setting in rehabilitation. The person-environment profile (PEP) was developed to explore an in idual's subjective view of personal and environmental factors on the achievement of rehabilitation goals. A draft PEP underwent initial face validity testing, and the resulting version was then piloted with 13 participants across 34 rehabilitation goals within a goal-based community rehabilitation setting. Results of this pilot suggest that PEP may have the ability to detect differences in perceived barriers and facilitators across personal and environmental factors for different rehabilitation goals. While showing promise as a clinical tool, the pilot identified feasibility concerns over implementation as a standardized assessment. Substantial additional psychometric evaluation and testing needs to be undertaken before the tool can be recommended for clinical use.
Publisher: AOTA Press
Date: 09-2009
Abstract: OBJECTIVES. We explored the clinical application of goal-directed therapy in community-based rehabilitation from the perspective of clients with traumatic brain injury (TBI), their significant others, and their treating occupational therapists. METHOD. Twelve people with TBI and their significant others completed an outpatient, goal-directed, 12week occupational therapy program. Semistructured interviews with 12 participants, 10 significant others, and 3 occupational therapists involved in delivering the therapy programs explored their experiences of goal-directed therapy. RESULTS. Participants, their significant others, and therapists described goal-directed therapy positively, expressing satisfaction with progress made. CONCLUSION. Goals provide structure, which facilitates participation in rehabilitation despite the presence of barriers, including reduced motivation and impaired self-awareness. A therapist-facilitated, structured, goal-setting process in which the client, therapist, and significant others work in partnership can enhance the process of goal setting and goal-directed rehabilitation in a community rehabilitation context.
Publisher: Informa UK Limited
Date: 02-2013
Publisher: Wiley
Date: 03-09-2019
Abstract: Descriptions of community-based speech-language therapy (SLT) dysphagia practices and services are underrepresented in the research literature, despite the prevalence of dysphagia in the community. Owing to a globally ageing population and government drives to support people to remain living at home rather than in hospital or aged care, there is a growing need for SLT services to be responsive to the needs of clients living at home in the community, referred to in this study as 'community-based clients'. Exploration of current SLT services and dysphagia care practices for this population may identify ways services can be designed and enhanced to better meet the needs of clients and carers. To explore the nature (i.e., characteristics) of dysphagia services and SLT clinical practices for adults with dysphagia living at home in the community. Using a qualitative descriptive approach positioned within an explanatory sequential mixed methods design, this study explored SLT services and practices for adults with dysphagia living in the community to explain further and elaborate on findings from an earlier quantitative study. A total of 15 SLTs working with community-based clients with dysphagia were recruited using purposive representative s ling. Content analysis was used to explore the data. The overarching theme of community commands a different approach and was illustrated by three subthemes that highlighted how and why a different approach to dysphagia care in the community setting was necessary: (1) skills and mindset require adaptation in the community context (2) values and approaches are different in the community context and (3) organizational influences impact service delivery in the community context. From the data, it is apparent that the work undertaken in the community setting differs from dysphagia care in other settings and requires adapted SLT skills, values and approaches that encompass holistic care, client autonomy and carer engagement. SLT practices are also informed by organizational influences such as policies and resourcing, which in some services were enablers, while for others these presented challenges. Community-based SLT services must continue to foster flexible, responsive practices by SLTs to ensure the needs of clients and carers are met now and in future.
Publisher: Informa UK Limited
Date: 2009
DOI: 10.1080/09638280902738425
Abstract: This study aimed to evaluate the effectiveness of an intervention based on the ICF 'Environment' dimension for enhancing the well-being and psychosocial outcomes of patients with acquired brain injury in an outpatient (day hospital) setting. A mixed methodology cohort study comparing an intervention group with an historical non-intervention group using pre- and post-intervention and follow-up measures. The 6-week group intervention involved participants and their significant others. Pre- and post-intervention data from the intervention group and the non-intervention group were compared using 2 x 2 analyses of variance for five standardised outcome measures. Semi-structured interviews with intervention participants and significant others were used to provide qualitative feedback. A significant group by time interaction was found for level of community integration on the Sydney Psychosocial Reintegration Scale and depression scores on the Hospital Anxiety and Depression Scale, with greater improvements for the intervention group compared with the non-intervention group. No other significant differences between groups were found. Gains in community integration were maintained by the intervention group at 1-month follow-up. Qualitative feedback from participants indicated the value of: sharing experiences, the group content, goal setting, comparing with others and the group processes. The Environment-focused intervention was useful in improving patient outcomes in terms of better self-reported community integration.
Publisher: Stichting Liliane Fonds
Date: 05-02-2013
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.AJP.2012.12.003
Abstract: To apply the "Operationalized Predicaments of Suicide" (OPS) to coroners' reports with a view to classifying the drivers/triggers of suicide in the Northern Territory (Australia) for the years July 2000-December 2010, with attention to the total population, and to a comparison of suicide triggers for the Indigenous and non-Indigenous communities. A total of 411 reports (Indigenous, 198 non-Indigenous, 213) were obtained from the National Coroners Information System (NCIS). A research officer thematically analysed each case report and classified each according to the four categories of the OPS. Calculations were performed for the entire s le and comparisons were made between Indigenous and non-Indigenous groups. For the total s le, 20% of suicides were triggered by mental illness, and 58% were triggered by social/environmental events. In 9% there were both mental illness and social/environmental factors, and in 14% no triggers could be identified. There were group differences the non-Indigenous group was over represented in the mental illness category and the Indigenous group was over represented in the social/environmental category (χ(2) (3) = 41.5, p = 0.000). Social/environmental stressors are important triggers of suicide in the Northern Territory. Social/environmental stressors were more often the suicide trigger in Indigenous community suicide compared to non-Indigenous community suicide.
Publisher: Springer Science and Business Media LLC
Date: 21-05-2014
DOI: 10.1007/S00455-014-9527-8
Abstract: The implication of dysphagia for people treated nonsurgically for head and neck cancer (HNC) and its detrimental effects on functioning and quality of life has been well documented. To date, however, there has been a paucity of research on the effects of dysphagia following HNC on carers, independent of the consequences of a gastrostomy. The objective of this qualitative study was to report on the experiences of carers of people with dysphagia (non-gastrostomy dependent) following nonsurgical treatment for HNC and to identify the support needs of this group. A purposive, maximum-variation s ling technique was adopted to recruit 12 carers of people treated curatively for HNC since 2007. Each participated in an in-depth interview, detailing their experience of caring for someone with dysphagia and the associated impact on their life. Thematic analysis was adopted to search the transcripts for key phases and themes that emerged from the discussions. Analysis of the transcripts revealed four themes: (1) dysphagia disrupts daily life, (2) carers make adjustments to adapt to their partner's dysphagia, (3) the disconnect between carers' expectations and the reality of dysphagia, and (4) experiences of dysphagia-related services and informal supports. Carers generally felt ill-prepared for their role in dysphagia management. The qualitative methodology successfully described the impact of dysphagia on the everyday lives of carers, particularly in regard to meal preparation, social events, and family lifestyle. Clinicians should provide adequate and timely training and support to carers and view carers as copartners in dysphagia management.
Publisher: Wiley
Date: 02-2001
DOI: 10.1046/J.1440-1584.2001.00333.X
Abstract: In response to widely recognised dilemmas associated with rehabilitation and disability service provision in remote and rural areas of Australia, a community-based, participatory approach to service development was adapted for a disability service project in central Queensland. The service framework, known as Community Based Rehabilitation (CBR), fosters the involvement of community members in disability service provision. Although this framework has been described previously, few guidelines exist regarding appropriate implementation of such an approach. Consequently, the implementation strategy known as Participatory Rural Appraisal (PRA) was adopted. Participatory Rural Appraisal has been reported to foster the participation and decision-making of community members in community projects. The present article describes the application of this implementation strategy to disability service provision in a relatively under-resourced rural shire. The rationale, framework and process of the pilot are described. A subsequent publication will document the service component, detail evaluation findings and describe the long-term outcomes of this research.
Publisher: AMPCo
Date: 04-2008
DOI: 10.5694/J.1326-5377.2008.TB01751.X
Abstract: Successful, "innovative" primary health care (PHC) models exist that have adapted to the specific circumstances of their rural and remote context. A typology of discrete, integrated, comprehensive and outreach rural and remote services exists rather than a "one coat fits all" PHC health service model. Successful models are characterised by macro-scale environmental enablers (supportive health policy, federal-state relations, and community readiness) and five essential service requirements (workforce organisation and supply funding governance, management and leadership linkages and infrastructure). Service sustainability depends on ensuring that key systemic service requirements are met at the local level in ways that accord with, and are supported by, the broader macro-scale environmental enablers. Based on these principles, these model types are amenable to generalisation and evaluation in other regions.
