In recent years there has been considerable interest and research examining psychological distress resulting from athletic injuries, as well as coping strategies for an enhanced recovery. The purpose of this study was to examine the psychological effects of sport related concussions and to determine if participation in support groups can reduce these psychological side effects. Participants included concussed male and female varsity or comparable elite level athletes who were placed in either a control or an experimental group. All subjects completed the Profile of Mood States and the Post Concussion Rating Scale. Participants in the experimental group received three support group intervention sessions, while those in the control group received no intervention. Data was analyzed using descriptive statistics. It was revealed that participants in the experimental group improved their mood state. In addition to the impact of support groups on concussed athletes, factors influencing their moods were also identified including the concussion history of the athletes, the stage of rehabilitation, gender, and number of concussion symptoms.

Self-help groups have emerged as a system of care for groups of people sharing a common problem or condition. Most of the interest in research came from professionals in mental health and social services. Educators have traditionally viewed self-help groups as outside their domain. The focus of this study is the phenomenon of personal change within self-help groups. This is viewed as “learning with peers.” The subject of the study was HOPE Cancer Health Centre, a non-profit community based self-help organization in Vancouver, B.C. Appropriate to the study of phenomena in their natural surroundings, data collection methods were qualitative in nature. Fourteen in-depth interviews were carried out with members and leaders of the self-help group. Two introductory workshops were attended for participant observation and several pertinent documents were reviewed. A full description of HOPE Cancer Health Centre as a self-help group and as a context for adult learning was developed. To clarify the description of HOPE, a framework of characteristics of self-help groups was developed. It was used to organize data collection and analysis. Compilation and analysis of the findings created a description of HOPE that adds to the understanding of self-help groups as organizations in a larger system of care provision. It also adds to the understanding of HOPE as an organization with the purpose to assist cancer patients who are interested in actively participating in their cancer treatment and recovery. In order to enhance understanding of adult learning in the context of a selfhelp group, three perspectives from the literature on adult learning were selected for their potential to organize and explain the resulting data. Four important themes emerged from the data on the learning experiences of the members of HOPE. First, the ideology of HOPE, “self as participant in healing,” is the framework of learning and within that frame there are four forms of learning, the forms of transformative learning being the most significant. Second, for the learners of HOPE, the basis of knowledge is their personal experience; therefore, processes of experiential learning are important as well as those of perspective transformation. Third, the affective dimension of the experiential learning process was found to be integral in the process of learning. The fourth theme is “learning with peers,” the innate characteristic of self-help groups. All members interviewed placed high value on their experiences of learning with peers and of learning at HOPE. Meaningful interpretation of the data resulted from application of concepts and theoretical propositions from three perspectives on adult learning: experiential learning, transformative learning and situated learning.

The individualization and medicalization of the emotional distress of those given psychiatric diagnoses deny the social, political, and economic context in which the presenting behaviours arose and leads away from making changes to society. Some people who are psychiatrically labelled join in groups for solidarity in the face of being stigmatized. In these groups the members can resist the disempowerment and helplessness learned in the psychiatric system. With co-researchers from a self-help group this study gives expression to the usually silenced voices of psychiatrized people. Feminist and standpoint theories, co-cultural and living systems theories form a framework for this narrative study. A structural narrative method is used to analyze the stories, found in the transcripts of six individual interviews, told by the co-researchers about their experiences in psychiatric services and in the recovery process. The stories reveal how the ideology and practices of psychiatry use stigma, oppression and the creation of the identity of psychiatric patient for control and management. The stories also reveal the reality of hope for recovery through the support of peers and from the role models of those who have significantly recovered their mental health. Two focus group interviews were conducted with members of the self-help group where suggestions for programs were developed to address issues raised within the groups and in the individual interviews. The findings of the research will be reported to the self-help group who will use the study to back proposals for the funding of recovery-oriented programs. When social workers and other mental health professsionals recognize the importance of supporting the process of recovery, consumer/survivor-run programs will be acknowledged as effective and integral parts of any mental health system

The effects of pre-stroke exercise and levesl of brain-derived neurotrophic factor (BDNF) on behavioural and functional recovery were examined following focal cortical ischemic infarct. Intracortical microstimulation (ICMS) was used to derive topographical maps of forelimb representations within the motor cortex and ischemia was induced via bipolar coagulation of surface vasculature. One month of excerise prior to ischemia significantly increased the amount of peri-infarct movement represnetations and initiates vascular changes within motor cortex. Further, this exercise-induced preservation of peri-infarct movement representations is associated with behavioural recovery and is dependent on BDNF levels in the motor cortex. These results provide further support for the idea that endurance exercise prior to stroke may enhance functional and behavioural recovery. / 140 leaves : ill. (some col.) ; 29 cm.

