https://hdl.handle.net/2123/9312 2026-06-05T08:30:54Z https://hdl.handle.net/2123/33822.3 Home-based, tailored intervention to reduce rate of falls after stroke (FAST): a randomised trial. Data Set Clemson, Lindy; Scrivener, Katharine; Lannin, Natasha; Ada, Louise; Day, Sally; Lin, Ingrid; Isbel, Stephen; Cusick, Anne; Gardner, Benjamin; Preston, Elisabeth; Heller, Gillian; Dean, Catherine M DATA SET for FAST trial. FAST was a two-armed, randomised trial which recruited ambulatory stroke survivors from three states in Australia who were within 5 years of stroke and had been discharged from formal rehabilitation to the community. Between August 2019 and December 2023, 370 people with stroke were enrolled. Primary outcome was rate of falls over 12 months. Secondary outcomes were: proportion of participants experiencing a fall, community participation, self-efficacy, balance, mobility, physical activity, ADL, depression and health-related quality of life. 2026-01-16T00:00:00Z https://hdl.handle.net/2123/32962 Mental health recovery resources Mackenzie, Lynette This is a sample of some interviews produced as part of the mental health recovery project. This was designed for health science students to gain an insight into mental health challenges from the perspective of people with lived experience. 2024-08-16T00:00:00Z https://hdl.handle.net/2123/32819 Home Care Survey Mackenzie, Lynette This survey was used in a large study to determine the level of workplace violence experienced by health workers who visit clients in their own homes. 2024-07-19T00:00:00Z https://hdl.handle.net/2123/29645 Home Falls and Accidents Screening Tool (HOME FAST) Manual Mackenzie, Lynette This is a manual for users of the HOME FAST tool in clinical practice. It includes background materials related to the home environment and falls, theories to underpin the identification of falls risk in the home environment, and the purpose of the HOME FAST. Other chapters involve the psychometric properties of the HOME FAST, scoring the HOME FAST, description of the 25 individual items on the HOME FAST, and copies of the versions of the HOME FAST. 2019-01-01T00:00:00Z https://hdl.handle.net/2123/29095 Rehabilitation and COVID-19: update of the rapid living systematic review by Cochrane Rehabilitation Field as of December 31st, 2021 Negrini, F.; De, Sire, A.; Andrenelli, E.; Lazzarini, S.G.; Patrini, M.; Ceravolo, M.G.; Kiekens, C.; Arienti, C.; Ceravolo, M.G.; Côté, P.; Cusick, A.; De, Groote, W.; Gimigliano, F.; Heinemann, A.W.; Rathore, F.A.; Rizzi, M.; Verheyden, G.; Walshe, M.; Negrini, S.; The International Multiprofessional Steering Committee of Cochrane Rehabilitation REH-COVER action 2022-01-01T00:00:00Z https://hdl.handle.net/2123/21969 Working with cancer: a pilot study of work participation amongst cancer survivors in Western Sydney. Markovic, Cresta; Mackenzie, Lynette; Lewis, Joanne; Singh, Michelle Background: Around forty percent of cancer diagnoses occur in working-age adults. Improvements in screening and treatment means that most are expected to live years beyond their diagnosis. However, many experience persistent impairments from treatment such as fatigue, cognitive difficulties and emotional distress. Work is a key occupation for this population yet little is understood about working with cancer in the Australian context. Aim: This pilot study aims to investigate work participation amongst cancer survivors in Western Sydney and identify factors associated with returning to work. Methods: A cross-sectional online survey was developed to measure work participation and factors associated with work. Study participants aged 20-65 years, employed at diagnosis, with basic English and computer literacy were recruited from a cancer clinic in Western Sydney over a three-month period. Results: Nineteen survey responses were received and analysed. Participants had returned or remained at work (n=9, 47.4%), unsuccessfully attempted to return to work (RTW) (n=2, 10.5%), or were on leave from work (n=8, 42.1%). Of those on leave most did not plan to RTW (n=6, 31.6%). Fatigue (n=15, 78.9%), difficulty concentrating (n=8, 42.1%), memory issues (n=8, 42.1%), stomach upset (n=7, 36.8%), sleep disturbance, (n=7, 36.8%), and psychological distress (n=7, 36.8%) impacted perceived work ability. Physically demanding work (n=8, 42.1%), length of workday (n=6, 31.6%), productivity demands (n=5, 26.3%) and commuting (n=4, 21.1%) were challenging to manage after cancer. Approximately a quarter of participants reported discussing RTW with people other than their employer (n=5, 26.3%). A supportive workplace was a facilitator for work, whereas a non-supportive workplace was considered a major barrier. Overall participants reported positive attitudes towards work. Conclusion: Cancer survivors in Western Sydney may face challenges engaging in work after treatment. Work participation may be influenced by side effects of treatment, difficulty performing work demands and the work environment. 2020-03-27T00:00:00Z https://hdl.handle.net/2123/21104 CERVICAL SPINAL CORD INJURY AND UPPER LIMB ROBOTIC THERAPY Rolfs-Webb, Dinny; Mackenzie, Lynette; Bernad, Lisa; Tan, Emma Abstract. A major debilitating factor of sustaining a cervical level spinal cord injury is the loss of independence in completing activities of daily living as a result of impaired upper limb function. Early intervention has been hypothesised to preserve upper limb function in this population and enhance capacity to perform functional tasks. The use of robotics as an upper limb therapy modality is increasing in the neurorehabilitation field, however there is limited evidence to support their use in the cervical spinal cord injury population. Despite this, occupational therapists are using them as part of a therapy program. Aim: This study aimed to explore the upper limb outcomes of using a computer assisted robotic device in acute therapy for people who have sustained a cervical spinal cord injury. Methods: A single case pre-post study design was performed with one middle aged male who had who was an inpatient at a public metropolitan hospital in Australia. They undertook a three week therapy program using the Diego by Tyromotion in conjunction with standard occupational therapy interventions. Range of motion, muscular strength, pain, fatigue the Spinal Cord Independence Measure, and the Canadian Occupational Performance Measure were used as outcome measures. Results: Increases were seen in range of motion and muscular strength and functional status; objective and subjectively. Conclusion: Preliminary findings suggest that the Diego may be a useful tool for improving upper limb outcomes when combined with occupational therapy in this population, however greater research and participants are required for definitive data. 2019-09-11T00:00:00Z https://hdl.handle.net/2123/21105 The impact of non-pharmacological cancer-related fatigue interventions on activity performance and participation outcomes in adult cancer survivors: A systematic review. Schroder, Jodie; Mackenzie, Lynette Introduction: Increased cancer survivorship means more people are living with cancer-related fatigue (CRF). CRF is the most distressing symptom survivors experience and is associated with activity performance limitations, restricted participation in meaningful life roles and reduced quality of life. Occupational therapists have skills relevant to fatigue management, however, the role of occupational therapy in CRF management is unclear. Synergies between the focus of occupational therapy on enabling participation in everyday life and challenges experienced by survivors living with CRF suggests opportunity for considerable occupational therapy involvement in CRF management. Thesis overview: This thesis contains two sections, a literature review and a systematic review study. The literature review examined and critiqued existing research exploring the experience of survivors living with CRF, current occupational therapy involvement within CRF management and identified an evidence gap pertaining to participation within CRF research. Subsequently, the systematic review study presented in section two of this thesis aimed to identify whether existing non-pharmacological interventions effective in minimising CRF also had an impact on everyday activity performance and participation outcomes for adult cancer survivors. Study methods: The study was a systematic review with narrative synthesis. Eight databases were searched (Medline, CINAHL, PsychINFO, EMBASE, Scopus, OT Seeker, CENTRAL, Cochrane SR database), from 1998-2018 and limited to randomised controlled trials (RCTs) published in English. Study results: A total of 29 studies met selection criteria and were included in the review. Four intervention categories were identified: physical activity, psychosocial, multi-modal and ‘hands on’ therapies. In 28 studies (97%) quality of life, not participation or activity performance, was investigated as a primary or secondary outcome. Correspondingly, instruments measuring quality of life were used in 28 studies (97%). Three studies (10%) used additional instruments to measure participation, however, outcomes were not always reported. No obvious pattern of impact was identified between intervention type and survivors’ quality of life subscale data. Conclusion: Findings of this review indicate there is insufficient evidence to determine whether survivors’ activity performance and participation is impacted by CRF interventions. Consideration of the sensitivity and precision of quality of life instruments to measure activity performance and participation should be incorporated into future CRF research designs. 