Occupational Therapy Practice Research Articles

Fostering the discussion of planetary health in occupational therapy and physiotherapy.

Occupational therapists and physiotherapists aim to promote health, prevent various diseases and help people in their rehabilitation processes. So far, there is a paucity of understanding of the big picture of how the new paradigm of planetary health (PH) is connected to the education and practice of these professionals. This research aimed to address this gap by investigating and deploying a bibliometric analysis to elucidate the pivotal role of occupational therapists and physiotherapists in addressing PH challenges. The ultimate goal is to construct a comprehensive framework crosschecking the bibliometric analysis and the collection of 10 case studies selected by experts to outline how best practices in occupational therapy and physiotherapy, related to the three pillars of sustainability and the UN's Sustainable Development Goals (SDGs), can contribute to increasing PH. The bibliometric analysis revealed four major research strands: 1) enhancing patient care and quality of life; 2) integrating sustainability in health care and rehabilitation; 3) professional development and clinical competence; and 4) evidence-based practice and quality improvement. Moreover, further temporal analysis revealed how the topic evolved, from advancing evidence-based practice and clinical effectiveness, exploring the strengthening of health care and person-centred practices, to connecting the topic to aspects also predicted by the SDGs, such as integrating environmental and climate concerns in therapy and addressing psychological and self-care impacts on health. The case studies confirmed this trend, and a framework of PH in occupational therapy and physiotherapy through the lens of the SDGs was developed to support future research and practitioners in advancing this research field. Occupational therapists and physiotherapists are essential players in public health and can integrate sustainability at every level of practice, from using resources during therapy sessions to advocating for more sustainable lifestyles.

Effectiveness of Comprehensive Environmental Support for Community-Dwelling Older Adults: A Single-Blind Randomized Controlled Trial.

The importance of developing age-friendly environments is globally recognized. However, few clinical trials have comprehensively evaluated physical and social components of environments and examined the effects of offering support. To clarify the effectiveness of occupational therapy-based comprehensive environmental support for community-dwelling older adults. A single-blind parallel-groups randomized controlled trial with blinded participants. Eight community-based settings under the long-term-care insurance system in regional towns and cities throughout Japan. Sixty older adults age ≥65 yr who were new users of adult day care or adult day health care and allocated by stratified block randomization on the basis of age. Comprehensive environmental support was provided to participants for 3 mo according to results on the Comprehensive Environmental Questionnaire for older adults (CEQ) to make improvements in environmental factors participants wanted to change to create a more satisfying life. The primary outcome measure was the Japanese Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) score at 3 mo postrandomization. Additionally, scores on the Short-Form Six-Dimension utility index were calculated. The experimental group showed significant improvements in the SF-36's Role/Social Component Summary (p = .005) and Role-Physical (p = .02), Role-Emotional (p = .01), and Mental Health (p = .05) domains, with moderate effect sizes. The number needed to treat was 3.46, showing statistical significance. Occupational therapy-based comprehensive environmental support based on CEQ scores was effective, resulting in moderate improvements in health-related quality of life among community-dwelling older adults. Plain-Language Summary: Older adults experience a decline in physical and mental functions along with changes in social relationships. These problems make it challenging for older adults to perform valuable occupations, thus reducing their quality of life. This study demonstrated that occupational therapy based on the Comprehensive Environmental Questionnaire for older adults can improve health-related quality of life among community-dwelling older adults. Our findings pave the way for the development of an effective compensatory intervention model in occupational therapy practice.

Occupational Therapy and Imprisoned Adolescents: An Analysis of Professional Practices.

The care of adolescents in reclusion has been a field of work for occupational therapists in different parts of the world. The objective of this study was to describe and analyze Brazilian occupational therapists' practices with adolescents in reclusion. Research conducted in Brazil, identifying 56 professionals, invited to answer a questionnaire (n = 43); participate in discussion groups (n = 9); and interview (n = 4). Professionals reported different visions that guide their practices, including the identification of individual skills and the profession's possibilities for social action. Occupational therapists have specificities to work in these institutions, highlighting the possibilities of acting with a focus on social change. Practices in occupational therapy can lead to social change if focused on social issues. Social occupational therapy offers theoretical and methodological elements that inform the profession. Reflections on the practice carried out, according to a critical perspective, enable a performance in occupational therapy that intends social change.

