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Bassingthwaighte L, Gustafsson L, Molineux M. Lifespace and occupational participation following acquired brain injury during driving disruption: a mixed methods study. Disabil Rehabil 2024:1-15. [PMID: 38592071 DOI: 10.1080/09638288.2024.2338192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 03/28/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE To examine the lifespace of participants referred for occupational therapy driving assessment following acquired brain injury, to understand how, why, where and with whom access and participation in community-based occupations is occurring during the period of driving disruption. MATERIALS AND METHODS The mixed methods, convergent research design utilised a travel diary and Lifespace Mobility Assessment-Composite quantitative elements and semi-structured interviews analysed qualitatively with an interpretive description lens. RESULTS Forty-eight participants (56.25% male) aged between 26 and 65 years, left home on average once/day, primarily to conduct instrumental activities of daily living, health management, and social participation community-based occupations. Most reported restricted lifespace (54.2%) requiring assistance to conduct community occupations (68.1%). Support was primarily provided by family members (80.3%). Analysis of semi-structured interviews (n = 15) created three themes that shaped participant occupational experience during driving disruption: (i) changes to occupational participation; (ii) reliance on others for community access and participation; and (iii) trying to move forward. CONCLUSION The period of driving disruption following the onset of acquired brain injury is a time of occupational disruption which restricts lifespace, changing how, why, where and with whom participation in community-based occupations occurs. Rehabilitation facilitating occupational adaptation process to enhance community access capacity is indicated.
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Affiliation(s)
- Louise Bassingthwaighte
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
- Driving Assessment and Rehabilitation Service, Princess Alexandra Hospital, Brisbane, Australia
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
| | - Matthew Molineux
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
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Mc Kittrick A, Gustafsson L, Hodson T, Di Tommaso A. Clinical utility and validity testing of a co-designed outcome measure for hand burn injuries. Burns 2024; 50:666-673. [PMID: 38040615 DOI: 10.1016/j.burns.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 10/19/2023] [Accepted: 11/12/2023] [Indexed: 12/03/2023]
Abstract
INTRODUCTION A new outcome measure for hand burn injuries was co-designed within a Participatory Action Research framework with expert clinicians and individuals with hand burn injuries. The outcome measure reviews activities which are commonly interrupted post hand burn injuries and includes 18 activities. OBJECTIVE The aim of this study was to establish the clinical utility, face, and content validity of the newly developed outcome measure. METHODS Three constructs of interest were examined using study specific questionnaires from the perspectives of clinicians and individuals with hand burn injuries. Clinicians working in burns centres around Australia and New Zealand and individuals attending a burn centre within one tertiary hospital trialled the outcome measure. Upon testing the outcome measure each participant completed the questionnaire. RESULTS Twenty individuals with hand burn injuries and eight clinicians trialled the outcome measure. There was 85% agreement from individuals and 100% agreement from clinicians for face validity. Content validity was tested across the domains of relevance and clarity. Individuals rated all activities and clinicians rated 16 activities as relevant. Clarity of activities was high for both participant groups (>75% agreement). Clinical utility (measured in the domains of appropriateness, accessibility, practicability, and acceptability) was high, 95% of individuals reported agreement for practicability and 100% agreement for acceptability. Clinicians reported agreement of > 87.5% for appropriateness, accessibility, practicability, and acceptability. CONCLUSION The results demonstrated agreement for clinical utility, face, and content validity of the co-design outcome measure for hand burn injuries. Further validity and reliability testing is planned, including Rasch analysis.
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Affiliation(s)
- Andrea Mc Kittrick
- Department of Occupational Therapy, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia; Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, QLD 4111, Australia.
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, QLD 4111, Australia
| | - Tenelle Hodson
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, QLD 4111, Australia
| | - Amelia Di Tommaso
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, QLD 4111, Australia
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3
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Gustafsson L, Cox R, Miller E. Enhancing inclusive and visible consumer authorship: Recommendations for research and publishing practice. Aust Occup Ther J 2024; 71:209-212. [PMID: 38497212 DOI: 10.1111/1440-1630.12946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/19/2024]
Affiliation(s)
| | - Ruth Cox
- Queen Elizabeth II Jubilee Hospital, Coopers Plains, Australia
| | - Elizabeth Miller
- Queen Elizabeth II Jubilee Hospital, Coopers Plains, Australia
- Consumer Co-Researcher
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Trevorrow S, Gustafsson L, Hodson T. Leisure Engagement Among People Living With Acquired Brain Injury: A Scoping Review. OTJR (Thorofare N J) 2024; 44:263-277. [PMID: 38234279 DOI: 10.1177/15394492231221962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Return to previously valued occupations is a common goal of individuals following acquired brain injury (ABI). However, the focus of rehabilitation is often on self-care and productivity occupations. Return to leisure should be a priority of rehabilitation to support a person's physical, cognitive, social, and emotional well-being. Consequently, the aim of this article was to review the research evidence on engagement in leisure occupations among community-dwelling adults living with ABI. A six-step scoping review was conducted searching five databases. Articles were included if they focused on leisure engagement post-stroke or traumatic brain injury. Seventeen studies were included. Leisure engagement decreased post-ABI with engagement primarily in solitary, sedentary, cognitively inactive, home-based leisure. Leisure engagement was impacted by personal and contextual factors. The findings identify a need to focus on and address changes to leisure following ABI, with exploration of why these changes have occurred beyond personal factors.
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Affiliation(s)
- Shane Trevorrow
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Louise Gustafsson
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Tenelle Hodson
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
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Peterson CM, Ingvalson S, Birkeland RW, Louwagie KW, Scott TL, Pachana NA, Liddle J, Gustafsson L, Gaugler JE. CarFreeMe™-Dementia: Potential Benefits of a Driving Retirement Intervention Supporting Persons With Dementia and Their Families. Innov Aging 2024; 8:igae022. [PMID: 38529511 PMCID: PMC10962632 DOI: 10.1093/geroni/igae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Indexed: 03/27/2024] Open
Abstract
Background and Objectives Driving retirement can be a necessary but challenging and emotionally complex transition, especially for people living with dementia. This pilot study evaluated the utility of CarFreeMe™-Dementia (CFM™-D), a telehealth intervention providing tailored education and social support to those living with dementia and their care partners, as they prepare for or adjust to driving retirement. Delivered by empathetic health professionals, CFM™-D is a person-centric, flexible program tailored to address challenges specific to the participants' driving retirement stage and individualized contexts. Research Design and Methods A single-arm, mixed-methods design was used to follow participants over a 6-month period. Participants received CFM™-D, a 7-8-module semistructured intervention, including education and planning support for driving retirement (impact of dementia, transportation options) and emotional adjustment (grief and loss, stress management). Surveys evaluated the perceived utility of intervention components as well as changes in well-being and readiness for driving retirement over time. An open-ended survey item and semistructured interviews provided additional feedback and a contextual understanding of the empirical data. Results A total of 50 families enrolled (17 care partners, 16 retiring/retired drivers with memory loss, and 17 care partner-retiring/retired driver dyads). Nearly all participants would recommend the intervention. Care partners reported significantly reduced (p < .05) isolation and relationship strain, and retiring drivers reported significant reductions in depressive symptoms. Driving retirement preparedness scores improved. Driving retirement phase, enrolling as a dyad, and retiring driver cognitive/functional impairment were associated with these outcomes. Participants also engaged in more driving retirement activities outside of the intervention (e.g., talking with health professionals). Discussion and Implications CFM™-D is a useful intervention for retiring drivers with dementia and their family members, with preliminary data suggesting it supports improved well-being and driving retirement preparedness. A randomized controlled trial is needed to determine the efficacy of the CFM™-D intervention and future translation needs.
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Affiliation(s)
- Colleen M Peterson
- University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, Michigan, USA
| | - Stephanie Ingvalson
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Robyn W Birkeland
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Katie W Louwagie
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Theresa L Scott
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Nancy A Pachana
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Jacki Liddle
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
- Department of Occupational Therapy, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Louise Gustafsson
- School of Health Sciences and Social Work, Griffith University, Nathan, Queensland, Australia
| | - Joseph E Gaugler
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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Dobe J, Gustafsson L, Walder K, Bower K, Lachman R. Co-creation of self-management support during inpatient stroke rehabilitation. PEC Innov 2023; 3:100191. [PMID: 37521957 PMCID: PMC10371841 DOI: 10.1016/j.pecinn.2023.100191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 02/04/2023] [Accepted: 07/08/2023] [Indexed: 08/01/2023]
Abstract
Objective This study aimed to identify priority self-management skills and behaviours in partnership with stroke survivors, and to co-create approaches to support self-management during inpatient stroke rehabilitation. Methods Three stroke survivors and two communication partners participated in the three-stage Participatory Action Research project with embedded co-design processes after undertaking inpatient rehabilitation at a metropolitan tertiary hospital. Results Participants identified key factors influencing self-management during inpatient rehabilitation including motivation, emotional well-being, and fatigue. Three approaches to support people to self-manage post-stroke were co-created. (1) A health professional concierge and early family meeting. (2) A peer support person. (3) Adapting the hospital environment. Conclusion Findings suggest post-stroke self-management support should commence during inpatient rehabilitation to optimise its research-informed benefits. This support should focus on empowering stroke survivors and their key support people through active involvement in decision-making, and provision of multi-modal individualised education. The impact of hospital environments on emotional-wellbeing and self-management post-stroke also requires further investigation. Innovation The identification of a health professional concierge as a co-designed solution to the current challenges with self-management support is an innovative recommendation for practice. The findings support changes to the traditional processes of rehabilitation towards a consumer and family-led practices.
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Affiliation(s)
- Joshua Dobe
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
- The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Queensland, Australia
| | - Kim Walder
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
| | - Kylie Bower
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia
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Campbell A, Gustafsson L, Grimley R, Gullo H, Rosbergen I, Summers M. Mapping the trajectory of acute mild-stroke cognitive recovery using serial computerised cognitive assessment. BRAIN IMPAIR 2023; 24:629-648. [PMID: 38167363 DOI: 10.1017/brimp.2022.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Cognitive impairment is common post-stroke. There is a need to understand patterns of early cognitive recovery post-stroke to guide both clinical and research practice. The aim of the study was to map the trajectory of cognitive recovery during the first week to 90-days post-stroke using serial computerised assessment. METHOD An observational cohort study recruited consecutive stroke patients admitted to a stroke unit within 48 hours of onset. Cognitive function was assessed using the computerised Cambridge Neuropsychological Test Automated Battery (CANTAB) daily for seven days, then 14, 30 and 90 days post-stroke. The CANTAB measured visual episodic memory and learning, information processing speed, visuo-spatial working memory, complex sustained attention and mental flexibility. Repeated measures MANOVA/ANOVA with Least Squares Difference post-hoc analyses were performed to ascertain significant change over time. RESULT Forty-eight participants, mean age 73, primarily mild, ischaemic stroke, completed all assessment timepoints. There was a trajectory of early, global cognitive improvement, indicative of a post-stroke delirium, that largely stabilised between 6 and 14-days post-stroke. Change over time was examined within each cognitive test, with one measure stabilising by day 6 (Reaction Time) and others detecting improving performances up to 14 days post-stroke. CONCLUSIONS Serial, computerised cognitive assessment can effectively map post-stroke cognitive recovery and revealed an early phase of global improvement over 14 days that is evidence for an acute post-stroke delirium. Resolution of post-stroke delirium in the second week following mild stroke indicates more extensive neuropsychological testing may be undertaken earlier than previously thought.
