Frikkie Maas

The Barthel Index and ADL Evaluation in Stroke Rehabilitation in Australia, Japan, the UK and the USA.

At present many of the activities of daily living indices used in Australia lack essential characteristics of an index yielding desirable results. This study argues that the Barthel Index as modified by Shah, Vanclay and Cooper (1989a) is robust and has the required biometric and psychometric qualities. It presents evidence in support of the use of the Barthel Index as a preferred measure of the activities of daily living function to report therapeutically meaningful and valid information of patient care and stroke rehabilitation outcomes in Australia. It also presents the functional performance on the modified Barthel Index and the outcome of all 258 first stroke patients admitted for inpatient rehabilitation in Brisbane, Australia. Using the Barthel Index as a measure of activities of daily living functions, the study then compares the performances and outcomes of stroke patients between Australia, Japan, the United Kingdom and the United States of America.

The effects of pre-coronary angioplasty education and counselling on patients and their spouses: A preliminary report

The effect of a pre-coronary angioplasty education and counselling program on knowledge and psychological status of patients and on knowledge and quality of life/coping status of their spouses was evaluated. Forty patients and their spouses participated in a pre-coronary angioplasty education and counselling program and 40 served as controls. Knowledge, psychological status and quality of life/coping status were assessed prior to coronary angioplasty and at a mean of four and 11 months post-coronary angioplasty. At four months, improved knowledge and reduced anxiety were found for patients in the experimental group. At 11 months, spouses in the experimental group showed continued improvement in quality of life compared to those in the control group. It was concluded that pre-coronary angioplasty education and counselling can impact favourably upon knowledge in patients and quality of life in spouses.

The Therapeutic Relationship

The relationship established between the occupational therapist and the patient is a key element in facilitating therapy. This article examines the nature of the therapeutic relationship and discusses the various issues that need to be considered when estabilshing this relationship.

Interpersonal Skills and Occupational Therapy

Carkhuff has been instrumental in defining and operationalising the core dimensions in the helping relationship. Research has shown that the level of the helpers interpersonal skills bears a direct relationship to the outcome of therapy. The interpersonal skills required in occupational therapy services are examined and suggestions are made concerning how to increase the level of interpersonal skills functioning of therapists.

Prediction of functional and psychological status after percutaneous transluminal coronary angioplasty

OBJECTIVE To examine symptom, functional status, and psychological status profiles after percutaneous transluminal coronary angioplasty (PTCA) and determine indicators of outcome. DESIGN Descriptive and correlational with repeated measures. SETTING Hospital or home (2.1 days before PTCA) and home (3.9 and 10.2 months after discharge). MEASURES Self-administered questionnaires (developed for study) for functional status (personal and instrumental activities of daily living), and cardiac symptoms (chest pain and shortness of breath at rest and on exertion). General Health Questionnaire(16) for psychological status. PATIENTS One hundred thirty with PTCA (mean age 57 years, 84% male, 15% with prior PTCA). RESULTS Chest pain and shortness of breath at rest and on exertion decreased and functional and psychological status improved 3.9 months after PTCA, with measures maintained at 10.2 months. At 3.9 months after PTCA, poorer psychological status was predicted by having had a longer duration of coronary artery disease before PTCA. Post-PTCA indicators of poor psychological status were continued chest pain and shortness of breath on exertion and not working. The presence of post-PTCA chest pain on exertion and not working were also correlated with reduced functional status. CONCLUSIONS Although pre-PTCA variables such as duration of coronary artery disease can predict post-PTCA outcome, the use of variables measured after PTCA may also provide clinicians with accurate estimates of functional and psychological status after PTCA.

The effect of music-based life review on the life satisfaction and ego integrity of elderly people.

Although music-based life review has frequently been used to facilitate personal adjustment in elderly people, minimal empirical evidence exists as to its effectiveness. An experiment was designed to evaluate the effectiveness of music-based life review. It was hypothesized that a programme of music-based life review would more effectively promote life satisfaction and ego integrity than a programme of verbal life review. Twenty-six elderly female patients residing in nursing homes or hostel accommodation were selected, matched and randomly assigned to either a treatment group (music-based life review) or a control group (verbal life review). Following a 6-week intervention period, all subjects completed the Ego Integrity Subscale (EIS) and the Life Satisfaction Index A (LSIA) and indicated on a linear scale the degree to which they enjoyed the treatment or found it helpful. Results provided support for the use of music-based life review by health care professionals aiming to improve the elderly persons personal adjustment.

Occupational Therapy Group Work in Psychiatric Settings

Traditionally, occupational therapists have used group therapy as part of their overall treatment regimens in psychiatric settings. The therapeutic factors evident in group therapy play an important part in the process of change. The traditional group therapy approach needs to accommodate modern trends, such as the shorter length of client stay, the rapid client turnover and the validity of client feedback. The purpose of the present article is to summarise recent research findings in order to provide information about the state of current research and to consider implications for occupational therapy practice.

The Impact of Restructuring Mental Health Services on Occupational Therapy

Major reform of mental health services in Australia has been taking place. In Queensland, the Queensland Mental Health Plan set out specific objectives and strategies for implementing mental health services reform which have had an impact on the professional role of staff working in those services. A pilot study, using a qualitative design, was conducted to examine the impact of restructuring mental health services on occupational therapy. The results of this study indicate a commitment to the profession of occupational therapy, enthusiasm, and a highly perceived sense of competence in and contributions to mental health.

Pre-admission education/counselling for patients undergoing coronary angioplasty: Impact on knowledge and risk factors

This study aimed to evaluate whether a pre‐procedural education/counselling program can improve knowledge and coronary risk factors in 130 patients (65 experimental; 65 comparison) approximately four months after having percutaneous transluminal coronary angioplasty (PTCA). Knowledge and physical activity levels (p=0.00) improved for both groups from pre‐PTCA to the follow‐up. Further, the experimental group showed favourable change in total cholesterol level (p=0.02) at follow‐up. That participation in the intervention did not improve knowledge or risk factor prevalence may reflect the adequacy of standard ward care, the influence of factors not under the control of the study or the overall experience of PTCA. Limitations of educational programs without follow‐up sessions are discussed and alternate rehabilitation approaches suggested.

The helping relationship: the application of Carkhuff's model.

Research has shown that good interpersonal skills are a prerequisite for a helping relationship to be effective. Carkhuffs helping model provides a framework in which to examine the nature of the helping relationship. The core helper dimensions and phases of helping are outlined. It is suggested that by incorporating this model into occupational therapy practice the delivery of care will be enhanced.