Evidence-based Occupational Therapy Practice Research Articles

Attitudes and perceived barriers to evidence-based practice among occupational therapists in Jordan.

Evidence-based practice (EBP) refers to the clinical decision-making process incorporating the best available evidence from research, therapists' clinical experience, and patient values. The current study aimed to examine the experience of Jordanian occupational therapy practitioners (OTs) in using EBP and to identify the perceived barriers to implementing EBP among OTs in Jordan. The study utilized a cross-sectional descriptive study design. A questionnaire was emailed to OTs who have been working in Jordan for the last six months of their practice in a clinical setting. The majority of the participants had a positive attitude toward EBP. However, they reported several barriers to implementing EBP, including a lack of tools and equipment in clinical settings as a major barrier (65.8%). National collaborative actions are needed to develop strategies to improve the utilization of EBP in occupational therapy (OT) practice and to overcome the barriers therapists experience with implementing EBP.

Enhancing evidence-based practice into healthcare: Exploring the role of scientific skills in occupational therapists-

Background Research utilization and evidence-based practice (EBP) in occupational therapy rely on essential scientific skills. Despite prior research exploring factors influencing EBP, a gap remains in understanding the specific scientific competencies crucial for effective EBP application. Objectives To (1) describe the level of scientific skills for EBP and research application, and (2) investigate the factors influencing higher scientific competence among 1159 Spanish-speaking occupational therapists. Material and Methods We assessed the scientific skills using the HACTO-Screen online survey. Recruitment was conducted through a non-probability convenience sampling method between April to June 2020, using social networks and email dissemination to education and professional organizations in Spain and Spanish-speaking Latin American countries. Results Out of a total score of 115 points, participants showed a moderate level of scientific skills (mean: 62.7, SD: 21.6), with literature searching skills ranking the highest and scientific writing skills ranking the lowest. Associations were found between greater scientific competence and advanced degrees, ongoing research training, and on-the-job research. Conclusions Continuous research training, higher academic degrees, and active research engagement are essential for enhancing scientific competence among occupational therapists. Significance Targeted training to enhance scientific skills and promote research utilization are crucial in advancing EBP in occupational therapy.

Psychometric evaluation of the Finnish version of the Worker Role interview (WRI-FI)

Background The assessment of work ability with reliable, thoroughly tested instruments, is central to evidence-based occupational therapy practice. Aims/Objectives The aim of this study was to investigate the psychometric properties of the Finnish version of the WRI with a focus on construct validity and measurement precision. Material and Methods Ninety-six WRI-FI assessments were performed by 19 occupational therapists in Finland. A Rasch analysis was conducted to evaluate the psychometric properties. Results The WRI-FI presented an overall fit to the Rasch model, with good targeting and separation among persons. The four-point rating scale structure was supported by the Rasch analysis, except for one item with disordered thresholds. The WRI-FI indicated stable measurement properties across gender. Seven of the 96 persons showed misfit, which slightly exceeds the criteria of 5%. Conclusions The findings from this first psychometric evaluation of the WRI-FI provided evidence of construct validity and support for measurement precision. The hierarchy among items corresponded with previous studies. The WRI-FI can offer occupational therapy practitioners a valid tool to evaluate psychosocial and environmental perspectives of persons’ work ability.

Student perspectives on factors that influence the implementation of evidence-based practice in occupational therapy.

