Allied health has a valuable role in providing services to people living in residential aged care. The recent Royal Commission into Aged Care Quality and Safety included several important recommendations relating to the nursing, personal care, and allied health workforce and the care that they provide. The purpose of this paper is to review these recommendations and the Australian Government's policy responses and explore the emerging changes in allied health service provision in residential aged care.
Methods
Data from the four available Quarterly Financial Reports from the 2022–2023 financial year were extracted and analysed in relation to staff costs and time per person per day across personal care, nursing, and allied health workers. Supplementary data sources including the 2020 Aged Care Workforce Census were accessed to provide contextual data relating to individual allied health professions, including occupational therapy.
Results
The analysis shows a modest increase in median registered nurse minutes per person per day, and cost per person per day, from the first to second quarter, and again in the third and fourth. By contrast, median time and cost for allied health declined. From 5.6 minutes per person per day in the first quarter, reported allied health minutes fell to 4.6 minutes per person per day in the second quarter, an 18% decrease, and by the fourth quarter was 4.3 minutes per person per day. This is just over half the Australian average of 8 minutes reported to the RCACQS in 2019.
Conclusion
Under recent residential aged care reforms, aged care providers have regulatory incentives to concentrate their financial resources on meeting the mandated care hours for registered nurses, enrolled nurses, personal care workers, and assistants in nursing. These same reforms do not mandate minutes of allied health services. Although providers of residential aged care in Australia continue to employ and value allied health, we argue that mandating care minutes for personal and nursing care without mandating the provision of allied health creates a perverse incentive whereby access to allied health services is unintentionally reduced.
导言：专职医疗在为居住在养老院的老人提供服务方面发挥着重要作用。最近成立的皇家老年护理质量与安全委员会（Royal Commission into Aged Care Quality and Safety）提出了几项与护理、个人护理和专职医疗队伍及其提供的护理有关的重要建议。本文旨在对这些建议和澳大利亚政府的政策回应进行回顾，并探讨住院式老年护理中提供的专职医疗服务正在发生的变化：从2022-2023财政年度的四份《季度财务报告》中提取数据，并对个人护理、护理和专职医疗工作者的员工成本和每人每天的工作时间进行分析。我们还获取了包括 2020 年老年护理人员普查在内的补充数据来源，以提供与包括职业治疗在内的个别专职医疗人员相关的背景数据：分析表明，从第一季度到第二季度，注册护士每人每天的工作时间中位数和每人每天的成本中位数略有增加，第三季度和第四季度再次出现这种情况。相比之下，专职医疗的时间和费用中位数有所下降。第一季度每人每天的专职医疗时间为 5.6 分钟，第二季度下降到每人每天 4.6 分钟，降幅为 18%，第四季度为每人每天 4.3 分钟。这仅仅是澳大利亚 2019 年向 RCACQS 报告的平均 8 分钟的一半多一点：根据最近的住院养老护理改革，养老护理提供方有监管激励措施，以集中财政资源满足注册护士、注册护士、个人护理员和护理助理的规定护理时间。同样的改革并没有规定专职医疗服务的护理时间。尽管澳大利亚的养老院服务提供者继续雇用并重视专职医疗服务，但我们认为，强制规定个人护理和护理服务的护理时间，而不强制规定提供专职医疗服务，会产生一种反向激励，从而无意中减少了专职医疗服务的提供。
{"title":"Reform and reverberation: Australian aged care policy changes and the unintended consequences for allied health","authors":"Diane Gibson, Stephen Isbel","doi":"10.1111/1440-1630.12953","DOIUrl":"10.1111/1440-1630.12953","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Allied health has a valuable role in providing services to people living in residential aged care. The recent Royal Commission into Aged Care Quality and Safety included several important recommendations relating to the nursing, personal care, and allied health workforce and the care that they provide. The purpose of this paper is to review these recommendations and the Australian Government's policy responses and explore the emerging changes in allied health service provision in residential aged care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the four available Quarterly Financial Reports from the 2022–2023 financial year were extracted and analysed in relation to staff costs and time per person per day across personal care, nursing, and allied health workers. Supplementary data sources including the 2020 Aged Care Workforce Census were accessed to provide contextual data relating to individual allied health professions, including occupational therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis shows a modest increase in median registered nurse minutes per person per day, and cost per person per day, from the first to second quarter, and again in the third and fourth. By contrast, median time and cost for allied health declined. From 5.6 minutes per person per day in the first quarter, reported allied health minutes fell to 4.6 minutes per person per day in the second quarter, an 18% decrease, and by the fourth quarter was 4.3 minutes per person per day. This is just over half the Australian average of 8 minutes reported to the RCACQS in 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Under recent residential aged care reforms, aged care providers have regulatory incentives to concentrate their financial resources on meeting the mandated care hours for registered nurses, enrolled nurses, personal care workers, and assistants in nursing. These same reforms do not mandate minutes of allied health services. Although providers of residential aged care in Australia continue to employ and value allied health, we argue that mandating care minutes for personal and nursing care without mandating the provision of allied health creates a perverse incentive whereby access to allied health services is unintentionally reduced.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"71 3","pages":"392-407"},"PeriodicalIF":1.8,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12953","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Araceli Ortiz-Rubio, Carita Håkansson, Hélène Pessah Rasmussen, Eva Månsson Lexell
Introduction
Occupational balance has been investigated in different populations but less in stroke survivors. Previous studies have focussed on occupational balance among stroke survivors of working age (15–64 years of age), showing they did not perceive they had occupational balance. There is, therefore, a lack of knowledge of how older stroke survivors perceive their occupational balance. The aims of this study were to describe occupational balance in community-dwelling stroke survivors 65 years or older and to investigate if there were any associations between their perceived stroke impact and occupational balance.