Profile of paediatric occupational therapy practice in Eastern Mediterranean countries

Background Paediatric occupational therapy (OT) is considered the largest practice area in OT in several regions, including the Eastern Mediterranean (EM) countries. Aims/objectives This study aimed to establish a profile of paediatric occupational therapists in EM countries to identify theoretical models, assessments and interventions employed. It also investigated the therapists’ usage of evidence-based practice in their practice. Material and methods We conducted a cross-sectional survey using a questionnaire which was distributed electronically to occupational therapists working with children. Results The participants included 118 therapists. Majority of the participants were working at rehabilitation centres. The primary client groups were pre- and school-age children with autism spectrum disorder and cerebral palsy. The most frequently used assessments were sensory-related tools. Activities of daily living and play were the most often targeted interventional area. Participants highlighted some of the challenges faced in implementing evidence in their practice. Conclusion Paediatric occupational therapists are usually exposed to specific age groups and conditions. However, a lack of knowledge practice in some areas and challenges in others exist. Significance Within the EM region, knowledge regarding therapists’ practices is lacking. Actions should be taken to improve current practice and meet the current needs of clients, and utilise evidence-based practices.

Relationship Between Directly Observed Sensory Reactivity Differences and Classroom Behaviors of Autistic Children.

Differences in sensory reactivity are a core feature of autism; however, more remains to be learned about their role in classroom learning. To use direct observational measures to investigate whether there is a link between sensory reactivity differences and classroom behaviors of autistic children. Correlational study. Two special educational needs schools. Children with a clinical diagnosis of autism, ages 5 to 18 yr (N = 53). Sensory reactivity differences were assessed with the Sensory Assessment for Neurodevelopmental Differences. Classroom behaviors were measured using the Behavior Assessment for Children-Second Edition Student Observation System. Total sensory reactivity differences were correlated positively with behaviors that impede learning (r = .31, p < .05) and negatively with behaviors that facilitate learning (r = -.38, p < .05). Hyporeactivity differences were correlated positively with behaviors that impede learning (r = .28, p < .05) and negatively with behaviors that facilitate learning (r = -.31, p < .05). Hyperreactivity and sensory-seeking differences were not significantly correlated with behavior. Results suggest a link between sensory reactivity differences and classroom behaviors, highlighting a need for further research using observational measures in special education settings. Plain-Language Summary: Differences in hyporeactivity for children with autism may play a bigger role in classroom behavior and learning than previous literature has suggested. This has implications in occupational therapy practice for how to tailor support for children with hyporeactivity differences.

Enlightening Stakeholders on the COVID-19 Pandemic Impacts and Preparation for Minimizing Future Pandemics’ Negative Effects on Occupational Therapists

The COVID-19 pandemic has affected all aspects of professional disciplines including occupational therapy; however, little is known about how much of an impact the COVID-19 pandemic affected occupational therapy practice in Ghana. This study examined the impacts, coping strategies, and COVID-19 pandemic lessons for occupational therapy practices in the future. A descriptive qualitative design was employed with a purposive and convenience sampling methods to recruit occupational therapists from four practice settings in Ghana. Semi-structured interviews were conducted with seven participants. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. Four major themes were identified from the analysis enlightening stakeholders on the impact and preparation for minimizing the impact of future pandemics on the workloads of an occupational therapist. The major themes are (1) impacts of the COVID-19 on occupational therapy practice and practitioners; (2) aspects or domains of work significantly affected by the pandemic; (3) the existing strategies employed to handle the challenges; and (4) strategies to minimize these challenges in the future. The current study has enlightened stakeholders on the need to make alternate preparations including telehealth, continuous support for telehealth infrastructures, training of practitioners, and research to adapt intervention strategies effectively.

Practicing During the COVID-19 Pandemic: Experiences of Canadian Hospital-Based Occupational Therapists.

