Perceptions Of Occupational Therapists 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.

Perceptions of occupational therapists in the United Kingdom on the applicability of the reflective framework for community development in occupational therapy

Introduction: Community development approaches are increasingly used by occupational therapists in response to occupational justice theory, which posits that both individuals and community groups may be denied access to meaningful occupations through societal powers outside their control. Previous research has found that occupational therapists feel insufficiently prepared for a role in community development and tend to use their general skill set, sometimes in combination with generic community development approaches. This study explored whether the reflective framework for community development in occupational therapy is applicable and useful for occupational therapists in the United Kingdom. Methods: A mixed methods approach was used, combining an online questionnaire and focus groups with occupational therapists who already work in community development. Findings were compared with the framework. Findings: The participants recognised most aspects of the Framework in their own practice, but some key aspects such as collaboration with the community at every stage were less prominent. They found the framework applicable to the UK context, particularly for occupational therapists inexperienced in community development practice. Conclusion: This study has highlighted community development practice by occupational therapists in the United Kingdom and concluded that the framework would support them in fulfilling this role more effectively.

Mobile Videoconferencing for Occupational Therapists' Assessments of Patients' Home Environments Prior to Hospital Discharge: Mixed Methods Feasibility and Comparative Study.

BackgroundOccupational therapists who work in hospitals need to assess patients’ home environment in preparation for hospital discharge in order to provide recommendations (eg, technical aids) to support their independence and safety. Home visits increase performance in everyday activities and decrease the risk of falls; however, in some countries, home visits are rarely made prior to hospital discharge due to the cost and time involved. In most cases, occupational therapists rely on an interview with the patient or a caregiver to assess the home. The use of videoconferencing to assess patients’ home environments could be an innovative solution to allow better and more appropriate recommendations.ObjectiveThe aim of this study was (1) to explore the added value of using mobile videoconferencing compared with standard procedure only and (2) to document the clinical feasibility of using mobile videoconferencing to assess patients’ home environments.MethodsOccupational therapists assessed home environments using, first, the standard procedure (interview), and then, videoconferencing (with the help of a family caregiver located in patients’ homes, using an electronic tablet). We used a concurrent mixed methods design. The occupational therapist's responsiveness to telehealth, time spent on assessment, patient’s occupational performance and satisfaction, and major events influencing the variables were collected as quantitative data. The perceptions of occupational therapists and family caregivers regarding the added value of using this method and the nature of changes made to recommendations as a result of the videoconference (if any) were collected as qualitative data, using questionnaires and semistructured interviews.ResultsEight triads (6 occupational therapists, 8 patients, and 8 caregivers) participated. The use of mobile videoconferencing generally led occupational therapists to modify the initial intervention plan (produced after the standard interview). Occupational therapists and caregivers perceived benefits in using mobile videoconferencing (eg, the ability to provide real-time comments or feedback), and they also perceived disadvantages (eg, videoconferencing requires additional time and greater availability of caregivers). Some occupational therapists believed that mobile videoconferencing added value to assessments, while others did not.ConclusionsThe use of mobile videoconferencing in the context of hospital discharge planning has raised questions of clinical feasibility. Although mobile videoconferencing provides multiple benefits to hospital discharge, including more appropriate occupational therapist recommendations, time constraints made it more difficult to perceive the added value. However, with smartphone use, interdisciplinary team involvement, and patient participation in the videoconference visit, mobile videoconferencing can become an asset to hospital discharge planning.International Registered Report Identifier (IRRID)RR2-10.2196/11674

Death and Other Losses in the COVID-19 Pandemic in Long-Term Care Facilities for Older Adults in the Perception of Occupational Therapists: A Qualitative Study.

Long-term care facilities for older adults (LTCFs) were directly affected by the COVID-19 pandemic. This study aimed to discuss the perceptions of occupational therapists about deaths and other losses in LTCFs during the pandemic. This qualitative study is anchored in social phenomenology, and conducted in-depth interviews with eight occupational therapists who worked in LTCFs. Thus, two themes were generated after the Thematic Analyses: “The proximity of death” and “Losses associated with living and dying in a LTCF.” In the first theme, the interviewees addressed the feeling of imminent death in the daily life of the LTCF, and feelings related to their own death, that of their family members and other older adults. In the second, the professionals highlighted three groups of losses: social, functional, and psychological/cognitive. These results highlighted the challenges faced by occupational therapists and can contribute to improve behavior and care for institutionalized older adults during the pandemic.

