School of Allied Health

Permanent link for this collectionhttps://hdl.handle.net/10292/10495

The School of Allied Health encompasses Physiotherapy, Podiatry, Occupational Therapy, and Rehabilitation.

Browse

Now showing 1 - 20 of 324

Longitudinal, Multi-cycle Evaluation of Passive Function Improvement in People With Arm Spasticity Treated With Botulinum Toxin A
(MDPI AG, 2026-01-19) Ashford, Stephen A; Buchwald, Khan; Fheodoroff, Klemens; Jacinto, Jorge; Narayanan, Ajit; Siegert, Richard J; Hannes, Christian; Turner-Stokes, Lynne
Improvement in passive function (i.e., ease of caring for a limb) is a common goal for treatment of spasticity in the arm with botulinum toxin. A large international, observational, 2-year longitudinal study (ULIS-III, N = 953) was conducted in real-life practice. This original secondary analysis examines whether improvement in passive function goals were met over repeated injection cycles. We report changes by cycle measured by the Passive Function sub-scale of the Arm Activity measure (ArmA-PF) and examine predictors of improvement and injection occurrence. Inclusion in this analysis was based on passive function being selected as a primary or secondary goal for one or more cycle of treatment (n = 542/953). Goals were assessed at the start and end of each cycle using the Goal Attainment Test score and the ArmA-PF. Over all cycles of treatment, goals were set for 1641/2187 injections (75.0%) and achieved in 1250 (76.2%). Significant improvements in ArmA-PF score were identified for at least six cycles (p < 0.001) with evidence of cumulative benefit over successive cycles. This occurred regardless of patient-related baseline characteristics, with the possible exception of some relationship with injection localization techniques. In conclusion, repeated botulinum toxin injections provide significant improvement in passive function, which was sustained over repeated cycles of treatment.
Experiences of New Zealand Podiatrists Providing Podiatry Care to People With Foot Osteoarthritis
(Wiley, 2025-12-17) Molyneux, P; Ma, M; Bowen, C; Ellis, RF; Rome, K; Carroll, MR
Background: Current care provided by health professionals for individuals with osteoarthritis (OA) is inconsistent with clinical guideline recommendations. Although OA guidelines have been developed for more commonly studied joints such as the knee and hip, foot OA remains comparatively underrepresented. Despite its high prevalence and significant impact on functional ability, foot OA lacks standardised classification criteria. The absence of clinical guidelines for foot OA underscores its importance as a research priority. Understanding current assessment and management strategies is crucial before designing clinical trials. This study aims to assess New Zealand (NZ) podiatrists' knowledge of foot OA, their assessment practices and their management strategies. Although foot OA is both highly prevalent and functionally disabling, the absence of standardised classification criteria persists. Methods: A qualitative descriptive approach was employed for data collection and analysis. Using purposive sampling, semistructured interviews were conducted with 10 NZ registered podiatrists. An interview schedule guided discussions on diagnosing and managing foot OA. Interviews were audio-recorded and transcribed verbatim. Reflexive thematic analysis was used to identify key meanings and patterns within the data. Results: Five key themes were derived regarding the assessment of foot OA: (1) chief complaint versus incidental finding; (2) obtaining patient history through subjective interviews; (3) targeted objective assessments for foot OA; (4) determining individual biomechanical factors and (5) further investigations. Five themes were identified relating to the management of foot OA: (1) knowledge and language used to provide education about OA; (2) clinical uncertainty necessitates an iterative approach; (3) podiatry administered treatments; (4) referral pathways to other health professionals and (5) management influences. Conclusion: New Zealand podiatrists utilise a comprehensive diagnostic approach, integrating symptom history, joint mobility assessment and radiographic imaging particularly in the absence of formal diagnostic criteria. Management strategies align with international guidelines, emphasising education, exercise and weight management alongside podiatrist-led interventions such as foot orthoses and footwear modifications. However, the study highlights several challenges: limited evidence-based guidance, uncertainty around optimal orthotic strategies and a disconnect between evolving OA knowledge and its application into clinical practice.
