dr sarah cook s.p.cook@shu.ac.uk

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Being an occupational therapy researcher and collaborating on the current study: Lifestyle Matters. Dr Sarah Cook s.p.cook@shu.ac.uk. OT Educator's conference SHU 18.06.14. Aim of this talk. Picture a career of an OT involved in research - PowerPoint PPT Presentation

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Prof Gail Mountain

Being an occupational therapy researcher and collaborating on the current study: Lifestyle Matters

Dr Sarah Cooks.p.cook@shu.ac.ukOT Educator's conferenceSHU 18.06.141Aim of this talkPicture a career of an OT involved in researchLook at the many ways and levels OTs can be involved in researchStress that collaboration is vitalDemonstrate the importance of OT informed research for our clients and populationsuse the Lifestyle Matters study as an example

2

It starts with curiosityAs children we all engage in the occupation of research3

Save the Children Fund programme evaluation: Community Based Rehabilitation in Zanzibar 4Together with Jan Duffy, Clinical Psychologist

DESCRIPTIONService evaluation in a Community Mental Health Team. 1990? Problems with staffing, timing, poor attendance

Methods:Staff discussion groups; standardised symptom questionnaire completed by clients.

Results:As a team we changed things:rolling programme of anxiety management courses, day time and an evening course; and a woman only and a mixed courses paired inexperienced staff with experienced group leaders Routinely measured clients' outcomes

Improving Anxiety Management Groups5Learning to use a standardised outcome measureDESCRIPTIONResearch Question:What outcomes do clients attribute to their experiences of the therapy process?How do these outcomes relate to any goals or expectations?Methods:Qualitativeresearchers fore-understandings in generating interpretationsfocussed interviews with 7 former clients of mental health OT ResultsIntermediate outcomes:Engagement in activityLearning, and regaining confidence in abilitiesAchievement of satisfying resultsContribution to other peopleCreative expression

A study of outcomes of Occupational Therapy in mental health services Masters dissertation6Final outcomes of OTIntrapersonal Outcomes:Increased motivationRelease of emotional pressureChanges in attitudes and beliefsIncreased self awarenessImproved self value or acceptance

Adaptive Outcomes:Acquisition of skillsAcquisition of knowledgeManagement of time and routinesAcquisition of coping strategies concerning:Altering negative habits of thinkingControlling and expressing emotionsSolving problemsCoping with disabilitiesManaging anxiety and panic attacksPacing time spent on work, leisure and restBeing assertive

Subjective outcomes:Lifting of moodReduction of distressReduction of feeling isolatedFeeling in controlExperience of pleasureFeeling physically fit and reduction of pain

Performance outcomes:Changed rolesImproved ways of relating to othersFunctional competence and independence in the communityEngagement in productive and creative activitiesInteraction with the local environment and community

7DESCRIPTIONWith my job share partner, Penny Spreadbury, Trent Region Head OTs employed us to stimulate, support and study clinical audits across the region, in a wide range of OT teams.Methods:Literature searching and putting on a database Participant observation, Developing tools for outcome measurement, Group interviews evaluating the process, thematic analysis Results:Several barriers and enablers were established. Individualised goal setting way forwardDevelopment of a tool: Binary Individualised Outcome Measure. Alternative to SOAP notes: ACTOR notes (Activity, Clients observations, Therapists observations Overall analysis, Re-planning.)

Trent Region Occupational Therapy Clinical Audit and Outcomes Project.a research job!8DESCRIPTIONgroup of service users had set up their own organisation, commissioned an evaluation. Methods: qualitative analysis of:Individual interviews, group interviews, Observed meetings, Evaluation workshop (including a roving microphone).Results: recommendations on policy and implementation for the organisation staff roles, clarification of different types of advocacy

Mental Health Advocacy Group evaluation Paid consultancy work9DESCRIPTIONJob as a research practitioner in an inner-city GP surgery. About 100 patients with psychotic conditions, became my PhD study. Methods: 1) Needs Assessment Survey using standardised assessments Development of new service

2) Case study of the new primary care mental health serviceSingle cohort, before and after quasi-experimental study using standardised assessmentsQualitative interviews with staff (interviews carried out by a student OT)Survey of patient satisfaction (interviews carried out by service user interviewers)Economic evaluation of costs

