Physiotherapy - Research Publications
Permanent URI for this collection
Search Results
1 - 10 of 13
-
Item'I know they are not trained in dementia': Addressing the need for specialist dementia training for home care workers(WILEY-HINDAWI, 2020-03)Global population ageing has meant a rapid increase in the numbers of older people with dementia, most of whom live in their own homes. Staying at home is an important determinant of health and well-being. As care needs increase, the quality of community support which older people receive directly influences their capacity to remain in their own homes. While many are supported informally by family carers, formal support provided by home care workers often enables them to remain at home for longer period. However, providing community-based care for people with dementia can be challenging. Workers often lack training in dementia-specific care for clients with increasingly complex needs, and typically work without direct supervision. As the demand for person-centred home care for people with dementia increases, specialist dementia training for home care workers is urgently needed. In this qualitative study, we used in-depth interviews of a purposive sample, comprising 15 family carers and four older people with dementia, to understand the experience of receiving community care. Data analysis was guided by Braun and Clarke's approach to thematic analysis and revealed the following five overlapping themes, relating to home care workers' understanding of dementia, person-centred care, communication and rapport, mutual collaboration, and the influence of organisational constraints on continuity of care. Although participants acknowledged that service providers operated under challenging circumstances, they were frustrated with home care workers' lack of dementia knowledge and inconsistent staff rostering. Conversely, an understanding of the lived experience of dementia, effective communication and rapport, and continuity of care contributed significantly to a positive experience of receiving care. The findings of this study will be used to inform the essential elements of a training program aimed at enabling and empowering a skilled, specialist home care workforce to support older people with dementia to live well at home for as long as possible.
-
ItemFacilitators and barriers to advance care planning implementation in Australian aged care settings: A systematic review and thematic analysis(WILEY, 2019-09)OBJECTIVES: There are many studies investigating implementation of advance care planning (ACP) in aged care around the world, but few studies have investigated Australian settings. The objective of this study was to determine facilitators and barriers to implementation of ACP in Australian residential and community aged care. METHODS: Evidence from Australian studies published between 2007 and September 2017 of ACP in residential and community aged care was sourced from electronic databases using predetermined search strategies. Data were extracted and synthesised using thematic analysis, and summarised according to themes. RESULTS: Nine studies described facilitators and barriers of ACP implementation. Six themes were identified: "Education and Knowledge," "Skills and Training," "Procedures and Resources," "Perceptions and Culture," "Legislation" and "Systems." CONCLUSIONS: A whole of systems approach is necessary to facilitate uptake of ACP in residential aged care settings. More research is needed to understand facilitators and barriers to ACP in community aged care.
-
Item"An ant against an elephant': Retirement village residents' experiences of disputes and dispute resolution(WILEY, 2018-09)OBJECTIVE: To record Victorian retirement village residents' experiences of dispute management and satisfaction levels related to dispute resolution processes. METHODS: Survey distributed to 6500 retirement village residents. RESULTS: Surveys returned from 1876 residents (29% return rate). Most residents rated life in retirement villages as positive (mean 7.9/10), with an association between life satisfaction and management's ability to resolve disputes (rs = 0.44, P < 0.01). Almost 70% of respondents reported issues of concern to management were resolved satisfactorily; 38% were not resolved to residents' satisfaction. One-fifth reported contacting regional managers or higher personnel regarding issues affecting them, with two-thirds of these respondents reporting a negative outcome. Over 30% did not know if their village had dispute resolution processes in place. CONCLUSION: Despite finding retirement village life positive, residents of retirement villages found disputes and dispute resolution processes unsatisfactory and desired change to address these concerns.
