Views Of Therapists Research Articles

Play as Occupation: The State of Our Science and a Research Agenda for the Profession.

Occupational therapists view play through a unique lens. Considering play as a human occupation, and one to which all people have a right, places occupational therapists among a special group of professionals championing play. This State of the Science article seeks to increase awareness regarding the occupational therapy profession's contributions and to situate those contributions within the larger body of literature on play while also promoting further study of play as an occupation.

Improved motor skills in autistic children after three weeks of neurologic music therapy via telehealth: a pilot study.

Many autistic children experience motor skill deficits which can impact other areas of functioning, and research on therapeutic interventions for motor skills in autism is in a preliminary stage. Music-based therapies have been used extensively to address motor skills in non-autistic populations. Though a handful of studies exist on the effects of music-based therapies for movement in autistic children, none have investigated the possibility of administering sessions via telehealth. This mixed-methods pilot study investigated whether nine Neurologic Music Therapy (NMT)® sessions via telehealth would improve motor and attention skills in autistic children. Five autistic children between five and 10 years of age participated in the study, with support from their caregivers. Motor skills were assessed using the Bruininks-Oseretsky Test of Motor Proficiency second edition, short form (BOT-2 SF), and a selective attention and sustained attention task were taken from the Test of Everyday Attention for Children, Second Edition (TEA-Ch2). Caregivers and the two neurologic music therapists involved in the study provided qualitative input about the perceived effectiveness of telehealth NMT for the children involved. Their responses were analyzed using qualitative content analysis. Caregivers also filled out a Sensory Profile 2 assessment prior to the onset of sessions so that each child's sensory profile could be compared to their motor and attention results. Statistically significant improvements in motor skills were observed between pre-test assessment and a two-week follow-up assessment. Results from attention test scores were not significant. Caregivers and neurologic music therapists generally perceived sessions positively and noted the importance of having caregivers actively involved. When compared with individual progress on the BOT-2 SF assessment, sensory profile results revealed that children with fewer sensory sensitivities tended to improve the most on motor skills. The improvements in motor skills and positive caregiver and therapist views of telehealth indicate that NMT motor interventions administered via telehealth are a promising avenue of therapeutic support for movement skill development in autistic children.

1897 Older stroke survivors and rehabilitation therapists’ views on home-based resistance exercise for upper limbs

Abstract Introduction Upper limb recovery after stroke depends on participating in personalised task-specific exercise programmes. However, older adults with stroke find it challenging to maintain an optimal level of engagement with such exercise programmes due to personal and environmental factors. The aim of this study was to explore the views of stroke survivors and rehabilitation therapists on home-based resistance exercises for upper limbs. Method A qualitative study of semi-structured virtual and in-person interviews was conducted between January and March 2023 in England. Participants were 11 older adults >65 years (6 females (55%), with chronic stroke (>1 year after a stroke) and moderate to severe disabilities. Twenty rehabilitation therapists were also interviewed (3 physiotherapists, and 17 Action for Rehabilitation from Neurological Injury (ARNI) instructors). The group was asked about perceived personal and environmental barriers and facilitators as well as expectations of resistance exercises in relation to upper limb neurorehabilitation programmes. Interview sessions were audio recorded for transcription and thematic data analysis. The study was approved by Sheffield Hallam University ethics committee (reference number: AA43961583). Results Both groups mentioned that the main barrier to performing upper-limb exercises is weakness in the paretic arm affecting grip strength with consequent adverse impact on adherence to a home-based programme and poor patient motivation. Patients also reported safety concerns such as dropping equipment and being dependent on a carer to undertake regular exercises. Stroke survivors preferred a program that activates the paretic arm and is relevant to their daily functional activities. They preferred simple exercise instructions and demonstrations through visual aids and video materials. Patients also valued regular feedback on adjusting their exercise dose, monitoring progress over time, and ongoing encouragement. Conclusions Our study showed that designing home-based resistance exercises for upper limb in older stroke survivors should be individualised, functionally orientated, and motivational.

