Australian Occupational Therapy Journal最新文献_第10页

Preliminary mixed-methods investigation: Impact and acceptability of a combined life skills and adventure therapy program for adolescents 初步混合方法调查：青少年生活技能与探险疗法相结合计划的影响和可接受性

IF 1.6 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2024-01-13 DOI: 10.1111/1440-1630.12933

Hannah K. Burke, Caroline E. Hui, Lynette M. Burke, Shelly J. Lane

Introduction

Meaningful occupational therapy interventions for neurodivergent, transition-age adolescents are understudied, and novel intervention approaches that are motivating to this population are needed. Accordingly, in this study we explored the acceptability and impact of a combined life skills/adventure therapy (LS/AT) intervention program for addressing self-identified goals for adolescents with regulation- and sensory-based challenges.

Methods

We used a convergent mixed-methods design. All adolescents accepted into the intervention program were invited to participate. We described our sample using data from the Child Occupational Self-Assessment. Participants created and rated goals through a modified Canadian Occupational Performance Measure interview before intervention, after intervention and 3 months post-intervention and participated in semi-structured interviews pre- and post-intervention. We calculated COPM change scores, analysed qualitative interview data, and integrated findings into a joint display for interpretation following recommended procedures for mixed-methods data.

Results

Ten adolescents consented to participate (n = 6 males, n = 4 females; mean age 13.92 years, SD = 0.54). Mean COPM performance change scores were 3.72 (SD = 1.39) from pre- to post-intervention and 2.40 (SD = 1.19) from pre- to 3 months post-intervention, with the largest change scores for goals related to life skills. Data from semi-structured interviews expanded on these findings, revealing that participants made changes related to being in the moment, finding a sense of purpose and achieving a sense of belonging. Participants reported high acceptability of the intervention.

Conclusion

This exploratory research supports the use of combined LS/AT intervention with transition-age adolescents experiencing sensory and regulation-based limitations on participation. Preliminary data shows positive changes in performance and satisfaction in self-identified goal areas as well as changes related to mindfulness, a personal sense of competence and relatedness. In practice, occupational therapists should consider integrating elements of this LS/AT intervention to support this population, including addressing life skills through engagement in unique and motivating activities.

针对神经发育迟缓、处于过渡年龄段的青少年进行有意义的职业治疗干预的研究并不多，因此需要对这一人群具有激励作用的新型干预方法。因此，在本研究中，我们探讨了生活技能/冒险治疗（LS/AT）相结合的干预计划的可接受性和影响，以解决青少年在调节和感官方面面临的挑战所提出的自我目标。

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引用次数: 0

Evaluative judgement in practice education: How does the ability to judge the quality of work impact placement performance? 实践教育中的评估判断：判断工作质量的能力如何影响实习表现？

IF 1.8 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2024-01-08 DOI: 10.1111/1440-1630.12927

Kelli Nicola-Richmond, Natalie Ward, Sally Logan, Nikki Lyons, Rola Ajjawi

Introduction

Occupational therapy students need to be ready to work autonomously in a range of environments as soon as they complete their degree. Practice education experiences are considered key to students developing the competencies that autonomous work requires. To function autonomously in practice environments, it is argued that practitioners need to be able to judge the quality of their own work and the work of others. This is referred to as evaluative judgement. However, there is limited empirical literature relating to evaluative judgement and even less exploring the concept within occupational therapy.

Methods

This study used qualitative methods, seeking to understand the evaluative judgements of clinical practice made by third- and fourth-year occupational therapy students during practice education.

Results

Twenty-one interviews were conducted with third- (n = 10) and fourth-year occupational therapy students (n = 1), university support staff supporting practice education (n = 4), and practice education supervisors (n = 5) at one Australian university. Practice education grades and documentation were also used as data. Data were analysed thematically, and two themes, each with three sub-themes, were identified: students coming to understand expected standards, with the following sub-themes: students attuning to cues, cues that inform supervisors about students' meeting the standards, and barriers and frustrations to understanding standards; and practising and developing evaluative judgement, with the following sub-themes: making comparisons, acting on feedback, and reflective practice.

