2 resultados para Resource use
em Worcester Research and Publications - Worcester Research and Publications - UK
Resumo:
Background: Primary total knee replacement is a common operation that is performed to provide pain relief and restore functional ability. Inpatient physiotherapy is routinely provided after surgery to enhance recovery prior to hospital discharge. However, international variation exists in the provision of outpatient physiotherapy after hospital discharge. While evidence indicates that outpatient physiotherapy can improve short-term function, the longer term benefits are unknown. The aim of this randomised controlled trial is to evaluate the long-term clinical effectiveness and cost-effectiveness of a 6-week group-based outpatient physiotherapy intervention following knee replacement. Methods/design: Two hundred and fifty-six patients waiting for knee replacement because of osteoarthritis will be recruited from two orthopaedic centres. Participants randomised to the usual-care group (n = 128) will be given a booklet about exercise and referred for physiotherapy if deemed appropriate by the clinical care team. The intervention group (n = 128) will receive the same usual care and additionally be invited to attend a group-based outpatient physiotherapy class starting 6 weeks after surgery. The 1-hour class will be run on a weekly basis over 6 weeks and will involve task-orientated and individualised exercises. The primary outcome will be the Lower Extremity Functional Scale at 12 months post-operative. Secondary outcomes include: quality of life, knee pain and function, depression, anxiety and satisfaction. Data collection will be by questionnaire prior to surgery and 3, 6 and 12 months after surgery and will include a resource-use questionnaire to enable a trial-based economic evaluation. Trial participation and satisfaction with the classes will be evaluated through structured telephone interviews. The primary statistical and economic analyses will be conducted on an intention-to-treat basis with and without imputation of missing data. The primary economic result will estimate the incremental cost per quality-adjusted life year gained from this intervention from a National Health Services (NHS) and personal social services perspective. Discussion: This research aims to benefit patients and the NHS by providing evidence on the long-term effectiveness and cost-effectiveness of outpatient physiotherapy after knee replacement. If the intervention is found to be effective and cost-effective, implementation into clinical practice could lead to improvement in patients’ outcomes and improved health care resource efficiency.
Resumo:
Purpose: to consider and evaluate the student and supervisor experience of doctoral supervision (dyadic and triadic) and specifically the value of using coaching and mentoring approaches (process and relationship) in supervisory practice. Design/methodology/approach: phase one is a mixed methods study exploring the use of coaching and mentoring in doctoral supervision on traditional and taught doctoral programmes in one UK university business school. The focus is on developing a conceptual model for doctoral supervisory practice for the transfer of learning and the improvement of practice. Phase two will be a collaborative action research study in a range of UK university business schools to use, reflect on and refine the conceptual model of supervision. Findings: the initial findings from phase one will be reported on at the conference presentation. Research limitations/implications: we have tentative agreements from four UK university business schools for phase two (subject to ethics approval). Practical implications: students and supervisors participating in the research will benefit from having the opportunity to review and improve their practice; the participating business schools will have the opportunity to review and potentially revise their doctoral student and supervisor training; and a business school’s reputation for high quality doctoral supervision could be enhanced. Social implications: could potentially benefit numerous future students and supervisors across a wide range of UK university business schools. Originality/value: there does not appear to be any previously published research on the use of coaching and mentoring in doctoral supervision in UK university business schools for the transfer of learning and improvement of practice.