Occupational Engagement Research Articles

PILOTING COMMUNICATION TOOLS TO ENHANCE RESIDENT/FAMILY ENGAGEMENT IN NURSING HOMES CARE CONFERENCES

Abstract Nursing home (NH) regulations mandate resident and family engagement in care planning. Additionally, our previous research indicated residents/families want to be involved in care decisions. Care conferences are an important opportunity for residents/families to engage in decision-making. However, there is a lack of guidance or tools to support their engagement and a dearth of research on the most effective approaches to doing so. This study aimed to pilot test a family engagement intervention using resident, family, and staff communication tools that refocus the agenda of care conferences to topics identified as important by residents/families. The feasibility of the intervention was evaluated using a pre/post-implementation design and a preliminary analysis of effects was performed. A total of 16 (n=8 pre; n=8 post-implementation) care conferences (average length ~22min) were observed, audio-recorded, and coded using the Roter Interaction Analysis System and our prior engagement coding schemas. Frequencies of engagement outcomes were compared pre- and post-implementation using Mann-Whitney U and Fisher’s exact tests. Results suggest participants found the intervention valuable for care planning. The agenda and focus of care conferences also shifted to topics residents/families deemed important. Levels of engagement in relationship building and information exchange generally trended in a positive direction. Resident/family agenda setting was significantly higher after implementation (p=0.001). This study provides important insights into enhancing resident/family engagement in decision-making and suggests incorporating communication tools into care conferences may promote resident/family engagement. Future studies using randomized controlled trial designs and larger samples should be conducted to further evaluate effects.

STRATEGIES FOR ENGAGING LOW-INCOME SENIOR HOUSING RESIDENTS IN INTERDISCIPLINARY WELLNESS CLINICS

Abstract Engaging residents in low-income senior housing communities in health and wellness services can be challenging. Despite the significant healthcare needs of residents in senior housing communities, numerous barriers to engaging residents exist including the mistrust of academic or healthcare institutions, stigma about health conditions and treatment, and lack of awareness about services available. To successfully implement Interdisciplinary Wellness Clinics, a participatory approach was used through engagement of stakeholders in the housing communities. The Interdisciplinary Wellness Clinic team worked closely with the Senior Program Manager and the community and regional property managers to establish a plan for implementation. The needs of the communities, day and timing of the clinics that would fit with their schedules, and a plan for ways to invite and engage the residents was developed. Flyers were made by the interdisciplinary team for visits at each community and sign-up sheets for the services provided on any given month. The flyers were posted on bulletin boards within the communities or in a central location for residents to access them by the community property managers. Intermittently, associated with holidays for example, we also held raffles for gifts for anyone who attended the clinic. Regular meetings were held with the property managers at each of the senior housing communities to solicit their input and brainstorm strategies for continued engagement of residents and identify new approaches to increase engagement in wellness clinic services.

THE ASSOCIATION BETWEEN RESIDENT ENGAGEMENT AND QUALITY OF CARE INTERACTION AMONG ACUTE CARE PATIENTS WITH DEMENTIA

Abstract Care interactions are essential to patients with dementia. The purpose of the study was to describe the quality of staff-patient care interactions among acute care (AC) patients with dementia and to test whether the quality of staff-patient care interactions varied by resident level of engagement in the interaction. Specifically, it was hypothesized that controlling for age, cognition, pain, behavior, and function, actively engaged patients would have more positive care interactions with staff compared with passively engaged patients. This secondary data analysis used baseline data from the Function Focused Care for Acute Care (FFC-AC- EIT), an ongoing intervention study. The sample included 286 patients. Descriptive statistics and a multiple linear regression were conducted. The majority of interactions that occurred were positive care (n = 225, 79%). Actively engaged patients had significantly more positive interactions compared to passively engaged patients (b = 1.49, p < .001). Patients with more pain (b = -0.26, p < .001) and behavioral symptoms (b = -0.12, p < .05) had significantly poorer care interactions. Passively engaged patients or patients with pain and behavioral symptoms may be at risk to receive poor quality care interactions. Findings from this study will inform future interventions and training for AC staff to promote positive care interactions among patients with dementia. Managing pain, managing behavior, and supporting resident engagement in care will likely help increase the frequency of positive care interactions in future work.

