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Biomedical subjects

Sharon Warren

Publications and source records attributed to Sharon Warren.

16 recordsLinked to original sources
PubMed2006

Incidence of multiple sclerosis among First Nations people in Alberta, Canada.

Multiple sclerosis (MS) is thought to be rare among North American aboriginals, although few population-based frequency studies have been conducted. Data from government health databases were used to describe the incidence of MS among First Nations aboriginal people in the province of Alberta compared to the general population from 1994 to 2002. The general population rates were consistently higher than First Nations rates, but were essentially stable across this time span for both groups. For First Nations the MS incidence was 7.6 per 100,000 and 20.6 per 100,000 for the general population in 2002. During 2000-2002 for First Nations the incidence was 12.7 for females and 7.6 for males, with a female-to-male ratio of 1.7:1. During the same period the general population incidence was 32.2 for females and 12.7 for males, with a female-to-male ratio of 2.5:1. The peak incidence for both First Nations and the general population of Alberta was in the age group 30-39 years in 2002. The high incidence rates are consistent with high prevalence rates reported for both groups in 2002: 99.9 per 100,000 for First Nations and 335.0 per 100,000 for the general population. While the MS incidence in First Nations people is lower than in the general population of Alberta, it is not rare by worldwide standards.

Adult↗
PubMed2006

Perceptions of patient education in spinal cord injury rehabilitation.

PURPOSE: Patient education is a key part of spinal cord injury (SCI) rehabilitation with the goal of preparing persons with SCI to meet life's daily challenges. The purpose of this study was to evaluate experiences of the patient education program from the patients' perspective. METHODS: The qualitative design of this study involved a semi-structured interview format to gather descriptive information relevant to the aspects of the patient education program identified to facilitate or impede learning. Twenty-two patients participated in the individual interviews. RESULTS: The framework that emerged from the analysis of the interview transcripts included a total of six main categories, two subcategories and two main themes. There were two central categories of Need to know and Information access and delivery that were influenced by categories of: Learning readiness, Learning affects, Problem exploration and Family involvement. The category of Information access and delivery included two subcategories labeled Resources and Learning strategies. From these categories the main themes of Learning partnership and Individuality were identified. CONCLUSIONS: This research provides valuable information from the patients' perspective that may be used to enhance patient education programs. The importance of incorporating principles of adult learning is highlighted.

Access to Information↗
PubMed2006

Evaluation of patient education in spinal cord injury rehabilitation: knowledge, problem-solving and perceived importance.

PURPOSE: Through inpatient education programmes the person with spinal cord injury (SCI) learns to understand and monitor his or her own physical, emotional and social well-being. The purpose of this study was to determine the patients' knowledge and problem-solving skills regarding SCI at admission, discharge and follow-up at 6 months after discharge; and to determine the perceived importance of each content topic included in the education programme. METHODS: A one-group repeated measures design was used to evaluate the outcomes. Knowledge was evaluated with a Multiple Choice Questionnaire (MCQ). Problem-solving ability based on participants' responses to Life Situation Scenarios relevant to each topic area was rated on a standardized four-point criterion reference scale. Perceived importance for each topic area was rated on a five-point Likert scale. RESULTS: Twenty-three participants completed all assessments. There was significant improvement in MCQ scores from admission to discharge (P = 0.04) and admission to follow-up (P = 0.02). For problem-solving ability, there was a trend toward improvement in all content topics with significant improvement from admission to follow-up for the topic of bowel care (P = 0.004). However, many participants continued to demonstrate poor problem-solving ability. Bowel, Bladder and Skin Care were consistently perceived as the most important education topics. CONCLUSIONS: Improvements in knowledge do not necessarily translate to improvements in problem-solving ability even for the topics perceived as important. This may indicate the need to incorporate more active learning strategies or contextually based strategies within patient education programmes to facilitate the transfer of knowledge within life situations.

Adolescent↗
PubMed2006

Accessible support for family caregivers of seniors with chronic conditions: from isolation to inclusion.

Accessible support programs can improve health outcomes for family caregivers of older relatives with a chronic condition. Over the course of 6 months, 27 experienced family caregivers provided weekly support via the telephone to 66 individuals, either new family caregivers of seniors recently diagnosed with stroke or newly vulnerable family caregivers (i.e., facing increasing demands from the deterioration of their senior relative's condition) of seniors with Alzheimer's disease. Qualitative data documented the perceived impact of the intervention, including increased satisfaction with support, coping skills, caregiving competence and confidence, and decreased caregiver burden and loneliness. Caregivers identified varied support processes that overcame support deficits in their social networks. These processes can facilitate replication in future research and inform practice, programs, and policies.

Adaptation, Psychological↗
PubMed2005

Therapists' perspectives on the management and delivery of occupational therapy and physical therapy services.

