British Journal of Occupational Therapy最新文献

Introduction: Individuals diagnosed with schizophrenia face significant barriers that impact their quality of life and restrict their social participation. This study explores the lived experiences of individuals with schizophrenia, focusing on the challenges they encounter in social settings.

Method: A qualitative research design with an Interpretative Phenomenological Analysis approach was employed to examine the subjective experiences of 18 participants diagnosed with schizophrenia. Data were collected through semi-structured interviews and observational field notes to capture both verbal and non-verbal expressions.

Findings: Three primary themes emerged from the analysis: (1) personal growth and well-being, (2) adaptation to social environments, and (3) social contexts and support.

Conclusion: The study highlights restricted social networks, challenges in daily functioning, and the impact of stigma on social participation. Findings emphasize the need for structured interventions focusing on social skills training, occupational engagement, and reducing stigma. The role of occupational therapy in enhancing autonomy, fostering meaningful social interactions, and promoting long-term community integration is underscored.

Introduction: Spirituality is a fundamental aspect of human existence. Additionally, spirituality is acknowledged within many occupational therapy models of practice. Despite this, other health professions are dominant in published spirituality research and resources. Therefore, to develop our profession-specific perspective, a broad range of occupational therapy spirituality literature was explored to identify how international occupational therapists integrate spirituality into practice.

Methods: This study undertook a scoping review using the Joanna Briggs Institute's (JBI) approach. Six databases were searched for peer-reviewed sources which focused on the experience of occupational therapists, and on concepts relating to spirituality and religion. Fifty-four articles were included in the scoping review. Reflexive thematic analysis was used to present these findings as a narrative synthesis.

Results: The three main findings were as follows: (a) key concepts of spirituality definitions included a person finding 'meaning', 'purpose in life' and 'connection'; (b) a spectrum of approaches were used to address client spirituality; (c) training and spirituality supportive healthcare approaches were facilitators, whereas lack of time and funding were the chief barriers.

Conclusion: Occupational therapy in many countries would benefit from further research, guidelines and policies and training that applies spirituality and its related concepts to occupational therapy practice.

Background: Goal-oriented care is prominent in primary care settings due to the rising number of people living with (multiple) chronic conditions. Before goal-oriented care can be fully implemented, a better understanding about the concept of goals needs to be gained. This study aimed to elicit in-depth knowledge through the narratives of people with (multiple) chronic conditions regarding their view on goal setting.

Method: In a qualitative research design within a phenomenological-hermeneutical paradigm, 15 in-depth interviews were performed with people living with (multiple) chronic conditions (mean age 65; 38-81) based on a homogeneous sampling strategy.

Results: This study revealed that goal setting starts from talking about everyday activities embedded in a real-life context. A well-defined goal should consist of the context, the life narrative of the patient, the engagement towards a particular goal, the reason why this goal is important in terms of underlying values, the emotions going along the activity, and the relevance for the patient. This leads to CLEVER goals.

Conclusion: These findings prompt a reconsideration of traditional goal setting in healthcare, which typically adheres to SMART. Based on the participants' experiences, goals should be defined as CLEVER first before they can be transposed into SMART goals.

Introduction: Occupational therapy roles are increasing across General Practice in primary care. The evidence base is growing; however, the best way to evaluate outcomes and the impact of practice in this setting remains unclear. Consideration for how methods used align to ambitions of value-based healthcare is also required. This study explored evaluation methods used by occupational therapists, providing services to General Practice in Wales within the context of value-based healthcare.

Method: An online focus group was conducted with 13 members of a Welsh Primary Care Occupational Therapy network. Mixed methods were used and Mentimeter results and findings from group discussion were analysed through content and framework analysis.

Results: A multifaceted but inconsistent approach to evaluation was reported. Methods used, strengthened by professional core values, broadly aligned practice to shared ambitions of value-based healthcare. The use of validated patient rated scales were most commonly used to evaluate patient experience, whilst cost-effectiveness was least well considered.

Conclusion: Further research is required to understand occupational therapy evaluation in this setting to identify what is needed by stakeholders to determine impact and establish value. This could inform care at both an individual level and across populations if consistent data are collected at scale.

Background: Professional reasoning in occupational therapy has become a key line of research. Updating and analyzing recent publications is crucial for the discipline. The objective of the research was to describe new findings and changes in the characteristics of research on professional reasoning in occupational therapy between 2019 and 2023.

Method: A scoping review was used with the aim of identifying the development and scope of the literature on professional reasoning in occupational therapy from 2019 to 2023. The review was conducted in five stages following the PRISMA-ScR guidelines.

Results: Seventy-six articles were described in terms of their nature and volume under the following categories: specific fields of practice, educational strategies for professional reasoning, theoretical discussions, and instruments related to professional reasoning. New findings include two professional reasoning modalities, five practice-related areas, and intervention programs that had not been previously described. Additionally, there has been an increase in the use of mixed methods.

