American Journal of Occupational Therapy最新文献

Importance: Burnout is common among occupational therapy professionals and associated with poor health and well-being, absenteeism, turnover, and exit from the profession. This study identified specific job titles, job characteristics, and resources related to burnout.

Objective: To identify specific aspects of occupational therapy jobs related to burnout and to investigate job crafting as one approach for reducing burnout.

Design: Cross-sectional survey.

Participants: Four hundred occupational therapy professionals from 45 states across the United States.

Outcomes and measures: This study investigated the relative importance of job demands (e.g., workload, emotional labor, role ambiguity), job resources (e.g., professional identity, autonomy, perceived support), and burnout and examined job crafting as a strategy for reducing burnout.

Results: Burnout varied across occupational therapy positions and practice areas and was most strongly associated with excessive workload. Occupational therapy professionals who engaged in job crafting reported less burnout. Several positive job resources, including meaningful work, job involvement, and perceived organizational support, were also associated with job crafting.

Conclusions and relevance: This study identified specific occupational therapy roles, settings, and job characteristics related to burnout and job crafting behaviors that may help reduce burnout. Plain-Language Summary: Burnout is common among occupational therapy professionals and is associated with poor health and well-being, absenteeism, turnover, and people leaving the profession. This study identifies occupational therapy positions, practice areas, and work conditions at most risk for burnout and highlights job resources that can prevent and mitigate burnout. The study found that burnout varied across occupational therapy positions and practice areas and was most strongly associated with excessive workload. Recommendations to address burnout include engaging in job crafting, optimizing job demands and resources, and fostering meaningful work to reduce burnout.

Given the number of occupational therapy doctorate (OTD) programs and graduates with professional doctoral degrees, the concept of practice scholarship is increasingly important. The scholarly work of occupational therapy practitioners guided by a research model is appropriate for those who have trained as researchers or OTD students and practitioners receiving mentorship from occupational therapy research scientists. A research model of scholarship may not fit the scholarly work of most occupational therapy practitioners with an OTD. We propose the Scholarship of Knowledge Discovery in Practice model, which emphasizes how contextual factors influence the generation and application of knowledge, particularly in addressing feasibility and sustainability challenges when integrating evidence into practice. This model prioritizes discovery when solving practice problems through quality improvement, program development, and innovation. OTD students and occupational therapy practitioners may use this model in generating scholarly work through capstones and ongoing enactment of the scholarly role. The recognition of practice scholarship as making important contributions to the profession may generate multiple vehicles through which to disseminate the discovery of knowledge in practice.

Importance: The application of interpersonal skills is considered therapeutic use of self, a pillar of occupational therapy practice, and a required competency for occupational therapy education (American Occupational Therapy Association [AOTA], 2020). Medical improvisation (medical improv) uses the principles of improvisational theater to enhance professional competencies and shows promising results in health professions education (Gao et al., 2019).

Objective: To understand the effect of medical improv on occupational therapy students' therapeutic use of self.

Design: A 6-wk randomized controlled waitlist trial.

Setting: Occupational therapy education.

Participants: A cohort of 36 occupational therapy students.

Intervention: Two 2-hr sessions of medical improvisation.

Outcomes and measures: Standardized patients rated students' therapeutic use of self with the Empathy and Clarity Rating Scale (Terregino et al., 2019), and students completed the Self-Efficacy for Therapeutic Use of Self (SETUS; Yazdani et al., 2021). Data were analyzed using independent samples t tests and multivariate mixed-methods models.

Results: There was a significant difference between the intervention and waitlist control group in three SETUS subtests (modes, p = .004; traits, p = .04; total score, p = .03) and a significant interaction effect in SETUS modes (p = .03). The waitlist control group responded with comparable increases, and all participants demonstrated a significant increase in self-efficacy of therapeutic use of self after the medical improv intervention (p < .001).

Conclusions and relevance: These findings provide the first evidence for the positive effects of medical improv in building self-efficacy of therapeutic use of self in occupational therapy students. Plain-Language Summary: Medical improvisation (medical improv) in health professions education uses the principles of theatrical improvisation to build the interpersonal skills of students. This study's application of medical improv to occupational therapy education found significant change in students' self-efficacy of therapeutic use of self. The inclusion of medical improv in occupational therapy education can better prepare students to build and maintain therapeutic relationships.

Cesarean sections (c-sections) are the most commonly performed surgery in the United States, and the country is currently facing a maternal health crisis. Surprisingly, women do not receive rehabilitation services to support the acute stages of c-section recovery. When someone undergoes a knee or hip replacement, it is standard practice for the physician to order home health services, including occupational therapy, for a client before they are discharged from the hospital. The role transition to motherhood, which requires the provision of newborn care, physical limitations after surgery, and the associated mental health changes position occupational therapy practitioners as professionals who can provide essential services to mothers after a c-section. In this column, we argue for occupational therapy practitioners' important role in serving women in the home environment immediately after a c-section and provide a tangible action plan for implementing these crucial services to improve maternal health outcomes. This column gives a voice to the often-invisible struggles of mothers suffering in silence in the acute postpartum stage of c-section recovery in the hope of bringing positive change to maternal health outcomes through the provision of skilled occupational therapy services.

This AOTA Position Statement describes how occupational therapy practitioners work as part of an interprofessional collaborative practice in various settings, including, but not limited to, hospitals, skilled nursing facilities, school systems, and community agencies.

Importance: The scope of early intervention (EI) programs, which mostly focus on motor skills, needs to be expanded.

Objective: To examine the effects of an EI on developmental domains and parent-child interactions.

Design: Randomized controlled study.

Participants: Children ages 24-36 mo with developmental delay (DD; intervention group, n = 30; control group, n = 40).

