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“Surthriving” Hand Rehabilitation: Proposing Interventions to Support Novice Occupational Therapists Working in Underserved Contexts "超越 "手部康复:提出干预措施以支持在缺乏服务的环境中工作的职业治疗师新手
IF 1.5 4区 医学 Q3 REHABILITATION Pub Date : 2023-12-14 DOI: 10.1155/2023/5562025
Kirsty van Stormbroek, Tania van der Merwe, Lisa O’Brien, Hellen Myezwa
Hand rehabilitation delivered to underserved South African communities is often the responsibility of novice or generalist occupational therapists. Novice therapists typically work with restricted supervision, support, and resources. Little is known about how these therapists should be supported in order to strengthen the services that they deliver. This study is aimed at understanding how novice occupational therapists in their first year of practice describe their experience of delivering hand rehabilitation in order to identify their support and development needs and propose interventions to address these needs. A qualitative instrumental case study design was used. Data were collected from novice occupational therapists () who participated in an online community of practice. Data collection techniques included photoelicitation, facilitated reflection activities, and case discussion. Reflexive thematic analysis was employed. Trustworthiness strategies included reflexive writing, prolonged engagement, data source triangulation, member checking, and peer audit. Analysis generated three themes: (1) “submerged: I had to drown a little” captured participants’ experience of being saturated by contextual features including poverty and poor basic management of hand injuries. (2) “Starting somewhere” captured participants’ journey of treating patients with hand injuries. They transitioned from an initial sense of having “no idea” to developing “some idea”; their clinical reasoning was challenged when working with no diagnosis, unfamiliar presentations, or when contextual features rendered traditional approaches to therapy inappropriate. Finally, (3) “dynamics of ‘surthrival’” captured elements that contributed to participants either thriving or merely surviving their hand rehabilitation experience. The proposed strategies identified in this study to address the support and development needs of novice therapists include interventions focused on systems and health services; learning opportunities to support competency and physical resources; and emotional support. Beyond application to the South African context, these strategies may be considered for supporting generalist or novice therapists delivering hand rehabilitation in other low- to middle-income countries.
向服务不足的南非社区提供的手部康复通常是新手或全才职业治疗师的责任。新手治疗师通常在有限的监督、支持和资源下工作。对于如何支持这些治疗师以加强他们提供的服务,人们知之甚少。本研究旨在了解新手职业治疗师在第一年的实践中如何描述他们提供手部康复的经验,以确定他们的支持和发展需求,并提出解决这些需求的干预措施。采用定性工具案例研究设计。数据是从参加在线实践社区的新手职业治疗师()中收集的。数据收集技术包括光激发、促进反思活动和案例讨论。采用反身性主题分析。可信度策略包括反身性写作、长期参与、数据源三角测量、成员检查和同行审计。分析产生了三个主题:(1)“淹没:我不得不淹死一点”捕捉了参与者被环境特征(包括贫困和手部受伤的基本管理不善)淹没的经历。(2)“从某处开始”记录了参与者治疗手部损伤患者的旅程。他们从最初的“没有想法”转变为“有想法”;他们的临床推理在没有诊断、不熟悉的情况下工作时受到挑战,或者当环境特征使传统的治疗方法不合适时。最后,(3)“生存动力”捕获了参与者在手部康复过程中茁壮成长或仅仅幸存下来的因素。本研究提出的解决新手治疗师支持和发展需求的策略包括:关注系统和卫生服务的干预措施;学习机会,以支持能力和物质资源;以及情感支持。除了适用于南非的情况外,这些策略可被考虑用于支持其他中低收入国家提供手部康复的全科医生或新手治疗师。
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引用次数: 0
Predictors of Academic and Fieldwork Performance in Occupational Therapy Students: A Systematic Review. 职业治疗专业学生学业表现和实地工作表现的预测因素:一项系统综述。
IF 1.5 4区 医学 Q3 REHABILITATION Pub Date : 2023-11-25 eCollection Date: 2023-01-01 DOI: 10.1155/2023/7281505
Yun Wang, Lai-Ha Chung, Chao-Yi Cheng, Wei-Jiun Wang, Li-Chin Chang, Yu-Ming Huang, Sheng-Yuan Tso, Yu-Lin Chen, Ching-Yi Wu

Introduction: Occupational therapy (OT) educational programs are aimed at enrolling a diverse student population that is likely to succeed in the academic and fieldwork components of the program. Comprehending the array of factors that influence students' learning and academic and fieldwork success is important for university educators. This study investigated the existing literature on predictors of academic and fieldwork performance in OT students.

