1,721,064 research outputs found
Navigating multiple research identities: reflexivity in discourse analytic research
No full textContents Part I: Introducing Reflexivity - Introduction;Chapter 1. The reflexive journey, mapping by multiple routes;Chapter 2. Deconstructing reflexivity;Part II: Personal Reflexivity - Introduction;Chapter 3. Necessary subjectivity: exploiting researcher's motives, passions and prejudices in pursuit of answering the 'true' questions;Chapter 4. Three journeys towards reflexivity;Chapter 5. Navigating multiple research identities: reflexivity in discourse analytic research;Chapter 6. Doing reflexivities? Dilemmas in developing a critically reflexive position using discourse analysis;Chapter 7. Reflexivity as presence: a journey of self-inquiry;Part III: Reflexivity Within Relationships IntroductionChapter 8. Through the looking glass: inter-subjectivity and hermeneutic reflection;Chapter 9. Analysing the interviewer: the joint construction of accounts of psychotic experience;Chapter 10. Reflexivity, 'bias' and the in-depth interview: developing shared meanings;Chapter 11. Shifting researcher positions during a group interview study: a reflexive analysis and review;Part IV: Reflexivity Through Collaboration IntroductionChapter 12. Doing reflexivity: a collaborative, narrative approach;Chapter 13. Shifting identities: the negotiation of meanings between texts and between persons;Chapter 14. Researcher as storyteller and performer: parallels with playback theatre;Chapter 15. Using reflexivity to looses theoretical and organisational knots within participatory action research;Chapter 16. Holding up the mirror to widen the view: multiple subjectivities in the reflexive team;EpilogueChapter 17: The next turn: reflexively analysing reflexive research
A critical review of the effectiveness of environmental assessment and modification in the prevention of falls amongst community dwelling older people
No full textIntroduction: The potential of environmental assessment and modification to reduce falls has recently received attention within the gerontology literature. Research investigating the clinical effectiveness of this intervention in falls prevention reports conflicting results. Discrepancies are due to variation in the risk profile of study participants and the health care background of the person providing the environmental intervention or the intensity of the intervention provided.Method: The purpose of this paper is to compare and contrast two systematic reviews, which include meta-analyses, of environmental interventions for falls prevention in community dwelling older people, using the critical appraisal skills programme tool for systematic reviews. Findings: Both reviews found that: environmental assessment and modification was effective in falls prevention; intervention was effective with high but not low risk participants; and that high intensity environmental assessment was effective, whereas low intensity intervention was not. Environmental interventions which were delivered by occupational therapists were deemed high intensity, probably because their underpinning theoretical frameworks focus on the impact of the environment on function.Conclusion: We discuss possible reasons why occupational therapist led environmental assessment and modification is clinically effective in falls prevention, for people at high risk of falls, whereas non occupational therapist led intervention is not
Unpacking the black box of therapy - a pilot study to describe occupational therapy and physiotherapy interventions for people with stroke
No full textObjective: To describe the components used in the practice of occupational therapy and physiotherapy for people with stroke and to examine variability between services.Design: A time-sampling strategy in which therapists recorded their face-to-face interventions with stroke patients during 12 weeks over a total of 17 months.Settings and subjects: Six occupational therapists and seven physiotherapists from four services (three day hospitals and one domiciliary stroke rehabilitation service) recorded interventions with 89 stroke patients recruited to a larger randomized controlled trial.Main outcome measures: Frequencies of use of interventions, together with other details about delivery of therapy, were recorded using a data collection booklet and coding system designed by the participating therapists.Results: The median treatment time for a session was 45 minutes. The most frequently recorded components of physiotherapy intervention were 'walking', 'standing balance' and 'upper limb movement pattern', and of occupational therapy 'physical function', 'social and leisure activities' and 'other'. There was variability between the services in terms of median treatment time, use of intervention codes, frequency of treatment sessions, amount of time spent working with assistance and amount of group work.Conclusions: The findings support the view that occupational therapy and physiotherapy with people with stroke are not homogeneous activities, and vary between therapists and services. Recommendations include further development of the tool, and use of other methodologies to explore the process and nature of stroke rehabilitation
Evaluating equipment for people with disabilities: user and technical perspectives on basic commodes
No full textDisabled people often do not use the equipment supplied to them. Past work indicates that there are many reasons for this, including the low priority given to user views by the designers and manufacturers of such equipment. A number of different methodologies have been used to evaluate equipment. This paper describes an evaluation of basic commodes, a project funded by the Medical Devices Agency, Department of Health, in which both a user survey and technical tests were employed. A sample of 18 basic commodes, divided into four categories, was evaluated by 40 users, a questionnaire being administered to determine user views. A series of 13 technical tests was also carried out. The results showed that the preferred commodes as indicated by the users did not necessarily perform well in the technical tests, with at least one of the products having potentially serious design faults. It is suggested that users, therapists and engineers each have an essential contribution to make in the evaluation of equipment for disabled people
The circumstances of falls among people with Parkinson's disease and the use of Falls Diaries to facilitate reporting
No full textPurpose: falls are common in Parkinson's disease (PD). Falls Diaries are one way of recording fall frequency and the surrounding circumstances; completing them encourages recall, and their content focuses intervention. We reviewed the diaries completed by people with PD during a randomized controlled trial (RCT) of fall prevention to ascertain the key circumstances surrounding falls.Method: we asked independently mobile, cognitively intact people with a diagnosis of PD to maintain a Falls Diary throughout a six-month RCT. We sent monthly diary sheets on which to answer questions about the 'Location', 'Fall-related activity', 'Perceived cause', 'Landing' and 'Consequences' of every fall. We coded responses and counted frequencies.Results: of the 142 RCT participants (mean age 72 years; mean years since diagnosis 8), 135 completed the trial and their diary. We excluded 11 (8%) for missing data and/or unintelligible writing. The 124 remaining diaries recorded 639 falls: 80% happened at home, commonly in bedrooms, living areas, kitchens and gardens. Fallers had been ambulant in 45% of events, standing in 32% and transferring in 21%. Six 'activity-cause combinations' accounted for 55% of falls (tripping 13%; freezing, festination and retropulsion 11%; and postural instability when bending or reaching 9%, transferring 8%, walking 7% and washing or dressing 7%). Misjudgement and distraction played a part in 12% of falls described.Conclusions: of over 600 falls surveyed, most happened at home, provoked by postural instability, tripping and freezing. Environmental adaptation and cognitive training should be trialled in falls prevention in PD, plus or minus traditional movement rehabilitation. Most participants completed Falls Diaries successfully. We advocate diary use, with follow-up interviews, in research and clinically. People with handwriting difficulty may require a typed diary, proxy diarist or intervie
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