Occupational Engagement Research Articles

Impact of implementing the pain best practice guideline in a long-term care home using the knowledge-to-action framework

Introduction. Assessment and management of pain in older adults can be challenging, with persistent pain prevalence ranging from 25% to 80%, especially in long term care homes (LTCH), where most seniors are unable to verbalize their pain. This article describes the implementation of the Registered Nurses’ Association of Ontario (RNAO) Assessment and Management of Pain (Third Edition) best practice guideline (BPG) in a LTCH in Toronto, Canada. Methodology. Using mixed descriptive study methodology, this 391-bed home housing older adults over 80 years implemented the Pain guideline using the knowledge-to-action framework and audit procedures to evaluate the impact of implementing this guideline. Key implementation activities included educating residents, families, and staff about pain while integrating validated pain screening and assessment tools into practice. A mixed methods approach of qualitative and quantitative data was utilized to monitor improvements in clinical and organizational outcomes. Results. The impact of implementing Pain BPG is: improved utilization of pain assessment and management tools, reduced incidence of worsening pain, improved pain scores and improved resident quality of life. The structured and integrated, evidence-based approaches to pain assessment and management reflected that long-term care residents don’t have to live with pain regularly, which leads to a better quality of life and resident/family satisfaction. Discussion. In conjunction with the structured approach of the knowledge-to-action framework and the Pain BPG, the LTCH utilized tailored approaches to meet the needs of their resident population. Recognizing the unique needs of seniors in a residential setting, organizational structural facilitators, and barriers and cultural needs, the LTCH developed multi modal approaches based on a person and family centred approach. This evidence-based and resident focused approach was the key to the successful implementation and subsequent outcomes that were resultant. Conclusion. The systematic implementation of the RNAO pain BPG and the utilization of the knowledge-to-action framework was shown to improve resident outcomes, improve organizational processes and generate staff satisfaction. Participation and engagement of residents, their families and health professionals in the process was one of the greatest facilitators.

The Relationship Between Children’s Screen Time and the Time They Spend Engaging in Play: An Exploratory Study

ABSTRACT Introduction Play is a critical daily occupation that facilitates children’s learning of essential life skills. However, with the growing use of, and accessibility to, online-linked devices, children are engaging more and more in screen-time linked activities and less time in non-technology play. Therefore, it is crucial to understand the influence of children’s screen-time use on their play patterns. This study aims to explore the relationship between school-age children’s screen time and their engagement and participation in play occupations. Methods Twenty-six pairs of parents and children were recruited to complete the Children’s Play Scale (CPS), parent and child versions of the Children’s Screen Time Use Report (CSTUR), and the Children’s Perceptions of Their Play (CPTP). Data were analyzed using Spearman’s rho correlations and linear regressions with bootstrapping. Results Two regression models found that weekday social screen time accounted for 30.7% of the total variance (p = .002) of social play while weekend educational screen time, weekday interactive screen time, and weekday passive screen time together accounted for 55.6% of the total variance (p < .001) of active play. Conclusion The study findings provide evidence that a relationship exists between school-aged children’s screen time and play engagement and participation. Further research is recommended on this topic.

The role of Occupational Therapy in community development to combat social isolation and loneliness

Background: Social participation activities, an important area of occupation, have been effective in reducing social isolation and loneliness. However, most attendees are women, warranting the need to explore older men’s social participation needs. Methods: Qualitative methods, including interviews and a collaborative workshop, were used to explore the research aim. Public involvement included establishing partnerships with six staff from four community organisations and twelve older men. The project was informed by a steering committee. The steering group offered insight into all aspects of the research except analysis, which was performed thematically. Findings: Intergenerational engagements and the appropriate environment to establish connections with their communities were highlighted as beneficial to men. However, there is a lack of appropriate local spaces to connect communities through social participation. This suggests the need for occupational therapists to diversify their roles, moving beyond the individual and into community development. Conclusions: Occupational therapists’ unique and varied skill set, including the understanding of the profound impact of the environment on occupational engagement and, thus, well-being would offer valuable contributions to community development roles, including the built environment to ensure all communities have places for connection where individuals of all ages can thrive.

Occupation-based practice in hand therapy - perspectives from a South African occupational therapy survey.

