Practice Of Occupational Therapists Research Articles

Occupational transition in the process of becoming housed following chronic homelessness: La transition occupationnelle liée au processus d'obtention d'un logement à la suite d'une itinérance chronique.

Studying the occupations of formerly homeless persons as they transition to becoming housed following long-term homelessness has the potential to offer a meaningful contribution to the ongoing dialogue on homelessness. Occupational transition was explored with a sample of persons with a history of chronic homelessness to contribute an occupational perspective to current scholarship on homelessness and to inform the practice of occupational therapists who support this population. Interpretive phenomenology guided the study. Eleven persons with a history of chronic homelessness were engaged in semistructured interviews 3 to 24 months after becoming housed. Six themes emerged that highlighted occupation as a means of promoting social and psychological integration, and the meaning and experience of occupational transition. A more comprehensive support strategy acknowledging the occupations of chronically homeless persons is essential to incorporate into future research and practice aimed at promoting community inclusion and housing retention.

Changing practice in the assessment and treatment of somatosensory loss in stroke survivors: protocol for a knowledge translation study

BackgroundThe treatment of somatosensory loss in the upper limb after stroke has been historically overshadowed by therapy focused on motor recovery. A double-blind randomized controlled trial has demonstrated the effectiveness of SENSe (Study of the Effectiveness of Neurorehabilitation on Sensation) therapy to retrain somatosensory discrimination after stroke. Given the acknowledged prevalence of upper limb sensory loss after stroke and the evidence-practice gap that exists in this area, effort is required to translate the published research to clinical practice. The aim of this study is to determine whether evidence-based knowledge translation strategies change the practice of occupational therapists and physiotherapists in the assessment and treatment of sensory loss of the upper limb after stroke to improve patient outcomes.Method/designA pragmatic, before-after study design involving eight (n = 8) Australian health organizations, specifically sub-acute and community rehabilitation facilities. Stroke survivors (n = 144) and occupational therapists and physiotherapists (~10 per site, ~n = 80) will be involved in the study. Stroke survivors will be provided with SENSe therapy or usual care. Occupational therapists and physiotherapists will be provided with a multi-component approach to knowledge translation including i) tailoring of the implementation intervention to site-specific barriers and enablers, ii) interactive group training workshops, iii) establishing and fostering champion therapists and iv) provision of written educational materials and online resources. Outcome measures for occupational therapists and physiotherapists will be pre- and post-implementation questionnaires and audits of medical records. The primary outcome for stroke survivors will be change in upper limb somatosensory function, measured using a standardized composite measure.DiscussionThis study will provide evidence and a template for knowledge translation in clinical, organizational and policy contexts in stroke rehabilitation.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR) retrospective registration ACTRN12615000933550.

Early Childhood Development: The Disability Policy and its implications for occupational therapists

The White Paper on the Rights of Persons with Disabilities encapsulates the vision not only for persons with disabilities in South Africa, but for every member of a diverse society. This paper discusses the vision of inclusion and mainstreaming contained in the White Paper and critiques the specific provisions for early childhood development, exploring their implications for training and practice of occupational therapists. Recommendations are made as to how these can be strengthened in achieving the vision of an inclusive society in which young children with disabilities are able to realise their potential. Key words: children with disabilities, early childhood development, inclusion, mainstreaming, policy

Building Executive Functioning to Facilitate Instrumental Activities of Daily Living for Emerging Adults with Autism Spectrum Disorder

Building Executive Functioning to Facilitate Instrumental Activities of Daily Living for Emerging Adults with Autism Spectrum Disorder K. A. Lavin, OTD, OTR/L Abstract Autism Spectrum Disorder (ASD) is a complex neurologically based developmental disorder that can affect an individual’s thinking, feeling, language development and social interactions (American Psychiatric Association, 2017). These symptoms frequently limit independence in instrumental activities of daily living. There is growing evidence that executive dysfunction may contribute to these functional deficits. The prevalence of ASD continues to rise and today is identified in approximately 1 in 68 children. As a result, more and more occupational therapists are finding themselves working with individuals with ASD. Facilitation of cognitive processes (which includes executive function) through the use of occupations and activities, is within the scope of practice for occupational therapists (Giles et al., 2013); However, there is a significant lack of evidence-based interventions that address executive functioning for emerging adults with ASD. The program outlined was developed to address this identified need. It is a comprehensive program based on current research that facilitates instrumental activities of daily living by addressing underlying executive functioning skills. A thorough literature review, methods for program implementation, and program evaluation are described. Full Text: PDF DOI: 10.15640/jpbs.v6n2a1

