Mary Egan

Mary Egan
University of Ottawa · School of Rehabilitation Sciences

PhD

About

160
Publications
45,370
Reads
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3,077
Citations
Education
September 1992 - January 1999
McGill University
Field of study
  • Epidemiology and biostatistics
September 1988 - May 1991
University of Alberta
Field of study
  • Occupational Therapy
September 1978 - May 1982
The University of Western Ontario
Field of study
  • Occupational Therapy

Publications

Publications (160)
Article
Full-text available
Introduction Stroke rehabilitation teams’ skills and knowledge in treating persons with cognitive impairment (CI) contribute to their reduced access to inpatient rehabilitation. This study examined stroke inpatient rehabilitation referral acceptance rates for persons with CI before and after the implementation of a multi-faceted integrated knowledg...
Article
Background: Many individuals who experience a moderate or severe traumatic brain injury (TBI) have long-term deficits in physical activity, balance, and mobility requiring specialized care. New delivery models are being investigated for interventions to address challenges caused by living in remote communities, difficulties with transportation, and...
Article
Purpose: Further investigation into the feasibility of using videoconferencing and activity tracking devices to provide high-intensity home-based exercise programs for people with a moderate or severe traumatic brain injury (TBI) is needed to inform clinical implementation and patient adoption. This study aimed to (1) determine if home-based telere...
Article
Background: According to Self-Determination Theory, the fulfillment of basic psychological needs of autonomy, competence, and relatedness plays an important role in one's motivation, engagement, and well-being. How a therapist is perceived to support or thwart these needs can impact adherence to treatment, thus influencing the effectiveness of the...
Article
Aim: To estimate the impact of a multifaceted knowledge translation intervention on patient rehabilitation outcomes in an inpatient stroke setting. Methods: Interprofessional stroke rehabilitation teams were trained in Cognitive Orientation to daily Occupational Performance as part of the larger knowledge translation study. This study describes...
Article
Purpose Stroke impacts independent activities, particularly personal care such as oral hygiene. Existing guidelines lack details about how to provide effective oral care. This study explores the frequency of oral care based on staff adherence to oral care policies. Method As part of a quality improvement initiative, we conducted a retrospective ch...
Article
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Almost half of all Canadians live with sensory, cognitive, or physical impairment due to injury, illness, or ageing. Yet, research investigating the complex relationship between well-being and impairment is limited. Existing research has largely rendered invisible peoples’ experiences of a good life while living with impairment. In response, resear...
Article
Individuals with mild cognitive impairment are at risk of cognitive and physical decline. Virtual reality (VR) exercise may provide beneficial physical and cognitive exercise. The objectives of this study were to assess the feasibility and safety of home-based VR exercise and to provide pilot data for physical and cognitive efficacy. Eleven individ...
Article
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Background Client-centred practice has been part of occupational therapists’ identity for several decades. However, therapists have begun to question whether the term obstructs critical relational aspects of therapy. Purpose The purpose of this article is to summarize critiques of the use of the term client-centred and propose an expanded descript...
Poster
Results from feasibility study on the implementation of remotely delivered high-intensity home-based exercise programs for survivors of moderate or severe TBI.
Article
Purpose: Activities of daily living including oral care may be challenging after stroke. Some stroke survivors are not able to complete oral care independently and need assistance from healthcare professionals and care partners. Poor oral hygiene may impact stroke recovery and rehabilitation possibly incurring issues such as aspiration pneumonia,...
Article
Objective: The objectives of this scoping review are to i) identify adaptive stroke rehabilitation interventions using metacognitive or self-management approaches targeting participation as an outcome; ii) determine the explicit and implicit theories underlying these interventions; and iii) ascertain the elements in each intervention. This review...
Article
Background Returning to work is important for many people following stroke. An estimate of the prevalence of people intending to return to work post-stroke would be helpful in planning services supporting work reintegration. Purpose This study examined the prevalence of intention to return to work after discharge among stroke rehabilitation inpati...
Article
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For older adults with complex health conditions, transitions between care settings are common and a major risk to quality of care and patient safety. Care transition interventions have shown positive impacts on continuity of care and health service use, however, most require additional human resources (e.g., transition coach), focus on one transiti...
