Occupational Therapy International最新文献

Introduction: The prospective, historically controlled study evaluated whether a collaborative practice (CP) model between nurses and occupational therapists improves activities of daily living (ADLs) and reduces the use of disposable absorbent products and physical restraints in hospitalized older patients.

Methods: Data from the historical control group (n = 72), who received usual care, were collected from medical records, and the intervention group (n = 46), who participated in the CP-based intervention, was recruited in a community-based care ward in a regional hospital. The CP model was designed to facilitate collaborative planning for improving ADLs between nurses and occupational therapists. Outcome measures included disposable absorbent product use, physical restraint use, and the functional independence measure (FIM). Assessments were conducted at admission and discharge. Propensity score matching was applied to balance baseline characteristics between groups and to reduce potential confounding factors.

Results: Propensity score matching generated 45 pairs ("historical controls," n = 45, and "interventions," n = 45). Although physical restraint use was reduced in both groups (p ≤ 0.007), the use of disposable absorbent products in the intervention group was significantly reduced compared to the historical control group (p = 0.020). Additionally, significant interaction effects were observed between time and group for all FIM scores, indicating greater improvements in ADLs in the intervention group, with moderate to large effect sizes (p ≤ 0.013, partial η ² ≥ 0.068).

Conclusions: This study demonstrated the positive impact of a CP model between nurses and occupational therapists in improving ADLs and reducing disposable absorbent product use in older patients. These findings suggest that this model of CP enhances the quality of geriatric care. Trial Registration: UMIN Clinical Trials Registry number: UMIN000047072.

The use of ultrasound as an assessment tool by occupational therapists in the context of intensive care can support the clinical reasoning in identifying the impacts of musculoskeletal alterations on the ability to perform activities of daily living and other meaningful occupations. However, ultrasonography is not part of the core curriculum in occupational therapy education, and the knowledge and technical requirements necessary for its use by these professionals remain unclear. Therefore, the aim of this study was to analyze the intraexaminer and interexaminer reliability of ultrasound muscle assessment among occupational therapy students and occupational therapists after the completion of a standardized training program. Data collection included 8 h of examiner training and image acquisition. Three examiners were trained by an occupational therapist experienced in muscle assessment using ultrasound, including two occupational therapy undergraduate students and one occupational therapist. Each examiner performed two assessments of each muscle group, without knowing the results of their own evaluations or those of the other examiners. Participants were recruited by convenience, including adults and older people who were admitted to the intensive care unit. The sample size of this study was seven participants. For descriptive analyses, categorical variables were expressed in absolute and relative frequency. Continuous variables were presented as median and interquartile range or as mean and standard deviation. For the interobserver and intraobserver reliability analyses, the values of the intraclass correlation coefficient were performed. A total of 280 US images were analyzed. In regards to inter-examiner reliability, excellent results were found for all muscle groups (ICC: 0.785-0.986). For the intraexaminer reliability, excellent results were found in the majority of analyzes performed (ICC: 0.779-0.997), with two exceptions. Occupational therapy students and occupational therapists demonstrated excellent reliability in the ultrasound assessment of muscle thickness. These findings may support the clinical reasoning of occupational therapists to improve outcomes in occupational performance and participation of critically ill survivors.

Introduction: Current occupational therapy assessments for schizophrenia rely primarily on behavioral observation, with limited access to objective neurofunctional indicators of cognitive-motor engagement. Digital tools combined with neurophysiological monitoring offer new opportunities to address this gap. This study examined a digital cognitive-motor occupational training application paired with quantitative electroencephalography (QEEG) to explore neurofunctional engagement during task performance.

Methods: Thirty individuals with schizophrenia completed structured occupational tasks under two conditions: with and without QEEG-based Brain Mapping Performance (BMP). Task engagement was characterized using participant-prioritized daily activities grouped into dopaminergic, serotonergic, oxytocinergic, and endorphin-related behavioral domains, conceptualized as theoretical behavioral associations rather than direct neurochemical measures. QEEG indices included theta relative power, beta relative power, and theta/beta ratio recorded from six frontal and temporal scalp sites.

