Role Of Occupational Therapy Research Articles

Functional Cognition: An Opportunity to Highlight the Role of Occupational Therapy in Post-Concussion Care

As concern surrounding concussion and the associated long-term effects grow, a continued need for comprehensive, holistic concussion care emerges. Occupational therapists are well-equipped to address the wide variety of symptoms and deficits that clients may experience post-concussion. Functional cognition is one area in which occupational therapists can demonstrate their unique value on the interdisciplinary treatment team. In this Opinions in the Profession paper, we describe how occupational therapists are poised to further establish their role in post-concussion care by becoming the primary discipline for assessing and treating functional cognition. The aim of this paper is to outline the role of occupational therapy in post-concussion care in regard to becoming the primary discipline for assessing and treating functional cognition and distinguishing occupational therapists as experts in functional cognition. Implications for practice, education, and research are discussed.

Working with clients of higher weight in Australia: Findings from a national survey exploring occupational therapy practice.

Occupational therapists are key members of the multidisciplinary team and regularly work with people of higher weight across age groups and practice settings. There is limited existing research regarding the occupational therapy role with this client group. The aim of this study was to explore occupational therapy practice and barriers to service provision for Australian occupational therapists working with clients of higher weight. A cross-sectional study design using a self-administered online survey was distributed to members of the national occupational therapy professional association. The survey was designed to identify common assessments and interventions used with clients of higher weight and explore occupational therapists' perspectives on their knowledge and confidence and the barriers to service delivery. Descriptive statistics were used to summarise rating scales, and open-ended responses were analysed using thematic analysis. Eighty Australian occupational therapists working in a range of settings and with varied experience levels participated in the study. Participants described the most common areas of occupational therapy assessment and intervention when working with clients of higher weight to be self-care, equipment prescription, home modifications and pressure care. Respondents were least confident in interventions related to psychosocial, leisure and employment interventions. Barriers to service delivery included accessibility and cost of equipment, lack of training and weight stigma. Occupational therapy practice promotes and enables participation in everyday occupations with people of higher weight. This study highlights not only the occupational therapy skills and unique approach to the person, their environment and occupations but also the challenges faced by occupational therapists when working with people of higher weight. Occupational therapists could consider utilising the weight-inclusive paradigm to broaden their contribution from self-care to other important aspects of participation and well-being.

Occupational Therapy within the Response to Intervention Team: Focus Group Identifies Opportunities and Barriers

ABSTRACT Evidence indicates that universal screening can support academic participation. Response to Intervention (RtI) is a model that has been designed to identify student needs and support them within the academic setting. A focus group was held with 20 school-based occupational therapy practitioners to explore the existing role of occupational therapy within different tiers of intervention and identify barriers and further opportunities for collaborating on interdisciplinary teams. Four themes emerged identifying 1) Developmental, academic, and health-related needs, 2) Key periods for universal screening, 3) Communication and systematic barriers in interdisciplinary collaboration, and 4) Lack of identified roles for occupational therapy practitioners within RtI teams. Findings of the focus group indicate a need for advocacy using data to establish the occupational therapy role across all RtI levels. Through advocacy efforts, role release, and interdisciplinary knowledge sharing opportunities can support students during academic participation.

Exploring the Role of Occupational Therapy and Forced Migration in Canada.

Background. In response to increasing forced migration across the globe, Canadian occupational therapists are returning to the profession's social justice roots by exploring this emergent area of practice. Purpose. This research explores occupational therapy practices with forced migrants in a Canadian context. Method. Grounded in critical epistemologies, the researchers conducted 12 semi-structured interviews with occupational therapists, students, and researchers connected to displacement. Data were analyzed using thematic analysis. Findings. Four themes describe current occupational therapy practices related to forced migration: 1) engaging clients in new environments, 2) translating the everyday, 3) connecting and networking, and 4) advocating for occupational justice. Implications. This research contributes to the advancement of occupational therapy and forced migration by documenting the diverse and fluid nature of occupational therapy roles. Further, the paper outlines promising reflexive practices while forwarding advocacy priorities for (occupational) justice.

Occupational therapy service provision in adult intensive care units in Australia: A survey of workload practices, interventions and barriers.

