Scandinavian Journal of Occupational Therapy最新文献

Background: The vast majority of older adults live in their own homes. Many of them live with chronic conditions that lead to activity limitations and participation restrictions. To support them adequately, we need to better understand how they cope with everyday difficulties.

Aim: To identify and examine difficulties in everyday life older people with chronic conditions who live in private homes face and how they and their significant others interpret, navigate, and overcome these difficulties.

Material and methods: We conducted a focus group interview with 10 participants including eight older adults with chronic conditions and two of their significant others. We then transcribed the interviews verbatim and thematically analysed them.

Results: We generated the three closely interrelated themes struggling not to lose control, a shifting balance between resources and environmental challenges, and negotiating independence and interdependence. Participants interpreted the difficulties they faced as multicausal. Their main goal was maintaining autonomy, agency, and a positive identity. They employed individual, creative strategies to achieve these goals.

Conclusions: Older persons with chronic conditions prioritise autonomy and agency in order to maintain a positive identity.

Significance: Interventions to support older persons with chronic conditions should centre their priorities and build on their creativity.

Background: The occupational therapy intervention programme ABLE 1.0 was designed to enhance the ability to perform activities of daily living in persons living with chronic conditions. There is a need to determine if content and delivery of the ABLE 1.0 are acceptable among occupational therapists (OTs) and clients after having delivered or received the programme, respectively.

Objectives: The paper reports on evaluation of content and delivery of the ABLE 1.0 among OTs and clients. This, in terms of acceptability of intervention in principle, and perceived value, benefits, harms, or unintended consequences of the intervention.

Material and methods: Qualitative semi-structured interviews were conducted with OTs having delivered and clients having received ABLE 1.0 in a Danish municipality. Content analysis was performed.

Findings: Two OTs and three clients participated. Analyses revealed six categories related to content and delivery; 'Overall perception of the programme'; 'Potential for implementation'; 'Evaluation, goal setting and clarification of reasons for ADL task performance problems'; 'Intervention: compensatory solutions'; 'Format and duration' and 'Preconditions for delivery'.

Conclusions and significance: The findings provided valuable information used for further development of the ABLE programme.

Background: The concept of an occupational pattern in occupational therapy and occupational science has evolved with varying definitions, ranging from activity patterns to patterns of daily occupation.

Aims: This study aimed to explore the concept of occupational pattern, develop an updated definition of the concept, and theoretically validate the concept's definition.

Method: Walker and Avant's concept analysis method was used, where both theoretical frameworks and peer-reviewed scientific literature were searched and synthesized to clarify and define the concept. Furthermore, seven occupational therapists theoretically validated the concept.

Findings: The analysis included forty-nine references from various research contexts and theoretical perspectives. The synthesis yielded a conceptualization of the concept of occupational pattern, outlining it into three overarching categories: 'content in an individual's occupational pattern', 'designing an occupational pattern', and 'balancing the occupational pattern'.

Implications: An updated operational definition of the multifaceted concept of an occupational pattern now exists, with practical implications for enhancing the education of occupational therapy students and guiding the utilization of the concept. Moreover, it holds significance for instrument development and outcome measurement in research; especially in lifestyle intervention studies within the field of occupational therapy.

Background: While study approaches have been directly associated with students' academic performance, learning environment factors may play a more indirect role. The aim of this study was (i) to assess learning environment factors as predictors of students' average exam grades, and (ii) whether study approaches mediated associations between learning environment factors and exam grades.

Methods: Three annual surveys (2017-2019) yielded data from a total of 263 Norwegian occupational therapy students. Learning environment factors were assessed with the Course Experience Questionnaire, and the Approaches and Study Skills Inventory for Students were used to assess study approaches. Linear regression analyses and mediation analyses were performed.

Results: Higher levels of 'student autonomy' were directly associated with lower averaged grades whereas higher levels of 'appropriate workload' were associated with higher averaged grades. There were statistically significant total indirect effects of 'clear goals' and 'appropriate workload' on grades; these effects occurred through the study approach variables. However, all learning environment variables showed one or more relationships with academic performance that was mediated by study approach variables.

Conclusion: Learning environment variables appear to be complexly associated with academic performance, both directly and indirectly.

Background: Research has identified diverse constraints to the adoption of school-based occupational therapy approaches and a lack of attention to addressing the barriers to children's play opportunities. Critical contextualised research is advocated to inform practice possibilities.

Aims/objectives: This inquiry aimed to explore with occupational therapists their existing practices in Irish schoolyards to generate practice possibilities concerned with play, as an issue of occupational justice.

Materials and methods: Using the theory of practice architectures, six occupational therapists from diverse sites of practice participated in the first phase of a critical action research process using dialogical focus group and occupational mapping methods.

Results: Three themes were generated (1) Existing practices as situated (2) (Re)mattering play and practices as occupations and (3) Practice possibilities - 'Finding the play' between responsiveness and responsibilities. A further interrelated dimension was how the research methods provided mechanisms of raising consciousness.

Conclusions, and significance: Alongside constructing knowledges on existing practices in an Irish context, this inquiry contributes to understandings of practices as socially embedded generative processes of 'finding the play', highlighting ethical responsibilities to make visible inequities reproduced in habitual practices and engage in relationships of solidarity to (re)construct alternative shared practices.

