Occupational Therapy Perspective Research Articles

Long-Term Impact of an Occupational Therapy Intervention for Children With Challenges in Sensory Processing and Integration.

Research is limited regarding parent-caregiver perspectives of occupational therapy (OT) intervention for children with challenges in sensory processing and integration and whether changes immediately following OT intervention are sustained over time. To evaluate whether changes in identified goals are maintained following OT intervention and to determine what aspects of OT intervention parents-caregivers perceive to be most valuable. A mixed-methods research design. A large midwestern pediatric hospital, with follow-up telephone interviews with parents-caregivers. Sixteen children with sensory challenges and their parents-caregivers. Children participated in 1-hr OT intervention sessions, 3 days per wk, for 6 to 7 wk. Parents-caregivers of children who completed OT intervention were interviewed via the telephone 6 to 12 mo after the intervention. The Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) were used to determine whether changes were made and sustained over time. Qualitative data on caregiver perceptions of OT intervention were collected via open-ended questions during phone interviews. COPM and GAS scores before intervention were statistically significant compared with scores immediately following intervention and at 6- to 12-mo follow-up. Five themes emerged from the qualitative data. Children with sensory challenges made significant changes related to occupational performance following OT intervention, and goal achievement was sustained over time. Parents-caregivers valued many aspects of the OT program, including the increased frequency of therapy services, the occupational therapist's advanced knowledge and skills, and the education and information provided during the program. Plain-Language Summary: This study supports the results of previous studies on OT intervention for children with challenges in sensory processing and integration. The study also adds to the body of knowledge that shows that changes and progress toward goals that result from skilled OT intervention can be sustained over time. The study showed that children participating in OT intervention made statistically significant changes while receiving OT services and maintained progress after intervention ended; however, the children did not continue to make significant progress toward goals once skilled OT services ended. Parents and caregivers of children with sensory challenges reported that they found OT intervention to be beneficial. Other important factors influencing the effectiveness of OT intervention that were identified by parents-caregivers included the education provided by the occupational therapist, the increased frequency of therapy services, and the increased knowledge and skills of the occupational therapists who provided the intervention.

Perspectives of Occupational Therapy Graduates on Sentinel Events During Transitions to Practice: A Phenomenographic Study

Perspectives of Occupational Therapy Graduates on Sentinel Events During Transitions to Practice: A Phenomenographic Study

The impact of a residential fire on occupational engagement and performance: A reflexive narrative approach

Residential fires are a devastating and stressful life event. The high number of residential fires per year and significant associated stressors impacts all aspects of daily life. This reflexive narrative approach highlights gaps in inpatient and outpatient burn care for those who have suffered a residential fire from an occupational therapy perspective. The findings show that healthcare professionals need to consider social support systems, use therapeutic listening, provide stress management techniques and be advocates throughout the recovery process.

Program to Support Child Sleep from the Occupational Therapy Perspective during the COVID-19 pandemic.

Introduction. Here we describe the interim results of the Program to Support Child Sleep from the Occupational Therapy Perspective (Programa de Acompañamiento al Sueño en la Infancia desde Terapia Ocupacional, PASITO) for children with neurodevelopmental disorders (NDDs) aged 3-10 years with insomnia, conducted between June 2020 and September 2021. Population and methods. Pre- and post-intervention quasi-experiment in an intervention group and a control group using the Sleep Habits Questionnaire (SHQ) and the Consensus Sleep Diary (CSD). Results. A total of 22 children with NDDs participated, 8 in the control group. The overall SHQ score for the intervention group improved (p < 0.001) from 54.9 (SD: 5.5) to 48.4 (SD: 4.5) and moved closer to the reference range of 42.6 (SD: 4.9). The CSD showed an increased sleep duration, earlier sleep onset, and fewer night wakings. Conclusion. These interim favorable results demonstrate that the PASITO may be a possible intervention to manage sleep problems in children with NDDs.