Hand injuries affect occupational engagement and participation, yet anecdotal evidence reports a focus on body structures and functions within hand therapy. Failing to address occupational challenges may result in sub-optimal patient outcomes. In line with the growing body of evidence of positive outcomes relating to occupation-based practice (OBP), this article aimed to describe the knowledge, attitudes and practices towards OBP of occupational therapists treating hand-related conditions in South Africa. In this quantitative, cross-sectional study, South African occupational therapists treating hand conditions were recruited. Data were collected via an emailed survey developed for the study. Data were analysed descriptively. Sixty-seven responses met the inclusion criteria, a response rate of 62%. Most respondents worked in the private sector (73%) with many holding postgraduate qualifications (54%). Lack of access to evidence and a preference for biomedical literature impacted on acquiring knowledge on OBP. Attitudes towards OBP were mostly positive. Barriers were contextual, patient-related and therapist-related. Practice focussed predominantly on performance components and aimed to reduce impairment rather than promoting occupational engagement. Current hand therapy services in South Africa reflect a biomechanically-focused practice that is mis-aligned with occupational therapy philosophy. In line with existing research, OBP should be adopted more routinely in hand therapy in South Africa.

Just transitions and sociotechnical innovation in the social housing sector: An assemblage analysis of residents’ perspectives

Creating low-carbon pathways for domestic electricity and heating is a core aspect of the UK Government's housing strategy. Understanding issues of energy justice and the socio-technical dynamics of low-carbon innovation are vital for successfully implementing new technologies and retrofit measures across diverse communities and different housing types. The social housing sector is particularly important in the study of just domestic low-carbon transitions due to the challenges faced by residents concerning energy affordability and insecurity during the ongoing cost of living crisis in the UK. This qualitative study, conducted in the Northeast of England, adopts an assemblage thinking approach to examine the experiences of social housing residents. Through thematic analysis of interviewee responses, we identify themes related to cost and affordability; decision-making dynamics and energy justice; disruption, retrofit and ‘fabric first’; energy autonomy and the practicalities of technology choice; and environmental values and collective climate action. We find that justice in the low-carbon home requires social housing organisations to strengthen mechanisms for resident engagement and interconnectedness before retrofit roll-out, to identify independent sources and arbiters of information on upfront and long-term energy costs, to ensure effective mechanisms for the social control of energy use, and to provide a platform to encourage nascent energy citizenship through which residents link pro-environmental behaviours in the home to broader networks of social action on climate change.

Exploring occupational therapy practice in Australian residential aged care facilities: A cross-sectional survey.

Occupational therapy in residential aged care facilities (RACFs) can enhance residents' occupational engagement and wellbeing. However, industry reports suggest that occupational therapists in Australian RACFs have mostly provided physical therapies such as pain management via massage and not addressed residents' occupations. There is limited literature on what constitutes occupational therapists' practice in RACFs to inform policy and practice. The aim of this cross-sectional survey was to explore practice patterns of occupational therapists working in Australian RACFs and influences on their practice. Occupational therapists working in Australian RACFs were invited from July 2019 to March 2020 to complete a self-report online questionnaire via email and advertisements on industry websites, newsletters, and social media. The questionnaire asked therapists about their caseload, referrals, assessments, and interventions. Data were analysed descriptively and presented as frequencies and percentages. A total of 214 occupational therapists completed the survey. Occupational therapists' daily practice largely focussed on pain management; other areas of practice included falls prevention, pressure care, and mobility. The Aged Care Funding Instrument in place at the time of the survey was identified as the leading factor influencing therapists' choice of assessments and interventions. Organisational policies and procedures were also perceived as key factors influencing occupational therapy practice. This paper highlights the influence of government funding and organisational policies in limiting occupational therapists' scope of practice and their ability to fully address the occupational needs of residents. Occupational therapists and the profession in general should be aware of factors in aged care funding models, and their application, that restrict occupational therapy practice and inhibit residents' function and advocate for change where needed. With the introduction of the Australian National Aged Care Classification funding model replacing Aged Care Funding Instrument, future research should explore potential changes to therapists practice following the implementation of the new funding model.

