Canadian Association Of Occupational Therapists Research Articles

The impact of COVID-19 restrictions on the delivery of occupational therapy: How technology use affected practice during COVID-19 among occupational therapists in British Columbia.

COVID-19 activity restrictions altered clinical practice around the world. Anecdotal evidence observed by the Canadian Association of Occupational Therapists - British Columbia (CAOT-BC) suggested a rapid adjustment to virtual care technologies occurred among occupational therapists in the initial restrictions. The purpose of the study was to determine the scope of how COVID-19 restrictions impacted the use of technology to provide client care in British Columbia. It will inform the future provision of occupational therapy in the developing technological landscape related to heath care provision. This descriptive cross-sectional survey was completed using Qualtrics, an online survey tool. Registered occupational therapists received the survey via email invitations. The data were analysed using descriptive statistics in IBM SPSS Software. Of 342 participants, 98.4% reported increased technology use to support practice with the advent of COVID-19 restrictions. Those with some technology experience prior to COVID-19 reported higher intent to continue using technology following COVID-19 restrictions. Overall, occupational therapists were confident in their perceived abilities to use technology in their practice. Occupational therapist-related, client-related, and practice area considerations occurred with the rapid uptake of technology. Some components of practice were perceived to be improved and others impaired with the use of technology. Occupational therapists substantially increased their use of technology to enable ongoing client care during the Covid-19 restrictions. Implications for improvements and reduction of limitations in care delivery are substantial, given the intent to continue using technology going forward. These implications can be further explored to understand how the advances in occupational therapists' ability to use technology may impact rural or remote care, which practice areas may be most amenable technology use, and how policies and funding can facilitate effective and appropriate use of technology to support clinical care in public and private settings.

“Everyone knows there is a battle”: Colleges, Universities, and the Education of Occupational Therapists in Ontario, 1970 to 1985

Following the creation of Ontario’s Colleges of Applied Arts and Technology (CAATs) in 1965, an interested group of health care providers and educators in Hamilton began to advocate for the creation of a program in occupational therapy at Mohawk College. Historically, occupational therapy education in Canada took place within universities, so a college-based program was viewed as a significant development by the Canadian Association of Occupational Therapists (CAOT) and its provincial branches. The idea of the Mohawk program was developed concurrently with the work of Ontario’s Healing Arts Committee, which put forward more than two hundred recommendations that would reshape the education of health care workers. These two elements, the development of an occupational therapy program within a CAAT and a major review of education for health care workers, were viewed with concern by the CAOT. This paper analyzes the history of this educational development and the response of the profession of occupational therapy. It illustrates the strategies used by the CAOT, and the Ontario Society of Occupational Therapists, to delay the implementation of the program. The paper also illustrates the development of minimum standards for entry to practice, accreditation policies for education programs, and membership requirements for the CAOT, all of which were connected to employment prospects. All of this had implications for the viability of the Mohawk College program and for its graduates.

Concussion Management Practices for Youth Who Are Slow to Recover: A Survey of Canadian Rehabilitation Clinicians.

Purpose: The objective of this study was to estimate the scope of concussion management practices for youth used by Canadian rehabilitation clinicians. A secondary objective was to determine the use of aerobic exercise as a management strategy. Method: Members of the Canadian Association of Occupational Therapists, Canadian Athletic Therapists Association, and Canadian Physiotherapy Association were invited to participate in an online cross-sectional survey. Two clinical vignettes were provided with a brief history. The respondents were asked about the type of treatments they would provide (e.g., manual therapy, education, aerobic exercise, return-to-learn or return-to-play protocol, goal setting). Results: The survey was completed by 555 clinicians. The top five treatment options were education, sleep recommendations, goal setting, energy management, and manual therapy. Just more than one-third of the clinicians prescribed aerobic exercise. Having a high caseload of patients with concussion (75%-100%) was a significant predictor of prescribing aerobic exercise. Conclusions: A wide variety of treatment options were selected, although the most common were education, sleep recommendations, energy management, and goal setting. Few clinicians used aerobic exercise as part of their concussion management strategy.

Doing Occupational Justice: A Central Dimension of Everyday Occupational Therapy Practice.

The Canadian Association of Occupational Therapists (CAOT) and the American Occupational Therapy Association (AOTA) state that occupational justice is part of the domain of occupational therapy and that occupational justice is "an aspect of contexts and environments and an outcome of intervention" (AOTA, 2014, p. S9). Despite the increasing focus on justice in the occupational therapy and the occupational science literature, many practitioners in traditional settings do not see its relevance to their everyday practice (Galvin, Wilding, & Whiteford, 2011) or have difficulty envisioning how to enact a justice-informed practice. This paper demonstrates how occupational justice is germane to all settings of occupational therapy, and how it can be enacted at micro, meso, and macro levels of occupational therapy practice. We argue that occupational therapy is a justice-oriented profession at its core and will discuss how occupational justice can be enacted at all levels of practice.