Experiences of participating in a group-based sensory modulation intervention for mental health service users

Background People with mental health issues often experience difficulties with sensory modulation affecting occupational engagement. Research conducted in inpatient units has shown positive effects of individual sensory modulation interventions, however, research on experiences of group-based interventions in outpatient units is limited. Hence, a group-based sensory modulation intervention was adapted and tested within Swedish mental health outpatient units. Aim To explore the experiences of participating in a group-based sensory modulation intervention for service users in mental health outpatient units. Material and methods This qualitative study involved interviews with 25 informants who had participated in the intervention. The interview data were analysed using reflexive thematic analysis. Results Synthesis of the interviews resulted in one overarching theme of ‘Embodied awareness facilitates improved coping and sense of self’ organised into four themes: (1) ‘Developing embodied awareness and strategies’, (2) ‘Taking control of everyday life’, (3) ‘Creating a stronger sense of self’, and (4) ‘From alienation to belonging’. Conclusion and significance The informants experienced the intervention to provide new embodied coping strategies that had previously been neglected. This understanding may enrich occupational therapy practice in new ways to support service users’ engagement in occupations.

Mothering occupations: A review identifying mothering occupations.

This review aimed to retrieve and collate a list of culturally relevant mothering occupations in the New Zealand context with mothers positioned as experts of their experience. Mothering occupations influence wellbeing and this study aimed to better inform on the daily occupations mothers participate in that contribute to feelings of maternal confidence. Two main sources were used to identify mothering occupations: A systematic search of mothering literature, and participant additions. The first step involved mothering literature being searched, collated and condensed. The second step involved presenting the compiled list of mothering occupations to a panel of mothers for review and to invite additions. Mothers were asked to consider the occupations they participate in that evoke feelings of confidence and mastery in their mothering. Fifteen mothers with infants 12 to 18 months old were recruited, eight contributed to the mothering occupations list. A list of 203 items was collated then condensed based on the inclusion criteria for the participant group, and was tracked in a table. The list was reduced to 36 items. Eight participants added to the mothering occupations list, bringing the total number of items to 47. Mothers indicated through their contributions to the list that some types of mothering occupations are more relevant to them when considering feelings of maternal confidence and mastery. The mothers of this study indicated that connecting with their infant, their culture and nature are of high value to them. Developing a list of culturally relevant and relatable mothering occupations is a significant undertaking, highlighting the subjective experiences of mothers. Mothering occupations are vast and influenced by context. Mothers valuing some types of occupation more in relation to maternal confidence indicates a role for occupational therapy with this population to support with engagement and participation in occupations that promote wellbeing.

Occupational Concepts: An Underutilized Resource to Further Disabled People and Others Being Occupied: A Scoping Review

Background: Being occupied is an important factor in human well-being and ranges from paid and unpaid work to activities of daily living. Various occupational concepts that do not contain health in the phrase such as “occupational justice” are employed to engage with the social barriers people experience in being occupied. The aim of this study was to understand better to what extent the non-health occupational concepts are used in the academic literature to discuss the social barriers disabled people face in being occupied and whether these occupational concepts are used to enrich discussions in areas that impact the reality of occupation in general such as equity/equality, diversity and inclusion (EDI), science and technology governance, well-being and the impact of environmental issues. Methods: a scoping review of academic abstracts employing SCOPUS, the 70 databases of EBSCO-HOST and Web of Science was performed. Results: We found 24,104 abstracts for the 28 occupational concepts we used in general and 624 abstracts in conjunction with disability terms. Of these 28 occupational concepts, “occupational performance” was mentioned the most (in 9739 of the 24,104 and 397 of the 624 abstracts). The next concept “occupational engagement” was already present in one tenth or less. Occupational justice was present in 700 of the 24,104 and 14 of the 624 abstracts. Furthermore, within the 24,104 and 624 abstracts EDI, science and technology governance, environmental topics, and well-being measures were rarely or not mentioned. Most of the 624 abstracts originated from occupational therapy journals. Only 23 of the 624 abstracts originated from journals with “disability”, and none with “disability studies” in the title. Conclusion: Non-health occupational concepts are underutilized in discourses that focus on decreasing the social barriers to being occupied in general and in relation to disabled people, which is a missed opportunity and should be fixed.

