iCAHE PhD Corner
As iCAHE expands its' research capacity, so too does the number of
PhD students. Many of our students are creating high quality research in
all areas of evidence based practice. The aim of this section is to
promote and display the great work that iCAHE's PhD students are doing
within South Australia, as well as nationally and internationally.
Our students work also features in the PhD Corner section of the
Allied & Scientific Health News,
don't forget to check it out.
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PhD Students: |
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| Ryan Causby | Debbie Howson |
| Janine Dizon | Lucylynn Lizarondo |
| Val Dones | Julie Luker |
| Caroline Fryer | Liz Pridham |
| Michelle Guerin | Emily Ward |
| Honours Student: | |
| Jess Stanhope | |
For contact details for PhD Students please go
here
Ryan Causby
Student Home Page
Recent Findings
Information coming soon.
Project Overview
Information coming soon.
Janine Dizon
Student Home Page
Recent Findings
Janine piloted her EBP training program in September 2010, along with
the study she developed a large resource to aid in training participants.
For information about the pilot please visit the
EBP in the Philippines page.
Project Overview
The use of evidence to guide clinical practice has been a growing area
of interest in the health professions worldwide, particularly in
physiotherapy. In the Philippines, there is no documented information on
what really guides clinical practice and if the use of research evidence
does have a role in guiding the physiotherapists in making their clinical
decisions on patient care. This was the primary driver of Janine Dizon's PhD
project focusing on the development and implementation of a tailored
evidence based practice educational program for Filipino physiotherapists.
Very little research has been done and documented in physiotherapy practice
in the Philippines. In this context, the beginnings of physiotherapy
practice in the Philippines was traced and explored. This helped inform how
the historical context of practice and the international and cultural
influences shaped the framework of current practice. The World Confederation
of Physical Therapy (WCPT) regulates the practice of physiotherapy, but
"considerable variations in population, cultures and health care systems in
influence the various ways in which physiotherapy is practised and
regulated" (Higgs et al 2001). For this reason, the context of practice has
to be clearly understood to provide updates and training which are "fitted"
to the type of practice. This phase of the project has become very
motivating as archival search of documents and interviews with key persons
involved in setting up physiotherapy practice in the Philippines were done
to provide a comprehensive and accurate account of historical events. Very
interesting findings came out in this project, of which Janine has planned
to present in the form of a coffee table book!
To develop and implement a tailored evidence based practice educational
training for Filipino physiotherapists, the current profile of practice has
to be explored apart from its historical context. A survey was done among
the local physiotherapists to identify their level of training, areas and
setting of practice, treatment preferences and basis for treatment
decisions. Most of the local physiotherapists had a bachelor's degree,
working in private and public hospitals, used a wide range of treatment
techniques (from exercises to electrotherapy and alternative therapy) and
based their treatment decisions from undergraduate education, textbooks and
physiatrists (medical doctors who specialized in the field of
rehabilitation). Relationships between these variables were also explored to
further understand what needs to be done in the tailored evidence based
practice educational program. It is worth mentioning that this phase of
Janine’s project was done through the Philippine Physical Therapy
Association (PPTA), which is the local professional organization of Filipino
physiotherapists.
The tailored EBP training program for Filipino physiotherapists has been
pilot tested last September 2010. The pilot testing resulted to significant
changes in knowledge and skills to EBP with a high effect size of 0.8. The
EBP training program has been named as the “EBP for FilPTs” and is
acceptable and feasible to be conducted in a larger population. To
complement the EBP training program, an online support has been developed
and can be accessed by the participants who have undergone the training and
can be accessed at this link:
http://www.unisa.edu.au/cahe/iCAHEGroups/EBPPhil. Information
about the whole project and the feedback from the pilot testing is also
available in this link.
The findings from this iterative process of research and the preliminary
scope of the literature will frame the first documented EBP program
developed for the needs of Filipino physiotherapists. Currently, the RCT to
test the effect of the EBP for FilPTs is being conducted. This program is
expected to provide an update to the local practice, up skill the local
physiotherapists and eventually lead to better health care.
References:
1. Schreiber J and Stern P (2005): A review of the literature on
evidence-based practice in physical therapy. The Internet Journal of Allied
Health Sciences and Practice 3(4).
2. WCPT (1999). Description of physical therapy. 14th General meeting, May.
London: World Confederation for Physical Therapy.
3. Higgs J, Refshauge K and Ellis E (2001): Portrait of the Physiotherapy
Profession. Journal of Interprofessional Care 15 (1): 79-89
Val Dones
Student Home Page
Recent Findings
Information coming soon.
Project Overview
Val's current study is on the diagnosis and upper extremity
biomechanics of patients suffering from lateral epicondylitis.
