Medicine and Health Sciences Commons^™

Investigation Of A Communication Enhanced Environment Model After Stroke: A Mixed Methods Before-And-After Pilot Study, Sarah D’Souza

Theses: Doctorates and Masters

Background: Aphasia is an acquired communication disorder that affects approximately 30% of first ever stroke survivors and persists one-year post-stroke in up to 61% of survivors. Aphasia impacts on all communication modalities with significant negative consequences for social participation, interpersonal relationships, autonomy, capacity to work and quality of life. It is recognised that the environment can influence neural remapping during early stroke recovery. However, patients with aphasia (PWA) following stroke have been observed to spend less than 30% of their day communicating and 44% of their day alone during their first weeks of in-patient rehabilitation. Inadequate opportunities for communication places …

Drumbeat© For Arthritis “ A Shared Purpose” Rather Than A “Lonely Struggle”, Jannette Warhurst

Theses: Doctorates and Masters

Australia is regarded as a healthy nation, with life expectancy one of the highest in the world. Yet the latest National Health Survey tells a very different story. Almost 50% of Australians are now living with one or more chronic conditions, with arthritis and other musculoskeletal (MSK) conditions representing the most expensive chronic disease group in Australia. As the leading cause of chronic pain and second most common cause of disability and early retirement due to ill health in Australia, Arthritis is costing the economy over $7 billion a year, in addition to over $1.1 billion in extra welfare costs …

Delegation Practices Between The Registered Nurse And The Assistant In Nursing In The Acute Care Setting In Western Australia, Carol Crevacore

Theses: Doctorates and Masters

Background:

Delegation is an essential skill that allows the Registered Nurse (RN) to allocate aspects of patient care to other team members including the unregulated Assistant in Nursing (AIN). Concerns have been raised about the activities delegated to AINs in the acute care environment.

Aim:

The aim of this research was to explore the practice of delegation between the RN and the AIN in the acute care environment. This delegation practice was examined through the lens of both the RN and the AIN.

Methodology:

This study used a mixed method explanatory sequential design. The participants were RNs and AINs working …

Treatment Fidelity In The Very Early Rehabilitation In Speech (Verse) Randomised Controlled Trial: An Exploration Of Treatment For Aphasia, Emily Louise Brogan

Theses: Doctorates and Masters

Background

Aphasia is a neurological condition that affects the expression and/or comprehension of language and can have considerable impact on a person’s quality of life. Treatment for aphasia from speech language pathologists is effective. However, more information is needed on the nature of effective intervention including consideration for what therapy is provided, when it is commenced and how it is delivered. Treatment fidelity is concerned with ensuring research treatment protocols are implemented as they were intended, which assists in uncovering the specifics of how and why treatments work. When treatment fidelity is investigated thoroughly, researchers and research consumers can be …

The Effect Of Maximal Isometric Training On Doublet-Induced Force Enhancement And Its Relationship With Changes In Voluntary Rate Of Force Development, David Vernon Murray

Theses: Doctorates and Masters

Motor unit double discharges (i.e. doublets), which are excitatory potentials that occur at shorter-than-normal intervals (e.g. 5-10 ms) during normal muscle activation, are known to cause muscle force to exceed that predicted from a standard, linear summation of twitch forces. However, although a marked increase in the occurrence of motor unit doublets at the onset of a contraction has been observed after explosive-type exercise training, and has been correlated with changes in RFD (Van Cutsem et al., 1998), little is known about the influence of strength training on the physiological and biomechanical benefits derived from the phenomenon. The present research …

The Role Of Simulation-Based Learning Environments In Preparing Undergraduate Health Students For Clinical Practice, Brennen Mills

Theses: Doctorates and Masters

Experiential learning (EL), whereby students are able to integrate theory with practice, is an essential component of learning for health professionals. Traditionally, EL in the health education context has been achieved through clinical placements (CPs) that see students ‘apprentice’ in real clinical settings. The literature suggests there are a number of factors that diminish a student’s ability to learn in such environments, including limited opportunities to practice, being confined primarily to observation roles as opposed to participate in tasks, being exposed to skills/procedures outside their level of learning/understanding, and institutional learning objectives being secondary to workplace goals. Simulation-based learning environments …

