Occupational Therapy Research Research Articles

Frailty: perceptions of occupational therapists in Ireland

Purpose Ireland’s ageing population has resulted in an increasing number of older adults living with frailty. Despite growing attention towards older adults’ and health professionals’ perspectives of frailty, occupational therapy research is limited. This study aims to explore occupational therapists’ perceptions of frailty and how their perceptions impact their approach to the assessment and management of frailty. Design/methodology/approach Using qualitative descriptive design, 19 occupational therapists working with older adults participated in online focus groups. Data were analysed using thematic analysis. Findings Perceptions of occupational therapists were constructed into three main themes: conceptualising frailty; management of frailty; and advancing frailty practice. Findings indicate that occupational therapists perceived frailty as a multidimensional concept but highlight a reluctance to use frailty terminology with patients. Findings also suggest that although occupational therapists are involved in provision of care for older adults living with frailty, the profession’s scope is not optimised in the assessment and management of frailty. Originality/value Findings provide insight into occupational therapists’ perceptions of frailty. Development of a shared understanding of frailty between clinicians and patients and enhancement of undergraduate frailty education are recommended to progress occupational therapy’s role in frailty management.

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.

Surveying the Landscape of Persistent Concussive Symptoms in Adults Through an Occupational Lens.

Little is known about how and to what extent persistent concussive symptoms affect occupational performance in adults. To evaluate the impact of persistent postconcussive symptoms on occupational performance. A cross-sectional study design was used in which the occupational performance needs of adults with persistent concussion symptoms were identified by a trained occupational therapist via semistructured interview. University research space. Adults ages 18 to 60 yr experiencing persistent concussion symptoms. Occupational performance was evaluated using the Canadian Occupational Performance Measure. Data were then categorized by two researchers using the Occupational Therapy Practice Framework: Domain and Process (4th ed.). The most commonly affected occupational performance areas included education and work, social participation, and performance of instrumental activities of daily living. Aligning with prior knowledge of the impact of psychosocial difficulties and higher order cognitive deficits on daily life, performance of complex occupations is heavily affected in adults with persistent concussive symptoms. Plain-Language Summary: The functional impact of symptoms that adults experience postconcussion becomes apparent as they return to their life occupations. The results of this study showed that adults with persistent concussive symptoms more commonly experienced occupational challenges with participation in education, social activities, and the performance of instrumental activities of daily living, with subtle, important variations in symptoms across adults. Detailed, client-centered evaluation of occupational performance changes postconcussion is an area of potential growth for occupational therapy practice and research.

Refocusing research: A mixed methods study to evaluate utilisation of the top 10 priorities for occupational therapy research in the United Kingdom

Introduction: The top 10 priorities for occupational therapy research in the United Kingdom were identified via a priority setting partnership and published in 2020. This study aimed to evaluate utilisation of the top 10 priorities since 2020 and identify recommendations to re-focus research efforts. Method: A mixed methods approach involving evidence checking and stakeholder consultation was undertaken. Direct and selective methods were used to recruit stakeholders, including previous steering group members, who were invited to take part in 30-minute semi-structured interviews. Results: Eighty-one evidence sources were included and addressed the research priorities 127 times. Stakeholders ( N = 7) discussed the top 10 priorities in relation to five key themes: (1) what has been done; (2) the most addressed priorities; (3) the least addressed priorities; (4) barriers to using the priorities (three barriers emerged); and (5) what should be done next (six strategies emerged). Conclusion: There was strong agreement that research priority 1 (how does occupational therapy have an impact and make a difference on everyday lives?) was the most addressed; however, all research priorities require more attention. Recommendations to refocus research efforts included continuing to support priority-driven research and greater promotion of the priorities.

Race and Ethnicity Reporting in Occupational Therapy Research Among Autistic Youth.

Historically marginalized racial and ethnic groups are underrepresented in autism research broadly; however, patterns of inclusion in occupational therapy research are unknown.In this secondary data analysis, we examined race and ethnicity reporting across articles included in a systematic review of evidence related to occupational therapy practice with autistic individuals <18 years (2013-2021).Two team members reached >90% interrater coding agreement in race and ethnicity reporting across articles in ADLs/IADLs, education/work, play, sleep, and social participation in clinics, homes/communities, and schools.Intervention outcomes of ADL/IADLs (66.7%) and play (66.7%) had low rates of reporting, while social participation in schools (100%) and education/work (100%) had higher rates of reporting. Sample diversity was greatest among research in schools and most limited in clinic-based settings.Systemic racism that limits individuals' participation in occupational therapy research perpetuates racial and ethnic health inequities among autistic children and adolescents.