Power Dynamics of Knowledge in Physiotherapy Education: The Case of Mensendieck
(University of Manitoba, 2025-08-29) Dahl Michelsen, Tone; Nicholls, David; Messel, Jan; Synne Groven, Karen
Over the years, various theorized movement systems have impacted the development of physiotherapy. In Norway, Mensendieck developed into an otherwise physiotherapy program. The existence of the Mensendieck program has been debated ever since its inception, but it managed to survive for decades, until 2019, when the program no longer was offered as a standalone option. In the Mensendieck program, personal experience combined with guiding movement was essential. Students were trained to perform exercises in the Mensendieck system and leading their own movement group was part of their physiotherapist training. The learning process was organized in a hermeneutic manner through the learning principle of spiral wherein learners revisit earlier learning over time. In higher education healthcare programs, the evidence-based practice model (EBPM) has become paramount in recent decades and the curricula are expected to be designed accordingly. In this chapter, we explore the emphasized knowledge in the Mensendieck program in relation to the power dynamics of knowledge embedded in the EBPM. Through a Foucauldian lens, we show how Mensendieck embodied an “otherwise” form of physiotherapy that needed to be marginalised within conventional physiotherapy thinking to maintain existing power/knowledge structures, professional subjectivities, and practice truths.
The Possibilities for a Post-Human Physical Therapy
(University of Manitoba, 2025-08-29) Nicholls, David; Low, Matthew; Maric, Filip
This chapter offers a radically revised concept of therapy. Therapy is a concept that lies at the heart of what it means to be a physiotherapist, so it seems surprising that the profession has never defined what the therapy in its name actually means. In recent years, physiotherapists have been looking for new ways to express an expanded idea of their profession, but these have concentrated on more humanistic forms of practice. Here we take a different, post-human approach, understanding therapy as a universal process common to all entities. We begin by critiquing the paradoxes and inconsistencies evident in physiotherapy’s present understanding of therapy and then contrast this with an approach drawn from the writings of Gilles Deleuze. We conclude that therapy is a much more inclusive and complex phenomenon than the profession has previously understood, and suggest it has the potential to radically transform the physical therapies in the future
Escalated Care Pathways: A Retrospective Review of Patient-specific Outcomes Following Anterior Cruciate Ligament Injury
(New Zealand Society of Physiotherapists Inc, 2025-12-19) Collett, Joel; Reid, Duncan; Harvey, Daniel; Potts, Geoff
Due to increasing rehabilitation costs associated with anterior cruciate ligament (ACL) injury, the Accident Compensation Corporation instigated an innovative pilot scheme, the escalated care pathway (ECP). Introduced in 2019, ECPs were designed to improve patient outcomes through timely assessment and interdisciplinary treatment. The aim of this study was to quantify patient-reported outcome measures, functional measures, and treatment volumes for patients enrolled in one of the ECP pilots following ACL injury. Data including the Knee Osteoarthritis Outcome Score (KOOS), limb symmetry index (LSI), demographic information, number of physiotherapy visits, and overall treatment duration were extracted from the Careway ECP database for patients who completed the programme between 2020 and 2023. Data from 750 patients, surgical (n = 332 (43%); M (SD) age 33.1 (13.1) years) and non-surgical (n = 418, (55.7%); M (SD) age of 35.8 (15.1) years), were analysed. Mean (SD) treatment duration was significantly longer in the surgical (317.2 (141.5) days) vs non-surgical group (285.8 (156.0) days) (p < 0.01). Surgical patients had more physiotherapy visits (25.4 (19.6) vs 13.2 (15.3), p < 0.01). The KOOS improved in both groups; however, the M (SD) change scores between groups (surgical (29.1 (20.0); non-surgical (25.8 (18.4)) were not statistically significant (p = 0.052). Mean (SD) LSI increased from baseline to exit from the programme (surgical 72.3 (26.8) to 100.8 (29.7); non-surgical 77.1 (36.3) to 104.7 (33.3)) (p = 0.055). These findings provide insight for physiotherapists managing ACL injury and demonstrate that surgical and non-surgical patients achieve positive outcomes through the ECP.