Communication: How Do Females With Rett Syndrome Perform This Activity And What Factors Influence Performance?, Anna Urbanowicz

Theses: Doctorates and Masters

Background Rett syndrome is a neurodevelopmental disorder primarily caused by mutations in the X-linked methyl-Cp2G-binding protein 2 (MECP2) gene. The disorder affects approximately 1 in 9000 females and is usually associated with language, physical and intellectual impairments, each of which contributes to difficulties with communication. In Rett syndrome, eye gaze is considered a common form of communication and conventional methods, such as talking and gestures, less common. Females appear to use these forms of communication to serve a number of functions including choice making, requesting, social convention, bringing attention to themselves, and to reject, comment and answer. However, the literature …

Early Intervention Of Parent-Infant Interactions In Preterm Infants: A Systematic Review, Stacey Osborne

Theses : Honours

Every year approximately 15 million babies are born preterm. These infants are at an increased risk of language, and other developmental delays due to their immature brain development and higher incidence of brain abnormalities. They also have poorer health outcomes in the early stages of life which may go on to hinder successful parent-infant interactions. Successful parent-infant interactions are important for infant developmental outcomes such as language, cognition and behaviour. While interventions targeting the promotion of positive interactions have been found to have positive effects in a number of populations to date, interactions involving preterm infants have not been explored. …

Indirect Approaches: A Systematic Review Of Paediatric Dysphagia Interventions, Bianca Piano

Theses : Honours

Background and purpose: Dysphagia can be described as difficulty within the oral, pharyngeal and/or oesophageal phases of deglutition and occurs in approximately 80% of children with developmental disabilities, according to the American Speech and Hearing Association (2015). It occurs when there is impairment to the motor and/or sensory aspects of swallowing, due to a range of disorders affecting the voluntary and reflexive components of deglutition. The ability to swallow safely is essential in preventing medical complications, sustaining life and maintaining social participation. Paediatric interventions can be categorized into three broad approaches; direct, indirect and mixed. At present, two systematic reviews …

Resting Energy Expenditure Using Indirect Calorimetry In Individuals With Moderate To Low Burns: A Pilot Study Of Associated Factors, Patient Acceptability And Comparison With Predictive Equations, Janica Bell

Theses : Honours

Background: Energy expenditure increases following a burn injury. The extent of hypermetabolism is dependent on a range of factors including burn total body surface area. Moderate to low burn injuries (< 15% TBSA) represent majority of hospital admissions for burn injuries however, their energy expenditure remains unpublished. While indirect calorimetry (IC) is the gold standard for determining energy requirements, less accurate predictive equations are often used in practice. Acceptability of IC from a burn patient perspective has not been published.

Aim: To describe the resting energy expenditure (REE) of patients with a moderate to low burn injury using IC; compare measured REE to predictive equations; and determine the patient acceptability of IC.

Methods: Demographic, anthropometric and dietary data were collected for five male and three female burn patients. REE was determined using indirect calorimetry (Ultima CPX) and five predictive methods (Schofield, Harris-Benedict, Toronto and the Ireton-Jones …

Factors That Influence The Decision-Making Of An Integrated Rehabilitation Team When Choosing A Post-Hospital Discharge Destination For Survivors Of Stroke, Jessie M. Johnson

Theses: Doctorates and Masters

Stroke is one of the more disabling conditions which may result in the inability for survivors to care for themselves independently. Stroke survivors benefit most when they receive early onset assessment, treatment, and rehabilitation. Increasingly, stroke care in Canadian hospitals relies on an interdisciplinary rehabilitation team approach to provide immediate rehabilitation services and to make decisions about discharge destination for stroke survivors. Currently, there is little research on how interdisciplinary rehabilitation teams decide upon rehabilitation placements for stroke survivors or how individuals on the team, stroke survivors, or their families participate in and contribute to this decision. This research studied …

The Creation And Validation Of A Youth Fundamental Hitting Scale: The Assessment Of Youth Baseball And Softball Hitting Fundamentals And The Perceived Psychological Barriers To Hitting A Pitched Ball, Andrew Walsh

Theses: Doctorates and Masters

The primary purpose of the thesis was to create a hitting scale for youth players that assess the fundamentals of a baseball swing. Secondly, the purpose of this thesis was to determine the interactions between the changes in anxiety, perceived competence and fear variables have with actual hitting competence over a four week sport specific training program.