Conclusions

Practice education experiences provide many context-specific opportunities for students to develop their evaluative judgement. Students may be supported to come to know what quality work looks like by offering scaffolded opportunities to develop evaluative judgement in university and practice education settings.

导言：职业治疗专业的学生在完成学业后，需要尽快做好在各种环境中自主工作的准备。实践教育经验被认为是学生发展自主工作所需能力的关键。要想在实践环境中自主开展工作，从业人员必须能够判断自己和他人工作的质量。这被称为评价性判断。然而，与评价性判断有关的实证文献十分有限，而在职业疗法中探讨这一概念的文献则更少：本研究采用定性方法，试图了解职业疗法专业三年级和四年级学生在实习教育期间对临床实践的评价性判断：对澳大利亚一所大学的职业治疗专业三年级（10 人）和四年级（1 人）学生、支持实践教育的大学辅助人员（4 人）以及实践教育督导员（5 人）进行了 21 次访谈。实践教育成绩和文件也被用作数据。对数据进行了主题分析，确定了两个主题，每个主题有三个次主题：学生理解预期标准，次主题如下：学生适应提示、向督导员通报学生达标情况的提示、理解标准的障碍和挫折；实践和发展评价判断，次主题如下：进行比较、根据反馈采取行动、反思性实践：结论：实践教育经验为学生提供了许多针对具体情况的机会来发展他们的评价判断力。通过在大学和实践教育环境中提供培养评价判断能力的支架式机会，可以帮助学生了解高质量的工作是什么样的。

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引用次数: 0

Supports that help me to live well in the community: experiences of people living with schizophrenia 帮助我在社区生活得很好：精神分裂症患者的经历。

IF 1.8 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2023-12-27 DOI: 10.1111/1440-1630.12919

Kylie Stewart, Nicola Hancock, Christine Chapparo, Emeritus Roger J. Stancliffe

Introduction

People with schizophrenia are more likely to be hospitalised than any other psychiatric diagnosis. Occupational therapists working in mental health are often required to assess and recommend supports that will assist people with schizophrenia to live successfully in the community. There is little research exploring consumer perspectives regarding the support they find useful to stay out of the hospital. The aim of this study was to explore what supports people living with schizophrenia identify as helping them to live in the community and stay out of the hospital.

Method

Qualitative data were collected via semi-structured interviews with adult consumers (N = 18) diagnosed with schizophrenia. Data were thematically analysed using constant comparative analysis methods. Inductive analysis was followed by a deductive phase of analysis.

Findings

Participants highlighted personal-, occupational- and environmental-focused supports. Person-focused supports addressed cognitive and psychological needs. Occupation-focused supports included assisting people to manage daily life with a mental illness; engage in social activities; and engage in meaningful activities. Environment-focused supports included access to financial security; accommodation security; and community of choice. In addition to types of support, participants highlighted the importance of quality of support including the need for flexible; timely; and non-judgemental support.

Conclusion

These results emphasise the multifaceted nature of support required by people living with schizophrenia to stay out of the hospital. Both type and quality of support are important. People in this study were able to clearly articulate the types and qualities of support that were important to them. Occupational therapists may benefit from greater collaboration with consumers during assessments of support needs and the development of recommendations. Further exploration of how occupational therapists identify people's multifaceted support needs is required.

