The aim of this study was to explore sustainability of a self-management program in inpatient rehabilitation (‘My Therapy’) 6 months following a randomised controlled trial.
A patient audit of rehabilitation hospital medical records was completed to determine program reach and an electronic survey of occupational therapists/physiotherapists to understand perceptions of program sustainability.
This study included a lived experience consumer as part of the trial steering committee.
Of 185 patients audited, the program reach was 41%. Of 13 therapists surveyed, most reported they knew how to deliver self-management programs (93%), that they provided My Therapy as part of usual care ‘some of the time’ (77%), and that appointing a My Therapy clinical champion on the ward supported sustained implementation (77%). They also reported reduced confidence delivering ‘My Therapy’ with patients who were not motivated or when time was limited.
Six months post-trial, a self-management program was still being delivered by therapists in rehabilitation. Ongoing support strategies are required to sustain self-management programs.
Doing exercises and practising tasks is an important part of rehabilitation. A self-management program called ‘My Therapy’ enables patients to do exercises or tasks on their own. Patients doing My Therapy completed an extra 26 minutes of exercises or tasks each day. This study in Melbourne, Australia, found out if the program was still being used 6 months later. We also found out what therapists thought about the program. Less than half of patients were doing My Therapy at 6 months. Therapists reported they liked their patients doing the program. However, they found it harder to deliver to patients who lacked motivation. It was also hard to deliver when the therapist felt they had little time.
Practice education is a key component in the education of occupational therapists, and yet there is limited understanding of the long-term impact of practice education experiences. This study explored transformational experiences on practice education to better understand their long-term impact. Transformational experiences are those that cause a profound and fundamental change in a person's view of themselves and/or the profession. The aim of this study was to explore the transformational experiences, both positive and negative, of occupational therapists while they were on practice education as students.
A phenomenological research design was used to understand the lived experiences of occupational therapists who had undergone transformational experiences while students on practice education. Data were collected using semi-structured interviews from 11 participants who had graduated at least 5 years prior to this study. Data analysis was completed using interpretative phenomenological analysis.
No consumers were involved in this study.
An overarching theme of similar but different was identified, which recognised that while each experience was unique there were some shared elements: the experiences were challenging, emotionally laden, took time to process and had long-term impacts. Positive and negative experiences were precipitated by a challenge of some kind. Participants experienced a wide spectrum of emotions at the time of the event and for some the emotional response lasted long afterwards. It took time and reflection to process their experiences, and they often required help to develop insights into the experience and its impact. Long-term impacts were experienced personally and professionally.
This study demonstrated that students have transformational experiences on practice education. These can be ordinary or extraordinary and therefore unique to each student, making them difficult to predict. The findings highlight the value of practice educators and university educators checking in with students to support them to reflect on and process transformational experiences.
Occupational therapy practice focuses on occupation-based interventions, considering the interaction between the person, environment, and task. In Australia, combining supervised therapy with self-directed practice is feasible, even for health-care consumers with cognitive impairments. This study aims to explore the self-practice programs developed by occupational therapists and delivered in inpatient rehabilitation and develop core recommendations for such interventions.
Ethical approval for this Delphi consensus study was granted by Monash University Human Research Ethics Committee. The study involved an online survey and two focus groups with Australian occupational therapists. Participants were recruited via snowball sampling and required to meet specific experience criteria. Content analysis was used to analyse data, and consensus was reached on core recommendations for prescribing self-practice in inpatient rehabilitation.
Occupational therapists who prescribe self-practice to health-care consumers were the community of interest and directly involved in the Delphi consensus process to inform study findings. Consumers using self-practice activities were not included in the study.
In Round 1 of the Delphi process, 21 occupational therapists participated in an anonymous online survey about prescribing self-practice in inpatient rehabilitation. The survey identified key recommendations across various categories. Round 2 focus groups further refined these recommendations, and Round 3 achieved consensus, incorporating additional feedback and suggestions for implementing self-practice programs. It found variability in implementation, with neurological and general rehabilitation health-care consumers most likely to receive self-practice tasks.
This Australian study explored how occupational therapists prescribe self-practice during inpatient rehabilitation. The study emphasised the importance of clinical reasoning and environmental factors, offering recommendations to guide goal-focused, client-centred self-practice interventions for better health-care consumer outcomes.
