Occupational Therapy Program Research Articles

Client Perceptions of an Occupational Therapy Program in a Community Rehabilitation Residence

Occupational therapy programs in mental health community rehabilitation residences (CRRs) are unrecognized in occupational therapy literature. This study utilized a prospective observational cohort design with a mixed method approach to answer the question: what are clients’ perceptions of OT in a mental health CRR? Participants completed a researcher developed Likert scale survey and semi-structured interview. The results indicated positive views for occupational therapy services received and the desire for expansion of services. Most participants reported meeting goals through learning a skill or improving performance in known tasks. Limitations included a small sample size, a singular site, and the study design.

DECREASE: Decrease Cognitive Decline in Alzheimer’s Disease Through Occupational Therapy: A Randomized Controlled Phase III Trial Protocol

Introduction: Alzheimer’s disease (AD) accounts for more than 80% of dementia cases worldwide and imposes a significant economic burden on the healthcare system. Currently, there is no cure for AD, and pharmacological treatments alleviate AD symptoms but fail to decrease cognitive decline. Occupational Therapy (OT) for AD patients targets symptoms without the side effects of drugs and may even play a disease-modifying role by preserving cognitive functions. The DECREASE trial aims to assess the effectiveness of a cognitive-based OT intervention amongst AD patients. Methods: The DECREASE Trial is a randomized, controlled, multicentric, phase III, superiority trial comparing the effect of OT and standard of care versus standard of care alone on cognition in AD patients. OT will entail a five-week group cognitive rehabilitation program with remote maintenance sessions until six months of follow-up. We will include 278 mild AD patients aged between 65 and 80. Changes in cognitive function between groups will be measured and compared by the ADAS-cog after six months. Discussion: The strengths of this OT program are that it is non-invasive, safe, highly standardized, and accessible to occupational therapists and caretakers worldwide. There is broad evidence of the benefits of functionality. Nevertheless, there needs to be more literature on its effect on cognitive function. AD is a public health emergency that needs to be promptly addressed. This trial will finally determine if an OT-based intervention can decrease cognitive decline and whether it should be included in the standard of care for AD.

Teaching and Evaluating an Occupational Perspective in Canada: A Descriptive Qualitative Study.

Background. Occupation is the core domain of occupational therapy, and an occupational perspective is foundational for practice. Research has explored how an occupational perspective is taught. Yet, little has explored the Canadian occupational therapy educational context. There are national differences in core competencies and accreditation standards and nuances in how occupation is defined and what conceptual models are used. As such, a Canadian perspective may offer new understandings of value both within and outside of Canada. Purpose. To understand how, in Canada, educators teach and evaluate student occupational perspectives in entry-level master of occupational therapy programs. Method. This study used a descriptive qualitative design with an interpretive approach. Semi-structured interviews were used to gather data from 12 educators from Canadian entry-level occupational therapy programs. Reflexive thematic analysis was used for data analysis. Findings. Five themes were identified: (1) occupational perspectives as pedagogy (2) it's a process, not an end state; (3) "everybody is involved": a community of educators; (4) thinking critically; and (5) "hard to evaluate." Conclusion. The complex, dynamic, and contextualized nature of an occupational perspective calls for critical, reflexive, communal, and innovative pedagogical and assessment approaches.

Occupational practice in patients with hereditary transthyretin amyloidosis, a qualitative study

BackgroundHereditary transthyretin amyloidosis (ATTRv) is a rare genetic disease that negatively affects patients' quality of life through the involvement of various organs and tissues. Despite a large amount of research on medical and psychosocial interventions, the impact of occupational therapy (OT) on patients with ATTRv is not well understood.ObjectiveThe aim of this study was to develop an OT programme to improve the daily functioning and quality of life of patients with ATTRv.MethodsFourteen patients with ATTRv were interviewed. Together they developed short- and medium-term occupational goals. Patients received the OT intervention for six months. Outcomes were measured using scores for activities of daily living and psychological well-being.ResultsThe study found that OT can have a positive impact as a complementary intervention to medical and other psychosocial treatments. Of the 14 patients, 12 maintained the same scores in activities of daily living. Two deteriorated and eight improved their psychological scores.ConclusionThis study highlights the need for further research in this area and the importance of OT in the management of patients with ATTRv. Early intervention is of paramount importance and further research is needed to evaluate the long-term effects of OT interventions in patients with ATTRv.