-
ItemThe perceptions of translation apps for everyday health care in healthcare workers and older people: A multi-method study(WILEY, 2020-09)AIMS AND OBJECTIVES: To understand the attitudes and perceptions of older people with limited English proficiency (LEP) and healthcare workers to using mobile translation technology for overcoming language barriers in the healthcare setting. BACKGROUND: Australia's cohort of people aged 65 and over has a sizeable population with LEP. In healthcare settings, difficulties with communication may potentially result in inadequate care. Mobile language translation applications have been identified as a potential way to improve communication between patients and healthcare staff when used as an adjunct to professional interpreters in low-risk scenarios; however, the perceptions of the use of mobile translation applications for such communication is unknown. METHODS: A multi-method design was used. Focus group discussions were conducted with older people from culturally and linguistically diverse (CALD) backgrounds and nursing and allied health professionals to understand their perceptions of translation technology. Qualitative data were analysed using inductive content analysis. Qualitative findings were reported using the Standards for Reporting of Qualitative Research (SRQR) checklist. Participants also appraised three existing translation apps via survey and results were analysed using descriptive statistics. RESULTS: Overall, older people from CALD backgrounds (n = 12) and healthcare staff (n = 17) agreed that translation technology could play a role in reducing communication barriers. There was enthusiasm amongst older people to learn and use the technology, while healthcare staff saw the potential to address communication barriers in their own work. Barriers identified by older people and healthcare staff included: accuracy of translation and phrases, possible technological learning curves, risk of mistranslation in high-risk conversation and inability to check accuracy of translation. Fixed-phrase translation apps were seen as more favourable than real-time voice-to-voice mobile translation applications. CONCLUSIONS: Older people from CALD backgrounds and healthcare staff were open to the use of mobile translation applications for everyday healthcare communications. RELEVANCE TO CLINICAL PRACTICE: Translation applications may have a role in reducing language barriers in everyday healthcare communication but context, accuracy and ease of use need to be considered.
-
ItemNo Preview AvailablePhysical Activity and Exercise for Older People During and After the Coronavirus Disease 2019 Pandemic: A Path to Recovery(ELSEVIER SCIENCE INC, 2020-07)
-
ItemIs increased carer knowledge of the health care system associated with decreased preventable hospitalizations for people in the community diagnosed with dementia? A systematic review protocol(BMC, 2018-11-24)BACKGROUND: People living with dementia (PLWD) are admitted to hospital twice as often as those without dementia, for ambulatory care sensitive conditions (ACSC) that could have been managed in ambulatory and primary care settings. PLWD are at greater risk of poor outcomes during and following hospital admission. Compared to those without dementia, they are almost twice as likely to die in hospital and two to three times more likely to experience an adverse event. Although some hospitalizations are clinically necessary, there may be a proportion related to ACSC that could be potentially avoided with additional support and education for PLWD and their carers. This study aims to assess the effectiveness of interventions focused on reducing avoidable hospitalization for PLWD by supporting carers to manage the health care needs of the PLWD, via improved awareness and understanding of health and the healthcare system. METHOD: Scientific and gray literature will be searched using a combination of keywords pertaining to dementia, caregivers, education, and support. Included studies will involve community-dwelling PLWD and caregivers, with interventions aimed at improving carer's understanding of the healthcare system and ability to manage the caregiving role. The primary outcome will be hospitalization related to the PLWD and secondary outcomes will be carer burden, stress, wellbeing, and quality of life. All study designs will be considered. Data from included studies will be analyzed using descriptive statistics and content analysis. If the data permits, we will perform a meta-analysis and subgroup analyses, related to the intervention and participant characteristics. DISCUSSION: This review will provide a comprehensive picture of the knowledge available on the subject and identify knowledge gaps in existing literature. The findings may highlight the lack of existing interventions for PLWD and their carers who live in the community and will help stakeholders to identify needs and develop programs targeted to carers and care recipients that prevent avoidable hospitalization for PLWD. SYSTEMATIC REVIEW REGISTRATION: PROSPERO number: 49655 .
-
ItemExercise interveNtion outdoor proJect in the cOmmunitY for older people - results from the ENJOY Seniors Exercise Park project translation research in the community(BMC, 2020-11-04)BACKGROUND: Many research studies evaluate physical activity interventions for older people in the community, however relatively few successfully promote maintenance of physical activity beyond the completion of the intervention. This study aimed to implement and evaluate the effects of sustained engagement in physical activity on mental, social and physical health outcomes through the use of the Seniors Exercise Park physical activity program for older people (the ENJOY project). METHOD: People aged ≥60 years underwent a 12-week structured supervised physical activity program using outdoor exercise park equipment followed by 6 months unstructured independent use of the exercise park. Participants were assessed at baseline, 3 months and 9 months and completed a test battery evaluating physical activity, physical function and health related quality of life measures. Repeated measures ANOVA was used to compare differences between baseline, 3 and 9 months. RESULTS: Of the 95 participants, 80 (84.2%) completed the 3 months supervised program, and 58 (61%) completed the 9 month assessment (the latter impacted by COVID-19 restrictions). A significant increase in physical activity level was demonstrated following the 12 weeks intervention (p < 0.01). Significant improvements were also demonstrated in all physical function measures (p < 0.01), self-rated quality of life (p < 0.05), wellbeing (p < 0.01), fear of falls (p < 0.01), falls risk (p < 0.01), depressive symptoms (p = 0.01) and loneliness (p = 0.03) at 3 months. At the 9 months follow up, significant improvements from baseline were demonstrated in the frequency, duration and total of physical activity level (p < 0.05), and all physical function measures (p < 0.05), with no decline in these measures from 3 to 9 months. At 9 months, significant changes were observed in the health related quality of life mobility and self care domains with reductions in both fear of falls and falls risk (p < 0.05). CONCLUSION: The Seniors Exercise Park may be an effective modality for improving and sustaining older people's physical function and wellbeing and can be an important public health infrastructure investment in promoting physical activity for older people. Future work should focus on wider implementation of the program and on scaling up this initiative to achieve public health benefit for the community. TRIAL REGISTRATION: Trial registration number ACTRN12618001727235, Date of registration 19th October 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375979.
