Need For Occupational Therapy Research Articles

Occupational Therapy’s Role within the Middle and High School Settings in the United States

ABSTRACT There is a need for occupational therapy (OT) in the middle and high school settings, yet the role practitioners (OTPs) play in these settings is not clearly defined. School-based OT is in alignment with the Occupational Therapy Practice Framework (OTPF) which recognizes health is supported and maintained when clients are able to engage in their home, school, workplace, and community (American Occupational Therapy Association, 2020). OTPs serving students in the middle and high school settings ensure successful engagement while at school by addressing not only the occupations specific to education but also by addressing the factors that disrupt or empower these occupations American Occupational Therapy Association (2020). Evidence suggests OTPs are struggling to provide relevant service due to limited clarity of their role . A scoping review was conducted to describe the role of American-based OT in the middle and high school settings, identify barriers that affect practitioners, and provide practitioners with information about the role of the OT. Researchers utilized Preferred Reporting Items for Systematic Reviews and Meta Analyses-Scoping Review extension guidelines. Inclusion criteria included were articles published in English, peer-reviewed journals, within the past twenty years and within the scope of OT practice. A total of 1,107 records were identified of which 24 articles were included. Three themes emerged: 1. specific interventions used in middle and high school settings such as transition readiness, social participation, fine motor/handwriting, assistive technology, literacy participation, and life skills; 2. barriers to service delivery; 3. and the need for advocacy. More research is needed to develop conclusive evidence relating to the current practices of occupational therapy in the middle and high school settings.

Mapping the Gap: Understanding the Need for Occupational Therapy Among Older Adults With Visual Impairment.

Visual impairment (VI) affects more than 9 million Americans age 65 yr and older, and it limits meaningful participation in daily living. Occupational therapy can have a considerable impact on the functional performance of those with VI; however, information is limited on the existing occupational therapy services available for older adults with VI across the United States. To calculate the prevalence of VI by U.S. county and quantify and locate the existing occupational therapy practitioners with certification in vision rehabilitation. Synthetic estimation was used to calculate the prevalence of VI among those age 65 yr and older in the United States by county. Geographic Information Systems mapping was used to illustrate the prevalence of VI and availability of occupational therapy practitioners with specialized training in vision rehabilitation by U.S. town. Communities with high concentrations of older adults with VI were more prevalent in the center of the United States, whereas occupational therapy practitioners with specialty training in vision rehabilitation were concentrated primarily on the east coast of the United States, on both Florida coasts, in selected cities in Texas and California, in western Pennsylvania, and in Alabama. The availability of occupational therapy practitioners with specialty training in vision rehabilitation does not match the visual rehabilitation needs of older adults in the United States. These findings can be used to prioritize efforts for new service provision, provide outreach to underserved populations, and guide occupational therapy education to improve access to vision rehabilitation throughout the United States. What This Article Adds: The data provided in this study can inform resource allocation, workforce development, and entry-level occupational therapy education to address the ongoing needs of older adults with VI.

Unmet Need for Outpatient Occupational Therapy Services Among Veterans With Mild Traumatic Brain Injury in the Veterans Health Administration: The Role of Facility Characteristics

