Canadian Model Of Occupational Performance Research Articles

Telehealth interventions in occupational therapy with older adults: Results from a scoping review targeting better health promotion.

Telehealth interventions have the potential to enhance access to care and improve efficiency while reducing the burden on patients. Although telehealth interventions are well accepted and adopted in physical therapy, their usage in occupational therapy for older adults is less common, and limited information exists regarding their setting and context. To provide an inventory and synthesis of telehealth interventions in occupational therapy for older adults. For published studies on telehealth-based occupational therapy interventions in older adults between 2000 and 2022, six databases were reviewed. Data extraction and analysis were guided by the taxonomies developed by Tulu, McColl and Law and informed by the Canadian Model of Occupational Performance and Engagement. Twenty-three studies on telehealth interventions in occupational therapy for older adults were identified, mostly from North American authors (n = 11; 47.8%) and randomised clinical trials (n = 9; 39.1%). Most participants had a health problem (n = 20; 87.0%), mainly stroke (n = 9; 39.1%). Interventions focussed primarily on symptom management education (n = 12; 52.2%) of community-dwelling adults with health conditions, using videoconferencing systems or applications (n = 14; 60.7%). Interventions were delivered from the healthcare centre (n = 6; 26.1%) to the person's home (n = 18; 78.3%) synchronously (n = 19; 82.6%). About one third (n = 8; 34.8%) of the studies specified the therapist's location. Published studies on telehealth interventions in occupational therapy with older adults have mainly focussed on the synchronous training and education of participants using videoconferencing systems or applications. According to these studies, the scope of interventions is limited and could be expanded, for example, through occupational development and environmental modification. To better understand and describe best practices in the use of telehealth in occupational therapy, future studies should provide more details about the interventions performed, the technology used and the environmental settings of the therapist.

Management of chronic pain by occupational therapist: A description of practice profile.

Background. Current state of knowledge regarding occupational therapy's contribution to chronic pain (CP) management has evolved over the past decade. Yet, has this been transferred to clinical practice? Purpose. Describe the current state of practice of CP management-specific occupational therapy. Method. An online survey was sent to occupational therapists working with CP patients. Findings. Of the 90 respondents (11.9%), 42.2% worked in primary care and 52.2% in secondary care. They reported that their primary role aimed at enabling occupation and providing vocational rehabilitation. The Canadian Model of Occupational Performance and Engagement (CMOP-E) (87.8%), semi-structured interview (86.7%), and education on energy conservation (65.6%) and postural hygiene (60.0%) were the most frequently reported conceptual model, assessment, and intervention methods. Implications. Results illustrate the diversity of current occupational therapy practice in CP management and suggest opportunities for improvement to ensure best practices are adopted, by emphasizing an occupation-based vision of health and well-being.

What makes older adults feel good?

Background and aimTo inform health promotion interventions, there is a need for large studies focusing specifically on what makes older adults feel good, from their own perspective. The aim was to explore older adults’ views of what makes them feel good in relation to their different characteristics.MethodsA qualitative and quantitative study design was used. Independently living people (n = 1212, mean age 78.85) answered the open-ended question, ‘What makes you feel good?’ during preventive home visits. Following inductive and summative content analysis, data was deductively sorted, based on The Canadian model of occupational performance and engagement, into the categories leisure, productivity, and self-care. Group comparisons were made between: men/women; having a partner/being single; and those with bad/good subjective health.ResultsIn total, 3117 notes were reported about what makes older adults feel good. Leisure activities were the most frequently reported (2501 times), for example social participation, physical activities, and cultural activities. Thereafter, productivity activities (565 times) such as gardening activities and activities in relation to one’s home were most frequently reported. Activities relating to self-care (51 times) were seldom reported. There were significant differences between men and women, having a partner and being single, and those in bad and good health, as regards the activities they reported as making them feel good.Discussion and conclusionsTo enable older adults to feel good, health promotion interventions can create opportunities for social participation and physical activities which suit older adults’ needs. Such interventions should be adapted to different groups.