Aim : The study was explored within the context of a survey to determine the need and scope for a cardiac rehabilitation programme at Grey’s Hospital in Kwa Zulu-Natal. A multi-disciplinary perspective was sought as a cardiac rehabilitation programme with a multi-disciplinary approach is holistic. Also it is an effective intervention as secondary prevention in the care of the cardiac patient. Design : Exploratory survey in a “case-study”. Setting : a provincial, tertiary hospital in Kwa-Zulu Natal Participants : Permanent healthcare workers employed by the Department of health and working in the various units at Grey’s Hospital with more than 3 years experience. Staff included nurses and doctors in the coronary care unit, medical ward D1, catheterization unit and the cardiac clinic. Allied staff such as occupational therapists, dieticians, psychologists and physiotherapists also participated in this study. Staff not satisfying the above criteria and those not consenting to be part of the study were excluded. 58 questionnaires were distributed and 35 were returned completed. Intervention : A self developed questionnaire was used and information was obtained about the demographics of the healthcare workers, relevant interaction with cardiac patients and aspects of training related to cardiac conditions. Questions were directed to professionals as pertained to their respective scope of practice. Some questions were “open” ended and required responses with descriptions and/ or explanations. Admission records were perused in various cardiac units to determine the number of cardiac patients accessing services at Grey’s Hospital. Results : The total number of cardiac patients that attended Grey’s Hospital from January 2007 to December 2011 was 19983. The cardiac clinic showed an increase annually in the number of patients each year from 2495 in 2007 to 3569 in 2011 with a total number of 15928 over 5 years. All professionals assisted patients with achieving cardiac rehabilitation goals. There was a need demonstrated for the implementation of written resources for patient education; and training of staff in cardiac rehabilitation according to international guidelines. Basic life support (CPR) training is present among some professionals. A structured referral of patients for cardiac rehabilitation is not present and a phase I-IV cardiac rehabilitation programme with updated protocols is not present at Grey’s Hospital. Health professionals listed the scope of practice for current and potential interventions with cardiac patients. Healthcare workers also expressed their views on the value of a multi-disciplinary cardiac rehabilitation programme at Grey’s Hospital. Benefits for a multi-disciplinary cardiac rehabilitation programme at referral hospitals were listed by the multi-disciplinary healthcare workers. It was found there is a strong agreement to have a cardiac rehabilitation programme at Grey’s Hospital across all disciplines. An overall agreement of 32/35 for rehabilitation programme is statistically significant with p < 0.001. Conclusion : There is a need for a multi-disciplinary cardiac rehabilitation programme at Grey’s Hospital. / Thesis (M.Physio.)-University of KwaZulu-Natal, Durban 2012.

This study assessed differences in the knowledge of cardiac risk factors and the attitude toward computer assisted instruction (CAI) in cardiac rehabilitation patients instructed by lecture and transparencies or CAI. The quasi-experimental two-group posttest design used a convenience sample of 30 volunteers enrolled in a cardiac rehabilitation program. After randomization, cardiac risk factor instruction was conducted via lecture or the investigator developed CAI. The subjects completed a knowledge instrument which demonstrated content validity and a Kuder-Richardson formula 20 reliability coefficient of .0 and the Attitude Toward CAI scale which demonstrated content validity and a Cronbach's alpha .853 and .759. The data were analyzed by the two-sample t-test utilizing the .05 probability level. The results indicated a nonsignificant t value of .00 (df 28, p = 1.00) in the knowledge scores and a nonsignificant t value of 2.00 (df 28, p = .05) in attitude scores therefore the results failed to reject both null hypotheses. The conclusions drawn from this study are that CAI was as effective as lecture for patient education and that attitudes toward CAI were favorable. / School of Nursing