Background: Stroke rehabilitation consists of restorative and adaptive approaches. Multiple adaptive approaches exist.

Aims/objectives: The objective of this study was to develop a framework for categorising adaptive stroke rehabilitation interventions, based on underlying theory.

Material and methods: We searched multiple databases to April 2020 to identify studies of interventions designed to improve participation in valued activities. We extracted the name of the intervention, underlying explicit or implicit theory, intervention elements, and anticipated outcomes. Using this information, we proposed distinct groups of interventions based on theoretical drivers.

Results: Twenty-nine adaptive interventions were examined in at least one of 77 studies. Underlying theories included Cognitive Learning Theory, Self-determination Theory, Social Cognitive Theory, adult learning theories, and Psychological Stress and Coping Theory. Three overarching theoretical drivers were identified: learning, motivation, and coping.

Conclusions: At least 29 adaptive approaches exist, but each appear to be based on one of three underlying theoretical drivers. Consideration of effectiveness of these approaches by theoretical driver could help indicate underlying mechanisms and essential elements of effective adaptive approaches.

Significance: Our framework is an important advance in understanding and evaluating adaptive approaches to stroke rehabilitation.

Background: Dementia is an age-related disease associated with complex health and care needs. Due to demographical shifts, the number of older people with dementia is forecasted to increase. Occupational therapists encounter people with dementia in their daily work, yet little is known about their experience of working with people with dementia.

Aim/objectives: To explore occupational therapist's experiences of working with people with dementia.

Material and methods: Ten occupational therapists were interviewed using semi-structured interviews. Data were analysed using reflexive thematic analysis.

Results: The results are presented in five different themes: Working with persons who do not recognise decline in their abilities; Saving-face of the person in assessment situations; Facilitating continued engagement in everyday activities; Utilising information provided by care staff; Balancing different preferences on how to proceed.

Conclusion: Occupational therapists perceive a need in their work to employ various face-saving strategies and facilitate engagement in everyday activities. The results are exploratory and additionally research is needed to understand the therapists' experiences of working with persons with dementia.

Significance: Everyday activities should be tailored to the person's abilities, with an emphasis on facilitating the person in carrying them out rather than the social environment taking them over.

Background: Information and communication technology (ICT) provides one solution to meet increasing demands for occupational therapy for older adults.

Aims/objectives: To examine if and how municipality-based occupational therapists (OTs) include ICT in their work, and which factors are associated with use of occupational therapy at a distance.

Material and methods: Survey study including 167 OTs. Data were presented descriptively. Associations were analysed by Chi² test and logistic regression models.

Results: Forty-eight percent of OTs used ICT once a month or more. OTs belief on possibilites to use ICT is associated with replacement of physical home visits. Managers expectations and support also seem to be important factors.

Conclusion: ICT solutions are frequently used by OTs in home health care and can be considered complementing rather than replacing physical home visits. More knowledge is needed on when and how ICT solutions can be used by OTs and how factors that impact the use of ICT can be managed.

Background: People with mental health issues often experience difficulties with sensory modulation affecting occupational engagement. Research conducted in inpatient units has shown positive effects of individual sensory modulation interventions, however, research on experiences of group-based interventions in outpatient units is limited. Hence, a group-based sensory modulation intervention was adapted and tested within Swedish mental health outpatient units.

Aim: To explore the experiences of participating in a group-based sensory modulation intervention for service users in mental health outpatient units.

Material and methods: This qualitative study involved interviews with 25 informants who had participated in the intervention. The interview data were analysed using reflexive thematic analysis.

Results: Synthesis of the interviews resulted in one overarching theme of 'Embodied awareness facilitates improved coping and sense of self' organised into four themes: (1) 'Developing embodied awareness and strategies', (2) 'Taking control of everyday life', (3) 'Creating a stronger sense of self', and (4) 'From alienation to belonging'.

Conclusion and significance: The informants experienced the intervention to provide new embodied coping strategies that had previously been neglected. This understanding may enrich occupational therapy practice in new ways to support service users' engagement in occupations.

Background: Within and beyond occupation-based scholarship, concerns abound regarding the pervasiveness of discourses that promote a negative, deficit-based view of intellectual disability and associated consequences for disabled people's lives. Such representations risk reducing the complexities of human doing and being and can limit the occupational possibilities of this group. Yet, there is a lack of critically reflexive research exploring how disability is discursively constructed in occupation-based literature.

Aims/objectives: This paper critically analyses representations of intellectual disability within occupation-based literature. It considers the influence of such representations on the occupational possibilities of people labelled intellectually disabled.

Methods: This review employed a critical interpretive synthesis of 21 peer-reviewed articles from occupational therapy and occupational science that focused on intellectual disability.

Results: Three analytic threads were identified as contributing to how intellectual disability was represented across the reviewed literature: habilitating expected doings, becoming productive citizens, and activated, but insufficient.

Conclusion & significance: Occupation-based discourses have powerful influence within society, particularly within occupational therapy, regarding understandings of intellectual disability and how these shape occupational possibilities for persons labelled intellectually disabled. Drawing attention to taken-for-granted representations of intellectual disability is essential to promote transformative occupational therapy practice and enhance occupational possibilities for this population.