Methods
A cross-sectional study was performed with 58 stroke survivors, with a median age of 75 years at stroke onset and a median time since stroke onset of 11 months. The participants were recruited from a local stroke register and answered questionnaires on occupational balance and stroke impact. Data were analysed with descriptive statistics, correlations and logistic regression.
Results
The participants had a median score of 29 (min 12 to max 33), indicating a very high occupational balance, a low stroke impact, and a good recovery (median 82.5; min 0 to max 100). An association between participation and occupational balance (OR 1.13; 95% CI 1.04–1.23) was found.
Conclusion
The stroke survivors perceived a low stroke impact and a high occupational balance. It is possible that older community-dwelling stroke survivors, of whom many have retired, juggle less occupations leaving them with more time to engage in those occupations they want to, leading to a better occupational balance.
{"title":"Occupational balance and stroke impact among community-dwelling stroke survivors 65 years or older: a cross-sectional study","authors":"Araceli Ortiz-Rubio, Carita Håkansson, Hélène Pessah Rasmussen, Eva Månsson Lexell","doi":"10.1111/1440-1630.12962","DOIUrl":"10.1111/1440-1630.12962","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Occupational balance has been investigated in different populations but less in stroke survivors. Previous studies have focussed on occupational balance among stroke survivors of working age (15–64 years of age), showing they did not perceive they had occupational balance. There is, therefore, a lack of knowledge of how older stroke survivors perceive their occupational balance. The aims of this study were to describe occupational balance in community-dwelling stroke survivors 65 years or older and to investigate if there were any associations between their perceived stroke impact and occupational balance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was performed with 58 stroke survivors, with a median age of 75 years at stroke onset and a median time since stroke onset of 11 months. The participants were recruited from a local stroke register and answered questionnaires on occupational balance and stroke impact. Data were analysed with descriptive statistics, correlations and logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The participants had a median score of 29 (min 12 to max 33), indicating a very high occupational balance, a low stroke impact, and a good recovery (median 82.5; min 0 to max 100). An association between participation and occupational balance (OR 1.13; 95% CI 1.04–1.23) was found.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The stroke survivors perceived a low stroke impact and a high occupational balance. It is possible that older community-dwelling stroke survivors, of whom many have retired, juggle less occupations leaving them with more time to engage in those occupations they want to, leading to a better occupational balance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"71 5","pages":"746-755"},"PeriodicalIF":1.6,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12962","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Sensory Processing Measure 2 (SPM2) and the Sensory Profile 2 (SP2) are two sensory processing scales often used by occupational therapists. The SPM2 and SP2 both claim to assess aspects of children's sensory processing. This cross-sectional study examined the convergent validity of the SPM2-Home Form (SPM2-HF) and Child SP2 for school-aged neurotypical children.
Methods
Thirty parents/caregivers of neurotypical children aged 7 to 12 completed the SPM2-HF and the Child SP2 about their child. Spearman rho's correlation coefficient with bootstrapping was used to investigate the correlations among the sensory, behavioural, and quadrant scores of the Child SP2 and SPM2-HF subscale scores.
Consumer and Community Involvement
Given the topic, consumers and community members were not involved in the design, execution, or write up of the study results.
Results
Several statistically significant correlations were found between the sensory and quadrant subscales of the Child SP2 with the SPM-HF. Strong to moderate correlations were established between the sensory subscales of the Child SP2 and the SPM2-HF, ranging from 0.40 to 0.74 (p < 0.05). Additionally, correlations between the quadrant subscales of the Child SP2 and the subscales of the SPM2-HF ranged from weak (0.38) to strong (0.77) correlations (p < 0.05).
