Occupational Therapy Practitioners Research Articles

Identifying Facilitators of and Barriers to Referrals to Occupational Therapy Services by Israeli Cancer Health Care Professionals: A Qualitative Study.

Persons living with and beyond cancer (PLWBC) are rarely referred to occupational therapy services despite their functional difficulties. An understanding of the barriers to and facilitators of occupational therapy referrals from the perspective of cancer health care professionals could help minimize referral gaps. To explore cancer health care professionals' perspectives on and knowledge of occupational therapy's role in cancer care, identify the barriers, and explore solutions to optimize referrals. Multiexplanatory qualitative case study. Community and hospital cancer clinics in Israel. Six in-person focus groups of cancer care Israeli nurses and social workers, totaling 28 participants. Two main themes were identified: (1) barriers to occupational therapy referrals and (2) partial facilitators of occupational therapy referrals. The four barriers subthemes were (1) gaps in knowledge about symptoms' effects on daily functioning, (2) gaps in knowledge regarding occupational therapy's role in cancer care, (3) bureaucratic and organizational barriers, and (4) unavailability of occupational therapy services. The two facilitators subthemes were (1) collaborations and communication with occupational therapists and (2) awareness of occupational therapy services. Participants suggested practical solutions for improving occupational therapy referrals, interdisciplinary collaboration and communication, and integrating occupational therapy into cancer care. Barriers to referrals included gaps in participants' knowledge that link side effects to functional difficulties indicating a need for referral to occupational therapy. Participants' suggestions to bolster referrals can be implemented by occupational therapists to reduce patients' unmet needs and bridge existing gaps in cancer care. Plain-Language Summary: This research helped to identify barriers and facilitators regarding insufficient knowledge about occupational therapy's role in cancer care and adds a better understanding of gaps in referrals to occupational therapy. In addition, cancer health care professionals who participated in the study suggested practical solutions for reducing barriers and maximizing support for referral. With these nuances, occupational therapy practitioners can work with medical cancer care units (i.e., acute care hospitals, medical cancer centers, and community health care clinics) to target the use of strategies that work for their units to ensure that persons living with and beyond cancer receive needed occupational therapy services.

Pilot Study Evaluating a Brief Chronic Pain Education Program in Occupational Therapy Practitioners, Occupational Therapy Students, and Lay People

Pilot Study Evaluating a Brief Chronic Pain Education Program in Occupational Therapy Practitioners, Occupational Therapy Students, and Lay People

Effectiveness of a Driving and Community Mobility Intervention for Teens and Young Adults With Autism Spectrum Disorder.

Driving and community mobility (DCM) is key to supporting independence in teens and young adults (TYA) with autism spectrum disorder (ASD). To determine whether an intervention focused on DCM can effectively improve DCM knowledge and skills in TYA. A pretest-posttest design using the same intervention and outcome measures. University research setting. Thirty-eight participants with ASD completed the program (M age = 17.76 yr, SD = 3.58). Twenty-six (68%) were male, and 12 (32%) were female. A 5-day intensive intervention using group and individualized strategies, including driving simulation, focused on improving performance skills needed for DCM. Total and category scores of the Performance Analysis of Driving Ability (P-Drive) were analyzed using a repeated-measures analysis of variance measuring time (pretest vs. posttest), gender, and year of intervention. Paired t tests were used to determine the outcomes of the Canadian Occupational Performance Measure (COPM), anxiety measure and perception survey. Results indicated a significant main effect for time (p < .001) and year (p < .036), but not gender (p < .26), with no significant interaction effects, supporting the fidelity of the intervention. The COPM showed significant changes (p ≤ .001) in both performance and satisfaction, as well as a reduction in anxiety (p = .008). Outcomes suggest that the intervention successfully improved DCM knowledge and skills for TYA. This adds new evidence that an occupational therapy intervention specific to TYA with ASD is effective in developing independence in DCM. Plain-Language Summary: Driving is the primary mode of community mobility in North America and other Western countries. Adults with autism spectrum disorder (ASD) who have a means of community mobility have a chance of employment that is 5 times greater than that for those who do not. Driving and community mobility are key to supporting independence among teens and young adults with ASD. However, teens and young adults with ASD have significantly lower rates of getting a driver's license. The results of this study show that occupational therapy practitioners can play a critical role in addressing driving and community mobility. Occupational therapy interventions that are specifically designed for and unique to each teen and young adult with ASD can effectively improve driving and community mobility skills and increase independence.

