Scandinavian Journal of Occupational Therapy最新文献

Background: Despite valuing occupation, occupational therapists report barriers to enacting occupation-based practice. One barrier noted in the literature is hegemony, the dominance of one social group's ideas over others. Specifically, biomedical and business models dominating healthcare are reported to significantly impact occupational therapists.

Objective: To describe how occupational therapists experience and manage hegemony in an acute mental health setting in the United States.

Methods: A community of practice scholars composed of nine occupational therapists participated in a practice-based enquiry. Scholars recorded their reflections on their practice and engaged in collective research discussions. All data were transcribed and analysed using narrative and thematic processes.

Results: Data analysis resulted in three themes that reflect the shifting and varying narratives of the community of practice scholars: (1) making waves; (2) staying afloat; and (3) sailing away.

Conclusions and relevance: The findings highlight the varied experiences and changing responses of the therapists as they gained awareness of hegemony in an acute mental health setting. While some therapists remained passive and 'stayed afloat' and others left the practice site or 'sailed away', others were empowered to 'make waves' and advocate for change and counter hegemony.

Background: As parental burnout is increasingly recognised for its severe impact on parents and children, identifying factors that exacerbate or alleviate this condition is crucial. Reliable assessment tools in clinical settings are essential to detect those at risk of or experiencing burnout, enabling timely intervention.

Aims/objectives: This study aims to adapt the Parental Burnout Assessment for use in Iceland and evaluate its psychometric properties while exploring how personal and socio-demographic factors influence parental burnout.

Materials and methods: A sample of 1,110 parents participated. Descriptive statistics analysed the main dataset characteristics, and confirmatory factor analysis evaluated the psychometric properties of the adapted version.

Results: Satisfactory structural validity and internal consistency (α 0.96) of the PBA-IS was demonstrated. Factors influencing parental burnout included marital status, number of children, perceived support, and personal causation.

Conclusions: The PBA-IS is a valid and reliable translated tool for assessing parental burnout in Iceland. Personal causation, a key concept in occupational therapy, appears pivotal in parental burnout. Occupational therapists can provide holistic support to help parents effectively manage stress.

Significance: The PBA-IS enables parental burnout to be identified in Icelandic clinical settings, supporting early interventions that reduce stress, promote mental health, and enhance well-being.

Background: The assistive technology (AT) service delivery process is complex and includes a comprehensive assessment of the citizen's situation to inform decision making. This assessment is required by Danish law to ensure that citizens receive solutions matched to their needs, including other services than the AT.

Aim: To investigate how Danish occupational therapists, involved in the AT service delivery process, perform the comprehensive assessment.

Material and methods: The study is a cross-sectional survey. The target population was occupational therapists providing AT through the AT service delivery process in municipal units. Data were analysed using descriptive statistics.

Results: The sample included n = 206 Danish occupational therapists completing the questionnaire. Participants represented the five regions in Denmark. Variations were seen across age, years of working experience, and years in current position. Fifty nine percent of the participants often used telephone interviews, and 74% reported to do home visits to gather information as part of the assessment process. During home visits, participants typically combined methods of interview and observation. Most participants reported not using standardised assessment tools, or not using them in their full length. Almost 80% reported having no guidelines about tool(s) to be used at their workplace. Overall, participants were satisfied with the assessment process.

Conclusions: When Danish occupational therapists perform comprehensive assessments to ensure that citizens receive solutions matched to their needs, including other services than the AT, the assessment approach and methods employed vary across therapists, since local guidelines for assessment and the use of standardised assessment tools are sparse.

Significance: To support a high-quality comprehensive assessment process, also ensuring a sustainable client-centred process, a standard minimum guideline is recommended within the Danish AT service delivery system.

Background: Occupational therapists strive to provide evidence-based cognitive rehabilitation for everyday functional activities in community-based rehabilitation.

Objective: In this study, we investigated the effectiveness of the Perceive, Recall, Plan and Perform (PRPP) Intervention in enhancing and maintaining task performance and cognitive strategy use during home-based rehabilitation for individuals with cognitive challenges following acquired brain injury.

Material and methods: This study is a systematic replication of a single-case experimental designs using multiple baselines applied to three participants (67+ years old) undergoing nine PRPP Intervention sessions. The participants completed repeated measurements during baseline, intervention, post-intervention and follow-up phases. They were compared to their baseline phases, which was a control. Outcome measures included PRPP Assessment Stages 1 and 2. The analysis involved visual inspection of graphed data and the Tau-U method.

Results: The analysis revealed that all three participants showed positive changes in task mastery and effective cognitive strategy use after receiving PRPP Intervention, including maintenance immediately after intervention and 4 weeks later. A weighted Tau-U across participants indicated a very large effect (0.94) on task mastery.

Conclusions and significance: The PRPP Intervention showed promising results in improving real-world task mastery and effective cognitive strategy use during home-based rehabilitation.

Trial reg.no: NCT05148247.

Background: The occupational therapy intervention Balancing Everyday Life (BEL)^TM aims to support mental health service users towards improved occupational balance and personal recovery. Yet, no research has specifically addressed recovery experiences among BEL^TM participants.

Aim: To investigate how the recovery process was experienced by mental health services users who had participated in BEL^TM.

Methods: The study was based on qualitative interviews with 11 participants. A deductive content analysis was performed based on the CHIME framework, a research-based tool for characterising the recovery process.

Results: All categories and most subcategories described in the CHIME framework could be found in the participants' experiences. The most prominent categories were Sense of connectedness and Empowerment. Most subcategories were identified as well. Additionally, two subcategories not covered in CHIME were distinguished - occupational balance, and self-esteem and self-confidence - which may be specific to an occupational therapy intervention like BEL^TM.