The engagement of Polish residents with their home space in single-family houses and flats in multi-family blocks of flats

The engagement of Polish residents with their home space in single-family houses and flats in multi-family blocks of flats

"You're Someone Different Now": An Autoethnography on Identity and Occupational Identity Disruption After Traumatic Brain Injury.

Identity disruption and occupational identity disruption are common after traumatic brain injury (TBI), but the relationship between these two phenomena is underexplored. Occupational therapy practitioners should be knowledgeable about identity challenges after TBI and ways to reconstruct a sense of self. To sensitize readers to the experience of identity disruption and occupational identity disruption and describe how those two experiences are interrelated and transactional in nature. We completed an autoethnography, because this method privileges the insider perspective of participants as members of the research team. We interviewed Andi's family and friends, with textual and nontextual data being reviewed during team meetings that occurred 3 times per month over 3 yr. Data were analyzed by hand-coding transcripts to organize findings until we identified themes and salient text for constructing a narrative. Setting: Community. TBI survivor. Identity disruption after TBI occurs because of physiological difficulties, psychological changes, and cognitive deficits. Additionally, survivors face interruptions in occupational participation that affect their identity as doers. Andi experienced identity disruption that was exacerbated by being unable to engage in written expression. When he was able to resume writing and regain his occupational identity, Andi was able to reconstruct his sense of self. Identity is created by occupational engagement. Occupational therapy practitioners can better serve their clients by exploring identity disruption and occupational identity disruption after TBI. Plain-Language Summary: This article describes the lived experience of identity disruption and occupational identity disruption with an emphasis on the transformative nature of occupation. Occupational therapists should work collaboratively with clients to identify key occupations that support their sense of identity.

Resident Burnout, Wellness, Professional Development, and Engagement Before and After New Training Schedule Implementation

Burnout is a work-related syndrome of depersonalization (DP), emotional exhaustion (EE), and low personal achievement (PA) that is prevalent among internal medicine resident trainees. Prior interventions have had modest effects on resident burnout. The association of a new 4 + 4 block schedule (4 inpatient weeks plus 4 outpatient weeks) with resident burnout has not previously been evaluated. To evaluate the association of a 4 + 4 block schedule, compared with a 4 + 1 schedule, with burnout, wellness, and self-reported professional engagement and clinical preparedness among resident physicians. This nonrandomized preintervention and postintervention survey study was conducted in a single academic-based internal medicine residency program from June 2019 to June 2021. The study included residents in the categorical, hospitalist, and primary care tracks in postgraduate years 1 and 2 (PGY1 and PGY2). Data analysis was conducted from October to December 2022. In the 4 + 4 structure, resident schedules alternated between 4-week inpatient call-based rotations and 4-week ambulatory non-call-based rotations. The primary outcome was burnout, assessed using the Maslach Burnout Inventory subcategories of EE (range, 0-54), DP (range, 0-30), and PA (range, 0-48), adjusted for sex and PGY. Secondary outcomes included In-Training Examination (ITE) scores and a questionnaire on professional, educational, and health outcomes. Multivariable logistic regression was used to assess the primary outcome, 1-way analysis of variance was used to compare ITE percentiles, and a Bonferroni-adjusted Kruskal Wallis test was used for the remaining secondary outcomes. The findings were reexamined with several sensitivity analyses, and Cohen's D was used to estimate standardized mean differences (SMDs). Of the 313 eligible residents, 216 completed the surveys. A total of 107 respondents (49.5%) were women and 109 (50.5%) were men; 119 (55.1%) were PGY1 residents. The survey response rates were 78.0% (85 of 109) in the preintervention cohort and 60.6% (63 of 104) and 68.0% (68 of 100) in the 2 postintervention cohorts. The PGY1 residents had higher response rates than the PGY2 residents (119 of 152 [78.2%] vs 97 of 161 [60.2%]; P < .001). Adjusted EE scores (mean difference [MD], -6.78 [95% CI, -9.24 to -4.32]) and adjusted DP scores (MD, -3.81 [95% CI, -5.29 to -2.34]) were lower in the combined postintervention cohort. The change in PA scores was not statistically significant (MD, 1.4 [95% CI, -0.49 to 3.29]). Of the 15 items exploring professional, educational, and health outcomes, a large positive association was observed for 11 items (SMDs >1.0). No statistically significant change in ITE percentile ranks was noted. In this survey study of internal medicine resident physicians, a positive association was observed between a 4 + 4 block training schedule and internal medicine resident burnout scores and improved self-reported professional, educational, and health outcomes. These results suggest that specific 4 + 4 block combinations may better improve resident burnout than a 4 + 1 combination used previously.

