Final Report of the Evaluation of the San Mateo County Children's Health Initiative

Summarizes key findings from a five-year evaluation of the county's Children's Health Initiative -- its outreach and enrollment efforts, the impact on children enrolled in the Healthy Kids program, areas for improvement, and financing challenges

The Educational Interaction Between Physical Therapy and Occupational Therapy Students

The objectives of this study were to identify the prevalence of shared learning in U.S. physical therapy (PT) and occupational therapy (OT) education programs; determine what terminology is used for these courses; and identify perceived barriers, benefits, and challenges of the educational interactions. A survey, designed to collect information about the educational interaction between PT and OT students, was mailed to all program directors (n = 206) at each of the academic institutions (N = 103) in the United States with accredited or developing entry-level programs in PT and OT. A census study was conducted, and the entire study population received a survey. A total of 206 surveys were mailed, and 123 were returned (59.7% response rate). Of program directors, 40 (67.8%) of the PT and 42 (65.6%) of the OT program directors reported that their students shared courses with each other. None of the PT and only 8 (12.5%) of the OT directors reported that students shared clinical experiences. The term interdisciplinary was used most frequently to refer to shared educational experiences. Benefits of shared learning included sharing resources, collaboration, learning about the other profession, and gaining respect for the other profession. Challenges to shared learning included resource constraints, curricular differences, competition and differences between disciplines, relevance of course work, and different faculty expectations. Barriers reported by program directors whose students did not engage in interdisciplinary education were resource constraints, curricular differences, faculty attitude, and failure of past attempts. A model of interdisciplinary education that seeks to instill collaboration and understanding among professions is difficult to implement without shared clinical experiences. Most students in entry-level PT and OT programs in the United States do not currently have the opportunity to practice the teamwork that will be essential when they enter their respective professions

Patient Experiences When Preparing for Discharge Home after Total Knee Replacement

Purpose: Following total knee replacement (TKR), patients must prepare quickly for discharge to home via education and rehabilitation. Patient needs may not fully be met prior to discharge after TKR surgery. The purpose of this descriptive study using transcendental phenomenology methods was to understand patients’ experiences when preparing to return home after TKR surgery. Method: Data was collected using semi-structured interviews that occurred 1 to 2 days prior to discharge in patients’ hospital rooms. Four participants were interviewed prior to discharge and interviews were transcribed verbatim for data analysis. Data analysis and data collection were concurrent, permitting subsequent interviews to be altered as needed based on results from previous participants. Thematic analysis of the interview transcriptions was conducted to identify significant meaning statements through a process of horizonalization. Significant statements were organized into shared themes among participants. Results: Three themes emerged: being supported for discharge home; having confidence in self, family and health care staff; and persevering: overcoming obstacles. Participants overall felt prepared for their surgery and the post-operative phase. The following factors increased readiness for discharge: having prior positive experience with TKR through the experiences of others, attending pre-operative education, interacting with knowledgeable staff, and having the appropriate support at home. Some patients were unprepared for the amount of pain they experienced after surgery. Conclusions/Recommendations: Health care providers should educate patients about safety for the home environment, adaptive techniques for functional tasks, and when to resume normal activities at home. Other implications include encouraging patients to attend pre-operative education, addressing patients’ previous experiences with TKR, both positive and negative, as well as providing realistic information regarding pain after surgery

Clarifying Analysis and Interpretation in Grounded Theory: Using a Conditional Relationship Guide and Reflective Coding Matrix

Although qualitative methods, grounded theory included, cannot be reduced to formulaic procedures, research tools can clarify the process. The authors discuss two instruments supporting grounded theory analysis and interpretation using two examples from doctoral students. The conditional relationship guide contextualizes the central phenomenon and relates categories linking structure with process. The reflective coding matrix serves as a bridge to the final phase of grounded theory analysis, selective coding and interpretation, and, ultimately, to substantive theory generation

Experiences of Veterans Transitioning to Postsecondary Education

An increasing number of U.S. military veterans are entering postsecondary education with problems attributed to deployed military service. The primary objective of this research was to describe the lived experiences of student veterans transitioning from active military service to postsecondary education. Phenomenological interviews were performed with 13 student veterans who had transitioned from military deployment to postsecondary education. An overall essential meaning of “emerging in college culture” was manifested from three themes, supported by rich textural and structural descriptions of student veterans’ experiences: (1) repurposing military experiences for life as a student veteran, (2) reconstructing civilian identity, and (3) navigating postsecondary context and interactions. These findings highlight implications that may facilitate occupational therapists’ efforts in supporting the needs of student veterans

Perceptions of the Impact of Non-contact Boxing on Social and Community Engagement for Individuals with Parkinson’s Disease: A qualitative study

Purpose: To explore the perceptions of individuals with Parkinson’s disease (PD) on their experiences within a community based, non-contact boxing program. Specifically, this study considered how these individuals perceived non-contact boxing to influence their social and community engagement and factors influencing ongoing participation in this program. Method: This was a phenomenological case study that utilized qualitative methods for data collection including semi-structured interviews and observation. Colaizzi’s method was used for data analysis. A convenience sample obtained from a boxing club that offered PD specific boxing classes was used. The sample included 10 participants (3 female, 7 male) ranging in age from 52 to 84 years. Participants typically attended a 75 minute boxing class two to three times per week. Results: The exhaustive description of the phenomenon was that individuals with PD have a strong desire to maintain the life they had prior to their diagnosis and chose activities, such as non-contact boxing, which supported their ability to sustain that lifestyle. Two themes were identified which included 1) “The people I’ve met here and spent time with will be friends forever” and 2) “I don’t have to be Muhammed Ali. It’s not about that.” Conclusions: This study provided a basic understanding of the subjective experiences of individuals with PD who participated in non-contact boxing. Findings demonstrated that non-contact boxing facilitates the growth of supportive relationship for individuals with PD. The study also found that individuals with PD believe non-contact boxing provided a variety of physical, cognitive, and emotional benefits which facilitated their ability to maintain participation in valued activities

Optimizing critical illness outcomes through the family experience-A theoretical review

An estimated six to eight million patients are admitted to the intensive care unit (ICU) in the United States every year [1, 2]. It is possible that new and innovative medical therapies have provided patients with treatment options that enhance survival of a critical illness and allow them go home with more medical support than previously available in earlier years. This may explain why there are now millions of ICU survivors are a result of declining mortality rates (8-19%) even though there are increased ICU admissions [3, 4]. This also indicates a change in direction of the attitudes and beliefs of the family unit today and their desire for the family member to return home after critical illness instead of moving to a tertiary facility for care