Results: Theta relative power was higher at frontal and central sites (Fz and Cz) during BMP-monitored conditions, reflecting executive and motor planning demands. Beta relative power varied across memory- and emotion-related task phases, indicating task-dependent modulation of cognitive effort. Engagement Intensity Scores were consistently higher in the unmonitored condition, while BMP monitoring was associated with longer task completion times and increased neurofunctional engagement.

Conclusion: QEEG-guided occupational task performance reveals distinct, task-dependent neurofunctional patterns in schizophrenia rehabilitation. The integration of digital task-based assessment with neurophysiological monitoring provides exploratory neurofunctional indicators that may support individualized, functionally informed occupational therapy interventions.

Background: Participation in meaningful activities is essential for children's development and well-being, making it a key focus of rehabilitation outcomes. The PEM-CY assesses participation frequency, involvement, and environmental support in home, school, and community settings. While it has been validated in several languages, its psychometric properties have not yet been evaluated in the Dutch context.

Objectives: Therefore, the aim of our study is to assess the internal consistency, test-retest reliability, and construct validity of the Dutch PEM-CY including its ability to differentiate between children with and without disabilities and to examine associations between environmental supportiveness, participation, and parental satisfaction.

Methods: A cross-sectional study involving parents of 161 Dutch children 5-17 years old with and without disabilities was conducted to psychometrically evaluate the Dutch PEM-CY in the Netherlands. Internal consistency was evaluated using Cronbach's alpha, test-retest reliability with intraclass correlation coefficients (ICCs), and construct validity through known-group comparisons and correlations between environmental supportiveness, participation outcomes, and parental desire for change.

Results: The Dutch PEM-CY demonstrated acceptable to good internal consistency (α = 0.54-0.68) and good to very good test-retest reliability (ICC = 0.60-0.80). Known-group comparisons revealed significant differences between children with and without disabilities, particularly in involvement and environmental barriers. In addition, higher perceived environmental support was significantly associated with greater involvement and less parental desire for change, but not with participation frequency. These findings support the Dutch PEM-CY's reliability and validity in assessing participation and environmental influences among Dutch children aged 5-17 years old.

Conclusion: The Dutch PEM-CY is a reliable and valid instrument for assessing participation and environmental influences among Dutch children aged 5-17 years. Its ability to identify both group differences and associations with environmental support underscores its value for guiding tailored occupational therapy interventions and informing inclusive policy development.

Background: This study is aimed at calculating and categorizing the composition ratios of physical activity categories in relation to total daily physical activity among older adults living in a community using the Occupational Therapy-Based Physical Activity Questionnaire (OTBPAQ) and at examining their characteristics.

Participants and methods: The survey used the OTBPAQ to evaluate the composition of physical activity categories as well as a questionnaire on participant characteristics (sex, age, presence of family members, subjective well-being, hobbies and activities, physical pain, frailty, and physical activity). The OTBPAQ was developed as an evaluation chart concerning the "occupation" category. Subsequently, cluster analysis was conducted based on the composition ratios of physical activity categories in relation to total daily physical activity, and the relevance of the participant characteristics was confirmed for each extracted group.

Results: A total of 499 participants were allocated using cluster analysis into five groups, namely, "balance-oriented group," "aerobic exercise group," "shopping group," "sports group," and "recreational gymnastics group," based on the main activity categories of each cluster. Results showed that participant characteristics, such as the amount of physical activity and number of physical activity categories, differed among the clusters.

Conclusion: The OTBPAQ could extract five clusters of older adults in a community based on the composition ratio of physical activity categories. Examining the composition ratio of physical activity categories can facilitate a highly individualized approach to physical activity for each group, leading to more effective care prevention measures to increase healthy life expectancy.

