ORCID Profile
0000-0002-6805-078X
Current Organisations
Monash University
,
Peninsula Health
,
Alfred Health
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Publisher: Informa UK Limited
Date: 2010
DOI: 10.3109/09638280903171576
Abstract: To assess the inter-rater reliability, internal consistency and convergent validity of the Modified Rivermead Mobility Index (MRMI) in a mixed neurological population. The MRMI was scored for 30 consecutive patients (mean age 54.5+/-15.6 years) by two in idual testers. Reliability was examined using intraclass correlation coefficients (ICC3,1) and Bland and Altman plots internal consistency reliability using Cronbach's alpha (alpha) and convergent validity using Spearman's correlation coefficient (rho) test to compare the MRMI to the 10-m walk test as a gold standard of mobility. As the majority of patients had bilateral deficits, the MRMI was measured and added independently for both sides. The inter-rater reliability was excellent: ICC (95% CI)=0.93(0.86, 0.96). The Bland and Altman plots contained most data points and there was perfect agreement between raters bilaterally in 27% of cases, with a difference of one point in 60% of cases on the left and 63% of cases on the right. Internal consistency was good at alpha=0.72 (Rater 1) and 0.80 (Rater 2). The Spearman rho between MRMI and the 10-m walk test was high at 0.86. The MRMI was shown to have high levels of reliability in a mixed neurological population but we recommend that its psychometric properties are further investigated to establish the true clinical utility of this measure.
Publisher: Informa UK Limited
Date: 17-01-2019
DOI: 10.1080/09638288.2017.1423520
Abstract: To evaluate if a changed physical environment following redesign of a hospital ward influenced neurological patient physical and social activity. A "before and after" observational design was used that included 17 acute neurological patients pre-move (median age 77 (IQR 69-85) years Ward A and 20 post-move (median age 70 (IQR 57-81) years Ward B. Observations occurred for 1 day from 08.00-17.00 using Behavioral Mapping of patient physical and social activity, and location of that activity. Staff and ward policies remained unchanged throughout. An Environmental Description Checklist of each ward was also completed. Behavioral Mapping was conducted pre- ost-move with a total of 801 Ward A and 918 Ward B observations. Environmental Description Checklists showed similarities in design features in both neurological wards with similar numbers of de-centralized nursing stations, however there were more single rooms and varied locations to congregate in Ward B (30% more single-patient rooms and separate allied health therapy room). Patients were alone >60% of time in both wards, although there was more in bed social activity in Ward A and more out of bed social activity in Ward B. There were low amounts of physical activity outside of patient rooms in both wards. Significantly more physical activity occurred in Ward B patient rooms (median = 47%, IQR 14-74%) compared to Ward A (median = 2% IQR 0-14%), Wilcoxon Rank Sum test z = -3.28, p = 0.001. Overall, patient social and physical activity was low, with little to no use of communal spaces. However we found more physical activity in patient rooms in the Ward B environment. Given the potential for patient activity to drive brain reorganization and repair, the physical environment should be considered an active factor in neurological rehabilitation and recovery. Implications for Rehabilitation Clinicians should include consideration of the impact of physical environment on physical and social activity of neurological patients when designing therapeutic rehabilitation environments. Despite architectural design intentions patient and social activity opportunities can be limited. Optimal neurological patient neuroplasticity and recovery requires sufficient environmental challenge, however current hospital environments for rehabilitation do not provide this.
