1,722,774 research outputs found
Getting together to prevent falling in older people: a multidisciplinary and a multinational approach
No full textAn exploration of the facilitators and barriers for people with osteoarthritis to engage in exercise – an exploratory approach with participant involvement
No full textBackground/Aims: The benefits of exercise on general health are well publicised for people with people with osteoarthritis (OA). However, there is a lack of engagement in healthy activity and exercise by people with OA and despite the known benefit of exercise there is a lack of understanding of the factors that facilitate people with OA engaging with physical activity and exercise. The aim of the study was to explore the perceptions of Patient and Public Involvement representatives with OA on the facilitators and barriers for their engagement with exercise. Methods: Using a qualitative semi-structured interview, transcripts of the participants’ conversations with the interviewer were analysed using thematic analysis. Findings: Seven separate themes were identified that acted as facilitators and barriers for people with OA to engage with exercise. These were: type of exercise; benefits of exercise; drawbacks of exercise; effects of exercise; public information; psychological impact; and social support. The main findings indicated that:1. When a person knows and understands the health benefits of exercise, then they are more likely to engage in exercise. 2. For those with OA, greater emphasis on physical activity rather than exercise may be more useful to encourage engagement.3. Simple, clear consistent messages related to exercise for people with OA are required from all public health bodies and health care professionals. Conclusions: These findings are useful to guide future research by informing which areas are important to people with OA when considering engagement with exercise. These may help with the design of studies and interventions. The use of language was particularly important when engaging with this group with older people expressing feelings of isolation where particular terms relating to sport and exercise were used. There is a need for a consistent public information message to clearly communicate to the public about the benefits of exercise both on general health and for OA. <br/
Children’s and adolescents’ views on upper limb prostheses in relation to their daily occupations
No full textIntroductionProsthetic treatment is widely used for children and adolescents with upper limb difference, for functional benefit, cosmetic restoration or the performance of specific activities. Children and adolescents feel, however, that prostheses do not help function, are uncomfortable, are unreliable, are heavy and are not aesthetically acceptable. This research aims to develop an understanding of children’s and adolescents’ views on upper limb prostheses in relation to their daily occupations.MethodEight children and adolescents with upper limb difference participated in a focus group (n=4) or an individual interview (n=4). Data was analysed using thematic analysis.ResultsParticipants described both positive and negative views of their prostheses. Participants described experiences where their prosthesis was helpful to them for social interactions, when playing and in self-care and productive activities. However, participants also described choosing not to use prostheses due to lack of functional benefit, causing a hindrance in certain activities and restriction of movement.ConclusionProstheses can be useful tools for occupational participation for children and adolescents. General purpose functional prostheses for children and adolescents can result in the prosthesis not being useful, becoming a hindrance and restricting movement. Task specific devices can overcome these issues to help children and adolescents in social interactions, when playing and in carrying out self-care and productive activities
Chronic obstructive pulmonary disease (COPD) patient experiences of pulmonary rehabilitation (PR): a longitudinal qualitative UK study
No full textIntroduction and Background: attendance at PR in the UK is sub-optimal. Reasons for this have been explored. However, patient experiences have rarely been explored longitudinally through a PR programme regardless of patient participation. Furthermore, limited research has been performed in patient experiences of PR in primary care.Aims and Objectives: this research aimed to explore COPD patient experiences before and after PR, whether they completed, did not attend, or dropped out of PR.Method: fifteen participants were interviewed before and after PR regardless of patient completion. COPD patients were recruited from 2 Primary Care Trusts in the UK. Data were collected during semi-structured interviews using phenomenological research methodology.Results: of the 15 participants, 8 completed and 7 did not complete PR. Participants experienced uncertainty with regard to COPD, the care they received, PR, and their comparison with others. Prior to PR, uncertainty manifested itself in participants' experience of panic and vulnerability. The experience of uncertainty reduced following PR programme completion. Non-completers seemed angry with their care, less able to cope with comorbidities or wished to remain naïve regarding COPD.Conclusion: patient experiences of PR in primary care have been explored. Uncertainty was experienced by participants prior to PR which reduced following PR completion. Completers appeared better able to cope with comorbidities than non-completers. The importance of social comparison in PR requires further research
Measuring barriers to adherence: validation of the problematic experiences of therapy scale
No full textPurpose: To present the psychometric properties of the Problematic Experiences of Therapy Scale (the PETS), a brief measure to assess self-reported perceived barriers to adherence to physical rehabilitative therapy.Methods: Participants (study 1: n?=?128, study 2: n?=?227) taking part in trials of rehabilitative exercises completed the PETS and adherence questions at 12 weeks. Participants in study 2 were also asked about maintained adherence at 6-month follow-up.Results: Principal component analysis identified a four-factor structure relating to symptoms, uncertainty, doubts and practical problems. Cronbach's alphas ranged between 0.84 and 0.96 for study 1 and study 2. Correlations between factors varied, ranging between -0.22 and -0.53 for study 1, and 0.12 and 0.36 for study 2. Adherence was associated with all subscales at 12 weeks, and with the symptoms and doubts subscales at 6-months.Conclusions: The PETS is a valid and reliable measure that can be used to assess participants' perceived reasons for non-adherence to a home-based rehabilitative therapy. It can be easily incorporated into treatment trials and as subscales were associated with reported adherence and maintained adherence, it provides potentially valuable indicators of reported barriers to adherence or might be used in clinical practice to facilitate conversations about adherence.Implications for RehabilitationLow levels of adherence are commonly reported among people with chronic conditions who are required to undertake self-managed, home-based rehabilitation, yet patient-perceived barriers to adherence are rarely measured. The Problematic Experiences of Therapy Scale (the PETS) is a brief self-report measure that assesses the extent to which respondents perceive that they have been prevented from carrying out an intervention by common and plausible reasons. A patient-centered approach to reasons for non-adherence could facilitate conversations about adherence and identify areas in which the respondent may benefit from additional support or interventions to aid adherence