Communication as a Dynamic Dance: Physiotherapy Clinical Educators’ Conceptualisations of Effective Communication in Final Year Physiotherapy Students in New Zealand
(Physiotherapy New Zealand, 2025-12-12) Wilson, Carolyn; Bright, Felicity; Mooney, Sarah
Effective communication between the physiotherapist and patient is fundamental to physiotherapy practice. In Aotearoa New Zealand, students must demonstrate “effective communication” to become registered, yet it is unclear what constitutes effective communication. Nor is it clear how clinical educators, who assess students’ communication, conceptualise effective communication. This lack of clarity may have implications for how students’ competency is supported and assessed. This research explores how clinical educators conceptualise effective communication in final year physiotherapy students in musculoskeletal clinical settings in Aotearoa New Zealand. Guided by Interpretive Description, data were gathered from physiotherapy clinical educators using two data sources: written reflections from watching a pre-recorded student-patient interaction, and semi-structured interviews. Data were analysed using reflexive thematic analysis. Analysis of data from seven clinical educators suggested effective communication to be a dynamic dance, featuring continuous interplay between the physiotherapy student and patient. This primary theme had three subthemes each highlighting a distinct feature of communication: 1) Adapting communication moves in response to patients; 2) Control of the interaction; and 3) Building rapport with patients. Findings indicate communication skill development is complex and evolves over the course of one’s professional life. Skill development is also embedded within broader understandings of the role and function of the physiotherapist and, accordingly, supporting students to develop communication competencies requires further attention from educators and researchers alike.
Unique RNA Gene Expression Profile Is Seen in Chronic Non-Specific Low Back Pain
(MDPI AG, 2025-12-27) Sannes, Ann-Christin; Amjad, Imran; Duehr, Jenna; Ghani, Usman; Rice, David; Haavik, Heidi; Niazi, Imran Khan; Moberget, Torgeir; Gjerstad, Johannes
Previous reports suggest that the progression from subacute to chronic non-specific low back pain (nsLBP) involves functional changes in both the nervous and immune systems. The purpose of the present study was to characterize the gene expression profiles of circulating immune cells that affect the interaction between these two systems when subacute nsLBP turns into chronic nsLBP. Participants aged 18–55 were included based on the presence or duration of LBP, with peripheral blood mononuclear cells collected for RNA sequencing from 20 healthy controls (no nsLBP), 20 subclinical patients (intermittent nsLBP), and 19 chronic patients (long-term nsLBP). The data revealed that chronic nsLBP is linked to a distinct gene expression profile, with 139 uniquely differentially expressed genes (DEGs), differing from those in the subclinical and control groups. Interestingly, comparing chronic and subclinical groups showed minimal overlap in DEGs, indicating a clear inflammatory distinction between subclinical nsLBP and chronic nsLBP. The findings also indicated that patients with chronic nsLBP were different from other individuals regarding axon guidance, indicating neuroplastic changes when intermittent nsLBP turns into chronic nsLBP. Hence, early recognition of the transition from subclinical to chronic nsLBP using RNA profiling may pave the way for more precise therapeutic strategies targeting neuroplastic changes and inflammatory processes.
“Within Their Spaces, Within Their Context”: Māori Therapists’ Perspectives of Robotic Technology in Upper Limb Stroke Rehabilitation
(New Zealand Society of Physiotherapists Inc, 2025-07-09) Boardsworth, Kate; Barlow, Rhiannon; Wilson, Tammi; Wilson, Bobbie-Jo; Olsen, Sharon; Shrestha, Robin; Signal, Nada
Upper limb impairment following stroke is common, contributing to restrictions in functional capacity and reduced quality of life. Robotic devices are being developed to augment rehabilitation and support upper limb recovery. However, a lack of end-user input has resulted in devices that fail to fully meet therapist and patient needs. In Aotearoa New Zealand, involving Māori (Indigenous) rehabilitation therapists is essential for developing culturally responsive devices and interventions. This qualitative study utilised a Māori-centred approach underpinned by Kaupapa Māori (Indigenous research) principles to explore the requirements for effective upper limb robotic rehabilitation with Māori following stroke. Semi-structured interviews were conducted with six Māori stroke rehabilitation therapists to explore their perspectives. Five interconnected themes were interpreted through thematic analysis. Inequities imposed by The system (Theme 1) and burden from The stroke (Theme 2) profoundly impact Māori people’s experiences of rehabilitation and recovery, requiring devices that avoid perpetuating or exacerbating these challenges. Hononga (Joining and connection) (Theme 3) highlights how robotic devices could support connections to Te Ao Māori (Māori worldview), whānau (family and communities), and meaningful activities. Whanaungatanga (Relationships) (Theme 4), emphasised the importance of building trusting relationships between therapists, patients, and whānau. Therapists can uphold Tino rangatiratanga (Self-determination) (Theme 5) by supporting Māori patients and whānau to have control over their rehabilitation. The participants’ clinical and cultural expertise provided valuable insights for advancing robotic device design and implementation, emphasising the importance of inclusive approaches that address the diverse needs of Māori and promote culturally responsive rehabilitation technology.
