Scandinavian Journal of Occupational Therapy最新文献

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: The Occupational Balance Questionnaire (OBQ11) is a commonly used instrument for measuring self-rated occupational balance. It needs further development, and therefore an additional 11 tentative items have been developed. One aspect of this is studying the interpretations and reasoning of people responding to the items/instrument.

Aim: The aim of this study was to explore and describe how adults interpret and reason in relation to OBQ11 overall, the individual items in the instrument as well as the new tentative items.

Method: Cognitive interviews were conducted with eight participants varying in age, gender, living situation, education, native language, and self-reported disability. They were included using a combination of purposive and convenience sampling. The interviews were analysed using a content analysis with an inductive approach.

Results: The analysis resulted in three main categories: 'Difficulties understanding the items' (with two subcategories), 'Structure of the instrument' (with four subcategories) and 'Missed perspectives in the instrument' (with four subcategories).

Conclusions: The participants considered the items and the instrument relevant for assessing occupational balance. However, the results also revealed the need for more clarifications and changed item order prior to introducing a potential new version of the instrument.

Background: Few evidence-based resources exist to support generalist occupational therapists address driving in practice. This pilot study aimed to evaluate whether a driving clinical decision pathway can assist generalist occupational therapists to address driving with clients.

Methods: Using a before (Timepoint-1) and after (Timepoint-2) design, data were collected at a multi-site outpatient community rehabilitation service. Medical record audits documenting how driving was addressed in practice and descriptive surveys of therapist's perceptions of pathway use were collected at Timepoints 1 and 2. A driving clinical decision pathway was implemented over 6 months. Descriptive statistics and content analysis were used to analyse and compare data over time.

Results: Timepoint-1 data from 102 client medical records, and 13 clinician surveys were compared against Timepoint-2 data from 144 records and 8 surveys. Following implementation of the pathway, the number of assessments used by generalist occupational therapists increased three-fold, to inform driving process recommendations which increased two-fold. Clinicians' self-reported knowledge, skills and confidence also increased two-fold.

Conclusion: A comprehensive driving clinical decision pathway provided clinicians with increased structure and support to guide practice change and promote role fulfilment in addressing return to driving with adults following a change in health status.

Background: Artificial intelligence (AI) technology is constantly and rapidly evolving and has the potential to benefit occupational therapy (OT) and OT clients. However, AI developments also pose risks and challenges, for example in relation to the ethical principles of OT. One way to support future AI technology aligned with OT ethical principles may be through human-centered AI (HCAI), an emerging branch within AI research and developments with a notable overlap of OT values and beliefs.

Objective: To explore the risks and challenges of AI technology, and how the combined expertise, skills, and knowledge of OT and HCAI can contribute to harnessing its potential and shaping its future, from the perspective of OT's ethical values and beliefs.

Results: Opportunities for OT and HCAI collaboration related to future AI technology include ensuring a focus on 1) occupational performance and participation, while taking client-centeredness into account; 2) occupational justice and respect for diversity, and 3) transparency and respect for the privacy of occupational performance and participation data.

Conclusion and significance: There is need for OTs to engage and ensure that AI is applied in a way that serves OT and OT clients in a meaningful and ethical way through the use of HCAI.

Background: Obesity and being overweight can hinder participation in daily activities and impact engagement. Occupational therapists offer a unique perspective on this issue, yet their practice is seldom described in the literature.

Aim: To explore how Australian occupational therapists use their occupational perspective when working with people who are obese or overweight.

Methods: A qualitative dominant crossover mixed methods approach was adopted. Eleven semi-structured interviews with occupational therapists were conducted and analysed. Questions explored clinical decision-making, barriers, facilitators, and therapist knowledge and confidence about working with these clients. Three Likert scale questions on client contact frequency, perceived intervention effectiveness and knowledge of weight-related occupational therapy provided contextualisation.

Results: Occupational therapists reported average confidence and variability in the effectiveness of weight-related interventions. Three key themes were identified: 1) Exploring clients' needs for weight management; 2) Incorporating weight management strategies in occupational therapy intervention; and 3) Organisation of current occupational therapy practice for people with obesity.

Conclusion: Occupational therapists should leverage an occupational perspective to enhance participation and engagement for people with obesity, thereby ensuring the client's best interests are met.