Infant Positioning, Baby Gear Use, and Cranial Asymmetry

Objectives This study aimed to identify predictors of cranial asymmetry. We hypothesize that among infants diagnosed with cranial asymmetry in the sampled region, there is an association between exposure to more time in baby gear and less awake time in prone and side-lying than in infants who do not present with this condition. Methods The study employed a cross sectional survey of caregivers of typically developing infants and infants diagnosed with cranial asymmetry. Results A mutivariable model reveals that caregivers of children who are diagnosed with cranial asymmetry report their children spending significantly less time in prone play than those children without a diagnosis of cranial asymmetry. Side-lying and time spent in baby gear did not attain statistical significance. Conclusions for Practice Occupational therapists, physical therapists, pediatricians, nurses and other health care professionals must provide parents with early education about the importance of varying positions and prone play in infancy and address fears and concerns that may serve as barriers to providing prone playtime.

Intervention and management of developmental coordination disorder: Are we providing evidence-based services?: Intervention et traitement d'un trouble du développement de la coordination : Les ergothérapeutes fournissent-ils des services fondés sur les faits scientifiques?

Occupational therapists are well positioned to provide intervention to improve outcomes for children with developmental coordination disorder. However, little is known about what occupational therapy services are provided for these children. As part of a larger study exploring service provision for children with developmental coordination disorder, the purpose of this study was to examine intervention and referral practices of occupational therapists in British Columbia, Canada. An online survey was e-mailed to a convenience and snowball sample of paediatric occupational therapists, with 165 therapists responding. Descriptive statistics were used for the data analysis. Results show that the type and duration of intervention varied greatly throughout the province, as well as within health regions. Although 70% (87/124) of therapists reported being at least moderately familiar with current evidence, only 47% to 59% selected task-based methods as their primary intervention approach. Findings provide a baseline for current intervention and an opportunity for targeted knowledge translation initiatives.

Learning from the margins: Enabling effective occupational therapy

IntroductionThis study investigated the practice of occupational therapy in marginal settings to see if it could offer anything to take forward the development of occupational therapy theory and practice.MethodThe study began with the assumption that occupational therapy consists of an idea and a practice, both embedded in particular times, places and contexts. An interpretive methodology was selected to explore how the idea and practice develop as practitioners try to make sense of their practice. A multiple case study design was employed, using qualitative interview methods to explore the perceptions of practitioners working in marginal settings. The research design was not fully specified from the beginning, but emerged during the course of the study.FindingsThe practice of occupational therapists working on the margins differed from that in the mainstream in several features, but the differences tended to be of degree. Practitioners shared five characteristics which enabled them to practise effectively in resource-poor conditions: agency; openness; commitment; responsiveness; and resourcefulness.ConclusionDeveloping these enabling characteristics in occupational therapy students and practitioners has the potential to make them better able to make an effective contribution to meeting complex health and social care needs in developed and developing countries.

Exploring the lived experience of homelessness from an occupational perspective

Background: Working in homelessness is a growing area of practice for occupational therapists, however, there is limited literature on the lived experiences of homelessness and occupational engagementStudy aim: To explore the lived experience of homeless men in relation to how they engaged in day-to-day occupations when sleeping rough or hostel dwellingMethods: Data were gathered from five men residing in a homeless hostel in the UK. Data collection included semi-structured interviews and photographic diaries. Data were analyzed using Interpretative Phenomenological AnalysisResults: Participants described their experiences of occupational engagement whilst sleeping on the streets which included engaging in survival occupations, the significance of apparently ordinary occupations and moving beyond survival occupations. The homeless hostel provided opportunities for occupational engagement that the men perceived in an idiosyncratic manner. The men described benefits of engaging in novel occupations and reengaging in known occupations. Occupational injustices were a common theme that occurred throughout participants experiencesConclusion: This study has highlighted the diversity of occupational engagement for ‘roofless’ or ‘houseless’ participants and how different individuals experience occupational adaptionSignificance: This study has furthered understandings of the concept of ‘survival occupations’ and the importance of community resources to facilitate occupational engagement whilst homeless.