2019-09-11T00:00:00Z https://hdl.handle.net/2123/21103 Computer Assisted Robotic Therapy for Incomplete Spinal Cord Injury: Can it work in the acute setting? Aram, Simsar; Mackenzie, Lynette; Bernad, Lisa; Tan, Emma Problem: Computer assistive robotic therapy is an innovative treatment offering an interactive experience that may benefit individuals with spinal cord injury, however it is not known if such a treatment is feasible in the acute setting. Aims: To assess the experience of individuals and practitioners during the process of implementing computer assisted robotic therapy and to determine the feasibility of using such a therapy during acute rehabilitation. Methods: To accomplish the aims of this study a qualitative feasibility study was carried out, consisting of semi-structured interviews (N=4) with a participant, their partner and the administering practitioners at a public hospital in a metropolitan area of Australia. These interviews were conducted using a guide created to ensure comprehensive and rich responses. These responses were then transcribed verbatim and thematic analysis was completed using NVIVO 11. Established feasibility constructs were then related to the exposed themes. Results: This study provided qualitative findings on the implementation of computer assisted robotic therapy with a patient with cervical spinal cord injury and interrelated these findings with theoretical constructs relating to feasibility. Conclusion: High demand for computer assisted robotic therapy both from patients and practitioners was reported along with many potential benefits especially regarding participant immersion, motivation and engagement. However, the practicality of such a treatment is complicated by prohibitive costs, time constraints and the vulnerable state of patients. Consequently, when considering current protocol, computer assisted robotic therapy may not be feasible in acute spinal cord rehabilitation. More rigorous research is suggested to support this therapy given the context. 2019-09-11T00:00:00Z https://hdl.handle.net/2123/21106 Occupational Therapy Handwriting Practice in South Korea Lee, Siwon; Cusick, Anne Background. Internationally, handwriting difficulty is a common issue among children. Occupational therapists are involved in helping children to improve their handwriting. Previous studies have summarised occupational therapy research and practice in handwriting, but these have not included information about occupational therapy practice for children’s handwriting in South Korea. To understand the nature of practice and identify the scope of evidence relating to South Korean occupational therapy for children with handwriting difficulties, a review of published literature on this topic is required. Methods. A scoping review was conducted to identify and summarize published literature on occupational therapy paediatric handwriting practice in South Korea. A detailed context of the review was provided in a background chapter (Chapter 1 “Introduction”). The introduction provided comprehensive information about the hand, handwriting, South Korea and the occupational therapy profession in South Korea to define terms and to help provide an understanding of occupational therapy practice conducted in Korea.  Chapter 2 “A scoping review of occupational therapy handwriting literature” is presented in the form of a manuscript for submission to a peer-reviewed journal (Occupational Therapy International). This background, the gap in evidence and research design used is presented. This study used a scoping review methodological framework suggested by Arksey and O’Malley (2005). This five-step framework was followed. First, the research question was identified; second, a search strategy was designed in Korean and English, and implemented in three databases which published or may have published Korean occupational therapy research. Third, after inspection a total of 22 articles were selected for inclusion from 151 sources. Fourth, a data-extraction form in Excel™ was created and this recorded the characteristics of each of these studies. At the last stage, a descriptive analysis of numerical data and thematic analysis were used to collate, summarise and synthesise the data from the 22 included papers. Results. Key findings of the scoping review demonstrate that hospitals and school-based settings were the most commonly studied service sites. Most studies were with Korean children with cerebral palsy. Standardized assessments were predominantly used, and these measured various performance components, rather than the “task” or “activity” of handwriting. Author-designed handwriting assessments which were reported to be based on previous studies were frequently used for measurement of handwriting quality. These did not ⅳ go through standardisation or validation processes. A sensory integration approach was the most popular approach to intervention, and the most targeted performance component of handwriting was fine-motor skills. Most study designs were of low research rigour in the evidence-based hierarchy. This study highlights that there is a diverse approach to assessments and intervention in Korean occupational therapy handwriting research, indicating that there is no consensus on the best handwriting approach in Korean occupational therapy literature. Conclusion. Most of the found evidence was focussed on clinical samples and used a sensory integrative approach. This is different to international occupational therapy research literature (which used standardised instruments) which focused mostly on typically developing children and used a wide number of conceptual approaches. Korean research was similar in the low level of research evidence generated. In the future, Korean occupational therapy handwriting research should use rigorous designs and should use assessments to accommodate the cultural and linguistic uniqueness of Korea. This will provide more opportunities to enhance the diversity of evidence on handwriting research. 2019-09-11T00:00:00Z https://hdl.handle.net/2123/20258 Participant information statement for online HOME FAST project Mackenzie, Lynette 2019-04-08T00:00:00Z https://hdl.handle.net/2123/20253 The reliability of an outcome measure for animal assisted therapy in youth with Autism Spectrum Disorder Dennehy, Alessandra; Mackenzie, Lynette; Lovarini, Meryl A reliable outcome measure is crucial to understand the impact of emerging interventions, such as animal assisted therapy (AAT) for individuals diagnosed with Autism Spectrum Disorder (ASD). A video analysis tool was created to measure the impact of AAT on people with ASD by recording the frequency and duration of positive, play and negative behaviours. This study aimed to determine the inter-rater and test re-test reliability of the video analysis tool and to investigate if session complexity and eater factors influenced the reliability of the tool in this population. Following training in the use of the tool, 23 occupational therapy students from an Australian metropolitan university rated a simple or complex video-recorded AAT session on two occasions. The raters also completed a survey to obtain demographic information. Expert raters determined acceptable score ranges which were compared with collected data in SPSS to determine Intraclaas Correlation Coefficients ( ICC). The ICCs of the video analysis tool were 0.84 (simple session) and 0.894 (complex session ) for inter-rather and 0.84 (simple session) and 0.89 (complex session) for test re-test reliability. The percentage agreement was similar regardless of session complexity and rater experience with children and ASD but varied across subscales and rater animal experience. This study indicates the video analysis tool has potential as a reliable outcome measure for AAT with individuals with ASD, however further research utilising increased sample sizes is required to establish the effectiveness of the tool. 2019-04-07T00:00:00Z https://hdl.handle.net/2123/20254 Measuring quality of life following neurosurgical treatment for brain tumour patients Tadle, Angelica; O'Donnell, Joan 2019-04-07T00:00:00Z https://hdl.handle.net/2123/20252 Parent perspectives:The value of trained dogs in animal assisted therapy for children and adolescents with Autism Spectrum Disorder Richardson, Kathleen; Mackenzie, Lynette; Lovarini, Meryl Dogs may elicit positive therapy outcomes for children with Autism Spectrum Disorder (ASD). Despite growing research into Animal Assisted Therapy (AAT) for ASD, the parent perspective has not yet been fully engaged. This study aimed to explore parent perspectives regarding AAT. Sixteen semi-structured interviews were conducted with parents following their child's completion of an AAT program. Thematic analysis, line by line coding and consensus theme refinement were used for data analysis. Three themes emerged. Parents valued that the dogs supported their child: stress and anxiety management; engagement and participation; and social-communication. Parents valued the dogs as having a calming effect that facilitated child participation in several life-skill activities and social-communication. Future studies should investigate how best to target AAT with dogs for children with ASD. 2019-04-05T00:00:00Z https://hdl.handle.net/2123/19815 The understanding and experience of falls among older people living in the community with mental illness: A qualitative study Koh, Ling; Mackenzie, Lynette; Lovarini, Meryl Introduction: Compared to the general older population, older adults with mental illness living in the community have an increased risk of falls. However, little is known about falls experienced by this group. This study aimed to explore the understanding and experience of falls from the perspectives of older adults living in the community with mental illness as well as to identify any falls prevention strategies valued by them. Methods: Ten consumers aged 50 and over with experiences of falling were recruited at a community mental health service in Sydney ( four male and six female; mean age 70.4 years). An audiotape, semi-structured interview was conducted with each participant. Recordings were transcribed verbatim and data were thematically analysed using Nvivo11 software to identify key themes. Results: Four major themes were generated: 1. Making sense of falls, 2. Being self reliant, 3. Enduring the consequences of falls, and 4. Preventing future falls - perceptions and strategies. Conclusion: Most participants were uncertain about the cause of their falls and seemed to not understand their falls risks. They were also less likely to seek help after a fall, despite injuries. Consequences of falls included physical injury negative emotional impacts. Most participants expressed concern about future falls, however their strategy to prevent falls was simply to be careful. Future occupational therapy practice should focus on designing targeted fall prevention approaches tailored to the needs of this group of older adults. 