Current Perspectives of New Zealand Physiotherapists on Rehabilitation and Return to Sport Following Anterior Cruciate Ligament Reconstruction: A Survey
(Elsevier, 2021-12-21) Fausett, WA; Reid, DA; Larmer, PJ
Objective: To investigate the clinical beliefs and practices of New Zealand physiotherapists regarding pre- and post-surgical rehabilitation and return to sport (RTS) criteria following anterior cruciate ligament reconstruction (ACLR). Design: Online cross-sectional survey. Methods: A survey was adapted from a previously published survey and disseminated to New Zealand physiotherapists who were considered more likely to be involved in post-ACLR rehabilitation. Results: The number of completed surveys was 318. Most physiotherapists (85%) preferred to first consult patients within 14 days of ACLR. In the first six weeks following ACLR, 89% of physiotherapists see patients at least once per week. Between 3- and 6-months post-ACLR, 76% of physiotherapists see patients at least once a fortnight. Pre-operative rehabilitation and post-operative rehabilitation exceeding six months are considered essential or important to patient outcomes by over 95% of physiotherapists. While 63% of physiotherapists support RTS 9–12 months after ACLR, 11% permit RTS within 6–9 months of surgery. Common RTS considerations include functional capacity, movement quality during functional tasks, time from ACLR, and knee strength. Conclusion: The survey revealed variability in the beliefs and practices of NZ physiotherapists regarding post-ACLR rehabilitation, and these beliefs and practices are at times inconsistent with best practice recommendations.
Towards a Multidisciplinary Approach in Degenerative Cervical Myelopathy: Opportunities of Non-Surgical Clinicians in Assessment and Management
(Elsevier, 2025-12-03) Paus, Annalena; Chauhan, Rohil V; Anderson, David A
Is Your Ethnicity Data Up to Standard?
(Physiotherapy New Zealand, 2025-12-12) McCambridge, Alana B
Patient Acceptance of Knee Symptoms and Function After Anterior Cruciate Ligament Reconstruction Improves With Physiotherapy Treatment
(Physiotherapy New Zealand, 2023-03-29) Fausett, Wayne; Reid, Duncan; Larmer, Peter; Garrett, Nick
Physiotherapy is considered an important component of rehabilitation following anterior cruciate ligament reconstruction (ACLR). The relationship between physiotherapy treatment and patient-reported outcomes following ACLR in New Zealand (NZ) is not clear. We used repeated measures logistic regression to examine the relationship between patient-reported outcome data from the NZ ACL Registry and physiotherapy treatment data from the Accident Compensation Corporation (ACC). Outcome measures utilised were the patient acceptable symptom state (PASS) on the Knee Injury Osteoarthritis and Outcome Score (KOOS4) and a normative score on the Marx Activity Rating Scale (MARS) within 24 months of ACLR. Data from 5,345 individuals were included in the final analysis, with a mean (SD) of 11.7 (10.5) (range 0–91) physiotherapy treatments received, over an average (SD) of 185 (153) (range 0–725) days, in the two years following ACLR. Physiotherapy treatment post-ACLR increased the likelihood of achieving a KOOS4 PASS score at 6 and 12 months, but not at 24 months, following surgery. Physiotherapy did not increase the likelihood of achieving a normative MARS score in the 24 months after ACLR. Multiple factors likely contribute to people who have had an ACLR in NZ receiving a low dosage of physiotherapy treatment following surgery. Physiotherapy treatment after ACLR may increase patient acceptance of any post-surgical symptoms and functional limitations, but the effect on post-operative activity levels is less clear.
Physioethology: A Post-Humanist Perspective on Physiotherapy
(Taylor and Francis Group, 2025-07-18) Low, Matthew; Moffatt, Fiona H; Kerry, Roger; Nicholls, David A
Physiotherapy faces mounting challenges in an era of planetary crisis. This paper proposes a reorientation of physiotherapy through the philosophy of Gilles Deleuze and Félix Guattari, specifically their concept of ethology, which foregrounds affect, relation, and immanence. We argue that contemporary physiotherapy remains tethered to anthropocentric, essentialist, and representational assumptions that limit its capacity to respond to complex ecological entanglements. Drawing on ethology, we explore how bodies, human and non-human, can be understood not as stable entities but as dynamic assemblages defined by what they can do. We consider the implications of this approach for practice, education, and planetary health, suggesting that physiotherapy shift from its traditional forms of praxis toward a dynamic composition of capacities. In doing so, the profession might cultivate an ecologically attuned, affectively sensitive, and experimentally oriented practice capable of engaging in the world.