Experiences of long-term unemployment from an occupational perspective: A scoping review

ABSTRACT Long-term unemployment impacts a person’s life and opportunities for participating in occupations. Despite the frequent occurrence of short-term unemployment, the proportion of long-term unemployment in Western contexts remains high and is growing, which particularly affects vulnerable groups and thus is an issue of relevance for occupational science. Research into the lived experiences of being long-term unemployed and how it affects daily life is limited, although the need to look more closely into unemployment has been recognized. The aim of this study was to describe people’s experiences of long-term unemployment from an occupational perspective. Due to the dearth of studies in this area, a scoping review methodological framework was used, resulting in nine relevant studies reported in English to be included in a thematic analysis. Results revealed three analytical themes: Experiences of occupations during and due to long-term unemployment; Experiences of occupational obstacles; and Experiences of occupational enablers. The daily lives of long-term unemployed people consist largely of occupations they perform for obligatory reasons, that is, to be eligible for economic subsidies for their survival, and less of anything related to what they want or need. People also experience obstacles that limit and restrict their opportunities of engaging in meaningful occupations. These obstacles could be seen as occupational injustices. Enabling factors also exist, but they are not available or possible for all. Being long-term unemployed changes people’s participation and engagement in occupations. By understanding the experience of long-term unemployment, it is possible to plan and implement better services.

THE IMPACT OF HYDROLOGICAL RESEARCH, MUNICIPAL AUTHORITIES, AND RESIDENTS ON RAINWATER MANAGEMENT IN GDAŃSK (POLAND) IN THE PROCESS OF ADAPTING THE CITY TO CLIMATE CHANGE

Aim of the study: The city of Gdańsk faces changing climatic conditions that result in a higher frequency of extreme weather events. In response to the increasingly frequent appearance of flash floods, scientific research was carried out on changes in the probability of the occurrence of maximum daily precipitation in Gdańsk. The purpose of this paper is to show the role of hydrological research (science), decisions of local authorities and the engagement of residents in the process of adapting Gdańsk to climate change. Material and methods: The hydrological analysis was carried out using rainfall observations from the Gdańsk Rębiechowo station (1974-2021). Log-normal distribution was used as a statistical model for the precipitation probability distribution. To show the role of the city authorities’ decisions, the methodology developed and used by Gdańsk Water company for rainwater management was presented. To emphasize the importance of city residents in climate adaptation process, the methods adopted by city authorities to involve citizens in the advisory process are discussed, namely Civic Panels and the Gdańsk Climate Change Forum. Results and conclusions: The probability distributions of maximum precipitation for different periods were developed, showing a substantial increase of precipitation with a probability of p=1%. Consequently, changes were introduced in the rainwater management practices by the company Gdańsk Water. Being aware of rising flood hazard, Gdańsk City Hall has embraced a plan for adapting the city to climatic changes by 2030. The local authorities decided to involve citizens in the decision-making process. To this end, discussion panels were organized, and the Gdańsk Climate Change Forum was initiated.

