Meredith Perry - Academia.edu (original) (raw)

Papers by Meredith Perry

Research paper thumbnail of Non‐invasive ventilation for people with neuromuscular disorders in Australia and New Zealand: a qualitative study of clinician perspectives

Medical Journal of Australia

Research paper thumbnail of “At risk” and “vulnerable”! Reflections on inequities and the impact of COVID-19 on disabled people

New Zealand Journal of Physiotherapy, 2020

This professional perspective provides background knowledge and evidence to support reflection on... more This professional perspective provides background knowledge and evidence to support reflection on disability outcomes internationally and in Aotearoa New Zealand. Over one billion people live with disability worldwide. Approximately 4.5% of the world’s population live with significant difficulties in function, activity, and participation. In Aotearoa New Zealand, approximately 1.1 million (24%) people have a disability, making disability the largest minority group. Yet disabled people face extreme health inequities. These are exacerbated when response planning and service delivery during times of humanitarian emergency, such as COVID-19, fail to include and consider the impact decisions will have for disabled people. Disabled people are more “at risk” of contracting COVID-19, and some disabled people are “at risk” of poorer health outcomes from COVID-19. However, “vulnerability” arises from the continuation and exacerbation of discriminatory policies, including health professionals’...

Research paper thumbnail of PARCS Tool

Research paper thumbnail of Park-based physical activity interventions for persons with disabilities: A mixed-methods systematic review

Disability and Health Journal, 2019

Research paper thumbnail of What Works and Does Not Work in a Self-Management Intervention for People With Chronic Pain? Qualitative Systematic Review and Meta-Synthesis

Physical Therapy, 2018

Background Self-management interventions fostering self-efficacy improve the well-being of people... more Background Self-management interventions fostering self-efficacy improve the well-being of people with chronic pain. Purpose The purpose of this study was to synthesize the enablers (what works) and barriers (what does not) of incorporating self-management strategies for people in everyday life after completion of a pain self-management intervention. Data Sources Major electronic databases (MEDLINE, AMED, PsycINFO, Cochrane Library, PubMed, CINAHL, Scopus, and Google Scholar) were searched from inception to July 2016. Study Selection Study selection included qualitative and mixed-method studies that explored the perceptions of individuals with chronic pain after completion of a self–management intervention. Data Extraction A thematic analysis approach was used to synthesize the review findings, and a Confidence in the Evidence from Reviews of Qualitative Research (CERQual) Approach was used to assess the level of confidence. Data Synthesis Thirty-three studies with 512 participants ...

Research paper thumbnail of The effectiveness of play as an intervention using International Classification of Functioning outcome measures for children with disabilities – a systematic review and meta-synthesis

Disability and Rehabilitation

Research paper thumbnail of Do pain management websites foster self-management support for people with persistent pain? A scoping review

Patient Education and Counseling, 2019

To evaluate if the contents of pain management websites include the current best practice self-ma... more To evaluate if the contents of pain management websites include the current best practice self-management support strategies for people with persistent pain, are cultural tailored and to determine the website quality. Methods: Websites were searched from three major search engines (Google, Bing, and Yahoo). Websites providing information on self-management strategies and websites that were freely available to the public were included. The website contents were evaluated using a 14-item self-management support (SMS-14) checklist. Website quality was assessed using the Health On the Net code (HONcode) certification. Results: Of the twenty-seven websites evaluated, the websites scored a median of nine items (range 1-13) from the SMS-14 checklist. The websites LivePlanBe, ACI Pain Management Network and MyJointPain top-scored (13/14) from the SMS-14 checklist. One website (ACI Pain Management Network) provided culturally tailored information and HONcode certification was present in six websites. Conclusions: The review identified 27 contemporary pain management websites that could be used for self-management skills training. Practice Implications: Clinicians could refer people with persistent pain to top ranked websites-LivePlanBe, ACI Pain Management Network, and MyJointPain for enabling self-management skills, with the caveats that most websites lacked cultural tailoring, and have limited or no evidence of clinical efficacy.