Conclusion
These results provide evidence of convergent validity between the SPM2-HF and Child SP2 for neurotypical school-aged children. Further research on the psychometric properties of the SPM2-HF and Child SP2 is recommended.
{"title":"Convergent validity between the school-age versions of the Sensory Processing Measure 2 (SPM2) and the Sensory Profile 2 (SP2): A pilot study","authors":"Sarah Jones, Mong-Lin Yu, Ted Brown","doi":"10.1111/1440-1630.12958","DOIUrl":"10.1111/1440-1630.12958","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The Sensory Processing Measure 2 (SPM2) and the Sensory Profile 2 (SP2) are two sensory processing scales often used by occupational therapists. The SPM2 and SP2 both claim to assess aspects of children's sensory processing. This cross-sectional study examined the convergent validity of the SPM2-Home Form (SPM2-HF) and Child SP2 for school-aged neurotypical children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty parents/caregivers of neurotypical children aged 7 to 12 completed the SPM2-HF and the Child SP2 about their child. Spearman rho's correlation coefficient with bootstrapping was used to investigate the correlations among the sensory, behavioural, and quadrant scores of the Child SP2 and SPM2-HF subscale scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Consumer and Community Involvement</h3>\u0000 \u0000 <p>Given the topic, consumers and community members were not involved in the design, execution, or write up of the study results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Several statistically significant correlations were found between the sensory and quadrant subscales of the Child SP2 with the SPM-HF. Strong to moderate correlations were established between the sensory subscales of the Child SP2 and the SPM2-HF, ranging from 0.40 to 0.74 (<i>p</i> < 0.05). Additionally, correlations between the quadrant subscales of the Child SP2 and the subscales of the SPM2-HF ranged from weak (0.38) to strong (0.77) correlations (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These results provide evidence of convergent validity between the SPM2-HF and Child SP2 for neurotypical school-aged children. Further research on the psychometric properties of the SPM2-HF and Child SP2 is recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"71 5","pages":"718-732"},"PeriodicalIF":1.6,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12958","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140839133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The importance of holidays, traditions, and family celebrations to human culture and occupational engagement has been neglected. The aim of this study was to explore how older adults experienced holidays and celebrations with social and physical distancing during the COVID-19 pandemic.
Methods
A secondary analysis was made on data from the At-Risk Study. Seventeen community-living adults (11 women and 6 men) aged 71–87 years, from Sweden participated. They were interviewed remotely four times during the first year of the pandemic. Data were analysed with qualitative content analysis. No consumer/community involvement occurred.
Findings
Three categories on how the participants hoped for, planned, decided, adapted, avoided, and experienced holidays and celebrations with social and physical distancing included expectations and preparations in unpredictable times; the constant need for re-evaluation; and almost everything turned out differently.
Conclusions
The desire to celebrate despite pandemic restrictions shows the importance and meaning holidays hold for older adults. Celebrations can be disrupted for many reasons, not only as extreme as the ongoing pandemic. For wellbeing in later life health care, social care, and society need to understand the inherent components and acknowledge ways of supporting participation in occasional events such as holidays, traditions, and family celebrations.
{"title":"‘Normality in all the abnormality’—Older adults' experiences of holidays and celebrations from the COVID-19 pandemic","authors":"Marianne Granbom, Oskar Jonsson, Gunilla Carlsson, Sofi Fristedt, Elin Stormstege, Elvira Martinsson, Maya Kylén","doi":"10.1111/1440-1630.12949","DOIUrl":"10.1111/1440-1630.12949","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The importance of holidays, traditions, and family celebrations to human culture and occupational engagement has been neglected. The aim of this study was to explore how older adults experienced holidays and celebrations with social and physical distancing during the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A secondary analysis was made on data from the At-Risk Study. Seventeen community-living adults (11 women and 6 men) aged 71–87 years, from Sweden participated. They were interviewed remotely four times during the first year of the pandemic. Data were analysed with qualitative content analysis. No consumer/community involvement occurred.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Three categories on how the participants hoped for, planned, decided, adapted, avoided, and experienced holidays and celebrations with social and physical distancing included e<i>xpectations and preparations in unpredictable times</i>; <i>the constant need for re-evaluation</i>; and <i>almost everything turned out differently</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The desire to celebrate despite pandemic restrictions shows the importance and meaning holidays hold for older adults. Celebrations can be disrupted for many reasons, not only as extreme as the ongoing pandemic. For wellbeing in later life health care, social care, and society need to understand the inherent components and acknowledge ways of supporting participation in occasional events such as holidays, traditions, and family celebrations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"71 5","pages":"661-673"},"PeriodicalIF":1.6,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12949","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140839294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gemma Wall, Claire Pearce, Louise Gustafsson, Stephen Isbel
Introduction
Occupation-based interventions use engagement in a person's daily activities to achieve change. There is growing research into the use of occupation-based group interventions in the inpatient rehabilitation setting. It remains unclear whether occupation-based groups offer comparable outcomes to occupation-based interventions delivered individually; this research will precede a clinical trial aimed at comparing these two approaches for improving occupational performance outcomes. This study details the process of co-designing the intervention. Partnering with clinicians and patients in the design of healthcare interventions can promote patient-centred care, enhance uptake, and improve applicability and sustainability of the intervention to that setting.
