British Journal of Occupational Therapy最新文献

Introduction: Sjögren's disease is an autoimmune disease with dry eyes and mouth and chronic pain, more frequent in middle-aged women. The aim of this study is to understand the impact of Sjögren's disease on quality of life and occupational health.

Method: Quantitative and qualitative comparative study, with 20 Sjögren's disease and 25 healthy controls. Questionnaires and interviews were applied to assess occupational performance, quality of life, mood disorders, and sleep.

Results: The combined major diagnostic parameters for Sjögren's disease (focus score and anti-SSA/Ro positivity) were present in 85% of the Sjögren's disease group. There was a correlation between the sicca symptom measured by the European League Against Rheumatism Sjögren's Syndrome Patient Reported Index (ESSPRI), anxiety, and depression measured by the Hospital Anxiety and Depression Scale (HADS; r = 0.56; p = 0.009), as well as fatigue measured by the Profile of fatigue and discomfort questionnaire (PROFAD) (r = 0.78; p < 0.0001). Sjögren's disease patients reported a loss of physical abilities, sleep disturbance, change in mood, social and occupational participation, and lower quality of life.

Conclusions: Sjögren's disease patients have poorer quality of life, loss of competencies, and sleep disturbances compared to controls. Novel strategies are necessary to improve occupational health in SjD.

Background: Enhancing self-compassion (SC) was found to enhance Quality of Life (QoL). There is a need to comprehend SC manifestations among adults with attention deficit hyperactivity disorder (ADHD) who experience low QoL to provide a foundation for Recovery-based interventions aiming to enhance SC and QoL among adults with ADHD.

Objective: To explore SC manifestations and their relationships with ADHD symptoms and ADHD related QoL.

Methods: A cross-sectional survey used self-rated questionnaires for ADHD symptoms, QoL and SC among 32 adults with ADHD, recruited by a volunteer community sampling.

Results: Moderate overall SC was noted. Negative SC means were found to be higher than the positive SC means. The positive SC subscale common humanity had the lowest mean while the negative SC subscale overidentification had the highest mean. Overall SC level was found to significantly contribute to ADHD symptoms in predicting QoL variance. Overidentification was found to be a significant partial mediator between ADHD symptoms and QoL.

Conclusion: Recovery-based interventions aiming to decrease the tendency of adults with ADHD to overidentify with their negative thoughts and feelings and to enhance their realization that their difficulties are shared by others, may have the potential to enhance SC and QoL.

Introduction: Establishing inter-rater agreement and reliability ascertains that multiple raters consistently evaluate observed interventions to ensure that clinical research protocols are delivered as intended by the trial protocol.

Purpose: Using the Guidelines for Reporting Reliability and Agreement Studies, we (a) exemplified the steps to establish inter-rater reliability and inter-rater agreement on the occupation-based coaching Video Evaluation Tool and (b) evaluated best practices that promoted high inter-rater reliability and inter-rater agreement between blinded raters prior to starting a pilot randomized controlled trial. The randomized controlled trial examined the preliminary effectiveness of occupation-based coaching via telehealth for rural families with children living with type 1 diabetes to improve family quality of life, participation, self-efficacy, and child health outcomes.

Method: We created a library of 13 occupation-based coaching videos portraying a range of evaluations, scores, and ratings. The inter-rater agreement and reliability on the occupation-based coaching Video Evaluation Tool were established through the iterations of (a) blinded rater training, (b) data collection using the tool, and (c) statistical analysis using Cohen's kappa and Cronbach's alpha.

Findings: Occurrence and Non-Occurrence Checklist (κ = 0.881, p < 0.001); "Caregiver Talk" and "Interventionist Talk Analysis" (ICC = 0.991-0.999, p < 0.001); Evidence of Independent Capacity Rating (ICC = 0.867 p = 0.006).

Conclusion: Strong inter-rater reliability and inter-rater agreement was established by engaging two blinded raters through multifaceted training, integrating real-life clients and contexts into the instrumentation and training, and precisely defined rubric criteria. By employing such practices, high inter-rater reliability and agreement can be achieved in clinical research involving interventions and instruments that are highly subjective and individualized. To ascertain greater scientific confidence in the intervention effect, developing a multidomain fidelity framework and establishing high inter-rater agreement and reliability in the instruments a priori to implementation of clinical trials are necessary.

Introduction: From occupational therapy perspective, this study investigates the nature and impact of Long COVID symptoms on individuals in Hong Kong according to their gender, age, and occupation and to understand their treatment needs.

Method: A total of 193 participants with an acute COVID-19 episode 3 months ago and having recovered from it who were experiencing subjective symptoms of Long COVID were recruited through snowball sampling from local COVID-19 support groups and healthcare facilities to participate in a cross-sectional design via an online survey assessing their symptoms and the impact on daily activities, and exploring their treatment preferences.

Findings: Respiratory, systemic, sleep, and cognitive symptoms were found to be the most prevalent, with significant variations in symptom severity and impact on daily life across different age and occupational status groups. The treatment preference was quite strongly inclined to traditional Chinese medicine.