Methods: The search process used in this review included screening, eligibility, and study quality. We searched the PubMed and Cochrane Library databases for literature published in the past 10 years (1 January 2012 to 30 March 2022). As a comprehensive search, the following keywords were used for abstract, title, and keywords sections: occupational therapy student, predictors, fieldwork, academic, academic success, academic performance, fieldwork success, and fieldwork performance. The Medical Education Research Study Quality Instrument was used to assess the quality of studies.

Results: The systematic review retrieved 14 articles that met inclusion criteria. Most were cross-sectional studies, followed by cohort, retrospective analysis of secondary data, and exploratory studies. Four articles focused on academic success, eight focused on fieldwork success, and two explored both aspects. Promising predictors of academic performance included the admission grade point average and the student's approach to studying. Predictors of fieldwork performance included a graduate record examination score, emotional intelligence, and interpersonal relationships.

Conclusion: This systematic review explores predictors of academic and fieldwork success in OT students, which provide opportunities to identify early the learning difficulties of students and assist educators to target modifiable predictors so they can provide high-quality education.

简介:职业治疗(OT)教育计划旨在招收不同的学生群体,这些学生很可能在该计划的学术和实地工作部分取得成功。对大学教育者来说,理解影响学生学习、学业和实地工作成功的一系列因素是很重要的。本研究以现有文献为基础,探讨职旅学生学业表现与田野工作表现的预测因子。方法:本综述中使用的检索过程包括筛选、资格和研究质量。我们检索了PubMed和Cochrane图书馆数据库中过去10年(2012年1月1日至2022年3月30日)发表的文献。作为一个综合搜索,以下关键词被用于摘要、标题和关键词部分:职业治疗学生、预测者、实地工作、学术、学术成功、学术表现、实地工作成功和实地工作表现。采用医学教育研究质量量表评估研究质量。结果:系统评价检索到14篇符合纳入标准的文献。大多数是横断面研究,其次是队列研究、回顾性分析二手数据和探索性研究。四篇文章关注学术上的成功,八篇文章关注实地工作的成功,两篇文章同时探讨了这两个方面。有希望的学业成绩预测指标包括入学平均成绩和学生的学习方法。野外工作表现的预测因子包括研究生入学考试成绩、情商和人际关系。结论:本系统综述探讨了OT学生学业和实地工作成功的预测因素,为早期发现学生的学习困难提供了机会,并帮助教育工作者针对可修改的预测因素,以便他们提供高质量的教育。
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引用次数: 0
Is Birth Method Associated with Sensory Hyperreactivity in Children 3-4 Years in an Upper-Middle-Income Country? 中高收入国家3-4岁儿童的分娩方式与感觉过度反应有关吗?
IF 1.5 4区 医学 Q3 REHABILITATION Pub Date : 2023-11-25 eCollection Date: 2023-01-01 DOI: 10.1155/2023/5598392
Ann Frances Watkyns, Pamela Joy Gretschel, Helen Buchanan

Background: Research has shown that pressure in the vaginal birth process aids the infant's neurophysiological adaption to extrauterine life, including their ability to regulate their responses to diverse sensory stimuli. As pressure is absent in elective caesarean section births, we hypothesised that these children may be at higher risk for developing sensory hyperreactivity (SHR), a sensory modulation difficulty which negatively impacts on the child's engagement in their occupations. This paper reports on a study which investigated associations between birth method and SHR.

Method: In this cross-sectional study, 91 children aged three and four years from various language, cultural, and socioeconomic groups were recruited and categorised based on birth method (caesarean section or vaginal birth). Caregivers of each child completed the Short Sensory Profile-2 and a demographic questionnaire. The prevalence of SHR between the birth method groups was compared.