Methods
A modified nominal group technique (NGT) design was applied to facilitate two meetings and an electronic survey with an expert panel of clinicians and patients. Twelve participants (n = 4 occupational therapists, n = 1 registered nurse, n = 1 physiotherapist, n = 1 occupational therapy assistant, n = 1 occupational therapy manager, and n = 4 patients) were purposively recruited. A modified approach to the technique's four stages was used: silent generation, round robin, clarification, and voting. Consensus was set at >50%. Qualitative data from group discussions were analysed thematically.
Findings
All participants agreed the intervention should include patient-centred, goal-directed, practice of daily activities, including breakfast and lunch preparation, domestic tasks, and laundry. Other components that were agreed included where the groups could run, group size, eligibility criteria, and frequency. Key themes from clinicians included needing a goal-directed intervention, focused on progressing towards hospital discharge; time and resource requirements were also discussed. Patients emphasised the importance of building social connections, opportunity to engage in meaningful activity, and the importance of linking participation to patient goals.
Conclusion
Through collaboration with clinicians and patients, an occupation-based group intervention considering the available evidence, alongside clinical, experiential, and contextual sources of knowledge was developed; this resulted in an evidence-based, patient-centred, and contextually relevant intervention.
{"title":"Designing an occupation-based group intervention for adult inpatient rehabilitation: Partnering with clinicians and patients using a nominal group technique design","authors":"Gemma Wall, Claire Pearce, Louise Gustafsson, Stephen Isbel","doi":"10.1111/1440-1630.12950","DOIUrl":"10.1111/1440-1630.12950","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Occupation-based interventions use engagement in a person's daily activities to achieve change. There is growing research into the use of occupation-based group interventions in the inpatient rehabilitation setting. It remains unclear whether occupation-based groups offer comparable outcomes to occupation-based interventions delivered individually; this research will precede a clinical trial aimed at comparing these two approaches for improving occupational performance outcomes. This study details the process of co-designing the intervention. Partnering with clinicians and patients in the design of healthcare interventions can promote patient-centred care, enhance uptake, and improve applicability and sustainability of the intervention to that setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A modified nominal group technique (NGT) design was applied to facilitate two meetings and an electronic survey with an expert panel of clinicians and patients. Twelve participants (n = 4 occupational therapists, n = 1 registered nurse, n = 1 physiotherapist, n = 1 occupational therapy assistant, n = 1 occupational therapy manager, and n = 4 patients) were purposively recruited. A modified approach to the technique's four stages was used: silent generation, round robin, clarification, and voting. Consensus was set at >50%. Qualitative data from group discussions were analysed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>All participants agreed the intervention should include patient-centred, goal-directed, practice of daily activities, including breakfast and lunch preparation, domestic tasks, and laundry. Other components that were agreed included where the groups could run, group size, eligibility criteria, and frequency. Key themes from clinicians included needing a goal-directed intervention, focused on progressing towards hospital discharge; time and resource requirements were also discussed. Patients emphasised the importance of building social connections, opportunity to engage in meaningful activity, and the importance of linking participation to patient goals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Through collaboration with clinicians and patients, an occupation-based group intervention considering the available evidence, alongside clinical, experiential, and contextual sources of knowledge was developed; this resulted in an evidence-based, patient-centred, and contextually relevant intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"71 5","pages":"674-685"},"PeriodicalIF":1.6,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12950","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140839151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Melanie Cusso, Ian Cooper, Kelly Beer, Chiara Naseri, Simon Garbellini, Althea Doverty, Geoff Corcoran, Merrilee Needham
Introduction
Idiopathic inflammatory myopathies (known as ‘myositis’) are a group of rare sporadic inflammatory muscle disorders that significantly impact function and quality of life. There are no standardised approaches in the use of assistive technologies in myositis. This study was initiated to investigate current use and perceived value of assistive technology (AT) by people with myositis.
Methods
A cross-sectional online questionnaire (Qualtrics) was designed to capture information regarding AT use and perceived value and demographic information from people with myositis across Australia. The questionnaire was distributed via the Myositis Association of Australia and specialist myositis clinics. Participants were asked to identify which AT items they owned and how frequently the item was used and to rate the ‘usefulness’ of those items. Information was also collected on participants' engagement with health professionals regarding assistive technologies.
