Occupational Therapy Department Research Articles

Design Attributes for Adaptive Tool’s Innovation in Rehabilitation Setting: A Scoping Research

Innovation in rehabilitation represents creative design which involve adaptive tool (AT) for patients in the occupational therapy department. Earlier, an online survey on innovative activities among OT has been conducted on thirty Malaysian occupational therapists. Findings indicate that 80% of the occupational therapists innovate new tools during rehabilitation. The purpose of this study is to identify design attributes of AT as issues highlighting the low rate of AT usage based on several factors; non-compliance, uncomfortable design, insufficient instruction and training, and also due to user’s personality i.e. lack of personal acceptance and confidence in using AT. A scoping review of 20 relevant literatures related to the usage, effectiveness and barriers of AT are drawn widely from the rehabilitation journal in the period between 1968 – 2018, and from design psychology journals to support the findings. A summary of each themes that has been highlighted from this review are AT prescribe factors, AT equipment factors and AT education factors. This review suggests that future research for creative activities in rehabilitation shall be provided with design consideration in order to bring better AT creation. The implications of these findings for the effects of innovation are discussed.

Occupational therapists’ perceptions of service transformation towards contemporary philosophy and practice in an acute specialist paediatric hospital

IntroductionThe acute occupational therapy department at a specialist paediatric hospital in metropolitan Australia is undergoing a service transformation to increase their alignment with contempor...

Editorial Genetic Rites and Authorship in Journals

The research we will present aims to further develop a discussion started in the master’s degree research entitled Publishing mediation in scientific communication: a study of two human sciences journals, focusing on a fundamental issue of the current times: the constitution of authorship in scientific communication. In order to investigate that issue, we aim to examine the defining conditions of authorship in the production of scientific papers in different areas of knowledge. Therefore, the corpus is composed by four important journals nationwide, Geousp: espaço e tempo, from the Postgraduate Program in Geography of the FFLCH-USP, Cerâmica Industrial, from the Brazilian Ceramic Association, Cadernos Brasileiros de Terapia Ocupacional, from the Occupational Therapy Department of UFSCar, and Revista do Instituto de Estudos Brasileiros (Rieb), from the Brazilian Studies Institute of USP. Having the French discourse analysis as theoretical framework, we take into account the relationship between the author and other co-enunciators in the editorial genetic rites (Salgado, 2011), also considering the place of the author as a creative paratopy (Maingueneau, 2014). At the event, we will discuss more precisely the current stage of the research, focusing on the methodology of data collection, in which we used interviews with different professionals involved in the publishing of the mentioned journals.

29 Adapting Dementia and Delirium Awareness Training to a Rehabilitation Setting

Abstract Background The patient profile in a Dublin rehabilitation hospital has changed in recent years to include older adult rehabilitation alongside orthopaedic rehabilitation. A snapshot audit completed by the occupational therapy department on one day in 2018 demonstrated that 64% of patients had an assessment score indicative of a cognitive impairment. A subjective gap in knowledge regarding dementia care and a misunderstanding of the ability of people with dementia to engage in rehabilitation was identified. It was imperative that dementia awareness training was provided with a particular focus on modifying rehabilitation techniques to cater for these patients. Methods A dementia care committee was established with an Educational Development subgroup responsible for addressing dementia and delirium awareness training. Educational material was received from the field of occupational therapy, nursing, medicine, pharmacy and dietetics. The programme was accredited by the Nursing and Midwifery Board of Ireland. A focus group was completed pre/post formulation of the presentation with various departmental representatives. Feedback provided was used to inform and finalise the training content. Results Sessions are completed once monthly. One hundred and seven participants to date have attended. Ten-point Likert scales are completed pre and post training. Data from the Likert scales were analysed revealing on average a 24.4 % increase in knowledge of dementia, a 27.6% increase in awareness of the impact of dementia on function and a 23.3% increase in confidence in caring for a patient with dementia. Highest contingent of staff members trained were household and catering staff (19%) nursing staff (18%), and health care attendants (13%). Conclusion This essential training is ongoing with thirty per cent of staff trained to date. The objective is for all staff to complete this training for enhanced care and rehabilitation for all patients with dementia. It will also aim to review treatment for all patients with cognitive impairment so unique rehabilitation programmes can be tailored.