Continuing Competence Trends of Occupational Therapy Practitioners

The purpose of this pilot study was to examine the perceptions and practices of occupational therapists regarding the types of professional development activities they seek to ensure competency. A self-report survey was used to investigate the therapists’ selection of and engagement in professional learning activities. The results from 43 occupational therapists were analyzed. Descriptive results identified the value of a professional development plan and collaboration with colleagues. Self-assessment and searching for and analyzing journal articles emerged as frequently used continuing competence learning practices. The results showed that therapists actively plan and select formal and informal professional activities to promote meaningful learning for continuing competence practices. Productivity standards were considered the main challenge that impeded the participants’ professional development plans and continued competence.

Occupational therapy students' technological skills: Are'generation Y' ready for 21st century practice?

Technology is becoming increasingly integral to the practice of occupational therapists and part of the everyday lives of clients. 'Generation Y' are purported to be naturally technologically skilled as they have grown up in the digital age. The aim of this study was to explore one cohort of 'Generation Y' occupational therapy students' skills and confidence in the use of technologies relevant to contemporary practice. A cross-sectional survey design was used to collect data from a cohort of 274 students enrolled in an Australian undergraduate occupational therapy programme. A total of 173 (63%) students returned the survey. Those born prior to 1982 were removed from the data. This left 155 (56%) 'Generation Y' participants. Not all participants reported to be skilled in everyday technologies although most reported to be skilled in word, Internet and mobile technologies. Many reported a lack of skills in Web 2.0 (collaboration and sharing) technologies, creating and using media and gaming, as well as a lack of confidence in technologies relevant to practice, including assistive technology, specialist devices, specialist software and gaming. Overall, the results suggested that this group of 'Generation Y' students were not universally skilled in all areas of technology relevant to practice but appear to be skilled in technologies they use regularly. Recommendations are therefore made with view to integrating social networking, gaming, media sharing and assistive technology into undergraduate programmes to ensure that graduates have the requisite skills and confidence required for current and future practice.

Technology for dementia: attitudes and practices of occupational therapists in providing assistive technology for way finding

Purpose: One of the many difficulties a person with dementia can experience is difficulty with way finding and subsequently getting lost in the community. Prescriptions of assistive technology are a key role for occupational therapists. This study aimed to describe the attitudes and practices of occupational therapists in recommending and using assistive technology for persons with dementia who have difficulties with way finding in the community.Methods: An online survey was distributed to members of Occupational Therapy Australia NSW and included 25 items on demographics, frequency of use of assistive technology and assessment.Results: A total of 85 occupational therapists responded to the survey. Significant differences were identified in the approaches used, the types of assistive technology used and the evaluation of outcomes, between community-based and hospital-based occupational therapists. Over half of the participants had never prescribed any of the assistive devices listed in the survey for people with dementia. The most frequently prescribed assistive devices were low-tech items that were already freely available to carers and other professions.Conclusion: Therapists used a conservative approach to problem solving with their clients with dementia. There is a limited understanding from occupational therapists about available interventions for people with dementia.Implications for RehabilitationThere is limited awareness on how assistive technology might be used to support occupational performance for persons with dementia.This survey suggests that occupational therapists experience barriers in identifying and providing appropriate assistive technology for this group.Access to targeted education and online resources for occupational therapists is recommended to provide better awareness of the types of assistive technology available to assist persons with dementia and their caregivers.

The Influence of a Mexican Cultural Immersion Experience on Personal and Professional Healthcare Practices.