2019-01-21T00:00:00Z https://hdl.handle.net/2123/18337 Systematic review (and meta-analysis) of interventions studies with GP involvement in falls prevention for community dwelling older people Beavis, Anne-Marie; Mackenzie, Lynette; Clemson, Lindy; Tan, Amy Falls are a significant health problem for the ageing population as health outcomes decline as 30% of people over the age of 65 experience at least one fall annually. Prevention interventions are well established in the literature but falls continue in high numbers in Australia, in line with global trends. General practitioners are well situated to reduce falls for community dwelling older people but research is unclear which interventions are effective in the general practice context. Using a systematic review methodology with meta-analysis this review has addressed the question of which interventions are applicable in the general practice context. This study has identified falls risk screening, medication screening and management, and general practitioner training and education to be effective interventions to reduce falls in older people. 2018-06-07T00:00:00Z https://hdl.handle.net/2123/18338 The Lived Experience of Refractory Breathlessness Tieck, Kezia; Mackenzie, Lynette; Lovell, Melanie Introduction: Refractory breathlessness is breathlessness at rest or on minimal exertion that persists chronically even with optimal treatment of the underlying cause. Despite its burden and prevalence globally, symptoms remain under-treated and under-researched and those affected struggle daily with the condition. Aim: The aim of the study was to gain a greater understanding of the lived experience of refractory breathlessness. Also, it was anticipated that a deeper insight into its impacts on daily activities would allow more effective occupational therapy interventions to be developed. Method: A qualitative phenomenological approach using NVivo software, with one-on-one, semi-structured interviews and themes established through thematic analysis. The study recruited consecutive patients until thematic saturation was reached. Participants were recruited from a Sydney-based outpatient Breathlessness Clinic at a palliative care hospital. Results: 6 participants were interviewed and 4 main themes identified. 1) Living on the Edge, referring to the extreme feeling of breathlessness experienced by patients; 2) Social Needs, describing the significance of social support; 3) Reduced to the Basics, referring to the effect breathlessness has on basic daily tasks, and 4) Sources of Security, which describes the measures participants take to protect themselves from their own breathlessness. For each of the four themes, three to five subthemes were also identified through the analysis. Conclusion: Of the 4 themes identified in this study, number 3 and 4 may represent the best targets for occupational therapy interventions. Patients noted the importance of functional participation for improved engagement and quality of life. There is scope to develop specific interventions for self management and equipment prescription given lack of published literature in this area. 2018-06-07T00:00:00Z https://hdl.handle.net/2123/17982 Factors Associated with Falls Self-Efficacy in Community Dwelling Older Adults Johnson, Brianne BACKGROUND: This thesis will include a literature review and journal manuscript to be submitted to the Australasian Journal on Aging. Accidental falls affect 27% of older Australians each year and cost the government $558.5 million. Falls self-efficacy can be used to understand the concern older people have for falling while doing different activities. AIMS: This paper aims to investigate associations between falls self-efficacy and other health related factors in community-dwelling older adults. METHODS: A quantitative, cross-sectional study was conducted with 560 older adults in the Sydney North Primary Health Network (SNPHN) through completing an interview style questionnaire that included questions about falls history, the Short Falls-Efficacy Scale- International (FES-I), physical activity, social participation, health service use, comorbidities, and medications. The data was analysed through descriptive and inferential statistics. RESULTS: Significant factors associated with increased concern for falling as rated by the FES-I were being injured in a past fall, having a walking aid, physical activity, social participation, being hospitalized in the past month, number of comorbidities, and number of medications, though these relationships were all weak (r<0.300 and r>-0.300). Multiple linear regression found that having or using a walking aid, having a higher number of comorbidities, having panic or anxiety disorders, and being concerned about falling were predictors of FES-I score. CONCLUSIONS: Having a healthy level of respect for the risk of falls as people age is essential to healthy ageing. Falls self-efficacy is a valid measure of the concern that community-dwelling older adults have about falling, and understanding falls self-efficacy can be used to implement more effective falls prevention strategies. 2018-03-14T00:00:00Z https://hdl.handle.net/2123/17981 Evaluating the effectiveness of the Training in Interaction, Communication and Literacy (TICL) program in primary schools: A mixed-method pilot study Alshare, Heba Background: The increasing diversity of children in today’s classrooms is posing complex considerations for teachers when designing instructions to support the learning needs of all students with and without disabilities in regular classrooms. Theoretical evidence recognises inter-professional collaboration and coaching as useful approaches to assist teachers in developing inclusive education competencies and integrating therapeutic strategies into classroom routines. However, there are limited empirical studies to support the link between coaching and positive changes in teachers’ practices and students’ outcomes. The Training in Interaction, Communication and Literacy (TICL) is a 10-week coaching program delivered by trained speech-language pathologists (SLPs) and/or occupational therapists (OTs) to support the Continuing Professional Development (CPD) of teachers in three skill areas: interaction, communication and literacy; in order to facilitate the children’s learning in these areas. TICL was originally developed for a pre-school setting, but has been adapted and implemented in primary schools. Aims: This pilot study aimed to evaluate the effectiveness of TICL for integrating speech-language strategies into classroom teaching practices at two primary schools in Sydney, Australia, and to explore the experiences of participating teachers to accommodate TICL to primary-school settings. Methods: This study utilised a mixed-method approach. Focus group interviews were the primary data sources conducted to understand the experiences of participants, and analysed using inductive analysis. Nine teachers participated in the focus group interview at school 1, and three teachers participated in the focus group interview at school 2. The Interaction, Communication and Literacy (ICL) Skills Audit was used as a self-assessment tool to measure change in the participants’ confidence across six skill areas and related 18 sub-skills through pre-post data. Descriptive analysis of this pre-post quantitative data was conducted. Findings: Quantitative data analysis showed a statistically significant improvement in the participants’ confidence in nine sub-skills of the ICL Skills Audit (P-value < 0.05). Results showed that the majority of participants across the 18 sub-skills either improved in their confidence or did not change. On very few occasions, the participants’ confidence decreased. Focus group interviews revealed that (a) The relationship between participants and TICL coaches crossed over from feeling judged to reflecting on teaching practices through a collaborative approach, (b) The ICL Skills Audit was a useful reflective tool that raised the participants’ awareness of their existing teaching skills, (c) TICL facilitated the participants’ learning through modelling and coaching in context., (d) the need to further discuss family involvement in TICL, and (e) TICL needs to be more literacy-based to accommodate the nature of primary classes. Conclusion: There is a critical need for improved collaboration between teachers and SLPs/OTs to address diverse literacy needs of all children in classroom. This study showed that TICL coaching could be a promising approach to incorporate therapeutic strategies into teaching practices. Future long-term research is recommended with a larger sample to evaluate the effectiveness of TICL for integrating therapeutic strategies into teaching practices in primary schools. 2018-03-14T00:00:00Z https://hdl.handle.net/2123/17795 Beyond Breast Cancer: An exploration of the experiences of middle-aged female breast cancer survivors in Australia. Campbell, Bridie Objective: Middle-aged women (40 – 65 years) who live with, through and beyond breast cancer (survivors), are a relatively under-researched population group, particularly within an Australian context. The unmet needs reported within this population include fatigue, psychological distress, body image concerns, early onset menopause, and a lack of information of these issues. The present study aims to explore how the experiences of breast cancer survivorship impact the lives of Australian middle-aged women (n = 644), and to inform future provision of care and support. Methods: This qualitative study used secondary survey data from the Australian Longitudinal Study of Women’s Health (ALSWH) middle-age cohort gathered between 1996 – 2013. Researchers conducted a thematic analysis using consensus coding on data collected from participants in this group who reported breast cancer (including metastasised) in any survey. Results: This cohort reported a unique experience of breast cancer survivorship due to their age. Analysis developed the following themes: the middle-aged context of breast cancer; care and support, body changes, overcoming fears and maintaining balance; and finding a ‘new normal’. Conclusions: Breast cancer survivorship is a subjective experience; for many it involves chronic limitations and challenges. Investigation and application of survivorship care plans in Australia would benefit from greater inclusion of multidisciplinary professionals. This will help satisfy heretofore unmet information needs and associated psychological distress of breast cancer survivors which go above their biomedical concerns. Further recommendations include development of online support groups providing access to rehabilitation professionals, especially for otherwise isolated rural women. 