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    Occupational Therapists' Perceptions Of Preterm Children's Academic Difficulties In The Early Years Of Mainstream Schooling
    (Queen Margaret University, 2011) Giatsi Clausen, Maria
    Preterm infants born before 37 weeks of gestation constitute up to 10% of all births, and can display development that, frequently, differs from those of full- term infants. Studies indicate that school children born preterm present with a, generally, higher incidence of performing poorly academically. The present study investigated the perceptions of paediatric OTs regarding the type of difficulties with which children born preterm present, and explored the role of OT. In the first, quantitative part of this study, paediatric OTs completed a postal questionnaire (N=353). The second, qualitative part, used asynchronous, online discussions (N=13), by utilising the virtual environment of WebCT, to further explore the topic. The survey was also designed to capture: • information on the extent of this paediatric population within OT services, and how identifiable and accessible it is • OT practices when working with these children • what informs therapists’ clinical decision making. The discussion groups provided a forum for OTs’ “reflexive comment” on the issues emerging from the questionnaire analysis. Despite sensorimotor and attentional difficulties reaching the highest frequencies, the findings revealed rather a combination of problems in most developmental domains. Writing emerged as the predominant problematic area within the school curriculum. A “persistence” of sensorimotor difficulties throughout the preschool years also emerged. More frequent and/or severity difficulties, more medical issues, a higher co morbidity of SLD with other conditions for the preterm group, were other findings. These insights could lead to a further exploration of the need for differentiating assessment and treatment practices for this group. Occupational therapy was highlighted as particularly “advantageous” for this population due to a number of OTspecific contributions e.g. ability to “detect “subtle” difficulties at a young age. The implications of a “shift” of more OTs into the area of early intervention, are discussed. The findings of the study constitute tacit, professional knowledge, and they are based on subjective clinicians’ views. They could, however, help frame hypotheses to be further explored verified with the use of empirical research. KEYWORDS: Prematurity; Specific Learning Difficulties; Early Intervention; Paediatric Occupational Therapy; School; Clinical Decision Making; Assessment; Intervention; Survey; WebCT; Asynchronous Online Discussions
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    An action research study of Palliative Care for people with A Dementia and their carers
    (Queen Margaret University, 2009) Smith, Stephen D M.
    The objectives of this participatory action research were to: identify the palliative care needs of PWAD and their carers in West Lothian; analyse two dementia care services as they develop practice in the assessment and management of distress for PWAD, and supporting carers; determine implications for practice development and service delivery. Multiple data collection methods were used including; focus groups, interviews, participant observation, reflective accounts, case studies, documentation review, action learning and notes recorded from meetings with staff. The first phase was a dementia palliative care needs assessment. Eight PWAD, 25 carers and 63 service providers participated in interviews and focus groups. Overall findings were that a palliative care approach provided a useful and appropriate framework to understand the needs of PWAD. Recognition of and support for family carers should take a high priority when considering a model for dementia palliative care. More specific needs were identified, these included: the need to develop person centred approaches; enhance the management of pain and distress and enhance individual support for carers. Two services participated in the action phase; a day centre and a hospital ward. Eleven people with a dementia, 28 carers and 86 service providers participated. Services focused on carer support or assessing pain / distress. Carer support findings: implementing an assessment tool enhanced staffs understanding of carers needs; carers preferred flexible and individual support interventions; family carers experienced cumulative factors that restricted access to support. Assessment of distress findings: assessing distress from the behaviour of PWAD was complex. The implementation of the Disability Distress Assessment Tool (DisDAT) identified new evidence that it provided a person centred assessment suitable for PWAD. It was identified that the theoretical concept of relationship centred care, could provide a way of working, that complemented the adoption of a palliative care approach for PWAD, whilst enhancing carer support and assessment of distress practices.