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Affiliation(s)
- Alana Campbell
- The University of Queensland (School of Health and Rehabilitation Sciences), Brisbane, Queensland, Australia
- Queensland Health (Sunshine Coast Hospital and Health Service), Sunshine Coast, Queensland, Australia
| | - Louise Gustafsson
- Griffith University (School of Health Sciences and Social Work), Brisbane, Queensland, Australia
| | - Rohan Grimley
- Queensland Health (Sunshine Coast Hospital and Health Service), Sunshine Coast, Queensland, Australia
- Griffith University (School of Medicine), Sunshine Coast, Queensland, Australia
| | - Hannah Gullo
- The University of Queensland (School of Health and Rehabilitation Sciences), Brisbane, Queensland, Australia
| | - Ingrid Rosbergen
- Queensland Health (Sunshine Coast Hospital and Health Service), Sunshine Coast, Queensland, Australia
- University of Applied Sciences, UAS, Leiden, The Netherlands
| | - Mathew Summers
- University of the Sunshine Coast (School of Health and Behavioural Sciences), Sunshine Coast, Queensland, Australia
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8
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Hoyle M, Meredith P, Ownsworth T, Khan A, Gustafsson L. Associations between participation and personal factors in community-dwelling adults post-stroke. BRAIN IMPAIR 2023; 24:456-473. [PMID: 38167356 DOI: 10.1017/brimp.2022.31] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To examine associations between post-stroke participation and personal factors, including demographic characteristics, self- and threat appraisals, and personality variables. METHODS An exploratory cross-sectional study with purpose-designed survey was completed online or via mail. The survey was comprised of demographic and health-related questions and multiple questionnaires, including the Stroke Impact Scale Version 3.0 (SISv3) (participation/perceived recovery), Community Integration Questionnaire (CIQ) (participation), Head Injury Semantic Differential III (pre- vs post-stroke self-concept/self-discrepancy), Appraisal of Threat and Avoidance Questionnaire (threat appraisal), Life Orientation Test - Revised (optimism) and Relationships Questionnaire (adult attachment style) that measured variables of interest. Sixty-two participants, aged 24-96 years who had experienced a stroke (one or multiple events) and had returned to community living, completed the survey. Associations were examined using correlations, and univariate and multiple linear regression analyses. RESULTS Regression analysis showed that greater participation, measured using the CIQ, was associated with younger age, female gender, lower self-discrepancy and higher perceived recovery, explaining 69% of the variability in CIQ participation. Further, greater participation on the SISv3 was associated with lower self-discrepancy and higher perceived recovery, explaining 64% of the variability in SISv3 participation. CONCLUSIONS Results indicate that personal factors, particularly self-appraisals like self-concept/self-discrepancy, in combination with perceived recovery may be important in explaining a large portion of variance in post-stroke participation. Specifically, findings highlight the interrelatedness of self-concept change, perceived recovery and post-stroke participation. Further longitudinal research is needed to clarify the directionality of these associations throughout the hospital-to-home transition.
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Affiliation(s)
- Melanie Hoyle
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Pamela Meredith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
| | - Tamara Ownsworth
- School of Applied Psychology, Griffith University, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Louise Gustafsson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
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Liddle J, Gustafsson L, Scott T, Byrnes J, Salmon A, Pachana NA. Still in first gear: Exploration of barriers for implementing driving cessation support. Australas J Ageing 2023; 42:796-800. [PMID: 37236918 DOI: 10.1111/ajag.13218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/14/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Driving cessation is a major life transition; lack of support in this process may lead to deleterious outcomes in terms of physical, mental and social well-being. Despite approaches to driving cessation being developed, their integration into ongoing geriatric clinical practice has been slow. METHODS Health-care providers were surveyed about their impressions of the barriers and facilitators to implementing a driving cessation intervention as part of regular clinical services. Methods of funding the intervention were queried. Surveys were sent via professional listserves and a snowballing strategy employed. Twenty-nine completed surveys were analysed by content analysis. RESULTS Participants identified that an understanding of driving cessation and optimal driving cessation supports was required. They identified four key approaches to support the implementation of driving cessation support: the need to consider complexity and emotional support needs in clinical contexts; knowing and showing the outcomes by clearly communicating the benefits and values to different stakeholders; managing systemic barriers included workforce issues, funding models and efforts required for initiating and sustaining an intervention; and not doing it alone, but instead developing processes supports to collaboratively provide access to programs. CONCLUSIONS The current study reveals a recognition of unmet needs of older persons and families regarding driving cessation as well as signalling service delivery, costing and workforce needs which act as barriers.
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Affiliation(s)
- Jacki Liddle
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Louise Gustafsson
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Theresa Scott
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Joshua Byrnes
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Amanda Salmon
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
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10
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Marnane K, Gustafsson L, Liddle J, Molineux M. Interventions for Driving Disruption in Community Rehabilitation: A Chart Audit. Disabil Rehabil 2023; 45:4424-4430. [PMID: 36448310 DOI: 10.1080/09638288.2022.2152501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 11/22/2022] [Indexed: 12/02/2022]
Abstract
PURPOSE After injury or illness, a person's ability to drive may be impacted and they may experience a period of "driving disruption," a period during which they cannot drive although they have not permanently ceased driving. They may require additional information and supports from treating rehabilitation services; however, this process is less understood than others related to driving. MATERIALS AND METHODS This study aimed to document the prevalence of driving-related issues and the current practices of a community rehabilitation service, regarding driving interventions. An audit of 80 medical records was conducted in a multidisciplinary community rehabilitation service in Brisbane, Australia. RESULTS In total, 61% of clients were "driving-disrupted" on admission and 35% remained driving-disrupted on discharge. Majority of driving-disrupted clients had an acquired brain injury (ABI). Driving-related interventions were not routinely provided, with 29% receiving no information or supports. Clients with ABI more frequently received information; provision of psychosocial support and community access training was infrequent. CONCLUSIONS This study highlights that return to driving is a common issue and goal for people undergoing community rehabilitation, with the period of driving disruption extending beyond rehabilitation discharge. It also highlights gaps in community rehabilitation practice, and opportunities to better support these clients.IMPLICATIONS FOR REHABILITATIONMany clients of community rehabilitation services experience driving disruption, often beyond discharge.Driving disruption should be recognised and documented by community rehabilitation services.Current practices may not adequately address the practical and psychological needs of clients experiencing driving disruption.
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Affiliation(s)
- Kerry Marnane
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
- Acquired Brain Injury Outreach Service, Princess Alexandra Hospital, Brisbane, Australia
| | - L Gustafsson
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
| | - J Liddle
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
| | - M Molineux
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
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Laurie K, Foster MM, Borg DN, Gustafsson L. Perceived service adequacy and unmet need after discharge from brain injury rehabilitation. Disabil Rehabil 2023; 45:3252-3261. [PMID: 36111685 DOI: 10.1080/09638288.2022.2123054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 07/30/2022] [Accepted: 08/30/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The present study aimed to quantify the perceived needs and adequacy of realised access to post-acute services in a sample of people with acquired brain injury in the first 6-months after discharge from inpatient rehabilitation. A secondary focus was the influence of access to funding and specialist transitional rehabilitation on unmet needs. MATERIALS AND METHODS Participants were 51 adults with a median age of 50 (IQR 35-57) recruited from an inpatient rehabilitation unit in an Australian tertiary hospital. The sample was those who had an acquired brain injury, including 23 who sustained a traumatic injury and 28 who sustained a non-traumatic injury. Measures were collected via telephone at 3- and 6-months, in a prospective observational cohort design using the Needs and Provisions Complexity Scale. A series of logistic regression models were used to determine the effects of participation in a transitional rehabilitation program and funding pathway on adequacy and unmet needs. RESULTS Unmet needs for rehabilitation were most commonly reported (60%), followed by unmet needs in relation to health care (40%), social care (35%), personal care (32%) and environment-related (14%). Participants who attended transitional rehabilitation were more likely to indicate unmet health care needs (OR = 6.40, 95% CI = 1.40-29.24, p = 0.02). CONCLUSIONS The study highlights the need to look beyond functional impairment when conceptualising appropriate access. Additionally, the present research highlighted the need for greater work into an expectation of services.IMPLICATIONS FOR REHABILITATIONThe majority of people with an acquired brain injury report unmet needs at 6 months post discharge.Present findings support the utility of patient reported measures when considering treatment evaluation with people with ABI, where assessing the personal appraisal of individuals needs may prove to be a key indicator to facilitate optimal service access.There are specific services that needed and not provided including psychological, speech pathology, family carer needs and vocational rehabilitation, and therefore are a key target for ensuring appropriate support is provided.
