Although the contribution of the rehabilitation instruction, and particularly that of individual health care professionals, was acknowledged by the subjects, the adequacy of the preparation of clinicians for their role as adult educators in the rehabilitation process is questioned. A theory of transformative learning is introduced as a possible explanatory model for the study findings, application of which may facilitate a more client-centered approach to rehabilitation practice.
Background: In clinical weight‐loss trials, the majority of those who lose weight will regain almost all of it within 5 years, yet there is limited evidence about effective strategies to support weight maintenance. The present study aimed to increase understanding of the experiences of those who have been successful at weight maintenance. Methods: This qualitative study used a phenomenological approach. Semi‐structured interviews were undertaken with a purposive sample of 10 participants who had maintained a minimum of 10% weight loss for at least 1 year. Interviews were transcribed and then analysed using a foundational thematic approach based on the Colaizzi method. Results: Participants believed that a more relaxed approach to weight management with realistic, long‐term goals was more appropriate for long‐term control. They had a strong reason to lose weight often with a medical trigger and had elicited support to help them. Most described the presence of saboteurs. Participants took personal responsibility for their weight management and were in tune with their nutrition and activity needs. Self‐monitoring was a strategy commonly used to support this. They described the lack of positive reinforcement in the maintenance phase as a major difficulty. Conclusions: This small‐scale study provides evidence to suggest the importance of a medical prompt to lose weight; planning for how to manage saboteurs and identifying methods of minimising the impact of a reduction in positive reinforcement. It reinforces the importance of many of the strategies known to support the weight‐loss phase.
Aim: To explore patient experiences of using a new web-based cardiac rehabilitation programme. Methods: A qualitative approach was chosen and semi-structured interviews were conducted with sixteen participants. Data were analysed using a foundational thematic analytic process. Results: Two overarching themes – ‘patient benefits and programme facilitators’ and ‘programme barriers’ – were identified. Participants reported increased physical activity, improved psychological wellbeing and greater patient empowerment when managing angina symptoms. Certain programme components (exercise goal setting, the online exercise diary, tailored comprehensive information and communicating with rehabilitation specialists) were discussed in terms of facilitating engagement. Participants valued the intervention particularly as they had not been offered a rehabilitation programme during their standard care and, in particular, the convenience of the web-based programme with no restrictions on time or location. Programme barriers included family/work commitments, bad weather, receiving the programme late in relation to their angina diagnosis, preconceptions about an internet-based programme being suitable for a younger age group, the difficulty of making lifestyle changes when in older age, and the need to be motivated when carrying out the programme independently. Conclusions: Primary care angina patients could benefit from an online version of rehabilitation. Patients’ views about useful programme components should be incorporated when developing web-based interventions.
Exercise programs, to be implemented by families at home and support workers in school, are often characterized as prescriptive and focused on the child's impairment. These need to be integrated into a more holistic approach that considers family and child preferences. If this is to be achieved, parents' perspectives must play a legitimate part in evaluating the effectiveness of practice.
The purpose of this article is to discuss the theoretical concept of moral distress in the context of current physical therapy practice and ethics knowledge and differentiate it from emotional distress and burnout. Moral distress, largely discussed in nursing, is a theoretical concept that has the potential to elucidate the experiences of physical therapists delivering direct care to patients in complex health care situations and to contribute to physical therapy ethics knowledge and education. It focuses attention on the role of moral agent and the ethical dimensions of practice, offers a basis for dialogue among health professionals, and promotes analysis of the impact of the organizational environment on practice. The article concludes by suggesting how an understanding of the concept of moral distress might inform existing physical therapy ethical decision-making models and future research directions by which the experience of moral distress in physical therapy might be explored.
Adults with acquired communication difficulties find digital communication, such as e-mail and social media, and mainstream technologies, such as iPads, beneficial in communicating with others. Current communication technologies present a number of challenges for adults with disabilities and are limited in their communicative functions to support desired interactions. The implications for AAC technology development and speech and language therapy service delivery are addressed.
rofessional isolation is a contributing factor to poor recruitment and retention of physical therapists in rural positions (Paterson et al, 2004; Struber, 2004a; Kalisch et al, 2005). In 2001 a task force was formed to examine the recruitment and retention issues for paediatric therapy services in British Columbia, Canada (Cameron et al, 2001). The report described the shortage of physical therapists with paediatric experience in British Columbia, particularly in rural areas, and the authors concluded that 'the supply of paediatric therapists and the demand for paediatric therapy services is at a critical juncture' (Cameron et al, 2001: p18). In addition, their demographic analysis indicated that a large number of experienced paediatric physical therapists will be ready to retire in the next 5-10 years. According to Cameron et al (2001: p6): 'Geographical location makes professional development a challenge, while isolation makes it essential for professional growth and peer support…' Electronic mentoring: An innovative approach to providing clinical support The role of mentoring Mentoring has been promoted as a means to overcoming professional isolation and a way to provide clinical support for health-care workers (Greene and Puetzer, 2002; Rideout, 2006) A mentor is a more experienced colleague who comes alongside a less experienced colleague or a mentee to facilitate their professional development through teaching, counselling, support and guidance. Mentorlink is one example of a facilitated distance mentoring programme developed by the Australian Occupational Therapy Association that 'arose as a creative response to requests for more professional support' (Wilding and Marais-Strydom, 2002: p225). This programme was designed to match mentors with mentees to provide clinical support to therapists in distant areas of Australia and has proven to be very successful. The use of technology may offer a solution to the problem of isolation experienced by health professionals in geographically large and Aims: Professional isolation is a contributing factor to poor recruitment and retention of physical therapists in rural positions. This article describes the implementation and evaluation of a pilot electronic mentoring, or e-mentoring, programme to address the need for support of physical therapists working in rural positions, in British Colombia, Canada. Methods: An action research approach was used to examine whether an e-mentoring programme could effectively support physical therapists in paediatric clinical practice. The pilot programme involved an experienced physical therapist who mentored two sole charge physical therapists with no paediatric experience from a distance using their laptop computers. Programme evaluation data was obtained through questionnaires, field notes and a final group meeting using videoconferencing. Findings: The key to the success of the e-mentoring programme was the collaborative interaction between the mentor and the mentee. Other factors that supported this interaction and beneficial ou...
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