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Biomedical subjects

Mary Ann McColl

Publications and source records attributed to Mary Ann McColl.

18 recordsLinked to original sources
PubMed2006

'Participate to learn': a promising practice for community ABI rehabilitation.

OBJECTIVE: To identify best practices and promising practices to enhance participation in meaningful and productive activities. METHOD: An electronic search of the ABI rehabilitation research literature since 1990 yielded 974 articles of which 30 focused on interventions that targeted participation and evaluated effectiveness using direct measures of participation. Three reviewers rated these articles according to the standards set out by the Centre for Reviews and Dissemination. Following the systematic review, an interpretive review of the same articles was completed. RESULTS: Only three studies were rated as strong. No best practices were identified. Three promising practices found some support. The interpretive review suggested 'Participate to learn' as a useful rehabilitation model. The model rests on roles as goals, learning by experience in real-life contexts and the use of personal and environmental support to enable participation. CONCLUSIONS: 'Participate to learn' is both a credible rehabilitation model and deserving of more study.

Brain Injuries↗
PubMed2005

Factors affecting long-term-care residents' decision-making processes as they formulate advance directives.

PURPOSE: The purpose of this study was to describe factors contributing to the decision-making processes of elderly persons as they formulate advance directives in long-term care. DESIGN AND METHODS: This study was qualitative, based on grounded theory. Recruitment was purposive and continued until saturation was reached. Nine residents of a long-term-care facility were interviewed by use of a semistructured format. Open and axial coding of interview transcripts were carried out and the factors contributing to the decision process were defined. RESULTS: Elders based their decisions primarily on information gathered from personal experiences with death and illness. They obtained very little information from professionals or the media. Major factors considered by elders as they weighed information included spiritual, emotional, and social considerations. IMPLICATIONS: The factors considered during the decision-making process were oriented more toward the individual's experiences and less on contributions from objective sources than anticipated. Decision making for advance directives is a highly personalized process. The approach of health professionals when assisting with end-of-life decision making should be planned with these contributing factors in mind, so that the services offered to the individuals in this population best meet their needs.

Advance Directives↗
PubMed2005

Challenges and strategies related to hearing loss among dairy farmers.

CONTEXT: Farming is often imagined to be a serene and idyllic business based on historical images of a man, a horse, and a plow. However, machinery and equipment on farms, such as older tractors, grain dryers, and vacuum pumps, can have noise levels, which may be dangerous to hearing with prolonged, unprotected exposure. PURPOSE: This qualitative study in Ontario, Canada, explored the challenges and coping strategies experienced by dairy farmers with self-reported hearing loss and communication difficulties. Through in-depth interviews, 13 farmers who experience significant hearing loss were questioned about the challenges they face as a result of hearing loss and the strategies they use to overcome or compensate for problems. FINDINGS: The 2 major challenges encountered by dairy farmers with a hearing loss were: (1) obtaining information from individuals, within groups, and through electronic media; and (2) working with animals, machinery, and noise. To cope with these challenges, participants used strategies identified as problem and emotion focused. CONCLUSIONS: Four themes arose from analysis of the challenges encountered and strategies used: 1. Hearing loss is experienced as a "familiar," but "private," problem for dairy farmers. 2. Communication difficulties can negatively affect the quality of relationships on the farm. 3. Safety and risk management are issues when farming with a hearing loss. 4. The management or control of excessive noise is a complex problem, because there are no completely reliable yet practical solutions.

Activities of Daily Living↗
PubMed2005

Home and community occupational therapy for children and youth: a before and after study.

BACKGROUND: There has been an increased focus on home care service provision in recent years, yet there are few data available about the provision of home and community occupational therapy for children and youth. PURPOSE: To evaluate key elements of a service provision model for home care occupational therapy in terms of occupational performance outcomes, perception of care and cost. METHODS: Eleven centres in Ontario and Quebec recruited 167 children and youth up to 18 years of age to a before and after study of occupational therapy services in the home and community. Occupational performance, quality of life and costs were measured at baseline and study end. Perception of care was measured at study completion. RESULTS: A statistically and clinically significant improvement in occupational performance was demonstrated (p < 0.001). The clients' families gave high ratings to the process of care provided by the occupational therapists. These data did not demonstrate a clear relationship between amount of service, cost and occupational performance outcome. PRACTICE IMPLICATIONS: Children receiving home and community occupational therapy services change in their occupational performance abilities. These changes are not directly related to the amount or focus of the occupational therapy services.