A pilot evaluation of a training and supervision pathway for Augmented Depression Therapy (ADepT) in a Devon NHS Talking Therapies Service

Abstract Augmented Depression Therapy (ADepT) is a novel wellbeing and recovery-oriented psychological treatment for depression. A recent pilot trial run in a university clinic setting suggests ADepT has potential to be superior to cognitive behavioural therapy (CBT) at treating anhedonic depression in a NHS Talking Therapies for anxiety and depression (NHS–TTad) context. Before proceeding to definitive trial in pragmatic settings, it is important to establish if therapists in routine NHS-TTad settings can be trained to deliver ADepT effectively and to assess therapist views on the feasibility and acceptability of ADepT in this context. A bespoke training and supervision pathway was developed (2-day workshop, four 2–hour skills classes, and 6 months of weekly supervision) and piloted with 11 experienced therapists working in a single NHS–TT service in Devon. Nine out of 11 therapists completed the placement, treating 24 clients with a primary presenting problem of depression; 21/24 completed a minimum adequate dose of therapy (≥8 sessions), with 17/24 (71%) showing reliable improvement and 12/24 (50%) exhibiting reliable recovery. Eight out of nine therapists submitted a session for competency assessment, all of whom were rated as competent. Nine therapists submitted feedback on their experiences of training. Eight out of nine therapists felt the ADepT model would be effective in an NHS–TTad context; that training was interesting, useful, well presented and enhanced their own wellbeing; and that they felt sufficiently skilled in core ADepT competencies at the end of the placement. This suggests that NHS–TTad therapists can be trained to deliver ADepT competently and view the treatment as feasible and acceptable. Key learning aims (1) To become familiar with the Augmented Depression Therapy (ADepT) approach for enhancing wellbeing in depression. (2) To evaluate the potential utility and feasibility of ADepT model in NHS Talking Therapies Services (NHS–TTad). (3) To understand the pilot ADepT training and supervision pathway for CBT therapists in NHS–TTad services. (4) To consider the opportunities and challenges of training therapists to deliver ADepT in NHS–TTad services.

Telehealth practice in aphasia: A survey of UK speech and language therapists, with a focus on assessment.

Evidence suggests telehealth in speech and language therapy can enhance access to care, cost-effectiveness and satisfaction. However, little is known about use of telehealth in the United Kingdom. Moreover, many assessments/outcome measures for aphasia have been tested for face-to-face administration only, posing challenges to reliable use within the telehealth context. We explored the experiences and views of speech and language therapists (SLTs) working with people with aphasia on using telehealth to conduct assessments/outcome measures, perceived barriers and facilitators in telehealth, and their priorities for research in telehealth aphasia assessment. We explored views of UK SLTs through an online cross-sectional survey (2021) delivered through the Qualtrics platform. The survey covered three main areas: (i) participant demographics; (ii) experience of using telehealth and doing telehealth assessments with people with aphasia post-stroke during the COVID-19 pandemic; and (iii) plans for telehealth post-pandemic. Response formats included yes/no, multiple choice, 5-point Likert scales and open-ended text responses. The survey was expected to take no more than 10min to complete. Survey data were analysed through descriptive statistics and content analysis of open-ended questions. One hundred twenty-four SLTs responded to the survey. The majority (>80%) used telehealth during the COVID-19 pandemic and >90% planned to continue to use telehealth in the future. The most used platforms were Zoom, Microsoft Teams and Attend Anywhere. Access to internet and telehealth platforms, and practical problems (e.g., difficulties sharing resources online, limited functionality of telehealth platforms for assessment) were common barriers. Therapists highlighted that training, resources and materials that assist the administration of assessments were important. Most participants responded that there was a need for existing measures to be tested for administration via telehealth (n = 68, 70.8%). Participants overall felt there was a need for online interactive assessments, more online resources that have been trialled for use via telehealth, accessible formats for resources for people with aphasia and clear instructions for how people with aphasia can access resources. This study provides new insights into the current use of telehealth assessment with people with aphasia in the United Kingdom and directions for future research. Barriers and facilitators identified can support the implementation of telehealth assessment in SLT services. What is already known on the subject The use of telehealth in speech and language therapy has advantages in terms of access to care, cost-effectiveness and satisfaction with care. However, little is known about the use of telehealth in aphasia rehabilitation in the United Kingdom, especially in the area of assessment and outcome measurement. What this paper adds to existing knowledge This study identified that the majority (>80%) of aphasia therapists used telehealth during the COVID-19 pandemic and >90% planned to continue to use telehealth in the future. A need was identified for existing measures to be tested for administration via telehealth and for training, resources (e.g., online interactive assessments) and materials (e.g., accessible formats for people with aphasia). What are the potential or actual clinical implications of this work? To facilitate the successful implementation of telehealth assessment, there is a need for measures validated for use via telehealth and more online resources that have been trialled for use via telehealth.