Vocational rehabilitation for young stroke survivors in Gauteng public healthcare: Occupational therapists' perceptions1.

The prevalence of working-aged stroke survivors is increasing yearly. Stroke is an expensive disease, causing financial burden to the government, the family and caregivers of the patient, thus making it imperative for working-aged stroke survivors to work to remain financially independent. Survivors' need to work necessitates occupational therapists to shift their focus from basic activities of daily living, to rehabilitating work. This study aimed to determine the perceptions of occupational therapists working with younger stroke survivors in public hospitals and clinics in Gauteng South Africa, about rehabilitating working-aged stroke survivors' work ability. Ethical clearance was obtained. A qualitative research design was used to obtain narrative, descriptive data from six focus groups. Therapists from public healthcare settings, who had more than six months' experience and had worked in neurological rehabilitation within the six months preceding the focus group, were invited to participate. Focus groups were audio recorded and transcribed. Inductive content analysis was used to identify themes and categories. Few participants are involved in rehabilitating younger stroke survivors' work ability or facilitating return to work (RTW). The study identified perceived barriers and enablers to rendering OT services that meet working-aged stroke survivors' needs. Despite enabling employment equity laws in South Africa, OTs working in the public sector appear to experience a sense of futility when trying to rehabilitate young stoke survivors to RTW. Fragmentation of the public sector and limited resources impede successful RTW for working-aged stroke survivors. Survivors' employment status and motivation to RTW facilitated rehabilitating work ability.

Cross-Cultural Adaptation of the Tailored Activity Program for Brazilian Portuguese

Brazil lacks an Occupational Therapy methodology of action, justifying the cross-cultural adaptation of TAP. Objectives were to adapt TAP reference materials to the Brazilian culture and evaluation of the applicability of the Portuguese version by perceptions of Occupational Therapists (OT) and family caregivers. The methodology used translation, back translation, evaluation of semantic, idiomatic, conceptual and cultural equivalences and pre-test of materials for production in Portuguese. The OT applied the translated version and evaluated its applicability. Caregivers evaluated the social impact of the adapted program. The cross-cultural adaptation process adapted the entire materials program to Portuguese culture. The OT perception is a need to include one session to guide caregivers and to modify the cognitive assessment used. The caregivers pointed out that TAP helps them in understanding and caring for the elderly with dementia. The TAP-BR has been adapted to the Brazilian culture. Part of a symposium sponsored by the Behavioral Interventions for Older Adults Interest Group.

The role of occupational therapy in the Solomon Islands: experiences and perceptions of occupational therapists and rehabilitation health workers.

In most Western countries occupational therapy is well established as a crucial aspect of overall health care; however, in low-middle-income countries it is still an emerging profession. This article investigates the role of occupational therapy in the Solomon Islands by examining the experiences and perceptions of occupational therapists (OTs) and other rehabilitation health workers who have worked there. Using a qualitative research design, participants were recruited using purposive sampling, and data were gathered through in-depth interviews, diary entries and observations of an occupational therapy setting in the Solomon Islands. Ten participants were interviewed. A significant role in health-promoting practices was revealed through the various tasks undertaken by OTs in the Solomon Islands, including influencing health policy and practice broadly through advocacy and education. Challenges relating to geography, cultural, language and resource barriers, and professional practice issues were identified. Implications for practice were drawn from the data including the need for culturally safe practice, pragmatism, creativity and practising across disciplinary boundaries. Results illustrate a clear role for occupational therapy in promoting health and sustainability of rehabilitation therapy services in the Solomon Islands, which also have relevance throughout Pacific island nations.

Introducing robotic upper limb training into routine clinical practice for stroke survivors: Perceptions of occupational therapists and physiotherapists.