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Affiliation(s)
- Kirstyn Laurie
- Division of Rehabilitation, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
| | - Michele M Foster
- Division of Rehabilitation, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
| | - David N Borg
- Division of Rehabilitation, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
| | - Louise Gustafsson
- Division of Rehabilitation, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
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12
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Gustafsson L. Consumer and community involvement in research-The disconnect between policy and practice. Aust Occup Ther J 2023; 70:533-534. [PMID: 37743065 DOI: 10.1111/1440-1630.12907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 09/11/2023] [Indexed: 09/26/2023]
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13
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Gustafsson L, Liddle J, Pachana NA, Scott TL, George S, Laver K. Understanding barriers to evidence-based support for driving cessation. Int Psychogeriatr 2023:1-2. [PMID: 37752718 DOI: 10.1017/s1041610223000753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Affiliation(s)
- Louise Gustafsson
- Griffith University, Brisbane, Australia
- The Hopkins Centre - Menzies Health Institute of Queensland, Brisbane, Australia
| | - Jacki Liddle
- University of Queensland, Brisbane, Australia
- Princess Alexandra Hospital, Brisbane, Australia
| | | | | | | | - Kate Laver
- Flinders University, Adelaide, Australia
- South Australian Local Health Network, Adelaide, Australia
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Hogan C, Gustafsson L, Di Tommaso A, Hodson T, Bissett M, Shirota C. Establishing the normative and comparative needs of assistive technology provision in Queensland from the agency and funding scheme perspective. BRAIN IMPAIR 2023; 24:204-218. [PMID: 38167189 DOI: 10.1017/brimp.2023.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
BACKGROUND AND AIMS Assistive technology services and devices support the participation and inclusion of people living with disability. In Australia, the regulatory bodies, agencies and schemes that manage assistive technology provision are governed by national and / or state-based Acts and Legislation. This study examined the assistive technology sector from the perspective of the regulatory bodies, agencies and schemes. DESIGN AND METHODS Regulatory bodies, agencies and schemes that manage funding for assistive technology in Australia were identified by the research team. A website audit reviewed publicly available documents and information. Semi-structured interviews with representatives from the agencies and schemes were audio-recorded and transcribed verbatim. FINDINGS The audit (n =17) found that the range and level of information publicly available was variable. The availability of assistive technology for driving and transport, design and building for access and safety, and mobility was most often promoted. The qualitative findings (n = 11) indicated variability and challenges within four themes: operationalising the legislation; internal assistive technology processes; reasonable and necessary; and risks in the assistive technology pathway. CONCLUSIONS Regulatory bodies, agencies and schemes are critical to the effectiveness of the sector. The findings identified opportunities for the organisations to review how internal processes are communicated publicly, and for the sector to address the perceived risks related to health professional availability, knowledge and skills, and limited accessibility to trial assistive technology. Subsequent studies explored the perspectives of the assistive technology advisors and suppliers and the recipients of assistive technology services and devices.
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Affiliation(s)
- Christy Hogan
- The Hopkins Centre, Menzies Health Institute, Queensland, Australia
| | - Louise Gustafsson
- The Hopkins Centre, Menzies Health Institute, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Queensland, Australia
| | - Amelia Di Tommaso
- The Hopkins Centre, Menzies Health Institute, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Queensland, Australia
| | - Tenelle Hodson
- The Hopkins Centre, Menzies Health Institute, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Queensland, Australia
| | - Michelle Bissett
- School of Health Sciences and Social Work, Griffith University, Queensland, Australia
- Faculty of Health, Southern Cross University, Queensland, Australia
| | - Camila Shirota
- The Hopkins Centre, Menzies Health Institute, Queensland, Australia
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Marshall K, Patterson F, Fleming J, Gustafsson L, Atresh S. "Be ready to learn": a qualitative study of the patient perspective of falls and fall prevention following discharge from a spinal injuries unit. Disabil Rehabil 2023:1-8. [PMID: 37559389 DOI: 10.1080/09638288.2023.2245755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/29/2023] [Accepted: 08/03/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE Falls following a spinal cord injury (SCI) can have physical and psychological consequences, although some risk of falls may be acceptable to enable participation in meaningful activity. The study aimed to explore the patients' perspective of falls and fall prevention after discharge from a inpatient spinal injuries unit. METHODS An interpretive descriptive approach guided the study. Semi structured interviews were conducted in the 6-12 months post discharge period. Thematic analysis was used to analyze the data and identify themes. RESULTS Fifteen individuals with SCI, with a mean age of 57 years and varied fall experiences were included. Three themes were identified including: 1. Expectation of falling; 2. Learning from my own experience and the experience of others' and 3. How to prevent falls. Learning from their own experience and the experience of others was highly valued by persons with SCI and influenced expectations of falls. A variety of strategies were used to prevent falls. CONCLUSIONS Strategies that include learning from others, include activities that are individual and provide skills in self-reflection may aid to make fall prevention meaningful.Implications for RehabilitationPatients want to learn from practical experience and the experience of others with spinal cord injury (SCI).Clinicians need to consider patients' readiness to receive education and could benefit from the inclusion of peers in the delivery of information/education provided.A shift of focus for clinicians providing fall prevention education to skills in risk assessment, self-reflection and ability to formulate fall management plans may be beneficial to patients with SCI.Patients appreciate demonstration of skills. Clinicians are encouraged to learn wheelchair skills when performing functional tasks and demonstrate them to add credibility to their fall prevention education.
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Affiliation(s)
- Kathryn Marshall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Department of Occupational Therapy, Princess Alexandra Hospital, Brisbane, Australia
| | - Freyr Patterson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Louise Gustafsson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Sridhar Atresh
- Queensland Spinal Cord Injuries Service, Division of Rehabilitation, Princess Alexandra Hospital, Brisbane, Australia
- School of Medicine, The University of Queensland, Brisbane, Australia
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Baker A, Cornwell P, Gustafsson L, Lannin NA. Implementing a tailored, co-designed goal-setting implementation package in rehabilitation services: a process evaluation. Disabil Rehabil 2023:1-12. [PMID: 37551867 DOI: 10.1080/09638288.2023.2243589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
PURPOSE This study aims to evaluate the process of implementing an evidence-based goal-setting package into five rehabilitation services across the continuum of rehabilitation. MATERIALS AND METHODS This study used a mixed methods approach guided by Medical Research Council (MRC) recommendations for conducting process evaluations, the RE-AIM framework, and the Theoretical Domains Framework (TDF). This study will evaluate the reach, adoption, implementation, and maintenance of the goal-setting package over six months. RESULTS Environmental context and resources, the clinician's social and professional role and identity, social influences and clinician beliefs about goal-setting consequences and individuals' capabilities were all identified as barriers or enablers throughout the implementation process. Community rehabilitation services faced challenges implementing paper-based resources, whilst inpatient rehabilitation sites faced challenges engaging nursing staff in the interdisciplinary approach to goal-setting. Social influences were an enabler in two sites that used the case conference format to facilitate setting common goals. Clinicians in all sites continued to express difficulties implementing shared decision-making with people who had cognitive impairments or were no longer progressing in their rehabilitation. CONCLUSIONS A team-based approach to implementing the goal-setting interventions centred around the case conference format appeared to be the most successful mode for implementing interdisciplinary person-centred goal-setting.
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Affiliation(s)
- Amanda Baker
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
- Statewide Rehabilitation Clinical Network, Clinical Excellence Division, Queensland Health, Brisbane, Australia
- Allied Health, Physiotherapy Department, Sunshine Coast Hospital and Health Service, Queensland Health, Nambour, Australia
| | - Petrea Cornwell
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
| | - Louise Gustafsson
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
| | - Natasha A Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
- Alfred Health, Melbourne, Australia
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Baker A, Cornwell P, Gustafsson L, Stewart C, Lannin NA. Implementation of best practice goal-setting in five rehabilitation services: A mixed-methods evaluation study. J Rehabil Med 2023; 55:jrm4471. [PMID: 37548542 PMCID: PMC10424097 DOI: 10.2340/jrm.v55.4471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 04/05/2023] [Indexed: 08/08/2023] Open
Abstract
OBJECTIVE This implementation study aimed to enhance the key elements of clinical practice goal-setting across 5 rehabilitation services. DESIGN This study followed a participatory action research approach guided by the Knowledge to Action framework. METHODS Medical record audits and structured client interviews were conducted prior to and following 12 weeks of implementation, in order to evaluate the success of the goal-setting implementation package. RESULTS Medical record audits and interviews conducted pre-implementation (audits n = 132, interviews n = 64), post-implementation (audits n = 130, interviews n = 56) and at 3-month follow-up (audits n = 30) demonstrated varied success across sites. Following implementation 2 sites significantly improved their common goal focus (site 1 p ≤ 0.001, site 2 p = 0.005), these sites also demonstrated a significant increase in clients reporting that they received copies of their rehabilitation goals (site 1 p ≤ 0.001, site 2 p ≤ 0.001). Four sites improved client action planning, feedback and review, and 3 sites enhanced their specificity of goal-setting. At 3-month follow-up 4 sites had continued to improve their common goal focus; however, all sites decreased the specificity of their goal-setting. CONCLUSION Elements of the implementation package were successful at enhancing the goal-setting process; however, how the package is implemented within the team may impact outcomes.
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Affiliation(s)
- Amanda Baker
- School of Health Sciences and Social Work, Griffith University, Brisbane; Statewide Rehabilitation Clinical Network, Clinical Excellence Division, Queensland Health, Brisbane; Allied Health, Physiotherapy Department, Sunshine Coast Hospital and Health Service, Queensland Health, Sunshine Coast.
| | - Petrea Cornwell
- School of Health Sciences and Social Work, Griffith University, Brisbane; The Hopkins Centre, Menzies Health Institute Queensland, Brisbane
| | - Louise Gustafsson
- School of Health Sciences and Social Work, Griffith University, Brisbane; The Hopkins Centre, Menzies Health Institute Queensland, Brisbane
| | - Claire Stewart
- Allied Health, Physiotherapy Department, Sunshine Coast Hospital and Health Service, Queensland Health, Sunshine Coast
| | - Natasha A Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia; Alfred Health, Melbourne, Australia
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Wall G, Isbel S, Gustafsson L, Pearce C. Occupation-based interventions to improve occupational performance and participation in the hospital setting: a systematic review. Disabil Rehabil 2023:1-22. [PMID: 37524307 DOI: 10.1080/09638288.2023.2236021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 07/07/2023] [Accepted: 07/07/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE To critically review the evidence for occupation-based interventions in improving occupational performance and participation outcomes in the hospital setting. METHODS Five databases were searched from 2000-2022. Peer-reviewed studies of any design investigating the impact of occupation-based interventions in the hospital setting were included. Methodological quality was assessed using the appropriate tool for each study design. Following data extraction, a narrative synthesis was conducted. RESULTS Thirty-three studies comprising of 26 experimental, five non-experimental, and two mixed methods studies were included (n = 1646 participants). Results indicate good evidence to support occupation-based interventions to improve occupational performance and participation outcomes in inpatient rehabilitation; it is unclear whether they are more effective than any control/alternative intervention. Research in the acute and mental health hospital settings were scarcer. Understanding the benefits of occupation-based interventions was enhanced through qualitative results including improving independence and confidence to discharge home, increasing motivation for therapy, connecting with others, and peer-based learning. CONCLUSIONS Heterogeneity and methodological weaknesses across existing studies limits the conclusions that can be drawn on the impact of occupation-based interventions in the hospital setting. More rigorous research should be conducted with better reporting of intervention design and the use of robust measures of occupational performance.Implications For RehabilitationThe use of occupation-based interventions should be considered to improve occupational performance and participation outcomes in the hospital setting.There is good evidence to support the impact of occupation-based interventions on improving occupational performance and participation outcomes in the inpatient rehabilitation setting; evidence in the acute and mental health settings is scarcer.Occupation-based interventions are valued by both patients and clinicians for their impact on patient outcomes and the patient experience.
