OCCUPATIONAL THERAPY IN HEALTH CARE最新文献

This case report highlights the effectiveness of the early application of the Management Tool for Daily Life Performance (MTDLP) in acute-phase stroke occupational therapy, with coordination of occupational therapy services across the continuum of care. A male patient in his 70s with left hemiparesis received interdisciplinary goal-oriented, personalized activities of daily life training. Care transitions were actively managed via transfer sheets and follow-up communication to ensure seamless occupational therapy delivery between facilities. On follow up, one year later, the client regained full ADL independence and meaningful participation suggesting early MTDLP application and coordinated occupational therapy across care settings can improve long-term outcomes.

This study aimed to describe the functional profiles of children with unilateral cerebral palsy who participated in constraint-induced movement therapy and correlate change in hand function after the intervention with factors across the International Classification of Functioning, Disability, and Health (ICF). Twenty-three children aged 5.0 to 13.5 years (SD = 3.08) with unilateral cerebral palsy participated in a two-week (60-h) group-based constraint induced movement therapy program as part of a blinded randomized controlled trial comparing a constraint induced movement therapy camp to constraint induced movement therapy plus virtual reality. The International Classification of Functioning, Disability, and Health Brief Core Set for Cerebral Palsy (ICF CP Core Set) was administered at baseline. Changes in hand function were measured using the Assisting Hand Assessment at baseline and after intervention. Descriptive statistics were used to summarize the ICF CP Core Set results, providing functional profiles of children with unilateral cerebral palsy who participated in constraint induced movement therapy across ICF domains. Assisting Hand Assessment change scores were correlated with the ICF CP Core Set using Spearman's rank analysis to identify characteristics associated with favorable responses to intervention. Positive correlates to change in hand function only included the following ICF CP Core Set environmental supports: Health services, systems, and policies [p = 0.03]; Education and training services, systems, and policies [p = 0.01]; and the Environmental sum score [p ≤ 0.01]. While the clinical presentation of this population necessitates a heavy focus on motor deficits, these findings highlight that environmental factors also play an important role in functional improvement and, ultimately independence in this population.

This study describes the development of the Experiencing Day-to-Day Life Questionnaire (EDLQ) and the initial evaluation of its content validity. The EDLQ was designed to capture both objective participation and subjective experience across seven experiential occupational categories. Using a quantitative descriptive design, content validity was assessed through the input of two participant groups: content experts (N = 11 occupational therapists) and mothers of children with ADHD with lived expertise (N = 10). Content experts rated item relevance and representativeness, while mothers evaluated clarity and comprehensibility through written feedback. Findings demonstrated strong indices of content validity, with revisions suggested to improve clarity, phrasing, and accessibility. These results provide initial support for the EDLQ as a client-centered measure of occupational experience, offering potential to enhance understanding of how objective participation and subjective experience may jointly shape health and well-being.

Pursuing management training within a health profession is motivated by multiple considerations varying according to individuals' values, personalities, and context. This article aims to describe the Quebec-Canada occupational therapists' motivations to become healthcare managers and their appreciation of the management (likes and dislikes/challenges), all analyzed from an ethical perspective. A descriptive phenomenologically inspired approach was used. Data were collected using sociodemographic questionnaires and semi-structured individual interviews. The verbatims were analyzed using Husserlian phenomenological reduction. Public- and private-sector managers' groups were compared with descriptive statistics. Results were discussed using the Quadripartite Ethical Framework (Drolet; Drolet & Hudon; and Drolet & Ruest). Twenty-seven occupational therapists-managers (n = 27) from public (n = 15) and private (n = 12) sectors were interviewed. Time as clinician before starting management and training aspects were different between sectors. Three main emerging motivations to become a manager are common to both sectors: personality-related factors, external factors, and desire to improve things. Dissatisfaction with work in the public sector emerged as a fourth motivation within the private sector. In public sector, the most cited motivation was to get involved in decision-making, while it was the desire to work according to one's ways within the private sector. For both sectors, the human dimension and the love of management were the higher appreciated aspects, whereas human resources management issues and heavy workload were the greater challenges. This study highlights duality between professional and managerial logics and the challenge of multiple loyalties. Management training does not necessarily make the work any easier. Occupational therapist managers have ideals, too often shattered by the organizational constraints encountered. Results can contribute to improve occupational therapist' training and leadership development and to better understand ethical issues surrounding healthcare management.

The Cognitive Orientation to daily Occupational Performance is an innovative, goal-directed approach designed to enhance occupational performance. This umbrella review synthesizes evidence from six systematic reviews published (2001-2024) involving children with developmental coordination disorder, cerebral palsy, neurodevelopmental disorders, and adults with post-stroke. Although Cognitive Orientation to daily Occupational Performance demonstrates promise, conclusions remain inconclusive due to methodological limitations, including a high risk of bias, small sample sizes, and short follow-up periods. Importantly, the review underscores the need for culturally adaptable and methodologically rigorous studies to ensure global applicability. Future research should prioritize robust designs and explore alternative delivery methods to enhance effectiveness and generalizability.

