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PURPOSE: To explore the rehabilitation goals and evaluate goal attainment outcomes of people with severe acquired brain injury (ABI), and investigate the relationship between goal engagement and goal attainment. MATERIALS AND METHODS: Mixed-methods cohort study with twenty-nine adults with severe ABI in Australia. Demographic data, goal statements and pre-post program Goal Attainment Scale scores as well as Goal Engagement Scale scores were collected. Goals were coded using inductive content analysis and categorised by ICF component and domain. Goal attainment within ICF categories was described and compared using descriptive statistics. Pre-post program change in goal attainment was evaluated using Wilcoxon signed rank tests and correlations between goal engagement and attainment was explored using Spearman's (rho). RESULTS: 94% of 320 goals were categorised as ICF Activity and Participation. There was significant improvement in goal attainment between admission and discharge (z=-0.47, p < 0.01). There was no significant relationship between goal engagement and goal attainment however there was a positive association between engagement in goal setting at admission and discharge.Conclusions: This interdisciplinary, inpatient rehabilitation program underpinned by key-worker facilitated person-centred, role-based goal setting resulted in goal attainment in chosen goals, which were primarily activity and participation-focused.

Goal setting is a core rehabilitation practice and service delivery models that facilitate collaborative goal setting which engages patients, their significant others and health professionals as a team are necessary to enable person-centred care.Role-based goal setting effectively engaged patients with acquired brain injury and their families, facilitating goal setting and the formation of activity and participation-focused rehabilitation goals in this extended rehabilitation setting.

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BACKGROUND: Decreased participation and life satisfaction are common post-stroke. Exploratory studies have indicated associations between these outcomes and personal factors. Information remains limited and experiences of people with stroke are not well-represented or understood. AIMS/OBJECTIVES: The aim of this study was to explore how personal factors influence experiences of participation and life satisfaction for people with stroke living in the community. MATERIAL AND METHODS: Qualitative in-depth semi-structured interviews were conducted with eight participants living in the community post-stroke, chosen purposively based on participation and life satisfaction levels. Data were interrogated using interpretative phenomenological analysis. RESULTS: Three themes were identified: (1) What does participation mean to me? (2) Looking forward or looking back, and (3) Appraisals, avoidance, and "getting on with it". The first acknowledged the multifaceted nature of participation, although it was typically viewed as incorporating active involvement and social interaction. The additional two themes explored impacts of pre/post-stroke self-discrepancies and threat appraisals on participation and life satisfaction outcomes. CONCLUSIONS AND SIGNIFICANCE: Relationships between participation and personal factors seem to be bidirectional. Life satisfaction appeared to be influenced by rumination on negative self-discrepancies based on difference in pre/post-stroke participation. Findings suggest there may be value in examining the influence of personal factor-related interventions on post-stroke outcomes.

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PURPOSE: To examine associations between post-stroke participation and personal factors, including demographic characteristics, self- and threat appraisals, and personality variables. METHODS: An exploratory cross-sectional study with purpose-designed survey was completed online or via mail. The survey was comprised of demographic and health-related questions and multiple questionnaires, including the Stroke Impact Scale Version 3.0 (SISv3) (participation/perceived recovery), Community Integration Questionnaire (CIQ) (participation), Head Injury Semantic Differential III (pre- vs post-stroke self-concept/self-discrepancy), Appraisal of Threat and Avoidance Questionnaire (threat appraisal), Life Orientation Test - Revised (optimism) and Relationships Questionnaire (adult attachment style) that measured variables of interest. Sixty-two participants, aged 24-96 years who had experienced a stroke (one or multiple events) and had returned to community living, completed the survey. Associations were examined using correlations, and univariate and multiple linear regression analyses. RESULTS: Regression analysis showed that greater participation, measured using the CIQ, was associated with younger age, female gender, lower self-discrepancy and higher perceived recovery, explaining 69% of the variability in CIQ participation. Further, greater participation on the SISv3 was associated with lower self-discrepancy and higher perceived recovery, explaining 64% of the variability in SISv3 participation. CONCLUSIONS: Results indicate that personal factors, particularly self-appraisals like self-concept/self-discrepancy, in combination with perceived recovery may be important in explaining a large portion of variance in post-stroke participation. Specifically, findings highlight the interrelatedness of self-concept change, perceived recovery and post-stroke participation. Further longitudinal research is needed to clarify the directionality of these associations throughout the hospital-to-home transition.

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OBJECTIVE: This single-case study investigated the effectiveness of compression bandaging from the finger to the axilla in reducing poststroke edema in the upper limb. METHOD: Repeated circumferential measurements were recorded at five points along the participants' hand and forearm. Analysis of the data included the generation of graphs, celeration lines, and visual analysis. RESULTS: Five participants with edema (mean 38 days poststroke) were recruited to the study. Fluctuations in edema were observed in all three study phases, with an increasing to decreasing trend in edema between the baseline and intervention phases. There was no clear trend from the intervention to second baseline phase. CONCLUSION: Bandaging from the fingers to the axilla appears to be effective in reducing edema in the hand and forearm. However, return of edema after removal of the bandaging suggest that a greater understanding of underlying mechanisms and the appropriate intervention protocols is warranted.