导言精神分裂症患者比其他精神病患者更容易住院治疗。从事精神卫生工作的职业治疗师经常需要对精神分裂症患者进行评估，并提出建议，帮助他们在社区中顺利生活。目前很少有研究从消费者的角度出发，探讨他们认为哪些支持措施有助于他们远离医院。本研究旨在探讨精神分裂症患者认为哪些支持有助于他们在社区生活并远离医院：方法：通过对被诊断患有精神分裂症的成年患者（N = 18）进行半结构化访谈收集定性数据。采用恒定比较分析方法对数据进行主题分析。归纳分析之后是演绎分析阶段：参与者强调了以个人、职业和环境为重点的支持。以人为本的支持满足了认知和心理需求。以职业为重点的支持包括帮助人们管理患有精神疾病的日常生活、参与社交活动以及从事有意义的活动。以环境为重点的支持包括经济保障、住宿保障和社区选择。除了支持的类型外，参与者还强调了支持质量的重要性，包括需要灵活、及时和非评判性的支持：这些结果强调了精神分裂症患者在出院时所需支持的多面性。支持的类型和质量都很重要。本研究中的患者能够清楚地表达出对他们来说重要的支持类型和质量。在评估支持需求和制定建议的过程中，职业治疗师可能会从与患者的更多合作中受益。需要进一步探讨职业治疗师如何确定人们多方面的支持需求。

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引用次数: 0

Current clinical practice patterns and perspectives of Australian hand therapists during the treatment of adults with distal radius fracture: A national survey 澳大利亚手部治疗师在治疗成人桡骨远端骨折时的当前临床实践模式和观点：全国调查。

IF 1.8 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2023-12-27 DOI: 10.1111/1440-1630.12925

Terra M. Bredy, Freyr Patterson, Celeste Glasgow

<div> <section> <h3> Introduction</h3> <p>Successful return to pre-injury occupational performance following distal radius fracture (DRF) may be influenced by person and environment factors such as pain, age, social support, and socioeconomic status. The primary aim of this study was to explore Australian hand therapists' current clinical practice and determine whether they consider these factors during the management of DRF.</p> </section> <section> <h3> Methods</h3> <p>A mixed methods online survey was distributed to members of the Australian Hand Therapy Association. Descriptive statistics were used to examine the quantitative data, and the qualitative data were analysed by content analysis.</p> </section> <section> <h3> Results</h3> <p>Of the 120 members who completed the survey, 68% were occupational therapists and 32% were physiotherapists with 74% in the private and 26% in the public health-care setting. Most factors perceived to influence recovery were consistent with person factors and a biomechanical approach. Other factors related to occupational performance, such as social and leisure skills, environment and culture were reported less often. When asked about defining occupational performance, the key categories identified through qualitative open responses were ‘performing meaningful activities/occupations’, ‘performing work/employment’, and ‘completing activities/function’.</p> </section> <section> <h3> Conclusion</h3> <p>The data suggest that hand therapists in Australia primarily identify person factors as key to recovery after DRF. Context and environmental factors that influence occupational performance did not appear to be considered as often during treatment or when defining occupational performance. Further research is needed to explore the contextual and environmental factors that influence hand therapy intervention and determine whether they play a role in the successful return to pre-injury occupational performance following DRF.</p> </section> <section> <h3> Consumer and community involvement</h3> <p>The survey was conceptualised by the research team, which included two experienced hand therapists and piloted with 10 consumers. Hand therapists (consumers) of various years of experience and discipline (i.e., occupational therapy and physiotherapy) provided feedback to improve the survey in terms of content, comprehensibility, and length. No clients/patients of hand therapists were involved in the development of the survey or