Research paper thumbnail of Measuring Māori Health, Wellbeing, and Disability in Aotearoa Using a Web-Based Survey Methodology

International Journal of Environmental Research and Public Health

High-quality evidence on the prevalence and impact of health, wellbeing, and disability among Māo... more High-quality evidence on the prevalence and impact of health, wellbeing, and disability among Māori, and other Indigenous peoples, is crucial for mitigating health inequities. Current surveys are predominantly centred within a biomedical paradigm, with the constructs mismatched with Indigenous worldviews. We aimed to develop and deploy an accessible and culturally grounded survey exploring Māori health, wellbeing, and disability using a Kaupapa Māori Research methodology. An extensive codesign process with Māori community partners interrogated all aspects of the design to ensure the process and outcomes met the needs of Māori. A large-scale, nationally representative survey of people of Māori descent was conducted. We used a multi-modal deployment approach that included online and alternate methods of completion. Our analysis included a novel dual-weighting system to ensure generalisability of results to the national Māori population. This achieved a survey of 7230 participants, a s...

Research paper thumbnail of The Otago shoulder health study: A feasibility study to integrate formalised patient education with usual physiotherapy

New Zealand Journal of Physiotherapy

The overall study aim was to explore feasibility of a complex intervention that integrates formal... more The overall study aim was to explore feasibility of a complex intervention that integrates formalised patient education with pragmatic, individualised physiotherapy for patients with rotator cuff-related shoulder pain (RCRSP). Specific aims were to determine: (a) participant recruitment and retention rates, (b) changes in patient-reported outcomes, (c) intervention fidelity, and (d) to scope intervention costs. Twenty-nine participants (M = 60.0 years, SD = 10.5) with RCRSP (duration ≥ 3 months) were recruited within 3 months. They attended up to eight physiotherapy sessions that included structured education about age-related shoulder pathoanatomy, pain biology and self-management, shoulder-specific exercise, general physical activity, and lifestyle considerations. The Shoulder Pain and Disability Index (SPADI) and other patient-reported outcomes measures (PROMs) were assessed at baseline, discharge, and 3-month follow-up. Completion rates for physiotherapy and PROMs were > 80%,...

Research paper thumbnail of Perspectives of People with Mild to Moderate Cognitive Impairment and Their Caregivers about Physical Activity and Exercise for Fall Prevention: A Qualitative Study

Disabilities

Older adults with cognitive impairment are at high risk of experiencing falls. Although no specif... more Older adults with cognitive impairment are at high risk of experiencing falls. Although no specific fall prevention guidelines presently exist for this population, exercise programmes to prevent falls are recommended. Limited literature exploring what older adults with mild to moderate cognitive impairment think about or how they make sense of the need for such programmes exists. This study explored the perspectives of older adults with mild to moderate cognitive impairment and their caregivers about exercise and physical activity in the context of fall prevention. Underpinned by Interpretive Phenomenological Analysis, qualitative semi-structured interviews were undertaken with nine community-dwelling adults (>65 years) with mild to moderate cognitive impairment and their caregivers (N = 6). Three themes of acceptance, denial, and accommodation were identified. The fluctuating concept of ‘self’ appeared to influence individual decisions to exercise or be physically active and wha...

Research paper thumbnail of Moving forward with innovation in 2023

New Zealand Journal of Physiotherapy

Research paper thumbnail of Physiotherapists’ attitudes and beliefs about self-management as part of their management for low back pain

Musculoskeletal Science and Practice

Research paper thumbnail of ‘Thinking about pain in a different way’: Patient perspectives of a neuroscience-informed physiotherapy programme for rotator cuff-related shoulder pain

Musculoskeletal Science and Practice

Research paper thumbnail of “Me and ‘that’ machine”: the lived experiences of people with neuromuscular disorders using non-invasive ventilation

Disability and Rehabilitation

Research paper thumbnail of Health System Factors Affecting the Experience of Non-Invasive Ventilation Provision of People with Neuromuscular Disorders in New Zealand