The impacts of language decoding and literacy of adults in the cognition of elderly people and its occupational engagement

AbstractBackgroundBrazil has a population of 11 million illiterate individuals. This percentage among Brazilians over 60 equals 18%. In view of this, researchers from the Colleges of Medicine and Education from Federal University of Minas Gerais, Brazil, created Alfabetização e Memória (PROAME) – a project that investigates the relations of late literacy with adults’ psychosocial health. The analysis carried out associated the variables of mental and social health to the literacy process, taking into account memory and language aspects.MethodThis study evaluated 130 illiterate adults living in the city of Belo Horizonte, Brazil. 108 participants fitted all criteria and agreed to undergo this survey. There were 31 men (28,4%) and 78 women (71,5%); their average age was 58,5 (±9,6). Regarding race, 91% were black/brown (83,4%), 11 were white (10,1%) and 1 was indigenous (0,1%). 80 of those participants completed all clinical evaluations, interviews and pedagogical diagnoses before and after our intervention through a period of 7 months. The goal was to qualitatively analyze the participants’ discourse, focusing on evidence of the improvement of their autonomy. This was done by associating aspects from occupational engagement to the so‐called social literacy, which consist in the practical application of reading and writing on previously illiterate adults.ResultThe average age of the participants who completed the evaluations was 58,9 (±9,1), and 64 of them were women (80,0%). Both the interviews (made before and after our intervention) and the pedagogic report of 15 random individuals were analyzed. The results show progress in: their engagement in meaningful activities of daily life; their autonomy, sociability and self esteem; their use of technological applications; their occupational repertoire and their reading and writing abilities.ConclusionA pedagogical intervention made up by specific reading and writing activities, carried out with illiterate adults during 6 months, resulted in benefits for the participants. However, in face of the high illiteracy levels in Brazil, it is necessary a broader engagement in developing studies and literacy programs for adults as political, educational and health goals. By raising the literacy levels, we expect to guarantee the rights of marginalized individuals in Brazilian society.

Chicken vs. Egg? A Lifespan Perspective on Education and IQ in Cognitive Reserve Research

AbstractBackgroundInferences about cognitive reserve and related constructs may be subject to reverse causation, but too often the possibility of reverse causation is not addressed in research on reserve and resilience. A lifespan perspective can shed light on the relationships among education, IQ, and related constructs and what can be concluded about causality with respect to late‐life cognitive and dementia outcomes.MethodWe use general cognitive ability (GCA) to refer to IQ or IQ‐like measures. We provide examples from the literature plus some new findings examining the effect of cognitive reserve on late‐life outcomes and how modifiable factors may impact reserve and resilience effects. Some of the data presented are from genetically‐informative studies that help to clarify issues related to causality.ResultThere is a bidirectional relationship between education and GCA, but the directional influences change across the lifespan. The relationship is not unidirectional in childhood and adolescence, but during that period more education does increase GCA. The effect reaches an asymptote, and in late adolescence and early adulthood, the causal direction shifts toward GCA driving educational attainment. When both education and GCA are in the same model, both longitudinal phenotypic and Mendelian randomization studies show that GCA is a stronger driver of late‐life cognitive and dementia outcomes than education. Appropriately designed studies often support the idea that occupational complexity and engagement in enriching activities are not directly causal, but are downstream effects of GCA. Finally, earlier lifestyle factors can moderate associations between cognitive reserve and late‐life outcomes. For example, favorable early midlife social/health behaviors can offset advanced brain aging in individuals with lower cognitive reserve (i.e., lower young adult GCA).ConclusionThe results have implications regarding interventions to improve cognitive reserve and resilience, and what the balance should be when it comes to resources for early‐ versus late‐life interventions. The primary direction of causal effects raises questions about how and, importantly, when during the lifespan, increased education, cognitive enrichment/training programs (which may be thought of as a type of education), or other lifestyle factors are likely to increase reserve or resilience, thereby improving cognitive function and reducing dementia risk.