Adolescent↗
PubMed2005

Targeted applications of the Canadian Occupational Performance Measure.

BACKGROUND: The Canadian Occupational Performance Measure (COPM) is an outcome measure designed to assess performance and satisfaction with occupation. It was developed to coincide with the occupation-focused, client-centred Canadian Model of Occupational Performance. PURPOSE: The COPM has been a feature of the occupational therapy landscape for approximately 15 years and has pervaded the consciousness of occupational therapists around the world. In this paper, we examine issues associated with application of the COPM in targeted clinical and non-clinical situations. RESULTS: The paper suggests considerations required to ensure that the highest quality of information is derived from the COPM in all situations. PRACTICE IMPLICATIONS: Although the paper emphasizes the centrality of the client-centred approach, it also demonstrates the flexibility and adaptability of the COPM to different situations, clients, settings and purposes.

Activities of Daily Living↗
PubMed2004

Aging, gender, and spinal cord injury.

OBJECTIVE: To identify differences in the aging experiences of men and women with spinal cord injury (SCI). DESIGN: This study is part of a longitudinal international study of aging and SCI. SETTING: Five centers in England, Canada, and the United States. Three were spinal cord rehabilitation facilities (Stoke-Mandeville Hospital, Southport Hospital, Craig Hospital) and 2 were community agencies (Ontario and Manitoba divisions of the Canadian Paraplegic Association). PARTICIPANTS: A matched sample of 67 men and 67 women with SCI for at least 20 years. The 2 groups were matched on age, country of origin, and duration of disability. Participants had an average age of 57 years and an average disability duration of almost 33 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Two measures were taken by interview: demographic form and current status interview. Five others were self-administered and returned by mail: the Perceived Stress Scale, Craig Handicap Assessment and Reporting Technique, Index of Psychological Well-Being, Current Problem Questionnaire, and Life Satisfaction Index. RESULTS: Although both sexes rated their quality of life about equally, women characterized their aging experience as "accelerated," while men characterized it as "complicated." Women reported more effects of pain, fatigue, and skin problems and more transportation problems. Men experienced more health problems, more diabetes, and more adaptive equipment changes. Older men and women with SCI spent their time differently, consistent with traditional gender roles. CONCLUSIONS: These results underline the need for gender-specific consideration of aging experiences associated with SCI and further emphasize the need for primary and preventive care to promote health and well-being as people with SCI survive into old age.

Adult↗
PubMed2004

Aging with a spinal cord injury: factors associated with the need for more help with activities of daily living.

OBJECTIVES: To determine (1) the frequency of the need for more help with activities of daily living (ADLs), (2) the frequency of medical complications, and (3) the association between medical, injury-related, and sociodemographic factors and the need for more help with ADLs among those aging with spinal cord injury (SCI). DESIGN: Cross-sectional survey. SETTING: General community, international. PARTICIPANTS: Volunteers (N=352) with SCI for more than 20 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The need for more help with ADLs. RESULTS: The need for more help with ADLs during the last 3 years was reported by 32.1% of participants. At least 1 medical complication was reported by 85%. Constipation (47.9%), diarrhea/bowel accidents (41.8%), and pressure ulcers (38.7%) were common. Constipation, pressure ulcers, female gender, and years postinjury were associated with needing more help with ADLs. Constipation and pressure ulcers were associated with a 97% and a 76% increase, respectively, in the likelihood of needing more help with ADLs during a 3-year time period. Female gender was associated with a 96% increased odds of needing more help with ADLs. There was a 42% increased odds of needing more help with ADLs per decade after SCI. CONCLUSIONS: People aging with SCI are vulnerable to medical complications, and additional help is required to function. Knowledge of the effect of these factors, particularly the tetrad of constipation, pressure ulcers, female gender, and number of years postinjury, should increase awareness that more help with ADLs may be needed over time.

Activities of Daily Living↗
PubMed2004

Parental coping following childhood acquired brain injury.