Changes of Effective Criteria in Marriage (1978 to 2021) from the Point of View of Couple Therapists: A Qualitative Study

Aim: The purpose of this research was to identify the indicators of changes in marriage from 1978 to 2022. Methods: To achieve the set goals, qualitative method (Strauss and Corbin's Grounded Theory) was used. Ten psychologist experts in marrage field with an average of 30.6 years of specialized activity in the field of couple relationship were selected using the purposeful sampling method and interviewed in depth until theoretical saturation. The data were recorded, coded and then classified in the form of concepts, sub-categories and main categories. Findings: The analysis of the professional experience of experts led to the identification of 138 secondary codes, 27 concepts, 8 sub-categories and 3 main categories. Changes in extra-spousal, inter-spousal and individual factors are the main categories of this research. Changes in factors such as roles, the phenomenon of divorce, the degree of influence of society, social teachings, the media, increasing the awareness of society, demographic characteristics, social experiences, policies, economic issues, modernization, cultural integration, attitudes, religious issues, the role of the family, the nature of relationship, relationships between the sexes, infidelity, commitment to responsibilities, drug/alcohol abuse, needs, choosing a spouse, motivation, knowledge of life, openness to new experience, and individual identity have been mentioned. Conclusion: This research showed that marriage during the years (1978-2022) was affected by changes in intra-individual, inter-spousal and extra-spousal factors. From the point of view of correcting the unfavorable situation of marriage at the time of research, stable and constructive economic, social and cultural policies seem necessary. Also, taking into account the current conditions of the society and the world, dealing with trainings that are appropriate to the changes that have occurred, paying attention to the individual identity and the needs of the new generation, can also help in arranging the marriage situation

Why do some people with stroke not receive the recommended 45 min of occupational therapy and physiotherapy after stroke? A qualitative study using focus groups

ObjectivesTo generate qualitative data on the views of Occupational Therapists and Physiotherapists about why people do not receive the Royal College of Physicians’ recommended minimum of 45 minutes (min) of...

Parent and Therapist Perceptions of the Feasibility, Acceptability, and Benefits of a Weekly Therapist-Led Massage Program for Extremely Preterm Infants in Neonatal Intensive Care.

Mothers of extremely preterm infants experience high rates of mental health disorders that impair maternal-infant interaction and lead to worse infant developmental outcomes. Therapist Education and Massage for Parent-Infant Outcomes (TEMPO) is a therapist-led program that standardizes the nature and frequency of parent education through weekly scheduled therapy sessions. Using a family-centered approach, the therapist facilitates positive maternal-infant interactions and massage interventions from birth throughout hospitalization with the goal of improving maternal mental health. This qualitative study presents the results of 19 parent interviews and of a focus group of four TEMPO interventionists to elicit feedback about the program. Overall, parents and therapists viewed the program positively. Parents and therapists valued the focus on parent education and engagement to increase parent competence and bonding opportunities. Both groups acknowledged that infant massage had both infant-centered and parent-centered benefits. One area where parent and therapist views did not align was regarding feasibility of TEMPO. Parents noted multiple logistical challenges to regular NICU visitation, but ultimately agreed that attending weekly therapy sessions was feasible. Therapists noted increased time and effort required of TEMPO and felt that institutional and system-level changes would be necessary to implement weekly parent education as standard of care.