Perceptions of Hand Surgery Patients About Occupational Therapy

Occupational therapists provide holistic health care and social care and seek to promote health through occupation. This study measured how hand surgery patients who received referrals for occupational therapy perceive occupational therapy and occupational therapists. A cross-sectional online survey was designed to determine the meaning of an occupation, the role of occupational therapists, the services and benefits provided by occupational therapists, the populations served, and the work settings of occupational therapists. This study included 634 patients who responded to the survey (three-fourths were women). Most participants were uncertain about the professional environment of occupational therapists. Approximately one-third of the respondents believed that occupational therapists work at general hospitals. Most participants believed that occupational therapists manage orthopedic conditions and hand injuries; however, the least participants believed that occupational therapists manage cases involving cardiorespiratory conditions. No significant correlation was noted between the participants' overall awareness of occupational therapy and their sex or age. However, a notable statistical relationship was found between the comprehensive knowledge of occupational therapy and the educational level of the participants. To receive the benefits of occupational therapy, it is necessary for the population to be aware of those benefits. Patient perspectives of occupational therapy can help in patient's education and their treatment plan.

Designing and Implementing an Integrated Occupational Therapy Foundations Course: Occupational Science and Occupational Therapy Perspectives

Designing and Implementing an Integrated Occupational Therapy Foundations Course: Occupational Science and Occupational Therapy Perspectives

Sensory integration from an occupational therapy perspective

An analysis of Sensory Integration in the view of Occupational Therapy (OT) in Neonatal Intensive Care Units (NICUs), which is important for the development of newborn babies, considering the medical and surgical involvement, and the excessive sensory stimuli to which these babies are subjected at a stage when they should be in an intrauterine environment. Occupational Therapy (OT) is fundamental to Sensory Integration as it combines theoretical concepts, the needs of preterm babies, their families and the environment, with practice. An interview script was used to gather information about the units, and nine health professionals who worked in the area, or in pediatrics with premature babies, took part. It was found that there is a great shortage of professionals in the NICU teams, essentially in rehabilitation, and that OT is proving to be an asset in the rehabilitation process of this population.

Feasibility and Implementation Determinants of a Structured Goal Setting and Goal Management System.

There is no evidence-based system to guide occupational therapists in implementing theory-based, client-engaged goal setting and goal management. A new system is needed to support high-quality goal setting and goal management. To determine the acceptability, appropriateness, feasibility, credibility, and expectancy of a new structured theory-based, client-engaged goal setting and goal management system, called MyGoals, for occupational therapists. We explored MyGoals' implementation determinants, potential positive outcomes, and comparative advantages. This was a mixed-methods feasibility study. Community. Occupational therapists (N = 7). Acceptability, appropriateness, and feasibility were assessed using the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM). Credibility and expectancy were assessed with the Credibility and Expectancy Questionnaire (CEQ). Semistructured 1:1 interviews were conducted to explore occupational therapy perspectives on MyGoals and its implementation-related factors. MyGoals had high AIM (M = 18.1, SD = 1.9), IAM (M = 17.9, SD = 2.2), FIM (M = 17.3, SD = 2.1) scores and high CEQ Credibility (M = 22.1, SD = 5.0) and Expectancy (M = 20.6, SD = 4.3) scores. Interview data revealed suggestions to improve MyGoals, implementation determinants across the individuals involved, inner setting, and intervention characteristic domains, client- and clinician-related potential positive outcomes, and comparative advantages. MyGoals is an acceptable, appropriate, feasible, credible, and promising system to guide occupational therapists in implementing theory-based, client-engaged goal setting and goal management for adults with chronic conditions in community-based rehabilitation. What This Article Adds: MyGoals is an easy-to-use, appealing, and helpful system to support occupational therapists in delivering theory-based goal setting and goal management components and to enable adults with chronic conditions to actively engage in their rehabilitation. This study supports the usefulness of MyGoals in community-based rehabilitation to improve goal setting and goal management quality and personally meaningful rehabilitation goal achievement in this population.