Occupational therapy services in primary care: a scoping review.

To examine and describe the current evidence about occupational therapy services in primary care. Interprofessional primary care teams have been introduced to support the changing demographics and provide more comprehensive and coordinated care. Occupational therapists have the opportunity to play an important role in this expanding area of practice. To do so, occupational therapists must develop roles built on evidence and a clear understanding of the care delivery context. A scoping review was conducted based on the scientific and grey literature. Studies that described or examined the occupational therapy role with clients (individuals, groups, communities, populations) of all ages, conditions or occupational issues in a primary care context and that presented or referred to an occupational therapist working in a primary care setting were included. Studies were excluded if they were not in English or French. The Canadian Model of Occupational Performance and Engagement was used to chart the data. 129 articles were identified, with 62 non-research and 67 research-focussed articles. A total of 268 assessments and 868 interventions were identified. The top interventions offered by occupational therapists were referring to/advocating for/coordinating/linking to and navigating community services (n = 36 articles), chronic disease management (n = 34 articles)/self-management education (n = 28 articles), health promotion (n = 30 articles) and falls prevention (n = 27 articles). The predominant focus in the literature is on adult and older adult populations.

Engajamento ocupacional: alguns pressupostos para informar a terapia ocupacional

Abstract Occupational engagement has been conflated with other concepts, such as participation, active occupational performance, and therapeutic engagement. This critical review will discuss occupational engagement as a unique concept that describes a form of involvement in doing that does not require performance and foregrounds the subjective-affective and cognitive experiences of doing. We present some attributes of occupational engagement and the implications for the lack of clarity of this concept within the literature. The difference between occupational engagement and therapeutic engagement is discussed by comparing the foundational tenets of the Model of Human Occupation (MOHO) and the Canadian Model of Occupational Performance and Engagement (CMOP-E). Through one illustrative narrative, we discuss how occupational engagement can be understood as a phenomenon that is not performance-dependent and has different levels of engagement. To conclude, we point out some assumptions about occupational engagement that can inform occupational therapy research and practice.

Stress Management Programme on the Stress of Chiang Mai University Students: A Pilot Study

Stress is the problem that is often found in students due to their higher expectations and the changes happening at the personal, social and environmental levels. The main objective of the present study was to develop and analyze the results of a stress management programme conducted for students at Chiang Mai University, Chiang Mai, Thailand. This was quasi-experimental research, conducted according to the one-group plan. The student initiatives included five Chiang Mai University students, selected through purposive sampling after passing the initial screening. They were evaluated by completing the basic information questionnaire of the Suanprung Stress Test-20 (SPST-20) and the Suanprung Stress Test-60 (SPST-60) before and after the programme. The tools used in this study were developed from the conceptual framework according to the Canadian Model of Occupational Performance and Engagement (CMOP-E) model. The researcher used the breathing technique using the diaphragm, and muscle relaxing technique. The concept of emotional awareness was conducted according to the four foundations of mindfulness, and cognitive behavioral therapy (CBT) with group process in occupational therapy. The results of the study revealed that the sample population had significantly lower stress levels after joining the stress management programme. However, it was observed that there was no difference in the susceptibility to stress levels before or after joining the programme. In general, this stress management programme can be undertaken by other students of Chiang Mai University to monitor their stress levels.

