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

Background. The Canadian Occupational Performance Measure (COPM) is used by occupational therapists (OTs) to identify problems in the occupational performance of patients, and its use is currently expanding within geriatric rehabilitation (GR). However, due to the complexity of the target group concerns have been raised regarding consistency of administration between OTs. Purpose. To assess the interrater reliability of the COPM in routine GR practice. Method. In two GR wards with patients aged 65 years and older, two different OTs administered the COPM to the same patient. We calculated the overlap in prioritized occupational problems, as well as the intraclass correlation coefficients (ICC) of the COPM-Performance and COPM-Satisfaction scores. Findings. Twenty-six participants, mean age 79 (SD 7.6) with largely orthopaedic and neurological diagnoses, were assessed twice within 2-5 days (mean 3, SD 0.9). We identified a total of 355 problems, mostly in the domain selfcare (N = 222). For the 112 prioritized problems, two OTs had a 65% overlap. ICC values for COPM-Performance and COPM-Satisfaction were 0.566 and 0.567, respectively. Conclusion. In GR, the COPM has moderate IRR and a moderate percentage of overlapping prioritized occupational performance problems. Therapists should be aware of the potential scoring problem within GR and should invest in training.

Background. Previous research addressing the use of humour in rehabilitation has demonstrated positive benefits that have potential to contribute to collaborative relationship-focused practice. Some research points toward the multidimensional functions of humour in stroke practice, although little is known about the use of humour within occupational therapy specifically. Purpose. This study aims to uncover Canadian occupational therapists' perspectives on the risks and benefits of humour use with people who have sustained a stroke. Method. Through a Delphi study consisting of three rounds of surveys, occupational therapists identified and ranked risks and benefits of using humour. Findings. Consensus was reached on a total of 32 benefits, highlighting the role of humour in building rapport, enhancing communication, promoting emotional well-being, and increasing client motivation and engagement in therapy. These findings underscore the potential of humour to build relational capital and thereby potentially facilitate positive rehabilitation outcomes in ways consistent with collaborative relationship-focused practice. Two risks associated with humour use also gained consensus, focusing on comprehension/interpretation challenges and differences in humour preferences between clients and therapists. Conclusion. This study contributes evidence-informed insights to guide clinical practice and education, advancing our understanding of humour use as a relational practice of use in promoting collaborative relationship-focused practice for individuals post-stroke.

Background. Technology can be a bridge to support the strategy of aging-in-place and enable older adults to remain at home and live more independently. Purpose: To investigate the impact of occupational therapist-led smart home technology educational sessions for older adults. Method: A concurrent embedded mixed methods design was used, wherein a descriptive qualitative sub-study was embedded within the predominant quasi-experimental quantitative design. Technology use, independence, social isolation, and experiences were documented. Findings: Thirty-nine older adults participated in the learning program and 14 participants completed semi-structured interviews. Most participants discussed being interested in purchasing technology in the future. Of those that purchased technology, they predominantly felt the technology helped them to feel safer in their homes and regarding their health. All participants stated that they learned about technologies they did not know were available and that the course was helpful. Conclusion: Educating older adults about the benefits and uses of smart home products contributed to the purchase or intent to purchase these products among most participants. The ability for this technology to address home safety and health monitoring is important for health providers and home modification experts to keep in mind while informing policymakers supporting aging-in-place.

Background. Many Canadians experience health disparities when accessing health care. Occupational therapists have historically advocated for the elimination of health disparities. However, occupational therapy was founded in colonial ideals and systems, which continue to perpetuate health disparities. Purpose. Understand how Canadian occupational therapists describe the challenges and opportunities involved in addressing health disparities in provision of care. Methods. We used an interpretative descriptive methodology. Criterion and snowball sampling was used to recruit participants across Canada. Data from semistructured individual interviews were analyzed using reflexive thematic analysis. Findings. A total of 11 occupational therapists (M = 1, F = 10) participated. Four central themes were identified: (1) health equity is a core principle of occupational therapy, (2) systemic barriers are central to the occupational therapy process and can affect the delivery and access of equity-centric care, (3) occupational therapists as advocates against health disparities, and (4) health disparities must be considered when hiring and retaining occupational therapists in practice. Conclusion: Our study highlights the successes and challenges of the field of occupational therapy in addressing health disparities, providing constructive suggestions to move the field forward. Our study provides important implications for research, practice, and policy; these goals are aligned with recent initiatives from the Canadian Association for Occupational Therapists.