Background. The COVID-19 pandemic disrupted hospital operations worldwide, including services delivered by occupational therapists (OTs). Purpose. This study aimed to understand the experiences of OTs at one Canadian, tertiary care hospital during the 2021-2022 period of the pandemic. Method. We used a qualitative descriptive approach to describe the experiences of OTs during the pandemic. Findings. While there were similarities in the 10 participating OTs' experiences, salient differences were largely linked to the method of service delivery. Inpatient OTs benefitted from the support of colleagues and developed coping strategies in response to high levels of workplace stress and anxiety and a perceived lack of support from many levels of society. Clinically, they spent more time on discharge planning with fewer resources. OTs providing virtual/hybrid services experienced unique challenges related to adapting their practice to a virtual platform, including challenges assessing patients. They described benefits associated with virtual/hybrid service delivery and brought up concerns around equity of service provision. Conclusion. OTs in this hospital setting faced challenges in providing patient care and supporting their own wellness during the pandemic. Future research could explore the role of leadership in supporting occupational therapy practice during public health emergencies.

Occupational Therapists’ Experiences in Providing Training to Caregivers of Hospitalized Older Adults: A Way Forward for Occupational Therapy Practice

Aims This study explores the experiences of occupational therapists in training caregivers of hospitalized older adults, with the aim of identifying strategies to enhance this practice. Methods Six occupational therapists participated. Results Two major themes were generated: (1) challenges in providing training to caregivers and (2) ways to improve caregiver training services. Seven sub-themes were also identified. The findings highlighted several challenges regarding the provision of training to caregivers that need to be taken into consideration by occupational therapists, as well as valuable suggestions regarding the need for effective guidelines, appropriate content, and the utilization of technology to support occupational therapists in the provision of quality caregiver training services Conclusions Integrating healthcare professionals’ experiences is vital for improving services, recognizing the need for ­caregiver-centric approaches, emphasizing communication improvement within healthcare teams, and advocating for deeper insights into older adults’ needs, while highlighting the importance of technology integration in caregiver training.

Occupational therapy practice with burn injuries: A Rapid Review

Introduction: The Occupational Therapy Association of South African commissioned a task team to gather evidence that would inform upcoming National Health policies on the role and practice of occupational therapists. This rapid review aimed to identify level 1 and 2 peer reviewed published evidence that describes occupational therapists’ practice and intervention in all types of burn injuries, at all levels of care, and for all age groups.&#x0D; Method: Using the South African Department of Health template and the Cochran Rapid Reviews method guide, a search for level 1 and 2 evidence sourced articles from CINAHL (EBSCO), MEDLINE (EBSCO), the Cochrane Library (Wiley) and OTSeeker data bases through the Stellenbosch University library with hand searching of references in the selected articles. Rayyan was used for the screening and selection of articles. The CASP appraisal tool was used for risk bias and quality assessment of the selected articles. Data was captured in Excel and Word, and analysed and synthesised in Microsoft Excel and Taguette. Results were presented in the form of an online workshop to stakeholders and discussions and questions incorporated into the discussion and conclusion of this review.&#x0D; Results: Eleven articles were selected and their quality assessed. Seven categories of evidence of occupational therapy interventions were extracted from selected articles: pain, oedema, scaring and abnormal skin sensations, joints and range of motion, psycho-social and functional impact of burn injuries, the education of burn injury victims and their families, and vocational rehabilitation. All interventions took place in healthcare facilities. Nine articles referred to occupational therapists working in multi-disciplinary teams. Occupational therapist worked with children and adult burn injury victims and with a variety of type of burn injury from acute to post discharge phases.&#x0D; Conclusion: There is level 1 and 2 evidence conderming occupational therapy intervention with burn injury victims with all ages and at all stages of injury within healthcare facilities. None of the evidence found is from the South African context. Such levels of evidence are needed to promote occupational  therapy  intervention  in  primary,  preventative  and community contexts.&#x0D; Implications for practice:&#x0D; Internationally there is level 1 and 2 evidence that conderms occupational therapists are members of multi-disciplinary teams addressing the functional ability and participation in activities of burn injury victims. None of this evidence is from South Africa. As a matter of priority, South African clinical occupational therapy practice and intervention within the deeld of burn injury, need to be researched and disseminated as level 1 and 2 evidence&#x0D;  

Laying claim to occupational therapy practice, one rapid review at a time

Laying claim to occupational therapy practice, one rapid review at a time

The role of occupational therapy serving LGBTQIA+ people: Retrospective perceptions of an occupational therapist

