Melanie Hoyle

A driving cessation program to identify and improve transport and lifestyle issues of older retired and retiring drivers

BACKGROUND This study explored the transport and lifestyle issues of older retired and retiring drivers participating in the University of Queensland Driver Retirement Initiative (UQDRIVE), a group program to promote adjustment to driving cessation for retired and retiring older drivers. METHODS A mixed method research design explored the impact of UQDRIVE on the transport and lifestyle issues of 55 participants who were of mean age 77.9 years and predominantly female (n = 40). The participants included retired (n = 32) and retiring (n = 23) drivers. Transport and lifestyle issues were identified using the Canadian Occupational Performance Measure and rated pre- and post-intervention. RESULTS Paired t-tests demonstrated a statistically significant improvement in performance (t = 10.5, p < 0.001) and satisfaction (t = 9.9, p < 0.001) scores of individual issues. Qualitative content analysis identified three categories of issues including: protecting my lifestyle; a better understanding of transport options; and being prepared and feeling okay. CONCLUSIONS Participation in UQDRIVE had a positive and significant effect on the issues of the participants. The results highlight that although all participants stated issues related predominantly to practical concerns, there were trends in the issues identified by the drivers and retired drivers that were consistent with their current phase of the driving cessation process.

Participant feedback and satisfaction with the UQDRIVE groups for driving cessation

Background. Driving cessation can lead to negative consequences, such as depression and reduced social activities. Purpose. The University of Queensland Driver Retirement Initiative (UQDRIVE) intensive support program is a six-week program to assist older people with driving cessation. Methods. Fifty-five participants completed a survey of satisfaction with the program, including identification of the aspects of the program that were useful and they had applied in real life. Findings. There was overall satisfaction with the program, and content analysis identified three areas that were highlighted as particularly useful: “Finding alternative means: transport and service options,” “Planning with more wisdom: thinking about driving cessation,” and “Being with people: sharing experiences with peers.” Implications. These findings indicate that program participants were satisfied with the current UQDRIVE intensive support group program and found both the psychosocial supports and practical strategies to be useful in managing driving cessation.

Single-case design evaluation of compression therapy for edema of the stroke-affected hand

OBJECTIVE. To explore the efficacy of low- and high-stretch compression bandaging for edema management in the stroke-affected upper limb. METHOD. A single-case, ABA-design study was conducted with 8 participants alternately allocated to receive low- or high-stretch bandaging. Edema was measured with circumferential tape at four specified points from the hand to the mid-forearm. All measurements were represented graphically for visual analysis, and celeration lines were calculated to indicate the degree of slope in each phase. RESULTS. Visual analysis indicated fluctuating edema volume in the first baseline phase, decreasing edema volume in the intervention phase, and increasing edema volume in the second baseline phase. The results did not clearly distinguish between the two bandaging groups. CONCLUSION. Compression bandaging may have benefits in the management of edema after stroke. Further research is required to identify factors contributing to the long-term maintenance of reductions gained after compression bandaging.

The impact of STRENGTH on the expected and actual transition to home experience

Abstract Purpose: The purpose of this study was to investigate the experiences and expectations of people with stroke, during their transition from hospital to home, after participating in a novel inpatient outreach program, entitled STRENGTH. Methods: A qualitative study was conducted using semi-structured interviews, which were undertaken at discharge and 4–6 weeks post discharge. Thematic analysis was used to code the interview transcripts. Results: The study incorporated data from seven people with stroke, who had a mean age of 61 years. Thematic analysis derived two themes, each with two sub-themes. The first theme was “Hospital and home” and described clients’ experiences of therapy and the hospital environment. The second theme was “Life will never be what it was before” and elaborated on the adaptations and changing expectations that clients had before and after discharge. Conclusions: People with stroke described the therapy they received in both the hospital and home as beneficial. The results support the addition of the home-based inpatient program, STRENGTH, to the current rehabilitation system, as it appeared to realign the expectations of people with stroke and better prepare them for their discharge home. Implications for Rehabilitation STRENGTH aids clinicians to identify difficulties in the home environment for people with stroke. STRENGTH improves the confidence of people with stroke while they transition home. Further research is warranted for psychological interventions that prepare people with stroke for difficulties that arise in the community.

Developing the Australian activity card sort (young adults) for stroke research and clinical practice

Synopsis: No area of clinical practice in speech language pathology has advanced as rapidly in recent years as dysphagia diagnosis and management. There are enormous changes in how we understand swallowing neurophysiology and manage patients with swallowing impairment. From greater precision in diagnostic specificity to far greater options in rehabilitative approaches, the skilled clinician will struggle to stay abreast and provide optimal care. However, in our eagerness to move forward, it is critical that we maintain a solid foundation for this growth. This pre-conference workshop will solidify the skills we should already know, with a review of physiology in the context of innervation and muscular anatomy. Fluent application of these skills will allow for increased sensitivity and specificity in the clinical swallowing assessment. Case examples will be used to illustrate the importance of a careful clinical assessment for inferring pharyngeal physiology. Abstracts 1

Evaluating compression bandaging for the hemiplegic upper limb

Hypothesis / aims of study Urinary incontinence following acute stroke is common, affecting between 40%-60% of people admitted to hospital [1]. It is related to poor outcome and is poorly managed in many cases. Our NIHR funded research programme aims to develop, implement and explore the potential effectiveness and costeffectiveness of a systematic voiding programme for the in-patient management of urinary incontinence after stroke. The systematic voiding programme includes bladder training and pelvic floor muscle training for patients who are cognitively able and prompted voiding for patients with cognitive impairments.