Publisher: Wiley
Date: 06-05-2015
DOI: 10.1111/AJR.12161
Abstract: There is considerable potential for allied health assistant roles to address rural workforce shortage, but there is also a need to ensure quality of these roles. A total of 41 allied health assistant trial roles were audited using an intensive onsite audit by independent clinicians. Queensland public health services across rural/regional and metropolitan settings. Audit ratings of rural/regional and metropolitan positions were compared on indicators of training, supervision, performance, duties and scope of practice as measured through multiple sources. Appropriately targeted in-service training may facilitate more effective utilisation of rural allied health assistants. Metropolitan and rural/regional audits showed consistency across qualifications, provision of duty statements and formal supervision arrangements. However, rural positions were not able to provide comparable levels of in-service training and supervision, and rural positions reflected a more restricted scope of practice. Training in reflective practice may be a step to realising the potential of this crucial and emerging sector of the rural health workforce.
Publisher: Cambridge University Press (CUP)
Date: 2006
DOI: 10.1017/S135561770606005X
Abstract: Very few empirically validated interventions for improving metacognitive skills (i.e., self-awareness and self-regulation) and functional outcomes have been reported. This single-case experimental study presents JM, a 36-year-old man with a very severe traumatic brain injury (TBI) who demonstrated long-term awareness deficits. Treatment at four years post-injury involved a metacognitive contextual intervention based on a conceptualization of neuro-cognitive, psychological, and socio-environmental factors contributing to his awareness deficits. The 16-week intervention targeted error awareness and self-correction in two real life settings: (a) cooking at home and (b) volunteer work. Outcome measures included behavioral observation of error behavior and standardized awareness measures. Relative to baseline performance in the cooking setting, JM demonstrated a 44% reduction in error frequency and increased self-correction. Although no spontaneous generalization was evident in the volunteer work setting, specific training in this environment led to a 39% decrease in errors. JM later gained paid employment and received brief metacognitive training in his work environment. JM's global self-knowledge of deficits assessed by self-report was unchanged after the program. Overall, the study provides preliminary support for a metacognitive contextual approach to improve error awareness and functional outcome in real life settings. ( JINS , 2006, 12 , 54–63.)
Publisher: Informa UK Limited
Date: 2009
DOI: 10.1080/01674820701817938
Abstract: This study utilized the Environment dimension of the ICF, to explore needs of outpatients and their family members in the context of system and professional needs in an outpatient rehabilitation unit. A two-phase qualitative exploration comprised structured workshops with outpatient rehabilitation unit professional staff and semi-structured interviews on two occasions with 18 outpatients and their significant others. Data was thematically analysed and categorized according to ICF Environment dimensions. The study found that the ICF Environment dimension was a worthwhile area for research, beneficial for outpatient professionals, relevant to patient and family members' concerns, and useful for conceptualizing intervention. The study found that key foci for outpatient assistance at the Environment level should include: psychosocial support and relationships information transfer and communication in transition to outpatient rehabilitation and subsequent connection with community, vocational and support services. Research using the ICF Environment dimension provides a practical means of connecting some of the features of a community-oriented approach with hospital or centre-based outpatient rehabilitation.
Publisher: Hindawi Limited
Date: 2016
DOI: 10.1155/2016/9373786
Abstract: Interpersonal interactions and relationships can influence an in idual’s perceptions of health and quality of life in the presence of disability. In the case of people with spinal cord injury (SCI), positive interpersonal interactions and relationships have been shown to contribute to resilience and adaptability. Understanding factors which facilitate or impede the development and maintenance of relationships after SCI may form the basis for proactive relationship support for people with SCI. To gain a broad insight into these factors, a scoping review was undertaken. Databases were searched for English language studies published between 2000 and 2015 that informed the review question. Sixty-two (62) studies were identified. Thematic analysis was conducted on data extracted from the studies and 51 factors which may facilitate relationships and 38 factors which may impede relationships after SCI were noted. The majority of factors could be categorized as environmental or personal according to the domains of the International Classification of Functioning, Disability, and Health (ICF). The facilitating factors included partner and social support, reciprocity in relationships, and presenting oneself positively. Impeding factors included physical environmental barriers, real and perceived social biases, and poor self-image. Factors identified may inform the provision of supportive, holistic rehabilitation for people with SCI.
Publisher: Wiley
Date: 23-07-2023
DOI: 10.1111/AJR.13017
Publisher: Australasian College of Health Service Management
Date: 16-12-2018
Abstract: Background: Increasing demand for allied health services is driving workforce redesign towards greater productivity within budgetary constraints. To date, there has been limited research into workforce redesign tools at an organisational level. The aim of this article was to evaluate an implementation of The Calderdale Framework for state-wide service delivery workforce redesign within allied health settings across Queensland. Method: A multi-phase methodology with mixed methods of data collection was used. This included analysis of documents, staff surveys, and semi-structured, in-depth interviews with staff from work units utilising the Framework across the state. Findings: The primary mechanisms for implementation were staff training and provision of centralised resources. Across the state, all health services engaged in training and most completed associated workforce redesign projects. However, the number and type of projects varied across the state as did the successful projects. Feedback from staff indicated the structured nature of the framework was viewed positively, but was time intensive to perform. Local contextual factors heavily influenced workforce redesign success. Conclusion: Key factors pertaining to state-wide workforce redesign include: providing coordinated and centralised systems to support staff, ensuring adequate training, prioritising the development of key local staff, and proactively managing local contextual factors.
Publisher: Stichting Liliane Fonds
Date: 17-08-2014
Publisher: Informa UK Limited
Date: 18-05-2016
DOI: 10.3109/09638288.2015.1046563
Abstract: Third-party disability pertains to the consequences of a person's impairment which impacts on the functioning and ability of their family members or significant others. With the emergence of research demonstrating the pervasive effects of dysphagia following head and neck cancer (HNC) on the carer, the aim of this study was to identify the International Classification of Functioning, Disability and Health (ICF) domains and categories that describe the third-party disability of carers of people with dysphagia following HNC. Twelve carers of people with dysphagia following HNC participated in in idual semi-structured, in-depth interviews. Categories and sub-categories identified from the qualitative analysis were mapped to the ICF using the established linking rules. The majority of the categories and sub-categories from the qualitative analysis were successfully linked to the ICF with most linking to the Activities and Participation component. A number of contextual factors were also identified as impacting on the functioning of carers. The ICF can be successfully used to describe the third-party disability in carers of people with dysphagia following HNC management. This information could be used by clinicians, researchers and policy makers to help establish evidence-based guidelines that include carers in the assessment and management of dysphagia associated with HNC. Clinical levels of distress and reduced quality of life have been associated with caring for a person with dysphagia following head and neck cancer. The flow-on effects of dysphagia experienced by a carer or close family member can be understood as a third-party disability, which impacts on their functioning, activities and participation in the context of the environment and personal factors. Using the ICF to describe the indirect effects of dysphagia on the carer may help to guide the assessment and support of this population, and advocate for the inclusion of the concerns of the carer in dysphagia management.
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/AH13042
Abstract: Background The uptake and utilisation of allied health assistants as professional support staff has been variable across disciplines and jurisdictions. Although they are potentially very important in the current health workforce context, there is little agreement on their roles or the most suitable methods to define these roles. Method Based on a review of literature, existing role descriptions and focus groups, a Delphi survey process was undertaken. This process comprising three rounds of discussion and clarification via email, with between 107 and 188 participants, was undertaken to define and establish consensus on allied health assistant roles at three levels. Results Three cycles of editing, qualitative feedback and rating of agreement with statements resulted in substantial clarification of roles and a meaningful degree of consensus regarding the role and scope of such positions. High levels of agreement were not reached for more high-level or contested clinical tasks. Conclusions The Delphi process resulted in key tasks and roles being defined and contentious aspects clearly identified. The process facilitated engagement with workforce members most closely affected by these questions. It was a useful means of drawing together the opinions of the workforce and informing implementation trials to follow. What is known about the topic? Allied health assistants are important members of health teams. Current developments in health services necessitate considerable growth in these positions. The role and scope of practice of allied health assistants is poorly defined and varies between disciplines, settings and facilities, which threatens the establishment of these positions. What does this paper add? This study describes a methodology used to define the role and scope of practice of allied health support staff, which resulted in high levels of consensus and documentation of concerns regarding these positions. Tasks and roles have been defined at different allied health assistant position levels. What are the implications for practitioners? The definition of roles and establishment of scope of practice of emerging positions can be substantially advanced by well researched and widely consultative methods. For more advanced allied health assistant positions to be effectively implemented, tasks relating to treatment, leadership, documentation, assessment and team participation must be clearly elucidated and agreed.