ObjectiveTo investigate whether participation restrictions, an indicator of need for occupational therapy (OT), was associated with outpatient OT utilization in the Veterans Health Administration (VHA) among Veterans with mild traumatic brain injury (mTBI), and whether this relation differs by facility characteristics. DesignIn a secondary analysis of national VHA data, we used modified Poisson regression to model OT utilization (yes/no) as a function of participation restrictions (Mayo-Portland Adaptability Inventory Participation Index [M2PI]), facility characteristics, and covariates. Facility characteristics included complexity, geographic region, and self-reported access to specialty care. Covariates included prior OT utilization, sociodemographic factors, injury characteristics, and spatial access (eg, drive time). Interactions estimated whether the relation between participation restrictions and OT utilization differed across facility characteristics. SettingOutpatient setting in the VHA. Participants8684 Veterans with a clinician-confirmed mTBI who received outpatient VHA care between 2012 and 2020 (N=8684). InterventionsNone. Main Outcome Measure(s)OT utilization was measured within a year of M2PI administration using VHA administrative data. ResultsMany Veterans who did not receive OT reported participation limitations, indicating unmet need for OT (eg, 67% with leisure restrictions). Participation restrictions were associated with increased likelihood of receiving OT (risk ratio [RR]=1.01; 95% confidence interval [CI]=1.006-1.019), suggesting a tendency for Veterans’ OT-related needs to be satisfied. However, interactions indicated that this was not the case among Veterans receiving care in lower complexity facilities, and those in the South. Veterans with longer drive times were less likely to receive OT (RR=0.82; 95% CI=0.744-0.904). ConclusionsParticipation restrictions were associated with OT utilization, yet many Veterans with mTBI who may have benefited did not receive such care. Specific barriers to accessing OT (eg, OT practitioner supply) should be investigated. Novel care models can ensure access to OT services among Veterans seeking care at less-resourced and/or geographically distant VHA facilities.

Human Trafficking Survivors’ Self-Reported Satisfaction and Performance in Daily Life Activities

ABSTRACT The purpose of the study is to identify occupational performance problems self-identified by survivors of human trafficking through the use of the Canadian Occupational Performance Measure to further understand the occupational needs of this population. This retrospective cross-sectional study categorized 428 occupational performance problems into areas of occupation. The results indicated that social and emotional health promotion and maintenance (n = 57), leisure exploration/participation (n = 52), sleep preparation and participation (n = 49), financial management (n = 49), and symptom and condition management (n = 42) were the most common areas of occupation that victims identified as occupational performance problems. The National Action Plan to Combat Human Trafficking calls for comprehensive social and health care services to support recovery and for identification and meeting of research gaps. This study answers these calls by identifying areas of daily life that are difficult for individuals who exit trafficking. Additionally, this information identifies the need for occupational therapy as part of the comprehensive service team to support stability and recovery.

Women's Experiences After Ovarian Cancer Surgery: Distress, Uncertainty, and the Need for Occupational Therapy.

Despite the growing literature on the association of functional, physical, and quality-of-life (QOL) deficits with poor postoperative outcomes, there is a gap in the literature identifying women's occupational performance needs after ovarian cancer surgery. To describe the experiences of women hospitalized after ovarian cancer surgery to identify potential areas for intervention. Goals were to (1) identify functional needs and limitations at time of discharge as measured by the typical acute care occupational therapy evaluation and semistructured interview and (2) understand the women's perspectives of their needs for occupational therapy and a safe return to home. Single-arm, cross-sectional descriptive study. Mixed-methods data collection and analysis. Academic cancer center. Women with ovarian cancer (N = 11) who had completed surgery. Semistructured interviews and patient-reported outcome measures (PROMs) completed postsurgery. PROMs included the National Comprehensive Cancer Network (NCCN) Distress Thermometer and Problem List, the PROMIS® Global Physical Health (GPH) and Global Mental Health (GMH) scales, and the Possibilities for Activity Scale-Women (PActS-W). The mean NCCN Distress score was 6.0 (standard deviation [SD] = 3.1, with the top three concerns being pain (80%), worry (80%), and fatigue (78%). Mean GPH and GMH T scores were 38.0 (SD = 8.8) and 48.2 (SD = 8.4), respectively. Women scored a mean of 39.2 (SD = 11.2, range = 26-58) on the PActS-W. Thematic analyses found that the women were uncertain about potential functional limitations and significantly distressed. Women with ovarian cancer experienced high levels of uncertainty and distress after surgery. Integrating in-home or community-based occupational therapy into routine care could decrease functional distress and uncertainty and help women manage concerns related to pain, worry, and fatigue. This study suggests that occupational therapy evaluation and intervention are needed to decrease distress and improve QOL of women upon discharge after ovarian cancer surgery.

