Scandinavian Journal of Occupational Therapy最新文献

Background: The Swedish Government is implementing a Transition To Integrated and Person-Centred Care, with telehealth as a key component. This transition affects both patients and healthcare professionals, including occupational therapists. However, knowledge about occupational therapists' views on telehealth in their practice is limited.

Objective: To explore and describe how occupational therapists within regional primary care reason about telehealth in an occupational therapy practice context.

Material and methods: A qualitative interview study was conducted, using semi-structured interviews with 14 occupational therapists. Data was analysed using systematic text condensation.

Results: The occupational therapists reasoned about telehealth in three main areas: Through the lens of the patient, Through the lens of their profession, and In relation to the context.

Conclusions: The study indicates that conventional occupational therapy is not always feasible through telehealth. To fully utilize telehealth, the occupational therapists see a need to adopt new ways of working. They emphasized the importance of retaining in-person meetings, and that further developed telehealth could constitute a valuable complement to the service they provide.

Significance: These insights regarding telehealth could guide the profession and support development in relation to the transition to integrated care and person-centred care, ultimately benefiting those who need occupational therapy.

Background: Performance of activities of daily living (ADL) tasks is essential for most people's everyday lives. However, there is limited information regarding which ADL tasks and how their performances are typically impacted among persons with Long COVID.

Aim: To explore the types of ADL tasks typically affected and how the quality of ADL task performance is impacted in persons with long COVID and to explore relationships between ADL ability and health-related, social, or personal factors.

Material and methods: This cross-sectional study involved individuals participating in a municipality-based rehabilitation program for persons with Long COVID. Data on ADL ability and health-related, social, and personal factors were gathered.

Results: The sample included n = 30 individuals with Long COVID. The participants reported decreased quality of ADL task performance related to both Personal ADL and Instrumental ADL tasks. A moderate relationship was identified between participants' ADL-I ability measures and ratings of fatigue. None of the remaining health-related, social and personal variables were related to ADL ability.

Conclusions: Individuals diagnosed with Long COVID reported decreased quality of performance in both PADL and IADL tasks, with increased time and effort being the primary issues. The most prevalent symptom, fatigue, was moderately related to participants' ADL ability.

Background: People with chronic conditions often experience decreased ability to perform activities of daily living (ADL). ABLE is a structured, client-centred, occupational therapy programme developed to address ADL ability using adaptational strategies.

Aims: Evaluate the feasibility of ABLE in terms of content and delivery, i.e., intervention development and components, mechanisms of action, perceived value, feasibility in practice, and fidelity.

Material and methods: Study was conducted alongside a randomised controlled trial collecting data from clients and occupational therapists. Quantitative and qualitative data were analysed descriptively.

Results: ABLE was delivered with high fidelity and perceived meaningful and satisfactory. Goals were attained in 55 out of 64 cases (86%). Key mechanisms included standardised ADL evaluations, collaborative goal setting, and adaptational strategies. Minor deviations occurred, and goal setting posed challenges.

Conclusions: ABLE was feasible and acceptable in municipal rehabilitation services. Findings support potential for enhancing ADL ability among people with chronic conditions.

Significance: This study adds to a comprehensive evidence base for ABLE and informs future implementation, highlighting the importance of training in goal setting and standardised evaluation.

Trial registration: Prospective registration on www.ClinicalTrials.gov [registration date: 05/03/2020; identifier: NCT04 295837] prior to data collection that occurred between August 2020 and July 2021.

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.

The Paediatric Evaluation of Disability Inventory (PEDI), has been revised as a computer adaptive test; the PEDI-CAT. Many items have been added making it relevant for children and youth from birth to 20 years of age. The PEDI-CAT measures performance in the Functional Skills domains of Daily Activities, Mobility and Social/Cognitive. The PEDI-CAT's Responsibility domain measures the extent to which the caregiver or child takes responsibility for managing complex, multi-step life tasks. In this exploratory study the normative scores of children with typical development of Switzerland (n = 51) and Germany (n = 61) were compared with the American normative sample to investigate its applicability. The mean age of the children was 5.78 years with a standard deviation of 1.39 years and a range of 4.10 years. Statistically significant differences in comparison with the mean normative scores with moderate to strong effect were found in all domains. Still, 95% or more of all scores from the participants were within a 2 standard deviation range from the mean normative scores. The results indicate that the normative scores should right now be applied to the German version of the PEDI-CAT with caution. Further studies are needed to further investigate applicability of the normative values.

Background: Occupational therapists aim to deliver interventions to enhance clients' occupational performance and document the outcomes of clients' experience. The Canadian Occupational Performance Measure (COPM) is a measurement tool designed for such documentation, and a recognised measurement used worldwide. However, the authors' research and teaching experiences have revealed that there are often misinterpretations and uncertainties administering the COPM. Therefore, the aim of this paper was to present information to answer these issues.

