Development of Violence Across the Lifespan: A Preliminary Model

<p>Violence has serious implications for both the victim and the wider community. The current adult rehabilitation programmes accept violent offenders ranged from 20 years and older. This age range could have serious rehabilitation consequences, as a twenty year olds violence and violence related goals may differ substantially to a 70 year old. For this reason an understanding of the development of violence and violence related goals can aide rehabilitation and punitive policies. A review of recent research highlights there are many methodological and empirical gaps in the development of violence whereby the current research aimed to assuage this issue. The current research used grounded theory to develop a model on the development of violence over the life-course. For this research twelve men currently incarcerated at Rimutaka Prison in a violence rehabilitation unit were interviewed. This method developed two models. The “Influences on violence development” model outlines how environment and personal choices had an impact on the development of violence. The “development of violence” model outlines the increasing severity and frequency of violence over time, and the increasing complexity of violence related goals. This model is nested within the influences on violence development model. Comparing the current models to Loeber et al's (1993) pathways model, and Sampson and Laub's life-course perspective on offending, has found support for both models. Thus this model's theoretical value lies within its ability to draw together other areas of research and provide a holistic understanding of both how and why violence develops. One implication of these models is the understanding of the varying influences of environment on violence, upon both different individuals and different ages. This implies that rehabilitation should perhaps follow a more individual based focus. There are many limitations to the research, the most salient one being lack of saturation in the model and low sample size.</p>

Development of Violence Across the Lifespan: A Preliminary Model

<p>Violence has serious implications for both the victim and the wider community. The current adult rehabilitation programmes accept violent offenders ranged from 20 years and older. This age range could have serious rehabilitation consequences, as a twenty year olds violence and violence related goals may differ substantially to a 70 year old. For this reason an understanding of the development of violence and violence related goals can aide rehabilitation and punitive policies. A review of recent research highlights there are many methodological and empirical gaps in the development of violence whereby the current research aimed to assuage this issue. The current research used grounded theory to develop a model on the development of violence over the life-course. For this research twelve men currently incarcerated at Rimutaka Prison in a violence rehabilitation unit were interviewed. This method developed two models. The “Influences on violence development” model outlines how environment and personal choices had an impact on the development of violence. The “development of violence” model outlines the increasing severity and frequency of violence over time, and the increasing complexity of violence related goals. This model is nested within the influences on violence development model. Comparing the current models to Loeber et al's (1993) pathways model, and Sampson and Laub's life-course perspective on offending, has found support for both models. Thus this model's theoretical value lies within its ability to draw together other areas of research and provide a holistic understanding of both how and why violence develops. One implication of these models is the understanding of the varying influences of environment on violence, upon both different individuals and different ages. This implies that rehabilitation should perhaps follow a more individual based focus. There are many limitations to the research, the most salient one being lack of saturation in the model and low sample size.</p>

Use of technology in supporting goal setting in rehabilitation for adults: a scoping review

ObjectiveTo map the extant literature evaluating the use of technology for goal setting in adult rehabilitation and the impact of technology for patient outcomes.DesignScoping review.MethodsMEDLINE (via Ovid), CINAHL (via EBSCO), AMED and Scopus were searched for articles describing observational or interventional studies. ProQuest Dissertations and Theses database were searched for grey literature. Two review authors independently screened all titles and abstracts for potentially relevant articles. We included articles describing studies that had evaluated the development or application of technology to facilitate goal setting in rehabilitation for adults. Articles were excluded if the technology described did not include features to facilitate goal setting or were not in English. Narrative reviews, opinion pieces and editorials were also excluded.ResultsAfter screening 1640 publications of potential interest, we identified 27 studies for inclusion. These 27 articles described studies involving a total of 16 different technologies including, seven mobile apps, three websites, two mobile apps/website hybrids, two apps and two websites connected to a pedometer. We found that most technologies described were designed to facilitate self-management with goal setting as a feature and that only five included a shared decision moment around goal setting. Only six of the 16 technologies had research providing evidence of effectiveness in terms of improved patient outcomes, with the best evidence of beneficial effects associated with technologies that linked goal setting to pedometer use.ConclusionsThe identified technologies for use in adult rehabilitation that included goal setting as a feature were largely accepted and valued by patients and health professionals. The limited data suggest that there is a need for further research; specific foci may include the impact of incorporation of a shared decision-making moment and evaluation of effectiveness on patient outcomes.

