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Driving a motor vehicle and living with a mental health condition: The personal and professional experiences of consumer lived experience staff 驾驶机动车与精神健康状况并存：消费者生活体验工作人员的个人和职业经历。
IF 1.6 4区 医学 Q2 REHABILITATION
Australian Occupational Therapy Journal
Pub Date : 2024-11-12 DOI: 10.1111/1440-1630.13000
Carolyn Dun, Catherine Palmer, Megan Turville

Introduction

Driving a motor vehicle is an important activity for people living with a mental health condition, as it can support engagement in the community as part of recovery. There is little research exploring mental health consumers' experiences with driving and no found research on the role of mental health lived experience staff in assisting consumers with safe driving. It is essential to learn about consumers' experiences of driving to know the supports they find useful in understanding their driver responsibilities and self-regulating their driving through periods of changing health and wellness. This study explored the personal and professional experiences of lived experience consumer staff related to driving a motor vehicle while also living with a mental health condition.

Method

The research was guided by the interpretive paradigm and codesign principles. Qualitative data were derived from semi-structured interviews with (n = 9) lived experience consumers working in a public mental health service. Data were thematically analysed.

Consumer and community involvement

Our research team involved consumer and occupational therapy coresearchers.

Findings

Five main themes were identified: (1) Driving means freedom and independence, (2) A nuanced understanding about the impact of mental health on driving, (3) I/we can manage: A range of strategies, (4) Driving is not something mental health staff tend to discuss, and (5) Do not beat around the bush, just talk about it.

Conclusion

Consumers want support and direct conversations about driving and their mental health, medication side effects, and strategies to gain their licence, maintain, or return to driving. Alongside mental health clinicians, consumer lived experience staff could play a vital role in supporting safe driving.

简介驾驶机动车对于患有精神疾病的人来说是一项重要的活动，因为它可以帮助他们融入社 区，成为康复的一部分。目前很少有研究探讨心理健康消费者的驾驶经验，也没有研究发现心理健康生活经验工作人员在协助消费者安全驾驶方面所起的作用。有必要了解消费者的驾驶经验，以了解他们在了解自己的驾驶责任以及在健康和幸福感发生变化的时期自我调节驾驶方面所需要的支持。本研究探讨了消费者工作人员在驾驶机动车的同时还患有精神疾病的个人和职业经历：研究以解释性范式和编码设计原则为指导。定性数据来自于对在公共精神健康服务机构工作的消费者（n = 9）进行的半结构化访谈。对数据进行了主题分析：消费者和社区参与：我们的研究团队包括消费者和职业治疗核心研究人员：研究发现了五大主题：(1) 驾驶意味着自由和独立，(2) 细致入微地了解精神健康对驾驶的影响，(3) 我/我们可以处理：(4) 驾驶不是心理健康工作人员倾向于讨论的话题，以及 (5) 不要拐弯抹角，直接谈论它：结论：消费者希望得到支持，并能直接对话驾驶与他们的心理健康、药物副作用，以及获得驾照、 保持或恢复驾驶的策略。与心理健康临床医生一起，消费者生活经验工作人员可以在支持安全驾驶方面发挥重要作用。
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引用次数: 0
Interoception and its application to paediatric occupational therapy: A scoping review 互感及其在儿科职业治疗中的应用：范围审查。
IF 1.6 4区 医学 Q2 REHABILITATION
Australian Occupational Therapy Journal
Pub Date : 2024-11-06 DOI: 10.1111/1440-1630.12997
Emma Clark, Ted Brown, Mong-Lin Yu

Introduction

Paediatric occupational therapists assess and provide intervention for children presenting with sensory processing challenges that impact their daily occupational performance. Interoception, the ability to sense internal body signals, is an emerging practice area, yet it remains unclear how and why paediatric clinicians are applying interoception and related concepts in practice.

Methods

A scoping review was conducted to report on the current body of published literature related to interoception and its application to paediatric occupational therapy practice. A comprehensive search of 10 electronic databases and related grey literature was conducted. Title and abstract screening were completed prior to full-text review of evidence. The PRISMA-ScR Checklist and the Crowe Critical Appraisal Tool were used to support a systematic scoping review process and increase robust extraction and appraisal of data. Narrative synthesis was used to analyse and synthesise data.