Research on the Recognition of Freshmen in the Department of Occupational Therapy about Occupational Therapist's Job

Research on the Recognition of Freshmen in the Department of Occupational Therapy about Occupational Therapist's Job

A Photovoice study of user experiences of an occupational therapy department within an acute inpatient mental health setting

IntroductionPeople admitted to acute mental health wards benefit from access to activities, but occupational therapy departments that are separate to wards have not been investigated from the user ...

Feasibility and clinical experience of implementing a myoelectric upper limb orthosis in the rehabilitation of chronic stroke patients: A clinical case series report.

Individuals with stroke are often left with persistent upper limb dysfunction, even after treatment with traditional rehabilitation methods. The purpose of this retrospective study is to demonstrate feasibility of the implementation of an upper limb myoelectric orthosis for the treatment of persistent moderate upper limb impairment following stroke (>6 months). Methods: Nine patients (>6 months post stroke) participated in treatment at an outpatient Occupational Therapy department utilizing the MyoPro myoelectric orthotic device. Group therapy was provided at a frequency of 1–2 sessions per week (60–90 minutes per session). Patients were instructed to perform training with the device at home on non-therapy days and to continue with use of the device after completion of the group training period. Outcome measures included Fugl-Meyer Upper Limb Assessment (FM) and modified Ashworth Scale (MAS). Results: Patients demonstrated clinically important and statistically significant improvement of 9.0±4.8 points (p = 0.0005) on a measure of motor control impairment (FM) during participation in group training. It was feasible to administer the training in a group setting with the MyoPro, using a 1:4 ratio (therapist to patients). Muscle tone improved for muscles with MAS >1.5 at baseline. Discussion: Myoelectric orthosis use is feasible in a group clinic setting and in home-use structure for chronic stroke survivors. Clinically important motor control gains were observed on FM in 7 of 9 patients who participated in training.

Anatomy Observational Outreach: a Multimodal Activity to Enhance Anatomical Education in Undergraduate Students

Undergraduate students often have difficulty relating Anatomy and Physiology (A&P) course contents to their future careers, leading to a lack of interest and degree completion. The purpose of the Anatomy Observational Outreach (AOO) was to raise students' interest in STEM and Allied Health fields, help students make the connection and application between the information presented in A&P labs and real‐world activities, as well as to effectively encourage students to pursue graduate degrees in Allied Health Careers. The outreach consisted of 100 undergraduate A&P students from Texas Woman's University's biology, nursing, kinesiology, health studies, physical therapy, and occupational therapy departments. The methodology consisted of a 15‐minute orientation, graduate student panel Q&A session, 30‐minute cadaver and organ prosections, 30‐minute Anatomage table demonstration, anatomical models, and x‐rays. To measure the impact of the outreach, students were given identical 10‐question pretests and post‐tests, of which each question accounted for 1 point. The results of the students' post‐tests demonstrated a 98% increase in anatomical knowledge and an 84% increase in interest in graduate degrees in STEM and Allied Health fields. Moreover, 81% of students felt all of the activities and tools were useful, while 19% concluded the cadaver prosections were the strongest sole educational aids. It was also found that of the 100 students in attendance, 55% were ethnic minorities and 90% were gender minorities. We conclude that the AOO yielded distinguished results in the depth, retention, and application of A&P knowledge, along with increased interest, excitement, and motivation for pursuing tertiary STEM and Allied Health degrees among undergraduates. The future goal for the AOO is to establish a biannual “Anatomy Week” to encourage and inspire students and minority scholars to further their tertiary education in STEM and Allied Health fields.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Economic evaluation of simulated and traditional clinical placements in occupational therapy education.