Intensive and comprehensive aphasia therapy—a survey of the definitions, practices and views of speech and language therapists in the United Kingdom

AbstractBackgroundResearch evidence suggests aphasia therapy must be delivered at high intensity to effect change. Comprehensive therapy, addressing all domains of the International Classification of Functioning, Disability and Health, is also called for by people with aphasia and their families. However, aphasia therapy is rarely intense or comprehensive. Intensive Comprehensive Aphasia Programmes (ICAPs) were designed to address this challenge, but such programmes are not widely implemented.AimsThis study surveyed the views of UK‐based speech and language therapists (SLTs) regarding intensive and comprehensive aphasia therapy. It explored definitions of intensive and comprehensive therapy, patterns of provision, views about candidacy and barriers/facilitators. It also investigated awareness of ICAPs and perceived potential of this service model. Differences across UK regions and workplace settings were explored.Methods & ProceduresAn e‐survey ran for 5 months. Quantitative data were analysed using descriptive and inferential statistics. Qualitative free text comments were analysed using content analysis.Outcomes & ResultsTwo hundred twenty‐seven respondents engaged in the e‐survey. Definitions of intensive aphasia therapy did not reach UK clinical guideline/research‐level thresholds for most of the sample. Those providing more therapy provided definitions with higher standards of intensity. Mean therapy delivered was 128 min/week. Geographical location and workplace setting influenced the amount of therapy delivered. The most frequently delivered therapy approaches were functional language therapy and impairment‐based therapy. Cognitive disability and fatigue were concerns for therapy candidacy. Barriers included lack of resources and low levels of optimism that issues could be solved. 50% of respondents were aware of ICAPs and 15 had been involved in ICAP provision. Only 16.5% felt their service could be reconfigured to deliver an ICAP.Conclusions & ImplicationsThis e‐survey evidences a mismatch between an SLT's concept of intensity and that espoused by clinical guidelines/research. Geographical variations in intensity are concerning. Although a wide range of therapy approaches are offered, certain aphasia therapies are delivered more frequently. Awareness of ICAPs was relatively high, but few respondents had experience of this model or felt it could be executed in their context. Further initiatives are needed if services are to move from a low‐dose or non‐comprehensive model of delivery. Such initiatives might include but not be confined to wider uptake of ICAPs. Pragmatic research might also explore which treatments are efficacious with a low‐dose model of delivery, given that this model is dominant in the United Kingdom. These clinical and research implications are raised in the discussion.What this paper addsWhat is already known on this subject There is a gap between the high intensity of aphasia treatment provided in research versus mainstream clinical settings. A lower standard of 45 min/day set by UK clinical guidelines is also not achieved. Although speech and language therapists (SLTs) provide a wide range of therapies, they typically focus on impairment‐based approaches.What this study adds This is the first survey of UK SLTs asking about their concept of intensity in aphasia therapy and what types of aphasia therapy they provide. It explores geographical and workplace variations and barriers and facilitators to aphasia therapy provision. It investigates Intensive Comprehensive Aphasia Programmes (ICAPs) in a UK context.What are the clinical implications of this work? There are barriers to the provision of intensive and comprehensive therapy in the United Kingdom and reservations about the feasibility of ICAPs in a mainstream UK context. However, there are also facilitators to aphasia therapy provision and evidence that a small proportion of UK SLTs are providing intensive/comprehensive aphasia therapy). Dissemination of good practice is necessary and suggestions for increasing intensity of service provision are listed in the discussion.

Identification of main characteristics influencing the suitability for telerehabilitation in stroke patients: Quantitative analyses of the REHA2030 Assessment