Consumer and Community Involvement

No consumer and community involvement.

Results

A total of 18 articles were included in this review, including original research articles (n = 8), published books (n = 4), theses/dissertations (n = 3), opinion pieces (n = 2), and one government document. Narrative synthesis analysis identified six themes: (1) occupational therapy principles relevant to interoception, (2) what is interoception?, (3) assessment of interoception, (4) clinical application of interoception, (5) clinical populations receiving interoception-based intervention, and (6) relationships between interoception and other performance components. Findings indicated that paediatric occupational therapists are integrating interoception concepts alongside occupational therapy principles to inform assessment and intervention processes. Several assessments and interventions are utilised to support children; however, evidence to strengthen use is lacking. Further, there are limited occupation-based assessments and intervention programs to address interoception deficits in children.

Conclusion

Findings from this scoping review contribute to the emerging body of empirical evidence related to interoception and paediatric occupational

导言：儿科职业治疗师会对有感官处理障碍的儿童进行评估并提供干预，这些障碍会影响儿童的日常职业表现。内感知是一种感知身体内部信号的能力，是一个新兴的实践领域，但儿科临床医生如何以及为何在实践中应用内感知及相关概念仍不清楚：方法： 我们进行了一次范围界定审查，以报告目前已发表的与内感知及其在儿科职业治疗实践中的应用相关的文献。对 10 个电子数据库和相关灰色文献进行了全面检索。在对证据进行全文检索之前，完成了标题和摘要筛选。采用 PRISMA-ScR 核对表和 Crowe 批判性评估工具来支持系统的范围界定审查过程，并提高数据提取和评估的稳健性。叙事综合法用于分析和综合数据：无消费者和社区参与：本综述共收录了 18 篇文章，包括原创研究文章（8 篇）、出版书籍（4 本）、论文/学位论文（3 篇）、观点文章（2 篇）和一份政府文件。叙事综合分析确定了六个主题：(1) 与内感知相关的职业治疗原则；(2) 何为内感知；(3) 内感知评估；(4) 内感知的临床应用；(5) 接受基于内感知干预的临床人群；以及 (6) 内感知与其他表现要素之间的关系。研究结果表明，儿科职业治疗师正在将内感知概念与职业治疗原则相结合，为评估和干预过程提供信息。一些评估和干预措施被用来为儿童提供支持；然而，缺乏加强使用的证据。此外，以职业为基础的评估和干预计划也很有限，无法解决儿童的互感缺陷问题：本次范围界定审查的结果为正在出现的与内感知和儿科职业治疗实践相关的实证证据做出了贡献。这些研究结果为职业治疗师在这一领域的实践和研究提供了可靠的依据。通俗易懂的语言摘要：内感知使我们能够感受到身体内部发生了什么，并帮助我们注意到身体可能会有的感觉（例如，如果我们的肚子咕咕叫，我们可能会感到饥饿；如果我们的心跳得很快，我们可能会感到害怕；如果我们在出汗，我们的身体会感到过热）。有些儿童可能在识别自己身体的互感时出现问题。因此，职业治疗师可以帮助儿童了解自己与身体有关的内感知。这对治疗师来说是一个新课题，他们需要对此有更多的了解，这样才能更好地帮助儿童及其家人。关于如何在职业治疗实践中使用互感的信息并不多，我们想知道已有哪些关于互感和职业治疗的信息。本综述对目前已有的知识进行了总结和归纳。我们发现了一些有关内感知及其与儿童职业治疗服务之间关系的信息，但还需要更多有关该主题的研究知识。
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引用次数: 0
The experiences of rural generalist occupational therapists in provision of palliative care in rural, regional, and remote Australia: A phenomenological inquiry 在澳大利亚农村、地区和偏远地区，农村普通职业治疗师在提供姑息关怀方面的经验：现象学调查。
IF 1.6 4区 医学 Q2 REHABILITATION
Australian Occupational Therapy Journal
Pub Date : 2024-11-05 DOI: 10.1111/1440-1630.13005
Isabelle Oxley, Daniel Lowrie

Introduction

Access to specialist palliative care in rural and remote Australia is limited, resulting in a reliance on generalist health professionals to provide these services. Although literature exists concerning the experiences of some health professions in providing rural generalist palliative care, little is known about the experiences of occupational therapists who fill these roles. This paper aims to address this gap in knowledge by exploring the experiences of rural generalist occupational therapists in the provision of palliative care in rural, regional, and remote Australia.