Conclusion: This study has uncovered the critical and yet recognized roles of occupational therapy in managing Long COVID impact by identifying the potential gaps of occupational therapy in its management and calling for advocating promotion in the community and interdisciplinary collaboration with traditional Chinese medicine. Implications about occupational therapy management and the healthcare policies for tailoring treatment programs are discussed.

Introduction: Little is known about the use and aspects impacting the use of the activity chair, which is a device supporting seated activities in everyday life. The aim was to understand (a) purpose of provision, (b) frequency and magnitude of use, (c) barriers impacting use, (d) instruction provided and (e) overall satisfaction with the activity chair.

Method: This is a cross-sectional study involving 141 adult activity chair users. Data were collected through telephone interviews using a study-specific questionnaire with 21 items. Descriptive statistics were used to summarise the quantitative results, and data-driven text analysis was conducted to analyse open-ended question responses.

Results: Most respondents (87%) were provided the activity chair for kitchen work, 87% used the device on a daily basis, 75% used the device for additional activities beyond the provision purpose, 65% experienced barriers impacting use, instructions varied, with 28% receiving none and 16% had received activity-based training, 85% were satisfied with the activity chair.

Conclusion: The activity chair appears to be regularly utilised and appreciated by respondents. However, improved device provision, particularly concerning activity-based training in relevant context and systematic follow up, may be required to reduce barriers impacting use. Findings emphasise the importance of learning from users.

Background: Occupational therapists (OT) are commonly tasked with assessing the functional impact of an executive dysfunctional following a brain injury. Research has highlighted uncertainty in the literature regarding how this phenomenon is understood in occupational therapy.

Purpose: To explore the conceptual understanding of executive function in OT literature and how this influences the professions approach to assessment.

Method: An integrative review of 13 studies was completed using thematic analysis to generate themes in the literature.

Results: Four themes were generated: (1) There is inconsistency in our working definition of executive functions (EF) and what constitutes a component (2) EF is conceptualised in singular complex tasks in the OT literature, (3) There is uncertainty on the accuracy of assessing EF performance in one-off tasks (4) There is uncertainty about what constitutes normal EF performance in an occupation.

Conclusions: This integrative review identifies challenges in the conceptualisation and assessment of executive functions within OT. Inconsistent definitions, reliance on neuropsychological frameworks and standardised assessments, such as the multiple-errands test and executive function performance test, fail to capture the complex and individualised nature of occupational performance. The limited integration of occupational science further hampers the development of OT-specific approaches. Clearer definitions and qualitative research would enable advancements in practice and enhance client-centred interventions.

Objectives: This study examined the effects of a cognitive stimulation group program on cognitive functions, depression, activities of daily living (ADL), and quality of life in patients with mild Alzheimer's disease (AD).

Methods: Sixty patients with mild AD were randomized into the experimental or control groups (30 in each). Both groups underwent conventional occupational therapy for 30 minutes, followed by a 50-minute session of a cognitive stimulation group program for the experimental group and a cognitive workbook group program for the control group. Interventions for both groups were carried out for 4 weeks, five times a week, and once a day.

Results: After the interventions, both groups showed significant differences in cognitive functions, depression, ADL, and quality of life (p < 0.01, p < 0.001), with the experimental group demonstrating slightly higher scores in all assessment items. Significant intergroup differences were found in the scores for memory, the shortened Korean version of the Boston Naming Test, the Elderly Seoul Verbal Learning Test, the Korean version of the Trail Making Test Part A (depression), the Korean version of the Instrumental ADL scale, and quality of life (p < 0.05, p < 0.01, p < 0.001).

Conclusion: It has been shown that the cognitive simulation group program can be an effective intervention method to reduce the depression of mild AD patients and improve cognitive function, ADL, and quality of life. In addition, it is significant that various enjoyable activities were organized for each cognitive domain to induce active participation and motivation of the subjects. It is expected that this study can be usefully used as a guideline for the treatment of AD patients in the future.

Introduction: Picky eating is a complex phenomenon, impacting family routines and relationships. Occupational therapists often work with picky eaters and their families, yet little is understood about the occupational therapy process and reasoning in this context. This study was guided by the following research question: How do Australian occupational therapists choose and deliver interventions for children with picky eating and their families?

Method: This qualitative interpretive descriptive study used in-depth semi-structured online interviews with 10 Australian-based occupational therapists working with children who are picky eaters. Data was analysed inductively following a thematic analysis process, and emergent themes were identified.

Findings: Participants indicated that they used a complex reasoning process, with 'Tailoring Occupational Therapy for Picky Eating' emerging as the central finding. Key factors underpinning these tailored interventions were finding the why; addressing the why; and practising within context.

Conclusion: To our knowledge, this is the first qualitative study to investigate occupational therapists' reasoning processes when working with families impacted by picky eating. Occupational therapists described the complexity of picky eating, and the subsequent reasoning to find suitable interventions. Findings may guide occupational therapists' clinical practice when working with children with picky eating and their families.