American Journal of Occupational Therapy最新文献

Importance: Participation is a central determinant of older adults' health and quality of life (QoL). Examining participation and QoL among older adults from different ethnic groups through an occupational justice lens is vital in occupational therapy.

Objective: To compare participation (objective and subjective) and QoL among older adults from two ethnic populations (Arab and Jewish) and to examine the relationships between sociodemographics, health-related variables, and participation with QoL in both groups.

Design: Cross-sectional quantitative and comparative.

Setting: Community-dwelling older adults in Israel.

Participants: A total of 190 adults ages 65 yr and older (90 Arabs, 100 Jews) who had not been hospitalized in the past month.

Outcomes and measures: We used a background questionnaire, the four-item Patient Health Questionnaire for Anxiety and Depression, the Experiencing Day-to-Day Life Questionnaire, and the World Health Organization Quality of Life-Brief Version.

Results: The minority group reported lower education, poorer health, and lower participation and QoL scores compared with the majority group. Making ends meet, education, health-related variables, and participation were significantly correlated with QoL in both groups, with a higher correlation between subjective participation and QoL in the Arab group.

Conclusions and relevance: Participation and QoL vary among older adults from different ethnic groups, with sociodemographics and health-related variables interconnected in both groups. The findings support the study hypotheses, highlighting the potential role of social factors on participation and the importance of encouraging subjective participation to enhance QoL, especially among minority groups. Further studies among diverse minority groups are recommended. Plain-Language Summary Participation, or involvement in purposeful and meaningful daily activities, is a central determinant of older adults' health and quality of life. This study examined differences in sociodemographics, health, participation, and quality of life among older adults from ethnic majority versus minority groups. The study emphasizes the potential impact of social aspects on participation and the importance of encouraging subjective participation to improve quality of life, especially among minority groups. Developing and tailoring occupational therapy intervention programs that address inequities through the lens of occupational justice can promote participation in meaningful activities and enhance older adults' quality of life, especially among minority groups.

The occupational therapy profession is well positioned to play a pivotal role in advancing the health and well-being of communities with different lived experiences. The articles included in this special issue on Diversity, Equity, Inclusion, Justice, Accessibility, and Belonging (DEIJAB) in Occupational Therapy Practice and Education provide a snapshot of research and scholarship aimed at interrogating systems and standards of practice and promote evidence-informed strategies to support the unique concerns of nondominant groups. Specifically, authors take stock of practice trends with these populations; describe processes for developing culturally affirming measures; examine the effectiveness of target-based interventions; and articulate the value of applying DEIJAB principles across practice settings, academic programs, advocacy, and professional leadership. Across all of the articles, scholars call on members of the profession to be critically reflective and actively antiracist and to challenge dominant paradigms to shape the future of practice through education, training, leadership, and community partnership.

Systematic review briefs provide a summary of the findings from systematic reviews evaluated in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each systematic review brief summarizes the evidence on a theme related to a systematic review topic. This systematic review brief presents findings related to the effectiveness of interventions using Ayres Sensory Integration® for children and youth 0-21 yr of age.

The issues faced by racialized; female; immigrant; and two-spirit, lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual/agender + (2SLGBTQIA+) occupational therapy academics and practitioners highlight the overlapping systems of oppression due to their multiple minoritized identities (MMIs). Through critical reflection, the authors bring to light how oppressive occupational therapy structures and processes continue to sustain Othering within the profession, including the paradox of occupational justice. The authors caution that ignoring issues faced by occupational therapy academics with MMIs might end in tragic intersectionality. Positionality Statement: Natasha Smet identifies as an immigrant queer woman of color, scholar, and practitioner who was born and raised in South Africa during the Apartheid era when laws were enforced to segregate people solely on the basis of race. Although Apartheid ended in 1994, her experiential knowledge of systemic racism, overt discrimination, and oppression continued as a survivor of educational and academic workplace violence and abuse in the United States. Her lived experience of oppression continues to be her catalyst to disrupt white supremacy across academic institutional settings. Jeffrey John Andrion is a racialized, straight, cisgender, immigrant male academic who was born and raised in the Philippines. Although he is an immigrant settler of Canada, he is also a descendant of former colonizees in his native home country. With experiential knowledge of racialization and Othering, he grew up with the terms resistance and oppression. In this column, we define Othering as "the process whereby an individual or groups of people attribute negative characteristics to other individuals or groups of people that set them apart as representing that which is opposite to them" (Rohleder, 2014, p. 1306).

Importance: Occupational therapy lacks workforce diversity. Academic programs (APs) are uniquely positioned to create learning experiences that align with diversity, equity, and inclusion (DEI) efforts within occupational therapy.

Objective: To examine the acceptability of a student-led outreach program from the perspectives of occupational therapy students.

Design: Qualitative, cross-sectional study that used occupational therapy students' reflections as part of routine educational assessments. Thematic analysis was used to identify and define themes within reflections. Reflexivity and prolonged engagement in the field enhanced trustworthiness.

Setting: Urban, Midwestern OTD program.

Participants: Sixty-eight occupational therapy students enrolled in their second semester.