Methods

An interpretive phenomenological approach guided this research. Data were collected from eight rural generalist occupational therapists across Australia, using semi-structured, in-depth interviews. Data were thematically analysed to develop a nuanced understanding of lived experience in provision of palliative care.

Consumer and Community Involvement

Due to the focus of this research on the practice experiences of occupational therapists, consumer and/or community involvement was not undertaken in its design or implementation.

Findings

Three key themes were identified: ‘community connections – a double-edged sword’; ‘frustrations with structural and contextual factors limiting quality palliative care service provision’; and ‘education and support as enablers of professional preparedness for palliative care service provision.’ Taken collectively, these findings shed light on a variety of challenges and opportunities associated with rural generalist palliative care occupational therapy practice, as well as clues to their effective management.

Conclusion

Knowledge of rural generalist occupational therapists' experiences can inform workforce development, promote retention of rural occupational therapists, and improve outcomes for dying persons, their families and caregivers. This study offers new insights into challenges and opportunities for rural generalist occupational therapy practice in palliative care and highlights the way in which both, new and existing support structures may be of value in promoting practice capacity and therapist wellbeing.

PLAIN LANGUAGE SUMMARY

It can be hard to get expert support for dying people in areas outside of cities in Australia. Healt

导言：在澳大利亚农村和偏远地区，获得专科姑息关怀服务的机会有限，因此需要依靠普通医护人员来提供这些服务。尽管已有文献介绍了一些医疗专业人员在提供农村普通姑息关怀服务方面的经验，但对担任这些角色的职业治疗师的经验却知之甚少。本文旨在通过探讨农村普通职业治疗师在澳大利亚农村、地区和偏远地区提供姑息关怀服务的经验，填补这一知识空白：本研究采用解释现象学方法。通过半结构化的深度访谈，从澳大利亚各地的八名乡村普通职业治疗师那里收集了数据。对数据进行了主题分析，以深入了解姑息关怀服务中的生活经验：由于本研究的重点是职业治疗师的实践经验，因此在设计和实施过程中没有考虑消费者和/或社区的参与：研究确定了三个关键主题：社区联系--一把双刃剑"；"对限制提供优质姑息关怀服务的结构和环境因素的不满"；以及 "教育和支持作为姑息关怀服务提供的专业准备的促进因素"。综合来看，这些发现揭示了与农村普通姑息关怀职业治疗实践相关的各种挑战和机遇，以及有效管理这些挑战和机遇的线索：了解农村全科职业治疗师的经验可以为劳动力发展提供信息，促进农村职业治疗师的留任，并改善临终者、其家人和照护者的治疗效果。这项研究为农村普通职业治疗师在姑息关怀实践中面临的挑战和机遇提供了新的见解，并强调了新的和现有的支持结构在提高实践能力和治疗师福利方面的价值。应帮助这些地区的医疗工作者提供良好的护理服务。在这项研究中，我们与农村和偏远地区的一些医务工作者进行了交谈，他们偶尔会与临终者打交道。他们告诉我们，这些地区的人通常会帮助支持临终者，因为他们觉得自己离他们很近。但他们也说，这让医疗工作者更加难过，因为有时他们与临终者也很亲近。工作太多、经验不足、路途遥远，使得提供良好的护理变得格外困难。医护人员说，获得专家建议或使用在线教学可以帮助他们改进实践，但要抽出时间来做这些事情却很难。
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引用次数: 0
The responsiveness and clinical utility of the Australian therapy outcome measure for indigenous clients 澳大利亚治疗结果测量法对土著客户的响应性和临床实用性。
IF 1.6 4区 医学 Q2 REHABILITATION
Australian Occupational Therapy Journal
Pub Date : 2024-11-05 DOI: 10.1111/1440-1630.13001
Nick Sheahan, Rosamund Harrington, Alison Nelson, Loretta Sheppard, Ashley Potgieter, Amy Bartlett, Rebekah White, Renee Brown

Introduction

The Australian Therapy Outcome Measure for Indigenous Clients (ATOMIC) is a goal-setting tool designed to measure therapy outcomes with First Australians. It was originally developed and validated for use with First Australian children as a culturally responsive alternative to traditional western outcome measures. This research explored the applicability, responsiveness and clinical utility of the ATOMIC when used with First Australian adults attending an urban health service.

