OCCUPATIONAL THERAPY IN HEALTH CARE最新文献

With an aging population living longer with diverse medical conditions, screening tools to measure driving risk are needed. The use of virtually administered screening tools has the potential to improve access to medical or rehabilitation services for individuals. This study compared 50 community living older adults with driver's licenses on their performance using the app DriveSafe DriveAware under two clinician-administered conditions. All participants were randomly assigned to complete one administration in-person using a touchscreen tablet and the other by verbal responses via a virtual connection with a clinician. Using the intraclass correlation coefficient, it was 0.65 (95% Confidence Interval = 0.45 - 0.78); the two types of administration demonstrated moderate agreement with no order or gender effects. Normal aging differences were evident, but within the non-risk category. These results suggest that practitioners can use scores from the DriveSafe DriveAware regardless of administration in-person or through a virtual means of communication. However, caution should be used until further research with medically-at-risk drivers is completed.

Individuals with visual impairment are at high risk of falls due to sensory, functional, and environmental challenges. Existing fall risk assessment tools rarely address vision-related challenges. This scoping review identified and summarized questionnaire-based tools used to assess fall risk in individuals with visual impairment to map the literature, highlight research gaps, and inform preventive strategies. Adhering to Joanna Briggs Institute Scoping Review methodology and PRISMA-ScR guidelines, 19 studies met inclusion criteria, yielding 11 vision-specific questionnaires. Findings highlight gaps in evidence and indicate the need for future research examining measurement properties and developing approaches.

This study uses discourse analysis to examine the types of services occupational therapy private practice clinics claim to provide for autistic people as well as the roots and impacts of the language that is used on the clinics' websites to describe these services. We conducted a web-based search of relevant websites, using content from 24 sites. We examined the discursive practices contained on the websites and compared them to foundational tenets of neurodiversity affirming practice. We found that the discursive patterns on the sites reflect a complex, mixed, and varied array of language, beliefs, and practices, some of which align with neurodiversity affirming practice, some of which diverge, and some of which inhabit a "grey zone". While many occupational therapists express intentions to provide neuro-affirming care, the services described and language used often reveal underlying tensions or inconsistencies. We discuss these gaps between stated intentions and implicit beliefs. We suggest a need for deeper reflexivity and critical examination of how our communications, interventions, and understanding align with neurodiversity affirming principles. Finally, we offer concrete strategies for changing discursive practices to support occupational therapists in our shift toward neurodiversity affirming practice.

The aim of this study was to understand how to develop and maintain a therapeutic relationship with autistic children and their caregivers. Ten pediatric occupational therapists participated in this descriptive qualitative study by engaging in semi-structured interviews, answering open-ended questions about their clinical practice working with autistic children and their caregivers. Data was analyzed with thematic analysis resulting in three themes. The first theme describes a relationship-based therapeutic process that allows the occupational therapy practitioner to partner with the caregiver and to utilize co-regulation to support the autistic child. The second theme highlighted the importance of the occupational therapy practitioner as a facilitator or barrier to the development of the relationship. Lastly, several external factors were found to limit a relationship-based approach and to challenge therapists' well-being and longevity in clinical practice settings. This study identified that the therapeutic relationship is dynamic and critical for the success of occupational therapy with autistic children and their caregivers.

There is a need for greater visibility of occupational therapy within interdisciplinary practice and research, especially in the context of intellectual disability. This case study examines the nuanced role of occupational therapy in supporting an individual with intellectual disability and behaviours of concern during a critical transition. Drawing on data from multiple sources, the study explores occupational therapy involvement and its impact. A two-stage analysis revealed two overarching contributions: (1) the implementation of occupational therapy, and (2) the contribution and mechanisms through which occupational therapy enabled change. The findings highlight how environmental modifications, strategies to reduce participation barriers, sensory-based approaches, and interdisciplinary collaboration contributed to meaningful outcomes. Additionally, mechanisms of change were embedded in occupational therapists' practice of working competently within their scope of expertise, drawing on diverse ways of knowing, and navigating external influences. Key changes were observed for the individual through improved perceived quality of life: evidenced by reduced behaviours of concern, increased occupational participation, and a stabilised daily routine; enhanced occupational performance with greater engagement in daily activities; increased staff knowledge and confidence in supporting occupational needs; and a positive cultural shift and self-efficacy among staff, marked by increased motivation and hopefulness. This study illustrates the value of occupational therapy in enabling participation and fostering change within complex practice contexts.