Practitioner Burnout and Productivity Levels in Skilled Nursing and Assisted Living Facilities, Part 1: A Descriptive Quantitative Account.

Understanding burnout among practitioners in skilled nursing facilities (SNFs) and assisted living facilities (ALFs) while considering contextual factors may lead to practices that enhance therapist and patient satisfaction as well as quality of care. To examine productivity standards and burnout in the context of setting and role, as reported by therapy practitioners in geriatric settings, and to explore relationships between productivity standards and perceived ethical pressures. Cross-sectional online survey with descriptive data. Practitioners (N = 366) included occupational therapists, physical therapists, speech-language pathologists, and occupational and physical therapy assistants working in SNFs and ALFs in the United States. A survey integrating the Maslach Burnout Inventory: Human Services Survey for Medical Personnel (MBI-HSS) and questions addressing demographics and contextual factors was distributed via social media. Of 366 practitioners, 20.5% were burned out, exhibiting extreme scores for Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA) on the MBI-HSS. Significant relationships between productivity requirements and EE, DP, and PA, after accounting for covariates, were evident. Significant relationships between productivity standards and five of the six ethically questionable behaviors existed. Role affected productivity requirements, specifically between therapists and assistants, whereas setting did not. Productivity standards and related pressures are associated with concerning aspects of burnout among practitioners working in geriatric settings. Advocating for change in defining productivity and incorporating positive support in the work environment may assist in reducing burnout and turnover rates and improve patient satisfaction and care. Plain-Language Summary: This research highlights the prevalence of burnout and perceived pressures related to productivity requirements among occupational therapy practitioners working in skilled nursing and assisted living facilities.

Building Bridges: A Mentor Education Program for Occupational Therapy Practitioners

Building Bridges: A Mentor Education Program for Occupational Therapy Practitioners

Feasibility of Mindfulness at Work: A Continuing Education Program for Occupational Therapy Practitioners Experiencing Burnout

Feasibility of Mindfulness at Work: A Continuing Education Program for Occupational Therapy Practitioners Experiencing Burnout

Structural Relationships Between Behavioral Problems, Sensory Processing Traits, and Sleep Among Preschoolers.

An association between sensory processing difficulties and behavioral problems among children has been reported in previous studies. Sleep problems among children can lead to both externalizing and internalizing behavioral problems. However, the relationships between sensory processing and sleep among children are not well understood. To develop a structural causal model (SCM) predicated on the hypothesis that sensory processing difficulties and sleep problems are closely related among preschoolers and may contribute to behavioral issues. Cross-sectional study. A total of 168 children ages 3-5 yr who were enrolled in a preschool or an accredited kindergarten (four facilities in total) in a Japanese prefecture participated in the analysis. After gaining the cooperation of educators, we distributed the following items to the children's parents: an informed consent form, the Short Sensory Profile-Japanese version (SSP-J), the Japanese Sleep Questionnaire for Preschoolers (JSQ-P), and the Child Behavior Checklist for Ages 1.5-5. Through factor analysis of the SSP-J and the JSQ-P, we identified common factors. We developed an SCM using structural equation modeling. Four factors were identified by factor analysis: attention deficit, sensory sensitivity, sleep problems, and restless legs syndrome symptoms. The final structural equation modeling analysis had an acceptable goodness of fit (goodness-of-fit index = .862; root-mean-square error of approximation = .087). The model suggests that sensory sensitivity and sleep difficulties may contribute to behavioral issues among preschoolers. Plain-Language Summary: The results of this study suggest that relationships exist between behavioral problems, sensory processing, and sleep among preschoolers. The authors developed a model that identified four common factors that contribute to behavioral issues among preschoolers: attention deficit, sensory sensitivity, sleep problems, and restless legs syndrome symptoms. Children's behavioral problems are an important consideration for occupational therapy practitioners working with preschoolers. Sensory processing and sleep must be accurately evaluated to address preschoolers' behavioral issues.

Path Analysis to Assess Diversity of Occupational Opportunities Within Walking Distance and Community Health.

Built environment structures affect a population's occupational participation and health outcomes. To examine how occupational opportunities available within walking distance are related to a community's overall health. Secondary data analysis. Community. Community-dwelling adults. Data from the AARP Livability Index and Walk Score® for 78 zip codes were used for path analysis and multiple regression analysis to investigate the relationship between various community factors and the health of the community. Path analysis for 78 zip codes revealed that the primary determinants of health score were destination diversity and social walk score. Multiple regression analysis revealed that destination diversity (β < .001) and exercise opportunity (β < .001) were significant factors for health score. Multiple regression analysis revealed that destination diversity (β < .001) was a significant factor for social score. The results suggest that increased diversity of destinations in a community and opportunities available for social participation within walking distance are associated with better health of residents in the community. Plain-Language Summary: This study highlights how the built environment and opportunities for social participation are associated with a community's overall health. This study found that participation in a variety of group activities contributes to community members' well-being. Understanding how the built environment is related to health outcomes may better equip occupational therapy practitioners to improve the health of an individual, group, or population.