The purpose of this study was to understand the influence of a cultural immersion experience on personal and professional healthcare practices of occupational therapists. The experience, a 10-day course in Oaxaca, Mexico, exposed participants to alternative and complementary medicine through interactive sessions with Mexican indigenous traditional healers. The literature indicates that cultural immersion experiences can increase the perceived cultural effectiveness of healthcare professionals. Three focus groups were conducted with eight occupational therapists and two occupational therapy fieldwork students who had participated in the course. Themes were coded based on responses to each question by two graduate students and a qualitative researcher. Four major themes emerged regarding the influence of a cultural immersion experience on personal and professional healthcare practices of occupational therapists: (1) Natural Remedies; (2) Mind, Body, Spirit Connection; (3) Increased Openness; and (4) Challenges of Integrating Traditional and Western Medicine. The themes derived from this study confirmed the advantages of a cultural immersion experience on both the personal and professional views and practices of occupational therapists. Cultural immersion courses can assist occupational therapists to better understand different cultural views of health, disability and healing in order to provide quality occupational therapy care in a multicultural society. Copyright © 2016 John Wiley & Sons, Ltd.

A review of occupational therapy's contribution to and involvement in the work-to-retirement transition process: An Australian perspective.

Retirement from paid work is an occupational transition, which can have a profound impact on a person's life. This review explored occupational therapy's contribution to and involvement in the work-to-retirement transition process in Australia. An integrative literature review was undertaken using seven article repository databases. PRISMA guidelines informed searches. Articles were included if participants were Australian; researchers' discussed retirement from an occupational perspective or the scope of practice of occupational therapists; and publication was from 1994 to June 2015 in a peer-reviewed journal. Articles were critically appraised and thematic analysis explored: (i) occupational perspective, (ii) occupational therapy scope of practice, (iii) theory and (iv) retirement definitions. Eight articles met the review criteria. Three occupational perspective themes were identified: retirement intention influences, retirement preparation and retirement roles and activities. No articles on the current scope of practice of occupational therapy were found. Three articles discussed potential occupational therapy approaches. Three themes on what retirement is were identified: complete cessation, gradual transition and intermittent worker. Four theory themes were identified: occupational therapy, ageing, identity and work. Occupational therapy has the potential to be involved in improving health and well-being for people in the work-to-retirement transition process. It is suggested that future research explore not only people's experiences but also the approaches of occupational therapy in assisting people through this occupational transition. The use of theory to guide Australian occupational therapy practice on retirement should also be explored. The use of consistent retirement definitions will assist in understanding research.

Translating Evidence to Increase Quality and Dose of Upper Limb Therapy for Children with Unilateral Cerebral Palsy: A Pilot Study

ABSTRACTAims: To pilot efficacy of a tailored multifaceted implementation program to change clinical practice of occupational therapists (OTs) providing upper limb (UL) therapy for children with unilateral cerebral palsy (UCP). Methods: This before and after study piloted a multifaceted implementation program comprising audit/feedback, barrier identification, and education. Medical chart audits were conducted prior to and 12 months after the intervention. Primary process outcomes included proportion of children with UCP with (1) goals set; (2) goals measured; (3) received contemporary motor learning approach; (4) an adequate dose (30–40 hours); and (5) measured UL outcomes. Results: Three teams of OTs (n = 9) participated. Forty-three audits at baseline and 53 at 12 months postimplementation program were conducted. Average time to complete audits was 10 min and four out of the five evidence criteria had complete data extracted from files. Changes in clinical behavior included greater measurement of goals before (+17%) and after (+22%) therapy; use of constraint therapy (+38%), bimanual therapy (+26%), home programs (+14%); measurement of UL outcomes before (+29%) and after (+23%) therapy. Children receiving the target dose increased from 0 to 10%. Conclusions: A tailored multifaceted implementation program was feasible to implement and led to meaningful changes in clinical practice behavior.

A systematic review of evidence-based assessment practices by allied health practitioners for children with cerebral palsy.