Executive Function After Yoga: Adults With Acquired Brain Injury-A Pilot Study.

Acquired brain injury (ABI) may result in deficits in executive function (EF), which affects engagement in occupations. To explore the impact of group yoga on EF in people with ABI. Single-arm pilot study with preyoga assessments and postyoga assessments (after 8 wk of yoga). Yoga classes and assessments were completed within university buildings on a college campus. Twelve participants with chronic ABI (>6 mo post-ABI) were recruited through convenience and purposive strategies from the local community. An 8-wk adaptive group yoga intervention was provided by an adaptive yoga specialist. Yoga classes were 60 min and occurred once per week. EF was assessed before and after the yoga intervention using the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) self-report form. Normative data were analyzed with paired sample t tests. Nine participants completed all study procedures. Results from paired sample t tests showed significant improvements on the Behavioral Regulation Index of the BRIEF-A (p = .046). No significant improvements were found on individual EF scales, the Metacognition Index, or the Global Executive Composite (ps > .05). Group-based yoga may improve some aspects of EF for adults with chronic ABI; however, further research with larger sample sizes is needed. Plain-Language Summary: Yoga, an intervention increasingly used in occupational therapy practice, may be beneficial in improving behavioral regulation (an executive function) for adults with acquired brain injury.

Effect of the Occupational Engagement Home Program (MyHOeME©) for Older Persons in the Community

Malaysia faces a pressing issue as its older population is projected to reach 16% by 2030. While global and national initiatives focus on health and independence, there exists a gap in structured activities for older persons. Our study introduces MyHOeME, a 5-week program designed by an occupational therapist, which addresses the physical, cognitive, and social facets of ageing through personalized activities. This quasi-experimental study involved 78 older persons in the community. The results indicate a significantly enhanced health-related quality of life after attending MyHOeME, emerging as a promising solution for the well-being of Malaysia's ageing population.

Residents’ Environmentally Responsible Behavior and Tourists’ Sustainable Use of Cultural Heritage: Mediation of Destination Identification and Self-Congruity as a Moderator

In the face of escalating global concerns surrounding environmental sustainability and the preservation of cultural heritage, this research explores the intricate connection between residents’ environmentally responsible conduct (ERB) and tourists’ sustainable involvement with cultural heritage sites (SU). Highlighting the pivotal importance of destination identification (DI) as a mediator and self-congruity (SC) as a moderator, our study utilizes a quantitative data approach to investigate the nuanced relationships inherent in the domain of tourism destinations. The data were collected from 324 tourists (visiting Luxor heritage city in Egypt) and analyzed by PLS-SEM, and the results showed a positive correlation between residents who strongly identify with their local environment and an increased dedication to environmentally responsible actions. Moreover, tourists who demonstrate elevated levels of self-congruity with the cultural heritage destination are inclined to embrace more sustainable behaviors, thereby making positive contributions to heritage preservation initiatives. This study enriches the evolving domain of sustainable tourism by providing insights into the intricate interactions between residents and tourists, fostering environmentally responsible behavior, and promoting the sustainable utilization of cultural heritage. Practical applications encompass the formulation of community-based interventions, the design of destination marketing strategies, and the proposal of policy recommendations. These initiatives aim to enhance the engagement of both residents and tourists, fostering the long-term preservation of cultural and environmental assets. Ultimately, the research seeks to guide sustainable tourism practices that strike a balance between the economic advantages of tourism and the essential preservation of cultural heritage and natural environments for future generations.