International Journal of Environmental Research and Public Health

Non-invasive ventilation (NIV) is a critical therapy for many patients with neuromuscular disorde... more Non-invasive ventilation (NIV) is a critical therapy for many patients with neuromuscular disorders (NMD), supporting those with respiratory failure to achieve adequate respiration and improve their quality of life. The aim of this study was to explore the experiences of access to, consent, uptake, maintenance and safe use of non-invasive ventilation by people with NMD. Semi-structured individual interviews were conducted with 11 people with NMD, each using NIV for more than 12 months. A critical realism ontological paradigm with contextualism epistemology guided the Reflexive Thematic Analysis. An Equity of Health Care Framework underpinned the analysis. Three themes were interpreted: Uptake and informed consent for NIV therapy; Practicalities of NIV; and Patient-clinician relationships. We identified issues at the system, organization and health professional levels. Conclusions: We recommend the development of national service specifications with clear standards and dedicated fund...

Research paper thumbnail of Noninvasive ventilation in New Zealand: a national prevalence survey

Internal Medicine Journal

Research paper thumbnail of Does physiotherapy prehabilitation improve pre-surgical outcomes and influence patient expectations prior to knee and hip joint arthroplasty?

International Journal of Orthopaedic and Trauma Nursing, 2018

Introduction: Evidence supporting physiotherapy prior to hip or knee replacement for decreasing p... more Introduction: Evidence supporting physiotherapy prior to hip or knee replacement for decreasing pain and improving function pre and post-operatively is equivocal. This observational cohort study used a mixed-methods approach to investigate whether 8 weeks of physiotherapy led exercise and education ('prehabilitation') would change pain and functional outcomes prior to surgery, and if patients' expectations and satisfaction post-surgery were influenced. Methods: Participants awaiting THR or TKR were recruited (n = 75). Fifty two opted into the 'prehabilitation' group while twenty three opted for usual care. The prehabilitation group included a 45 min exercise and 15 min education session twice weekly for 8 weeks. All participants completed the WOMAC, NRS, Health Thermometer, 5xSTS and TUG outcome measures. Data were collected before and after prehabilitation and 6 weeks after surgery. Qualitative data were collected from 22 participants via telephone interviews and analysed inductively. Results: Both groups improved post surgery. The prehabilitation group showed statistically significant improvements in all outcome measures after prehabilitation (pre-surgery). Participants' felt prehabilitation prepared them well for surgery and influenced expectations post-operatively. Group education talks and the experience of friends and family appeared highly valued information sources. Conclusion: Prehabilitation improved patients' pain and function before hip or knee replacement surgery.

Research paper thumbnail of Accessibility and usability of parks and playgrounds

Disability and Health Journal, 2017

Conflict of interest disclosure: On behalf of all the authors, I wish to confirm that there are n... more Conflict of interest disclosure: On behalf of all the authors, I wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome. On behalf of all the authors, I confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us. This research did not receive any specific grant from funding agencies in the public, commercial, or not-forprofit sectors. Acknowledgements: We would like to thank the Wellington City Council, Hutt City Council and Porirua City Council for their support with this study. We would like to thank CCS Disability Action and The Blind Foundation for assisting in the development of the evaluation tool.

Research paper thumbnail of EP-2102: “We’re all here for the patient”: exploring the process of interprofessional learning

Radiotherapy and Oncology, 2016

Research paper thumbnail of Are we just dishing out pills constantly to mask their pain? Kaiāwhina Māori health workers' perspectives on pain management for Māori

AIM To explore kaiāwhina (Māori community health workers) perspectives on supporting whānau Māori... more AIM To explore kaiāwhina (Māori community health workers) perspectives on supporting whānau Māori with chronic pain, and to understand their views on the use of online resources for pain management. METHOD A Māori-centred, qualitative design using focus groups as the primary data collection method. Analysis using the general inductive approach. RESULTS Thirteen kaiāwhina working in the Greater Wellington region took part in the focus groups. Four key themes were identified: (1) treatment of chronic pain in primary health relies exclusively on medication, (2) health literacy approaches to pain management are urgently required, (3) Māori have significant unmet need for culturally responsive pain management, and (4) the availability of, and referral practices to, specialist pain services are inadequate for Māori communities. CONCLUSION Current chronic pain management was predominantly biomedical, and educational strategies lack health literacy approaches. Primary health services exclud...

