Repository logo
 

Occupational Therapy and Arts Therapies

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/25

Browse

Author: search.filters.author.McVittie, Chris

Search Results

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Identifying and responding to delirium in acute stroke: Clinical team members’ understandings
    (Sage, 2020-09-24) Carin-Levy, Gail; Nicol, Kath; van Wijck, Frederike; Mead, Gillian; McVittie, Chris; Funder: Chest Heart and Stroke Scotland; FundRef: 10.13039/501100007919
    Delirium is associated with increased mortality, morbidity and length of hospital stay. In the acute stroke setting, delirium identification is challenging due to the complexity of cognitive screening in this patient group. The aim of this study was to explore how members of interprofessional stroke unit teams identified and responded to a potential delirium in a patient. Online focus groups and interviews utilizing case vignettes were conducted with 15 participants: nurses, occupational therapists, speech and language therapists, and physiotherapists working in acute stroke services. Participants’ understandings of delirium varied, most participants did not identify the symptoms of a possible hypoactive delirium, and nearly all participants discussed delirium symptoms in tentative terms. Aspects of interprofessional working were discussed through the expression of distinct roles around delirium identification. Although participants demonstrated an ethos of person-focused care, there are ongoing challenges involved in early identification and management of delirium in stroke survivors.
  • No Thumbnail Available
    Item
    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).
  • Thumbnail Image
    Item
    Staff response to delirium in acute stroke: Knowledge, awareness and barriers to early identication
    (Wiley, 2015-10-23) Carin-Levy, Gail; Nicol, Kath; van Wijck, Frederike; Mead, Gillian; McVittie, Chris
    Introduction: Delirium is a serious medical complication, which can have adverse effects on patients. Identifying delirium following a stroke can be challenging due to the complexity of cognitive screening. This study explored how multidisciplinary team (MDT) members understand delirium following a stroke and what actions are taken when working with a patient exhibiting delirium symptoms. Method: A grounded theory exploration utilising two online focus groups and email exchanges with nurses, physiotherapists, speech and language and occupational therapists working in acute stroke across Scotland. 2 case vignettes were used to elicit responses: 1 described a stroke patient with hypoactive delirium, the other, a hyperactive delirium. Results: 15 participants from various professional groups were recruited. A minority of participants who received delirium training in the past were able to identify symptoms and suggest relevant screening tools. Most participants struggled to identify a hypoactive delirium, mistaking it for dementia or depression and using more tentative language to discuss delirium symptoms. Participants placed an emphasis on the roles of MDT members as instrumental in working out the clinical picture: nurses saw their role as identifying the biomarkers as well as using a delirium screening tool. Allied health staff tended to defer to nurses and medical staff to take these actions. Discussion: MDT members can struggle to identify delirium in acute stroke, particularly the hypoactive subtype. Education and raising awareness of all MDT members working in stroke units has the potential to increase identication rates and possibly lead to more favourable outcomes for these patients.