Australian Occupational Therapy Journal最新文献_第5页

An evaluation of intervention appropriateness from the perspective of parents: A peer-mediated, play-based intervention for children with ADHD 从家长的角度评估干预措施的适宜性：以同伴为媒介、以游戏为基础的多动症儿童干预。

IF 1.6 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2024-07-20 DOI: 10.1111/1440-1630.12981

Sarah Wilkes-Gillan, Lauren Parsons, Dave Parsons, Natasha Mahoney, Nicola Hancock, Reinie Cordier, Michelle Lincoln, Yu-Wei (Ryan) Chen, Anita Bundy

<div> <section> <h3> Introduction</h3> <p>A peer-mediated, play-based intervention has been developed to address social participation challenges experienced by children with ADHD. To facilitate implementation into clinical practice, interventions should be evaluated for appropriateness to the end-user, as well as effectiveness. Previous research demonstrated the approach is effective for improving children's social play skills. This study aimed to evaluate the appropriateness of the intervention for children with ADHD and their families.</p> </section> <section> <h3> Methods</h3> <p>Parents of children with ADHD who participated in the play-based intervention were interviewed 1 month after completion. Parents were asked about their perspective of parent and children's experiences of the intervention, the perceived benefits for children and parents, the logistics of participating, and recommended adaptations to the intervention. Interviews were analysed thematically, and themes were mapped to the elements of the adopted definition of appropriateness to understand whether parents supported the appropriateness of the intervention for their families.</p> </section> <section> <h3> Consumer and Community Involvement</h3> <p>Consumers were not directly involved in the decisions made about this study.</p> </section> <section> <h3> Findings</h3> <p>One core theme, ‘collaborative efforts’, emerged from the data. Major themes comprising the core theme were ‘on the same page’, ‘therapeutic relationship’, and ‘getting the job done’. Three sub-themes of ‘engagement and motivation’, ‘the effort was worth it for the reward’, and ‘Rome wasn't built in a day’ were nested within the major themes.</p> </section> <section> <h3> Conclusion</h3> <p>Parents largely supported the appropriateness of the intervention, indicating it addressed an important goal for their child, participation was a positive experience, and they perceived the intervention to be beneficial. Future adaptions of the intervention are needed to increase its ecological validity and to generalise the strategies to other social environments and playmates, such as peers at school.</p> </section> <section> <h3> PLAIN LANGUAGE SUMMARY</h3> <p>This study looked at an intervention that uses play with peers to help children with ADHD develop their play skills. The researchers wanted to know if parents thought

简介我们开发了一种以同伴为媒介、以游戏为基础的干预措施，以应对多动症儿童在社会参与方面遇到的挑战。为便于在临床实践中实施，应评估干预措施是否适合最终用户以及是否有效。先前的研究表明，该方法能有效提高儿童的社交游戏技能。本研究旨在评估该干预措施对多动症儿童及其家庭的适宜性：方法：参加游戏干预的多动症儿童的家长在干预完成 1 个月后接受了访谈。家长们被问及他们对家长和儿童在干预中的体验的看法、对儿童和家长带来的益处的看法、参与干预的后勤保障以及对干预的调整建议。对访谈内容进行了主题分析，并将主题与所采用的适当性定义的要素进行了映射，以了解家长是否支持干预措施对其家庭的适当性：消费者和社区的参与：消费者没有直接参与本研究的决策：数据中出现了一个核心主题，即 "合作努力"。构成这一核心主题的主要主题是 "同心协力"、"治疗关系 "和 "完成工作"。三个次主题分别是 "参与和动力"、"付出是值得的 "和 "罗马不是一天建成的"：结论：家长们普遍支持该干预措施的适当性，并表示它解决了他们孩子的一个重要目标，参与是一种积极的体验，而且他们认为该干预措施是有益的。今后需要对干预措施进行调整，以提高其生态效度，并将干预策略推广到其他社会环境和玩伴中，如学校里的同伴。研究人员想知道家长是否认为这种干预适合他们的家庭，是否对他们的孩子有帮助。干预结束一个月后，家长们接受了采访。他们被问及对干预的看法、干预对他们的孩子和他们自己有什么帮助、参加干预的难易程度，以及有哪些改变可以使干预更好。在对家长的回答进行分析后，研究人员发现家长们大多认为干预措施非常合适。他们说，这有助于孩子与同伴一起玩耍，而且他们玩得很开心。家长们认为这种干预很有帮助，他们喜欢这种由他们和职业治疗师共同努力的方式，而且他们觉得这种努力是值得的。不过，他们也提出了一些修改建议。他们希望干预能融入其他现实生活中的社交场合，如学校，这样他们的孩子就能在其他地方使用学到的技能。总的来说，家长们认为这项干预措施对他们的孩子和他们自己都很有帮助，也很合适，但一些改变可能会使它更有帮助。

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引用次数: 0

Co-design: Do we need to (co-)change our (co-)thinking? 共同设计：我们需要（共同）改变我们的（共同）思维吗？

IF 1.6 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2024-07-18 DOI: 10.1111/1440-1630.12986

