Occupational Engagement Research Articles

Rural-urban disparities in healthcare factors and long-term health outcomes in individuals with pediatric-onset spinal cord injury.

Adults with pediatric-onset spinal cord injury (SCI) require long-term care and demonstrate elevated risk of secondary health conditions and psychosocial challenges. Medical providers are typically found in more populous and wealthy areas, resulting in a relative lack of providers in rural areas, a discrepancy even more pronounced among specialty providers. As a result, those who reside in rural regions potentially have unmet medical needs, representing a significant public health concern. The purpose of this study was to assess differences between rural and urban-residing participants with pediatric-onset SCI in factors affecting healthcare usage (e.g., employment, income, access to private insurance, community integration) and long-term healthcare outcomes (i.e., secondary health conditions and psychosocial functioning). Data were gathered from an ongoing study examining long-term outcomes of adults with pediatric-onset SCI. Participants (N = 490) completed measures of sociodemographics, injury characteristics, and medical outcomes. Participant zip codes were classified as rural or urban using the ProximityOne database based on the ZIP Code Tabulation Areas from the 2020 census. Individuals residing in rural regions report lower levels of education, income, employment rates, private health insurance, and community integration (mobility, occupation, and social engagement), as well increased incidence of pressure injuries, urinary tract infections, hospitalizations, bowel incontinence, sleep difficulties, and perceived physical health. No differences in incidence of psychosocial functioning were identified. Mitigating identified disparities and obstacles to treatment of SCI due to residing in rural environments would result in important improvements in treatment outcomes and future prevention efforts of secondary health complications, improving the overall health of adults with pediatric-onset SCI.

Occupational participation and engagement of woman experiencing premenstrual syndrome: A qualitative study

Introduction: Premenstrual syndrome is commonly experienced by women of reproductive age and encompasses somatic, psychological and behavioural symptoms that recur during the luteal stage of menstrual cycle and resolves during or after menstruation. Although premenstrual syndrome has gained growing interest in recent years, the experience of women living with premenstrual syndrome has not yet been explored from an occupational perspective. Method: This qualitative study an used exploratory and descriptive design to gain a deeper understanding of the lived experience of women with premenstrual syndrome through an occupational lens. Data were collected using semi-structured interviews with four women living with premenstrual syndrome symptoms. Each interview was transcribed verbatim and thematically analysed. Findings: Three themes were identified: (1) occupational disturbance, (2) social impairment and occupational disengagement, and (3) the importance of self-awareness to engage in occupations. Women with premenstrual syndrome symptoms experienced difficulties that impacted their ability to engage in occupations including self-care, productivity and leisure, interfering with their occupational routine and interpersonal relationships. A level of awareness was considered important to manage premenstrual syndrome symptoms. Conclusion: The findings of this study are relevant to understanding the impact of premenstrual symptoms on daily living and for tailoring future interventions to address the occupational needs in women with premenstrual syndrome.

A System Dynamics Model of Urban Rainstorm and Flood Resilience to Achieve the Sustainable Development Goals

The combined effects of climate change and accelerated urbanization have increased the risk of urban rainstorm and flood disasters, which seriously affects the achievement of the Sustainable Development Goals (SDGs) in cities. Improving urban flood resilience is one of main ways to deal with flooding. This study established an urban rainstorm and flood resilience model to sort out the behavioral mechanisms of multiple subjects (government, flood control department, residents and media) and the internal action mechanisms from different dimensions (economic, social, natural, infrastructure and information) of urban rainstorm and flood resilience using system dynamics approach, and to investigate the urban rainstorm and flood resilience in Xi'an city. The results show that the damage losses rate reduced by 44.44%, 10.8%, 9.48% and 3.37% by improving flood resilience, resident engagement, government attention degree and information construction level, respectively. The degree of improvement of urban rainstorm and flood resilience varied for six development scenarios when predict flood resilience. The development pattern can be divided into the beginning phase, preparation phase and development phase, and three improvement strategies are proposed based on the development pattern of flood resilience. This study helps to provide refined strategies for urban rainstorm and flood resilience assessment construction.