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.APMR.2017.02.024
Abstract: To report and synthesize the experiences, needs, and preferences of carers of stroke survivors undergoing inpatient rehabilitation. MEDLINE, CINAHL, Embase, PsycINFO, and Web of Science were searched to March 2016. Reference lists of relevant publications were searched. No language restrictions were applied. Eligible qualitative studies reported the experiences of carers of stroke survivors who underwent inpatient rehabilitation. The search yielded 3532 records 93 full-text publications were assessed for eligibility, and 34 documents (33 studies) were included. Comprehensiveness of reporting was assessed using the Consolidated Criteria for Reporting Qualitative Health Research framework. Data on the characteristics of included studies were independently extracted by 2 authors. Differences in data extraction between authors were resolved through discussion or by a third author. All text in studies' results and discussion sections were extracted for analysis. Extracted texts were analyzed inductively using thematic synthesis. Seven analytical themes were developed that related to the carers' experiences, needs, and preferences: (1) overwhelmed with emotions (2) recognition as a stakeholder in recovery (3) desire to be heard and informed (4) persisting for action and outcomes (5) being legitimate clients (6) navigating an alien culture and environment and (7) managing the transition home. This systematic review provides new insights into the experiences, needs, and preferences of carers of stroke survivors undergoing inpatient rehabilitation. Carers experienced distress as they navigated a foreign culture and environment without adequate communication and processes in place for their inclusion. We recommend deliberate efforts to provide a more inclusive environment that better supports and prepares carers for their new role.
Publisher: SAGE Publications
Date: 29-01-2020
Abstract: We aimed to examine the nature and extent of theory application in studies of built environment attributes and impact on adults in healthcare facilities. Many varied theories are described when providing the rationale for research into built environments in healthcare. Uncertainty exists around the right theory to frame a research question, alignment with measurement tools, and whether healthcare setting makes a difference. This poses challenges to researchers seeking to build the evidence base for built environment design that benefits patients and staff. Our multidisciplinary review team scoped the literature to determine how theories are used to inform research investigating the impact of the built environment of healthcare on adults. When researchers recorded theory at development of the study question, in data collection, and in data analysis/interpretation, we called this explicitly theory-based application. Synthesis occurred using a narrative approach. Overall, we found 17 erse theories named in studies. Explicitly theory-based use occurred with eight theories, comprising 47% of all theories used. Five theories were named more frequently in studies out of all theories identified. In 20% of studies, theory was not used explicitly during the research inquiry. We argue that researchers must continue to strive toward explicit use of theories, similar to development of other health interventions that employ multifactorial components.
Publisher: Wiley
Date: 12-09-2022
DOI: 10.1111/IMJ.15750
Abstract: Telehealth was widely adopted in health services during the COVID‐19 pandemic. It is unknown what the attitudes and ongoing needs of healthcare staff are after a rapid implementation of telehealth. To evaluate staff attitudes to telehealth utilisation after a rapid implementation. A health service‐wide bespoke survey was sent to all clinicians, managers and administration staff in June–July 2021. We evaluated attitudes to: (i) telehealth application in the model of care and (ii) the barriers and enablers to use of telehealth. Descriptive statistics were used for quantitative data, and content analysis for the textual data. One hundred and thirty‐four respondents completed the survey (response rate = 22.5% of healthdirect users (71/315), and 3.2% of total healthcare staff population). Most commonly, telehealth was identified as being important (78%) and safe (79%) by clinicians, and important (100%) and encouraged (88%) by managers. In contrast, telehealth was identified as not the same as face to face (56% 50%), but easy to add to usual work arrangements (43% 44%) by clinicians and managers respectively. The most common enablers of telehealth were: (i) having others use the same telehealth platform (74.3% 100%) and (ii) completing training (68.9% 72.7%) by clinicians and managers respectively. The most common barriers were having: (i) reliable Internet connectivity (39.2% 45.5%) by clinicians and managers, respectively (ii) the right equipment (clinician 37.8%) and (iii) a private area (managers 36.3%). Despite training and having support from colleagues to implement telehealth, ongoing needs were identified that may promote uptake in specific health settings.