Matthew McShane, Louise Gustafsson

<p>The origin of co-design is first traced back to the ‘northern’ and ‘southern’ traditions of participatory research. The ‘northern’ tradition of Kurt Lewin (<span>1948</span>) promoted empowerment and social equity through action cycles as means of work that was ‘with’ or ‘by’ marginalised groups rather than ‘to’, ‘on’, or ‘for’. The ‘southern’ tradition from Freire (<span>1970</span>) had origins in emancipatory theory and posited that people should be active in determining their own needs and solutions, as full participants in any form of inquiry. At the core was the philosophy of inclusivity and agency of the group of focus in the process of inquiry and not as the focus of the inquiry. The participatory co-operative design tradition of Scandinavia emerged from this background in technology and information system projects during the 1970–1980s. The projects incorporated a politically based desire to increase democracy within the workplace and promote inclusion of the workforce in the design processes of the computer systems utilised by their organisations (Bødker et al., <span>2000</span>; Gregory, <span>2003</span>). This work from Scandinavia is regularly cited as the origin of the term ‘co-design’ and the evolution of experience-based co-design (EBCD). Initially developed and piloted as evidence-based design within a UK health service design project, EBCD has become the participatory design method of choice for healthcare quality improvement.</p><p>EBCD was devised to promote participatory action research, user-centred design, learning theory, and narrative-based approaches to change (Donetto et al., <span>2015</span>). However, recently, it has been highlighted that the co-design aspect may at times be lost in translation (Donetto et al., <span>2015</span>). We agree and propose that the toolkits developed for EBCD have led to the process becoming the focal point, while the skills, principles, and approaches necessary to authentically power share and privilege the voices of the individuals and collectives has been lost. Or as recently highlighted by Dancis et al. (<span>2023</span>), EBCD has become a ‘watered down, de-politicised, checklist approach’, which is at risk of not honouring the power-sharing, user-driven intent of the Scandinavian tradition of participatory research. Increasingly this issue appears to extend beyond EBCD and to any project claiming to utilise co-design.</p><p>Collaboration, capability building empowerment, and positive societal impact are principles that should be at the core of co-design (Greenhalgh et al., <span>2016</span>). This requires careful attention to iterative and flexible approaches that support power sharing, shared decision making, and sustained consumer and community engagement (Butler et al., <span>2022</span>). The widespread adoption of co-design appears to have been accompanied by inconsistent attention to these fundamental principles and approaches. Service development activities within hea

共同设计的起源首先要追溯到参与式研究的 "北方 "和 "南方 "传统。库尔特-勒温（1948 年）的 "北方 "传统提倡通过行动周期来增强能力和社会公平，以此作为 "与 "或 "由 "边缘化群体而不是 "对"、"对 "或 "为 "边缘化群体开展工作的手段。弗莱雷（Freire，1970 年）的 "南方 "传统起源于解放理论，认为人们应作为任何形式调查的全面参与者，积极决定自己的需求和解决方案。其核心理念是调查过程中的包容性和重点群体的能动性，而不是调查的重点。斯堪的纳维亚的参与式合作设计传统就是在这种背景下产生的，产生于 20 世纪 70-80 年代的技术和信息系统项目中。这些项目包含了一种基于政治的愿望，即增强工作场所的民主性，促进员工参与其组织所使用的计算机系统的设计过程（Bødker 等人，2000 年；Gregory，2003 年）。斯堪的纳维亚的这项工作经常被认为是 "协同设计 "一词的起源和基于经验的协同设计（EBCD）的发展。EBCD 最初是在英国的一个医疗服务设计项目中作为基于证据的设计而开发和试行的，现已成为医疗质量改进的首选参与式设计方法。然而，最近有人强调，共同设计方面有时可能会在翻译中丢失（Donetto 等人，2015 年）。我们同意并认为，为 EBCD 开发的工具包已导致过程成为焦点，而真正分享权力和赋予个人和集体发言权所需的技能、原则和方法却被遗忘了。正如 Dancis 等人（2023 年）最近强调的那样，EBCD 已成为一种 "淡化、去政治化、清单式的方法"，有可能无法体现斯堪的纳维亚参与式研究传统中的权力共享、用户驱动意图。合作、能力建设赋权和积极的社会影响是协同设计的核心原则（Greenhalgh 等人，2016 年）。合作、能力建设、赋权和积极的社会影响是共同设计的核心原则（Greenhalgh 等人，2016 年）。这就要求仔细关注支持权力共享、共同决策以及消费者和社区持续参与的迭代和灵活的方法（Butler 等人，2022 年）。在共同设计被广泛采用的同时，对这些基本原则和方法的关注似乎并不一致。医疗保健领域的服务开发活动往往被贴上共同设计的标签，尽管这些活动被描述为以服务为主导的咨询更为恰当。被贴上共同设计标签的研究项目可能并没有在项目的各个阶段纳入所需的权力分享和用户（消费者）驱动意图。在设计领域，从优先考虑美观和功能，到更加以人为本，强调共同设计以满足人们的需求，已经发生了显著的变化。然而，在设计领域，共同设计的实施仍然在很大程度上依赖于设计师的诠释。在实际操作和教育环境中，这往往更像是一种用户观察设计方法，用户并不是设计过程的重点，他们只是被邀请以咨询的形式对设计特点提供反馈意见。生活经验专家（消费者）告诉我们，在共同设计过程中，他们常常感到自己的意见被忽视，结果导致设计成果不符合目的。他们认为，共同设计应该是一种协作和贡献的体验，而不是参与和合作。这种语义上的区别对消费者有着深远的影响。他们认为，合作和贡献的机会不足，影响了以往共同设计流程和解决方案的成果和质量。对步骤的关注以及对真正合作所必需的原则和方法的关注有限，导致丧失了将成果从 "还行 "提升到 "很棒 "的机会。共同设计似乎已被广泛用于描述那些未能包含支持参与式、以用户为中心的方法的基本原则和方法的过程。我们担心的是，广泛过度的使用可能意味着不再可能对正确使用该术语负责。

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引用次数: 0

Occupational therapy experiences of interprofessional collaboration in the support of autistic children 跨专业合作支持自闭症儿童的职业治疗经验。

IF 1.6 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2024-07-18 DOI: 10.1111/1440-1630.12982

