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

Background. Despite local training opportunities for Cognitive Stimulation Therapy (CST) for occupational therapists, there has been limited evaluation of the feasibility of implementation in Canada. Purpose. This study explored the feasibility of CST delivery by an occupational therapist in an Ontario health care setting and the impact it may have on self-efficacy and hope measures of individuals with dementia. Methods. A mixed-methods experimental pre/post design was used. Survey measures included hope, self-efficacy, feasibility, satisfaction, and individual session evaluation. Semistructured focus groups were held for participants and facilitators. Findings. Quantitative findings are summarized descriptively for the 10 participants. Qualitative findings were grouped into themes: social connectedness, knowledge gained and shared, tailored implementation adjustments, and need for long-term programing. Implications. Occupational therapists are well-positioned to implement CST and should be a part of further research to test the intervention rigorously for applicability within a range of Canadian health care settings.

Background. Many people with spinal cord injury (PW-SCI) in the Gaza Strip in Palestine are discharged from inpatient rehabilitation with limitations in their ability to meet basic needs, and reach their full potential. There is limited evidence of how clinicians can promote occupational justice for PW-SCI. Purpose. To describe participants' perspectives revealed during a participatory action research (PAR) process used to develop an education manual for PW-SCI in Gaza, using Participatory Occupational Justice as a lens. Methods. Following ethical approval, a four-step PAR design was utilized by eight researchers to co-construct the Spinal Cord Injury Activities of Daily Living-education Manual with 54 participants from SCI rehabilitation settings in Gaza. Qualitative data from eight focus groups were analyzed using inductive thematic analysis. Findings. Two main themes were evident in the participants' viewpoints: Enabling occupational justice and Removing barriers to occupational justice. Implications. Occupational justice is a central value that needs to be considered when developing occupational therapy educational interventions for this client group. PW-SCI health education may facilitate occupational justice in practical and culturally relevant ways when participatory methods are used to develop educational resources.

Background. Integration of occupational therapy into a camp environment may support participation for children with neurodevelopmental differences, but evidence is limited. Purpose. This study examines the effects of participation of children with regulation/sensory processing differences at one such integrated camp on parent-established functional goals. Method. We used a pre-test/post-test repeated measures cohort design. Individualized goals were established with parents three months before camp using the Canadian Occupational Performance Measure (COPM) (n = 82, child ages 4-13). Parents re-rated goals immediately before, one month after, and three months after camp. Findings. Repeated measures ANOVA revealed improvement in occupational performance over the week of camp significantly exceeded change within the three months prior. Improvements remained stable three months post-camp. Implications. Integrating occupational therapy within a camp setting is beneficial for children with neurodevelopmental differences. The COPM can be integrated into a camp setting to document meaningful change in individualized parent-established goals.

Background. The occupational therapy profession needs to respond to the calls to action from the Truth and Reconciliation Commission (TRC) to engage in the process of reconciliation with Indigenous populations. Purpose. To inform development of a survey intended to determine the knowledge gaps of occupational therapists in relation to Indigenous health. Method. A Delphi process engaging 18 occupational therapists with membership in an Indigenous health network was used to prioritize and refine potential themes identified via literature review. Findings. Results of three consensus rounds and Dunn-Bonferroni post-hoc testing demonstrated three statistically distinct hierarchical tiers of 10 priority themes to inform survey development. Implications. The consensus prioritized themes from the literature to underpin further research on occupational therapists' knowledge in relation to Indigenous health and can provide a learning scaffold for occupational therapists to support a continued response to the TRC calls to action.

Background. Occupational therapy interventions that promote and prevent children's health and well-being aim to reduce health inequalities and foster protective factors. The purpose of this study is to describe a pilot community-based occupational therapy project for preschoolers in partnership with community organizations and childcare services. Method. A participatory action research approach was implemented with support from an advisory committee. An occupational therapist provided community-based occupational therapy services in a tiered organization model over one year. Findings. Services were offered in three tiers: 7 awareness workshops for parents and caregivers (Tier 1), 57 visits and 27 consultations in 8 community agencies (Tier 2), and 23 individual follow-ups (Tier 3). Implications. There is an opportunity to implement with community agencies and daycare settings an occupational therapy service based on community-based rehabilitation for children under 5 years of age.

