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Browsing by Person "Lane, Judith"

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    A Pilot Study to Explore the Predictive Validity of 4 Measures of Falls Risk in Frail Elderly Patients
    (Elsevier, 2005-08) Thomas, Janet I.; Lane, Judith
    Objectives To test the hypothesis that scores on 4 falls risk measures will differ significantly in patients reporting recurrent falls compared with those who do not; and to explore the validity of each measure to predict such falls status. Design A convenience sample was tested to establish the sensitivity and specificity of the Functional Reach Test, Timed Up & Go test, one-leg stance test (OLST), and balance subsection of the Performance Oriented Mobility Assessment (B-POMA). A 12-month retrospective falls history was used to identify recurrent fallers. Setting A day hospital for the elderly. Participants Convenience sample of 30 day hospital patients. The inclusion criteria were: ability to rise from a chair and walk 6m; no severe cognitive impairment or blindness; age 65 years or older. Interventions Not applicable. Main Outcome Measures Scores on the 4 tests and retrospective falls histories. Results Scores on the B-POMA and OLST showed significant differences between fallers and nonfallers (P<.05). An OLST time of 1.02 seconds or less (odds ratio [OR]=15.2; 95% confidence interval [CI], 1.72–133.95) and B-POMA score of 11 or less (OR=18.5; 95% CI, 2.05–167.79) were predictive of day hospital patients having a history of recurrent falls. Conclusions OLST and B-POMA both have potential as screening tools for risk of falls, but this observation requires confirmation in a prospective study.
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    Assessing the Viability of the EQ-5D as Part of a Battery of Outcomes in Elderly Total Knee Arthroplasty Patients: A Comparison of Generic, Condition-Specific, and Preference-Based Patient-Reported Outcome Measures
    (2011-10-07) Davis, Jessica; Lane, Judith; MacDonald, Deborah; Howie, Colin
    Background In the current economic climate it has become increasingly important to evaluate the effectiveness of expensive procedures such as total knee arthroplasties (TKAs). Patient-reported outcome measures, such as generic and condition-specific profile measures, are popular ways of determining outcomes. However, these cannot be used reliably for the purpose of economic evaluations. The EQ-5D, designed for cost-utility analysis, could offer potential advantages to outcome measurement; however, little is known about the viability and performance of this measure in more elderly (_ 75 years) patient cohorts. Aims The aim of this study was to assess the viability of the EQ-5D for use in the evaluation of TKA and to provide justification for its continued inclusion in the clinical audit of patients undergoing arthroplasty in a large general hospital. Methods Seven-hundred and seventy-nine consecutive patients undergoing TKA participated in this study. Self-report audit questionnaire booklets were administered at baseline (during a pre-admission clinic appointment) and six months post-operatively (postally). Booklets comprised of the Oxford Knee Scale (OKS;), 12-dimension Short Form (SF-12;), and the EQ-5D (). Results Two-hundred and forty-six subjects completed both the baseline and follow-up audit surveys. Correlations were strongest between the EQ-5D and OKS instruments (baseline: Tb=-0.58; p0.01; follow-up: Tb=-0.41; p0.01),.. The EQ-5D displayed large effect sizes (d=0.94) and was able to detect clinically important HRQoL improvements (ROC P-value=0.65; CI0.08; p0.001), discriminate those patients who were experiencing poorer pre-operative health (p0.001), and detect those who deteriorated post-operatively (p0.001). Adequate reliability (Cronbach's =0.79) of the EQ-5D instrument was seen post-operatively as well. Conclusions Results from this study reveal that the EQ-5D instrument shows good responsiveness to health changes in elderly TKA patients post-operatively. Its correlations with the OKS, detection of poorer pre-operative health, and detection of deterioration post-operatively also suggest good validity for the EQ-5D in this cohort. Finally, the relatively large reliability statistic post-operatively supports the use of the EQ-5D in audits. Together, these findings support the continued use of the EQ-5D instrument in future arthroplasty audits and provide evidence that it is viable for the use in cost-utility analysis.
