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

Background. National and provincial professional associations and regulatory bodies for occupational therapists (OTs) in Canada emphasize culture, equity, and justice as essential competencies. This study investigates the diversity within the occupational therapy profession and explores OTs' perspectives on providing culturally responsive care to members of equity-deserving groups, with a particular focus on cultural competence and agility. Method. OTs were administered a cross-sectional mixed-methods survey that included demographics, the Cultural Competence Assessment Instrument (Two subscales: Awareness and Sensitivity and Competence Behaviour), and an open-ended question examining their perceived cultural competence. Quantitative data were analyzed using descriptive statistics, and qualitative themes were determined through content analysis. Findings. A total of 240 OTs participated in this survey, with an average age of 45.3 (22.5), identifying primarily as females/women (90.7%). Less than half of respondents (41%) identified their race; of those who did, they were primarily of Southeast Asian descent (21.3%). OTs had lower scores for Cultural Awareness and Sensitivity (3.17/7 [3.11, 3.23]) and for Cultural Competence Behavior (3.22/7 [3.08, 3.37]). While highlighting the healthcare system distrust and barriers to culturally responsive care, most felt confident addressing them. OTs reported that greater awareness and inclusivity at individual and systemic levels are needed. Conclusion. Our sample of OTs suggests little diversity related to gender, race, and ethnicity. OTs in Canada vary in their perceptions of health disparities, barriers for patients in accessing and receiving health care, and efficacy in addressing barriers.

Background: School-based occupational therapy (SBOT) is shifting from pull-out interventions for students with special needs to tiered models focused on inclusion and participation. There are several noted benefits of tiered models. However, research has suggested that challenges exist in the transition to tiered models that are consistent with ethical tensions. It is unclear how occupational therapists are navigating the transition to tiered models, including addressing ethical tensions.

Purpose: The purpose was to advance knowledge and understanding regarding ethical tensions experienced by school-based occupational therapists in transitioning to tiered models of SBOT. The research question was: What are the perceived ethical tensions experienced by occupational therapists in transitioning to tiered models of service delivery in SBOT?Method.Interpretive description was employed. Interviews were conducted with 11 self-nominated occupational therapists. Data analysis consisted of preparation, organization, and interpretation followed by a member checking focus group.

Findings: Occupational therapists experienced ethical tensions around five inter-related ethical principles-fidelity, veracity, autonomy, confidentiality, and distributive justice.

Conclusion: The transition to tiered SBOT exacerbated or created ethical tensions. Engaging established implementation guidelines can provide a structured framework to inform large-scale service delivery changes, lessening ethical tensions while eliciting desired outcomes.

Background. Cultural humility is increasingly embraced as a theoretical lens that occupational therapists, educators, and researchers can use to promote justice and inclusion in diverse contexts. Cultural humility differs from cultural competence in its recognition of power and bias and its invitation to embrace advocacy and lifelong learning. Key Issues. Occupational therapy scholarship on cultural humility neither confronts the profound challenges of putting cultural humility into practice nor articulates strategies to integrate cultural humility into daily life and work. These challenges, including perceived objectivity, difficulty identifying power structures, and emotional responses to difference, are particularly salient when belief systems are in clear opposition. In such situations enacting cultural humility requires intellectual, emotional, relational, and community building strategy and skill. Implications. To support development of such skills, conceptual practices are outlined here with a focus on uprooting biases, building self-compassion, identifying multiple, co-occurring dimensions of power, and supporting development of collaborative advocacy vision and strategy. This work offers both theoretical and practical knowledge to advance cultural humility praxis in occupational therapy.

Description. Occupational therapists support individuals and organizations in achieving healthy participation in the workplace. In this context, it is important to consider multiple identities, such as gender, ethnicity, or disability, when analyzing occupational inequalities and injustices that people encounter at work. The concept of intersectionality has the potential to support occupational therapists, but it remains difficult to recognize in practice. Purpose. The purpose of the study was to identify the operational characteristics of the concept of intersectionality at work. Methodology. Based on a scoping review design, 29 documents from various disciplines were selected. Data were extracted using a structured grid and analyzed using a thematic approach. Results. The results identified five operational characteristics of the concept: the interrelation of identities, the interaction between disadvantages and privileges, power dynamics, idiosyncratic subjective experience, and the relationship to oneself and others. Our results also reveal that these characteristics must be considered within their context, particularly their historical context. Conclusion. This study provides occupational therapists with a framework for analyzing and intervening in complex situations, thereby helping to promote equitable participation in the workplace.

Background. The 2015 Truth and Reconciliation Commission of Canada issued Calls to Action, urging Canadians, including health-care providers, to address colonial harms and pursue reconciliation. Occupational therapists, guided by the Canadian Association of Occupational Therapist's Position Statement, are called to provide culturally safer care. However, little is known about how they engage in reconciliation in practice. Purpose. This study examines how occupational therapists integrate reconciliation into their practice and identifies influencing factors. Method. Reflexive thematic analysis was applied to data from semi-structured interviews with 11 occupational therapists. Discussions explored reconciliation efforts and related challenges. Findings. Occupational therapists foster reconciliation through building relationships with Indigenous communities and engaging in lifelong learning, such as accessing Indigenous knowledge and resources. Key barriers include gaps in foundational education and difficulties translating rhetoric into meaningful action. Participants stressed the need to deconstruct Western paradigms and adopt culturally responsive, non-Western approaches. Relationality, community engagement, and continuous learning emerged as central to reconciliation and culturally safer care. Conclusion. This study contributes to the national dialogue on truth and reconciliation by offering a foundation to understand truth and reconciliation in the context of occupational therapy. This may help to address systemic and anti-Indigenous racism in the profession.