Methods

Separate parallel studies investigated responsiveness and clinical utility. The first employed quantitative methods to investigate change over time via pre- and post-intervention data. The second employed a qualitative phenomenological approach to determine the clinical utility of the tool. Semi-structured interviews and focus groups were used, respectively, to understand the experience of using the ATOMIC from a client and clinician perspective. Client perspectives on the purpose of the tool and its alignment with their views on health care and therapists' perspective on the ease of use and applicability of the tool to the health service setting were explored. These data were analysed using reflexive thematic analysis.

Consumer and community consultation

The methodological approach followed National Health and Medical Research Council (NHMRC, 2018) guidelines in considering cultural continuity, reciprocity and equity. This project was initiated and guided by Aboriginal and Torres Strait Islander leaders (the advisory group) as a prioritised need for a robust way of reporting outcomes to complement existing statistical and narrative data within a large community-controlled health service. The advisory group provided high level governance from project conception to conclusion and were involved in yarn-backs about research findings.

Results

Responsiveness: Wilcoxon test showed a statistically significant increase (P = 0.00) in ATOMIC scores pre- (mean = 1.8) and post- (mean = 8) intervention. Effect size (Cohen d) was deemed significant calculated at 2.1.

Clinical utility: Findings included: First Australian clients are adept at self-managing their conditions; the ATOMIC is a clinically useful outcome measure, which reflects this; ATOMIC is an acceptable tool to First Australian clients and clinicians and supports culturally responsive goal setting and occupational

简介澳大利亚土著客户治疗结果测量法（ATOMIC）是一种目标设定工具，旨在测量原住民澳大利亚人的治疗结果。它最初是为澳大利亚原住民儿童开发和验证的，作为传统西方治疗结果测量法的一种文化响应替代方法。本研究探讨了ATOMIC用于在城市医疗服务机构就诊的澳大利亚原住民成年人时的适用性、响应性和临床实用性：方法：分别进行平行研究，调查响应性和临床实用性。第一项研究采用定量方法，通过干预前后的数据调查随时间推移发生的变化。第二项研究采用定性现象学方法来确定该工具的临床实用性。分别采用半结构式访谈和焦点小组的方式，从客户和临床医生的角度了解使用 ATOMIC 的体验。研究人员从客户的角度了解了该工具的目的及其与客户对医疗保健的看法的一致性，并从治疗师的角度了解了该工具在医疗服务环境中的易用性和适用性。这些数据采用反思性专题分析法进行分析：方法论方法遵循了国家健康与医学研究委员会（NHMRC，2018 年）在考虑文化连续性、互惠性和公平性方面的指导方针。该项目由土著居民和托雷斯海峡岛民领袖（咨询小组）发起和指导，因为在一个由社区控制的大型医疗服务机构中，优先需要一种稳健的结果报告方式来补充现有的统计和叙述数据。咨询小组从项目构思到结束提供了高层次的管理，并参与了对研究结果的反馈：响应性：Wilcoxon检验显示，干预前（平均值=1.8）和干预后（平均值=8）的ATOMIC得分均有显著提高（P=0.00）。效果大小（Cohen d）为 2.1：研究结果包括澳大利亚原住民客户善于自我管理病情；ATOMIC是一种临床实用的结果测量方法，反映了这一点；ATOMIC是一种澳大利亚原住民客户和临床医生都能接受的工具，支持具有文化敏感性的目标设定和职业治疗实践。本研究调查了它是否也适用于成年原住民。研究人员进行了两项研究：一项是定量研究，以了解 ATOMIC 分数在治疗前后是否发生变化；另一项是定性研究，以了解人们对使用 ATOMIC 的看法。ATOMIC得分在治疗后有所上升，这表明它对变化很敏感，客户和治疗师都喜欢使用ATOMIC，并认为它很有用。它非常符合第一批澳大利亚成年人对医疗保健的看法，有助于设定治疗目标。研究结果表明，ATOMIC 有助于客户和治疗师了解治疗效果如何，并帮助设定具有文化意义的目标。这项研究针对的是一个地区的一家医疗服务机构，因此还需要更多的研究来确定它在其他地方是否有效。总之，研究结果表明，ATOMIC 是为澳大利亚土著居民提供更好的治疗而迈出的充满希望的一步。
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引用次数: 0
Online interventions for the mental health and well-being of parents of children with additional needs: Systematic review and meta-analysis 针对有额外需求儿童的父母的心理健康和幸福的在线干预：系统回顾和荟萃分析。
IF 1.6 4区 医学 Q2 REHABILITATION
Australian Occupational Therapy Journal
Pub Date : 2024-10-31 DOI: 10.1111/1440-1630.13004
Monica Leo, Helen Bourke-Taylor, Sorcha Odgers, Loredana Tirlea, Laura