There is a gap in research concerning effective training of school-based occupational therapy practitioners on application of the trauma-informed approach. The aim of this quantitative study was to examine the effectiveness of training on the trauma-informed approach among school-based occupational therapy practitioners. Participants (N = 26) attended two virtual, synchronous trainings on the trauma-informed approach. Outcome measures included surveys and the Creating Trauma-Informed Care Environments: An Organizational Self-Assessment. Quantitative results showed statistically significant improvements in knowledge (z = -4.246, p < .001), confidence (z = -4.498, p < .001), application (z = -3.098, p = .002), and overall effectiveness score (z = 4.466, p < .001) and were supported by qualitative statements. Participants requested more training to enhance application and maintain post-training confidence.

This study aimed to develop the Handwriting Assessment Tool for Primary School Students as a Thai handwriting assessment and evaluate its psychometric properties. Participants were 25 primary school students in Grades 1-3, four classroom teachers, and one school-based occupational therapist. The study comprised two phases: (1) developing the tool, and (2) investigating its psychometric properties, including content validity, internal consistency, inter-rater agreement, and stability reliability. The final tool consisted of two parts: general information on students and writing-related factors, and handwriting performance across five domains including alphabet and numerical writing, copying, dictation, legibility, and writing speed. Results indicated acceptable content validity (IOC = 0.80-1.00), excellent internal consistency (α = 0.96), acceptable inter-rater agreement (IRA = 92.22%), and excellent stability reliability (ICC = 0.97). The Handwriting Assessment Tool appears to be a valid and reliable instrument for evaluating handwriting performance. Further studies with larger samples are recommended to enhance generalizability.

This quantitative study aimed to investigate their self-reported stress levels and work factors that could help to predict occupational stress in pediatric occupational therapists. A cross-sectional survey design study used voluntary response sampling of 154 pediatric occupational therapists. Two-thirds of the surveyed therapists reported moderate to dangerous levels of workplace stress. Analysis of the scores on the Workplace Stress Scale and the Work Environment Impact Scale-Self Report demonstrated a significant positive relationship. In addition, the negative correlations on both of these scales with the scores on the Scales of General Well-Being-clinical tool were significant. Multiple regression analyses resulted in one significant predictor of increased occupational stress and decreased well-being: married marital status. The significant well-being predictors of occupational stress were calmness, connection, autonomy, awareness, optimism, and development. These findings provide new insight into occupational stress and the general well-being of pediatric therapists, which may affect their health, employee retention, and professional sustainability.

Background: Recidivism presents significant barriers to occupational performance and community reintegration. Individuals transitioning from incarceration often face structural stigma, limited access to meaningful occupation, and disrupted occupational identity. These challenges fall within the scope of occupational therapy, yet the profession's role in reentry remains underexplored in the literature.

Objective: In this study, we set out to explore the lived experiences of formerly incarcerated individuals and examine how recidivism affects occupational performance and community participation.

Methods: This qualitative study used a phenomenological design with in-depth, semi-structured interviews conducted with nine formerly incarcerated individuals. Data were analyzed thematically using an inductive approach, with rigor supported by bracketing, member checking, and peer debriefing.

Results: Five central themes emerged, (1) occupational disengagement and mental health barriers; (2) environmental barriers and systemic stigma; (3) structured occupational engagement as a protective factor; (4) the role of social support and mentorship; and (5) the need for individualized rehabilitation approaches. In addition, one intersecting theme was identified across all narratives: the scarcity of resources and support systems post-release. Participants described diverse reentry experiences but consistently emphasized systemic and occupational barriers to reintegration.

Conclusion: Occupational therapy has the potential to play a critical role in supporting reentry through trauma-informed, identity-driven, and community-integrated interventions. Addressing structural stigma and building therapeutic alliances may be essential strategies for both practice and advocacy.

The purpose of this project was to investigate sitting pressure distribution in manual wheelchair users while propelling across different surfaces, and whether differing terrain would generate more significant pressures on the sitting surfaces compared to others. Sitting pressure refers to any pressure experienced by any body tissue while sitting but is generally on the buttocks, dorsal thighs and lower back for individuals who can maintain a typical sitting posture of flexed ankles, knees, and hips along with an upright torso that is in midline. Wheelchair sitting pressure was measured on 39 adult novice wheelchair participants. Participants self-propelled and were pushed across three surfaces. Results were that self-propulsion generates greater sitting pressure on the wheelchair user compared to being pushed across three different surfaces of carpet, tile and concrete (ps <.0167). The integral pressure was greater during passively traversing on carpet compared to concrete (p=.002). During active propulsion, carpet elicited greater pressure than both tile and concrete surfaces (ps<.0167). Occupational therapists should consider the impact that passive versus active wheelchair propulsion and floor surfaces have upon wheelchair sitting pressure.