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    Assessing treatment outcomes using a single question: the Net Promoter Score
    (British Editorial Society of Bone & Joint Surgery, 2014-05) Hamilton, D. F.; Lane, Judith; Gaston, P.; Patton, J. T.; MacDonald, Deborah; Simpson, Hamish; Howie, Colin
    Satisfaction with care is important to both patients and to those who pay for it. The Net Promoter Score (NPS), widely used in the service industries, has been introduced into the NHS as the 'friends and family test'; an overarching measure of patient satisfaction. It assesses the likelihood of the patient recommending the healthcare received to another, and is seen as a discriminator of healthcare performance. We prospectively assessed 6186 individuals undergoing primary lower limb joint replacement at a single university hospital to determine the Net Promoter Score for joint replacements and to evaluate which factors contributed to the response. Achieving pain relief (odds ratio (OR) 2.13, confidence interval (CI) 1.83 to 2.49), the meeting of pre-operative expectation (OR 2.57, CI 2.24 to 2.97), and the hospital experience (OR 2.33, CI 2.03 to 2.68) are the domains that explain whether a patient would recommend joint replacement services. These three factors, combined with the type of surgery undertaken (OR 2.31, CI 1.68 to 3.17), drove a predictive model that was able to explain 95% of the variation in the patient's recommendation response. Though intuitively similar, this 'recommendation' metric was found to be materially different to satisfaction responses. The difference between THR (NPS 71) and TKR (NPS 49) suggests that no overarching score for a department should be used without an adjustment for case mix. However, the Net Promoter Score does measure a further important dimension to our existing metrics: the patient experience of healthcare delivery.
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    ‘Being and becoming a practice educator’: An AHP online programme
    (2023-08-25) Hislop, Jane; Lane, Judith; Hegarty, David; Thomas, Janet
    Background: Five higher education institutions (HEIs) in Scotland with qualifying allied health professional (AHP) programmes developed an online programme in practice education. This paper focuses on the design, development and evaluation of this programme. Approach: The programme was developed using the ADDIE approach for instructional design and was launched on TURAS (NHS e‐learning platform) in November 2020. In November 2021, an online questionnaire was distributed to evaluate the e‐learning programme and AHPs' preferences for future practice education training. Evaluation: Of the 407 responses, 95% (n = 388) were working in the NHS. There was no preference for online or face‐to‐face format of training. For the majority, having flexibility of time and place was deemed to be important to manage learning particularly given high workloads and staff shortages. Out of the 29% (n = 118) who answered questions regarding the programme, more than 60% (n > 75) of respondents reported it was well organised, the content relevant and would support their learning. Free text comments suggested a desire for networking opportunities to discuss learning. Implications: An e‐learning programme for new and existing AHP practice educators in Scotland was developed and launched in November 2020. Key feedback from participants was that they wanted to have opportunities for interaction with other learners to discuss and share their learning whether this was online or face‐to‐face. The programme now forms the foundation education in practice education for AHPs in Scotland and is supplemented with networking opportunities through synchronous online training with HEIs and via NHS Education for Scotland's virtual community.
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    Chapter 13: Critical conversations on decolonising the physiotherapy curriculum
    (Critical Publishing, 2023-05-26) Jagadamma, Kavi; Lane, Judith; Culpan, Jane; Marcus, Geetha; Van de Peer, Stefanie
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    Constructing a measure of balance recovery confidence for older persons: Content themes from different stakeholders
    (Foundation of Nursing Studies, 2021-05-19) Soh, Shawn Leng-Hsien; Gilmour, Fiona; Lane, Judith; Asokan, Shalini; Ling Woan, Kang; Tan, Chee-Wee
    Background: The absence of patient-reported outcome measures (PROMs) for a specific construct or target population suggests a need for such measures to be developed. A case in point is the domain of falls efficacy; a PROM for balance recovery confidence was proposed to improve older persons ’agency to arrest a fall. Appropriate participation in its development by relevant stakeholders was identified as essential to maximise the utility of the PROM and its potential to enhance patient care. There is a gap in the practice development literature in terms of PROMs for older persons. This article aims to encourage researchers to use the principles of practice development to address this gap by involving relevant stakeholders to gain greater insight.
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    Evaluation of a peer tutoring scheme to empower students in their transitions through the student journey
    (Elsevier Science B.V. Amsterdam, 2015-05) Hislop, Jane; Lane, Judith
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    Exploring decolonising the curriculum in physiotherapy: our learning stories as dedicated novices.