导言：桡骨远端骨折（DRF）后能否成功恢复到受伤前的职业表现可能受到个人和环境因素的影响，如疼痛、年龄、社会支持和社会经济地位。本研究的主要目的是探讨澳大利亚手部治疗师目前的临床实践，并确定他们在处理桡骨远端骨折时是否考虑了这些因素：向澳大利亚手部治疗协会的会员发放了一份混合方法在线调查问卷。对定量数据采用描述性统计，对定性数据采用内容分析法进行分析：在完成调查的 120 名会员中，68% 是职业治疗师，32% 是物理治疗师，其中 74% 在私人医疗机构工作，26% 在公共医疗机构工作。大多数被认为影响康复的因素与个人因素和生物力学方法一致。其他与职业表现相关的因素，如社交和休闲技能、环境和文化，则较少被提及。当被问及如何定义职业表现时，通过定性开放式回答确定的主要类别是 "从事有意义的活动/职业"、"从事工作/就业 "和 "完成活动/功能"：数据表明，澳大利亚的手部治疗师主要认为人的因素是 DRF 后康复的关键。在治疗过程中或在定义职业表现时，影响职业表现的背景和环境因素似乎并不经常被考虑。需要进一步开展研究，探索影响手部治疗干预的背景和环境因素，并确定这些因素是否对 DRF 后成功恢复到受伤前的职业表现起到作用：调查问卷由研究小组构思，其中包括两名经验丰富的手部治疗师，并在 10 名消费者中进行了试点。不同年资和学科（即职业治疗和物理治疗）的手部治疗师（消费者）提供了反馈意见，以便在内容、可理解性和长度方面改进调查。手部治疗师的客户/患者没有参与调查或研究的开发，研究的消费者被视为手部治疗师。

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引用次数: 0

Occupational Therapy Observation Tool–Adjustment Support Details for autistic children: Investigation of content validity and clinical utility 自闭症儿童作业疗法观察工具--调整支持细节：内容有效性和临床实用性调查。

IF 1.8 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2023-12-26 DOI: 10.1111/1440-1630.12924

WingKwan Michelle Kwok, Helen Bourke-Taylor, Stuart Carey, Maria McKenzie

Introduction

Standardised testing is crucial for autistic children to receive appropriate interventions, necessary services, and funding. Behaviours associated with autism can hinder children's test performance and participation. The 18-item, two-page Occupational Therapy Observation Tool–Adjustment Support Details (OTOT-ASD) is used in conjunction with standardised assessments. The OTOT-ASD enables the recording of autism-related behaviours and the reasonable assessment accommodations made to support participation in testing. The current study aims to investigate the content validity and clinical utility of the OTOT-ASD from occupational therapists' perspectives.

Method

A specifically designed online questionnaire was distributed Victoria-wide to occupational therapists with clinical experience with autistic children. The questionnaire was designed in line with the COnsensus-based Standards for selection of health Measurement INstruments (COSMIN), including relevance, comprehensiveness, and comprehensibility of items evaluated for content validity. Applicability and clinical usefulness were also investigated. Quantitative data were analysed using descriptive statistics.

Results

Seventy-one occupational therapists responded to the questionnaire and 46 provided a full dataset. Over 96% of the respondents considered documenting behaviours and testing accommodations as important, yet less than 45% reported having resources to record this information. Ninety-five percent of the respondents perceived the OTOT-ASD to be useful in clinical practice. Over 70% agreed that OTOT-ASD items were significantly relevant to practice and comprehensive. To improve comprehensibility, identified items were altered following feedback.

Conclusion

The findings suggest that the OTOT-ASD is clinically useful and content validity is sound. Further research on other psychometric properties of the OTOT-ASD and users' qualitative experiences in utilising the tool is recommended.

导言：标准化测试对于自闭症儿童获得适当的干预措施、必要的服务和资金至关重要。与自闭症有关的行为会妨碍儿童的测试表现和参与。18 个项目、两页纸的职业治疗观察工具--调整支持细节（OTOT-ASD）可与标准化评估结合使用。OTOT-ASD 能够记录与自闭症有关的行为以及为支持参与测试而做出的合理评估调整。本研究旨在从职业治疗师的角度调查 OTOT-ASD 的内容有效性和临床实用性：方法：我们在维多利亚州范围内向具有自闭症儿童临床经验的职业治疗师发放了一份专门设计的在线问卷。问卷的设计符合基于共识的健康测量工具选择标准（COSMIN），包括相关性、全面性和可理解性，并对项目的内容效度进行了评估。此外，还对适用性和临床实用性进行了调查。采用描述性统计对定量数据进行了分析：71名职业治疗师对问卷做出了回复，其中46人提供了完整的数据集。超过 96% 的受访者认为记录行为和测试适应情况很重要，但只有不到 45% 的受访者表示有资源记录这些信息。95%的受访者认为 OTOT-ASD 在临床实践中很有用。超过 70% 的受访者认为 OTOT-ASD 的项目与临床实践密切相关，而且内容全面。为提高可理解性，根据反馈意见对已确定的项目进行了修改：研究结果表明，OTOT-ASD 具有临床实用性，内容效度良好。建议进一步研究 OTOT-ASD 的其他心理测量特性以及用户在使用该工具过程中的定性体验。