Introduction and aim:  LGBTQIA+ people constitute a minority group that navigate their occupational engagement within a historically entrenched system of oppression. This opinion piece addresses a subject matter that is increasingly garnering attention from the international health science community, yet it remains insufficiently explored in South African occupational therapy dialogues. The aim of this paper is to stimulate critical reflection among occupational therapists on the discourses that underpin our daily practice. By utilising the person- environment-occupation model, we seek to demonstrate the unique and essential role of occupational therapy in serving LGBTQIA+ people within the South African context.&#x0D; Conclusion: Although occupational therapists are trained to consider all aspects of a person, discussions around gender are rarely emphasised in undergraduate  training  or  clinical  practice.  This  opinion  piece demonstrates the roles that occupational therapists may play when working with LGBTQIA+ people to provide services that are holistic and relevant to their needs and contexts. Recognizing the impact of everyday occupational therapy practices on LGBTQIA+ individuals is crucial, requiring a commitment to inclusivity and continuous reflection within the field of occupational therapy.&#x0D; Implications for practice&#x0D; Occupational therapists can play an important role in serving LGBTQIA+ individuals when they are committed to recognizing how dominant discourses about this group can be sustained through the everyday practices of delivering occupational therapy.&#x0D;  

Application of the Person-Environment-Occupation-Performance Model: A Scoping Review.

The Person-Environment-Occupation-Performance (PEOP) Model is one of several occupation-based models in occupational therapy. The model describes the transactional nature of person, environment, and occupation factors that support performance (doing), participation (engagement), and well-being (health and quality of life). The purpose of this study was to explore the extent and nature of evidence on the PEOP Model. We used a scoping review to identify and analyze journal articles that used the PEOP Model as a framework for study. The PRISMA extension for scoping reviews (PRISMA-ScR) criteria were used to develop the research methods. We found 109 articles that adopted the PEOP Model as an organizing framework. The studies reviewed represent the breadth of occupational therapy practice and the transactional nature of person, environment, occupation, and performance in the PEOP Model. The PEOP Model is a useful international framework for research and practice across populations, conditions, life circumstances, settings, and areas of practice.

Occupational therapy role in enhancing creativity and intelligence development—A review study

This article provides a comprehensive review of the impact of occupational therapy (OT) on the development of creativity and intelligence, areas of growing interest within the field of cognitive and developmental psychology. Through a systematic examination of the literature, this review aims to elucidate the role of OT in enhancing cognitive functions that underpin creativity and intelligence, including problem-solving skills, cognitive flexibility, and executive functioning. The methodology employed involves a rigorous search of peer-reviewed articles, employing inclusion and exclusion criteria designed to capture relevant studies, followed by a qualitative synthesis of findings to identify common themes and insights. The review reveals that OT interventions, particularly those incorporating creative activities and tasks targeting executive functions, can significantly contribute to cognitive development. Studies highlighted within the review demonstrate improvements in cognitive flexibility, problem-solving abilities, and overall intelligence quotients (IQ) among participants engaging in OT. Theoretical frameworks, such as Cognitive Stimulation Theory and Environmental Enrichment Theory, provide insight into the mechanisms through which OT may foster creativity and intelligence. In conclusion, this article underscores the potential of OT to enhance creativity and intelligence, suggesting that OT interventions could be a valuable component of educational and developmental programs. By fostering engagement in meaningful and challenging activities, OT not only supports the rehabilitation and adaptive capabilities of individuals with various needs but also contributes to the cognitive and emotional growth of a broader population. This review advocates for the integration of creative and cognitively stimulating activities within OT practice, highlighting the importance of further research to expand our understanding of these relationships.

Occupations and occupational therapy practice with Chinese older adults living with life-limiting illnesses in Singapore: A focus group study.

