Wheelchair Mounted Robotic Arms: Occupational Therapy Perceptions and Practices

Purpose Despite the benefits of wheelchair-mounted robotic arms (WMRAs), occupational therapists are not yet widely involved in the recommendation or implementation of these assistive devices. The purpose of this study was to investigate and compare the current practices and perspectives of occupational therapists who had and had not recommended a WMRA on the recommendation, training, and implementation of WMRAs. Methods This was a descriptive cross-sectional study. An online survey was sent to Canadian, European, and American occupational therapists who had or had not worked with WMRAs. Respondents were asked close-ended questions about their experience, role, barriers, motivations, and future needs regarding WMRAs. We compared results between respondents who had and had not recommended WMRAs using descriptive statistics. Results Ninety-three North American and European occupational therapists completed the survey. Of those, 29 (31.2%) had recommended a WMRA, mostly the JACO robotic arm (n = 26, 89.7%) in rehabilitation centres (n = 18, 62.1%). Their perspectives on their role and barriers related to WMRAs were similar to those who had never recommended a WMRA. All respondents recognised the relevance of occupational therapists’ contribution, and most reported interest in WMRAs (n = 76, 81.7%). However, many barriers emerged, mainly related to limited funding (n = 49, 76.6%), lack of training and knowledge (n = 38, 59.4%), and resource constraints (n = 37, 54.4%). Future needs identified matched these barriers. Conclusion This survey provides novel insight into occupational therapists’ perspectives on WMRAs. It highlights that health professionals need to have easier access to funding, formal training, and resources to support their involvement with WMRAs. Implications for rehabilitation Most occupational therapists are interested in working with WMRAs, considering the potential of these devices to support individuals with upper extremity impairments in their daily activities. They also recognise their unique contribution to the assessment, recommendation, and implementation process among multidisciplinary teams. WMRA recommendation is relevant in various clinical settings and with a wide range of client populations. Nevertheless, it appears that occupational therapists working with adults, in rehabilitation centres or specialised clinics, may have more opportunities to get involved in this process and to attend formal training on this technology, as compared to other settings. Many barriers remain, impeding occupational therapists’ role in the recommendation and implementation of WMRAs. Addressing these barriers may increase the number of devices that are successfully adopted and utilised by individuals with upper extremity impairments. In particular, future research and health policies should focus on access to sufficient funding, formal training, and resources for occupational therapists relative to their role in recommending and implementing WMRAs.

Is Occupational Therapy Adequately Meeting the Needs of People With Chronic Pain?

Deimplementation in Clinical Practice: What Are We Waiting For?

Occupational therapy in residential aged care facilities (RACFs) can enhance residents' occupational engagement and wellbeing. However, industry reports suggest that occupational therapists in Australian RACFs have mostly provided physical therapies such as pain management via massage and not addressed residents' occupations. There is limited literature on what constitutes occupational therapists' practice in RACFs to inform policy and practice. The aim of this cross-sectional survey was to explore practice patterns of occupational therapists working in Australian RACFs and influences on their practice. Occupational therapists working in Australian RACFs were invited from July 2019 to March 2020 to complete a self-report online questionnaire via email and advertisements on industry websites, newsletters, and social media. The questionnaire asked therapists about their caseload, referrals, assessments, and interventions. Data were analysed descriptively and presented as frequencies and percentages. A total of 214 occupational therapists completed the survey. Occupational therapists' daily practice largely focussed on pain management; other areas of practice included falls prevention, pressure care, and mobility. The Aged Care Funding Instrument in place at the time of the survey was identified as the leading factor influencing therapists' choice of assessments and interventions. Organisational policies and procedures were also perceived as key factors influencing occupational therapy practice. This paper highlights the influence of government funding and organisational policies in limiting occupational therapists' scope of practice and their ability to fully address the occupational needs of residents. Occupational therapists and the profession in general should be aware of factors in aged care funding models, and their application, that restrict occupational therapy practice and inhibit residents' function and advocate for change where needed. With the introduction of the Australian National Aged Care Classification funding model replacing Aged Care Funding Instrument, future research should explore potential changes to therapists practice following the implementation of the new funding model.