Results: The prevalence of SHR was greater in the vaginal birth group (29%) than the caesarean section group (9%). Mothers in the vaginal birth group were younger (p ≤ 0.001), of lower-income level (p = 0.003), and more likely to be single (p = 0.037). During data collection with the vaginal birth group, comprehensibility of certain items in the Short Sensory Profile-2 proved challenging for many caregivers.

Conclusion: The statistically significant higher prevalence of SHR in the vaginal birth group supported a null hypothesis. However, the results are questioned due to the challenges related to data collection. Given this, the study supports the need for further investigation of how sociocultural and socioeconomic factors influence the assessment of SHR in the South African context.

背景:研究表明,阴道分娩过程中的压力有助于婴儿对子宫外生活的神经生理适应,包括他们调节对各种感官刺激反应的能力。由于选择性剖宫产没有压力,我们假设这些孩子可能有更高的风险发展为感觉过度反应(SHR),这是一种感觉调节困难,对孩子的职业参与产生负面影响。本文报道了一项调查生育方式与SHR之间关系的研究。方法:在这项横断面研究中,91名来自不同语言、文化和社会经济群体的3至4岁儿童被招募,并根据分娩方法(剖腹产或阴道分娩)进行分类。每个孩子的看护人都完成了短感官档案-2和人口调查问卷。比较不同生育方式组间SHR患病率。结果:阴道分娩组SHR患病率(29%)高于剖宫产组(9%)。顺产组的母亲更年轻(p≤0.001),收入水平较低(p = 0.003),单身的可能性更大(p = 0.037)。在数据收集与阴道分娩组,某些项目的可理解性短感官档案-2证明了许多护理人员的挑战。结论:阴道分娩组SHR的发生率有统计学意义,支持零假设。然而,由于数据收集方面的挑战,结果受到质疑。鉴于此,该研究支持有必要进一步调查社会文化和社会经济因素如何影响南非环境中SHR的评估。
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引用次数: 0
Mapping Effectiveness Studies of Occupational Therapy in Africa: A Scoping Review. 非洲职业治疗的有效性研究:范围综述。
IF 1.3 4区 医学 Q3 REHABILITATION Pub Date : 2023-11-22 eCollection Date: 2023-01-01 DOI: 10.1155/2023/6688222
Nicola Ann Plastow, Monique de Wit, Megan Brown, Monica de Kock, Patricia Pretorius, Saskia Pienaar, Wernice Venter

Background: Contextual relevance is an important consideration for evidence-based practice, especially in low- and middle-income countries where the nature of practice may differ from high-income countries. Resources and access to rehabilitation are constrained, and service-users face a range of intersecting challenges to activity and participation.

Aim: To evaluate the body of evidence for the effectiveness of occupational therapy in Africa, and to determine if systematic reviews with meta-analysis and/or meta-synthesis are feasible. Methods and Analysis. We conducted a systematic scoping review of published and grey literature by following PRISMA-ScR guidelines across 13 databases and through personal contact with occupational therapists across Africa. Covidence software was used to manage a blind review process by at least three reviewers per included article. The McMaster Quantitative Review Form, NHMRC levels of evidence, the Cochrane PROGRESS-Plus health equity criteria, and the TIDieR checklist informed data extraction using Microsoft Forms.

Results: The search yielded 4199 articles, of which 45 were included. Evidence in six fields of practice included paediatrics, mental health, physical rehabilitation, hand therapy, work practice, and community development, although the evidence was largely limited to South Africa (93% studies). Levels of evidence varied but included 13 RCTs. In all, 1957 participants were included, ranging in age from 25 days to 99 years, with a wide range of health conditions. Most studies reported a positive outcome for occupational therapy.

Conclusion: Findings suggest a moderate body of evidence to support occupational therapy in Africa. Systematic review with meta-analysis, assessment of risk of bias, and in-depth analysis of specific areas of practice are now required. All effectiveness studies in occupational therapy should include measures of occupational performance or participation, minimum reporting standard checklists should be used more consistently, and effect sizes should be consistently calculated and reported in effectiveness research.