National assessment of obstetrics and gynecology and family medicine residents’ experiences with CenteringPregnancy group prenatal care

ObjectiveTo examine family medicine (FM) and obstetrician-gynecologist (OB/GYN) residents’ experiences with CenteringPregnancy (CP) group prenatal care (GPNC) as a correlate to perceived likelihood of implementing CP in future practice, as well as knowledge, level of support, and perceived barriers to implementation.MethodsWe conducted a repeated cross-sectional study annually from 2017 to 2019 with FM and OB/GYN residents from residency programs in the United States licensed to operate CP. We applied adjusted logistic regression models to identify predictors of intentions to engage with CP in future practice.ResultsOf 212 FM and 176 OB/GYN residents included in analysis, 67.01% of respondents intended to participate as a facilitator in CP in future practice and 51.80% of respondents were willing to talk to decision makers about establishing CP. Both FM and OB/GYN residents who spent more than 15 h engaged with CP and who expressed support towards CP were more likely to participate as a facilitator. FM residents who received residency-based training on CP and who were more familiar with CP reported higher intention to participate as a facilitator, while OB/GYN residents who had higher levels of engagement with CP were more likely to report an intention to participate as a facilitator.ConclusionEngagement with and support towards CP during residency are key factors in residents’ intention to practice CP in the future. To encourage future adoption of CP among residents, consider maximizing resident engagement with the model in hours of exposure and level of engagement, including hosting residency-based trainings on CP for FM residents.

Engagement in meaningful occupations for people with dementia: A valuable source for maintaining the quality of life in institutional settings

Engagement in meaningful occupations for people with dementia: A valuable source for maintaining the quality of life in institutional settings

The Meaning of Roles and Routines for Families Experiencing Homelessness in the COVID-19 Pandemic

This study explored the experiences of mothers experiencing homelessness amidst the COVID-19 pandemic. Semi-structured interviews were completed with nine mothers and analyzed using thematic analysis. Themes uncovered during the interviews highlighted sources of motivation and perseverance, additional and ongoing impacts of COVID-19, sources of further mental anguish, and unmet needs challenging roles and routines. Notably, the identity of being a mother and the value placed on that role significantly influenced their daily routines and engagement in meaningful occupations. Occupational therapy practitioners can utilize these findings to deliver contextually sensitive care tailored to the unique circumstances and immediate requirements of this population.

Having a Voice: Resident Perceptions of Supervision, Decision-Making and Patient Care Ownership

ObjectiveHeightened resident supervision due to patient safety concerns is increasingly common in pediatrics and may leave residents with fewer opportunities for independent decision-making, a diminished sense of autonomy, and decreased engagement. This may ultimately threaten their development into competent clinicians. Understanding how pediatric residents experience supervision’s influence on their involvement in decision-making, engagement in patient care, and learning is crucial to safeguard their transition to independent practice. In relation to supervision, our research investigated: 1) how residents navigated their involvement with clinical decision-making and 2) how opportunities to make clinical decisions influenced their engagement in patient care and learning. MethodsFrom 2019–2020, we recruited 38 pediatric residents from three different programs for a qualitative interview-based study. Through a constructivist stance, we explored clinical decision-making experiences and performed thematic analysis using an iterative and inductive process. ResultsWe identified three themes: 1) Residents perceived having autonomy when they had space to make independent decisions, regardless of supervisor’s presence; 2) Patient care ownership resulted from having a voice in a variety of contributions to patient care; and 3) Supervisors’ behaviors modulated patient care ownership and thereby residents’ sense of feeling heard, their engagement in patient care, and their learning. ConclusionsOur results suggest that focusing on patient care ownership may better fit with current learning environments than aiming for independence and autonomy. They provide insight on how, in the pediatric learning climate of enhanced supervision, supervisors can preserve resident engagement in patient care and learning by augmenting patient care ownership and ensuring residents have a voice.

Climate Change and Occupational Therapy: Meeting the Urgent Need for Adaptation, Mitigation, and Resilience

Climate change may be the most pressing existential threat to human health and wellbeing in the twenty first century. In this paper, the authors provide context and critique on barriers to climate action in the United States and other high-income countries, including the profit-driven approach to health, consumerism, and the climate change countermovement. The reciprocal connections between occupational engagement and climate damage are examined from a lens of collective and irresponsible occupations and subsequent accountability. The authors propose the United Nations’ Sustainable Development Goals as a basis for recommendations occupational therapy practitioners could implement within the priorities of adaptation, mitigation, and resilience.

