Mapping Occupational Therapy Practice with Postsecondary Students: A Scoping Review

Background: Legislation supports a role for occupational therapy in postsecondary settings, but this area is not a common practice area and the practice area is not well understood. This scoping review maps current literature of occupational therapists working with students in postsecondary settings in order to inform future research and practice. Method: After identifying included articles, a narrative description of the quantitative studies along with a concept map were completed. A qualitative thematic analysis of the articles was also conducted. Results: Twenty-five articles met the inclusion criteria. Quantitative results describe occupational therapy services as both a direct and indirect service provided through offices of disability services, assistive technology, and supported education programs, among others. The primary population with whom occupational therapists engage with are students with mental illness. Three qualitative themes emerged from the scoping review, including the focus on occupation and skills needed for success, using the campus environment, and campus collaboration. Conclusion: The structure of occupational therapy services varies from location to location and occupational therapists work with various populations of students. Future research needs to support the distinct value of occupational therapy in this practice area, including the scope and outcomes of occupational therapy services with different populations of students

Exploring resilience for people with type 2 diabetes who have a wound

Comorbidities related to diabetes such as chronic wounds can increase the need for surgical procedures, with at least 10% of all patients undergoing surgery having diabetes. Being diagnosed with diabetes can be seen as a risk factor for developing wound healing problems. Discussion: This short report highlights the potential positive influences gained from providing resilience education and self- management education to people with type 2 diabetes, potentially enhancing self-managing abilities and reducing poor wound healing. Summary: Modern wound care practice is centred on symptom reduction and working with pathology; however, working with people to enhance their personal resilience and promoting positive psychological adaptation can impact positively on their mental health

Exploring Resilience When Living with a Wound — An Integrative Literature Review

The psychological impact for patients with wounds can be significant, and adverse psychological effects frequently occur when there are permanent changes in the body’s structure or function. Evidence suggests that anxiety, depression and stress can adversely affect the wound healing process. An integrative review examined any paper that discussed any patient in any health care setting who had experienced a psychological impact from the experience of having a wound and the experience of being resilient in that context. Ninety nine papers were located in the initial search with twelve meeting the inclusion criteria and being reviewed. A review of the papers identified that improvement and maintenance of quality of life was perceived to be an important aspect of patient management, but none focused on resilience as a primary endpoint. Further research is required into the clinical benefits of resilient behaviours in patients living with a wound

Exploring quality of life, physical and psychosocial morbidity for patients with non-infected wounds: a pilot study

This article reports on the results of a pilot study exploring health-related quality of life and the experience of being resilient in patients who develop acute, non-infected surgical wounds. By investigating this under-researched area of wound management, the project team intended to highlight the aspects of patient empowerment in healing post-surgery, encompassing the physical, social and psychological domains. Participants were recruited from patients who had undergone a surgical procedure resulting in an acute non-infected healing wound, and who met the inclusion criteria of the study. Patients were excluded if they had a chronic wound in addition to their acute surgical wound. Valid scores on the physical health (PCS) and mental health (MCS) domains of the SF-12 could only be obtained from six patients pre-operatively. A further six patients completed the SF12 instrument pre-operatively (five valid sets of scores obtained); these patients did not complete the HADS scale. Paired samples t-tests conducted on patients from whom both pre- and postoperative scores were obtained found no significant difference between pre-operative and postoperative PCS scores (p=0.468) or MCS scores (0.806); or between pre-operative and postoperative scores on the anxiety subscale on the HADS scale (p=0.951) or the depression subscale (p=0.951). However, as a pilot study, the study was not powered to detect significant differences. Higher levels of anxiety were revealed in this pilot study than in the wider population. No differences were observed between pre-operative and postoperative scores for physical and mental wellbeing. The findings, while from a small sample set, indicate anxiety is experienced by people living with a wound, and needs to be a consideration in care management plans to enhance adaptation

A qualitative study of parents' experiences using family support services: applying the concept of surface and depth