Background. Although Lifestyle Redesign^® is an important preventive occupational therapy approach fostering meaningful routines to support health and well-being, little data exists to support its implementation in new sociocultural contexts. Purpose. To explore facilitators and barriers to a future implementation of the French-Canadian Lifestyle Redesign^® (Remodeler sa vie^®) in occupational therapy practice, as perceived by occupational therapists (OTs), occupational therapy students, decision makers and community partners. Method. Guided by the Consolidated Framework for Implementation Research, this action-research study involved 58 purposefully selected participants trained in the approach. Eleven focus groups were conducted using three semi-structured interview guides and facilitation tools. Findings. Participants (86.2% women, aged 20 to 72; mean = 43.2, SD = 12.5) identified 36 influential factors, with public sector OTs facing the most barriers. Key facilitators included the approach's strong evidence base, its relevance to aging populations, key actors' openness and engagement, and new social trends. Barriers stemmed from the approach's complexity, resource constraints, socio-political challenges, implementation efforts and uncertainty about older adults' engagement in this approach. Equitable access to the approach was a common concern. Conclusion. By addressing the factors influencing the implementation of Remodeler sa vie^®, this study advances knowledge on integrating preventive approaches to promote healthy aging in Canada and internationally.

Background. The concept of occupational possibilities has been integrated within guiding documents for Canadian occupational therapy to turn attention towards implicit and explicit root factors producing occupational inequities. Purpose. This mixed-methods citation analysis examined how the concept of occupational possibilities has been used in occupation-focused scholarship, attending to the knowledge generated and how its critical intents are enacted. Method. Peer-reviewed articles citing one or both of the two seminal publications regarding occupational possibilities were included. A descriptive analysis of 93 articles was conducted, along with a qualitative analysis of 43 articles that extensively integrated the concept. Findings. The concept of occupational possibilities has been increasingly used in scholarship since 2016 in ways that have deepened understanding of the discursive, systemic and structural forces perpetuating occupational inequities, and countered individualistic conceptualizations of occupational "choice." This scholarship has identified key starting points for promoting equity through transforming occupational possibilities. Conclusion. There is an emerging body of knowledge that can inform reconfigurations of occupational therapy scholarship, education and practice in ways aligned with contemporary calls to counter occupational inequities through diversifying occupational possibilities, with such reconfigurations requiring sustained engagement in collective critical reflexivity to ensure disruption of oppressive power relations.

Background. The Research on Education Committee of the Association of Canadian Occupational Therapy University Programs (ACOTUP) hosts an educational research community of practice (CoP). Occupational therapy educators across Canada meet through this CoP to network and advance research on education. While the literature has noted benefits of participating in a CoP for the professional development of occupational therapists, there is a paucity of studies focusing on educational researchers' participation in a CoP. Purpose. This study aimed to examine CoP members' perceptions of the value of, and barriers to, participation in an educational research CoP. Method. A mixed methods design, consisting of an online survey followed by focus groups, was employed to gain insight into participants' perspectives and experiences of involvement in the CoP. Data were analyzed inductively and deductively using collaborative qualitative analysis. Findings. Members identified benefits of participation arising from networking and being a part of a supportive community. They described gaining new insights, social relationships, and inspiration to continue their pedagogical research. The data also highlighted limitations to participation and suggested ways to enhance meaningful engagement within a CoP. Conclusion. The CoP provides value to educators and researchers in supporting their pedagogical practices and professional careers. This knowledge could be leveraged to support its members and other CoPs.

Background. Excessive screen time is a real public health issue among young people given its negative consequences. It is important to rely on proven interventions to better support young people in adopting a healthy and meaningful lifestyle. The Lifestyle Redesign occupational therapy approach could help achieve this, but it has not yet been documented or explored with this population. Purpose. To demonstrate the relevance of adapting and testing the Lifestyle Redesign approach with young people who spend excessive amounts of time in front of screens, in the hopes of inspiring research or innovation projects in youth practice settings. Key issues. Many young people spend too much time using screens during their leisure activities. During adolescence, young people tend to increase their screen time during leisure activities, while also isolating themselves socially, struggling with boredom, and replacing physical activity with sedentary activities. Therefore, effective interventions would help to improve the life balance of these young people. Implications. A project to adapt and test the Lifestyle Redesign approach for young people would address this need. This project could include young people aged 10 to 12, their parents, and key partners. Drawing on other evidence-based practices related to commitment and screen time reduction would be beneficial to the intervention, which should also target, among other things, developing young people's repertoire of interests.

Background. Fieldwork is essential in postsecondary health professions programs and can present challenges for disabled students. Fieldwork coordinators, responsible for student placements, play a pivotal role in supporting disabled students. However, limited research exists regarding the experiences of these coordinators in accommodating students with disabilities. Purpose. This mixed methods study aims to understand the perspectives of academic fieldwork coordinators in occupational therapy programs, focusing on their practices to support disabled students and promote a sense of inclusion. Method. Using a mixed methods approach, fifteen academic fieldwork coordinators completed a quantitative survey followed by in-depth semistructured interviews with five coordinators. Results. Participants' experiences presented two main themes. First, academic fieldwork coordinators constantly navigated tensions with institutional norms regarding fieldwork. Second, academic fieldwork coordinators manage fieldwork accommodations within ever-changing human dynamics and social norms, including students' decisions about disclosure. Despite these gaps, the participants emphasized opportunities for enhancing and refining occupational therapy programs by addressing challenges to improve inclusivity for students with disabilities. Conclusion. Addressing these accessibility issues can contribute to the overall improvement of educational practices, fostering a more inclusive learning environment. Examination of the institution's infrastructure, collaboration with disabled individuals, and greater personnel training are key in promoting a more inclusive and supportive environment for both academic fieldwork coordinators and disabled students.