Peer-mentorship, when a peer shares a connection to a group provides knowledge, empathy, and validation through the unique perspective of their lived experience of practical and social–emotional knowledge following disease or disability. However, there is a paucity of research on peer-mentorship among individuals with lower limb amputations particularly those who live in small communities. This study aimed to investigate peer-mentorship among individuals with lower limb amputations in small communities during pre-amputation procedures and adjustment to life post-amputation.
Qualitative description, semi-structured telephone interviews were conducted with peer-mentors or mentees who experienced lower limb amputation in a small community.
One member of the research team was a person with lived experience, and another member of the research team was a clinician (orthopaedic surgeon). Both team members contributed to the study concept, design and analysis of the data and have read and approved the final manuscript. The team member with lived experience additionally supported participant recruitment.
Four themes emerged: ‘satisfying an unmet need’ explores the desire to learn from others who have similar experiences living with lower limb amputation; ‘improving independence’ describes the unique guidance offered by peer-mentors for returning to daily activities; ‘friendship’ considers peer-mentors' therapeutic delivery including its long-lasting guidance and connection; ‘advocating for support and resources’ examines how peer-mentors fulfil supportive roles such as health-care navigation.
Results demonstrate peer-mentorship's role in improving independence and social support and providing advocacy during adjustment to lower limb amputation among people residing in small communities.
People who have had their leg amputated need support programs. This is very true for people living in small communities. In this study, we talked to people who have had a leg amputated and who live in a small community. We wanted to know their thoughts about peer-
Parenting is a highly valued and challenging occupational role in which many parents experience challenges. Yet the involvement of occupational therapy in supporting parenting for adults with disability and other challenges is relatively low. This paper explores what is needed to increase occupational therapy support for parents with disability and other challenges.
An international online survey was developed based on previous literature and refined via cognitive interviews. It was reviewed by international occupational therapy academics from 11 countries and translated into eight languages. The survey sought the experiences and views of occupational therapists who work with adult populations about supporting parenting occupations. For this paper, fixed-choice and free-text responses illuminating what is needed to increase the provision of that support were analysed. A mixed methods design was used, combining descriptive statistics and interpretive content analysis. Multivariate multinominal logistic regression analyses were used to assess associations between needs identified and participant and practice characteristics.
This survey and paper were developed with input from occupational therapists and occupational therapy academics from 13 countries.
Participants (n = 1347) identified six types of factors needed to increase occupational therapy support for parenting occupations in adult populations. These were supportive institutional structures; training, resources and assessments; and recognition of occupational therapists' suitability to support parenting both within and outside the profession. Responses varied somewhat by country, setting, population, previous training and clinical experience.
Increasing occupational therapy support for parents with a variety of disabilities and other challenges requires efforts from individual occupational therapists, professional bodies, organisations and educators.
Trauma is prevalent among preschool children and can significantly impact development, mental health, and engagement in childhood occupations. Evidence suggests trauma affects sensory processing, impacting engagement in everyday activities. Preschool settings may offset the impacts of trauma with social and developmental opportunities. Occupational therapy may provide interventions for trauma in preschools at both organisational and individual levels. Evidence for trauma-informed (organisational) preschool approaches is limited but growing; however, little is known about the use of sensory-based (individual) practices. The purpose of this study was to review trauma-informed and sensory-based practices in preschool settings, including implementation and evaluation.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review (PRISMA-ScR) guided the search of six databases for peer-reviewed primary studies of trauma-informed and/or sensory-based practices with children and/or educators in preschool settings.
No consumers were involved in study design or analysis.
Eighteen studies were included in this review (US publications n = 17). Studies involved preschool children (n = 7), preschool educators (n = 8), or both preschoolers and educators (n = 3). Included studies reported on trauma-informed practices (n = 11), sensory-based interventions (n = 6), or a combination of both (n = 1). Intervention implementation was multi-disciplinary; however, occupational therapy was minimally represented. Interventions were for specific durations (defined) or integrated into daily routines (embedded), with defined interventions used predominantly for sensory-based practices. Interventions were predominantly applied class and/or school-wide (n = 9). Evaluation encompassed child, staff, and organisational outcomes; however, follow-up evaluations were infrequent.
Further research on trauma-informed and/or sensory-based practices in preschool settings is needed, focussing on implementation methods and long-term follow-up evaluations. Limited implementation of interventions by occupational therapists highlights an opportunity to play a more active role in future research, including consultation
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