A Call to Shift to Competency-Based Education

Abstract This column explores the concept of competency-based education (CBE). A shift to CBE is a key trend for the future of health care education. Health care professions that have adopted, or started to adopt, a CBE framework include physical therapy, speech-language pathology, social work, medicine, nursing, pharmacology, and dentistry. Internationally, many occupational therapy programs are in the process of shifting to, or have shifted to, a CBE model. This column discusses how although select occupational therapy programs in the United States may individually be considering shifting to, or have shifted to, a CBE framework, there is no national movement to explore adopting the model for occupational therapy or a consensus on defined outcomes for the profession.

Evaluation of virtual problem-based tutorials in healthcare professional education

Purpose To explore student and tutor perspectives on the learning efficacy of virtual, compared to in-person, problem-based tutorial (PBT) in occupational therapy, physiotherapy, and speech-language pathology health professional programs. Materials and Methods This was a quality improvement study using a cross sectional survey at a single institution. Separate student and tutor surveys were disseminated online. Students received the survey at two timepoints, tutors received the survey at one timepoint. Descriptive statistics summarized quantitative survey questions. Chi-squared or Fischer’s Exact analyses explored differences between in-person and virtual PBT. Exploratory analyses determined if associations amongst programs and/or between cohorts existed on variables of interest. Open-ended survey questions were analyzed using content analysis. Results A total of 241 students and 85 tutors completed the survey. Results demonstrate most students and tutors were satisfied with the use of virtual tutorials (77%; 89% respectively) and felt that they were effective in exploring content within the PBT course. However, students in the most recent cohort rated virtual tutorials more highly (p = 0.01). Conclusions Virtual modes of PBT were successful in achieving course objectives and led to high satisfaction in users. Health professional programs can use this information when designing virtual problem-based tutorial courses in the post-pandemic era.

Perspectives on Promotion of Quality of Life for Individuals Recovering from Substance Abuse: Priority for Occupational Therapy Programmes

The prevalence of substance abuse in South Africa is growing fast, impacting negatively on quality of life. Individuals abusing substances present with impaired occupational functioning, which warrants occupational therapy intervention. Meaningful engagement in occupations contribute to well-being and quality of life of an individual. It is important for the occupational therapist to be aware of the enhancers of quality of life for the intervention programme of persons living with substance use issues. The barriers of quality of life need to be addressed in the programme in order to guard against relapse. A holistic approach to the intervention of substance abuse is of paramount importance.

A randomized controlled trial on the effectiveness of the abridged illness management and recovery program for people with schizophrenia spectrum disorders.

This study aimed to investigate the effectiveness of an abridged version of the Illness Management and Recovery Programme (AIMR) that was modified and developed in Hong Kong through a mult-centre randomized controlled trial for patients with schizophrenia spectrum disorders. This study was implemented in 10 occupational therapy departments, psychiatric day hospitals of 7 Hospital Authority clusters in Hong Kong. A total of 211 patients with schizophrenia or schizoaffective disorder was recruited and randomized into either the experimental or the control condition. In the control group, the subjects went through conventional occupational therapy programmes. In the experimental group, the subjects went through an additional 10-session programme of AIMR. were measured at baseline, completion of the AIMR, and 3-month after the AIMR programme. Measures include the expanded version of the Brief Psychiatric Rating Scale (BPRS-E), the client version of the Illness Management and Recovery Scale (IMRS), the Snyder Hope Scale, the Social and Occupational and Occupational Functioning Assessment Scale (SOFAS), the WHO Quality of Life Scale (WHOQOL-BREF), and the Chinese Version of the Short Warwick-Edinburgh Mental Well-Being Scale (C-SWEMWBS). Both the experimental and control cohorts had comparable clinical and socio-demographic characteristics except years of education and duration of illness. These two variables were entered as covariates in the linear mixed model which showed that the experimental group had significantly higher improvement than the control group in terms of illness management (F = 4.82; p = .03; Cohen's d = .45), functional (F = 10.65; p = .001; Cohen's d = .58), and hope (F = 5.52; p = .02; Cohen's d = .08) measures after the completion of treatment. The results supported the effectiveness of the AIMR programm which would be important in the recovery oriented practices in psychiatry.