Research paper thumbnail of Non‐invasive ventilation for people with neuromuscular disorders in Australia and New Zealand: a qualitative study of clinician perspectives

Medical Journal of Australia

Research paper thumbnail of “At risk” and “vulnerable”! Reflections on inequities and the impact of COVID-19 on disabled people

New Zealand Journal of Physiotherapy, 2020

This professional perspective provides background knowledge and evidence to support reflection on... more This professional perspective provides background knowledge and evidence to support reflection on disability outcomes internationally and in Aotearoa New Zealand. Over one billion people live with disability worldwide. Approximately 4.5% of the world’s population live with significant difficulties in function, activity, and participation. In Aotearoa New Zealand, approximately 1.1 million (24%) people have a disability, making disability the largest minority group. Yet disabled people face extreme health inequities. These are exacerbated when response planning and service delivery during times of humanitarian emergency, such as COVID-19, fail to include and consider the impact decisions will have for disabled people. Disabled people are more “at risk” of contracting COVID-19, and some disabled people are “at risk” of poorer health outcomes from COVID-19. However, “vulnerability” arises from the continuation and exacerbation of discriminatory policies, including health professionals’...

Research paper thumbnail of PARCS Tool

Research paper thumbnail of Park-based physical activity interventions for persons with disabilities: A mixed-methods systematic review

Disability and Health Journal, 2019

Research paper thumbnail of What Works and Does Not Work in a Self-Management Intervention for People With Chronic Pain? Qualitative Systematic Review and Meta-Synthesis

Physical Therapy, 2018

Background Self-management interventions fostering self-efficacy improve the well-being of people... more Background Self-management interventions fostering self-efficacy improve the well-being of people with chronic pain. Purpose The purpose of this study was to synthesize the enablers (what works) and barriers (what does not) of incorporating self-management strategies for people in everyday life after completion of a pain self-management intervention. Data Sources Major electronic databases (MEDLINE, AMED, PsycINFO, Cochrane Library, PubMed, CINAHL, Scopus, and Google Scholar) were searched from inception to July 2016. Study Selection Study selection included qualitative and mixed-method studies that explored the perceptions of individuals with chronic pain after completion of a self–management intervention. Data Extraction A thematic analysis approach was used to synthesize the review findings, and a Confidence in the Evidence from Reviews of Qualitative Research (CERQual) Approach was used to assess the level of confidence. Data Synthesis Thirty-three studies with 512 participants ...

Research paper thumbnail of The effectiveness of play as an intervention using International Classification of Functioning outcome measures for children with disabilities – a systematic review and meta-synthesis

Disability and Rehabilitation

Research paper thumbnail of Do pain management websites foster self-management support for people with persistent pain? A scoping review

Patient Education and Counseling, 2019

To evaluate if the contents of pain management websites include the current best practice self-ma... more To evaluate if the contents of pain management websites include the current best practice self-management support strategies for people with persistent pain, are cultural tailored and to determine the website quality. Methods: Websites were searched from three major search engines (Google, Bing, and Yahoo). Websites providing information on self-management strategies and websites that were freely available to the public were included. The website contents were evaluated using a 14-item self-management support (SMS-14) checklist. Website quality was assessed using the Health On the Net code (HONcode) certification. Results: Of the twenty-seven websites evaluated, the websites scored a median of nine items (range 1-13) from the SMS-14 checklist. The websites LivePlanBe, ACI Pain Management Network and MyJointPain top-scored (13/14) from the SMS-14 checklist. One website (ACI Pain Management Network) provided culturally tailored information and HONcode certification was present in six websites. Conclusions: The review identified 27 contemporary pain management websites that could be used for self-management skills training. Practice Implications: Clinicians could refer people with persistent pain to top ranked websites-LivePlanBe, ACI Pain Management Network, and MyJointPain for enabling self-management skills, with the caveats that most websites lacked cultural tailoring, and have limited or no evidence of clinical efficacy.