2018-01-29T00:00:00Z https://hdl.handle.net/2123/17800 Outcomes of Dog-Assisted Therapy for Children and Adolescents with Autism Spectrum Disorder Clark, Brianna This study evaluated the outcomes of dog-assisted therapy for children and adolescents with Autism Spectrum Disorder (ASD). Secondary aims were to understand needs of youth with ASD and to evaluate therapy procedures. This study used a one group pre-post design. Thirtyfour individuals with ASD aged between 4 and 19 attended five weekly sessions of dogassisted therapy. The Autism Treatment Evaluation Checklist (ATEC) and Social- Responsiveness Scale 2 (SRS-2) assessment tools were used to evaluate changes in autistic behaviour and social impairment, respectively. Final sessions were rated on activity-specific dog involvement, participant independence and engagement. Findings indicated no significant difference between ATEC or SRS-2 pre- and post-test scores. Further studies with experimental designs and longer treatment duration are warranted to clarify efficacy of dogassisted therapy for ASD. 2018-01-29T00:00:00Z https://hdl.handle.net/2123/17799 Animal Assisted Therapy for Children and Adolescents with Autism Spectrum Disorder: Parent Perspectives Condon, Maeve Doyle Background/aim: Animal Assisted Therapy (AAT) is a promising intervention for Autism Spectrum Disorder (ASD), but requires further research. This study aims to explore the parent perspective of the therapeutic impact of five AAT sessions on their children with ASD. Method: A phenomenological qualitative approach was used to access first-hand parent perspectives. In-depth, semi-structured interviews were conducted and a thematic analysis was consensus coded using NVIVO. Findings: Seventeen parents participated in the study. Participants reported the presence of the dogs engendered engagement, enjoyment, and motivation within their children. This reportedly contributed to gains in communication, regulation, and community access. Conclusion: Findings indicate that parents support the use of AAT for children with ASD. Dogs as nonverbal and nonjudgmental therapy partners facilitated therapeutic gains. 2018-01-29T00:00:00Z https://hdl.handle.net/2123/17796 Current methods in cancer-related cognitive change intervention: A systematic review with meta-analysis. Marshall, Kelsey Purpose Cancer-related cognitive change (CRCC) is a condition that is observed in a large proportion of cancer survivors, impacting activities of daily living and overall wellbeing. Objectives of this study were to identify and categorise interventions previously trialled to manage CRCC, and to analyse the impact of these interventions. Methods This study was a systematic review with meta-analysis. A search of six databases was completed, including years 2007-2017 and limited to randomised control trials (RCTs) published in English. Meta-analysis was accomplished using Comprehensive Meta-Analysis software. Results A total of 23 studies were identified that presented interventions for CRCC and met selection criteria. Interventions fell into three categories: cognitive training based intervention, cognitive behaviour therapy (CBT), and alternative/complementary therapies. Overall, CBT interventions had no significant impact on cognitive functioning, while the other categories significantly improved cognitive performance. Conclusions The findings of this study suggest that current research into intervention options for the management of CRCC is limited in scope, however suggests that alternative and complementary therapies are both effective and accessible to cancer survivors. Further, based on current research, CBT is not recommended as an effective CRCC intervention. Implications for Cancer Survivors This study provides insight into current options for the management of CRCC, which may improve the lives of those who experience it. The findings are significant to inform clinical practice and assist practitioners in recommending interventions. Awareness of limitations in the scope of the research, and the financial and time burdens associated with interventions will allow practitioners to make informed decisions around these recommendations. There is need for further, high-quality research in this area that addresses the broader population of cancer survivors. 2018-01-29T00:00:00Z https://hdl.handle.net/2123/17635 Home Falls and Accidents Screening Tool (SR) Mackenzie, Lynette; Hassani Mehraban, Afsoon The HOME FAST-SR is a self report version of the Home Falls and Accidents Screening Tool. It contains more detailed items to assist an older person to make their own evaluation of their falls risk due to home hazards in their home environment, compared to the HOME FAST - HP which is designed for use by health professionals. This document also includes instructions for how to transform the data from the HOME FAST-SR to the equivalent HOME FAST-HP score. 2017-12-05T00:00:00Z https://hdl.handle.net/2123/16304 Breast Cancer Screening Practices and Associated Factors among Chinese-Australian Women Living in Sydney Wang, Lei; Hossain, Syeda Zakia; Mackenzie, Lynette In Australia, early detection plays a leading role in reducing mortality from breast cancer. Little is known about how Chinese-Australian women engage in breast cancer screenings. This study aimed to investigate breast cancer screening practices and the associated factors amongst Chinese-Australian women. A cross-sectional quantitative method including convenient and snowball sampling was used to recruit 115 Chinese-Australian women living in Sydney (aged 35 years and older). The data was collected by self-administered questionnaires between July and September 2016. The results showed that the majority of participants performed breast self-examinations (78.1%), clinical breast examinations (69.8%) and mammograms (73.3%). Educational level was positively associated with having a breast self-examination. Age, religion, employment status and length of residence were significantly associated with performing a clinical breast examination. Income was related to having a mammogram. Significant associations between knowledge of breast cancer, cancer-related beliefs, and screening participation were also found. The length of residence was the strongest predictor of having a clinical breast examination and mammogram. The most common barrier to mammography screening was that doctors did not recommend it to participants. These findings can be used to develop tailored programs to promote the early detection of breast cancer among Chinese–Australian women. 2017-02-02T00:00:00Z https://hdl.handle.net/2123/16305 An evaluation of the falls prevention practice of community-based allied health professionals working in primary care Price, Thomas; Mackenzie, Lynette; O'Connor, Claire Objectives: This study aimed to explore allied health professional’s (AHP) current practice and understanding of falls prevention and to investigate self-reported change following a professional development workshop. Methods: Four professional development workshops were designed targeting exercise, home safety interventions, the LiFE program and medication reviews. Self-reported surveys were collected pre, post and at three-month follow-up. Results: Seven workshops were run in Northern Sydney with 161 participants. AHP identified practice barriers were regularly assessing falls risk and collaborating with other service providers. At three months, change in practice was reported by participants in the exercise (88.1%), home safety (48%), LiFE (78.6%), and medication review (62.5%) workshops. Discussion: These findings provide good support for the effectiveness of professional development workshops in knowledge translation for medication review and exercise based interventions. Further studies and initiatives into promoting screening for falls risk and greater collaboration between community service providers is recommended. 2017-02-02T00:00:00Z https://hdl.handle.net/2123/16256 Unveiling the Concept of Person-centered Dementia Care within Occupational Therapy in Residential Aged Care Facilities: A Critical Interpretive Synthesis Shen, Xizi Background: People with dementia living in residential aged care facilities are at risk of being deprived of occupational engagement. The link between occupational therapy and meaningful engagement of residents with moderate to advanced dementia has been established. Concepts regarding person-centered dementia care are adopted as the guiding principle for service providers in this field. However, it is unclear how occupational therapists embrace the essence of person-centered dementia care when promoting meaningful engagement of residents with moderate to advanced dementia. This study thus aims to explore how person-centered dementia care is presented from an occupational therapy perspective. Methods: Thirty peer-reviewed articles were used as the source sample for this study. A critical interpretive synthesis was conducted to critically consider the power structure underpinning occupational therapy practice in residential dementia care. Evidence pertaining to occupational therapy practice was integrated and analyzed using concepts regarding occupational justice and themes of doing, being, becoming, belonging, and co-occupation to generate synthesis. Results: This synthesis indicated that occupational therapists enhance occupational justice in residential dementia care by increasing access to meaningful engagement and enabling participation of residents in doing, being and belonging at the level of co-occupation where interdependence between residents and mainly staff members is 28 fostered. However, the becoming domain of occupation has not been comprehensively addressed. Thus, the needs of residents for continual growth and development as occupational beings have not been fully addressed by the current occupational therapy practice in residential dementia care. Conclusion: This finding suggests expanding the role of occupational therapists to empower people with moderate to advanced dementia to enact and build on continuing opportunities for agency. 