-
ItemGuidance about age-friendly outdoor exercise equipment and associated strategies to maximise usability for older people(WILEY, 2021-07)Outdoor exercise equipment has become popular as important environmental infrastructure to provide opportunities for physical activity and social connectedness in public settings. With higher sedentary behaviour and physical inactivity reported among older people, infrastructure changes and safe environments that promote older peoples' health and mobility are required. Due to ageing-related functional decline and health conditions associated with ageing, older adults may have special physical needs that require careful consideration when choosing outdoor equipment. However, limited information is available regarding the suitability of the types of exercise equipment for older people. This commentary provides further information on the type of equipment available, its functionality and suitability for older age populations and key considerations for the decision-maker involved in selecting, installing and supporting community use of outdoor exercise equipment. Recommendations on what is required to maximise usability from a system or organisational-based approach using research evidence is also discussed. Older people are more susceptible to the negative influences of their local environment and outdoor neighbourhood conditions. Consequently, the age-friendliness and suitability of the outdoor exercise equipment characteristics, location and settings may facilitate older adults' engagement in physical and social activities.
-
ItemThe Highway of Life: Social Virtual Reality as a Reminiscence Tool(Oxford University Press (OUP), 2020-01-01)A large body of research demonstrates the positive impact that reminiscence activities can have on older adult wellbeing. Within this space, researchers have begun to explore how virtual reality (VR) technology might be used as a reminiscence tool. The immersive characteristics of VR could aid reminiscence by giving the sense of being fully present in a virtual environment that evokes the time being explored in the reminiscence session. However, to date, research into the use of VR as a reminiscence tool has overwhelmingly focussed on static environments that can only be viewed by a single user. This paper reports on a first-of-its-kind research project that used social VR (multiple users co-present in a single virtual environment), and 3D representations of personal artifacts (such as, photographs and recorded anecdotes), to allow a group of older adults to reminisce about their school experiences. Sixteen older adults aged 70-81 participated in a four-month user study, meeting in groups with a facilitator in a social virtual world called the Highway of Life. Results demonstrate how the social experience, tailored environment, and personal artifacts that were features of the social VR environment allowed the older adults to collaboratively reminisce about their school days. We conclude by considering the benefits and challenges associated with using social VR as a reminiscence tool with older adults.
-
Item'We are very individual': anticipated effects on stroke survivors of using their person-generated health data.(BMJ Publishing Group, 2020-09-13)BACKGROUND: Person-generated health data (PGHD) are produced by people when they use health information technologies. People who use PGHD may experience changes in their health and care process, such as engagement with their own healthcare, and their sense of social support and connectedness. Research into evaluating those reported effects has not kept up; thus, a method for measuring PGHD outcomes was previously designed and applied to the exemplar case of Kinect-based stroke rehabilitation systems. A key step of the method ensures that the patient's voice is included. Allowing stroke survivors to participate in the development and evaluation of health services and treatment can inform healthcare providers on decisions about stroke care, and thereby improve health outcomes. OBJECTIVE: This paper presents the perspectives of stroke survivors and clinicians on the anticipated effects of stroke survivors' use of PGHD from a poststroke simulated rehabilitation technology. METHODS: This study gathered the perspectives of stroke survivors and clinicians through three focus groups and three interviews, recruited for convenience. Participants were also asked questions intended to encourage them to comment on the initial items of the patient-reported outcome measure-PGHD. Deductive thematic analysis was performed. RESULTS: This paper has further demonstrated that outcomes of using PGHD can be measured. For instance, stroke survivors described that using PGHD could result in positive, negative and nil effects on their health behaviours. Survivors and clinicians had varying perspectives in three of the six themes presented, and emphasise the importance of allowing stroke survivors to participate in the evaluation of digital health services.