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.
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Item 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, NickPhysiotherapy 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.Item Physioethology: A Post-Humanist Perspective on Physiotherapy(Taylor and Francis Group, 2025-07-18) Low, Matthew; Moffatt, Fiona H; Kerry, Roger; Nicholls, David APhysiotherapy 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.Item 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, PWAim: 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.Item 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, GwynBackground: 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.Item “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, HObjective: 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.Item 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, DaviesOBJECTIVES: 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.Item 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, ClaireObjectives: 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.Item Throw Away the Manual! Reflections on Psychotherapy and Crime(University of Ottawa Library, 2025-07-23) Manning, Seán; Nicholls, David; Day, ElizabethAotearoa 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.Item The Multiple Sclerosis-Fatigue Self-Efficacy (MS-FSE) Scale: Initial Validation(SAGE Publications, 2014-08-26) Thomas, S; Kersten, P; Thomas, PWObjective: 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.Item Experiences of Sensory Input in Daily Occupations for People with Serious Mental Illness(Informa UK Limited, 2020) Andersson, H; Sutton, D; Bejerholm, U; Argentzell, EBackground There is growing evidence that people with serious mental illness have impaired capacity for processing sensory inputs which affects daily occupation. Although this is known, research regarding the target groups experiences of sensory inputs in daily occupations is lacking. Aim To investigate the experience of sensory input and strategies used in daily occupations among people with serious mental illness. Material and methods Fourteen people with serious mental illness were interviewed regarding their experiences of sensory processing and strategies for managing sensory inputs in daily occupations. Data were analysed using content analysis. Results Sensory processing issues affected occupational engagement and strategies to control inputs were intuitively used to cope with sensory challenges. Informants either ignored, reduced or avoided sensory inputs. Informants also enabled daily life through strategies such as creating a home that provides rest, finding a safe place, using nature and animals for relaxing and using effects of calming and alerting occupations. Discussion Specific sensory inputs were difficult to process, which was experienced as stressful and affected occupations negatively. The results imply a need for further research exploring the management of sensory input and the use of sensory modulation approaches to enable engagement in daily activities.Item The Nijmegen Questionnaire: A Valid Measure for Hyperventilation Syndrome(New Zealand Journal of Physiotherapy, 2019-01-01) Li Ogilvie, V; Kayes, NM; Kersten, PHyperventilation syndrome is often undiagnosed due to its multi-systemic and apparently unrelated symptoms. The Nijmegen Questionnaire is used by clinicians to assess susceptible individuals, based on self-reporting symptoms attributed to hyperventilation syndrome. However, evidence of the psychometric properties of this questionnaire is lacking. This study investigated two types of validity using interviews and Rasch analysis. Data showed that the Nijmegen Questionnaire met criteria for content validity but not for structural validity. Content validity was supported by a high matching percentage between the symptoms identified within interview data and the current items on the Nijmegen Questionnaire (94%). Reported symptoms from study participants were conceptually congruent with most of the questionnaire items, with minor language inconsistencies between patients and clinicians. Rasch analysis indicated a poor fit of the Nijmegen Questionnaire to the Rasch model, demonstrating poor structural validity. This study also developed a revised 15-item version of the Nijmegen Questionnaire, which met criteria for structural validity. Subsequently, a conversion table was created for transforming raw total scores of the questionnaire in the clinical and research settings. Physiotherapists should use the revised 15-item Nijmegen Questionnaire for clinical and research purposes since it provides more accurate representation of the severity of patients’ symptoms than the original scoring.Item Person Centered Care in Neurorehabilitation: A Secondary Analysis(Taylor & Francis, 2019-01-29) Terry, Gareth; Kayes, NMPerson centered care has been described as being in its ascendency, despite some of the complexities of embedding it within healthcare systems. The emphasis of research now seems to be moving toward the promotion of cultures of care that support the efforts of practitioners. Informed by some of the principles of positive deviancy, where some of the solutions for change can be found within existing cultures and practices, this paper aimed to identify examples of person-centered care in existing practice. Reporting on a thematic analysis of qualitative datasets from three preexisting projects, we constructed four themes from these data: (1) That patient experience and needs should always be understood in terms of their difficult new reality; (2) the need for a relational orientation in care; (3) the importance of treating trust as a currency; and, (4) efficacy in rehabilitation is co-constructed, and enabled by the efforts of clinicians. Identifying positive examples of care, enacted irrespective of the framework of care they are found within, may provide opportunities to critically reflect on practice. The context for care and the extent to which that context constrains or makes possible person-centered care in practice will also be discussed.IMPLICATIONS FOR REHABILITATION Cultures of care are central to enhancing person-centered practice. Care begins with recognition of patient’s difficult new reality. Building trust helps enable capacity