The impact of resructuring healthcare services on the day-to-day practice of occupational therapists and physical therapists was examined. Four main issues emerged: limited understanding of scopes of practice; absence of a rehabilitation perspective at decision-making tables; lack of a career ladder; and barriers to the maintenance and enhancement of professional competence. This article describes the reported impact of these issues on patient care specifically and on the healthcare system in general. Recommendations for an improved structure within an interdisciplinary management paradigm that would ensure effective and efficient use of healthcare resources are provided.

Allied Health Personnel↗
PubMed2005

Highlights of the 2002 Canadian Neurological Society (CNS) manpower survey.

BACKGROUND: The Canadian Neurological Society commissioned a manpower survey in 2002 to assess demographics, distribution, specialty interests, working conditions, job satisfaction and future plans of neurologists across the country. METHODS: A survey was mailed to all known Canadian neurologists (n = 694) on two separate occasions. Further encouragement by telephone contact was undertaken. The response rate was 54%. RESULTS: The mean age of neurologists who responded was 51 years, with 14% being women. Approximately 55% of neurologists were community-based. Seventy-six percent designated a sub-specialty interest. On average, neurologists worked 57 hours per week and the majority had significant "on-call" commitments. Job satisfaction was higher among academic neurologists when compared with community-based neurologists, and greater among men than women. A greater percentage of older neurologists were satisfied with their work than their younger colleagues. Significant attrition in the neurological work force is a major concern, since up to 20% of neurologists reported that they are likely to retire in the next five years and about 15% are likely to reduce their practice. CONCLUSIONS: This survey suggests that substantial concerns are facing Canadian neurology over the next five years. Major efforts to retain existing expertise and enhance residency training will be required to simply maintain the present quality of neurological care in Canada.

Attitude of Health Personnel↗
PubMed2005

Continuing professional education and the Internet: views of Alberta occupational therapists.

BACKGROUND: Occupational therapists have identified barriers to accessing continuing professional education (CPE) in the traditional face-to-face formats. One alternative to traditional, centrally located, face-to-face CPE is course delivery through the Internet. PURPOSE: This study examined Alberta occupational therapists' perceptions of Internet-based CPE. METHOD: A questionnaire was mailed to 800 randomly sampled Alberta occupational therapists (response rate = 35.5%; n = 281). RESULTS: Respondents pursued CPE to increase skills, knowledge and maintain clinical competency. They reported that a face-to-face CPE course was more useful than distance courses. Although almost 90% of respondents had access to computers with an Internet connection at home or at work, and nearly 65% thought that their computer knowledge was sufficient, only 2.9% had previously taken Internet-based CPE. PRACTICE IMPLICATIONS: In order for the Internet to be accepted as a common, useful and alternative delivery tool for CPE in occupational therapy, the perceived barriers such as the lack of personal time, cost, and limited interaction with other learners and instructors will need to be addressed.

Adult↗
PubMed2004

Effects of profession and facility type on research utilization by rehabilitation professionals.

Information about the use of research by rehabilitation professionals to make clinical decisions in everyday practice is limited. This study compared perceived research use and knowledge sources across professions, practice situations, and work environments. Participants were 165 randomly selected Canadian occupational therapists, physical therapists, and speech-language pathologists. Self-report ratings during an interview, an interviewer rating, and questionnaire scores (Edmonton Research Orientation Survey, General Use of Research, Knowledge Acquisition Survey) were compared. Speech-language pathologists had the most education and the highest research use ratings. Research use was highest during program planning. Programs to encourage research use must consider the research available to guide practice and therapists' education level. Facility size and location (rural, urban) do not affect perceived research use.

Alberta↗
PubMed2003

The efficacy of pre-operative home visits for total hip replacement clients.

BACKGROUND: There is increasing realization among health care administrative decision makers and service providers that we must measure the true value of expensive services by demonstrating the achievement of identified goals. PURPOSE: The objective of this study was to determine whether clients who received the home-based intervention for a hip arthroplasty would result in a more timely discharge home from hospital. METHOD: Two hundred and eight clients receiving a total hip replacement at two acute care hospitals comprised the sample. One hospital included the more costly home-based pre-operative teaching by an occupational therapist as part of its protocol while the other provided comparative occupational therapy intervention within its hospital based pre-admission clinic. Discharge disposition and length of hospital stay were measured. RESULTS: Though no significant difference in either of these outcomes was found, a number of issues were raised indicating the complexity of resource allocation to this client population and the importance of the qualitative dimensions of care. PRACTICE IMPLICATIONS: The location for pre-operative teaching for total hip replacements was not found to impact the length of hospital stay nor whether clients are discharged directly home.

Arthroplasty, Replacement, Hip↗
PubMed2003

The impact of adult day programs on family caregivers of elderly relatives.