Background. Clinicians and researchers have observed that sensory processing and attachment difficulties frequently co-occur; however, little is known about which sensory processing and attachment patterns are interrelated across populations. Purpose. To review evidence of empirical relationships between sensory processing and attachment patterns across the life span. Method. Using the Arksey and O'Malley framework, four databases were searched up to June 2021 for studies that investigated relationships between sensory processing and attachment patterns. Findings. Twenty-two studies met inclusion criteria: nine considered sensory and attachment patterns in children/adolescents and thirteen in adults. In children, sensory modulation was positively associated with attachment security. In adults, more extreme patterns of sensory modulation (e.g., higher sensory sensitivity) were generally associated with attachment insecurity. Implications. Findings indicate empirical relationships between sensory processing and attachment constructs in children and adults that warrant further investigation. Occupational therapists should consider both sensory processing and attachment patterns when planning interventions.

Background. The Trail Making Test Part B (Trails B) and Useful Field of View® (UFOV) can predict on-road outcomes in drivers with cognitive impairment (CI); however, studies have not included drivers referred for comprehensive driving evaluations (CDEs), who typically have more severe CI. Purpose. We determined the predictive ability of Trails B and UFOV on pass/fail on-road outcomes in drivers with CI (Montreal Cognitive Assessment <26) referred for CDEs. Method. Retrospective data collection from two driving assessments centers (N  =  100, mean age  =  76.2  ±  8.8 years). Findings. The Trails B (area under the curve [AUC]  =  .70) and UFOV subtests 2 (AUC  =  .73) and 3 (AUC  =  .76) predicted pass/fail outcomes. A cut-point ≥467 ms on UFOV subtest 3 better-predicted pass/fail outcomes with 78.9% sensitivity and 73.5% specificity. In comparison, a cut-point ≥3.58 min on Trails B had lower sensitivity (73.7%) and specificity (61.8%). Implications. The UFOV subtest 3 may be more useful than the Trails B for predicting pass/fail outcomes in drivers with more severe CI referred for CDEs.

Background. Research in neuroscience shows that adults with schizophrenia or related psychotic disorders experience atypical sensory processing (e.g., deficits in sensory gating and mismatch negativity). Despite significant evidence proving these biomarkers are common among adults with serious mental illness, it is unclear how their sensory experiences impact their occupations in daily life (i.e., real-world implications of atypical sensory processing). Purpose. To explore how the lived sensory experiences of adults with psychotic disorders affect their occupations. Method. We used Walking with Video, photo-elicitation, and semi-structured interviews to study how the lived sensory experiences of adults with psychotic disorders (N  =  6) relate to their occupations. Informed by a phenomenological perspective, we analysed data from semistructured interviews, and undertook analyses through iterative rounds of coding to develop themes and two cycles of group reflective practices to identify researcher biases and assumptions. Findings. Analyses revealed the following themes: polysensoriality, embodied aesthetics of everyday life, habits of sensing and sensory anchors, and active sensory beings. Implications. In clinical contexts, occupational therapists should carefully consider the situatedness of sensory experiences while avoiding assumptions that sensory preferences and aversions mechanistically generalize across contexts and occupations.

Background: Patients with heart failure (HF) usually experience functional disabilities and face participation challenges. Self-care behavior is an essential component of long-term management of HF. Purpose: This study aims to investigate the effect of occupational performance coaching (OPC) on self-care behaviors and participation in people with HF. Method: This study is a parallel group, single-blind, randomized controlled trial of 44 adults with HF, to evaluate the efficacy of OPC. Patients will be randomly allocated (1:1) into two groups. Both groups will receive usual self-care education and the intervention group will receive eight weekly sessions of OPC as well. We will measure the primary and secondary outcomes at baseline, 8, and 12 weeks after the intervention initiation. Implications: If OPC is superior to usual self-care education on improving self-care behavior and participation, the finding will support the integration of OPC into practice to improve participation and self-care behaviors of HF patients.

Background. The Canadian Occupational Performance Measure (COPM) assists occupational therapists to identify occupational performance problems using a client-centred approach. Since its first publication in 1991, there has been abundant evidence of the ability of the COPM to detect a statistically significant difference as an outcome measure. There has also been a tacit understanding that a difference of 2 points from pre-test to post-test on either Performance or Satisfaction COPM score represents a clinically significant difference. There is however, some confusion about the origins of this claim. Purpose. To ascertain empirical evidence for the claim that a clinically significant difference is a change score ≥2 points. Method. We conducted a scoping review of peer-reviewed literature (1991-2020) for intervention studies using the COPM as an outcome measure and examined intervention type and change scores. Findings. One hundred studies were identified. The COPM was used to assess effectiveness of eight types of occupational therapy interventions. The common belief, however, was not empirically supported that clinical significance can be asserted on the basis of a two-point change in COPM scores. Implications. Further research is needed to test alternative approaches to asserting clinical significance or a minimal clinically important difference.