scholarly journals Managing post-stroke fatigue: A qualitative study to explore multifaceted clinical perspectives

2021 ◽  
pp. 030802262110422
Author(s):  
Avril Drummond ◽  
Fiona Nouri ◽  
Joanne Ablewhite ◽  
Laura Condon ◽  
Roshan das Nair ◽  
...  
Keyword(s):  
Occupational Therapists ◽  
Clinical Knowledge ◽  
Effective Management ◽  
Professional Background ◽  
Post Stroke ◽  
Professional Groups ◽  
Fatigue Management ◽  
Qualitative Interview Study ◽  
Framework Approach ◽  
Multidisciplinary Teamwork

Introduction Post-stroke fatigue (PSF) is common and debilitating. However, while its effective management is a priority for clinicians and stroke survivors, there remains little evidence to provide guidance or underpin practice. Our aim, therefore, was to gain insights into the experiences of clinicians who routinely manage patients with fatigue. Method Qualitative interview study. The target was to recruit a purposeful sample of approximately 20 participants with expertise in managing PSF and fatigue arising from other conditions. Maximum variation sampling was used to ensure a balance of participants across different settings. Data were analysed using a framework approach, iteratively developed and refined by including emergent themes. Results We recruited 20 participants: nine occupational therapists (OTs), five physiotherapists, three nurses and three psychologists, which included three ‘fatigue experts’ from Europe and Australia. Analysis generated core themes around management and strategies used; these were similar regardless of professional background, clinical or geographical setting or condition treated. OTs felt a particular responsibility for fatigue management, although multidisciplinary teamwork was stressed by all. Conclusion There are clear similarities in clinicians’ experiences of managing PSF and fatigue across different conditions and also across professional groups. Clinicians rely predominantly on their own clinical knowledge for guidance.

scholarly journals What is the present role for general practitioners in dementia care? Experiences of general practitioners, patients and family carers in Portugal

Dementia ◽  
2020 ◽  
pp. 147130122097771
Author(s):  
Conceição Balsinha ◽  
Steve Iliffe ◽  
Sónia Dias ◽  
Alexandre Freitas ◽  
Joana Grave ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Social Contexts ◽  
Dementia Care ◽  
Family Carers ◽  
Primary Care Teams ◽  
Qualitative Interview Study ◽  
Framework Approach ◽  
Advanced Stages ◽  
Patient Relationships

Background Governments are being challenged to integrate at least part of dementia care into primary care. However, little is known about the current role of general practitioners (GPs) regarding dementia care, especially in countries that do not have dementia strategies in place. The aim of this study was to explore the experiences of GPs, persons with dementia and their family carers in Portuguese primary care settings, to better understand GPs’ contribution to dementia care. Methods A qualitative interview study of participants recruited from six practices in different social contexts within the Lisbon metropolitan area was carried out. Purposive sampling was used to recruit GPs, persons with dementia and carers. Interviews with GPs explored dementia care comprehensiveness, including satisfactory and challenging aspects. Interviews with patients and carers explored the experience of talking to GPs about cognitive impairments and related difficulties and the type of help received. Thematic analysis of interview transcripts was carried out using the framework approach. Results Five major themes were identified: GPs have a limited contribution to dementia care, the case of advanced dementia, doctor–patient relationships, doctor–carer relationships and management of chronic conditions other than dementia. Conclusion General practitioners seemed to contribute little to dementia care overall, particularly regarding symptom management. The exception was patients with advanced stages of dementia, given that specialists no longer followed them up. Remarkably, GPs seemed to be alone within primary care teams in providing dementia care. These findings strongly suggest that Portuguese primary care is not yet prepared to comply with policy expectations regarding the management of dementia.

scholarly journals A qualitative study exploring therapists’ experiences of implementing a complex intervention promoting meaningful activity for residents in care homes

2018 ◽  
Vol 33 (3) ◽  
pp. 575-583 ◽  
Author(s):  
Raymond Smith ◽  
Julia Wood ◽  
Fiona Jones ◽  
Sue Turner ◽  
Michael Hurley
Keyword(s):  
Care Home ◽  
Complex Interventions ◽  
Occupational Therapists ◽  
Care Staff ◽  
Care Homes ◽  
Complex Care ◽  
Meaningful Activity ◽  
Qualitative Interview Study ◽  
Home Intervention ◽  
Trusting Relationships