The Research of the Need for Occupational Therapy in the Infant`s Foster Home

The aim of the research was to examine the need for occupational therapy in the infant foster home. The study was conducted in December 2009 – March 2010 in Kaunas Child’s Development Clinic „Lopšelis“. Self-dependence and fine motor function evaluation were made according to DISC (Diagnostic Inventory for Screening Children). Sensory integration disorders were valuated by the questionnaire of evaluation of sensory integration filled in by the teachers (for children from birth to 2 years) which helped the teachers to evaluate the babies growing in the foster home. Evaluating fine motor skills we estimated that 22 children (57.9%) were of normal development, 13 children (34.2%) had development retardation and 3 children (7.9%) had development difficulties. Evaluating the self-dependence of the children growing in the infant foster home, we determined that 25 children (65.8%) were of normal development, 12 children (31.6%) had development retardation and 1 child (2.6%) had development difficulties. Both child‘s self-dependence and fine motor skills depend on the age (varies with the growth of a child). To assess the influence of the changes in living conditions on child’s development regardless of age, we created a new character – children’s part time (in percent) spent in infant foster homes. The results of the research revealed that the longer a child lives in a foster home, the more their self-dependence and fine motor skills weaken. The results of the questionnaire for assessment of sensory integration disorders were analyzed and total score of 9 areas was counted. It varied from 55 to 95 points, the average of the total score was 76.2 points. The correlation coefficient between sensory integration disorder (total score) and the time children spent in the infant foster home was r = 0.35, p = 0.08. Therefore, it can be stated with the 90 % reliability that the longer a child lived in a foster home, the more pronounced his / her sensory integration disorders were. Conclusions. 1. A large proportion of infants (20 (42.1%)) growing in the infant foster home have fine motor function development disorders: 13 children (34.2%) were stated to have fine motor development retardation, 3 children (7.9%) had development difficulties. 2. Infants growing in a foster home have disorders of the development of self-dependence skills. We found that 12 children (31.6%) had characteristic retardation of self-dependence skills development, and 1 child (2.6%) had development disorders. 3. Infants growing in the infant foster home have sensory integration disorders. The results of the research showed that 9 (35%) of the respondents had light sensory integration disorders, 10 (38%) respondents had medium sensory integration disorders and 1 (4%) respondent had pronounced sensory integration disorder.Keywords: occupational therapy, developmental disorders, foster homes.

Occupational therapy outcomes in patients with Parkinson's disease

People living with this degenerative condition can benefit greatly from occupation therapy, explains Amelia Jackson. This therapy needs to be embedded in the treatment approach for all patients living with this condition, and practice nurses are well placed to direct care This article considers whether occupational therapy can improve the treatment experience and quality of life for patients living with Parkinson's disease. It also discusses whether occupational therapy has a direct correlation with improved treatment outcomes. This article will examine how this treatment should be provided and what treatment provision is available. Published literature was used to gain evidence and the findings were that integrated occupational therapy can improve both quality of life and treatment outcomes with this patient population. This article emphasises the need for occupational therapy to be embedded in the treatment approach to address non-motor symptoms which have the greatest impact on patient-reported reduced quality of life.

Opportunities for Occupational Therapy on a Primary Care Team.

Leaders in the occupational therapy profession have called for occupational therapy's inclusion in primary care, but little is known about the occupational needs of patients in this setting. To explore the need for and potential role of occupational therapy in a team-based primary care clinic. A qualitative descriptive study using a convenience sample of clinicians and patients. Meetings and semistructured interviews were recorded, transcribed, and coded by multiple coders using a general immersion-crystallization approach to identify relevant themes. Outpatient complex care clinic of an urban academic medical center. The study included a voluntary sample of clinicians and patients from the complex care clinic. Patients were recruited from a staff-provided list; eligible patients had attended the clinic for at least 1 yr. All patients had multiple chronic conditions and were uninsured or received Medicaid. Researchers attended 10 clinician team meetings and conducted 13 patient interviews and 10 clinician interviews. Four domains of patient need were identified by both patients and clinicians: complex medical management, patients' limited resources, mental health needs, and challenges to occupation. Clinicians also identified cognitive-behavioral challenges affecting care, including lack of engagement and poor problem solving. The makeup of the clinic team reflected their intent to address medical, socioeconomic, and mental health domains. However, cognitive-behavioral challenges and patients' occupational limitations were not consistently addressed. Thus, patients had unmet needs that occupational therapy practitioners were qualified to address. This study adds to the available literature examining patient needs and clinician challenges in a primary care clinic. Patients have occupational needs that are not being addressed in primary care, indicating a need for occupational therapy in this setting.