Conclusion: This scoping review identifies the nature and volume of literature on professional reasoning in recent years. The study reveals consolidated research lines focused on practice and teaching, alongside new findings and changes observed in recent studies.

Introduction: Rheumatic diseases significantly impact daily activities, emphasizing the need to understand their occupational profiles. Identifying these profiles using the Occupational Circumstances Assessment Interview and Rating Scale can aid in tailoring treatment approaches. This study aimed to evaluate the validity and reliability of the Turkish version of Occupational Circumstances Assessment Interview and Rating Scale in rheumatic diseases.

Method: The scale's internal construct validity was examined using the Rasch measurement model. Convergent validity of Turkish version of Occupational Circumstances Assessment Interview and Rating Scale was evaluated through Spearman's correlation coefficient, assessing associations with the Community Integration Questionnaire, World Health Organization Disability Assessment Schedule, Second Version and Canadian Occupational Performance Measure.

Results: Correlation analyses demonstrated a positive correlation between Turkish version of Occupational Circumstances Assessment Interview and Rating Scale Rasch-transformed scores and Canadian Occupational Performance Measure total (r = 0.208; p = 0.009), along with negative correlations with Community Integration Questionnaire (r = -0.210; p = 0.008) and World Health Organization Disability Assessment Schedule, Second Version (r = -0.539; p < 0.000).

Conclusion: Findings confirm Turkish version of Occupational Circumstances Assessment Interview and Rating Scale as a valid and reliable tool for assessing the occupational profiles of individuals with rheumatic diseases. It can guide treatment plans and help develop effective strategies to enhance daily life participation.

Background: Atypically developing children often present with a variety of sensory processing difficulties which have been proposed to reflect abnormal development of pathways integrating sensation and action. A brain system in which the process of sensorimotor integration is particularly well understood is the oculomotor system, but no studies to date have used computerised eye tracking to assess eye movements in children with sensory processing difficulties.

Method: Ten children with sensory processing difficulties completed a battery of oculomotor tasks comprising pro-saccades, anti-saccades, smooth pursuit tracking and sustained fixation. Eye movements were recorded using a high-resolution eye tracker.

Results: Compared to age-matched controls, children with sensory processing difficulties were found to make more directional errors in the anti-saccade task and less-accurate smooth pursuit and sustained fixation.

Conclusion: Consistent differences were found in oculomotor ability in children with sensory processing difficulties which are likely to impact children's ability to process and respond to visual information within home and school contexts. Further research is needed to understand the relationship between oculomotor deficits in children with sensory processing difficulties and the presence/absence of neurodevelopmental diagnoses. Eye tracking may be of value in the future for assessment and objective evaluation of interventions for sensory processing difficulties such as sensory integration therapy.

Introduction: People on chronic hemodialysis identify fatigue and its negative impact on their life participation (i.e., ability to accomplish valued daily occupations) as central to their illness experience. We explored how fatigue, as experienced by people on hemodialysis, shaped their participation in daily occupations, and participants' experiences in the Personal Energy Planning programme.

Method: This qualitative follow-up study to a pilot randomized controlled trial used an interpretive description approach with six participants who completed an energy management programme for people treated with hemodialysis in Calgary, Canada. Each participant completed one semistructured interview about their experiences with fatigue management, life participation and the programme. Data were analyzed using modified constant comparative analysis.

Findings: Participants described moving from an illness experience to one of living, where they could envision participation in both activities of daily living and social leisure occupations. Participants also described how they felt supported by the programme with its focus on applying the learning from the programme to improve their participation.

Conclusion: Fatigue has an extensive impact on various facets of life participation. For people treated with hemodialysis, the reconstruction of their occupational lives can be enabled through energy management education programmes focused on the development of personal metacognitive strategies.

Introduction: Immersive virtual reality is increasingly used to treat chronic pain. Commercial virtual reality experiences offer a way to integrate immersive virtual reality into clinical practice, but selecting appropriate virtual reality experiences for specific patient goals is challenging. We developed the Virtual Reality Activity Analysis for Pain to help occupational therapy professionals assess virtual reality experience physical, sensory, mental, and psychosocial components relevant to chronic pain treatment. This study aimed to evaluate the interrater reliability of the virtual reality activity analysis for pain instrument.

Method: Raters assessed 10 virtual reality experiences using the virtual reality activity analysis for pain instrument, which includes 30 items across physical, sensory, mental, and psychosocial categories. We conducted 40 measurements per item and compared them using inter-class correlation coefficients.

Results: The virtual reality activity analysis for pain demonstrated excellent interrater reliability (inter-class correlation coefficients = 0.91), with four out of five sections and 55% of items showing good to excellent reliability. Only 16% of items exhibited poor reliability.

Conclusion: The virtual reality activity analysis for pain is a reliable tool for analyzing virtual reality experience characteristics, with potential to standardize reviews of commercially available virtual reality experiences, aiding occupational therapy professionals to implement immersive virtual reality into chronic pain management.