Speech And Swallowing Rehabilitation In The Home: A Comparison Of Two Service Delivery Models For Stroke Survivors, Katy J. E. Stewart

Theses: Doctorates and Masters

Background and Aims

Speech and swallowing difficulties are common sequelae for people who have suffered a stroke. Recently, there has been an increase in early discharge, community rehabilitation and the use of therapy assistants to support health professionals in stroke rehabilitation. However, the impact of these factors on communication and swallowing outcomes remains under researched. This research explored Rehabilitation in the Home (RITH) Speech Pathology (SP) services for stroke survivors with dysarthria and dysphagia. More specifically, this research investigated whether traditional speech pathology interventions, supplemented with a home practice program are effective, as well as compare usual treatment to that …

A Model Of Management Learning For Occupational Therapists In Small Business In Australia, Jeannine Millsteed

Theses: Doctorates and Masters

This research sought to identify factors that contribute to occupational therapists developing management competencies when they become small business owners providing professional clinical services. This is an important for several reasons and precipitated by the Australian government’s introduction of incentives that encourage health professions to move from employment in public hospitals into the private sector, coupled with a recognition that occupational therapists receive no formal business training in their professional education, and the reported high levels of business failure in the small business sector. A review of the literature established the value of small business to the Australian economy, growth …

Community Participation Group Interventions For Children And Adolescents With Neurodevelopmental Disabilities : A Systematic Review ; And, Community Participation For Girls And Women Living With Rett Syndrome, Jaimi Andrews

Theses : Honours

Community participation group interventions for children and adolescents with neurodevelopment disabilities : A systematic review

Objective: To describe the effectiveness of community integration interventions on community participation, self-esteem and quality of life for children and adolescents with a neurodevelopment intellectual disability.

Method: Electronic searches of five databases and manual searches of reference lists were conducted. Community integration interventions which targeted friendship development, recreation participation, quality of life and self-esteem were included.

Results: Thirteen studies were included in this review. A variety of study designs and interventions were used. Following interventions, all but one study reported significantly increased …

The Impact Of Powered Mobility Devices On Occupational Performance : A Systematic Review ; And, The Experience Of Being A Motorised Mobility Scooter User, Ryan Fomiatti

Theses : Honours

The impact of powered mobility devices on occupational performance: A systematic review

Purpose: To systematically review the impact powered mobility devices have on engagement in independent occupations for adults with acquired mobility limitations. Method: The following databases were searched electronically: CINAHL Plus, Medline, PsychInfo, OT Seeker, Joanna Briggs Institute and Physiotherapy Evidence Database. The search terms used a combination of words to encompass all terms which are used for powered mobility. Studies were included if they evaluated adults’ use of a motorised mobility device, and if individuals used a powered mobility device due to acquired mobility limitation. Results: Eleven studies …

Scald Burn Admissions To Princess Margaret Hospital In 1998 And 2008: A Comparative Analysis, Lisa Martin

Theses: Doctorates and Masters

Scald is the most common form of burn in young children, accounting for over 50% of all paediatric burn admissions in Western Australia (WA). Interventions implemented over the past few years focussed on prevention, first aid, and improved services postinjury (Department of Health Western Australia, 2009). The population of children in WA is rising and an epidemiological study was undertaken to assess changes in the profile of scald injury among WA children and to assess priorities for future action. Data were collected from all acute inpatient admissions presenting with scald injury for 1998 and 2008. These data were compared with …

The Decision Making Process Involved When Changing Career: A Qualitative Study Of Registered Nurses Who Have Left The Profession, Katherine S. Gallager