Caroline Fryer
Student Home Page
Recent Findings
I will be presenting some of my key findings at the 9th Asia / Oceania
Congress of Geriatrics and Gerontology in Melbourne, Australia, from October
23-27.
Project Overview
Thesis title: How older people with limited English proficiency
experience their care after stroke. A constructivist grounded theory. I am
investigating the experience of healthcare after stroke for older people
with limited English proficiency. Using a constructivist grounded theory
approach to the study, interviews have been conducted with older people who
returned home after stroke and their informal carers. Participants were from
seven language groups and professional interpreters assisted with
interviews. Currently I am completing data analysis and writing my thesis.
The findings from my study will inform both the provision of healthcare for
people with limited English proficiency and the research practice of using
in-depth interviews with a multilingual sample (Journal of Advanced Nursing
article in press).
Michelle Guerin
Student Home Page
Recent Findings
Michelle has a webpage devoted to her project, go
here for more details.
Project Overview
Michelle's PhD is looking at community services involvement in
discharge planning. The overall purpose of this study was to develop a set
of guiding principles to improve the discharge process of older adults from
hospital into the community through concerted and planned involvement of
local community services.
The aged and community care industry is increasing in importance, with
demand for services expected to double in Australia over the next 20 years
(ACSA, 2001).This increase in demand is driven by the ageing population in
Australia, particularly in the very old age group (>85 years) (ACSA,
2001).As a result of this ageing demographic, services to address the
health, well-being and quality of life of older Australians are currently of
paramount importance, and this will continue to be into the future. As
people age they are at increased risk of developing diseases and
disabilities, and as a result older people are disproportionately high users
of health and community services (ASCA, 2001).With increasing usage of these
services there is a strong emphasis in Australia for community services to
play a larger role in optimising older peoples' health and wellbeing in the
community (ASCA, 2001; NCOSS, 2010).In doing so, and assisting in managing
older people discharged from hospital, community services can help to
alleviate some of the demand for acute care services by older people. My
research highlights that community services in South Australia play a vital
role in assisting to manage older peoples' health and wellbeing after
discharge from hospital. One of the factors influencing this role (as
identified by the community service providers who were interviewed) was the
different models under which the hospital and community services operate.The
community service providers identified that the hospital and the community
operate under different health models. With the hospital operating
predominately under a Biomedical Model (NCOSS, 2010; Wade & Halligan, 2004)
and community services under a Social Model (ASCA, 2001; NCOSS, 2010).
References:
Aged and Community Services Australia (ACSA) 2001, Submission to the Inquiry
into the Definition of Charities and Related Organisations, Australia.
Council of Social Services NSW (NCOSS), NCOSS Response to the NSW
Government's discussion paper on A National Health and Hospitals Network for
Australia's Future, NSW, Australia.
Wade, DT & Halligan, PW 2004 Do biomedical models of illness make for good
healthcare systems? British Medical Journal, vol 329, pp.1398-1401.
World Health Organisation (1986). Ottawa charter for health promotion: an
International Conference on Health Promotion, the move toward a new public
health, November 17-21, 1986, Ottawa, Ontario, Canada. Ottawa, World Health
Organisation:4.
Debbie Howson
Student Home Page
Recent Findings
Information coming soon.
Project Overview
Information coming soon.
Lucylynn Lizarondo
Student Home Page
Recent Findings
Currently, I am collecting data for my final study. The results of the
qualitative research were used to refine the current iCAHE model while the
findings from the systematic review informed data collection. Thirteen
groups of allied health practitioners agreed to organise iCAHE journal
clubs—two of which are multidisciplinary and the rest are
discipline-specific. All journal clubs were asked to nominate facilitators
who will lead journal club discussions.
Project Overview
Since working in iCAHE in 2008, I have been assisting allied health
practitioners in South Australia organise their journal clubs using the
iCAHE model (http://www.unisa.edu.au/cahe/Resources/JC/journalclub.asp).
This journal club initiative is part of iCAHE's commitment to promote the
use of research evidence in making decisions about health care. Because of
my exposure to this project, I have developed a strong interest in
evidence-based practice (EBP), specifically the role of journal club in
bridging the gap between research and practice.
In 2009, I have been successful in obtaining a place in higher degree
research (PhD) at the School of Health Sciences, University of South
Australia. Because of this opportunity, I am now a step closer to
understanding how individual allied health professionals respond to
interventions aimed at promoting EBP.
My PhD research aims to explore the determinants of individual allied health
practitioner’s uptake of EBP using the iCAHE journal club as a medium. This
research involves three studies. The first study utilises a qualitative
approach, and is aimed at understanding the perspectives of allied health
practitioners on the use of journal clubs as a medium for promoting EBP.
