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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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.
Experiences of Sensory Input in Daily Occupations for People with Serious Mental Illness
(Informa UK Limited, 2020) Andersson, H; Sutton, D; Bejerholm, U; Argentzell, E
Background 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.
The Nijmegen Questionnaire: A Valid Measure for Hyperventilation Syndrome
(New Zealand Journal of Physiotherapy, 2019-01-01) Li Ogilvie, V; Kayes, NM; Kersten, P
Hyperventilation 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.
Person Centered Care in Neurorehabilitation: A Secondary Analysis
(Taylor & Francis, 2019-01-29) Terry, Gareth; Kayes, NM
Person 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.
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, K
Active 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.
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, BE
Despite 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.
Governing Neurorehabilitation
(Informa UK Limited, 2021-05-14) Cummins, Christine; Payne, D; Kayes, NM
Purpose 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.
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 Team
BACKGROUND: 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 ).
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, C
Developing Connections for Engagement in Stroke Rehabilitation
(Cambridge University Press, 2021-12-27) Kayes, NM; Cummins, Christine; McPherson, KM; Worrall, L; Bright, Felicity
Background 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.
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, Joanna
Qualitative 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.
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, PJ
Osteoarthritis (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.
Development of a Self-Guided Web-Based Exercise Intervention (SPIN) to Treat Shoulder Pain in People Living with Spinal Cord Injury: Protocol of a Mixed Methods Study
(BMJ Journals, 2019) Stavric, Verna; Saywell, Nicola; Kayes, NM
Introduction: Chronic shoulder pain is common after spinal cord injury (SCI) and limits community mobility. This leads to loss of independence and reduced quality of life. Evidence suggests that exercises can help reduce shoulder pain. However, cost, expertise and transport barriers frequently limit access to treatment services. The objective of this study is to develop an evidence-based, acceptable, usable and persuasive self-guided web-based exercise intervention to treat shoulder pain in people living with SCI. Methods and analysis: An iterative and phased person-based approach (PBA) will capture users' perspectives on usability and acceptability to develop guiding principles that will shape the design of the intervention. The intervention will be based on key elements identified through participant input and from evidence identified through systematic and narrative reviews, to ensure the intervention addresses participants' needs and increase the likelihood of uptake. The prototype will be iteratively refined through focus groups and think-aloud sessions. Review data will be synthesised drawing on systematic and narrative review conventions. Qualitative data will be analysed using conventional content analysis (planning phase) and directed content analysis (development phase) to inform intervention design and refinement. Ethics and dissemination: Ethical approval has been granted by the Auckland University of Technology Ethics Committee (AUTEC) in Auckland, New Zealand. The results of the study will be published in a peer-reviewed journal and presented at relevant national and international conferences. A summary of findings will be presented to key stakeholder groups. We will progress to a definitive trial should the findings from this intervention development study indicate the intervention is acceptable and usable.
‘The Wairua First Brings You Together’: Māori Experiences of Meaningful Connection in Neurorehabilitation
(Cambridge University Press, 2022-12-13) Wilson, BJ; Bright, Felicity; Cummins, Christine; Elder, Hinemoa; Kayes, NM
Background and Aims: Therapeutic connections enhance patient experience and outcomes after neurological injury or illness. While we have some understanding of the components necessary to optimise therapeutic connections, these have developed from western-centric ideals. This study sought to explore the perspectives of Maori brain injury survivors, and their whanau (wider family and community), to develop more culturally informed understandings of what matters most for Maori in the development and experience of therapeutic connection. Design and Methods: A bicultural approach underpinned by principles of Kaupapa Maori Research was used. Whanau views and experiences were gathered through wananga (focus groups). These perspectives were analysed drawing on Maori methods of noho puku (self-reflection), whanaungatanga (relational linkage) and kaitiakitanga (guardianship). Findings: Three wananga were held with 16 people - 5 brain injury survivors and 11 whanau members. The phrase 'therapeutic connection' did not resonate; instead, people spoke of meaningful connections. For rehabilitation encounters to be meaningful, three layers of connection were acknowledged. The elemental layer features wairua (spirit) and hononga (connection) which both underpinned and surrounded interactions. The relational layer reflects the importance of whanau identity and collectivism, of being valued, known, and interactively spoken with. Finally, the experiential layer consists of relational aspects important within the experience: relationships of reciprocity that are mana-enhancing and grounded in trust. These layers are interwoven, and together serve as a framework for meaningful connections. Conclusions: Meaningful connections in neurorehabilitation are underpinned by wairua and hononga; are multi-layered; are enabled through interactions with people, practice, process and place; are inclusive of whanau and resonate with Maori worldviews. The primacy of wairua and whanau within an interconnected view of health, challenges individualistic notions inherent in western health models and deepens existing understandings of meaningful connections in neurorehabilitation which can guide future rehabilitation research, teaching and practice.