This economic evaluation complements results of the randomised controlled trial that established non-inferiority of the learning outcomes of a one-week simulated clinical placement (SCP) in occupational therapy qualifying degrees in comparison to an equivalent traditional clinical placement (TCP). This companion study presents detailed cost analyses of two placement alternatives and a cost-benefit study to assess the value for money of SCP. An economic evaluation of simulated versus traditional placements has not previously been conducted in Australia. Nine SCP/TCP rounds were conducted by six Australian universities. Costs were collected using study-specific instruments. Public health sector costs were sourced from available literature. Willingness-to-pay for SCP/TCP was estimated using both a Discrete Choice Experiment and a Contingent Valuation method. These methods were employed to assess a comparative 'value' of SCP/TCP from the perspective of heads of occupational therapy departments (N=28), who were asked to put a monetary value on the broader range of benefits associated with SCP/TCP. From the universities' perspective the average cost per student ranged from AUD$460 to AUD$1511 for simulated and AUD$144 to AUD$1112 for traditional placement. From the health care sector perspective, the difference in costs favoured simulated placements for four implementations and traditional placements for five. In the Discrete Choice Experiment respondents preferred traditional rather than simulated placement and would pay additional AUD$533. The estimated monetary value of simulated placements from a contingent valuation ranged from AUD$200 to AUD$1600. For universities that procure TCPs predominately at public health care facilities and sustain high administrative overheads, the SCP program could be a cost-saving alternative. From a broader value-for-money perspective, respondents favoured TCP over SCP, yet placed importance on placement availability and opportunity to demonstrate competence for students during the placement. Results should be interpreted with caution and further research with larger sample sizes is required.

Integrative biopsychosocial model – factor contributing to an increased quality of life in patients with psychiatric disorders

The “Doctor Gheorghe Preda” Psychiatric Hospital of Sibiu is the first psychiatric hospital founded in south-eastern Europe, with over 150 years of rich history and tradition, being established in 1863. Over time, at the head of the institution, have been several medical personalities, including Dr. Pandy, who developed “The Pandy Reaction”, and Dr. Preda, whom the hospital is currently named after. The interest towards complementary activities and medico-socio-administrative development was manifested early by involving the patients in administrative-household actions, the initiation of social inclusion programs such as “Family care” and the establishment of the “Medical-pedagogical school near the Mental and Nervous Illness Hospital of Sibiu”. These actions can be considered the prototype of today’s ergotherapy, having an important evolution continuously adapted to the needs of patients with psychiatric pathology and to the standards of a society in perpetual development. Currently, within The “Doctor Gheorghe Preda” Psychiatric Hospital, complementary activities are carried out both within the hospital and in the Mental Health Center, which aims to improve the quality of the patient’s life by supporting social and family reintegration. These include the ergotherapy and occupational therapy department, which comprises painting, clay sculpture, handcraft, ergoNet and ergocrafting workshops, but also melotherapy, complementary therapy through theater, music auditions and dance therapy. In addition there are multiple projects established with the help of The Psychiatric Hospital Association of Sibiu. Thus, the tradition of developing patient-centered activities continues by adapting according to his needs, having as primary objectives the regaining of daily abilities, social inclusion and increasing the quality of life.

CE: Original Research: Patient Handling and Mobility Course Content: A National Survey of Nursing Programs.

Faculty from baccalaureate and associate's degree nursing programs in the United States were invited via e-mail to complete a 64-item survey questionnaire, which was accessible through an online link. Participants were also invited to send documents related to SPHM course content to the research team. Faculty from 228 baccalaureate and associate's degree nursing programs completed the questionnaire. Most curricula included outdated manual techniques, taught reliance on body mechanics to reduce the risk of musculoskeletal injuries, and made use of nonergonomic aids such as draw sheets. Elements of SPHM in the curricula were less common, and nearly half of the respondents didn't know whether their affiliated clinical facilities had an SPHM program. The survey results suggest many possibilities for improvement-such as partnering with faculty in physical and occupational therapy departments, clinical partnering, and working with equipment vendors-to better incorporate evidence-based SPHM principles and practices into nursing curricula.

