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

Background. The COVID-19 pandemic led to abrupt occupational disruption for all people. However, some populations, like older adults, were disproportionately impacted particularly in the earlier waves. Purpose. The purpose of this study was to explore and understand how the occupational participation of community-dwelling older adults was experienced during the COVID-19 pandemic, using the Canadian Model of Occupational Participation (CanMOP) to contextualize findings. Method. Sixty-seven older adults participated in semi-structured interviews from September 2020 to May 2021, 37 of which also participated in a follow-up interview one-year later. Findings. Using reflexive thematic analysis, four themes were generated: (1) experiences of loss are complex and layered for older adults, (2) technology as a medium for occupational participation, (3) risk perception influences return to occupation, and (4) age-related challenges for older adults resuming volunteer work. Conclusion. Increasing frequency and severity of influenza pandemics and other disasters are a global concern, and OTs can use their skillsets to foster participation and expand occupational possibilities for older adults. The CanMOP was a helpful tool to understand the nuances underlying the participation of older adults in this context.

Background. To evaluate effectiveness of The Greenhouse for autonomy and independence to prepare adults with severe cerebral palsy (CP) for the transition from assisted to independent living. The intervention combines weekly individual sessions using Pathways and Resources for Engagement and Participation together with weekly group sessions. Method. Seven adults with severe CP ages 23-45 years (M = 35; SD = 10) participated in the 20-week program. An Interrupted Time Series quasi-experimental design was used, assessing the intervention effect over time. The Canadian Occupational Performance Measure was administered bi-weekly from baseline to post-intervention to assess activity performance. Functional Independence Measure (FIM), Wheelchair use Confidence scale (WheelCon) and Impact on Participation and Autonomy (IPA) were administered baseline (4 weeks pre-intervention), mid and post-intervention, using Freidman test. Interviews were conducted four weeks after intervention. Findings. All participants' activity performance improved over time with significant clinical improvement in 95% of COPM goals. Significant improvement was seen in FIM (χ²= 8.07, p = .018) and WheelCon (χ²= 7.18, p = .028) though not in IPA. Participants described being better prepared, however more aware of challenges. Conclusion. The findings suggest the program may be effective to help adults with severe CP attain goals related to independent living and enhance function.

Background. The prevalence of low vision and blindness in persons across the lifespan means that occupational therapists will encounter these conditions across all areas of practice. Practitioners must be equipped with competencies necessary to recognize and respond to vision loss-related concerns. Purpose. This study sought to identify essential occupational therapy competencies when providing services to people with low vision and blindness. Method. The study employed a three-phase modified Delphi methodology administered through online surveys and focus group. Respondents included people with low vision or blindness, professionals with special expertise in low vision/blindness, and occupational therapists in other practice areas. Data were analyzed using an iterative, consensus-generating strategy involving quantitative analysis of competencies, qualitative input, and expert panel review. Findings. The process yielded a 51-item competency framework organized into six domains. Implications. The framework provides the foundation for a common curriculum for Canadian occupational therapy programs and for the creation of educational resources.

Background. Adolescents with neurodevelopmental disorders (NDDs) have an increased risk of participation limitations. Occupational therapy faces knowledge-to-practice gaps among this population. Purpose. To examine the effectiveness of a continuing-education program for occupational therapists working with adolescents with NDDs. Methods. The study used a mixed-method design, including pre-post comparisons of competence and sense of self-efficacy of occupational therapists to work with adolescents with NDDs. Interviews regarding the program's perceived contribution to practice were conducted. Results. Post-program results showed significantly (p < .001) higher professional competence and self-efficacy for interventions and evaluation skills with NDD's adolescents and transition programs as well as higher knowledge about adolescence and NDDs characteristics. Contrary, there was no change in competence and self-efficacy regarding client-centred interventions with adolescents. Program participants increased their professional confidence and incorporated evidence-based methods into routine practice. Conclusions and Implications. The continuing-education program that was examined expanded the occupational therapy practitioner's knowledge and professional skills, resulting in a change in their capacity to practice with adolescents narrowing the knowledge-to-practice gap. Future studies involving the client perspective, regarding their participation may validate and support continuing-education program for occupational therapists.

Background. People with kidney failure who undergo hemodialysis treatment and experience chronic fatigue identify negative effects on occupational performance and participation as a key aspect of their illness experience. Purpose. To describe the occupational performance and participation problems of people treated with hemodialysis who live with debilitating fatigue. Method. Fifteen participants, who were randomized to participate in an energy management intervention as part of a randomized controlled trial, completed two occupation-based assessments at baseline and chose three priority occupational performance or participation problems to address as goals during the intervention. Results were analyzed using descriptive statistics (counts and percentages). Findings. Fifteen participants (mean age 60, 53% male) completed the occupation-based assessments. Participants stated that they wanted or needed more energy for a median of 22 of 55 occupations. Going out for food/drinks (n = 11), going to a movie/concert/performance (n = 10), and food preparation/clean-up (n = 10) were the top occupations for which participants required more energy. Prioritized occupational performance and participation problems most often fell within the household management (14 goals), self-care (6 goals), and hobbies (5 goals) domains. Conclusion. Occupational performance and participation problems are extensive among people treated with hemodialysis who live with debilitating fatigue. There is a clear need for occupation-based interventions that optimize occupational performance and participation in this population.