Vocational Interventions to Help Adults with Long-Term Health Conditions or Disabilities Gain and Maintain Paid Work: An Overview of Systematic Reviews
(BMJ, 2021-10-29) Levack, WMM; Fadyl, Joanna
Objective: To conduct an overview of systematic reviews to examine the effectiveness of vocational interventions to help adults with long-term health conditions or disability gain and maintain new paid work and to analyse the spread and quality of evidence in this area. Methods: We pre-published our protocol in PROSPERO (CRD42019132448). We searched Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, PsycINFO, AMED, CINAHL, ProQuest Dissertations and Theses database, NICE and Business Source Complete from inception to 21 August 2020. We included any systematic reviews of clinical trials on vocational interventions for adults with long-term health conditions or disability who were not in work or had recently gained work. We excluded reviews of vocational interventions for employed people on sick leave. Two researchers identified, critically appraised, using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2, and extracted data from included reviews. We used Grading of Recommendations Assessment, Development and Evaluation to evaluate strength of evidence underpinning overview findings. Results: We identified 26 reviews (5 high-quality and 21 critically low to moderate quality) that focused on vocational interventions for acquired brain injury, autism, intellectual disability, multiple sclerosis, mental health conditions, spinal cord injury and general disability populations. We identified moderate quality evidence that people with moderate to severe mental health conditions who participate in supported employment, particularly individual placement and support, are more likely to gain competitive employment compared with people who receive traditional vocational services (risk ratio 2.07; 95% CI 1.82 to 2.35; 27 studies, 6651 participants). We found only very low-quality to low-quality evidence on vocational intervention for people with any other health condition. We found little to no data on employer or employee satisfaction with work outcomes or the cost effectiveness of interventions. Conclusion: Given the importance placed on work opportunities for people with long-term health conditions or disability, there is urgent need for more high-quality research on vocational interventions for this population.
Learning From Those Who Have Gone Before: Strengthening the Rural Allied Health Workforce in Aotearoa New Zealand
(James Cook University, 2019-06-26) George, JE; Larmer, PJ; Kayes, NM
Context and issues: The pipeline for the allied health, scientific and technical workforce of Aotearoa New Zealand is under growing pressure, with many health providers finding recruitment and retention increasingly difficult. For health providers in rural settings, the challenges are even greater, with fewer applicants and shorter tenures. As the health needs of rural communities increase, along with expectations of uptake of technologies and the Ministry of Health's strategy to ensure care is provided closer to home, being able to retain and upskill the diminishing workforce requires new ways of thinking. Lessons learned: Understanding the activity that has been undertaken by medical and nursing workforces in New Zealand and abroad, as well as the work of the Australian allied health workforce provides context and opportunities for New Zealand. The challenge is for educators, professional bodies, the Ministry of Health and health providers to develop new ways of thinking about developing a rural workforce for the allied health scientific and technical professions.
A Feasibility Study of a One-to-One Mindfulness-based Intervention for Improving Mood in Stroke Survivors
(Springer, 2021-01-08) Wrapson, Wendy; Dorrestein, M; Wrapson, J; Theadom, A; Kayes, NM; Snell, DL; Rutherford, S; Roche, M; Babbage, DR; Taylor, S; Siegert, RJ
Objectives: Mindfulness is an evidence-based treatment for depression but has never been rigorously tested with stroke survivors with depression. This feasibility study examined several issues relevant to a potential trial of a mindfulness-based intervention (MBI) for improving mood after stroke. Methods: In 2017–2019 in New Zealand, we recruited 20 stroke survivors with low mood to undergo a 6-week, one-on-one MBI course delivered by an occupational therapist experienced in MBIs. Pre, post, and 4-week follow-up assessments were completed. Results: Fifteen participants completed all six sessions and a 4-week “booster” or top-up session. The 1-hour session duration was considered appropriate by participants and all enjoyed the face-to-face individualized format. Mean Beck Depression Inventory-II scores improved by more than one standard deviation and this was maintained at follow-up. However, the baseline assessment package was too long for some participants due to the cognitive component. Three participants indicated feeling emotionally challenged by some of the practices. These effects were managed by the mindfulness facilitator by adjusting the practice, so participants maintained their sense of agency, well-being, and overall benefit from the program. Conclusions: MBI training delivered individually over six weekly sessions was acceptable to stroke survivors with 14/15 participants reporting improved mood. Three participants reported feeling emotionally challenged by some of the practices and we recommend MBIs for stroke survivors be provided by practitioners experienced in mindfulness, working with stroke, and trauma-informed therapy. It is important now to conduct rigorous randomized controlled trials to test the effectiveness and efficacy of MBIs for stroke survivors.
Person-centred Rehabilitation – Theory, Practice, and Research [Editorial]
(Frontiers Media S.A., 2022-07-20) Morris, Jacqui; Kayes, NM; McCormack, Brendan

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