Occupational Therapy International最新文献

Background: Research indicates that play can facilitate communication and emotional connection for children with autism and their parents. Currently, there is no research exploring the perceptions that parents of twins and triplets with autism have regarding their children's play, despite these parents' unique opportunity to observe and interpret the play behaviours of multiple same-age, same-diagnosis children raised in the same home environment. The purpose of this descriptive phenomenological study was to describe the value that parents of twins and triplets with autism place on active play. Method: The researchers used purposive sampling to recruit abroad sample of mothers (N = 9) of twins and triplets with autism aged 4-11 years old. Participants took part in one semistructured online interview with the researcher which was then thematically analyzed. Results: One central theme emerged from our analysis. This theme is entitled active play as a "window into a child's world" and contains five subthemes: (1) parent perceiving child's strengths and weaknesses in active play, (2) parent facilitating active play experiences, (3) parent perceiving child's intrinsic motivations for active play, (4) parent interpreting child's active play behaviours, and (5) active play experiences as a medium for parent/child communication. Conclusions: These findings suggest that parents value active play because it affords them opportunity to observe their children's characteristics through their active play behaviours (e.g., strengths and weaknesses) and use what they have learned to facilitate new active play experiences that encourage overall development. Through active play, parents also practice communicating verbally and nonverbally with their child.

Background: Circus use by occupational therapists is an emerging practice area with limited evidence. Purpose: The study is aimed at exploring occupational therapists' current use of circus and identifying the potential for broader applications addressing both individual and community needs. Method: Purposive sampling was adopted to recruit eight circus-using occupational therapists to participate in this collective case study. Semistructured interviews yielded qualitative data, which were coded and thematically analyzed. Findings: Circus is being used primarily to address performance capacity limitations but with an awareness of its potential to address broader community and sociopolitical needs. Analysis yielded two distinct "cases." The first, individual-focused circus, exemplifies how circus is used to address performance capacity, while the second, community-focused circus, describes current and envisaged future circus use as community development. Conclusion: There is potential to move toward a more occupation-focused and community-driven use of circus in sociopolitical contexts. Further exploration is needed into the therapeutic benefits of circus use by occupational therapists. The inclusion of educational content that builds students' capacity to adopt community development approaches in practice, alongside enhanced understanding of collaboration benefits between occupational therapists and "activist" disciplines, is paramount, if we are to address occupational injustices and promote occupational rights.

Background: Handwriting is a crucial skill for elementary school students that involves complex subskills, including visual coordination, motor planning, cognitive abilities, and self-regulation. To inform intervention plans and support occupational performance and participation, occupational therapists use occupational profiles and performance analysis to assess children's strengths, weaknesses, handwriting performance, and school and personal contexts. Objective: This study is aimed at identifying and assessing the characteristics, as perceived by parents and teachers, that both facilitate and impede the improvement of children's handwriting. Methods: We employed a qualitative approach with inductive content analysis and collected data via semistructured individual interviews following purposive sampling of parents and teachers (N = 8) in Indonesia. The initial and subsequent interviews lasted 30-60 min and 20-40 min, respectively. Results: We analyzed the results based on two themes: (1) client factors that enhance handwriting abilities and (2) environmental factors that contribute to improving handwriting abilities. Psychological well-being, cognitive abilities, and motor performance significantly influenced handwriting skills. Children with poor emotional control, boredom, lack of age readiness, and memory difficulties often struggled with writing. Additionally, underdeveloped fine motor skills contributed to impaired handwriting abilities. Conclusions: Our findings have significant implications for occupational therapists. It highlights the impact of motor-related and external factors on handwriting abilities in children. The study suggests that occupational therapists can tailor interventions to children's needs by understanding parents' and teachers' perspectives. Additionally, it underscores the importance of collaboration between parents, therapists, and teachers in improving handwriting skills and emphasizes the critical role of siblings and peers in enhancing children's handwriting performance.

Introduction: With little evidence to guide practice, the decision to conduct a predischarge home visit poses challenges for occupational therapists. This study is aimed at evaluating the impact of a newly developed support tool for home visit decision-making on therapists' confidence, ease, and accuracy in decision-making and stakeholders' satisfaction in the communication of the decision and examining its clinical utility and reliability. Method: The predischarge home visit decision-making support tool was trialed by occupational therapists from five facilities across an Australian metropolitan health service. Using a pre-post study design, therapists completed a purposefully developed questionnaire on decision-making practice including ease and confidence in decision-making. Accuracy of decision-making was also evaluated using case studies. Clinical utility and reliability data was also gathered. Results: While therapists' confidence and ease in decision-making did not change with use of the tool, accuracy in decision-making improved regardless of therapist's experience in home visiting. The interrater reliability of the tool was moderate, with a Fleiss' kappa value of 0.51. Good internal consistency was demonstrated with the removal of one item (α = 0.83). Clinical utility was supported with therapists rating the tool as timely and easy to use. Conclusion: The developed tool offers therapists a reliable tool to support clinical practice, by providing guidance in clinically reasoning the decision to conduct a home visit.