Racismo e antirracismo nas práticas de terapia ocupacional: um protocolo de revisão de escopo

Abstract Introduction Worldwide, the life of the Black population is marked by racism and different forms of violence that have negative effects on their daily occupations, as well as impact their subjectivity, their ways of being in the world, their identity, and social relationships. Objective The scoping review protocol aims to describe the theoretical and methodological frameworks that guide the practices of occupational therapy practitioners who provide services to Black populations. Methods The JBI methodological framework for scoping reviews will be adopted for this scoping review. A search strategy was designed in collaboration with a health sciences librarian based on titles and abstracts of relevant articles. A 3-step search strategy consisting of an initial limited search, a full search, and a screening of the reference lists of all included articles will be undertaken. Databases such as CINAHL (EBSCOhost), MEDLINE (PubMed), PsycINFO (EBSCOhost), LILACS (BIREME/PAHO/WHO), SCIELO, Web of Science, and Scopus will be searched to identify relevant full-text articles, including original research, editorials, and opinion articles. Inclusion criteria Peer-reviewed articles published in Portuguese and English between the years 2013 and 2024 will be included. Two reviewers will screen sources and extract data using a tool that will be modified, and revised, as necessary. The data will be presented using diagrams, tables and/or word clouds, accompanied by a narrative summary. Quantitative and qualitative analyses, through description and categorization, will accompany the mapped results, correlating them to the objective and research question of the scoping review. The approach recommended by JBI for study selection, critical evaluation, data extraction, and data synthesis will be used.

Use of AI in Pediatric Occupational Therapy: A Review

The utilization of artificial intelligence (AI) in pediatric occupational therapy (OT) has emerged as a promising avenue for enhancing assessment, intervention, and outcomes for children with diverse developmental needs. This paper provides a comprehensive review of the current state of AI applications in pediatric OT, highlighting key findings, benefits, challenges, and future directions. AI technologies, including machine learning algorithms, computer vision systems, and wearable sensors, offer innovative approaches to assess children’s motor skills, sensory responses, and cognitive functions objectively and efficiently. AI-driven intervention strategies, such as personalized treatment planning, adaptive task selection, virtual reality environments, and gamified activities, promote engagement, motivation, and skill acquisition among pediatric patients. Additionally, AI-powered telehealth platforms enable remote delivery of OT services, real-time monitoring of patient progress, and access to care for underserved populations. However, challenges related to data privacy, ethical decision-making, disparities in access, and therapist education must be addressed to ensure the ethical, effective, and equitable integration of AI into pediatric OT practice. By embracing ongoing research, collaboration, and innovation, pediatric OT practitioners can harness the transformative potential of AI to improve outcomes and quality of life for children and families worldwide.

INFLUENCE OF PERSON AND ENVIRONMENTAL FACTORS ON OLDER ADULT ENGAGEMENT IN VIDEO TELEHEALTH

Abstract Rural patients at Veterans Health Administration (VHA) are older and have more complex chronic conditions than Veterans receiving care outside VHA. Rural patients face challenges accessing care, particularly specialty services which are often in urban areas. Though video telehealth can increase access to care by older patients, video was underutilized by this group even during the rapid increase in use of video in response to COVID. The unequal uptake of video telehealth by older patients during a time when there were limited options suggests a gap in our understanding of the factors involved with older adults’ utilization of video telehealth. To explore these factors, we interviewed occupational therapy practitioners who were high users of video telehealth (N=27) about their experiences with video telehealth. According to interviews, successful utilization of video telehealth involves consideration of complex factors operating at the person (i.e., patient and clinician) and environmental levels. Person-level factors for the patient and/or family caregiver include technological literacy, sensory impairments, and stress tolerance. Clinician person-level factors include confidence with technology, attitudes towards video (including perceived benefits for clinical care), and specific skills like communication and flexibility. Environmental level factors include the physical setting (e.g., whether the patient/clinician are in a private space), availability of technical assistance for patients and clinicians, caregiver assistance on the patient side, and presence of a device and adequate broadband for patients. Elucidating the network of factors involved with video telehealth may enable sustained integration of video telehealth by rural patients most in need of care.

