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

Background. Chronic pain brings on many lifestyle changes. Redesign your Everyday Activities and Lifestyle with Occupational Therapy (REVEAL(OT)) is an evidence-based Danish intervention that benefits the daily functioning of individuals living with chronic pain. Purpose. To understand the perspectives of patients, clinicians and managers about REVEAL(OT) and identify format- and content-related modifications that are necessary to adapt to the Canadian context. Method. Based on a qualitative descriptive approach, focus groups and individual interviews with partners (n = 45 participants in total) were conducted in two Montreal specialized pain clinics. The interview guide was inspired by Proctor's implementation model and a qualitative rapid analysis was performed. Findings. Participants recognized the need for (a) a flexible, personalized and hands-on intervention, (b) integrating multimodal approaches, (c) support to develop and implement healthy life habits, (d) addressing gaps in care supporting the need for an OT intervention, and (e) pragmatic organisational considerations for implementation. Conclusion. REVEAL(OT) is capable of addressing the occupational needs of patients but adaptations are required to fit within a new healthcare ecosystem. Our findings promote the use of lifestyle-oriented interventions along with current care and will generate the initial intervention manual to be tested and refined.

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. Developmental coordination disorder (DCD) may persist into adulthood, reduce function, participation, and quality of life (QOL). The negative impacts of DCD are mainly studied in children. Purpose. To explore the interrelations between factors affected by DCD in adults, with a focus on emotional/cognitive burdens, self-efficacy, and examine their direct/indirect effects on QOL. Methods. Based on Adult Developmental Co-ordination Checklist (ADC) cutoff scores, 240 adults were divided into three groups: (1) suspected DCD (s-DCD), (2) probable DCD (p-DCD), and (3) normal motor coordination. Participants completed the Depression, Anxiety and Stress Scale - 21, General Self-Efficacy scale, Daily Living Questionnaire (functional cognition), and The World Health Organization Quality of Life Questionnaire brief form. Structural equation modeling examined mediation effects. Findings. The p-DCD group had the lowest emotional status, functional cognition, self-efficacy, and QOL and significantly differed from the s-DCD group in functional cognition. Emotional distress and self-efficacy mediated between motor coordination and QOL. Conclusion. The emotional-cognitive burdens in adults with DCD are related to motor deficits severity, reduced self-efficacy, and lower QOL. DCD should be screened and treated in adults to reduce daily life restrictions and elevate QOL.

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.

[Formula: see text]Aliki ThomasOccupational therapy has long drawn strength from its ability to integrate diverse forms of knowledge, scientific evidence, clinical expertise, patient narratives, and embodied wisdom. This lectureship explores the profession's epistemic identity: how we develop, validate, and apply knowledge in practice, and how this identity enables us to respond to complex health and social challenges. Drawing on historical and contemporary case examples, the author examines the evolution of occupational therapy knowledge, tracing shifts from intuitive, relational care to evidence-based models and toward today's epistemically pluralistic landscape. She argues that occupational therapy is not only shaped by multiple forms of knowledge but also functions as an epistemic community, one that holds authoritative, policy-relevant knowledge and contributes meaningfully to interdisciplinary networks. This identity positions occupational therapists to influence care models, policy directions, and systems transformation. However, our influence depends on epistemic humility, strategic collaboration, and a commitment to bridging research, practice, and lived experience. The author then outlines three key calls to action: (1) strengthening our knowledge base through pluralism and reflexivity; (2) amplifying our collective voice by clarifying professional identity and reducing fragmentation; and (3) increasing our policy influence through purposeful collaboration and leadership. In rapidly evolving healthcare environments, occupational therapy must assert its role not only in delivering services, but in stewarding integrated, context-sensitive knowledge that drives equity, participation, and justice.