The routine use of psychometrically robust assessment tools is integral to best practice. This systematic review aims to determine the extent to which evidence-based assessment tools were used by allied health practitioners for children with cerebral palsy (CP). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols 2015 was employed. A search strategy applied the free text terms: 'allied health practitioner', 'assessment', and 'cerebral palsy', and related subject headings to seven databases. Included articles reported assessment practices of occupational therapists, physiotherapists, or speech pathologists working with children with CP aged 0 to 18years, published from the year 2000. Fourteen articles met the inclusion criteria. Eighty-eight assessment tools were reported, of which 23 were in high use. Of these, three tools focused on gross motor function and had acceptable validity for use with children with CP: Gross Motor Function Measure, Gross Motor Function Classification System, and goniometry. Validated tools to assess other activity components, participation, quality of life, and pain were used infrequently or not at all. Allied health practitioners used only a few of the available evidence-based assessment tools. Assessment findings in many areas considered important by children and families were rarely documented using validated assessment tools.

Enhancing occupational performance in the virtual context using smart technology

Statement of context Physical limitations restrict occupational performance in the virtual context for people with cervical spinal cord injuries. Critical reflection on practice A review of smart device goals in 10 health care records at one hospital identified three types of occupational therapy intervention. Compensation involved alternative methods of physical access, positioning, and customisation of devices. Acquisition involved providing opportunities for learning and overcoming challenges. Education and training sought to empower users and their families to use smart devices successfully. Implications for practice Occupational therapists need to incorporate virtual occupations and the use of personal smart devices within current practice. This requires keeping abreast of mainstream technology advances as well as providing clients with opportunities and support within the virtual context.

Practitioners’ Perceptions of Occupational Therapy in Middle School Settings

Abstract Date Presented 4/17/2015 In this qualitative study, we explored the practices of occupational therapists working in middle schools to identify current trends in an effort to ascertain what would be considered best practice for adolescents in middle schools as well as to support therapists in understanding their roles in this setting.

Development of a new occupational therapy service in a Singapore prison

Statement of context In April 2011, a contract between Singapore Prison Service and Institute of Mental Health paved the way for setting up the first occupational therapy service within the prisons. A well-defined workflow was put in place and a variety of group activities were drawn up to improve life management and social skills among offenders. Critical reflection on practice Occupational therapists found it challenging to provide authentic occupations for offenders within the custodial prison setting, but were able to gradually create pockets of opportunities to improve socialization and assign worker roles for them. After 1 year of occupational therapy intervention, the offenders showed an improvement in all functional domains of the adapted Task Behavioural Scale. Through close collaboration, correctional officers were also gradually supportive of new therapeutic initiatives. Summary Overall, the occupational therapists found that they had gained new valuable skills in adjusting therapy to cater to different risk levels.

‘Drive Safe’ initiatives: An analysis of improvements in mental health practices (2005–2013) to support safe driving

Statement of context Driving can be important for enabling community participation. Mental illness and its treatment may disrupt fitness to drive, or people’s opportunities for learning to drive. This paper reflects on practice improvements in an Australian mental health organization. Critical reflection on practice Occupational therapists identified gaps in knowledge among the multi-disciplinary workforce about service users’ driver status, how to identify and manage driving issues, and how to support their beginning or resuming driving during recovery. Implications for practice The key initiatives: policy and practice guidelines, workforce training, driver assessment and consultation services, and service user information resources — have become embedded supports within the organization for promoting safe driving.

Screening for sensory impairment in older adults: Training and practice of occupational therapists in Quebec.

The goal of occupational therapy education is to train generalists who can refine their knowledge after graduation according to the requirements of the professional environment. However, it is currently unclear to what extent sensory screening should be included in the educational curricula. The purpose of this study was to examine the sensory screening education for and practice by occupational therapists working with older adults. A cross-sectional survey was used to collect data from members of the Quebec Order of Occupational Therapists. Descriptive statistics were used in the analysis. Data from 102 respondents indicated that training on sensory impairment-related topics was minimal and in stark contrast to the proportion who reported serving clients with a visual (92%), hearing (84%), or combined impairment (53%). Occupational therapy considers numerous aspects of physical, cognitive, and emotional well-being. The question remains as to what extent vision and hearing health should take their place among these priorities.