Objectives: To explore the experiences of occupational therapists and physiotherapists and to reveal any factors that can facilitate delivering a complex care home intervention promoting meaningful activity. Design: Qualitative interview study using data from three focus groups conducted longitudinally post intervention implementation. Data were analysed thematically. Setting: Three residential care homes in South London, UK. Subjects: All therapists involved in the implementation of the intervention: three occupational therapists and three physiotherapists. Results: Three interconnected themes emerged from the analysis: (1) developing trusting relationships, (2) empowering staff and (3) remaining flexible. Therapists described how successfully implementing a complex care home intervention was dependant on developing trusting relationships with care staff. This enabled the therapists to empower care staff to take ownership of the intervention and help embed it in care home culture, facilitating long-term change. The therapists described how remaining flexible in their approach helped keep care staff engaged for the duration of implementation. Conclusion: This study has revealed several important factors that can help facilitate therapists delivering complex interventions in care homes.

scholarly journals Children with neurodisability and feeding difficulties: a UK survey of parent-delivered interventions

2021 ◽  
Vol 5 (1) ◽  
pp. e001095
Author(s):  
Helen Taylor ◽  
Lindsay Pennington ◽  
Dawn Craig ◽  
Christopher Morris ◽  
Helen McConachie ◽  
...  
Keyword(s):  
Health Professionals ◽  
Best Practice ◽  
Occupational Therapists ◽  
Feeding Difficulties ◽  
Professional Groups ◽  
Mapping Review ◽  
Swallowing Difficulties ◽  
Food And Drink ◽  
Mealtime Environment ◽  
Two Populations

BackgroundEating, drinking and swallowing difficulties (EDSD) are common in children with neurodisability, and have physical and non-physical causes. EDSD have substantial impacts on the child and family. Little is currently documented about what advice is usually given by professionals, including the interventions commonly used, and what informally constitutes ‘best clinical practice’. We aimed to identify current UK practice of parent-delivered interventions for EDSD for children with neurodisability, and the outcomes valued by professionals and parents.MethodsTwo populations were sampled: health professionals working with children and young people (aged 0–18 years) with neurodisability who experience EDSD (n=421); parents of children with neurodisability aged up to 12 years who experience EDSD (n=359). Questionnaires were developed based on the findings from updates of three systematic reviews, a mapping review of interventions used with this population, and in consultation with health professionals and parents. The questionnaires were distributed through UK health professional and parent networks and mainstream and specialist schools.ResultsDiverse professional groups, including speech and language therapists, occupational therapists, paediatricians and dietitians, support children with EDSD and neurodisability. A range of parent-delivered interventions, such as food and drink modification, positioning and modification of mealtime environment, were recommended by health professionals and are used by and acceptable to parents. Health professionals thought the interventions were effective but parents’ views were less consistent. Both health professionals and parents rated better general health and improved nutrition as the most important outcomes.ConclusionsThese survey findings outline current UK practice of parent-delivered interventions for EDSD in young children with neurodisability. The survey suggests key outcomes to measure in assessing the effectiveness of interventions. Further research is now needed to fully evaluate the effectiveness of interventions and move towards an evidence-based approach to best practice.

Able to Work?

1986 ◽  
Vol 49 (11) ◽  
pp. 354-356 ◽  
Author(s):  
Myra S Kennedy
Keyword(s):  
National Health Service ◽  
Pilot Study ◽  
Occupational Therapists ◽  
Holistic Approach ◽  
Role Identity ◽  
Present System ◽  
Professional Groups ◽  
System A ◽  
Work Assessment ◽  
Disabled Workers

Occupational therapists have traditionally included work assessments and resettlement in their holistic approach to disabled workers. In Britain, a second approach to the evaluation of disabled workers was developed outside the National Health Service (NHS), within the present system of Employment Rehabilitation Centres (ERCs). Disabled workers may receive assessment and resettlement services within either or both these systems but the information is not shared between them. The process for deciding whether or not and within which system a disabled person should receive a work assessment and resettlement programme is complicated by several factors. A literature review of the influence of the early development of work assessments and resettlement within occupational therapy and ERCs and a summary of a pilot study serves as a basis for presenting some of the problems and raising further questions about the role identity of and communication between the two professional groups involved — Occupational therapists and the staff of ERCs.

scholarly journals A Delphi survey of practitioner’s understanding of mental capacity

2018 ◽  
Vol 20 (5/6) ◽  
pp. 174-186
Author(s):  
George Clerk ◽  
Jason Schaub ◽  
David Hancock ◽  
Colin Martin
Keyword(s):  
Delphi Method ◽  
Design Methodology ◽  
Occupational Therapists ◽  
Mental Capacity ◽  
Capacity Assessment ◽  
Content Type ◽  
Professional Groups ◽  
Clinical Scenarios ◽  
Clinical Responses ◽  
Mental Capacity Act