The mediational role of individual and organizational factors in the work engagement and occupational stress relationship

This study investigated the mediating role of individual and organizational factors on the relationship between work engagement and occupational stress among males and females, junior, mid-level and senior staff members in the banking sector using a cross-sectional survey. Employing a quantitative study, data was gathered from 288 banking staff. Findings show a significant positive relationship between work engagement and age, educational level, one’s position in an organization and organization tenure, and a significant negative relationship between work engagement and gender and occupational stress. There were age, educational level and gender differences in work engagement. There were differences in the level of work engagement in relation to organizational tenure. One’s position, educational level and gender significantly predicted work engagement but age and organization tenure did not. However, educational level, age, one’s position and organizational tenure mediated the relationship between occupational stress and work engagement. These findings have implications for employee well-being and satisfaction and productivity in the organizational setting.

Participation in Everyday Occupations Among Rohingya Refugees in Bangladeshi Refugee Camps

Abstract Importance: Bangladesh hosts a large number of Rohingya refugees from Myanmar. Living in refugee camps, the Rohingya refugees face challenges in everyday occupations because of violence, limited opportunities, and corporal punishment by the community. Objective: To explore how Rohingya refugees experience participation in everyday occupations while living in temporary refugee camps in Bangladesh. Design: Phenomenological study to describe, understand, and interpret the meanings of life experiences in particularly adverse conditions. Setting: Rohingya refugee camps in Bangladesh. Participants: Fifteen purposively selected participants from the camps. Outcomes and Measures: In-depth semistructured interview, as well as participant and environmental observations. Researchers used line-by-line data analysis to capture quotations and patterns using interpretive phenomenological analysis, which included establishment of initial codes, interpretation, determining selected codes, and categorization. Results: The research identified four major themes—(1) mental stress, sleep disturbances, and daily occupations; (2) adjustment to inconsistent daily activities; (3) complex relationships and limited social roles that decreased occupational engagement; and (4) involvement in precarious occupations that exacerbated severe health risks—and four subthemes—(1) fragmented family relationships, (2) formation of new relationships to perform social roles, (3) inconvenient and inaccessible living conditions, and (4) continuation of unlawful work to survive. Conclusions and Relevance: Rohingya refugees should receive comprehensive health and rehabilitative care because of their perilous mental health conditions, precarious occupations, and lack of trustworthy relationships with family and neighbors. What This Article Adds: Rohingya refugees experience imbalanced, deprived, and maladapted occupations in refugee camps. Suggestions to improve their lived experience with further peer support programs may help them participate in occupation-based rehabilitation services to facilitate their social integration.

Occupational Therapists' Beliefs and Experiences Managing Chronic Pain, Wellness, and Occupational Performance.

Chronic disease prevention, health, and wellness have become primary practice areas for occupational therapy. Occupational therapists (OTs) in pain rehabilitation are established as essential members of comprehensive and multidisciplinary pain management teams, focusing on increasing occupational performance through participation. This study's purpose was to investigate OTs' experiences managing chronic pain and to explore OTs' effectiveness in supporting clients' wellness and occupational performance through interventions. Eleven OTs (n = 11) participated with three themes emerging on chronic pain, interventions, and holistic teams. Findings suggest that OTs are successful at treating chronic pain, supporting wellness and occupational performance when their interventions are health-promoting, and clients are enabled to take an active role in their chronic pain management. This study demonstrates the critical impact OTs can have in multidisciplinary teams on clients' outcomes, such as increased occupational performance, wellness, and quality of life (QOL) through engagement in meaningful occupations.

Building Resident Quality Improvement Knowledge and Engagement Through a Longitudinal, Mentored, and Experiential Learning-Based Quality Improvement Curriculum.