PRIMARY OBJECTIVE: To examine parental coping following an acquired brain injury of their child, the relationship between maternal and paternal coping, and the extent to which social support and family environment affect parental coping. RESEARCH DESIGN: A cross-sectional design was used. METHODS AND PROCEDURES: Parents (n = 30) of children with acquired brain injury provided relevant demographic data and completed questionnaires investigating coping, social support and perceptions of family environment. MAIN OUTCOMES AND RESULTS: Perception-focused coping strategies were used most often by parents. Mothers had a more extensive repertoire than fathers, and the relationship between maternal and paternal coping appeared to be complementary. Relationships were found between emotion-focused coping and instrumental support (r = 0.39) and perception-focused coping and family cohesion (r = 0.37). CONCLUSIONS: Recognizing parental coping styles, enhancing the development of positive strategies, and underscoring the importance of social support and the family environment will assist parents to cope positively with their child's acquired brain injury.

Adaptation, Psychological↗
PubMed2004

The Canadian Occupational Performance Measure: a research and clinical literature review.

BACKGROUND: It has been 13 years since the Canadian Occupational Performance Measure (COPM) was published. In that time there has been a remarkable growth in its acceptance as an outcome measure within the occupational therapy practice and research. PURPOSE: The purpose of this paper is to review the emerging research and clinical literature related to the COPM since 1994 and to document its impact upon occupational therapy practice and research throughout the world. METHOD: A systematic search was conducted to the professional and research literature in English publications (primarily occupational therapy). Eighty-eight papers that met the inclusion criteria were reviewed, 86% of which examined the COPM in relation to its psychometric properties (19 papers), research outcomes (33 papers) or practice (33 papers). RESULTS: Overall, although there are a few limitations discussed in the review, the conclusion is that the COPM is a valid, reliable, clinically useful and responsive outcome measure acceptable for occupational therapist practitioners and researchers. PRACTICE IMPLICATIONS: The COPM is used with a wide variety of clients, enables client-centred practice, facilitates evidence-based practice and supports outcomes research.

Biomedical Research↗
PubMed2003

Aging, spinal cord injury, and quality of life: structural relationships.

OBJECTIVE: To quantify relationships among 3 sets of factors: demographic factors, health and disability factors, and quality of life (QOL). DESIGN: Part of a program of longitudinal research on aging and spinal cord injury (SCI) involving 3 populations: American, British, and Canadian. The present analysis uses data from the 1999 interval. SETTING: The Canadian sample was derived from the member database of the Ontario and Manitoba divisions of the Canadian Paraplegic Association. The British sample was recruited from a national and a regional SCI center in England. The American sample was recruited through a hospital in Colorado. PARTICIPANTS: A sample of 352 participants was assembled from 4 large, well-established databases. The sample included individuals who had incurred an SCI at least 20 years earlier, were admitted to rehabilitation within 1 year of injury, and were between the ages of 15 and 55 at the time of injury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: A combination of self-completed questionnaires and interviews. Data included demographics, injury-related variables, health and disability-related factors, QOL, and perceptions about aging. RESULTS: Using linear structural relationships modeling, we found that QOL was affected both directly and indirectly by age, health and disability problems, and perceptions of aging. Two surprising findings were as follows: those who experienced fewer disability-related problems were more likely to report a qualitative disadvantage in aging, and the younger members of the sample were more likely to report fatigue. CONCLUSIONS: Fatigue is a concern because of the relationship of fatigue with perceived temporal disadvantage in aging, health problems, and disability problems. This finding highlights the need for clinical vigilance among those just beginning to experience the effects of aging.

Activities of Daily Living↗
PubMed2003

Community integration: a useful construct, but what does it really mean?

The primary objective of this paper is to contribute to a clearer understanding of the construct of community integration. Rehabilitation literature is discussed in relation to three measures of community integration: the AIMS Interview, Community Integration Measure and Community Integration Questionnaire. Results of a principal components analysis with varimax rotation indicated that the measures are independent and coherent. Significant correlations were not found between total scores on the three measures and problem behaviour or quality of life. However, analysis of individual items on the scales yielded one significant correlation between the first item on the Community Integration Measure (i.e. sense of belonging) and quality of life. The need for a clear statement in future research regarding the definition of community integration is emphasized, and inclusion of both subjective perceptions and objective indicators of community integration is recommended.

Activities of Daily Living↗
PubMed2003

A secondary guy: physically disabled teenagers in secondary schools.

