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Approaches to the Treatment and Care of Elderly Stroke Patients by Occupational Therapists and Physiotherapists
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Approaches to the Treatment and Care of Elderly Stroke Patients by Occupational Therapists and Physiotherapists HELEN SHAFFNER
MPhil MCSP DipTP
Thesis: Master of Philosophy, Polytechnic of Central London, 1981 Reference copy available from the author
A STUDY was undertaken t o elucidate further some aspects of the interrelationship between occupational therapists and physiotherapists and to consider some possible implications for organisation, education and training, particularly at the preregistration level. Therapists' activities w i t h and for patients and the problems that they were attempting t o alleviate, were studied in order t o identify areas of overlap in therapists' roles. Account was taken of some of the possible influences on therapists' work: these factors included other members of the health care team, facilities, and education and training.
Stress Among Newly Qualified Physiotherapists ELAINE MOTTRAM
MCSP DMS
Course: Diploma in Management Studies, Robert Gordon's Institute of Technology, 1 9 8 7 Housed at: Business School, Robert Gordon's Institute of Technology, Aberdeen
I
Data were collected from 30 therapists in Surrey and Hampshire and encompassed 135 patients of 65 years and over w h o had suffered a cerebrovascular accident (stroke). Therapists were interviewed in their o w n hospitals in order t o collect information on factors influencing their work w i t h elderly stroke patients: they completed questionnaires on their activities and their patients' problems. After analysis of the results, therapists were followed u p by postal questionnaire in order t o extend the results of the first survey. The study was limited to therapists' perceptions of their situation: there was n o direct patient involvement. Overlap was identified between the t w o professions in terms of their activities and the particular problems of their patients, but differences were found in the extent of their involvement and concern. While the same factors often affected their work, there was some variation in the actual influence. The interface between the t w o professions operating this clinical area was identified: the question of the need for t w o professions was considered t o require further investigation. Some implications for the education and training of both occupational therapists and physiotherapists were derived from the findings.
THIS study set out t o investigate the incidence of stress and its causes among n e w l y qualified physiotherapists. Against the background of the National Health Service the role of the physiotherapist was described. Current theories and models of stress and recent work on stress in the caring professions were used as a basis for the study itself which was carried out by means of recorded interviews and questionnaire. A large amount of information regarding early work experiences and attitudes t o work was gained. It was concluded that the nature of the work and the climate of scarce resources within the NHS make the potential for stress quite significant and that newly-qualified staff are subject t o moderate amounts of stress. It would appear that the possibilities for eliminating causes of stress are limited but several strategies for coping w i t h the effects of stress were suggested.
Educational Innovation in Post-registration Training in the Remedial Professions ~
~~
~
Course: Master of Education, University of Leeds, 1983/84 Housed at: University of Leeds IN 1979 the Department of Health and Social Security (DHSS) responded t o the constant and co-ordinated requests from the representatives of the three remedial professions - occupational therapy, physiotherapy and remedial gymnastics - for financial assistance towards post registration education w i t h the award of an annual grant This grant enabled the formation of the Education Development Unit for the Remedial Professions (EDURP) t o be run by a joint committee comprising representatives from the professions and the DHSS Its aim was t o work towards the development of a sound, realistic system of post-registration education t o meet the needs of therapists and enhance professional competence
88
This extended study describes some of the political and professional difficulties met by the remedial professions in their pursuit of recognition for such an award. It then looks at a major development work of EDURP, including its first substantial course, 'Care of the Elderly', and tries t o put these events into a theoretical perspective drawing upon curriculum theory. It explains h o w the educational needs of therapists were elicited; how they were ranked in order of importance; and h o w a structure in which t o organise them was achieved. It further considers the opposing curriculum models, 'content' versus 'process', and details the arguments leading t o the choice of the latter as EDURP policy. Finally it examines the 'Care of the Elderly' course itself, outlining a model of professional competence and its underlying philosophy and shows h o w it was 'brought t o life'. Full details of organisation and structure, assessment and awards and evaluation are included with appropriate appendices.
