OCCUPATIONAL THERAPY IN HEALTH CARE最新文献

As occupational therapists develop their roles in promoting the health of populations, it is important to understand the nature of population-based practice. Seventeen occupational therapists engaged in population-based practice participated in semi-structured interviews that explored major aspects of their practice. Qualitative descriptive analysis was used to summarize results. The population-based practice of participants was primarily at the community level and focused on health teaching and coaching, and collaboration and consultation. Four topic areas within population-based practice were identified (with respective themes): characteristics (bigger impact, respond to specific needs of communities, and emphasize prevention), preparation (community engagement within occupational therapy education, education beyond occupational therapy, and networking and leadership experiences), challenges (difficulty obtaining funding, resistance, and time consuming), and benefits (doing more within the scope of practice, and positive client impact). These themes can inform the work of occupational therapists engaged in population-based practice.

This study explored the lived experience of transition from adolescence to adulthood for young people with cerebral palsy to inform occupational therapy practitioners as to what might promote positive life opportunities. A phenomenological methodology was used with six participants, aged 18 to 25 years with cerebral palsy. The findings are presented in the form of hermeneutic stories and three themes: The storm of uncertainty; time, space and the body, Capsizing in a world of others and, Securing anchorage; being heard and understood. Recommendations include service integration across health, social care and education based on partnership and provision of coordinators.

Occupational therapy practitioners who care for individuals post burn often prescribe home programs to facilitate continued progress toward occupational therapy goals. This study identified the components included in home programs, how practitioners create and prescribe home programs, and perceived supports and barriers to adherence in this population. Thirty-nine practitioners employed at American Burn Association-verified centers completed an online survey. Results suggest that home programs are primarily designed to address range of motion with less emphasis on function. The highest-ranked barriers to adherence were pain and lack of motivation while the highest-ranked supports were client motivation and family/caregiver support. Practitioners reported using handouts and demonstration frequently for delivery, with infrequent use of technology. Recommendations for incorporating evidence-based strategies into home program creation and administration are included.

This article explores the new surgical population of gender affirming surgery, specifically vaginal surgeries for transgender and gender diverse people. There are established perioperative rehabilitation guidelines for nearly all other surgeries. A growing population of people is seeking gender affirming healthcare which includes vaginal surgery. This article reviews the guidelines set forth by the World Professional Association for Transgender Health Standards of Care (Version 8), explores the occupational needs of this population, as well as provides suggestions for future versions of official documents of the American Occupational Therapy Association to provide more inclusive language for the unique needs of this population following surgery.

Multitasking measures, such as dual task assessments, are particularly useful in detecting subtle deficits that can influence occupational performance after injuries, like sports-related concussion (SRC). In past work, our research team developed and revised a dual task assessment, the Dual Task Screen (DTS). Here, we evaluated nineteen healthy athletes using the revised DTS to address two specific research objectives. First, to replicate pilot study findings and demonstrate that the revised DTS is sensitive to dual task motor costs (i.e. poorer motor performance under dual task conditions, compared to single task conditions). Second, to evaluate if the revised DTS is sensitive to dual task cognitive costs (i.e. poorer cognitive performance under dual task conditions, compared to single task conditions). We confirmed that the revised DTS was sensitive to both dual task motor and cognitive costs; thus it is a valid measure of dual task performance. These positive findings support its prospective, future use by occupational therapists to evaluate multitasking performance after injuries, like SRC, or other injuries and illnesses that elicit deficits affecting optimal occupational performance.

Community development and population-oriented approaches are emphasized to advance the occupational therapy profession's scope of practice to meet the increasing demands created by socio-cultural-political and economic changes. This study explored the practice processes of occupational therapists in community settings outside existing health care structures in Germany. Data was gathered through five individual qualitative interviews and one focus group and analyzed using thematic analysis. Three main themes were identified: navigating parallel processes within the larger context or system; building community connections through occupation; growing professional identity. The utilization of occupational science concepts was essential to work successfully on a community level.

Occupational therapy's whole-person approach is well-suited to address the complex needs of children and youth with fetal alcohol spectrum disorder (FASD). However, literature regarding best practices for occupational therapy practitioners working with this population is lacking. This article delineates the role and scope of occupational therapy practice for children and youth with FASD, focusing on holistic and strengths-based approaches. The value of occupational therapy practice is illustrated through application of the person-environment-occupation-performance model and case examples at key developmental stages. Understanding occupational therapy's scope of practice will support the growth of the profession's role and facilitate successful participation of children with FASD in everyday life.

Adults with lower-limb (LL) amputation have difficulty dual-tasking which may elicit falls and is required for instrumental activities of daily living (IADLs). The purpose of this study was to explore the relationships between dual-task performance, falls, and IADLs for Veterans with LL amputation. A cross-sectional study was completed with dual-task performance, retrospective fall reporting, and participation in IADLs. Dual-task performance varied across participants (n = 24) and although it was not significantly correlated to IADL participation, the relationships between dual-tasking, falls, and IADLs warrants further study to maximize dual-task training that can translate to everyday life.

This study investigated differences in independent living skills and executive functioning skills between autistic and neurotypical young adults in addition to how executive functioning skills contribute to independent living skills in autistic young adults. Participants completed the Adaptive Behavior Assessment System as a measure of independent living skills and the Behavioral Rating Inventory of Executive Function Adult version to measure executive functioning abilities. The Weekly Calendar Planning Activity was also used as a novel measure of performance-based executive functioning skills. Results demonstrated that independent living skills and executive functioning skills were significantly lower in autistic adults (p<.001) than neurotypical young adults. The WCPA also indicated deficits in the autistic population as demonstrated by following fewer rules, utilizing fewer strategies, lower accuracy, and lower self-awareness of performance. Within autistic adults, self-reported measures of executive functioning skills robustly correlated with independent living skills. While the Weekly Calendar Planning Activity accuracy correlated strongly with self-reported measures of executive function, the accuracy did not significantly correlate with the ABAS-3 scores suggesting a discrepancy between self-report and performance-based measures of executive functioning skills. Results indicated that the Weekly Calendar Planning Activity shows promise to inform clinical practice by providing a window into how the integration of multiple executive functioning skills impact challenges with everyday living in the adult autistic population.

The purpose of this paper is to propose the Intentional and Attuned Therapeutic Relationship Model as a means to emphasize an intentional and attuned therapeutic relationship among the therapist, autistic child, and their caregiver. Neurodiversity-affirming practice is strengths-based, collaborative, and inclusive of the needs and goals of the autistic child and their caregiver. As this necessitates reevaluating occupational therapy models of care delivered to autistic children, this paper provides a brief review of sensory processing and emotional regulation; discusses the Intentional Relationship Model and the phenomenon of attunement, respectively; and proposes the Intentional and Attuned Therapeutic Relationship Model, which combines elements of the Intentional Relationship Model and attunement to develop the therapeutic relationship in alignment with the neurodiversity-affirming paradigm.