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Affiliation(s)
- Gemma Wall
- Discipline of Occupational Therapy, Faculty of Health, University of Canberra, Canberra, Australia
- Occupational Therapy Department, University of Canberra Hospital, Canberra, Australia
| | - Stephen Isbel
- Discipline of Occupational Therapy, Faculty of Health, University of Canberra, Canberra, Australia
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Nathan, Australia
| | - Claire Pearce
- Discipline of Occupational Therapy, Faculty of Health, University of Canberra, Canberra, Australia
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Aplin T, Gustafsson L. Assistive technology funding and policy in Australia: Moving towards a healthier assistive technology ecosystem. Aust Occup Ther J 2023. [PMID: 37409610 DOI: 10.1111/1440-1630.12895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 06/10/2023] [Indexed: 07/07/2023]
Affiliation(s)
- Tammy Aplin
- Associate Editor, Australian Occupational Therapy Journal, Melbourne, Australia
- The Hopkins Centre, Griffith University, Brisbane, Australia
| | - Louise Gustafsson
- Editor-in-Chief, Australian Occupational Therapy Journal, Melbourne, Australia
- The Hopkins Centre, Griffith University, Brisbane, Australia
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20
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Scott TL, Rooney D, Liddle J, Mitchell G, Gustafsson L, Pachana NA. A qualitative study exploring the experiences and needs of people living with young onset dementia related to driving cessation: 'It's like you get your legs cut off'. Age Ageing 2023; 52:afad109. [PMID: 37481262 PMCID: PMC10362976 DOI: 10.1093/ageing/afad109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND driving disruptions have significant impact on individuals living with dementia, their care partners and family members. Previous studies show that for older people with dementia, stopping driving is one of the hardest things that they cope with. To date, no studies exist that address the expressed needs and experiences of people living with young onset dementia (YOD) who are adjusting to life without driving, whose needs are not well understood and whose needs might be expected to differ from those of older people with dementia. METHODS a multi-perspective, qualitative descriptive phenomenological approach was undertaken. A topic guide was developed in consultation with lived experience experts. In-depth interviews (n = 18) with 10 people with YOD and eight family caregivers were conducted, to elicit lived experiences in relation to changing and cessation of driving. Interviews were recorded and transcribed verbatim. Data were analysed using a hybrid approach, employing deductive and inductive coding. RESULTS core findings reflected the impact and coping strategies employed by people with YOD and their care partners across four themes: (i) losses and burdens, (ii) the unique challenges of YOD, (iii) coping and adjustment and (iv) how to meet needs. CONCLUSIONS driving disruptions often come at a time when people living with YOD are likely to have significant financial and family commitments, or they/their partners may be employed or raising a family, negatively impacting individual's roles and self-identities. Intervention to support emotional and practical adjustment and reduce social isolation is essential for coping.
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Affiliation(s)
- Theresa L Scott
- School of Psychology, The University of Queensland, St Lucia, QLD 4072, Australia
| | - Donna Rooney
- School of Psychology, The University of Queensland, St Lucia, QLD 4072, Australia
| | - Jacki Liddle
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD 4072 Australia
| | - Geoffrey Mitchell
- General Practice Clinical Unit, Faculty of Medicine, The University of Queensland, St Lucia, QLD, Australia
| | - Louise Gustafsson
- School of Health Sciences and Social Work, Griffith University, Nathan, QLD 4111, Australia
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, St Lucia, QLD 4072, Australia
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21
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Tonkin K, Gustafsson L, Deen M, Broadbridge J. Multiple-Case Study Exploration of an Occupational Perspective in a Persistent Pain Clinic. OTJR (Thorofare N J) 2023; 43:303-312. [PMID: 36082460 DOI: 10.1177/15394492221121742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There is growing interest in an occupational perspective when working with people experiencing chronic pain. The Activity Card Sort Australia (18-64) is a client-centered and occupation-centered tool that has not been explored with this population. The aim of this study was to explore the process and experience of completing the ACS-Aus (18-64) with people experiencing chronic pain. This observational multiple-case study included video and audio-recordings of three participants (one male, one female, one nonbinary) completing the ACS-Aus (18-64) and semi-structured interviews at 1-week follow-up. Findings The findings for the process included two themes: the interaction (understanding engagement, therapeutic relationship and rapport, motivational interviewing) and the card sort (storytelling and reminiscing, identifying gaps and possibilities, categorizing and grouping cards). Occupational narratives of participants were developed from the experience. The ACS-Aus (18-64) supported participants to re-engage with their occupational selves and imagine future occupational engagement. Longitudinal studies are required to explore outcomes.
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Affiliation(s)
| | - Louise Gustafsson
- Griffith University, Queensland, Australia.,The Hopkins Centre, Brisbane, Queensland, Australia
| | - Michael Deen
- The Hopkins Centre, Brisbane, Queensland, Australia.,Metro South Hospital and Health Service, Brisbane, Queensland, Australia
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22
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Barroso MG, Gustafsson L, Barclay V, Linder C. A validated method for the determination of hematocrit in dried blood spots using image analysis. Bioanalysis 2023; 15:331-341. [PMID: 36961376 DOI: 10.4155/bio-2023-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
Aim: To develop a nondestructive method for the estimation of hematocrit (HCT) in dried blood spots (DBSs). Materials & methods: Standards and controls were created (HCT range: 0.20-0.50 l/l) and DBS scanned using a flatbed scanner. Gray values and pixel areas were analyzed with open-source software to estimate HCT and volume, respectively. HCT obtained in whole blood using hematological analyzer was compared with DBS scanner method (n = 50). Results: Between-run precision was 4.7-10.2% and between-run accuracy was 89.6-102.1%. In the hematological instrument comparison, 96% of the patient sample results were within ±15%. Conclusion: The nondestructive method can be used to exclude patient DBS samples with extreme HCT levels from further analysis and avoid bias on measured concentration.
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Affiliation(s)
- Miguel Gambell Barroso
- Department of Clinical Pharmacology, Therapeutic Drug Monitoring Laboratory, C1:68, Karolinska University Hospital, Stockholm, 141 86, Sweden
| | - Louise Gustafsson
- Department of Clinical Pharmacology, Therapeutic Drug Monitoring Laboratory, C1:68, Karolinska University Hospital, Stockholm, 141 86, Sweden
| | - Victoria Barclay
- Department of Clinical Pharmacology, Therapeutic Drug Monitoring Laboratory, C1:68, Karolinska University Hospital, Stockholm, 141 86, Sweden
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Camilla Linder
- Department of Clinical Pharmacology, Therapeutic Drug Monitoring Laboratory, C1:68, Karolinska University Hospital, Stockholm, 141 86, Sweden
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institute, Stockholm, Sweden
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23
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Peterson CM, Birkeland RW, Louwagie KW, Ingvalson SN, Mitchell LL, Scott TL, Liddle J, Pachana NA, Gustafsson L, Gaugler JE. Refining a Driving Retirement Program for Persons With Dementia and Their Care Partners: A Mixed Methods Evaluation of CarFreeMe™-Dementia. J Gerontol B Psychol Sci Soc Sci 2023; 78:506-519. [PMID: 36149829 PMCID: PMC9985324 DOI: 10.1093/geronb/gbac151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES We adapted the CarFreeMe™-Dementia program created by The University of Queensland for drivers in the United States. CarFreeMe™-Dementia aims to assist drivers living with dementia and their care partners as they plan for or adjust to driving retirement. This semistructured program focuses on driving retirement education and support. Topics include how dementia affects driving, lifestyle planning, stress management, and alternative transportation options. This study evaluated the feasibility, acceptability, and utility of the CarFreeMe™-Dementia intervention. METHODS This pilot phase of the study included 16 care partners and 11 drivers with memory loss who were preparing for or adjusting to driving retirement. Participants completed 4-8 CarFreeMe™-Dementia intervention telehealth sessions. Online surveys (baseline, 1- and 3-month) and postintervention semistructured interviews informed evaluation of the intervention program using a mixed methods approach. RESULTS This study established initial support for CarFreeMe™-Dementia in the United States. Participants indicated the program facilitated dialogue around driving retirement and provided guidance on community engagement without driving. Respondents appreciated the program's emphasis on overall well-being, promoted through lifestyle planning and stress management. They also reported the program offered practical preparation for transitioning to driving retirement. DISCUSSION The CarFreeMe™-Dementia intervention, tailored to an American audience, appears to be a feasible, acceptable, and useful support program for drivers with memory loss (and/or their care partners) who are preparing for or adjusting to driving retirement. Further investigations of the efficacy of the CarFreeMe™-Dementia intervention in the United States, as well as in other countries and cultural contexts, are warranted.
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Affiliation(s)
- Colleen M Peterson
- Transportation Research Institute, University of Michigan, Ann Arbor, Michigan, USA
| | - Robyn W Birkeland
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Katie W Louwagie
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Lauren L Mitchell
- Department of Psychology and Neuroscience, Emmanuel College, Boston, Massachusetts, USA
| | - Theresa L Scott
- School of Psychology, The University of Queensland, St Lucia, Brisbane, Queensland, Australia
| | - Jacki Liddle
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, Australia and the Princess Alexandra Hospital in Woolloongabba, Australia
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, St Lucia, Brisbane, Queensland, Australia
| | - Louise Gustafsson
- School of Health Sciences and Social Work, Griffith University, Nathan, Queensland, Australia
| | - Joseph E Gaugler
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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Mc Kittrick A, Gustafsson L, Hodson T, Di Tommaso A. Exploration of individuals perspectives of recovery following severe hand burn injuries. Burns 2023; 49:467-475. [PMID: 35570111 DOI: 10.1016/j.burns.2022.04.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/21/2022] [Accepted: 04/26/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Burns to one or both hands can impact how a person interacts with the world around them. Research regarding the specific impact of hand burn injuries and the experiences of individuals who have sustained hand burn injuries remains limited. OBJECTIVE The aim of this study was to explore the lived experiences of people with severe hand burn injuries, including their return to daily activities. METHODS This study used an interpretive description approach, incorporating 23 semi-structured interviews with people who had sustained severe hand burn injuries. RESULTS A major theme, "changes over time ", was identified and reflected the progressive nature of the experience over time. This was present in all three sub-themes: physical recovery, activities of daily living recovery, and psychosocial impact. Participants described a dual process of managing the recovery of the burn injury and burn rehabilitation interventions, whilst simultaneously learning to live with their injury and finding ways to engage in their occupations to the best of their abilities. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS The findings of the study suggest that burns recovery could be described in terms of performance rather than impairment and needs to be continuously monitored overtime.
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Affiliation(s)
- Andrea Mc Kittrick
- Department of Occupational Therapy, Royal Brisbane and Women's Hospital, Herston, 4029 QLD, Australia; Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, QLD 4111, Australia.