Greta Ryan, Valerie Watchorn, Sherryn Evans

<div> <section> <h3> Introduction</h3> <p>Autistic children commonly receive simultaneous services from various health-care and other professionals, including occupational therapy, throughout their journey of diagnosis and consequent therapeutic support. Current best practice guidelines for supporting autistic youth emphasise the importance of interprofessional collaboration. Despite this, collaboration among health-care professionals does not always occur, and little is understood about clinicians' experiences of collaborative care. The aim of this study was to explore Australian paediatric occupational therapists' experiences of interprofessional collaboration and their perception of factors influencing collaboration when supporting autistic children.</p> </section> <section> <h3> Methods</h3> <p>This study employed an exploratory qualitative descriptive design. Semi-structured interviews were conducted with 13 Australian paediatric occupational therapists involved in service provision to autistic children. Questions explored clinicians' experiences and perceptions of interprofessional collaboration. Reflexive thematic analysis was used to inductively analyse data.</p> </section> <section> <h3> Consumer and Community Consultation</h3> <p>This study was conceptualised and conducted by a team of researchers with a range of personal and professional experiences with the autistic community. The research design was strongly informed by the Autism CRC'S research guidelines.</p> </section> <section> <h3> Findings</h3> <p>Three themes were generated highlighting factors that influence collaboration between occupational therapists and other professionals. The first emphasised that ‘clinicians' capacity to collaborate’ at both organisational and individual levels was understood to be greatly influenced by funding structures. The second emphasised that ‘relationships are key to collaboration’ with these often established through shared workplaces or clients. The third, ‘shared perceptions make collaboration easier’ described how shared perceptions of collaboration, the occupational therapy role, and autism-related frames of reference were perceived to influence interprofessional collaboration.</p> </section> <section> <h3> Conclusion</h3> <p>Findings indicate that, while occupational therapists perceive interprofessional collaboration as valuable in the support of autistic children, there are barriers to effective collaboration, particularly in the context

导言：自闭症儿童在接受诊断和治疗支持的整个过程中，通常会同时接受包括职业治疗在内的各种医疗保健和其他专业人员的服务。目前为自闭症青少年提供支持的最佳实践指南强调了跨专业合作的重要性。尽管如此，医护人员之间的合作并不总能实现，而临床医生对合作护理的体验也知之甚少。本研究旨在探讨澳大利亚儿科职业治疗师在支持自闭症儿童时的跨专业合作经验，以及他们对影响合作因素的看法：本研究采用探索性定性描述设计。对 13 名参与自闭症儿童服务的澳大利亚儿科职业治疗师进行了半结构式访谈。问题探讨了临床医生对跨专业合作的经验和看法。采用反思性主题分析法对数据进行归纳分析：消费者和社区咨询：这项研究是由一个研究团队构思和实施的，该团队成员在自闭症社区工作方面有着丰富的个人和专业经验。研究设计主要参考了自闭症儿童权利委员会的研究指南：研究产生了三个主题，强调了影响职业治疗师与其他专业人员合作的因素。第一个主题强调，"临床医生在组织和个人层面的合作能力 "在很大程度上受到资金结构的影响。第二点强调 "关系是合作的关键"，这些关系通常是通过共享工作场所或客户建立起来的。第三，"共同的认知使合作更容易 "描述了对合作、职业治疗角色和自闭症相关参照系的共同认知是如何影响专业间合作的：研究结果表明，虽然职业治疗师认为跨专业合作在支持自闭症儿童方面很有价值，但在有效合作方面存在障碍，尤其是在市场化服务提供模式的背景下。尽管建议专业人员共同为自闭症儿童及其家庭提供支持，但这种情况并不总是发生。在这项研究中，研究人员对 13 名职业治疗师进行了访谈，询问他们与其他专业人员合作的感受，哪些方面对他们有帮助，哪些方面会导致合作困难。从这些访谈中，研究人员发现很多事情都会影响职业治疗师与其他医疗专业人员和教师合作为自闭症儿童提供支持的效果。资金和工作场所规则等因素都会影响专业人员的合作方式。如果有人担任领导角色，并且专业人员之间关系融洽，那么合作起来就会更加容易。如果职业治疗师和其他专业人员在如何支持自闭症儿童的问题上有相似的想法，也会很有帮助。如果能收集更多有关职业治疗师所受教育的信息，以及他们在与其他专业人员合作方面所学到的知识，这项研究就会更完善。总体而言，本研究中的治疗师认为，共同为自闭症儿童及其家庭提供支持非常重要，但要做到这一点还面临许多挑战。对这一主题进行更多的研究将会有所帮助。

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引用次数: 0

What supports do autistic adolescents and adults need? Perspectives of self-reporting adults and caregivers 自闭症青少年和成人需要哪些支持？自述成人和照顾者的观点。

IF 1.6 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2024-07-17 DOI: 10.1111/1440-1630.12979

Jessica Hill, Jodie Copley, Sophie Donovan, Jill Ashburner, Jennifer Taylor, Natasha Bobir

<div> <section> <h3> Introduction</h3> <p>Increasingly, autistic adolescents and adults are accessing occupational therapy. However, limited evidence exists on the type of supports that are important to them. Examining the patterns of supports valued by autistic adolescents and adults will inform the design of occupational therapy services. Therefore, this study aimed to identify what supports autistic adolescents and adults believed to be the most important.</p> </section> <section> <h3> Methods</h3> <p>This study involved two anonymous online surveys. Survey one involved 54 items and was distributed to caregivers of autistic adolescents and/or adults. Survey two included 41 items and was distributed to self-reporting autistic adults. Surveys sought closed and open-ended responses about the support needs of autistic individuals living in Australia. Quantitative data were analysed as counts and frequencies of responses, whereas short-answer responses were analysed through content analysis.</p> </section> <section> <h3> Community and consumer involvement</h3> <p>There was no consumer or community involvement in the completion of this project.</p> </section> <section> <h3> Results</h3> <p>A total of 68 caregivers of autistic adolescents or adults and 59 self-reporting adults completed the survey resulting in 127 responses. Quantitative data from both autistic adolescents' and adults' closed-answer responses showed that the highest support needs were for supporting participation in employment and supporting health and wellbeing. Content analysis of open-ended responses, performed separately for each participant group, revealed six categories: employment, promoting independence, supporting positive social and communication experiences, supporting health and wellbeing, caregiver support, and promoting autism acceptance.</p> </section> <section> <h3> Conclusion</h3> <p>Results highlight that autistic individuals and their caregivers have a diverse range of priorities, all of which align with the scope of occupational therapy practice. Differences between the priorities of autistic individuals and their caregivers highlight the importance of therapists providing person and family-centred approaches tailored towards both the autistic person's and their caregiver's needs.</p> </section> <section> <h3> Plain language summary</h3> <p>Increasingly, autistic adolescents and adults are accessing occupational therapy services. However, limited information exists regarding the type of su

