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

Background. Occupational Performance Coaching (OPC) is a goal-oriented approach in which client agency takes precedence in goal selection, analysis, choice of action, and evaluation of success. The intended outcomes of OPC are improved occupational performance and participation in clients' life situations. Randomized clinical trials are needed to determine the effectiveness of OPC. Purpose. This study protocol outlines a randomized controlled trial (RCT) of OPC compared to usual care with caregivers of children with neurodisability in improving child, caregiver, and family occupational performance. Method. A single-blind, 2-arm parallel-group, cluster RCT of OPC compared to usual care is planned. Therapists delivering the intervention (N = 14) are randomized to "OPC training" or "usual care" groups. The primary outcome is occupational performance improvement in caregiver (N = 84) identified goals. Implications. Findings will provide translational evidence of the effectiveness of OPC and clarify intervention processes. Areas of future OPC research and development will be indicated.

Background. Many caregivers of autistic children experience increased stress, and diminished health often due to the caregiving demands. Purpose. The project aim was to design a feasible and sustainable wellness program tailored to these caregivers' lives. Methods. In this collaborative research-informed project, participants (N = 28) were mostly female, white, and well-educated. In focus groups, we delineated lifestyle issues, then designed, delivered and assessed an initial program with one cohort; and repeated this process with a second group. Findings. Focus group data were transcribed then coded qualitatively to inform following steps. Data analysis identified lifestyle issues key to program design, desired program elements, and after program delivery, affirmed elements and recommended changes. The team used meta-inferences to guide program revisions after each cohort. Implications. Caregivers viewed resulting 5Minutes4Myself program as filling a significant service gap; its hybrid design used in-person coaching and a habit-building app with mindfulness content to support lifestyle change.

Background. Pregnancy-related lumbopelvic pain is common and can impact quality of life. Purpose. To synthesize existing qualitative research on people's experiences of pregnancy-related lumbopelvic pain in pregnancy and during the postpartum period. Method. A keyword search of four electronic databases between 2000 and 2022 was completed. Included studies were appraised and synthesized using a meta-ethnographic approach. Findings. Twenty-three studies were included. Analysis identified four core themes: (1) uncertainties about pregnancy-related lumbopelvic pain, (2) struggles to attain achieve treatment and pain management, (3) profound activity consequences, and (4) emotional wellbeing, relationship, and identity impacts of pregnancy-related lumbopelvic pain. Implications. The occupational therapy role with this population has not to our knowledge yet been described. Given the centrality of occupational disruption to the experience of this population we argue that developing and evaluating occupational therapy interventions to address functional, work, parenting and wellbeing outcomes for this population is warranted and should be prioritized.

Background. There is a need for the occupational therapy profession to respond to the Truth and Reconciliation Commission of Canada Calls to Action and work towards supporting the health and well-being of Indigenous Peoples. Purpose. (1) To determine the knowledge gaps of occupational therapists about Indigenous health and (2) to create recommendations to address identified gaps and inform responses from the profession. Method. A national needs survey was created and distributed to occupational therapists across Canada to determine the knowledge of occupational therapists about Indigenous health. Survey results were analyzed using thematic analysis and descriptive statistics. Findings. Data collected from 364 survey responses informed six distinct themes representing knowledge gaps of occupational therapists related to Indigenous health as follows: lack of foundational knowledge, power relations, lifelong learner, need for appropriate tools/approaches, respectful collaboration, and environmental influences. Implications. The project offers insight into the role of the occupational therapy profession in the process of reconciliation. Insights are focused on decolonizing occupational therapy practice, building trusting relationships with Indigenous Peoples, and the provision of appropriate training for occupational therapists to engage in culturally safer practices.

Purpose. Occupations have "implications for individuals, societies, and the earth". This article focusses on implications of occupation in relation to the earth and examines the potential to expand occupational justice beyond anthropocentric viewpoints to honour interspecies justice. Approach. A 'theory as method' approach is used to explore the literature. Transgressive decolonial hermeneutics informs analysis. Key issues. The discussion advances understandings about human occupation in relation to more-than-humans, intersections with human occupations and animals, and ethical relationality. Implications. Occupational justice includes honouring interdependence of species, engaging in occupations in ways that are sustainable, considering future generations, and refraining from occupations that have a destructive or detrimental impact on the earth and more-than-humans. The profession has a collective responsibility to honour Indigenous worldviews and Indigenous sovereignty, recognising and welcoming the potential for Western conceptualisations of occupation to be transformed.