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, QLD 4111, Australia; Honorary Associate Professor School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, 4072 QLD Australia
| | - Tenelle Hodson
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, QLD 4111, Australia
| | - Amelia Di Tommaso
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, QLD 4111, Australia
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Abstract
People with an acquired brain injury (ABI) experience substantial access inequalities and unmet health needs, with many experiencing insufficient access to appropriate rehabilitation in the community. To deepen our understanding of what appropriate access to post-acute care services is for this population, and to facilitate optimal recovery, there is a need to synthesise research from the service user perspective. A scoping review study was conducted to identify key characteristics of 'appropriate' access to post-acute care services, as defined by the personal experiences of adults with ABI. Electronic scientific databases Medline, PsycINFO, Proquest Central and CINAHL were searched for studies published between 2000 and 2020. The initial search identified 361 articles which, along with articles retrieved from reference list searches, resulted in 52 articles included in the final analysis. Results indicated that a majority of the studies sampled participants with an average of over 1 year post-injury, with some studies sampling participants ranging over 10 years in difference in time post-injury. A thematic synthesis was conducted and results indicated a number of dominant elements which relate to (1) the characteristics of services: provider expertise, interpersonal qualities, partnership and adaptability; (2) characteristics of the health system: navigable system, integrated care, adequacy, and opportunity. These findings provide some insight into what might be considered appropriate. However, rigorous research, focused on personalised access to post-acute care services, is recommended to verify and elaborate on these findings.
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Affiliation(s)
- Kirstyn Laurie
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute, Brisbane, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Michele Foster
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute, Brisbane, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Louise Gustafsson
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute, Brisbane, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
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26
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McCowan A, Gustafsson L, Bissett M, Sriram BK. Occupational therapy in adults with chronic respiratory conditions: A scoping review. Aust Occup Ther J 2023. [PMID: 36725667 DOI: 10.1111/1440-1630.12861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 12/08/2022] [Accepted: 01/17/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Chronic respiratory diseases have a clear impact on occupational performance and engagement. Although occupational therapists have long provided services to this population, evidence regarding the unique role and true impact of occupational therapy is emerging. AIMS/OBJECTIVES The purpose of this scoping review was to explore the range, context, and outcomes of occupational therapy services for adults with chronic respiratory conditions. METHODS A scoping review guided by the methodological framework of Arksey and O'Malley was completed. To be included articles needed to be peer reviewed primary studies published in English between 2000 and September 2022 describing occupational therapy service delivery for people with chronic respiratory conditions. RESULTS Twenty-six articles met inclusion criteria including 12 cohort studies, seven randomised control trials, four qualitative, two case reports, and one service evaluation. Interventions were targeted at body functions and structures (n = 18), activities and participation (n = 17), and environmental factors (n = 14). Ten studies reported impacts of occupational therapy ranging from physiological responses through to quality of life. CONCLUSION Occupational therapy service delivery is common for this population, often occurring as part of multidisciplinary programs, and is inclusive of a range of assessments and interventions. Further details in future primary research are needed to describe the mode and unique occupational nature of service delivery.
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Affiliation(s)
- Amanda McCowan
- Griffith University, Queensland, Australia.,Gold Coast Hospital and Health Services, Queensland, Australia
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Spalding K, Gustafsson L, Di Tommaso A. Evaluation of an inpatient occupation-based group program using a process evaluation framework. Aust Occup Ther J 2023; 70:32-42. [PMID: 35854625 PMCID: PMC10083955 DOI: 10.1111/1440-1630.12829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/25/2022] [Accepted: 06/28/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Occupation-based groups are used in inpatient rehabilitation to enhance delivery and intensity of intervention; however, little research is available to understand their effectiveness. The aim of this study was to examine the process of an occupation-based group to understand mechanisms and success factors. METHODS A mixed methods process evaluation using an evidence-based framework guided implementation and analysis. Participants were those involved in the 'LifeSkills' group run daily in an adult inpatient general rehabilitation ward. Quantitative administrative data, goal achievement outcome measures, group observations and qualitative semistructured interviews were conducted. RESULTS Thirty participants were recruited. Factors for success included consistency in group structure and support, using meaningful practise opportunities and facilitating a real-world experience. There was no significant relationship between patient outcomes and dose of training or patient demographics. CONCLUSION This evaluation contributes to a growing body of evidence for incorporating occupation-based approaches into rehabilitation and offers insights into practice implementation.
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Affiliation(s)
- Kaitlyn Spalding
- Discipline of Occupational Therapy, School of Health Sciences and Social WorkGriffith UniversityNathanQueenslandAustralia
- Occupational Therapy Department, Surgical Treatment and Rehabilitation ServiceBrisbaneQueenslandAustralia
- Occupational Therapy DepartmentRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Health Sciences and Social WorkGriffith UniversityNathanQueenslandAustralia
| | - Amelia Di Tommaso
- Discipline of Occupational Therapy, School of Health Sciences and Social WorkGriffith UniversityNathanQueenslandAustralia
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Spalding K, Di Tommaso A, Gustafsson L. Uncovering the experiences of engaging in an inpatient occupation-based group program: The LifeSkills group. Scand J Occup Ther 2023; 30:251-260. [PMID: 35655359 DOI: 10.1080/11038128.2022.2081604] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Consumer engagement is an important element for developing and maintaining value-based healthcare standards. Occupation-based practice in the context of a group has been adopted by inpatient rehabilitation clinicians, but little research has explored if these groups are valuable and useful to patients. AIMS/OBJECTIVES To explore the experiences of patients participating in an occupation-based group intervention for instrumental activities of daily living to understand its value and usefulness in an inpatient rehabilitation setting. MATERIAL AND METHODS Interpretive description guided the development of the study. Semi-structured interviews were completed with 15 participants of an occupation-based group, the LifeSkills group. Comparative analysis was used to analyse the data and develop themes. RESULTS Five themes were reported by participants: choice and control, confidence through doing, a real-world connection, the power of the therapeutic relationship and the impact of the shared experience. CONCLUSIONS AND SIGNIFICANCE In line with current rehabilitation literature, patient experiences around client-centredness, occupational engagement in a 'real-world' environment, and valued relationships can be facilitated through an occupation-based group. This study supports the implementation of valued-based healthcare in understanding patient perceptions of occupation-based interventions into rehabilitation; ensuring that the right intervention is being used at the right time for the right patient.
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Affiliation(s)
- Kaitlyn Spalding
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia.,Occupational Therapy Department, Surgical Treatment and Rehabilitation Service, Brisbane, Australia
| | - Amelia Di Tommaso
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
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Abstract
PURPOSE Co-creation is identified as a concept with potential to address many challenges in modern healthcare systems. Its application within stroke rehabilitation is yet to be reviewed. The purpose of this paper is to identify when and how co-creation has been used in the literature to develop services and approaches to stroke survivor care and rehabilitation. MATERIALS AND METHODS A scoping review was conducted guided by the framework outlined by Arksey and O'Malley. Articles were included if they involved co-creation with stroke survivors and identified co-creation as their methodology to develop post-stroke services. Quality appraisal of included articles was completed. RESULTS The search strategy identified 565 articles. Fourteen articles met inclusion criteria. The results demonstrate that co-creation as a methodology to develop stroke rehabilitation services is a contemporary field, producing both technology and non-technology-based interventions, predominately in the community context. Co-creation application was inconsistent, with a plethora of methodologies used, and terminology to describe co-creation varying between the studies. CONCLUSIONS Co-creation in stroke rehabilitation is currently in an expanding and rudimentary phase. This review identified the variability of its application, with future work needed to establish clarity and consistency in terminology and methodologies utilised to operationalise co-creation in stroke rehabilitation.Implications for rehabilitationCo-creation is a contemporary and evolving service improvement approach in stroke rehabilitation, utilised most commonly in the community context.Inconsistent terminology and diverse methodologies are utilised to enact co-creation in stroke rehabilitation.Opportunities exist to advance co-creation in the stroke rehabilitation space through developing consistency in its application, and further investigation into its use with the stroke survivor population.
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Affiliation(s)
- Joshua Dobe
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
- The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Queensland, Australia
| | - Kim Walder
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
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Marshall K, Fleming J, Atresh S, Scott JR, Gustafsson L, Patterson F. Falls on an inpatient rehabilitation spinal injuries unit: the characteristics, circumstances, and consequences. Spinal Cord 2023; 61:57-64. [PMID: 36273103 PMCID: PMC9836933 DOI: 10.1038/s41393-022-00861-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 01/17/2023]
Abstract
STUDY DESIGN Retrospective audit OBJECTIVES: To describe the nature of falls and fallers in a spinal injuries unit (SIU) and identify factors associated with having more than one fall (recurrent fallers) and falls with physical or psychological consequences (consequential falls). SETTING An Australian inpatient rehabilitation SIU. METHODS Data were retrospectively extracted from falls incident reports and electronic medical records over a 5-year period. Data were analysed descriptively to summarise participant and fall details. Univariate analyses identified candidate variables for further investigation in a multivariate model for recurrent fallers and consequential falls. RESULTS Of the 566 persons admitted to the SIU, 132 (23%) participants experienced 207 falls over the 5 years. Of the fallers, 41 (31%) were recurrent fallers experiencing between 2 and 7 falls and 78 (59%) experienced a consequential fall. No significant variables were identified for recurrent fallers. For consequential falls, older age (OR = 1.038, 95% CI, 1.012 to 1.064, p = 0.004) and female gender (OR = 3.581, 95% CI, 1.269 to 10.103, p = 0.016) were significant, as well as falls that occurred on a Sunday (OR = 0.196, 95% CI, 0.061 to 0.630, p = 0.006). Falls while transferring were less likely to be consequential (OR = 4.100, 95% CI, 1.706 to 9.856, p = 0.002). CONCLUSIONS Nearly one quarter of SIU inpatients experienced a fall with almost a third of those who fell experiencing recurrent falls. Older age, female gender, and Sundays were risk factors for falls with consequence.