简介越来越多的自闭症青少年和成年人开始接受职业治疗。然而，有关对他们而言重要的支持类型的证据却很有限。研究自闭症青少年和成人所重视的支持模式将为职业治疗服务的设计提供参考。因此，本研究旨在确定自闭症青少年和成人认为哪些支持是最重要的：本研究涉及两项匿名在线调查。调查一包括 54 个项目，发放给自闭症青少年和/或成人的照顾者。调查二包括 41 个项目，发放给自我报告的成年自闭症患者。调查寻求有关澳大利亚自闭症患者支持需求的封闭式和开放式回答。定量数据以计数和回答频率的形式进行分析，而简答回答则通过内容分析进行分析：社区和消费者参与：本项目的完成没有消费者或社区的参与：共有 68 名自闭症青少年或成人的照顾者和 59 名自我报告的成人完成了调查，共收到 127 份回复。从自闭症青少年和成人的封闭式回答中获得的定量数据显示，支持参与就业和支持健康与幸福的支持需求最高。对每个参与者群体的开放式回答分别进行了内容分析，结果显示了六个类别：就业、促进独立、支持积极的社交和沟通体验、支持健康和幸福、照顾者支持以及促进对自闭症的接受：研究结果表明，自闭症患者及其照顾者的优先事项多种多样，所有这些优先事项都符合职业疗法的实践范围。自闭症患者及其照护者优先考虑事项之间的差异凸显了治疗师根据自闭症患者及其照护者的需求提供以个人和家庭为中心的方法的重要性。然而，有关对他们来说重要的支持类型的信息却很有限。了解自闭症青少年和成人重视哪些支持将有助于职业治疗师提供有效的个性化服务。因此，本研究旨在确定自闭症青少年和成人认为哪些支持对他们最重要。本研究涉及两项匿名在线调查。调查一由自闭症青少年和/或成人的照顾者填写。调查二由自我报告的自闭症成人完成。调查包括开放式和封闭式回答，以便更好地了解生活在澳大利亚的自闭症患者的支持需求。共有 68 名自闭症青少年或成人的照顾者和 59 名自我报告的成人完成了调查，共收到 127 份回复。来自照顾者和自我报告的自闭症青少年和成人的封闭式回答问题显示，最大的支持需求是支持参与就业和支持健康与福利。开放式回答问题显示了六个主要优先事项，包括就业、促进独立、支持积极的社交和沟通体验、支持健康和幸福、照顾者支持以及促进对自闭症的接受。本研究发现，自闭症患者及其照顾者的优先事项多种多样，所有这些优先事项都与职业疗法的范围相一致。此外，参与者的回答还强调了治疗师针对自闭症患者及其照顾者的需求，提供以个人和家庭为中心的方法的重要性。

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引用次数: 0

Using FRAME to adapt an evidence-based dyadic intervention program for people living with dementia in residential aged care: A pilot feasibility study 使用 FRAME 为养老院中的痴呆症患者调整以证据为基础的伴侣关系干预计划：试点可行性研究。

IF 1.6 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2024-06-27 DOI: 10.1111/1440-1630.12978

Miia Rahja, Ann Pietsch, Helen Radoslovich, Natalie Galligani, Nicholas Burton, Maria Crotty, Kate Laver

<div> <section> <h3> Introduction</h3> <p>The purpose of this study was to examine the feasibility of adapting and translating an evidence-based occupational therapist-delivered program shown to be effective in the community to residential aged care (RAC). The program aims to improve quality of care and quality of life for people living with dementia and the wellbeing of the family care partner.</p> </section> <section> <h3> Methods</h3> <p>This study took place in a not-for-profit RAC home in Adelaide, South Australia. Mixed methods, specifically questionnaires, activity logs, focus group, and one-on-one interviews were used to evaluate the feasibility of the program implementation. Staff working in the participating home, occupational therapists trained to deliver the program, and residents and their family carer partners were included. Quantitative data were analysed using proportions, means, and standard deviations. Qualitative data were analysed using a thematic approach.</p> </section> <section> <h3> Consumer and Community Involvement</h3> <p>This study was conducted together with a consumer (person living with dementia) and a carer representative (family member of someone residing in RAC). These representatives provided input towards the study design, interpretation of study data, discussion of results, and recommendations for future consideration.</p> </section> <section> <h3> Results</h3> <p>Small changes to the program improved feasibility and acceptability for delivery in RAC. While the care home staff required added support during implementation, the intervention therapists felt that the program could be delivered in this setting. Family care partners of residents with dementia felt that the program may be better suited if provided upon entry to RAC or in early stages of dementia.</p> </section> <section> <h3> Conclusion</h3> <p>Adapting a community-based dementia care program to RAC can be safe and feasible. Program adaptations are necessary for feasibility. Further adaptations and evaluations of associated outcomes (related to residents with dementia and their family care partners) are needed to assess the program effectiveness in larger scale.</p> </section> <section> <h3> Plain language summary</h3> <p>Spending quality time with family members in residential aged care is important. However, many struggle to know what to say or do wh

