1,721,058 research outputs found
Investigating the internal validity of the Trunk Impairment Scale (TIS) using Rasch analysis: the TIS 2.0
No full textA review of the evidence in support of the SF-36 and general-efficacy scale to evaluate a vocational rehabilitation service
No full textThe purpose of this paper is to examine the evidence for using the General self-efficacy scale and physical functioning scale of the SF-36 to evaluate a vocational rehabilitation service to 1) inform researchers, clinicians and commissioners about the properties of the measures in use and 2) make recommendations for the future evaluation of vocational rehabilitation.Methods: Electronic databases, United Kingdom government websites, generic internet search engines and hand searches of reference lists were reviewed for relevant articles. Abstracts were selected against inclusion criteria and relevant articles retrieved for appraisal.Findings: 19 articles were retrieved and reviewed for inclusion criteria.7 articles met the inclusion criteria and contributed to the review of the evidence. The use of the SF-36 and GSES in vocational rehabilitation settings appears to be based on evidence drawn from studies with methodological flaws. No evidence could be found in support of the sensitivity and responsiveness of the GSES.Discussion and implications for practice: The use of outcome measures that have questionable reliability and validity, and an absence of evidence with regard to responsiveness and sensitivity in vocational rehabilitation populations, contributes to an inability to evaluate the effectiveness of vocational rehabilitation services. Further enquiry into how vocational rehabilitation operates, would help to clarify the nature and range of specific activities to be targeted and aid the selection of existing appropriate measures or the development of new measures that reflect the conceptual premises that supportvocational rehabilitation
Needs and outcome indicators for rehabilitation services
No full textSIGLEAvailable from British Library Document Supply Centre-DSC:DXN025914 / BLDSC - British Library Document Supply CentreGBUnited Kingdo
The developing role of hand therapists within the hand surgery and medicine services: an exploration of doctors' views
No full text Extended scope practitioners (ESPs) are specialist occupational therapists and physiotherapists working beyond their recognised scope of practice. Thirty-five hand therapists were identified as working in this role in Britain, primarily in pre- and post-operative settings. A postal survey of the 31 consultants with whom they worked investigated their views on the nature of this role and service; the facilitating and constraining factors to this development; and on required qualifications, training and supervision. Seventeen consultants, all hand surgeons, replied. They reported that the principle reasons for the development of ESPs were the need to reduce the waiting list and the consultants’ workload. A variety of roles had been created, reflecting the different service needs and the skills of the therapists. Training was largely experiential. Extended scope practitioners had had a significant impact on waiting lists. There was variation in the surgeons’ views regarding further development of these posts. Concerns were identified regarding these posts, such as professional isolation, the transferability of skills, inappropriate extension of the role and the potential for litigation. </jats:p
An exploration of the developing role of hand therapists as extended scope practitioners
No full text Extended scope practitioners (ESPs) are specialist occupational therapists and physiotherapists working beyond their recognised scope of practice. The aims of this study were to identify the number, training and scope of practice of hand therapists working as ESPs. Thirty-five ESPs were identified and sent a questionnaire examining aspects of their practice. Thirty-two ESPs (91%) replied. The findings show that the ESPs worked in four models of practice: own clinic environment, rheumatology, preoperative and post-operative clinics. Their activities included making diagnoses, injections, joint aspirations and wound care. ESPs referred patients for surgery, investigative procedures and therapy. Training was largely experiential and there were unmet training needs. It can be concluded from this study that ESPs are undertaking aspects of care that traditionally have been undertaken by doctors and nurses. The development of ESPs has training implications. </jats:p
The visual analogue WOMAC 3.0 scale - internal validity and responsiveness of the VAS version
Full text linkBackground: Many people suffer with Osteoarthritis (OA) and subsequent morbidity. Therefore, measuring outcome associated with OA is important. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been a widely used patient reported outcome in OA. However, there is relatively little evidence to support the use of the Visual Analogue Scale (VAS) version of the scale. We aimed to explore the internal validity and responsiveness of this VAS version of the WOMAC. Methods: Patients with chronic hip or knee pain of mechanical origin, waiting for a hip or knee joint replacement completed the WOMAC as part of a study to investigate the effects of acupuncture and placebo controls. Validity was tested using factor analysis and Rasch analysis, and responsiveness using standardised response means. Results: Two hundred and twenty one patients (mean age 66.8, SD 8.29, 58% female) were recruited. Factor and Rasch analysis confirmed unidimensional Pain and Physical Functioning scales, capable of transformation to interval scaling and invariant over time. Some Differential Item Functioning (DIF) was observed, but this cancelled out at the test level. The Stiffness scale fitted the Rasch model but adjustments for DIF could not be made due to the shortness of the scale. Using the interval transformed data, Standardised Response Means were smaller than when using the raw, ordinal data. Conclusions: The WOMAC Pain and Physical Functioning subscales satisfied unidimensionality and ordinal scaling tests, and the ability to transform to an interval scale. Some Differential Item Functioning was observed, but this cancelled out at the test level and, by doing so, at the same time removed the disturbance of unidimensionality. The scaling characteristics of sets of items which use VAS require further analysis, as it would appear that they can lead to spurious levels of responsiveness and scale compression because they exaggerate the distortion of the ordinal scale
Met and unmet needs reported by severely disabled people in Southern England
No full textPurpose: To examine the met and unmet needs for rehabilitation of disabled people living in the community in Southern England.Method: A cross sectional interview study of people with a primary physical disability, aged 16± 65. Disabled people were randomly selected from two existing disability registers, which comprised disabled people who had been identified by community rehabilitation services as being in need of regular surveillance by formal assessment of their care needs. A new semi-structured needs assessment questionnaire was developed and validated for the study (the Southampton Needs Assessment Questionnaire, SNAQ). Level of disability was examined with the OPCS Disability and Severity Scales.Results: Ninety three disabled people participated. Their median (IQR) OPCS score was 8 (6± 10). Participants reported a median (IQR) of three unmet needs (2± 7). The most prevalent unmet needs were for adaptations, equipment, physiotherapy and wheelchairs, rather than unmet needs for intellectual and social fulfilment.Conclusions: Disabled people who were already in touch with community rehabilitation services continued to express unmet needs for further services. Meeting the more basic needs relating to people’s housing, equipment, physiotherapy and wheelchairs may enable them to be more independent and fulfilled in other areas of their lives
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