Guidelines for Contributors to AJOT.

The American Journal of Occupational Therapy (AJOT) is the official journal of the American Occupational Therapy Association (AOTA). The primary mission of AJOT is to publish peer-reviewed research examining the effectiveness and efficacy of occupational therapy practice so that occupational therapy professionals can make informed, evidence-based decisions about best practice. In addition, the journal aims to publish (1) research documenting the reliability and validity of occupational therapy instruments; (2) studies demonstrating a relationship between occupational engagement and the facilitation of community participation and health; and (3) articles that provide a forum for scholars to debate professional issues that affect education, practice, and research. This Guidelines for Contributors to AJOT is also available at the American Journal of Occupational Therapy manuscript submission website, ScholarOne (go to https://mc04.manuscriptcentral.com/ajot and click "Instructions & Forms" in the upper right). These guidelines are published annually in a supplement to the journal; any changes implemented in the interim are published to the Author Guidelines page on the AJOT website (go to https://research.aota.org/ajot/pages/authorguidelines).

Development of a Multi-site Curriculum for Inequities in Newborn Care (CINC) Informed by Pediatric Resident and Community Engagement.

Inequities in health care are a well-identified contributor to adverse outcomes in neonates of vulnerable populations. 1 2022 March of Dimes Report Card. Accessed March 8, 2023. 〈https://www.marchofdimes.org/report-card〉 Google Scholar , 2 Warren M.D. Hirai A.H. Lee V. Accelerating Upstream Together: Achieving Infant Health Equity in the United States by 2030. Pediatrics. Published online January. 2022; 3e2021052800https://doi.org/10.1542/peds.2021-052800 Crossref Scopus (2) Google Scholar , 3 Sigurdson K. Morton C. Mitchell B. Profit J. Disparities in NICU quality of care: a qualitative study of family and clinician accounts. Journal of Perinatology. 2018; 38: 600-607https://doi.org/10.1038/s41372-018-0057-3 Crossref PubMed Scopus (61) Google Scholar Societal and institutional inequities rooted within implicit biases and racism result in variable quality of care in the nursery, such as differences in time spent skin-to-skin with infants, clinical resource allocation based on racial background, and a lack of motivation to establish a therapeutic alliance with families who have differing social and cultural needs. 3 Sigurdson K. Morton C. Mitchell B. Profit J. Disparities in NICU quality of care: a qualitative study of family and clinician accounts. Journal of Perinatology. 2018; 38: 600-607https://doi.org/10.1038/s41372-018-0057-3 Crossref PubMed Scopus (61) Google Scholar Most significantly, this inequitable care results in the increased mortality of non-Hispanic black and Hispanic infants as compared to infants of non-Hispanic white backgrounds. 4 National Vital Statistics Reports Volume 69, Number 7 July 16, 2020, Infant Mortality in the United States, 2018 : Data From the Period Linked Birth/Infant Death File. Google Scholar In light of these inequities, the Academic Pediatrics Association (APA) implemented initiatives rooted in active anti-racism to dismantle oppressive power structures across pediatric organizations. 5 Cohen A. et al. Changing Who Has a Seat and Voice at the Table: How the Academic Pediatric Association is Responding to Systemic Racism. Academic Pediatrics. 2022; 22: 352-355https://doi.org/10.1016/j.acap.2022.01.002 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar This urgent commitment to action is further supported by the Association of Pediatric Program Directors (APPD) which maintains that anti-racism involves actively dismantling racism in all that we do. 6 Blankenburg B. et al. Dismantling Racism: Association of Pediatric Program Directors’ Commitment to Action. Academic Pediatrics. 2020; 20: 1051-1053https://doi.org/10.1016/j.acap.2020.08.017 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar Focus groups of trainees at 4 Bay Area academic medical centers explored gaps in education on newborn health inequities to best understand how to support providers in actively practicing anti-racism in clinical care. Trainees spotlight inequities in their rotations, but feel helpless to address them given a lack of action-based tools, education on inequities, protected time for reflection, and faculty role-modeling. 7 Hume P. , Bowers K. , Robertson L. , et al. Residents’ Perspectives on Neonatal Health Inequities to Guide an Innovative Curriculum. Poster Presentation presented at: APPD; March 2023; Atlanta, Georgia. Google Scholar Given these highlighted gaps, we sought to provide our pediatrics faculty and trainees with action-oriented education to address inequities.