Robot-assisted therapy for the upper limb (RT-UL) is an emerging form of intervention for stroke survivors with upper limb deficits. However, there is limited knowledge regarding therapists' perceptions of RT-UL and the factors influencing the implementation of RT-UL into the clinical setting. This is important when considering that therapists in Australia are primarily responsible for the prescription of RT-UL in daily practice. This study aimed to explore occupational therapists' and physiotherapists' perceptions of RT-UL and the perceived barriers and enablers influencing implementation. Two discipline-specific focus groups were conducted involving occupational therapists (n=6) and physiotherapists (n=6). Participants were members of the same multidisciplinary team working in an Australian public health rehabilitation facility where RT-UL (i.e. InMotion2) was being introduced for the first time. Focus groups explored therapist perceptions of the new RT-UL as well as perceived barriers and enablers to implementation. Focus groups were recorded, transcribed and deductively analysed using the Theoretical Domains Framework (TDF). Out of the 14 domains of the TDF, 7 were raised by participants during the focus groups: environmental context and resources, beliefs about consequences, optimism, knowledge, skills, social influences, and social and professional role and identity. Therapists' expressed their optimism towards the introduction of RT-UL but believed successful implementation would be primarily dependent on the availability of clinical leadership, training and a suitable client mix. Therapists perceived that RT-UL would provide opportunity for increased upper limb practice particularly for patients with severe upper limb impairment. To facilitate implementation, support of RT-UL should come from both management and clinical leaders and training include RT-UL efficacy, device functionality and patient suitability. The availability of a single RT-UL device in a workplace may create unique interdisciplinary and logistical challenges.

Perceptions of Occupational Therapists and Yoga Practitioners of the Effects of Yoga on Health and Wellness

Perceptions of Occupational Therapists and Yoga Practitioners of the Effects of Yoga on Health and Wellness

Content Validity of the Parentship Protocol: A Multidimensional Intervention for Parents of Adolescents with High-Functioning Autism Spectrum Disorder

The Parentship protocol is a short-term intervention program in occupational therapy for parents of adolescents with High-Functioning Autism Spectrum Disorder (HFASD). Its purpose is to promote parental resilience and enhance adolescents’ participation in daily life. Aims: To explore and analyze the perceptions of occupational therapists and parents of individuals with HFASD, regarding the content of the protocol and its theoretical framework. Methods: Implementation of a phenomenological qualitative approach using two focus groups (six occupational therapists and five parents). A transcript-based analysis was used for analyzing the data. Results: The degree of agreement regarding the potential purposes and contents of the protocol was high. In addition, nine themes were raised and led to changes and additions in the protocol. Conclusions: The study provided support for content validity and acceptability of the Parentship protocol. Future research should test the feasibility of this new intervention program.

Patients’, Caregivers’, and Parents’ Perceptions of Occupational Therapists

Abstract Date Presented 3/31/2017 This qualitative grounded theory study explored patients’, caregivers’, and parents’ perceptions of occupational therapists using an online survey. Participants were solicited from Facebook and other Internet sources. Results show how participants viewed their occupational therapists and services provided. Primary Author and Speaker: Sierra Thompson Additional Authors and Speakers: Kiarra Morris, Ryan Smith, Barbara Kornblau, Debora Oliveira, Aurelia Alexander, Sarah Mbiza

Perceptions of Occupational Therapists on the Patient Protection and Affordable Care Act: Five Years After Its Enactment

ABSTRACTThis study explored the perceptions of occupational therapists regarding the impact and implications of the Patient Protection and Affordable Care Act (PPACA or ACA) on occupational therapy practice. Fifteen occupational therapists participated in an interview to answer open-ended questions related to their thoughts and perceptions regarding the impact and implications of the ACA on their practice. The participants were practicing in eight different states and worked in five different settings with clinical experience ranging from 3 to 38 years; their positions ranged from staff therapist to owner of a free-standing outpatient clinic. Qualitative content analysis was used to synthesize the interview transcripts. Results showed that therapists did not have sufficient knowledge on the various mandates and provisions of the ACA, or were uncertain about what implications the ACA would have on practice, with the ACA affecting some settings more than others. Data revealed the perceived impacts of the ACA on occupational therapy practice include greater attention on documenting outcome-focused care, external accountability pressures on productivity, conscientiousness about clients' insurance coverage, uncertainty about collaborative care delivery, and survival of small businesses. Findings suggest training regarding knowledge about and implications of different elements of the ACA is needed as well as practices needing to promote the services that occupational therapists can provide to improve cost-effectiveness and outcomes in collaborative care environments.