Забезпечення участі клієнтів в реабілітаційному процесі з позиції Канадської моделі виконання занять

The purpose of the study is to define aspects of the patient's participation in the rehabilitation process and to define a conceptualization that improves the participation of the client. Materials and methods. The main research method is the method of analysis, which has been used to comprehensively review and evaluate the participation of the client in the rehabilitation process and an overall assessment of the structure that could improve the participation of the client. Results and discussion. One of the goals of the world community development is to preserve and strengthen human physical, social, mental and spiritual health. However, humanity has faced global environmental, economic, social and moral problems. The genetic burden of mankind, the ecological crisis, natural disasters and man-made disasters, wars and local conflicts and social instability lead to an increase in the need for rehabilitation. Therefore, in recent decades, the role of both the client and relatives in the rehabilitation process has changed, taking into account the participation of the client. In this paper, we consider the process of rehabilitation taking into account the participation of the client, as a variant of the client-oriented structure, the Canadian Occupational Performance Measure is evaluated primarily from the point of view of clients, occupational therapists and members of the rehabilitation team. The main goal is to maximize the participation of patients in the rehabilitation process. The emphasis of the occupational therapist is on the participation of the patient in determining outcomes and goals. Through years of practice and experience, occupational therapists have developed a model for client-centered practice in occupational therapy, namely the Canadian Model of Occupational Performance. And the result of using this model is the development of the Canadian Occupational Performance Measure, which has become a good tool for obtaining a result based on the client’s perception. Conclusion. Implementing a customer-centric approach is easier when a structured approach is used, but this is not enough. Participation and motivation of all team members are required, as well as support during the implementation period. Management support, knowledge of the underlying theory, time for discussion and reflection, as well as the opportunity to develop a personal interview technique, which indicates important factors for successful implementation, are also required

Occupational Therapy Theory and School-Based Filial Therapy: Intervention Rationale and Formulation.

Background: Emotional-behavioural problems in children present a barrier to engagement and participation in school occupations. Applying practice theory is an essential process to explore the impact of clinical problems and to orient clinical thinking to the domain of occupation. Purpose: Occupational therapy practice theory and frameworks are applied to the formulation of School-Based Filial Therapy, a viable treatment response to emotional-behavioural problems in children. Key issues: Bowen family systems theory, the Occupational Therapy Practice Framework IV and the Canadian Model of Occupational Performance and Engagement are applied to intervention formulation. Implications: School-Based Filial Therapy engages the dynamic interaction of the person, the occupations he/she engages in and the environment via therapeutic medium of play. It is consistent with the Occupational Therapy Practice Framework IV and the Canadian Model of Occupational Performance and Engagement and provides new possibilities as an intervention for occupational therapists working in children's mental health.

Історичний розвиток, порівняння і використання заняттєво-орієнтованих моделей ерготерапії

The purpose of the study is to make a comparative analysis of occupational therapy models based on Person-Environment-Occupation-Performance Model, Canadian Model of Occupational Performance, and competent environmental activities (Care of People with dementia in their Environments), as well as to provide a brief historical review of the development and formation of models in occupational therapy. Materials and methods. The main research method is the method of analysis, which is used to comprehensively consider and describe the historical development, comparison and using activity-oriented models in occupational therapy. Results and discussion. Selecting more effective activity-oriented models requires comparing occupation models, making recommendations for selecting and combining these models in practice, and providing a systematic approach to integrating occupational engagement models with reference systems for guidance, evaluation, and intervention. All models follow a common line of thinking, and this reinforces theories. The choice of model to be used to support the practice will ultimately depend on the therapist's knowledge. Understanding these models will provide the therapist with the knowledge to view the individual as a person and to guide the therapist to clinical considerations. Models are not identified with a specific group of customers, but Canadian Model of Occupational Performance is suitable for situations where a client-oriented approach is required. The Care of People with dementia in their Environments model with a flexible approach will support the therapist's reasoning in situations where clients are unable to solve the problem or the therapist requires more guidance. It is worth noting that at the moment, a very popular practice, which is focused primarily on the client, is the basis for interaction with people in all countries. During occupational therapy, the therapist should move smoothly from one section to another to provide adjustment and improvement. In fact, success in occupational therapy is seen as an important element, because it is believed that it increases self-esteem and motivation to accept new challenges. Conclusion. The analysed models of occupational therapy are based on humanistic values, indicating that occupational therapy distinguishes classes as a positive interaction between man and the environment to influence the general well-being. All three discussed models provide a clear structure of the occupational therapy process. The practical value of the research in this area is to identify and explain opportunities for the most effective use of occupation-focused models