Stroke upper extremity rehabilitation: Effect of bilateral arm training

OBJECTIVES: The main objective of this study is to investigate the effect of bilateral arm training on upper extremity motor and functional recovery in stroke hemiparesis. METHODOLOGY: Twenty-eight patients with chronic stroke, attending the Department of Occupational Therapy, National Institute for the locomotor disabilities, Kolkata, West Bengal, India, participated in a single-blinded randomized pretest and posttest control group experimental study. Patients were randomized over two intervention groups; experimental group received bilateral arm training (n = 14) and the control group received an equally intensive conventional treatment program (n = 14). Each group received intensive training for 1 h/day, 5 days/week, and for 6 weeks. Pretreatment and posttreatment measurements were taken for upper extremity motor ability, functional ability, and functional use of the upper extremity using Fugl-Meyer Assessment of Physical performance (FMA-upper extremity section), Action Research Arm Test, and Motor Activity Log, respectively. RESULTS: Bilateral arm training (P = 0.01) group showed statistically significant improvement in upper extremity functioning on Action Research Arm Test score in comparison to the conventional therapy group (P = 0.33). The bilateral arm training group also had greater improvements in FMA and Motor Activity Log score compared to conventional therapy group. CONCLUSION: Bilateral arm training can be used as a better treatment choice for improving upper extremity function in comparison to conventional therapy.

Outcome of individualized task related circuit training program on walking ability in a 9 years old female child with Moya-moya disease: a case report

Walking difficulty of childhood stroke due to Moya-moya disease needs functional rehabilitation to recover to a normal state of walking. Task related circuit training program is one of the rehabilitation programs that improve functional strength of lower limb muscles to aid in improved walking ability. This case report aimed at investigating the effectiveness of task related circuit training on walking ability of a 9 years old female child diagnosed with stroke due to Moya-moya Disease. The child was attending Indoor rehabilitation services, Department of Occupational Therapy, National Institute for Locomotor Disabilities, Kolkata, West Bengal. Baseline measurement of the child’s lower limb muscle strength, 10m walk test, 6-minute walk test was done prior to the circuit training. After baseline measurement, the child was explained the sequence of tasks to be used in circuit training and was given individualized task related circuit training for a session of 45 minutes, 3 days per week for 08 weeks. Post training the child showed improvement in lower limb muscle strength, 10m walk test (walking speed) and 6-minute walk test (walking endurance), thereby an improved walking ability.

A case study of the development of occupational therapy at St. Patrick’s Hospital Dublin, 1935-1969

PurposeThis paper aims to examine the relationship between psychiatry and occupational therapy in Ireland through a case study of the development of the occupational therapy department in St. Patrick’s Hospital, Dublin, from 1935 to 1969. Patronage by psychiatrists was an important factor in the professionalisation of occupational therapy internationally.Design/methodology/approachDocumentary sources and oral history interviews were analysed to conduct an instrumental case study of occupational therapy at St. Patrick’s Hospital from 1935 to 1969.FindingsThe research identified key individuals associated with the development of occupational therapy at St. Patrick’s Hospital, including psychiatrist Norman Moore, occupational therapy worker Olga Gale, occupational therapist Margaret Sinclair, and social therapist Irene Violet Grey. Occupational therapy was considered by the hospital authorities to be “an important part in the treatment of all types of psychiatric illness” (Board Meeting Minutes, 1956). It aimed to develop patient’s self-esteem and facilitate social participation. To achieve these objectives, patients engaged in activities such as dances, arts and crafts, and social activities.Originality/valueThis study has highlighted the contributions of key individuals, identified the links between occupational therapy and psychiatry, and provided an insight into the development of the profession in Ireland prior to the establishment of occupational therapy education in 1963. Occupational therapy practice at St. Patrick’s Hospital from 1935 to 1969 was congruent with the prevailing philosophy of occupational therapy internationally, which involved treatment through activities to enhance participation in society.

Effect of reactive postural adjustment and anticipatory postural adjustment in improving sitting balance in children with spastic diplegic cerebral palsy