İnsan Aktivite Modeli Temelli Ergoterapi Müdahalesinin Aile İçi Şiddet Yaşayan Kadınlarda Etkinliği

Purpose: Experiences of violence negatively affect women's independence and daily activities. The aim of this study was to investigate the effectiveness of the "Model of Human Occupation (MOHO)"-based occupational therapy intervention on the occupational competence and occupational participation of women affected by domestic violence and living in a women's shelter. Materials and Methods: The MOHO-based occupational therapy program, which includes 10 intervention areas, was applied to 13 women in two women’s shelters. Four-week (16 sessions) individual and group training and environmental interventions were provided. Participants' occupational competence was assessed with the “Occupational Self-Assessment” and occupational participation with the “Model of Human Occupation Screening Tool”. Assessments were conducted before the intervention, after the intervention, and at the 3-month follow-up. Results: Statistically significant differences were found in occupational competence (p=0.002) and occupational participation (p=0.004) between pre-intervention and 3-month follow-up assessments. Improvements were noted in all domains (OSA-competence, and volution, habituation, communication-interaction, process skills, and environment parameters of MOHOST) (p0.05). Discussion: MOHO-based occupational therapy interventions delivered in women's shelters could have a positive impact on the occupational competence and occupational participation of women experiencing violence.

Funcionalidad antes y después de fisioterapia en pacientes post COVID-19

Background: COVID-19 is a disease that since its appearance in 2019 has represented a challenge for health services. The sequelae are a consequence of a deterioration in the quality of life, fatigue, dyspnea and joint pain. Objective: Compare physical, respiratory, cognitive and functional independence functional parameters in post-COVID-19 patients, with respiratory sequelae before and after a respiratory physical and occupational therapy program. Methods: A comparative, quasi-experimental, prospective study was conducted in outpatients discharged from hospitalization due to COVID-19 in a 3rd level hospital of the Instituto Mexicano del Seguro Social in Puebla, Mexico during 2020-2021. Scales were applied before and after the rehabilitation program. Descriptive statistics were used. Results: We included 116 patients, 57.7% men, mean age 47.32 years (min. 20, max. 79); 77 (66.3%) patients had moderate symptoms in hospitalization. A significant p value was obtained (p <0.000) Conclusions: Significant improvement is observed in post-COVID-19 patients after receiving respiratory physical and occupational therapy.

Promoting Health Equity Through Holistic Admissions in Occupational Therapy Education.

As the U.S. population shifts away from a White majority, it is imperative that the health care workforce reflect the diversity of client populations served. Increased diversity in the health care workforce fosters access to more personalized, culturally responsive, and client-centered care, thereby facilitating improved outcomes and reduced health disparities. Occupational therapy education programs function as gatekeepers for diversity and need to be accountable for representation in the profession and to produce graduates who reflect the diversity of the broader population. Holistic admission practices, which ensure that no single factor excludes an applicant from admission, are recognized as a meaningful strategy for increasing student diversity in higher education and provide a pathway to create a representative workforce with the ability to improve care disparities and client outcomes. As one of the largest occupational therapy programs in the country, and located in a diverse urban area, the University of Southern California's Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy has embraced the profession's responsibility toward greater health equity through holistic admissions. In this column, we discuss holistic admission best practices and report diversity outcomes resulting from enactment of these practices within our occupational therapy education program.