Reliability and Validity of a Functional Cognition Screening Tool to Identify the Need for Occupational Therapy.

The Centers for Medicare & Medicaid Services (CMS) has identified the need to assess functional cognition as part of the postacute care planning process. We examined the reliability, validity, and clinical utility of the Menu Task (MT) as a screening measure of functional cognition to assess the need for occupational therapy services. Cross-sectional study testing a convenience sample of community-dwelling older adults (n = 130) and adults hospitalized for elective orthopedic surgery (n = 60). The MT and four neuropsychological screening tests-the Brief Interview of Mental Status, the Montreal Cognitive Assessment, Trail Making Tests A and B, and an instrumental activities of daily living (IADL) scale-were administered. Community-dwelling participants were tested at the University of Wisconsin occupational therapy program and in community settings. Hospitalized participants were tested at the University of Missouri Orthopedic Institute. We recruited healthy community-dwelling adults in Madison, WI (community sample; n = 130) and patients hospitalized for elective orthopedic surgery in Columbia, MO (hospital sample; n = 60). Inclusion criteria were age 55 yr or older, living in the community, and willingness to be tested in English; for the hospital sample, participants had to be referred for elective orthopedic surgery requiring a hospital stay and be independent in activities of daily living before being admitted for surgery. We found significant differences between groups classified as impaired or not impaired on the basis of MT scores. Participants classified as impaired on the MT performed significantly less well than those classified as not impaired on the neurocognitive and IADL measures. The reliability and validity of the MT were supported. The American Occupational Therapy Association and the occupational therapy experts advising CMS have stressed the importance of a brief performance-based screening tool to identify people who need more comprehensive occupational therapy evaluation. The implementation of a functional cognition screening tool as part of the required CMS assessment protocol should greatly increase the number of patients referred for occupational therapy evaluation and treatment. The MT has the capacity to address the gap in the proposed CMS assessment of Medicare recipients across postacute care settings.

WHO OCCUPIES DISABILITY?

Locating occupational therapy within gendered and racialized systems of power, the authors consider the intersectional nature of critical disability studies discourse and the need for occupational therapy to incorporate such values into practice. This article discusses ways in which occupational therapy as a profession and individual therapists can align with or resist the economic determination which has come to dominate medical systems. It considers some of the political background to the history of the profession and its relationship with power. This positioning of the profession is explored against the impact of neoliberal economic policy on health, rights, service delivery and disability, and against some key issues, the pressure of ageing populations and the positon of occupational therapists as women professionals. Current policies present a critical challenge to central occupational therapy tenets. Occupational therapists may find themselves working both in alliance with disabled people and disability activists, and against them.

Functional Deficits and Quality of Life Among Cancer Survivors: Implications for Occupational Therapy in Cancer Survivorship Care.

This study aimed to explore functional deficits and perceived quality of life (QoL) among cancer survivors. Sixty-six participants completed the Post Cancer Outcome Survey developed for the purpose of this study. The results indicated (1) modest to moderate degrees of functional deficits in 28 of the 70 items measuring areas of occupation, performance skills, body functions, and psychosocial well-being within the first year after cancer treatment; (2) significantly lower perceived QoL during the first year of survivorship compared with that before diagnosis, at present, and 5 yr hereafter (p < .001); (3) significant moderate negative correlations between the reported functional deficits and QoL (rs = -.45 to -.57); and (4) a very low percentage of participants (4.5%) receiving occupational therapy during the first year posttreatment. Functional difficulties and compromised QoL identified in this study indicate the need for occupational therapy among cancer survivors. Increasing clients' awareness of occupational therapy for postcancer care is also suggested.