While Singapore is rapidly ageing and the need for palliative care services is projected to rise, there has been limited exploration of the occupations of Chinese older adults with life-limiting conditions. This study is the third in a series of three studies aimed to address this issue. This study also sought to discuss future directions for occupational therapy practice with Chinese older adults living with life-limiting illnesses in Singapore. The study adopted a qualitative exploratory design using focus groups. Participants were recruited using convenience and snowball sampling. Inclusion criteria were occupational therapists who had attained full registration status with the Allied Health Professionals Council in Singapore, had two or more years of practice as an occupational therapist, and had a current or recent palliative care caseload. Three focus groups with 16 participants were conducted, and three themes were constructed from the data through reflexive thematic analysis. Reflections on culture and occupations is about the impact of a collectivist culture on occupations, such as tensions new caregivers experience between keeping clients safe and respecting clients' choices. It also highlights that there will always be individual differences within any cultural group. Challenges of occupational therapy practice in palliative care describe the need for therapists to be comfortable with rest and ethical tensions participants faced with billing for sessions that mainly involved time spent conversing with clients and when clients and caregivers' goals differed. Finally, Moving forward is about the importance of having mentors and the learning needs of occupational therapists in palliative care. Occupational therapists experienced in providing services to palliative care clients in Singapore emphasised the collectivist nature of Singaporean Chinese families and contributed more information to its possible impact on occupations and occupational therapy practice and made suggestions for future practice.

Care, kindness and collegiality in occupational therapy practice and academic life

ABSTRACT This paper explores the reflections of occupational therapy academics about the experience of kindness in academic and professional life. Data were derived from a reflective group conversation in the context of a larger overarching research project exploring occupational therapy academic development. The findings elaborate how kindness and care played out for us as participant-researcher academics, including how it was mediated by expression of values and behaviours in our roles, and how we experienced the values and behaviours of others in the academy. We found that degrees of kindness and care were distributed along a continuum from more kind to less kind. A notable aspect of our conceptualisation of kindness involves recognising others' potential and a willingness to work collectively. We argue that it is critical to create and maintain communities that value and are capable of acting with authentic care and kindness. Prioritising our time to engage in emotion-based, relational work beyond ‘duty of care’ is vital to support collective success and longevity in the academy. Recognition of, and action to challenge, the forces that erode kindness and care are vital next steps in creating academic and professional contexts that will support our flourishing.

Effects of Occupational Therapy Professional Development Training on School-Based Practice

ABSTRACT Purpose A training program was provided to school-based occupational therapy practitioners (SBOTPs) in Massachusetts to support practices aligned with educational policies and regulations. The purpose of this study was to determine the impact of this training program on school-based practice patterns. Methods This study used a researcher-designed online exploratory survey to determine occupational therapy practice patterns in Massachusetts public schools following the training program. The survey was emailed to the 309 SBOTPs who participated in a Massachusetts Department of Education sponsored training between 2007 and 2019. The survey questions analyzed the frequency of reported participation-based intervention methods, in-context and out-of-context services, and interdisciplinary collaboration used by these practitioners. A Chi Square Goodness of Fit Test was performed to determine if there were categorical differences in the frequency of responses to each research question. Results After analyzing our 29 responses we determined that the training program was effective and had an impact on how SBOTPs practice within their schools. After the training, SBOTPs in Massachusetts reported engaging more frequently in participation-based practice in natural school contexts, and collaborating with teachers and other school professionals. Contribution to Occupational Therapy This research serves as evidence that professional development courses can impact how SBOTPs practice. This study suggests that practice patterns of SBOTS can be influenced by participating in trainings that include a model with rationale and facilitated practice for providing occupation-based services in the least restrictive environment and for increasing collaborative practices in schools. School-based occupational therapy (SBOT) is integral to the educational development of children who require this service as part of their individual educational program (IEP). SBOT helps students to achieve success in occupations within the school setting, such as education, play and leisure, activities of daily living (ADLs), and social participation. Students who receive special education services are eligible for occupational therapy if the IEP team determines that SBOT is necessary to achieve the prioritized student goals developed by the team, enhancing the student’s ability to succeed in the educational program. The overarching goal of school-based occupational therapy in working with eligible students with disabilities under the federal special education law, the Individuals with Disabilities Education Act (IDEA), is to support students’ abilities to successfully participate (academically and functionally) in their educational program in the least restrictive environment in order, ultimately, to prepare them for adult living (AOTA, 2017; IDEA, 2004).

The potential role of occupational therapy in the treatment of avoidant/restrictive food intake disorder.