Background. Racism is ingrained within the Canadian healthcare system, resulting in health inequities for Black, Indigenous, and people of colour (BIPOC) service users, healthcare workers, and students. Occupational therapy students spend a large amount of their training with fieldwork educators within these environments. Purpose. Explore the experiences of occupational therapy fieldwork educators in relation to supporting students witnessing or experiencing racism during fieldwork education. Method. Using an interpretive description research design, with a semi-structured interview guide, we conducted individual and group interviews with nine occupational therapy fieldwork educators with a minimum of two years of clinical experience. Data analysis included data immersion, independent coding by multiple team members, and grouping and collapsing data to develop categories. Findings. All participant educators discussed racism with students, but had varying levels of comfort doing so. The participants used reflection as a tool to support students learning about racism. Participants were "self-taught" regarding racism and wanted help to develop their own, as well as their students' skills in responding to racism. Conclusion. Health organizations and universities need to work in an integrated way to prioritize anti-racism education for all occupational therapy students and practitioners, and to develop multipronged systems for the disclosure and addressing of racism.

Background. Occupational therapists have a responsibility to strive for culturally safer assessments with Indigenous Peoples. Purpose. Explore occupational therapists' approaches related to culturally safer assessment strategies with Indigenous Peoples, including their perspectives, recommendations, and challenges. Method. Occupational therapists working with Indigenous Peoples across Canada were invited to participate in online surveys and virtual storytelling groups. Data was analyzed with descriptive statistics and thematic analysis. Member checking and collaboration with Indigenous project members consolidated final themes. Findings. Forty-three participants completed surveys and 16 participated in storytelling groups, with three distinct themes emerging: importance of building relationships, the complex nature of obtaining consent, and how systemic barriers negatively affect occupational therapists' capacity to provide culturally safer assessments. Findings are presented in a composite conversation between an occupational therapist and an Indigenous Knowledge Keeper. Conclusion. Despite systemic pressures towards efficiency and standardized approaches, occupational therapists are attempting efforts towards culturally safer assessments by advocating for occupation-based, culturally relevant, and flexible assessment processes that respect the autonomy of Indigenous service recipients. Future research could explore the current state of curricula related to assessment practices with Indigenous Peoples in Canadian entry to practice occupational therapy programs and perspectives from Indigenous occupational therapists and service recipients.

Background. Cultural approaches are used to acknowledge the diversity and the social positioning individuals bring into the therapeutic relationship. Purpose. This scoping review describes the utilization of cultural approaches to build and sustain therapeutic relationships between immigrant families of disabled children and occupational therapists. Method. This scoping review was based on the methodological framework developed by Arksey and O'Malley. Six databases were searched, and 24 articles published between 2010 and 2025 were included. Results. Cultural competence, cultural sensitivity and cultural humility were the cultural approaches mentioned in 15 studies, with nine not mentioning a specific cultural approach to facilitate the therapeutic relationship. All the studies outlined strategies to facilitate the relationship. Various culturally appropriate communicative and collaborative strategies were used to (i) establish rapport and trust (ii) align goals and intervention and (iii) facilitate advocacy and participation. These strategies were independently described and were not specific to any approach. Conclusion. Facilitating the therapeutic relationship with immigrant families of disabled children does not align specifically with any of the cultural approaches within occupational therapy. This reinforces the need to focus not on the cultural approaches, but on refining the strategies required to facilitate the therapeutic relationship.

Background. Fine motor skills such as folding, writing, and cutting are daily activities of children, yet reliable, valid tools to qualitatively assess these skills remain limited. Purpose. To develop the Hands-On! observation tool and evaluate its reliability and validity in assessing fine motor skills in 5- to 10-year-old children. Method. Hands-On! was created using literature review and expert feedback to determine intratask components for folding, writing, and cutting. The sample included 178 typically developing children (M_age 8.06 ± 1.58 years, 47.8% boys). Inter- and intraobserver reliability were measured, alongside concurrent (duration and errors DCDDaily) and construct validity (age, sex) for each task. Findings. Moderate to very strong interobserver (folding 84.5%-84.9%, writing 81.8%-86.0%, cutting 75.4%-83.8%) and intraobserver reliability (folding 92.8%, writing 91.7%, cutting 93.7%) were found. Concurrent validity was supported by moderate to strong correlations between qualitative scores for folding (ρ_duration = 0.624, ρ_folds = -0.441) and cutting (ρ_duration = 0.335, ρ_errors = 0.377) with DCDDaily metrics, though no significant correlation was found for writing. Construct validity was supported for folding and cutting, with age and sex explaining 22.1% and 14.1% of the variance. Conclusion. Hands-On! is a reliable and valid qualitative observation tool for assessing fine motor skills in children, enhancing assessment practices, and informing effective interventions.