Consumer and community involvement
Consumer involvement via the Myositis Research Consumer Panel identified a knowledge gap regarding AT. The questionnaire was designed with consumer input and review.
Results
One hundred two people (102) with myositis completed the questionnaire. One hundred (100) participants owned at least one AT device, with a median of 12.5 items and a maximum of 65 items. The most used devices were associated with toileting, personal care and mobility. Participants rated AT devices relating to environmental support, sleeping, seating and body support as most useful. There was a positive correlation between disease duration and number of devices used (r2 = 0.248, p = 0.012). Majority of participants (75.5%) were interested in talking to health professionals about AT; however, only 50% had done so.
Conclusion
AT device usage is high among people with myositis, with most items deemed to be useful. Greater occupational therapy input into recommendations and potential funding options may improve knowledge and access to AT.
{"title":"Consumer-driven evaluation of assistive technology usage and perceived value in people with myositis in Australia","authors":"Melanie Cusso, Ian Cooper, Kelly Beer, Chiara Naseri, Simon Garbellini, Althea Doverty, Geoff Corcoran, Merrilee Needham","doi":"10.1111/1440-1630.12954","DOIUrl":"10.1111/1440-1630.12954","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Idiopathic inflammatory myopathies (known as ‘myositis’) are a group of rare sporadic inflammatory muscle disorders that significantly impact function and quality of life. There are no standardised approaches in the use of assistive technologies in myositis. This study was initiated to investigate current use and perceived value of assistive technology (AT) by people with myositis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional online questionnaire (Qualtrics) was designed to capture information regarding AT use and perceived value and demographic information from people with myositis across Australia. The questionnaire was distributed via the Myositis Association of Australia and specialist myositis clinics. Participants were asked to identify which AT items they owned and how frequently the item was used and to rate the ‘usefulness’ of those items. Information was also collected on participants' engagement with health professionals regarding assistive technologies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Consumer and community involvement</h3>\u0000 \u0000 <p>Consumer involvement via the Myositis Research Consumer Panel identified a knowledge gap regarding AT. The questionnaire was designed with consumer input and review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred two people (102) with myositis completed the questionnaire. One hundred (100) participants owned at least one AT device, with a median of 12.5 items and a maximum of 65 items. The most used devices were associated with toileting, personal care and mobility. Participants rated AT devices relating to environmental support, sleeping, seating and body support as most useful. There was a positive correlation between disease duration and number of devices used (<i>r</i><sub><i>2</i></sub> = 0.248, <i>p</i> = 0.012). Majority of participants (75.5%) were interested in talking to health professionals about AT; however, only 50% had done so.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AT device usage is high among people with myositis, with most items deemed to be useful. Greater occupational therapy input into recommendations and potential funding options may improve knowledge and access to AT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"71 5","pages":"686-698"},"PeriodicalIF":1.6,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12954","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140839209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Given all health and social care sits within context, there is an imperative for occupational therapists to be socio-politically aware and advocate for both the occupational therapy profession and the consumers of occupational therapy services (Kirsh, <span>2015</span>). As such, occupational therapists need to be heard and present where key effectual decisions are being made about how to prioritise and allocate resources at global, national, state, and local levels (Lane et al., <span>2019</span>; Zwolsman, <span>2020</span>). Effective policy advocacy work in occupational therapy must be strategic and occur through the lens of our values and philosophy (Berndt, <span>2017</span>). This editorial will focus on the role of leadership, responsiveness to societal trends, issues, and needs and future-focussed thinking in policy advocacy.</p><p>In 2010, members of state divisions of the Australian Association of Occupational Therapists voted to join Occupational Therapy Australia Limited, thus creating national leadership and a voice for collective advocacy. One of the roles of peak bodies or professional associations is to lobby and advocate to influence policy and system design. In 2012, Sylvia Rodger asked all occupational therapists to ‘confidently take up and lead causes, being confident in the uniform voice that Occupational Therapy Australia provides’ (Rodger, <span>2012</span>, p. 178). This voice is one method to provide a strategic focus on influencing change that is likely to have a systemic effect and raise the profile of occupational therapy within powerful entities. This advocacy may in turn lead to future invitations to contribute and be involved in decision making. Consistent with decisions being made at all levels of government, so too should advocacy leadership occur at all levels of practice (Bissett et al., <span>2021</span>; Rodger, <span>2012</span>).</p><p>Advocacy functions may include speaking up in decision making meetings and in multi-disciplinary teams (Brian et al., <span>2015</span>), responding to discussion papers, making representation to government bodies and funding organisations, preparing consultation papers and submissions in response to proposed government policy changes or to reviews, such as Royal Commissions, and raising issues of concerns regarding the policy stances of the different parties before elections. Some examples of leadership from Occupational Therapy Australia include (1) advocating against the introduction of independent assessments for those people seeking to have NDIS funding for the first time. This avoided the replacement of functional assessments by occupational therapists with assessments by non-clinicians to determine need for services (Occupational Therapy Australia, <span>2021b</span>). (2) Lobbying to increase occupational therapy fees for services to veterans which had remained the same for many years and this advocacy continues (Occupational Therapy Australia, <span>2021a</span>).