Most individuals with avoidant/restrictive food intake disorder (ARFID) never receive treatment, and treatment needs far exceed the current capacity of mental health services. Occupational therapy (OT) focuses on enhancing function in daily activities, including eating and feeding. Given OT's rich history in mental health and pediatric feeding disorder treatment, we spotlight the potential role of OT in ARFID treatment, current knowledge, and opportunities for future research. Through a preliminary exploratory inquiry involving a review of current literature and clinical practice, we investigated OT's current involvement, knowledge, and interprofessional collaborative practice gaps in ARFID treatment. While many occupational therapy practitioners (OTPs) engage in ARFID treatment, interventions lack rigorous evaluation, and there is limited evidence defining OT's distinct role in interprofessional ARFID treatment. OTPs are uniquely positioned to provide interventions for individuals with ARFID across the lifespan, though research is needed to evaluate the efficacy of OT interventions. Future research suggestions include standardizing OT approaches to ARFID treatment and conducting single-case experiments and randomized controlled trials to compare OT approaches with alternative methods. Recommendations to address practice gaps include enhancing ARFID education for OT students and practitioners and fostering a greater understanding of OT's role on the interprofessional team. PUBLIC SIGNIFICANCE: Individuals with ARFID face barriers to eating that impact their health and function. On a multidisciplinary team, OTPs can treat diverse client populations by identifying and addressing barriers to daily participation, such as physical impairments, trauma history, and environmental barriers. More research is needed to evaluate the efficacy of OT practices in ARFID treatment.

Attention Autism™ training for occupational therapists: a pilot study

Purpose At present, there is no reference to Attention Autism (AA) as a framework and therapeutic tool with autistic children in occupational therapy (OT) literature. By way of introducing AA as a potential intervention to the OT community, this study aims to investigate the extent to which participation in a two-day AA training could contribute to increasing confidence and inspire changes in practice for Irish occupational therapists (OTs) supporting autistic children. Design/methodology/approach A pilot study design with mixed qualitative and quantitative methods was used to evaluate the impact of a two-day AA training on six OTs. The OTs support autistic children throughout Ireland across public, private and voluntary sectors. They completed brief, non-standardised questionnaires 2 weeks before the training (Time 1) and again 12 weeks post (Time 2) training session. At Time 2, additional exploratory questions were answered by OTs regarding their use of AA in practice. Findings This explorative study’s quantitative findings presented percentage change increases within three areas of confidence for all OTs. These include establishing attention, motivating and developing functional skill goals with autistic children. One of the participants did not score any change in confidence in a fourth area, building rapport, however, the five other participants scored percentage change increases. Qualitative data provided by participants showed that they were implementing AA in practice since attending the training. Five of the participants reported positive experiences of using AA and one participant reported the programme was not suitable for her caseload because of their level of understanding and need. Research limitations/implications This was a small, exploratory, practice-based study. As this is the first study exploring this area of practice for OTs, to the best of the authors’ knowledge, there were no standardised methods of assessment available, therefore a self-designed survey was used by the author which had a limited number of open-ended questions and four Likert scale questions. This study was also limited in that there was one main researcher who also delivered the two-day AA training. The sample data set was small which resulted in the limitation of the choice of methods used to analyse the quantitative data. Percentage changes were used as the only available and reliable method for a small data set. Originality/value Findings of this study, despite their preliminary nature, indicate that AA training may be a useful professional development consideration for OTs who provide a service for autistic children. Further AA research in OT is required including larger and more rigorous studies. An alternative training option of The Curiosity Programme may be considered for OTs supporting children who may not yet be ready to participate in AA.

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.

Let's Talk About Ethics: Addressing Ethical Tensions and Building Moral Resilience in the Occupational Therapy Profession.

Health professionals across all care delivery settings, including occupational therapy practitioners, are experiencing high levels of moral distress. The mental, emotional, and physical consequences of unresolved moral distress are resulting in burnout, decreased quality of care, and poor patient outcomes. Moral resilience is a teachable and learnable skill that can nullify some of the adverse consequences of moral distress. To ensure quality care outcomes and improve the well-being of individual occupational therapy practitioners and the profession, it is essential that occupational therapy practitioners be provided with the education, training, resources, and strategies needed to address moral distress, foster moral resilience, and cultivate the skills necessary to cope with ethical tensions. In this column, we call the profession to action to address the phenomenon of moral distress as it relates to occupational therapy practitioner well-being. We also discuss resources and strategies for addressing ethical tensions and building moral resilience in occupational therapy practice.