Learning Together: Exploring Instructional Support Personnel’s Perceptions of Occupational Therapists in School Mental Health—A Pilot Study

Abstract Date Presented 4/9/2016 The purpose of this pilot study was to investigate the perspectives of instructional support personnel (ISP) with regard to the involvement of occupational therapy (OT) practitioners in school-based mental health. After a training, ISP were more knowledgeable about OT’s role in school mental health. Primary Author and Speaker: Susan Cahill Additional Author and Speaker: Brad Egan

Organisational support for evidence-based practice: occupational therapists perceptions.

Barriers to the use of evidence-based practice extend beyond the individual clinician and often include organisational barriers. Adoption of systematic organisational support for evidence-based practice in health care is integral to its use. This study aimed to explore the perceptions of occupational therapy staff regarding the influence of organisational initiatives to support evidence-based practice on workplace culture and clinical practice. This study used semi-structured interviews with 30 occupational therapists working in a major metropolitan hospital in Brisbane, Australia regarding their perceptions of organisational initiatives designed to support evidence-based practice. Four themes emerged from the data: (i) firmly embedding a culture valuing research and EBP, (ii) aligning professional identity with the Research and Evidence in Practice model, (iii) experiences of change: pride, confidence and pressure and (iv) making evidence-based changes to clinical practices. Organisational initiatives for evidence-based practice were perceived as influencing the culture of the workplace, therapists' sense of identity as clinicians, and as contributing to changes in clinical practice. It is therefore important to consider organisational factors when attempting to increase the use of evidence in practice.

Hippotherapy in occupational therapy practice

8BACKGROUND: There has recently been renewed interest in hippotherapy, which can be a strategy of choice within therapy programmes involving the use of a horse. In this study, the authors endeavoured to explore the experiences and perceptions of occupational therapists in the use of hippotherapy as a therapeutic intervention strategy. METHODS: A quantitative descriptive study design was selected utilising an online questionnaire. Two hundred and thirty seven therapists were purposively sampled with data being obtained from 53 respondents. Data were analysed using descriptive statistics. RESULTS: The majority of respondents (n=39 i.e. 76.3%) indicated awareness of hippotherapy, with a number of the respondents indicating exposure to hippotherapy during their studies (n=24 i.e. 46.2%). Only six of the respondents were currently using hippotherapy, either directly or through referrals. It is significant to note that out of the 47 of the respondents who were not currently using hippotherapy, 42 respondents indicated that they would consider using it in the future. CONCLUSION: The high percentage of respondents interested in this therapeutic intervention strategy can be linked to their perception of the benefits of hippotherapy. In particular, all respondents indicated that they viewed hippotherapy as being beneficial for neurological conditions, as well as for specific aspects of functioning including postural control, mobility, processing and integration, self-confidence, self-esteem, mood and motivation. Relevant barriers impacting on the use of hippotherapy included limited centres available and lack of awareness. The majority of respondents currently not using hippotherapy indicated that there was limited training for occupational therapists. As benefits become validated by future research studies, as well as by limiting barriers to the use of this intervention strategy, hippotherapy may become a more widespread and acceptable adjunctive therapeutic intervention strategy. Key words: occupational therapists, occupational therapy, hippotherapy

Maintenance of professional currency: Perceptions of occupational therapists

In common with other health professionals, occupational therapists have a growing ethical and legal obligation to maintain competence and currency in their area of practice. Despite this context of increasing demands for professional accountability, there is little known about how occupational therapists perceive the role and meaning of professional currency in their day-to-day practice. This qualitative study sought to explore this further. Four focus group interviews were conducted, with 17 South Australian occupational therapists. Participants worked in a variety of practice areas. They covered both metropolitan and rural settings and ranged from being recent graduates to experienced therapists. The interviews involved facilitating small group discussion around a series of open-ended semi-structured questions. The resulting discussions were recorded and transcribed. Thematic analysis was utilised to explore participants' perspectives. Thematic analysis of the transcripts revealed five themes. These included: self-determination; perceived capacity; workplace impact; you need to have people around; and looking after yourself. These themes were conceptualised as incorporating dynamic foundational and constructional aspects. Foundational aspects facilitate or hinder the pursuit of professional currency, and constructional aspects encompass the meaning and value ascribed to professional currency. These findings yield some interesting insights into the way therapists think about and structure their professional learning, and provide direction to plan professional development activities based on self-identified need and preference.