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引用次数: 0

Potential of virtual reality to meaningfully engage adults living with dementia in care settings: A scoping review 虚拟现实技术在让成年痴呆症患者有意义地参与护理环境方面的潜力：范围综述。

IF 1.8 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2023-12-22 DOI: 10.1111/1440-1630.12916

Vivianne To'mah, Sanetta Henrietta Johanna du Toit

Introduction

Older adults living with dementia in residential aged care homes receive physical care but may have limited access to meaningful engagement. Due to its multimodal and versatile nature, virtual reality (VR) is speculated to be an effective means of meaningfully engaging residents individually and/or in groups. However, there is little evidence regarding its efficacy as a means of meaningfully engaging older adults living with dementia. The objective of this scoping review is to identify and synthesise published research investigating the use of VR technology in promoting the meaningful engagement of older adults living with dementia in residential aged care facilities.

Methods

A scoping review following Arksey and O'Malley's (2005) established process was conducted and included identifying and selecting relevant studies from seven databases (i.e., AgeLine, CINAHL, Medline, Cochrane, Embase, PsycINFO and Scopus), data charting, and collating, summarising and reporting findings. Two independent reviewers used Covidence and Excel to support data extraction and analysis.

Results

The 20 eligible studies revealed discrepancies in the classification of VR and strengths, weaknesses, opportunities and threats associated with its implementation. Findings indicate that the most influential factor in eliciting meaningful engagement is when VR use facilitates interpersonal interactions and opportunities for human connection.

Conclusion

Although VR seems to be a promising medium in engaging older adults living with dementia, the efficacy of implementing VR technology within care facilities should be considered alongside potential environmental enablers and barriers. The apparent strength of implementing VR as a means of encouraging restoration, pleasure and productivity in older adults living with dementia lies in the fact that it creates opportunities for meaningful engagement on social and occupational levels.

介绍：居住在养老院的老年痴呆症患者可以得到身体护理，但获得有意义参与的机会可能有限。虚拟现实（VR）具有多模态和多用途的特性，因此被认为是一种有效的手段，可以让居民个人和/或团体有意义地参与其中。然而，关于虚拟现实作为一种让患有痴呆症的老年人有意义地参与其中的手段的有效性，却鲜有证据。本范围综述旨在确定并综合已发表的研究成果，这些研究调查了如何使用 VR 技术促进居住在养老机构中的老年痴呆症患者有意义地参与：方法：按照 Arksey 和 O'Malley（2005 年）的既定流程进行了范围界定综述，包括从七个数据库（即 AgeLine、CINAHL、Medline、Cochrane、Embase、PsycINFO 和 Scopus）中识别和选择相关研究，绘制数据图表，以及整理、总结和报告研究结果。两名独立审稿人使用 Covidence 和 Excel 支持数据提取和分析：结果：20 项符合条件的研究显示，在虚拟现实的分类以及与实施虚拟现实相关的优势、劣势、机遇和威胁方面存在差异。研究结果表明，吸引有意义的参与的最有影响力的因素是虚拟现实的使用促进了人际互动和人与人之间联系的机会：尽管虚拟现实技术似乎是吸引患有痴呆症的老年人参与的一种很有前景的媒介，但在护理机构中实施虚拟现实技术的效果应与潜在的环境促进因素和障碍一并考虑。将虚拟现实技术作为一种鼓励患有痴呆症的老年人恢复健康、愉悦身心和提高工作效率的手段，其明显优势在于它能创造机会，让老年人在社会和职业层面上进行有意义的参与。