This paper explores pedagogical approaches for teaching Chinese graduate health science students by identifying students' perceptions of teaching and learning strategies that support learning. This study used a survey design to answer the research question: "How do Chinese English as a Foreign Language (EFL) graduate health science students perceive the impact of teaching pedagogies on their educational experience?" Descriptive methods and the Friedman test were used to analyze the data. Data from 34 completed surveys revealed that students perceive responsive instruction and guided feedback (clear, frequent, verbal, and written) as most beneficial to learning. Advance access to notes and materials also supported learning. Student-led oral discussions and nonverbal communications (via student response systems) were deemed less beneficial. Students valued the opportunity to learn and practice clinical skills in the classroom and the clinic. These findings highlight the need for Western instructors to modify teaching strategies to meet the needs of the EFL learner while maintaining the rigor of the health science curriculum content.

Confidence plays a critical role in students' academic performance, particularly in complex foundational content such as neuroscience. While confidence is often discussed interchangeably with self-efficacy, the two constructs are distinct yet complementary. Few studies have examined how confidence changes over time in occupational therapy neuroscience courses or what factors contribute to its development. This longitudinal mixed-methods study examined confidence changes throughout a 15-week neuroscience course in an Occupational Therapy Doctorate program. The study integrated quantitative measurements with qualitative reflections to understand both the magnitude and mechanisms of confidence development. Data were collected from 73 students across two independent cohorts in consecutive years (2023: n = 37; 2024: n = 36). Students completed weekly surveys with four Likert scale questions assessing neuroscience-related confidence and three open-ended questions at baseline, mid-course, and end-of-course exploring factors influencing confidence. Analysis included nonparametric statistical tests for quantitative data and thematic analysis with sentiment analysis for qualitative responses. Both cohorts demonstrated statistically significant confidence increases from baseline to end-of-course (p < 0.001). Qualitative analysis revealed four themes replicating across both years: prior academic experiences (mixed effect), instructional support and learning environment (facilitator), interest in neurological practice (facilitator), and content complexity with anticipatory anxiety (barrier). Students attributed confidence gains to hands-on learning activities, peer collaboration, and structured feedback. Sentiment patterns showed predominantly positive baseline attitudes despite concerns, shifting to more neutral mid-course assessments reflecting realistic recalibration, then highly positive end-of-course reflections on self-assessment value. Integration of quantitative and qualitative findings revealed that confidence development follows predictable patterns influenced by cognitive and emotional factors. Replication across two independent cohorts strengthens validity. Implications for occupational therapy education include intentional scaffolding, active learning opportunities, peer collaboration, and attention to Generation Z learners' needs for external validation and structured support. These findings inform curriculum design strategies to enhance confidence, self-efficacy, and clinical reasoning preparation.

Introduction: Prefieldwork students often experience challenges transitioning from academic learning to clinical practice due to gaps in competency development. While established frameworks define postgraduate competencies, the specific needs of prefieldwork students remain underexplored. This study is aimed at identifying core competencies essential for prefieldwork students in adult therapy settings.

Method: A two-phase study design was employed. In Phase 1, focus group discussions involving clinical supervisors, faculty members, and prefieldwork students identified key competency domains. In Phase 2, a modified Delphi method was conducted with clinical supervisors (n = 22 in Round 1, n = 20 in Round 2) to establish consensus on competency inclusion and definitions. Data analysis included thematic coding, interrater reliability assessment (Cohen's kappa), and statistical evaluation using mean scores, interquartile range (IQR), and content validity ratio (CVR).

Results: The focus group discussions identified key competency challenges, including insufficient knowledge of splinting principles, limited assessment skills, and difficulties in professional communication. Initial thematic analysis mapped these challenges to nine established competency domains. The Delphi survey further added five emerging competencies: reflection, coping strategies, resource linking, multiple perspectives, and local-global awareness. Five emerging competencies were organized into three thematic groups: interpersonal adaptation, contextual cognition, and system navigation. However, the management competency was excluded due to low consensus.

