Voices Beyond Bars: Formerly Incarcerated Women's Barriers and Facilitators to Reintegration.

The menopause transition is a significant stage of a woman's life, marking the transition from reproductive to postreproductive life. Occupational identity often shifts in response to life transitions but this has not been explored in relation to menopause. Therefore, our study aims to explore women's experiences of menopause through an occupational perspective, in relation to occupational participation and occupational identity. A descriptive qualitative design was implemented. Semistructured interviews were completed with five perimenopausal women online via Microsoft teams. Reflexive thematic analysis was employed to analyse data gathered. The findings of this study revealed that a lack of understanding and awareness during the initial stages of menopause negatively affected women's well-being. Women faced disruptions to their engagement in meaningful occupations, which in turn, impacted their occupational competence and occupational identity. The experience of menopausal-related changes influenced women's sense of self-efficacy in engaging in occupations and roles that aligned with their occupational identity. Women face significant occupational disruption during the menopause transition. Negative impacts on occupational identity and participation were evident from the participants. This study explores menopausal women's experiences from an occupational perspective and findings offer potential direction for future research.

There is recognition within the literature that the role of care-giving can have a negative impact on care-givers' general well-being. Less is understood about the role of care-giving on an individual's occupational participation and in turn occupational identity. Occupational therapists have a unique understanding of the interplay between occupational participation and health, though this is an area that has been under researched in relation to mental health care-givers. Therefore, the current research aims to understand how the role of care-giving for an individual with a mental illness impacts on occupational participation and identity. A qualitative semi-structured interview the Occupational Performance and History Interview-Version 2 was utilised to understand life experiences. Six mental health care-givers were interviewed, and these interviews were transcribed for thematic analysis. Three main themes were identified: being me, roles and responsibilities associated with care-giving and services. The findings suggest being a mental health care-giver does have a detrimental impact on occupational participation and therefore occupational identity. As care-givers gained more experience in their role, they used occupational adaption as a positive coping mechanism that helped them achieve occupational balance. Using their unique understanding of occupational participation and occupational identity, occupational therapists are well placed to utilise their knowledge and skills to work in a systemic way supporting both the person with mental illness and their care-giver.

Purpose: Following the widespread transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), multiple business and schools drastically reduced face-to-face services. Additionally, many state and local governments enacted face mask mandates and other legislations aimed at decreasing the spread of the virus. Current research is being conducted to evaluate the epidemiology, recognition, treatment, and prevention of coronavirus disease 2019 (COVID-19), the disease associated with SARS-CoV-2. At the time of this study, there is no published research on the attitudes and usage of face masks or face coverings among certified occupational therapy professionals during the COVID-19 Pandemic. The purpose of this study is to describe the attitudes and usage of face masks or face coverings among occupational therapy professionals in the state of Texas during the COVID-19 pandemic. Methods: A total of 107 occupational therapy professionals (age= 42 ± 12, years of certified experience = 18 ± 11) opened the survey link and completed the instrument. Participants were sent an electronic survey via email that collected demographic information and assessed attitudes and usage of face masks or face coverings. Data was downloaded and analyzed using a commercially available statistics package. Results: The overwhelming majority of occupational therapy professionals in this study agreed on some level that the use of face masks to mitigate the transmission of SARS-CoV2 was strongly supported by the available evidence (Strongly Agree = 65.4%, Agree = 19.6%, Somewhat Agree = 5.6%). Most occupational therapy professionals also reported that their institutions currently had a mandate in place requiring face masks during patient encounters and coworker interactions (Patient Encounters = 94.4%, Coworker Interactions = 86.9%). Most occupational therapy professionals reported wearing face masks the majority of the time when entering public spaces. Occupational therapy professionals cited the influence of their personal use of face masks was for personal health, health of those in their household, and the health of their patients. Conclusions: The findings of this study suggest a majority of occupational therapy professionals in Texas are wearing face masks or face coverings, even when not actively involved in patient care or other aspects of their jobs. Future research should be conducted to assess the use of face masks among other allied health care professions