Conclusion: The study showed that CHIME was relevant for characterising the recovery process among BEL^TM participants and identifying the features shaping that process. The findings support CHIME, while also indicating that BEL^TM offers some additional avenues for personal recovery.

Significance: An occupational therapy intervention can support mental health service users towards personal recovery.

Background: Research is limited on registered healthcare professionals (RHCP) usage of research and evidence-based practice (EBP) in Swedish municipal primary healthcare work.

Aim/objectives: The aim of this study was to increase the understanding of experiences, attitudes, and conditions of usage of research and implementation of EBP among RHCPs in a Swedish municipality setting. Further, the study aimed to explore whether those attitudes and conditions were associated with RHCP basing their work on research.

Material and methods: The study was a mixed- methods study of a convergent design with five dialogue meetings and a web-based survey. Participants were RHCP recruited from one large size municipality.

Findings: Registered healthcare professionals struggled between personal and organisational conditions to use research and work according to EBP. They were torn between personal ambitions and lack of skills to use research, whereas having an advanced level education was significantly associated with basing work on research. Lack of organisational resources and support made usage of research and implementation of EBP difficult.

Conclusion: There is a need to strengthen the RHCP competence in using research evidence in clinical practice. Managemental support, education and clinical goals could improve the conditions for usage of research and implementation of EBP.

Background: Existing research has shown that those ageing with severe mental illness face significant challenges in daily life. Attendance at community-based day centres (DCs) is offered to support daily structure and break isolation. However, little is known about the experiences of those receiving this type of support while transitioning into retirement age.

Aim: To explore experiences of everyday occupations among older mental health service users attending DC while transitioning into retirement age.

Materials/methods: Fourteen older DC attendees were interviewed on three occasions, spanning a time frame of four and a half years. The material was analyzed using grounded theory.

Results: An overarching theme emerged; A sense of belonging - creating, recreating, and maintaining my occupational identity while ageing, with three underlying categories: Enablers helping to pave a pathway to social contacts and occupations, Struggling through changing conditions, and Recreating and maintaining my occupations and occupational identity.

Conclusions/significance: Attending DC contributed with enablers that helped to maintain an occupational identity, despite ageing with complex health conditions. This study can be useful when planning optimal support focusing on occupational identity.

Background: Fostering social participation for active and healthy ageing among older adults is an urgent issue in a changing society that requires new approaches from occupational therapists as well as from society at large.

Aim: To explore possibilities to foster social participation for older adults in society from the perspective of stakeholders.

Material and methods: A qualitative design was applied. 18 key informants, engaged in supporting older adults in their organisational roles as either professionals or volunteers, participated in five different focus groups discussions.

Results: The results involved two overarching themes that reflects different perspectives on key informants' possibilities to foster social participation for older adults. The first theme describes how they direct their attention towards their roles within the organisations to foster social participation in their own context. The second theme describes the broader societal perspectives that they address to establish a common ground for collaboration and knowledge-sharing among different stakeholders.

Conclusions: The findings emphasise how addressing common challenges and developing collaboration are essential to foster older adults' social participation. It is therefore necessary to involve policy-makers and decision-makers. Occupational therapists and researchers should consider the value of occupational justice to drive collective and social approaches.

Introduction: Swedish healthcare has undergone significant changes since the transferral of home healthcare from a regional to municipal responsibility, and since the new 2018 law regulating discharge from hospital. This meant changes to ways of working for Occupational Therapists (OTs), as OTs play a key role in planning for discharging patients, a crucial process before patients return home, and in the transition between care givers.

Aim: The aim of this study is to illuminate how OTs experience the intra-professional collaboration during the discharge process between inpatient care and home healthcare.

Methods: Interviews were conducted with OTs (N = 12), with even distribution between inpatient care and home healthcare, in three geographical locations in Sweden. Data analysis was performed according to qualitative content analysis.

Results: A central theme ran through all categories; the multi faces of intra-professional communication are challenging, intertwined and emotional. The categories illuminate experiences in terms of important but neglected patient participation and safety, different forms of mind-set depending on setting, complex rapid communication, unpredictable paths of discharge, unclear responsibility and organisational guidelines and, impact on work health and OT emotions.

Conclusion: Intra-professional communication is complex with many aspects and perspectives of importance for collaboration to run smoothly, but also the many individuals involved in the collaboration process of discharging a patient. This situates high demands on the professionals involved to distinguish and identify necessary information to make the discharge sound and safe for patient, as well as for relatives, involved services, and manageable for OTs.

Background: Acquired Brain injury (ABI) causes ripples throughout the occupational and social fabric. It enters people's lives at a significant personal cost, encroaching on people's sense of self. Vocational rehabilitation is a viable venue to regain control of their life and support them in forming a new sense of self. From an occupational perspective, little is known about how vocational rehabilitation can support people through transforming their sense of self.

Aim: This study aims to explore how vocational rehabilitation may influence the relationship between sense of self and occupational engagement for persons with ABI. Material and Methods: Six persons with ABI were purposely sampled. Data were collected using semi-structured individual interviews and analysed using a hermeneutic approach.

Results: The analysis resulted in three themes: a new sense of my former self, engaging in occupations as transformation, and the significance of support.

Conclusions: Participating in vocational rehabilitation can enable persons with ABI to form a new sense of self. Engaging in occupations and professional support is significant in the transformation process.

Significance: From an occupational perspective, the knowledge gained in this study stresses the essential role occupational engagement and proper targeted support have for people struggling to return to work after ABI.