British Journal of Occupational Therapy最新文献

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.

Introduction: Upper limb dysfunction is common in people with Parkinson's. This study aimed to pilot and establish the initial psychometric properties of the timed upper limb assessment (TULA), a 10-item timed functional upper limb assessment tool.

Method: A prospective observational study was conducted with 381 participants (202 with Parkinson's, 179 controls). The TULA was administered to both groups, with inter-rater reliability assessed in a subset (n = 47). Principal component analysis examined structural validity, while convergent validity was explored through correlations with cognitive and motor assessments.

Results: The TULA demonstrated high internal consistency (Cronbach's α = 0.81 for Parkinson's group) and high inter-rater reliability (intraclass correlation coefficient (ICC) > 0.9). People with Parkinson's took significantly longer to complete all items (mean (SD) 22.2 ± 7.5) compared to controls (16.8 ± 3.7, p < 0.001). The tool showed moderate correlation with the timed up and go test (r = 0.56, p < 0.001), a significant low correlation with the Hoehn and Yahr Scale (r = 0.44, p ⩽ 0.001) and a significant low correlation with both the Montreal Cognitive Assessment (r = -0.37, p ⩽ 0.001) and the Mini Mental Status Examination (r = -0.31, p ⩽ 0.001).

Conclusion: This study provides an alternative functional upper limb assessment tool for people with Parkinson's attending occupational therapy. Initial data have been provided to support the reliability and validity of the TULA.

Introduction: There is a small and low-quality body of evidence to support bed positioning as an intervention. Difficulties in developing the evidence base through experimental studies have been recognised and further research has been recommended.

Method: Using a qualitative descriptive design, 13 occupational therapists were recruited from a health board in Wales, UK. Two separate focus groups (n = 5 and n = 8) were held using a semi-structured interview schedule. The data were analysed using Braun and Clarke's six-stage approach to thematic analysis.

Results: Five key themes were established. These relate to role ambiguity, variations across services, the need for training, recognising bed positioning as an individualised intervention, and effectiveness of the intervention.

Conclusion: The following key findings and recommendations are outlined: (1) Bed positioning interventions are individualised. (2) The optimal timing of bed positioning assessments and interventions for inpatients is debated. (3) Multidisciplinary involvement is needed for effective implementation of bed positioning interventions. (4) Variations across services exist, causing inconsistencies in service provision. (5) More training and support in this area of practice are desired by occupational therapists. (6) More research into the clinical effectiveness of bed positioning interventions is welcomed to support clinical justification.

Introduction: Adequate sleep is crucial for health and cognitive performance, yet university students often experience inadequate sleep. In Singapore, academic pressures and long work hours exacerbate sleep issues. This study explores sleep health among university students, focusing on cultural, behavioural and environmental factors, and its impact on occupational balance.

Method: A mixed-methods study using a convergent parallel design was conducted at a Singapore university. Students from Health and Social Sciences and Engineering faculties participated in an anonymous survey on sleep quality and severity of symptoms of depression, anxiety and stress. Separate focus groups were conducted to understand students' sleep experiences.

Results: A total of 147 students completed the survey; 36 joined focus groups. Key findings include (1) Sleep Quality and Daytime Functioning - 79% of participants reported difficulties maintaining enthusiasm, and 52.4% experienced daytime sleepiness at least once in the past month, impacting academic performance and social balance. (2) Sleep and Health - poor overall sleep quality was significantly correlated with emotional distress. (3) Sleep and Social Availability - Social commitments often dictated sleep times, affecting overall sleep quality.

Conclusion: Addressing sleep challenges can enhance academic performance and overall well-being among university students. Interventions addressing sleep quality should consider cultural and societal influences on occupational balance.

Introduction: Occupational balance, a foundational concept in occupational therapy and science, plays a critical role in enhancing health and well-being. Recent studies have revealed its association with epidemiological factors. This study evaluated the validity and reliability of the Japanese version of the Occupational Balance Questionnaire 11 (OBQ11-J).

Methods: Adhering to the COnsensus-based Standards for the selection of health Measurement INstruments and Rasch Reporting Guidelines for Rehabilitation Research, analyses were conducted on the OBQ11-J using a cohort of 462 generally healthy individuals.

Results: The mean OBQ11-J score was 17.7 ± 5.1, ranging from 2 to 33. Two items (Items 1 and 9) exhibited ceiling effects. The 4-point rating scale was validated. Although two items (Items 1 and 10) did not strictly conform to the Rasch model, the overall one-dimensionality and single-factor structures were supported. This confirms the structural validity of the OBQ11-J with its 11 items and 4 rating stages. Reliability, assessed through internal consistency, person separation reliability and test-retest reliability, further affirmed the instrument's robustness.

Conclusion: The OBQ11-J demonstrated validity and reliability in a sample of healthy Japanese individuals. Future investigations should establish normative values for the Japanese population and examine criterion-related validity, responsiveness and interpretability.