mysiotherapy, February 1988, vof 74,
RO
2
Approaches to the Treatment and Care of Elderly Stroke Patients by Occupational Therapists and Physiotherapists HELEN SHAFFNER
MPhil MCSP DipTP
Thesis: Master of Philosophy, Polytechnic of Central London, 1981 Reference copy available from the author
A STUDY was undertaken t o elucidate further some aspects of the interrelationship between occupational therapists and physiotherapists and to consider some possible implications for organisation, education and training, particularly at the preregistration level. Therapists' activities w i t h and for patients and the problems that they were attempting t o alleviate, were studied in order t o identify areas of overlap in therapists' roles. Account was taken of some of the possible influences on therapists' work: these factors included other members of the health care team, facilities, and education and training.
Stress Among Newly Qualified Physiotherapists ELAINE MOTTRAM
MCSP DMS
Course: Diploma in Management Studies, Robert Gordon's Institute of Technology, 1 9 8 7 Housed at: Business School, Robert Gordon's Institute of Technology, Aberdeen
I
Data were collected from 30 therapists in Surrey and Hampshire and encompassed 135 patients of 65 years and over w h o had suffered a cerebrovascular accident (stroke). Therapists were interviewed in their o w n hospitals in order t o collect information on factors influencing their work w i t h elderly stroke patients: they completed questionnaires on their activities and their patients' problems. After analysis of the results, therapists were followed u p by postal questionnaire in order t o extend the results of the first survey. The study was limited to therapists' perceptions of their situation: there was n o direct patient involvement. Overlap was identified between the t w o professions in terms of their activities and the particular problems of their patients, but differences were found in the extent of their involvement and concern. While the same factors often affected their work, there was some variation in the actual influence. The interface between the t w o professions operating this clinical area was identified: the question of the need for t w o professions was considered t o require further investigation. Some implications for the education and training of both occupational therapists and physiotherapists were derived from the findings.
THIS study set out t o investigate the incidence of stress and its causes among n e w l y qualified physiotherapists. Against the background of the National Health Service the role of the physiotherapist was described. Current theories and models of stress and recent work on stress in the caring professions were used as a basis for the study itself which was carried out by means of recorded interviews and questionnaire. A large amount of information regarding early work experiences and attitudes t o work was gained. It was concluded that the nature of the work and the climate of scarce resources within the NHS make the potential for stress quite significant and that newly-qualified staff are subject t o moderate amounts of stress. It would appear that the possibilities for eliminating causes of stress are limited but several strategies for coping w i t h the effects of stress were suggested.
Educational Innovation in Post-registration Training in the Remedial Professions ~
~~
~
Course: Master of Education, University of Leeds, 1983/84 Housed at: University of Leeds IN 1979 the Department of Health and Social Security (DHSS) responded t o the constant and co-ordinated requests from the representatives of the three remedial professions - occupational therapy, physiotherapy and remedial gymnastics - for financial assistance towards post registration education w i t h the award of an annual grant This grant enabled the formation of the Education Development Unit for the Remedial Professions (EDURP) t o be run by a joint committee comprising representatives from the professions and the DHSS Its aim was t o work towards the development of a sound, realistic system of post-registration education t o meet the needs of therapists and enhance professional competence
88
This extended study describes some of the political and professional difficulties met by the remedial professions in their pursuit of recognition for such an award. It then looks at a major development work of EDURP, including its first substantial course, 'Care of the Elderly', and tries t o put these events into a theoretical perspective drawing upon curriculum theory. It explains h o w the educational needs of therapists were elicited; how they were ranked in order of importance; and h o w a structure in which t o organise them was achieved. It further considers the opposing curriculum models, 'content' versus 'process', and details the arguments leading t o the choice of the latter as EDURP policy. Finally it examines the 'Care of the Elderly' course itself, outlining a model of professional competence and its underlying philosophy and shows h o w it was 'brought t o life'. Full details of organisation and structure, assessment and awards and evaluation are included with appropriate appendices.
mysiotherapy, February 1988, vof 74,
RO
2