Publisher: Stichting Liliane Fonds
Date: 16-08-2012
Publisher: Informa UK Limited
Date: 2012
Publisher: Informa UK Limited
Date: 14-08-2013
DOI: 10.3109/09638288.2013.821182
Abstract: To examine the relevance of the International Classification of Functioning, Disability and Health (ICF) to CBR monitoring and evaluation by investigating the relationship between the ICF and information in published CBR monitoring and evaluation reports. A three-stage literature search and analysis method was employed. Studies were identified via online database searches for peer-reviewed journal articles, and hand-searching of CBR network resources, NGO websites and specific journals. From each study "information items" were extracted extraction consistency among authors was established. Finally, the resulting information items were coded to ICF domains and categories, with consensus on coding being achieved. Thirty-six articles relating to monitoring and evaluating CBR were selected for analysis. Approximately one third of the 2495 information items identified in these articles (788 or 32%) related to concepts of functioning, disability and environment, and could be coded to the ICF. These information items were spread across the entire ICF classification with a concentration on Activities and Participation (49% of the 788 information items) and Environmental Factors (42%). The ICF is a relevant and potentially useful framework and classification, providing building blocks for the systematic recording of information pertaining to functioning and disability, for CBR monitoring and evaluation. Implications for Rehabilitation The application of the ICF, as one of the building blocks for CBR monitoring and evaluation, is a constructive step towards an evidence-base on the efficacy and outcomes of CBR programs. The ICF can be used to provide the infrastructure for functioning and disability information to inform service practitioners and enable national and international comparisons.
Publisher: Australasian College of Health Service Management
Date: 06-2006
Publisher: Springer Science and Business Media LLC
Date: 29-11-2017
DOI: 10.1038/SC.2016.169
Abstract: Sequential mixed method design. Determine factors associated with community participation for in iduals with spinal cord injury (SCI). Queensland, Australia. Phase I consisted of a quantitative telephone survey of 270 people who had sustained a SCI within the past 50 years. To verify and interpret survey findings, Phase II involved a qualitative investigation. One focus group, one dyadic and one in-depth interview were conducted with a separate s le of eight people who had sustained a SCI within the past 50 years. In Phase I, employment, paid or unpaid, was the strongest independent factor associated with community participation, whereas time since injury, completeness of injury, secondary conditions and functional independence were also independently associated. In Phase II, participants expressed that survey findings were consistent with their lived experiences. They explained that overall, they needed a strong reason to participate so that benefits outweigh the effort required to participate. Once out in the community, they recognised that other opportunities for participation arise. Rehabilitation services need to support in iduals with SCI to find meaningful employment and to engage in activities that provide them with a strong reason to participate.
Publisher: Informa UK Limited
Date: 07-2005
DOI: 10.1080/09638280500030589
Abstract: To use a taxonomy of goal content, developed in community-based brain injury rehabilitation to examine and compare the content of goals set within two different service settings and to further examine the potential of the taxonomy to be a reliable and comprehensive framework for classifying goals. Qualitative analysis and categorization of 1492 goal statements extracted from a community-based brain injury rehabilitation service over two time periods (1996--97, 1998--99), and cross-organizational comparison of ratings of goal classifications using a random s le of 100 goal statements drawn from this data set and the original 1765 goal statements used in developing the taxonomy. Application of the taxonomy beyond the original service setting in which it was developed indicated a strong inter-rater reliability, with a high test-retest agreement reported over time. For both services, a small number of categories accounted for a substantial proportion of goals set within the two time periods, while considerable change was evident in goals between the two periods for one service. Further, both placed emphasis on in idually focused goals rather than relationship or family-related goals. The taxonomy provides a reliable means for classifying goals and is a useful tool for exploration of the multiple influences on goal setting. Further application of the taxonomy to examine the relative influence on goal setting of client factors versus a range of organizational factors would be beneficial.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2006
Publisher: Springer Science and Business Media LLC
Date: 07-01-2019
DOI: 10.1007/S00455-018-09971-8
Abstract: Factors including health policy reform and the aging population are increasing demand for quality healthcare in the community. People with dysphagia are supported by speech-language pathologists (SLPs) in hospital and community settings however, little is known about the nature of dysphagia services offered by SLPs in the community. The aim of this study was to investigate SLP services and practices provided to community-based adults with dysphagia. A national cohort (n = 144) of SLPs working with community-based clients with dysphagia completed an online survey. Results revealed that clients with neurological conditions comprised the largest proportion of the caseload. Primary referral sources were family doctors (42.4%) or other health professionals (37.5%), with low rates of self-referral. Services were primarily delivered via in idual sessions (84.1%), usually within the client's home (80% saw clients at home). While many clinicians were using both clinical and instrumental assessments, half had to refer clients to the other services to access instrumental assessment. Most provided assessment and rehabilitation services, though a few (28.5%) reported using formal outcome or quality-of-life measures. Only 43.8% referred or encouraged clients or caregivers to access support or social groups and a few SLPs incorporated social participation or client well-being aspects in treatment. Speech-language pathology (SLP) practices in the community appear similar to what occurs in the acute setting, which are inherently biomedical. This may not be optimal care for clients with dysphagia who live at home and their caregivers. Further exploration about what clients and caregivers want from community-based SLP services is warranted.
Publisher: Informa UK Limited
Date: 2011
DOI: 10.3109/09638288.2010.525286
Abstract: To explore how therapy in a home and day hospital setting impacts on rehabilitation processes and outcomes from the perspective of the patients, their significant others and their treating occupational therapists. Fourteen participants with severe traumatic brain injury received a one-to-one, goal-directed, client-centred outpatient occupational therapy programme (a) in their home for 6 weeks and (b) in a day hospital clinic for 6 weeks. The experience of rehabilitation in both settings was explored using semi-structured interviews with the participants, their significant others and their treating occupational therapists. Participants and their significant others described the two environments as disparate with home-based therapy perceived as more relaxing, normal, satisfying and effective. The approach to therapy at home was commonly described as 'real-life' whereas the therapy approach in day hospital was characterised as 'simulation of real life tasks' and 'remedial exercises'. Participants' experience of therapy relationships at home was characterised as 'friendship', in which the therapist was a 'visitor', whereas in the hospital, participants were characterised as 'patients' and therapists as 'bosses' and 'teachers'. The experience of home-based therapy was perceived as more convenient, positive and preferred by patients and their family members. Therapists described more therapeutic benefits and the ability to work more effectively on activity and participation level goals in the client's real-life environment.
Publisher: Wiley
Date: 26-01-2020
DOI: 10.1002/MSC.1448
Abstract: Successful management of musculoskeletal conditions depends on active patient engagement and uptake of recommended health services and self-management strategies. Clinicians have a strong influence on patient uptake behaviours. Both clinicians and educators need to recognise the clinician's influence on patient uptake as a specific clinical skillset to be professionally developed. To inform professional development strategies this study explored priority clinician attributes that underpin the clinical skillset of fostering patient uptake. A three-round Delphi process engaged relevant stakeholders including a professional panel (clinicians, health managers, education providers) and a patient panel. Panel members deliberated and reached consensus regarding key attributes required by allied health clinicians who manage patients with musculoskeletal disorders to optimize patient uptake behaviours. In the final round, panel members rated the importance of each attribute on a numerical rating scale. Overall 12 attributes were finalised. Both the professional and the patient panel provided a high rating of importance for all finalised attributes with 'patient centred communication' rated the highest importance (median scores 9.5-10/10) and 'contemporary electronics and media' rated the lowest (median scores 6-7/10). There appears to be agreement on a basic inventory of clinician attributes which positively influence patient uptake when managing musculoskeletal conditions. Professional development and training programs for clinicians managing musculoskeletal conditions may need to consider discipline relevant aspects of these attributes to advance the development of clinicians in this aspect of professional practice to attain better patient outcomes.
Publisher: Springer Science and Business Media LLC
Date: 06-03-2008
Publisher: Elsevier BV
Date: 11-2009
Publisher: Informa UK Limited
Date: 15-03-2016
Publisher: Springer Science and Business Media LLC
Date: 28-06-2022
DOI: 10.1038/S41393-022-00824-8
Abstract: Longitudinal cohort study. To investigate the longitudinal effects of time since injury and age at injury on outcomes of quality of life, physical function, secondary conditions and participation, in people with traumatic spinal cord injury (SCI). Community resident people with spinal cord injury in Queensland, Australia. A baseline s le of 270 people with SCI was recruited. Telephone surveys on measures of quality of life (WHOQOL-Bref), secondary conditions (Secondary Conditions Surveillance Instrument, subset), physical functioning (Functional Independence Measure motor subscale) and participation (Community Integration Measure) were conducted each year between 2004 and 2008, and again in 2018. Random-effect within-between models were used to determine the effect of time since injury and age at injury on each outcome variable. Inverse probability-of-censoring weights were used to correct for selection bias. There was an effect of time since injury on secondary conditions, with a one-year change associated with 9% higher odds of having worse Secondary Conditions Surveillance Instrument scores (odds ratio = 1.09, 95% confidence interval = 1.02, 1.17 p = 0.006). We did not find any evidence of a time since injury effect on quality of life, physical function, or participation. Similarly, we did not find any evidence of an age at injury effect on any outcome variable. Secondary conditions may increase with longer time since injury among people with SCI, suggesting appropriate formal and informal supports are required to minimise the impact of these emerging health problems as in iduals age.