Status, influencing factors and paths on professional identity of special education teachers

ABSTRACT The aim of the present study was to explore the status, influencing factors and paths on professional identity of special education teachers. The statistical population of the study included 438 special education teachers in Guangdong Province, China. The age of the participants ranged from 22 to 57 years old (M = 32.16, SD = 1.85 years). Of the 438 teachers, 346 were females, 92 were males. The Occupational Stress Questionnaire (He, J. H. 2013. A Study on the Occupational Stress and Work Engagement of Special Education Teacher. Hangzhou: Hangzhou Preschool Normal College of Zhejiang Normal University), School Support Questionnaire (Zhang, Y. 2018. Study on Professional Identity and School Support of Special Education Teachers in Guizhou. Chengdu: Sichuan Normal University), and Professional Identity Questionnaire (Tang, J. R. 2012. Study on Professional Identity of Special School Teachers. Shanghai: East China Normal University) were used. The independent sample t-test, one way ANOVA, correlation analysis, and multiple stepwise regression were used for the data analysis. The results show that: (1) the professional identity of special education teachers is relatively high in the overall and dimensions. (2) There are significant differences in the professional identity in terms of leadership, marriage, education level, teaching years and professional titles. (3) Both occupational stress and school support can significantly predict the professional identity of special education teachers.

An Occupational Perspective on Psychedelic Therapy: A Scoping Review.

Background. Interest in the use of psychedelics for mental health therapy is burgeoning. Qualitative research methods are increasingly used to understand patient's experiences; however, there is a lack of literature that explores psychedelic use from an occupational perspective. Purpose. To conduct a scoping review of qualitative literature on the experiences of psychedelic use for the purpose of mental health therapy, through an occupational lens. Key Issues. Wilcock's occupational perspective of health was employed to analyze the use of psychedelics in mental health from an occupational perspective. Despite heterogeneous therapy contexts and substances used, patients reported comparable benefits regarding occupational engagement, such as increased mindfulness and autonomy in doing, a renewed sense of being, greater motivation to grow and become, and an improved sense of connection and belonging. Implications. This review demonstrates how psychedelic use in the context of mental health support can be experienced as a meaningful occupation and may contribute to overall health. In turn, this review highlights the utility of an occupational perspective for "non-sanctioned" or stigmatized occupations like psychedelic use, as well as the need for more research on psychedelic use from an occupational perspective. Using an occupational perspective of health can help to de-stigmatize psychedelic use as a meaningful occupation, rather than a deviant one, and shed light on how psychedelics may also positively impact one's participation in everyday life and overall health.

A scoping review into the service needs of people from culturally and linguistically diverse backgrounds living with disability to engage in meaningful occupations.

Although there is a large proportion of people from culturally and linguistically diverse backgrounds within Australia, their rate of access to disability services is disproportionately low. This review aims to understand the service needs of people from culturally and linguistically diverse backgrounds with disability to facilitate engagement in meaningful occupations. Arksey and O'Malley's scoping review framework was employed. Ten databases were searched for Australian studies. A deductive content analysis framework was applied in the synthesis. Fourteen papers were included. Themes that emerged include language and cultural needs and considerations, which highlights the need for information sharing to take account of intergenerational, intercultural and sociolinguistic differences. It also identified the need for improved training and skills of existing interpreters. Culturally competent and responsive services was another theme identified, which emphasised the need to enhance the workforces' understanding of cultural practices. There is also a strong call for a more culturally diverse workforce to reduce the use of some interpreters and to build a more culturally competent workforce. The last theme was responsive service delivery, which requires the governance to support the development of a nurturing trusting therapeutic relationship. Service providers should be trained on the inequities and intersectionality of this population. Further research is required to explore current disability policy in Australia with an intersectionality lens to ensure recommendations can be made to address barriers and ensure this population receives services in a manner that enhances their ability to engage in occupations meaningfully.

These are tenants not guinea pigs: Barriers and facilitators of retrofit in Wales, United Kingdom