IntroductionOccupational therapy practice within intensive care units (ICUs) is limited with respect to published research evidence and guidelines regarding scope of practice. An understanding of the current level of service provision, feasibility of services in ICUs and training and development needs of occupational therapists is required to enable consistent best practice and promote the occupational therapy profile. This study aimed to explore occupational therapy practice within ICUs in Australia including the barriers and enablers to practice perceived by occupational therapists.MethodsIn this cross‐sectional study, a national customised online survey was completed by registered occupational therapists who provide services in intensive care settings in Australia. Recruitment was from July to September 2019 through Occupational Therapy Australia and other professional networks and interest groups.ResultsThe survey was completed by 43 respondents. The majority were experienced therapists from Queensland with greater than 10‐years post‐qualification and working in a tertiary hospital setting. The most common length of time spent working in the ICU was 0–2 h per week. Formal and informal self‐care measures, cognitive screens and physical outcome measures were commonly used. Bed‐based grooming retraining, pressure care management, functional upper limb retraining and passive ranging were the most frequent interventions provided on a daily basis. Perceived barriers to occupational therapy service provision in ICU included lack of funding for staffing, competing workload demands, lack of occupational therapy role delineation and scope of practice and lack of published evidence and training.ConclusionOccupational therapy services in intensive care settings in Australia are limited. Published practice guidelines, further research, applications for service funding and ongoing education of the ICU multidisciplinary team regarding the scope of occupational therapy practice are recommended to promote the development of occupational therapy services in ICU.

Motor skills and intelligence in children with fetal alcohol spectrum disorder.

To determine the relationship between motor abilities and intelligence in children and young people with prenatal alcohol exposure (PAE) being assessed for fetal alcohol spectrum disorder (FASD). This was a cross-sectional correlational study of children and young people with PAE being assessed for FASD. The relationship between motor abilities (Movement Assessment Battery for Children, Second Edition) and intelligence (Wechsler Intelligence Scale for Children, Fourth or Fifth Edition) was calculated using correlation and regression analyses. Attention and executive function were considered as potential confounding variables. The relationship between motor abilities and intelligence in 73 children and young people (48 males, 25 females; aged 6-17y, mean age 10y 5mo [SD 2y 9mo]) assessed for FASD was small and statistically non-significant (r=0.05, p=0.67). The findings confirm that motor abilities and intelligence should be assessed separately when investigating an FASD diagnosis. Intelligence scores should not be used to estimate motor abilities, nor should they dictate when motor testing be completed. Assessing intelligence and motor domains separately will enhance diagnostic accuracy, identify the need for strategies or interventions to address functional motor skills, and further define the role of physiotherapy and occupational therapy in FASD assessment and intervention.

Role of occupational therapy in epilepsy patients after left temporal lobe surgery

There is a relevant risk of psychosocial as well as cognitive impairments in epilepsy patients with resective surgery in the left temporal lobe. Surgery in the speech-dominant hemisphere can be associated with deterioration of speech related functions including verbal memory. There are only limited studies addressing the impact of occupational therapy in postoperative rehabilitation of epilepsy patients.Method: In this study, a mixed-methods design based on the grounded theory concept was administered. Seven patients with left temporal lobe epilepsy and a risk profile for postoperative cognitive decline were investigated over various time points. Neuropsychological assessments occurred before surgery, 1 week, 3 months, and 6 months postoperatively. According to our rehabilitation concept, every patient started occupational therapy 1 month before surgery. Therapy lasted for at least 6 months after surgery. For all patients, extensive qualitative interviews with the occupational therapists and anamnestic data were analyzed.Results: In all patients, postoperative psychosocial difficulties emerged. Language and memory tests showed a decline after 6 months specifically for name retrieval. Occupational therapy was adapted to find individual solutions for the patients problems and to implement effective coping strategies.Conclusion: Cognitive training lead to consistent improvements over time. The results show that occupational therapy can be an efficient tool in the treatment of psychosocial and cognitive impairments after epilepsy surgery.