Purpose: After the widespread transmission of the novel coronavirus that causes COVID-19, the first COVID-19 vaccination received emergency use authorization in the United States in December of 2020. Current research has shown the authorized COVID-19 vaccines to be safe and effective at preventing severe illness. At the time of this study, there appears to be no published research on the attitudes and receipt of COVID-19 vaccinations among occupational therapy professionals and students. The purpose of this study is to describe the attitudes and receipt of COVID-19 vaccinations among occupational therapy professionals and students in early 2021. Methods: A total of 114 occupational therapy professionals and students (age= 41 ± 15, years of certified experience = 13 ± 13) opened the survey link and completed the instrument. Participants were sent an electronic survey via email that collected demographic information and assessed attitudes and receipt of COVID-19 vaccination. Data was downloaded and analyzed using a commercially available statistics package. Results: The majority of occupational therapy professionals in this study agreed on some level that they were comfortable (Strongly Agree = 36.0%, Agree = 16.7%, Somewhat Agree = 10.5%). Most occupational therapy professionals and students stated they had or would receive a COVID-19 vaccination. The majority of participants reported personal, household, and community safety as the primary considerations for receiving a COVID-19 vaccination. In general, these factors were a larger factor for participants than public perception or personal liberties being infringed upon. Conclusions: The findings of this study suggest a majority of occupational therapy professionals and students are comfortable with the current level of approvals for available COVID-19 vaccinations, and at the time of the survey had or intending to be vaccinated. As occupational therapy professionals and students continue to work in day-to-day patient care, it is imperative to consider the best means of educating occupational therapy professionals and students on the potential benefits of COVID-19 vaccinations.

Hoarding Disorder is a condition often referred to occupational therapy for comprehensive assessment and intervention, however the strategies that occupational therapy professionals use in the clinical management of hoarding behaviors is poorly understood. The purpose of this mixed methods survey design research was to collect and analyze information on the beliefs, attitudes, and perceptions of common and effective intervention techniques currently used among occupational therapy professionals to address hoarding behaviors. A total of 18 (n = 18) responding occupational therapy professionals met inclusion criteria. Occupational therapy professionals universally indicated that environmental modification strategies were utilized as an intervention to manage hoarding behaviors, and the majority of participants also indicated the use of ADL training, IADL training, household mobility training, occupation-based therapeutic activity, personal safety training and self-management training as interventions for Hoarding Disorder. Regression analysis between the perceived effectiveness of a given intervention and the reported frequency of how often the intervention was used indicated that occupational therapy professionals found that the following interventions were generally most effective for the management of Hoarding Disorder: environmental modification, <i>rs</i>(18) =.550, <i>p</i> =.018, VS-MPR = 5.09; personal safety training, <i>rs</i>(18) =.543, <i>p</i> =.020, VS-MPR = 4.70; creative expression activities, <i>rs</i>(18) =.624, <i>p</i> =.006, VS-MPR = 11.98; ADL training, <i>rs</i>(18) =.412, <i>p</i> =.066, VS-MPR = 2.05; self management training, <i>rs</i>(18) =.443, <i>p</i> =.075, VS-MPR = 1.89; and occupation-based therapeutic activities, <i>rs</i>(18) =.444, <i>p</i> =.063, VS-MPR = 2.11. The results of this study affirm that occupational therapy professionals generally find complex systems of techniques as more effective than single techniques for treating those with hoarding disorders, however further research is needed to better understand which occupational therapy assessments and interventions work well together as effective treatment systems.

Burnout is common among occupational therapy professionals and associated with poor health and well-being, absenteeism, turnover, and exit from the profession. This study identified specific job titles, job characteristics, and resources related to burnout. To identify specific aspects of occupational therapy jobs related to burnout and to investigate job crafting as one approach for reducing burnout. Cross-sectional survey. Four hundred occupational therapy professionals from 45 states across the United States. This study investigated the relative importance of job demands (e.g., workload, emotional labor, role ambiguity), job resources (e.g., professional identity, autonomy, perceived support), and burnout and examined job crafting as a strategy for reducing burnout. Burnout varied across occupational therapy positions and practice areas and was most strongly associated with excessive workload. Occupational therapy professionals who engaged in job crafting reported less burnout. Several positive job resources, including meaningful work, job involvement, and perceived organizational support, were also associated with job crafting. This study identified specific occupational therapy roles, settings, and job characteristics related to burnout and job crafting behaviors that may help reduce burnout. Plain-Language Summary: Burnout is common among occupational therapy professionals and is associated with poor health and well-being, absenteeism, turnover, and people leaving the profession. This study identifies occupational therapy positions, practice areas, and work conditions at most risk for burnout and highlights job resources that can prevent and mitigate burnout. The study found that burnout varied across occupational therapy positions and practice areas and was most strongly associated with excessive workload. Recommendations to address burnout include engaging in job crafting, optimizing job demands and resources, and fostering meaningful work to reduce burnout.

