Australian Occupational Therapy Journal最新文献

Introduction

There is a longstanding debate about using Ayres Sensory Integration® (ASI) as an occupational therapy approach, fuelled partly by queries about its alignment with the current occupation-centred paradigm. Despite many voicing their opinions, no studies have considered the extent to which occupational therapy using ASI with children might be implemented in a way that aligns with occupation-centred practice. This study was designed to explore that alignment.

Methods

This mixed-methods study involved eight occupational therapists certified to implement ASI. Data collection involved (1) an online survey to gather demographic data and rate structural fidelity elements; (2) a review and rating of a video-recorded session using process fidelity elements and the occupation-centred practice checklist for observable items (e.g. therapist–child collaboration); and (3) a review and rating of semi-structured interview data using the same checklist for non-observable items (e.g. child- or family-chosen goals). Two coders independently analysed the data.

Consumer and Community Involvement

No consumers were involved in this study.

Findings

The extent to which interventions aligned with occupation-centred practice varied among the participants, with partial uptake of several components observed across therapists. Some occupation-centred practice components were more consistently met, including identifying client concerns, developing trust with the child, and considering the child's unique features when planning interventions. Other components were more consistently missed, such as collaborating with caregivers, co-creating and reviewing goals, establishing occupational outcome measures, considering the client's broader context, and drawing on multiple theories and approaches to guide practice.

Conclusion

Some participants' therapeutic approach was more closely aligned with occupation-centred practice, evidencing the potential for occupation-centred implementation of ASI. Nevertheless, findings underscore the need to strengthen the occupational focus. Therapists may benefit from occupation-centred practice training and using the checklist presented in this study to self-monitor alignment with the profession's paradigm.

Introduction

Accidental falls among older people pose a significant threat to both morbidity and mortality. Falls Hazard Reduction at Home (FHR@Home) when delivered by occupational therapists has been demonstrated as an effective fall prevention intervention. Despite the evidence, FHR@Home is not routinely implemented in practice. This scoping review seeks to explore existing literature to support implementation of FHR@Home by answering the question: ‘What is known about implementation strategies used to support home and community environmental falls prevention intervention in health care?’

Methods

This review used the Joanna Briggs Institute (JBI) methodological guidance for the conduct of scoping reviews. A comprehensive search was conducted across electronic databases, government websites, and web-based search engines. Studies were included if they incorporated FHR@Home as part of their intervention and explicitly referenced implementation science or knowledge translation concepts. Data were extracted from the included studies and reported implementation strategies were mapped using the Expert Recommendations for Implementing Change (ERIC) taxonomy and their associated clusters. A separate thematic analysis process was also conducted.

Consumer and Community Involvement

There was no consumer and community involvement.

Results

Nineteen studies met the inclusion criteria. All ERIC implementation strategy clusters are reported on in the studies. Strategies relating to engagement and education of stakeholders appear more often in the literature. Three themes were identified as having influence on implementation outcomes: (1) Home as a practice context; (2) Collaboration is key to success; and (3) Balance of assumed knowledge, experience and fidelity.

Conclusion

The findings underscore the need for further research to explore how implementation strategies can better support occupational therapists in delivering FHR@Home, particularly in ways that respect the consumer's sense of home while maintaining fidelity to evidence-based protocols. Expanding the literature in this area will be beneficial to improve uptake and sustainability of FHR@Home practices.

Introduction

While sexuality is gaining recognition as a relevant domain of occupational therapy practice, the scope of empirical research involving occupational therapy practitioners or students in relation to sexuality remains unclear. This study aimed to map the extent and focus of this research.

Methods

A scoping review was conducted using four databases: MEDLINE, Embase, CINAHL, and PsycINFO. The search strategy included keywords related to ‘Occupational therapy’ and ‘Sexuality’. Two independent reviewers screened the references by title and abstract, and then by full text. The team conducted a bibliometric and collaborative inductive content analysis of included papers to categorise them by themes addressed.