Research paper thumbnail of Measuring Māori Health, Wellbeing, and Disability in Aotearoa Using a Web-Based Survey Methodology

International Journal of Environmental Research and Public Health

High-quality evidence on the prevalence and impact of health, wellbeing, and disability among Māo... more High-quality evidence on the prevalence and impact of health, wellbeing, and disability among Māori, and other Indigenous peoples, is crucial for mitigating health inequities. Current surveys are predominantly centred within a biomedical paradigm, with the constructs mismatched with Indigenous worldviews. We aimed to develop and deploy an accessible and culturally grounded survey exploring Māori health, wellbeing, and disability using a Kaupapa Māori Research methodology. An extensive codesign process with Māori community partners interrogated all aspects of the design to ensure the process and outcomes met the needs of Māori. A large-scale, nationally representative survey of people of Māori descent was conducted. We used a multi-modal deployment approach that included online and alternate methods of completion. Our analysis included a novel dual-weighting system to ensure generalisability of results to the national Māori population. This achieved a survey of 7230 participants, a s...

Research paper thumbnail of The Otago shoulder health study: A feasibility study to integrate formalised patient education with usual physiotherapy

New Zealand Journal of Physiotherapy

The overall study aim was to explore feasibility of a complex intervention that integrates formal... more The overall study aim was to explore feasibility of a complex intervention that integrates formalised patient education with pragmatic, individualised physiotherapy for patients with rotator cuff-related shoulder pain (RCRSP). Specific aims were to determine: (a) participant recruitment and retention rates, (b) changes in patient-reported outcomes, (c) intervention fidelity, and (d) to scope intervention costs. Twenty-nine participants (M = 60.0 years, SD = 10.5) with RCRSP (duration ≥ 3 months) were recruited within 3 months. They attended up to eight physiotherapy sessions that included structured education about age-related shoulder pathoanatomy, pain biology and self-management, shoulder-specific exercise, general physical activity, and lifestyle considerations. The Shoulder Pain and Disability Index (SPADI) and other patient-reported outcomes measures (PROMs) were assessed at baseline, discharge, and 3-month follow-up. Completion rates for physiotherapy and PROMs were > 80%,...

Research paper thumbnail of Perspectives of People with Mild to Moderate Cognitive Impairment and Their Caregivers about Physical Activity and Exercise for Fall Prevention: A Qualitative Study

Disabilities

Older adults with cognitive impairment are at high risk of experiencing falls. Although no specif... more Older adults with cognitive impairment are at high risk of experiencing falls. Although no specific fall prevention guidelines presently exist for this population, exercise programmes to prevent falls are recommended. Limited literature exploring what older adults with mild to moderate cognitive impairment think about or how they make sense of the need for such programmes exists. This study explored the perspectives of older adults with mild to moderate cognitive impairment and their caregivers about exercise and physical activity in the context of fall prevention. Underpinned by Interpretive Phenomenological Analysis, qualitative semi-structured interviews were undertaken with nine community-dwelling adults (>65 years) with mild to moderate cognitive impairment and their caregivers (N = 6). Three themes of acceptance, denial, and accommodation were identified. The fluctuating concept of ‘self’ appeared to influence individual decisions to exercise or be physically active and wha...

Research paper thumbnail of Moving forward with innovation in 2023

New Zealand Journal of Physiotherapy

Research paper thumbnail of Physiotherapists’ attitudes and beliefs about self-management as part of their management for low back pain

Musculoskeletal Science and Practice

Research paper thumbnail of ‘Thinking about pain in a different way’: Patient perspectives of a neuroscience-informed physiotherapy programme for rotator cuff-related shoulder pain

Musculoskeletal Science and Practice

Research paper thumbnail of “Me and ‘that’ machine”: the lived experiences of people with neuromuscular disorders using non-invasive ventilation

Disability and Rehabilitation

Research paper thumbnail of Health System Factors Affecting the Experience of Non-Invasive Ventilation Provision of People with Neuromuscular Disorders in New Zealand