BackgroundAssessing self-efficacy in evidence-based practice (EBP) is crucial for identifying training needs, evaluating the effectiveness of educational programs, and assessing the overall application confidence of EBP in healthcare professions, including occupational therapy (OT). Thus, the objectives of this study were to cross-culturally adapt the Evidence-Based Practice Confidence Scale (EPIC) for Spanish-speaking OT students and professionals and to evaluate its internal consistency, test–retest reliability, and construct validity.MethodsA professional translation and cross-cultural adaptation of the EPIC was developed, including a pilot study that resulted in the EPIC Spanish version. A total of 260 OT students and 202 professionals completed the Spanish EPIC at baseline, with 177 (68.1%) students and 129 (63.9%) professionals participating in the test–retest reliability assessment two weeks later. The EPIC’s internal consistency was evaluated using Cronbach’s alpha. Test–retest reliability was assessed using Spearman’s correlations and intra-class correlations (ICC). Known-groups validity hypothesis based on participants' roles (students, diploma/bachelor’s, master’s, and doctorate) was explored using ANOVA. Finally, an exploratory factor analysis with oblique Promax rotation was conducted to examine the EPIC factor structure.ResultsCronbach’s alpha for the total EPIC score was excellent in both OT professionals (α = 0.91) and students (α = 0.90). For OT students, Spearman’s correlation was 0.67 (p < 0.001) for the total score, and the ICC was 0.66 (95%CI 0.57–0.73). Conversely, for OT professionals, test–retest reliability showed a Spearman’s correlation of 0.87 (p < 0.001) for the total score, and the ICC was 0.87 (95%CI 0.81–0.90). The highest scores were observed in professionals with a doctorate followed by those with a master’s degree (p < 0.001). The exploratory factor analysis yielded a 3-factor solution that explained 71% of the observed variance, with item-level loadings ≥ 0.35.ConclusionsThe EPIC scale showed excellent internal consistency, strong test–retest reliability, and adequate construct validity for evaluating EBP self-efficacy among Spanish-speaking OT professionals using the total score. However, test–retest reliability was moderate among Spanish-speaking OT students, indicating that changes in EBP confidence assessed with the EPIC scale in this group should be interpreted with caution.

Changes in the ability to participate in meaningful occupations are common during and following significant life changes and/or events. Using qualitative methods, this study explored how changes in occupational participation can influence an individual's identity as exemplified during the transitional period from driving to driving cessation in older adulthood. The findings discussed in this paper illustrate the interdependent relationship that exists between occupational participation and occupational identity. In particular, this study highlights the potential consequences on identity when meaningful occupations are disrupted. The findings in this study lend support to previous findings, which identified a critical link between engagement in meaningful occupations and identity as an occupational being. Given that individuals may experience many transitional periods in their lifetime, this study provides preliminary evidence regarding the importance of occupational adaptation. Based on findings in this study, occupational participation may provide the context in which individuals begin the process of reconstructing their lives thereby linking their past and future occupational self.

