ORCID Profile
0000-0003-1310-4020
Current Organisation
Newcastle University
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Publisher: Springer Science and Business Media LLC
Date: 19-11-2014
Publisher: SAGE Publications
Date: 13-01-2015
Abstract: To identify interventions that aim to reduce dependency in activities of daily living (ADL) in homecare service users. To determine: content effectiveness in improving ability to perform ADL and whether delivery by qualified occupational therapists influences effectiveness. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, OTseeker, PEDro, Web of Science, CIRRIE, and ASSIA. We included: randomised controlled trials, non-randomised controlled trials and controlled before and after studies. Two reviewers independently screened studies for inclusion, assessed risk of bias and extracted data. A narrative synthesis of the findings was conducted. Thirteen studies were included, totalling 4975 participants. Ten (77%) were judged to have risk of bias. Interventions were categorised as those termed ‘re-ablement’ or ‘restorative homecare’ ( n=5/13) and those involving separate components which were not described using this terminology ( n=8/13). Content of the intervention and level of health professional input varied within and between studies. Effectiveness on ADL: eight studies included an ADL outcome, five favoured the intervention group, only two with statistical significance, both these were controlled before and after studies judged at high risk of bias. ADL outcome was reported using seven different measures. Occupational therapy: there was insufficient evidence to determine whether involvement of qualified occupational therapists influenced effectiveness. There is limited evidence that interventions targeted at personal ADL can reduce homecare service users’ dependency with activities, the content of evaluated interventions varies greatly.
Publisher: SAGE Publications
Date: 31-10-2012
Abstract: To assess the feasibility of conducting a randomized controlled trial of occupational therapy predischarge home visits for people after stroke. Randomized controlled trial and cohort study. We randomized eligible patients for whom there was clinical uncertainty about the need to conduct a home visit to a randomized controlled trial patients for whom a visit was judged ‘essential’ were enrolled into a cohort study. Stroke rehabilitation unit of teaching hospital. One hundred and twenty-six participants hospitalized following recent stroke. Predischarge home visit or structured, hospital-based interview. The primary objective was to collect information on the feasibility of a randomized controlled trial, including eligibility, control intervention and outcome assessments. The primary outcome measure was the Nottingham Extended Activities of Daily Living Scale at one month after discharge from hospital. Secondary outcomes included mood, quality of life and costs at one week and one month following discharge. Ninety-three people were allocated to the randomized controlled trial 47 were randomized to intervention and 46 to control. Thirty-three were enrolled into the cohort study. More people were allocated to the randomized controlled trial as the study progressed. One hundred and thirteen people (90%) received the proposed intervention, although there was a need for stricter protocol adherence. Follow-up was good: at one month 114 (90%) were assessed. There were no significant differences between the groups in the randomized controlled trial for the primary outcome measure at one month. The average cost of a home visit was £208. A trial is feasible and warranted given the resource implications of predischarge occupational therapy home visits.
Publisher: Springer Science and Business Media LLC
Date: 11-10-2017
Publisher: BMJ
Date: 08-2016
Publisher: SAGE Publications
Date: 21-06-2020
Abstract: To determine the feasibility of recruiting to and delivering a biopsychosocial intervention for carers of stroke survivors. Feasibility randomised controlled study with nested qualitative interview study. The intervention was delivered in the community in either a group or one-to-one format. Carers and stroke survivors within one year of stroke onset. A carer targeted intervention delivered by a research psychologist in six structured two-hour sessions or usual care control. The intervention combined education about the biological, psychological and social effects of stroke with strategies and techniques focussing on adjustment to stroke and caregiving. Stroke survivors in both groups received baseline and follow-up assessment but no intervention. Recruitment rate, study attrition, fidelity of intervention delivery, acceptability and sensitivity of outcome measures used (health related quality of life, anxiety and depression and carer burden six months after randomisation). Of the 257 carers approached, 41 consented. Six withdrew before randomisation. Eighteen participants were randomised to receive the intervention and 17 to usual care. Attendance at sessions was greater when treated one-to-one. Feedback interviews suggested that participants found the intervention acceptable and peer support particularly helpful in normalising their feelings. Thirty participants were assessed at follow-up with improvements from baseline on all health measures for both groups. Our results suggest that a biopsychosocial intervention was acceptable to carers and can be delivered in group and one-to-one formats. Timing of approach and mode of intervention delivery is critical and requires tailoring to the carers in idual needs.
Publisher: SAGE Publications
Date: 18-04-2018
Abstract: Despite clear compatibilities between the tenets of occupational therapy and re-ablement, there is limited research on occupational therapy in homecare reablement services. This article describes an occupational therapy intervention that was delivered as part of a feasibility randomised controlled trial (Occupational Therapy intervention in HomEcare Re-ablement Services), and evaluates whether the intervention was acceptable to participants. There were three phases: (1) a bespoke pro forma was completed, recording the activities undertaken after each therapy visit (2) an acceptability questionnaire was sent to every intervention participant and (3) semi-structured interviews were completed with key informants who received the intervention. The principal activities undertaken were assessment, case management, goal-setting, advice and support, and practising activities in relation to bathing/showering or kitchen activities. Participants particularly valued the advice and support provided. However, there were difficulties due to fluctuations in circumstances and with activities of daily living outside the home within the 6 week timescale. An intervention focusing on activities of daily living within the home was acceptable for participants and consistent with their goals however, they also had goals beyond personal activities of daily living and the timescale of the re-ablement episode. Further research should focus on extended activities of daily living, beyond this time-limited period.
