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

Introduction. Occupational therapy (OT), a profession deeply entrenched in colonial ideologies, also holds the potential to re-imagine healthcare in collaboration with Indigenous communities. Purpose. This review aims to (1) identify decolonizing practices in OT that can be applied at micro, meso, and macro levels of service delivery and (2) elevate the voices and viewpoints of Indigenous scholars. Method. I conducted a literature review based on a decolonized and relationship-focused approach, using the work of Tynan and Bishop. Seventeen articles were reviewed and guided by moss bag teachings. Findings. By encouraging actions people can do to enact decolonization practices, we hope that non-Indigenous people can critically think about ways in which to challenge coloniality and enact meaningful, relational, and respectful relationships. (1) micro: Before building relationships, occupational therapists need to understand their work environment to create meaningful connections and improve service delivery. (2) meso: occupational therapists in leadership should support Indigenous occupational therapists and fairly compensate them to respect Indigenous knowledge genuinely. (3) macro: occupational therapists involved in creating knowledge must recognize and promote Indigenous knowledge to benefit Indigenous OT students and communities. This paper is not meant to be a prescriptive "what not to do" as this varies across each unique situation. Conclusion. Effective actions must be implemented at all levels of service provision, recognizing that all clinicians, researchers, and educators are urged to transform and challenge the normative and colonial status quo ingrained in the OT profession.

Background. The environment is essential to occupational participation. However, the involvement and training of occupational therapists in universal accessibility (UA) seems limited. Purpose. To explore the content on UA taught in university occupational therapy programs in Canada. Method. This study adopts a mixed methodology. A survey, including mostly quantitative data, was distributed to occupational therapy programs across Canada, and course syllabi related to UA, providing qualitative data, were requested. Analysis included descriptive statistics and content descriptive analysis. Findings. Thirteen out of 14 programs responded to the survey and five provided course syllabi. While all programs cover UA content, only seven offer specific courses on accessibility. Internships related to UA are offered by seven programs. Some gaps identified include limited knowledge, lack of in-depth content, and limited interprofessional collaboration. There are variations in emphasis on UA and teaching approaches. Boundaries between universal approaches and knowledge of specific disability groups are poorly delineated. UA is unanimously considered essential in the training of occupational therapists. Conclusion. The content in UA is heterogeneous across programs. Consensual definitions of accessibility concepts related to occupational therapy are needed to better define the role of the occupational therapist in this area.

Background. Parents of children with special needs are more likely to experience stress and have health-related problems. Pediatric occupational therapy interventions that build parents' capacity are often considered to be effective. It remains unclear how they can be offered without overburdening parents. Purpose. The purpose of this article is to share the findings from the evaluation of a flexible capacity-building occupational therapy service with seven families. Method. A convergent parallel mixed methods design was used to document parents' and occupational therapists' perspectives on the services, including outcomes, strengths, weaknesses, opportunities, and threats. Findings. Parents reported understanding their children better, having more positive attitudes toward the challenges experienced, feeling more confident that they could help them, and having more satisfactory family routines. The importance for therapists to develop nonjudgmental collaborative relationships, to be flexible and to use the time available to help families with what matters the most in their daily lives came out particularly loudly. Conclusion. This study provides a concrete example of how it is possible to build families' capacities without overburdening them. It also provides guidance to establishments wishing to take a step back to think about how they build families' capacities.

Background. People with kidney failure who undergo hemodialysis treatment and experience chronic fatigue identify negative effects on occupational performance and participation as a key aspect of their illness experience. Purpose. To describe the occupational performance and participation problems of people treated with hemodialysis who live with debilitating fatigue. Method. Fifteen participants, who were randomized to participate in an energy management intervention as part of a randomized controlled trial, completed two occupation-based assessments at baseline and chose three priority occupational performance or participation problems to address as goals during the intervention. Results were analyzed using descriptive statistics (counts and percentages). Findings. Fifteen participants (mean age 60, 53% male) completed the occupation-based assessments. Participants stated that they wanted or needed more energy for a median of 22 of 55 occupations. Going out for food/drinks (n = 11), going to a movie/concert/performance (n = 10), and food preparation/clean-up (n = 10) were the top occupations for which participants required more energy. Prioritized occupational performance and participation problems most often fell within the household management (14 goals), self-care (6 goals), and hobbies (5 goals) domains. Conclusion. Occupational performance and participation problems are extensive among people treated with hemodialysis who live with debilitating fatigue. There is a clear need for occupation-based interventions that optimize occupational performance and participation in this population.

Background. To evaluate effectiveness of The Greenhouse for autonomy and independence to prepare adults with severe cerebral palsy (CP) for the transition from assisted to independent living. The intervention combines weekly individual sessions using Pathways and Resources for Engagement and Participation together with weekly group sessions. Method. Seven adults with severe CP ages 23-45 years (M = 35; SD = 10) participated in the 20-week program. An Interrupted Time Series quasi-experimental design was used, assessing the intervention effect over time. The Canadian Occupational Performance Measure was administered bi-weekly from baseline to post-intervention to assess activity performance. Functional Independence Measure (FIM), Wheelchair use Confidence scale (WheelCon) and Impact on Participation and Autonomy (IPA) were administered baseline (4 weeks pre-intervention), mid and post-intervention, using Freidman test. Interviews were conducted four weeks after intervention. Findings. All participants' activity performance improved over time with significant clinical improvement in 95% of COPM goals. Significant improvement was seen in FIM (χ²= 8.07, p = .018) and WheelCon (χ²= 7.18, p = .028) though not in IPA. Participants described being better prepared, however more aware of challenges. Conclusion. The findings suggest the program may be effective to help adults with severe CP attain goals related to independent living and enhance function.