Chronic pain, defined as intermittent or continuous pain for a minimum of 3 months, is a prevalent and pervasive health issue that commonly results in occupational participation changes and individuals spending more time within the home. Yet the role of the home environment in pain and pain management has not been specifically explored. This study had two aims. The first aim was to explore how home is experienced for people with chronic pain across the six dimensions of home using the Dimensions of Home Measure. The second aim was to explore relationships between pain, mood, and dimensions of home to understand how the experience of home influences reported pain and its co-morbidities. An online cross-sectional survey collected data from people with chronic pain across Australia. Participants provided information on their demographic characteristics, experience of home (Dimensions of Home Measure), pain and interference (Brief Pain Inventory), and symptoms of psychological distress (Depression, Anxiety, and Stress Scale 21 items). Descriptive statistics and mediation regression analyses from pain interference (PI) on psychological distress through aspects of dimensions of home were conducted. An interprofessional chronic pain rehabilitation team, including medical doctors and allied health, highlighted the need for this study and partnered with academics. Professional and consumer pain associations throughout Australia supported the study by promoting the study details and assisting with participant recruitment. The research team included members with lived experience of chronic pain, caring for people with pain, and treating pain who were involved in the design, analysis, and reporting of results. A total of 107 people aged 18 years or older participated. The results suggest that the experience of home is generally considered to be positive for people living with chronic pain; however, some aspects of home life such as perceiving the home as a place for activities, safety within the home, and in temporal aspects of home life (e.g., daily and weekly routines and feeling that the home is set up for the future) may be less positively regarded compared to other aspects of home life. Mediation findings, with pain interference as the predictor, suggest a strong reciprocal relationship between feelings of safety within the home and symptoms of anxiety and with perceiving the home as a place for activities and in temporal dimensions of home life with depressive symptoms. The results of this study provide preliminary support for the further examination of the home as a determinant of health, including as a potential factor to be considered beyond the biopsychosocial model of pain. Occupational therapists working with clients for pain management within their home should consider how the home can be modified or structured to improve occupational participation, particularly in relation to safety, the home as a place for activities, the routines of daily life, and that the home is well set up for the future. This may have a profound impact on how home is experienced for people with chronic pain and on their emotional wellbeing.

Purpose After a stroke, most individuals cannot participate in some of their valued occupations, disrupting their occupational identity. The aim of this interpretive synthesis is to systematically review the existing body of research to develop an understanding of the experience of occupational identity disruption post-stroke. Methods A systematic review of the literature that included nine electronic databases, reference lists screening and grey literature checking was completed. Ten studies published between January 2012 and October 2018 were included. Meta-ethnography was used for the interpretive synthesis. Findings A three-staged process model was created. Stage 1 illustrates the four factors involved in occupational identity disruption: “A fragmented and externalized body”, “losing control, freedom and independence”, “changed social and familial interactions”, and “occupational participation loss”. Stage two explains the experience of occupational identity disruption: “Occupational identity loss”, “a de-valued self”, and “threat to identity continuity”. Stage three shows the individual’s coping strategies: “protecting one’s self”, “social isolation”, and “re-inventing one’s occupational self”. Conclusions Stroke impacts on an individual’s occupational identity, compromising the continuity of a stroke survivor’s sense of self. However, occupational identity is fluid; this can be used to support individuals to re-invent the occupational self. A conceptual model was developed to support the application of these results in clinical practice. Implications for rehabilitation Occupational identity disruption impacts on stroke survivors’ self-value and sense of self continuity. Health care professionals’ understanding of stroke survivors experience of occupational identity disruption could contribute to realign stroke survivors and clinicians’ rehabilitation goals. Occupational participation and social interaction should be core aspects of stroke rehabilitation. Occupation-focus rehabilitation could provide opportunities for stroke survivors to pursue their desired occupational identity.

Internationally, there is recognition that the transition from military service to civilian life is challenged by a military identity. The aim of this study was to present the impact of an occupational military identity on the transition to civilian life from the perspective of former serving Australian Defence Force members. A narrative inquiry methodology was employed to explore the transition experience of the participants who each shared the story of their transition, presenting a narrative for data analysis. This analysis utilised Braun and Clarke’s thematic analysis (2006, 2020), and the a priori theme of identity. The 12 participant narratives led to the presentation of four themes: 1) Transition and a military identity; 2) Military service and a military identity; 3) Military identity and separation type (voluntary and involuntary); and 4) Enabling transition and the military identity in civilian life. The participants’ narratives highlighted how their occupational participation in military training and culture shaped an identity to challenge transition. Yet, they also highlighted the positive influence of a military identity, offering insights into how best to enable the transition from military service to civilian life.