Background. Parkinson's disease (PD) leads to cognitive dysfunction which limits participation and occupational performance. Cognitive Orientation to Daily Occupational Performance (CO-OP) approach is effective in other adult neurological populations and warrants investigation in PD. Purpose. To describe a study protocol evaluating the preliminary efficacy and feasibility of CO-OP approach in PD. Method. A randomised controlled trial (RCT) with adults with PD was assigned to either: CO-OP training-intensive (CO-OP-I, 20 sessions) or waitlist control (WLC) followed by CO-OP-standard (CO-OP-S, 10 sessions). Outcomes. Occupational performance and satisfaction of adults with PD in chosen goals. Measures will be obtained at baseline, post-intervention, and 3-month follow-up. Implications. As the first RCT focused on CO-OP in PD, this trial will provide evidence for the potential of this approach in PD and lay the groundwork for future large-scale trials. Trial Registration. Australian New Zealand Clinical Trials registry, ACTRN12621001483842. Registered November 1, 2021; retrospectively registered 3 months after commencement.

Background. The role of positive psychological factors in acute rehabilitation after total hip replacement (THR) is unclear. Purpose. (a) Examine the trajectory of functional ability among older adults after THR from presurgery to discharge from acute rehabilitation and (b) determine which physical and psychological factors at admission would predict functional ability at discharge and length of stay in rehabilitation. Methods. This prospective cohort study included 30 participants (age M = 76.20 years) from an inpatient geriatric rehabilitation center. They completed the Geriatric Depression Scale and Positive Affect questionnaire. The FIM® Motor domain of Functional Independent Measure (mFIM) was recorded presurgery, at admission, and upon discharge. Findings. Functional ability improved at discharge; however, the presurgery functional ability was not regained. Positive affect explained the length of stay in rehabilitation above and beyond the presurgery mFIM. Implications. Occupational therapists should improve ways to enhance self-care and positive affect in acute rehabilitation.

Background. There is a lack of knowledge on the scope and nature of the research by faculty members in occupational science (OS) and/or occupational therapy (OT) programs in Canada. Purpose. To describe the research activities of faculty members in these programs and directions. Method. A cross-sectional survey was distributed to 173 faculty members across all 14 Canadian OT that addressed: 1) research topics and methods, 2) populations, and 3) funding. Findings. Based on respondents (N  =  121), research is focused on a range of topics and populations with most conducting qualitative research. Many conduct research examining the effectiveness of interventions, with few respondents focused on OS research. Federal and provincial grants agencies were the largest source of funding. Implications. Research topics studied were not always proportional to practice although emerging areas were being investigated that can expand the evidence base and scope of practice. Despite limited occupation-specific funding options, respondents were accessing funding from varied sources. Collaborations among faculty members, clinicians, and individuals with lived experience can create priorities for future OS and/or OT research in Canada.

Background. Technologies are embedded in all daily life activities and are utilized by occupational therapy practitioners to facilitate participation; evidence on technology for adults with intellectual disability (ID) can support practice with the population. Purpose. Summarize the evidence on technology to support adults with ID. Method. Secondary analysis of a scoping review of articles published between 2002 and 2018. Articles in the original scoping review addressed participation, assessment, or interventions with adults with ID. Authors completed a secondary analysis of 159 articles to identify articles with information on technology. Findings. In total, 56 articles met the inclusion criteria. Technology categories were cognitive supports, mainstream technologies, supplemental communication, aids for daily living, seating and mobility, control interfaces, and preparatory technologies. Implications. This secondary analysis demonstrates the range of evidence identifying technology as a key support, the impacts of the proliferation of technologies, and the need for occupational therapy practitioners to advocate for accessible technologies.

Background. Threshold concepts are key to professional identity development, transforming the way individuals think, act, and perceive the world. Purpose. To understand how occupational therapy students describe their professional identity, its importance, and how threshold concepts contribute to identity. Method. Mixed-method survey of final-year occupational therapy students (n = 58) at an Australian University. Findings. (i) High agreement on most identity and threshold questions; but up to 24% uncertain about confidence/competence in understanding specific concepts; (ii) occupation-focus is unique to our professional identity; (ii) identity develops over time; (iii) occupation-based, client-centered, and evidence-based practices are central to thinking like and becoming an occupational therapist; and (iv) practice education provides context for threshold concepts to be transformative. Implications. Identity is defined by a focus on occupation and its relationship to health. Traversing threshold concepts through academic and practice education is essential to developing professional identity.