Publisher: Cold Spring Harbor Laboratory
Date: 20-12-2022
DOI: 10.1101/2022.12.19.22283679
Abstract: Mobile devices offer a scalable opportunity to collect longitudinal data that facilitate advances in mental health treatment to address the burden of mental health conditions in young people. Sharing these data with the research community is critical to gaining maximal value from rich data of this nature. However, the highly personal nature of the data necessitates understanding the conditions under which young people are willing to share them. To answer this question, we developed the MindKind Study, a multinational, mixed methods study that solicits young people’s preferences for how their data are governed and quantifies potential participants’ willingness to join under different conditions. We employed a community-based participatory approach, involving young people as stakeholders and co-researchers. At sites in India, South Africa, and the UK, we enrolled 3575 participants ages 16-24 in the mobile app-mediated quantitative study and 143 participants in the public deliberation-based qualitative study. We found that while youth participants have strong preferences for data governance, these preferences did not translate into (un)willingness to join the smartphone-based study. Participants grappled with the risks and benefits of participation as well as their desire that the “right people” access their data. Throughout the study, we recognized young people’s commitment to finding solutions and co-producing research architectures to allow for more open sharing of mental health data to accelerate and derive maximal benefit from research.
Publisher: Informa UK Limited
Date: 2008
DOI: 10.1080/09638280701216847
Abstract: Neurological physiotherapists recognize the need to include standardized outcome measures (OMs) in clinical practice but lack of information about the OMs available h ers utilization. This paper reports on the first stage of a project to identify the most robust OMs for use in neurological physiotherapy. To identify what physiotherapists perceive that they need to measure during a neurological assessment. Three separate workshops were held using patient vignettes to represent the acute, rehabilitation and community settings. Thirty senior neurological physiotherapists participated and were asked: 'What would you observe, test or measure if assessing this patient?' Data were analysed using thematic content analysis performed independently by each of the authors. Internal and external member checking ensured validity. In addition, the authors produced definitions of the items and domains identified in the data collection and subsequent content analysis. Items from the data collection were classified into 16 domains that physiotherapists need to measure: Weakness range of movement/contracture pain muscle tone/spasticity sensation ataxia/co-ordination personal fatigue oedema subluxation postural and balance impairment walking impairment upper limb balance disability walking disability mobility disability and falls. The domains that physiotherapists need to measure during clinical assessment were identified. In the second stage of the project these domains will inform systematic reviews to identify the most robust outcome measures for use in clinical practice.
Publisher: Informa UK Limited
Date: 29-11-2018
Publisher: Consortium of Multiple Sclerosis Centers
Date: 2010
DOI: 10.7224/1537-2073-12.3.115
Abstract: In a survey of its members conducted by the MS Society of Ireland, access to physiotherapy was reported as the greatest unmet need. This national multicenter profiling study surveyed people with multiple sclerosis (MS) receiving physiotherapy services at a range of locations to determine their characteristics and the amount of intervention received. A standardized data-collection sheet was developed, and data were collected over a 3-month period. The lower-extremity section of the Guys Neurological Disability Scale was used to classify mobility level, which varied widely. A total of 295 people received physiotherapy at 17 services during the 3-month period. Of these, 72% were female, and most had relapsing-remitting (43%) or secondary progressive MS (39%). Those using walking aids made up the largest proportion of participants (47.5%). On average, participants received 3.6 hours of physiotherapy over the 3-month period, with 36% of participants receiving 1 hour or less and 9.5% of participants receiving more than 8 hours. The main problems cited were balance, fatigue, walking, mobility, and strength. Further research is required to determine whether the small amount of physiotherapy being received by MS patients in Ireland is sufficient to bring about improvement or prevent further deterioration in functional status.
