Scandinavian Journal of Occupational Therapy最新文献

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: Parents' perceptions of children's sleep problems when using a weighted blanket could enhance the understanding of challenges faced by families with ADHD and sleep problems. This is in alignment with a client-centred approach. Acknowledging, what parents perceive as a problem in a family context.

Aim: To explore changes in parents' perceptions of their children's sleep problems before and after participation in a sleep intervention with weighted blankets.

Methods: Children with ADHD (n = 45) aged 6-14 participated in a sleep intervention with weighted blankets. Data-collection (baseline + 16-week) using the Children's Sleep Habits Questionnaire.

Results: Common sleep problems, such as bedtime resistance, daytime sleepiness, sleep onset delay, and sleep duration, were reported to have improved in 50-75% of the children after using a weighted blanket, according to their parents. Changes were seen also for the less commonly reported parasomnias and nightly awakenings, and these problems were rarely perceived as persistent.

Conclusions: Reported improvements covered various sleep domains, though some sleep issues persisted. Future evaluation of the effects of weighted blanket should assess multiple dimensions of sleep, before and after use.

Significance: The client-centred approach, including parents' perceptions of children's sleep problems, is important in the evaluation of weighted blankets for children with ADHD.

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: Ensuring inclusive participation in daily physical activities is crucial and valid and reliable instruments are needed.

Aim: To evaluate the test-retest reliability and internal consistency of the self-reported web-based physical participation instrument, ActiveYou II.

Material and methods: Reliability was examined in 41 children (mean age 10,5 years), and 41 adults (mean age 49 years) with disabilities using intraclass correlation coefficients (ICC), Kappa statistics, percentage of absolute agreement, and Cronbach's alpha.

Results: The test-retest reliability was good for the participation frequency scores (ICC; 0.66 to 0.95) and moderate for the skill-competency and involvement scores (ICC; 0.43 to 0.89). The alpha values for internal consistency were acceptable for the frequency (α = 0.749), skill competency (α = 0.833), and involvement scores (α = 0.795).

Conclusions: ActiveYou II demonstrated good psychometric properties, indicating its potential to inform intervention planning and enhance service provision for individuals with disabilities. Lower reliability in skill competency and involvement scores suggests these factors are transient, varying with experiences, well-being, and mood. ActiveYou II maps and evaluates the interaction between individual and environmental factors, enhancing understanding of participation in physical activities.

Significant: Leveraging insights from ActiveYou II, stakeholders can enhance participation in physical activities and well-being for individuals with disabilities, thereby fostering a more inclusive society.

Background: In stroke rehabilitation, instruments assessing the value individuals attribute to everyday activities are vital. The Occupational Value with pre-defined items (OVal-pd) questionnaire was devised for this purpose.

Aim: To evaluate the psychometric properties of the Swedish OVal-pd-floor and ceiling effects, internal consistency, construct validity, responsiveness, long-term stability, and measurement error-in individuals with stroke who maintained independence in activities of daily living and had preserved cognitive abilities.

Methods: Stroke patients (n = 95) were included in a secondary analysis of a randomized controlled trial with a 14-month follow-up. Participants completed the OVal-pd and questionnaires addressing quality of life, emotional status, and mental fatigue. Cronbach's α, Pearson's correlation, ROC analysis, intraclass correlations, and smallest detectable change were calculated.

Results: The Swedish OVal-pd showed good psychometric properties concerning construct validity, internal consistency, test-retest stability, with no floor or ceiling effects. However, the low rate of improvement in mental fatigue over the follow-up period limited the ability to evaluate responsiveness using an anchor-based method.

Conclusion: The 18-item Swedish OVal-pd is suitable for use in clinical and research contexts, though further trials are recommended.

Significance: The OVal-pd can facilitate dialogue between individuals with stroke and occupational therapists and be used for cross-sectional comparisons.

Background: Rehabilitation of age-related dysphagia in older adults remains a complex clinical challenge. The Danish occupational therapy intervention ACTING (ACTivity-based Skill Training of INGestion) was developed employing an occupation-centred approach. Before large-scale evaluation, a proof-of-concept study is needed to explore its potential in real-world practice.

Objectives: To evaluate clinically meaningful outcomes of ACTING and assess implementation fidelity in municipal occupational therapy for dysphagia rehabilitation.

Materials and methods: A proof-of-concept case-series (N = 5) with pre-post outcome assessment was employed. Primary outcomes included mealtime task performance, dietary variety and perceived change. Secondary outcomes included dysphagia severity, ingestion-related muscle function, nutritional status, interference with joy of life, quality of life, and aspiration pneumonia. Structural and process fidelity data were collected.

Results: All participants increased dietary variety, and four achieved clinically meaningful improvements in mealtime performance, accompanied by perceived improvements in eating and drinking. Secondary outcomes showed trends towards improvement. However, outcome variability and inconsistent fidelity were observed, and intervention delivery was influenced by context, resources, and clinician training.

Conclusion and significance: ACTING shows promise as a potential occupation-centred approach to dysphagia rehabilitation in municipal practice. Findings support further development, with attention to strengthening implementation fidelity and clinician training before larger-scale testing.

Background: Levels of sickness absence due to common mental disorders (CMD) vary between industrial sectors and managers are key for prevention and rehabilitation.

Objective: To assess industry differences in managers' experiences and ratings of work capacity in employees with depression and anxiety.

Material and methods: Differences between industries in managers' (n = 1819) experiences were investigated by chi-squared tests and managers' ratings were analysed through MANCOVA.

Results: The proportion of managers who had experienced several employees with depression and anxiety was higher in municipalities and counties, and in industries with people as the main work object such as education, health and social care settings, compared with other industries. There was no significant effect of industry on managers' ratings of how work capacity is affected by depression and anxiety.

Conclusions: Having experienced several employees with common mental disorders is more common among managers of female dominated service sectors, but managers rate capacity to work in employees with depression and anxiety similarly, irrespective of industrial sector.

Significance: It is important that managers receive the support they need to handle employees with reduced work capacity due to CMD, however, support does not need to be tailored to different industries.

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.

Introduction: Unemployment is known to have effect on occupational well-being and thus is issue of relevance and importance to occupational therapy. However, knowledge about occupational therapy practices among unemployed people in the Finnish context is scarce.

Aim: This study aims to explore the various ways occupational therapists work among unemployed people, and how this work could be further developed.

Method: The study followed a phenomenographic approach. Data was gathered combining focus group discussion and interviews.

Results: The ways of working among unemployed were identified as Assessing, Coaching and Collaborating. Practices could be further developed by Adapting to new ways of working, Increasing awareness of occupational therapy and Advocating for better opportunities to participate in working life.

Conclusions and significance: The results imply that occupational therapists in Finland engage with unemployed people's situation at late stages of unemployment, limiting the integration of occupational perspective in current services. Therapists wish to advocate but are simultaneously acting as gatekeepers, emphasizing the need for preventive and collaborative approaches. Study suggests that occupational therapists may contribute to bridging health, social, and employment services. Further research including client perspectives is needed to expand the profession's role and effectiveness in addressing the situation of unemployed people.