Online occupational therapy in the caregivers of people with Multiple sclerosis: a randomized control trial

Purpose Caregivers of people with Multiple sclerosis (MS) face various challenges in the occupations of daily lives. We investigated the effect of an online occupational therapy program on the mastery and performance in caregivers of people with MS. Method In a single-blind randomized controlled trial twenty-four eligible caregivers of people with MS participated in the control and an occupational therapy group program. Caregivers completed The Canadian Occupational Performance Measure (COPM) and the Relative Mastery Scale (RMS) before and after the intervention and one-month later. Findings The level of performance, satisfaction and mastery were significantly improved in the intervention group after the intervention (p<.001) and there were significant differences in performance and satisfaction scores between the groups (p<.001). Implications Online Occupational therapy shows promising results in facilitating the adaptation process and improving caregivers’ performance and satisfaction levels. IMPLICATIONS FOR REHABILITATION Caregivers of people with multiple sclerosis face various challenges when engaging in their daily occupations. Managing the challenges faced by caregivers as essential members of the treatment team contributes to improving their performance level in daily occupations and can finally enhance the quality of treatment interventions for patients. Online delivery can overcome caregivers’ time constraints for attendance in the treatment centers for training. Online occupational therapy can enhance mastery, occupational performance level, and satisfaction, and is recommended for caregivers of people with multiple sclerosis.

Effectiveness and Changes in Brain Functions by an Occupational Therapy Program Incorporating Mindfulness in Outpatients with Anxiety and Depression: A Randomized Controlled Trial

Introduction: This study examined the efficacy of an 8-week occupational therapy program incorporating mindfulness (MOT) as a form of psychiatric rehabilitation to ameliorate residual social and occupational impairment in patients with anxiety disorders and depression. The objective was to evaluate the effects of MOT on their personal well-being and to assess the impact of MOT on brain function using quantitative electroencephalography (qEEG). Methods: This study was a randomized, wait-list control trial with assessments performed at baseline, post-intervention (9 weeks), and follow-up (18 weeks) in outpatients with anxiety disorders and depression. The MOT was conducted in small groups, comprising eight weekly 1.5-h sessions. The primary outcome was the mean score change between the pre- and post-interventions with Questionnaire about the Process of Recovery (QPR) scale. Other clinical assessments and qEEG served as secondary and biological outcomes, respectively. Results: A total of 25 patients (mean age: 44.1) were included in the analysis. The MOT group demonstrated a significantly improved QPR compared to the control group after adjusting for baseline covariates (p < 0.01). This improvement was sustained for 9 weeks after the 8-week intervention. In the qEEG analysis, a significant increase in current source density in the β2 band of the left dorsolateral prefrontal cortex was observed in the MOT group compared to the control group (p < 0.02). Conclusion: This study demonstrates that MOT improves subjective well-being and potentially, global function. This suggests that MOT may serve as a viable option for those whose symptoms have abated but who still struggle with social and occupational functioning.

Enhancing Quality of Life in Parkinson’s Disease: A Systematic Review of Occupational Therapy Interventions on Balance and Reaction Time

Background: Parkinson's disease (PD) is a common neurodegenerative disorder affecting the elderly population and can lead to impaired balance, reaction time, and overall quality of life (QoL). Occupational therapy interventions have shown promise in managing the motor and non-motor symptoms of PD. This systematic review aims to evaluate the effectiveness of occupational therapy intervention on balance and reaction time to enhance the quality of life in patients with Parkinson's disease.&#x0D; Methods: A comprehensive search was conducted on various electronic databases, including PubMed, Google Scholar, and ResearchGate. Studies published between 2010 and 2022 were included in the review. Inclusion criteria were set for age, clinical diagnosis of Parkinson's disease, MoCA score, and cooperation for participation. Studies that did not meet the inclusion criteria or reported other interventions were excluded. Data from selected studies were analyzed for relevance, appropriateness, clarity, and methodology.&#x0D; Results: Out of the initial 250 potentially relevant articles, 200 were identified as duplicates and removed. Another 25 studies did not meet the inclusion criteria, and 15 studies did not provide sufficient information on the interventions. Eventually, 10 studies were included in this systematic review. All the studies were qualitative in nature and were published between 2010 and 2023.&#x0D; Conclusion: Occupational therapy interventions have shown promising results in enhancing balance, reaction time, and quality of life in patients with Parkinson's disease. The review emphasizes the importance of goal-oriented occupational therapy programs to improve the overall well-being of patients with PD. Further research in this area is warranted to strengthen the evidence and guide clinical practice for better management of Parkinson's disease.