Publisher: Informa UK Limited
Date: 10-04-2013
DOI: 10.3109/09638288.2013.770078
Abstract: To identify and analyse tools and methods that have been reported in the literature for the monitoring and evaluation of community-based rehabilitation (CBR) programmes. A literature review and descriptive analysis were carried out to scope CBR monitoring and evaluation methods and tools. A search was conducted using PubMed and Google Scholar databases, hand searches and reference lists. Reports were retrieved, screened and information was extracted and analysed against research questions. There were 34 reports which met the inclusion criteria. Analysis of the 34 reports showed that most reports used demographic and programme data. A range of methods were used: interviews, focus groups and questionnaires being the most common. Apart from this, no common standardised procedures or tools were identified and there was not a standard approach to the inclusion of people with disabilities or other CBR stakeholders. The findings suggest that there would be value in creating resources such as guidelines, common processes and checklists for monitoring and evaluation of CBR, to facilitate efficient and comparable practices and more comparable data. This needs to be done in partnership with people with disabilities, CBR providers, partners and researchers to ensure that all stakeholders' needs are understood and met. Implications for Rehabilitation While there is broad scope and complexity of CBR programmes, there needs to be consistency and a valid approach in the monitoring and evaluation methods and tools used by CBR programmes. The principles of CBR and CRPD require that monitoring and evaluation involve people with disabilities, CBR managers and staff not only as informants but also in the design and execution of monitoring and evaluation activities. The consistent use of appropriate and valid monitoring and evaluation methods and tools will contribute to developing a stronger evidence base on the efficacy and effectiveness of CBR.
Publisher: Informa UK Limited
Date: 05-08-2014
DOI: 10.3109/13561820.2013.821601
Abstract: This report highlights complexity in health care and the relevance of integrated and interprofessional care and learning. It is proposed that appropriate workforce training in response to complexity should be contextually relevant and workplace integrated, and should focus on building interprofessional capability for reflective practice and critical thinking. This training should be interprofessional and foster systems thinking. It is suggested that the World Health Organization's International Classification of Functioning, Disability and Health (ICF) is a useful integrating framework.
Publisher: CSIRO Publishing
Date: 2006
DOI: 10.1071/PY06010
Abstract: In the course of a large retrospective research study exploring implications of ageing with a spinal cord injury (SCI), 84 participants were asked to provide responses to a brief telephone questionnaire regarding the nature and quality of their utilisation of various health and disability services. The aim of this study was to explore service utilisation, level of satisfaction with the services utilised, and the nature of the support received from these services for a s le of people ageing with spinal cord injury (SCI). Findings highlighted that people ageing with SCI have need of a range of health and disability services predominantly focusing on achieving instrumental assistance. Satisfaction with service was generally high and demonstrated the importance of interpersonal communication skills, technical competence and responsiveness in the delivery of outcomes.
Publisher: Informa UK Limited
Date: 08-09-2011
DOI: 10.3109/02699052.2011.607788
Abstract: To determine (i) the effectiveness of a goal-directed, environment-focused occupational therapy intervention and (ii) to compare rehabilitation gains across a day hospital (outpatient) setting and home setting. Repeated measures cross-over design with pre-post test measures and a baseline control period, random allocation to a treatment setting sequence and an independent outcome assessor who was blinded to treatment sequence. Descriptive and non-parametric comparative analyses employed. Fourteen participants with severe traumatic brain injury completed a 12 week outpatient occupational therapy programme. The programme was directed by the participant's chosen goals, which were established using a client-centred, structured, goal-planning process. Outcome measures included Goal attainment scaling, the Canadian Occupational Performance Measure, the Sydney Psychosocial Reintegration Scale, the Mayo-Portland Adaptability Index, the Craig Hospital Inventory of Environmental Factors and self-rated satisfaction with therapy. The therapy programme resulted in significant improvements in goal attainment, occupational performance, psychosocial reintegration and ability and adjustment levels, compared with baseline. Differences in gains made in home vs day hospital settings were not statistically significant, with the exception of higher levels of patient satisfaction with therapy at home. To assist further with decision-making about where to conduct therapy, further research is needed to compare the outcomes and determine the cost effectiveness of therapy at home and in day hospital settings.
Publisher: Elsevier BV
Date: 11-2009
Publisher: Lepra
Date: 03-2019
DOI: 10.47276/LR.90.1.88
Publisher: SAGE Publications
Date: 09-2008
DOI: 10.1177/030802260807100902
Abstract: The aim of this study was to explore therapists' opinions about the rehabilitation approaches that they perceived contributed to positive outcomes for people with acquired brain injury in community-based rehabilitation settings in order to develop a set of practice principles for clinicians working in this area. Semi-structured interviews were conducted with eight Australian and three British therapists, with a mean of 5.2 years' experience of working with people with acquired brain injury in community-based rehabilitation settings. The interviews were analysed thematically. A summary of the themes was presented to a larger group of acquired brain injury service providers (n = 35) for validation. The participants emphasised the importance of environmental factors, such as collaboration with and inclusion of others in rehabilitation, especially those in the person's support network. Strategy use, client-centred goal setting, the provision of education and the development of a therapeutic relationship were identified as facilitators in community-based rehabilitation. Problems with self-awareness and motivation, drug and alcohol use, and behavioural difficulties were commonly identified barriers to optimal outcomes. The key practice principles derived from the findings were the need for community-based rehabilitation for people with acquired brain injury to be (1) environment focused and contextually appropriate, (2) collaborative and (3) goal directed and client centred.
Publisher: Elsevier BV
Date: 06-2020
DOI: 10.1016/J.PMN.2019.07.008
Abstract: This paper reports findings of a pilot singing intervention to assist people living with chronic pain. Pain Management Clinic outpatients participated in 10 weekly group singing sessions. Benefits of the intervention and its impact on participants' (N = 4) experiences of pain were explored qualitatively. Three main themes comprising over 20 separate codes indicated physical, psychological, and social dimensions associated with the intervention. People with chronic pain identify multiple benefits from participating in a group singing program. Results indicate that group singing in chronic pain settings has multiple benefits and may positively complement clinical outcomes, serving as an effective adjunct to conventional pain management care and nursing.
Publisher: Springer Science and Business Media LLC
Date: 16-06-2014
Abstract: Allied health assistants provide delegated support for physical therapists, occupational therapists and other allied health professionals. Unfortunately the role statements, scope of practice and career pathways of these assistant positions are often unclear. To inform the future development of the allied health assistant workforce, a state-wide pilot project was implemented and audited. New allied health assistant positions were implemented in numerous settings at three levels (trainee level, full (standard) scope and advanced scope level). Six months after implementation, 41 positions were audited, using a detailed on-site audit process, conducted by multiple audit teams. Thematically analysed audit findings indicated that both the full (standard) scope and the advanced scope positions were warranted, however the skills of the allied health assistants were not optimally utilised. Contributing factors to this underutilization included the reluctance of professionals to delegate clinical tasks, inconsistencies in role descriptions, limitations in training, and the time frame taken to reach an effective skill level. Optimal utilisation of assistants is unlikely to occur while professionals withhold delegation of tasks related to direct patient care. Formal clinical supervision arrangements and training plans should be established in order to address the concerns of professionals and accelerate full utilisation of assistants. Further work is necessary to identify the key components and distinguish key features of an advanced allied health assistant role.
Publisher: Macrothink Institute, Inc.
Date: 05-05-2018
Abstract: Introduction: The area of psychosocial screening for surgery holds considerable potential for social work practice, but to date there is little clarity regarding tools or roles.Methods: A practice-based scoping review was conducted by social workers to provide an overview of relevant issues. Articles were screened for alignment with the research question, as well as for quality and relevance. Of the 26 articles included, quality and relevance varied considerably.Results: The review summarised key psychosocial factors, screening issues, intervention issues and organisational aspects in the literature. It elucidated the importance of psychosocial factors in the acute hospital setting and specifically in the case of surgery. While the review found that there were many tools associated with psycho-social screening, there was no consensus as to which tool was most appropriate. There appeared to be little connection between tools and potential interventions, or indeed little consensus on suitable interventions.Conclusion: Reviewed articles suggested that appropriate psychosocial screening and intervention would result in considerable in idual and systems benefits. This is an area that requires greater clarity and research investment from the social work profession.
