Occupational Therapy International最新文献

Introduction: Poor fit between the work environment and work expectations is associated with high levels of workplace-related stress. Work stress in occupational therapy has been attributed to the nature of the profession and various other workplace-related factors. Workplace-related stress leading to burnout has been found to be higher in early career occupational therapists with less than 5 years of experience. This study explored workplace factors that result in poor person-work environment fit in six work-life areas in South African early career occupational therapists. Methods: A descriptive electronic survey design was used to access a sample of South African 261 occupational therapists with 2-5 years of work experience. The Area of Work-Life Survey (AWS) considers six work-life areas: control, workload, community, rewards, values, and fairness, which were used to collect data. Data were analysed to determine low, moderate, and high work environment fit for workplace factors including employment setting, field of practice, years' experience, time with current organization, and hours worked. Results: Of the six work-life areas, only the scores for workload fell below the norm for the respondents. All six work-life areas were impacted by employment settings, with respondents in public health hospitals and clinics indicating significantly low person-environment fit in most areas. Respondents in physical rehabilitation had a significantly low fit for workload, as did years of experience, length of time with organization, and hours worked. Fairness had a low fit for physical rehabilitation and medicolegal fields of practice. Conclusion: Workload impacted workplace-related stress in respondents with scores below the norm on the AWS for this work-life area. Although some work-related factors affected workplace-related stress, the overall scores for the other work-life areas were above the norm, with only respondents in public service settings and in the field of physical rehabilitation reporting low work environment fit.

Background and Purpose: The present study is aimed at evaluating the effects of the COVID-19 pandemic on Iranian adolescents' participation in various domains of life. The electronic version of the Iranian Adolescent Participation Assessment Tool-COVID-19 (IAPAT-C) was developed and validated for this purpose. Methods: This study was conducted in two phases. In the first phase, the electronic version of the IAPAT-C was developed and validated through a methodological study involving five stages: content validity review, cognitive interviews, item analysis, structural validity assessment using confirmatory factor analysis, and reliability analysis. The tool was adapted from the previously validated IAPAT and revalidated for this study. In the second phase, the effects of COVID-19 on adolescents' participation were evaluated using a longitudinal one group before and after comparative design. The study involved 654 adolescents aged 13-18, and the data were analyzed using SPSS19 and G⁣^∗Power 3 software. Results: The IAPAT-C evaluates the participation of Iranian adolescents in 54 daily life activities before and after the COVID-19 pandemic. It utilizes a 5-point Likert scale and was validated through an expert panel review for content validity. Additionally, cognitive interviews with six adolescents confirmed its comprehensibility, relevance, and comprehensiveness. Item analysis, based on data from 38 participants, demonstrated strong interitem correlations (0.6-0.94) and excellent internal consistency (Cronbach's alpha > 0.7). The tool's structural validity was supported by confirmatory factor analysis, which showed that the measurement model was a good fit. Convergent and discriminant validity of model constructs were also confirmed. Notably, COVID-19 significantly impacted all aspects of adolescents' lives, except for work. Conclusion: The electronic version of the IAPAT-C was valid and reliable. COVID-19 significantly affected various aspects of Iranian adolescents' daily lives. Accordingly, it is necessary to provide appropriate interventions and policies for this sensitive class.