    (Foundation of Nursing Studies, 2022-11-23) Lane, Judith; Jagadamma, Kavi; Culpan, Jane; Bulley, Catherine
    Background: There is increasing awareness that we must engage with decolonising physiotherapy curricula to respect plurality of knowledge and become more consistent with global priorities towards humanising healthcare. Aim: By reflecting on our discomfort and vulnerabilities, we strove to understand and engage in decolonising the physiotherapy curriculum. Through this we hope to motivate others and contribute to this important transformation. Conclusions: Using Mezirow’s transformative learning theory, we reflected on our struggle with our disorienting dilemmas regarding the need to engage in decolonising the physiotherapy curriculum. We have become alert to insecurities about our knowledge and ability to engage sensitively in the necessary conversations. As we progress towards ‘full’ transformation, we have concluded that we must take action to generate change while continuing to learn and reflect.
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    Factors that shape the patient's hospital experience and satisfaction with lower limb arthroplasty: an exploratory thematic analysis
    (BMJ Group, 2016-05-23) Lane, Judith; Hamilton, D. F.; MacDonald, Deborah; Ellis, Carla; Howie, C. R.
    Objective: It is generally accepted that the patients' hospital experience can influence their overall satisfaction with the outcome of lower limb arthroplasty; however, little is known about the factors that shape the hospital experience. The aim of this study was to develop an understanding of what patients like and do not like about their hospital experience with a view to providing insight into where service improvements could have the potential to improve the patient experience and their satisfaction, and whether they would recommend the procedure. Design: A mixed methods (quan-QUAL) approach. Setting: Large regional teaching hospital. Participants: 216 patients who had completed a postoperative postal questionnaire at 12 months following total knee or total hip arthroplasty. Outcome measures: Overall satisfaction with the outcome of surgery, whether to recommend the procedure to another and the rating of patient hospital experience. Free text comments on the best and worst aspects of their hospital stay were evaluated using qualitative thematic analysis. Results: Overall, 77% of patients were satisfied with their surgery, 79% reported a good-excellent hospital experience and 85% would recommend the surgery to another. Qualitative analysis revealed clear themes relating to communication, pain relief and the process experience. Comments on positive aspects of the hospital experience were related to feeling well informed and consulted about their care. Comments on the worst aspects of care were related to being made to wait without explanation, moved to different wards and when they felt invisible to the healthcare staff caring for them. Conclusions: Positive patient experiences were closely linked to effective patient-health professional interactions and logistics of the hospital processes. Within arthroplasty services, the patient experience of healthcare could be enhanced by further attention to concepts of patient-centred care. Practical examples of this include more focus on developing staff-patient communication and the avoidance of 'boarding' procedures.
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    Falls efficacy instruments for community-dwelling older adults: A COSMIN-based systematic review
    (BMC, 2021-01-07) Soh, Shawn Leng-Hsien; Lane, Judith; Xu, Tianma; Gleeson, Nigel; Tan, Chee-Wee
    Background: Falls efficacy is a widely-studied latent construct in community-dwelling older adults. Various self-reported instruments have been used to measure falls efficacy. In order to be informed of the choice of the best measurement instrument for a specific purpose, empirical evidence of the development and measurement properties of falls efficacy related instruments is needed. Methods: The Consensus-based Standards for the Selection of Health Measurement Intruments (COSMIN) checklist was used to summarise evidence on the development, content validity, and structural validity of instruments measuring falls efficacy in community-dwelling older adults. Databases including MEDLINE, Web of Science, PsychINFO, SCOPUS, CINAHL were searched (May 2019). Records on the development of instruments and studies assessing content validity or structural validity of falls efficacy related scales were included. COSMIN methodology was used to guide the review of eligible studies and in the assessment of their methodological quality. Evidence of content validity: relevance, comprehensiveness and comprehensibility and unidimensionality for structural validity were synthesised. A modified GRADE approach was applied to evidence synthesis. Results: Thirty-five studies, of which 18 instruments had been identified, were included in the review. High-quality evidence showed that the Modified Falls Efficacy Scale (FES)-13 items (MFES-13) has sufficient relevance, yet insufficient comprehensiveness for measuring falls efficacy. Moderate quality evidence supported that the FES-10 has sufficient relevance, and MFES-14 has sufficient comprehensibility. Activities-specific Balance Confidence (ABC) Scale–Simplified (ABC-15) has sufficient relevance in measuring balance confidence supported by moderate-quality evidence. Low to very low-quality evidence underpinned the content validity of other instruments. High-quality evidence supported sufficient unidimensionality for eight instruments (FES-10, MFES-14, ABC-6, ABC-15, ABC-16, Iconographical FES (Icon-FES), FES–International (FES-I) and Perceived Ability to Prevent and Manage Fall Risks (PAPMFR)). Conclusion: Content validity of instruments to measure falls efficacy is understudied. Structural validity is sufficient for a number of widely-used instruments. Measuring balance confidence is a subset of falls efficacy. Further work is needed to investigate a broader construct for falls efficacy.