How a group-based occupational therapy program works in woman with fibromyalgia: A process evaluation of the ADAPT program

Background The ADAPT Program have improved activities of daily living (ADL) in women with fibromyalgia. To understand the functioning of the program, it is relevant to evaluate how program theory components are linked to outcomes (mechanisms) and how the randomised controlled trial (RCT) context, influenced delivery and outcomes Objective To evaluate ADAPT in terms of dose, mechanisms of change and contextual factors. Material/Methods Dose was recorded on the n = 21 participants receiving ADAPT in the IMPROvE trial (NCT01352052). A subsample of n = 16 attended one of three 2-hour focusgroups, evaluating mechanisms of change and contextual factors. Interview questions explored participants’ interaction with four program components, i.e. how the ‘client-centred approach’, ‘group-based peer-exchange format’, ‘teaching-learning strategies’ and ‘long-term program format’ triggered mechanisms facilitating/hindering outcomes. Moreover, how randomisation procedures influenced delivery and outcomes. Results Attending a long-term educational peer-exchange program, in which participants experienced met by a health professional that legitimised difficulties, facilitated participants knowledge, insights and motivation for changing habits. With time and support, participants experienced increased acceptance of their situation and began to implement more effective ways to perform ADL tasks. Conclusions/Significance Results support previous findings of improved ADL ability post-ADAPT and provide initial evidence to support the ADAPT Program theory.

“Everyone knows there is a battle”: Colleges, Universities, and the Education of Occupational Therapists in Ontario, 1970 to 1985

Following the creation of Ontario’s Colleges of Applied Arts and Technology (CAATs) in 1965, an interested group of health care providers and educators in Hamilton began to advocate for the creation of a program in occupational therapy at Mohawk College. Historically, occupational therapy education in Canada took place within universities, so a college-based program was viewed as a significant development by the Canadian Association of Occupational Therapists (CAOT) and its provincial branches. The idea of the Mohawk program was developed concurrently with the work of Ontario’s Healing Arts Committee, which put forward more than two hundred recommendations that would reshape the education of health care workers. These two elements, the development of an occupational therapy program within a CAAT and a major review of education for health care workers, were viewed with concern by the CAOT. This paper analyzes the history of this educational development and the response of the profession of occupational therapy. It illustrates the strategies used by the CAOT, and the Ontario Society of Occupational Therapists, to delay the implementation of the program. The paper also illustrates the development of minimum standards for entry to practice, accreditation policies for education programs, and membership requirements for the CAOT, all of which were connected to employment prospects. All of this had implications for the viability of the Mohawk College program and for its graduates.

Exploring the Impact of an Occupational Therapy Program for Former Sex Workers: A Mixed Methods Pilot Study

This mixed-methods pilot study explored the impact of the Coping for Living a Healthy Life (CLHL) program, an occupational therapy intervention focused on teaching coping skills to former sex workers. Two former sex workers between the ages of 18-41 participated in an online six-session CLHL program. Participants completed six questionnaires and two interviews regarding occupational competence, balance, and coping skills before and after CLHL. Results indicated progression toward increased occupational balance and a sense of competence through engaging in healing by utilizing healthy coping skills. Further investigation on the effectiveness of coping skills programs for former sex workers appears warranted.