导言：本研究的目的是探讨将一项在社区有效的循证职业治疗师项目应用于养老院（RAC）的可行性。该项目旨在改善痴呆症患者的护理质量和生活质量，以及家庭护理伙伴的福祉：本研究在南澳大利亚阿德莱德的一家非营利性 RAC 养老院进行。研究采用了混合方法，特别是问卷调查、活动日志、焦点小组和一对一访谈，以评估计划实施的可行性。评估对象包括参与计划的疗养院工作人员、接受过计划实施培训的职业治疗师、院友及其家庭护理伙伴。定量数据采用比例、平均值和标准差进行分析。定性数据采用主题方法进行分析：这项研究是与一名消费者（痴呆症患者）和一名照护者代表（居住在康复中心的患者家属）共同进行的。这些代表为研究设计、研究数据的解释、结果讨论以及未来考虑的建议提供了意见：结果：对计划进行的微小改动提高了在康复咨询中心实施的可行性和可接受性。虽然护理院的工作人员在实施过程中需要更多的支持，但干预治疗师认为该计划可以在这种环境下实施。痴呆症住户的家庭护理伙伴认为，如果在住户进入康复中心时或痴呆症早期阶段提供该项目，可能会更加合适：结论：将基于社区的痴呆症护理计划调整到康复中心是安全可行的。为确保可行性，有必要对计划进行调整。需要进一步调整和评估相关结果（与痴呆症患者及其家庭护理伙伴相关），以评估该计划在更大范围内的有效性。然而，许多人在探望患有痴呆症的家人时，却不知道该说些什么或做些什么。在安老院中，还没有教导家人如何与痴呆症患者沟通、如何支持他们参与重要的日常生活活动或如何理解行为变化的原因的课程。本文介绍了我们如何将这样一个以证据为基础的项目从社区调整到养老院环境中。我们咨询了痴呆症患者、照护者和家人，发现该计划在这种照护环境中也很有价值。安老院的工作人员介绍说，该计划与安老院通常提供的服务大相径庭，但他们乐观地认为，只要有正确的支持，该计划就能成为支持痴呆症患者及其家人的重要方式。痴呆症院友的家人和实施该计划的治疗师认为，处于安老院生活早期阶段和/或痴呆症早期阶段的院友可以从这些计划中获益最多。我们发现，在干预过程中让家庭成员参与进来，对家庭和院友来说都是有益的，也能增强他们的能力。未来的工作也应侧重于让其他照顾住客的工作人员参与到干预过程中来。工作人员与家属之间的沟通是项目实施和成功的关键，也是将每个人视为一个独立个体的关键。

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引用次数: 0

Collaborative practice with parents in occupational therapy for children: A scoping review 儿童职业疗法中与家长的合作实践：范围综述。

IF 1.6 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2024-06-25 DOI: 10.1111/1440-1630.12974

Carla R. Lage, Shelley Wright, Rafaelle G. de S. Monteiro, Luisa Aragão, Kobie Boshoff

<div> <section> <h3> Introduction</h3> <p>In childhood intervention, parent–therapist collaboration is central to the family-centred approach. Despite long-standing discussion in occupational therapy literature, the field faces challenges, including inconsistent terminology and difficulties in translating theory into practice. This paper represents the first part of a comprehensive scoping review study aimed at developing foundational concepts for collaborative practices with parents in occupational therapy for children. Therefore, this paper focusses on mapping existing practices, types, and approaches articulated in the literature.</p> </section> <section> <h3> Methods</h3> <p>We searched English-language sources published worldwide from 1998 to 2022 discussing collaborative practices with parents in occupational therapy for children aged 0–10 with any diagnosis, including multidisciplinary practices. Seven databases were searched. Data from peer-reviewed indexed literature, theses and dissertations, and book chapters were extracted and analysed through basic numerical and descriptive analyses before being synthesised into similar categories. The Joanna Briggs Institute Manual and the Preferred Reporting Items for Systematic reviews and Meta-Analysis—extension for Scoping Reviews were used.</p> </section> <section> <h3> Results</h3> <p>The scoping review yielded 299 papers. Parent–therapist collaboration was prominent in clinics, family homes, schools, and hospitals, particularly during therapy implementation, goal setting, and planning. Most reported practice types included ‘interventions with parent engagement’, ‘parent-directed interventions’, and ‘parent education’. ‘Family-centred’, ‘occupational-focussed’, and ‘client–therapist collaborative’ approaches were frequently mentioned. There were inconsistencies in the terms used to describe collaborative practice characteristics.</p> </section> <section> <h3> Conclusion</h3> <p>Over the past 24 years, the collaborative practice literature has expanded and evolved, with parent–therapist collaboration observed across various occupational therapy settings. Inconsistencies in this collaboration across different therapeutic stages were revealed, which could impact intervention success and sustainability. Further research is needed to explore parent–therapist collaboration mechanisms within and across stages. This scoping review also underscores the need for a common framework to guide practice and research.</p> </section> <section>

简介在儿童干预中，家长与治疗师的合作是以家庭为中心方法的核心。尽管职业治疗文献中的讨论由来已久，但这一领域仍面临着挑战，包括术语不统一以及将理论转化为实践的困难。本文是全面范围综述研究的第一部分，旨在为儿童职业治疗中与家长的合作实践提出基础概念。因此，本文重点关注文献中阐述的现有实践、类型和方法：我们检索了 1998 年至 2022 年期间在全球范围内发表的、讨论在对 0-10 岁患有任何诊断的儿童进行职业治疗时与家长合作实践的英文资料，包括多学科实践。共检索了七个数据库。从同行评审的索引文献、论文和书籍章节中提取数据，并通过基本的数字和描述性分析进行分析，然后将其归纳为类似的类别。采用了《乔安娜-布里格斯研究所手册》和《系统综述和Meta分析首选报告项目--范围界定综述扩展》：结果：范围界定审查产生了 299 篇论文。家长与治疗师的合作在诊所、家庭之家、学校和医院都很突出，尤其是在治疗实施、目标设定和规划过程中。报告最多的实践类型包括 "家长参与干预"、"家长指导干预 "和 "家长教育"。以家庭为中心"、"以职业为中心 "和 "客户-治疗师合作 "等方法也经常被提及。结论：在过去的 24 年中，合作实践在不断发展：在过去的 24 年中，合作实践的文献不断扩展和发展，在各种职业治疗环境中都能观察到家长与治疗师的合作。研究发现，在不同的治疗阶段，家长与治疗师之间的合作并不一致，这可能会影响干预的成功率和可持续性。需要进一步开展研究，探索各阶段内和各阶段间家长与治疗师的合作机制。本综述还强调需要一个共同的框架来指导实践和研究。合作对于了解和满足儿童在家庭和社区环境中的需求至关重要。然而，职业治疗师和家长在应用以家庭为中心的实践以及使用共同语言沟通理论与实践方面面临着挑战。为了应对这些挑战，我们研究了 1998 年至 2022 年间发表的 299 篇论文，以了解文献中是如何描述与家长的合作实践的。我们的研究发现，治疗师和家长在诊所、学校、家庭和医院等不同环境中进行合作，主要是在治疗过程、目标设定和干预计划中。合作的形式多种多样。例如，治疗师通常鼓励家长积极参与并主导治疗，要求治疗师认识并尊重家长的优先事项和学习偏好。他们通常会共同制定策略，在家庭常规中为儿童提供支持。虽然我们发现了一些关于治疗师与家长合作的研究，但综述中对这一做法的描述和应用并不一致，这可能会影响其成功与否。因此，需要开展更多研究，以了解在治疗的每个阶段开展合作的最佳方式。研究还发现，职业治疗中与家长的合作实践需要一个核心指南。虽然治疗师与家长的合作被用于儿童职业治疗，但显然需要尽量减少文献中发现的不一致和差距，并确保有共同的语言来促进干预的质量和成功。

