Participation In Occupational Therapy Research Articles

Functional Changes After Occupational Therapy Among Individuals With a Distal Radius Fracture: A Longitudinal Study.

Identifying the outcomes of occupational therapy after a distal radius fracture (DRF) is important so that effective strategies can be developed to mitigate the consequences associated with this common fracture. To determine whether participation in occupational therapy improved functional status. Secondary objectives were to assess its effects on body functions and to examine the association between changes in outcome measures and occupational therapy-related factors. Longitudinal, with consecutive sampling over a 12-mo period. Outpatient rehabilitation service. Participants were 38 adults with a unilateral DRF (ages 31-75 yr.; 81.6% female). Multicomponent occupational therapy, including supplemental techniques and activity-based interventions. Functional status and body functions were assessed before and after therapy. All standardized measures of functional status showed significant improvements, which were large in size. Several body functions improved significantly (pain, sleep, wrist and forearm movements, and grip strength fraction), and effect sizes ranged from medium to large. For several outcome variables, earlier therapy was significantly associated with better results; moreover, the likelihood of achieving better outcomes was significantly higher among participants who attended more sessions. Occupational therapy services have an important role to play after a DRF in terms of returning to daily activities and reducing impairments in body functions. Earlier intervention and attending a higher number of occupational therapy sessions are likely to further improve these outcomes. What This Article Adds: Because the effects of occupational therapy among people with a DRF remain uncertain, we quantified the outcomes of this intervention in an outpatient rehabilitation service, revealing medium to large improvements in the performance of daily activities and in various body functions. Our findings identified two factors associated with better results: early initiation of therapy and a higher number of occupational therapy sessions.

Quality of life, sense of coherence and occupational balance one year after an occupational therapy intervention for people with depression and anxiety disorders.

Quality of life (QOL), sense of coherence (SOC) and occupational balance (OB) have been found to increase after rehabilitation among people living with depression and anxiety. However, these aspects have not been investigated over time in participants with different paid work situations, such as being on sick leave or not. To describe and compare the self-rated QOL, SOC and OB after participation in occupational therapy in three groups of people with depression and anxiety disorders based on their work situation during the study period: continuous sick leave, return to work and continuous work. Forty-seven women and seven men, 19-60 years old with depression and anxiety were followed over time. They completed questionnaires on QOL, SOC and OB on four occasions. Data were analyzed with non-parametric statistics. No statistically significant differences between the groups were identified. All groups improved in at least one of the studied areas over time: the sick leave group in OB; the return-to-work group in QOL and OB; and the Work group in QOL and SOC. The results indicate variations in QOL, SOC and OB between people with different work situations over time after occupational therapy. Studies with larger samples are, however, warranted.

Occupational Therapy Psychosocial Interventions for Middle-Childhood Aged Refugee Children in High Income Countries: Focus Group Perspectives

Refugee children are at risk of developing psychosocial problems. Occupational therapy practitioners can address some of these problems. Focus groups were held with 17 occupational therapy participants to identify interventions promoting refugee children’s psychosocial wellbeing in middle childhood in high income countries. Four themes emerged: (1) Making the most with what you have, (2) The child in their various environments, (3) Occupational Therapy lens helping to build a bridge between old and new lives, and (4) Sensitivity matters/considerations. Findings indicate research is needed to identify intervention effectiveness and increase use of macro-level interventions. interventions.

Caregiver Support Role in Occupational Therapy Video Telehealth: A Scoping Review.

Caregiver involvement may facilitate patient participation in occupational therapy (OT) video telehealth. However, little is known about the extent to which caregivers participate and what they do. This scoping review aims to, 1) describe the caregiver role supporting patient participation in OT video telehealth, and, 2) identify barriers and facilitators to caregiver involvement. Findings reveal caregiver involvement in a range of OT evaluation and intervention processes, with details on what caregivers did overall lacking. Barriers and facilitators are also described. This study underscores the need for clear and robust descriptions of caregiver participation to increase best practices in video telehealth.

Psychosocial Risk Stratification in Upper Extremity Transplantation Candidates.