Significance: As change agents, occupational therapists can advocate for shifts in care culture, influence leadership and challenge systemic issues that limit occupational performance and participation for people with obesity.

Background: Disabilities can hinder children's and youths' participation (frequency of attendance and engagement) and independence in everyday life.

Aims: To identify factors that predict levels of participation and independence in everyday activities in Swedish children and youths with disabilities.

Material and methods: This cross-sectional study, including 131 participants, utilised instruments about child and environmental factors. LASSO regression analyses were conducted to identify predictors of participation and independence.

Results: An item screening for comprehension difficulties was the strongest predictor of attendance, engagement, and independence in daily activities. Other influential child factors included the presence of seizures, speech abilities, age, pain levels, and motor functions. None of the studied environmental factors were retained as predictors in the models.

Conclusions: Difficulties in intellectual functioning need to be evaluated and considered in planning interventions to improve participation and independence. Likewise, multifaceted nature of challenges found in this study underscores the need for diversity of interventions tailored for individual needs.

Significance: The result underscores the critical role of comprehension and intellectual functioning in predicting and enhancing participation and independence in children and youths with disabilities, advocating for comprehensive assessments and sustained support.

Background: Everyday lives of adolescents reflects a pattern and balance of occupations across the awake-sleep continuum. Despite ongoing discussions regarding overconsumption, play in digital spaces is an occupation of choice for many adolescents.

Aim: To explore and identify how the meaning of playing video games is situated in adolescents' everyday life.

Material and method: Five participants aged 16-17 years were recruited. Data was generated through interviews and encounters using recorded clips of their play in digital spaces. Narrative analysis was utilised to explore the stories of adolescent's digital play in everyday life.

Results: The overall plot of 'bridging the divide' represents and symbolises how play in the digital space is integrated in adolescents' everyday life as they negotiate and balance the habits and routines of everyday life. Four storylines help demonstrate the stories told.

Conclusion: Playing in digital spaces enabled the participants to be part of an ongoing story where meaning could be negotiated and created. Play was interwoven in the complexity of routines reflecting the importance of examining the integrated whole of adolescents' everyday life.

Significance: These findings are significant in shifting current assumptions and discourses of how digital play is situated in everyday life.

Background: Perceived occupational value is closely linked with well-being and there is need worldwide for assessment tools that target this phenomenon. The Occupational Value with pre-defined items (OVal-pd), measuring three dimensions of occupational value; concrete, socio-symbolic and self-rewarding, was designed for that purpose.

Aim: To pilot an Arabic version of OVal-pd and evaluate its psychometric properties in terms of content validity, factor structure, homogeneity, construct validity, test-retest stability, floor and ceiling effects, and measurement error.

Methods: Snowball sampling was used to recruit Arabic-speaking persons living in Sweden (n = 55). They completed the OVal-pd and questionnaires addressing background factors, content validity and feasibility. Confirmatory factor analysis, Spearman's rank correlation, Cronbach's α, intraclass correlation coefficients, and minimum detectable change were calculated.

Results: A 22-item version of the Arabic OVal-pd was found to have acceptable content validity and feasibility and the proposed three occupational value dimensions were confirmed. Good properties in terms of construct validity, internal consistency and test-retest stability were also established. No floor or ceiling effects were observed.

Conclusion: The Arabic OVal-pd showed good validity and reliability on various psychometric aspects.

Significance: In today's multicultural societies, the Arabic OVal-pd can be an important tool for occupational therapists working with Arabic-speaking clients.

Background: Occupational therapy's connection to positivist science predates the profession's formal beginning, with important contributing knowledge sources coming from mathematics, physics, psychology, and systems theory. While these sources of objective knowledge provide a rational, defendable position for practice, they can only explain a portion of what it means to exist as an occupational being.

Aims/objectives: This article aims to reveal some of the history of science within occupational therapy and reveal the subjective, ontological nature of doing everyday activities that the profession's preoccupation with positivist science has obscured.

Methods: This research used a history of ideas methodology to uncover how occupational therapy perceived people and how practice was conceptualised and conducted between 1800 and 1980s, as depicted in writing of the time.

Conclusion: Analysis showed that, through history, people were increasingly categorised and delimited. Practice also became systematically controlled, moving occupational therapy into a theoretical, scientific, and abstract realm.

Significance: The emphasis placed on objectivity diminishes the attention given to human ways of practicing, where the subjective experience is central to our thinking.