Goal setting in mental health: a scoping review to inform occupational therapy practice

Purpose Goal setting is a crucial aspect of client-centered practice in occupational therapy (OT) for mental health conditions. However, it remains to be seen how goal-setting has been delivered in mental health, particularly the OT process. The purpose of this scoping review was to explore the nature and extent of goal setting delivered in mental health and informed OT practice. Design/methodology/approach The authors followed the guidelines of Arksey and O’Malley (2005) and searched three databases using key search terms: “mental disorder,” “goal setting,” and “occupational therapy” and their synonyms. Findings After excluding duplicate records, the authors initially screened 883 records and resulted in 20 records in total after the screening process. Most of the identified articles used goal-setting delivered by both a health professional and a client (n = 14), and focused on people with schizophrenia or schizoaffective disorder (n = 13), but three interventions were delivered by occupational therapists. Further research needs on goal-setting in mental health OT, exploring the reliability and validity of different goal-setting strategies and investigating the effectiveness of goal-setting for promoting behavior change and client engagement across various mental health conditions and settings. Research limitations/implications The scoping review has some limitations, such as not investigating the validity and reliability of goal-setting strategies identified, and excluding conference papers and non-English articles. Originality/value This scoping review presents a mapping of how goal-setting has been delivered in mental health and informed OT practice. The findings suggest limited research in OT and highlight the need for more studies to address the evidence gap in individualized client-centered OT.

Participatory Research with Persons who Experience Mental Illness in Occupational Therapy: A Scoping Review.

Background. Persons who experience mental illness also face stigma and discrimination that frequently lead to a loss of ability to exercise autonomy and agency in their lives. Purpose. The range and breadth of literature exploring participatory research with persons living with mental illness are unknown in occupational therapy and occupation science. We initiated this study to fill this gap in the existing occupational therapy and occupational science literature. Method. Using the method of Arksey and O'Malley, we have conducted a scoping review to identify the range and breadth of literature. A qualitative content analysis was performed. Findings. A total of 34 articles were included in the narrative synthesis. The content analysis led to three related themes from the included studies: (1) coming together; (2) unique potential of participatory research; and (3) challenges in conducting participatory research. Conclusions. This review highlights that participatory research is well suited to research conducted with persons living with mental illness to support meaningful engagement and minimize stigma throughout the research process. This review can guide future participatory research and practice in occupational therapy and occupational science with persons living with mental illness.

An international study of diversity in occupational therapy research- A bibliographic review of English research literature.

The cornerstone of a strong profession is the research that supports its knowledge base and practice. However, little is known about the range of international occupational therapy research. To explore the range and diversity of the international occupational therapy research from published peer reviewed literature in English during the year 2018. Limited to 2018, a review was conducted of sources from i) health-related search engines using search terms associated with occupational therapy practice, and ii) content pages of occupational therapy publications. Articles were excluded if they i) had no occupational therapy author, ii) were not peer reviewed, iii) not in English, and iv) did not include primary data collection (e.g., opinion pieces, position statements, study protocols). Of articles selected for analysis, data were extracted and synthesized according to the study's origin country, publishing research journal, the characteristics of the represented research, and its alignment with World Federation of Occupational Therapists research priorities. A total of 4,169 articles were retrieved from the search (i.e., 3,459 from health-related search engines and 710 through a manual search of occupational therapy journals). After exclusions, 2,345 articles were included for analysis. The review identified English published research was predominantly conducted in economically privileged countries. In addition, it revealed several research priorities that need further development such as evaluating the effectiveness of occupational therapy interventions.

Occupational Therapy and Assistive Technology: Experience in Using 3D Printing and Open Source Platforms

Three-dimensional printing technology has evolved rapidly, being widely spread throughout the world and used in various fields such as design, engineering, medicine, and dentistry, among others. However, it is still little used in research and clinical practice in occupational therapy. A report is presented on the use of three-dimensional printing and open source platforms in clinical practice, based on experience in research and extension activity developed by the Laboratory for Research in Neuropediatrics, Technology and Inclusion (LINTI), which aims to provide an assistive product made in 3D printing to patients treated in the Supervised Internship in Occupational Therapy services that take place at the Specialized Rehabilitation Center (CER II). The actions are developed in four stages: 1- identification of the need; 2 - problem analysis and specification of the open source product;3 – 3D printing production; 4- user assistive product validation tests. This project has highlighted the possibility of creating functional, accessible assistive products, with desired aesthetics, and above all, with modification alternatives and adjustments for the user. 3D printing technology and open source platforms can be applicable and innovative tools in the practice of occupational therapists working in assistive technology.