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引用次数: 0

Individual placement and support: A qualitative investigation of carers' experiences supporting someone experiencing mental illness into employment 个人安置和支持：对照顾者支持精神病患者就业的经验进行定性调查。

IF 1.8 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2023-12-18 DOI: 10.1111/1440-1630.12922

Jocelyn Kernot, Jiin Goh, Alejandra Aguilar, Ali, Jess Muller, Suzanne Dawson

Background

Unemployment rates for people living with mental illness remain persistently high. Individual Placement Support (IPS) is an evidence-based employment model that supports people with severe mental illness to gain employment. Although carers provide emotional and instrumental support for people with mental illness, there is limited research exploring carers' perspectives of IPS.

Aims

To explore carers' perspectives of their experience as caregivers of individuals living with mental illness who have participated in IPS.

Methods

This qualitative descriptive study gained carers' perspectives through semi-structured interviews. A convenience sample of eight carers was recruited via a community mental health service in Adelaide. Data were analysed thematically.

Findings

Three main themes were identified: (1) employment benefits, (2) factors that may impact on employment, and (3) knowledge and opinions of IPS. Within each theme, four sub-themes emerged.

Conclusions

This study addresses a gap in research and provides insights into carers' experiences of IPS. Increased communication and involvement of carers in IPS may benefit IPS participants and staff as carers provide invaluable additional insight into supporting individuals through their employment journey.

背景：精神病患者的失业率一直居高不下。个人安置支持（IPS）是一种以证据为基础的就业模式，可帮助严重精神疾病患者获得就业。虽然照护者为精神病患者提供了情感和工具性支持，但探索照护者对 IPS 的看法的研究却很有限。目的：探索照护者作为参与 IPS 的精神病患者的照护者对其经历的看法：这项定性描述性研究通过半结构化访谈来了解照护者的观点。研究人员通过阿德莱德的社区精神健康服务机构招募了八名照顾者。研究结果：确定了三大主题：(1) 就业福利；(2) 可能影响就业的因素；(3) 对 IPS 的认识和看法。在每个主题中，又出现了四个次主题：本研究填补了研究领域的空白，为了解照护者对 IPS 的体验提供了深入的见解。在 IPS 项目中加强与照护者的沟通并让照护者参与其中，可能会使 IPS 参与者和工作人员受益，因为照护者为支持个人完成就业历程提供了宝贵的额外见解。

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引用次数: 0

Mothering occupations: A review identifying mothering occupations 母亲职业：确定母亲职业的综述

IF 1.8 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2023-12-17 DOI: 10.1111/1440-1630.12921

Sorcha Odgers, Yvonne Thomas, Ema Tokolahi

Introduction

This review aimed to retrieve and collate a list of culturally relevant mothering occupations in the New Zealand context with mothers positioned as experts of their experience. Mothering occupations influence wellbeing and this study aimed to better inform on the daily occupations mothers participate in that contribute to feelings of maternal confidence.

Methods

Two main sources were used to identify mothering occupations: A systematic search of mothering literature, and participant additions. The first step involved mothering literature being searched, collated and condensed. The second step involved presenting the compiled list of mothering occupations to a panel of mothers for review and to invite additions. Mothers were asked to consider the occupations they participate in that evoke feelings of confidence and mastery in their mothering. Fifteen mothers with infants 12 to 18 months old were recruited, eight contributed to the mothering occupations list.

Results

A list of 203 items was collated then condensed based on the inclusion criteria for the participant group, and was tracked in a table. The list was reduced to 36 items. Eight participants added to the mothering occupations list, bringing the total number of items to 47. Mothers indicated through their contributions to the list that some types of mothering occupations are more relevant to them when considering feelings of maternal confidence and mastery. The mothers of this study indicated that connecting with their infant, their culture and nature are of high value to them.

