Biomedical subjects

Rose Wiles

Publications and source records attributed to Rose Wiles.

6 recordsLinked to original sources

PubMed2006

The experience of being disabled and obese.

PURPOSE: This qualitative study was designed to explore the experiences of disabled and severely obese people living in the community. The challenges that their size and disabilities posed within their homes and in accessing community facilities were explored, with particular reference to the provision and use of assistive technologies. METHODS: The study comprised in-depth interviews with a sample of six severely obese, disabled people using a grounded theory approach. RESULTS: Three key themes emerged: the experience of daily life; accessing services; and responses to challenges. The study participants found that their home and community environments were seldom adequate for their size. Difficulties were identified in relation to accessing and using NHS services and negative attitudes and treatment from staff. Assessments and quality of assistive devices and housing adaptations received were criticised by some. Participants identified a range of responses to these challenges. CONCLUSION: The challenges that obesity bring are compounded by disability, including the need for higher levels of care and the higher costs of assistive devices for this client group. The study suggests there may be a need for training for professionals who work with obese, disabled people to ensure their needs are met in appropriate and cost-effective ways.

Activities of Daily Living↗

PubMed2004

Falling in Parkinson's disease: the impact on informal caregivers.

PURPOSE: The aim of this study was to explore the views and experiences of the informal caregivers of repeat fallers with Parkinson's disease. METHOD: Individuals were invited to participate in this study if they were the informal caregiver of a person with Parkinson's disease (PD) who had experienced more than one fall in the previous 12 months. Participants were interviewed about their experience of managing falls using a semi-structured interview schedule. Interview data were transcribed and analysed using thematic analysis. RESULTS: Fourteen caregivers (11 female) participated in the study. All were marital partners of a repeat faller with Parkinson's disease. The average age of the participants was 69.9 years (44-79). Their partners had had PD for an average of 16.7 years. Six major themes emerged from the analysis of the interview data, four directly related to falls management (the falls; consequences of the falls for the person with PD; caregivers' experiences of falls; consequences of falls for the caregiver). The majority of caregivers were frightened about their spouse falling. They used a number of methods of getting their spouse up from the floor but often injured themselves as a consequence. Caregivers highlighted the high level of care they provided and the social and psychological impact of the condition on them. They received limited help in looking after their spouse and little information about falls or about the disease in general. CONCLUSION: Caregivers in this study felt unprepared for their role and expressed a need for more support and advice, especially about managing falls.

Accidental Falls↗

PubMed2004

Discharge from physiotherapy following stroke: the management of disappointment.

Stroke tends to result in a range of disabilities which have been shown to benefit from rehabilitation, in particular physiotherapy. Patients tend to have high expectations of the extent of recovery they can achieve through physiotherapy, and subsequently view discharge from physiotherapy before they have achieved that degree of recovery as disappointing and distressing. Current literature suggest that explicit discussion between physiotherapists and patients of the anticipated extent of recovery tends to be avoided during the programme of physiotherapy treatment, making discharge from physiotherapy the point at which potentially differing expectations might be expected to be confronted. This paper explores how the process of discharge is managed and experienced by patients and physiotherapists. It draws on Craib's (1994) ideas about how disappointment is managed in modern society. A qualitative longitudinal study was conducted with 16 stroke patients and their physiotherapists. These data comprise interview and observational material. The study found that the discharge of stroke patients from physiotherapy is not a point when patients' expectations and optimism about recovery are confronted. The notion of natural recovery that was raised with patients by physiotherapists at discharge and the information physiotherapists gave about exercise post-discharge had the effect of maintaining patients' high expectations and hopes about recovery. This has implications for the process of adaptation and adjustment that the patient eventually goes through in order to accommodate their altered abilities and identity. We argue that a number of factors contribute to the denial of disappointment within this interaction and that services need to be developed in ways that enable physiotherapists to engage with the possibility of disappointment about stroke outcome with patients, thereby making a positive contribution to the process of adaptation and adjustment that stroke survivors experience following discharge.

Adaptation, Psychological↗

PubMed2003

Nurse-led intermediate care: patients' perceptions.

Intermediate care currently forms one of the UK Government's main initiatives for improving the quality of post-acute care. This paper examines patients' and carers' experiences of a nurse-led unit, which aims to provide intermediate care for people no longer acutely ill. Drawing on findings from qualitative interview data, we demonstrate that patients viewed this model of care as acceptable but that they had markedly inconsistent experiences of care and reported considerable variation in their perceptions of the Unit's purpose. Some possible reasons for this are explored. Implications for the development of good quality nurse-led intermediate care are outlined.

Aged↗

PubMed2002

Referrals for bereavement counselling in primary care: a qualitative study.

The growth in the provision of counselling services in British primary care offers an opportunity for general practitioners (GPs) to refer patients to counsellors following bereavement. This study explores the factors that influence GPs referral decisions. Qualitative interviews were conducted with 50 GPs from two cities in southern UK. The study found that GPs draw on notions of abnormal bereavement in making referral decisions. Indicators of bereavement problems related to: the nature of the death; level of social support; and reaction to the death. GPs views about the types of patients likely to benefit from counselling were further criteria employed in referral decisions. The study indicated that consideration of these factors may discriminate against certain types of patients being referred. Further education in the range of psychological theories of bereavement may assist GPs in understanding their bereaved patients' experiences and in developing their skills in recognising abnormal reactions and making appropriate referrals.

Bereavement↗

PubMedDate not supplied

Recovery plateau following stroke: fact or fiction?

PURPOSE: 'Plateau' is an expression frequently used in relation to decisions to discharge patients from physiotherapy following stroke. This paper critically considers the concept of recovery plateau in stroke, exploring (i) the evidence for plateau, (ii) potential contributing factors, and (iii) the consequences for patients, therapists and services. SEARCH STRATEGY: The concept of recovery plateau in stroke was reviewed drawing on standard critical appraisal methodology for the search strategy and critique. Electronic searches using Web of Knowledge, MEDLINE, CINAHL, Department of Health Website and the Cochrane Library from the earliest dates of coverage until February 2005 identified quantitative and qualitative literature related to stroke, plateau, recovery, outcome, rehabilitation and physiotherapy. DISCUSSION: The concept of plateau is ambiguous. Recovery has been considered to plateau within the first 6 months, yet recent studies indicate later recovery is possible. We suggest that 'plateau' relates not only to the patient's physical potential, but is influenced by how recovery is measured, the intensity and type of therapy, patients' actions and motivations, therapist values, and service limitations. CONCLUSION: 'Plateau' is conceptually more complex than previously considered. Current conceptualizations may limit potential recovery and hinder service development. Research into plateau which takes account of contextual issues of therapy provision is required.

Attitude of Health Personnel↗