Publisher: Springer International Publishing
Date: 2016
Publisher: Springer Science and Business Media LLC
Date: 28-11-2022
DOI: 10.1007/S13364-022-00660-4
Abstract: The spotted-tailed quoll ( Dasyurus maculatus ) is an endangered mesopredator endemic to Australia. It is generally considered a forest-dependent species associated with large, intact forested habitats. In Australia’s mainland, quoll research has typically been conducted in contiguous forest, and consequently, the species’ presumed forest-dependency might reflect s ling bias rather than preferred habitat niche. Recent studies have revealed that quolls also persist in fragmented agricultural landscapes, raising questions about their true habitat requirements and preferences. In this study, we investigated quoll habitat use within a fragmented agricultural landscape in mainland Australia. We deployed 42 lured camera traps to determine quoll habitat preferences across four broad vegetation types (open grassland, grassy woodland, dry sclerophyll forest, and wet sclerophyll forest) based on quoll activity and occupancy. Quolls were detected in all vegetation types, and quoll activity indicated a preference for dry sclerophyll forest and grassy woodlands, although this preference varied depending on the time of year. Our results suggest that quoll habitat use in mainland Australia is more flexible than previously assumed, and we recommend further research on factors that may influence habitat preference such as prey availability and seasonal behavior. Understanding the factors that drive habitat use by quolls outside of contiguous forested landscapes will inform and improve conservation and management strategies to ensure critical habitat for the species is protected and retained in an increasingly fragmented landscape.
Publisher: Informa UK Limited
Date: 23-08-2018
DOI: 10.1080/09638288.2017.1367425
Abstract: To explore the perceived determinants of participation in life after spinal cord injury and incorporate these into a framework for the promotion of participation suitable for use by rehabilitation professionals. Four people with spinal cord injury and one health service researcher engaged in a process of sharing narratives of life after spinal cord injury over a period of one year. The narratives were distilled using thematic analysis. The relevant subset of data from the narratives categorized as This is what we think determines our participation in life was analyzed in depth to reveal nine themes (1) The world can be my friend or foe (2) I am who I am (3) It is a personal journey (4) Some like to talk, others like to do (5) We have the technology (6) A support network is vital and it can be built (7) Life involves tradeoffs (8) Push and (9) Be flexible. These themes were combined into a framework for the promotion of participation to be used by rehabilitation professionals. The collaboratively developed framework has three aspects - Help me, Encourage me and Accept. The proposed participation promotion framework is grounded in the narratives of the research group but needs to be tested before it can be endorsed for practice. Implications for Rehabilitation In order to promote participation in life after spinal cord injury rehabilitation professionals can help people with spinal cord injury to negotiate the world, build and maintain a support crew and access equipment and technology. Spinal cord injury rehabilitation professionals can encourage people with spinal cord injury to push themselves, be assertive and be flexible, as these attributes can assist participation in life after spinal cord injury. In the pursuit of participation goals, rehabilitation professionals must accept the in iduality of each person with spinal cord injury, respect that they may or may not be willing to make tradeoffs to achieve participation goals and that they are on an ever changing life journey.
Publisher: Informa UK Limited
Date: 02-2004
Publisher: Elsevier BV
Date: 03-2012
DOI: 10.1016/J.APMR.2011.10.014
Abstract: To track changes in quality of life and function for people with spinal cord injury (SCI) along the lifespan. A wave panel design in which data were collected annually over 5 years across 6 strata that represented different periods since injury. Telephone interviews with participants in their home environment. People (n=270) who had sustained a traumatic SCI in Queensland, Australia, over the previous 60 years. Not applicable. Quality of life was measured using the World Health Organization Quality of Life-8. Human functioning was measured in 3 components. Body structure/function was measured using the Secondary Conditions Surveillance Instrument. Activity was measured using the motor subscale of the FIM (mFIM) and the Clinical Outcomes Variables Scale. Participation was measured using the Community Integration Measure (CIM) and the Impact on Participation and Autonomy questionnaire. Quality of life remained relatively constant across the lifespan. For body structure/function, there was a significant increase in secondary conditions with time since injury. There was a significant decrease in activity as measured by the mFIM for higher functioning in iduals. Participation, as measured by the CIM, showed a significant increase with time since injury, but not when adjusted for the American Spinal Injury Association Impairment Scale, income level, and living situation. The findings of this study highlight that people with SCI are able to maintain quality of life and participation along the lifespan however, increases in secondary conditions and a decline in function over time are likely. Rehabilitation services could work more effectively at addressing secondary prevention through enhanced monitoring over time, while broader societal responses are likely to hold the key to optimizing human functioning.
Publisher: Public Library of Science (PLoS)
Date: 02-04-2021
DOI: 10.1371/JOURNAL.PNTD.0009329
Abstract: Leprosy and leprosy-related stigma can have a major impact on psychosocial wellbeing of persons affected and their family members. Resilience is a process that incorporates many of the core skills and abilities which may enable people to address stigma and discrimination. The current study aimed to develop and pilot an intervention to strengthen in idual and family resilience against leprosy-related discrimination. We used a quasi-experimental, before-after study design with a mixed methods approach. The 10-week family-based intervention was designed to strengthen the resilience of in iduals and families by enhancing their protective abilities and capacity to overcome adversity. The study was conducted in two sites, urban areas in Telangana state, and in rural areas in Odisha state, India. Persons affected and their family members were included using purposive s ling. Two questionnaires were used pre-and post-intervention: the Connor-Davidson Resilience Scale (CD-RISC, maximum score 100, with high scores reflecting greater resilience) and the WHOQOL-BREF (maximum score of 130, with higher scores reflecting higher quality of life). In addition, semi-structured interviews were conducted post-intervention. Data were collected at baseline, a few weeks after completion of the intervention, and in the Odisha cohort again at six months after completion. Paired t-tests measured differences pre- and post- intervention. Qualitative data were thematically analysed. Eighty participants across 20 families were included in the study (23 persons affected and 57 family members). We found a significant increase in CD-RISC scores for persons affected and family members from Odisha state (baseline 46.5, first follow-up 77.0, second follow-up 70.0), this improvement was maintained at six-month follow-up. There was no increase in CD-RISC scores post-intervention among participants from Telangana state. WHOQOL-BREF scores were significantly higher at follow-up for persons affected in both states, and for family members in Odisha state. No families dropped out of the study. In the qualitative feedback, all participants described drawing benefit from the programme. Participants especially appreciated the social dimensions of the intervention. This pilot study showed that the 10-week family-based intervention to strengthen resilience among persons affected by leprosy and their family members was feasible, and has the potential to improve resilience and quality of life. A large-scale efficacy trial is necessary to determine the effectiveness and long-term sustainability of the intervention.
Publisher: AOTA Press
Date: 09-2014
Abstract: OBJECTIVE. We examined participation in goal planning and development of self-awareness for people with impaired self-awareness after traumatic brain injury. METHOD. We performed a mixed-methods study of 8 participants recently discharged from inpatient rehabilitation. Self-awareness was measured using discrepancy between self and significant other ratings on the Mayo–Portland Adaptability Index (MPAI–4) at four time points. We calculated effect size to evaluate the change in MPAI–4 discrepancy over time. RESULTS. Seven participants identified their own goals. We found a large reduction in mean MPAI–4 discrepancy (M = 8.57, SD = 6.59, N = 7, d = 1.08) in the first 6 wk and a further small reduction (M = 5.33, SD = 9.09, N = 6, d = 0.45) in the second 6 wk of intervention. Case data indicated that 7 participants demonstrated some growth in self-awareness. CONCLUSION. Engagement in occupation-based, goal-directed rehabilitation appeared to foster awareness of injury-related changes to varying extents.
Publisher: Macrothink Institute, Inc.
Date: 04-10-2018
Abstract: Background: Social worker input into hospital emergency department (ED) services would appear to be central to the provision of effective, durable and comprehensive services. Unfortunately, there are few literature overviews to summarise this potential.Methods: A practice-based scoping review was conducted to identify the role and potential of social worker involvement in emergency department settings. After initial screening, abstracts of 252 articles were read and screened, resulting in 37 articles, which were reviewed and thematically analysed by pairs of reviewers, and also appraised for quality and relevance.Results: Three key practice areas of social work involvement in emergency departments were identified: mental health, suicide risk and crisis, and chronic disease. Details of social work involvement in each key practice area as noted in the literature were outlined. Beyond this, two priority focus areas were also noted: social work screening and assessment in ED, and developing a social work model that is relevant to ED.Conclusion: The identified key practice areas and priority focus areas provide a useful guide for practitioners (to more clearly define their assistance and interventions in ED), and for managers and academics (to more clearly guide the development of social work policy, practice and staffing models in ED settings).
Publisher: Informa UK Limited
Date: 18-12-2014
DOI: 10.3109/17549507.2013.861869
Abstract: The prevalence and severity of dysphagia in people treated non-surgically for primary head and neck cancer (HNC) is well documented. However, few studies have looked beyond the physiological impairment to explore the lived experience of dysphagia in the post-treatment period of HNC. The current study adopted a person-centred, qualitative approach to describe the experiences of people living with dysphagia in the months and years following non-surgical treatment for HNC. Using maximum variation s ling, 24 participants who had undergone radiotherapy treatment for HNC were recruited. In idual interviews were conducted to explore the impact of dysphagia on participants' everyday lives. The themes identified included: (1) physical changes related to swallowing (2) emotions evoked by living with dysphagia (3) altered perceptions and changes in appreciation of food and (4) personal and lifestyle impacts. The data revealed the breadth and significance of the impact of dysphagia on the lives of people treated curatively for HNC. Assessment and management in the post-treatment period must be sufficiently holistic to address both the changing physical states and the psychosocial needs of people with dysphagia following HNC. Rehabilitation services which focus only on impairment-based management will fail to fully meet the support needs of this clinical population.
