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

Background. Research on racism within occupational therapy is scant, though there are hints that racialized therapists struggle. Purpose. This paper examines experiences of racism in occupational therapy, including coping strategies and resistance. Method. Ten therapists from racialized groups (not including Indigenous peoples) were recruited for cross-Canada, in-person or telephone interviews. Transcripts were coded and inductively analysed, with data thematically organized by types of racism and responses. Findings. Interpersonal racism involving clients, students, colleagues and managers is supported by institutional racism when incidents of racism are met with inaction, and racialized therapists are rarely in leadership roles. Structural racism means the experiences of racialized people are negated within the profession. Cognitive sense-making becomes a key coping strategy, especially when resistance is costly. Implications. Peer supports and community building among racialized therapists may be beneficial, but dismantling structures of racism demands interrogating how whiteness is built into business-as-usual in occupational therapy.

Background: Cognitive orientation to daily occupational performance (CO-OP) is a client-centered treatment approach that was developed in the 1990s by occupational therapists. Purpose: Exploring current evidence about the effectiveness of CO-OP on children with cerebral palsy (CP). Method: Major electronic databases were searched. A narrative synthesis of current literature and meta-analyses on randomized control trials (RCTs) were conducted on changes in occupational performance. Findings: Seven studies with 103 participants were included. Four studies were RCTs with moderate levels of evidence, and three studies had single-subject designs. Although beneficial effects of CO-OP on goal achievement and transferring learned skills were reported, meta-analyses showed that CO-OP had no significant effect on the performance (WMD = 1.52, 95% CI = -1.58 to 4.63, P = .33) and satisfaction domains (WMD = 1.71, 95% CI = -1.14 to 4.57, P = .24) of Canadian Occupational Performance Measure scores compared to alternative interventions. Implications: CO-OP improves occupational performance but not more than alternative interventions. Results are inconclusive due to small sample sizes and heterogeneity of alternative interventions and participants. Therefore, research with a larger number of participants with sound RCT methods is needed.

Background: Psychosocial sequelae are common for individuals with physical injuries to the upper extremity. However, psychosocially oriented interventions are not common in this occupational therapy practice area. Purpose: This study implemented an online survey of hand therapy patients' psychological symptoms. Second, it explored patients' interest in one psychosocially oriented intervention: mindfulness meditation. Methods: The design was a cross-sectional survey of 120 consecutively recruited hand therapy patients. Survey measures included functioning, psychosocial factors, and trait mindfulness. Findings: Anxiety was prevalent in this sample, and moderately correlated with trait mindfulness (r = -0.542, p < .001). While most participants (77%) indicated mindfulness meditation would be an acceptable intervention, women were 2.8 times as likely to be interested (p = .044). Implications: Psychosocially oriented interventions are indicated in hand therapy based on the prevalence of these symptoms. Further examination of using mindfulness meditation in hand therapy is warranted due to patient interest.

Background. A growing body of occupational therapy knowledge and practice focuses not on health but on social transformation, and couples occupational therapy with community development. A tension in both these fields is the disconnect between what practitioners espouse and what they do, limiting the potential of practice. To address this, practitioners are encouraged to engage in praxis-the critical synthesis of theory and practice. Purpose. To explore whether and how Australian occupational therapy-community development practitioners engage in critical praxis. Method. A critical dialogical method was employed to complete multiple in-depth interviews with four occupational therapy-community development practitioners. Interviews were transcribed and analyzed using thematic analysis. Findings. Practitioners appeared capable of praxis but were not consistently employing it. Findings were grouped into themes: disjointed praxis, authentic praxis, supporting praxis, and praxis challenges and solutions. Implications. Occupational therapists need to be supported to develop, use, and maintain skills in critical praxis.

Background: Emotional-behavioural problems in children present a barrier to engagement and participation in school occupations. Applying practice theory is an essential process to explore the impact of clinical problems and to orient clinical thinking to the domain of occupation. Purpose: Occupational therapy practice theory and frameworks are applied to the formulation of School-Based Filial Therapy, a viable treatment response to emotional-behavioural problems in children. Key issues: Bowen family systems theory, the Occupational Therapy Practice Framework IV and the Canadian Model of Occupational Performance and Engagement are applied to intervention formulation. Implications: School-Based Filial Therapy engages the dynamic interaction of the person, the occupations he/she engages in and the environment via therapeutic medium of play. It is consistent with the Occupational Therapy Practice Framework IV and the Canadian Model of Occupational Performance and Engagement and provides new possibilities as an intervention for occupational therapists working in children's mental health.

Background. Algo is an integrated knowledge translation (IKT)-based algorithm for supporting occupational therapists (OTs) with skill mix for selecting bathing equipment. While IKT approaches are increasingly valued in implementation science, their benefits with respect to the utilization of knowledge in clinical settings are scarcely documented. Purpose. To identify Algo's level of utilization and the characteristics associated with its level of utilization. Method. A cross-sectional correlational study was conducted with OTs working in homecare services (HCS) through an online survey based on Knott and Wildavsky's classification and the Promoting Action on Research Implementation in Health Services (PARIHS) framework. Findings. Almost half (48%) of the OTs surveyed (n = 125; participation rate: 16%) reached one of the seven levels of utilization. While Evidence characteristics are perceived as facilitators to its utilization, Context statements indicate an unfavorable organizational climate to the implementation of change. Implications. Strategies should target additional stakeholders (e.g., HCS managers) and organizational adjustments in HCS to sustain Algo's utilization.