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引用次数: 0

Foundational concepts of collaborative practice with parents in occupational therapy for children 儿童职业疗法中与家长合作实践的基本概念。

IF 1.6 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2024-06-25 DOI: 10.1111/1440-1630.12952

Carla R. Lage, Shelley Wright, Rafaelle G. de S. Monteiro, Luisa Aragão, Kobie Boshoff

Introduction

In occupational therapy for children, collaborative practice with parents is crucial for meaningful family-centred interventions, yet it remains undefined and inconsistently addressed. This study aimed to establish foundational concepts for collaborative practice with parents in occupational therapy for children in progressing the field with a universal description.

Methods

This paper encompasses the second dataset of a larger scoping review and a preliminary validation of findings by an advisory panel. Data were gathered from indexed sources on collaborative practice with parents in occupational therapy for children (ages 0–10) using MedLine, PsychInfo, ERIC, Embase, OTSeeker, Scopus, and ProQuest Central. Data were extracted, charted, and descriptively analysed by paired independent reviewers. The Joanna Briggs Institute Manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis—extension for Scoping Reviews were used. A draft definition of collaborative practices, developed based on preliminary review findings and an operational definition, was validated by an advisory panel of 13 experienced Australian occupational therapists, whose input was integrated into a final, comprehensive description of collaborative practice.

Results

The scoping review encompassed 299 sources, revealing three major components of collaborative practice: ‘collaborative practice aims’, ‘parent–therapist partnership’, and ‘strategies for collaboration’. The advisory panel endorsed the draft definition, confirmed its professional relevance, and suggested some modifications.

Conclusion

The major outcome of this study is an evidence-based and discipline-specific preliminary description of collaborative practice with parents in occupational therapy for children. This description provides a common language and foundational concepts for the future development of a collaborative practice framework to guide practice and research. Future studies can explore specific components, exploring their mechanisms and significance. Further expanded validation is required, incorporating the perspectives of a wider community of occupational therapists and families to enhance the description's applicability.

导言：在儿童职业治疗中，与家长的合作实践对于以家庭为中心的有意义的干预措施至关重要，但这一问题仍未得到明确界定，而且处理方式也不一致。本研究旨在建立儿童职业治疗中与家长合作实践的基本概念，以通用的描述推动该领域的发展：本文是一项大型范围研究的第二个数据集，并由一个顾问小组对研究结果进行了初步验证。我们使用 MedLine、PsychInfo、ERIC、Embase、OTSeeker、Scopus 和 ProQuest Central，从有关儿童（0-10 岁）职业治疗中与家长合作实践的索引来源收集数据。数据由配对的独立审稿人进行提取、制表和描述性分析。研究中使用了乔安娜-布里格斯研究所的《手册》和《系统综述和 Meta 分析--扩展范围综述的首选报告项目》。由 13 名经验丰富的澳大利亚职业治疗师组成的顾问小组对根据初步审查结果和操作定义制定的协作实践定义草案进行了验证，并将他们的意见纳入了协作实践的最终综合描述中：范围审查包括 299 个资料来源，揭示了协作实践的三个主要组成部分："协作实践目标"、"家长-治疗师伙伴关系 "和 "协作战略"。咨询小组认可了定义草案，确认了其专业相关性，并提出了一些修改建议：本研究的主要成果是对儿童职业疗法中与家长的合作实践进行了循证和学科特定的初步描述。这一描述为今后制定合作实践框架以指导实践和研究提供了共同语言和基础概念。未来的研究可以探讨具体的组成部分，探索其机制和意义。还需要进一步扩大验证范围，纳入更多职业治疗师和家庭的观点，以增强描述的适用性。

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引用次数: 0

Calculating the social impact of home automation for people with disability: A social return on investment study 计算家庭自动化对残疾人的社会影响：社会投资回报研究。

IF 1.6 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2024-06-25 DOI: 10.1111/1440-1630.12977

Claire Hutchinson, Jenny Cleland, Patricia A. H. Williams, Kisani Manuel, Kate Laver