Interventions Addressing Vision, Visual-perceptual Impairments Following Acquired Brain Injury: A Cross-sectional Survey.

The existing literature on the effectiveness of interventions targeting vision, visual-perceptual impairments following acquired brain injury (ABI) is scarce and unlinked to occupational performance. To explore current occupational therapy practice in vision-rehabilitation among adults with ABI in Canada, and to determine the evidence-practice gaps. An online survey was made available through the Canadian Association of Occupational Therapists (CAOT) website, and disseminated to seven public healthcare institutions in Quebec. The survey collected respondent demographic information, and the types and frequency of treatments delivered. Descriptive statistics were conducted to determine interventions' frequency. Participant comments were collected and grouped into recurring themes. Over half (55%) of respondents regularly use evidence-based interventions when addressing visual acuity (VA) and visual field (VF) deficits, but only very few (3%) use it when dealing with oculomotor function and visual stress impairments. Results gave a glimpse of interventions used and suggested the need for further research in vision rehabilitation.

Indigenous perspectives on health: Integration with a Canadian model of practice.

The Canadian Association of Occupational Therapists and the Truth and Reconciliation Commission recommend change within the Canadian health care system, respecting and valuing Indigenous health and healing practices. Adjusting the lens through which occupational therapists practice to incorporate Indigenous views of health and wellness is one potential change. This critical interpretive synthesis of the literature incorporates Indigenous perspectives on health and wellness into the Canadian Model of Occupational Performance and Engagement (CMOP-E) framework, strengthening that model to better serve all peoples in Canada. Integrating Indigenous worldviews can add to the CMOP-E the importance of balance among physical, emotional, spiritual, and mental health; the inseparability of person, community, and land; and understanding occupations as dimensions of meaning. These are incorporated in a proposed integrated model (ICMOP-E). Effectively integrating Indigenous perspectives may be an important first step in a longer journey toward engaging more respectfully with Indigenous perspectives on health and wellness.

Opportunities for well-being: The right to occupational engagement.

The Canadian Association of Occupational Therapists' 2017 conference theme prompted thoughts about shaping our profession's future. This Muriel Driver Memorial Lecture explores how occupational therapy's future might be shaped to become more important, relevant, and valuable to society. Because occupational engagement is integral to human well-being and because well-being is integral to human rights, occupational therapy could usefully advance the right of all people to engage in occupations that contribute positively to their own well-being and the well-being of their communities. Occupational therapy's importance to society will be manifested when we focus unambiguously on well-being; extend our efforts beyond enhancing the abilities of individuals whose lives are already impacted by illness, injury, or impairment; and address the opportunities for achieving well-being through occupational engagement of all those whose capabilities-their opportunities to do what they have the abilities to do-are inequitably constrained.

Facilitators and barriers to the use of iPads as a therapy tool: A Canadian survey of pediatric occupational therapists

Technological advancements are leading occupational therapists to alter traditional methods of addressing intervention with clients by incorporating intervention tools like the iPad to enhance rehabilitation and improve participation in the everyday activities of children they engage with as a means of increasing motivation and interest. The use of iPads as a therapeutic tool is on the rise due to the ease of access, their versatility, and acceptance by learners whose learning styles the iPads appeal to. Occupational therapists registered with the Ordre des Egotherapeutes du Québec and members of the Canadian Association of Occupational Therapists were surveyed to study the use of technology like iPads in treatment and to identify possible facilitators and barriers involved in using iPads as a therapeutic tool. Almost half of the respondents reported iPad usage in practice. Portability and small size, ease of use, and increased use of technology were identified as the principal facilitators; while, lack of iPad availability, funding, and training/knowledge were the principal barriers found. For the nonusers, the lack of knowledge or evidence to support iPad’s effective use as a therapeutic tool was the leading barrier reported. However, these nonusers expressed a willingness to use iPads if they were made available to them. Further research is required to address the barriers identified and to determine the effectiveness and applicability of iPads in practice. This would shed light on clinical changes that might be required to promote iPad use in pediatric occupational therapy.