Establishing Diversity, Equity, and Inclusion Priorities for Occupational Therapy Research

Abstract In this State of the Science column, we examine evidence that aligns common applications of diversity, equity, and inclusion (DEI) and occupational therapy research and suggest areas of focus to advance a culturally affirming and antiracist science of occupation. More specifically, we describe why DEI is important to the study of occupation, identify DEI gaps in the occupational therapy knowledge base, suggest DEI priorities for occupational therapy research and their implications for practice, and recommend practical strategies for occupational therapy scholars to apply in more immediate efforts to address DEI in their research endeavors.

A Comprehensive Review of Treatment Approaches and Perspectives for Management of Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an inflammatory illness that mostly affects the joints, although it can also affect other organs and limit movement. This symmetrical, chronic illness typically manifests between the ages of 35 and 60 and causes joint degradation, pain, and systemic symptoms. Because of their different clinical manifestations, RA and osteoarthritis must be distinguished from one another. Osteoarthritis is caused by wear and tear, whereas RA is symmetrical and involves an immunological response. The goals of RA management are to lessen discomfort, reduce inflammation, and avoid joint deformities and destruction because there is currently no known treatment for RA. A combination of medication, specialized exercise, education, and rest are used in treatment plans, taking into account the disease's course, the joints that are impacted, and the patient's general health. The two main forms of treatment are corticosteroids and nonsteroidal anti-inflammatory medications (NSAIDs), which reduce inflammation and discomfort but frequently present varying side effects. Disease modifying anti-rheumatic medications commonly called DMARDs, provide a backup plan by delaying the deterioration of joints and easing associated symptoms. Modern treatment options include methotrexate, hydrochloroquine, and more recent drugs like leflunomide and biologics like interleukin inhibitors and tumor necrosis factor (TNF) inhibitors, each with unique advantages and disadvantages. In order to improve joint function and reduce discomfort, surgical interventions—which have become less common as a result of medical advancements are taken into consideration for severe cases or end-stage RA. Physcial and occupational therapy, nutritional supplements, complementary therapies, and current molecular mechanism research provide further options for controlling RA symptoms and enhancing the quality of life for patients. This review offers a thorough analysis of both traditional and contemporary RA treatments, emphasizing the need for a multimodal strategy to effectively manage the disease and pointing out possible directions for future research and development. Keywords: Autoimmune disease, Rheumatoid arthritis, Disease-modifying drugs, Joint degradation, Osteoarthritis, Joint pain.

Wrestling with evidence-based practice: An evidence mapping review of publication trends in the South African Journal of Occupational Therapy

Introduction: Occupational therapy research to support clinical decision-making must be responsive to local needs, illustrate our unique value to clients, communities and providers, and demonstrate efficacy for quality assurance and reimbursement. This article examines the publication trends in the South African Journal of Occupational Therapy (SAJOT) with the intention of contributing to dialogues about evidence-based practice. Methods: A mapping review was undertaken of articles published in the SAJOT from January 2009 to December 2021. All articles excepting commentaries, book reviews and editorials were included. Articles were categorised by year of publication, title, author, research approach, study design, practice area, research affiliation, and nature of authorship.Quantitative research articles were classified according to the Australian National Health and Medical Research Council (NHMRC) levels of evidence. Results: Of the 265 articles published in the 13-year period, slightly more took a quantitative approach (52.1%) comparedwith qualitative approaches (42.4%). Most quantitative studies were Level 111-2 studies (31.3%). Children and Youth was the practice area with the highest number of articles (34.8%) and the strongest evidence base. Conclusion: As occupational therapy continues to wrestle with EBP, further dialogue about a national occupational therapy research strategy to identify and harness enablers and explore and mitigate the barriers identified in this review, is recommended. Implications for practice • This research serves as a bridge between theoretical findings and practical applications, by providing data from research that can be put into action through the development of research agendas by institutions. • By understanding what research has been done, professionals can make informed decisions that are backed by evidence-based findings. This not only enhances the quality of their work but also improves overall efficiency and effectiveness. • The study helps practitioners identify areas where improvements or interventions are needed. They shed light on potential challenges and offer possible solutions that can be implemented to address specific issues or concerns within their respective fields. • This data provides a platform for collaboration between researchers and practitioners across institutions in terms of common research agendas.