<div> <section> <h3> Introduction</h3> <p>Home automation can deliver important outcomes for people with disabilities, including enhanced independence. Despite the millions of dollars spent on home automation in Australia and other developed nations, to date, there has been no economic evaluation of this type of assistive technology.</p> </section> <section> <h3> Method</h3> <p>A social return on investment analysis of home automation study was undertaken. Primary data were collected using qualitative interviews with home automation consumers and other key stakeholders, including occupational therapists, a spinal rehabilitation physician, peer support advocate, and managers and technical personnel from home automation providers (<i>n</i> = 17). The analysis was supported by (1) secondary data from a scoping review on outcomes from home automation and (2) additional literature searches to identify suitable financial proxies and to make estimates of the proportion of home automation users expected to experience each outcome. A scenario approach was used with three home automation scenarios developed with increasing complexity and costs to calculate the social return on investment.</p> </section> <section> <h3> Results</h3> <p>Eight outcomes from the use of home automation were identified, including reduced reliance on carers and family members, increased independence, and improved energy and comfort. The social return on investment ranged from $38.80 (low cost) to $15.10 (high cost) for every $1 invested across a 10-year benefit period, with the financial proxy for reduced care attendant hours contributing the most to the social return ratio. Even the highest cost scenario was repaid in social value within the first year of the benefit period.</p> </section> <section> <h3> Conclusion</h3> <p>This study suggests that home automation represents a sound investment and has a significant impact on the overall quality of life of people with disabilities. Focusing on the financial savings in care attendant hours alone should be compelling evidence for funders to recognise home automation's value and continue to fund this assistive technology.</p> </section> <section> <h3> Consumer and Community Involvement</h3> <p>A consumer representative was a member of the project steering group, which supported the research team at all stages of the project.</p> </section> <section> <h3> Plain Langua

导言：家庭自动化可以为残疾人带来重要的成果，包括增强他们的独立性。尽管澳大利亚和其他发达国家在家庭自动化上花费了数百万美元，但迄今为止，还没有对这类辅助技术进行过经济评估：方法：对家庭自动化研究进行了社会投资回报分析。通过对家庭自动化消费者和其他主要利益相关者（包括职业治疗师、脊柱康复医师、同伴支持倡导者以及家庭自动化供应商的管理人员和技术人员，共 17 人）进行定性访谈，收集了原始数据。分析得到了以下两方面的支持：(1) 有关家庭自动化成果的范围综述中的二手数据；(2) 其他文献检索，以确定合适的财务替代指标，并对预期体验每种成果的家庭自动化用户比例进行估算。我们采用了一种情景假设法，根据复杂程度和成本的增加，设计了三种家庭自动化情景，以计算投资的社会回报：结果：确定了使用家庭自动化的八项成果，包括减少对护理人员和家庭成员的依赖、提高独立性、改善能源和舒适度。在 10 年的受益期内，每投资 1 美元可获得 38.80 美元（低成本）到 15.10 美元（高成本）不等的社会投资回报，其中以减少护理人员工时的财务代理对社会回报率的贡献最大。即使是成本最高的方案，也能在受益期的第一年内收回社会价值：这项研究表明，家庭自动化是一项合理的投资，对残疾人的整体生活质量有重大影响。仅从节省护理人员工时这一点来看，就足以让资助者认可家庭自动化的价值，并继续资助这项辅助技术：消费者和社区参与：一名消费者代表是项目指导小组的成员，该小组在项目的各个阶段都为研究小组提供了支持。通俗易懂的语言总结：当人们受伤时，他们的残疾会使他们无法在家中做以前能够做的事情。科技可以帮助残疾人做一些事情，比如按下按钮开关门和关闭水龙头，这样他们就不必等待别人来帮助他们。这种技术可能很昂贵，但没有人研究过它是否物有所值。我们采访了一些使用这种技术的残疾人，他们告诉我们，使用这种技术后，他们的生活变得更好了。例如，他们告诉我们，他们能够自己做事情，不那么需要照顾者了，而且他们的精神健康状况也更好了。我们向企业了解了可用于家庭的各类技术的成本。然后，我们对残疾人告诉我们他们的生活得到改善的方式进行了美元估值。例如，为了改善心理健康，我们计算了看心理医生一年的费用。我们发现，残疾人生活改善方式的美元价值至少是技术成本的 15 倍。因此，这项研究表明，这项技术物有所值，可以改善重伤后残疾人的生活。

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引用次数: 0

Utility of 3D modelling of the patient's living environment as perceived by occupational therapists 职业治疗师眼中病人生活环境三维建模的实用性。

IF 1.6 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2024-06-24 DOI: 10.1111/1440-1630.12975

Manon Guay, Claudine Auger, Noémie Séguin-Tremblay, François Michaud, Mathieu Labbé, Natalie Chevalier, Michelle Plante, Janice Polgar

Introduction

Visiting a patient's living environment is important for occupational therapists, albeit costly and time consuming. MapIt is a mobile app producing a 3D representation of a home with the possibility of taking measurements. The purpose of this study was to explore the utility of a 3D representation of a patient's home for the clinical practice of occupational therapists.

Methods

Case study in which the unit of analysis was the utility of MapIt as defined by ISO 9241-11:2018 and as perceived by occupational therapists in four different occupational therapy clinical settings (Canada). Onsite observations with 10 occupational therapists (and their patients) were triangulated with data from interviews, diaries, and logbooks. Inductive thematic condensation led to emerging conclusions for each clinical setting, fuelling the next case data collection and analysis. Inter-case analysis was corroborated by additional occupational therapists, through crowdsourcing and expert review.

Results

Occupational therapists' clinical reasoning was supported by the MapIt app, enhancing and streamlining their work and inducing adjustments to treatment plans. Occupational therapists saw and measured the patient's environment remotely, to better match person-environment-occupation and promote occupational engagement. MapIt's 3D representations were judged useful to communicate between occupational therapists and stakeholders, to educate, allow continuity, optimise resources, minimise the patient's time on a waitlist for homecare, and save time for everyone.

Discussion

MapIt allowed occupational therapists who performed home visits to bring a little of the patients' home to their office, whereas occupational therapists without access to the home could see it and take measurements. MapIt's utility was confirmed for practice in clinical settings and for better continuity of care between settings.

Conclusion

MapIt makes it possible for occupational therapists to ‘walk around’ the patient's home remotely, but the possibility of measuring environmental elements is a 3D model's true added value over currently used photos or short videos.