此外，之前的一篇社论呼吁采取行动，开展更多的卫生政策和系统研究，认识到这在加强康复环境中的作用（Frontera et al.Fortune及其同事（2013年）呼吁职业治疗师需要在日益复杂的实践环境中提高政治敏锐度，并强调学生有机会通过项目、新兴角色和工作综合学习实习来发展这些能力。在加拿大的一项研究中，Lavoie-Trudeau等人（2023年）强调，职业治疗教育课程需要向学生传授有效的变革推动者能力，以发展微观和宏观层面实践所需的宣传和沟通技能。总体而言，该综述的结论是，国际社会呼吁职业治疗师提高政治意识，更多地参与其中，并在影响政策或就政策采取行动时将职业治疗的价值观放在首位（Lencucha & Shikako-Thomas, 2019）。职业疗法的地位日益提高，因此必须在职业疗法的广度和范围内采取量身定制的积极主动的政策方法。所有职业治疗师都有责任进行政策倡导，在应对政策变化时要有政治意识和行动导向。积极响应和主动出击的方法可能涉及 "深入 "政治环境，并对这些方法的时机保持敏感（Osman 等人，2020 年）：构思；写作-原稿；写作-审阅和编辑；项目管理。斯蒂芬-伊斯贝尔构思；撰写-原稿；撰写-审阅和编辑。卡罗尔-麦金斯特里Carol McKinstry 教授是澳大利亚职业疗法协会董事会董事和澳大利亚职业疗法协会前任主席。
{"title":"Being present and heard: The pivotal role of leadership, responsiveness, and future-focussed thinking in policy advocacy","authors":"Carolyn M. Murray, Stephen Isbel, Carol McKinstry","doi":"10.1111/1440-1630.12955","DOIUrl":"10.1111/1440-1630.12955","url":null,"abstract":"<p>Given all health and social care sits within context, there is an imperative for occupational therapists to be socio-politically aware and advocate for both the occupational therapy profession and the consumers of occupational therapy services (Kirsh, <span>2015</span>). As such, occupational therapists need to be heard and present where key effectual decisions are being made about how to prioritise and allocate resources at global, national, state, and local levels (Lane et al., <span>2019</span>; Zwolsman, <span>2020</span>). Effective policy advocacy work in occupational therapy must be strategic and occur through the lens of our values and philosophy (Berndt, <span>2017</span>). This editorial will focus on the role of leadership, responsiveness to societal trends, issues, and needs and future-focussed thinking in policy advocacy.</p><p>In 2010, members of state divisions of the Australian Association of Occupational Therapists voted to join Occupational Therapy Australia Limited, thus creating national leadership and a voice for collective advocacy. One of the roles of peak bodies or professional associations is to lobby and advocate to influence policy and system design. In 2012, Sylvia Rodger asked all occupational therapists to ‘confidently take up and lead causes, being confident in the uniform voice that Occupational Therapy Australia provides’ (Rodger, <span>2012</span>, p. 178). This voice is one method to provide a strategic focus on influencing change that is likely to have a systemic effect and raise the profile of occupational therapy within powerful entities. This advocacy may in turn lead to future invitations to contribute and be involved in decision making. Consistent with decisions being made at all levels of government, so too should advocacy leadership occur at all levels of practice (Bissett et al., <span>2021</span>; Rodger, <span>2012</span>).</p><p>Advocacy functions may include speaking up in decision making meetings and in multi-disciplinary teams (Brian et al., <span>2015</span>), responding to discussion papers, making representation to government bodies and funding organisations, preparing consultation papers and submissions in response to proposed government policy changes or to reviews, such as Royal Commissions, and raising issues of concerns regarding the policy stances of the different parties before elections. Some examples of leadership from Occupational Therapy Australia include (1) advocating against the introduction of independent assessments for those people seeking to have NDIS funding for the first time. This avoided the replacement of functional assessments by occupational therapists with assessments by non-clinicians to determine need for services (Occupational Therapy Australia, <span>2021b</span>). (2) Lobbying to increase occupational therapy fees for services to veterans which had remained the same for many years and this advocacy continues (Occupational Therapy Australia, <span>2021a</span>).","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"71 3","pages":"365-368"},"PeriodicalIF":1.8,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12955","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140839131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Mc Kittrick, Amber Jones, Lachlan T. Morgan
<div> <section> <h3> Introduction</h3> <p>The Canadian Occupational Performance Measure (COPM) was implemented at a state-wide burns service to ensure compliance with current best evidence as outlined by the Australian and New Zealand Burns Association ‘burn trauma rehabilitation: allied health practice guidelines’- Chapter 7 Measuring Post-Burn Recovery, as a standard outcome measure for individuals with an admission time greater than 24 h. The primary aim of this study is to determine if individuals have a minimal important change in performance and satisfaction with activities that were identified as problematic on the COPM prior to their acute discharge.</p> <p>Previous research confirmed the feasibility of using the COPM in the acute burn ward and recommended the most appropriate timepoint for re-measurement be confirmed, which is the secondary objective of this study. The benefits of confirming this timepoint include ensuring efficient use of clinicians' time without compromising the accuracy of the assessment and ensuring effective translation of the guidelines' recommendation.