Return to work following traumatic brain injury: An exploration of using the Brannagan Executive Functions Assessment to increase self-awareness in practice

Aim and Background: The Brannagan Executive Functions Assessment is an occupation-based approach for increasing self-awareness. This study explores the application of the Brannagan Executive Functions Assessment in traumatic brain injury return to work intervention. It describes changes in self-awareness, goal achievement and perspectives of occupational therapy and people with brain injury. Methods: Case study design using a mixed-methods approach: with pre-post evaluation of outcomes and semi-structured interviews. Participants with traumatic brain injury completed the assessment with two occupational tasks related to return to work. Primary outcomes were self-awareness (Self-awareness Deficits Interview and Awareness Questionnaire) and Goal performance/satisfaction using the Canadian Occupational Performance Measure. Mood was a secondary outcome. Analysis was descriptive for quantitative data, thematic for qualitative data. Results: Two participants with brain injury, two support people and one occupational therapist were recruited. One participant with brain injury had an increase in self-awareness scores. Brain injury participants and the occupational therapist identified benefits including an increased awareness of needing to incorporate planning to meet goals. Conclusion: The Brannagan Executive Functions Assessment offers benefits to practice in brain injury rehabilitation, facilitating a structured occupational approach to self-awareness and participation in meaningful return to work tasks.

פרויקט שילוב טיפול באמצעות בובות לאנשים עם דמנציה בבית אבות - קידום מעורבות בפעילות משמעותית

Occupational therapy treatment for people with dementia in nursing homes faces two major issues: Coping with challenging behaviors, such as shouting and wandering, and finding activities residents can engage in over time. There is preliminary evidence that doll therapy can address these issues. The article describes a project, led by occupational therapists, of integrating doll therapy in a nursing home in Jerusalem. The project aimed to improve the quality of life of residents living with dementia by reducing challenging behaviors and encouraging engagement in meaningful activities. There were two phases to the project: A preparation phase during which the management was recruited to support the project and staff members were trained, and an execution phase during which the treatment was administered. The article provides guidelines for implementing the project in nursing homes. Our experience from this project suggests that the treatment resulted in a reduction in challenging behaviors. In addition, it improved communication and facilitated engagement in activities. As doll therapy might raise objections among staff and family members, it is imperative that the issue be addressed when this treatment is implemented as part of the implementation. In the discussion, we addressed the ethical issues related to the use of a doll as a mean of treating people living with dementia. In addition, we discussed possible explanations for the treatment's beneficial effects from an occupational therapy perspective. The importance of the project is in providing an additional tool for occupational therapists and nursing home staff that can also be used in cases of advanced dementia. Doll therapy is an accessible, affordable, and easy-to-implement method for improving quality of life for people living with dementia.

The Therapeutic Benefits of Hippotherapy: Occupational Therapy Perspective

Bu derleme makalede, Ergoterapi bakış açısı ile atların ritmik salınımları ve vücut sıcaklığının binicinin lökomotor ve duyusal faaliyetlerini etkilemesi esasına göre çalışan bir rehabilitasyon yaklaşımı olan hippoterapinin terapatik yararlarının ortaya konulması amaçlanmıştır. Son yıllarda hippoterapi ile ilgili yapılan araştırmaların çoğu, özellikle postür, denge, kuvvet, koordinasyon ve sensorimotor programlamayı içeren fiziksel engellere uygulanan rehabilitasyon faydaları üzerine olmuştur. Fiziksel hedeflere ulaşma sırasında hippoterapi uygulamalarının benzersiz yaklaşımı beraberinde sosyal, billişsel, akademik, davranışsal, psikolojik ve iletişim alanındaki sonuçları da etkilemektedir. Hippoterapi uygulamaları sırasındaki tedavi yaklaşımı çok yönlü olup, tüm vücut sistemlerinde olağanüstü etkiler göstermektedir. Hippoterapide doğru yöntem, doğru at ve profesyonel bir ekip ile birçok hastalığın tedavisi ve problemlerinin giderilmesinin mümkün olabileceği görülmektedir. Hippoterapi uygulamalarında profesyonel ekibin içerisinde yer alan Ergoterapistler sağlığı ve refahı aktiviteler yoluyla geliştirirler. Ergoterapistler günlük aktivitelerde motor kontrolü, koordinasyonu, dengeyi, dikkati, duyusal süreçleri ve performansı iyileştirmeyi hedeflemektedir. Bu hedeflerine atın ritmik ve dinamik hareketinden, dokusundan ve sıcaklığından yararlanarak ulaşırlar. Ülkemizde hippoterapinin önemi hekimler ve terapistler tarafından daha derinden anlaşıldıkça daha fazla hasta ve ailelerinin bu tedaviden fayda göreceği öngörülmektedir.