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Affiliation(s)
- Kathryn Marshall
- grid.1003.20000 0000 9320 7537School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD Australia ,grid.412744.00000 0004 0380 2017Department of Occupational Therapy, Princess Alexandra Hospital, Brisbane, QLD Australia
| | - Jennifer Fleming
- grid.1003.20000 0000 9320 7537School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD Australia
| | - Sridhar Atresh
- grid.412744.00000 0004 0380 2017Queensland Spinal Cord Injuries Service, Division of Rehabilitation, Princess Alexandra Hospital, Brisbane, QLD Australia ,grid.1003.20000 0000 9320 7537School of Medicine, The University of Queensland, Brisbane, QLD Australia
| | - Justin, R. Scott
- grid.1003.20000 0000 9320 7537QCIF Bioinformatics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD Australia
| | - Louise Gustafsson
- grid.1003.20000 0000 9320 7537School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD Australia ,grid.1022.10000 0004 0437 5432School of Health Sciences and Social Work, Griffith University, Brisbane, QLD Australia ,grid.1022.10000 0004 0437 5432The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, QLD Australia
| | - Freyr Patterson
- grid.1003.20000 0000 9320 7537School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD Australia
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Trojman A, Hough J, Hides J, Gustafsson L, Flores O, Paratz J. Physiotherapy practices when treating patients with COVID-19 during a pandemic: A survey study. Heart Lung 2023; 57:152-160. [PMID: 36209724 PMCID: PMC9536211 DOI: 10.1016/j.hrtlng.2022.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 09/13/2022] [Accepted: 09/19/2022] [Indexed: 12/02/2022]
Abstract
Background Specific details pertaining to the clinical and other challenges faced by physiotherapists managing patients with COVID-19 during the pandemic are still largely unknown. Objectives To determine how physiotherapists clinically managed patients with COVID-19 in a hospital-based setting during the pandemic and to identify the personal and professional effects of working as a physiotherapist at this time. Methods Self-administered electronic cross-sectional survey. Participants included physiotherapists from around the world involved in the clinical management of patients with COVID-19. Results Of the 204 participants who returned the questionnaire, 39% worked as senior physiotherapists, 29% as consultant or specialist physiotherapists, 23% as general physiotherapists and 4% as graduate physiotherapists. Seventy-two percent of participants worked in the intensive care unit. The largest barrier to treating patients with COVID-19 was a lack of intensive care trained physiotherapists (70%). Eighty-three percent of participants reported performing activities outside of their typical work duties, including proning patients (55%), tutoring and advising other staff in the intensive care unit (55%) and adjusting or changing ventilator settings (52%). Almost all participants (90%) reported being aware of physiotherapy specific guidelines for treating patients with COVID-19, yet most participants performed techniques that were not recommended. Conclusions The experience of the pandemic highlighted the need for specialist training and availability of experienced cardiorespiratory physiotherapists to manage patients with COVID-19, specifically in intensive care. Furthermore, clear guidelines on the management of patients with COVID-19 should be established to ensure optimal management of patients and ensure the safety of physiotherapy staff.
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Affiliation(s)
- Anthony Trojman
- School of Health Sciences and Social Work, Griffith University, 0404893646, Nathan, Australia.
| | - Judith Hough
- School of Allied Health, Australian Catholic University, Banyo, Australia
| | - Julie Hides
- School of Health Sciences and Social Work, Griffith University, 0404893646, Nathan, Australia; Menzies Health Institute Queensland, Nathan, Australia
| | - Louise Gustafsson
- School of Health Sciences and Social Work, Griffith University, 0404893646, Nathan, Australia; Menzies Health Institute Queensland, Nathan, Australia
| | - Orlando Flores
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Jennifer Paratz
- School of Health Sciences and Social Work, Griffith University, 0404893646, Nathan, Australia; Menzies Health Institute Queensland, Nathan, Australia
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Hoyle M, Gustafsson L, Meredith P. Personal factors, participation, and satisfaction post-stroke: A qualitative exploration. Scand J Occup Ther 2022; 30:572-584. [PMID: 36537995 DOI: 10.1080/11038128.2022.2154708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Decreased participation and life satisfaction are common post-stroke. Exploratory studies have indicated associations between these outcomes and personal factors. Information remains limited and experiences of people with stroke are not well-represented or understood. AIMS/OBJECTIVES The aim of this study was to explore how personal factors influence experiences of participation and life satisfaction for people with stroke living in the community. MATERIAL AND METHODS Qualitative in-depth semi-structured interviews were conducted with eight participants living in the community post-stroke, chosen purposively based on participation and life satisfaction levels. Data were interrogated using interpretative phenomenological analysis. RESULTS Three themes were identified: (1) What does participation mean to me? (2) Looking forward or looking back, and (3) Appraisals, avoidance, and "getting on with it". The first acknowledged the multifaceted nature of participation, although it was typically viewed as incorporating active involvement and social interaction. The additional two themes explored impacts of pre/post-stroke self-discrepancies and threat appraisals on participation and life satisfaction outcomes. CONCLUSIONS AND SIGNIFICANCE Relationships between participation and personal factors seem to be bidirectional. Life satisfaction appeared to be influenced by rumination on negative self-discrepancies based on difference in pre/post-stroke participation. Findings suggest there may be value in examining the influence of personal factor-related interventions on post-stroke outcomes.
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Affiliation(s)
- Melanie Hoyle
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Louise Gustafsson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Pamela Meredith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
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Gustafsson L, Arfaras T. Sexuality early after stroke. Aust Occup Ther J 2022; 69:511-513. [DOI: 10.1111/1440-1630.12841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 12/01/2022]
Affiliation(s)
| | - Toni Arfaras
- Australian Occupational Therapy Journal Melbourne Australia
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Spalding K, Gustafsson L, Di Tommaso A. Exploring Patient Outcomes After Participation in an Inpatient Occupation-Based Group: A Longitudinal Observational Cohort Study. Am J Occup Ther 2022; 76:23880. [PMID: 35943844 DOI: 10.5014/ajot.2022.049241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Occupation-based interventions are used during inpatient rehabilitation, and group models may enhance intervention delivery. However, little is known about the impact of occupation-based groups on patient outcomes. OBJECTIVE To examine the effect of an occupation-based group on patient outcome measures of instrumental activities of daily living (IADL) skills over time and explore demographic differences among patients. DESIGN Longitudinal observational cohort study with four time points: preintervention, postintervention, 30-day follow-up, and 90-day follow-up. SETTING Tertiary hospital general rehabilitation ward. PARTICIPANTS Inpatient adults age 18 or older recruited using consecutive sampling from those referred to the group. INTERVENTION The LifeSkills group, which focused on repetitive practice of meaningful occupation-based activities. OUTCOMES AND MEASURES Demographic data were obtained, and the Canadian Occupational Performance Measure (COPM), Goal Attainment Scaling, Lawton IADL scale, and a self-efficacy scale were administered at each data point. RESULTS Thirty people (21 women, 9 men; ages 35-91 yr) participated, with 5 lost to follow-up. A statistically significant increase in scores postintervention occurred on all measures and was also seen at 90-day follow-up for COPM occupational performance, satisfaction, and self-efficacy scores. Lawton IADL scale scores at follow-up were lower than those at preintervention and statistically significant. No significant differences were found for age and diagnosis. CONCLUSIONS AND RELEVANCE Positive patient outcomes of goal achievement, occupational performance, satisfaction, and self-efficacy were seen at discharge, with evidence of sustainability over time. This could be a resource alternative for addressing skill retraining because people with different diagnoses and in different age groups benefited equally. What This Article Adds: Occupation-based group programs have encouraging application in general inpatient rehabilitation for addressing patient outcomes.
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Affiliation(s)
- Kaitlyn Spalding
- Kaitlyn Spalding, MPhil, BOccThy, is Graduate Master of Philosophy Student, Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia, and Advanced Occupational Therapist, Occupational Therapy Department, Surgical Treatment and Rehabilitation Service, Brisbane, Queensland, Australia;
| | - Louise Gustafsson
- Louise Gustafsson, PhD, BOccThy(Hons), FOTARA, is Professor, Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Amelia Di Tommaso
- Amelia Di Tommaso, PhD, BHlthSc(OT)(Hons), is Lecturer, Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
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Gustafsson L, McKinstry C, Buchanan A, Laver K, Pepin G, Aplin T, Hyett N, Isbel S, Liddle J, Murray C. Doing, being, becoming, and belonging—A diversity, equity, and inclusion commitment. Aust Occup Ther J 2022; 69:375-378. [DOI: 10.1111/1440-1630.12831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Carol McKinstry
- Editorial Board Australian Occupational Therapy Journal Australia
| | - Angus Buchanan
- Editorial Board Australian Occupational Therapy Journal Australia
| | - Kate Laver
- Editorial Board Australian Occupational Therapy Journal Australia
| | - Genevieve Pepin
- Editorial Board Australian Occupational Therapy Journal Australia
| | - Tammy Aplin
- Editorial Board Australian Occupational Therapy Journal Australia
| | - Nerida Hyett
- Editorial Board Australian Occupational Therapy Journal Australia
| | - Stephen Isbel
- Editorial Board Australian Occupational Therapy Journal Australia
| | - Jacki Liddle
- Editorial Board Australian Occupational Therapy Journal Australia
| | - Carolyn Murray
- Editorial Board Australian Occupational Therapy Journal Australia
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Campbell A, Gustafsson L, Gullo H, Summers M, Rosbergen I, Grimley R. Uncharted territory: The feasibility of serial computerised cognitive assessment the first week post-stroke. J Stroke Cerebrovasc Dis 2022; 31:106614. [PMID: 35858514 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 06/05/2022] [Accepted: 06/20/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cognitive impairment is common and problematic post-stroke, yet vital information to understand early cognitive recovery is lacking. To examine early cognitive recovery, it is first necessary to establish the feasibility of repeat cognitive assessment during the acute post-stroke phase. OBJECTIVE To determine if serial computerised testing is feasible for cognitive assessment in an acute post-stroke phase, measured by assessment completion rates. METHOD An observational cohort study recruited consecutive stroke patients admitted to an acute stroke unit within 48 hours of onset. Daily assessment with the Cambridge Neuropsychological Test Automated Battery (CANTAB) was performed for seven days, and single Montreal Cognitive Assessment (MoCA). RESULTS Seventy-one participants were recruited, mean age 74 years, with 67 completing daily testing. Participants had predominantly mild (85%; NIHSS ≤6), ischemic (90%) stroke, 32% demonstrated clinical delirium. The first day of testing, 76% of participants completed CANTAB batteries. Eighty-seven percent of participants completed MoCA a mean of 3.4 days post-stroke. The proportion of CANTAB batteries completed improved significantly from day 2 to day 3 post-stroke with test completion rates stabilizing ≥ 92% by day 4. Participants with incomplete CANTAB were older, with persisting delirium, and longer stay in acute care. CONCLUSION Serial computerised cognitive assessments are feasible the first week post-stroke and provide a novel approach to measuring cognitive change for both clinical and research purposes. Maximum completion rates by day four have clinical implications for optimal timing of cognitive testing.