Consumer and community consultation.

Consumer and community were not involved

Findings

Of the 4491 references screened, 136 studies were included. The papers addressed at least one of seven themes: (1) Influencing factors reported by occupational therapy practitioners and students regarding sexuality (41.9%); (2) Assessment or intervention implemented by occupational therapists to address sexuality (27.2%); (3) Educating occupational therapy practitioners and students regarding sexuality (13.2%); (4) Development or validation of assessment tools regarding sexuality (7.4%); (5) The role of occupational therapists regarding sexuality (5.1%); and (6) Frameworks, models, practice guides or guidelines related to sexuality (4.4%). Several studies (41.9%) addressed more than one topic.

Conclusion

The occupational therapy literature on sexuality reveals a disproportionate emphasis on certain topics, while others remain underexplored. Most studies examined the challenges encountered by occupational therapy practitioners and students in incorporating sexuality into practice. Future studies should not only focus on developing and implementing evidence-based assessments and interventions but also on advancing theoretical understanding at the intersection of sexuality, occupation, and occupational therapy practice.

Introduction

The Living My Life Program was co-created with rural and remote stroke survivors by applying the Living My Life Framework as a lens on recovering. The aim of this study was to determine whether the Program stayed true to the lens when piloted and to refine the Program ahead of broader implementation.

Methods

A qualitative design integrating case study methods, narrative portraits, and features of constructivist grounded theory within an action research approach was used. Narrative portraits were crafted for five participants who piloted the individualised stroke recovery intervention and then analysed according to the categories of the Framework.

Consumer and Community Involvement

Four stroke survivors who piloted the Program contributed their experiences and reflections to craft the narratives, member-checked findings, provided feedback to refine the Program, and contributed as co-authors to disseminate findings. The fifth participant did not complete the Program; however, his contribution was acknowledged through a reflective narrative by the coach and cultural mentor.

Findings

Participants spoke about their unique experiences of the Program. Analysis confirmed the Program stayed true to the lens and illuminated further depth to the Framework. Conceptual (e.g., working out what works for me) and practical (e.g., options for measuring progress) refinements were incorporated iteratively.

Conclusion

The Living My Life Program stayed true to the stroke survivors' lens on recovering. This suggests the Program can be used by health professionals to support stroke survivors to live their life as it evolves, while recovering their way, in their world. Stroke survivors' expertise needs to be prioritised when implementing the Program more broadly.

Introduction

Play is fundamental to children's holistic development, encompassing cognitive, emotional, and social growth. Whereas play preferences are often shaped by sociocultural and environmental factors, limited research exists on how children from different Malaysian settings, particularly in East Malaysia, perceive and engage in play. This study explores the rationale behind play experiences and preferences among urban and rural children in Sarawak.

Methods

A qualitative approach was employed to capture the experiences of 10 (n = 10) typically developing children aged 7 to 9 years from both urban and rural areas in Sarawak. Participants were purposively selected and interviewed using a semi-structured protocol via Google Meet. Data were transcribed and analysed using thematic analysis.

Consumer and Community Involvement

Consumers and community members were not involved in the development or implementation of the research or writing of the manuscript.

Findings

Four major themes emerged: (1) play as a source of enjoyment and emotional fulfilment, (2) play preferences shaped by environment and accessibility, (3) social and relational dynamics of play, and (4) the structure of time and space in children's play. Children described play as a joyful, essential part of their daily lives. Urban children favoured digital and indoor play, whereas rural children preferred outdoor and imaginative play. Peer interactions, adult roles, and digital access significantly influenced their play preferences.

Conclusion

Children in Sarawak demonstrate nuanced understandings of play that reflect their social, environmental, and developmental contexts. However, the small and ethnically limited sample (Malay and Lunbawang children only) constrains the generalisability of findings. These insights have important implications for designing child-centred, culturally responsive, and equitable play environments in therapeutic, educational, and policy settings.