Quality improvement (QI) training is an essential component of resident medical education and a part of the ACGME core competencies. We present our residency's evidence-based QI curriculum, which outlines key components identified in the literature for successful QI education. Our curriculum included a mandatory five-part longitudinal educational series during ambulatory education sessions for second-year residents. Modeled after the Institute for Healthcare Improvement model for improvement and taught by a chief resident, our curriculum introduced residents to key QI concepts through case-based, just-in-time didactics and applied experiential learning via concurrent resident-led longitudinal QI projects. Residents received structured, multilayer mentorship from a faculty mentor in their field of interest and the chief resident of quality and patient safety. Their work-in-progress projects were presented to faculty QI experts and institutional leadership for additional feedback and mentorship. Since 2016, a total of 234 internal medicine residents have completed our QI curriculum and developed 67 QI projects, which have been presented at various local, regional, and national conferences. In the 2 most recent academic years, Quality Improvement Knowledge Application Tool Revised (QIKAT-R) scores significantly increased from 4.6 precurriculum to 6.3 postcurriculum (p < .001). A longitudinal, experiential, and mentored QI curriculum teaches residents QI skill sets through incorporating mechanisms associated with successful educational initiatives and adult learning theory. Our QIKAT-R results and project output show that our curriculum is associated with improved trainee QI knowledge and systems-level improvements.

Development of Classifier of Engagement in Occupation With Machine Learning (CEOML) for Quantifying Context

In the evaluation of engagement in occupation, it is important to access the qualitative data, including the client context. However, there are no tools capable of quantifying such data. The purpose of this study is to develop a Classifier of Engagement in Occupation with Machine Learning (CEOML) that is capable of quantifying context and evaluating engagement in occupation through the application of Natural Language Processing (NLP) and to validate the model performance. A supervised machine learning approach was adopted in this study for the development of clinical artificial intelligence, and it was conducted based on the Minimum Information about Clinical Artificial Intelligence Modeling. The research object was the Twitter data comprising 1,542 tweets posted over a one-week period, beginning on April 1, 2020. Bidirectional Encoder Representations from Transformers, an NLP model, was fine-tuned to learn a dataset labeled for the status of engagement in occupation. The model performance was validated using indicators (sensitivity, specificity, positive predictive value, negative predictive value, F-measure, and area under the curve of receiver operating characteristic curve), Cohen’s weighted kappa coefficient, and the attention level of the model to the text. The CEOML demonstrated suitable model performance, on par with the Canadian Occupational Performance Measure. High interpretability of the CEOML was also confirmed based on its level of attention. The developed CEOML can quantify and classify problems of engagement in occupation based on the client context.

Scoping review of methods for engaging long-term care residents living with dementia in research and guideline development

ObjectivesTo describe: (1) methods used to engage long-term care (LTC) residents living with dementia in research and guideline development; (2) the outcomes of engagement; and (3) barriers and facilitators to...

How Consistent are International Rotations Between Plastic Surgery Training Programs?

All 101 integrated and independent plastic surgery program directors/coordinators were asked to participate. The survey identified the requirements and details of existing international rotations. In total, 57 programs responded (56% response rate) to the survey. An estimated 54% of all programs offered international rotations to their residents, and 94% of these programs obtained institutional approval. Additionally, 69% of these programs have received national approval. Institutional requirements for programs to provide international rotations vary significantly across institutions, which results in disparate experiences for residents and poses potential risks to international partners. This study will help promote transparency regarding international rotation requirements and better equip faculty to enhance international rotations that cater to the needs of the institution, residents, and most importantly, the host countries.

Job crafting and boredom as mediators of the relationship between occupational self-efficacy and work engagement

Previous studies have examined the impact of occupational self-efficacy and work engagement, but studies investigating job crafting and boredom as mediators of the relationship between occupational self-efficacy and work engagement among traffic control officers are lacking. Therefore, the present study tested the indirect effects of job crafting and boredom on work engagement, alongside the sequential effects of occupational self-efficacy, job crafting, and job boredom on work engagement. Time- lagged data were collected at three points of measurement among 320 traffic control officers from South-eastern Nigeria. Results of the multiple serial mediation analysis indicated that occupational self-efficacy positively predicted higher work engagement by activating higher job crafting behaviours. We also found an indirect effect of job boredom,which suggests that a higher level of occupational self-efficacy reduces job boredom via job crafting which increased work engagement. Results of the study supported the sequential mediating effects of occupational self-efficacy, job crafting and job boredom on work engagement. These results imply that occupational self-efficacy and job crafting are resources that can be used to relief employees’ feeling of boredom about their job, which in turn enhances work engagement. The limitations of the study and suggestions for further research were highlighted.

