Scandinavian Journal of Occupational Therapy最新文献

Background: Living in residential aged care (RAC) facilities can have a passivating effect on older adults. Reablement is an approach to increase activity and participation in daily life. However, research on reablement in RAC facilities remains limited, making further research necessary.

Aims/objectives: This study aimed to investigate the feasibility of an 8-week reablement programme, Reablement in Residential Aged Care (Re-RAC), prior to a planned randomized controlled trial (RCT).

Material and methods: Re-RAC aligns with the Swedish RAC context and international reablement principles. Qualitative and quantitative data on occupational performance, physical activity, psychological well-being, quality of life, adherence, and residents' and staff experiences were collected at an RAC facility in Sweden. Descriptive statistics and content analysis were used.

Results: Six residents and 12 staff participated in the intervention. The methodology and intervention procedures were feasible overall. Participants requested more regular occupational therapy support, and staff requested support to motivate participants.

Conclusions: This study demonstrates that Re-RAC was a feasible and well-accepted intervention in a Swedish RAC facility, although some areas for improvement were identified. Maintaining motivation was highlighted, and extended support will be incorporated.

Significance: This study provides practical guidance for reablement in RAC facilities, emphasizing resident motivation and staff engagement.

Background: Menopause defines a transition in women's lives; it can cause physical, psychological and cognitive symptoms that require adaptation. Research shows that menopause-related symptoms can have a negative impact on women's self-rated productivity and work ability. The work environment can both promote and hinder the individual's ability to do their work. In a Swedish context, knowledge is lacking on how women experience factors in the work environment that affect work ability. Investigating women's experiences can contribute to new knowledge focusing on increasing the working capacity of the group.

Aim: To investigate what women in menopause experience as supporting and hindering factors in the work environment.

Material and methods: A qualitative method with an inductive approach; through semi structured interviews (N = 6) and qualitative content analysis.

Result: Two main categories were identified: The necessity for enhanced awareness and education regarding menopause and Adaptations and recovery opportunities in the work environment.

Conclusion: Individual adaptation is crucial due to the personalised impact of the work environment. Awareness and knowledge about menopause and an open and flexible organisational culture facilitate necessary adjustments. Recognising the social environment as a supportive factor is essential. Occupational therapy interventions considering the individual in relation to the workplace environment can contribute to sustainable changes.

Background: The number of nursing home residents with obesity is increasing. Despite the complex physical and social challenges that nursing home residents with obesity face daily, there is a lack of knowledge of how they experience things seen from their perspective.

Objectives: This study explored how nursing home residents with obesity experience everyday life.

Materials and methods: 11 nursing home residents living with obesity were interviewed. A phenomenological analysis ad modum Giorgi was applied.

Results: Three themes encapsulated essential aspects of the nursing home residents' experiences of living with obesity: (1) From cake to crispbread - living and coping with an oversized body. (2) It keeps me in shape - wanting to keep going. (3) She is the best at making low-fat food for me - navigating the possibilities and barriers in the social and institutional environment of the nursing homes.

Conclusion: Participants' oversized bodies shaped their daily life and thoughts, often involving concerns about bodily appearance and desires to maintain or lose weight. The findings highlight the need for occupational therapists to support residents' everyday strategies for managing life with obesity, including habitual change and environmental adaptation.

Significance: Nursing home staff should support residents in maintaining self-reliance, routines, and targeted weight management.

Background: Teaching and learning are core components of occupational therapy practice, with therapists commonly positioned as 'educating' the client. Despite its acknowledged importance, however, little attention has been given to developing discipline-specific learning theories that reflect current practice.

Aim: This research aimed to construct a theory explicating the process of learning that occurs between therapists and clients.

Methods: The study was conducted in the context of therapy provision to pre-school children requiring long-term intervention. Constructivist grounded theory methodology was used to analyse data generated through 23 interviews with 11 parents and eight occupational therapists who worked with them, five filmed routine therapy sessions, and nine photographs of instructional materials. A substantive theory of 'Responsive learning: Learning from and with each other' was constructed.

Findings: The learning process is complex, dynamic, and bidirectional, with participants learning from and with each other in response to changing needs, situations, and context. It is deeply relational, where ongoing connection and partnership are crucial for mutual learning, moving forward together, and integrating learning into everyday life.

Conclusion and significance: These findings reveal the importance of therapists establishing collaborative relationships, being cognizant co-learners with clients, and responding to learning in practice.

Background: Three Danish versions of the Clinical Assessments of Modes (CAM) have been adapted for practice: CAM-Client Time 1 (D-CAM-C1), CAM-Client Time 2 (D-CAM-C2) and CAM-Therapist (D-CAM-T), collectively referred to as D-CAMQs. Evidence on clinical utility is limited.

Aims/objectives: To explore clinical utility of the D-CAMQs.

Material and methods: Occupational therapists (OTs) and clients were recruited. Clients completed D-CAM-C1 before and D-CAM-C2 after therapy; OTs completed D-CAM-T after therapy. Surveys addressed appropriateness, accessibility, practicability and acceptability.

Results: Eleven OTs and 47 clients (23-97 years, mostly neurological conditions) participated. Clients rated all six therapeutic modes as relevant, with 'Instructing' most and 'Advocating' least important. Group patterns of perceived mode use were similar for clients and OTs. However, correlations between preferred and perceived use were moderate (r_s = 0.26-0.48), and client-therapist agreement was weak to trivial. Most clients found D-CAMQs appropriate and beneficial (≥57% to a great extent). OTs expressed mixed views, particularly regarding appropriateness and time investment. Both groups found instructions clear and acceptability high (>80%).

Conclusion and significance: D-CAMQs appear useful for supporting therapeutic dialogue in Danish practice. Client-therapist discrepancies and varying OT perceptions highlight the need for further research. Small sample size represents a limitation.

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.

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.