Background: The purpose of this study was to examine the effect of providing activities which give internal and external perturbations on the static and dynamic trunk balancing abilities of children with cerebral palsy and generate some postural response in the trunk of these children with cerebral palsy. Objectives: To find out the effect of activities providing reactive postural adjustments and anticipatory postural adjustments, in improving sitting balance, in children with spastic diplegic cerebral palsy. Study Design: Pre- and posttest study design. Methods: Children with spastic diplegic cerebral palsy who were fulfilling the inclusion criteria were selected by convenient sampling from the department of occupational therapy, with a sample size of 60. Written informed consent was obtained from the guardians. Ethical permission was taken from the institute. Pediatric balance scale and pediatric reach test were used as instruments for measuring improvement in sitting balance. A frame for reaching and a platform for external perturbation were designed for the study. Therapy for both groups was given for 1 h/session. Children in the experimental group were exposed to 15 min each of reactive postural adjustment and anticipatory postural adjustment along with 1 h of conventional occupational therapy, whereas children in the control group were exposed to 1 h of conventional occupational therapy. Results: The results of the Wilcoxon signed-rank test of pediatric reach test were significant for experimental and control groups (P = 0.004; 95% confidence interval [CI]: 5.34–10.67 and P = 0.014; 95% CI: 4.16–7.89, respectively). There was also significance of the results of the Wilcoxon signed-rank test of pediatric balance scale in the experimental and control groups (P = 0.025; 95% CI: 8.98–11.12 for experimental group and P = 0.005; 95% CI: 8.09–9.54 for control group), with the level of significance set at P ≤ 0.05. This shows that the results were significant for experimental group as well as control group. Furthermore, the results of the Mann–Whitney U-test showed that Z = −3.507 for pediatric balance scale is more, making it more sensitive to capture changes in balances in children than that for pediatric reach test with Z = −3.905 (P = 0.002; 95% CI: 4.14–9.00 for pediatric balance scale and P = 0.001; 95% CI: 7.56–9.70 for pediatric reach test), with the level of significance set at P ≤ 0.05. Conclusion: It can be concluded that activities providing reactive postural adjustment and anticipatory postural adjustment can be used to enhance and improve sitting balance among children with spastic diplegic cerebral palsy, so that they can have the functional balance in sitting, to safely meet the demands of everyday life.

Effects of an oral-pharyngeal motor training programme on children with obstructive sleep apnea syndrome in Hong Kong: A retrospective pilot study

BackgroundThis study aimed to investigate the effects of an oropharyngeal motor training programme on children with Obstructive Sleep Apnea Syndrome (OSAS) in Hong Kong.MethodsIn this retrospective study, we reviewed the outcomes of 10 children with OSAS who had received an oropharyngeal motor training programme in Occupational Therapy Department of an acute hospital in Hong Kong over a 1-year programme. Each participant attended an individual oropharyngeal motor training programme plus a follow-up session after 2 months. The training programme consisted of 10 individual mobilization exercises involving the orofacial and pharyngeal area for 45 minutes. Each exercise had to be repeated for 10 times. Three outcome measures were chosen to study the effectiveness of the training programme including tongue strength, tongue endurance level and orofacial function. Tongue strength and tongue endurance level were assessed using the Iowa Oral Pressure Instrument (IOPI). The Nordic Orofacial Test-Screening (NOT-S) Assessment was used to assess the orofacial function. Seven out of 10 participants completed the training programme and attended the follow-up session after two months.ResultsThe tongue strength and the scores of NOT-S of the 7 participants were found to have significant improvement after training. However, there was no significant difference in tongue endurance level.ConclusionThe findings of this study support the role of occupational therapist in oromotor training modalities to improve the respiratory function for children with OSAS in Hong Kong. Copyright © 2017, Hong Kong Occupational Therapy Association. Published by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Dorsal capsulodesis associated with arthoscopy-assisted scapholunate ligament reconstruction using a palmaris longus tendon graft

ObjectivesTo measure the quality of life, the time to work return, and clinical, functional, and radiographic parameters of patients treated with dorsal capsulodesis associated with scapholunate (SL) reconstruction, assisted by arthroscopy. MethodsFrom January 2015 to September 2016, 14 adult patients with SL dissociation underwent surgical treatment with the SL reconstruction procedure assisted by arthroscopy, using the new technique proposed in this study. All patients were assessed by the occupational therapy department at regular intervals after surgery and performed the same sequence of rehabilitation. The parameters analyzed were: range of motion (ROM), Disability of the Arm, Shoulder, and Hand (DASH), visual analog scale (VAS), and radiographic analysis to visualize the pre- and postoperative SL gap and the pre- and postoperative dorsal intercalated segment instability (DISI) deformity the. The complications and the time to return to work activities were described. ResultsThe follow-up time was 12 months (3–17). The ROM averaged 321° (96.9% of the normal side). VAS was 1.79/10 (1–6). DASH was 6.50/100 (1–30). The time to work return work was 4.42 months (2–17). As for complications, one patient developed SLAC, and underwent four-corner fusion one year after ligament reconstruction. Currently, he has experienced pain relief, with a functional range of motion of the wrist, and has not yet returned to professional activities.The preoperative SL gap was 4.29mm (2–7); in the postoperative period, it was 1.79mm (1–4). The DISI deformity was present in ten patients with SL angle>70° (preoperative) and it was corrected after surgery, in all patients. SLAC stage I was identified in a patient. Arthroscopy was performed in all cases. The SL instability was classified as Geissler grade III in four cases and as grade IV in ten cases. ConclusionThe new approach (dorsal capsulodesis associated with SL reconstruction, assisted by arthroscopy) presented in this study is safe and effective in the treatment of SL dissociation, since it offers satisfactory clinical, radiographic and functional results, showing low rates of complications. For patients, it allows the return to their social and professional activities, and increases their life quality.

