‘Companioning’ in artistic inquiry: Warren Lett and the role of personal process in research

This article explores the unique features of Warren Lett’s practice of companioning and its significance within the international community of artistic inquiry. Emphasis is given to the role of personal process as research content and its inseparable relationship to reality. The author’s experiences with this aspect of research are compared to Lett’s work. The article also explores the parallel developments of integrated arts therapy in the United States and multimodal arts therapy in Australia, both grounded in an integral, multisensory and whole art experience that contrasts to the silos of specialized arts therapy disciplines.

210 Nursing Home Residents in Acute Hospital – a Targeted ANPc Program to Improve Care

Background NHR are the frailest group of older people and require a gerontologically attuned approach to combat multiple challenges presented to the practitioner. The in-reach ANPc liaison service aims to confront such challenges, by providing comprehensive gerontological input to all nursing home residents admitted to hospital under all specialities medical, geriatric, and surgical. Methods This service commenced in September of 2018, working 9-5 Monday to Friday with limited leave cross-cover. All nursing home residents are reviewed by a Gerontology Advanced Nurse Practitioner candidate. Each patient received comprehensive geriatric assessment (CGA) with recommendations for care. All had follow up 2 weeks after discharge in telephone review clinic. Results 118 nursing home residents were admitted for acute care in the study period; 96/118 (82%) were reviewed by the ANPc. 16/118 (14%) were discharged prior to review and 6/118 (5%) died within 24 hours of admission. All other patients were reviewed within 72 hours. All assessed residents had >1 recommendation for intervention to enhance care following CGA: Interventions included 31% (30/96) undiagnosed delirium identified and management advice given. 21% (20/96) had recurrent falls work up and advice. 27% (26/96) had recommendations and changes to admission medications. 37% (36/96) referrals to other HSCP therapy disciplines for complete holistic care. 11% (11/ 96) had advanced care planning regarding future illnesses. 13% (13/96) had palliative care advice and referral to community palliative care. Follow up telephone review clinics have further resulted in reduced readmission rates through liaison with NH staff post-discharge. Conclusion The high complexity of this cohort of patients requires a timely, comprehensive gerontological approach in order to provide holistic care. They require a clearly defined approach to enhance care and minimise the need for unnecessary hospitalisations.

The patient specific functional scale in outpatient cancer rehabilitation.

94 Background: Cancer rehabilitation is an underutilized service within the oncology care spectrum. Approximately 65% of survivors have functional impairments, while only 6% receive services. The effectiveness of cancer rehabilitation must be demonstrated to increase access to care, however there are no nationally recognized outcome tools for use with the oncology population across therapy disciplines. The Patient Specific Functional Scale (PSFS) is validated for use in many traditional rehabilitation populations, and has been referenced in one study with breast cancer patients. The purpose of this quality improvement project was to investigate the utility of the PSFS with cancer patients seen in an outpatient therapy setting. Methods: The PSFS was selected for its comprehensiveness and the ability to use across rehabilitation therapy disciplines. The PSFS measures patient perception of functional improvement during rehabilitation. Patients select up to three limiting activities and rate them on an 11-point scale. An average score is computed. Occupational, physical, and speech therapists were trained on administration, scoring, and reporting of the PSFS. The initial score was obtained at evaluation and the final score was collected during the last treatment session. PSFS scores were collected over a one-year period. Results: 307 new patients were evaluated in the outpatient clinic and 65 of those patients completed the PSFS at both the initial and final visits. Most patients had breast, prostate, and brain cancers. Barriers to completion of PSFS included patients not being appropriate for treatment, therapist compliance with the tool, and patients not returning for their final therapy appointment. Of the 65 patients, 86% reported the minimal clinically important change of 2-points or greater. The average increase in PSFS score was 3.7 points. Conclusions: The PSFS was successfully utilized in the outpatient rehabilitation setting with oncology patients. Therapists perceived the tool as quick, patient-centered, and easy to use. Patients showed functional improvement using the PSFS. Further research is necessary to understand the psychometric properties of the PSFS with the oncology population.