Introduction:Social engagement in health encompasses the idea of involving (parts of) society as full partners in the decision-making regarding both development and implementation of health technologies. Evidence shows that patient engagement is linked with fewer adverse events, better patient self-management, fewer diagnostic tests, decreased use of healthcare services and shorter lengths of stay in hospitals. Matching the escalating healthcare requirements to face the ongoing societal and economic challenges regarding access and coverage to (new) health technologies is not an easy task for health providers.Methods:We conducted a systematic review (CRD42017068714) designed to address the institutional implementation of social engagement by the Brazilian Ministry of Health. All systematic reviews were evaluated using the new version of AMSTAR and, once all findings are synthesized, we will use the GRADE-CERQual approach to assess for confidence.Results:From 399 publications that met the inclusion criteria, 80 described the implementation of social engagement during the development and implementation of (new) health technologies at various levels (local, regional, national, supranational), countries and for different health technologies and social actors. The remaining 319 publications constitute case studies describing barriers and enablers to implementing social engagement in HTA and coverage decision-making processes. By mapping barriers and facilitators, we explored effectiveness and sustainability, further observing how citizen science-based strategies can ultimately reform health service delivery by innovating the social engagement in health technology development and implementation.Conclusions:This systematic review addresses the know-do gap on social engagement in health technology development and implementation, from a global perspective, as a way of improving the Brazilian Ministry of Health's HTA activities and enabling a Brazilian strategy to reform health service delivery. Enabling social engagement as early as possible, during all the stages of the development cycle, grants a more effective and sustainable health care system.

Physiotherapy and occupational therapy professionals are at high risk of developing occupational musculoskeletal injuries globally. Musculoskeletal pain is the most common problem. To determine the extent of discomfort that physiotherapy and occupational therapy health professionals report while working at a physical rehabilitation centre. Physiotherapy and occupational therapy professionals which include both graduate and diploma physiotherapists and occupational therapists as well as physiotherapy and occupational therapy assistants. A self administered questionnaire (survey) was conducted on a convenient sample of 101 physiotherapy and occupational therapy personnel. The mean age of the 101 participants was 27.8 (± 4.5) years and most of the participants (62%) had less than 5 years of work experience. Ninety-five percent of the participants complained of work related pain. Most of the participants reported pain in the lower back (n=84) followed by upper back (n=71) and neck (n=66). Significant associations were found for pain in ankles/feet with age (p=0.05) and pain in neck with gender (p=0.01). Physiotherapy and occupational therapy professionals suffer from pain in relation to the work they do as therapists which may be due to non-practice of appropriate body mechanics. Mechanism to assess level of practice during dealing with patients may be introduced to enable corrective measures. Incentives should be considered for appropriate practice.

Social media are increasingly used by the public to share information and opinions. This study explores social media engagement in health and climate change through an analysis of English-language posts on Twitter, one of the most widely-used platforms. We searched Twitter from 21 March 2023 to 11 May 2023 for posts related to climate change using climate-related textwords and hashtags; we then used health keywords (‘health’, ‘wellbeing’, ‘illness’, ‘illnesses’, ‘disease’, ‘death’) to identify posts related to health. Focusing on posts from general public users, we investigated the proportion of climate change posts referring to health and, for a random sample of these tweets, undertook a content analysis to identify the ways in which climate change and health were represented. The content analysis drew on media research on ‘framing’, a selective process through which particular aspects of an issue—for example, its causes, impacts and solutions—are highlighted. 668 810 posts related to climate change were posted during the study period. Health-related text words were included in 2.3% (15 434) of these posts. The content analysis pointed to two divergent frames. The first frame represents climate change as real, with real effects on people’s health. The second frame portrays climate change as a hoax, with hoax-generated health effects. While the ‘reality’ frame does not engage with the hoax frame, the latter provides an insistent counter-narrative that questions trust in mainstream science and government policy. Neither frame engages with people’s experiences of health and climate change. In conclusion, our study points to low levels of engagement in health in a key forum for public discussions about climate change. It also asks whether the failure of the ‘reality’ frame to engage either with people’s lived experiences or with hoax framings may be contributing to a polarised debate about climate change and health and hindering consensus-building.

The majority of individuals on long-term sick leave experience negative effects in their lives associated with limitations on their participation, decreased income, and feelings of guilt. The aim was to describe the experiences that women on long-term sick leave have of participation in occupation. Unstructured interviews were used for the data collection, which involved eight women; a grounded theory approach was used. The results showed that the women's long-term sick leave changed their roles, daily habits, and routines, and their participation in occupations was negatively influenced. Their occupational performance also diminished, thereby having a negative influence on their social relationships. However, over time they came to find different strategies that contributed to a feeling of occupational competence and thence they started to rebuild their occupational identity. Through this began the process of occupational adaptation, which resulted in an increased experience of participating in occupation. As a conclusion, it should be noted that occupational therapy interventions should be directed at women on long-term sick leave at an early stage in the rehabilitation process to address the adaptation of their roles, habits, routines, and social environment.