Background. The severe functional impact of long COVID presents a significant challenge for clients seeking to return to work. Despite emerging clinical management guidelines, long COVID remains a concern in the rehabilitation field. There is a need to establish optimal practices for sustainable rehabilitation paths that enhance the recovery of clients with long COVID, all while understanding the challenges faced by rehabilitation professionals working with this population. Purpose. This study aimed to explore the perspectives of rehabilitation professionals intervening in long COVID rehabilitation with the goal of returning to work. Methods. A qualitative study was conducted involving online semi-structured interviews with rehabilitation professionals in Quebec from public and private sectors across various regions who had experience treating individuals with long COVID. Thematic analysis was employed for data analysis. Findings. Nine rehabilitation professionals participated in the study, yielding five themes: (a) reassessment of RTW goals; (b) education and self-management as primary interventions; (c) gradually reintegrating daily activities and life habits; (d) progression of interventions and dealing with post-exertional malaise (PEM); and (e) challenges in long COVID rehabilitation. Conclusion. Education, gradual activation and self-management appear as central components in supporting patient recovery, however, achieving return to work remains challenging without proper accommodations.

Background. Amid growing calls for relational teaching approaches in higher education to improve student learning outcomes and student and educator well-being, a need remains for effective relational pedagogies. Therapeutic-use-of-self (TUS) is an occupational therapy skill that centers the client-occupational therapist relationship, yet there is a dearth of research exploring its application as a pedagogy. This presents an opportunity for a widely used occupational therapy skill, TUS, to be adapted as a much-needed relational pedagogy. Objective. We explored the experience of TUS as a relational pedagogy in occupational therapy education from educator and student perspectives. Method. This qualitative description study borrowed from the evocative methodology of collaborative autoethnography. We, six researcher-participants, across two Canadian entry-to-practice occupational therapy programs, engaged in five discussions exploring the relationship between participant stories and contexts. Reflective memoing and reflexive thematic analysis were applied for analysis. Findings. Four themes were described: (a) education as transaction, (b) authenticity in learning, (c) experiencing TUS, and (d) relationship as resistance. Conclusion. With an emphasis on authenticity, empathy, power equity, and critical reflexivity, TUS challenges status quo approaches to education. Although neoliberalism challenges the feasibility of relational pedagogy in higher education, TUS holds promise as a relational and critical pedagogy.

Background: In inclusive schools, collaboration between occupational therapists (OTs) and teachers has the potential to build capacities among these school-team members working with students with disabilities. Current evidence supports multi-tiered delivery models, such that OT interventions are integrated within the context of school life. Collaboration, however, is a complex multifaceted phenomenon that poses systemic, organizational, or interpersonal challenges. Purpose: This qualitative descriptive study explored the perspectives on current and ideal collaborative practices and associated contextual barriers and facilitators related to collaboration, as described by elementary teachers and OTs. Method: Two focus groups were conducted with OTs (n = 5) and elementary teachers (n = 6) working in inclusive schools in Québec (Canada) in French and English language settings. Qualitative data were transcribed and analyzed thematically. Findings: Four thematic categories were identified: Organization of services scaffolds collaborative practices; varying perspectives of the OT role influence collaboration; establishing and navigating collaborative relationships; and considerations for optimal collaboration. Conclusion: These findings have practice and policy implications regarding the organization of OT services as well as team professional development. Understanding these challenges is fundamental to tailoring future knowledge translation interventions to optimize school collaboration.

Background. Motor vehicle accident (MVA) injuries can result in persistent impairments which contribute to chronic pain, mental health symptoms, and decreased quality of life. Occupational therapists play a key role in the rehabilitation of those injured in MVAs yet there is lack of evidence to inform occupational therapy practice. An explicit understanding of the factors influencing post-MVA recovery from occupational therapists' perspectives is needed to inform clinical service delivery. Purpose. This study addressed the following question: From the perspective of occupational therapists, what factors are identified as influencing recovery following a noncatastrophic injury sustained in an MVA? Method. An interpretive descriptive study design was used. Data were collected through semistructured interviews with 10 occupational therapists who provide auto-insurer funded occupational therapy to clients with noncatastrophic injuries from an MVA. Data were analyzed using constant comparative analysis. Results. Physical symptoms and accessibility, acceptance, social support, access to occupational therapy, and navigating the insurance system were factors identified as influencing post-MVA recovery. Conclusion. This study highlights the importance of using a biopsychosocial lens when working with clients post-MVA. Recovery post-MVA needs to be considered in the context of the insurance system, as navigating the insurance system was a predominant factor influencing recovery.

Background: Given the well-documented professional identity challenges experienced by occupational therapists, reinforcing the profession's identity (collective and individual) is crucial for navigating changing environments and optimizing its contribution. The Muriel Driver Memorial Lectureship is an important component of the collective identity of the profession in Canada.

Purpose: A professional identity lens was used to trace the evolution of the profession's collective identity in Canada through this lectureship.

Method: Using sociological professional identity theory, a documentary longitudinal analysis was conducted on the 43 published lectureship articles (1975-2023), identifying key messages, values, knowledge, and practices.

Findings: Eight main themes were identified: professional identity, epistemology, axiology, change and leadership, contribution, history, quality, and technology. The analysis revealed an evolving common base of values (occupation, client-centred, social justice) and knowledge (occupation-centred). Persistent challenges included defining theoretical foundations, resisting the biomedical model, and realizing the social vision in practice. The lectures highlighted occupational therapists' evolving roles and ability to contribute to and lead change.

Conclusion: The lectures provide insights into the evolution of occupational therapy's collective identity in Canada. Despite ongoing challenges, the contemporary context appears to be increasingly favourable for occupational therapists to practise consistent with the collective identity trends identified.