Occupational Therapy’s Role in the Foster Care System

Children and youth who spend time in the foster care system face a variety of obstacles perpetuated by childhood trauma and limitations in service provision. Literature regarding this population demonstrates challenges, including the inability to form attachments and productive peer relationships, deficits in cognition and educational performance, and unpreparedness upon transitioning from the system. In addition, literature demonstrates the significantly increased prevalence of mental health challenges among those in foster care. Parents of foster children report inadequate services and supports to address the ongoing ramifications of a child raised in a constant state of traumatic stress. Following a depiction of the challenges, a solution in the form of occupational therapy services is demonstrated in this paper. The distinct value of occupational therapy is presented along with implications for this population in the scope of practice, thus highlighting an opportunity to expand service provision in this regard. This Opinions in the Profession paper seeks to demonstrate the possibility and importance of establishing a permanent role for occupational therapy in the child welfare system by presenting a review of several challenges at various levels in the system followed by a detailed depiction of the profession’s role in this future opportunity.

Official Documents Available From the American Occupational Therapy Association.

Official documents and professional policies are approved by the AOTA Representative Assembly and undergo scheduled review and approval by the Representative Assembly Coordinating Committee (RACC). These documents are used by the Association and its membership to guide education, practice, advocacy, and policy on behalf of the profession. The documents are a valuable resource for occupational therapy practitioners and provide a solid grounding in the profession for students, consumers, and external stakeholders.The Representative Assembly adopted the RACC Standard Operating Procedures, Attachment A, at the fall online meeting in November 2020. As a result of this motion, the types of official documents have been renamed and are categorized and described below.Items in bold are new for 2021 and are available in this supplement to the American Journal of Occupational Therapy. Official documents are periodically reviewed, and documents may be superseded by newer versions or rescinded. A complete list of the most current documents is available at https://www.aota.org.Guidance documents provide comprehensive perspective and guidance on topics that shape advancement of the profession and its future direction. Guidelines for Documentation of Occupational Therapy (2018)Guidelines for Occupational Therapy Services in Early Intervention and Schools (2017)Guidelines for Reentry Into the Field of Occupational Therapy (2020)Guidelines for Supervision, Roles, and Responsibilities During the Delivery of Occupational Therapy Services (2020)Occupational Therapy Practice Framework: Domain and Process, 4th Edition (2020)The Practice of Occupational Therapy in Feeding, Eating, and Swallowing (2017)A Descriptive Review of Occupational Therapy Education (2016)Scholarship in Occupational Therapy (2016)Position statements present an official stance on the provision of services, practice of occupational therapy, or role of occupational therapy. They are developed in response to a professional issue, concern, or need. Academic Terminal Degree (2017)Assistive Technology and Occupational PerformanceCognition, Cognitive Rehabilitation, and Occupational Performance (2019)Complex Environmental Modifications (2015)Continuing Professional Development in Occupational Therapy (2016)Driving and Community Mobility (2016)Fieldwork Level II and Occupational Therapy Students (2018)Importance of Collaborative Occupational Therapist-Occupational Therapy Assistant Intraprofessional Education in Occupational Therapy Curricula (2017)Importance of Interprofessional Education in Occupational Therapy Curricula (2015)Importance of Primary Care Education in Occupational Therapy Curricula (2017)Mental Health Promotion, Prevention, and Intervention in Occupational Therapy Practice (2017)Obesity and Occupational Therapy (2013)Occupational Therapy and Complementary Health Approaches and Integrative Health (2016)Occupational Therapy Fieldwork Education: Value and Purpose (2016)Occupational Therapy for Children and Youth Using Sensory Integration Theory and Methods in School-Based Practice (2015)Occupational Therapy in the Promotion of Health and Well-Being (2019)Occupational Therapy Scope of Practice (2021)Occupational Therapy Services for Individuals Who Have Experienced Domestic Violence (2017)Occupational Therapy Services in Facilitating Work Participation and Performance (2017)Occupational Therapy Services in the Promotion of Mental Health and Well-Being (2016)Occupational Therapy’s Commitment to Diversity, Equity, and Inclusion (2020)Occupational Therapy’s Perspective on the Use of Environments and Contexts to Facilitate Health, Well-Being, and Participation in Occupations (2015)Occupational Therapy’s Role in Case Management (2018)Occupational Therapy’s Role in Medication Management (2017)Occupational Therapy’s Role in the Neonatal Intensive Care Unit (2018)Philosophical Base of Occupational Therapy (2017)Philosophy of Occupational Therapy Education (2018)Role of Occupational Therapy in End-of-Life Care (2016)Role of Occupational Therapy in Pain Management (2021)Physical Agents and Mechanical Modalities (2018)Role of Occupational Therapy in Primary Care (2020)Role of Occupational Therapy in Wound Management (2018)Scope of Occupational Therapy Services for Individuals With An Autism Spectrum Disorder Across The Life Course (2015)Telehealth in Occupational Therapy (2018)Value of Occupational Therapy Assistant Education to the Profession (2019)Vestibular Impairment, Vestibular Rehabilitation, and Occupational Performance (2017)Professional standards describe and define minimal standards for practice, continued competence, and other professional behaviors. AOTA 2020 Code of EthicsStandards for Continuing Competence (2021)Standards of Practice for Occupational Therapy (2021)Societal statements are written in the form of public announcements and identify a societal issue of concern; state how the issue affects the participation of individuals, families, groups, or communities in society; and may offer action to be taken by individuals, families, groups, or communities. AOTA’s Societal Statement on Disaster Response and Risk Reduction (2017)AOTA’s Societal Statement on Health Disparities (2013)AOTA’s Societal Statement on Health Literacy (2016)AOTA’s Societal Statement on Livable Communities (2016)AOTA’s Societal Statement on Stress, Trauma, and Posttraumatic Stress Disorder (2017)AOTA’s Societal Statement on Youth Violence (2016)