Optik Disk Hipoplazili Bir Çocukta Kanada Okupasyonel Perfomans Modeli’ne Göre Ergoterapi Müdahalesinin Etkinliğinin İncelenmesi: Olgu Çalışması

Optic disc hypoplasia (ODH) is a non-progressive condition that can develop unilaterally or bilaterally, with decreased retinal nerve fiber count and normally developing retinal tissue. Decreased vision, visual field changes and defects in color vision mau be seen in individuals with ODH. A 3-year-old male pediatric case with ODH in the right eye was included in the study. The Canadian Model of Occupational Performance (CMOP) was used for the holistic evaluation of the individual, environmental and ocupational factors of the case, and the Visual Perception Reference Frame was used for the intervention application. The problem areas within the scope of CMOP were determined as difficulty in holding cutlery and therefore eating by spilling food, inability to distinguish small pictures on paper, weakness in perception of color and figure-ground, and weakness in gross motor skills (standing on one leg, jumping in place). The short-term goals in the 8-week intervention plan, development of visual discrimination (recognition, matching, classification) skills, development of color perception and figure perception, increasing the level of independence in eating with the help of auxiliary equipment (thickened cutlery); the long-term goals were determined as the development of figure-ground perception, the development of visual attention and the development of visual motor integration. With the target spesicif occupational therapy intervention program, the case was able to eat independently with the help of thickened cutlery, to be able to combine simple figures, large pieces and brightly colored puzzle pieces, to increase the time to stand on one leg, and to jump on two legs. There is a need for more evidence-based occupational therapy studies including visual perception studies in diagnoses affecting the visual field such as ODH.

Occupational therapy for people with mask anxiety undergoing radiotherapy

Up to one third of people with head and neck cancer undergoing radiation therapy experience mask anxiety. However, there is limited literature guiding the role of health professionals, including occupational therapists, in managing mask anxiety. This study aimed to explore the content of occupational therapy interactions with people who have identified mask anxiety. A cohort of 20 participants with identified mask anxiety engaged in semi-structured interviews with occupational therapists. Theoretical thematic analysis and the framework provided by the Canadian Model of Occupational Performance and Engagement (CMOP-E) were employed to explore the content of occupational therapy interactions with people experiencing mask anxiety. Theoretical thematic analysis identified 13 relevant themes with 49 codes relating to the interaction between participants and occupational therapists. Analysis of these interactions identified the occupational therapy role to be holistic and multifaceted. The cognitive, affective, and institutional components of the CMOP-E were dominantly explored by the occupational therapists with participants. Occupation, spirituality, and the cultural environment were either not addressed or minimally discussed with participants. The management of mask anxiety during radiation therapy is a novel area of practice for occupational therapists. The results of this study suggest that the occupational therapy profession explores a range of factors with the person undergoing radiation therapy with mask anxiety, and that the CMOP-E model can be used to guide these interactions. Future research is required to further define this role and its efficacy in managing mask anxiety.

Goals of children with unilateral cerebral palsy in a brain stimulation arm rehabilitation trial.