Candidate selection for upper extremity transplantation remains an inherently subjective process. This work evaluated the effect that psychosocial factors have on outcomes, both to standardize evaluation of potential candidates and in optimizing these factors prior to transplantation. Our goal was to measure and quantify the risk that various psychosocial factors have on transplant outcomes. Given that we do not have sufficient post-transplant patients to examine specific factors, we chose to have experts in the field evaluate hypothetical patients based on their experience. We used a Generalized Estimating Equation to estimate and compare surgical candidacy scores using patient scenario vignettes based on the presence or absence of permutations of the following: (1) depression; (2) participation in occupational therapy (OT); (3) expectation of post-transplant function; (4) punctuality; and (5) family support were given to experts in the field. This work suggests there is a decrease in predicted success with increasing numbers of negative factors with participation in OT and realistic expectations of outcomes being most important. An increase in the summarizing risk score from 0 to 1.7 was associated with a decrease in the outcome surgical candidacy score from 8.6 to 5.3, meaning candidates with 2 risk factors would often observe a large drop in surgical candidacy score. Focusing on optimizing psychosocial variables in transplant candidates may help improve hand transplant success.

Picky eating in children: Current clinical trends, practices, and observations within the Australian health-care context.

Childhood picky eating occurs when there is limited intake or variety of food and/or unwillingness to try new foods. Within research settings, standardised assessments are used to describe picky eating behaviours in children. However, little is known about assessment practices of occupational therapists. Similarly, occupational therapy interventions for picky eating in the literature focus on; providing strategies for parents, and working with the child on self-feeding skills. Despite this, interventions and strategies utilised by occupational therapists in clinical practice within an Australian health-care context are unknown. This study examines Australian health professionals' observations of picky eating behaviours, the use of childhood picky eating assessments and interventions, and differences between occupational therapists and other professionals. Health professionals (n= 179) were recruited through professional organisations, such as Occupational Therapy Australia. Participants completed an online survey between March and May 2021. Independent variables were reported using descriptive statistics, with logistic regression used to consider differences between occupational therapists and other health professionals. Conventional content analysis was used to analyse responses to open-ended questions. The final sample included 109 eligible participants, with an average of 8.5 years working with picky eaters. Results indicated picky eating behaviours aligned with those reported in the literature. Participants relied on clinical observations and workplace designed assessments. The most common interventions were education, coaching, and the sequential oral sensory approach to feeding. Occupational therapy participants were significantly more likely than other health professional participants to report always using coaching and education. Although few health professionals used standardised or validated assessments, the use of education and coaching by occupational therapists aligned with the literature. Results highlight the need for more rigorous investigation to determine the sensitivity of current assessments to differentiate between clinical and typical picky eating, and the effectiveness of interventions for childhood picky eating.

A non-randomised feasibility study of the Rehabilitation Potential Assessment Tool (RePAT) in frail older people in the acute healthcare setting

BackgroundRehabilitation potential involves predicting who will benefit from rehabilitation. Decisions about rehabilitation potential must take into account personal, clinical and contextual factors, a process which is complicated in the presence of acute ill-health and frailty. This study aimed to evaluate the feasibility and acceptability of the Rehabilitation Potential Assessment Tool (RePAT) – a 15 item holistic, person-centred assessment tool and training package – in the acute hospital setting.MethodsA non-randomised feasibility study with nested semi-structured interviews explored whether RePAT was feasible and acceptable. Feasibility was tested by recruiting physiotherapy and occupational therapy participants delivering the RePAT intervention to patients alongside usual clinical care. Acceptability was tested by conducting semi-structured interviews with staff, patient and carer participants. Staff and patient characteristics were analysed using descriptive statistics. Interview data were analysed thematically. Fidelity of completed RePAT items was assessed against a priori criteria on how closely they matched tool guidance by two researchers. Mean values of the two scores were calculated. RePAT content was analysed and supported with verbatim quotes.ResultsSix staff participants were recruited and trained. They assessed 26 patient participants using RePAT. Mean (SD) patient age was 86.16 (±6.39) years. 32% were vulnerable or mildly frail, 42% moderately frail and 26% severely or very severely frail using the Clinical Frailty Scale. Mean (SD) time to complete RePAT was 32.7 (±9.6) minutes. RePAT fidelity was good where 13 out of 15 items achieved a priori fidelity. RePAT was acceptable and tolerated by staff and patients. Staff participants reported RePAT enabled them to consider rehabilitation decisions in a more structured and consistent way. Patients and carer participants, although unable to comment directly on RePAT, reported being satisfied with their rehabilitation assessments which were found to embrace a person-centred approach.ConclusionsRePAT was found to be acceptable and feasible by staff, carers and patients. It allowed clinicians to make explicit their reasoning behind rehabilitation assessments and encouraged them to become more cognisant of factors which affected their clinical decision-making.Trial registrationID ISRCTN31938453. Registered 05/10/2021.