导言：对职业治疗师来说，探访病人的居住环境非常重要，尽管这样做既费钱又费时。MapIt 是一款移动应用程序，它能以三维方式显示患者的住所，并可进行测量。本研究的目的是探讨病人住宅的三维显示对职业治疗师临床实践的实用性：方法：案例研究，分析单位为 ISO 9241-11:2018 所定义的 MapIt 的实用性，以及职业治疗师在四种不同的职业治疗临床环境（加拿大）中的感知。对 10 名职业治疗师（及其患者）的现场观察与访谈、日记和日志中的数据进行了三角测量。归纳式专题浓缩法为每个临床环境得出了新的结论，为下一步的案例数据收集和分析提供了依据。通过众包和专家评审，其他职业治疗师对案例间的分析进行了确证：结果：MapIt 应用程序为职业治疗师的临床推理提供了支持，加强并简化了他们的工作，并促使他们对治疗计划进行调整。职业治疗师可以远程观察和测量病人的环境，从而更好地匹配人-环境-职业，促进职业参与。MapIt的三维表现形式被认为有助于职业治疗师与利益相关者之间的沟通、教育、连续性、优化资源、最大限度地减少病人等待家庭护理的时间，并为每个人节省时间：讨论：MapIt 使进行家访的职业治疗师能够将患者家中的一些情况带到他们的办公室，而无法进入患者家中的职业治疗师则可以看到这些情况并进行测量。MapIt 的实用性在临床实践中得到了证实，并能更好地在不同环境之间保持护理的连续性：MapIt使职业治疗师远程 "漫步 "患者家中成为可能，但与目前使用的照片或短视频相比，测量环境要素的可能性才是三维模型的真正附加值。

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引用次数: 0

Occupational therapy practice for post-acute COVID-19 inpatients requiring rehabilitation 为需要康复的 COVID-19 住院病人提供职业治疗。

IF 1.6 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal

Pub Date : 2024-06-14 DOI: 10.1111/1440-1630.12976

Hayley M. Scott, Sharon Neale, Elizabeth Harrington, Hayley Hodgson, Danielle Hitch

<div> <section> <h3> Introduction</h3> <p>COVID-19 caused significant occupational disruption to people's life roles, with some people requiring an inpatient rehabilitation admission. Occupational therapists assessed and treated these patients using previous knowledge of similar conditions due to limited specificity in available guidelines to inform practice. The aim of this study was to investigate current practice with post-acute COVID-19 (PAC) patients within an inpatient rehabilitation setting in Australia, to better understand the role and impact of occupational therapy.</p> </section> <section> <h3> Methods</h3> <p>A mixed-method study was conducted, including electronic medical record audits (October 2021 October 2022) and descriptive patient interviews at a large metropolitan subacute service. Descriptive statistics and qualitative analysis were used to summarise and interpret data.</p> </section> <section> <h3> Consumer and Community Involvement</h3> <p>No involvement.</p> </section> <section> <h3> Results</h3> <p>A total of 24 patient electronic medical records were audited, and 10 patient interviews were completed. Three overarching categories were identified within the 685 occasions of occupational therapy service audited—occupational engagement, education provision and discharge planning. Patients identified the value of occupational therapy by reflecting on their lived experiences of engaging with occupational therapists and associated changes in occupational performance between COVID-19 diagnoses and discharge home.</p> </section> <section> <h3> Conclusion</h3> <p>Occupational therapists possess a unique skill set that directly addresses the occupational needs and priorities of PAC patients. This study adds to the growing body of evidence supporting the contribution of occupational therapy to the management of COVID-19; however, further research is needed to develop evidence-based practice resources and advocate for system changes that improve quality of life for COVID-19 patients.</p> </section> <section> <h3> PLAIN LANGUAGE SUMMARY</h3> <p>During the COVID-19 pandemic, a lot of people got very sick. Some of these people needed more time and support to get better. Occupational therapists were important during this time because they helped these people to do their daily activities again. Because there were not many resources on how t

简介COVID-19 对人们的生活角色造成了严重的职业干扰，有些人需要住院康复治疗。职业治疗师在对这些患者进行评估和治疗时，会利用以往对类似病症的了解，这是因为现有指南的针对性有限，无法为实践提供参考。本研究的目的是调查澳大利亚住院康复环境中急性COVID-19（PAC）后患者的现行治疗方法，以更好地了解职业疗法的作用和影响：研究采用了混合方法，包括对一家大型都市亚急性服务机构进行电子病历审计（2021 年 10 月至 2022 年 10 月）和描述性患者访谈。采用描述性统计和定性分析来总结和解释数据：无参与：共审核了 24 份患者电子病历，完成了 10 次患者访谈。在审核的 685 次职业治疗服务中，确定了三个主要类别--职业参与、教育提供和出院规划。患者通过反思自己与职业治疗师接触的生活经历，以及从COVID-19诊断到出院回家期间职业表现的相关变化，确定了职业治疗的价值：职业治疗师拥有一套独特的技能，可直接满足 PAC 患者的职业需求和优先事项。这项研究补充了越来越多的证据，支持职业治疗对 COVID-19 管理的贡献；然而，还需要进一步的研究，以开发循证实践资源，倡导系统变革，提高 COVID-19 患者的生活质量。其中一些人需要更多的时间和支持才能好转。在此期间，职业治疗师非常重要，因为他们帮助这些人恢复日常活动。因为没有太多的资源可以帮助他们，所以我们研究了职业治疗师是如何帮助这些人的。我们查阅了病人的住院档案，并与他们进行了交谈，以便更好地了解这方面的情况。我们发现职业治疗师主要集中在三个方面：帮助病人从事对他们来说重要的活动、教他们了解 COVID-19 以及帮助他们计划出院。这项研究表明，职业治疗师能够熟练地帮助 COVID-19 患者。但还需要更多的研究来提供资源，并帮助改变医疗保健系统，以进一步帮助人们从 COVID-19 中康复。

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引用次数: 0