Introduction: Cerebral palsy (CP) is a common motor and postural developmental disability impacting daily activities like toileting. Despite its importance, toileting has often been undervalued in healthcare. This study is aimed at identifying and assessing the level of influence of various factors affecting toileting in individuals with CP using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) framework. Methods: The Delphi method was employed to reach a consensus on factors influencing toileting in individuals with CP. One hundred fifty-eight professionals from 17 countries, each with at least 3 years' experience in CP and/or toileting, participated in this two-round study. Ethical approval (IR.IUMS.REC.1400.1111) and informed consent were obtained. The questionnaire, available in Farsi and English, used a Likert scale (5 = very high impact to 1 = no impact). Factors with 75% agreement and a mean above 3.75 were included in the final list, while those with 50%-75% agreement or a mean between 2.5 and 3.75 proceeded to the second round. Factors were initially identified through a literature review and research team consultation and categorized according to the ICF-CY framework using the ICF 10 RULES. Validation and refinement were done through focus groups with caregivers and experienced professionals to ensure alignment with the framework and methodological rigor. Results: The study highlighted significant factors influencing toileting activities in individuals with CP. Within the ICF-CY framework, "neuromusculoskeletal and movement-related functions" scored highest at 94.5% in "body functions and structures." "Toilet environment" scored 90.5% in "environmental factors." Support and relationship factors scored 82.3%. Attitudes toward "menstruation" ranked highest at 92.9%. Associated deficits with CP ranked top in personal factors at 93.7%. Conclusion: The study identifies key factors influencing toileting activity performance in individuals with CP. "Main caregiver" emerges as a pivotal factor, followed by neuromusculoskeletal functions, personal factors, attitudes toward menstruation, the toilet environment, and support and relationships.

This study investigated the treatment methods used by physical and occupational therapists for poststroke paretic upper limbs and the factors influencing their decision-making processes. For the treatment methods of poststroke paretic upper limbs, the respondents were asked to select the most clinically used treatment according to the severity of the patient's condition. For the factors influencing their decision-making processes, the respondents were asked to indicate each determinant using a 5-point Likert scale (1 = no influence at all to 5 = very strong influence). Six hundred thirty-eight therapists participated in this study. Exploratory factor analysis was used to assess the validity of the questionnaire. The findings indicated task-specific training (N = 333, 52%) as the most popular for mild cases, followed by repetitive facilitative exercise (n = 143, 22.3%) for moderate cases and electrical stimulation (n = 246, 38.4%) for severe cases. This study revealed that evidence about treatment (very strong: n = 171 (27.0%), and strong: n = 287 (45.0%)) and patient preferences (very strong: n = 203 (31.8%), and strong: n = 251 (39.3%)) affected decision-making significantly regarding treatment methods for the poststroke paretic upper limb.

Parenting with a physical disability often brings with it a range of challenges. Occupational therapists are well positioned to support parents to address these challenges, yet occupational therapy research and practice around parenting is relatively scarce. This paper addresses the questions: (1) How should occupational therapists support parenting occupations for people with physical disability? (2) How do parents with physical disability experience occupational therapy? An anonymous survey of 62 parents, primarily mothers, with physical disability about their experiences with parenting challenges and occupational therapy was analysed using both quantitative and qualitative techniques. Parents experienced challenges in engaging in a range of parenting tasks with children over a range of age groups. Parents reported that support was often needed and indicated that occupational therapy could assist them directly with specific parenting goals as well as the more usual biomechanical goals that influence parenting. Yet less than half of participants who received occupational therapy services reported that parenting tasks were addressed, and only one-fifth reported that their goals had been fully met. The data also indicated that the knowledge, skills, and attitudes of occupational therapists with regard to working with parents with disability can be improved. Findings suggest a need to better incorporate parenting occupations in standard occupational therapy training to increase occupational therapists' comfort and competence in working with clients on parenting issues.

Introduction: The article reports the healing elements of an eclectic life skills programme (ELSP) from the perspective of group members. An ELSP utilising open groups was developed to manage clients with mixed diagnostic profiles and different stages of recovery simultaneously. The aim was to explore the healing elements of an ELSP. Methods: Maximum variation purposive sampling was used to select six participants for the phenomenological inquiry. Data collection is comprised of observations, semistructured interviews, and reflective journals. Data analysis comprised an inductive thematic analysis. Consumer Involvement: Participants all attended groups offered within the ELSP. They participated in two semistructured interviews: the first interview in the week following admission and the second just before discharge. In addition, they documented their experiences in reflective journals for the duration of their participation. Findings: The analogy of a kaleidoscope portrayed the four themes; three pertained to structural dynamics, namely, programme mirror, facilitator mirror, and mirror of other group members. The fourth theme, namely, the magical pattern, pertained to personal sense-making by individual group members. Conclusions: The dynamic interplay of healing factors, captured in the themes, facilitated healing. Self-reflection was integral to the creation of a bespoke, facilitated self-learning process with direct application in group members' own lives.