for improvement.Item Mobility Barriers and Enablers and Their Implications for the Wellbeing of Disabled Children and Young People in Aotearoa New Zealand: A Cross-Sectional Qualitative Study(Elsevier BV, 2021) Smith, M; Calder-Dawe, O; Carroll, P; Kayes, NM; Kearns, R; Lin, E-Y (Judy); Witten, KActive participation in community and cultural life is a basic right of all children and young people (CYP) and is central to wellbeing. For disabled CYP, mobility can be constrained through a range of environmental and social/attitudinal barriers. The aim of this research was to understand the enablers and barriers to mobility from the perspectives of disabled CYP. Thirty-five disabled CYP aged between 12 and 25 years took part. Data were collected in Tāmaki Makaurau Auckland, Aotearoa New Zealand from mid-2016 to early 2018. Face-to-face interviews and go-along interviews were conducted and were transcribed verbatim. An iterative, thematic approach to analysis was undertaken. Mobility played an essential role in enabling wellbeing, connecting CYP to people, places and possibilities. While the possible impediments to smooth transit appeared infinite, numerous examples of overcoming barriers to mobility were evidenced across a range of factors. Dis/ableism was a pervasive barrier to mobility. The rights to access and experience the city for young people in this study were compromised by transport networks and social norms as well as values that privilege the movement of non-disabled bodies. The findings demonstrate that reducing ableist presumptions about preferences and abilities of disabled CYP, alongside ensuring practical enablers across the transport system must be key priorities for enhancing the wellbeing of this group.Item Is the Assumption of the Autonomous Individual Holding Us Back in Vocational Rehabilitation?(Emory University, 2021-12-17) Fadyl, Joanna; Reid, L; Cummins, Christine; Gibson, BEDespite a move toward sophisticated conceptual work in the field of vocational rehabilitation, an assumption that the subjects of intervention are autonomous ‘individuals’ continues to be taken for granted. This has many effects, including how services are funded and the way that practitioners think about what it is they do; these effects flow on into what is possible for people who experience disability. Although the field of vocational rehabilitation is not the origin of the assumption of the autonomous individual, it may be a useful place for challenging it. This article provides a brief analysis of the assumption and its effects, with the purpose of exploring what it makes visible, and where a focus for action could be.Item Governing Neurorehabilitation(Informa UK Limited, 2021-05-14) Cummins, Christine; Payne, D; Kayes, NMPurpose Person centred approaches to rehabilitation are promoted as an ethical means of addressing paternalistic power relations in clinician dominated medical encounters and improving outcomes. However, they fail to account for the complex nature of power. We sought alternative ways to explain the use of power in health service provision. Methods A poststructural discourse analysis using the view of power offered by Michel Foucault was undertaken. Foucault’s concept of governmentality is useful to explain the way health services deploy technologies of power to achieve objectives of the state. Governmentality refers to not just political structures but all the strategies and procedures for directing human behaviour. Results Our investigation uncovered a web of strategic relationships operating that were both potentially productive and problematic and illuminate how client centred approaches in neurorehabilitation intertwines its subjects in strategic power relationships that involve webs of obligations and responsibilities. Conclusion The client-professional relationship promoted in neurorehabilitation as a moral way to practice can be a tool for mastery of one over the other, and assist the client to achieve their desired ends, but also has the potential to marginalise others who are unable to shape themselves into the desired ideal client. Implications for rehabilitation This analysis shows how power is subtle and productive in that it produces knowledge and roles for both clients and practitioners. It demonstrates how neurorehabilitation’s disciplinary practices assist the client to achieve their recovery goals. It reveals how certain clients might be marginalised when they cannot shape themselves into the ideal rehabilitation client. As a final point we hope that by being aware of how power works in neurorehabilitation, practitioners can become aware of opportunities for challenging disciplinary practices that do not serve the best interest of the client.Item Optimising Function and Well-Being in Older Adults: Protocol for an Integrated Research Programme in Aotearoa/New Zealand.(BioMed Central, 2022-03-16) Lord, S; Teh, R; Gibson, R; Smith, M; Wrapson, Wendy; Thomson, M; Rolleston, A; Neville, S; McBain, L; Del Din, S; Taylor, L; Kayes, NM; Kingston, A; Abey-Nesbit, R; Kerse, Ngaire; AWESSoM Project TeamBACKGROUND: Maintaining independence is of key importance to older people. Ways to enable health strategies, strengthen and support whanāu (family) at the community level are needed. The Ageing Well through Eating, Sleeping, Socialising and Mobility (AWESSOM) programme in Aotearoa/New Zealand (NZ) delivers five integrated studies across different ethnicities and ages to optimise well-being and to reverse the trajectory of functional decline and dependence associated with ageing. METHODS: Well-being, independence and the trajectory of dependence are constructs viewed differently according to ethnicity, age, and socio-cultural circumstance. For each AWESSoM study these constructs are defined and guide study development through collaboration with a wide range of stakeholders, and with reference to current evidence. The Compression of Functional Decline model (CFD) underpins aspects of the programme. Interventions vary to optimise engagement and include a co-developed whānau (family) centred initiative (Ngā Pou o Rongo), the use of a novel LifeCurve™App to support behavioural change, development of health and social initiatives to support Pacific elders, and the use of a comprehensive oral health and cognitive stimulation programme for cohorts in