Background. Presented as a response to unmet social needs and a way toward a more equitable, sustainable, and healthier society, social prescribing (SP) is gaining international attention. However, it also faces challenges and criticisms, particularly regarding its evidence base, implementation processes, and relevance across diverse contexts. To date, little is known about its compatibility with preventive occupational therapy, notably with Lifestyle Redesign (LR), a landmark intervention that shares similarities with SP. Purpose. To synthesize knowledge about SP, its areas of compatibility and tension, as well as its linkages with LR. Key issues. While evidence regarding SP is conflicting, a critical examination of its connection with LR could help better meet the complex and evolving needs of older adults, especially those facing structural or social marginalization. Given their affinities, SP and LR present several promising points of integration, including: (1) offering LR within social prescription, (2) assigning a dedicated SP navigator to LR, and (3) positioning occupational therapists as SP navigators. Implications. Linking social prescribing and LR could contribute to tackling global public health priorities such as loneliness, social isolation, and chronic diseases, while advancing knowledge and practices that empower occupational therapists to address social determinants of health.

RésuméDescriptionLa crise climatique est une source de préoccupations pour plusieurs individus. Elle peut induire plusieurs éco-émotions comme l'éco-anxiété, laquelle est une inquiétude occasionnée par les conséquences visibles et nombreuses de la crise climatique. L'éco-anxiété peut mener à l'éco-paralysie chez un individu, notamment lorsque celui-ci s'impose des auto-privations occupationnelles qui ont un impact sur sa santé et son bien-être. Bien que l'éco-anxiété puisse avoir des impacts occupationnels, le rôle des ergothérapeutes auprès des individus éco-anxieux n'a pas à ce jour été exploré.ButCette étude avait pour objectif d'explorer les rôles des ergothérapeutes auprès de clients éco-anxieux.MéthodologieUn devis de recherche inductif de nature qualitative a été utilisé. Des entretiens individuels semi-dirigés ont été menés avec des ergothérapeutes de la francophonie de trois pays (Canada, France, Suisse).RésultatsQuinze ergothérapeutes s'identifiant comme femmes ont participé à l'étude. Elles estiment toutes que l'ergothérapeute peut soutenir les individus éco-anxieux et décrivent comment y parvenir, et ce, en clinique, en enseignement, en milieu communautaire et en recherche. Ce faisant, elles utilisent des ressources théoriques et pratiques propres à l'ergothérapie et d'autres externes à la profession.ConclusionLes résultats de cette étude identifient des moyens de transformer les pratiques ergothérapeutiques pour mieux soutenir les individus éco-anxieux. Considérant que leur nombre est appelé à croître et que les activités humaines sont au cœur de la crise climatique, l'ergothérapeute se révèle un acteur de choix pour soutenir ces individus.

Background: Lifestyle Redesign^® occupational therapy (LR-OT) originated in the Well Elderly studies as a preventive intervention for older adults, demonstrating positive health and cost outcomes. Although LR-OT later expanded to chronic condition management and inspired numerous programme adaptations for different contexts and populations, systematic reporting of intervention modifications remains scarce. This gap extends beyond OT, reflecting a broader movement in implementation science.

Purpose: This study applies the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) to systematically document adaptations across four LR-OT programmes. Additionally, we examine fidelity-consistency by mapping programme components to the Well Elderly programme and core LR-OT elements.

Methods: Four teams implementing adapted programmes-diabetic foot ulcer self-management, primary care chronic condition management, Remodeler sa Vie for French-Canadian older adults, and LR weight management-participated in a structured mapping exercise to align programmes with FRAME and LR-OT principle components.

Results: Adaptation approaches varied from highly structured to loosely standardized methods. Despite numerous modifications, all programmes strongly aligned with LR-OT's core characteristics and domains.

Conclusion: This study highlights LR-OT's adaptability across diverse contexts while maintaining fidelity to its foundational framework. Findings contribute to implementation research, providing a model for systematically documenting and characterizing adaptations made to client-centred, evidence-based OT programmes.

Background. Engagement in meaningful social and everyday activities is crucial for maintaining overall well-being and quality of life. However, individuals diagnosed with dementia are more likely to experience a decline in participation, which can lead to social isolation and loneliness. This highlights the need for programs that help individuals to adapt to the changes following a dementia diagnosis. Journeying through Dementia (JtD) is one such program, designed to encourage continued meaningful participation. Purpose. This study aimed to explore the feasibility of implementing the JtD program in Quebec and to collect preliminary data to inform future trials. Five feasibility criteria were assessed: (a) acceptability of the program; (b) appropriateness of content and delivery; (c) adherence and retention; (d) suitability of recruitment strategies; and (e) appropriateness of outcome measures. Methods. A single-site exploratory feasibility study was conducted, guided by the Medical Research Council (MRC) framework. The intervention consisted of eight 2-hour group sessions held at a research center. The MRC framework also guided data collection and analysis. Finding. Three participants completed the program. They reported several benefits and found both the content and delivery appropriate. Adherence and retention rates were high. Partners also expressed interest in participating in the study and contributed valuable insights. Feedback on recruitment and the use of outcome measures was provided for consideration in the next phases of the study. Conclusion. Findings support the feasibility and acceptability of the JtD program in the Québec context and highlight considerations for future evaluation.