BackgroundThe Austria-Slovenian project REHA2030, with a broad spectrum of expertise, was focused on making the process of telerehabilitation (TR) possible as valuable user-centred post-clinical rehabilitation of stroke patients in rural areas. Health-related factors, impairments, and environmental and demographic factors influence the patients´ suitability for stroke TR interventions and serve as possible risk factors for patients´ non-adherence or drop-out. The REHA2030 Assessment aimed to identify barriers and resources that should be considered to enable people to participate in TR according to the REHA2030 approach. For that, a structured questionnaire, the “REHA Assessment”, with 88 items, was developed and conducted by therapists about 160 stroke survivors in two rehabilitation clinics. The effect of the 87 characteristics on suitability was statistically analysed using parametric and non-parametric tests.ResultsTwenty-five main personal and environmental characteristics significantly influencing TR's suitability in stroke patients were identified. Significant factors differences between participants ranked as suitable or not suitable for TR were short-term memory, motivation, visual and hearing abilities, and the ambulation scale. Furthermore, the ability to use technology (self-tech knowledge), daily phone or tablet use, and the general willingness to participate in the therapy were considered. The living situation (housing) and their independence in performing daily tasks such as eating (grooming, dressing, and use of toilet also influence the suitability of the participants. Another essential variable to indicate suitability is compliance.ConclusionsAnalysis of the study results showed cognitive abilities, visual and hearing abilities, compliance and willingness to participate in the therapy, together with the knowledge of using technology, as the most enabling factors influencing the suitability for TR in stroke patients in chronic stage. Additionally, the patients´ compliance depends on intrinsic motivation to participate in the REHA2030 TR system, which could be supported by increasing proficiency in digital technologies. In the deliberations of TR assessment, the acquired knowledge from the presented study should be considered with caution to limitations of the research data representing personal views of therapists on the patient´s suitability for REHA2030 TR.

Exploring the uptake of CATALISE recommendations from the perspective of speech and language therapists working in the Irish context: A qualitative online survey

BACKGROUND: The Irish Association of Speech and Language Therapists (IASLT) has led on a series of implementation efforts since the publication of recommendations regarding terminology and diagnosis of developmental language disorder (DLD) by the CATALISE Consortium in 2017. OBJECTIVE: To explore the views of speech and language therapists (SLTs) about the effectiveness of IASLT dissemination efforts in relation to the CATALISE recommendations to inform the development of a national DLD implementation strategy. METHODS: A self-administered qualitative e-survey was designed. A purposive sample of SLTs working in Ireland was recruited using a maximum variation strategy. The survey included closed and open questions. Qualitative data were analysed deductively using constructs from the Consolidation Framework for Implementation Research. Findings were integrated using concepts from the RE-AIM framework. RESULTS: Dissemination methods were considered effective at the preadoption stage. However, barriers to early use of the CATALISE recommendations were identified related to low practitioner self-concept, the complex nature of the required practice changes, and a lack of compatibility with service pathways. Misalignment across health and education policy was identified as a barrier to uptake of the recommendations for those working in schools. Ongoing opportunities for case-based discussion was viewed as an important component of future implementation efforts. The importance of engaged leadership in overcoming implementation barriers is also highlighted. CONCLUSIONS: A targeted multi-level implementation strategy developed by an inclusive stakeholder network including speech and language therapy managers is required to support the full adoption of the CATALISE recommendations into policy, service, and practice in the Irish context.

Misalignment in Community Mental Health Leader and Therapist Ratings of Psychological Safety Climate Predicts Therapist Self-Efficacy with Evidence-Based Practices (EBPs).

Therapist self-efficacy in delivering evidence-based practices (EBPs) is associated with implementation outcomes, including adoption and sustainment in community mental health settings. Inner context organizational climate, including psychological safety, can proximally shape therapist learning experiences within EBP implementation. Psychologically safe environments are conducive to learning behaviors including taking risks, admitting mistakes, and seeking feedback. Organization leaders are instrumental in facilitating psychological safety, but may have differing perspectives of organizational climate than front-line therapists. Discrepant leader and therapist views of psychological safety may have independent associations with therapist EBP learning and implementation outcomes over and above average therapist perceptions of climate. This study examined survey data from 337 therapists and 123 leaders from 49 programs contracted to deliver multiple EBPs within a study examining determinants of sustainment within a large system-driven implementation. Both leaders and therapists completed measures of psychological safety climate and therapists reported on their self-efficacy in delivering multiple EBPs in children's mental health services. Polynomial regression and response surface analysis models were conducted to examine the associations of therapist and leader reports of psychological safety and therapist EBP self-efficacy. Greater discrepancies between leader and therapist reports of psychological safety, in either direction, were associated with lower therapist EBP self-efficacy. Alignment in leader and therapist views of psychological safety climate may impact EBP implementation outcomes. Strategies for improving alignment in perceptions and priorities among organizational members can be included in organizational implementation interventions and may represent unexamined implementation mechanisms of action.