To explore relationships between category classifications for children's rehabilitation goals, outcomes, and participant characteristics. Children with hemiparetic cerebral palsy due to perinatal stroke rated self-selected goals with the Canadian Occupational Performance Measure (COPM) and completed the Assisting Hand Assessment (AHA) and Box and Block Test (BBT), at baseline and 6 months, in a randomized, controlled 10-day neuromodulation rehabilitation trial using repetitive transcranial magnetic stimulation. Goals were classified with the Canadian Model of Occupational Performance and Engagement and the International Classification of Functioning, Disability and Health. Analysis included standard linear regression. Data for 45 participants (mean age 11y 7mo, SD 3y 10mo, range 6-19y, 29 males, 16 females) on 186 goals were included. Self-care goal percentage corresponded with baseline BBT by age (standardized ß=-0.561, p=0.004). Leisure goal percentage corresponded with baseline BBT (standardized ß=0.419, p=0.010). AHA change corresponded with productivity goals (standardized ß=0.327, p=0.029) and age (standardized ß=0.481, p=0.002). COPM change corresponded with baseline COPM and age by AHA change (p<0.05). Younger children with lower motor function were more likely to select self-care goals while those with better function tended to select leisure goals. Functional improvement corresponded with older age and productivity goals. COPM change scores reflected functional improvement among older children. Children chose functionally and developmentally appropriate goals. Consequently, children should be free to set goals that matter to them. Children in a brain stimulation trial chose divergent upper extremity functional goals. Younger children with lower ability chose more self-care goals. Children with higher ability chose more leisure goals. Older children's goal ratings reflected objective functional motor gains. Children chose goals appropriate to their function and level of development.

Looking into the Content of the Canadian Occupational Performance Measure (COPM): A Danish Cross-Sectional Study.

Purpose To examine the content validity of the Danish version of the Canadian Occupational Performance Measure (COPM-DK). Materials and Methods This cross-sectional study was performed in a hospital and a community rehabilitation centre. The content validity of the COPM was assessed by relating the clients' prioritized occupational performance issues (OPIs) to the conceptual model of the Canadian Model of Occupational Performance and Engagement (CMOP-E) and the levels of the Taxonomic Code of Occupational Performance (TCOP). Six occupational therapy lecturers participated in classifying the OPIs using the TCOP. Results A total of 112 clients from a regional and community-based rehabilitation participated. The 56% regional participants came from a hospital's hand and knee surgery department. The remaining 44% participants came from a community-based rehabilitation centre with in- and outpatient departments. There were 44% males, with a mean age of 65.2 years. They prioritized 495 OPIs, of which 40% concerned self-care, 32% productivity, and 28% leisure. The prioritized OPIs were divided into a total of 224 different OPIs. There were significant differences in which areas were prioritized in the various population groups. Of the OPIs, 64.3% could be classified into the TCOP levels of occupation and activity, i.e., 1/3 of the OPIs were related to tasks and actions, and thus beyond the scope of the COPM. The interrater agreement of the OPI classification was only fair (kappa 0.3). Conclusion The content validity of the COPM seems to depend on how and with which clients it is administered. Caution must be taken to secure OPIs on the higher levels of the TCOP, while maintaining the clients' right to nominate OPI preferences. Therefore, an introductory course and on-going support are recommendable. Bearing this in mind, the COPM seems useful to identify individual clients' prioritized OPIs in a Danish context.

57 Improving Patient Centred Care On An Acute Older Persons Unit: A Quality Improvement Project

Abstract Topic Improving patient centred care through the implementation of an occupational therapy assessment that is framed by ‘gold standard’ intervention of comprehensive geriatric assessment (CGA) and Canadian Model of Occupational Performance and Engagement (CMOP-E). Occupational therapy staff had limited knowledge of the CGA process. Intervention Implementation of an adapted occupational therapy assessment form that reflects the CMOP-E and addresses the domains of the CGA; using the Plan, Do, Study, Act methodology to support a sequential cycle of change over a three month period (Dec 2019 – Feb 2019). The form also addresses patient centred care and personalised care planning. An education session was undertaken with occupational therapy staff to increase the knowledge and understanding of the CGA process resulting in more effective participation in multidisciplinary team (MDT) meetings. Improvement The above intervention resulted in successful implementation of an adapted occupational therapy assessment form for older people addressing the domains of the CGA within the CMOP-E framework and encompassing patient centred care. Occupational therapy staff had increased confidence with their knowledge of the CGA and participation in MDT meetings and patients felt more involved in their care. Discussion It is possible to have both an evidenced MDT model of practice and a uni-professional occupational therapy model working alongside each other to provide patient centred care and effectively address the complex needs of frail, older people.