Article
Background: Traumatic brain injury (TBI) may impact an individual physically, cognitively, socially, and emotionally. Poor balance, reduced mobility, and low daily physical activity often will require ongoing physical rehabilitation intervention. However, face-to-face specialized physiotherapy is not always accessible for individuals living in rur...
Article
Aims: Occupational performance coaching (OPC) helps people reengage in personally valued occupations despite physical or cognitive challenges. We explored the potential of OPC in the context of assisted living. Methods: An instrumental case study was used. A student occupational therapist provided OPC to one resident in one assisted living facility...
Article
Objective Guidelines for palliative and spiritual care emphasize the importance of screening patients for spiritual suffering. The aim of this review was to synthesize the research evidence of the accuracy of measures used to screen adults for spiritual suffering. Methods A systematic review of the literature. We searched five scientific databases...
Preprint
BACKGROUND Traumatic brain injury may impact an individual physically, cognitively, socially and emotionally. Poor balance, reduced mobility and low daily physical activity often will require ongoing physical rehabilitation intervention. Face-to-face specialized physiotherapy is not always accessible for individuals living in rural settings. OBJEC...
Article
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Introduction: Implementation of the Canadian Stroke Best Practice Recommendations has improved inpatient rehabilitation. As attention is turned to the design and allocation of rehabilitation after hospitalization, examination of their implications for post-discharge rehabilitation could help optimize service planning Methods: Critical discourse ana...
Article
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The objective of this paper is to provide a theoretical and practical understanding of these challenges with re-engagement in personally valued occupations following stroke, as well as to make recommendations to guide practice. First, we review the current understanding of the impact of low income on the experience of rehabilitation and on later pa...
Article
Background.: Late stroke rehabilitation interventions often target impairment with limited carryover to daily occupation. Purpose.: This study explored whether the LSVT BIG program could lead to improved performance in client-identified occupations and decreased impairment late poststroke. Method.: A single-case experimental design with one re...
Article
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Background The Cognitive Orientation to daily Occupational Performance (CO-OP) approach is a complex rehabilitation intervention in which clients are taught to use problem-solving cognitive strategies to acquire personally-meaningful functional skills, and health care providers are required to shift control regarding treatment goals and interventio...
Article
Full-text available
Objective Improving care transitions is of critical importance for older patients, especially those with complex care needs. Our study examined the “Transitions of Care” (ToC) of complex, post-acute older adults at multiple time points. The objective of this article is to identify domains relevant to health care transitions of post-acute older pati...
Article
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Introduction: Up to 40% of hospitalised seniors are frail and most want to return home after discharge. Inaccurate estimation of risks in the hospital may lead to inadequate support at home. This study aimed to document convergences and divergences between risks and support needs identified before hospital discharge and perceived at home post-disc...
Article
Purpose: Low income is known to influence participation post stroke, but the process by which this occurs is poorly understood. Methods: A qualitative multiple case study approach, focusing on the experience of returning to participation in personal projects among eight low-income francophone stroke survivors living in eastern Ontario (Canada). Dat...
Article
Objective: To examine operational definitions of return-to-work (RTW) after stroke and provide more precise estimates of RTW through meta-analysis. Data Sources: A systematic search was conducted using MEDLINE, CINAHL, PsycINFO, and SCOPUS (2005 to March 26, 2018). The search strategy involved expansion of medical subjective headings using terms r...
Article
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Background: Leadership by point-of-care and senior managers is increasingly recognized as critical to the acceptance and use of research evidence in practice. The purpose of this systematic review was to identify the leadership behaviours of managers that are associated with research use by clinical staff in nursing and allied health professionals...
Article
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Background: Traumatic Brain Injury (TBI) rehabilitation is an intensive process aimed at reducing disability. The experience of care is lived not only by the patient with TBI, but by the family as well. Methods: Five women family members of patients with TBI were interviewed. Based on a descriptive qualitative approach informed by phenomenology, t...
Article
Background: Client-centred goal setting is central to the process of enabling occupation. Yet, there are multiple barriers to incorporating client-centred goal setting in practice. We sought to determine what might facilitate or impede the formation of client-centred goals in a context highly supportive of client-centred goal setting Methods: We us...