Publisher: SAGE Publications
Date: 05-10-2021
DOI: 10.1177/17474930211042485
Abstract: Healthcare facilities are among the most expensive buildings to construct, maintain, and operate. How building design can best support healthcare services, staff, and patients is important to consider. In this narrative review, we outline why the healthcare environment matters and describe areas of research focus and current built environment evidence that supports healthcare in general and stroke care in particular. Ward configuration, corridor design, and staff station placements can all impact care provision, staff and patient behavior. Contrary to many new ward design approaches, single-bed rooms are neither uniformly favored, nor strongly evidence-based, for people with stroke. Green spaces are important both for staff (helping to reduce stress and errors), patients and relatives, although access to, and awareness of, these and other communal spaces is often poor. Built environment research specific to stroke is limited but increasing, and we highlight emerging collaborative multistakeholder partnerships (Living Labs) contributing to this evidence base. We believe that involving engaged and informed clinicians in design and research will help shape better hospitals of the future.
Publisher: Springer Science and Business Media LLC
Date: 24-10-2022
DOI: 10.1186/S12913-022-08642-7
Abstract: Allied health assistants (AHAs) are support staff who complete patient and non-patient related tasks under the delegation of an allied health professional. Delegating patient related tasks to AHAs can benefit patients and allied health professionals. However, it is unclear whether the AHA workforce is utilised optimally in the provision of patient care. The purpose of this study was to determine the proportion of time AHAs spend on patient related tasks during their working day and any differences across level of AHA experience, clinical setting, and profession delegating the task. A time motion study was conducted using a self-report, task predominance work s ling method. AHAs were recruited from four publicly-funded health organisations in Victoria, Australia. AHAs worked with dietitians, occupational therapists, physiotherapists, podiatrists, social workers, speech pathologists, psychologists, and exercise physiologists. The primary outcome was quantity of time spent by AHAs on in idual task-categories. Tasks were grouped into two main categories: patient or non-patient related activities. Data were collected from July 2020 to May 2021 using an activity capture proforma specifically designed for this study. Logistic mixed-models were used to investigate the extent to which level of experience, setting, and delegating profession were associated with time spent on patient related tasks. Data from 51 AHAs showed that AHAs spent more time on patient related tasks (293 min/day, 64%) than non-patient related tasks (167 min/day, 36%). Time spent in community settings had lower odds of being delegated to patient related tasks than time in the acute hospital setting (OR 0.44, 95%CI 0.28 to 0.69, P 0.001). Time delegated by exercise physiologists and dietitians was more likely to involve patient related tasks than time delegated by physiotherapists (exercise physiology: OR 3.77, 95% 1.90 to 7.70, P 0.001 dietetics: OR 2.60, 95%CI 1.40 to 1.90, P = 0.003). Time delegated by other professions (e.g. podiatry, psychology) had lower odds of involving patient related tasks than physiotherapy (OR 0.37, 95%CI 0.16 to 0.85, P = 0.02). AHAs may be underutilised in community settings, and by podiatrists and psychologists. These areas may be targeted to understand appropriateness of task delegation to optimise AHAs’ role in providing patient care.
Publisher: JMIR Publications Inc.
Date: 19-06-2023
DOI: 10.2196/42963
Abstract: Public involvement in research is a growing phenomenon as well as a condition of research funding, and it is often referred to as coproduction. Coproduction involves stakeholder contributions at every stage of research, but different processes exist. However, the impact of coproduction on research is not well understood. Web-based young people’s advisory groups (YPAGs) were established as part of the MindKind study at 3 sites (India, South Africa, and the United Kingdom) to coproduce the wider research study. Each group site, led by a professional youth advisor, conducted all youth coproduction activities collaboratively with other research staff. This study aimed to evaluate the impact of youth coproduction in the MindKind study. To measure the impact of web-based youth coproduction on all stakeholders, the following methods were used: analysis of project documents, capturing the views of stakeholders using the Most Significant Change technique, and impact frameworks to assess the impact of youth coproduction on specific stakeholder outcomes. Data were analyzed in collaboration with researchers, advisors, and YPAG members to explore the impact of youth coproduction on research. The impact was recorded on 5 levels. First, at the paradigmatic level, a novel method of conducting research allowed for a widely erse group of YPAG representations, influencing study priorities, conceptualization, and design. Second, at the infrastructural level, the YPAG and youth advisors meaningfully contributed to the dissemination of materials infrastructural constraints of undertaking coproduction were also identified. Third, at the organizational level, coproduction necessitated implementing new communication practices, such as a web-based shared platform. This meant that materials were easily accessible to the whole team and communication streams remained consistent. Fourth, at the group level, authentic relationships developed between the YPAG members, advisors, and the rest of the team, facilitated by regular web-based contact. Finally, at the in idual level, participants reported enhanced insights into mental well-being and appreciation for the opportunity to engage in research. This study revealed several factors that shape the creation of web-based coproduction, with clear positive outcomes for advisors, YPAG members, researchers, and other project staff. However, several challenges of coproduced research were also encountered in multiple contexts and amid pressing timelines. For systematic reporting of the impact of youth coproduction, we propose that monitoring, evaluation, and learning systems be designed and implemented early.