Publisher: Wiley
Date: 10-2023
DOI: 10.1111/AJR.13049
Publisher: Medical Journals Sweden AB
Date: 2008
Abstract: To compare in idual, group and combined intervention formats for improving goal attainment and psychosocial function following acquired brain injury. Randomized controlled trial, waiting list controls. Thirty-five participants with a mean time of 5.29 years (standard deviation = 3.9) since acquired brain injury were randomly allocated into 6 groups involving an intervention or waiting list control condition for 1 of 3 intervention formats. Interventions were 3 h/week for 8 weeks. Formats included: group-based support (n = 12), in idual occupation-based support (n = 11), and a combined group and in idual support intervention (n = 12). Participant outcomes were examined at pre-, post-, and 3-month follow-up assessment on the Canadian Occupational Performance Measure, Patient Competency Rating Scale, and Brain Injury Community Rehabilitation Outcome 39 Scales. Overall, the findings indicated that the in idual intervention component appeared to contribute particularly to gains in performance in goal-specific areas. The combined intervention was associated with maintained gains in performance and satisfaction. However, gains in behavioural competency and psychological well-being were more likely to occur after the group and in idual interventions. These findings generally support the efficacy of brief intervention formats following acquired brain injury, although further research is needed to examine clients' suitability for particular interventions.
Publisher: Springer Science and Business Media LLC
Date: 19-07-2008
Publisher: Stichting Liliane Fonds
Date: 15-02-2012
Publisher: JMIR Publications Inc.
Date: 07-10-2017
Abstract: ntroduction. The area of psychosocial screening for surgery holds considerable potential for social work practice, but to date there is little clarity regarding tools or roles. Methods. A practice-based scoping review was conducted by social workers to provide an overview of relevant issues. Articles were screened for alignment with the research question, as well as for quality and relevance. Of the 26 articles included, quality and relevance varied considerably. Results. The review summarised key psychosocial factors, screening issues, intervention issues and organisational aspects in the literature. It elucidated the importance of psychosocial factors in the acute hospital setting and specifically in the case of surgery. While the review found that there were many tools associated with psycho-social screening, there was no consensus as to which tool was most appropriate. There appeared to be little connection between tools and potential interventions, or indeed little consensus on suitable interventions. Conclusion. Reviewed articles suggested that appropriate psychosocial screening and intervention would result in considerable in idual and systems benefits. This is an area that requires greater clarity and research investment from the social work profession.
Publisher: Springer Science and Business Media LLC
Date: 07-08-2014
DOI: 10.1007/S00455-014-9563-4
Abstract: The International Classification of Functioning, Disability, and Health (ICF) is an internationally recognized framework which allows its user to describe the consequences of a health condition on an in idual in the context of their environment. With growing recognition that dysphagia can have broad ranging physical and psychosocial impacts, the aim of this paper was to identify the ICF domains and categories that describe the full functional impact of dysphagia following non-surgical head and neck cancer (HNC) management, from the perspective of the person with dysphagia. A secondary analysis was conducted on previously published qualitative study data which explored the lived experiences of dysphagia of 24 in iduals with self-reported swallowing difficulties following HNC management. Categories and sub-categories identified by the qualitative analysis were subsequently mapped to the ICF using the established linking rules to develop a set of ICF codes relevant to the impact of dysphagia following HNC management. The 69 categories and sub-categories that had emerged from the qualitative analysis were successfully linked to 52 ICF codes. The distribution of these codes across the ICF framework revealed that the components of Body Functions, Activities and Participation, and Environmental Factors were almost equally represented. The findings confirm that the ICF is a valuable framework for representing the complexity and multifaceted impact of dysphagia following HNC. This list of ICF codes, which reflect the erse impact of dysphagia associated with HNC on the in idual, can be used to guide more holistic assessment and management for this population.
Publisher: Informa UK Limited
Date: 12-2014
DOI: 10.2147/CIA.S72731
Publisher: Informa UK Limited
Date: 2010
DOI: 10.3109/09638281003797356
Abstract: To conduct a systematic literature review that identifies and summarises the findings of studies that have compared the outcomes of outpatient, brain injury rehabilitation programmes conducted in real-life home settings and day hospital clinic settings. A systematic search, using specific inclusion and exclusion criteria, of English language electronic databases, as well as manual search of reference lists of identified articles. Each study was evaluated and rated using 11 methodological criteria. The findings are summarised. Database searches, using key terms, initially yielded 4484 articles. Of these articles, 17 articles were included in the review and rated according to methodological quality. The majority of studies indicated that the outcomes of rehabilitation programmes conducted in home settings are at least equivalent to rehabilitation conducted in day hospital and outpatient settings for people with acquired brain injury. Most identified studies (15/17) were with groups of people with a diagnosis of stroke, primarily over the age of 65 years. Assessments of impairment or activity limitation were primarily used to reflect outcomes and no studies used participation or goal-based outcome measures. The available studies indicate that outcomes of outpatient rehabilitation programmes delivered at home, of short-term duration (mostly 3 months) for people with stroke recently discharged from hospital, are at least equivalent to day hospital-based outpatient rehabilitation programme outcomes. However, there have been no controlled studies designed to investigate the influence of therapy context (home and clinic settings) on outcomes for people receiving outpatient neurological rehabilitation. Furthermore, investigations of the efficacy of community-based rehabilitation with younger people with brain injuries, caused by mechanisms other than stroke, are required.
Publisher: Macrothink Institute, Inc.
Date: 21-06-2018
Abstract: Background: Despite the growing recognition of recovery oriented principles as the preferred way of working with children and young people in a mental health context, translating these principles to practice remains unclear. For mental health clinicians, collaborative treatment planning with young people who experience significant mental health difficulties is complex.Objective: To identify clinical practices to enhance the participation of young people in mental health treatment planning.Methods: A scoping review was conducted, using narrative summaries. From 1172 articles identified in a database search and evaluated against inclusion criteria, 22 were included for review. Basic thematic analysis was used to identify key themes from the literature.Results: The studies reviewed suggested that participatory treatment planning leads to improved processes and outcomes for the young person, the clinician and services. Clinical practices that may enable participation in treatment planning included relational engagement, contracting, therapeutic strategies, strength-based treatment planning and working systematically. A number of consumer, contextual and service delivery factors were also identified which constrain such participation.Discussion: The categorised findings, ranked according to prominence, provide a useful framework to enable practitioners to maximise the participation of young people in treatment planning. While the findings should be considered as preliminary, due to limitations of studies and methodology, they provide a useful starting point for future studies.
Publisher: Springer Science and Business Media LLC
Date: 07-2008
DOI: 10.1038/SC.2008.82
Abstract: Prospective cross-sectional survey. To compare quality of life (QOL) for people with spinal cord injury (SCI) and their able-bodied peers and to investigate the relationship between QOL and disability (impairments, activity limitations and participation restrictions) across the lifespan, for people with SCI. A community outreach service for people with SCI in Queensland, Australia. A random s le of 270 in iduals who sustained SCI during the past 60 years was surveyed using a guided telephone interview format. The s le was drawn from the archival records of a statewide rehabilitation service. QOL was measured using the World Health Organization Quality of Life Assessment Instrument-Bref, impairment was measured according to the American Spinal Injury Association classification and the Secondary Condition Surveillance Instrument, activity limitations using the motor subscale of the Functional Independence Measure and participation restrictions using the Community Integration Measure. Lifespan was considered in terms of age and time since injury. Correlation and regression analyses were employed to determine the relationship between QOL and components of disability across the lifespan. QOL was significantly poorer for people with SCI compared to the Australian norm. It was found to be associated with secondary impairments, activity limitations and participation restrictions but not with neurological level, age or time since injury. The single most important predictor of QOL was secondary impairments whereas the second most important predictor was participation. To optimize QOL across the lifespan, rehabilitation services must maintain their focus on functional attainment and minimizing secondary conditions, although at the same time enabling participation.