Evidence-based practice (EBP) is perceived as an integral component of contemporary allied health practice. While allied health clinicians (such as occupational therapists) have generally positive attitudes towards EBP, research suggests that they find its implementation consistently challenging. The professional literature increasingly suggests that more effective EBP learning takes place when social constructivist approaches to learning are adopted. The authors of this study sought to use the pre-existing knowledge and perceptions of occupational therapy students to inform a curriculum review of an EBP unit. Therefore, the aim of this content analysis study was to investigate how occupational therapy students perceive and critically analyse factors that influence the implementation of EBP, specifically strengths, weaknesses, opportunities and threats (SWOT). The study sampled students in the third year of a 4-year, Bachelor level Australian Occupational Therapy Program. The students were undertaking the first of two EBP units, and data were collected from the first assignment they submitted for these units. The assignment required the students to complete a SWOT analysis of EBP in occupational therapy, and response to a statement around whether it should be mandatory. Data were collected over 2 consecutive years from a total of 64 occupational therapy students. All data collected were subjected to content analysis, with themes identified by at least 25% of students in each cohort retained for analysis and formation into overall themes. Participating occupational therapy students identified five strengths, four weaknesses, six threats but only one opportunity for EBP. Three key themes were identified within the data: first, the role and purpose of EBP; second, the resources it requires and third, factors that influence its success. The students perceived the main purpose of EBP as supporting positive practice change, and highlighted its roles in building clinician capacity and professional credibility. They also characterized EBP as a separate and specialist practice that requires specific training and resourcing to achieve, and questioned its feasibility as an integrated part of daily practice. Along with previously identified challenges around time and resourcing, the students also highlighted negative attitudes and beliefs from senior colleagues as an important negative influence on the success of EBP. The current study consolidates a growing body of international literature about the value of social constructive approaches to EBP in undergraduate education. Vertical constructive alignment that embeds EBP through undergraduate education, rather than the provision of 'EBP'-specific units, should now be considered best practice. However, this embedded approach requires the explicit and repeated communication of the presence of EBP in all learning opportunities, to enable students to recognize opportunities to deploy their existing knowledge and skills.

Critical perspectives on implementation of evidence-based practice in occupational therapy – Exemplified by Lifestyle Redesign® in a Danish context

Introduction Evidence-based practice is an increasing demand in occupational therapy (OT), although multiple barriers can hinder the translation of research knowledge into practice. The article illuminates the transformation of results from a randomised controlled trial into a practice development project with future practice implementation in mind. Method A case study was carried out, consisting of a comparison of the US randomised controlled trials (RCTs) Lifestyle Redesign® and the derived Danish practice development project. Results The study showed how results from RCTs of Lifestyle Redesign® were transformed into a practice development project with intentions to implement the programme in a Danish context. The modifications of the US RCT into a practice development project in Denmark compromised the study’s scientific execution. The practice development project was used to legitimise the intervention within OT locally by testing an evidence-based intervention, without using associated scientific tools and without considering barriers and facilitators for implementing the project in clinical practice. Conclusion Research design compromises in practice development projects may have implications for the internal and external dynamics of professionalisation processes regarding OT and the recognition of OT as a scientific discipline and an autonomous profession, nationally and internationally.

Interventions Within the Scope of Occupational Therapy to Improve Activities of Daily Living, Rest, and Sleep in People With Parkinson's Disease: A Systematic Review.

People with Parkinson's disease (PD) commonly experience difficulty in performing activities of daily living (ADLs), which affects their perceived quality of life. To examine the evidence for the effectiveness of interventions within the scope of occupational therapy to improve performance and participation in ADLs, rest, and sleep in adults with PD. Databases searched were MEDLINE, PsycINFO, CINAHL, OTseeker, and Cochrane Collection. Included articles were published between January 2011 and December 2018. Study Selection and Data Collection: Articles describing Level 1b, 2b, and 3b studies that examined outcomes related to ADLs, rest, and sleep in people with PD were included following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Forty-five articles (10 Level 1b, 27 Level 2b, and 8 Level 3b) met the inclusion criteria. Strong strength of evidence was found to support inpatient multidisciplinary intensive rehabilitation treatment (MIRT) to improve ADLs, and moderate strength of evidence that MIRT improves sleep performance. Low strength of evidence was present for outpatient occupational therapy to improve ADL and sleep outcomes. Low strength of evidence was found for resistance exercise programs to improve ADLs, but moderate strength of evidence indicates that multimodal exercise programs and targeted exercise programs can improve ADLs. Low to moderate strength of evidence suggested that alternative therapies and cognitive-behavioral therapy have a positive impact on ADLs and sleep. These results can be used to inform evidence-based occupational therapy practice. What This Article Adds: This article provides information for practitioners on the effectiveness of interventions within the scope of occupational therapy practice to improve ADLs and sleep.

Current practices and factors affecting evidence-based occupational therapy practice for patients with dementia in Japan.