2017-01-25T00:00:00Z https://hdl.handle.net/2123/16255 The invisible malady: a critical review of the quality of instruments to measure cancer-related cognitive changes (CRCC) in women with breast cancer Nunn, Hannah; Mackenzie, Lynette Purpose: The purpose of this critical review was to determine what assessment instruments are potentially available for identifying cancer related cognitive changes (CRCC) in women with breast cancer. It sought to determine valuable psychometric properties to be considered when approaching assessment tools for clinical use in this population. Methods: A replication of a scoping review (originally conducted in February 2013) was performed in order to identify potential instruments. Searches were completed in eight databases to: (a) identify any new literature from 2013 to 2016, (b) identify instruments that may have clinical utility for the use of practitioners and (c) extract evidence for psychometric properties of the identified measures. Critical analysis of both the studies and the instruments identified within the studies were undertaken in order to assess quality of research. Results: Twenty-two studies were identified, with a total of nineteen assessment instruments potentially available for use with the breast cancer population. Four instruments were identified as having the strongest psychometric properties and potential availability for current clinical utility. Conclusions: Results indicate a lack of consideration for psychometric properties when selecting an instrument for the assessment of CRCC in research studies. These results indicate that clinician’s ability to identify issues relating to CRCC in a standardised way is impacted, thus impeding the development of evidence-based care plans for individuals recovering from breast cancer. 2017-01-25T00:00:00Z https://hdl.handle.net/2123/15938 Non-OT HOME FALLS AND ACCIDENTS SCREENING TOOL (HOME FAST) Mackenzie, Lynette This is an adapted version of the original HOME FAST designed to be used by people without an occupational therapy background 2016-11-21T00:00:00Z https://hdl.handle.net/2123/15810 How do occupational therapy curricula align with priorities identified by occupational therapists to prepare graduates for working in mental health? Scanlan, Justin Newton; Pepin, Genevieve; Ennals, Priscilla; Meredith, Pamela J.; Haracz, Kirsti; Webster, Jayne S.; Wright, Shelly; Arblaster, Karen; The ANZOTMHA network All professional preparation programs need to ensure that university curricula remain reflective of current practice, and also prepare graduates for practice in the future. Upon formation, the Australia and New Zealand Occupational Therapy Mental Health Academics (ANZOTMHA) network identified that there was insufficient or poorly organised information available about how well current occupational therapy curricula prepared students for practice in the field of mental health. One of the first priorities established by ANZOTMHA was to undertake a program of research to examine this issue. The aim of this report is to summarise and integrate the outcomes of two inter-related studies to explore the extent to which current occupational therapy university curricula in Australia and New Zealand match educational priorities identified by practising occupational therapists in mental health. 2016-10-25T00:00:00Z https://hdl.handle.net/2123/15642 Cancer Survivorship Survey Instrument for Occupational Therapy study Buckland, Nicole; Mackenzie, Lynette This survey was used as part of a project to define the role of occupational therapy in cancer survivorship 2016-09-12T00:00:00Z https://hdl.handle.net/2123/15257 Recovery Assessment Scale - Domains and Stages (RAS-DS) Manual - Version 2 Hancock, Nicola; Scanlan, Justin Newton; Bundy, Anita C.; Honey, Anne Manual to guide administration of the Recovery Assessment Scale - Domains and Stages (RAS-DS). The RAS-DS has 38 items or statements for the consumer to rate. It is a Likert scale with 4 rating categories for consumers to select from: “untrue”; “a bit true”; “mostly true” and “completely true”. The items have been divided into 4 recovery domains: Doing Things I Value (functional recovery); Looking Forward (personal recovery); Mastering My Illness (clinical recovery) and Connecting and Belonging (social recovery). 2016-07-05T00:00:00Z https://hdl.handle.net/2123/14750 The Home Falls and Accidents Screening Tool (HOME FAST) Mackenzie, Lynette The HOME FAST is a tool designed to identify older people at risk of falling because of hazards within their home environment. The tool consists of 25 items, and a higher score indicates a higher risk of falling. The following references provide evidence of the psychometric properties if the HOME FAST: 1. Mackenzie, L., Byles, J., & Higginbotham, N. (2002). Reliability of the Home Falls and Accidents Screening Tool (HOME FAST) for measuring falls risk for older people. Disability and Rehabilitation, 24, 266-274. 2. Mackenzie, L., Byles, J., & Higginbotham, N. (2002). Professional perceptions about home safety: Cross-national validation of the Home Falls and Accidents Screening Tool (HOME FAST). Journal of Allied Health, 31, 22-28.47. 3. Mackenzie, L., Byles, J., D’Este, C. (2009). A longitudinal study of the Home Falls and Accidents Screening Tool (HOME FAST) to predict falls in older community dwelling people. Australasian Journal on Ageing, 28, 64-69. 4. Vu, V., & Mackenzie, L. (2012). The inter-rater and test retest reliability of the Home Falls and Accidents Screening Tool. Australian Occupational Therapy Journal, 59, 235-242. 2000-01-01T00:00:00Z https://hdl.handle.net/2123/14462 Exploring the integration of behavioural experiments into eating disorders treatment Machina, Machina; Scanlan, Justin; Wheatley, Jessica This dissertation explores the value and usefulness of behavioural experiments in the treatment of eating disorders. The dissertation is presented as two components: • Section One: A literature review • Section Two: A journal manuscript The literature review provides background on the characteristics, aetiology and prevalence of eating disorders, empirical evidence of current treatment approaches, and empirical evidence of the efficacy of behavioural experiments. The review also details the role of maladaptive assumptions and beliefs on the development and maintenance of eating disorders, specifically for the purpose of highlighting the need for further investigation into the treatment potential of behavioural experiments. The findings of the literature review informed the conceptualization and design of the research study, a qualitative study with an exploratory approach. Qualitative data in the form of Behavioural Experiment – Practical Food Group record sheets were analysed to investigate the value and usefulness of behavioural experiments in the treatment of eating disorders. The second section of this dissertation is a journal manuscript of the research study. It contains the findings of the study and the clinical implications of this research. This research manuscript will be submitted to the Journal of Eating Disorders. 2016-03-03T00:00:00Z https://hdl.handle.net/2123/14322 Goal setting with older people in acute care before and after discharge: Occupational therapists' perspectives Docker, Melissa; Mackenzie, Lynette; Clemson, Lindy Background: The World Health Organisation identified that there is an increased risk to elderly of readmission to hospital following an acute hospital admission due to decreased function and deconditioning during hospitalisation. As such, researchers have reviewed the discharge process of older adults to identify areas for potential improvement. The aim of this study was to explore the experiences of occupational therapists during goal setting in acute aged care in Australia and to determine whether implementing training and a structured goal setting procedure such as the HOME protocol is feasible and beneficial. Method: This study used a phenomenological study design and semi-structured interviews. Four therapists who participated in the HOME trial were recruited from New South Wales and Victoria. Interviews were conducted by telephone and focused on the therapist experiences of goal setting before, during and after the HOME study. Interviews were recorded and transcribed verbatim. Thematic analysis of the interview data was conducted and involved coding, data reduction, categorisation and determining themes and relationships. Results: Results suggested three themes related to goal setting in acute aged care: (a) developing client-centred goals, (b) the therapist experience and training and (c) the ideal goal setting practice. However, therapists perceived that the reality of practice puts a number of pressures on them when setting goals in order to manage the return home for older persons – as such, some elements of best practice in goal setting must be forfeited. Conclusions: Goal setting in acute aged care in Australia is complex and therapists face many of the same challenges as those in other western countries. Furthermore, therapists found structured goal setting frameworks to be beneficial, however, felt that they are not feasible in the current context of practice. 