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Having graduated earlier this month, in this blog post I’m sharing the key findings of my PhD research, along with some of my highlights from 2018.
My PhD research focused on the impact of a pre-dementia diagnosis on stroke rehabilitation. Stroke and dementia are associated with age and incidences of both are increasing worldwide; it is likely that we will see more people coming into hospital after a stroke who also have a diagnosis of dementia. This makes treatment more complex and means people may have different needs from rehabilitation than patients without dementia.
Unfortunately, there is a perception among some of those working in stroke services that people with dementia cannot benefit from stroke rehabilitation in the same way and so they are given low priority for rehabilitation and are thus less likely to be referred to rehabilitation services. There is currently no evidence that people with dementia cannot benefit from stroke rehabilitation so there is no reason that rehabilitation services should use a dementia diagnosis as a reason to exclude people.
As part of my research, I interviewed local clinicians working in stroke services and found they felt that they did not have the knowledge, confidence or skills required for working with people with dementia. I believe that education in care for people with dementia needs dramatic improvement, starting at a university level for health professionals. I am an Occupational Therapist and received around half a day’s training on dementia at university even though around one third of the patients I saw when working on general hospital wards were diagnosed with dementia.
Dementia is a complex condition with differing presentations; clinicians need suitable knowledge of it in order to provide the best possible care.
2018 has been a busy third and final year of my PhD. In February, I presented my qualitative interview study at the Society for Research in Rehabilitation annual conference and won the Verna Wright Prize for best oral presentation. I was extremely pleased with this because presentations are something I’ve worked hard on throughout the course of my PhD. I still get nervous, but this has really improved my confidence. And it turns out knowing there’s a cash prize for best presentation is also great motivation for practising!
Throughout the spring I worked with four local NHS Trusts to complete one of my research studies. This involved reviewing patient notes to see whether there was a difference in the amount of stroke therapy received by people with and without dementia. I found that people with dementia receive fewer therapy sessions (16 fewer sessions over 8 weeks) than those without – even when in rehabilitation services. This is important because people with dementia have poorer outcomes after stroke than those without. We can’t currently say whether this is due to receiving less rehabilitation, and therefore further research is required based on my findings.
I’ve been lucky to have CLAHRC funding for my PhD which has enabled me to attend a number of events. In July, I attended the NIHR Infrastructure Doctoral Training Camp, a three-day event involving work to develop a funding application for a fictitious grant with groups of PhD students from around the UK. I’d highly recommend this event to anyone if they have the opportunity – it’s deliberately made quite stressful but it’s also fun. I also went to Exeter University in September for the final Research Capacity in Dementia Care Programme meeting; this was a national initiative by the NIHR to fund dementia research and funded my PhD along with around 12 other students around the UK. We’ve met up 4 times throughout our PhDs (including once in Sweden!) and it was great to hear how everyone has got on and present our final findings to each other.
I submitted my PhD thesis at the end of September at had my viva at the start of October (10 days after submission – people are shocked about this quick turnaround!). I passed with minor corrections and recently graduated.
In October I also started work as a Research Occupational Therapist on SPATIAL, a study of prism adaptation training for people with spatial inattention after stroke. This work is being led by Professor Audrey Bowen, my PhD supervisor. It was good to be familiar with the team already during such a busy time. I am also working for CLAHRC on their current stroke projects, which is great because I enjoy having such a varied workload.
Finally, in December I presented my work at the UK Stroke Forum conference, which is the biggest stroke conference in the UK, and was delighted to be awarded the British Stroke Research Group Prize for highest scoring abstract submitted to the conference, beating over 400 submissions from top academics. I found out I’d won in advance of actually doing my presentation, which put a bit of pressure on but it went well! I graduated a week later so I’m looking forward to having a break over Christmas.
I still need to disseminate my PhD work further to local clinicians, so it’s not quite over yet...!
Find out more about the CLAHRC Stroke Programme here.