Use of Patient-Reported Outcome Measures in Physiotherapy Clinical Trials in Six Major Physiotherapy Journals Two Decades Apart (2000–2018): A Meta-Research Design
(Informa UK Limited, 2025-07-03) Quel De Oliveira, C; Mehta, P; Nasser, A; Anderson, DB; Kennedy, DS; Pate, JW; Verhagen, AP; Waddell, A; Hildenbrand, C; Wu, L; McCambridge, AB; Stubbs, PW
Aim: Using patient-reported outcomes in research has been incentivised to encourage patient-centred care and ensure patient views are considered. We compared the use of patient-reported outcome measures (PROMs) in trials published in physiotherapy journals in 2000 and 2018, and evaluated whether the number of PROMs used differed between musculoskeletal, neurological, and cardiopulmonary subdisciplines. Design: Meta-research. Methods: Six major physiotherapy journals were searched for trials published in 2000 and 2018. Two independent reviewers extracted data on study characteristics and reporting of PROMs. PROMs were classified according to their outcome domains. Descriptive statistics and inferences were made based on proportions. A 20% difference between 2000 and 2018 was regarded as meaningful. Results: A total of 140 trials were included, 39 were published in 2000 and 101 in 2018. Eighty-four percent (n = 118/140) of trials reported ≥1 PROM, while 89% (n = 125/140) included ≥1 non-PROM. We found no meaningful differences on the average use of PROMs in 2000 and 2018: 74% (29/39) of trials in 2000 versus 88% (89/101) in 2018. PROM use in 2000 and 2018 was 88.5% and 84.4% in musculoskeletal physiotherapy, 57.2% and 86.1% in neurological physiotherapy and 0% and 88% in cardiopulmonary physiotherapy. The most used PROM outcome domains were symptoms and symptom burden (75%) and functional status (65%). Conclusion: Most trials from the six major physiotherapy journals sampled in 2000 and 2018 used PROMs, with no meaningful differences when comparing years. Fewer publications in 2000 than 2018 may account for the differences seen in neurological and cardiopulmonary physiotherapy.
Physiotherapist Factors Associated With the Intention to Deliver Psychologically Informed Physiotherapy in Persistent Low Back Pain: An Online Cross-sectional Vignette Study
(Elsevier BV, 2025-12-04) Earl, Claire; Bean, Debbie; Lewis, Gwyn
Background: Prior qualitative research has revealed several barriers to physiotherapists delivering psychologically informed physiotherapy (PIP). It is not known which factors are most relevant to PIP delivery. Objectives: To determine the proportion of physiotherapists in Aotearoa/New Zealand who intend to deliver PIP to persons with non-specific low back pain (LBP), and to determine factors associated with the intention to deliver PIP. Design: This study used a cross-sectional online vignette case survey design. Setting Aotearoa/New Zealand registered physiotherapists who regularly treat LBP were invited to participate. Methods: Participants (n=224) outlined their intended assessment and treatment plan for two vignettes with persistent LBP. They then completed the Knowledge and Attitudes of Pain Questionnaire (KNAP), components of the Determinants of Implementation Behaviour Questionnaire (DIBQ) and demographic questions. The proportion of physiotherapists intending to deliver PIP was determined by scoring participants’ vignette plans as psychologically informed or non-psychologically informed. Binary regression was used to determine which questionnaire and demographic variables were associated with the intention to deliver PIP. Results: One third of participants intended to deliver PIP in the management of LBP. Binary regression analysis showed that pain knowledge and attitudes were consistently associated with the intention to deliver PIP across vignettes (OR=1.05, 95% CI=1.01 – 1.08; p=.015) (OR=1.05, 95% CI=1.02 – 1.09, p=.005). Beliefs about the consequences of PIP was associated with the intention to deliver PIP in one vignette (OR=2.15, 95% CI=1.12 – 4.11, p=.021). Conclusion: Findings suggest that physiotherapists’ knowledge and attitudes towards pain and their belief that PIP is effective are associated with PIP delivery. Improving pain knowledge and beliefs around PIP may improve the quality of LBP management.
