British Journal of Occupational Therapy最新文献

Introduction: Menstruation is known to have potentially adverse impacts at multiple levels of occupational performance. However, little research has directly investigated the everyday menstruation experiences of autistic individuals, for whom menses and menarche are widely thought to be particularly occupationally disruptive.

Method: A qualitative research design was employed to address the lived experiences of menstruation among N = 6 autistic adults living in the United Kingdom. With institutional ethical approval, in-depth online interviews were conducted, yielding 34,734 words of transcript. Thematic analysis of these revealed interconnected global themes.

Findings: The global themes identified were: (1) 'Sense of self', addressing participants' sensory overload and experiences of anxiety, 'brain fog' and concern with cleanliness. (2) 'Attributional work', addressing events and contexts which were taken to trigger and/or exacerbate key problems (such as the need to use public restrooms). (3) 'Reclaiming orderliness', addressing participants' pragmatic strategies for overcoming increased unpredictability in their lives during periods.

Conclusion: Menstruation poses specific, significant challenges for autistic individuals that require autism-specific solutions. These challenges impact individuals' ability to perform occupations of self-care, productivity and leisure. As such, Occupational Therapists have a key role in the provision of support to address the impact of menstruation on occupational engagement and participation.

Introduction: In the Danish public healthcare sector, leading occupational therapists (LOTs) and physiotherapists (LPTs) hold key managerial roles. However, fewer LOTs engage in management development activities compared to LPTs, despite both needing similar tools for effective management. This study explores (1) the leadership styles of LOTs and LPTs, (2) their expectations from management practices, and (3) any discrepancies in their leadership roles.

Method: A phenomenological-hermeneutic design was used, with in-depth interviews conducted with eight LOTs and eight LPTs. A comparative analysis identified differences in their leadership practices. The interview guide was based on Danish management studies and theories of motivation and leadership identity. The data were analyzed using qualitative content analysis.

Results: Both LOTs and LPTs, with 10 years of managerial experience, are motivated by personnel management and value a modern leadership style. LOTs appear to have a stronger professional identity as occupational therapists. Minor differences were observed, with LOTs being more reserved in decision-making and seeking internal support, while LPTs were more direct and sought external guidance.

Conclusion: The study found slight discrepancies between LOTs and LPTs regarding management identity, decision-making, and support needs. LPTs may benefit from strategic management support, while LOTs could strengthen their managerial identity.

Background: The menopause transition is a significant stage of a woman's life, marking the transition from reproductive to postreproductive life. Occupational identity often shifts in response to life transitions but this has not been explored in relation to menopause. Therefore, our study aims to explore women's experiences of menopause through an occupational perspective, in relation to occupational participation and occupational identity.

Method: A descriptive qualitative design was implemented. Semistructured interviews were completed with five perimenopausal women online via Microsoft teams. Reflexive thematic analysis was employed to analyse data gathered.

Findings: The findings of this study revealed that a lack of understanding and awareness during the initial stages of menopause negatively affected women's well-being. Women faced disruptions to their engagement in meaningful occupations, which in turn, impacted their occupational competence and occupational identity. The experience of menopausal-related changes influenced women's sense of self-efficacy in engaging in occupations and roles that aligned with their occupational identity.

Conclusion: Women face significant occupational disruption during the menopause transition. Negative impacts on occupational identity and participation were evident from the participants. This study explores menopausal women's experiences from an occupational perspective and findings offer potential direction for future research.

Aim: To explore occupational therapy students' perspectives on ableism and its implications for occupational therapy practice. This formed part of a wider study that also explored occupational therapy educators' perspectives.

Method: An online survey was used to collect students' perspectives, using a mixture of Likert scales and open-ended questions.

Findings: The sample comprised 56 occupational therapy students from the United Kingdom (n = 36), United States of America (n = 16) and Canada (n = 4) enrolled in a mixture of undergraduate (n = 13) and postgraduate (n = 43) pre-registration degree programmes. Thirty-four percent of respondents perceived occupational therapy as inherently ableist. This rose to 50% after respondents were presented with a comprehensive definition of ableism. Students reported witnessing and/or experiencing ableism within education (63%) and practice placements (55%). Eighty-six percent of students recognised they may hold unconscious ableist views, and 96% agreed they would like more support to engage in disability studies.

Conclusion/impact: Findings indicated a potential link between understanding of ableism and students' views that occupational therapy is ableist. Most students were aware of the potential they hold unconscious biases and welcomed support to engage further with disability studies. Further qualitative research is needed. Following this, systemic changes to address the harm of ableism can begin to be addressed.

Introduction: Older people with chronic conditions prioritize living arrangements that let them maintain their autonomy. However, many face activity limitations and participation restrictions. Stakeholders involved in their health and social care have a unique perspective on these challenges. The aim of this study was to examine how these stakeholders view the difficulties older people with chronic conditions living at home face in their everyday lives.