Low-Cost Technology-Aided Programs for Supporting People With Motor, Visual, and Intellectual Disabilities in Functional Forms of Occupation and Communication: Proof-of-Concept Study.

People with motor, visual, and intellectual disabilities may have serious problems in independently accessing various forms of functional daily occupation and communication. The study was aimed at developing and assessing new, low-cost technology-aided programs to help people with motor or visual-motor and intellectual disabilities independently engage in functional forms of occupation and communication with distant partners. Two programs were set up using a smartphone interfaced with a 2-switch device and a tablet interfaced with 2 pressure sensors, respectively. Single-subject research designs were used to assess (1) the first program with 2 participants who were blind, had moderate hand control, and were interested in communicating with distant partners through voice messages; and (2) the second program with 2 participants who possessed functional vision, had no or poor hand control, and were interested in communicating with their partners through video calls. Both programs also supported 2 forms of occupational engagement, that is, choosing and accessing preferred leisure events consisting of songs and music videos, and listening to brief stories about relevant daily topics and answering questions related to those stories. During the baseline phase (when only a conventional smartphone or tablet was available), 2 participants managed sporadic access to leisure or leisure and communication events. The other 2 participants did not show any independent leisure or communication engagement. During the intervention (when the technology-aided programs were used), all participants managed to independently engage in multiple leisure and communication events throughout the sessions and to listen to stories and answer story-related questions. The findings, which need to be interpreted with caution given the nature of the study and the small number of participants, seem to suggest that the new programs may be viable tools for helping people with motor or visual-motor and intellectual disabilities independently access leisure, communication, and other forms of functional engagement.

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.

The impact of the BEL intervention on levels of motivation, engagement and recovery in people who attend community mental health services

Background Community-based day centres (DC) in Sweden provide support to people with severe mental health problems. The role of DC motivation for outcomes in terms of occupational engagement and personal recovery is yet unknown. Aims To compare two groups who received DC services, one of which also received the 16-week Balancing Everyday Life (BEL) intervention. The focus was motivation for DC services at baseline and after 16 weeks of services, while also investigating the importance of DC motivation for the selected outcomes and service satisfaction. Material and Methods Sixty-five DC attendees were randomised to BEL (n = 27) or standard support (n = 38) and responded to questionnaires about motivation, the selected outcomes and satisfaction with DC services. Results The groups did not differ on any measured aspects of motivation; nor were changes seen over time. The BEL group, but not those receiving standard support, improved from baseline to 16 weeks on occupational engagement and recovery. Motivation for attending the DC was related to service satisfaction. Conclusion The BEL program could be a viable enrichment tool in the DC context and boost occupational engagement and personal recovery among the attendees. Significance The study provided knowledge of importance when developing community-based services while enhancing motivation.

Autism and Mental Health: The Role of Occupational Therapy

Research has indicated a high prevalence of mental health problems among autistic people, with elevated rates of depression, anxiety, and suicidality. The profession of occupational therapy has its roots in mental health and can offer a unique focus on occupation to support the mental health needs of autistic clients. In this Guest Editorial we introduce articles for this special issue of the American Journal of Occupational Therapy related to autism and mental health and use the Person-Environment-Occupation Model. The articles offer insights into how interactions among person, environment, and occupation factors affect the mental health of autistic populations and demonstrate ways that mental health can be supported through occupational engagement. Opportunities to support the mental health of autistic people include promoting engagement in meaningful activities, supporting individual strengths, and bolstering clients' sense of self and identification with their autistic identity. Future research is needed to uncover and test interventions to support autistic clients and should reflect cultural humility and participatory approaches. We chose to use identity-first language (rather than person-first language) to describe the autistic community in this Guest Editorial out of respect for common community member preferences and in accordance with recommendations for anti-ableist language use (Bottema-Beutel etal., 2021). Decisions about language for each article in this special issue were made by the respective authors.

A Sensory Integration Intervention in the School Setting to Support Performance and Participation: A Multiple-Baseline Study.