Occupational therapy clinical report writing in South Africa - factors influencing current practice

INTRODUCTION: Report writing is considered an essential competency for all health professionals. Current research indicates that this area of professional practice appears to be routinely neglected or poorly executed. Previous studies have aimed at understanding the reasons for this neglect; however studies specific to occupational therapy practice are lacking. PURPOSE: This study aimed to explore occupational therapists' perceptions of the factors influencing current practice in report writing within the South African context. METHOD: This qualitative study included six focus group interviews with occupational therapy participants from a variety of clinical sites, fields of practice and health sectors in South Africa, with the exception of medicolegal practice. The qualitative data were inductively analysed to determine specific themes to understand the research question. RESULTS: While occupational therapists voiced uncertainty about ethical and legal aspects concerning report writing, certain profession-specific challenges, such as professional identity and the use of professional language, are perceived to cause a disconnect between the occupational therapists' reporting and their clinical practice. CONCLUSIONS: The findings of the study indicate that participants were unsure of the details regarding the legal and ethical requirements of practice for report writing and voiced both positive and some negative sentiments in terms of reflecting professional identity and profession-specific, occupation-based language, acknowledging the challenge of being in a medical setting. The complexity of writing occupational therapy reports was perceived to be influenced by the audience receiving reports, which varied widely.

Occupational performance issues in a longitudinal perspective in people with depression and/or anxiety on sick leave, returning to work or working

Background People with depression and anxiety disorder may experience occupational performance issues (OPIs). Further knowledge about these issues longitudinally and about potential differences between people is valuable. Aim To explore experienced OPIs longitudinally in a sample living with depression and/or anxiety disorder participating in occupational therapy and varying in terms of their work situation. Material and methods The Canadian occupational performance measure (COPM) was completed by 54 participants with depression and/or anxiety at four measure-points from baseline to one-year after participation in occupational therapy. The participants constituted three groups: continuously on sick leave (SL), returned to work within a year and continuing working. Descriptive and non-parametric analysis was used. Results Participants in all groups identified OPIs in all occupational areas in the COPM. All groups increased their occupational performance and satisfaction with their occupational performance in the area socialisation. Each group also made improvements in relation to other occupational areas, varying between the groups. Conclusions OPIs and improvements were identified among the participants regardless of them being on SL, returning to work or working. Significance The diverse nature of OPIs and improvements in the clients indicate the relevance of occupational therapy.

Predicting discharge from long-term forensic treatment: patients characteristics, protective factors, needs and treatment-related factors study in the Czechia

ABSTRACT One of the challenges in forensic psychiatry is determining when an inpatient is ready to be discharged and return to the community. The comprehension of factors that predict extended treatment or discharge is relatively limited. We assessed the treatment progress of a cohort of forensic inpatients (N=80) divided into two groups: discharged patients and patients who remain detained. We derived socio-demographic and clinical variables from each patient’s medical records and scores on the HoNOS-Secure, GAF, and SAPROF scales. The dataset was subjected to logistic regression and Chi-square analysis to determine the relevant factors. We gained insights into illness as a strong predictor of discharge, which is also associated with the patient’s general compliance with the facility program and participation in occupational therapy. The majority of our sample has moderate or severe functional impairment according to GAF. The instruments used can capture dynamic factors related to discharge or continuing hospitalization, namely the SAPROF total or external factors score, the HoNOS-Secure subscale, and significant items from the HCR-20 clinical and risk subscales.

Social participation in occupational therapy: Is it possible to establish a consensus?