Student Physical Therapists' Orientation to Postprofessional Education and Perceptions of Strain: Identification of 4 Subgroups of Students Based on Cluster Analysis.

Determining why physical therapists choose certain pathways to expertise is not well understood. Developing an understanding of these different choices is important for the physical therapy profession and the future of postprofessional education. Pathways to expertise as a physical therapist have evolved over the history of the profession, including the most recent emergence of residency education. Regardless of the path taken, physical therapists have a societal duty to be lifelong learners. The decision on which path to pursue is influenced by many factors, including financial stress, personal factors, and relational obligations. Developing an understanding of these different pathways and barriers for physical therapists is essential if the physical therapy profession is to advance with the evolving needs of society. Participants were from a stratified purposive sample of Doctor of Physical Therapy Students (n = 124) across the eastern, central, and western regions of the United States. This study was a secondary analysis using hierarchical cluster analysis based on students' orientation toward lifelong learning and future professional engagement, self-rated likelihood of pursuing various postprofessional education pathways, and perception of personal and interpersonal strains as a barrier to postprofessional education. The cluster analysis resulted in a 4-cluster solution representing different student subtypes: clinically oriented average learners; resilient, clinically oriented lifelong learners; academically oriented lifelong learners; and strain-limited, clinically oriented lifelong learners. Results from this study describe important differences in how student physical therapists view postprofessional education and the pathways they choose to pursue. Factors such as lack of awareness and the perception of personal or interpersonal strain may influence these decisions. Understanding postprofessional education decision making of student physical therapists is of particular interest to the physical therapy profession given the current debates related to student debt and the necessity of residency education. Further research is needed to understand how to increase awareness and diminish barriers to quality postprofessional education for physical therapists.

Comunidade de Práticas em Terapia Ocupacional no Sistema Único de Assistência Social: articulando encontros e promovendo debates em terapia ocupacional social

Abstract With the growing number of occupational therapists working at the Unified Social Assistance System (SUAS) in Brazil, there has been an increasing need for education processes focusing on the critical development of professional practice in this field. From this education demand, a project was created in October 2020: “Communities of Practice in Occupational Therapy at SUAS: professional planning and construction of strategies” aiming to promote the exchange of knowledge and experiences between occupational therapists working in social assistance. This study aims to present the work possibilities and limits at SUAS from the point of view of occupational therapists who work at its units and who participated in the Community of Practice, analyzing whether and how their professional actions have been related to the social occupational therapy theoretical-methodological framework. To this end, all the recording material produced in the two project cycles from October 2020 to July 2021 was revisited. The collected information was organized in a table that grouped the themes found. Data analysis revealed two main aspects that allow the correlation of the professionals’ actions with the social occupational therapy theoretical-methodological framework, namely, the necessary interpretation of the inseparability between micro- and macro-social factors for the development of work and the professional and political dimensions of the occupational-therapeutic actions. In both debates, the social occupational therapy theoretical-methodological framework has been the guiding thread of the process, enabling a social reading and a greater understanding of technical-professional purposes within the scope of social assistance.

Assistive products to support daily time management of older persons with dementia in India: experiences and views of informal caregivers and occupational therapists

