While collaborative, team-based care has the potential to improve medication use and reduce adverse drug events and cost, less attention is paid to understanding the processes of well functioning teams. This paper presents the findings from key informant interviews and reflective journaling from pharmacists, physicians and nurse practitioners participating in a multicentre, controlled clinical trial of team-based pharmacist care in hospitalized medical patients. A phenomenological approach guided the data analysis and content analysis was the primary tool for unitizing, categorizing and identifying emerging themes. Pharmacists experienced highs (developing trusting relationships and making positive contributions to patient care) and lows (struggling with documentation and workload) during integration into the medical care team. From the perspective of the participating pharmacists, nurse practitioners and physicians, the integration of pharmacists into the teams was felt to have facilitated positive patient outcomes by improving team drug-therapy decision-making, continuity of care and patient safety. Additionally, the study increased the awareness of all team members' potential roles so that pharmacists, nurses and physicians could play a part in and benefit from working together as a team. Focussed attention on how practice is structured, team process and ongoing support would enable successful implementation of team-based care in a larger context. (ClinicalTrials.gov number, NCT00351676).
The results of this evaluation may have important implications for educational programs, students, graduates, fieldwork supervisors, and employers.
Online learning continues to have a significant impact on higher education. Increasingly students seek a combination of online learning and face-to-face instruction at undergraduate and graduate levels and occupational therapists ask for online continuing professional development opportunities. However, occupational therapy educators have been slow to adopt web-based instructional technology. This paper presents background information on the use of web-based learning in the general sphere of higher education and outlines the current range of usage in occupational therapy education. Research findings are presented to stimulate discussion regarding online learning and occupational therapy professional socialisation, student satisfaction and outcomes. There is a fine line between full and partial online course delivery, so research on technology-enhanced campus-based delivery is also included in the review. Evidence suggests that blending combinations of technologies with computer mediated learning enhances interaction and could address the higher order learning needs of professional programmes such as occupational therapy.
Adaptation to stroke requires complex, long-term change in stroke survivors' lives. This study aimed at identifying those factors that influence quality of life (QOL) of geriatric stroke survivors 1-3 years post-discharge. The objectives were: to describe the overall quality of life of stroke survivors; to examine the relationships between sociodemographic variables, neurological variables, functional status, social support, perceived health status, depression, and overall QOL; and to determine the best predictors of QOL. Data were collected on 50 stroke survivors using a cross-sectional design and standardized questionnaires, including the Quality of Life Index, the Functional Independence Measure, the Social Support Inventory for Stroke Survivors and the Centre for Epidemiologic Studies Depression Scale. The overall quality of life of the study participants was low. The most important predictors of QOL were depression, marital status, quality of social support, and functional status. Depression was the strongest predictor of QOL. By employing a multi-dimensional perspective, this study confirmed that adaptation to stroke involves much more than physical function. Thus, rehabilitation programs for this group would be more effective if they are based upon a holistic approach.
This study examined the number of repetitions, increase in heart rate, increase in blood pressure, and rating of perceived exertion of subjects performing the most-preferred and least-preferred tasks from a predetermined list under purposeful and nonpurposeful conditions. Twenty healthy women completed the four experimental tests in random order for a period of 10 min each. The results indicated that there was no significant interaction (p greater than .05) between task choice and condition, thus implying that the subjects' performance was not influenced by task preference regardless of whether the activity was purposeful or nonpurposeful. Comparisons between the purposeful and nonpurposeful conditions revealed that the increase in heart rate and rating of perceived exertion were significantly higher (p less than .05) during nonpurposeful activity for both the most-preferred and the least-preferred tasks. On the basis of these results, it is recommended that therapists use purposeful, or goal-directed, activities in their practice, even if they are unable to provide their patients with a choice of therapeutic tasks.
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