Retrofitting existing homes with new energy efficient technologies is essential to reduce emissions and move towards achieving a ‘net zero’ carbon emission target. This paper reports on research that investigated the process of retrofitting new technologies in existing social rented homes in Wales, United Kingdom. It used mixed-methods consisting of pre- and post-retrofit surveys, qualitative interviews with tenants, and a documentary analysis of retrofit tenant engagement materials. Interviews and focus groups were also undertaken with a variety of professionals involved in the delivery of the new technology, including tenant liaison officers, architects, surveyors, and a civil servant.Findings reveal that many of the barriers to deploying new technologies in social rented properties were around communication and information issues. The interface between the technology and residents was a challenge as mechanisms of the new technologies operation and sensors and monitoring were not understood well and residents were kept out of the loop often through digital exclusion. Disruption to norms, the home and everyday practices were also key barriers. Facilitators to successful deployment of new technologies included good tenant engagement, demonstrating and showcasing the technology prior to deployment and actively reducing disruption to norms and practices.Social Practices Theory and Energies Culture Framework describe the findings well, especially around changes in material culture (the actual technology and hardware) and disruption to norms and social practices, which explains how the use of the technology by the residents notably changes and can disrupt their lives. These disruptions create anxiety creating further barriers which can lead to resistance to engaging with the technology. Better communication and more resident involvement and engagement are needed, allowing people ownership and some perceived control over the decision-making, deployment and changes happening to their everyday lives.Findings suggest that communications and trust in the retrofit process are crucial to the success of delivering low-carbon technologies to tenants in social housing. The technology must also be usable and understood by the tenants; exemplar demonstrator properties to help tenants see and understand the technologies are helpful to successful deployment. In conclusion, more involvement of tenants is needed when delivering low-carbon technologies to their homes to resolve further exacerbating the already noticeable inequalities.

Exploratory Study On Psychosocial Influences of Spinal Cord Injury to Patients: Basis for Medical Social Work Intervention Plan

This study investigates the psychosocial influences of Spinal Cord Injury (SCI) on patients at the Philippine Orthopedic Center Hospital, analyzing their social functioning and proposing targeted interventions for reintegration. Employing a concurrent triangulation research design, quantitative data were collected through surveys, and qualitative insights were derived from interviews. The findings illuminate significant psychosocial challenges faced by SCI patients, affecting various aspects of their lives, including relationships, family dynamics, work, friendships, parenting, education, and self-care. Demographic profiles revealed nuanced variations in psychosocial functioning, emphasizing the necessity of tailored interventions based on age, marital status, gender, education, and occupation. The triangulation of data led to the identification of four prominent themes: "Resilient Navigation of Intimacy and Connection," "Family Dynamics and Care Challenges," "Occupational Hurdles and Work Engagement," and "Social and Community Integration Obstacles." The study proposes a holistic intervention plan, encompassing emotional support, the establishment of support networks, vocational rehabilitation, the promotion of community engagement, and sustained collaboration with healthcare professionals.

Life satisfaction and time-use among full-time and part-time working mothers in Brazil.

Working part-time or full-time is a persistent dilemma for women, especially mothers, as they strive to manage their time across various roles. However, the existing literature remains unclear on whether part-time work contributes more to life satisfaction than full-time work. This study aims to describe and compare time-use patterns in different occupational roles and levels of life satisfaction among 795 mothers in Brazil who are employed either part-time or full-time. Data was collected through an online survey and the snowball technique. Regression and correlation analyses were performed on the data obtained from the following instruments: the Role Checklist for assessing time-use within occupational roles, the Satisfaction with Life Scale, and demographic information. Our analysis revealed no significant differences in life satisfaction between mothers working full-time and those working part-time (t (793)=1.160, p = 0.24). However, life satisfaction scores were positively correlated with the number of occupational roles performed (r = 0.222, p < 0.01), higher family income (P < 0.001), and engagement in social roles such as Friend (r = 0.106, p = 0.003), Hobbyist/Amateur (r = 0.08, p = 0.018), and Caregiver (r = 0.07, p = 0.026). While our society places significant emphasis on time spent at work, our findings highlight that life satisfaction extends far beyond the dichotomy of working part-time or full-time. There are deeper dimensions to consider, including the number of occupational roles, family income, and engagement in social roles, which have a more substantial impact on overall life satisfaction.

Empowering Ontario’s long-term care residents to shape the place they call home: a codesign protocol

BackgroundCanada’s long-term care (LTC) homes were founded on an institutional model that viewed residents as passive recipients of care. Many homes continue to follow this model leaving residents removed from...

Customised knowledge-sharing platform to foster resident quality improvement activities, tracking and scholarship

IntroductionMeeting accreditation requirements to train resident physicians in quality improvement (QI) may require more than education. Barriers to resident QI engagement underscore the need to demonstrate the impact and value...