Objective/backgroundThe rapidly increasing incidence of patients with dementia in Japan is creating an urgent demand for evidence-based occupational therapy (EBOT), which has been reported to improve clinical efficacy. This study aimed to examine the current practice of EBOT for patients with dementia in Japan and clarify factors influencing its application.MethodsWe conducted an anonymous, self-administered questionnaire survey by mail. The participants were 432 occupational therapists treating patients with dementia at 432 designated medical institutions nationwide. Descriptive statistics were calculated, and multiple regression analysis was performed to clarify the factors influencing the present application of EBOT.ResultsThe response rate was 31.3%. Among the participants, 46.3% responded ‘somewhat frequently’ or more (5, 6, and 7 on a 7-grade scale) to a question on the frequency of practice of EBOT. Using multiple regression analysis with the stepwise method, we selected the model with the highest degree of fit. This model extracted three factors, namely, ability to understand scientific papers, sufficiency of means of getting information, and availability of advice, which had standardized partial regression coefficients (β) of 0.419, 0.214, and 0.158, respectively.ConclusionsThe three factors extracted using the multiple regression analysis indicate that in order to encourage EBOT for patients with dementia, occupational therapists need to acquire reading comprehension skills, so that they can assess the quality of scientific papers. Furthermore, it is important to create environments where they have access to publications and can discuss research with superiors and colleagues.

Which models can be used as a clinical education model in occupational therapy? Introduction of the models: A scoping review study.

Background: Clinical education is a vital part of occupational therapy education process. High clinical education quality in fieldwork settings leads to higher clinical competency and occupational proficiency. One of the most effective clinical education methods in equalizing the conditions of clinical education to students is the correct use of educational models related to each field of medical sciences. In the field of clinical education, various models have been designed with a specific subject. However, limited research has been done on the introduction of the usability of these models in occupational therapy settings. This study was conducted to determine which models have the potential to be used as clinical education models in occupational therapy. Methods: A scoping review was conducted and studies published in English between 2000 and 2018 that examined clinical education models were selected. Results: A total of 8 articles were entered in the review, and a central theme of implementing clinical education models in occupational therapy was determined by thematic analysis. This central theme consisted of 3 categories: (1) evaluative models, (2) acting models, and (3) evaluative/acting models. Conclusion: Occupational therapists, especially who work as educators should be aware of the different types of clinical education models and try to use these models in clinical education process and minimize the variation of teaching methods in fieldwork settings to promote the clinical education quality. However, more research should be done to improve evidence-based occupational therapy practice in clinical education.

The impact of clinical research and evidence-based practice in occupational therapy

The impact of clinical research and evidence-based practice in occupational therapy

Psychometric properties of home accessibility assessment tools: A systematic review.

Although home environment assessments are commonly performed by occupational therapists working in home care, use of nonstandardized measures created in-house or lack of measure use can cast a shadow over the quality of these assessments for people with disabilities. To ensure quality of home environment assessments, occupational therapists need standardized measures with demonstrated psychometric properties. This study provides a critical appraisal of objective accessibility measures of the home environment. A systematic review was undertaken for which three databases-CINAHL, PubMed, and Embase-were searched to identify accessibility measures of the home environment and evaluate their psychometric properties. Two authors independently assessed the quality of selected studies using the critical appraisal form for psychometric articles. Ten studies discussing seven accessibility measures were identified and selected for this review. No measures showed strong evidence of both good reliability and validity. Only one study addressed the responsiveness of a measure of accessibility. As occupational therapists are specialists of the person-environment relationship, the lack of evidence of the psychometric properties of objective accessibility measures of the home environment harms evidence-based occupational therapy practice. This review identified the most promising assessment tools, but further research is needed.

Occupational therapy intervention addressing weight gain and obesity in people with severe mental illness: A scoping review.

Individuals diagnosed with severe mental illness have higher rates of obesity than the general population due to a range of factors, including: medication side effects, poor nutrition and reduced physical activity. Obesity is associated with increased mortality and reduced quality of life. Evidence suggests that lifestyle interventions can be effective in addressing this issue. While such interventions would appear to fit within the scope of practice of occupational therapy, there is no publication synthesising the existing literature regarding occupational therapy interventions addressing lifestyle factors associated with obesity. To determine what is known from the existing literature about occupational therapy interventions addressing weight gain and obesity in adults diagnosed with severe mental illness. A scoping review was conducted. Searches were performed in online databases, occupational therapy journals and grey literature databases. Thematic analysis occurred across all articles included in the review. A total of 14 articles were included in the review. Analysis revealed a central theme of supporting occupational performance and participation in health promoting occupations. This central theme consisted of four categories; facilitating client-centred practice, addressing personal performance issues, addressing environmental barriers and providing the 'just right' challenge. These findings suggest occupational therapists are providing occupation focused interventions that are aligned with current clinical guidelines. However, more research is required to strengthen evidence-based occupational therapy practice in this important area.

