British Journal of Occupational Therapy最新文献

Purpose: Measurement of postburn injury is important to assess impact of interventions, monitor symptoms, and direct treatment. Outcome measures are important to enable patients' views to be incorporated into their clinical care and direct healthcare. To date, there are few patient-reported outcome measures specific for the burn's population, only one specific patient reported questionnaire exists for hand burn injuries. For outcome measures to be person focused, it is important to have individuals who have experienced the injury join the development team to consult and advise on properties for inclusion. The aim of this study was to co-design a specific outcome measure for severe hand burn injuries.

Methods: Participatory Action Research was used to co-design the outcome measure with experienced allied health professionals, individuals with hand burn injuries, and researchers. Participatory Action Research acknowledges the depth and breadth of experience of all co-researchers. Content analysis was used to systematically analyze meaning and relationships from each cycle.

Results: In cycle 1-the constructs for measurement and activities for inclusion in the outcome measure were selected over a series of virtual meetings. The 18 activities included measure patterns of hand movement, pinch, and grip strength, which can be repeatedly measured over time across recovery. In cycle 2-two rating scales were developed one for clinicians and one for patients.

Conclusion: The newly developed outcome measure will require further testing to determine psychometric properties.

Introduction: There are over 43,000 occupational therapists across the United Kingdom, with mental health occupational therapists being acknowledged as a main workforce of OT services. However, staff shortages are occurring, and urgent action is needed to retain this important workforce.

Methods: The systematic literature search was conducted in the CINAHL, PsycINFO and Scopus databases to identify research literature published since 2008. Due to the heterogeneity of the included studies, a narrative synthesis was utilized.

Results: A total of 20 studies (21 papers) were included in the review. Five thematic factors - well-being at work, organizational work environment factors, job resources, supervision and staffing, along with various subtheme factors emerged from the synthesis. The findings suggest that retaining mental health occupational therapists is a complex issue, affected by many factors. The study emphasizes the triangular relationship among three aspects of well-being (job satisfaction, professional identity and burnout) at work and introduces the concept of a 'Retention Ecosystem'. This illustrates how subtheme factors interconnect and influence the retention of mental health occupational therapists.

Conclusion: The retention of mental health occupational therapists is revealed to be a multifaceted challenge. There is a need for developing more targeted, meaningful and holistic strategies for retaining the current mental health occupational therapist workforce.

Introduction: This study aims to evaluate the effect of an occupation-focused and occupation-based group intervention for fatigue management on the perception of environment barriers and social participation, and secondarily the impact on quality of life and sleep quality.

Material and methods: For this quasi-experimental study, 19 participants with a mean age of 45 (13.7), with 84.2% having Relapsing-Remitting Multiple Sclerosis with Expanded Disability Status Scale mean 2.6, were recruited. The outcome measures were administering pre-post test, and the follow-up was at 3 months using T-test for inferential analysis. The outcome measures used for the primary outcomes were the Craig Hospital Inventory of Environmental Factors scale, the Community Integration Questionnaire, and the Impact on Participation and Autonomy.

Results: All outcomes showed statistically significant improvement after treatment. At 3-month follow-up, the results maintained positive results except for the General Sleep Disturbance Scale and the MSQoL-54, which showed a slight worsening in total scores with respect to post-treatment.

Conclusion: This study fits into a widely studied context, emphasizing the importance of implementing occupation-focused group interventions for fatigue management. Furthermore, this study showed that this type of intervention leads to an improvement on the perception of environmental barriers and social participation.

Introduction: The recent UK Royal College of Occupational Therapists survey found a significant proportion of respondents expressed an intention to leave the profession despite the majority agreeing that occupational therapy is a rewarding career. This scoping review aimed to synthesize the literature on enablers and barriers to career planning and development for occupational therapists working in mental health.

Methods: We searched Embase, CINAHL, Medline, Scopus, Web of Science, TROVE, Research Direct and websites of relevant professional organizations.

Results: Twenty-six papers were included. Most of the articles were set exclusively in Australia and can be categorized into: career planning and development, workforce planning, onboarding, recruitment and retention. Resource shortages, gender, age, unmet expectations, organizational demands and the lack of a career pathway framework were identified as barriers. Enablers of career success include undergraduate mental health practice placements, early career programmes, personal motivation, greater flexibility, professional resilience, leadership training and research opportunities.

Conclusion: A better understanding of the factors that influence career development can facilitate focused recruitment and help retention.

Introduction: Occupational therapists in acute practice are increasingly likely to work routinely with people in later life who drink alcohol. Therefore, this knowledge translation study aimed to evaluate the development of a continuing professional development Learn@Lunch programme, designed to enhance awareness and understanding of occupational therapists who work in an acute hospital setting, of drinking alcohol as an occupation in later life.

Method: Guided by the Promoting Action of Research Implementation in Health Sciences framework, the continuing professional development programme was developed, and a qualitative evaluation undertaken. This included pre- and post-focus groups with occupational therapists (n = 8) in an acute setting, where the programme was delivered, pre- and post-programme delivery interviews with the research champion recruited from the site, and one interview with the Allied Health Professions Service Lead.