背景:背景相关性是基于证据的实践的一个重要考虑因素,特别是在实践性质可能与高收入国家不同的低收入和中等收入国家。资源和获得康复的机会受到限制,服务使用者在活动和参与方面面临一系列相互交叉的挑战。目的:评估非洲职业治疗有效性的证据,并确定采用meta分析和/或meta综合的系统评价是否可行。方法与分析。我们按照PRISMA-ScR指南对13个数据库中的已发表文献和灰色文献进行了系统的范围审查,并与非洲各地的职业治疗师进行了个人接触。使用covid软件对每篇纳入的文章进行至少三名审稿人的盲评过程进行管理。麦克马斯特定量审查表、NHMRC证据水平、Cochrane PROGRESS-Plus健康公平标准和TIDieR检查表为使用微软表格提取数据提供了信息。结果:检索到4199篇,其中纳入45篇。六个实践领域的证据包括儿科、精神卫生、身体康复、手部治疗、工作实践和社区发展,尽管证据主要局限于南非(93%的研究)。证据水平各不相同,但包括13项随机对照试验。总共有1957名参与者,年龄从25天到99岁不等,健康状况各不相同。大多数研究报告了职业疗法的积极结果。结论:研究结果表明,有适度的证据支持非洲的职业治疗。现在需要用荟萃分析进行系统评价,评估偏倚风险,并对具体实践领域进行深入分析。所有职业治疗的有效性研究都应该包括职业表现或参与的测量,最低报告标准检查表应该更一致地使用,效果大小应该在有效性研究中一致地计算和报告。
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引用次数: 0
Effectiveness of Robotics in Stroke Rehabilitation to Accelerate Upper Extremity Function: Systematic Review. 机器人在中风康复中加速上肢功能的有效性:系统综述。
IF 1.5 4区 医学 Q3 REHABILITATION Pub Date : 2023-10-27 eCollection Date: 2023-01-01 DOI: 10.1155/2023/7991765
Cora Carrillo, Devyn Tilley, Kaitlyn Horn, Michelle Gonzalez, Cassidy Coffman, Claudia Hilton, Karthik Mani

Objective: To examine the effectiveness of robot-assisted therapy (RAT) combined with conventional therapy (CT) compared to CT alone in accelerating upper extremity (UE) recovery poststroke. Data Sources. We searched five databases: Ovid, MEDLINE, CINAHL, PubMed, and Scopus Study Selection. Studies were selected for this review using the following inclusion criteria: randomized controlled trials of adults, RAT combined with CT compared to CT, and Fugl-Meyer Assessment (FMA) as an outcome measure. Studies focused on children with neurological impairments, and studies that used RAT to facilitate lower extremity recovery and/or improve gait were excluded. Data Extraction. The initial search yielded 3,019 citations of articles published between January 2011 and May 2021. Fourteen articles met the inclusion criteria. Randomization, allocation sequence concealment, blinding, and other biases were assessed. Data Synthesis. Current evidence suggests that the use of RAT along with CT may accelerate upper extremity recovery, measured by FMA, in the beginning of rehabilitation. However, the progress fades over time. More empirical research is needed to validate this observation. Also, the findings related to cost-benefit analyses of RAT are inconclusive.

Conclusions: It is unclear whether RAT accelerates UE recovery poststroke when used in conjunction with conventional therapy. Given the capital and maintenance costs involved in developing and delivering RAT, more controlled studies examining the effectiveness and cost-benefit analysis of RAT are needed before it can be used widely. This trial is registered with CRD42021270824.

目的:观察机器人辅助治疗(RAT)与常规治疗(CT)相结合与单纯CT相结合在加速卒中后上肢(UE)恢复方面的有效性。数据源。我们搜索了五个数据库:Ovid、MEDLINE、CINAHL、PubMed和Scopus Study Selection。本综述采用以下纳入标准选择了研究:成人随机对照试验、RAT与CT的比较以及Fugl-Meyer评估(FMA)作为结果衡量标准。研究重点是有神经损伤的儿童,排除了使用RAT促进下肢恢复和/或改善步态的研究。数据提取。最初的搜索产生了3019次引用2011年1月至2021年5月期间发表的文章。14篇文章符合入选标准。评估随机化、分配序列隐蔽性、盲法和其他偏倚。数据合成。目前的证据表明,在康复开始时,通过FMA测量,RAT和CT的使用可能会加速上肢的恢复。然而,随着时间的推移,进展逐渐减弱。需要更多的实证研究来验证这一观察结果。此外,与RAT成本效益分析相关的研究结果也没有结论。结论:目前尚不清楚RAT与传统疗法联合使用是否能加速UE卒中后的恢复。考虑到开发和交付RAT所涉及的资本和维护成本,在RAT被广泛使用之前,需要对其有效性和成本效益分析进行更多的受控研究。本试验在CRD42021270824注册。
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引用次数: 1
The Lived Experience of Persons with Spinal Cord Injuries Engaging in Remote Work: A South African Perspective. 从事远程工作的脊髓损伤患者的生活经历:南非视角。
IF 1.5 4区 医学 Q3 REHABILITATION Pub Date : 2023-10-24 eCollection Date: 2023-01-01 DOI: 10.1155/2023/8671123
Alicia Swart, Jerome Peter Fredericks, Lee-Ann Juliana Jacobs-Nzuzi Khuabi