“The fact [is] that there is no easy way”. A Qualitative Study of the Experiences of Aotearoa New Zealand Clinicians With Opioid Tapering for Chronic Non-Cancer Pain
(Dove Medical Press, 2025-11-18) Fu, R; Bean, Debbie; Te Morenga, L; Frei, D; Devan, H
Objective: Opioid tapering is a complex process for both clinicians and patients with chronic pain. This qualitative study explored the experiences of Aotearoa New Zealand clinicians in managing opioids for patients with chronic non-cancer pain. Methods: Purposive and snowball sampling were used to interview nineteen health professionals including general practitioners (n=5), pain medicine specialists (n=5), addiction medicine specialists (n=4), pain fellows (n=3), addiction medicine registrar (n=1) and a pain nurse practitioner (n=1). Data were collected using a face-to-face focus group and fourteen individual interviews conducted via Zoom. The data were analysed using a Reflexive Thematic Analysis approach. Independent parallel coding was done by members of our research team, and the final themes were iteratively developed by mutual consensus. Results: This qualitative study suggests that meaningful opioid tapering requires a patient-centred approach that considers the individual’s unique sociopsychobiomedical context. Clinicians emphasised the importance of building trust, addressing fears, and tailoring tapering regimens to patients’ needs and motivations. While opioid tapering is a complex process for all patients, participants acknowledged unique considerations for supporting people living in rural areas–Māori and Pasifika and their whānau (families and significant others) addressing social determinants of health. There were overwhelming accounts of clinician distress from all participants especially for rural general practitioners due to the lack of support, conflicting practices, limited resourcing, and time constraints. Conclusion: These findings call for a co-ordinated, multidisciplinary approach to opioid tapering that addresses systemic inequities and prioritises patient and clinician well-being.
Comparative Effectiveness of Educational Interventions in Neurological Disease for Healthcare Workers and Students: A Systematic Review
(BMJ Publishing Group, 2025-11-07) Veremu, Munashe; Jiang, Zhilin; Gillespie, Conor; Roman, Elena; Cook, William; Chauhan, Rohil; Fard, Amir; Toumbas, Georgios; Baig, Shehla; Zipser, Carl; Stacpoole, Sybil; Tetreault, Lindsay; Deakin, Naomi; Bateman, Antony; Benjamin, Davies
OBJECTIVES: To assess the comparative effectiveness of educational interventions in neurological disease for healthcare workers and students. DESIGN: Systematic review. DATA SOURCES: Medline, Embase and Cochrane through to 1 June 2025. ELIGIBILITY CRITERIA: Studies evaluating neurological disease educational interventions with a comparator group (observational cohort/randomised controlled trial (RCT)) were included. DATA EXTRACTION AND SYNTHESIS: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant systematic review was conducted (PROSPERO: CRD42023461838). Knowledge acquisition and educational methodologies were collected from each study. Study outcomes were classified using the Kirkpatrick and Kirkpatrick four-level model (learner reaction, knowledge acquisition, behavioural change, clinical outcome).1 Risk of bias was assessed using the Newcastle-Ottawa scale for non-randomised studies and the Cochrane Risk of Bias tool for RCTs.2 3 RESULTS: A total of 67 studies involving 4728 participants were included. Of these, 36 were RCTs, and 31 were observational studies. Virtual interventions were the most common (67.2%, n=45 studies), primarily targeting either medical students (46.3%, n=31 studies) or specialists (40.3%, n=27 studies). Overall, 70.1% (n=47) of studies demonstrated outcomes in favour of the intervention. However, few studies used K&K level 3/4 outcomes, with two studies evaluating behaviour change (level 3) and three assessing clinical outcomes (level 4 combined with other levels). No study exclusively assessed level 4 outcomes. Meta-analysis of 22 RCTs with calculable standardised mean differences (SMDs) (n=1748) showed a significant benefit of interventions (SMD 0.75, 95% CI 0.22 to 1.27, p=0.0056). CONCLUSIONS: This review highlights a growing body of research particularly focusing on virtual techniques, specialist audiences and treatment-oriented content. Few studies assessed changes in practice or patient care. Non-specialists remain underrepresented. Future studies should prioritise assessing the clinical impact of educational interventions within non-specialist audiences.