Daily Emotional Experiences in Persons with Parkinson Disease: Relations to Subjective Cognitive Complaints and Quality of Life

Aim This study aims to explore positive and negative emotional experiences during the performance of daily occupations in Persons with Parkinson Disease (PwPD). Methods This cross-sectional study included 32 PwPD and 14 healthy older adults. Participants completed three questionnaires that measured emotional experiences during daily occupations, subjective cognitive complaints, and quality of life. Results PwPD experienced higher rates of negative affect during all occupations. Lower rates of positive affect were found only during personal care tasks. Additionally, experiences of daily negative affect were positively associated with subjective cognitive complaints and negatively associated with quality of life. Conclusion Different rates of positive and negative affect are experienced by PwPD during daily occupations. The experience of daily emotions has implications for understanding emotional processing in neurological populations. Occupational therapy practitioners should consider the role of emotions when providing occupation-based interventions for PwPD.

Pandemic-Induced Occupational Disruption and Association With Health in Japanese Community-Dwelling Older Adults.

The COVID-19 pandemic caused occupational disruption and adverse health outcomes in community-dwelling older adults. This study aimed to investigate the extent of occupational disruption in older adults and its relationship to health-related quality of life (QOL), depression, and frailty. In this cross-sectional study, retention rates in four activity domains and relationships with health outcomes were examined in Japanese older adults aged ≥65 years (n=163) using canonical correlation analysis (CCA) and mixed linear models. More than 25% of activities were restricted compared with the pre-pandemic period. CCA demonstrated correlations between four retention rates and health outcomes (canonical correlation = .42, p = .0003). Retention in instrumental and social activities independently predicted QOL and depression (p < .05). This study highlights that different activities may have different effects on health outcomes and can provide community occupational therapy practitioners with a perspective to assess occupational disruption and identify activities for intervention.

The Meaning of Roles and Routines for Families Experiencing Homelessness in the COVID-19 Pandemic

This study explored the experiences of mothers experiencing homelessness amidst the COVID-19 pandemic. Semi-structured interviews were completed with nine mothers and analyzed using thematic analysis. Themes uncovered during the interviews highlighted sources of motivation and perseverance, additional and ongoing impacts of COVID-19, sources of further mental anguish, and unmet needs challenging roles and routines. Notably, the identity of being a mother and the value placed on that role significantly influenced their daily routines and engagement in meaningful occupations. Occupational therapy practitioners can utilize these findings to deliver contextually sensitive care tailored to the unique circumstances and immediate requirements of this population.

A Qualitative Study on Occupational Therapists’ Experiences with Gun Owners and Victims of Gun-Related Violence

With the widespread access to firearms and an increasing prevalence of gun violence, examining the experiences of occupational therapists in dealing with gun owners and gun violence victims is warranted. Sixteen semi-structured interviews were conducted with occupational therapy practitioners with experience working with this population in the United States. Using thematic analysis, three main themes emerged: psychological and emotional dimensions, occupational safety and management, and daily functioning. The findings of this study provide insights into the strategies used by therapists in this context.

Collaboration Between Occupational Therapy Practitioners and Elementary School Educators to Support Students with Attention Deficit Hyperactivity Disorder

Aims This study compares experiences of occupational therapy practitioners (OTPs) and other elementary school educators when supporting students with attention deficit hyperactivity disorder (ADHD). The aim is to establish collaborative methods for OTPs and other educators to support students with ADHD. Recommendations to overcome barriers to supporting students with ADHD are made based on study findings and current research. Methods An online survey of OTPs and other educators was conducted. The survey asked about the barriers to supporting elementary students with ADHD, and the training resources that would improve the ability to support students with ADHD. Results Responses from 147 OTPs and 35 other educators were compared using two-sample proportion tests. The groups shared common barriers and preferences for training resources, however, statistically significant (p < 0.05) differences were found in; 1) the barrier of limited knowledge and training about ADHD, with other educators being more limited by this barrier; and, 2) the preference for video formatted training, with other educators identifying a higher preference for this option. Conclusions The data suggest that there is an opportunity for OTPs and other educators to collaboratively develop ADHD training videos for all educators to foster the success of elementary students with ADHD.