Primary Mental Health Care Project a research-practitioner job,gave me the data for my PhD10DESCRIPTION. Mental Health Foundation promoting service user led research, What was the impact of dance on emotional wellbeing, as a health promotion activity, and what helps people take part. Methods: Participatory research with members of the public and service user researchers5 Rhythms dance free classesQuantitative survey questionnaire,Qualitative diaries, peer-pair interviews, focus groups, and feedback on draft report

Dancing for Living 11Worked as a volunteer

12Results Themes: Specific to the dance group: A safe place; freedom of expression; structure of the rhythms; power of music; group connections.Transformation through dance: moving from being stuck; releasing powerful feelings; integrating parts of ourselves.Effects on day to day living: Part of life now; physical wellbeing; dancing as a strategy for emotional wellbeing; appreciating music.What helps people take part: Out of 19 women, top scores:Can go on your own without a partner (18),Toilet nearby (17)Friendly and welcoming (16)Able to express self in own way (16)No spectators watching (15)Dont need special clothes or equipment (14)

Dancing for Living13DESCRIPTIONPost doctoral award from the Dept of Health research capacity awards. 4 years funding (75% time), a programme of research, + local research grants, funded a small research team.http://www.nihr.ac.uk/Lists/Research%20Training%20Awards/awards_current.aspxResearch team:& collaborators: Julie Coleman, Eleni Chambers, Melanie Hart, Sally Bramley, Nicky Watson, Helen Tompkins, Steve McGrath.MethodsDelphi survey, asking OTs to help define the intervention Pilot Randomised Controlled Trial & economic evaluation using standardised outcome measures, in community mental health teams. Qualitative study, individual interviews of people with psychotic conditions, carried out by a service user-researcher, using Framework analysis.

Occupational Therapy for people with psychotic conditions 14I won the award to pay for my salary and research costsResults: Intervention schedule for OT for people with psychosis, 11 stages listing 82 actions (obligatory & optional components). Pilot RCT showed that:no difference between the intervention and control groups, exceptOT group had more clinical improvement in relationships, independence performance, independence competence and recreation, and reduced negative symptoms. Qualitative study showed that:Some non OTs did OT, probably due to inter-disciplinary team workingWide range of factors impacted on what people wanted in their daily lives. OT was appreciated as focussing on achievement or independence; overcoming fears; organising time and widening horizons. This was different from having things done for you, or having someone as a companion or coming along for re-assurance.

Occupational Therapy for people with psychotic conditions15My recent collaboration in large research studies Improving Quality and Effectiveness of Services Therapies and Self-management on longer term depression (IQUESTS). a literature review and qualitative study of self-management strategies used by people with long term depression and development of a Guide. Sarah's contribution:co-leading Work Package 2.10 Qualitative interviews and analysishelping to write report and article

This study is within the Collaboration and Leadership in Applied Health Research and Care for South Yorkshire (CLAHRC-SY). 2010 - 2011.Rehabilitation Effectiveness and Activities for Life (REAL): a multicentre study of rehabilitation services and the efficacy of promoting activities for people with severe mental health problems. Sarah's contribution:a co-applicant on the bidmember of the steering groupdeveloping the intervention for the cluster randomised trial, supervising the therapists monitoring fidelity to the intervention.

January 2009 - March 2014.

16Lifestyle Matters: A large collaborative study involving OTs at every levelPrinciple investigators: Prof. Gail Mountain (University of Sheffield) and Gill Windle (Bangor University)Research Teams:Sarah Cook and Claire Craig (Sheffield Hallam University)Bob Woods, Cath Brannan, (Bangor University)Kirsty Sprang, Danny Hind, Anju Keetharuth, Lauren O'Hara, Katy Treherne, Maggie Spencer, Tim Chater, Lauren Powell, Stephen Walters, John Brazier (University of Sheffield)

Facilitators delivering the intervention:Johanna Warren & Samantha Bryan (Sheffield) + OT clinical supervisorElaine Hughes & Jessica Shirley (Bangor) + 2 OT clinical supervisors

Thanks to Prof. Gail Mountain for being an inspiring research leader, and Clair Craig for her creativity - both developed and piloted 'Lifestyle Matters' and both are OTs.

Gail produced the following slides. 18

The importance of ageing wellActive ageing and prevention of ill health in older people is a priority for policy makers across Europe

But also

Beautiful Old AgeIt ought to he lovely to be oldTo be full of the peace that comes of experienceAnd wrinkled life fulfilment.

DH Lawrence

19 The Well Elderly study of Lifestyle Redesign

Clark, et al (1997) Occupational Therapy for independent older living adults: a randomised controlled t

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