Background: To advance occupational therapy knowledge and practice in Southeast Asia, it is pivotal that quality master’s degree programs in occupational therapy are in place. Such a program must respond to the needs of the region in terms of occupational therapy education, practice, and scholarship. By recognizing the diversity of the occupational therapy education and training in the region, it has become possible to consider alternatives in establishing a graduate program in occupational therapy through partnerships and consortia. In order to make an informed decision to decide whether co-creating a master’s program in occupational therapy through an international consortium within the region is possible or not, a needs assessment is warranted. Objectives: To describe the profile of occupational therapists living and working in the Southeast Asian region who would like to pursue a master’s degree in occupational therapy via an international consortium. Materials and methods: An online survey design was used to produce data that would be used to inform the co-creation of an international master’s program in occupational therapy. The survey questionnaire was designed specifically for this study and included three sections: 1) information and consent form; 2) demographic information; and 3) information about the need for and preferences on a master’s program in occupational therapy. Participants were recruited through professional organizations and various social media platforms of national and international occupational therapy groups. Results: Eighty-five final-year occupational therapy students and 143 occupational therapists from the Philippines, Indonesia, Thailand, and other countries completed the survey. Majority (62%) of the respondents was interested in pursuing a master’s degree in occupational therapy because they perceived that an advanced degree can enable specialization in practice, promote personal and professional development, and help generate new knowledge for the field. The characteristics of the envisaged international master’s program must be: 1) completed ideally in 1.5 to 2 years, 2) taken by part-time students who are also working practicing, 3) delivered via a hybrid arrangement (i.e., online and face-to-face) with a fixed weekly schedule, and 4) matriculated for USD 1,000 per semester. Conclusion: While this cross-sectional survey cannot encapsulate the totality of occupational therapists’ needs in terms of their professional development, the survey provided an empirical basis to inform decisions in the creation of a master’s program in occupational therapy jointly offered by an international consortium of Southeast Asian universities.

Background: The provision of assistive devices (ADs) to enable function is a well-established component of occupational therapy (OT) practice. However, multiple client and therapist factors prevent the utilization of ADs in practice. Objectives: This study aimed to explore the utilization of ADs in OT practice in Tamil Nadu (TN). Study Design: The survey research design was used to conduct this study. A ten-item electronic survey was developed based on the research question. Methods: The survey was E-mailed to 295 occupational therapists in TN identified through convenience sampling. The survey link was also shared on four WhatsApp Messenger groups (Tamil Nadu Branch of All India Occupational Therapists' Association Official Group, OTist Group, Clinic OT, and Santosh Alumni) with many occupational therapists belonging to TN (snowball sampling). Data were collected between August 29, 2019, and September 20, 2019. Results: Thirty-five occupational therapists responded to the survey. Writing and eating utensils were the commonly prescribed ADs in TN OT practice. Client factors, cultural factors, lack of availability, cost, and therapists' skill may contribute to the limited usage of ADs in Indian OT practice. Innovating low-cost culturally acceptable ADs, educating stakeholders, and training practitioners on how to prescribe/utilize ADs in practice may mitigate the barriers related to ADs use. Conclusion: The usage of ADs in TN OT practice is limited. Multiple factors affect the utilization of ADs in the Indian context of practice. A multipronged approach focusing on innovative device development, advocacy, and skill development is needed to promote the utilization of ADs in Indian OT practice.