Integration of occupant voting systems and smart home platforms for collecting thermal feedback in indoor environments

The assessment of indoor thermal comfort is increasingly shifting from statistical to personalized models and therefore there is a growing interest in collecting feedback on occupants’ perceptions and preferences. Occupant Voting Systems (OVS) are emerging as a widely used tool in Post Occupancy Evaluations (POE) but the level of occupants’ interaction with these data collection devices, their scientific accuracy, and the integration of feedback data with building management systems, especially in residential buildings, still need to be further explored. This paper presents a study conducted on five dwellings, located in Italy, where smart home switches were used as feedback buttons to collect the thermal sensation of the occupants. These buttons were integrated into an open-source smart home platform, MOQA. The developed system is described in its technical features, highlighting the amount of information collected, the response rate and its interoperability with smart home systems. The results show that OVSs still have limitations in terms of occupant engagement and it is still rather complicated to correlate ratings with environmental variables. However, an easier integration, here described, with smart home systems would partially overcome these problems, turning the OVS into a useful tool for both users and research purposes.

Leisure and social occupational choice within nursing home facilities in Ireland: Residents perspectives

Background National standards for nursing homes in Ireland require that residents are offered a choice of recreational and stimulating activities to meet their needs and preferences. Aims/Objectives To investigate residents’ perceptions of leisure and social occupational choice in nursing homes in Ireland to determine if occupational choice is facilitated. Materials and method Qualitative-descriptive design – nursing home residents completed two semi-structured interviews that explored their experiences of leisure and social occupational engagement. Results Two overarching themes with six associated sub-themes emerged. From residents’ perspectives, social and leisure occupational choice was dependent on: Environmental factors (nursing homes’ Cultural, Social, Physical, and Temporal Environments) and Personal factors (residents’ Health Status and Personal Attitudes). Conclusion The cultural environment had the most significant influence on residents’ leisure and social occupational choice, highlighting the importance of person-centred care within nursing homes, to promote occupational choice. Resident’s health status was also identified as a contributing factor. Significance Occupational therapists could play a critical role in supporting the leisure and social occupational choices of nursing home residents by developing residents’ skills, educating staff and adapting tasks and the environment to limit/reduce occupational deprivation.

An Easily Implemented, Inexpensive, Useful Novel Surgical Intern Wellness Initiative

Determine whether use of reflective questions asked on a twice monthly basis is a useful addition to our intern wellness curriculum, with a goal of longitudinal development. Prior studies have demonstrated the use of reflection in processing educational experiences toward professional growth at both the medical student and resident level. During the first year, every 2 weeks, the 13 interns were asked and answered 2 reflective prompts by email. Their responses went to a single faculty member and were then blinded for analysis. The second year of the program, prompts were discussed by participants in a closed group setting. Participation was voluntary. The questions fell into 6 major categories: role expectations, role assessment, role affirmation, role reflection, emotional self-assessment, work-life integration, and boundaries. Thematic analysis of the responses was performed using an inductive approach by 2 independent expert reviewers. Brown General Surgery Residency Program, academic years 2021 to 2022 and 2022 to 2023. Use of reflective questions is a valuable tool as part of an intern wellness curriculum and can be easily implemented. It is inexpensive, does not require a huge time commitment, and is easily adaptable to a program's specific needs. It encourages developing surgeons to recognize and share in their emotions as they encounter the new and stressful experiences inherent in residency and may help to prevent burnout. Sustained participation through the year and robust responses suggest good resident engagement and acceptance of the program.