In South Africa, traumatic SCI cases are disproportionately high in comparison to other countries. Low retention and maintenance of work for persons with SCIs are further exasperated by structural barriers and societal stigma. Persons with SCIs have the ability to contribute to the labour market, and doing so could lead to the improvement of their quality of life and socioeconomic status. Addressing engagement in work as a meaningful occupation for persons with SCIs is essential to mitigate occupational risk factor and uphold occupational justice. Currently, there is a paucity of literature on remote work practices for persons with SCIs. This study seeks to add to this body of knowledge to increase occupational therapists' awareness of the possibility of remote work to facilitate the inclusion of persons with SCIs in the open labour market. This phenomenological study explored the facilitators and barriers of engaging in remote work in the open labour market for paid employment, as experienced by persons with SCI within the Gauteng metropole, South Africa. Data was collected via semistructured interviews from four participants and analysed thematically. Four themes were generated from the data: (1) intrinsic facilitators of remote work, (2) extrinsic facilitators of remote work, (3) intrinsic barriers to remote work, and (4) extrinsic barriers to remote work. Remote work can be utilised to include persons with SCIs in their chosen occupation of work and is a holistic and client-centred approach. Remote work should not be seen as the sole method of inclusion but can also be used in conjunction with traditional office work to accommodate persons with SCIs in the workplace.

在南非,与其他国家相比,创伤性脊髓损伤病例的比例过高。结构性障碍和社会污名进一步加剧了SCIs患者工作保留率和维持率低的问题。SCIs患者有能力为劳动力市场做出贡献,这样做可以提高他们的生活质量和社会经济地位。将参与工作作为SCIs患者的一种有意义的职业,对于减轻职业风险因素和维护职业正义至关重要。目前,关于SCIs患者远程工作实践的文献很少。本研究旨在增加这方面的知识,以提高职业治疗师对远程工作可能性的认识,从而促进SCIs患者融入开放的劳动力市场。这项现象学研究探讨了南非豪登大都市SCI患者在开放劳动力市场从事远程工作以获得有偿就业的促进因素和障碍。数据是通过对四名参与者的半结构化访谈收集的,并按主题进行分析。数据产生了四个主题:(1)远程工作的内在推动者,(2)远程工作外部推动者,(3)远程工作内部障碍,(4)远程工作外在障碍。远程工作可用于将SCIs患者纳入其选择的工作职业,是一种全面且以客户为中心的方法。远程工作不应被视为唯一的包容方法,也可以与传统的办公室工作结合使用,以适应工作场所的SCIs患者。
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引用次数: 0
Retracted: Assistive Relief Tool for Early Childhood and Special Psychological Symptom Groups during the Pandemic: Clothing Design Based on the Virtual Contact Principle. 退缩:疫情期间儿童早期和特殊心理症状群体的辅助缓解工具:基于虚拟接触原理的服装设计。
IF 1.5 4区 医学 Q3 REHABILITATION Pub Date : 2023-10-18 eCollection Date: 2023-01-01 DOI: 10.1155/2023/9851308
Occupational Therapy International

[This retracts the article DOI: 10.1155/2022/9701630.].