In the hospital setting, standardized cognitive screening and assessment tools are critical to determine the presence of cognitive changes for occupational therapy discharge planning and intervention approaches. However, there is limited understanding of trends related to standardized tool availability and use across different trauma center designations. This study aimed to identify commonly used standardized cognitive screens and functional performance assessments, and to explore factors influencing their selection and use. Electronic surveys were employed with a total of 28 questions. Two hundred and eight occupational therapy practitioners completed an electronic survey that measured demographics, availability and use of screens and performance assessments, and attitudes and perceptions regarding cognitive evaluation. Results support 86.5% of participants reported the use of paper-pencil-based standardized cognitive screens and 65.4% reported the use of cognitive performance assessments. Findings showed differences in access and availability of cognitive screening tools as well as performance-based assessments between trauma center designations. Implications of the results are discussed both with past studies and potential future work.

This pilot study examined the effectiveness of group activities on older adults aged 65 years and older with cognitive decline who were hospitalized due to bone fractures. The study used a quasi-experimental pre/post-test design with non-randomized group assignment. The group activities, which included social interaction and leisure activities, were conducted twice weekly over eight sessions. Both activity groups showed significant improvement in occupational function and social interaction, with a large effect size. Additionally, the social interaction group showed improvements in behavioral and psychological symptoms of dementia and occupational disruptiveness. No significant differences were found in all assessment tools between groups. With these preliminary results, future studies are warranted to conduct more precise and systematic surveys to rigorously examine the effectiveness and validity of these interventions.

This study investigated the impact of a 1-hour group pain management session on pain beliefs, kinesiophobia, and occupational engagement delivered by occupational therapists in a primary care setting. Thirty participants with chronic pain completed pre- and post-assessments about their pain beliefs and kinesiophobia. Significant improvements were observed immediately after the session and maintained at a 1-month follow-up. Participants reported an increased understanding of pain, as well as improved satisfaction and confidence in their daily activities. These findings suggest that brief, occupational therapy-led group interventions may have a positive impact on chronic pain management in primary care settings.

This study aimed to examine parents' perspectives on the influence of independent mobility provided by an adapted motorized ride-on vehicle (MROV) on social participation for children with limited mobility. This qualitative, multiple-case study consisted of semi-structured interviews and field notes with caregivers of three children who had received an adapted MROV four to six months prior to data collection. Three major themes emerged from the three families' responses: (a) increased independence and autonomy, (b) enhanced social engagement and participation, and (c) emotional growth, joy, and confidence. Additionally, six prominent subthemes were established based on parents' perception of their child and the adapted MROV. The findings demonstrated the critical value of independent mobility through play from the lens of a parent or caregiver for their child with limited mobility. The adapted MROV not only served as a means for mobility but also facilitated improvements in autonomy, peer interactions, and self-expression. These results highlighted the potential of this intervention form for enhancing the quality of life and promoting engaged participation in children with limited mobility needs.

Hearing loss can impact an individual's mental, emotional, physical, and spiritual well-being. This review identifies existing research on client-centered interventions for Deaf and Hard of Hearing (DHH) clients which occupational therapy practitioners should understand. Databases searched included CINAHL, JSTOR, ERIC, PsychINFO, and Google Scholar. Full-text articles published in English from December 2013 to December 2023 were reviewed. After data extraction and analysis, 77 articles were synthesized, and interventions were categorized by type, occupation, relevant age group, theme, and professional performing the intervention. Understanding these interventions will help occupational therapy practitioners support DHH clients across the lifespan.