Publisher: SAGE Publications
Date: 07-2014
Publisher: BMJ
Date: 10-2017
DOI: 10.1136/BMJOPEN-2017-018309
Abstract: Reducing length of hospital stay for stroke survivors often creates a shift in the responsibility of care towards informal carers. Adjustment to the caregiving process is experienced by many carers as overwhelming, complex and demanding and can have a detrimental impact on mental and physical health and well-being. National policy guidelines recommend that carers’ needs are considered and addressed despite this, few interventions have been developed and empirically evaluated. We developed a biopsychosocial intervention in collaboration with carers of stroke survivors. Our aim is to determine whether the intervention can be delivered in a group setting and evaluated using a randomised controlled trial (RCT). Feasibility RCT and nested qualitative interview study. We aim to recruit up to 40 stroke carers within 1 year of the stroke onset. Carers are randomised to usual care or usual care plus biopsychosocial intervention. Each intervention group will consist of five stroke carers. The intervention will focus on: psychoeducation, psychological adjustment to stroke, strategies for reducing unwanted negative thoughts and emotions and problem-solving strategies. The main outcome is the feasibility of conducting an RCT. Carer outcomes at 6 months include: anxiety and depression, quality of life and carer strain. Data are also collected from stroke survivors at baseline and 6 months including: level of disability, anxiety and depression, and quality of life. Favourable ethical opinion was provided by East Midlands – Nottingham2 Research Ethics Committee (14/EMI/1264). This study will determine whether delivery of the biopsychosocial intervention is feasible and acceptable to stroke carers within a group format. It will also determine whether it is feasible to evaluate the effects of the biopsychosocial intervention in an RCT. We will disseminate our findings through peer-reviewed publications and presentations at national and international conferences. ISRCTN15643456 Pre-results.
Publisher: Springer Science and Business Media LLC
Date: 02-07-2013
Publisher: SAGE Publications
Date: 09-2012
DOI: 10.4276/030802212X13470263980711
Abstract: Little is known about day-to-day procedures in conducting predischarge home visits in occupational therapy. The aim of this study was to identify current practice in relation to people with stroke. A questionnaire was designed and piloted 184 were posted to stroke units in England. Responses were analysed from 85 stroke units from 10 regions. The main reason for conducting visits was to ‘assess or practise activities of daily living in the home environment’ (93%), closely followed by to ‘identify or address safety issues’ (92%). Wide variations exist in time spent on the actual visit (range 10–135 minutes), with a mean time of 63 minutes (SD 20.36), and a mean time of 61 minutes (SD 33.13) for writing a report. Visits were generally conducted by an occupational therapist, with an occupational therapy hysiotherapy assistant. The majority (95%) of therapists reported having a home visit bag and the most common item included was incontinence pads (83%). This research has provided valuable information on, and highlights the variation in, day-to-day predischarge home assessment visits for patients after stroke. The next step must be to use this knowledge to evaluate patient selection and to examine the costs and effectiveness of such visits.
Publisher: SAGE Publications
Date: 08-2014
DOI: 10.4276/030802214X14071472109752
Abstract: The number of patients who have a pre-discharge home assessment visit following a stroke has been reported to vary nationally. The purpose of this research was to explore the factors influencing occupational therapists' decisions to complete such visits. Semi-structured interviews were completed with 20 senior occupational therapists working with stroke in-patients, from a range of urban and rural locations in the United Kingdom. The interviews explored their views about those patients for whom a pre-discharge home assessment visit would and would not be required. The interviews were analysed using thematic analysis. Three themes were identified: the patient's level of physical, cognitive, or perceptual impairment and its impact on performance in activities of daily living factors relating to the patient's home environment, including the availability of support within the home environment and other influences on occupational therapists. The presence of a cognitive impairment was a particularly important factor. Occupational therapists balanced aspects from each of these themes in order to determine whether a visit was needed or not. Although the level of impairment was important, the most dependent patients were not necessarily those believed to be the most likely to need a visit.
Publisher: BMJ
Date: 10-2016
Publisher: BMJ
Date: 13-10-2010
DOI: 10.1136/BMJ.C5633
Publisher: SAGE Publications
Date: 07-2011
DOI: 10.4276/030802211X13099513661234
Abstract: Obtaining research governance approvals for research involving the National Health Service (NHS) has become increasingly complex. In order to obtain the necessary approvals to interview 20 occupational therapists from a range of locations across the United Kingdom, the authors had to submit lengthy applications to all 20 sites. Before issuing their approvals, some sites raised numerous queries, whilst others did not raise any. The time taken to obtain approvals ranged from 6 to 197 days. These disparities highlight that the current research governance procedure for multisite studies is complex and subject to local interpretations. This opinion piece argues that the procedure is excessive for research that does not involve patients and involves NHS staff only. It also argues that this is an injudicious use of resources at a time of national austerity. Implications for the future of occupational therapy research in the United Kingdom are discussed.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
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 Phillip Whitehead.