Theses : Honours

Career choice is an important decision an individual has to make during their lifetime. Personal, environmental and organisational factors all assist this decision process as individuals strive for a work-life balance within careers that meet their needs and realise their potential. This research study investigated which factors contributed to the decision process of Registered Nurses (RNs) who have left the profession for a career change. There is currently a global shortage of RNs, which is of major concern to healthcare policy makers in most countries, including Australia. This qualitative study examined the narrative interviews often females over the age of25 …

Low Back Pain In Schoolgirl Rowers: Prevalence, Bio-Psycho-Social Factors And Prevention, Debra Perich

Theses: Doctorates and Masters

Rowing is one of the largest participant sports on the Independent Girls‟ Schools Sporting Association (IGSSA) in Western Australia with approximately 400 participants competing every year. Rowing is an extra-curricular sport offered to girls 14 years of age and above, with these girls competing and training in both sweep and scull boats. Whilst the benefits of regular physical activity and exercise are well known, musculoskeletal problems have been documented in rowing. In particular, clinical evidence and previous research suggests that low back pain (LBP) is common in rowers. Adolescents who suffer from LBP are at an increased risk of recurrent …

Neck Loading In High Performance Combat Pilots During Aerial Combat Manoeuvres And Specific Neck Strengthening Exercises, Kevin J. Netto

Theses: Doctorates and Masters

Background: Neck pain and injury is a common occurrence in high performance combat pilots (HPCP) around the world. The cause of this has been attributed to exposure to the unavoidable high mechanical loading related to the neck being positioned in non-neutral head postures whilst being exposed to moderate to high +Gz levels. Specific neck conditioning exercises have been proposed as being a possible method to decrease the incidence of neck pain and injury in this population. However, there has been sparsely published research examining the suitability of selected exercises for HPCP who participate in regular aerial combat manoeuvres (ACM).

Resistance Exercise In Men Receiving Androgen Deprivation Therapy For Prostate Cancer, Daniel A. Galvao

Theses: Doctorates and Masters

This thesis encompasses two literature reviews (chapter 2 & 3) and two experimental chapters (4 and 5) examining the available literature on exercise and cancer, resistance training and its anabolic responses in older men and women, the side effects of Androgen Deprivation Therapy (ADT) for prostate cancer and finally, the role of resistance exercise as a clinical intervention to counteract such changes as an adjuvant therapy.

Controlling Involvement To Promote Confidence In Palliative Care Decisions - A Grounded Theory From The Patient's Perspective, Susan F. Lee

Theses: Doctorates and Masters

Decision making in the context of palliative care is particularly complex given the unpredictable illness trajectories experienced by patients and the number of individuals who may be part of the decision making process. This grounded theory study explored and described from the perspective of patients with advanced illness, their experiences of making care decisions. A review of literature at the commencement of the study indicated that there was a lack of evidence to support the best way of ascertaining patient's preferences for involvement in decisions in a palliative care context and almost no research to guide clinicians about the involvement …

Fibromyalgia And Bladder Irritability, Carolyn K. Brand

Theses: Doctorates and Masters

Urinary tract sensory symptoms provide an additional symptomatic burden for women with fibromyalgia. The urogenital symptoms of both fibromyalgia and interstitial cystitis have been described as non-infective sensory disorders, suggesting the existence of substantial clinical overlap between the two conditions. Research suggests that although interstitial cystitis has been treated as a specific bladder condition, it may be part of the disorder of central processing of sensory information as seen in fibromyalgia.

The interstitial cystitis symptom index and problem index (ICSI/ICPI) have been used to measure lower urinary tract symptoms and to examine the impact of these symptoms in patients with …

The Effectiveness Of Back Belts As A Control Measure For Occupational Low Back Pain In A Retail Hardware Chain, Nick Merdith

Theses: Doctorates and Masters

The objective of this study was to examine the effect of the mandatory introduction of back belts on the incidence, days lost and cost of occupational low back injuries resulting from manual handling in 11 retail hardware chain. The study was of a non-experimental before-and-after design with all retail employees in Western Australia being included in a retrospective cohort. The pre-intervention period extended for 21 months and included 2,265,933 work hours with 647 full-time equivalent positions, while the intervention period was 32 months for 4,411,352 hours worked and 827 full-time equivalent positions. Workers' compensation claims for all occupational injuries occurring …