There is a paucity of research that explores the effectiveness of sensory integration interventions in the school setting. To test the effectiveness of a sensory integration intervention paired with teacher consultation, aligned with the principles of Ayres Sensory Integration® and the Sensory Therapies and Research Frame of Reference, to improve functional regulation and active participation in school for students with sensory integration and processing differences. Concurrent, multiple-baseline, single-subject design. Public elementary school in the United States. Students (N = 3; ages 5-8 yr) whose sensory integration and processing differences were affecting their school occupational performance and were not remediated by integrated support. For 15 wk, each student had one-to-one sensory integration intervention 2×/wk for 30 min and a consultation between the occupational therapist and teacher weekly for 10 min. The dependent variables, functional regulation and active participation, were measured weekly. The Short Child Occupational Profile and Behavior Assessment System for Children, Third Edition, were given before and after intervention. Goal Attainment Scaling and semistructured interviews with the teachers and participants were completed after intervention. All 3 students showed meaningful improvement in functional regulation and active participation in the classroom during the intervention period as demonstrated by a 2-SD band method or celeration line analysis. All additional measures noted positive change. Findings suggest that sensory integration intervention with consultation in the education setting can improve school performance and participation for children with sensory integration and processing challenges. What This Article Adds: This study offers an evidence-based model of service delivery for the school setting that is effective in improving the functional regulation and active participation of students whose sensory integration and processing challenges interfere with occupational engagement and are not mitigated by embedded supports.

Conquering Educational Mountains: Maintaining a Radiology Clinical Education Track

Establishing a clinical education track as part of a radiology residency is essential in shaping future radiology educators. Many obstacles will be encountered while starting, maintaining, and improving these educational pathways. Hurdles may include recruiting suitable residents for the track, recruiting and supporting faculty advisors, sustaining long-term resident engagement, counteracting educational exclusivity, and providing adequate time and financial support. Although every program and institution may face individualized "mountains" to overcome, they are not insurmountable. The goal of this review is to address different conflicts we have encountered while maintaining the clinical education tract at our institution and to provide tips for overcoming them.

대학생의 성찰학습이 진로관여행동에 미치는 영향: 학습몰입의 매개효과

이 연구는 대학생의 성찰학습, 학습몰입, 진로관여행동 간의 구조적 관계를 검증하고자 하였다. 먼저, 대학생의 성찰학습이 진로관여행동에 미치는 영향을 확인하고 성찰학습과 진로관여행동 사이에서 학습몰입의 매개효과를 검증하였다. 이러한 연구목적 달성을 위해 충북소재 4년제 대학의 항공계열 학생 대상으로 설문조사를 진행하였으며 203부의 설문응답을 최종 표본으로 사용하고, SPSS 25.0, AMOS 25.0 소프트웨어를 사용하여 분석을 실시하였다. 분석결과, 성찰학습은 학습몰입과 진로관여행동 모두와 유의한 정적관계를 갖는 것으로 밝혀졌다. 또한, 성찰학습은 진로관여행동에 직접적인 정적 영향을 미치고 학습몰입은 성찰학습과 진로관여행동의 사이에서 매개효과를 갖는다는 것을 확인하였다. 이는 대학생들의 성찰학습이 이루어질수록 진로관여행동이 증진된다는 것을 의미하며 인지적 특성인 성찰학습에 심리적 특성으로 볼 수 있는 학습몰입이 더 해질때 진로관여행동은 더욱 큰 효과를 만들어낼수 있는 것을 의미한다. 따라서 대학은 학생이 자기성찰의 학습태도를 습득하고 학업에 몰입할 수 있는 교육환경을 제공할 필요가 있다.

Normative Basis for Climate-Related Civic Engagement by Residents of Lake Superior’s North Shore region

This study examines the determinants of resident engagement in climate change using a survey of a sample of residents in Lake Superior’s North Shore region in Minnesota. We examine the influence of climate concern, responsibility, subjective norms and personal norms on civic engagement. Study findings indicate that climate concern, ascription of local responsibility, and subjective norms influence residents’ personal norms, or sense of personal obligation, which in turn positively predicts civic engagement. Study findings highlight the importance of norms as a motivator of climate-related engagement. Results point to the potential for engaging community members in climate-related activities by tapping feelings of personal obligation for climate change adaptation or mitigation.