Perceptions and Knowledge Around Substance Use Disorders and the Role of Occupational Therapy: A Survey of Clinicians.

Today's healthcare system requires practitioners to acquire a level of confidence, knowledge, and personal desire that enables them to treat a growing clientele with substance use disorders (SUDs). Although SUDs impact millions of Americans, there are many barriers to receiving treatment. It is important to understand how occupational therapy (OT) practitioners' perceptions of working with clients who experience SUDs relate to the knowledge and skills required to identify and provide treatment. Two surveys, the Medical Regard Scale and modified Drug Problems Perceptions Scale, were utilized to analyze participants attitudes, perceptions, and knowledge around working with individuals with SUDs. Data was collected from 116 practitioners with a variety of experience, practice settings, and backgrounds in understanding SUDs. The majority of respondents reported no formal training in treating clients with SUDs (72.4%). In terms of attitudes around working with this population, a fraction reported a preference not to work with patients experiencing SUDs (16.0%) or finding them "irritating" to work with (12.9%), while 62.0% reported they felt especially compassionate toward this population. The majority of respondents felt that insurance plans should cover patients like this to the same degree that they cover patients with other conditions; however, only 48.3% had a clear idea of their responsibilities in helping individuals with SUDs. In regard to knowledge around working with SUDs, just over half of respondents reported a true working knowledge of SUDs and SUDs related problems (53.4%). Occupational therapy practitioners would benefit from additional training, resources, and support related to provision of services to individuals with SUD. In addition, training to continue to reduce stigma within the profession can potentially increase access to care.

Offering Patients Valuable Occupations Post-Acute Cerebrovascular Disease: Role of Client-Centered Occupational Therapy

Offering Patients Valuable Occupations Post-Acute Cerebrovascular Disease: Role of Client-Centered Occupational Therapy

Role of Occupational Therapy in Pain Management

The American Occupational Therapy Association (AOTA) asserts that occupational therapists and occupational therapy assistants, collectively referred to as occupational therapy practitioners (AOTA, 2020b), are distinctly prepared to work independently and to contribute to interprofessional teams in the treatment of pain. Occupational therapy practitioners work to ensure active engagement in meaningful occupations for "persons, groups, or populations (i.e., the client)" (AOTA, 2020b, p. 1) at risk for and affected by pain.

Role of Occupational Therapy in Pain Management.

This new position statement from the American Occupational Therapy Association (AOTA) describes occupational therapy's role in pain management. AOTA asserts that occupational therapy practitioners are distinctly prepared to work independently and to contribute to interprofessional teams in the treatment of pain. Practitioners strive to ensure active engagement in meaningful occupations for clients at risk for and affected by pain.