Influence of Lexical versus Procedural Knowledge in Sentence Production in Response to Thematic Role Assignment Treatment

Influence of Lexical versus Procedural Knowledge in Sentence Production in Response to Thematic Role Assignment Treatment

A case study of a national association's actions to advance the integration of occupational justice and human rights in occupational therapy

ABSTRACTObjective: To consider a professional association's actions in supporting an occupational therapy community's awareness and learning about occupational justice and human rights-informed practice. Presentation: The Canadian Association of Occupational Therapists (CAOT) is a national professional association that promotes excellence in occupational therapy through advocacy, professional development opportunities, and resource and product development. For its 2015 Conference, CAOT focussed on the intersection between justice, human rights and occupational therapy. Technique: Conferences are intense knowledge mobilisation platforms and are an opportunity for professional associations to demonstrate leadership in advancing and promoting the occupational therapy profession. Conclusion: Occupational therapy associations are encouraged to use their resources and voice to unite occupational therapists within their region in pursuit of the goal to make our communities more just and inclusive for all.

Occupational therapists’ pain knowledge: a national survey

Purpose: This study surveyed Canadian occupational therapists to identify whether their pain knowledge is current or if the gaps identified in past studies have remained the same. The findings will provide information to guide the development of targeted pain knowledge translation strategies for occupational therapists. Method: A self-report survey, including demographic questions and part of the City of Boston’s Rehabilitation Professionals’ Knowledge and Attitude Survey (COBS), was disseminated electronically to all members of the Canadian Association of Occupational Therapists. Results: A total of 354 therapists, most came from Ontario, Alberta and Nova Scotia and working in the community, acute care and private practice, participated. Over 50% had 10 years or less of experience. Deficit knowledge areas were identified in pediatric pain, chronic versus acute pain, pain assessment and medications. These findings are largely consistent with deficits identified in pre-2000 studies. Conclusions: Pain knowledge gaps persist among Canadian occupational therapists and this can, and should, be addressed within the occupational therapist (OT) curriculum and in professional development initiatives. It is concerning that this study identified similar knowledge gaps as those identified in previous studies of OT students and clinicians. Pain is a growing and complex issue with negative impact on occupational performance across the lifespan. Knowledge dissemination of occupational therapy pain assessment and management approaches should be a priority for the profession.Implications for RehabilitationPain is a prevalent condition in all age groups of occupational therapists’ clients.There appear to be gaps in occupational therapists’ evidence-based knowledge of aspects of pain.Occupational therapy training programs and occupational therapy associations should provide education with a particular focus on identified pain knowledge gaps.

International MS Falls Prevention Research Network: Report from the Front Lines.