Purpose The present study aimed to understand how informal caregivers and occupational therapists support daily time management (DTM) of older persons with dementia (PwD) and their views regarding assistive products for DTM, i.e., time management products (TMPs). Methods The study involved a qualitative descriptive approach rooted in principles of naturalistic inquiry. Twelve caregivers of PwD and eight occupational therapists were interviewed. Conventional content analysis was performed. Results Findings are described in three categories. The first category “current strategies to support DTM” described the low-tech strategies used for specific cognitive functions. The second category “factors influencing DTM and TMP” entailed factors related to the PwD (especially premorbid time management), the caregiver (multiple caregivers, attitude towards technology), the occupational therapist (impairment-oriented practice, limited resources and training in DTM) and the context (attitude towards time, poor awareness and knowledge of dementia, an expectation of recovery, negative societal attitudes towards devices, affordability/access). The third category “expectations from TMP” described the participants’ expectations regarding device-related features (low-cost, easy to use, portable, low maintenance, customisable and useable across the disease continuum) and support for device use (maintenance, caregiver education). Conclusions The study provides contextually relevant recommendations and strategies to inform the provision, acceptance and adherence to DTM interventions and guide the development and prescription of indigenous TMP for PwD in India. Implications for rehabilitation Adoption of time management products (TMPs) for people with dementia in India requires an understanding of contextual factors, especially culturally influenced attitudes of persons with dementia and their family members towards time, assistive products and elders. Contextually relevant approaches and strategies are suggested to guide the provision of daily time management (DTM) interventions including TMPs for people with dementia and their families in India. It is imperative to assess the relevance, acceptance and feasibility of available TMPs for people with dementia and their families living in India and develop contextually relevant indigenous products. Occupational therapists working with people with dementia and their families would benefit from more opportunities for training and access to resources (including contextually relevant standardized assessments) to implement DTM interventions.

Забезпечення участі клієнтів в реабілітаційному процесі з позиції Канадської моделі виконання занять

The purpose of the study is to define aspects of the patient's participation in the rehabilitation process and to define a conceptualization that improves the participation of the client. Materials and methods. The main research method is the method of analysis, which has been used to comprehensively review and evaluate the participation of the client in the rehabilitation process and an overall assessment of the structure that could improve the participation of the client. Results and discussion. One of the goals of the world community development is to preserve and strengthen human physical, social, mental and spiritual health. However, humanity has faced global environmental, economic, social and moral problems. The genetic burden of mankind, the ecological crisis, natural disasters and man-made disasters, wars and local conflicts and social instability lead to an increase in the need for rehabilitation. Therefore, in recent decades, the role of both the client and relatives in the rehabilitation process has changed, taking into account the participation of the client. In this paper, we consider the process of rehabilitation taking into account the participation of the client, as a variant of the client-oriented structure, the Canadian Occupational Performance Measure is evaluated primarily from the point of view of clients, occupational therapists and members of the rehabilitation team. The main goal is to maximize the participation of patients in the rehabilitation process. The emphasis of the occupational therapist is on the participation of the patient in determining outcomes and goals. Through years of practice and experience, occupational therapists have developed a model for client-centered practice in occupational therapy, namely the Canadian Model of Occupational Performance. And the result of using this model is the development of the Canadian Occupational Performance Measure, which has become a good tool for obtaining a result based on the client’s perception. Conclusion. Implementing a customer-centric approach is easier when a structured approach is used, but this is not enough. Participation and motivation of all team members are required, as well as support during the implementation period. Management support, knowledge of the underlying theory, time for discussion and reflection, as well as the opportunity to develop a personal interview technique, which indicates important factors for successful implementation, are also required

OTs’ and Physical Therapists’ Use of Evidence-Based Practice for the Treatment of Motor Function in Infants With Cerebral Palsy

Abstract Date Presented 04/02/2022 This study consisted of an electronic survey distributed to licensed Ohio OTs and PTs, which identified the evidence-based interventions used by therapists for the treatment of children ages 0-3 with cerebral palsy (CP), the frequency of intervention use, and the facilitators and barriers to evidence-based practice (EBP) use. Overall, therapists view EBP as important and possess skills to engage in EBP but do not frequently use EBP because of several barriers. This study provides recommendations for workplaces to facilitate EBP use in practice. Primary Author and Speaker: Aminah Baig Additional Authors and Speakers: Ellie Cecala, Laney Gallagher, Elizabeth Gick Contributing Authors: Claire Morress

A focus group study of therapists’ views on using a novel neuroanimation virtual reality game to deliver intensive upper-limb rehabilitation early after stroke