Occupational therapy in oncology palliative care for adolescents and young adults: Perspectives of Australian occupational therapists.

Palliative Care Australia suggests current needs (emotional wellbeing, understanding of cancers impact on relationships, everyday activities, and life milestones) for adolescent and young adults in palliative care are unmet due to a lack of age-specific palliative care facilities in Australia. This includes the provision of occupational therapy that can impact these unmet needs. Although the occupational therapy role in palliative care has been documented, little is known about existing occupational therapy services or occupational needs for young people with palliative care needs. The aims of this study were to obtain occupational therapists insights of working with this population in Australia regarding (1) gaps in palliative care services for this population; (2) facilitators and challenges to providing occupational therapy for this group; and (3) perceived occupational needs of young people living with a life-limiting cancer diagnosis. Using snowball sampling, an online survey was distributed to occupational therapists with experience working in palliative cancer care with adolescents and young adults. Available for 6weeks, the survey included demographic, work history, and service delivery questions. Forced-choice questions were summarised descriptively, and content analysis was used to analyse free-text data. Eleven completed surveys were returned. Overall, therapists perceived current palliative care services for this population within Australia to be lacking. Two gaps emerged: age-appropriate facilities and gaps in provision of psycho-social and occupational therapy services. Funding, lack of knowledge of the occupational therapy role, and professional confidence were highlighted as challenges to practice. Main occupational needs related to maintenance of as "normal" a life as possible: maintaining occupational role engagement, continuing connection with others, and being heard regarding their occupational needs. Findings suggest a need for service changes, including custom-designed facilities, improved funding, training and mentoring, to support age-appropriate and occupation-focussed care for the young person in cancer-specific palliative care.

Innovation and invention: the role of virtual occupational therapy in the management of motor neurone disease

Background: Motor neurone disease (MND) is a progressive neurological condition with no known cure. Supportive management and symptom control by a multidisciplinary team forms the mainstay of treatment. Caring for patients with MND throughout the COVID-19 required service providers to think of ways to adapt the service in order to meet the acute and constantly changing needs of their service users within pandemic guidelines. Aims: This paper explores innovative changes within the occupational therapy service provision during the pandemic and how it supports the multidisciplinary team (MDT) working. It also evaluates the merits and disadvantages of using virtual technology in specific areas of occupational therapy intervention. Methods: A set of prioritisation criteria was developed to understand the rationale for virtual versus face-to-face input. A reflective process has been used to identify and evaluate innovative service provision in occupational therapy in the management of motor neurone disease. Findings: Virtual consultations were an effective way of providing certain aspects of occupational therapy input. Virtual consultations were found to be less effective during moving and handling assessments, complex environmental adaptations assessment and when managing complex cognitive presentations. During the pandemic there was a rise in referrals for cognitive behavioural management, a specialist area of expertise for occupational therapy in this clinical area. A holistic approach was paramount in meeting the evolving needs of patients across functional domains. Occupational therapy complemented the caring and supportive role of nurses and other members of the MDT in the management of MND. Conclusions: Occupational therapy input can support an MDT by providing valuable assessment of functional decline, specialist equipment, supporting cognitive-behavioural performance, restoring life roles and minimising the challenges imposed by the environment. Using virtual technology discernibly can be an invaluable approach to occupational therapy practice within an MDT setting for managing a progressive neurological condition, such as MND, during a pandemic.

Exploring the professional experiences of mental health occupational therapists during a period of COVID-19

Purpose: The COVID-19 pandemic has brought about disruption in the way health-care professionals carry out their day-to-day practices across communities. The purpose of this research paper is to explore the professional experiences of occupational therapists working in community and rehabilitation mental health settings during a period of the COVID-19 pandemic and to help gain an understanding of how their day-to-day work practices have been affected. Design/methodology/approach: A qualitative phenomenological research study explored the lived experiences of ten occupational therapists working within Health Service Executive community and rehabilitation mental health services during the COVID-19 pandemic. Participants included eight community mental health occupational therapists and two rehabilitative mental health occupational therapists. Data was collected through semi-structured interviews and analysed using reflexive thematic analysis. Findings: Three themes were identified: holding on to what we do;technology: friend and foe;and COVID as a catalyst to clarify the occupational therapy role. These themes capture the community changes, challenges and frustrations experienced by the occupational therapists while striving to provide quality mental health occupational therapy services during the pandemic. Originality/value: The findings demonstrate the adaptive nature of the profession, the importance of traditional observation methods of community-based care, the experiences with telehealth approaches and an opportunity to clarify misconceptions of aspects of the profession’s role in relation to employment-related issues and occupational therapy group work within such mental health settings. © 2021, Brendan Culleton.