International Journal of Environmental Research and Public Health

Non-invasive ventilation (NIV) is a critical therapy for many patients with neuromuscular disorde... more Non-invasive ventilation (NIV) is a critical therapy for many patients with neuromuscular disorders (NMD), supporting those with respiratory failure to achieve adequate respiration and improve their quality of life. The aim of this study was to explore the experiences of access to, consent, uptake, maintenance and safe use of non-invasive ventilation by people with NMD. Semi-structured individual interviews were conducted with 11 people with NMD, each using NIV for more than 12 months. A critical realism ontological paradigm with contextualism epistemology guided the Reflexive Thematic Analysis. An Equity of Health Care Framework underpinned the analysis. Three themes were interpreted: Uptake and informed consent for NIV therapy; Practicalities of NIV; and Patient-clinician relationships. We identified issues at the system, organization and health professional levels. Conclusions: We recommend the development of national service specifications with clear standards and dedicated fund...

Research paper thumbnail of Noninvasive ventilation in New Zealand: a national prevalence survey

Internal Medicine Journal

Research paper thumbnail of Does physiotherapy prehabilitation improve pre-surgical outcomes and influence patient expectations prior to knee and hip joint arthroplasty?

International Journal of Orthopaedic and Trauma Nursing, 2018

Introduction: Evidence supporting physiotherapy prior to hip or knee replacement for decreasing p... more Introduction: Evidence supporting physiotherapy prior to hip or knee replacement for decreasing pain and improving function pre and post-operatively is equivocal. This observational cohort study used a mixed-methods approach to investigate whether 8 weeks of physiotherapy led exercise and education ('prehabilitation') would change pain and functional outcomes prior to surgery, and if patients' expectations and satisfaction post-surgery were influenced. Methods: Participants awaiting THR or TKR were recruited (n = 75). Fifty two opted into the 'prehabilitation' group while twenty three opted for usual care. The prehabilitation group included a 45 min exercise and 15 min education session twice weekly for 8 weeks. All participants completed the WOMAC, NRS, Health Thermometer, 5xSTS and TUG outcome measures. Data were collected before and after prehabilitation and 6 weeks after surgery. Qualitative data were collected from 22 participants via telephone interviews and analysed inductively. Results: Both groups improved post surgery. The prehabilitation group showed statistically significant improvements in all outcome measures after prehabilitation (pre-surgery). Participants' felt prehabilitation prepared them well for surgery and influenced expectations post-operatively. Group education talks and the experience of friends and family appeared highly valued information sources. Conclusion: Prehabilitation improved patients' pain and function before hip or knee replacement surgery.

Research paper thumbnail of Accessibility and usability of parks and playgrounds

Disability and Health Journal, 2017

Conflict of interest disclosure: On behalf of all the authors, I wish to confirm that there are n... more Conflict of interest disclosure: On behalf of all the authors, I wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome. On behalf of all the authors, I confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us. This research did not receive any specific grant from funding agencies in the public, commercial, or not-forprofit sectors. Acknowledgements: We would like to thank the Wellington City Council, Hutt City Council and Porirua City Council for their support with this study. We would like to thank CCS Disability Action and The Blind Foundation for assisting in the development of the evaluation tool.

Research paper thumbnail of EP-2102: “We’re all here for the patient”: exploring the process of interprofessional learning

Radiotherapy and Oncology, 2016

Research paper thumbnail of Are we just dishing out pills constantly to mask their pain? Kaiāwhina Māori health workers' perspectives on pain management for Māori

AIM To explore kaiāwhina (Māori community health workers) perspectives on supporting whānau Māori... more AIM To explore kaiāwhina (Māori community health workers) perspectives on supporting whānau Māori with chronic pain, and to understand their views on the use of online resources for pain management. METHOD A Māori-centred, qualitative design using focus groups as the primary data collection method. Analysis using the general inductive approach. RESULTS Thirteen kaiāwhina working in the Greater Wellington region took part in the focus groups. Four key themes were identified: (1) treatment of chronic pain in primary health relies exclusively on medication, (2) health literacy approaches to pain management are urgently required, (3) Māori have significant unmet need for culturally responsive pain management, and (4) the availability of, and referral practices to, specialist pain services are inadequate for Māori communities. CONCLUSION Current chronic pain management was predominantly biomedical, and educational strategies lack health literacy approaches. Primary health services exclud...