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Occupational Therapy and Arts Therapies

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

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End date: 2019Subject: search.filters.subject.Older People

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    A modified gap analysis designed to generate research priorities in occupational therapy
    (Occupational Therapy New Zealand - Whakaora Ngangahau Aotearoa, 2019-07) Maclean, Fiona; Kantartzis, Sarah; McCormack, Brendan; Pentland, Duncan
    Where a limited body of evidence exists the traditional mechanisms of a literature or systematic review, which are often used to establish research gaps and priorities, can be problematic. This is especially the case in occupational therapy where evidence to guide future research directions can be sparse. A gap analysis of existing literature is one way to inform future research planning. This paper aims to describe a modified version of gap analysis specifically designed to identify research priorities in occupational therapy. This is illustrated using a small, disparate body of pre-existing, published work that explored practitioner knowledge of drinking alcohol in later life.
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    Outcomes for older telecare recipients: The importance of assessments
    (SAGE, 2019-10-30) Woolham, John; Steils, Nicole; Fisk, Malcolm; Porteus, Jeremy; Forsyth, Kirsty
    Summary This article explores the role of telecare assessment, review and staff training in meeting the needs of older people living at home. Using original empirical data obtained from an online survey of English local authorities it reveals considerable variation in assessment and review practice and in training given to social work and other staff who assess and review, which may impact on outcomes for telecare users. The study findings are situated within an English policy context and earlier findings from a large, government funded randomised controlled trial. This trial concluded that telecare did not lead to better outcomes for users.
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    Making use of evidence in commissioning practice: Insights into the understanding of a telecare study’s findings
    (Policy Press, 2019-12-16) Woolham, John; Steils, Nicole; Forsyth, Kirsty; Fisk, Malcolm; Porteus, Jeremy
    Background. This paper discusses findings from a study of English Local Authority (LA) Adult Social Care Departments (ASCDs) that explored how managers use telecare. A decade earlier, a large clinical trial, the ‘Whole System Demonstrator’ project (WSD), funded by the Department of Health (DH) investigated telecare’s effectiveness in promoting and maintaining independence among users. It found no evidence that telecare improved outcomes. Despite these conclusions, the DH did not change its policy or guidance, and LAs did not appear to scale back investment in telecare. Aims and objectives. The present study explores how English ASCDs responded to WSD findings and why investment continued despite evidence from the WSD. Methods. Data were obtained from an online survey sent to all telecare lead managers in England. The survey achieved a final response rate of 75%. Findings. The survey asked questions focused on awareness and use of research in general, and specifically knowledge about the findings of the WSD. Most respondents were highly critical of the WSD methods, and its findings. Discussion. Critical examination of telecare manager views found widespread inaccurate information about the trial methodology and findings, as well as the wider political and policy context that shaped it. Conclusions. The WSD could not explain why telecare did not deliver better outcomes. A more nuanced understanding of the circumstances in which it might achieve good outcomes has received little consideration. LA difficulties in using evidence in telecare commissioning potentially leaves the sector at risk of market capture and supplier induced demand. key messages Social care services in England continue to invest in telecare despite evidence it does not produce better outcomes for older users. Generalizable evidence for telecare effectiveness is not well understood by commissioners/providers. Better use of evidence is needed for telecare to be effective for older people. Without independent evidence there is a risk of ‘market capture’ by manufacturers.
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    Carers’ involvement in telecare provision by local councils for older people in England: Perspectives of council telecare managers and stakeholders
    (Cambridge University Press, 2019-10-08) Steils, Nicole; Woolham, John; Fisk, Malcolm; Porteus, Jeremy; Forsyth, Kirsty
    This paper explores telecare manager and other ‘stakeholder’ perspectives on the nature, extent and impact of family and other unpaid/informal carers’ involvement in the provision of telecare equipment and services for older people. Data used in the paper are derived from a larger study on telecare provision by local councils in England. The paper aims to add to the growing evidence about carers’ engagement with electronic assistive technology and telecare, and considers this in the context of typologies of professionals’ engagement with carers. How carers are involved in telecare provision is examined primarily from the perspectives of senior managers responsible for telecare services who responded to an online survey and/or were interviewed in 2016 as part of a wider study. The perspectives of three unpaid carers were captured in a separate strand of the main study, which comprised more detailed case study interviews within four selected councils. Thematic and comparative analysis of both qualitative and quantitative survey data revealed the varied involvements and responsibilities that carers assumed during the telecare provision process, the barriers that they needed to overcome and their integration in local council strategies. Findings are discussed in the context of Twigg and Atkin's typology of carer support. They suggest that carers are mainly perceived as ‘resources’ and involvement is largely taken for granted. There are instances in which carers can be seen as ‘co-workers’: this is mainly around responding to alerts generated by the telecare user or by monitored devices, but only in those councils that fund response services. Though some participants felt that telecare devices could replace or ‘supersede’ hands-on care that involved routine monitoring of health and wellbeing, it was also acknowledged that its use might also place new responsibilities on carers. Furthermore, the study found that meeting carers’ own rights as ‘co-clients’ was little acknowledged.
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    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).