Introduction. In 2022, the World Health Organization (WHO) predicted that climate change would cause thousands of additional deaths per year from malnutrition, malaria, diarrhea, and heat stress alone between the years of 2030 and 2050. With such health consequences and environmental changes, climate change is impacting human occupations globally. However, there is a gap in the literature regarding the occupational therapists' role in climate change, particularly in the Canadian context. Objectives. Our research aimed to explore what is the perceived role of occupational therapists in climate change and climate action from the perspective of Canadian occupational therapists and international experts. Methods. This qualitative study used interpretive description methodology. We recruited 12 occupational therapists, including 4 research experts in the field. We conducted semi-structured interviews with each participant. Data were analyzed thematically. Results. This study uncovered three themes that focused on the complex interconnections between climate challenges and climate actions that occupational therapists are wrestling with personally, clinically, and professionally. Specifically, this study emphasized the importance of supporting individual occupational therapists with their personal challenges, integrating climate actions into clinical practices, and incorporating climate change and climate justice into occupational therapy curricula and professional advocacy. Conclusions. The environment, including the planet's ecosystem, is a fundamental component in many models of occupational therapy practice. This research provides a rich understanding in the themes of occupational therapists' perceptions of climate change and climate actions, particularly within a Canadian context.

Background: Occupational therapy clinical education was disrupted because of the COVID-19 pandemic. This introduced both challenges and opportunities in clinical fieldwork education and created a naturalistic opportunity to study the innovations that occurred. Purpose: To identify and describe fieldwork education innovations that occurred during the COVID-19 pandemic and understand how these clinical learning contexts impacted competency development in occupational therapy learners. Method: A qualitative multi-case study methodology was used. The participants (N = 28) were occupational therapy learners and preceptors who self-identified as having participated in an innovative fieldwork placement during the pandemic either as a preceptor or learner. Data were collected via in-depth interviews and analyzed to identify cases of innovation. Within and across case analyses were conducted to describe innovations and competencies addressed. Findings: Three cases of fieldwork innovations were identified: (a) Virtual Care; (b) Intrapreneurship; and (c) Administration. The commonly addressed competency domains across the cases were OT Expertise, Excellence in Practice, and Communication and Collaboration. The competency domain, culture, equity, and justice, was only addressed in the virtual care case. Conclusion: Our findings indicate that innovative fieldwork placements can support competency development in occupational therapy; however, this development is complex and contextually based.

Background. Knowledge about the needs of parents with neurological disorders who take care of young children is limited. Purpose. The overall aim of this qualitative study was to explore the perceived unmet parent needs, current supports, and potential solutions to optimize supports of parents with neurological disorders in early childhood in a Canadian setting. Method. Focus groups and individual interviews with parents (n  =  8), spouses (n  =  5), rehabilitation clinicians (n  =  8), community partners (n  =  7), and researchers (n  =  7) were conducted with a total of 35 participants recruited using convenience sampling. Inductive iterative thematic analysis was performed. Findings. The participants identified the need for society to officially recognize parenting with disabilities, adjust public policies, increase the scope of public programs, consider child development and family well-being, and have barrier-free communities. Conclusion. Providing customized solutions that will adequately fill perceived service gaps is of utmost importance to address these families' needs.

Background. Occupation is the core domain of occupational therapy, and an occupational perspective is foundational for practice. Research has explored how an occupational perspective is taught. Yet, little has explored the Canadian occupational therapy educational context. There are national differences in core competencies and accreditation standards and nuances in how occupation is defined and what conceptual models are used. As such, a Canadian perspective may offer new understandings of value both within and outside of Canada. Purpose. To understand how, in Canada, educators teach and evaluate student occupational perspectives in entry-level master of occupational therapy programs. Method. This study used a descriptive qualitative design with an interpretive approach. Semi-structured interviews were used to gather data from 12 educators from Canadian entry-level occupational therapy programs. Reflexive thematic analysis was used for data analysis. Findings. Five themes were identified: (1) occupational perspectives as pedagogy (2) it's a process, not an end state; (3) "everybody is involved": a community of educators; (4) thinking critically; and (5) "hard to evaluate." Conclusion. The complex, dynamic, and contextualized nature of an occupational perspective calls for critical, reflexive, communal, and innovative pedagogical and assessment approaches.