A qualitative study exploring the educational needs of patients undergoing total knee replacement
No full textAn exploration of the facilitators and barriers for people with osteoarthritis to engage in exercise
No full textBackground/Aims: The benefits of exercise on general health are well publicised and indeed more so for people with osteoarthritis (OA), but there is a lack of engagement in exercise by the general public, and further lack of engagement by people with OA. The reasons for this are not known, despite the clear benefits for both groups. The aim of the study was to explore the perceptions of Patient and Public Involvement representatives with OA on the facilitators and barriers for their engagement with exercise. Methods: Using a qualitative semi-structured interview, transcripts of the participants’ conversations with the interviewer were analysed using thematic analysis. Findings: Seven separate themes were identified. These were: type of exercise; benefits of exercise; drawbacks of exercise; effects of exercise; public information; psychological impact; and social support. The main findings indicate:1. When a person knows and understands the health benefits of exercise, then they are more likely to engage in exercise. 2. For those with OA, greater emphasis on physical activity may be more useful to encourage engagement.3. Simple, clear consistent messages related to exercise for people with OA are required from public health bodies. Conclusions: These findings are useful to guide future research by informing which areas are important to people with OA when considering engagement with exercise. These may help with the design of studies and interventions. The use of language was particularly important when engaging with this group with older people expressing feelings of isolation where particular terms were used. There is a need for a consistent public information message to clearly communicate to the public about the benefits of exercise both on general health and for OA<br/
Occupational therapy interventions provided for service users while in seclusion within a medium secure mental health unit: a service evaluation
No full textBackground/aims: service users who have spent time in seclusion describe it as a negative experience, viewing it as punishment. Although occupational therapists work within these settings, there is limited research and documentation of interventions aimed at reducing occupational deprivation in seclusion. A service evaluation was conducted at a medium secure adult mental health unit to better understand the current practices of occupational therapists working in seclusion. Methods: a bespoke tool was developed to capture occupational therapy interventions within a 12-month timeline. Results: data showed that there were 31 interventions provided across 300 days of seclusion for 16 patients. Therapy lasted between 5 and 45 minutes involving a range of adapted interventions and resources appropriate for positive risk taking. Conclusions: despite creative and adaptive interventions identified, provision of occupational therapy appeared sporadic and restricted by a 5-day service. This illustrates the need for specialist training and guidelines to support an integrated and consistent approach
A qualitative study exploring the ritual-like activity and therapeutic relationship between Pilates teachers and clients with persistent low back pain
No full textBackground and purpose: Pilates is a commonly recommended exercise modality for the management of persistent low back pain. Whilst guidelines recommend the use of exercise for low back pain, research suggests that no one exercise is superior, creating a question over the mechanism of effect. The patient-practitioner relationship may be important in managing low back pain; however, the relationship between Pilates teachers and clients is not well understood. The purpose of this study was to identify the components of the relationship between Pilates teachers and clients with persistent low back pain, explore key influences on the relationship, and ascertain the nature of the relationship.Method: we conducted a qualitative, ethnographically-informed study at eight sites in the South of England, observing 24 Pilates sessions and interviewing 9 Pilates teachers and 10 clients with persistent low back pain. Fieldnotes and interview transcripts were analysed thematically.Results: the findings demonstrate a complex, multi-faceted interaction that occurs during Pilates sessions, grounded within certain health perceptions, and predicated on expectations of individuality, choice and expertise. A key finding reveals the perceived importance of mastery of prescribed movements with control and precision, in which clients particularly value the authority of the teacher in a directive learning environment.Conclusion: we contend that the role of the Pilates teacher in this study facilitated the alleviation of clients’ distress through the application of ritual-like Pilates activity. We conclude that the relationship between Pilates teachers and clients with persistent low back pain may be considered a therapeutic relationship
Meaningful clinical outcomes for young people and parents when treated for chronic musculoskeletal pain in the UK: Q set development.
No full textPrevious studies have established a core outcome set for paediatric chronic pain clinical trials. The aim of this research was to establish which outcomes young people and parents considered important to measure during treatment for chronic musculoskeletal pain. To the best of our knowledge, this is the first study to explore which outcomes could be used to tailor interventions within a clinical setting. Twenty-one young people (age 11-18 years) and twenty-one parents were recruited from two UK hospital sites and took part in semi-structured interviews that incorporated drawing a timeline of their treatment. They identified positive and negative outcomes showing the perceived effectiveness of treatment. Informed by Q methodology, the words and phases of young people and parents were developed into 101 statements that were mapped onto the core outcome set and represented wide-ranging opinions regarding the outcomes they considered important (Q set). This approach helped identify additional statements related to ‘parent and family functioning’ not routinely considered. Outcomes related to the treatment experience and adverse effects were highlighted as important, yet are not routinely prioritised in clinical research. Parents prioritised outcomes related to the treatment experience, whereas young people prioritised their overall wellbeing. Over the course of treatment, outcome focus changed, with some outcomes only deemed relevant at a specific time point. Overall, the research highlighted the need for clinical guidance on which outcome domains to measure during the treatment course to gauge treatment effectiveness and optimally tailor interventions.Perspective: this study established the range of outcomes that were important to young people and their parents during treatment for chronic musculoskeletal pain. The findings show how young people and parents have different outcome preferences and how their outcome focus changes during the treatment course
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