Canadian Stroke Best Practice Recommendations: Rehabilitation, Recovery, and Community Participation following Stroke. Part One: Rehabilitation and Recovery Following Stroke; 6th Edition Update 2019

The sixth update of the Canadian Stroke Best Practice Recommendations: Rehabilitation, Recovery, and Reintegration following Stroke. Part one: Rehabilitation and Recovery Following Stroke is a comprehensive set of evidence-based guidelines addressing issues surrounding impairments, activity limitations, and participation restrictions following stroke. Rehabilitation is a critical component of recovery, essential for helping patients to regain lost skills, relearn tasks, and regain independence. Following a stroke, many people typically require rehabilitation for persisting deficits related to hemiparesis, upper-limb dysfunction, pain, impaired balance, swallowing, and vision, neglect, and limitations with mobility, activities of daily living, and communication. This module addresses interventions related to these issues as well as the structure in which they are provided, since rehabilitation can be provided on an inpatient, outpatient, or community basis. These guidelines also recognize that rehabilitation needs of people with stroke may change over time and therefore intermittent reassessment is important. Recommendations are appropriate for use by all healthcare providers and system planners who organize and provide care to patients following stroke across a broad range of settings. Unlike the previous set of recommendations, in which pediatric stroke was included, this set of recommendations includes primarily adult rehabilitation, recognizing many of these therapies may be applicable in children. Recommendations related to community reintegration, which were previously included within this rehabilitation module, can now be found in the companion module, Rehabilitation, Recovery, and Community Participation following Stroke. Part Two: Transitions and Community Participation Following Stroke.

29 Adapting Dementia and Delirium Awareness Training to a Rehabilitation Setting

Background The patient profile in a Dublin rehabilitation hospital has changed in recent years to include older adult rehabilitation alongside orthopaedic rehabilitation. A snapshot audit completed by the occupational therapy department on one day in 2018 demonstrated that 64% of patients had an assessment score indicative of a cognitive impairment. A subjective gap in knowledge regarding dementia care and a misunderstanding of the ability of people with dementia to engage in rehabilitation was identified. It was imperative that dementia awareness training was provided with a particular focus on modifying rehabilitation techniques to cater for these patients. Methods A dementia care committee was established with an Educational Development subgroup responsible for addressing dementia and delirium awareness training. Educational material was received from the field of occupational therapy, nursing, medicine, pharmacy and dietetics. The programme was accredited by the Nursing and Midwifery Board of Ireland. A focus group was completed pre/post formulation of the presentation with various departmental representatives. Feedback provided was used to inform and finalise the training content. Results Sessions are completed once monthly. One hundred and seven participants to date have attended. Ten-point Likert scales are completed pre and post training. Data from the Likert scales were analysed revealing on average a 24.4 % increase in knowledge of dementia, a 27.6% increase in awareness of the impact of dementia on function and a 23.3% increase in confidence in caring for a patient with dementia. Highest contingent of staff members trained were household and catering staff (19%) nursing staff (18%), and health care attendants (13%). Conclusion This essential training is ongoing with thirty per cent of staff trained to date. The objective is for all staff to complete this training for enhanced care and rehabilitation for all patients with dementia. It will also aim to review treatment for all patients with cognitive impairment so unique rehabilitation programmes can be tailored.

The Association of Judgement Ability and Functional Status in Older Adult Rehabilitation Inpatients

Purpose: Older adults have an increased likelihood of requiring rehabilitative care due to cognitive and physical risk factors. Research has found a link between executive functioning performance and functional outcomes; however, there is a dearth of research on the assessment of judgement ability. In the current pilot study, we investigated the clinical utility of the Test of Practical Judgment (TOP-J) in an older adult rehabilitation sample.Methods: Inpatients of mixed diagnoses (n= 25, mean age = 72.60) completed the TOP-J and Functional Independence Measure (FIM). We assessed TOP-J performance in the entire sample and in those with intact vs. impaired global cognition (on the Mini-Mental State Examination; MMSE). Correlational analyses were conducted between the TOP-J, MMSE and relevant FIM items.Results: TOP-J performance fell between the means typically observed in individuals with mild cognitive impairment and mild Alzheimer's disease. Participants with intact global cognition obtained significantly higher TOP-J scores than those with impaired global cognition. Moderate to strong positive correlations emerged between TOP-J, MMSE and FIM items of problem solving, comprehension and memory.Conclusions: Results provide support for the clinical utility and validity of the TOP-J among older adults in the rehabilitation setting. Administering the TOP-J may help identify patients at risk for future injury and facilitate role transitions.