Experiences of patients post-stroke, occupational therapists in neurology, and health professional perceptions of sleep in palliative care: Snapshots of three qualitative studies.

Presenter: Dr Aislinn Lalor, Monash University

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About the presentation

Aislinn will be providing brief presentations of 3 honours projects she has supervised.

The first explores the expectations and experiences of transitioning home from in-patient rehabilitation for people who have had a stroke. In this qualitative study,10 adults who had a stroke completed semi-structured interviews prior to and following their discharge home from sub-acute rehabilitation. Six pre-discharge and three post-discharge themes were identified. Participants transitioning home from inpatient rehabilitation following stroke reported an overall positive experience, despite various changes. Environmental and personal factors influenced the transition home and impacted participants occupational performance and engagement. Participants consistently prioritised their physical mobility prior to, and following discharge home. Support from family at home and ongoing rehabilitation in the community assisted with the transition home process. Once home, participants experienced altered time use and changes to their occupational performance due to stroke related deficits, however home was perceived to be comfortable and familiar. Future researchers might consider a narrative enquiry to enable further exploration of transition home and possible changes in participant’s perspectives over time

The second study explores occupational therapist's perceptions of their role and their implementation of occupation-based practice in neurology. In this qualitative study, 7 occupational therapists working in acute or sub-acute neurology were interviewed with three themes identified: Conceptualisation vs implementation of occupations; Satisfaction using occupations; and Advocacy for occupational therapy. Participants described the importance of using occupations in their practice, however felt the challenges of the neurology environment hindered their ability to carry out occupation-based practice, particularly in an acute setting. Findings of this study demonstrate the continuing need for occupational therapists to advocate for their role and their use of occupations in a neurology setting.

Lastly, sleep is essential for restoration and regulation of physiological functioning in all individuals however sleep difficulties are highly prevalent for patients in palliative care, affecting their well-being and everyday participation. This qualitative study alsi used semi-structured interviews to investigate the perceptions and roles of health professionals in identifying and addressing sleep difficulties in patients receiving palliative care. Ten health professionals across six disciplines participated. Five themes were identified: (1) patient’s sleep is highly valued; (2) sleep in palliative care is complex; (3) perspectives and approaches to sleep management vary; (4) challenges in addressing sleep; and (5) health professionals desire for sleep knowledge. Findings highlight health professionals’ perceptions of sleep difficulties and consequential implications, and the importance of sleep for both patients and caregivers. However, participants perceive priorities of care and limited resources and training in sleep management, hindered their clinical practice in addressing sleep. Health professionals could benefit from reorienting practice, development of up-to-date resources regarding sleep, and support to provide sleep education for patients and caregivers.

About the presenter

Dr Aislinn Lalor is an Early Career Researcher and Lecturer in the Department of Occupational Therapy at Monash University.  Her initial clinical work was in acute aged mental health and community health positions prior to undertaking her PhD regarding sleep of older adults based at the Kingston Centre, Monash Health which she completed in 2017. Her current research focuses are broad and include sleep, older adults, and assistance animals.

Further information: [email protected]

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