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    Falls efficacy: Extending the understanding of self-efficacy in older adults towards managing falls
    (Hylonome Publications, 2021-09) Soh, Shawn Leng-Hsien; Tan, Chee-Wee; Thomas, Janet I.; Tan, Gideon; Xu, Tianma; Ng, Yoke Leng; Lane, Judith; Lyritis, George
    Falls efficacy is a widely studied construct. The understanding of falls efficacy has evolved over time. Falls efficacy was initially perceived to be suitably used as a measure of fear of falling. However, further research suggested that falls efficacy and fear of falling are distinct constructs, and therefore, would be inappropriate to be used as a proxy. Instead, some researchers posited that falls efficacy is synonymous with balance confidence. Falls efficacy has been conventionally understood as the perceived ability of individuals to perform activities without losing balance or falling. A recently conducted systematic review by the authors on existing falls efficacy related measures had revealed a fresh perspective of recognising falls efficacy as a perceived ability to manage a threat of a fall. Falls efficacy, with a broadened interpreted construct, relates to the individual’s perceived self-efficacy of performing necessary actions needed in different scenarios, including pre-fall, near-fall, fall-landing and completed fall. The conventional interpretation of falls efficacy needs a rethinking of perspective. An extended understanding of falls efficacy would provide an integral approach towards improving the agency of individual to deal with falls and would enhance person-centred care.
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    Interventions and measurement instruments used for falls efficacy in community-dwelling older adults: A systematic review.
    (2022-09-01) Soh, Shawn Leng-Hsien; Lane, Judith; Lim, Ashleigh Yoke-Hwee; Mujtaba, Mariana Shariq; Tan, Chee-Wee
    Falls efficacy has been defined as perceived self-belief in the prevention and management of falls. In the case of community-dwelling older adults, it is essential that interventions should address the different aspects of falls efficacy in terms of balance confidence, balance recovery confidence, safe landing confidence and post-fall recovery confidence to improve their agency to deal with falls. This review aims to provide the current landscape of falls efficacy interventions and measurement instruments. A literature search of five electronic databases was conducted to extract relevant trials from January 2010 to September 2021, and the CASP tool for critical appraisal was applied to assess the quality and applicability of the studies. Eligibility criteria included randomised controlled trials evaluating falls efficacy as a primary or secondary outcome for community-dwelling older adults. A total of 302 full texts were reviewed, with 47 selected for inclusion involving 7,259 participants across 14 countries. A total of 63 interventions were identified, using exercise and other components to target different aspects of falls efficacy. The novel contribution of this article is to highlight that those interventions were applied to address the different fall-related self-efficacies across pre-fall, near-fall, fall landing and completed fall stages. Appropriate measurement instruments need to be used to support empirical evidence of clinical effectiveness. [Abstract copyright: Copyright: © 2022 Hylonome Publications.]