Occupational Therapy Interventions to Improve the Reading Ability of Older Adults With Low Vision: A Systematic Review

This systematic review of the literature examined available evidence regarding the effectiveness of occupational therapy interventions for improving the reading performance of older adults with low vision. We reviewed 32 studies and found strong evidence supporting low vision programs that included occupational therapy and moderately strong evidence supporting the use of electronic magnification. Moderate evidence supported the influence of illumination on reading ability. Limited evidence was found to support eccentric viewing training and optical magnification. More evidence of higher quality is needed to validate the effectiveness of optical magnifiers, text eccentric viewing, characteristic preferences, and line guides within optical magnification. Additionally, further research is needed to develop a standard low vision rehabilitation program. The results of this review support the need for occupational therapy to be included in low vision rehabilitation. The implications of the findings for occupational therapy practice, research, and education are discussed.

Individuals with Stroke Reporting Unmet Need for Occupational Therapy Following Discharge from Hospital

ABSTRACTThe purpose of this study was to identify the characteristics and needs of individuals with stroke who report an unmet need for occupational therapy following discharge from hospital. Needs were assessed using a semi-structured interview and a survey in a sample of 209 adults hospitalized with a stroke. Participants were divided into three groups—those needing occupational therapy; those receiving occupational therapy, and those neither needing nor receiving occupational therapy. Thirteen percent (n = 28) reported an unmet need for occupational therapy and were more dependent in activities of daily living (ADL) before and after their stroke and had lower acute functional independence measure (FIM) scores than the comparison groups (p < .05). Participants with unmet needs for occupational therapy were more likely to report unmet needs related to upper extremity function, basic and instrumental ADL, leisure, assistive devices, and the resumption of social roles.

Cognitive Approach to Improving Participation After Stroke: Two Case Studies

Despite the need for occupational therapy to emphasize client-specific occupational performance, primary emphasis in stroke rehabilitation continues to be on the remediation of client factors and self-care. Such practice leaves many survivors of stroke with continuing performance deficits. Two case studies demonstrate a novel, alternative approach. The Cognitive Orientation to Daily Occupational Performance (CO-OP) treatment is a performance-based, problem-solving approach to developing functional skills that are client centered. CO-OP was used to guide treatment with 2 older women. The findings suggest that the approach has the potential to successfully help clients with stroke achieve their everyday occupational goals and support continued research in this area. This work will lead to a pilot randomized controlled trial.

Geriatric Research

The American Occupational Therapy Association's Centennial Vision articulates the need for occupational therapy to be science driven and evidence based in major practice areas. This article provides a review on the state of the occupational therapy research published in the American Journal of Occupational Therapy (AJOT) in the area of productive aging in the past 2 years (2008-2009). The article identifies the types of research published, assesses how well the journal is meeting the Centennial Vision in productive aging research, and discusses implications for utilization of the evidence by occupational therapy practitioners. Although many basic research articles provide a foundation for future intervention development and further define practice roles, the AJOT articles addressing productive aging represent diverse research questions and have produced a body of knowledge that is not easily translated to practice. More effectiveness studies are needed to provide adequate evidence for occupational therapy intervention with older adults.

Indicators of need for occupational therapy in patients with chronic pain: occupational therapists' focus groups

This study explores occupational therapists' (OT) perceptions of indicators for occupational therapy interventions among patients with chronic pain. An exploratory design was applied to six focus groups of OTs (n = 25) for data collection. Analysis was performed using content analysis through identification of meaning units, codes, categories and themes. Limitations of occupational performance was a major theme that included participant restrictions caused by physical, emotional and environmental barriers. Five subthemes of need were identified: 1) pain behaviour that prevented engagement in activities; 2) lack of knowledge about pain mechanisms and strategies to deal with pain; 3) occupational imbalance in work, leisure and home; 4) emotional stress and depression due to pain; and 5) physical or environmental strain resulting in limitations in occupational performance. Because of the variety and the diverse trends of approaches towards interventions for patients with chronic pain that exist in different cultures and settings, this study should be replicated in other contexts to increase the transferability of the findings.