대한치료과학지의 연구동향

Objective: The objective of this study is to analyze research trends in occupational therapy and propose future research directions. Additionally, the study aims to recommend a strategy for establishing foundational data, which can enhance the expertise of occupational therapy professionals and contribute to the formulation of relevant policies.ublished in the Korean Society of Medicine &amp; Therapy Science from 2009 to 2022, an analysis was conducted on the type of research, evidence level, field of research.&#x0D; Method: For the 223 articles pinformation regarding the first author, and the type of study participation.&#x0D; Results: Following the analysis, it was observed that experimental research constituted the highest proportion at 78.3 %, with level 2 evidence being predominant at 32.6 %. Notably, in the last three years, there was an increase in studies classified at levels 3 and 4. In terms of research fields, neurological occupational therapy held the majority at 60.9 %, while the primary position of the first author was occupied by occupational therapists, accounting for 80.4 %. Regarding participant demographics, studies targeting adults comprised the largest share at 81.3 %, and the most frequently studied diagnosis was stroke.&#x0D; Conclusion: The findings presented herein aim to provide readers with insights into the evolving landscape of occupational therapy research, contributing valuable information to enhance understanding and augment the available body of evidence in the field.

A small-scale study exploring the efficacy of scale modelling as an open intervention for military veterans with mental health conditions

Introduction: Medical discharges due to mental health conditions have steadily increased within the British Armed Forces since 2007, with post-traumatic stress disorder (PTSD) cited for 41% of these. Mental health conditions can adversely impact engagement in activities of daily living. Research has shown that meaningful activity has benefits for mental well-being and engagement in this population. Aims: This small-scale study aimed to determine whether scale modelling had a measurable impact on veteran well-being and to describe how the results of this study may inform future occupational therapy research with veterans. Method: This was a retrospective quantitative design using the Short Warwick and Edinburgh Mental Wellbeing Scale to gather pre- and post-engagement data from veterans attending scale-modelling groups. Results: N = 12. There was a positive difference between pre- and post-engagement in scale modelling, p &lt; 0.05, and effect size 0.61 within a limited participant pool. The Model-of-Human-Occupation and the Occupational Perspective of Health framework demonstrated that participants who found meaning and value in an activity were most likely to benefit from it. Conclusion: This study suggests that scale modelling enables health, well-being and independence for veterans if found meaningful by them. This is a limited-size study contributing to an under-researched area, opening pathways for further research with this participant group.

An Integrative Review of Outcome Measures Used in Occupational Therapy Research for School-age Children with Cerebral Palsy in Iran

Introduction: Identifying the currently-used outcome measures for clients with cerebral palsy (CP) in the Iranian occupational therapy (OT) research can declare the new trend of such researchers and identify the more focused domains regarding such individuals. Accordingly, this integrative review aims to define the utilized outcome measures for school-age children with CP in the Iranian OT research.&#x0D; Materials and Methods: We conducted an integrated review of online Persian and English databases, namely PubMed, Web of Science, Otseeker, Cochrane, Medline, Embase, CINAHL, PsycInfo, OVID Medline, Magiran, ISC, SID, IranMEDEX, Irandoc, and IRCT, along with the Google Scholar search engine from January 2000 to March 2021.&#x0D; Results: Out of 605 potentially relevant articles that were initially retrieved, 51 articles met the inclusion criteria, and their used outcome measure(s) was identified. A total of 42 identified outcome measure(s) were not diagnosis-specific and or child-report. A maximum of 15 tools, which assessed the motor components of CP children based on a biomedical bottom-up approach, was commonly used by the majority of studies.&#x0D; Conclusion: Most Iranian OT studies utilized bottom-up outcome measures. Iranian OT researchers were suggested to highlight the current paradigm of OT in their research regarding school-age children with CP to comprehensively address their multiple challenges and needs according to a top-down client-centered approach.

Transforming Occupational Therapy for the 21st Century PAIRE: Recognize Privilege, Acknowledge Injustice, and Reframe Perspective to Reach Equity

Theories, models, and frameworks provide the foundation for occupational therapy education, research, and clinical practice. While most have a systems approach focus, other factors, such as societal influences and structural inequities, also contribute to health. Using a cross-sectional design, this study identified the gaps in occupational therapy models of practice and presents a novel approach, the PAIRE (Recognize Privilege, Acknowledge Injustice, and Reframe Perspective to Reach Equity) Model. PAIRE is focused on achieving occupational equity through the reciprocal and intersectional impact of the provider/team, the person/people seeking occupational therapy, and the occupation-in-context, with continuous influences of access, context, and justice. We describe the components of PAIRE and illustrate its functionality in education, research, and clinical practice contexts as well as case examples.