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    Near-falls in Singapore community-dwelling older adults: A feasibility study
    (BMC, 2021-01-12) Soh, Shawn Leng-Hsien; Tan, Chee-Wee; Lane, Judith; Yeh, Ting-Ting; Soon, Benjamin
    Background: A near-fall is defined as a loss of balance that would result in a fall if sufficient balance recovery manoeuvres are not executed. Compared to falls, near-falls and its associated balance recovery manoeuvres have been understudied. Older adults may not recognise a near-fall or identify the use of their balance recovery manoeuvres to prevent a fall. The consensus on the methods to collect near-fall data is lacking. The primary objective of this study was to determine the feasibility of recruitment and retention. Secondary objectives were to establish evidence that Singapore community-dwelling older adults can identify near-falls and associated balance recovery manoeuvres. Texting and calling methods were explored as reporting methods. Methods: This study took place in Singapore (September to October 2019). Participants were healthy, community-dwelling adults aged 65 or older. Recruitment was done through poster advertisement, and all participants gave informed consent. Participants attended a briefing session and reported their near-fall or fall incidence over 21 days using either daily texting or calling. The primary outcome measures were the recruitment rate, retention rate, preferred modes for data reporting and ability to report near-falls or falls. Secondary outcomes included the self-reported incidence of falls and near-falls. Results: Thirty older adults were recruited in 5 weeks. All participants completed the study. They understood near-fall concepts and were able to report the occurrence and relevant balance recovery manoeuvres used to prevent a fall. 87% (26/30) chose to text while 13% (4/30) selected calling as their reporting method. One actual fall (0.16%) out of 630 responses was reported. Thirty-six incidents (5.7%) of near-falls were recorded. Sixteen participants (53.3%) experienced near-falls and half of this group experienced two or more near-falls. The use of reach-to-grasp strategy (36%), compensatory stepping (52.8%), and other body regions (11.2%) were used to prevent the fall. Conclusions: The study provided evidence that studying near-falls in Singapore community-dwelling older adults is feasible and can be applied to a large-scale study. Recruitment and retention rates were good. Older adults were able to identify near-falls and balance recovery manoeuvres. Both texting and calling were feasible reporting methods, but texting was preferred. Trial registration: ClinicalTrials identifier: NCT04087551. Registered on September 12, 2019
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    Patient interpretations of the term 'stiffness' prior to and following total knee arthroplasty
    (2011) Lane, Judith; Simpson, Hamish; Howie, Colin; Macmillan, Fiona
    Purpose: to gain further understanding of what patients mean when they say that their joint feels 'stiff' both prior to and following total knee arthroplasty. Relevance: Pain, function and joint stiffness are recommended as core outcome measures following joint replacement surgery although few studies have included stiffness . One study in patients with rheumatoid arthritis showed that the interpretation of the word 'stiffness' was varied. If groups with osteoarthritis and TKA were to demonstrate a similar variability, doubt could be cast upon the robustness of currently used measures of stiffness. Participants: Patients (n = 40) who were due to undergo TKA for osteoarthritis within 6 weeks were recruited from a pre-admission clinic. TKA patients (n = 76) were recruited from a group who had undergone primary TKA for osteoarthritis in the previous 10-14 months. Methods: Participants rated their level of perceived stiffness from 0 -100 using a visual analogue scale. They were also asked to select words that they felt best described their stiffness from a list of 21. The stiffness descriptors included words that were related to pain, difficulty with movement and sensation. Analysis: VAS stiffness was not normally distributed and therefore Mann-Whitney U tests were used to detect inter-group differences in self reported level of stiffness, number of words used. Chi-square tests were used to explore difference between the groups in the type of words used to describe stiffness. Results: The OA group had a higher median VAS stiffness score of 60.0 compared to 40.0 in the TKA group. These differences were significant (p < 0.001). The median number of words used to describe stiffness was 4.0 in the OA group compared to 1.0 in the TKA. Overall 49% of participants used words from the pain category to describe stiffness. A significantly greater proportion (2 = 19.65, p < 0.001) of participants in the OA group (78%) included words from the pain category to describe their stiffness compared to the TKA group (34%). A similar proportion of participants in the OA group (75%) included words from the difficulty with movement category compared to the TKA group (65%). A significantly higher proportion (2 = 42.88, p < 0.001) of participants in the OA group (60%) than the TKA group (5%) used words from the sensation category. The most common combination of words in the OA group was pain + stiffness+sensation (43%) whereas the largest proportion of TKA patients (41%) used the difficulty with movement category only. Conclusions: All participants were likely to use a range of words to describe stiffness but the OA group were more likely to use pain or sensation related words than the TKA group. Implications: When a patient reports stiffness either prior to and following TKA, care should be taken to explore with the patient what they mean. Many patients confused sensations of pain with sensations of stiffness and this could have implications for provision of adequate pain relief. Further work is necessary to ensure the validity of patient reported measures of stiffness.
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    Personality, function and satisfaction in patients undergoing total hip or knee replacement
    (Springer Verlag, 2014-03-21) Ramaesh, R.; Jenkins, P.; Lane, Judith; Knight, S.; Macdonald, D.; Howie, C.