Social participation has been incorporated by occupational therapists in Brazil, and worldwide, as a professional concept to guide practice. The concept has been studied, defined, and constructed from multiple fields of knowledge and can be defined as the social and political involvement of people in social groups and /or public and community spaces. There are different understandings of social participation in occupational therapy and the objective of this study was to explore how Brazilian occupational therapists define social participation in their fields of knowledge. Through application of the Delphi technique, Brazilian occupational therapy academics and professionals who have worked in the state of São Paulo, Brazil, collaboratively responded to an online questionnaire. In the consultation phase, occupational therapists wrote their conceptions about social participation and, in the consensus phase, expressed their opinions and judgements, in order to, in a collective construction, establish a consensus on the definition of social participation. In the first round of the consensus phase, 38 academics and 27 professionals participated and in the second round, 20 and 14, respectively. Results were analysed quantitatively, through the establishment of degrees of agreement for conceptions arranged in statements. Then, six categories of analysis were built, which identified the multiple ways of understanding social participation: social participation and social interactions, social participation and freedom of movement, social participation as an experience in public and political life, social participation and human activities, social participation and the process of social inclusion, and social participation in the fields of knowledge and practice in occupational therapy. There are theoretical-conceptual differences in the understandings and uses of social participation in occupational therapy that delimit specificity and design the identities of the profession in society. The need to discuss knowledge production, accumulation, and dissemination and practices is debated.

Psychosocial Predictors of Upper Extremity Transplantation Outcomes: A Review of the International Registry 1998-2016.

Upper extremity transplantation (UET) is becoming increasingly common. This article attempts to collate data from cases contributing to the International Registry on Hand and Composite Tissue Transplantation (IRHCTT), define psychosocial themes perceived as predictors of success using statistical methods, and provide an objective measure for optimization and selection of candidates. The IRHCTT provided anonymous data on UET recipients. A supplementary psychosocial survey was developed focusing on themes of depression, posttraumatic stress disorder (PTSD), anxiety, interpersonal functioning and dependence, compliance, chronic pain, social support, quality of life, and patient expectations. We determined the risk of transplant loss and psychological factors associated with higher risk of transplant loss. Sixty-two UET recipients reported to the IRHCTT. Forty-three psychosocial surveys (68%) were received, with 38 (88%) having intact transplants and 5 (12%) being amputated. Among recipients with a diagnosis of anxiety (N = 29, 67%), 5 (17%) reported transplant loss (P = 0.03). Among those with depression (N = 14, 33%), 2 recipients (14%) has transplant loss (P = 0.17); while 4 recipients (22%) with PTSD (N = 18, 42%) had transplant loss (P = 0.01). Of participants active in occupational therapy (N = 28, 65%), 2 (7%) reported transplant loss (P = 0.09). Of recipients with realistic functional expectations (N = 34, 79%), 2 (6%) had transplant loss versus 3 (34%) who were felt to not have realistic expectations (N = 9, 21%, P = 0.05). Recipients with strong family support (N = 33, 77%) had a lower risk of transplant loss compared with poor or fair family support (N = 10, 23%), but did not reach statistical significance (6% versus 30%, P = 0.14). Anxiety, depression, PTSD, participation in occupational therapy, expectations for posttransplant function, and family support are associated with postsurgical transplant status.

Improving Occupational Performance in Pediatric Hematopoietic Cell Transplant Recipients.

There is a critical gap in the literature regarding the efficacy of occupational therapy interventions for pediatric hematopoietic cell transplantation (HCT) patients. To demonstrate that occupational therapy 4-5×/wk during inpatient hospitalization positively affects strength, coordination, and independence in activities of daily living (ADLs) of pediatric patients during HCT. Retrospective study. Inpatient bone marrow transplant unit at a children's hospital. Thirty-two pediatric patients admitted for HCT. Patients were seen by an occupational therapist as part of an interdisciplinary program. Interventions included play and leisure engagement, upper extremity therapeutic exercises, fine motor activities, and ADL training. Strength, coordination, and daily living skills data were documented prospectively and analyzed retrospectively to compare differences between patients seen by occupational therapy at high versus low frequency. For grip strength (dynamometer), fine motor dexterity (the 9-Hole Peg Test), and independence in ADLs (an ADL functional measure and the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test Daily Activities), the high-frequency group had a significantly smaller decrease in performance from time of admission at pretransplant (baseline) to peak decline after transplant. Grip strength and ADL scores for the high-frequency group returned to baseline at time of discharge more readily than for the low-frequency group. Participation in occupational therapy 4-5×/wk had positive effects on strength, coordination, and independence in ADLs for patients undergoing HCT. This article provides evidence that occupational therapists are an important part of the interdisciplinary team treating pediatric bone marrow transplant patients. It also demonstrates that occupational therapy interventions delivered at a high frequency can have a positive impact on upper extremity strength and independence in ADLs.