UK policy and practice endorses family support for child well-being. Achieving such support requires multi-agency approaches, that consider all aspects of parents’ and children’s lives and which offer practical, social and emotional help. The potential for services to make a positive impact on parents and their families will depend in part on the level and nature of engagement. In this paper a case is made for the application of the two-part ‘surface and depth’ concept for understanding how practitioners engage with families and how they might improve the chances of supporting sustainable differences for parents and families. To illustrate, qualitative data from a review of family centre support provided by a north of England local authority, are presented. The review was commissioned to explore why families often need to re-engage with intensive support services. Data are drawn from interviews with parents (n=18, recruited following a survey of all those registered with the service during April – May 2009) and discussions with family centre support workers (n=4) and following thematic analysis three dominant themes emerged: ‘resources available’, ‘staff approach’ and ‘real life’, were appraised in light of the ‘surface and depth’ concept. Much of the work with parents effectively dealt with pressing needs. This felt gratifying for both parent and worker and supported immediate service engagement. However, each noted that the more complex issues in parents’ lives went unchallenged and thus the sustainability of progress in terms of parenting practice was questionable. A ‘strengths focused’ approach by staff, that understood needs in the context of parents’ ‘real life’ circumstances was important to parent engagement. Thus, longer term benefits from family support requires practitioners to work with parents to problem solve immediate issues whilst also digging deeper to acknowledge and seek to resolve the more complex challenges parents face in their real lives

Using e-learning to support international students' dissertation preparation

Purpose: A research paper on the design and implementation of an e-learning resource responding to the globalisation of education. The purpose of this paper is to focus on the challenges presented in learning and teaching on how to support international postgraduate (PG) students undertaking the specific task of a dissertation. Design/methodology/approach: Using findings from 250 PG students, 40 supervisors and two module tutors the research identified the content and language issues faced by students and recognised the need to design an enabler supporting the latter as independent learners and the academic staff delivering support. Findings: The e-learning tool provides an independent learning tool which addresses student concerns relating to the process and content of structuring a dissertation and the function of language. Initial responses have been positive from both staff and students in respect to providing a source of student support and feedback. Originality/value: The research shows how the Dissertation Game Model (DGM), evolved into an e-learning resource supporting student understanding of the content, structure, planning and writing of a dissertation. The e-learning tool focuses on helping international students understand what the generic contents of each chapter of a dissertation should contain and supports them in engaging in research as a transferable skill

Investigating staff knowledge of safeguarding and pressure ulcers in care homes

Objective: To investigate whether nursing/care home staff regard pressure ulceration as a safeguarding issue; and to explore reporting mechanisms for pressure ulcers in nursing/care homes. Methods: Sixty five staff members from 50 homes within one clinical commissioning group completed a questionnaire assessing their experiences of avoidable and unavoidable pressure ulcers, grading systems, and systems in place for referral to safeguarding teams. Understanding of safeguarding was assessed in depth by interviews with 11 staff members. Results: Staff observed an average of 2.72 pressure ulcers in their workplaces over the last 12 months; judging 45.6% to be avoidable. Only a minority of respondents reported knowledge of a grading system (mostly the EPUAP/NPUAP system). Most respondents would refer pressure ulcers to the safeguarding team: the existence of a grading system, or guidance, appeared to increase that likelihood. Safeguarding was considered a priority in most homes; interviewees were familiar with the term safeguarding, but some confusion over its meaning was apparent. Quality of written documentation and verbal communication received prior to residents returning from hospital was highlighted. However, respondents expressed concern over lack of information regarding skin integrity. Most staff had received education regarding ulcer prevention or wound management during training, but none reported post-registration training or formal education programmes; with reliance placed on advice of district nurses or tissue viability specialists. Conclusion: Staff within nursing/care homes understand the fundamentals of managing skin integrity and the importance of reporting skin damage; however, national education programmes are needed to develop knowledge and skills to promote patient health-related quality of life, and to reduce the healthcare costs of pressure damage. Further research to investigate understanding, knowledge and skills of nursing/care home staff concerning pressure ulcer development and safeguarding will become increasingly necessary, as levels of the older population who may require assisted living continue to rise

Do we understand health-related- quality-of-life outcomes?

Last year I was afforded the opportunity of investigating Health Related Quality of Life (HRQoL) outcomes for patients with wounds, through a Florence Nightingale Travel Scholarship. Since my return from Australia, I have been thinking about how we identify and enhance HRQoL outcomes for the range of wound conditions that we see and treat in clinical practice