Background: Statistics indicate a high prevalence of TBI in South Africa, with many individuals with TBI not returning to work. The lack of return to work among TBI survivors is particularly due to factors such as injury severity, preinjury educational and occupational status, and age at injury. However, in addition to the above factors, there was the COVID-19 pandemic, which resulted in the de-escalation of nonessential outpatient services in order to assist with curbing the spread of the virus. Objective: The aim of the article is to explore the experiences and perceptions of TBI survivors about accessing vocational rehabilitation during the COVID-19 pandemic and how this has affected their worker roles. Method: A descriptive, explorative qualitative research design was used, and semistructured interviews were conducted to collect data. The authors subsequently analysed the transcribed data using a thematic analysis approach. The COREQ (consolidated criteria for reporting qualitative research) checklist was used as a reporting guideline. Ten TBI survivors and two individuals working in the public health sector participated in this study. Two semistructured interviews were conducted with each research participant. Results: Three themes emanated from the study, namely, Theme 1: "The barriers to accessing rehabilitation during the COVID-19 pandemic" represents the participants' barriers to accessing rehabilitation programmes throughout the COVID-19 pandemic. Theme 2: "Lack of rehabilitation negatively influenced the individual with TBI occupational performance" describes how the lack of OT rehabilitation during the COVID-19 pandemic impacted the participants' quality of life. Theme 3: "Factors that facilitated access to rehabilitation during the COVID-19 pandemic" describes the factors that facilitated access to OT rehabilitation services during the COVID-19 pandemic. Conclusion: The study found that there were barriers and facilitators to accessing occupational therapy rehabilitation during the COVID-19 pandemic for TBI survivors. More research needs to be conducted to explore the efficacy of telehealth/telemedicine for occupational therapy rehabilitation and the role of the occupational therapist in global pandemics.

Occupational therapists need to comprehensively assess the participation of children with autism spectrum disorder (ASD) in daily activities and evaluate the effectiveness of relevant interventions. Several participation measurement tools have been developed for children with ASD, but these tools require expert involvement, which is a barrier to large-scale surveys. To address these concerns, a caregiver-administered questionnaire-the Participation Questionnaire for Preschoolers (PQP)-was developed. However, this tool could be improved due to its narrow age range of 48-72 months and because the item development process does not reflect the perspectives of children and caregivers. Therefore, we expanded the PQP's target age range to 36-83 months and developed new items that reflect the perspectives of professionals and caregivers. Interviews were conducted with eight experts in supporting children with ASD and 11 caregivers of children with ASD. The interviews were transcribed, and a content analysis was performed. The number of questions was reduced from 51 to 36, and the order of items was changed for clarity. Two of the eight subdomains were removed to clarify the conceptual difference between activity and participation. The updated version of the PQP has two unique features: (1) it can be administered without expert involvement, and (2) it includes items specific to the challenges faced by children with ASD. Future development of the scale and validation of its measurement properties are needed.

Background: Sensory reactivity (SR) difficulties are characterised by problems regulating an individual's responses to sensory input such that it interferes with occupational performance in daily tasks. South African occupational therapists use assessments developed in the United States to identify SR difficulties in children. These have been found to be inappropriate for the South African context. This study reports on the methodology used to adapt an assessment for use in the Western Cape Province of South Africa. Method: The SPM-2 Child and Preschool caregiver self-report questionnaires and seven tests of the performance-based Evaluation in Ayres Sensory Integration (EASI) that assess SR were identified for adaptation. A qualitative methodology was used to identify challenges using the assessment in a sample of the Western Cape population. Cognitive interviews were conducted with six community members from diverse socioeconomic groupings. Inductive analysis was used to identify and group the emerging themes. The test adaptation was conducted by expert occupational therapists based on these findings. Findings: Challenges were grouped into two themes, namely, language challenges, of which there were three subcategories and inappropriate or threatening assessment tasks. Fifty-three changes were made to the assessment. Conclusion: A detailed methodology was developed to adapt a SR assessment for use in the Western Cape Province. Challenges in using the assessment were elicited primarily from community members rather than professionals.