Intervention: Occupational therapy student-led outreach presentations in middle and high schools in which most students had Black, Indigenous, or People of Color backgrounds. Presentations lasted 45 to 60 min.

Outcomes and measures: After their presentations, occupational therapy students completed an open-ended reflection on their outreach experience of at least 250 words.

Results: Participants were primarily women (n = 63; 92.65%) and White (n = 50; 73.53%). Three themes emerged in the analysis of students' reflections: knowledge translation, opportunity versus assignment, and practical insights.

Conclusions and relevance: Occupational therapy APs are positioned to craft learning opportunities that can meet accreditation requirements, benefit students' professional development, and contribute to DEI efforts. To make these efforts sustainable, occupational therapy APs must cultivate meaningful relationships with local and diverse community partners while also evaluating opportunities to integrate DEI into their own curricula. Additional research is needed to examine the long-term impact of outreach efforts between occupational therapy students and recipients. Plain-Language Summary: Occupational therapy academic programs are uniquely situated to promote diversity, equity, and inclusion (DEI) in the profession. Focusing on racial and ethnic diversity, in this study we sought to capture the perspectives of first-year occupational therapy students who participated in a student-led outreach initiative embedded within their curriculum. We found that occupational therapy students benefited from participating in this educational experience because they were challenged to share their knowledge of occupational therapy with middle and high school students from underrepresented communities. Viewing this experience as an opportunity instead of an assignment, occupational therapy students felt that they contributed to DEI efforts while growing as future practitioners. Occupational therapy

Importance: Although occupational justice is an important construct for occupational therapy, the Occupational Justice Scale for Refugees (OJS-R) is, to our knowledge, the first of such scales developed in this field.

Objective: To develop an occupational justice scale designed specifically for refugees and to evaluate its psychometric properties.

Design: This study was conducted as face-to-face interviews and self-report surveys with refugees. The Davis technique was applied twice to 12 expert panelists, and the test form was administered to 603 individuals. Item analysis was conducted to evaluate the internal consistency of the scale. An exploratory factor analysis and confirmatory factor analysis were also performed to examine the construct validity of the scale.

Setting: Four different provinces in Turkey: Istanbul, Ankara, Elazig, and Bingöl.

Participants: Data from 603 Syrian refugees were included in the analyses.

Outcomes and measures: Information from completed informed consent forms, the OJS-R, and the Occupational Balance Questionnaire-11, Turkish version (OBQ11-T).

Results: The OJS-R explained 70.179% of the variance and revealed a five-factor structure (occupational deprivation, alienation, marginalization, apartheid, and imbalance). The scale demonstrated high reliability, with an interclass correlation of .989 and Cronbach's α of .993. Test-retest correlation coefficients were robust, and the correlation between the OJS-R and OBQ11-T were statistically significant (r = .987, p < .001). These results validate the 30-item scale structure consisting of five dimensions.

Conclusions and relevance: The OJS-R may be a reliable and valid measure of occupational justice and appropriate for populations such as refugees. Plain-Language Summary: Occupational justice is a critical perspective of social structures that promote social, political, and economic changes to enable individuals to meet their occupational potential and experience well-being. Refugees often experience occupational injustice, even though there is no scale to evaluate occupational justice. This study is a scale development study. We developed the Occupational Justice Scale for Refugees (OJS-R), which, to our knowledge, is the first scale designed specifically to measure the levels of occupational justice experienced by refugees. This study's results may simplify greater consideration and evaluation of occupational justice by occupational therapists. Furthermore, the OJS-R may encourage occupational therapists to include occupational justice in their refugee intervention programs.

The philosophical foundations of occupational therapy, originating in North America, primarily align with American philosophy, which leads to challenges when occupational therapy is applied in diverse cultural contexts. The occupational therapy profession needs to embrace multiple philosophical orientations to enhance cultural sensitivity. In this column, the authors use postcolonial theory to analyze colonial legacies and power dynamics within communities, highlighting the limitations of current Western-based adaptations in promoting diversity, equity, inclusion, justice, and accessibility. They argue that incorporating diverse philosophical orientations into occupational therapy can enrich the field by fostering adaptability and inclusivity. They also outline steps to integrate multiple philosophical orientations, including acknowledging historical influences and adopting practices that resonate with diverse values. Embracing multiple philosophical orientations signifies the profession's commitment to evolving and responding effectively to the complex needs of individuals and communities, thereby promoting more equitable and just outcomes in occupational therapy practice. Positionality Statement: The authors of this column include a Ghanaian nondisabled occupational therapist who studied and practiced occupational therapy in Ghana, West Africa, and the United States; a White, nondisabled, female Canadian occupational therapy scholar with practice experience across numerous international contexts; and an Asian, nondisabled, female occupational therapy scholar who has occupational therapy practice experience in both Asia and the United States. All three authors currently live and work in the United States. They drew from their personal experiences, knowledge of the profession, research evidence, and critical reasoning to conceptualize this column.

Systematic review briefs provide a summary of the findings from systematic reviews evaluated in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each systematic review brief summarizes the evidence on a theme related to a systematic review topic. This systematic review brief presents findings from the systematic review on the effectiveness of sensory-based interventions (excluding Ayres Sensory Integration® [ASI]) for children and youth 0-21 yr of age.

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.