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Affiliation(s)
- Alana Campbell
- Brisbane, Queensland, Australia; and Queensland Health (Sunshine Coast Hospital and Health Service), The University of Queensland (School of Health and Rehabilitation Sciences), Sunshine Coast, QLD, Australia.
| | - Louise Gustafsson
- Griffith University (School of Health Sciences and Social Work), Brisbane, QLD, Australia
| | - Hannah Gullo
- The University of Queensland (School of Health and Rehabilitation Sciences), Brisbane, QLD, Australia
| | - Mathew Summers
- University of the Sunshine Coast (School of Health and Behavioural Sciences), Sunshine Coast, QLD, Australia
| | - Ingrid Rosbergen
- Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Brisbane, QLD, Australia
| | - Rohan Grimley
- Griffith University and Queensland Health (Sunshine Coast Hospital and Health Service), Sunshine Coast, Queensland, Australia
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Baker A, Cornwell P, Gustafsson L, Stewart C, Lannin NA. Developing tailored theoretically informed goal-setting interventions for rehabilitation services: a co-design approach. BMC Health Serv Res 2022; 22:811. [PMID: 35733190 PMCID: PMC9214993 DOI: 10.1186/s12913-022-08047-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 04/21/2022] [Indexed: 11/11/2022] Open
Abstract
Background Several active ingredients contribute to the purposes and mechanisms of goal-setting in rehabilitation. Active ingredients in the goal-setting process include, interdisciplinary teamworking, shared decision-making, having meaningful and specific goals, and including action planning, coping planning, feedback, and review. Clinicians have expressed barriers and enablers to implementing these active ingredients in rehabilitation teams. Interventions designed to improve goal-setting practices need to be tailored to address context specific barriers and enablers. Attempts to understand and enhance goal-setting practices in rehabilitation settings should be supported using theory, process models and determinant frameworks. Few studies have been undertaken to enhance goal-setting practices in varied case-mix rehabilitation settings. Methods This study is part of a larger program of research guided by the Knowledge to Action (KTA) framework. A multisite, participatory, codesign approach was used in five sites to address three stages of the KTA. (1) Focus groups were conducted to understand barriers and enablers to implementing goal-setting at each site. Following the focus groups three staff co-design workshops and one consumer workshop were run at each site to (2) adapt knowledge to local context, and to (3) select and tailor interventions to improve goal-setting practices. Focus groups were analysed using the Theoretical Domains Framework (TDF) and informed the selection of behaviour change techniques incorporated into the implementation plan. Results Barriers and enablers identified in this study were consistent with previous research. Clinicians lacked knowledge and understanding of the differences between a goal and an action plan often confusing both terms. Clinicians were unable to demonstrate an understanding of the importance of comprehensive action planning and review processes that extended beyond initial goal-setting. Interventions developed across the sites included staff training modules, a client held workbook, educational rehabilitation service flyers, interdisciplinary goal-based case conference templates, communication goal boards and a key worker model. Implementation plans were specifically established for each site. Conclusions Rehabilitation teams continue to struggle to incorporate a truly client-centred, interdisciplinary model of goal-setting in rehabilitation. Whilst clinicians continue to lack understanding of how they can use aspects of goal-setting to enhance client outcomes and autonomy in rehabilitation settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08047-6.
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Affiliation(s)
- Amanda Baker
- School of Allied Health Sciences, Griffith University, Brisbane, Australia. .,Clinical Excellence Division, Statewide Rehabilitation Clinical Network, Queensland Health, Brisbane, Australia. .,Physiotherapy Department, Sunshine Coast University Hospital, Allied Health, Sunshine Coast Hospital and Health Service, Sunshine Coast, QLD, Australia.
| | - Petrea Cornwell
- School of Allied Health Sciences, Griffith University, Brisbane, Australia
| | - Louise Gustafsson
- School of Allied Health Sciences, Griffith University, Brisbane, Australia
| | - Claire Stewart
- Physiotherapy Department, Sunshine Coast University Hospital, Allied Health, Sunshine Coast Hospital and Health Service, Sunshine Coast, QLD, Australia
| | - Natasha A Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia.,Alfred Health, Melbourne, Australia
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Gustafsson L. Myth-busting the publishing practices of the Australian Occupational Therapy Journal: A society journal for the global occupational therapy community. Aust Occup Ther J 2022; 69:231-232. [PMID: 35506303 DOI: 10.1111/1440-1630.12810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/29/2022]
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Bassingthwaighte L, Gustafsson L, Molineux M. On-road driving remediation following acquired brain injury: a scoping review. Brain Inj 2022; 36:239-250. [DOI: 10.1080/02699052.2022.2033837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Louise Bassingthwaighte
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Queensland, Australia
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
- Menzies Health Institute Queensland, The Hopkins Centre, Australia
| | - Matthew Molineux
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
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Gustafsson L. Journal-based or article-based metrics: What should be applied to assess a researcher's performance? Aust Occup Ther J 2022; 69:1-2. [PMID: 35014062 DOI: 10.1111/1440-1630.12789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 11/28/2022]
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Liddle J, Ireland D, Krysinska K, Harrison F, Lamont R, Karunanithi M, Kang K, Reppermund S, Sachdev PS, Gustafsson L, Brauer S, Pachana NA, Brodaty H. Lifespace metrics of older adults with mild cognitive impairment and dementia recorded via geolocation data. Australas J Ageing 2021; 40:e341-e346. [PMID: 34698431 DOI: 10.1111/ajag.13007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Lifespace, the physical area in which someone conducts life activities, indicates lived community mobility. This study explored the feasibility of technology-based lifespace measurement for older people with dementia and mild cognitive impairment (MCI), including the generation of a range of lifespace metrics, and investigation of relationships with health and mobility status. METHODS An exploratory study was conducted within a longitudinal observational study. Eighteen older adults (mean age 86.7 years (SD: 3.2); 8 men; 15 MCI), participated. Lifespace metrics were generated from geolocation data (GPS and Bluetooth beacon) collected through a smartphone application for one week (2015-2016). Cognitive and mobility-related outcomes were compared from study data sets at baseline (2005-2007) and 6-year follow-up (2011-2014). RESULTS Lifespace data could be collected from all participants, and metrics were generated including percentage of time at home, maximum distance from home, episodes of travel in a week, days in a week participants left home, lifespace area (daily, weekly and total), indoor lifespace (regions in the home/hour), and a developed lifespace score that combined time, frequency of travel, distance and area. Results indicated a large range of lifespace areas (0.1 - 97.88 km2 ; median 6.77 km2 ) with similar patterns across lifespace metrics. Significant relationships were found between lifespace metrics and concurrent driving status and anteceding scores on the sit-to-stand test (at baseline and follow-up). CONCLUSIONS Further longitudinal exploration of lifespace is required to develop an understanding of the nature of lifespace of older community-dwelling people, and its relationship with health, mobility and well-being outcomes.
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Affiliation(s)
- Jacki Liddle
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Qld, Australia
| | - David Ireland
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Qld, Australia
| | - Karolina Krysinska
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia.,Centre for Mental Health, School of Population and Global Health, University of Melbourne, Melbourne, Vic, Australia
| | - Fleur Harrison
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
| | - Robyn Lamont
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia
| | - Mohan Karunanithi
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Qld, Australia
| | - Kristan Kang
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
| | - Simone Reppermund
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
| | - Louise Gustafsson
- School of Allied Health Sciences, Griffith University, Brisbane, Qld, Australia
| | - Sandra Brauer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia
| | - Nancy A Pachana
- School of Psychology, University of Queensland, Brisbane, Qld, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
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Ford E, Di Tommaso A, Molineux M, Gustafsson L. Identifying the characteristics of occupation-centred practice: A Delphi study. Aust Occup Ther J 2021; 69:25-37. [PMID: 34490901 DOI: 10.1111/1440-1630.12765] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 08/11/2021] [Accepted: 08/23/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Occupation-centred practice is key to aligning with the contemporary paradigm. Benefits of this approach for clients and the profession are well documented, yet how to identify occupation-centred practice is not yet understood. Therefore, this study aimed to uncover the characteristics of occupation-centred practice and how they can be identified in practice. METHODS A three round Delphi survey was conducted to gain consensus on the defining characteristics of occupation-centred practice. Purposive, convenience, and snowball sampling were used to distribute three survey rounds to occupational therapists internationally. Content analysis was used to create characteristics, descriptions, and examples of occupation-centred practice. Percentage agreement between occupational therapists were calculated to determine consensus. RESULTS Responses were received from 100 participants in round one, 89 in round two, and 70 in round three. Round one generated 12 characteristics that were refined and finalised into four defining characteristics, one of which had three subcharacteristics. The four characteristics are as follows: guided by theory and philosophy grounded in occupation, language and documentation promotes occupation among stakeholders, understanding and incorporating the person's context, and occupation as core to practice, which includes occupation in goal setting, assessment, and intervention. Descriptions and examples were generated for each characteristic. CONCLUSION This study presents valuable information for occupational therapists wanting to practise in an occupation-centred manner. The characteristics, descriptions, and examples provide a foundation upon which occupational therapists can understand and identify occupation-centred practice. Examples provided were highly influenced by factors including practice settings and preferred terminology. Future research will explore the creation of a tool for occupational therapists to evaluate their own practice against the characteristics to demonstrate areas of strength and for development.
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Affiliation(s)
- Ellie Ford
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia.,Occupational Therapist, Youthrive Integrated Therapy Services, Springfield, Queensland, Australia
| | - Amelia Di Tommaso
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
| | - Matthew Molineux
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
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Abstract
BACKGROUND Describing how occupation is used in practice can be challenging for occupational therapists. Occupation-centred, occupation-based, and occupation-focussed terminology are frequently used interchangeably and ambiguously to describe practice. However, ambiguous language creates confusion and inadequately demonstrates the value of occupation. AIMS/OBJECTIVES This scoping review aimed to identify how occupation-centred, occupation-based, and occupation-focussed terminology are defined and represented in occupational therapy literature. MATERIALS AND METHODS A five-step scoping review included papers published between 2014 and 2019 from four databases. Extracted data were summarised to outline how the terms were being used within the literature. RESULTS Initial searching yielded 819 articles and 35 papers met inclusion/exclusion criteria. Within current literature, occupation-focussed and occupation-based terminology were inconsistently described. A limited number of articles used occupation-centred and occupation-focussed terminology to describe practice, whilst occupation-based was more prominent. Occupation-based terminology was represented in numerous ways to describe assessments, practice tools, interventions, research, and theory. Discrepancies between the description and implementation of occupation-based practice were most prominent within interventions. CONCLUSION AND SIGNIFICANCE Findings demonstrated that occupation-based and occupation-focussed terminology were used interchangeably and inconsistently in literature. It is timely to consider how this is problematic for our professional identity and perceptions of occupation in practice.