The second study is a systematic review of the literature which examines
individual determinants of EBP uptake in allied health. The third study
involves a pre-post design that will examine variability of outcomes (i.e.
EBP knowledge, skills and uptake) after taking part in an iCAHE journal
club. It will also describe the characteristics of allied health
practitioners who are likely, or are not likely, to benefit from an iCAHE
journal club.
The first year of my candidature was spent mostly on preparing the proposal
and applying for ethics approval. Soon after the ethics committees approved
my research, I recruited participants for my qualitative research which
involved focus group interviews with allied health practitioners. Data
collection and analysis of results were completed before the end of my first
year. The findings from this study revealed that allied health
practitioners were positive about the use of journal club as a medium for
promoting EBP. Journal clubs were seen as a forum for reflective practice,
keeping up-to-date with research evidence, and learning the processes
involved in EBP. Clinical workload and limited knowledge of statistics were
reported as major barriers to participation in journal club meetings.
Support from managers, peers and researchers/academics and access to
resources were considered necessary for effective and sustainable journal
clubs. Suggestions were raised on how the current iCAHE model can be
improved to increase journal club participation.
I completed my systematic review at the beginning of my second year. In
this review, I have categorised the individual determinants extracted from
the relevant studies into socio-demographic factors such as age and gender,
education, beliefs and attitudes, involvement in research or EBP-related
activities, professional characteristics, clinical setting, and information
seeking. Of these variables, three were found to be predictive of
self-reported use of EBP: educational degree or academic qualification,
involvement in research or EBP-related activities, and practitioners’
perceptions, attitudes and beliefs about research and EBP. The effects of
other factors are less clear.
Prior to setting up an iCAHE journal club, the facilitators were required to
attend a once-off training workshop on EBP, which was held on February
2011. Journal club meetings are being held once a month, each lasting an
hour. Most journal clubs had their first meeting on March 2011 and a few
started on April 2011. Baseline measurements (EBP knowledge, skills, and
uptake using structured questionnaires, and other information based on
systematic review findings) were collected prior to the first journal club
meeting, and follow-up measurements will be gathered six months later
(September-October 2011). The figure below illustrates the processes
involved in iCAHE journal club.
Julie Luker
Student Home Page
Recent Findings
Information coming soon.
Project Overview
The influence of stroke patients' age on the quality of care they
receive from allied health professionals.
Liz Pridham
Student Home Page
Recent Findings
Information coming soon.
Project Overview
Information coming soon.
Emily Ward
Recent Findings
Emily has recently submitted her thesis, congratulations!!
Jess Stanhope (Honours Student)
Student Home Page
Recent Findings
Jess has only recently started her Honour program, so watch this space
for more information coming soon.
Project Overview
Project title: Validity and reliability of a perceived exertion tool
for use with high-level flautists – an exploratory study.
The prevalence of musculoskeletal problems amongst flautists is high, with 95% of the 20 Bachelor and Master of Music flute students involved in a recent, Australian survey, having experienced pain or injuries associated with flute playing (Ackermann et al. 2011). A larger (n=386), unpublished, international survey found that 49.7%of respondents had pain or discomfort severe enough to distract from performing. Despite this, there has been no published research investigating interventions to prevent these problems specifically for flautists.
A possible barrier to such research being conducted, is a lack of a valid, and reliable outcome measure which can be use to investigate flautists in real playing conditions (i.e. orchestral rehearsals, private practice) without impacting upon their playing. A potential measure for such use is the Borg CR10 Scale® used to rate perceived exertion in various body regions. Whilst this scale has been used in a number of occupational tasks including computer tasks (Chaparro et al. 1999) it has not been used with musicians to rate local perceived exertion. It is also unclear whether local perceived exertion, measured with this scale, can be used as a valid measure of muscle work.
The main aim of this study is to establish whether perceived exertion, rated with the Borg CR10 Scale®, in the upper trapezius region and posterior forearms, correlates with electromyography measures of muscle work in the upper trapezius and extensor digitorum, in high-level flautists, whilst playing.
References:
Ackermann, B, Kenny, D & Fortune, J 2011, Incidence of injury and attitudes
to injury management in skilled flute players, Work, 40, 255-259.
Chaparro, A, Bohan, M, Fernandez, J, Choi, SD & Kattel, B 1999, The impact
of age on computer input device use: psychophysical and physiological
measures, International Journal of Industrial Ergonomics, 24, 503-513.
Lonsdale, K 2011, Understanding contributing factors and optimizing
prevention and management of flute playing-related musculoskeletal
disorders, Unpublished thesis, Griffith University, Queensland.
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