Occupational Therapy Program for sportsmen (veterans) who specialize in Sambo wrestling of the "Masters" category

According to the Results of the analysis of Scientific-Methodical, Special and reference literature by the members of the Scientific Research Group, it was established that insufficient number of Scientific works are devoted to the urgent issue of the organization of the System of Physical Therapy and Occupational Therapy of athletes of older age groups (veterans) who specialize in wrestling (Martial Arts). This emphasizes the relevance and practical component of the chosen direction of Scientific Research. The main goal of the study is to develop an occupational Therapy Program for athletes of older age groups (veterans) who specialize in Sambo wrestling after knee joint injuries. Research Methods: axiomatic, idealization, historical and logical, descent from concrete, formalization (experience of physical Therapy and Occupational Therapy).&#x0D; As a result of an Empirical study, an Occupational Therapy Program was developed for wrestlers of older age groups (Veterans «Masters category») who specialize in Sambo wrestling after knee joint injuries. The Results of the empirical Research are implemented in the System of Physical Therapy of veteran athletes who Specialize in Sports types of wrestling (Judo, Sambo wrestling, Freestyle wrestling, Greco-Roman wrestling). Prospects for further Research in the chosen field of Scientific Research involve the determination of factors that affect the longevity of an individual in the chosen type of sports (combat).

Approbation of the Program of Occupational Therapy of Athletes who specialize in Sambo wrestling category "Masters" (veterans) after treatment of knee joint injuries

According to the results of the analysis of the scientific-methodical and special literature, it was established, that the topical issue of making changes to the existing occupational therapy programs of veteran athletes who specialize in martial arts at the stage of recovery after injuries of the musculoskeletal system with an emphasis on the use of kinesiological taping and modern fitness technologies is devoted to an insufficient number of scientific works. This emphasizes the relevance and practical component of the chosen direction of scientific research.&#x0D; The main goal of the study is to adjust and test the experimental program of occupational therapy of veteran athletes ("Masters") who specialize in sambo wrestling after treatment of knee joint injuries.&#x0D; As a result of the empirical study, the members of the research group adjusted and tested the experimental program of occupational therapy of veteran sportsmen ("Masters") who specialize in sambo wrestling after treatment of knee joint injuries. The experimental program developed and tested by us ensured a balanced and phased recovery of representatives of the studied category after treatment of injuries, diseases of the knee joint, which contributed to an increase in the indicators of their participation in competitions of various ranks.&#x0D; Prospects for further research in the chosen field of scientific research include the development of an experimental program to improve the theoretical knowledge of trainers who specialize in wrestling sports to the use of modern fitness technologies in professional activities.

Knowledge and attitudes of undergraduate occupational therapy students towards older adults with dementia

Purpose Due to the increasing incidence of dementia in Ireland, there is a need to prepare occupational therapy students for future careers in dementia-focused health care. The purpose of this study are to measure the knowledge and attitudes of Irish undergraduate occupational therapy students towards older people with dementia and examine related variables including year of study, personal and placement dementia experiences and future career choice. Design/methodology/approach Data was gathered using a cross-sectional online survey, incorporating the Alzheimer’s Disease Knowledge Scale and the Dementia Attitudes Scale, which was analysed using descriptive and inferential statistics. Findings Seventy-five responses were gathered and analysed, indicating more advanced occupational therapy students demonstrate higher levels of dementia knowledge, but dementia attitudes remain similar across different year groups. Students with clinical dementia experiences displayed comparable levels of dementia knowledge and attitudes to those without. However, students with familial dementia experiences displayed significantly more positive attitudes. The likelihood of selecting a future career with older adults with dementia significantly related to students’ positive dementia attitudes but not dementia knowledge. Originality/value To the best of the authors’ knowledge, this is the first Irish study that focuses on undergraduate occupational therapy students’ dementia knowledge and attitudes. The results could be used to inform and develop Irish undergraduate occupational therapy programmes.