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

Background. With a rapidly aging population, ensuring the safety and independence of older adults, particularly those with cognitive impairments, is a key public health priority. Occupational therapists (OTs) play a crucial role by recommending assistive technologies for cognition (ATCs) to support this population. However, little is known about how OTs choose ATCs, and the rehabilitation strategies involved in their implementation. Purpose. This study examines OTs' perspectives on prescribing ATCs to support aging in place, focusing on (1) factors influencing ATC recommendations and (2) effective rehabilitation strategies. Methods. We conducted a descriptive qualitative study with 15 geriatric-focused OTs across three focus groups. Discussions were analyzed through three steps: coding, refining, and creating data matrices. Findings. OT recommendations are influenced by client factors (e.g., learning ability), specific tasks (e.g., medication management), and contextual elements (e.g., financial support). OTs employ cognitive rehabilitation, practice simulations, and caregiver collaboration strategies to support ATC integration. Conclusions. Understanding how OTs choose and apply ATCs provides insights to optimize their use in geriatric care, promoting safer, independent living for older adults.

Background. Cognitive screening tools rely on vision and hearing. However, sensory impairments, alone or in combination, can hinder the accurate identification of cognitive difficulties. Purpose. We investigated how occupational therapists adapt the administration of cognitive screening tests to clients who present with vision and/or hearing impairments as well as their self-perceived satisfaction with comprehensive service delivery with this population. Method. An online survey of Canadian occupational therapists gathered cross-sectional data on their approaches in their practice. Results. Occupational therapists reported a range of environmental and person-level accommodations. However, the type and number of accommodations provided, as well as satisfaction with service delivery, did not vary by years of experience or work setting, regardless of the sensory group (hearing, vision, or both). More challenges were observed when screening the cognition of clients with dual sensory impairment, as indicated by fewer reported assessment modifications and lower self-satisfaction with service-delivery skills. Conclusion. The results of the current study highlight the need to develop standardized and effective strategies to enhance cognitive screening for individuals with sensory impairments, along with initiatives for education and training for occupational therapists.

Background: Stroke rehabilitation includes both restorative and adaptive interventions. There are few specific guidelines regarding adaptive interventions.

Purpose: To determine the effectiveness of adaptive interventions on participation outcomes generally, and more specifically by theoretical focus of the intervention.

Method: Systematic review. Relevant databases were searched for randomized controlled trials of adaptive interventions that included a participation measure. Data were extracted and Hedges' g was calculated for all interventions and then by intervention classification.

Results: Fourteen named interventions were examined in 24 studies. When all interventions were considered, the following was observed: a medium effect on person-specific participation goals that approached significance (0.60; [95% CI: -0.06; 1.26], p = .07), a negligible and non-significant effect on broad participation (0.10; [95% CI: -0.13; 0.33], p = .37), and a small to medium significant effect on instrumental activities of daily living (IADL; 0.37, [95% CI: 0.12; 0.62] p = .004). Studies evaluating person-specific participation were dominated by learning-focused interventions, while studies evaluating broad participation and IADL were dominated by coping-focused interventions.

Conclusion: Learning- or motivation-focused approaches appear to have an important impact on person-specific participation goals. Future research should focus on clarifying the effectiveness of these interventions and improving impact on broader participation.

Background: People with Parkinson's disease (PwPD) experience increasing disability due to progressive motor and non-motor symptoms. Comprehensive rehabilitation approaches are needed to maximize their daily functioning. CO-OP targets daily functioning and has established efficacy in populations with similar symptom profiles.

Purpose: To explore the potential of CO-OP for PwPD, a feasibility randomized controlled trial (RCT) was conducted.

Methods: Consenting PwPD (n = 20) were recruited to a parallel group, assessor masked RCT. Following baseline assessment, participants were randomized to CO-OP (20 sessions:10-weeks) or a waitlist control (WLC; 0 sessions: 10 weeks). Goal attainment, functional and cognitive status, quality of life, self-efficacy, transfer, and maintenance were measured. Data were analyzed using descriptive statistics and multiple regression analysis.

Results: Effort (M = 3.02/5) and enjoyment (M = 3.15/5) ratings; homework completion (M = 91%) and protocol adherence (M = 82%) indicate that CO-OP is feasible. CO-OP was superior to the WLC on Canadian Occupational Performance Measure (COPM) performance (p=<.001), COPM satisfaction (p=<.001), and Performance Quality Rating Scale (PQRS; p=<.001) but not the Goal Attainment Scale (GAS; p = .123).

Conclusions: Addressing a critical gap in Parkinson's disease management, findings suggest that CO-OP is implementable, feasible, and potentially beneficial for PwPD. Further research is warranted to further establish efficacy.

Background. Occupational therapists are obligated to promote human rights and are required to advocate for the profession's statements concerning social justice to align with its actions. Purpose. This Commentary provides an anti-oppressive perspective, developed from the different positions and identities of authors currently living in Canada, contending that the practices of occupational therapists cannot be viewed as disconnected from global conflicts such as the genocide of Palestinians, and providing guidance for those seeking to align their actions with the profession's espoused values and obligations. Key issues. Identifying anti-oppression as an ethical, moral, and professional imperative, this commentary articulates a principled examination of a complexified issue; providing suggestions for how occupational therapists, as individuals and as a profession, can engage in anti-oppressive practices through: (a) commitment to learning, (b) reflexive and reflective personal work, (c) the use of guiding frameworks, (d) building community, and (e) compassionate actions. Implications. Noting that there is never a neutral or apolitical position in the face of injustice, the paper invites dialogue, and provides suggestions and guidance for occupational therapists seeking to align their actions with their professional obligations in supporting human and occupational rights locally and globally.