Publisher: SAGE Publications
Date: 11-2020
Publisher: F1000 Research Ltd
Date: 08-08-2023
DOI: 10.12688/WELLCOMEOPENRES.19383.1
Abstract: Background : The global ubiquity of smartphone use among young people makes them excellent candidates for collecting data about in iduals’ lived experiences and their relationships to mental health. However, to-date most app-based studies have been conducted in North America and Europe. Understanding young people’s willingness to participate in app-based research and share information about their mental health is key to understanding the feasibility of broad-scale research using these approaches. We aimed to understand the recruitment and engagement approaches influencing young peoples’ (aged 16-24) participation in app-based studies of mental health. We hypothesised that providing a choice of study topics will improve engagement. Methods : We developed a 12-week pilot study of mental health implemented in the MindKind app, designed to assess participants’ willingness to engage in remote mental health research, both actively and passively. Enrollees were randomised to one of two different engagement arms, either selecting their study topics of interest or receiving a fixed assignment of study topics, in order to understand the role of choice in study engagement. This pilot study was conducted in India, South Africa, and the United Kingdom. Different recruitment strategies were employed in each location. Results : The MindKind Study recruited 1,034 (India), 932 (South Africa) and 1,609 (UK) participants. Engagement differed by country with median days of activity = 2, 6, and 11 for India, South Africa, and UK, respectively. Most surprisingly, participants given a choice of study topics showed lower engagement relative to participants assigned to fixed topics (Hazard Ratio = 0.82). Conclusions : We observe equal or better engagement compared to previous comparable app-based studies of mental health. While providing participants a choice of study topics showed no advantage in our study, our qualitative analysis of participant feedback provides additional suggestions for improving engagement in future studies.
Publisher: Public Library of Science (PLoS)
Date: 29-03-0004
DOI: 10.1371/JOURNAL.PONE.0279857
Abstract: Mobile devices offer a scalable opportunity to collect longitudinal data that facilitate advances in mental health treatment to address the burden of mental health conditions in young people. Sharing these data with the research community is critical to gaining maximal value from rich data of this nature. However, the highly personal nature of the data necessitates understanding the conditions under which young people are willing to share them. To answer this question, we developed the MindKind Study, a multinational, mixed methods study that solicits young people’s preferences for how their data are governed and quantifies potential participants’ willingness to join under different conditions. We employed a community-based participatory approach, involving young people as stakeholders and co-researchers. At sites in India, South Africa, and the UK, we enrolled 3575 participants ages 16–24 in the mobile app-mediated quantitative study and 143 participants in the public deliberation-based qualitative study. We found that while youth participants have strong preferences for data governance, these preferences did not translate into (un)willingness to join the smartphone-based study. Participants grappled with the risks and benefits of participation as well as their desire that the “right people” access their data. Throughout the study, we recognized young people’s commitment to finding solutions and co-producing research architectures to allow for more open sharing of mental health data to accelerate and derive maximal benefit from research.
Location: Australia
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Michelle Shannon.