[这收回了文章DOI:10.1155/2022/9701630.]。
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引用次数: 0
Retracted: Occupational Therapy Practice Based on New-Generation Information Technology for Employee Emotion Analysis and Management. 收回:基于新一代信息技术的员工情绪分析和管理的职业治疗实践。
IF 1.5 4区 医学 Q3 REHABILITATION Pub Date : 2023-10-18 eCollection Date: 2023-01-01 DOI: 10.1155/2023/9863210
Occupational Therapy International

[This retracts the article DOI: 10.1155/2022/3536911.].

[这收回了文章DOI:10.1155/2022/3536911.]。
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引用次数: 0
Retracted: Research on the Design of Interactive Children's Vocal Enlightenment Toys Based on Audiovisual Association Experience. 收回:基于视听联想体验的互动儿童声乐启蒙玩具设计研究。
IF 1.5 4区 医学 Q3 REHABILITATION Pub Date : 2023-10-18 eCollection Date: 2023-01-01 DOI: 10.1155/2023/9824371
Occupational Therapy International

[This retracts the article DOI: 10.1155/2022/7686818.].

[这收回了文章DOI:10.1155/2022/7686818。]。
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引用次数: 0
"Being Holistic Is a Lot to Ask": A Qualitative, Cross-National Exploration of Occupational Therapists' Perceptions and Experiences of Holistic Practice. “整体性是一个很大的问题”:职业治疗师对整体实践的看法和经验的定性、跨国家探索。
IF 1.5 4区 医学 Q3 REHABILITATION Pub Date : 2023-10-18 eCollection Date: 2023-01-01 DOI: 10.1155/2023/2432879
Mona Asbjørnslett, Lisebet S Skarpaas, Linda Stigen

Being holistic is often used by occupational therapists to describe their practice and philosophy worldwide. This study explores the perspectives of 33 occupational therapists, working in 13 different countries, on their understanding of holistic epistemology and practice and how they seek to incorporate holism in their work. On the basis of a qualitative study design, individual interviews were conducted with the participants by 18 Norwegian undergraduate occupational therapy students, supported by their supervisors. The authors subsequently analyzed the transcribed data, using a thematic analysis approach. Three principal themes emerged: (1) holism as a broad and narrow concept, (2) being holistic spans from treating body parts to teaching marginalized children, and (3) being holistic is a lot to ask. When talking about holism and holistic practice, participants described their holistic practices in various ways, and their accounts reflected different understandings and cultural contexts. Participants characterized a holistic approach as one emphasizing the importance of occupations and activities and helping patients regain independence in their everyday lives. However, they also highlighted the specific challenges they faced, including cultural factors and inadequate resources. Significantly, participants from both Western and non-Western contexts emphasized the importance of holistic practice, suggesting that a dichotomous understanding of Eastern versus Western philosophical approaches does not necessarily make sense in occupational therapy interventions. Therapists' degree of commitment to client-centered practice appears of greater relevance. With its international perspective, our study sheds light on important areas of contemporary occupational therapy practice, including the difficulties occupational therapists face when seeking to cover "everything" in an effort to be more holistic.

整体性经常被职业治疗师用来描述他们在世界各地的实践和哲学。本研究探讨了在13个不同国家工作的33名职业治疗师对整体认识论和实践的理解,以及他们如何寻求在工作中融入整体主义的观点。在定性研究设计的基础上,由18名挪威职业治疗本科生在导师的支持下对参与者进行了个人访谈。作者随后使用主题分析方法对转录的数据进行了分析。出现了三个主要主题:(1)整体主义是一个广义和狭义的概念,(2)从治疗身体部位到教育边缘化儿童,都是整体性的,(3)整体性是一个很大的要求。在谈到整体主义和整体实践时,参与者以各种方式描述了他们的整体实践,他们的叙述反映了不同的理解和文化背景。参与者将整体方法描述为强调职业和活动的重要性,并帮助患者在日常生活中重获独立。然而,他们也强调了他们面临的具体挑战,包括文化因素和资源不足。值得注意的是,来自西方和非西方背景的参与者都强调了整体实践的重要性,这表明对东方和西方哲学方法的二分法理解在职业治疗干预中不一定有意义。治疗师对以客户为中心的实践的承诺程度似乎更具相关性。从国际角度来看,我们的研究揭示了当代职业治疗实践的重要领域,包括职业治疗师在寻求涵盖“一切”以实现更全面时所面临的困难。
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引用次数: 0
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Occupational Therapy International
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