2016-02-05T00:00:00Z https://hdl.handle.net/2123/14323 Allied health education for disability rights: A Case study from the University of Sydney's Faculty of Health Sciences Bowley, Claire; Short, Stephanie; Furmage, Ann-Mason Introduction: Persons with disabilities are vulnerable to rights violations when accessing healthcare. As allied health professionals play a significant role in the care of persons with disabilities, it is important that allied health professional competencies and education recognise the rights of persons with disabilities. However, a preliminary literature review indicated that the incorporation of disability rights within allied health professional competencies and education has not been researched. The University of Sydney's Faculty of health Sciences offers health professional education to six allied health disciplines: Occupational Therapy, Rehabilitation Counselling, Speech Pathology, Physiotherapy, Diagnostic Radiography and Exercise Physiology. Aim: This study aimed to investigate the nature and extent to which the competencies and education of thee six allied health professions focus on disability rights, and to explore the supports, barriers and recommendation for the future incorporation of human right within allied health professional education. Method: This study used a mixed method design involving quantitative keyword searches and qualitative content analyses of competency documents, education documents and transcripts of interviews conducted with co-ordinators of disability rights subjects. The United Nations Convention on the Rights of Persons with Disabilities (2006) was used as a theoretical framework during data analysis. Results: An allied health continuum emerged from the results, suggesting the extent to which the professions focus on disability rights varies. Occupational Therapy, Rehabilitation Counselling and Speech Pathology had the strongest human rights focus. Conversely disability rights were no recognised by Physiotherapy, Diagnostic Radiography or exercise Physiology education. Interviews attributed this phenomenon to a biomedical rather than a rights-based approach to disability. Conclusion: There is considerable scope for allied health professions to strengthen human eights-based education through ethical codes, competencies, and accreditation and registration requirements, with the aim of reducing rights violations experienced by persons with disabilities when accessing allied health care. 2016-02-05T00:00:00Z https://hdl.handle.net/2123/14325 Occupational Therapy with Australian Indigenous children and their families: A rural and remote perspective Block, Corey; Bulkeley, Kim; Lincoln, Michelle Background/aim: Occupational therapy service delivery must be adapted when working with Indigenous communities, as there is a diversity of beliefs, values and customs. There are currently no evidence-based models of therapy service delivery to rural and remote Indigenous children and their families. This study aims to explore occupational therapy service delivery to rural and remote Indigenous children and their families. Methods: Semi-structured telephone interviews were conducted with seven occupational therapists with experience with Australian rural and remote Indigenous children and their families. A thematic analysis was conducted on each interview with constant comparison to refine themes across interviews. Results: A total of six service delivery themes emerged from the data gathered in the interviews; flexible and accessible services; tailored services; culturally sensitive therapist; culturally inclusive services; occupational therapy awareness; and collaboration. These results linked with the need for long-term solutions, as the limited access to occupational therapy within these communities is a social injustice. Conclusion: The findings demonstrate that each Indigenous community is unique. Therapists work in collaboration with the community and use their critical reasoning skills to adjust practice accordingly. Significance of the study: This study contributes to growing knowledge about occupational therapy service provision in rural and remote Indigenous communities with children and their families. The findings will assist therapist in these communities to provide culturally aligned services. They also advocate for these communities by emphasising the basic human right violations that Indigenous communities are experiencing by not having access to consistent and culturally appropriate occupational therapy services. 2016-02-05T00:00:00Z https://hdl.handle.net/2123/14324 Practical Food Groups: Exploring their contribution towards facilitating cognitive behavioural changes that suppport long term outcomes for individuals with eating disorders Biddiscombe, Rachel; Scanlan, Justin; Ross, Jessica Objective: Relapse and rehospitalisation in individuals with eating disorders is a critical issue, especially considering their high prevalence. Emerging evidence supports practical and activity-based interventions as a potential treatment for long-term recovery. This study aimed to evaluate the contribution of "practical food groups" in facilitating cognitive and behavioural changes that support improved long-term outcomes for individuals with eating disorders. Method: Individuals with mixed diagnoses attended practical food groups as part of their treatment at an eating disorders day program. Ninety-nine participants completed questionnaires at discharge and three follow-up time points (6, 12 and 24 months). Questionnaires explored participants' experiences of practice food groups using rating-scale and open-ended responses. Data were collected between January 2010 and December 2014, and analysed using thematic analysis. Descriptive statistics were calculated for responses to rating-scale questions. Findings: At discharge, participants rated the importance and usefulness of practical food groups highly (4.73 and 44.43 on a 5-point scale, respectively), but tended to rate their enjoyment of the groups lower (3.50 on a 5-point scale). One core theme emerged: "success through participation". Six sub-themes were identified: helpful components of practical food groups; perceived benefit of exposure; impact of applying cognitive and behavioural skills; challenges affecting participation; facilitating adaptation; and influence of eating disorders on challenging feared foods. Discussion: This study highlighted that practical food groups are considered a useful, challenging and highly valued aspect of day treatment. Results support the potential usefulness of activity-based interventions to facilitate sustained change. 2016-02-05T00:00:00Z https://hdl.handle.net/2123/14209 Ethical Dilemmas Experienced by Occupational Therapists Working in Private Practice Babic, Aleksandra Background: Contemporary healthcare systems are constantly evolving. Healthcare professionals including occupational therapists are required to adapt to increasing contextual demands while maintaining professional and ethical conduct. Ethical conduct in occupational therapy is guided by ethical principles which are often in conflict with each other resulting in ethical dilemmas. Ethical dilemmas may impact upon the well-being of a professional, quality of client care and the reputation of a profession as a whole. Despite this, there is limited research into the nature of ethical dilemmas experienced by occupational therapists, specifically those working in private practice. Aims: This research asks: What is the nature of ethical dilemmas, and their contributing factors, encountered by private practice occupational therapists? The study aims to explore the nature of ethical dilemmas experienced by occupational therapists working in private practice. Overview of Thesis: This thesis has been divided into two sections. Section One consists of a comprehensive literature review of the current knowledge base regarding ethical dilemmas in occupational therapy practice. Literature from other allied health professionals working in private practice was also consulted to provide insights about ethical dilemmas these professionals experience. Section Two contains a journal manuscript entitled “Ethical Dilemmas Experienced by Occupational Therapists Working in Private Practice”. Conclusions: Findings from this research project indicate the need to understand the nature of ethical dilemmas experienced by occupational therapists as they are a complex and unavoidable aspect of day-to-day practice. Further, knowledge of the topic at hand within the private sector is critical as these professionals encounter different dilemmas due to the conflict between providing quality services and ensuring a viable business. This knowledge can inform preparation of professional development programs to ensure ethical competency of the occupational therapy profession. Background/Aim: The dynamic nature of contemporary healthcare systems has imposed increasing demands on occupational therapists. As a result, ethical dilemmas have become an unavoidable encounter in occupational therapy practice. Ethical dilemmas may impact upon the wellbeing of a professional, quality of client care and the reputation of a profession as a whole. Despite this, there is limited research into the nature of ethical dilemmas experienced by occupational therapists, specifically those working in private practice. The aim of this study was to explore the nature of ethical dilemmas experienced by occupational therapists working in private practice. Methods: A qualitative design was used. Semi-structured interviews were conducted with a purposive sample of six private practice occupational therapists, and focused on experiences of most frequent and challenging ethical dilemmas. Data was analysed using deductive thematic analysis. Results: Four themes reflected the nature of occupational therapists’ ethical dilemmas in private practice: balancing benefit and harm, fidelity of business practices, personal and professional integrity and accessing and distributing funds. Conclusion: In their experience of ethical dilemmas, occupational therapists were required to balance competing ethical principles while ensuring provision of quality clinical care and fulfillment of business needs. Knowledge of these ethical dilemmas may inform training and professional development programs for occupational therapists working in the private sector. 2016-01-11T00:00:00Z https://hdl.handle.net/2123/14210 A critical comparison of the similarities and differences in the conceptualisation of disability between Indigenous people in Australia and New South Wales disability service agencies Ravindran, Subahari This thesis critically compares the conceptualisation of disability in the public discourse between Indigenous people and New South Wales (NSW) government and non-government disability service agencies. This study explores intersections of the conceptualisations of disability at the Cultural Interface using the Occupational Justice Framework (Gilroy, 2009; Durocher, Gibson and Rappolt, 2014). This thesis consists of two sections. Section 1: Literature Review Section 2: Journal manuscript The first section of this thesis is the literature review. The literature review examines the low participation rate of indigenous people in disability services and the need for culturally appropriate disability services for Indigenous people. In order to ensure culturally appropriate services are provided for Indigenous people, the Western and Indigenous perspectives of disability need to be understood and each are discussed in turn in the literature review. The review initially discusses the Western conceptualisation of disability, followed by the Indigenous conceptualisation of disability. The review also explores how both Indigenous and Western perspectives on disability influence each other. The developments in disability conceptualisation throughout history are also discussed, followed by the current literature that led to the development of this study. The second section of this thesis is a journal manuscript. The journal manuscript explores the intersections and tensions between Indigenous people and NSW government and non- government disability service agencies regarding the conceptualisation of disability. The journal manuscript also examines the outcomes and implications of the findings. 