Publisher: Informa UK Limited
Date: 20-02-2015
DOI: 10.3109/11038128.2015.1017530
Abstract: Client-centred philosophy is integral to occupational therapy practice and client-centred goal planning is considered fundamental to rehabilitation. Evaluation of whether goal-planning practices are client-centred requires an understanding of the client's perspective about goal-planning processes and practices. The Client-Centredness of Goal Setting (C-COGS) was developed for use by practitioners who seek to be more client-centred and who require a scale to guide and evaluate in idually orientated practice, especially with adults with cognitive impairment related to acquired brain injury. To describe development of the C-COGS scale and examine its construct validity. The C-COGS was administered to 42 participants with acquired brain injury after multidisciplinary goal planning. C-COGS scores were correlated with the Canadian Occupational Performance Measure (COPM) importance scores, and measures of therapeutic alliance, motivation, and global functioning to establish construct validity. The C-COGS scale has three subscales evaluating goal alignment, goal planning participation, and client-centredness of goals. The C-COGS subscale items demonstrated moderately significant correlations with scales measuring similar constructs. Findings provide preliminary evidence to support the construct validity of the C-COGS scale, which is intended to be used to evaluate and reflect on client-centred goal planning in clinical practice, and to highlight factors contributing to best practice rehabilitation.
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/PY12105
Abstract: People with traumatic spinal cord injury (SCI), although proportionally fewer in number, are known to be high users of primary health care services however, details of their visits to GPs are unclear. This study presents information about GP utilisation patterns of 193 people with SCI over a 5-year period. Results demonstrate substantially greater GP service utilisation, particularly for young men with SCI, compared with their counterparts in the general population. Interestingly, people with paraplegia were proportionally higher users of GP services than those with tetraplegia. Results indicate the need for specialist support for GPs to meet the SCI-specific needs of this patient group. Specialist SCI outreach teams may be a useful resource to primary health care practitioners.
Publisher: Lepra
Date: 06-2013
DOI: 10.47276/LR.84.2.166
Publisher: AOTA Press
Date: 30-05-2016
Abstract: OBJECTIVE. To examine the internal reliability and test–retest reliability of the Client-Centeredness of Goal Setting (C–COGS) scale. METHOD. The C–COGS scale was administered to 42 participants with acquired brain injury after completion of multidisciplinary goal planning. Internal reliability of scale items was examined using item–partial total correlations and Cronbach’s α coefficient. The scale was readministered within a 1-mo period to a subs le of 12 participants to examine test–retest reliability by calculating exact and close percentage agreement for each item. RESULTS. After examination of item–partial total correlations, test items were revised. The revised items demonstrated stronger internal consistency than the original items. Preliminary evaluation of test–retest reliability was fair, with an average exact percent agreement across all test items of 67%. CONCLUSION. Findings support the preliminary reliability of the C–COGS scale as a tool to evaluate and promote client-centered goal planning in brain injury rehabilitation.
Publisher: AOTA Press
Date: 11-2010
Abstract: OBJECTIVE. We investigated the clinical utility of combined use of Goal Attainment Scaling (GAS) and the Canadian Occupational Performance Measure (COPM) to plan goals and measure progress in a community rehabilitation setting. METHOD. Fourteen participants with traumatic brain injury completed an outpatient, goal-directed 12-wk occupational therapy program 53 goals were generated. Performance and satisfaction self-ratings and GAS ratings were collected before and after intervention. Self-awareness, motivation to change, and perceived client-centeredness measures were taken before intervention. RESULTS. Sensitivity to change was demonstrated by significant improvements after intervention for total performance self-ratings on the COPM and GAS T scores. CONCLUSION. Combined use of these tools, although time consuming, resulted in goals that were perceived almost unanimously as client centered, despite most participants' having moderate or severe impairment in self-awareness. The process also enabled subjective and objective demonstration of goal achievement, thereby supporting the clinical utility and treatment validity of the combined use of these tools.
Publisher: CSIRO Publishing
Date: 2009
DOI: 10.1071/AH090592
Abstract: Policy makers and researchers increasingly look to systematic reviews as a means of connecting research and evidence more effectively with policy. Based on Australian research into rural and remote primary health care services, we note some concerns regarding the suitability of systematic review methods when applied to such settings. It suggests that rural and other health services are highly complex and researching them is akin to dealing with ?wicked? problems. It proposes that the notion of ?wicked? problems may inform our understanding of the issues and our choice of appropriate methods to inform health service policy. Key issues including the complexity of health services, methodological limitations of traditional reviews, the nature of materials under review, and the importance of the service context are highlighted. These indicate the need for broader approaches to capturing relevant evidence. Sustained, collaborative synthesis in which complexity, ambiguity and context is acknowledged is proposed as a way of addressing the wicked nature of these issues.
Publisher: Stichting Liliane Fonds
Date: 13-02-2013
Publisher: Informa UK Limited
Date: 2003
Publisher: AMPCo
Date: 05-2007
Publisher: Elsevier BV
Date: 02-2007
DOI: 10.1016/J.SOCSCIMED.2006.09.012
Abstract: Current stroke rehabilitation tends to focus on the bio-medical course of disability, often responding to psychological and social issues only when they have been implicated in crises. Although this situation is costly, little evidence exists in relation to how psychological and social outcomes can be facilitated or how psychosocial decline can be prevented. In the area of adjustment following traumatic injury, there has been some suggestion that rehabilitation should focus on the expansion of resources, skills and self-efficacy as this will enable in iduals to cope more effectively with their medical condition and circumstances. The current study was a longitudinal randomised controlled trial involving 100 people with stroke, 58 of whom were randomly allocated to an intervention based on the notion of psychosocial skill expansion. All were patients of a major hospital in Queensland, Australia. An existing self-management intervention (The Chronic Disease Self-Management Course, Lorig et al., 2001) was used to operationalise the concept of psychosocial skill expansion. The control group reported declines in functioning during the first year following stroke in the areas of family roles, activities of daily living, self-care and work productivity, that were not reported by the intervention group. Although the groups had reached similar levels by one year post-stroke, this intervention may have a protective function, presumably by improving capacity to manage the functional requirements of daily life. However, the intervention did not appear to have its impact through self-efficacy, as was expected, and failed to influence outcomes such as mood or social participation. Nevertheless, the intervention warrants further investigation, given that it appears to improve rehabilitation outcomes, at least in the short-term.
Publisher: Lepra
Date: 06-2022
DOI: 10.47276/LR.93.2.166
Publisher: Springer Science and Business Media LLC
Date: 12-2008
Publisher: Oxford University Press (OUP)
Date: 06-02-2021
DOI: 10.1093/INTHEALTH/IHAB001
Abstract: In iduals affected by Hansen's disease (leprosy) often experience stigma and discrimination. Greater psychosocial resilience may enable people to deal with such discrimination. This study aimed to explore sources of strength and resilience for in iduals affected by Hansen's disease in Brazil. We used a cross-sectional study design with a qualitative approach. Semistructured focus groups were conducted. Analysis comprised thematic categorisation of transcripts. Thirty-one participants were included: 23 in iduals affected by Hansen's disease and 8 healthcare providers. We found that while a few in iduals affected were provided with formal psychological support in the early phases of their treatment, many noted the importance of providing such support at this time. Most participants described relationships with and social support from family members, friends and with others affected by Hansen's disease as their primary source of resilience. A key context for building resilience was through the peer-level sharing and engagement experienced in self-care and support groups. Participants also emphasised the importance of providing appropriate information about Hansen's disease and the importance of beliefs and spirituality. Hansen's disease services should seek to build resilience in early treatment through counselling and during treatment and beyond by having people affected getting together. Across both settings supporting family and social relationships, providing accurate information and acknowledging spiritual beliefs are important.
Publisher: Frontiers Media SA
Date: 31-05-2022
DOI: 10.3389/FRESC.2022.898143
Abstract: Greater understanding of the influences on participation in life after spinal cord injury (SCI) can inform rehabilitation theory and practice. Careful qualitative inquiry can reveal subjective meanings associated with the relevant experiences, strategies, and perceptions of those with lived experience of SCI. A search of literature, followed by a thematic synthesis of qualitative studies, was undertaken to bring together these insights in a meaningful way. The research question guiding the literature review and synthesis was, What do people with SCI perceive to be the influences on their participation in life ? Three critical databases were searched for qualitative studies examining influences on participation in life after SCI. Peer-reviewed studies published after 2006, involving adults with SCI living in countries with advanced economies, were included. Data were extracted from 24 articles and subjected to three-level thematic synthesis—the coding of primary data from the studies, the development of descriptive themes based on an organization of those codes, and the generation of analytical themes. The synthesis yielded five analytical themes, supported by 17 descriptive themes. The analytical themes were (1) external contextual influences, (2) personal physical context, (3) personal psychological context, (4) potential moderators of participation outcomes, and (5) temporal dimensions of participating in life after SCI. These themes highlight the complex interactions that shape participation from the perspective of people with SCI. Closer examination of the potential moderators may provide insights into effective rehabilitation interventions. Synthesis of qualitative inquiry provides valuable insights into the perceptions of influences on participation in life from the point of view of people with SCI. The findings of this synthesis are instructive for rehabilitation theory and practice. It can complement what we learn from using the ICF to understand participation.