Methods: Based on a state-of-the-art review, 856 papers were identified on PubMed, of which 36 were included together with the first author's work, to summarise relevant answers.

Results: Answers to the four key issues are unfolded to address the misinterpretations and uncertainties regarding: (1) the core content of the COPM, focussing on being client-centred; (2) understanding the term occupational performance; (3) reflecting on the psycho-metric status on the COPM, what it provides; (4) reflecting on necessary considerations when administering the measurement, understanding the measurement's five steps to ensure a valid and reliable use.

Conclusion: The valid, reliable, and applicable use of the COPM can be enhanced through therapists' commitments to and understanding of these four issues. Based on this, guidelines on how to best administer the COPM are provided.

Background: Primary health care is central to equitable health systems. Despite shared values, its integration into occupational therapy education remains unclear.

Aim: To explore and describe undergraduate students' perceptions of their readiness for primary health care, their experiences of the curriculum and to develop recommendations for curriculum enhancement.

Material and methods: A qualitative, two-phase study was conducted with Cypriot students. A focus group explored perceptions of preparedness and curriculum assets and challenges. A nominal group technique session prioritized recommendations for teaching methods. Focus group data were analysed using Framework Analysis; nominal group results were analysed descriptively and quantitatively.

Results: Students reported limited exposure to primary health care and felt unprepared for its diverse demands. Their experiences of the curriculum shaped a sense of partial readiness for primary health care. They identified the need for active, applied, and collaborative learning to bridge the gap between theory and practice.

Conclusions: Students perceived lack of readiness for primary health care roles, revealing curriculum gaps and advocating for transformative teaching.

Significance: This study highlights the need to reform occupational therapy education in Cyprus by incorporating primary health care competencies. This could enhance autonomy, professional identity, and the further development of occupational therapy practice areas.

Background: Return to work after stroke is a key goal in rehabilitation for people of working age. However, post-stroke fatigue is a common and complex symptom, and how it affects sustainable return-to-work and everyday life remains insufficiently explored.

Aims/objectives: To describe how persons of working age who experience fatigue after stroke perceive their prerequisites for sustainable return-to-work in the context of everyday life.

Material and methods: Forty-eight working-age individuals with stroke participated. Data were collected via the Worker Role Interview (WRI) and a survey. WRI data were analysed using qualitative abductive content analysis and descriptive statistical analysis were conducted.

Results: Upon returning to work, participants found themselves in an everyday life where fatigue affected their work ability. The process was marked by uncertainty, ongoing challenges handling work demands under reduced capacity, and inconsistent support. The stroke marked the beginning of a complex, emotionally charged process as participants sought to navigate their new self and redefine their occupational identity.

Conclusions/significance: Sustainable return-to-work when experiencing post-stroke fatigue requires person-centred rehabilitation that integrates work and everyday life. Flexible work environments are essential, along with close employer collaboration to ensure understanding of the work situation.

Background: Chronic fatigue impacts individuals' ability to engage in daily activities and their quality of life. The Activity Calculator is a method for fatigue management in relation to occupational participation that aims to: 1. Help patients to find a balance between what they want to do and what they are able to do. 2. Help patients to obtain congruence between occupational participation and their values and personal meaning.

Aims: Elaborate on a theoretical foundation for the Activity Calculator by addressing three concepts: occupational adaptation, patterns of daily occupational, and occupational balance.

Results: The three concepts are presented, and it is discussed how the concepts may serve as a theoretical foundation for the Activity Calculator when used in an occupational therapy intervention. The concept occupational adaptation is discussed as a transactional process, but also as an outcome as expressed by the two aims of the Activity Calculator.

Conclusion: The three addressed concepts seem to serve as a suitable theoretical foundation of the Activity Calculator.

Significance: The developed theoretical foundation makes it possible to evaluate the effects of the Activity Calculator in future research.

Background: People with visual impairment (VI) face barriers to participating in physical activity (PA). While research has explored ways to improve PA accessibility and documented short-term benefits, its long-term impact, particularly from an occupational perspective, remains underexplored.

Aims/objectives: To examine the long-term influence of a group-based PA programme for people with VI, exploring its impact on daily life and sustained wellness.

Methods: This qualitative study involved semi-structured interviews with 11 respondents who had participated in a 10-week PA programme. Data were collected two months and four months post-programme to assess lasting effects, and reflexive thematic analysis was applied.

Results: Three overarching themes were identified: 'I have a healthier body and mind', 'I perform better in my day-to-day life', and 'My connection with others is growing', reflecting participants' perceived improved health, enhanced daily activity engagement, and strengthened social connections.

Conclusions and significance: The influence of PA programmes for people with VI expands and becomes progressively more pronounced over time. This study underscores the role of structured PA programmes in fostering long-term positive changes. It highlights the importance of considering long-term PA outcomes in occupational therapy practice for people with VI.