2016-01-11T00:00:00Z https://hdl.handle.net/2123/14206 “I'm not telling an illness story. I'm telling a story of opportunity”: Making sense of voice hearing experiences Clements, Stephanie Coniglio, Francesca Mackenzie, Lynette Background/aim: Traditional approaches to voice hearing discourage the exploration of this experience. Current evidence suggests that understanding voice hearing experiences (VHE) facilitates recovery; yet, little is known about how voice hearers make sense of this phenomenon. This study aimed to explore how adults with lived experiences of voice hearing understand their VHE. Method: A phenomenological approach guided the study design. In-depth, semi-structured interviews were conducted with five participants who attended the Hearing Voices Recovery Support Group in Sydney, Australia. Participants completed the Self- Identified Stages of Recovery questionnaire and the Revised Beliefs About Voices Questionnaire. Thematic analysis was employed to uncover the ‘essence’ of this phenomenon. Findings: Understanding the voice hearing experience was characterized by an overarching theme of ‘tension and recalibration’. This overarching theme permeated each of five sub-themes: beliefs about voices; navigating the relationship with my voices; learning to live with my voices; rediscovering myself with my voices; and, influences to understanding my voices. Conclusion: This study highlights how voice hearer’s understanding of VHE evolves over time, and throughout phases of recovery. Clinical implications include early intervention to support individuals to: explore their VHE to derive personal meaning; navigate their relationships with voices to promote mutually beneficial relationships; and, regain a positive sense of self. 2016-01-11T00:00:00Z https://hdl.handle.net/2123/14205 The Perceptions of Australian Oncologists Regarding Cognitive Changes in Cancer Survivors Smidt, Kate Background: With survivorship increasingly recognised as a distinct phase of cancer care, uncertainty has emerged within the oncology community regarding the roles and responsibilities of those caring for cancer survivors. Consequently, many cancer survivors are ill-informed of the potential challenges associated with the survivorship phase. Cognitive changes experienced by cancer survivors have received growing attention as a survivorship issue. Though often subtle in nature, cancer related cognitive changes (CRCC) can have a profound impact on a cancer survivor’s quality of life (QOL). Nonetheless, cancer survivors report receiving limited information by treating oncologists regarding this phenomenon. Aim: To explore the perceptions of oncology specialists regarding CRCC, and how their views may influence decisions about patient care. Overview of the Thesis: The thesis is divided into two sections. Section I is a review of the existing and relevant literature relating to CRCC and their effects on cancer survivors’ QOL, with a particular focus on the survivorship phase. A description of the search strategies used to locate literature is also included. Section II is a manuscript formatted for submission to the journal Psycho-Oncology. This manuscript outlines the findings of a qualitative study exploring oncologists’ understandings of CRCC, and their perceived role in the management of cancer survivors’ cognitive concerns across the continuum of cancer care. Findings from the project as a whole demonstrate the uncertainty of oncology specialists regarding the appropriate management of CRCC, and the need for specific interventions and clinical practice guidelines to address the effects of CRCC on cancer survivors’ daily functioning and QOL. 2015-11-30T00:00:00Z https://hdl.handle.net/2123/14208 Occupational Therapy Goals during Acute Discharge for Older Adults Waller, Paige This thesis investigates the characteristics and nature of occupational therapy goals during acute discharge for older adults. The thesis is presented in two chapters: 1. Literature review 2. Journal manuscript The literature review chapter presented first provides a background of older adults and their experiences with acute hospitalisation. The literature describes the role of goal setting during discharge from acute and rehabilitation settings. The review examines existing research on the types of goals set by clients of various ages within a range of clinical settings. From this review it was identified that there is limited research into the characteristics and nature of occupational therapy goals for older adults during discharge from acute hospitalisation. The findings from the literature review were used to inform the design and completion of a parallel mixed methods study to identify the themes and categories of occupational goals and determine if there is an association between the goals and participant characteristics. The mixed methods study is presented as a journal manuscript in the second chapter of this thesis. The manuscript describes the methods, the results and implications of this research. Background: As the population ages, the number of older adults admitted to hospital can be expected to increase. Efficient and safe discharge planning, including goal setting, needs to be achieved to effectively manage this. Aim: To describe the characteristics and nature of occupational therapy goals set by older adults during and immediately following discharge from an acute hospital. Exploration of the characteristics and nature of goals and associations with specific characteristics of the sample can identify the needs of the older adult population during discharge. Methods: A parallel mixed-methods study design was conducted using secondary analysis of data from a randomised trial. Content analysis was used to identify key themes and categories within the goals. Descriptive statistics were used to describe characteristics of the participants. Chi-square was used to determine associations between participant characteristics and goal themes. Results: From a random sample of 50 participant files, 414 goals were identified. Two key themes, (a) ‘desire to get back to doing’, and (b) ‘engaging in doing’ emerged from the goals. Four sub-themes were identified describing the ‘what’, ‘how’, ‘who’ and ‘where’ components of goals. Instrumental activities of living goals were identified most frequently. An association was found between type of goals and living arrangement, participation, comorbidities and functional independence. Conclusion: Older adults set goals based on their desire or want to engage in occupations. The high frequency of instrumental activities of daily living goals needs to be considered in delivering health services to effectively meet the needs of older people during discharge from acute and medical wards. 2016-01-11T00:00:00Z https://hdl.handle.net/2123/14207 Ethical dilemmas experienced by Australian public practice occupational therapists Clarke, Emma Occupational therapists working within Australia’s dynamic and complex publicly-funded health sector may experience ethical dilemmas as they fulfill their professional responsibilities, compromising client care, straining collegial relationships and negatively affecting their personal well-being. This thesis describes and explores the nature of the ethical dilemmas experienced by public practice occupational therapists. Section One: LITERATURE REVIEW The literature review comprises two parts. First a background to ethics in health care is outlined, where the Person-Environment-Occupation Model is presented as a way of evaluating the ethical dilemmas experienced by occupational therapists. This is followed by a review of literature exploring the ethical dilemmas experienced by health professionals including occupational therapists, speech pathologists, physiotherapists, social workers, rehabilitation counsellors and nursing and medical professionals. However, no literature was identified exploring the nature of ethical dilemmas experienced by public practice occupational therapists, providing an opportunity for further research. Section Two: JOURNAL MANUSCRIPT The journal manuscript outlines a qualitative, descriptive study exploring the ethical dilemmas experienced by five public practice occupational therapists. Findings indicate that public practice occupational therapists experience an array of ethical dilemmas which reflect the complexities of working within Australia’s publicly-funded health care context. Ethical dilemmas reported by public practice occupational therapists are encompassed by five themes: defining boundaries in professional relationships, fair access to quality services, professional status, life choices and the complex client at the heart of the dilemma. Person, environment and occupation factors were all found to contribute to the ethical dilemmas experienced by participants. 2016-01-11T00:00:00Z https://hdl.handle.net/2123/13098 Modified Occupational Questionnaire (MOQ) Scanlan, Justin Newton; Bundy, Anita C. The Modified Occupational Questionnaire is a yesterday time diary / time use assessment designed to collect information about meaningful use of time. It can be used for research and clinical applications. 