With the decreasing length of hospitalization for the Coronary Artery Bypass Graft (CABG) patient population, it is becoming increasingly difficult to provide patients with necessary education. The purpose of this study was to examine patients' perceptions of the importance of patient teaching information, and how realistic they perceive it is to learn the information following CABG surgery. Patients' learning and understanding are increased when the information is perceived as important.The findings of this study indicated that CABG patients rated the areas of medication, diet and activity information as the most important to learn during the early recovery period. The patients indicated that it was less realistic to learn in the areas of anatomy and physiology, risk factors, medications, diet, activity, post surgical care, psychological factors, and other pertinent information during the early recovery period. The information gained from this study could be used to enhance educational content for patients who have undertaken CABG surgeries. / School of Nursing

The use of a structured goal setting program in injury rehabilitation has not been empirically tested, but many others have noted that its use could increase compliance. The primary purpose of this study was to determine the effect of a structured goal setting program on individuals' compliance to injury rehabilitation; secondly, to examine the hardiness levels of those individuals, and determine if there was a relationship between their levels of hardiness and compliance to the treatment. Individuals who sought services of Ball Memorial Hospital Health Strategies for a back injury (N = 15) participated by first completing the Personal Views Survey. Then, the control group ( = 6) completed their normal rehabilitation program, while the experimental group ( = 9) completed their rehabilitation program using a structured goal setting program. Finally, both groups completed a post-hardiness survey. The researcher found no significant difference in compliance rates between the two groups. All of the injured participants recorded moderate hardiness levels and a low correlation was observed between hardiness and compliance to treatment. / School of Physical Education

Cardiac rehabilitation is profoundly effective at improving physical activity and reducing morbidity and mortality of heart patients. Despite its effectiveness, it is highly underutilized. Research indicates proxy-efficacy and self efficacy positively correlate and predict exercise adherence after Phase II cardiac rehabilitation (Bray & Cowan, 2004; Bray, Brawley, & Millen, 2006). The purpose of the current study aims to investigate the relationship of Phase I patients' proxy-efficacy and self efficacy and their intention to enroll in Phase II cardiac rehabilitation. Thirty participants completed measurements of self-efficacy and proxy-efficacy, a demographic questionnaire, and asked to indicate intent to enroll. Results revealed proxy-efficacy does not predict intention to enroll into Phase II cardiac rehabilitation. Even though patients generally had high confidence in their cardiac rehabilitation specialists, proxy-efficacy was an insufficient predictor of intention to enroll in subsequent cardiac rehabilitation services. Moreover, results indicate proxy-efficacy and self efficacy for exercise are not related. / School of Physical Education, Sport, and Exercise Science

Purpose: Cardiac rehabilitation (CR) programs have been shown to promote numerous health benefits among patients with cardiovascular disease (CVD), but little is known about the characteristics of CR programs. Methods: A survey was developed and utilized to collect data on Early Outpatient Cardiac Rehabilitation programs (EOCR) in the USA. An email with a link to the survey was sent by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) to their members. Program directors/administrators were recruited to provide information about their program in operation during 2009 in the United States. The CR survey contained 13 questions, some with multiple answers, regarding the utilization and patient demographics of an Early Outpatient Cardiac Rehabilitation (Phase II) program. Results: Responses were received from 138 programs in 44 states. Of the responses, 19,689 patients completed at least one EOCR exercise session. Of the responses, 68% of patients were men and 32% of patients were women. Patients enrolled in EOCR programs had a primary diagnosis of CABG 4,803 (30%); AVR/MVR 1,401(9%); MI 3,583 (22%); PCI/Stent 4,961 (31%); stable angina 965 (6%); heart/lung transplant 53 (0.33%); other 385 (2%). 8.4% complete 0-6 sessions of EOCR; 12% complete 7-12 sessions; 22% complete 13-18 sessions; and 58% complete 19-36 sessions. 35% of patients enrolled in EOCR programs are discharged early. 84% of programs offer an outpatient maintenance CR program. 96% of EOCR programs offer education classes; 89% offer resistance equipment; 72% are AACVPR certified; 62% also offer pulmonary rehabilitation; 23% utilize outcome measurements; 62% are in rural locations; and the average patient-to-staff ratio is 4.2:1. Conclusions: CR programs are used by a minority of eligible patients. There is marked variation in the structure and content of EOCR programs. Alternative strategies to improve standardization and outcomes should be implemented. / School of Physical Education, Sport, and Exercise Science