aged residential care. Running parallel to these interventions is analysis of large data sets from primary care providers and national health databases to understand complex multi-morbidities and identify those at risk of adverse outcomes. Themes or target areas of sleep, physical activity, oral health, and social connectedness complement social capital and community integration in a balanced programme involving older people across the ability spectrum. DISCUSSION: AWESSoM delivers a programme of bespoke yet integrated studies. Outcomes and process analysis from this research will inform about novel approaches to implement relevant, socio-cultural interventions to optimise well-being and health, and to reverse the trajectory of decline experienced with age. TRIAL REGISTRATION: The At-risk cohort study was registered by the Australian New Zealand Clinical Trials registry on 08/12/2021 (Registration number ACTRN 12621001679875 ).Item Exploring the Value and Role of Creative Practices in Research Co-production(Bristol University Press, 2022-04-11) Langley, J; Kayes, NM; Gwilt, I; Snelgrove-Clarke, E; Smith, S; Craig, CItem Developing Connections for Engagement in Stroke Rehabilitation(Cambridge University Press, 2021-12-27) Kayes, NM; Cummins, Christine; McPherson, KM; Worrall, L; Bright, FelicityBackground and Aims: Engagement is increasingly recognised as important for maximising rehabilitation outcome following stroke. However, engagement can be challenging when neurological impairment impacts a persons' ability to activate the regulatory processes necessary for engagement and in the context of a changed self. We explored engagement in stroke rehabilitation from the perspective of people with stroke with a primary focus on identifying key processes that appeared important to engagement in stroke rehabilitation. Design and Methods: This study drew on Interpretive Description methodology. Maximum variation and theoretical sampling were used to capture diversity in the sample and access a depth and breadth of perspectives. Data collection included semi-structured interviews with people with stroke (n = 19). Data were analysed through a collaborative and iterative process drawing on range of analytical tools including coding, memoing, diagramming and group discussions. Findings: Our findings highlight that engagement is a complex, nuanced, responsive, flexible and inherently two-way process. Developing connections appeared central to engagement with connections taking various forms. The most fundamental was the therapeutic connection between the person with stroke and their practitioner as it provided the foundation on which to build other connections. Connection was made possible through five collaborative processes: Knowing, Entrusting, Adapting, Investing and Reciprocating. Conclusions: Engagement is a social and relational process enabled through an inherently person-centred approach and active and ongoing reflexivity - highlighting the importance of a humanising approach to care where aspects of self, care and emotion are evident, for both the person with stroke and their practitioner.Item Supporting People Experiencing a Burn Injury to Return to Work or Meaningful Activity: Qualitative Systematic Review and Thematic Synthesis(Physiotherapy New Zealand, 2021-11-15) van Bentum, J; Nicholson, J; Bale, N; Fadyl, JoannaQualitative studies contain in-depth information about facilitators and and barriers to to successful rehabilitation. This systematic review synthesised findings across qualitative studies to inform vocational rehabilitation practices for people who have experienced burn injury. PRISMA guidelines were used to determine inclusion criteria for the review and develop a comprehensive search strategy. Four databases were searched and results screened. Included studies investigated experiences of return to work (RTW) or meaningful activity in a burn injury population. Quality of included articles was examined using the CASP framework for qualitative research. Thematic synthesis was used to analyse the qualitative results. Six studies met inclusion criteria. Five analytic themes were identified regarding experiences of vocational support and ability to RTW after burn injury: addressing the complex impact of burn injury; personal connections as vital support; skilled and specialised healthcare as central to RTW; value of knowledge; and considering the work environment. No included studies investigated meaningful activity other than paid work. Findings support structured vocational rehabilitation, psychological interventions, social support, intensive rehabilitation and patient, clinician and workplace education as key in facilitating RTW after burn injury. Additionally, coordinated care is likely to improve vocational outcomes. Research is needed on supporting return to meaningful activity.Item The Lived Experiences of Ngā Tāne Māori with Hip and Knee Osteoarthritis(Physiotherapy New Zealand, 2021-11-15) Dixon, TW; O'Brien, DW; Terry, Gareth; Baldwin, JN; Ruakere, T; Mekkelholt, T; Larmer, PJOsteoarthritis (OA) is a debilitating condition affecting an individual’s quality of life in multiple ways. However, little is known about about the experiences of täne (men) Māori living with OA in Aotearoa New Zealand. We aimed to explore the lived experiences of ngā tāne Māori with OA. This qualitative study was guided by tikanga and kaupapa Māori philosophies. Interviews were conducted in a semi-structured method, with seven tāne Māori living with OA. Key themes were identified and developed from the data through thematic analysis, and were informed by Tā Mason Durie’s Māori health frameworks, Te Whare Tapa Whā and Te Pae Māhutonga. Four themes developed from the data and were named: (1) The interface of masculine embodiment and mana, (2) Taha whānau and connection as central to ngā tāne Māori wellbeing, (3) The benefits of taha wairua (spiritual wellbeing), and (4) Te urutau kia uru ki te punaha tiaki hauora: Adapting to access the health-care system. OA places a significant burden on ngā tāne Māori and their whānau, impacting on all aspects of hauora (health). The unique lived experiences and impact on wider whānau of Māori living with OA indicates the need to consider te ao Māori (Māori world view) when developing clinical services and a Model of Care for OA.