Browsing by Person "Mead, G."

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A survey of community exercise programmes for stroke survivors in Scotland
(Wiley, 2011) Best, C.; van Wijck, F.; Dennis, J.; Donaghy, Marie; Fraser, H.; Dinan-Young, S.; Mead, G.
Stroke is the most common cause of complex disability in the community. Physical fitness is often reduced after stroke, but training can improve fitness and function. UK and international stroke clinical guidelines recommend long-term exercise participation for stroke survivors. However, there has been no previous research into what services are available to support this. In 2009, we conducted the first European survey of community Exercise after Stroke services. A link to our web-based survey was emailed to health, leisure service and stroke charity contacts in Scotland with email and telephone follow-up to non-respondents. The overall response rate was 64% (230/361). A total of 14 Exercise after Stroke services were identified, the majority of which were run by charity collaborations (7/14), followed by leisure centre services (4/14) and health services (3/14). We sought information on session content, referral and assessment processes, and the qualifications of exercise instructors. This information was cross-referenced with current clinical and exercise guidelines to determine whether existing resources were sufficient to meet stroke survivors' needs for safe, effective and sustainable access to exercise. The results indicated a shortage of stroke-specific community exercise programmes. Further service development is required to ensure appropriate instructor training and referral pathways are in place to enable stroke survivors to access exercise services in accordance with current guidelines. 2011 Blackwell Publishing Ltd.
How do occupational therapists understand and respond to delirium in acute stroke? A grounded theory exploration
(SAGE, 2018-08-01) Carin-Levy, Gail; Nicol, Kath; McVittie, Chris; Van Wijck, F.; Mead, G.
Purpose and aims: Delirium is a serious complication following a stroke, often leading to severe adverse effects (Carin-Levy et al. 2012). Identifying delirium following a stroke can be challenging due to the complexity of cognitive screening in this population (Lees et al. 2013). This study explored how occupational therapists (OTs) understand delirium and what actions are taken when working with a patient exhibiting delirium symptoms. Design: Abbreviated grounded theory. Methods: Two online focus groups utilising case vignettes conducted with occupational therapists working in acute stroke units across Scotland. Analytical steps consistent with grounded theory methodology led to the emergence of themes. Results: Five participants were recruited. None of the participants received delirium training, and none confidently discussed delirium symptoms, frequently referring to the term ‘confusion’. Participants suggested using generic cognitive assessments rather than delirium-specific tools. Despite this, the key principles of the initial management of delirium were discussed confidently and participants demonstrated the values of person centredness, effective team work and a real care for the welfare of the persons with whom they are working. Conclusion: Occupational therapists can struggle to identify delirium in acute stroke; however, the key principles of delirium management were confidently discussed and an ethos of person centredness was demonstrated. Occupational therapists are experts in cognitive assessment of stroke patients (Scottish Intercollegiate Guidelines Network 2010), therefore, training in delirium identification should be targeted at this professional group in order to be able to comply with best practice guidelines on delirium management (Healthcare Improvement Scotland 2014).
The effects and experiences of goal setting in stroke rehabilitation - a systematic review
(Taylor & Francis Ltd, 2013-02) Sugavanam, Thavapriya; Mead, G.; Bulley, Catherine; Donaghy, Marie; van Wijck, Frederike
Objective: To systematically integrate and appraise the evidence for effects and experiences of goal setting in stroke rehabilitation. Design: Systematic review of quantitative and qualitative studies. Methods: Relevant databases were searched from start of database to 30 April 2011. Studies of any design employing goal setting, reporting stroke-specific data and evaluating its effects and/ or experiences were included. Results: From a total of 53998 hits, 112 full texts were analysed and 17 studies were included, of which seven evaluated effects while ten explored experiences of goal setting. No eligible randomized controlled trials were identified. Most of the included studies had weak to moderate methodological strengths. The design, methods of goal setting and outcome measures differed, making pooling of results difficult. Goal setting appeared to improve recovery, performance and goal achievement, and positively influenced patients' perceptions of self-care ability and engagement in rehabilitation. However, the actual extent of patient involvement in the goal setting process was not made clear. Patients were often unclear about their role in this process. Professionals reported higher levels of collaboration during goal setting than patients. Patients and professionals differed on how they set goals, types of goals set, and on how they perceived goal attainment. Barriers to goal setting outnumbered the facilitators. Conclusion: Due to the heterogeneity and quality of included studies, no firm conclusions could be made on the effectiveness, feasibility and acceptability of goal setting in stroke rehabilitation. Further rigorous research is required to strengthen the evidence base. Better collaboration and communication between patients and professionals and relevant education are recommended for best practice. Implications for Rehabilitation- Communication is key to collaborative goal setting. - Education and training of professionals regarding goal setting is recommended, especially in relation to methods of involving people with communication and cognitive impairments. - Educating patients about stroke and goal setting could enhance their participation in goal