British Journal of Occupational Therapy最新文献

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.

Introduction: Play is a crucial occupation of children's that requires reliable and valid assessment. This study aimed to investigate validity and reliability of the parent version of the Pretend Play Enjoyment Developmental Checklist (PPE-DC).

Methods: This cross-sectional psychometric study included 10 Iranian occupational therapists from paediatric clinical practice (mean age of 36.5 years) with an average of 14.5 years of experience. Thirty parents and their neurodivergent children (6 girls; mean = 55.90 months; SD = 14.25) and 30 parents and their neurotypical children (14 girls; mean age = 53.4 months; SD = 20.45) participated. Parents filled in the PPE-DC, and a trained therapist assessed children with the Child-Initiated Pretend Play Assessment (ChIPPA) within 10 days of parents filling in the PPE-DC.

Results: The content validity ratio was 1. Content validity index was >0.8. There were significant differences for all parent PPE-DC scores between neurotypical and neurodivergent children (p < 0.001). For concurrent validity, there were moderate significant relationships between the ChIPPA and PPE-DC items. Test-retest reliability was excellent (intraclass correlation coefficient > 0.99).

Conclusion: The PPE-DC Parent version is a reliable and valid parent's measurement of their child's level of complexity of play skills.

Introduction: Although occupational therapists work within mental health settings, there is limited research regarding their role in seclusion. This study aims to explore occupational therapists' experiences of delivering occupational therapy in seclusion whilst working as part of a multi-disciplinary team.

Method: An exploratory qualitative approach using a semi-structured virtual interview approach was adopted. A convenience sample of six participants with experience of working in inpatient mental health seclusions settings were recruited at a national level. Interviews were recorded, transcribed verbatim and analysed using reflexive thematic analysis.

Findings: Four key themes were identified: (1) the perception of seclusion as a punitive approach, (2) the role of occupational therapy in improving the patient's journey through seclusion, (3) grading and adapting occupations to manage risk and increase engagement, and (4) promoting the role of occupational therapy in seclusion.

Conclusion: Occupational therapists can play an important role in improving the experience of patients in seclusion. They have unique skills that enable them to work in this challenging environment. It has also highlighted the lack of understanding about occupational therapy within the multi-disciplinary team and how important it is for occupational therapists to promote their role.

Introduction: Occupational justice addresses social, political and economic factors influencing occupational participation as a human right. Implementing occupational justice is challenging due to institutional, personal, environmental and cultural barriers, and may be further complicated in non-Western contexts. Early career occupational therapists often struggle to apply these principles while transitioning from education to practice, despite their desire to advocate for justice-focused practices.

Methods: This qualitative descriptive study, grounded in social constructivism, explored the experiences of early career occupational therapists applying occupational justice in Singapore. Using snowball sampling of 2020 and 2021 graduates, participants engaged in one-time semi-structured interviews, which were transcribed verbatim and thematically analysed.

Findings: Of 140 potential participants, 10 responded and completed the study. Four themes were developed: (1) Feeling uncertain about occupational justice, (2) Perceived relevance in the Singaporean context, (3) Early career challenges and (4) Aspiration to be agents of change.

Conclusion: Early career occupational therapists expressed uncertainty in applying occupational justice concepts, often confusing them with occupation-centred practice. Despite recognising individual influences, they felt ill-prepared to tackle systemic barriers and advocate for broader social change. However, participants were aware and willing to support occupational justice ideals, suggesting a need for more guidance to integrate individual therapeutic goals with societal advocacy.

Introduction: The measurement of handgrip strength is widely accepted for assessing and evaluating hand function. Age and gender are known factors that correlate directly with the handgrip strength. This review aimed to identify whether other biological and functional factors influence adult handgrip strength and if so, which are the most important.

Method: A systematic review was performed on studies that examined handgrip strength in relation to biological and functional factors including anthropometric characteristics, occupation, hand dominance and ethnicity within a working-aged population.

Results: The search retrieved 19 studies which were critiqued using the McMasters Critical Appraisal Tool. This review concludes an individual's height, hand length, hand width/palm width, forearm circumference and hand dominance along with their occupation influence handgrip strength in addition to the established categories of age and gender. It is recommended that future research examines how these factors influence handgrip strength to allow for improved interpretation of handgrip strength in comparison to normative data sets.

Introduction: There is a growing body of evidence regarding the contribution to the management of chronic pain by occupational therapists. However, there is limited research available regarding contemporary practice in the United Kingdom (UK).

Method: An on-line questionnaire was circulated via social media, profession specific publications and specialist interest groups. Responses were requested from UK-based Health and Care Professions Council registered occupational therapists who identified working with those living with chronic pain and their friends, family and supporters.

Findings: A total of 26 occupational therapists responded. Occupational therapists are working in diverse service settings, offering a range of interventions and recognised the unique contribution by occupational therapists to this area of practice. Perceived barriers to delivering intervention included staffing levels, understanding of the occupational therapists' role and suggestions for additional interventions were stated.

Conclusion: This research increases understanding of UK-based occupational therapist's current practice in pain management and views of their role. It provides considerations for further research including how to increase awareness of occupational therapy's contribution to this area of practice, exploring the occupational needs of individuals and those of friends, family and supporters to ensure intervention is designed to best meet the needs of this population.