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Affiliation(s)
- Ellie Ford
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia.,Youthrive Integrated Therapy Services, Queensland, Australia
| | - Amelia Di Tommaso
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
| | - Matthew Molineux
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
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Gustafsson L, Brown T, Poulsen AA, McKinstry C. Australian occupational therapy academic workforce: An examination of retention, work-engagement, and role overload issues. Scand J Occup Ther 2021; 30:452-462. [PMID: 34344278 DOI: 10.1080/11038128.2021.1958002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The quality of the academic workforce is influenced by multi-level interactionist factors yet there is limited research into these influencing factors. AIM To investigate relationships between individual characteristics of Australian occupational therapy academics and work-related variables. METHOD An exploratory cross-sectional online survey collected demographic data and used standardized scales including the Turnover Intention Scale, 9-item Utrecht Work Engagement Scale, Work-Life Balance Scale, Role Overload Scale and Self-Defined Burnout Scale. Data were analysed using descriptive and inferential statistics. RESULTS Academics who were more than five years in their current academic level were: significantly more likely to consider leaving their job; more often frustrated when not given opportunity to achieve their work-related goals; and less engaged. Those who had worked in higher education for longer than ten years were more likely to report role overload while participants working in higher education for less than five years were less likely to report burnout. CONCLUSIONS AND SIGNIFICANCE To meet current and future demand for Australian occupational therapists, an engaged and supported academic workforce is needed. These findings suggest the need for attention to mentoring and career development particularly for those in academic levels longer than five years to increase work engagement and retention.
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Affiliation(s)
- Louise Gustafsson
- School of Allied Health Sciences, Griffith University, Brisbane, Australia
| | - Ted Brown
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Australia
| | - Anne A Poulsen
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Mater Medical Research Institute, South Brisbane, Australia
| | - Carol McKinstry
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
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Bryant C, Gustafsson L, Aplin T, Setchell J. Supporting sexuality after spinal cord injury: a scoping review of non-medical approaches. Disabil Rehabil 2021; 44:5669-5682. [DOI: 10.1080/09638288.2021.1937339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Chloe Bryant
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Louise Gustafsson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- School of Allied Health Sciences, Griffith University, Brisbane, Australia
| | - Tammy Aplin
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- The Prince Charles Hospital, Allied Health Research Collaborative, Chermside, Australia
| | - Jenny Setchell
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Gustafsson L. Authorship statements: A commitment to publishing ethics and research integrity. Aust Occup Ther J 2021; 67:285-286. [PMID: 32743828 DOI: 10.1111/1440-1630.12688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 06/27/2020] [Indexed: 11/28/2022]
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Mc Kittrick A, Gustafsson L. A Cross-sectional Survey of Health Professionals Across Australia and New Zealand to Determine What Outcome Measures Are Important From a Clinical Perspective Post Hand Burn Injury. J Burn Care Res 2021; 43:77-84. [PMID: 34226927 DOI: 10.1093/jbcr/irab086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Outcome measures are used in healthcare to evaluate clinical practice, measure efficiencies and to determine the quality of health care provided. The Burns Trauma Rehabilitation: Allied Health Practice Guidelines advocates for the collection of outcome measures post burn injuries across different time points. These guidelines recommend multiple tools which can be utilized when measuring outcomes post burn injuries. The aim of this study was to gather information from specialist clinicians regarding their clinical practice and the outcome measurement tools used post hand burn injuries. This cross-sectional study used a survey design to collect data at one given point in time across a sample population. A total of 43 clinical specialists allied health professionals responded to the survey. Respondents indicated that their patients considered hand dexterity was the most important outcome. Three months post burn injury was the most common timepoint for measurement (n = 31, 72.1%) followed by six months (n = 27, 62.8%). Patient report of hand function (n = 42, 97.7%) and observation (n = 41, 95.3%) were the most frequently reported assessment methods. The Jamar Dynamometer (n = 40, 93%), goniometer (n = 39, 90.7%) and pinch gauge (n = 36, 83.7) were the most frequency cited assessment tools. The findings of this study suggest that clinical specialist allied health collect some outcome measures in their routine practice. Based on the respondent's perceptions of barriers when using outcome measures and lack of reliable/validated tools to measure hand burn outcomes, there is a need for further studies in this area.
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Affiliation(s)
- Andrea Mc Kittrick
- Department of Occupational Therapy, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Louise Gustafsson
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia.,Discipline of Occupational Therapy, School of Allied Health Sciences, Griffith University, Nathan, QLD, Australia
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Marnane K, Gustafsson L, Bennett S, Rosbergen I, Grimley R. "Everyone needs rehab, but…": exploring post-stroke rehabilitation referral and acceptance decisions. Disabil Rehabil 2021; 44:4717-4728. [PMID: 33974463 DOI: 10.1080/09638288.2021.1918770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To explore the decision-making processes and experiences of acute and rehabilitation clinicians, regarding referral and acceptance of patients to rehabilitation after stroke. MATERIALS AND METHODS Multi-site rapid ethnography, involving observation of multidisciplinary case conferences, interviews with acute stroke and rehabilitation clinicians, and review of key documents within five (5) acute stroke units (ASUs) in Queensland, Australia. A cyclical, inductive content analysis was performed. RESULTS Seven key themes were identified, revealing the complex nature of post-stroke rehabilitation referral and acceptance decision making. Although the majority of clinicians felt that all patients could benefit from rehabilitation, they acknowledged this could not always be the case. Rehabilitation potential and goals were considered by clinicians, but decision making was impacted by ASU context and team processes, rehabilitation service availability and access procedures, and the relationships between the acute and rehabilitation clinicians. Patients and families were not actively involved in the decision-making processes. CONCLUSIONS Post-stroke rehabilitation decision making in Queensland, Australia involves complex processes and compromise. Decisions are not based solely on patients' rehabilitation needs, and patients and families are not actively involved in the decision-making process. Mechanisms are required to streamline access procedures, and improve shared decision making with patients.IMPLICATIONS FOR REHABILITATIONReferral decision making for post-stroke rehabilitation is complex and not always based solely on patients' needs.Clear and straightforward access procedures and positive relationships between acute and rehabilitation clinicians have a positive impact on referral decision making.Stroke services should review their processes to ensure shared decision making is facilitated when patients require access to rehabilitation.
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Affiliation(s)
- Kerry Marnane
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.,Community and Oral Health Directorate, Metro North Hospital and Health Service, Herston,Australia
| | - Louise Gustafsson
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.,School of Allied Health Sciences, Griffith University, Nathan, Australia
| | - Sally Bennett
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Ingrid Rosbergen
- Conjoint Research Fellow Physiotherapy, STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Hospital and Health Service, Australia
| | - Rohan Grimley
- School of Medicine, Griffith University, Sunshine Coast, Australia
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Abstract
BACKGROUND Goals are vital in rehabilitation; however, how goal-setting occurs varies widely in clinical practice. This study aims to review goal-setting practices across the rehabilitation continuum within varied case mix services in Queensland, Australia. METHOD A descriptive multisite qualitative case study with medical record audits and interviews of adult rehabilitation clients was used to evaluate four propositions across three inpatient and two community rehabilitation services. The propositions evaluated the process in which goal-setting occurs, action planning and review of goals, as well as the type, specificity and client-centeredness of goals set. RESULTS Goals (n = 1120) were often poorly defined, focussed on short term physical functioning and were predominantly set by individual disciplines with the client rather than using an interdisciplinary approach. Clients were not consistently given action plans to pursue goals (n = 59, 18%) and the review of goal progress (n = 60, 18%) was limited. Few clients reported receiving copies of their rehabilitation goals (n = 16, 25%). CONCLUSION Goal-setting in rehabilitation should be specific, meaningful and include the client in action planning, feedback and review. However, goal-setting in rehabilitation is often multidisciplinary and unstructured.Implications for rehabilitationBest-practice rehabilitation team goal-negotiation and goal-setting should include a common goal focus and incorporate components of staff and client action planning, coping planning, feedback and review.Rehabilitation clients prefer shared-decision making approaches to setting meaningful and personalised goals, however, require time and support to engage in the goal-setting and negotiation process.Rehabilitation clinicians need training and support to improve their goal negotiation and goal writing skills to create specific, understandable and meaningful goals with rehabilitation clients.
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Affiliation(s)
- Amanda Baker
- School of Allied Health Sciences, Griffith University, Brisbane, Australia.,Statewide Rehabilitation Clinical Network, Clinical Excellence Division, Queensland Health, Brisbane, Australia.,Allied Health, Department of Physiotherapy, Sunshine Coast Hospital and Health Service, Queensland Health, Nambour, Australia
| | - Petrea Cornwell
- School of Allied Health Sciences, Griffith University, Brisbane, Australia
| | - Louise Gustafsson
- School of Allied Health Sciences, Griffith University, Brisbane, Australia
| | - Natasha A Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia.,Alfred Health, Melbourne, Australia
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Abstract
IMPORTANCE Falls have a considerable physical and psychological impact on people with spinal cord injury (SCI). Occupational therapy practitioners require evidence to support the timely development of occupation-based programs that can be applied to fall prevention in daily life. OBJECTIVE To determine what is known about falls after SCI, including wheelchair users and people who are ambulatory, and to understand elements of fall prevention to be addressed by occupational therapy practitioners. We applied the Canadian Measure of Occupational Performance and Engagement to understand elements to be addressed in fall education and prevention with this population. DATA SOURCES We searched eight databases using the key words falls and spinal cord injury with no limit set on dates. Study Selection and Data Collection: Studies were included that reported on falls among adults with SCI and measured one or more of the following: incidence of falls, consequences of falls, contributing factors for falls, the person's experience of falls, and strategies to prevent falls. FINDINGS Thirty-five articles were included. The majority of the articles included information on the incidence (n = 20), consequences (n = 26), and contributing factors (n = 30) of falls. Two articles analyzed the person's experience of falls, and 1 study reviewed a fall prevention program for people with SCI specifically. CONCLUSIONS AND RELEVANCE Research on participants' experience of falls and fall prevention programs used in spinal cord rehabilitation is extremely limited. Future research on the lived experience of falls for people with SCI is warranted. What This Article Adds: This review of evidence on falls after SCI highlights gaps in the current available evidence.
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Affiliation(s)
- Kathryn Marshall
- Kathryn Marshall, BOccThy, is PhD Student, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia, and Occupational Therapist, Department of Occupational Therapy, Princess Alexandra Hospital, Brisbane, Queensland, Australia;
| | - Louise Gustafsson
- Louise Gustafsson, PhD, BOccThy(Hons), is Professor, School of Allied Health Sciences, Griffith University, Brisbane, Queensland, Australia, and Honorary Professor, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Andrea McKittrick
- Andrea McKittrick, BSc(Hons) CurrOcc, is PhD Student, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia, and Occupational Therapist, Department of Occupational Therapy, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Jennifer Fleming
- Jennifer Fleming, PhD, BOccThy(Hons), FOTARA, is Professor and Head of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
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