A Qualitative Study of Occupational Therapy's Role in Adolescent Transition in a Midwestern Coalition of Many School Districts

Two years after high school, adolescents with disabilities struggle with employment, independent living, and continuing education. These struggles call for school-based occupational therapists to take a role to impact outcomes. The perceptions of occupational therapists within transition services in a large Midwestern coalition were examined. Through semistructured interviews with 4 nonoccupational therapy transition professionals and a focus group with occupational therapists, 3 themes emerged: (a) “I couldn't even begin to describe the essential functions of an occupational therapist”; (b) “Unless the kids get direct services, which a lot of these kids aren't, I don't have any part in their transition services”; and (c) “I don't feel that [OT] is looked at as a priority in transition.” Occupational therapy continues to be underutilized in school-based transition services. Suggestions are provided to enhance the role within system-wide delivery changes.

A Descriptive Study on Level II Fieldwork Supervision in Hospital Settings

ABSTRACTThe objective of this study was to examine the factors influencing fieldwork educators’ ability and willingness to supervise Level II occupational therapy students in hospital-based settings. Qualitative focus groups were used to explore the perceptions of occupational therapists in four urban hospitals in Nebraska. The study presents the issues facing fieldwork supervisors and their suggestions on how to improve the fieldwork process. Both personal and professional factors influenced occupational therapists’ willingness to accept students, while facility constraints were the primary reason occupational therapists would not accept Level II students. Fieldwork educators believe that their facilities need structured fieldwork programs and that students need more formalized fieldwork preparation at their academic institutions. Themes highlight the need for continued collaborative endeavors between academic fieldwork coordinators and fieldwork educators.

Occupational therapists' experience of working with immigrant clients in mental health care

Sweden's cultural diversity generates considerable challenges for occupational therapists. The aim of this study was to explore experiences and perceptions of occupational therapists working with immigrant psychiatric clients from the Middle East region. The study included interviews with eight occupational therapists employed in mental health care and working in a variety of settings. The data collection and analysis were carried out in accordance with the grounded theory approach. One core category, “the challenges of the multicultural therapeutic journey—a journey on a winding road” was identified. The core category included three categories: dilemmas in clinical practice, feelings and thoughts, and building cultural bridges, in turn comprising sub-categories and components. The results showed that the many dilemmas influencing effective multicultural occupational therapy were cultural, societal, and professional in nature. The dilemmas influenced feelings and thoughts, in turn influencing both motivation for seeking cultural knowledge and choice of adequate strategies in which the multicultural therapeutic relationship could develop. The results imply that culturally congruent occupational therapy practice needs to be further developed and more research is needed on how cultural issues can be met in occupational therapy practice.

The Benefits of and Challenges to the Use of Occupation in Hand Therapy

ABSTRACTThis mixed methods survey examines the perceptions of occupational therapists working in hand therapy in the United States regarding the benefits of and barriers to occupation-based hand therapy. Electronic questionnaires containing open- and closed-ended questions were answered by 105 occupational therapists working in hand therapy and analyzed using descriptive statistics and qualitatively according to themes. Participants reported that occupation-based interventions benefit clients by facilitating functional activity, meaningful therapeutic experiences, and holistic approach to treatment. Reported barriers to occupation-based interventions include logistic issues, reimbursement issues, the limitations imposed by the client's medical condition or the treatment protocol, and credibility of occupation-based interventions. Overcoming the challenges to occupation-based practice in hand therapy requires research in the efficiacy of occupation-based hand therapy and education of the public as well as health professionals and occupational therapists working in hand therapy.