Impact of Burnout on Daily Activities from an Occupational Therapy Perspective: A Serial Mediation Model with the IDA Scale.

Burnout syndrome is one of the most frequent health complications among workers. Acknowledging the work perspective as something basic and essential in a person's life means that this disorder can have huge implications in their most basic daily activities. A cross-sectional, quantitative observational design was conducted with data from Spanish workers. A serial mediation model was applied to study the relationship between daily activities and burnout syndrome. For this purpose, the IDA scale was developed. The results show us that peoples' work situation has an impact on their daily life. There is quantitative evidence of the impact on daily life occupations and how it further decreases the levels of health and well-being of the person, on their independence and, consequently, on their quality of life.

P55 Work ready champions for young people: the role of occupational therapy in addressing the pre-vocational and early-employment needs of young people with long term health conditions

Introduction/BackgroundDeveloping a vocational identity is an important part of adolescent development and vocational morbidities have been recognized in young people with long term health conditions including rheumatic disease. Challenges in educational settings and/or workplaces have been reported by young people. Young people have also identified this area to be a research priority. Occupational Therapy (OT) is well placed to assume a lead role in this area, as it is the only health profession that has occupation at the core of its philosophy and practice.Description/MethodThe aim of this study was to explore the pre-vocational and early-employment needs of adolescents and young adults with long term health conditions from the perspectives of OTs and to examine their current and potential role in addressing these needs.MethodsA questionnaire was developed using Qualtrics software and piloted with two OTs and amended accordingly. A snowballing recruitment method via email and Twitter was employed. Initial contact was made via colleagues of the project team and cascaded to OT networks. Data included demographic, involvement in health care planning with education, perceived importance of addressing pre-vocational issues for young people, respondents’ knowledge and confidence, and the role of OT.Discussion/ResultsThe survey received 130 responses, of which 76 responses had complete data available (59%). A complete case analysis approach was taken. The majority of respondents were in clinical roles, primarily working in hospital or community settings and duration in practice ranged from 10 months to 40+ years. The perceived importance of addressing a wide range of vocational issues was consistently greater than the perceived knowledge and confidence of the professionals to address these. The majority of respondents (75%) perceived a need to address vocational issues for young people in their setting although only 22% reported that there was a designated member of their multidisciplinary team who would address these. The majority of such personnel identified by respondents were OTs but also included youth workers, education officer in the youth justice service, social worker.63% routinely assessed productive/vocational occupations such as employment/education. Half of respondents (51%) did not know where to signpost/refer young people for vocational/employment advice. The majority (92%) reported not having any training in addressing vocational/employment issues specifically for young people aged 10-24 years and only 20% reported training in this area with adults. The majority (70%) however did perceive a difference in providing such advice to young people compared to adults. The main perceived barrier to addressing this area in practice was limited clinical time.Key learning points/ConclusionThis study echoes previous calls for vocational issues to be addressed with young people with long-term health conditions and highlights the need for this to be addressed in both training and service provision.

Expanding Occupational Therapy Perspectives with Family Caregivers

Background. Family caregivers are ever-present and crucial collaborators in the work of occupational therapists but are rarely the focus of their efforts. Purpose. This lecture will discuss the greater inclusion of family caregivers in occupational therapy and the exciting possibilities that emerge from this change. Key issues. Family caregivers are a unique client population. This position statement is supported by recent research on occupational therapists’ values and shifts towards an occupational participation approach in the profession. Working with this client population requires a nuanced understanding of their experience. Caregiving can be burdensome, but it can also create positive effects many of which can be identified and understood through a relational lens. Implications. Through a three-fold approach, occupational therapists can work with caregivers to locate and mitigate negative caregiving effects, discover, and build on positive effects, and further develop positive outcomes by encouraging and balancing caregiving and non-caregiving occupations.

