Canadian Journal of Occupational Therapy-Revue Canadienne D Ergotherapie最新文献

Background. Occupational therapists have been writing about and practicing psychotherapy for almost a century. However, questions about competence and tensions regarding psychotherapy in occupational therapy persist both within and outside the profession. Purpose. To explore the scope of the existing literature on psychotherapy competence written by occupational therapists and/or pertaining to occupational therapy research or practice. Method. A secondary analysis of the 207 articles included in the scoping review by Marshall and colleagues was conducted. Using inductive and deductive approaches, data from 207 articles were screened, extracted, and analyzed to identify themes related to competence in psychotherapy. Findings. The 104 articles included spanned from 1927 to 2020; 50% were non-empirical. The narrative synthesis had one overall theme, Professional Identity, and three subthemes: Competence, Attaining and Maintaining Competence, and The Great Debate. There was no consistent pathway outlined for occupational therapists to attain psychotherapy competence, which may contribute to role confusion and dissonance. Conclusion. This review revealed the reciprocal relationship between professional identity and psychotherapy competence in occupational therapists. Future research should explore how the use of psychotherapy competence pathways impacts professional identity and contributes to practice competence.

Background: The relevance of supporting sustainability within occupational therapy is increasingly demonstrated and argued for. However, difficulties persist in supporting sustainability in practice, which presents occupational therapists with an occupational paradox. Why is sustainability still so difficult to include into occupational therapy practice? Purpose: The objective was to analyse certain assumptions underlying the profession that may constitute potential obstacles to the inclusion of sustainability in practice. Method: To identify and critically examine these assumptions, a philosophical analysis of five key concepts of the profession was carried out based on a triangulation of two philosophical methods. Findings: The results reveal that the five concepts analysed-person, occupation, environment, health, and justice-may act as barriers to support sustainability within the practice. Conclusion: A paradigm shift is therefore relevant, even necessary in the current climate emergency to mitigate its impacts. This is especially relevant as the climate crisis poses the greatest threat to health and endangers the ability of humans to engage in occupations essential for well-being and survival.

Background. Children with developmental disabilities are less likely than their peers without disabilities to meet the Canadian 24-Hour Movement Guidelines which provide daily recommendations for time spent in physical activity, sedentary behaviour, and sleep. Occupational Therapists (OTs) are well-positioned to support the engagement of preschoolers with developmental disabilities in movement but little is known about if, and how, they might use these guidelines. Purpose. This study examined knowledge, awareness, and guideline-, client-, and environment-related factors influencing the use of the guidelines by OTs working with children (aged 3-4 years) with developmental disabilities. The secondary purpose was to explore relationships between these factors and OT education and experience. Method. The validated Clinician Guideline Determinants Questionnaire (n = 51 items) was administered via Qualtrics to a sample of Canadian pediatric OTs. Descriptive statistics were employed. Findings. Participants (n = 28 OTs) reported moderate to high agreement with the guidelines varying by movement type. Participants agreed they possessed the skills, knowledge, and external support to use the recommendations in practice but were less likely to agree with having training, implementation tools, and self-efficacy to implement the guidelines. Conclusion. Canada's 24-Hour Movement Guidelines hold potential for use by OTs, but capacity-building is required to support implementation.

Background: In inclusive schools, collaboration between occupational therapists (OTs) and teachers has the potential to build capacities among these school-team members working with students with disabilities. Current evidence supports multi-tiered delivery models, such that OT interventions are integrated within the context of school life. Collaboration, however, is a complex multifaceted phenomenon that poses systemic, organizational, or interpersonal challenges. Purpose: This qualitative descriptive study explored the perspectives on current and ideal collaborative practices and associated contextual barriers and facilitators related to collaboration, as described by elementary teachers and OTs. Method: Two focus groups were conducted with OTs (n = 5) and elementary teachers (n = 6) working in inclusive schools in Québec (Canada) in French and English language settings. Qualitative data were transcribed and analyzed thematically. Findings: Four thematic categories were identified: Organization of services scaffolds collaborative practices; varying perspectives of the OT role influence collaboration; establishing and navigating collaborative relationships; and considerations for optimal collaboration. Conclusion: These findings have practice and policy implications regarding the organization of OT services as well as team professional development. Understanding these challenges is fundamental to tailoring future knowledge translation interventions to optimize school collaboration.