Toothbrushing for Dependent Neurological Patients in the Intensive Care Unit

IntroductionAs the majority of occupational therapy philosophy has Western origins, occupational therapists working with palliative care clients in Singapore can provide invaluable insight into the practice of occupational therapy within a non‐Western, family‐centric population. This study aimed to describe occupational therapists' perceptions of the occupations of terminally ill Chinese older adults and their caregivers and explore occupational therapy practice with terminally ill Chinese older adults in Singapore.MethodsEleven occupational therapists were recruited via convenience and snowball sampling. Inclusion criteria were being fully registered with the Allied Health Professionals Council (Singapore) with at least 2 years of working experience and currently working with/had experience working with terminally ill patients within the past 2 years. Interviews were transcribed verbatim, and data were analysed using reflexive thematic analysis.FindingsFive themes were constructed from the data: (1) Independence may not be for everyone, (2) it is a family unit, (3) contributing to others' lives is important, (4) what respecting clients means, and (5) a different way of engaging. These themes describe how occupational therapists adapted their practice to better meet the needs of clients and families in Singapore.DiscussionIn family‐centric societies, it may be more relevant for occupational therapists to facilitate interdependence instead of independence in activities of daily living. In addition, activities that contribute to others' lives tangibly/intangibly may be more meaningful and relevant. Finally, occupational therapists could engage clients through the ‘being’ instead of ‘doing’ dimension of occupation.ConclusionWhile occupational therapists in Singapore faced some challenges working with terminally ill clients and families due to differences between occupational therapy philosophy and practice context, by reframing their thinking, they were able to adapt their practices to meet the needs of a family‐centric population.

Background This research study emerged from the on-going quest of a team of occupational therapists to demonstrate that a local occupational therapy practice: was meeting the needs of adults with learning disabilities; was effective and achieving the objectives of the employing organisation; and was complying with the expectations of the College of Occupational Therapists regarding evidence based practice. Purpose The purpose of this study was to seek and to generate evidence on which to evaluate and improve a local community based occupational therapy practice with adults with learning disabilities. Methods Action research methodology was used in which the local occupational therapists were engaged as co-researchers over three stages. Stage one: essential criteria for occupational therapy assessments for adults with learning disabilities were developed. No standardised assessments were identified that could meet all of these criteria. Stage two: perceptions of occupational therapy assessment were gathered from a sample group of adults with learning disabilities, their carers and other stakeholders. Stage three: changes were made to occupational therapy practice in response to the findings of stage two and in order to meet referral to treatment targets imposed by the employing organisation. Data were collected on the changes made to occupational therapy practice, and how they were implemented, through the use of action learning sets and questionnaires. The perceptions of a new sample of participants with learning disabilities and other relevant people involved, about the occupational therapy practice that they had received, were ascertained. Throughout the whole study, data were collected from multiple sources using interviews, questionnaires and co-researcher discussions and reflections. The primary method of data analysis was thematic, with some descriptive analysis. Data from different sources were triangulated to develop key findings. Findings The participants with learning disabilities were able to provide valuable insights about their perceptions of occupational therapy practice. There was evidence that occupational therapists provided occupation focussed assessments and interventions which had a positive effect on the occupational performance of adults with learning disabilities. The occupational therapists used professional reasoning in their assessments and interventions with adults with learning disabilities rather than a standardised, formulaic approach. This ensured a flexible, holistic and person-centred approach which worked in a dynamic community context. Occupational therapists, as a service, creatively adapted their practice in response to organisational demands whilst maintaining occupational therapy principles. Conclusions The practice-based evidence generated from this research study could be relevant and transferable for other occupational therapy services working with adults with learning disabilities and contributes to the occupational therapy body of evidence within this speciality.

IntroductionAustralian occupational therapy practice in residential aged care facilities has been largely funded using the Aged Care Funding Instrument since March 2008. Literature indicates that the funding model constrains occupational therapy practice, impacting on therapists' and residents' experiences. In preparation for the implementation of the new funding model, the Australian National Aged Care Classification, it is timely to understand current practice. Therefore, the aim of this study was to explore occupational therapy practice in residential aged care facilities under the Aged Care Funding Instrument. The objectives were (1) to understand occupational therapists' experiences of working in residential aged care facilities under the Aged Care Funding Instrument; and (2) to explore occupational therapists' perceptions of how the Aged Care Funding Instrument influences residents' occupational performance and engagement.MethodsA phenomenological research design was employed to understand therapists' perspectives. Data were collected from seven occupational therapists using a demographic form and a semi‐structured interview. Data were analysed using a modified Colaizzi's descriptive phenomenological data analysis. Ethics approval was obtained.FindingsTwo themes emerged from the study's findings: a restrictive practice context that disables residents; and a restrictive practice context that inhibits occupational therapists. The first theme describes how the Aged Care Funding Instrument constrains practice and incentivises the disabling of residents. The second theme describes the challenges faced by occupational therapists throughout their journey of employment under the funding model.ConclusionOccupational therapists perceived that the Aged Care Funding Instrument restricts occupational therapy practice and prevents residents from living occupationally rich lives. With the introduction of the Australian National Aged Care Classification in late 2022, it is crucial that national associations and employers advocate to policymakers to ensure future practice reflects the profession's unique knowledge and skills to optimise the health and wellbeing of residents.