</p> </section> <section> <h3> Methods</h3> <p>A prospective longitudinal study was undertaken, where all individuals who previously completed a COPM prior to acute discharge were sought to complete a re-assessment while accessing outpatient services. Time frames for re-assessment were open. Only individuals who were actively receiving occupational therapy outpatient services were included. COPM assessments were completed in person where possible, particularly for participants who required an interpreter, with phone and video calls also used when needed.</p> </section> <section> <h3> Results</h3> <p>A total of 37 participants were included, with the timeframe between initial and post-COPM assessment ranging from 2 to 643 days. Outcomes plateaued at approximately 12 months (365 days) post-initial measurement (prior to discharge from acute ward). The most common occupational performance goals that participants identified were returning to work, sport, and driving. 86.5% of participants increased their satisfaction with these activities. The results of this study demonstrate improvements across the domains of performance and satisfaction occur for individuals with burns at approximately 3 months and 12 months post-injury.</p> </section> <section> <h3> Conclusion</h3> <p>Based on this study, it is suggested that when using the COPM assessment in a tertiary burn setting, re-measurement be completed no earlier than 3 months and later than 12 months from burn injury, or upon discharge from the service. The findings from this study wi
{"title":"Timepoint for return to occupations post-burn injury using the Canadian Occupational Performance Measure (COPM)","authors":"Andrea Mc Kittrick, Amber Jones, Lachlan T. Morgan","doi":"10.1111/1440-1630.12948","DOIUrl":"10.1111/1440-1630.12948","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The Canadian Occupational Performance Measure (COPM) was implemented at a state-wide burns service to ensure compliance with current best evidence as outlined by the Australian and New Zealand Burns Association ‘burn trauma rehabilitation: allied health practice guidelines’- Chapter 7 Measuring Post-Burn Recovery, as a standard outcome measure for individuals with an admission time greater than 24 h. The primary aim of this study is to determine if individuals have a minimal important change in performance and satisfaction with activities that were identified as problematic on the COPM prior to their acute discharge.</p>\u0000 \u0000 <p>Previous research confirmed the feasibility of using the COPM in the acute burn ward and recommended the most appropriate timepoint for re-measurement be confirmed, which is the secondary objective of this study. The benefits of confirming this timepoint include ensuring efficient use of clinicians' time without compromising the accuracy of the assessment and ensuring effective translation of the guidelines' recommendation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective longitudinal study was undertaken, where all individuals who previously completed a COPM prior to acute discharge were sought to complete a re-assessment while accessing outpatient services. Time frames for re-assessment were open. Only individuals who were actively receiving occupational therapy outpatient services were included. COPM assessments were completed in person where possible, particularly for participants who required an interpreter, with phone and video calls also used when needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 37 participants were included, with the timeframe between initial and post-COPM assessment ranging from 2 to 643 days. Outcomes plateaued at approximately 12 months (365 days) post-initial measurement (prior to discharge from acute ward). The most common occupational performance goals that participants identified were returning to work, sport, and driving. 86.5% of participants increased their satisfaction with these activities. The results of this study demonstrate improvements across the domains of performance and satisfaction occur for individuals with burns at approximately 3 months and 12 months post-injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Based on this study, it is suggested that when using the COPM assessment in a tertiary burn setting, re-measurement be completed no earlier than 3 months and later than 12 months from burn injury, or upon discharge from the service. The findings from this study wi","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"71 5","pages":"786-797"},"PeriodicalIF":1.6,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140584786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jane Hopkins, Joanne McVeigh, Keith Hill, Kathryn A. Ellis, Angela Jacques, Elissa Burton