    Background: The aim of this study was to investigate the relationships between personality and joint-specific function, general physical and general mental health in patients undergoing total hip (THA) and knee arthroplasty (TKA). Methods: One hundred and eighty-four patients undergoing THA and 205 undergoing TKA were assessed using the Eysneck Personality Questionnaire, brief version (EPQ-BV). General physical and mental health was measured using the Short-Form 12 (SF-12) questionnaire and the EuroQol (EQ-5D). Joint-specific function was measured using the Oxford hip or knee score. Results: The unstable introvert personality type was associated with poorer pre-operative function and health in patients with hip arthrosis. In patients with knee arthrosis, there was poorer general health in those with stable extrovert and unstable introvert types. Personality was not an independent predictor of outcome following TKA or THA. The main predictor was pre-operative function and health. Comorbidity was an important covariate of both pre-operative and postoperative function. Conclusions: Personality may play a role in the interaction of these disease processes with function and health perception. It may also affect the response and interpretation of psychometric and patient-reported outcome measures. It may be important to characterise and identify these traits in potential arthroplasty patients as it may help deliver targeted education and management to improve outcomes in certain groups. 2013 The Japanese Orthopaedic Association.
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    Physical function following TKA compared to age matched healthy controls
    (2011) Lane, Judith; Simpson, Hamish; Howie, Colin; Macmillan, Fiona
    Purpose: to explore whether physical and functional impairments exist in those who have undergone primary TKA compared to age matched healthy controls. Relevance: Many studies have suggested that although function generally improves following TKA, patients continue to experience significant functional limitations. Most of these studies however have assessed function using self-reported measures despite recommendations that both self-report and performance based measures are required to capture the full spectrum of functional ability. Furthermore, there have been no recent studies that have comprehensively compared outcomes in TKA with those who have no knee related pathology. Therefore, the evidence to suggest that functional limitations persist cannot be considered as robust. Participants: A group of patients (n = 15) were recruited who had undergone primary TKA for osteoarthritis between 10 and 14 months previously (median age = 71 years). A group of age matched health controls (n = 12, median age = 69.5 years) were recruited from local community groups. Methods: Self reported function (0-100 scale where 0 is best), timed-up-and-go, stair ascent/descent, walking speed, leg extensor power and range of motion were compared between groups. Analysis: Mann-Whitney U-tests were used to detect inter-group differences. The alpha level was set at 0.05. Results: Maximum flexion in the TKA group (median = 110o) was significantly less (p = 0.002) than the control group (median = 120o). The TKA group reported significantly worse function (median scores TKA = 10.0, control = 0.00, p = 0.028). No significant differences (p >0.05) however were found between groups in any of the performance based measures of function (timed up and go, timed stair ascent/descent, walking speed) or in knee extensor strength. Conclusions: although individuals with TKA perceived their functional ability to be significantly worse than their healthy counterparts, there was no evidence to suggest that significant functional impairments existed in this small group. Implications: expectations of outcome in TKA have been shown to be an important factor in overall patient satisfaction with their surgery. The results of this study could help to provide improved information regarding functional ability following TKA.
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    Postgraduate taught students and preparedness for Master's level study: polishing the facets of the Master's diamond
    (Taylor & Francis, 2017-08-09) Bamber, Veronica; Choudhary, Carolyn J.; Hislop, Jane; Lane, Judith
    Transitions are increasingly recognised as difficult, and less has been written about transitions to postgraduate taught programmes than about transitions into undergraduate or doctoral study. A Scotland-wide project found that new taught Post-graduate (PG), and staff teaching them, can be unclear about what is expected at Master's level, and proposed a framework of seven facets that indicate how students are expected to engage with Master's study. The facets and accompanying resources were designed to be discussion tools, to promote staff and student discussion of what is expected in their programme and subject. In a follow-up project at one university, a questionnaire was designed and distributed to postgraduate students asking them to rate their current level of ability against the skills and capabilities identified as facets for Master's level study. The project found students felt ill-prepared for particular aspects of Master's level study, with sub-group differences between disciplines. Master's courses are intensive and fast-moving, so this has implications for students' preparedness for successfully navigating through their programmes. Some suggestions on how students can be better briefed on what to expect are made.