Conclusion

Developing a list of culturally relevant and relatable mothering occupations is a significant undertaking, highlighting the subjective experiences of mothers. Mothering occupations are vast and influenced by context. Mothers valuing some types of occupation more in relation to maternal confidence indicates a role for occupational therapy with this population to support with engagement and participation in occupations that promote wellbeing.

本综述旨在检索和整理一份与新西兰文化相关的母亲职业清单，并将母亲定位为其经验的专家。母亲的职业影响着母亲的幸福，本研究旨在更好地了解母亲参与的日常职业，这些职业有助于增强母亲的自信心。

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引用次数: 0

Testing feasibility of relevant outcome measures in an inpatient setting to demonstrate the value of occupational therapy 在住院病人中测试相关结果测量的可行性，以证明职业治疗的价值。

IF 1.8 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2023-12-06 DOI: 10.1111/1440-1630.12920

Tamara Tse, Stefani Skorik, Ruby Fraser, Adrienne Munro, Susan Darzins

Introduction

Measures of participation restrictions in daily life occupations are not typically used and may aid discharge planning and demonstrate the impact of occupational therapy services in inpatient settings. The overall aim of this mixed-methods study was to test the feasibility of relevant outcome measures by (1) investigating which of the three identified measures—the Home Support Needs Assessment, the Personal Care Participation Assessment and Resource Tool, and the Functional Autonomy Measurement System—best identifies meaningful changes in participation restrictions in daily life occupations required for community life; and (2) investigating the acceptability, usefulness, and feasibility of each measure to support inpatient practice.

Methods

Occupational therapists (n = 3) completed the three measures with patient participants (n = 12) at admission and discharge. Each occupational therapist participated in a semi-structured interview. Outcome measure responses were summarised statistically. Qualitative data were analysed using reflexive thematic analysis.

Findings

Total scores on all three measures changed significantly between admission and discharge (P < 0.002). Three themes reflected the occupational therapist participants' perceptions of the acceptability, usefulness, and feasibility of the outcome measures: ‘Clinically and Professionally Meaningful Tools’, ‘Becoming Familiar’, and ‘Fostering My Daily Work’.

Conclusion

Each measure demonstrated a meaningful change. Selection and successful implementation of an outcome measure depends on its local acceptability to occupational therapists and organisational practices. All three measures are promising tools to address a measurement gap in occupational therapy practice. Future research could embed one measure into practice using knowledge translation methods, with a large-scale evaluation of the value of occupational therapy.

简介:日常生活职业的参与限制措施通常不使用，可能有助于出院计划，并证明在住院环境中职业治疗服务的影响。这项混合方法研究的总体目的是通过(1)调查三个确定的测量方法——家庭支持需求评估、个人护理参与评估和资源工具以及功能自主测量系统——中哪一个最能识别社区生活所需的日常生活职业参与限制的有意义的变化;(2)调查各项措施的可接受性、有用性和可行性，以支持住院患者的实践。方法:职业治疗师(n = 3)与患者(n = 12)在入院和出院时完成三项测量。每位职业治疗师都参加了一次半结构化的访谈。结果测量反应进行统计汇总。定性数据采用反身性主题分析进行分析。结果:所有三项指标的总分在入院和出院期间发生了显著变化(P)。结论:每项指标都有显著变化。结果测量的选择和成功实施取决于其对当地职业治疗师和组织实践的可接受性。这三种测量方法都是解决职业治疗实践中测量差距的有希望的工具。未来的研究可以使用知识翻译方法将一种测量方法嵌入到实践中，并对职业治疗的价值进行大规模评估。

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引用次数: 0

The experiences of older adults with cognitive impairment in using falls prevention alarms in hospital: A qualitative descriptive study 认知障碍老年人在医院使用防跌倒警报器的经验:一项定性描述性研究。