<div> <section> <h3> Introduction</h3> <p>Physical activity is known to positively influence cognitive performance. For adults with mild cognitive impairment (MCI), the relationship between physical activity levels and cognitive performance is unknown. This cross-sectional study aimed to determine if cognitive performance [as measured by the Montreal Cognitive Assessment (MoCA)] of people living in the community with MCI is associated with their physical activity levels or sedentary behaviour.</p> </section> <section> <h3> Methods</h3> <p>ActivPAL™ accelerometers were used to objectively measure physical activity and sedentary behaviour for seven full days. Cognitive performance was measured using the MoCA.</p> </section> <section> <h3> Consumer and Community Involvement</h3> <p>No involvement other than as research participants</p> </section> <section> <h3> Results</h3> <p>Eighty-two participants from the Balance on the Brain randomised controlled trial were included. Most participants were retired (88%), with 33 (40%) reporting a fall in the last year. The median MoCA score was 24 (IQR 22–26). Participants achieved a mean of 6296 (±2420) steps per day and were sedentary for 10.6 (±2) hours per day. The only physical activity outcomes that had a fair, positive correlation were moderate- to vigorous-intensity physical activity measures of total stepping time and total number of steps (with a cadence of ≥100 steps/min) with the orientation MoCA domain score (<i>r</i>(82) = 0.36, <i>p</i> ≤ 0.001 and <i>r</i>(82) = 0.37, <i>p</i> ≤ 0.001, respectively). Higher total sedentary time had a weak, positive correlation with better visuospatial/executive performance (<i>r</i>(82) = 0.23, <i>p</i> = 0.041). The orientation outcomes remained significant when analysed in an adjusted logistic regression model.</p> </section> <section> <h3> Conclusion</h3> <p>This study found that performance in the MoCA orientation domain had a fair-positive correlation with moderate-intensity physical activity (i.e., stepping time and step count with a cadence of ≥100 steps/min) as measured by a thigh-worn accelerometer for community-dwelling older adults with MCI. When considering the relationship between cognitive domains and sedentary behaviour, consideration may be needed regarding whether cognitive enhancing activities (such as crosswords and other brain games) are being performed, which may confound this relationship. Further investigation is required to confirm these re
{"title":"Associations between physical activity, sedentary behaviour and cognitive domain performance of people living with mild cognitive impairment in the community","authors":"Jane Hopkins, Joanne McVeigh, Keith Hill, Kathryn A. Ellis, Angela Jacques, Elissa Burton","doi":"10.1111/1440-1630.12944","DOIUrl":"10.1111/1440-1630.12944","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Physical activity is known to positively influence cognitive performance. For adults with mild cognitive impairment (MCI), the relationship between physical activity levels and cognitive performance is unknown. This cross-sectional study aimed to determine if cognitive performance [as measured by the Montreal Cognitive Assessment (MoCA)] of people living in the community with MCI is associated with their physical activity levels or sedentary behaviour.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>ActivPAL™ accelerometers were used to objectively measure physical activity and sedentary behaviour for seven full days. Cognitive performance was measured using the MoCA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Consumer and Community Involvement</h3>\u0000 \u0000 <p>No involvement other than as research participants</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-two participants from the Balance on the Brain randomised controlled trial were included. Most participants were retired (88%), with 33 (40%) reporting a fall in the last year. The median MoCA score was 24 (IQR 22–26). Participants achieved a mean of 6296 (±2420) steps per day and were sedentary for 10.6 (±2) hours per day. The only physical activity outcomes that had a fair, positive correlation were moderate- to vigorous-intensity physical activity measures of total stepping time and total number of steps (with a cadence of ≥100 steps/min) with the orientation MoCA domain score (<i>r</i>(82) = 0.36, <i>p</i> ≤ 0.001 and <i>r</i>(82) = 0.37, <i>p</i> ≤ 0.001, respectively). Higher total sedentary time had a weak, positive correlation with better visuospatial/executive performance (<i>r</i>(82) = 0.23, <i>p</i> = 0.041). The orientation outcomes remained significant when analysed in an adjusted logistic regression model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study found that performance in the MoCA orientation domain had a fair-positive correlation with moderate-intensity physical activity (i.e., stepping time and step count with a cadence of ≥100 steps/min) as measured by a thigh-worn accelerometer for community-dwelling older adults with MCI. When considering the relationship between cognitive domains and sedentary behaviour, consideration may be needed regarding whether cognitive enhancing activities (such as crosswords and other brain games) are being performed, which may confound this relationship. Further investigation is required to confirm these re","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"71 4","pages":"527-539"},"PeriodicalIF":1.6,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12944","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140584835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The ability of government policy to further promote the progression of enabling technologies for people living with disability","authors":"Natalie Chu, Rosalind Bye, David Lim","doi":"10.1111/1440-1630.12951","DOIUrl":"10.1111/1440-1630.12951","url":null,"abstract":"","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"71 3","pages":"443-444"},"PeriodicalIF":1.8,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140713010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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