Emergency Departments and Occupational Therapy: Integration, Unscheduled Care and Over-crowding

Introduction: Globally, over-crowding within Emergency Departments is becoming a serious concern (Walker et al 2016) impacting on patient safety (Pines et al 2011) and work-related stress (The College of Emergency Medicine 2013; Lavoie et al 2011). One reason for over-crowding is that, in addition to treating urgent medical and surgical conditions, Emergency Departments act as the ‘front doors’ of hospitals, and people wait for admission to acute-care (Walker et al 2016), a process known as unscheduled care (The Royal College of General Practitioners 2011). Occupational therapists are well-placed to address some of the issues around unscheduled care (Mearns et al 2008). This is because they assess and treat people directly in the Emergency Department and determine whether a discharge directly home is feasible (Mearns et al 2008). The College of Occupational Therapists recently claimed that 70% of patients referred to occupational therapy in this way were discharged directly (College of Occupational Therapists 2016). This presentation claims a role for occupational therapists in Emergency Departments in terms of their potential to reduce over-crowding. It will report on the findings from two linked studies: - a critical review of the literature (James et al 2016) and a qualitative study (James et al 2016a). Methods: A systematic search was performed for occupational therapy in the Emergency Department using database platforms, internet search engines and grey sources. Critical analysis of each record was undertaken and synthesised. An Interpretative Phenomenological Analysis framework was applied to the qualitative study. Nine occupational therapists with experience of working in the Emergency Departments were recruited from across Scotland. Individual, semi-structured interviews were audio-recorded and transcribed verbatim. Interview transcripts were analysed line-by-line and interpreted using Interpretative Phenomenological Analysis methods. Results: The systematic search returned 23 potentially relevant papers of which 16 met the criteria for further inclusion and seven were critically analysed. Not all study sample sizes were small, but variable methodological quality meant current evidence can only be taken into professional practice with caution. Findings from the qualitative study led to two over-arching themes. Theme one captured the experience of occupational therapists working in Emergency Departments. Theme two encapsulated what it was like to enter and establish a new role. Discussion: There are good reasons why occupational therapists are well-placed to address issues of over crowding in the Emergency Department. However, based on current evidence, there can only be a limited understanding of its role and efficacy. There is a need for large-scale, well designed research studies of occupational therapy within emergency care.

Safer transitioning Optimising Frail Elderly Patients Care From Hospital to Home

Safer transitioning Optimising Frail Elderly Patients Care From Hospital to Home

Screening of Chronic Alcoholics for Cognitive Impairment Using Montreal Cognitive Assessment—Occupational Therapy Perspective

Rationale:Chronic alcoholics suffer from cognitive impairment, thereby affecting their ADL and work performance.Objectives:The objective was to screen chronic alcoholics for cognitive impairment and assessing affectations in various components of MoCA. Early screening to help them from further deterioration in ADL and work.Materials and Methodology:In this case control study, 50 chronic alcoholics, males, age group 30–50 years, abstaining for more than two months, referred to outpatient De-addiction Occupational Therapy department of K. E. M. Hospital, Mumbai were screened using MoCA (Hindi) and compared with their age matched control group.Results:All patients showed mild cognitive impairment (MCI) on MoCA, irrespective of pattern and frequency of drinking. Their average mean score in MoCA test and control group was 21.02 and 26.03, respectively. The domains more affected were language, abstraction and memory, thus affecting their performance in ADL and work. Results were analyzed using unpaired ‘t’-test...