Conclusion: This study highlights critical competency gaps in prefieldwork OT education, emphasizing the need for structured curriculum interventions. Prefieldwork OT curricula should strengthen coping, reflection, and resource linking through reflective journaling, stress management, and resource planning. The role of local-global awareness should be clarified. The management competency was excluded from the final competency list due to limited appropriateness.

Introduction: Occupational therapists play a crucial role in supporting students' participation in primary school by assessing factors that influence their performance. Measurement tools are essential for identifying supports and barriers to participation; however, their alignment with the International Classification of Functioning, Disability, and Health-Child and Youth Version remains unclear.

Objective: This scoping review was aimed at identifying available measurement tools used in occupational therapy practice in the primary school setting and mapping their focus according to the International Classification of Functioning, Disability, and Health-Child and Youth Version components.

Methods: A comprehensive scoping review was conducted following the Joanna Briggs Institute Manual for Evidence Synthesis across four databases (PubMed, CINAHL, MEDLINE, and Web of Science), supplemented by a targeted gray literature search from ProQuest, and hand-searching articles between 2007 and 2025. Eligible studies included quantitative, qualitative, and mixed-method research that utilized measurement tools by OT in primary school settings. A total of 705 articles were retrieved, with 41 meeting the inclusion criteria.

Results: Fifty-two measurement tools used by school-based occupational therapy were identified. Although schools encompass various occupations such as self-care tasks, learning activities, school leisure activities, and social activities, this literature review found that school-based occupational therapy practice in primary school settings primarily addressed handwriting as a student occupational problem. The most frequently used tools were the Minnesota Handwriting Assessment, the Beery-Buktenica Developmental Test of Visual-Motor Integration, the Persian Handwriting Assessment Tool, and the Evaluation Tool for Children's Handwriting. At the same time, most tools focused on handwriting assessment, and only a few incorporated environmental factors.

Conclusion: These findings highlight the predominant focus of school-based occupational therapy measurements on cognitive and motor functions, with limited attention to environmental factors. Future research considers prioritizing the development of more comprehensive tools that holistically assess students' occupational performance.

Introduction: Occupation-based practice (OBP) is a core concept in occupational therapy, integrating meaningful and purposeful occupations into assessment, intervention, and outcomes. There were 561 Thai occupational therapists who specialize in treating clients with physical dysfunction who participated in this study. This study was aimed at examining the perspectives and experiences of occupational therapists using OBP for clients with physical dysfunction.

Method: In the survey phase, there was an online survey conducted using a Google survey found on a social media platform that was listed as the official website, and the results were analyzed using descriptive statistics. In the interview phase, nine participants were interviewed, and their responses were analyzed through thematic analysis.

Results: Sixty-two participants responded. Quantitative and qualitative results were integrated. Forty-seven percent strongly agreed, and 39% agreed that allowing clients to choose relevant occupations was essential. Fifty percent strongly agreed and 40% agreed that OT services should be based on real-life contexts. OBP was also used to encourage clients to pursue more occupations (47% strongly agreed, 48% agreed). The interviews support the notion that attitudes toward occupation drive OBP. When addressing the role of facilitators, 37% strongly agreed and 47% agreed that clients were key in enabling OBP. Therapists found OBP effective for treatment (36% strongly agreed, 45% agreed). Barriers included insufficient time for OBP (21% strongly disagreed, 39% disagreed) and that there are inadequate clinical settings (23% strongly disagreed, 34% disagreed). These findings concurred with interview data which highlighted limited time and inadequate space as key factors influencing OBP.

Conclusion: The core features of OBP are client-centered goals, implementation, motivation, and engagement, highlighting the importance of occupation in practice. Influencing factors include clients, therapists, policies, service systems, and clinical settings. When implementing OBP, therapists should consider these factors and their relationships.