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BACKGROUND/AIM: As the population ages, older adults are being encouraged through policy to remain living in their home and community. Occupational therapists are in a position to support individuals to engage in meaningful occupations, acknowledging the influence of personal and environmental factors on community participation. The purpose of this study was to understand the meaning and experience of community for older Australian adults. METHODS: A cross-sectional phenomenological research study design was utilised. Convenience and snowball sampling were used to recruit 32 participants with ages ranging from 65 to 94 years living in the south east region of Queensland, Australia. Semi-structured interviews were conducted and thematic analysis was used to explore the participants' responses. RESULTS: Four final themes were revealed: organised things in the community, community is people, community is what you make of it and the meaning of community is life. CONCLUSION: The results support that community extends beyond physicality, with personal motivation, the social environment and community involvement identified as important constructs within each of the themes. The findings provide a foundation for future research and occupational therapy practices to support older adults to age in place.

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BACKGROUND/AIM: The Activity Card Sort (ACS) is an interview-based, client-centred tool that measures the activity engagement of older adults aged 65 years and above. The tool consists of photos which clients are asked to sort into categories to reflect their previous and current level of engagement. The activities that older adults engage in may differ to that of younger adults and there is a need to explore the development of an ACS Australia for adults aged 18-64 years. METHODS: The Delphi survey method as applied by previous ACS development was used in this study. Purposeful and snowball sampling were employed to recruit participants between the ages of 18 and 64 years who were Australian citizens or residents. Demographic information was obtained via a questionnaire. There were two stages in the study. The first Delphi survey generated, selected and finalised activities and the second Delphi survey generated, selected and finalised categories. RESULTS: Australian citizens and residents were involved in the development of the activities (n = 61) and categories (n = 65). The final tool includes 85 activities sorted into three broad categories representing personal care, daily life and home maintenance; rest and relaxation; and high and low impact activities. CONCLUSIONS: This study has resulted in the development of a preliminary version of an ACS for adults aged 18-64 years. Further work is required to determine the psychometric properties of the tool.

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OBJECTIVE. To explore the efficacy of low- and high-stretch compression bandaging for edema management in the stroke-affected upper limb. METHOD. A single-case, ABA-design study was conducted with 8 participants alternately allocated to receive low- or high-stretch bandaging. Edema was measured with circumferential tape at four specified points from the hand to the mid-forearm. All measurements were represented graphically for visual analysis, and celeration lines were calculated to indicate the degree of slope in each phase. RESULTS. Visual analysis indicated fluctuating edema volume in the first baseline phase, decreasing edema volume in the intervention phase, and increasing edema volume in the second baseline phase. The results did not clearly distinguish between the two bandaging groups. CONCLUSION. Compression bandaging may have benefits in the management of edema after stroke. Further research is required to identify factors contributing to the long-term maintenance of reductions gained after compression bandaging.

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PURPOSE: The purpose of this study was to investigate the experiences and expectations of people with stroke, during their transition from hospital to home, after participating in a novel inpatient outreach program, entitled STRENGTH. METHODS: A qualitative study was conducted using semi-structured interviews, which were undertaken at discharge and 4-6 weeks post discharge. Thematic analysis was used to code the interview transcripts. RESULTS: The study incorporated data from seven people with stroke, who had a mean age of 61 years. Thematic analysis derived two themes, each with two sub-themes. The first theme was "Hospital and home" and described clients' experiences of therapy and the hospital environment. The second theme was "Life will never be what it was before" and elaborated on the adaptations and changing expectations that clients had before and after discharge. CONCLUSIONS: People with stroke described the therapy they received in both the hospital and home as beneficial. The results support the addition of the home-based inpatient program, STRENGTH, to the current rehabilitation system, as it appeared to realign the expectations of people with stroke and better prepare them for their discharge home.

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BACKGROUND: This study explored the transport and lifestyle issues of older retired and retiring drivers participating in the University of Queensland Driver Retirement Initiative (UQDRIVE), a group program to promote adjustment to driving cessation for retired and retiring older drivers. METHODS: A mixed method research design explored the impact of UQDRIVE on the transport and lifestyle issues of 55 participants who were of mean age 77.9 years and predominantly female (n = 40). The participants included retired (n = 32) and retiring (n = 23) drivers. Transport and lifestyle issues were identified using the Canadian Occupational Performance Measure and rated pre- and post-intervention. RESULTS: Paired t-tests demonstrated a statistically significant improvement in performance (t = 10.5, p < 0.001) and satisfaction (t = 9.9, p < 0.001) scores of individual issues. Qualitative content analysis identified three categories of issues including: protecting my lifestyle; a better understanding of transport options; and being prepared and feeling okay. CONCLUSIONS: Participation in UQDRIVE had a positive and significant effect on the issues of the participants. The results highlight that although all participants stated issues related predominantly to practical concerns, there were trends in the issues identified by the drivers and retired drivers that were consistent with their current phase of the driving cessation process.

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BACKGROUND: Driving cessation can lead to negative consequences, such as depression and reduced social activities. PURPOSE: The University of Queensland Driver Retirement Initiative (UQDRIVE) intensive support program is a six-week program to assist older people with driving cessation. METHODS: Fifty-five participants completed a survey of satisfaction with the program, including identification of the aspects of the program that were useful and they had applied in real life. FINDINGS: There was overall satisfaction with the program, and content analysis identified three areas that were highlighted as particularly useful: "Finding alternative means: transport and service options," "Planning with more wisdom: thinking about driving cessation," and "Being with people: sharing experiences with peers." IMPLICATIONS: These findings indicate that program participants were satisfied with the current UQDRIVE intensive support group program and found both the psychosocial supports and practical strategies to be useful in managing driving cessation.

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