The Role of Occupational Therapy in Managing Food Selectivity of Children with Autism Spectrum Disorder: A Scoping Review.

Food selectivity is common in children with autism spectrum disorder (ASD). It can be defined as the unwillingness to eat common or new foods, resulting in a lack of variety in the diet or limited food consumption for multiple reasons, such as inflexibility or sensory alterations. We conducted a peer scoping review to describe the interventions that are carried out from occupational therapy (OT) in children with ASD with food selectivity. Two authors independently searched the databases PubMed, Scopus, Web of Science, and EMBASE, as well as the OT journals indexed in Journal Citation Reports. Articles exploring OT interventions in children (≤12 years) with ASD and food selectivity, published in Spanish or English, with experimental design, and with full text available were included. Of the 1445 articles identified, 8 articles met the inclusion criteria. Three main intervention categories were identified: sensory–behavioral, family focused, and other interventions. Most of the interventions from OT were aimed at treating sensory–behavioral aspects. Only three articles described interventions led exclusively by occupational therapists, and the rest were led by a multidisciplinary team. Finally, although these interventions are not exclusive to OT, occupational therapists can participate together with other professionals as an essential component in the treatment of food selectivity in children with ASD.

Role of Occupational Therapy in Pediatric Primary Care: Promoting Childhood Development.

Occupational therapy practitioners have the opportunity to promote development for all children as new service delivery models are established for pediatric primary care. Three action steps are identified: (1) advocacy for legislation that requires developmental screenings and surveillance, (2) support of culturally responsive developmental monitoring, and (3) building evidence for occupational therapy in primary care settings. This article describes the role of occupational therapy practitioners on pediatric interprofessional teams in encouraging family capacity within the scope of health promotion and universal developmental monitoring.

The occupational impact of bowel cancer: Survivors' voices and advancing the role of occupational therapy assessment and intervention.

The aim of this study was to investigate the occupational impact (i.e., how engagement in occupation is affected) of having had bowel cancer and the role of occupational therapy with bowel cancer survivors and their significant others. Two rounds of semi-structured interviews were carried out with individuals who had completed treatment for bowel cancer, with interviews designed to gain insight into their occupational experiences post treatment. Thematic analysis was utilised to construct themes and patterns founded on the perceptions of participants. Analysis involved concurrent data collection and analysis, constant comparative analysis, and iterative analysis. Eighteen participants were interviewed, with occupational impact evident across multiple aspects of everyday life. Four themes were identified: Changes in eating habits, changes in toileting habits, changes in relationships, and rethinking occupational choices. Findings of the occupational impact of having had bowel cancer reveal a possible role for occupational therapists with people affected by bowel cancer. Occupation focused assessments and self-management programmes are identified as a possible means of meeting the needs of this population, making use of the experiences of peers to provide a credible, relatable voice.

The Role of Occupational Therapy in Supporting the Needs of Older Adults who Identify as Lesbian, Gay, Bisexual, and/or Transgender (LGBT)

There are growing numbers of older individuals who identify as lesbian, gay, bisexual, and transgender (LGBT) who are in need of health care services provided by culturally and clinically competent providers, including occupational therapists. The LGBT community presents with unique needs and circumstances that impact occupational therapy (OT) practice. This Opinions in the Profession article presents an overview of the unique narratives of and special considerations for LGBT older adults that the OT profession needs to address to meet the needs of this population and improve our service delivery. We assert essential implications for OT practice and education to better support the needs of LGBT older adults and strategies for occupational therapists to promote culturally and clinically competent care and serve as agents of change in practice.