Childhood autism in the UK and Greece: a cross-national study of progress in different intervention contexts

Aim: This is a cross-national study with the aim to explore the development of children with autism over time in the UK and Greece. The focus of the study was to investigate the differences in language and social skills between children with autism across the two countries who were receiving different types of treatment: speech and language therapy, psychoanalytic/psychodynamic psychotherapy, and occupational therapy.Study design: A cross-national longitudinal design with a mixed (between-subjects and within-subjects) design.Participants: A sample of 40 children in total. In the UK, 20 children with autism who had received psychotherapy (n = 10) and speech and language therapy (n = 10) were recruited and monitored post-therapy twice over a two-year period. In Greece, 20 children with autism who received occupational therapy (n = 10) and speech and language therapy (n = 10) were recruited and monitored post-therapy twice over a two-year period.Results: All children changed significantly over time on all aspects of measurement, demonstrating that children with autism are developing in a very similar way across the two countries. With respect to the effect of the therapy context on the development of children with autism, it was found that there were no differences across intervention contexts at the start of the study, and there were mainly nonsignificant interactions in the rate of change across the differing types of intervention. However, further analysis showed some important differences: speech and language therapy participants presented more widespread change on language scores across the measures; psychotherapy participants showed significant greater increase in imagination and decrease in stereotypical behavior; and occupational therapy participants presented significant reduction of stereotypical behavior.Conclusions: This study can help professionals who work with children with autism further their understanding of the disorder and how it manifests through time in order to provide appropriate services based on each child’s needs.Keywords: Childhood autism, speech and language therapy, psychotherapy, occupational therapy, UK, Greece

Impact of the Application of Behavioral Principles on Children’s Participation in Occupational Therapy From the Therapist’s Perspective

Abstract Date Presented 4/19/2018 Children can exhibit challenging behaviors in response to therapy intervention. This research examined the impact of application of behavioral principles on children’s participation in therapy from the therapist’s perspective. Primary Author and Speaker: Sandra Brown Additional Authors and Speakers: Mary Ellen Young, PhD Contributing Authors: Christine Myers

The effectiveness of parent participation in occupational therapy for children with developmental delay.

IntroductionThis study aims to explore the impact of Parent Participation Program on the development of developmental delay children.MethodsPretest-posttest equivalent-group experimental design study was used in this paper. A total of 30 pairs of developmental delay children aged 0–72 months and their parents participated into this study. They were divided into two groups, namely control group and experimental group, according to parents’ wishes. The objects of study in control group received 16 courses of direct rehabilitation therapy; those in experimental group received 8 courses of direct rehabilitation therapy and 8 courses of instruction and tracking of Parent Participation Program. The duration of the intervention was 8 weeks. All cases should be evaluated before and after the intervention, to analyze the difference before and after intervention and among groups. The statistical methods in this paper included descriptive analysis, Chi-square test, independent sample t-test, pair-sample t-test.Results and conclusionThe intervention of Parent Participation Occupational Program has positive impact on the development of developmental delay children in various fields. Among all the intervention results, the progress of the experimental group is 1.895 times more than that of the control group. With parent involvement, Parent Participation Occupational Therapy can promote the cognitive ability, language ability, action ability (gross and fine movement), social competence and self-care ability of children with developmental delay. Finally, the researcher presents suggestions and directions for future research in accordance with the results.

