Disability and rehabilitation
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To assess the ability to use and the usefulness of video-elicitation to study risks and potential ways to reduce transfer-related falls in long term care. ⋯ We were able to implement the novel participatory video-elicitation method developed and it was useful to identify risks and risk reduction strategies. Therefore, video-elicitation may be used in future studies to inform the design and testing of interventions to reduce transfer-related falls among LTC residents. Implications for Rehabilitation Falls are common among long term care residents. Visual-elicitation is a useful tool to be used in rehabilitation to assess risks and possible measures to reduce falls. The video-elicitation sessions optimized the ability and engaged residents, health care providers, and family members on providing information and discussing risks and potential measures to reduce transfer-related falls.
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After stroke, physical activity and physical fitness levels are low, impacting on health, activity and participation. It is unclear how best to support stroke survivors to increase physical activity. Little is known about the barriers and facilitators to physical activity after stroke. Thus, our aim was to explore stroke survivors' perceived barriers and facilitators to physical activity. ⋯ Physical activity post stroke can improve physical fitness and function, yet physical activity remains low among stroke survivors. Understanding stroke survivors' perceived barriers and facilitators to physical activity is essential to develop targeted interventions to increase physical activity. Beliefs about capabilities, environmental context and resources and social influences were the mostly commonly report influences on stroke survivors' perceived barriers and facilitators to physical activity.
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This study aimed to clarify the existing service provision of stroke-specific vocational rehabilitation (VR) in one English county, in order to facilitate future service development. ⋯ Stroke-specific VR should be delivered by an integrated, cross-sector multi-disciplinary team and integrated commissioning between health and other sectors is necessary. Although early intervention is important, support later on in the recovery process is also necessary. Service providers need adequate training to meet the needs of stroke survivors wishing to return to work and better awareness of best practice guidelines. Business cases which demonstrate the efficacy and cost-effectiveness of VR are vital. Implications for Rehabilitation The timeliness of a vocational rehabilitation (VR) intervention is complex; services need to be responsive to the changing needs of the stroke survivor throughout their recovery process and have better mechanisms to ensure re-entry into the stroke pathway is possible. Return to work is a recognised health outcome; health services need to develop better mechanisms for interagency/cross sector working and liaison with employers and not assume that VR is beyond their remit. Therapists and non-health service providers should receive sufficient training to meet the needs of stroke survivors wishing to return to work. Rehabilitation teams must decide how to implement national guidance within existing resources and what training is needed to deploy SSVR. The lack of a sanctioned pathway results in disorganised and patchy provision of VR for stroke survivors; mild stroke patients can fall through the net and receive little or no support. The journey back to work commences at the point of stroke. Mechanisms for identifying acute stroke survivors who were working at onset and for assessing the impact of the stroke on their work need to be put in place. The entire MDT has a role to play. In the absence of a VR specialist, even patients without obvious disability should be referred for ongoing rehabilitation with detailed work assessment and signposted to employment specialists e.g. disability employment advisors EARLY after stroke. Health-based VR interventions can influence work return and job retention. However, therapists must routinely measure work outcomes to inform their business case and be encouraged to demonstrate these outcomes to local commissioners. Commissioners should consider emerging evidence of early VR interventions on reduced length of stay, health and social care resource use and the wider health benefits of maintaining employment.
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To explore the perceptions of people with low back pain (LBP) treated within the Spanish National Health Service, and their experience while undergoing a new evidence-based treatment ("neuroreflexotherapy"). ⋯ Southern European LBP patients have similar perceptions to those in other cultural settings. LBP jeopardizes patients' QoL and self-esteem. When pain improves significantly, patients are happy to acknowledge it and resume their normal life. Implications for Rehabilitation People with low back pain (LBP) want to be treated with respect and empathy by clinicians who inspire confidence and refrain from judging them. When faced with a new evidence based treatment, people with subacute and chronic LBP are hopeful, but apprehensive. Most of those who experience a clinically meaningful improvement after treatment are happy to acknowledge it and resume an active and fulfilling life. People who report no improvements after being treated, should be believed.
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To identify the information needs of people with low back pain (LBP) in Australia, and the preferred methods to present this information online, as a basis for development of a patient-centred website. Available online LBP resources are limited in quality and content and it is not clear if they are meeting the needs of sufferers. ⋯ This study provides important guidance for development of a patient-centred website grounded in the expressed needs and preferences of people with LBP. Understanding the breadth of patients' questions and concerns is essential for provision of patient-centred information and interventions. Incorporating these with the current evidence base would provide an accessible and relevant LBP patient education referral point, which is currently lacking. Implications for Rehabilitation Use of the internet to obtain health information is increasing, although there is little evidence that existing low back pain websites are meeting the expressed needs of health consumers. Our research suggests that people with low back pain have difficulty finding relevant and trustworthy information about the condition on the internet. Taking patient information needs and presentation preferences into account when designing online information material will provide people with low back pain an accessible and relevant educational resource that is currently lacking.