Findings: Findings indicate the Learn@Lunch continuing professional development programme enhanced therapist knowledge and understanding of the changing patterns of drinking alcohol in later life. However, practical barriers exist impacting how participants perceived the value and delivery of the programme.

Conclusion: Learn@Lunch was an effective continuing professional development programme and supported enhanced knowledge and awareness of drinking alcohol as an occupation in later life, leading to changes in local acute occupational therapy practice.

Introduction: People ageing with long-term physical disabilities face unique challenges to maintaining independence. We developed a novel, evidence-based intervention - Removing Environmental Barriers to Independent Living - to support participation and reduce falls.

Methods: To examine Removing environmental barriers to independent living's feasibility and estimate its magnitude of efficacy, we conducted a single-blinded randomised controlled trial. Fifty participants who were aged 45-65 years with a physical disability for at least 5 years were randomised to intervention (n = 24) or control (n = 26). Activity performance, environmental barriers to performance, community participation, environmental fall hazards and fall prevention behaviours were assessed at baseline and at 6-month follow-up. Dose, adherence, fidelity and cost were examined. Linear mixed-effects models for repeated measures were used to assess the effects of time, group and group by time interaction on the continuous outcomes.

Results: Removing environmental barriers to independent living had high fidelity and adherence and a low implementation cost. There were trends for greater improvements in activity limitations and activity performance among intervention versus control participants.

Conclusion: Removing environmental barriers to independent living is a feasible intervention with high fidelity and adherence. Findings trended towards greater improvements in activity performance for intervention participants. Results could inform future planning for a larger pragmatic trial.

Background: Goal-directed training is an evidence-based occupational therapy intervention for children with cerebral palsy targeting motor performance and goal attainment. There is variability and limited description on goal-directed training delivery within the studies who found it a successful intervention. The aim of this study was to establish the who, what, why and how of goal directed training according to practicing occupational therapists.

Methods: Occupational therapists currently delivering goal-directed training to children with cerebral palsy were recruited. Qualitative data were collected from structured, open-ended interviews and analysed through content analysis. Themes and consensus answers were elicited and mapped to the Template for Intervention Description and Replication checklist.

Results: Four key elements were identified as essential for goal-directed training: goal setting, task analysis, active intervention and evaluation. Within each area, occupational therapists provided rich descriptions of what these elements looked like in practice. Despite having a clear understanding of goal-directed training, some barriers to implementation were identified.

Conclusion: Occupational therapists identified key elements and barriers to implementing goal-directed training in their practice. It is recommended that further support and training is provided to ensure that occupational therapists deliver goal-directed training with high fidelity.

Introduction: Current interventions provide limited success in managing mental health in adolescents with emerging difficulties. We describe using the Intervention Mapping framework to co-develop a novel occupational therapy theory-informed intervention for adolescents with emerging mental health difficulties, addressing the need for interventions tackling activity-related determinants.

Methods: We describe a mixed-method, multiphase, sequential study design informed by the six-step Intervention Mapping framework, to develop the Activity Time Use intervention. Involving a systematic scoping review, time-use survey, qualitative focus groups and Delphi consensus process informing the construction of an intervention logic model of the problem, the logic model of change and creation of an intervention programme.

Results: An eight-session intervention addresses three behavioural change outcomes: improving the balance of daily activities, improving occupational choice making abilities and improving occupational performance. The programme was positively reviewed through Patient and Public Involvement (PPI) consultation against the seven aspects of acceptability (Sekhon et al., 2017). Next steps include exploring the environmental determinants affecting implementation in different intervention delivery settings and full user acceptability.

Conclusions: This study has provided a real-world example of intervention-mapping, systematically developing an occupational therapy intervention to empower adolescents to adopt healthier time-use behaviours to improve their mental health.

Introduction: Fatherhood is a significant transition in a man's life, introducing new challenges. Yet men's experiences of this period remain poorly understood. Occupational therapists possess skills and knowledge to support individuals during transition. This study explored the experiences of men during the transition to fatherhood over the first postnatal year.

Method: Underpinned by an occupational therapy theoretical perspective, a systematic review was conducted. Following searches of databases: AMED, CINAHL, Medline and PsycINFO, qualitative studies meeting selection criteria were retrieved and quality assessed. Data was extracted and synthesised using an established meta-ethnographic approach.

Findings: Seven articles were included in the review. Four interconnected themes: (1) A New Occupational Identity, (2) Relationship Changes, (3) Challenges and Impact, (4) Unmet Occupational Needs, and four subthemes: Roles and Responsibilities, and Adjusting Priorities (theme 1); An Emotional Journey and Exhaustion (theme 3) were identified.

Discussion: Fathers' postnatal transitional experiences were reflective of a journey of adjustment and growth. Experiences indicated the requirement for greater support of fathers throughout the antenatal and postnatal transition. Occupational therapists have the skills to work with fathers to balance occupations, manage fatigue and adjust to new roles. Further research should focus on understanding experiences of men in under-represented groups.