DEFINITION AND ATTRIBUTES OF OCCUPATIONAL BALANCE FOLLOWING RETIREMENT

After retirement, the activities and roles of retirees change as their previously dominant activity and productivity is no longer a part of their routine. This transition can affect each retiree differently, and the risk of non-communicable diseases among retirees becomes more apparent due to lifestyle changes. Achieving occupational balance is crucial for successful ageing, life satisfaction, and subjective well-being in healthcare settings. However, occupational balance is defined and described differently across diverse populations. This study conducted a two-round Delphi study among 18 occupational therapy experts to identify the definition and attributes of occupational balance following retirement in Malaysia. The first round involved open-ended interviews exploring the definition and attributes of occupational balance, followed by a second round using close-ended questions to achieve experts' consensus. The study concluded that occupational balance is defined as an optimal engagement in meaningful and desired occupations, including self-care, productivity, and relaxing activities, according to the retirees' routines and contexts. The attributes were divided into four main groups, and 16 out of 21 statements achieved more than 80 per cent agreement among Malaysian OT experts. The study pioneers fundamental occupational therapy research central to Malaysian perspectives and contributes to healthcare research by exploring possible constructs associated with occupational balance following retirement. Future studies are necessary to explore the influence of each attribute on occupational balance.

The experience of flow by people living with disabilities: A meta-study of qualitative research

ABSTRACT Background Experiencing flow, an optimal psychological state, can support health and well-being. A developmental perspective on flow so far examines strategies to facilitate these experiences in the face of developmental losses such as ageing. People with disabilities experience restrictions in participation and thus fewer occupations that potentially induce flow. Therefore, contributions to this perspective can be gained from disabled people’s experiences. Thus, this meta-study synthesises qualitative research literature to determine the contribution to a developmental perspective on flow in people with disabilities. Methods Following a systematic search of four databases (PsycInfo (EBSCO), PubMed, CINAHL (EBSCO), Scopus) 10 qualitative, peer-reviewed studies were included, and critically appraised. Findings as well as methodologies, and underlying theories were analysed and synthesised. Findings Various methodologies have been used to explore flow experiences of people with disabilities. Incongruencies between underlying theories and chosen methods, as well as lack of researcher reflexivity impacted the trustworthiness of some studies. All studies originated within occupational therapy research and were located in the global North, implying assumptions about occupation and well-being and a rehabilitation framework. The individuals’ choice and control, and adaptations of environment and occupation emerged from the meta-synthesis as important factors to experiencing flow. Conclusion To enhance opportunities for flow in the lives of people with disabilities, a shift of perspective from individual impairments towards issues of accessibility and occupational justice is needed. Based on this meta-study, critical disability theory and participatory frameworks are recommended for future research to explore strategies to enhance access to flow inducing occupations.

Discourses on Sexuality and Occupations: Reflections for Occupational Therapy and Occupational Science

Sexuality and occupation are two constructs studied in different fields of knowledge. Particularly, in occupational therapy and occupational science, their relationship has been sparsely explored from a philosophical perspective. In the following reflection, we present some philosophical approaches to sexuality, occupation, and performativity to inquire about the impact of discourses about sexuality on the practice of occupations. For this analysis, we take an example developed by Foucault in one of his classes at the Collège de France. We believe that this helps us question the established discourses surrounding truth, especially concerning sexuality. Subsequently, we address the concept of occupation, taking into consideration Schliebener’s proposal from existentialist philosophy. Understanding occupation as a dimension of being, we explain how it can be comprehended through Butler’s theory of performativity and, consequently, express a sexual dimension. Finally, we establish an interconnection between the preceding concepts, taking sexual dissidents as an example. We propose that this reflection can broaden the possibilities of understanding occupations as points of resistance against normative discourses about sexuality. This may be relevant for contemplating practice and research in occupational science and occupational therapy, as it expands the understanding of sexuality beyond mere activities and centers it as a form of expression of being through occupation.

Responsible knowledge use: The importance of critical appraisal in occupational therapy research and publication

Responsible knowledge use: The importance of critical appraisal in occupational therapy research and publication