Setting: Pediatric occupational therapy unit of Hacettepe University.

Intervention: The intervention group received an intervention that used the Goal Activity and Motor Enrichment (GAME) approach and a home program, whereas the control group received a home program only. Both groups received the same intervention dosage.

Outcomes and measures: Developmental domains were assessed using the Bayley Scales of Infant and Toddler Development Third Edition (Bayley III) and the Ages and Stages Questionnaires (ASQ). Sensory processing was assessed with the Infant/Toddler Sensory Profile 2 (ITSP-2), social-emotional development with the ASQ:Social-Emotional (ASQ:SE), and parent-child interaction with the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO™). A compliance checklist was used to determine compliance with the home program.

Results: A significant between-groups difference was found on all Bayley III and PICCOLO subscales and on the Gross Motor, Fine Motor, Problem-Solving, and Social-Emotional domains of the ASQ and ASQ:SE in favor of the intervention group (p < .05). The intervention group showed more typification (normal sensory processing) in sensory quadrants and general processing. Both groups were 100% compliant with the home program.

Conclusions and relevance: The GAME-based intervention for children with DD, including sensory and cognitive activities, is effective in improving developmental domains and parent-child interactions. Plain-Language Summary: The scope of early intervention programs mostly focuses on motor skills and needs to be expanded to include the essential roles of children's sensory and cognitive abilities. This study provides important insights into early interventions by occupational therapists and the impact on children with developmental delay and parent-child interactions. We found that the Goal Activity and Motor Enrichment (GAME) intervention for children with developmental delay, which includes sensory and cognitive activities, is effective in improving developmental domains and parent-child interactions.

Importance: High stress and compromised mental health are well-documented among mothers of children with disabilities, but less is known about the factors that influence their participation and well-being, especially among Chinese mothers. Identifying these factors could lead to strategies to mitigate potential risks to maternal well-being.

Objective: To explore the relationships among participation in health-promoting activities, perceived stigma, perceived support, and well-being of ethnic Chinese mothers who have children with disabilities.

Design: Cross-sectional survey.

Setting: Community.

Participants: Ethnic Chinese mothers (N = 261) with children with disabilities of any age residing in Australia, Singapore, or Taiwan.

Outcomes and measures: Health Promoting Activities Scale, Personal Wellbeing Index, Warwick-Edinburgh Mental Wellbeing Scale; Kessler Psychological Distress Scale, Parental Perceptions of Public Attitudes Scale, and Multidimensional Scale of Perceived Social Support.

Results: Moderate to strong correlations were found between mental well-being and all measures. The frequency of participation in health-promoting activities was a predictor of mental well-being (β = .21, p = .001). Perceived support was the strongest predictor of participation in health-promoting activities (β = .25, p = .005), mental well-being (β = .39, p < .001), and personal well-being (β = .45, p < .001). Perceived stigma predicted psychological distress (β = .32, p < .001) and mental well-being (β = -0.29, p < .001).

Conclusions and relevance: Perceived support and stigma affected mothers' participation in health-promoting activities and well-being. Therapists can facilitate mothers' engagement in health-promoting activities and develop strategies to address stigma and enhance support. Plain-Language Summary: This research highlights factors that affect the well-being of ethnic Chinese mothers who have children with disabilities and provides cultural insights for occupational therapists who work with Chinese families. The article also encourages pediatric occupational therapists to address the occupational needs and well-being of mothers in parallel with therapy for their children. We discuss occupation-focused strategies, family-centered perspectives, and health promotion approaches in relation to improving the participation and well-being of ethnic Chinese mothers in their cultural context.

Importance: The Cognitive Orientation to daily Occupational Performance (CO-OP) is an evidence-based intervention approach that has significantly increased in popularity over the past two decades. However, how the research literature on this topic is patterned is still unknown, so it is difficult to identify potential areas for research and clinical interest.

Aims: To analyze the literature published on the CO-OP approach to provide a detailed and structured analysis of the publication patterns.

Data sources: All literature related to CO-OP included in the Web of Science database through June 15, 2024.

Study selection and data collection: All published studies related to CO-OP were included in the bibliometric analysis, which was conducted on the raw data retrieved from the Web of Science database using the Bibliometrix R package.

Findings: The annual growth rate in CO-OP research has been 0.8%, significantly increasing from 2015 onward. Most of the research has been published in occupational therapy and rehabilitation journals by English-speaking research teams, and its scope has expanded from developmental coordination disorder to a wide range of health conditions. In addition, two main lines of research have emerged: one focusing on understanding the underlying cognitive processes involved in CO-OP and the other focusing on its clinical effectiveness.

Conclusions and relevance: Research on CO-OP has significantly increased over the past decade, and it currently encompasses a wide range of areas. This analysis may facilitate the advancement of research on and the clinical practical application of CO-OP. Plain-Language Summary: The Cognitive Orientation to daily Occupational Performance (CO-OP) is an evidence-based intervention approach that has significantly increased in popularity over the past two decades. Occupational therapists use it to improve the occupational performance of both children and adults with movement difficulties. However, it is unknown how the research literature on this topic is patterned, so it is difficult to identify potential areas for research and clinical interest. This study found that scientific literature on CO-OP has significantly increased in the past decade and that its scope has expanded from developmental coordination disorder to a wider range of health conditions, such as cerebral palsy. Moreover, research is now focused on two main questions: What are the underlying cognitive processes involved during intervention, and how effective is the CO-OP approach? These findings can be used to further improve occupational performance and participation among occupational therapy clients who struggle with motor performance and planning.

This AOTA Position Statement describes how assistive technology (AT) fits within the occupational therapy scope of practice and how occupational therapy practitioners uniquely contribute to teams that provide AT evaluations, recommendations, and training.