Introduction: Mental health occupational therapy is an expanding workforce due to the increasing demand for services in many countries, including Australia. Due to the nature of the role, therapists can experience unique challenges that impact retention and wellbeing, consequently affecting career progression. It is, therefore, important to understand career planning and development for mental health occupational therapists to ensure their professional needs are addressed, which would also benefit service sustainability. This study is aimed at understanding the perspectives of mental health occupational therapists within the Nepean Blue Mountains Local Health District on career planning, development, and progression. This health district spans urban and regional areas and has recently introduced a new career framework underpinned by Benner's career planning model. The practical implications of this study are significant, as the insights gained will inform the development of strategies and policies that support the career progression and wellbeing of mental health occupational therapists, ultimately enhancing the quality and sustainability of service provision in this field. Method: In this qualitative descriptive study, seven occupational therapists shared their perspectives through semistructured interviews. The data were transcribed verbatim, and an inductive qualitative content analysis was employed. Results: Three categories and seven subcategories were identified. The health district career framework was found to be beneficial to support career planning and development, with a few adjustments suggested by participants. Conclusion: Having a career framework offers a structured approach to support career planning, development, and progression for mental health occupational therapists.

Introduction: Weighted blankets are an intervention used in healthcare settings for alleviating anxiety and sleep problems. Selection of appropriate outcome measures that capture relevant effects is important in clinical practice and research. However, outcomes used are diverse and not standardised. Therefore, this scoping review is aimed at identifying, synthesising, and describing available research and used outcome measures in research studies evaluating weighted blankets. Methods: A scoping review was conducted, with a search of four databases. The search included studies published until February 2024. Results were categorized according to target population (adult or child) and primary outcome (sleep or anxiety). A conceptual map was developed to describe outcome measures used in the field. Results: A total of 38 studies were identified, including 12 randomised controlled trials, 13 pre-post-studies, 6 case studies, 3 register studies, and 3 qualitative studies. The State-Trait Anxiety Inventory and the Anxiety Visual Analogue Scale were commonly used outcome measurements in evaluation of weighted blanket effects on anxiety and most commonly conducted in an adult population. There was considerable heterogeneity in the outcomes used, particularly within the domain of sleep. In studies evaluating weighted blankets as a sleep intervention for children, objective measurement methods such as actigraphy were common, as was the use of a sleep diary. Conclusion: Even though there is extensive research available evaluating weighted blanket use and effects, there is a lack of standardised outcome measures and instruments are not adapted to use within occupational therapy practice. More research is necessary, informing clinical practice about which measures to use and when. Furthermore, there is a need to develop an instrument specifically tailored for use within occupational therapy practice to evaluate sleep interventions.

Introduction: In this study, we aim to apply BIG to patients with schizophrenia to confirm changes in mental symptoms, task performance, and occupational balance through motor and cognitive enhancement. Method: This study used a single-subject A-B-A design. It consisted of a total of 22 sessions, with 4 sessions in the baseline period, 16 sessions in the intervention period (Lee Silverman Voice Treatment-BIG), and 2 sessions in the follow-up period. The subjects were three male patients diagnosed with chronic schizophrenia, all severe cases. During the 22 sessions, the timed up and go test (TUG) and functional reach test (FRT) and the Montreal Cognitive Assessment (MoCA) were used to determine changes in motor function and cognition, and the subjective cognitive and mental score (SS), Canadian Occupational Performance Measure (COPM), and Occupational Balance Questionnaire-Korean (OBQ-K) were used to determine changes in psychiatric symptoms, work performance, and work balance satisfaction before and after the intervention. Statistically significant changes were determined using the two standard deviation (2SD) band method. Results: The TUG, FRT, and MoCA showed significant results in the intervention period compared to the baseline period. The SS, COPM, and OBQ-K also showed positive changes in scores from pre- to postintervention. Conclusion: In this study, BIG was found to promote improvement in motor and cognitive function in chronic schizophrenia patients, with positive effects on psychiatric symptoms, task performance, and occupational balance satisfaction.