Towards Identifying Peer Supervision Competencies for Graduate-level Occupational Therapy Students: A Scoping Review

In the occupational therapy (OT) profession, peer supervision groups are recommended for professional development, lessening attrition, and relieving stress. Peer supervision is under researched, thus competencies to support this practice are unknown. The purpose of this scoping review was to: (1) summarize the research knowledge around peer supervision to support evidence-based practice in OT, (2) map supervision competencies and key themes in the literature, and (3) isolate peer supervision competencies that may be especially relevant to graduate-level OT students. The long-term aim of this research is to develop a framework for evidence-based peer supervision training. Researchers investigated the question: What competencies related to peer supervision, supervision in OT clinical education, and supervision in allied health are relevant to the education of graduate-level OT students? Using a six-step methodological framework, a scoping review of empirical, conceptual, and grey literature was conducted. Studies relevant to peer supervision, supervision in OT clinical education, and supervision practices in allied health professions were searched and appraised, yielding 15 high quality studies. Competencies were extracted and mapped, resulting in the following OT peer supervision competencies: flexibility, professional enculturation, providing constructive feedback, psychosocial support, teaching, and clinical skill acquisition. Findings suggest OT peer supervision competencies center on skillful relationship abilities, as supervision skills are not innate, not dependent on clinical skill, and typically need to be taught. This study warrants the need for additional efforts around supervision practices.

Practitioner Training for Use of Evidence-Based Practice in Occupational Therapy

ABSTRACTThe purpose of this integrative review was to examine the evidence-based practice (EBP) training literature for occupational therapy practitioners in order to describe the relationships between EBP use in practice and practitioner training for EBP. A systematic search of literature related to EBP training in occupational therapy was followed by a research evaluation, review of case examples, and qualitative content analysis. Findings suggest that comprehensive, contextually-relevant, and collaborative training approaches are necessary for practitioners to address implementation of EBP. Research investigating the mechanisms of practitioner training and ways to measure the relationships between training, changes in how practitioners use evidence-based practices, and client outcomes and other quality indicators is recommended.

A process for developing sustainable evidence-based occupational therapy practice

Objective: The purpose of this qualitative descriptive study was to describe how long-term improvement work based on the Occupational Therapy Intervention Process Model (OTIPM) evolved in an occupational therapy unit. Method: Data included written documents related to the improvement work (435 pages in total) from 2001 to 2013 that were analysed using pattern matching. Results: The findings from the analysis of the documents formed three main patterns describing reorientation towards the OTIPM, establishment of the implementation of the OTIPM, and ensuring the sustainability of the implementation. Each pattern contained a number of phases of the improvement work emanating from different reasons and resulting in different long-term achievements. The transformation between the phases was smooth, and several of the phases became starting points for improvement work that continued throughout the years. Conclusion: The findings showed how an occupational therapy model of practice, such as the OTIPM, can guide an improvement process and keep it going over a long period of time, thereby supporting sustainable improvements in practice.

Occupational therapists' experiences of improvement work: a journey towards sustainable evidence-based practice

Objective: The aim of this qualitative descriptive study was to describe occupational therapists' experiences of participating in long-term improvement work based on the Occupational Therapy Intervention Process Model. Method. Data were collected by focus groups interviewed on two occasions (2006 and 2011). Nineteen occupational therapists participated on each occasion. The data obtained were analysed using a qualitative content analysis. Findings. The long-term improvement work was experienced as a journey towards sustainable and evidence-based occupational therapy practice. The journey, guided by the Occupational Therapy Intervention Process Model, led to increased client-centred and occupation-focused practice. The long journey of change involved three intertwined themes. The first theme describes how the occupational therapists transformed their thoughts and actions on an individual and group level. The second theme describes how they dealt with conflicting feelings and faced the duality of change. The third theme describes a shared professional culture, including confidence, clarity, and inter-professional community. Conclusion: The study shows how the collective use of an occupational therapy model of practice can lead to an integration of evidence-based knowledge that has long-lasting achievements in practice.

