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Development version 19/06/2012
1 of 48Effectiveness of a postural care training programme © 2012
Effectiveness of a postural care education programme
Chief Investigator (EKHUFT & CCCU) Eve Hutton, [email protected]
Research Associate (CHSS, UKC) Sarah Hotham
Co-Investigator (CHSS, UKC) Annette King
Co- Investigator (CHSS, UKC ) Kate Hamilton-West
Development version 19/06/2012
Effectiveness of a postural care training programme © 2012
Background• Occupational Therapists & Physiotherapists support children at school.
•More children are educated in mainstream schools.
• Parents & teachers lack knowledge & confidence.
• This can affect a child’s function & well being (Hutton & Coxon 2011).
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The A-Z of postural care
Development version 19/06/2012
Effectiveness of a postural care training programme © 2012
Aim
• The aim of the study is to determine whether the intervention ( a postural care education programme) improves parents’ and teachers’ knowledge and confidence in providing postural care
Development version 19/06/2012
Effectiveness of a postural care training programme © 2012
Methods• Intervention targeted at two groups:
Inclusion criteria : care for a child who attends a mainstream primary school.
1. Parents
2. Teachers and Teaching Assistants
• Sample size: minimum 66 (based on G*Power calculation).
• Aimed to recruit 25-30 through each therapy team.
Development version 19/06/2012
Effectiveness of a postural care training programme © 2012
Methods: Recruitment
3 x Therapy Team
Admin based in therapy
team invites parents
Therapists identify children
Research team invites
teaching staff
Therapists identify schools
Development version 19/06/2012
Effectiveness of a postural care training programme © 2012
Intervention• Two key aims:
1. To improve knowledge and understanding of postural care
2. To improve confidence in providing postural care
• Facilitated by physiotherapists and occupational therapists in each locality.
• Intervention take place over 6-weeks consists of 3 main parts:
1. Postural Care Training 2-hour workshop
2. One-to-one visit
3. Telephone support
Development version 19/06/2012
Effectiveness of a postural care training programme © 2012
Evaluation of Intervention
• Use validated outcome measure.
• Baseline measurements. Prior to start of training workshop participants complete postural care questionnaire (Time 1).
• End of 6-week intervention complete postural care questionnaire again (Time 2).
• Changes in knowledge, understanding and confidence?
• ANOVAs comparing Time 1 vs. Time 2.
• Focus groups and child interviews to gather qualitative feedback.
Development version 19/06/2012
Effectiveness of a postural care training programme © 2012
Outcome Measure
•Majority of questions scored on a 4 point-Likert scale (1= Strongly disagree to 4 = Strongly agree).
• Higher scores = more knowledge /understanding & confidence.
• “ I understand how postural care may affects a child’s physical health”
• “I feel confident about providing postural care”
• Higher scores =more concerns.
• “ I am concerned I might be doing more harm than good”
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Timeline: May – August 2013
May: T2 data
collection & Focus groups
July: T2 data
collection & Focus groups
Aug:Analysis of
qualitative & quantitative
data
Sept:Final report
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Results (Time 1): N = 71
2
20
Site 1
ParentsTeaching Staff
6
17
Site 2
ParentsTeaching Staff
9
18
Site 3
ParentsTeaching Staff
Development version 19/06/2012
Effectiveness of a postural care training programme © 2012
Results: Reliability
• Cronbach’s Alpha : Above .70 indicates satisfactory reliability
1. Knowledge and Understanding (21 items) : α = .87
2. Confidence (23 items) : α = .85
3. Concerns (7 items) : α = .84
Development version 19/06/2012
Effectiveness of a postural care training programme © 2012
Results: Correlations
• Preliminary data from Time 1 outcome measure.
• Years of experience related to higher levels of confidence, lower levels of concerns.
• Positive correlation between levels of knowledge and confidence.
•Higher levels of knowledge = higher levels of confidence.
• Negative correlation between levels of concerns, knowledge and confidence.
• Lower levels of concerns = higher levels of knowledge and confidence.
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Results: Area Breakdown
Knowledge Confidence Concerns2
2.1
2.2
2.3
2.4
2.5
2.6
2.7
2.8
Site 1Site 2Site 3
Low
-Hig
h M
ean
R
esp
on
se
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Results: Parents vs. Teaching Staff
Parents Teaching Staff2
2.25
2.5
2.75
KnowledgeConfidenceConcerns
Role
Mean
Resp
on
se
*p<.05
Development version 19/06/2012
Effectiveness of a postural care training programme © 2012
Cost analysis and qualitative study
• NHS costs of the intervention
• Via process logs of activities
• Feedback from participants
• Group discussion and interviews with workshop participants
• Group discussion with therapist about their experience
• Interviews with children who have experience of postural care
• Using visual communication approach (talking mats)
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Final Thoughts
Impact:
• On-going partnership between the researchers and service users throughout.
• A parent is a co-applicant & other parents & teachers have been involved in the design & development of the intervention.
• Linking parents and teachers – sharing
experiences.
• Highlights importance of postural care for the child and the need for a ‘whole school approach’.
Implications:
• Promote knowledge sharing & closer working between parents, therapists & teachers.
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ThanksThis presentation presents independent research
commissioned by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB)
Programme (Grant Reference Number PB-PG-0110-21045).
The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of
Health