Purpose The purpose of this paper is to present the findings of a study considering the application of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). Practitioners from a range of professions were recruited to provide their views of how to respond to a variety of scenarios. GPs, nurses, social workers, physio/occupational therapists and care assistants were recruited to participate. Design/methodology/approach This study used the Delphi method to elicit participant views and generate consensus of opinion. The Delphi method recommends a large sample for heterogeneous groups, and round one had 98 participants from six different professional groups. Findings Participants did not respond consistently to the scenarios, but disagreed most significantly when patient decisions conflicted with clinical advice, and when to conduct a capacity assessment. These responses suggest that clinical responses vary significantly between individuals (even within settings or professions), and that the application of Mental Capacity Act (MCA) is complicated and nuanced, requiring time for reflection to avoid paternalistic clinical interventions. Originality/value Previous studies have not used a Delphi method to consider the application of MCA/DoLS. Because of this methods focus on developing consensus, it is uniquely suited to considering this practice issue. As a result, these findings present more developed understanding of the complexity and challenges for practitioner responses to some relatively common clinical scenarios, suggesting the need for greater clarity for practitioners.

scholarly journals Patient, client or service user? A survey of patient preferences of dress and address of six mental health professions

2003 ◽  
Vol 27 (8) ◽  
pp. 305-308 ◽  
Author(s):  
Rebecca Mcguire-Snieckus ◽  
Rosemarie Mccabe ◽  
Stefan Priebe
Keyword(s):  
Therapeutic Relationship ◽  
General Practitioners ◽  
Community Care ◽  
Occupational Therapists ◽  
Demographic Characteristics ◽  
Psychiatric Nurses ◽  
Clinical Implications ◽  
Professional Background ◽  
Community Psychiatric ◽  
Significant Difference

Aims and MethodA positive therapeutic relationship is essential to psychiatry and should take into account patients' preferences. Preferences of 133 community care patients were surveyed regarding dress and forms of address of six professions. Participants' sex, age, ethnicity and diagnosis were recorded.ResultsNinety-eight per cent of participants expressed a preference. While most preferred to be called ‘patients' by general practitioners (75%) and psychiatrists (67%), there was no statistically significant difference in preference for the term ‘patient’ or ‘client’ when used by community psychiatric nurses, occupational therapists, psychologists or social workers. Participants over the age of 40 preferred the term ‘client’. Asymmetrical relationships were preferred with general practitioners and psychiatrists, evidenced by a preference to be addressed by first name (71% and 68%, respectively), to address the professional by title (81% and 80%, respectively), and the professional to be ‘smartly’ dressed (67% and 66%, respectively).Clinical ImplicationsA more differentiated approach may be suggested by taking professional background and some demographic characteristics into consideration.

scholarly journals Reconsidering the nursing role in antimicrobial stewardship: a multisite qualitative interview study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e042321 ◽  
Author(s):  
Emma Kirby ◽  
Alex Broom ◽  
Kristen Overton ◽  
Katherine Kenny ◽  
Jeffrey J Post ◽  
...  
Keyword(s):  
Nursing Staff ◽  
Antimicrobial Stewardship ◽  
Resource Constraints ◽  
Hospital Setting ◽  
Hospital Nurses ◽  
Nursing Role ◽  
Interprofessional Cooperation ◽  
Qualitative Interview Study ◽  
Framework Approach ◽  
Nursing Roles

ObjectivesThis study responds to calls for greater focus on nursing roles, and the need for nursing integration within the antimicrobial optimisation agenda. The objective of this study was to explore Australian hospital nurses’ views on antimicrobial resistance and antimicrobial stewardship (AMS) in a hospital setting, in order to better understand the opportunities for and challenges to integration of nursing staff in antimicrobial optimisation within hospital settings.DesignQualitative one-on-one, semistructured interviews. Interview transcripts were digitally audio-recorded and transcribed verbatim. Data were subject to thematic analysis supported by the framework approach and informed by sociological methods and theory.SettingFour hospitals (three public and one private), across metropolitan, regional and remote areas, in two Australian states.Participants86 nurses (77 females, 9 males), from a range of hospital departments, at a range of career stages.ResultsFindings were organised into three thematic domains: (1) the current peripheral role of nurses in AMS; (2) the importance of AMS as a collaborative effort, and current tensions around interprofessional roles and (3) how nurses can bolster antimicrobial optimisation within AMS and beyond.ConclusionNursing staff are central to infection management within the hospital and are thus ideally located to enhance antibiotic optimisation and contribute to AMS governance. However, without increased interprofessional cooperation, education and integration in the AMS agenda, as well as addressing organisational/resource constraints in the hospital, the nursing role in stewardship will remain limited.

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