Research Utilization and Evidence-Based Practice in Occupational Therapy: A Scoping Study

Many articles have been written on the barriers to and facilitators of the use of evidence in practice in nursing and medicine, but to date no extensive review has been published of the literature on evidence-based practice (EBP) supports in occupational therapy. This article presents the results of a scoping review that examined factors that support the integration of research into practice. A review of 69 articles revealed four themes: (1) attitudes toward, perceptions of, confidence in, and use of research and EBP; (2) factors that support the use of research in practice; (3) effects of interventions targeting changes in knowledge, attitudes, skills, behaviors, and evidence-based practices; and (4) identification of the processes involved in the acquisition of EBP skills and their application in clinical practice. A process that integrates client-centered practice, structured reflection, case application, and peer consultations within a scholarship of practice model facilitates occupational therapists' evaluation and integration of research evidence.

Comparing the Responsiveness of the Assessment of Motor and Process Skills and the Functional Independence Measure

Selecting and utilizing appropriate assessments to evaluate outcomes is an important aspect of evidence-based occupational therapy practice. The Functional Independence Measure (FIM), to which occupational therapists contribute motor and cognitive scores, is currently the only required assessment for evaluating change from admission to discharge on an inpatient rehabilitation unit. However, occupational therapists are also using the motor and process scales from the Assessment of Motor and Process Skills (AMPS) to assess clients and evaluate change. To compare responsiveness of the AMPS and the FIM on an inpatient rehabilitation unit. A retrospective chart review of AMPS measures and FIM scores at admission and discharge was undertaken. Standardized response means and effect sizes were calculated to estimate responsiveness. No significant difference was found in the ability of the AMPS motor and FIM motor scales to detect change. The AMPS process scale was more responsive to change than the FIM cognitive scale. Using the AMPS as an assessment to evaluate outcomes allows practitioners to detect changes that may not be detected through the exclusive use of the FIM.

An overview of the current status of evidence-based occupational therapy in Finland

The change of the global paradigm in health care has made us aware of the value and importance of evidence based practice in occupational therapy (EBOT). In this article we will give a picture of Finnish EBOT including education, clinical practice, research, and examples of activities done to support EBOT. In the educational field, occupational therapy degree programmes are working with the challenge of how students will achieve the competences to integrate EBOT with clinical practice. The Finnish Association of Occupational Therapy has strongly supported, in different ways, the dissemination of EBOT in Finland. Occupational therapists have participated in national and multidisciplinary research projects that give the profession new arenas for scientific discussions.

Three educational approaches to enhance the evidence-based practice behaviour of Irish occupational therapists

Occupational therapists worldwide are urged by their professional bodies and health delivery organisations to demonstrate evidence-based practice (EBP) by drawing upon all components of the best practice evidence triad: therapist’s clinical expertise, current research, and the client’s preferences. Many studies report that most practitioners have positive attitudes about evidence-based occupational therapy practice. Nonetheless, in their clinical decision making, most rely on their clinical expertise and the advice of colleagues without also integrating current research evidence. This apparent disconnect between attitudes and actual behaviour can be addressed through a range of continuing education models. This paper describes a three-pronged Irish approach aimed at both individual therapists and entire teams: (1) one day workshops introducing the knowledge and skills underpinning EBP; (2) a multidisciplinary university module teaching research utilisation skills and the implementation of change and leadership theories; and (3) a service development project fostering an evidence-based work culture through team learning.

Evidence-based information-seeking behaviors of occupational therapists: a survey of recent graduates

For over a decade, occupational therapists have been engaged in a shift to an evidence-based practice (EBP) model, necessitating a concurrent emphasis on EBP in occupational therapy (OT) education. An essential element of this education is the development of information-seeking behaviors: how to locate, access, evaluate, and utilize the best available evidence in the course of answering a clinical question [1]. Indeed, prior studies [2–5] have pointed to the need to incorporate instruction on information-seeking behaviors into the curricula of OT programs. Previous studies of occupational therapists' information-seeking behaviors have primarily focused on undergraduate degree programs [4, 6]. Powell and Case-Smith recently provided the first examination of information-seeking behaviors in master of occupational therapy (MOT) graduates [7]. Further study of MOT graduates' information-seeking behavior is needed to inform decisions related to curriculum and instruction.