School Administrators’ Perceptions of Occupational Therapy’s Role in General Education Initiatives

ABSTRACT The Every Student Succeeds Act of 2015 has outlined an expanded role for school-based occupational therapy practitioners (OTPs) as specialized instructional support personnel in general education. However, OTPs have continued to be viewed as related service professionals under special education due to barriers of high caseloads and decreased administrative support. This study sought to understand school administrators’ perceptions of occupational therapy’s role in general education initiatives. A qualitative sample of ten Connecticut school administrators was utilized to answer the research question. Data was acquired through individual semi-structured interviews. Data analysis indicated three key themes which include school administrators highly regard OTPs, believe occupational therapy’s role should be expanded in general education, and are open to occupational therapy’s full scope of practice in the educational setting. However, administrators noted time and budget barriers hindered OTPs’ role expansion to support general education initiatives.

Climate Change and Occupational Therapy: Meeting the Urgent Need for Adaptation, Mitigation, and Resilience

Climate change may be the most pressing existential threat to human health and wellbeing in the twenty first century. In this paper, the authors provide context and critique on barriers to climate action in the United States and other high-income countries, including the profit-driven approach to health, consumerism, and the climate change countermovement. The reciprocal connections between occupational engagement and climate damage are examined from a lens of collective and irresponsible occupations and subsequent accountability. The authors propose the United Nations’ Sustainable Development Goals as a basis for recommendations occupational therapy practitioners could implement within the priorities of adaptation, mitigation, and resilience.

Occupational Therapy Assessments of Cortical or Cerebral Visual Impairment: A Systematic Review.

Cortical or cerebral visual impairment (CVI), a leading cause of visual dysfunction in children across the globe, can result in delayed development of fine and gross motor skills, functional mobility, and socialization, which affects all areas of occupation. No assessments are recommended for occupational therapy practitioners working with children with CVI. To appraise the measurement properties and clinical utility of CVI assessments appropriate for use by occupational therapy practitioners. MEDLINE via PubMed, Scopus, and Web of Science. We followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines for systematic reviews of patient-reported outcome measures for relevant studies. A total of 590 records yielded 15 studies of the measurement properties of 12 assessment tools, 8 patient-reported outcome measures and 4 clinician-reported or performance-based outcome measures. We report on the quality of measurement properties of 10 of the 12 outcome measures. None had high-quality evidence of content validity, structural validity, or test-retest reliability. Most had indeterminate internal consistency as a result of a lack of confirmatory factor analysis. Three instruments demonstrated high quality and sufficient construct validity. On the basis of the COSMIN guidelines, all 12 outcome measures have the potential to be recommended but require further study before definitive recommendations can be made. What This Article Adds: This is the first systematic review of assessments of CVI feasible for use by occupational therapy practitioners. High-quality studies of measurement properties are lacking. Further examination of the measurement properties of outcome measures is required.

Correlations Between Mindset and Participation in Everyday Activities Among Healthy Adolescents

Abstract Importance: Mindsets are personal beliefs that one’s abilities and personality traits can be improved and modified through education and effort. It is known that mindsets contribute to behavior and achievements; however, research on mindsets in the context of participation is still lacking. Objective: To assess the correlations between mindsets and dimensions of participation among healthy adolescents and to explore the unique contribution of mindsets to the total explained variance of adolescents’ participation diversity, frequency, independence, enjoyment, and satisfaction. Design: Cross-sectional. Setting: Community in Israel. Participants: Healthy adolescents (N = 115; 63 females, 52 males) ages 11 to 16 yr (M age = 13.77, SD = 1.22) and their parents. Outcomes and Measures: The Mindset and Perseverance Questionnaire was used to assess mindsets regarding intelligence, emotions and behavior, and perseverance. The Adolescence Participation Questionnaire was used to assess participation in daily activities. Results: Mindset regarding emotions, behavior, and perseverance was positively and moderately associated with all participation measures aside from diversity. Mindset regarding intelligence was not associated with participation. The regression analysis indicates that the explanatory variables had a significant modest contribution of 6% to 13% to the total explained variance in adolescents’ participation frequency, independence, and enjoyment. Of note, mindset regarding perseverance was found to be the main predictor. Conclusions and Relevance: Mindsets and participation are correlated. Beliefs regarding perseverance and effort contribute significantly to various dimensions of adolescents’ participation. Occupational therapy practitioners may find growth mindset theory capable of enriching interventions aimed at promoting adolescents’ optimal participation. What This Article Adds: This is the first study to assess adolescents’ mindset in the context of their participation. The findings demonstrate the significant contribution of mindsets regarding perseverance, effort, emotions, and behavior to participation in everyday activities among healthy adolescents. The findings can be incorporated into interventions aimed at promoting adolescents’ optimal participation.