What Are the Core Features of Stroke Care That Support Well-being? A Qualitative Study From the Perspectives of People With Stroke, Whānau, and Stroke Care Providers in Aotearoa New Zealand
(BMJ Publishing Group, 2025-11-27) Bright, Felicity; Ibell-Roberts, Claire
Objectives: To identify the core attributes of quality care that supports well-being from the perspectives of those who access, and provide, stroke services. Design: Qualitative Interpretive Description study design involving in-depth semi-structured individual and group interviews and analysis using journey mapping and conventional content analysis. Participants: 24 people with stroke, 13 family/whānau members and 34 healthcare professionals located throughout New Zealand. Setting: Participants were recruited through health services, stroke support organisations, and professional networks. Interviews were completed in person at people’s homes or workplaces or on an online videoconference. Results: Analysis generated a quality framework of domains. High quality care that supports well-being after stroke in Aotearoa: supports people through uncertainty; fosters a sense of belonging; prioritises relationships and connecting ‘as people’; attends to the emotional aspects of stroke; centres people’s preferences and supports people to have choice and control; honours Māori knowledges and practices; responds to the strengths and needs of friends and whānau; and attends to people’s holistic long-term well-being. Conclusions: This study offers a framework for considering holistic stroke care that supports areas of need not consistently addressed in stroke service. This framework can help structure practice and policy and can underpin future research in well-being.
Throw Away the Manual! Reflections on Psychotherapy and Crime
(University of Ottawa Library, 2025-07-23) Manning, Seán; Nicholls, David; Day, Elizabeth
Aotearoa New Zealand has a high rate of imprisonment, seventh or eighth among 36 OECD countries. The experience of imprisonment, isolation from family and the wider community, the company of a population where violence, misogyny, drugs, risk-taking and rule-breaking are normalised, sees the emergence and practice of a criminal subjectivity. This confers mana, a loyal peer group, mentors and a career, on a population well-endowed with obstacles to these ends. An intoxicating, adaptive, performative subjectivity emerges, is practiced every day, and is not readily given up, accounting for the failure of manualised rehabilitation and treatment models which locate the problem in the individual subject. The prison, a subjectifying machine that perpetuates drug use, violence, poverty, family harm and disenfranchisement, which reduces participation in the wider democracy, mitigates against individual change. Using the philosophy of Michel Foucault, in this paper the authors reflect on method in working with men with extensive prison experience, without relying on the idea of an agentive self – an unlikely fiction among graduates from the prison system.
The Multiple Sclerosis-Fatigue Self-Efficacy (MS-FSE) Scale: Initial Validation
(SAGE Publications, 2014-08-26) Thomas, S; Kersten, P; Thomas, PW
Objective: To examine the validity and sensitivity to change of the Multiple Sclerosis-Fatigue Self-Efficacy scale. Design: A validation study nested within a randomized controlled trial. Setting: Community setting. Participants: Adults with a clinically definite diagnosis of multiple sclerosis and significant fatigue taking part in a randomized controlled trial evaluating a group-based fatigue management programme (FACETS) for people with multiple sclerosis (N=164). Main measures: The 9-item Multiple Sclerosis-Fatigue Self-Efficacy scale was completed at baseline, 1-, 4- and 12 months post intervention. Validity, internal consistency and sensitivity to change were examined using classical test theory and Rasch analysis. Results: Item 3 was unanswered by 6% of respondents as they did not know any other people with multiple sclerosis; remaining analyses were carried out with this item deleted. All response choices were utilised, no floor or ceiling effects were evident and there were few missing responses. Cronbach’s alphas were high (baseline, 0.89; follow-up 1, 0.93; follow-up 2, 0.94; follow-up 3, 0.90). The Multiple Sclerosis-Fatigue Self-Efficacy scale (8-item) demonstrated good sensitivity to change following attendance of the FACETS programme (within participant effect sizes 0.66 and 0.69 and 0.54 at 1, 4, and 12 months follow-up). Principal Components Analysis yielded one component. In the Rasch analysis two items with disordered thresholds were rescored. Item 8 displayed differential item functioning by disability and was combined into a testlet with item 4, resulting in a unidimensional scale. The sample was well targeted to the scale. Conclusion: At a scale level the Multiple Sclerosis-Fatigue Self-Efficacy scale is internally valid and has good sensitivity to change.

Browse

Recent Submissions