Publisher: OMICS Publishing Group
Date: 2017
Publisher: Wiley
Date: 25-07-2012
DOI: 10.1111/J.1440-1584.2012.01284.X
Abstract: This paper reports on findings related to intersectoral collaboration stemming from an evaluation of a dementia awareness resource for use in remote Aboriginal communities*. The resource includes a DVD in English and three (3) Aboriginal languages of the Northern Territory. A qualitative evaluation was conducted in four Northern Territory Aboriginal communities/organisations where the resource had been implemented by external dementia educators. The method included five focus groups with Indigenous aged care workers, community members and aged care service users (n = 26), in idual interviews with health care professionals and service coordinators (n = 5), and observation. Data were analysed thematically. Specific findings relating to intersectoral collaboration as a key enabling factor of effective dementia awareness and care are discussed in this paper. In addition to context variables such as understaffing and under-resourcing, there might be a lack of knowledge or interest on the part of some health practitioners concerning clients with dementia within remote communities. Dementia awareness in remote communities needs to be tackled from a 'whole system' perspective and not be the exclusive domain of the aged care services. Strategies that increase the critical mass of informed caregivers as well as health professionals will contribute to better services.
Publisher: Lepra
Date: 09-2017
DOI: 10.47276/LR.88.3.416
Publisher: Lepra
Date: 03-2015
DOI: 10.47276/LR.86.1.6
Publisher: Informa UK Limited
Date: 11-06-2020
Publisher: AMPCo
Date: 07-2009
DOI: 10.5694/J.1326-5377.2009.TB02700.X
Abstract: To describe the factors and processes that facilitate or inhibit implementation, sustainability and generalisation of effective models of primary health care (PHC) service delivery in rural and remote Australia. Case-study approach, including review of relevant literature, interviews with key informants, site visits and direct observation. Thematic analysis and template analysis were used with interview transcripts. An expert reference group provided feedback and advice on policy relevance. Six PHC services in small communities across rural and remote Australia were selected based on results of a previous systematic review they reflected erse rural and remote settings and PHC models, and the multidisciplinary nature of PHC. Sites were visited, and 55 in iduals associated with the establishment and operation of these services were interviewed between July 2006 and December 2007. Independent and template analysis confirmed the usefulness of a conceptual framework, which identified three key "environmental enablers" - supportive policy federal and state/territory relations and community readiness - and five essential service requirements - governance, management and leadership funding linkages infrastructure and workforce supply. Systematically addressing each of these factors improves effectiveness and lessens the threat to service sustainability. Evidence from existing effective rural and remote PHC services can inform the health care reform agenda, in Australia and other countries. The evidence highlights the need for improved governance, management and community involvement, as well as strong, visionary political leadership to achieve a more responsive and better coordinated health system which could help eliminate existing health status differentials between cities and rural areas. In Australia, establishment of a single national health system, operationalised at a regional level, would obviate much of the current inefficiency and poor coordination.
Publisher: Springer Science and Business Media LLC
Date: 16-05-2019
DOI: 10.1007/S10597-019-00406-8
Abstract: There is an ongoing need to incorporate the perspectives of people in supported community housing to improve the provision of integrated mental health services. This study aimed to explore the satisfaction and experiences of people who have received supported housing and mental health services. We conducted a retrospective, mixed methods study using a data mining approach, analyzing consumer satisfaction survey responses collected on discharge from the service over a 7-year period. Responses from 178 consumers aged between 20 and 62 years were included. Quantitative results indicated that consumers rated the quality of services as relatively high. Analysis of qualitative responses identified seven themes describing people's views on how they had benefitted from the service. Consumers reported benefits in terms of practical and emotional supports, responsiveness of the team to their needs, socialization and community integration, personal growth and recovery, and finding 'my place'. Themes of learning and skills development were also important. These results suggest that practical support, together with emotional expressions of care and compassion are most valued by people who participated in this service. This research has implications for service evaluation and for future research, which may include focusing on the key role of connectedness, 'my place' and hope for recovery.
Publisher: Wiley
Date: 14-09-2021
DOI: 10.1002/AJS4.188
Abstract: A rapid review of the literature on inter‐organisational collaboration was undertaken to identify and describe key barriers and enablers of relevance to current disability policy developments in Australia. Term searches of four databases resulted in the identification of 433 articles published between 2009 and 2019. After removal of duplicates and refinement, 17 peer‐reviewed articles underwent full review, data extraction and synthesis to distil barriers and enablers of inter‐organisational collaboration at three levels. At the macro‐level, policy instruments, institutional arrangements and resources were salient. At the meso‐level, clarity of organisational purposes and roles, and organisational systems and processes were important, as were factors of leadership, management, power and workforce. At the micro‐level, values, trust, culture and personal relationships could be either barriers or enablers, depending on context. The review indicated that meaningful and sustained collaboration across organisations is unlikely without careful planning, clear actions and significant investment at all three levels, providing important learnings for the Australian National Disability Insurance Scheme context.
Publisher: Rural and Remote Health
Date: 16-05-2022
DOI: 10.22605/RRH7011
Publisher: Springer Science and Business Media LLC
Date: 24-04-2020
Publisher: CSIRO Publishing
Date: 2012
DOI: 10.1071/AH11102
Abstract: Background. The Orthopaedic Podiatry Triage Clinic (OPodTC) is a ‘skill mix’ model of care developed in Queensland Health to address the problem of lengthy waiting times for orthopaedic surgery on foot and ankle pathologies. It is based on the recognition that many orthopaedic surgery referrals can be identified early and treated conservatively with podiatry, averting the need for more costly and invasive surgical interventions. The model is collaborative and relies on screening and triage by the podiatrist, rather than delegation by the orthopaedic surgeon. Methods. Screening and triage through OPodTC was trialled at three Queensland Health hospital facilities during 2009 and 2010 to improve service timeliness. Patients identified by the OPodTC podiatrist as suitable for conservative management were provided with non-surgical podiatry interventions and discharged if appropriate. Those identified as still requiring surgical intervention after the benefit of interim conservative treatment provided by the podiatrist (or who chose to remain on the list) were returned to their previous place on the orthopaedic waiting list. This paper presents a summary and description of waiting list changes in association with this trial. Results. The OPodTC intervention resulted in a reduction in the non-urgent category of the waiting list across the three hospitals of between 23.3% and 49.7%. Indications from wait-list service data demonstrated increased timeliness and improved patient flow, which are core goals of these skill mix initiatives. Conclusions. This study highlights the potential of screening and triage functions in the skill mix debate. In this ex le, conservative treatment options were considered first, suitable patients did not have to wait long periods to receive timely and appropriate interventions, and those for whom surgery was indicated, were provided with a more targeted service. What is known about the topic? Shifting and delegation of tasks is a key issue in current global debate on models of care. Discussion regarding the mix and shifting of tasks in podiatry and orthopaedic surgery has been limited in Australia, and the appropriate measurement of outcomes and processes is a point for discussion. What does this paper add? This paper describes such an initiative in podiatry and orthopaedic surgery. It describes a skill mix initiative based on triage and screening rather than delegation. It reflects benefits of including waiting lists as a process measure. What are the implications for practitioners? Support for triage-oriented skill mix collaboration in Podiatry and Orthopaedic Surgery.
Publisher: Informa UK Limited
Date: 10-2013
DOI: 10.2147/JMDH.S51339
Publisher: Informa UK Limited
Date: 02-07-2016
Publisher: Informa UK Limited
Date: 08-02-2021
Publisher: Wiley
Date: 15-04-2014
Abstract: It is known that people with dysphagia experience a number of negative consequences as a result of their swallowing difficulties following head and neck cancer management (HNC). However their perceptions and experiences of adjusting to dysphagia in the post-treatment phase, and the services received to assist this process, has not been studied. To explore the lived experience of people with dysphagia following non-surgical treatment for HNC and examine their perceptions of service needs. A demographically erse group of 24 people who had received radiotherapy for HNC in the past five years, and experienced dysphagia as a result of treatment, were recruited using maximum variation s ling. Each participant took part in a semi-structured, in-depth interview, where they reflected on their adjustment to, and recovery from dysphagia following treatment for HNC, as well as the dysphagia-related services they received during their treatment. Thematic analysis was used to analyse the transcripts and to identify key themes that emerged from the data. The main integrative theme was the desire for ongoing access to dysphagia-related services in order to adequately manage dysphagia. Within this integrative theme were five additional themes including: (1) entering the unknown: life after treatment for HNC (2) making practical adjustments to live with dysphagia (3) making emotional adjustments to live with dysphagia (4) accessing support outside the hospital services and (5) perceptions of dysphagia-related services. The interviews revealed the need for both greater access to services and a desire for services which address the multitude of issues faced by people with dysphagia following HNC in the post-treatment period. Speech and language therapists managing this caseload need to ensure post-treatment services are available and address not only the physical but also the emotional and psychosocial changes impacting people with dysphagia in order to assist them to adjust to, and live successfully with dysphagia. Further research should be conducted to support the development of innovative services and to highlight dysphagia-related survivorship issues to governing bodies olicy makers.
Location: Switzerland
Location: Australia
No related grants have been discovered for Pim Kuipers.