Method: We conducted a qualitative descriptive study based on a focus group interview with eight stakeholders involved in health care, social care and housing for older people with chronic conditions. We transcribed the interview verbatim and analysed it using thematic analysis.

Findings: We generated four themes: fear of losing autonomy, inequality along socio-economic lines, persisting and new barriers, and 'what does "remaining living at home" really mean?'. Participants problematized the lack of awareness among key stakeholders for older people's needs and limited housing options beyond the dichotomous choice between ageing at home and in a care home.

Conclusion: Acknowledging diverse factors - fear of losing autonomy, socio-economic situation, limited awareness of key stakeholders, physical and other barriers, societal discourses - shaping older peoples' choices regarding their living arrangements informs how occupational therapists can support them.

Background: Telerehabilitation could be a substitution for regular rehabilitation in an epidemic situation. Furthermore, there is no evidence of the effectiveness of telerehabilitation in stroke inpatients.

Objectives: To assess the effects of telerehabilitation on daily life function, mobility, and quality of life in stroke inpatients.

Methodology: Inpatients with stroke were randomly assigned to either the telerehabilitation group (n = 12) or the control group (n = 12) for 10 treatment sessions.

Results: No significant differences were found in the outcome measures. However, both groups showed significant improvements in the Modified Barthel Index and Postural Assessment Scale for Stroke scores. The telerehabilitation group improved in Functional Ambulation Categories scores, while the control group showed improvement in Patient Health Questionnaire-9 scores.

Conclusion: This pilot study suggests that telerehabilitation may be a feasible alternative during the pandemic. However, due to the small sample size and the potential influence of natural recovery, the findings remain preliminary. Larger studies are necessary to more definitively assess the effectiveness of telerehabilitation compared to conventional rehabilitation.

Introduction: Further evidence is required to support the use of a combination of a generalist cognitive screen Addenbrookes Cognitive Exam-III and a specialist neuropsychological driving screen Rookwood Driving Battery to aid occupational therapists in making fitness-to-drive decisions for people with dementia.

Method: An exploratory retrospective study was completed for drivers with dementia or mild cognitive impairment living within Scotland. Data were extracted from patient notes of drivers referred to occupational therapy, who had an ACE-III and RDB completed within a 6-month timeframe.

Results: The study sample included 98 participants. A significant negative correlation was identified between both assessments. Lower cut-off scores were identified on the ACE-III below which no participant scored Rookwood Driving Battery <6 (Addenbrookes Cognitive Exam-III cut-off = 65), or the upper Rookwood Driving Battery pass of ⩽10 (Addenbrookes Cognitive Exam-III cut-off = 54). A small subset of participants (n = 14) sat the on-road test. No participant passed on-road with a score >7 on the Rookwood Driving Battery.

Conclusion: The ACE-III is a useful guide for referral to occupational therapy for assessment using the Rookwood Driving Battery and subsequent fitness-to-drive decisions for people with dementia.

Introduction: Globally occupational therapists are collaborating with teachers to support the inclusion of students with disabilities in mainstream schools. To begin to understand how collaboration promotes inclusion, this study aimed to measure occupational therapists and teachers perceived collaborative practice.

Method: A quantitative cross-sectional analysis of occupational therapists and teachers in mainstream primary schools in three Australian states was conducted via an anonymous online survey. Eligible participants were recruited via self-selection and snowballing, resulting in a nonprobability sample of 108 occupational therapists and 33 primary teachers. The Teacher - Therapist Collaboration Index, an instrument based on an existing conceptual framework and associated tool was developed to measure perceived collaborative practice.

Results: Occupational therapist and teacher profiles were similar. Both professions report above average collaborative practice, although teachers rated themselves more collaborative on two components. Ratings did not significantly differ by profession, demographic, or background. Personal, professional and systems influences positively correlated with collaboration ratings, with systems having the strongest relationship.

Conclusion: Systems changes may be necessary to improve collaboration. Therapists could use the framework and measurement instrument as tools to plan, execute and evaluate their collaborative practice.

Introduction: We aimed to investigate whether occupational therapists are exposed to violence in their professional lives and to identify the types of violence they encounter.

Method: This descriptive online-survey study was conducted with 158 female and 43 male occupational therapists, with a mean age of 23.92 years. The survey comprised three sections. The first section included questions pertaining to personal information and workplace details. The second section addressed experiences of violence under the following headings: overall violence, physical violence, psychological violence, and sexual violence. The third section comprised two questions regarding witnessing violence and exposure to the code white protocol.

Results: A total of 49% (n = 100) of the occupational therapists surveyed reported experiencing violence at least once in their professional lives. Of these, 63 individuals faced psychological violence exclusively, 14 experienced only physical violence, 20 encountered both physical and psychological violence, and 3 reported a combination of psychological and sexual violence.

Conclusion: Nearly half of the occupational therapists experienced violence, with psychological violence being the most common type. Addressing violence at the worker, patient, and system levels may help reduce its prevalence.