2015-04-06T00:00:00Z https://hdl.handle.net/2123/11666 Sampling Social Experiences in School: Feasibility of Experience Sampling Methodology on an iPlatform Jessup, Glenda M; Bundy, Anita C; Broom, Alex; Hancock, Nicola This paper reports on a pilot study testing the feasibility of an app as a survey tool for exploring the social experiences of high school students who are vision impaired. The Participation in Everyday Life Survey app was designed for use with the Experience Sampling Method. This method uses in-the-moment surveys to understand individuals’ experiences of everyday activities and situations. Pilot testing shows the app to be usable and accessible for people with vision impairments and high school students who are sighted but who have other disabilities. This pilot study has also shown that the Experience Sampling Method has the potential to provide useful insights into the social experiences of high school students who are vision impaired. 2013-01-01T00:00:00Z https://hdl.handle.net/2123/10300 Improving quality of life by increasing outings after stroke: Study protocol for the Out-and-About trial McCluskey, Annie; Ada, Louise; Middleton, Sandy; Kelly, PJ; Goodall, Stephen; Grimshaw, Jeremy M; Logan, Pip; Longworth, Mark; Karageorge, Aspasia Almost one third of Australians need help to travel outdoors after a stroke. Ambulation training and escorted outings are recommended as best practice in Australian clinical guidelines for stroke. Yet fewer than 20% of people with stroke receive enough of these sessions in their local community to change outcomes. The Out-And-About trial aims to determine the efficacy and cost-effectiveness of an implementation program to change team behaviour and increase outings by people with stroke. A two-group cluster-randomised trial will be conducted using concealed allocation, blinded assessors and intention-to-treat analysis. Twenty community teams and their stroke clients (n=300) will be recruited. Teams will be randomized to receive either the Out-And-About program or written guidelines only. The primary outcome is the proportion of people with stroke receiving multiple escorted outings during therapy sessions, measured at baseline and 13 months post-intervention. Secondary outcomes include number of outings and distance travelled, measured using a self report diary at baseline and six months post-baseline, and a global positioning system (GPS) after six months. Cost-effectiveness will measure quality-adjusted life years and health service use, measured at baseline and six months post-baseline. A potential outcome of this study will be evidence for a costed, transferable implementation program. If successful, the program will have international relevance and transferability. Another potential outcome will be validation of a novel and objective method of measuring outdoor travel (GPS) to supplement self-report methods. This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12611000554965) 2013-01-01T00:00:00Z https://hdl.handle.net/2123/10035 A Pilot Study to Investigate the Feasibility of an Occupational Therapy Early Referral Tool for Nurses in Acute Care Tan, Emma; Mackenzie, Lynette; Travassaros, Katrina; Yeo, Megan Background/aim: Acute care priorities are focused on stabilisation of a patient’s condition on admission. Patients with multi-morbidities affecting functional performance may not have their needs adequately met. Occupational therapy is well placed to address factors affecting functional decline thus early and accurate identification of patients requiring referral is imperative. This study investigated the feasibility of an occupational therapy early referral tool for acute care nurses. Methods: A mixed methods cross-sectional approach was used including: i) Completion of the Modified Blaylock Referral Tool (MBRT) on 305 patients by six acute care nurses in 3 wards. The tool results were analysed using descriptive and non-parametric statistics. ii) Semi-structured interviews with nurses on completion of the trial to understand their perspectives of occupational therapy and using the MBRT. Results: Of the assessed patients, 45% were recommended for occupational therapy referral. The main criteria associated with functional decline risk were mobility, memory and recent hospital admissions. Nurses indicated barriers to referral included resource limitations, lack of visibility and understanding of occupational therapy and lack of holistic assessment of patients. The MBRT identified patients consistent with nurses’ own recommendations and was easy to administer during admission to the ward. Conclusion: This study demonstrates the clinical utility of the MBRT for nurses to identify acute care patients at risk of functional decline. Recommended further research includes trials with larger nurse and ward samples and longitudinal studies to examine the effect of the MBRT on outcomes such as length of stay and post-discharge functional performance. 2014-02-11T00:00:00Z https://hdl.handle.net/2123/10038 The measurement properties of the original Barthel Index : A systematic review Wyatt, Elizabeth; Wales, Kylie Background: Worldwide many countries are experiencing ageing populations. Ageing can result in older adults experiencing compromised health and increased hospitalisations making older adults recurrent users of health care services. The process of ageing can reduce an older adult’s ability to perform everyday tasks and participate in the activities required for daily life. As a result, older adults are often referred to occupational therapists to improve functional capacity and support engagement in activities and occupations. One role occupational therapists perform when working with older adults in a hospital or rehabilitation setting is to enhance function in self-care tasks and plan for discharge. Occupational therapists use functional assessments to determine an older adult’s ability to carry out everyday tasks. Some occupational therapists use standardised assessments whereas others prefer to use non-standardised assessments. The major barriers to occupational therapists using non-standardised assessments are a lack of knowledge and skill. Standardised assessments are used to measure function, monitor change and determine the effectiveness of therapy. The quality of these measurements relies on the validity and reliability of standardised assessments when used with specific patient groups and clinical settings they were designed for. The original Barthel Index (BI) developed by Mahoney and Barthel (1965) is a standardised functional assessment widely used within rehabilitation, hospital and community settings with various patient groups. To date, the validity and reliability of the original BI has not been established with older adults. Aim: The aim of this research is to investigate the measurement properties of the original BI and to determine its suitability as a standardised assessment to measure function with older adults. Method: A comprehensive systematic review of the literature was undertaken and the following databases were searched; Cumulative Index of Nursing and Allied Health (CINAHL), Embase and Medline. Methodological quality of the included studies was assessed using the COnsensus-based Standard for the selection of health Measurement INstruments (COSMIN) checklist. Results: 3273 abstracts were screened and 5 articles included. COSMIN rated structural validity (good), cross-cultural validity (poor), hypothesis testing (fair to poor), internal consistency (poor) and responsiveness (fair). No studies investigated reliability, measurement error, criterion or content validity. Discussion: Limited research has been undertaken on the measurement properties of the original BI, highlighting the need for further robust research to be undertaken on the measurement properties of the original BI, so that the reliability, validity and limitations of the original BI to be established with older adults. Multiple versions of the BI were identified making interpretation of results problematic. This review recommends re-naming these versions to ensure transparency and straightforward interpretation of results. Implications: This and further research will continue to bridge knowledge gaps within the occupational therapy profession and enable occupational therapists to make informed decision when selecting the most appropriate standardised assessment to measure function with older adults. Breaking down the barriers to measuring outcomes through increased knowledge and use of standardised assessments will increase occupational therapists adherence to evidence base practice and professional accountability to the occupational therapy profession. This in turn will provide older adults with accurate measurements of their functional capacity which will ultimately impact on patient recovery, quality of care and earlier discharge. 2014-02-11T00:00:00Z https://hdl.handle.net/2123/10036 Exploring the Role of Occupational Therapy in Australian Cancer Care Buckland, Nicole; Mackenzie, Lynette Background / Aim: Increasing rates of cancer survival in Australia indicate that more people are living with long-term side effects of the disease and its treatment, and survivorship is now often considered a distinct phase of cancer care. Whilst occupational therapists play an integral role in multidisciplinary care for many chronic illnesses, there is little evidence documenting the profession’s role in cancer care. This study aimed to explore the views of Australian occupational therapists regarding current and best practice for people with cancer, from diagnosis through to survivorship. Methods: A cross-sectional online survey was developed and distributed through the Occupational Therapy Australia database to collect responses from occupational therapists in diverse areas of practice around Australia. Results: A total of 204 completed surveys were returned. More than 85% of respondents worked with people with cancer at least occasionally and 33% of practice occurred in community settings. Participants perceived equipment provision to be the most common intervention (94%), followed by energy conservation (90%) and pressure care (78%). Lack of funding for occupational therapy positions and a lack of recognition of the role of occupational therapy by health professionals and consumers were seen as key barriers to best practice. Conclusion: This study highlights the need for occupational therapists to commit to research efforts and to work collaboratively with the multidisciplinary team to develop long-term routine treatment pathways that address the needs of cancer survivors. 2014-02-11T00:00:00Z