Developmental surveillance: a prospective observational study on integrating occupational therapy

ABSTRACT The purpose of this study was to understand the interprofessional contributions of occupational therapy services within the pediatric primary care team during developmental surveillance for health promotion and prevention. A prospective observational study of 27 well-child visits was conducted. Well-child visits were conducted by a physician, physician assistant, or nursing practitioner. This research compared observed developmental surveillance from an occupational therapy perspective to identify opportunities for supporting daily childhood activity participation. Areas of occupational and developmental participation were generally well covered during developmental surveillance. While there were no observed differences in the scope of the well-child visit conducted by different primary care professionals, habits, routines, roles, rituals, and the environments and contexts that may be impacting participation for children and families were found to be an area of limited discussion during developmental surveillance. There is an opportunity for occupational therapy practitioners to be involved in developmental surveillance with an emphasis on occupational therapy’s expertise in habits, routines, roles, and contextual considerations to participation and development.

From Isolation to Connection: A Cross-Sectional Analysis of Older Adults’ Social Participation Using the COV19-QoL Scale

Background: Social isolation during COVID-19 has the capacity to impact older adults’ physical health, mental health, and quality of life. Using an occupational therapy perspective of social participation as an occupation, the current study explores (a) the extent to which social participation (habits/routines) has changed following the onset of the COVID-19 pandemic, (b) differences in perceptions of social participation in relation to the COVID-19 pandemic, and (c) differences in scores on the COVID-19 Quality of Life (COV19-QoL) scale by demographics, access to health care, and lifestyle routine.

The Effect of Occupational Engagement on Lifestyle in Adults Living with Chronic Pain: A Systematic Review and Meta-analysis.

Background Healthy lifestyle is important to decrease health risks in individuals living with chronic pain. From an occupational therapy perspective, human health and lifestyle are linked to occupational engagement in meaningful everyday activities. This study is aimed at investigating the effect of including occupational engagement in chronic pain interventions on lifestyle. Methods In this systematic review (PROSPERO reg. CRD42020159279), we included randomized controlled trials (RCTs) on interventions involving occupational engagement (i.e., occupational performance based on involvement, choice, positive meaning, and commitment) and assessing modifiable lifestyle factors: physical activity, body anthropometrics, alcohol consumption, smoking, stress, and sleep. We sought the databases Ovid MEDLINE, Embase, PsycINFO, CINAHL, Cochrane, Scopus, Web of Science, OTseeker, ClinicalTrials.gov, OpenGrey, and the web engine Google Scholar and citations and references of relevant publications. We evaluated methodological quality with the Cochrane risk-of-bias tool 2.0, determined the overall evidence certainty using the GRADE methodology, and performed meta-analysis when two or more trials reported on the outcomes. Results Of the 9526 items identified, 286 were full text screened. We included twelve articles with eleven RCTs comprising 995 adults and assessing physical activity, sleep quality, stress, and Body Mass Index. Sufficient data for meta-analysis was only available for physical activity and sleep quality. The meta-analysis suggested a moderate increase in physical activity after behavioral interventions for fibromyalgia and musculoskeletal pain (SMD = 0.69 (0.29; 1.09)) and a small increase in sleep quality up to 6 months after multidisciplinary self-management of fibromyalgia (SMD = 0.35 (95% CI 0.08; 0.61)). The overall certainty of the evidence was deemed low. Conclusion Including occupational engagement in chronic pain interventions may increase short-term physical activity and long-term sleep quality. Due to the few available RCTs including occupational engagement in chronic pain treatment for adults living with chronic pain, further high-quality RCTs are needed and will likely change the conclusion.