BACKGROUND: This study explored the perceptions and experiences of teenagers with physical disabilities attending regular secondary schools. In particular, the study focused on social integration and the factors that influenced it. Social integration was defined as a sense of belonging in the school community. METHODS: A phenomenological approach was used to explore the viewpoint of physically disabled young people themselves. Seven secondary school students with ambulation disabilities were interviewed using a semi-structured interview guide. RESULTS: The findings identified both factors that facilitated and those that limited integration. Extrinsic factors included peer and staff support, negative reactions and inaccessible activities. Intrinsic factors included the disability itself, as well as strategies of self-exclusion, masking the disability, finding a niche, making fun of the disability, and educating peers. Interpretation of the findings suggested that the participants occupied a secondary place in their schools, as opposed to being fully integrated. PRACTICE IMPLICATIONS: Occupational therapists have the opportunity, expertise and responsibility to be instrumental in the process of ensuring that schools are inclusive and that their young clients are capable of participating fully.

Adolescent↗
PubMed2003

Illness stories: themes emerging through narrative.

The purpose of this study was to explore the use of narrative as a tool to understand the experience of chronic illness. The study is phenomenological in nature, using elements of grounded theory and social constructionism to consider the data collected. As examples of the issues raised using the narrative approach, the paper describes four themes that were pervasive in the first-person accounts of these individuals: 1. Emotional reaction to the diagnosis--Because of both the form and content in the narratives, these are described as 'peak experiences'; 2. Impact of stress--As a precipitator of symptoms or illness, as an ongoing aggravator of the chronic illness, or as a factor in overall coping with the chronic illness; 3. View of death--Named by all four individuals as it relates to their view of life; 4. Illness meaning--Coined by two of the individuals as 'philosophy of life.' These themes were interpreted in terms of their implications for therapeutic relationships with people with disabilities and chronic illnesses.

Adaptation, Psychological↗
PubMed2002

Lifestyle risks for three disease outcomes in spinal cord injury.

OBJECT: The majority of research focusing on lifestyle risks in the spinal cord-injured population to date has mainly been descriptive in nature. Limited research has examined the relationships between lifestyle risks and morbidity. This study was undertaken to quantify the associations between selected lifestyle risks and morbidity associated with three top causes of mortality in adults with spinal cord injury (SCI). METHOD: Ninety-seven adults who had incurred a spinal cord injury between 1972 and 1992 were interviewed over the telephone to assess morbidity and lifestyle exposure history. Logistic regression modelling was used to assess the association between lifestyle risks and cardiovascular, respiratory and urinary tract disorders. RESULTS: Risk of cardiovascular morbidity was found to be positively associated with age and duration of cigarette use. Risk of respiratory morbidity was found to be positively associated with quadriplegia, number of cigarettes smoked per day, and the interaction between cigarettes smoked per day and excessive alcohol consumption. Risk of urinary tract morbidity was found to be positively associated with a complete lesion, number of cigarettes smoked per day and, surprisingly, physical activity. Risk of urinary tract morbidity was negatively associated with monthly alcohol consumption, a traumatic injury and the interaction between monthly alcohol consumption and a complete lesion. CONCLUSION: With respect to the three morbidity outcomes in this study, cigarette smoking is the most damaging lifestyle behaviour in the spinal cord-injured population. Attention and resources should be directed towards SCI-specific smoking prevention and cessation programmes to prevent the development and exacerbation of chronic diseases in this unique population. Further research is needed to fully understand the associations between lifestyle and chronic diseases in the SCI population.

Adolescent↗
PubMedDate not supplied

Disability studies at the population level: issues of health service utilization.

OBJECTIVE: In this paper, I propose a population-level analysis of disability to raise issues of access and equity in terms of use of health services. METHOD: The study was a cross-sectional analysis of the National Population Health Survey (Statistics Canada, 1998-1999). The sample consisted of 10,898 adults between 20 and 64 years of age. FINDINGS: The study showed that adults with disabilities used significantly more of all types of health professionals and health services than nondisabled adults. Disability was a significant determinant of all types of health service use, representing a two- to threefold increase in risk of seeing health professionals. Although poor health explained a large proportion of variance attributable to use of medical and nursing services, it did not explain the use of other allied health services. The results are interpreted in terms of structural barriers to access to health services. The findings also remind us of the potential role for occupational therapists as advocates within the health care system for persons with disabilities.

Adult↗