IF 1.8 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2023-11-28 DOI: 10.1111/1440-1630.12917

Kelly Stephen, Alison Campbell

<div> <section> <h3> Introduction</h3> <p>Bed and chair sensor alarms are commonly used for falls prevention in hospitals, despite questionable efficacy. Research analysing older adults' experiences of alarms is scarce, and adults with cognitive impairment are consistently excluded.</p> </section> <section> <h3> Aim</h3> <p>The aim of this study was to explore how older adults with cognitive impairment perceive and experience falls prevention alarms in hospital.</p> </section> <section> <h3> Method</h3> <p>A qualitative descriptive design investigated older adults' experiences of alarms in a Geriatric Evaluation and Management ward in Melbourne. Patients were included if they had been provided an alarm. Semi-structured interviews were the primary method of data collection with two observation sessions and medical record analyses completed to enable triangulation of findings. Data were subjected to thematic analysis, and the Person-Environment-Occupation framework was chosen to add insight into the complexities of older adults' experiences of alarms.</p> </section> <section> <h3> Findings</h3> <p>All 11 participants had a level of cognitive impairment with delirium, confusion, or impulsiveness recorded in their medical file. Two overarching themes were identified: <i>communication and collaboration with staff</i> and <i>rationalisation of alarm use</i>. Participants' perceived staff were focussed on falls prevention but experienced a lack of communication about the purpose of alarms. Participants wanted an individualised approach to alarms. Some were comforted with the thought of alarms alerting staff, making them feel well cared for and believed alarms were a useful ‘back-up’. Others found alarms uncomfortable, frustrating, and restricting. Application of the Person-Environment-Occupation framework provided insight into how enabling and restrictive factors can impact whether the alarm is experienced positively or negatively. Seven unwitnessed falls occurred during the participants' admissions. Thirty-four per cent of alarm triggers observed were considered false alerts.</p> </section> <section> <h3> Conclusion</h3> <p>Older adults commonly reported negative experiences using bed/chair sensor alarms. Occupational therapists have the training to collaborate with people with cognitive impairment and assess the usefulness of alarms in reducing falls, based on how they interact with the older adult's unique person, environment, and occupation domains.</

导读:床和椅子传感器报警器通常用于医院预防跌倒，尽管其有效性值得怀疑。分析老年人警报经历的研究很少，而且有认知障碍的成年人一直被排除在外。目的:本研究的目的是探讨有认知障碍的老年人如何感知和体验医院的跌倒预防警报。方法:采用定性描述设计调查墨尔本老年评估和管理病房的老年人对警报的体验。如果给病人提供了警报，他们也被包括在内。半结构化访谈是收集数据的主要方法，其中有两次观察期和完成的医疗记录分析，以便对结果进行三角测量。数据进行了专题分析，并选择了“人-环境-职业”框架，以深入了解老年人警报体验的复杂性。研究结果:所有11名参与者都有一定程度的认知障碍，包括精神错乱、精神错乱或冲动，这些都记录在他们的医疗档案中。确定了两个总体主题:与工作人员的沟通和协作以及使警报使用合理化。参与者认为工作人员专注于预防跌倒，但缺乏关于警报目的的沟通。参与者想要一种个性化的警报方法。一些人对警报器提醒员工感到欣慰，让他们感到受到了很好的照顾，并相信警报器是有用的“后备”。另一些人则觉得警报让人不舒服、沮丧和受限。人-环境-职业框架的应用提供了对使能因素和限制因素如何影响警报是积极的还是消极的见解。在参与者入院期间发生了七次无人目击的跌倒。观察到的34%的警报触发被认为是假警报。结论:老年人普遍报告使用床/椅子传感器报警器的负面经历。职业治疗师接受过与认知障碍患者合作的培训，并根据他们如何与老年人独特的人、环境和职业领域相互作用来评估警报器在减少跌倒方面的有用性。

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引用次数: 0