In a given year, nearly 60% of individuals with multiple sclerosis (MS) will experience a fall. A significant portion of these falls will result in an injury, ranging from mild bruising to bone fractures. Perhaps more insidious than any physical injuries are the reduced activity, fear of falling, and social isolation to which falls may contribute. Falls and their consequences are important targets of rehabilitation. Yet, despite the work of several individual research teams around the world, scientific knowledge about effective ways to reduce the number, severity, and consequences of falls experienced by people with MS is in its infancy. Overcoming this problem will require international collaboration and partnership that pools interdisciplinary expertise and produces evidence about the best approaches to reduce fall frequency, severity, and consequences for people with MS. In order to facilitate this collaboration and partnership, a group of seven MS researchers secured a planning grant from the Canadian Institutes of Health Research to support an inaugural meeting of the International MS Falls Prevention Research Network (IMSFPRN). Our grant team includes Principal Investigator Marcia Finlayson (Queen's University, Kingston, Ontario, Canada) and Co-Investigators (in alphabetical order) Michelle Cameron (Department of Neurology, Oregon Health & Science University, and Portland VA Medical Center, Portland, OR, USA), Davide Cattaneo (Don C. Gnocchi Foundation, Milan, Italy), Susan Coote (University of Limerick, Limerick, Ireland), Patricia N. Matsuda (University of Washington, Seattle, WA, USA), Elizabeth Peterson (University of Illinois at Chicago, Chicago, IL, USA), and Jacob J. Sosnoff (University of Illinois at Urbana-Champaign, Urbana, IL, USA). The founding members of the IMSFPRN, and those who may join in the future, will work collaboratively to develop and implement multisite research protocols to advance knowledge on falls and falls prevention among people with MS. The overarching goals of the initial meeting were as follows: 1) to build collaborative partnerships among researchers, clinicians, consumers, and other key stakeholders committed to strengthening evidence for MS falls prevention, and 2) to begin work on a protocol for an MS falls-prevention intervention trial. The long-term goal of the IMSFPRN is to develop and disseminate clinically relevant knowledge that will reduce the frequency, severity, and functional consequences of falls experienced by people with MS worldwide. The inaugural meeting was held at Queen's University in Kingston, Ontario, Canada, in March 2014. In addition to the IMSFPRN founding members, the meeting was attended by clinicians from a variety of fields (neurology, physical therapy, occupational therapy, nursing, kinesiology); experts in aging with MS, physical activity and disability, and postural control in older adults; individuals living with MS; and representatives from the Canadian Association of Occupational Therapists, the Canadian Physiotherapy Association, and the Multiple Sclerosis Society of Canada. Through-out the meeting, all participants had opportunities and were encouraged to share their ideas and expertise regarding the key elements of the falls-prevention intervention protocol that the IMSFPRN is developing. These opportunities were made possible through presentations, small- and large-group discussions, and formal nominal group methods. This theme issue of the International Journal of MS Care focuses on the recommendations concerning falls prevention that emerged from the March 2014 meeting of the IMSFPRN. An article by Ploughman et al. focuses on how research on postural control of older adults, physical activity promotion for people with spinal cord injury, and aging with MS can and should inform falls-prevention research in MS. Cameron et al. detail which people with MS should be targeted for falls-prevention trials. Gunn and colleagues discuss the advantages and disadvantages of various settings for falls-prevention trials that can be implemented for people with MS. Other articles provide the rationale and potential measurement tools for the three key outcomes the meeting participants identified for an MS falls-prevention intervention: number of falls (Coote et al.), dynamic balance (Cattaneo et al.), and participation (Finlayson et al.). Finally, Finlayson et al. examine how the RE-AIM framework can inform the ongoing work of the IMSFPRN in order to maximize the uptake of the evidence we plan to produce in the years to come. There is little doubt that determining best practices in falls prevention specific to people with MS is essential. This theme issue outlines an international effort to lay the foundation for falls-prevention research. As members of the IMSFPRN, our goal is to work together to maximize falls-prevention research efforts. We hope that this theme issue will encourage others to join our group in our effort to reduce the frequency, severity, and functional consequences of falls in people with MS. If you are interested in joining the Network or being kept abreast of our activities, please contact Marcia Finlayson at ac.usneeuq@nosyalnif.aicram.

Evidence-based practice supports among Canadian occupational therapists.

Supports for evidence-based practice (EBP) and research utilization are needed for moving evidence into practice. The purpose of this study was to identify the presence of individual and organizational EBP supports (based on a previous scoping review) and the attitudes toward the supports in a convenience sample of Canadian occupational therapists. A cross-sectional survey was used to collect data from members of the Canadian Association of Occupational Therapists. Data from 368 clinicians (21%) indicated that although factors that have been shown to support EBP, such as student supervision and participation in research and mentoring, were not common practice, attitudes toward these EBP supports were positive. EBP supports, although viewed favourably by clinicians, have yet to be integrated fully into clinical practice. These findings provide researchers with an opportunity to design studies to support clinicians who view EBP in a positive light in integrating evidence into their practice.

Developing the occupational therapy profession through leadership and mentorship: energizing opportunities

To successfully advance the profession of occupational therapy and improve access to our services, we need leadership as well as mentorship strategies and initiatives. Leaders help push boundaries and champion advancements in practice, policy, research and education to develop and promote client-centred, occupation-based enablement. To further develop leadership capacity, we need to put in place multiple, innovative mentorship strategies. This article illustrates some concrete strategies and initiatives undertaken by the Canadian Association of Occupational Therapists (CAOT) to foster mentorship and leadership such as the creation of a new Fellowship program. Our goal in sharing this information is to inspire and encourage occupational therapists worldwide to develop personalized and creative initiatives to foster the role of leaders and mentors.

The Community Development Progress and Evaluation Tool: Assessing community development fieldwork / Un outil pour évaluer les stages en développement communautaire: Le Community Development Progress and Evaluation Tool

Both the Canadian Association of Occupational Therapists (CAOT) and World Federation of Occupational Therapists (WFOT) fieldwork guidelines promote fieldwork experiences that build community capacity. Yet, no existing tool that assesses the unique skills of community development fieldwork could be identified within or outside of occupational therapy. This article describes the development of the Community Development Progress and Evaluation Tool (CD-PET), an assessment of community development fieldwork in occupational therapy. TOOL DEVELOPMENT: The CD-PET was developed in five distinct phases: (a) literature review, (b) identification of a theoretical framework, (c) tool construction, (d) pilot testing, and (e) ongoing refinement. Focus groups yielded input from preceptors and students. Once developed, the assessment was pilot tested with feedback received through an online survey completed by preceptors and students. Key enablement skills identified in Enabling Occupation II provided the foundation for the tool. The CD-PET is a student assessment and learning tool for occupational therapy students and preceptors that supports learning in the key enablement skills that are used in community development fieldwork.