Occupational Therapy Interventions and Outcomes Measured in Residential Care: A Scoping Review

Aims: This scoping review identified the interventions and outcome measures used by occupational therapists working with older adults in residential care facilities.Methods: A five-step approach was used to retrieve and screen studies from five databases. Included studies described an occupational therapy intervention with older adults living in residential care facilities, were published in English, between 1990 and 2019 in a peer-reviewed publication. Data were mapped using domains of the Canadian Model of Occupational Performance and Engagement.Results: Findings from 51 studies revealed that occupational therapists most commonly implemented occupations as the intervention with little focus on aspects of the environment. Outcomes predominantly measured person factors and less commonly occupational performance and engagement.Conclusion: The exploration of the past foci of practice and measurement of therapeutic impact enables occupational therapists to consider how their practice can enhance future occupational performance and engagement of residential care facility residents.

Occupational therapy in rehabilitation of complex patients: protocol for a superiority randomized controlled trial

ABSTRACTPatient-centered, interprofessional occupational therapy is feasible in complex patients in the early phase of rehabilitation, and it contributes to meet needs in the domains of self-care, productivity, and leisure, promoting social role. We planned this single-center single-blind two-arm parallel individual patient randomized controlled trial, to verify the superiority of interprofessional experimental occupational therapy (EOT) compared to standard rehabilitation (SR) in producing higher levels of patients’ social participation assessed by the Reintegration to Normal Living Index. EOT is a patient-centered, hospital/home-based rehabilitation intervention based on the Canadian Model of Occupational Performance and Engagement. This appropriately powered study will provide evidence regarding the effectiveness of EOT on the recovery of social participation in the critical transition of complex patients from hospital to the home setting.

An exploratory study of older persons’ perceptions of engaging in line dancing classes

ABSTRACT With the population of older adults expected to continue growing, understanding the benefits of leisure occupations will be vital in facilitating their active engagement. Line dancing is one such leisure occupation. A small, qualitative study was undertaken to identify the perceived benefits of engaging in line dancing. Semi structured interviews were conducted with four female participants aged 65-87 years. A deductive approach to content analysis was employed using the framework of the Canadian Model of Occupational Performance and Engagement. The participants reported that line dancing offered an opportunity for meaningful occupation in retirement and had positive outcomes for their physical health, mood, cognition, and spirituality. These findings corroborate existing evidence supporting engagement in active leisure occupations as key to promoting the mental health and well-being of older adults.

The Lived Experiences of People with Substance Use Issues Seeking Care from a Rapid Access Clinic: An Occupational Perspective

Addiction is a crisis affecting many Canadians. Rapid Access Clinics (RAC) are a novel means of providing immediate care, but research on how they improve functional well being in people with substance use issues (PSUI), which is intended to prevent relapse, is limited. In this pilot study, interviews were conducted with clients attending an RAC for PSUI in Toronto, Canada. A deductive thematic analysis was developed from the interviews, focusing on components of the Canadian Model of Occupational Performance and Engagement. Various subthemes related to model components have been identified and discussed, which could guide future research on supporting recovery of PSUI.

Development of a Consensus-Based OT Treatment Template for Veterans With Combat-Related Posttraumatic Stress Disorder (PTSD)

Abstract Date Presented 04/04/19 This poster presents a model OT treatment template for veterans with PTSD. Utilizing a modified Delphi method of consensus attainment, the study surveyed Canadian OTs to identify treatment template components. The resulting treatment template is present-focused, occupation-focused, occupation-based, and built upon the Canadian Model of Occupational Performance and Engagement, Behavioral Activation, and Acceptance and Commitment Therapy. Primary Author and Speaker: Steven Gerardi

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.