Practices and roles of Irish occupational therapists’ with adults with intellectual disabilities who access supported employment services

Purpose Work is good for one’s health and well-being. Work for people with disabilities should be encouraged because it is therapeutic and improves participation in the society, leading to better health outcomes. It develops interpersonal relationships and enhances life quality. Work is an aspiration for many people with intellectual disability. Within research literature, there appears to be a lack of research into the experience of occupational therapists in Ireland who refer adults with intellectual disabilities to supported employment services. The purpose of this paper was to explore the experience of Irish occupational therapists who refer adults with intellectual disabilities to supported employment services. Design/methodology/approach Semi-structured, in-depth interviews were conducted with four occupational therapists recruited through the Association of Occupational Therapists of Ireland (AOTI). Data were analysed using thematic analysis. Findings Themes that emerged were as follows: occupational therapy participants did not directly refer adults to supported employment but received referrals; occupational therapy roles included assessments, task analysis and development of client’s skills are major components of current practice; pragmatics involved factors that facilitate and challenge; and future roles. Originality/value This paper contributes to occupational therapy practice knowledge by providing a perspective on supported employment in Ireland. Occupational therapists should continue to work in the area of supported employment to support social inclusion and enable participation. Further research with occupational therapists working in this field is required to inform practice.

The Course and Predictors of Patient Participation in Inpatient Occupational Therapy: Understanding the Impact on Outcomes and Implementation Barriers

Abstract Date Presented 3/31/2017 Patient participation (engagement) is a keystone of patient-centered care. This study provided evidence to support how active participation in occupational therapy would enhance patient outcomes at discharge and 1 yr postinjury. We also identified barriers to patient participation in rehabilitation. Primary Author and Speaker: Alex Wong Contributing Authors: Christina Papadimitriou, Arielle Goldsmith, Katrina Christopher, Gale Whiteneck, Anne Deutsch, Eric Lenze, Allen W. Heinemann

Parent Training Occupational Therapy Program for Parents of Children with Autism in Korea.

Attitudes and beliefs about parent participation in occupational therapy are shifting toward family-centered practice worldwide. However, adopting a family-centered approach in a society such as Korea, where a Confucian culture of hierarchical roles is reflected in a strong medical model, can prove to be very difficult. A parent training program was developed at the HOPE Center, a pediatric occupational therapy center, to bridge the gap between the traditional medical model and the ideal family-centered model. This study examined the effectiveness of the parent training and gauged parents' perceptions and experiences of a more family-centered approach to therapy. Four parent-child dyads living with autism participated in five months of parent training at the HOPE center. The results on the Canadian Occupational Performance Measure showed that the parent training improved the occupational performance of both children and parents. Six open-ended questions were used to investigate parents' perceptions and experiences of parent training. Two broad themes emerged: improved self-efficacy and the cultural reality of living with autism in Korea. This study demonstrates that building parent training into an occupational therapy program may optimize the effectiveness of any therapy and introduce a more family-centered approach to therapy while maintaining cultural integrity.

CORRELATION BETWEEN THE PARTICIPATION OF ELDERLY PEOPLE IN THE OCCUPATIONAL THERAPY AND THEIR ASSESSMENT OF THE HEALTH-RELATED QUALITY OF LIFE

The aim of the research: discovering the relation between the participation of elderly people in the occupational therapy and their Health-Related Quality of Life. Research material and methods: research was carried out in the public social centres offering the occupational therapy devoted to the elderly people. 95 people whose average age was 72,1 years (58 women and 37 men) were examined. The examinees were divided into two groups: the participants and those who were not involved in the occupational therapy. The method of direct interview using EQ-5D-3L questionnaire - a standard instrument for measuring Health-Related Quality of Life of the elderly people was applied. The results: Seniors involved in occupational therapy reported better HRQL. Difficulties with mobility (<0,05), pain/discomfort (<0,001) and anxiety (<0,001) were substantially more visible around people who did not take part in the occupational therapy. The average self-reported health was better among the occupational therapy participants (<0,001) in comparison with the other elderly people who were not engaged in those activities (76,5 vs. 43,6 respectively). Conclusions: participation in the occupational therapy has a positive effect on the functioning of the elderly people in every sphere of their life: physical, mental and social one. Involvement in the occupations resulted in the improved perception of the Health-Related Quality of Life. Occupational therapy turned out to be an inexpensive and effective method that exerts a positive impact on maintenance of physical and intellectual abilities, social inclusion as well as physical rehabilitation of seniors.