Objective: The purpose of this study was to determine the impact of client-centered occupational therapy intervention on the mental health, activities of daily living (ADL), and community participation of older adults with depression. Methods: This study was a single-blind, randomized controlled study conducted on older adults with depression, and those who met the selection and exclusion criteria were randomly divided into an experimental group of 15 people and a control group of 15 people. The experimental group performed client-centered occupational therapy intervention using the Canadian Occupational Performance Measure (COPM) and Barth Time Construction (BTC), and the control group performed case management and a strength-brain exercise program. Both groups underwent intervention twice a week for 60 min, for a total of 16 sessions. Before and after the intervention, depression, anxiety, stress, ADL, and community partitioning were measured using assessment tools with proven reliability and validity in both the experimental group and the control group. Results: The experimental group exhibited significant changes after the intervention in depression, anxiety, stress, social integration, and community integration scores (p < 0.05 and p < 0.01), while the control group showed significant changes only in depression scores (p < 0.05). As a result of comparing the amount of change between the experimental and control groups, significant differences were found in social integration among the areas of depression, stress, and community integration (p < 0.05 and p < 0.01). Conclusion: These results suggest that client-centered occupational therapy intervention could serve as an effective intervention for improving mental health, ADL, and community participation in older adults with depression. Trial Registration: Korea Clinical Research Information Service (CRIS): KCT0009358.

Background: Individuals with intellectual disability (ID) exhibit various problems, such as attention, learning, and physical-motor difficulties. The study is aimed at investigating the effects of video game-based therapy programs on cognitive and physical functions in individuals with ID. Methods: The study, conducted through a three-arm randomized trial, involved 45 adults aged 18-30 with mild to moderate ID. Participants were divided into three groups: Group 1 received home-based video game-based therapy, supervised video game-based therapy, and occupational therapy-based activity training. Group 2 received video game-based therapy supervised by a therapist and an occupational therapy-based activity training program. Group 3 received occupational therapy-based activity training only. MOXO d-CPT was used to evaluate attention; sit-to-stand test, joint position sense, and nine-hole peg test were used to assess physical-motor functionality. Results: Results showed significant improvements in attention, functional performance, proprioception, and fine motor skills in all groups (p < 0.05). Group 1 was superior to Group 3 in nondominant JPS-flexion, sit-to-stand test, and nondominant JPS-abduction parameters (p < 0.017). When comparing Group 1 and Group 2, Group 1 was found to be more effective in the sit-to-stand test parameter compared to Group 2 (p < 0.017), while the other parameters of the two groups were similar to each other (p > 0.017). There were no significant differences between groups for different outcome measures (p > 0.017). Conclusion: The study suggests that video-based game exercises combined with occupational therapy interventions can effectively enhance cognitive functions, functional performance, proprioception, and fine motor skills in adults with ID. Trial Registration: ClinicalTrials.gov identifier: NCT06097819.

Introduction: The application of the person-environment-occupation-performance (PEOP) model in occupational therapy education offers valuable insights into the interaction between person, environment, and occupational factors and how these elements influenced the strategies used to adapt and navigate the transformation of health professions education during the COVID-19 pandemic. This study explored how individual characteristics, contextual demands, and the nature of educational occupations shaped the adaptation and performance of educators and students. Materials and Methods: The study used a qualitative, exploratory research design at a public higher education institution (HEI) in South Africa, focusing on the occupational therapy program. Purposive sampling was used to recruit key participants (n = 44), including management, academic educators, clinical supervisors (academics), academic support educators, and occupational therapy students. Data collection occurred via the Zoom platform for 45-60-min semistructured interviews. Thematic analysis, guided by the PEOP model, was employed to analyze qualitative data, which was recorded, transcribed, and coded using NVivo (Version 12 Pro). The study ensured trustworthiness and adherence to ethical principles. Results: The PEOP model was used as a framework to formulate the themes, namely, (1) person, (2) environment, (3) occupation, (4) occupational performance, and (5) occupational performance and participation. In the context of occupational therapy education, particular emphasis was placed on the adaptations and responses of educators and students as they navigated the demands of their educational occupations during the pandemic. Discussion: The curriculum underwent rapid adjustments, requiring theoretical instruction and clinical practice modifications. These changes posed significant challenges and highlighted pre-existing gaps within HEIs, as experienced by educators and students. Conclusions: This study highlighted the importance of supporting optimal occupational performance among educators and students, emphasizing the necessity of providing adequate resources and support. This ensures the well-being of educators and students, enabling effective engagement and participation as they navigate the evolving educational landscape.