Background. The severe functional impact of long COVID presents a significant challenge for clients seeking to return to work. Despite emerging clinical management guidelines, long COVID remains a concern in the rehabilitation field. There is a need to establish optimal practices for sustainable rehabilitation paths that enhance the recovery of clients with long COVID, all while understanding the challenges faced by rehabilitation professionals working with this population. Purpose. This study aimed to explore the perspectives of rehabilitation professionals intervening in long COVID rehabilitation with the goal of returning to work. Methods. A qualitative study was conducted involving online semi-structured interviews with rehabilitation professionals in Quebec from public and private sectors across various regions who had experience treating individuals with long COVID. Thematic analysis was employed for data analysis. Findings. Nine rehabilitation professionals participated in the study, yielding five themes: (a) reassessment of RTW goals; (b) education and self-management as primary interventions; (c) gradually reintegrating daily activities and life habits; (d) progression of interventions and dealing with post-exertional malaise (PEM); and (e) challenges in long COVID rehabilitation. Conclusion. Education, gradual activation and self-management appear as central components in supporting patient recovery, however, achieving return to work remains challenging without proper accommodations.

Background. COVID-19 pandemic restrictions necessitated curricular modifications in Canadian occupational therapy education. Documentation and reflection on temporary or permanent curriculum modifications and their perceived impact on student learning and outcomes is critical. Purpose. To explore and compare reported curricula changes (academic and fieldwork) during restricted and post-restricted delivery periods together with the perceived impact on learners. Method. A cross-sectional online descriptive survey was sent to key representatives from administration, curriculum, and fieldwork at all 14 accredited occupational therapy university programs in Canada. Findings. Overall, many pandemic-restricted curricula delivery and assessment changes shifted back toward pre-pandemic methods. Changes that were maintained were congruent with universal design or perceived limited adverse impact on learning. Both in-person and virtual learning were perceived as important for changing practice needs. Fieldwork placement recruitment remained a challenge, with some programs increasing the use of simulation. Interpersonal competency development and assessment method integrity were more visible and of concern. Conclusion. Interpersonal competency development and assessment method integrity were more visible and of concern. Programs demonstrated remarkable flexibility to shift, adapt, and deliver curricula, but the human cost for this accomplishment is still palpable.

[Formula: see text]Background. Societal structures and systems compel occupational therapists, at times, to behave in ways that perpetuate injustices. Justice theorists have described how Global North social structures have created the conditions for oppression of some groups while enabling additional groups to have unearned privileges. Mobilizing critical occupational therapy praxis is an essential response. Purpose. This lecture addresses three questions: why should occupational therapists integrate structural justice, equity, and rights into their everyday practices?; what gives occupational therapy the potential to be a structural justice-, equity-, and rights-oriented profession?; and, how can occupational therapy mobilize critical praxis that will promote structural justice, equity, and rights? Key issues. Occupational therapy's embeddedness in structures of injustice and therapists' obligations to integrate justice, equity, and rights into their everyday practices are increasingly evident. A focus on occupational participation, growing critical consciousness, socially transformative practices, and capacity for collective action position occupational therapy to be a structural justice-oriented profession. Critical reflexivity and reflection; justice-, equity-, and rights-based lenses; and acts of resistance and disobedience to oppressive systems can help mobilize critical praxis. Implications. Occupational therapists have individual and collective opportunities for exercising the moral imagination and moral courage to mobilize critical occupational therapy praxis.

Background. Performance-based outcome measures (PBOMs) are objective measures that assess physical capacity or performance in specific tasks or movements. Purpose. 1) to identify which PBOMs are most frequently reported to evaluate upper extremity (UE) function in pediatric rehabilitation 2) to determine the link between constructs of the ICF and meaningful concepts extracted from each identified PBOM. Methods. Pediatric UE PBOMs were searched in four databases. The selection of outcome measures included an initial title and abstract screening, followed by full-text review of the articles to be included based on identified selection criteria. Two reviewers were appointed to link the meaningful concepts identified in the outcome measures independently and a third reviewer was consulted in case of ambiguity to make a final decision. Findings. After the initial screening, 1786 full-text articles were reviewed, 1191 met the inclusion criteria, in which 77 outcome measures were identified and 32 were included in the linking process. From the included 32 outcome measures, 538 items were extracted and linked to the ICF. The most commonly cited measures included Assisting Hand Assessment, Jebsen-Taylor Hand Function Test, Melbourne Assessment of Unilateral Upper Limb. The Activity and Participation domain represented 364 codes followed by the Body Functions domain domain which represented 174 codes. Implications. A majority of the outcome measures identified were linked with the Mobility, Fine Hand Use of the ICF. Therefore, when selecting a PBOM, careful considerations need to be made regarding which concept of health is to be assessed.