Article
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Objectives Older cognitively impaired adults present a higher risk of hospitalisation and mortality following a visit to the emergency department (ED). Better understanding of avoidable incidents is needed to prevent them and the associated ED presentations in community-dwelling adults. This study aimed to synthetise the actual knowledge concerning...
Article
Introduction Occupational performance coaching modified for stroke survivors is a promising new intervention to improve occupational performance post stroke. In the intervention, following client-centred occupational goal-setting, clients are led through strengths-based problem-solving and experimentation. Emotional support, individualized educatio...
Article
Durocher and colleagues argue that Norman Daniels’ notion of just health could provide a useful framework for decreasing inequities in access to assistive technology. I argue that it would provide limited help for two reasons. First, Daniels’ reliance on normal species functioning as the goal of health care, and his assumptions regarding the impact...
Article
Person-centred care (PCC) is designed to focus care delivery on the needs and preferences of the individual. Transferring PCC principles into practice is especially difficult when staffing levels are insufficient to allow time to respond to individual needs. The objective of this project was to develop and implement a volunteer program that sensiti...
Article
Although the term self-regulation is appearing more frequently in the occupational therapy literature, the extent to which it is consistently conceptualized is not clear. The aim of this scoping review was to examine how the term self-regulation is used by occupational therapists in research and practice literature. A total of 58 publications that...
Article
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Background While standardized health assessments capture valuable information on patients’ demographic and diagnostic characteristics, health conditions, and physical and mental functioning, they may not capture information of most relevance to individual patients and their families. Given that patients and their informal caregivers are the experts...
Article
Purpose: Conceptualizations of risk in seniors' rehabilitation emphasize potential physical injury, functional independence and cost containment, shifting rehabilitation from other considerations essential to promoting a satisfying life. In a two-day multidisciplinary planning meeting we critically examined and discussed alternatives to dominant c...
Article
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Background: Stroke is a leading cause of disability in adults. Following stroke, 60% of people report needing help with everyday activities, and 80% report having very few meaningful activities. These restrictions often continue for years. This study explored the efficacy of Occupational Performance Coaching for stroke survivors (OPC-Stroke) on the...
Article
Purpose: Given the centrality of risk in geriatric rehabilitation, it is critically important to attend to how conceptualizations of risk shape research, policies, and rehabilitation practices. This paper presents a critical interpretive synthesis (CIS) of literature addressing risk and low vision rehabilitation for older adults with age-related v...
Article
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Introduction: Older adults with cognitive impairment represent a large portion (21-42%) of people (65+) who consult at an emergency department (ED). Because this sub-group is at higher risk for hospitalisation and mortality following an ED visit, awareness about 'avoidable' incidents should be increased in order to prevent presentations to the ED...
Article
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Purpose: Following stroke, re-engagement in personally valued activities requires some experience of risk. Risk, therefore, must be seen as having positive as well as negative aspects in rehabilitation. Our aim was to identify the dominant understanding of risk in stroke rehabilitation and the assumptions underpinning these understandings, determi...
Article
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Background: Client-centered occupational therapy begins with the identification of personally-relevant patient goals. This study aimed to determine whether the elicitation module of Personal Projects Analysis (PPA) could help patients in an acquired brain injury day hospital program identify more meaningful goals than those identified using the Can...
Article
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Background Patients with cognitive impairments following a stroke are often denied access to inpatient rehabilitation. The few patients with cognitive impairment admitted to rehabilitation generally receive services based on outdated impairment-reduction models, rather than recommended function-based approaches. Both reduced access to rehabilitatio...
Article
Audit and feedback (A&F) is commonly used to improve health care; yet enormous variability exists in effectiveness and little is known about A&F in home health care. This article explores A&F as a strategy to support evidence-based care for falls prevention and pain management. We use interviews to describe how A&F is currently used and explore how...
Article
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Introduction Personal Projects Analysis has been used in occupational therapy research to better understand occupation. The purpose of this scoping review is to describe Personal Projects Analysis and examine how it has been used in occupational therapy research. Method Occupational therapy studies using Personal Projects Analysis were identified...
Article
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Neighbourhood income level is associated with the incidence of stroke and stroke-related mortality. It has also been linked to receipt of appropriate services, post discharge motor recovery and functional status following a stroke. We examined the impact of neighbourhood income on participation among community-dwelling stroke survivors during the t...