The 30th Occupational Therapy Australia National Conference and Exhibition 2023: An opportunity to acknowledge, celebrate and <i>ignite</i> our occupational achievements

In occupational therapy practice, client assessments are essential for establishing treatment priorities and determining the effectiveness of interventions. However, occupational therapists' assessment practices are not well documented. This work aimed to provide an overview of the assessment practices of Quebec occupational therapists based on the person-environment-occupation components and clienteles. A cross-sectional survey was conducted using an online survey that was sent to occupational therapists in Quebec. In paediatrics, occupational therapists tend to use standardized tools to assess physical and neurological abilities. Adult assessment focuses mainly on physical abilities and productivity. For seniors, assessment focuses mainly on functional aspects (physical abilities, personal care, and home safety) and screening for cognitive difficulties. Occupational therapy assessment mostly focuses on physicial abilities. To ensure a holistic approach, more occupational and environmental components should be included in the assessment practices.

More Than Good Intentions: Advancing Adherence to Therapy Recommendations

Aims Interdisciplinary collaboration between health and education professionals is one of the principles of inclusive education. This study aimed to describe the practices and service delivery by pediatric occupational therapists (OTs) in schools in Spain. Methods Data came from a convenience sample of pediatric OTs recruited through Spanish professional colleges and associations for a web-based survey, mixed-method research study. Thirty-five respondents were excluded because they didn’t meet the eligibility criteria. Ninety-two responses were obtained for data analysis. Twenty-nine OTs (31.5%) work in schools (school-OTs), and sixty-three participants (68.5%) don’t work there but collaborate with schools (non-school OTs). Results Participants support students with and without a medical diagnosis. Services provided by OTs external to the educational system are mainly funded by families or only partially covered. Findings show that most participants use standardized assessments and apply several intervention approaches. They believe there are barriers to the collaboration and implementation of occupational therapy services in schools. Conclusions This preliminary study shows a need for changes in Spain’s State and Regional Education legislation and provides recommendations to improve school service delivery. Pediatric OTs are encouraged to reflect on and identify opportunities for changes to enhance school-based occupational therapy practice in Spain.

Introduction. Occupational therapy (OT), a profession deeply entrenched in colonial ideologies, also holds the potential to re-imagine healthcare in collaboration with Indigenous communities. Purpose. This review aims to (1) identify decolonizing practices in OT that can be applied at micro, meso, and macro levels of service delivery and (2) elevate the voices and viewpoints of Indigenous scholars. Method. I conducted a literature review based on a decolonized and relationship-focused approach, using the work of Tynan and Bishop. Seventeen articles were reviewed and guided by moss bag teachings. Findings. By encouraging actions people can do to enact decolonization practices, we hope that non-Indigenous people can critically think about ways in which to challenge coloniality and enact meaningful, relational, and respectful relationships. (1) micro: Before building relationships, occupational therapists need to understand their work environment to create meaningful connections and improve service delivery. (2) meso: occupational therapists in leadership should support Indigenous occupational therapists and fairly compensate them to respect Indigenous knowledge genuinely. (3) macro: occupational therapists involved in creating knowledge must recognize and promote Indigenous knowledge to benefit Indigenous OT students and communities. This paper is not meant to be a prescriptive "what not to do" as this varies across each unique situation. Conclusion. Effective actions must be implemented at all levels of service provision, recognizing that all clinicians, researchers, and educators are urged to transform and challenge the normative and colonial status quo ingrained in the OT profession.