What are the common areas of risk and their characteristics found in intermediate care from an occupational therapy perspective? A scoping review

Introduction Engaging with risk is a certain and unavoidable part of occupational therapy. Intermediate care services are mostly accessed by older people with complex needs, yet little is known in the literature about the extent, type and nature of risk involved in these services. Method A scoping review was systematically conducted to map the common areas of risk (risk domains) from an occupational therapy perspective. Thematic analysis was conducted in order to identify the risk characteristics related to the literature reviewed. Results 25 journal articles were identified and arranged into 10 risk domains: Falls, discharge, practice errors, activities of daily living, pressure care, frailty management, patient handling, loneliness, nutritional care and language barriers. Three risk characteristics were identified: (1) Risk awareness and identifying risk, (2) decision-making under risk and (3) improving safety. Conclusion Occupational therapists play a diverse role in migrating risk for older people which is not fully explored beyond addressing deficits in functional ability and hazardous environments. The process of how risk is controlled and reconciled with occupation and how positive risk-taking is facilitated are implicit and not directly addressed within the literature reviewed. The findings reveal gaps in knowledge and provide a foundation for further research.

P175 Work Ready Champions for Young People: the role of occupational therapy in addressing the pre-vocational and early-employment needs of young people with long term health conditions

Abstract Background/Aims Developing a vocational identity is an important part of adolescent development and vocational morbidities have been recognized in young people with long term health conditions including rheumatic disease. Challenges in educational settings and/or workplaces have been reported by young people. Young people have also identified this area to be a research priority. Occupational Therapy (OT) is well placed to assume a lead role in this area, as it is the only health profession that has occupation at the core of its philosophy and practice. The aim of this study was to explore the pre-vocational and early-employment needs of adolescents and young adults with long-term health conditions from the perspectives of OTs and to examine their current and potential role in addressing these needs. Methods A questionnaire was developed using Qualtrics software and piloted with two OTs and amended accordingly. A snowballing recruitment method via email and Twitter was employed. Initial contact was made via colleagues of the project team and cascaded to OT networks. Data included demographic, involvement in health care planning with education, perceived importance of addressing pre-vocational issues for young people, respondents’ knowledge and confidence, and the role of OT. Results The survey received 130 responses of which, 76 responses had complete data available (59%). A complete case analysis approach was taken. The majority of respondents were in clinical roles, primarily working in hospital or community settings and duration in practice ranged from 10 months to 40+ years. The perceived importance of addressing a wide range of vocational issues was consistently greater than the perceived knowledge and confidence of the professionals to address these. The majority of respondents (75%) perceived a need to address vocational issues for young people in their setting although only 22% reported that there was a designated member of their multidisciplinary team who would address these. The majority of such personnel identified by respondents were OTs but also included youth workers, education officers in the youth justice service and social workers. 63% routinely assessed productive/vocational occupations such as employment/education. Half of respondents (51%) did not know where to signpost/refer young people for vocational/employment advice. The majority (92%) reported not having any training in addressing vocational/employment issues specifically for young people aged 10-24 years and only 20% reported training in this area with adults. The majority (70%) however did perceive a difference in providing such advice to young people compared to adults. The main perceived barrier to addressing this area in practice was limited clinical time. Conclusion This study echoes previous calls for vocational issues to be addressed with young people with long-term health conditions and highlights the need for this to be addressed in both training and service provision. Disclosure J. Hackett: None. L. Lunt: None. C. Pidgeon: None. A. Farre: None. J. McDonagh: Consultancies; Pfizer, CSL-Behring.

Functional independence in left dorsolumbar congenital kyphoscoliosis – An occupational therapy perspective : A case report

Congenital scoliosis is caused by early embryologic errors in formation of vertebral column. The goal of treatment is to improve the children's quality of life and to give them the best chance to develop as an independent adult. The objectives were to assess the effects of occupational therapy (OT) intervention on balance, gait, and activities of daily living (ADL) in a case of congenital scoliosis. A 14-year-old young female studying in 10th standard diagnosed as left-sided dorsolumbar congenital kyphoscoliosis with apex of scoliosis at 11th dorsal segment level was assessed. She presented with lower extremity spasticity, imbalance, and scissoring gait. Assessment was done using the Berg Balance Scale (BBS) and Modified Barthel Index (MBI). Immediate postoperative OT intervention was started inclusive of balance and gait training. Significant improvement was observed on BBS score preoperatively before therapy from score 11 to post therapy score 50 after therapy was initiated and MBI score preoperatively 11 to post therapy 20 after ADL training at 8 months of therapy.