A Phenomenological Study Of Partners Of People With Parkinson's Disease Who Demonstrate Communication Changes, Elsie Janet Doherty

Theses: Doctorates and Masters

Parkinson's disease is a common progressive neurological illness for which there is no known cure. While the cardinal signs are tremor, bradykinesia or slowness of movement, muscle rigidity and postural instability (Jahanshahi & Marsden, 1998, p.3) the patient may face an extended number of years experiencing all, or any combination of, the many other manifestations of the disease process. These manifestations include changes to various aspects of communication including loss of voice volume, diminished body language and loss of facial expression. All of these affect both verbal and non verbal communication. Given the progressive nature of Parkinson's disease the patient …

The Effect Of Moderate +Gz On Cervical Muscle Strength Of Raaf Trainee Pilots Flying Pc-9 Aircraft, Elissa Jane Burton

Theses : Honours

External stimulus/loading initiates adaptations within skeletal muscle. Whilst performing flying manoeuvres under +Gz it has been previously found that the cervical area has the highest loading. The purpose of this study was to examine cervical muscle response to moderate +Gz force (+4-6Gz) loading generated during RAAF pilot training. Cervical muscle strength was monitored in nine RAAF pilots completing an eight-month flight training course and ten controls matched for gender, age, height and weight. Cervical muscle strength and range of movement were measured at baseline and at eight months using the Multi-Cervical Rehabilitation Unit (Hanoun, Canada). Also measured, using EMG, was …

Influence Of Public Image Of Nurses On Nursing Practice, Miyuki Takase

Theses: Doctorates and Masters

Many researchers believe that nurses live in a dual structure, encompassing both the social and nursing worlds. They contend that these two worlds have contrasting views toward nurses. This is, while nurses are guided to establish professional status, society still expects them to remain in a dependent role. This conflict is assumed to have a negative impact on nurses’ psychological and functional states (Kalisch & Kalisch, 1983 & 1987). However, this assumption has not yet been explored sufficiently. The aim of this descriptive correlational study was therefore to investigate the relationships among the public image of nurses, nurses’ self concept, …

Home Visiting: The Effect Of A Hospital Based Nurse Home Visiting Programme On The Rehabilitation Of Children Following Their Discharge From A Child Psychiatry Inpatient Unit, Gordon H. Peers

Theses: Doctorates and Masters

The purpose of this study was to examine the effect of a nurse home visiting programme on the rehabilitation of children following their discharge from a dedicated child psychiatry hospital. The research was based on the premise that a nurse home visiting programme may have a positive influence on the outcomes of the rehabilitation of children following their discharge from hospital, if it reduced the need of outpatient appointments with the psychiatrist and the need for children to be re-admitted to hospital.

Fear, Frustration And The Will To Overcome: A Social History Of Poliomyelitis In Western Australia, John H. Smith

Theses: Doctorates and Masters

This thesis investigates community responses to Poliomyelitis, and the Impact of the disease on those who experienced It, particularly during the epidemics that occurred In Western Australia between 1938 and 1956. The research sources an.: W.A. Health Department records, held mostly at the Battye Library, records held by Australian Archives and Royal Perth Hospital, newspaper reports, comparative studies from several states in Australia and overseas, oral history interviews, biographies and personal records. The history of polio has several layers and the presence or the disease In the community evoked varied and ambiguous reactions, summarised here as fear, frustration and the …

Art Therapy In The Paediatric Oncology Setting: An Assessment Of The Feasibility Of Art Therapy To Address The Psychosocial Needs Of Paediatric Cancer Patients, Anthea Carboni

Theses: Doctorates and Masters

It is well recognised that children with cancer have special needs. Art therapy has been shown to be effective in meeting some of these needs. An exploratory study was conducted to assess the feasibility of art therapy to address the psychosocial needs of paediatric cancer patients in a medical setting where art therapy has not been practised before. A qualitative research design was used to investigate the research questions, using interviews as the main instrument. Subjects were recruited from the oncology team of a metropolitan children's hospital. The sample of thirteen informants consisted of representatives from the medical, nursing and …