BackgroundIntensive training can significantly reduce upper-limb impairments after stroke but delivering interventions of sufficiently high intensity is extremely difficult in routine practice. The MindPod Dolphin® system is a novel neuroanimation experience which provides motivating and intensive virtual reality based training for the upper-limb. However several studies report that health professionals have reservations about using technology in rehabilitation. Therefore, this study sought to explore the views of therapists who had used this novel neuroanimation therapy (NAT) in a clinical centre to deliver intensive for the upper-limb of people after stroke in a phase 2 trial (SMARTS2).MethodsFour therapists (three female, two physical and two occupational therapists) who delivered NAT participated in a focus group conducted by two independent researchers. The theoretical domains framework and COM-B behaviour change models informed the discussion schedule for the focus group. An inductive approach to content analysis was used. Recordings were transcribed, coded and thematically analysed. Generated key themes were cross-checked with participants.ResultsWhilst therapists had some initial concerns about using NAT, these were reduced by training, reference materials and face-to-face technical support. Therapists noted several significant benefits to using NAT including multi-system involvement, carry-over to functional tasks and high levels of patient engagement.ConclusionsThese findings illuminate key areas that clinicians, technology developers and researchers should consider when designing, developing and implementing NAT. Specifically, they highlight the importance of planning the implementation of rehabilitation technologies, ensuring technologies are robust and suggest a range of benefits that might be conferred to patients when using intensive NAT as part of rehabilitation for the upper-limb after stroke.

Orthotic intervention following stroke: a survey of physiotherapist, occupational therapist and orthotist practice and views in the UK

Background/Aims Orthoses are often used to promote mobility and rehabilitation for patients in the UK after a stroke. The perspective of stroke therapists in the UK is an important factor determining current practice and orthotic provision. The purpose of this study was to investigate the views of orthotists, physiotherapists and occupational therapists on the delivery mechanisms and relationships that influence orthoses intervention and provision for patients with stroke in the UK. Methods A UK-based online survey was conducted. Participants were stroke therapy clinicians within acute and community settings, recruited through their membership of the British Association of Prosthetists and Orthotists, the Association of Chartered Physiotherapists Interested in Neurology, and the Royal Collage of Occupational Therapists—Specialist Section for Neurological Practice. Data were analysed using descriptive statistics and content analysis. Results A total of 305 questionnaires were completed (64 orthotists, 131 physiotherapists, 110 occupational therapists). Some 67% (n=190) of respondents identified the optimal timing for initial orthotic assessment as within the first days following a stroke or before discharge from hospital. Waiting times and operational barriers to orthoses provision were perceived to have a negative impact on patients’ rehabilitation. A closer working relationship between orthotists and the stroke rehabilitation team is desirable. Conclusions The survey found that the use of orthoses and orthotic specialist input are perceived to play an important role within the stroke rehabilitation pathway. Further evaluative research is warranted to explore the optimal timing and benefits, and the orthotist's role within the stroke rehabilitation team.

The therapeutic relationship and change processes in child psychotherapy: a qualitative, longitudinal study of the views of children, parents and therapists.

Through the perspectives of children, parents and therapists, this study explored the therapeutic relationship as a change facilitator in different moments of psychotherapy. The children, parents, and therapists (N=15) who formed part of five therapeutic treatments were studied using a qualitative, longitudinal design. Thirty semi-structured interviews were done; half at the beginning and half after four months of psychotherapy. Children’s drawings were incorporated, and data were analysed through grounded theory methods and qualitative analysis guidelines for drawings. Participants identified several aspects of the therapeutic relationship as change facilitators. From the first encounters, the therapists’ close and adaptable attitude promoted an improved motivation for psychotherapy and enhanced engagement among children and parents. Later in the process, a positive, child-centred and affective therapeutic relationship fostered the child’s trust with the therapist as well as a positive relational experience, promoting associated changes in children and the development of socio-affective tools. Parents and therapists saw their own relationship as a change facilitator, as well as a broader understanding in parents of their children and an improved relationship with them. Parent’s and child’s changes helped each other. Specific and common aspects between participants’ perspectives provided a richer understanding of the studied phenomena. This study supports the view that a positive therapeutic relationship facilitates early changes in the motivation of children and parents, and provides them with a healing, relational experience as it develops. A positive parent-therapist relationship is also key for changes to further progress.