Article
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Introduction The concept of personal projects has been used in occupational therapy research to understand occupation better. However, no clear distinction has been made between personal projects and occupations. An argumentative review was carried out to determine if the concepts of occupation, as outlined in the Canadian Model of Occupational Per...
Article
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Poor handwriting is a common reason for referral to school-based occupational therapy. A survey was used to explore the extent to which current practice patterns in Ontario, Canada, align with evidence on effective intervention for handwriting. Knowledge-to-practice gaps were identified related to focus on performance components versus occupational...
Article
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Rheumatoid arthritis (RA) affects 2.1% of the Australian population (1.5% males; 2.6% females), with the highest prevalence from ages 55 to over 75 years (4.4-6.1%). In Canada, RA affects approximately 0.9% of adults, and within 30 years that is expected to increase to 1.3%. With an aging population and a greater number of individuals with modifiab...
Article
Background: Stroke is a leading cause of disability worldwide. Stroke survivors living in the community require regular, ongoing, and coordinated services to prevent deterioration and maximize health outcomes. Published evidence, often conducted in large urban centres, suggests that community reintegration services are an important component of car...
Article
Background Many stroke survivors report participation challenges. Occupational Performance Coaching for stroke survivors (OPC-Stroke) is designed to assist stroke survivors to develop the ability to plan and manage engagement in occupation. This approach combines emotional support, individualized education, and goal-focused problem solving to promo...
Article
Full-text available
Many stroke survivors report participation challenges. Occupational Performance Coaching for stroke survivors (OPC-Stroke) is designed to assist stroke survivors to develop the ability to plan and manage engagement in occupation. This approach combines emotional support, individualized education, and goal-focused problem solving to promote occupati...
Article
AimThe overall aim of the proposed study is to examine a newly implemented navigation intervention intended to support stroke survivors' community integration during the first year following hospital discharge in four regions of Ontario, Canada.Background Stroke is a leading cause of disability worldwide. Stroke survivors living in the community re...
Article
Full-text available
Innovative and sustainable programs are required to support the well-being of stroke survivors. Peer support is a potentially low cost way to enhance well-being of recent stroke survivors and the well-being and community reintegration of their peer supporters. This article describes the perceptions of stroke survivors, care partners, peer supporter...
Article
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Background Nurses and allied health care professionals (physiotherapists, occupational therapists, speech and language pathologists, dietitians) form more than half of the clinical health care workforce and play a central role in health service delivery. There is a potential to improve the quality of health care if these professionals routinely use...
Article
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Background Eating together is promoted among hospitalized seniors to improve their nutrition. This study aimed to understand geriatric patients’ perceptions regarding meals in a common dining area versus at the bedside. Methods An exploratory qualitative study was conducted. Open-ended questions were asked of eight patients recruited from a geriat...
Article
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Little is known about the relationship between the characteristics of pre-stroke occupations and the continuation of these occupations post-stroke. Therefore the purpose of this study was to estimate the proportion of pre-stroke personal projects that are continued at 6 months post-stroke and to explore characteristics of projects that may be relat...
Article
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Research regarding valued occupations following stroke has been carried out almost exclusively with stroke survivors who have returned to their own homes following hospital discharge. We explored engagement in personally valued occupations following stroke and discharge to an assisted living facility. Four women aged 72–87 were followed at 6, 9, an...
Article
Objective The purpose of the study is to determine if an updated online evidence-based educational programme delivered through Facebook is effective in improving the knowledge, skills, and self-efficacy of patients with arthritis in relation to evidence-based self-management rehabilitation interventions for osteoarthritis (OA) and rheumatoid arthri...
Article
Objective. Observational learning has been suggested as a potential strategy for improving task performance and self-efficacy with stroke survivors. The present study explored the effectiveness of the use of peer mastery in addition to verbal instructions, to improve the task performance and self-efficacy, of a stroke survivor learning to exit a ca...
Article
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To explore reciprocal effects between participation and emotional and physical well-being during the first two years post stroke. Prospective cohort study SETTING: Community. An inception cohort of 67 adults who had been discharged from an acute stroke unit or stroke rehabilitation unit following a first stroke. Participation (Reintegration to Norm...