Conducting a needs assessment to justify the provision of occupational therapy services in a rheumatology outpatient clinic

Investigating the best method of service delivery, or the ‘need’ for a particular service is gaining increasing support as demands intensify across the health‐care system, often with reduced financial resources. Following a restructuring within the Occupational Therapy department at the Austin and Repatriation Medical Centre, a limited amount of time (0.2 EFT Grade II) became available to provide additional services within the hospital. Occupational therapy services to patients of the rheumatology outpatient clinics had ceased since funding cuts approximately 7 years before, yet there had been numerous requests for service. As part of quality assurance activities, a needs assessment was conducted, interviewing clients attending these outpatient clinics. The Health Assessment Questionnaire, a Visual Analogue Scale for Pain, and a non‐standardised questionnaire were used to assess the need for occupational therapy by this patient group. Thirty‐five people were interviewed over a period of 2 weeks. The results supported increased occupational therapy involvement with this client population within the rheumatology outpatient clinic specifically in the areas of improving functional performance, pain management and hand therapy. The study also highlighted a need for promotion of the occupational therapy role both with clients and the medical staff.

Cancer Patients' and their Physicians' Perceptions of the Formers' need for Occupational Therapy

The aims of the study were to identify cancer patients' need for occupational therapy by (a) describing their and their physicians' perceptions of the former's needs (b) exploring whether patients and physicians agree on the patient's need for occupational therapy, and (c) identifying the factors related to the physicians' and the patients' perceptions of patient needs. One-hundred-and-two patients with a cancer disease and the 11 physicians responsible for them completed the ?Occupational Therapy Needs Assessment? during a visit to a medical consultation unit. Fifty-six percent of the patients felt a need for occupational therapy. In 59% of cases, their physicians judged that there was a need for occupational therapy. Patients and physicians both judged that those patients who were older than 66 years and in the active phase of the disease needed therapy more than those patients under 66 years and not in an active phase of the disease. More patients judged by their physicians to have more than 6 months to live needed occupational therapy more than those judged to have less than 6 months. In conclusion, it seems that occupational therapy is felt by cancer patients and their physicians to be underutilised.

Assessment of Occupational Functioning for Screening of Patients to Occupational Therapy in General Psychiatric Care

A Swedish version of the Occupational Case Analysis Interview and Rating Scale (OCAIRS-S) has been tested earlier for interrater reliability. The present study, using the second version of OCAIRS-S and including a sample of 145 patients, showed interrater correlations between .88 and .96 (Intraclass Correlation Coefficient). The results indicate that OCAIRS-S predicts which patients should be included in and excluded from occupational therapy and identifies patients who should be observed more before making such decisions. The study indicates a need for further investigations regarding which components in OCAIRS-S influence the occupational therapist in judging the patient's need for occupational therapy.

Occupational Therapists' Agreement in Screening Patients in General Psychiatric Care for Occupational Therapy

The screening of psychiatric patients for occupational therapy service has traditionally relied on clinical experience, and the rational of the screening is seldom documented. The present study examines agreement among occupational therapists in judging need for occupational therapy for these patients on the basis of videotaped interviews. Occupational therapists (n = 38) working in general psychiatric wards saw videotaped interviews of 10 patients. Two different interview methods were used: a traditional occupational therapy interview and a semi-structured interview. After viewing each interview the occupational therapists had to decide whether to offer the patient occupational therapy treatment or not, or if he/she wanted more assessment information before making a decision. The agreement was high; the mean percentage agreement level of whether the occupational therapists should include or exlude patients from service was 81%. However, most of the occupational therapists wanted to offer occupational the...