Adult day programs for elderly people have been implemented throughout North America but not widely evaluated for their impact on family caregivers. This study examined caregiver outcomes at 14 programs in Alberta, Canada. Caregivers were measured on burden, quality of life, perceived health, opinion on institutionalization at 4 time points (just prior to client admission, 2 weeks, 2 months, and 6 months after admission), and satisfaction with the program at 3 points after client admission. Caregiver status on burden, quality of life, and perceived health status remained stable over time. In addition, caregivers' opinion on institutionalization remained negative and satisfaction with the programs high. Caregivers reported that client socializing and improved health were what they liked best about the programs, followed by respite for themselves. Time conflicts-limits and transportation were identified as problems. The results suggest that adult day programs may help caregivers to continue in their caregiving role and to keep clients in the community longer.

Adult↗
PubMed2002

Orthodontic treatment outcome in a First Nations population in Alberta, Canada: a comparative study.

The primary objective of this study was to determine whether there was a significant difference in the degree of improvement after orthodontic treatment between a sample of First Nations orthodontic patients and a control sample of non-First Nations orthodontic patients. The secondary objective was to determine whether there was a difference in the severity of malocclusions being treated in a sample of the First Nations patients compared with a control sample of the non-First Nations patients. Several factors that might affect treatment outcome, such as missed appointments, treatment duration, oral hygiene, extractions, dental classification, and geographic location, were also studied. A sample of 60 First Nations patients and a control group of 60 non-First Nations patients between the 11 and 18 years of age who had been treated with full fixed orthodontic appliances were evaluated. The weighted peer assessment rating (PAR) index was applied to pretreatment and posttreatment study models to address the study's main objectives. The results showed that the First Nations group had greater PAR scores pretreatment than did the controls, and their weighted PAR scores improved more with treatment. Posttreatment PAR scores were similar between the 2 groups. In addition to First Nations status, only extractions and geographic location affected PAR improvement scores.

Adolescent↗
PubMed2002

Development of a questionnaire to examine confidence of occupational therapy students during fieldwork experiences.

This paper describes the development of an instrument designed to examine the level of confidence of occupational therapy students during their fieldwork experiences. Confidence in this context refers to Bandura's concept of self-efficacy in Social Cognitive Theory. As this subject has received little formal study, no appropriate tool was found to measure confidence in students. The purpose of this study was to design a measure to provide students with an opportunity to self-assess their levels of confidence both within a placement and throughout their entire fieldwork experiences. The instrument was constructed in three phases: I--Instrument Development; II--Instrument Testing; 111--Instrument Implementation. In Phase III, the instrument was distributed to all students entering the first year of occupational therapy studies at the University of Alberta. Data was collected from these students during their four fieldwork placements to address the questions of whether confidence increases during a fieldwork placement regardless of placement level, whether confidence increases by placement level, and whether student or placement characteristics affect levels of confidence. Results of the study support the hypotheses that confidence levels increase both during a fieldwork placement and with successive placements. Reliability and validity analyses indicated that the measure may be a useful tool to assess confidence in students during fieldwork placements.

Adult↗
PubMedDate not supplied

Geographic and temporal distribution of mortality rates for multiple sclerosis in Canada, 1965-1994.

Statistics Canada data were used to calculate multiple sclerosis (MS) mortality rates per 100,000 population in the Canadian provinces from 1965 to 1994. For the period 1965-1994, the highest average annual MS mortality rates were in Quebec (4.4) and Ontario (3.9), while the Western Provinces had an intermediate rate (2.1) and the Atlantic Provinces had the lowest rate (1.2). Female mortality rates exceeded male rates in each of the four regions. Average annual MS mortality rates in Canada overall fluctuated during the past 30 years, with rates of 3.4 in 1965-1969, 4.2 in 1970-1974, 3.2 in 1975-1979, 2.3 in 1980-1984, 2.8 in 1985-1989 and 3.9 in 1990-1994. Female mortality rates exceeded male rates during each 5-year period. The highest mortality rates for both genders were in the 65 years plus age group. Rates in the under 45 years age group have remained stable, while rates in both the 45-64 and 65 years plus age groups have fluctuated. There is no apparent relationship between prevalence and mortality rates among the Canadian provinces.

Adult↗
PubMedDate not supplied

Classroom-based assessment: validation for the school AMPS.

The role of the occupational therapist working in the school system is to facilitate a student's task performance or ability to do purposeful and meaningful activities so that the student benefits from the educational experience. To fulfill this role, occupational therapists need assessments that address functional performance issues in the classroom and provide information for effective programming and consultation. The School Version of the Assessment of Motor and Process Skills (School AMPS) is an observational evaluation of functional skills in the classroom. Common classroom activities are observed to assess a child's school motor and school process skills. This study examined the validity of the School AMPS by comparing it to the Peabody Developmental Motor Scale-Fine Motor (PDMS-FM), a common assessment used in local area school districts in Edmonton, Alberta. Results show a higher correlation of the PDMS-FM with the motor scale of the School AMPS than with the process scale of the School AMPS, which was expected. The School AMPS appears to be a promising instrument for measuring the constructs of school motor and school process skills within a naturalistic setting.

Child↗