Les représentations de l’expert en habilitation des occupations par des ergothérapeutes superviseurs de stage

The use of occupation-focused language in clinical settings is essential to supervision of student occupational therapists since training is based, at least in part, on the competencies described in The Profile of Occupational Therapy Practice in Canada (Canadian Association of Occupational Therapists, 2007). This article describes how occupational therapists conceptualize the competencies related to the role of "expert in enabling occupation." Qualitative data collected from 56 occupational therapists across eight focus groups were categorized using content analysis through a process of constant comparison. Although the use of occupation-focused language is not widespread, the examples reported in the present study reflect occupation-focused client-centred practice. IMPLICATIONS. The use of occupation-focused language associated with the role of "expert in enabling occupation" can be fostered through discussion groups in the context of academic and clinical setting collaborations.

Work-Related Injuries in Canadian Occupational Therapy Practice

No studies investigate work-related injuries experienced by Canadian occupational therapists. To identify the nature and prevalence of work-related injuries, impact of practice context, cultural and structural factors that influence response to these injuries, and strategies used to manage return-to-work after injury. Members of the Canadian Association of Occupational Therapists were sent an electronic survey in June 2009. Over half of the 600 respondents reported at least one injury episode. Patient-handling and equipment-related incidents accounted for the largest proportion of injuries. Almost one-third of respondents reported being threatened at work or experiencing workplace violence. Injured occupational therapists tended to minimize the extent and impact of their injuries by underreporting incidents and continuing to work after injury. These behaviours may contribute to a failure to recognize the reality of work-related injuries in occupational therapy practice and thereby limit the development of profession-specific, risk-minimization strategies.

Enjeux Entourant la Participation du Personnel Auxiliaire Aux Services d'ergothérapie

With the current scarcity of occupational therapists, the idea of resorting to the use of support personnel in occupational therapy does not have consensus. In fact, occupational therapists are faced with service delivery options for which they are ill-informed. To provide a synthesis of the Canadian and Quebec perspectives pertaining to the possibility for "skill mix" that is to say the participation of support personnel in occupational therapy, and to discuss ways in which they can participate. "Skill mix" would allow an occupational therapist to delegate certain clinical activities to support personnel, so as to assert the full potential of occupational therapy. The Canadian Association of Occupational Therapists and l'Ordre des ergothérapeutes du Quebec recognize the contribution of support personnel and offer markers for the implementation of practices utilizing their services. This paper offers a critical reflection on this topic that is in need of further study.

Occupational Therapists Lead a National Injury Prevention Strategy to Help Older Drivers

As older adults are the fastest growing segment of the driving population, the Canadian Association of Occupational Therapists (CAOT) has taken older driver safety as a key priority. The purpose of this paper is to present the National Blueprint for Injury Prevention in Older Drivers (Blueprint) and its related activities. Since 2006, CAOT has been working on initiatives relating to the National Blueprint for Injury Prevention in Older Drivers. The most recent activities include the launch of informational brochures and a website. The Blueprint and its related activities were developed with the intent to prolong safe driving among older adults in Canada, and to propose future actions to be addressed by all stakeholders interested in older driver safety.

A Systematic Review of Cognitive Stimulation Therapy for Older Adults with Mild to Moderate Dementia: An Occupational Therapy Perspective

In response to the need for effective non-pharmacological approaches for individuals with mild to moderate dementia, cognitive stimulation therapy (CST) interventions aim to optimize cognitive function. The present literature review explored the effectiveness of CST and the congruence of this approach with occupational therapy. Twenty-four databases and 13 "grey" sources were searched. Relevant papers were analysed using the McMaster Critical Literature Review Guidelines, the Modified Jadad Quality Scale and the Oxford Centre for Evidence-based Medicine Levels of Evidence Scale. To establish the congruence of CST with occupational therapy, themes were identified using the International Classification of Functioning and professional values outlined by the Canadian Association of Occupational Therapists. Twelve studies demonstrated a trend towards delayed cognitive decline following CST. This intervention strategy is congruent with occupational therapy values and may provide a useful structural framework to build rehabilitation programmes for this population. Psychometric properties of the McMaster Guidelines have not yet been established, and there is no standardized way to extract quantitative data from this measure. There is a need for further research exploring outcomes of CST interventions within the context of everyday function in individuals experiencing cognitive decline.