Introduction

Parents of children with additional needs experience compromised physical and mental health and higher stress, and their ability to engage in meaningful occupations is impacted by their additional caregiving tasks. Online interventions targeting mental health, stress, and well-being for parents of children with additional needs have potential to increase supports alongside occupational therapy direct services. The aims of this review are to systematically identify and synthesise evidence of effectiveness of online interventions aimed at improving mental health, stress, and well-being of parents of children with additional needs.

Method

Eight databases were searched up to July 2024 to identify online interventions for parents of children with additional needs. Studies were appraised for methodological quality. Standardised effect sizes were calculated, and meta-analyses of randomised control trials (RCTs) were conducted on outcomes of mental health, well-being, and stress.

Consumer and Community Involvement

There was no consumer or community involvement.

Results

Systematic screening identified 30 papers that met inclusion criteria. Most were RCTs or controlled clinical trials (CCTs) with ‘moderate’ quality ratings: Three were designed by occupational therapists. There was substantial variation in intervention types, methods of delivery, outcomes, and outcome measures used. The pooled standardised effect size estimates (ES) and the lower and upper confidence intervals (CI) of online interventions from RCTs post-interventions were significant for mental health ES = 0.47, 95% CI (0.18, 0.77), p = 0.002; stress ES = 1.27, 95% CI (0.56, 1.98), p = 0.000; and well-being ES = 0.65, 95% CI (1.2, 0.06), p = 0.03, respectively.

Conclusion

The online interventions that aimed to improve mental health, stress, and well-being included in this meta-analysis were effective. Occupational therapists supporting families play an important role in guiding parents of children with additional needs to evidence-based interventions to support them with addressing their own mental health and well-being needs.

简介有额外需求儿童的父母身心健康会受到损害，压力也更大，他们从事有意义职业的能力也会受到额外照顾任务的影响。针对有额外需求儿童家长的心理健康、压力和幸福感的在线干预措施有可能与职业治疗直接服务一起增加支持。本综述旨在系统地识别和综合旨在改善有额外需求儿童的父母的心理健康、压力和福祉的在线干预措施的有效性证据：方法：检索了截至 2024 年 7 月的八个数据库，以确定针对有额外需求儿童家长的在线干预措施。对研究进行了方法学质量评估。计算了标准化效应大小，并对随机对照试验（RCT）的心理健康、幸福感和压力结果进行了荟萃分析：没有消费者或社区参与：结果：系统筛选出 30 篇符合纳入标准的论文。其中大部分是质量评级为 "中等 "的 RCT 或对照临床试验 (CCT)：其中三篇由职业治疗师设计。在干预类型、实施方法、结果和所使用的结果测量方法方面存在很大差异。干预后的RCT在线干预的集合标准化效应大小估计值（ES）和置信区间（CI）的下限和上限分别为：心理健康ES=0.47，95% CI（0.18，0.77），p=0.002；压力ES=1.27，95% CI（0.56，1.98），p=0.000；幸福感ES=0.65，95% CI（1.2，0.06），p=0.03：本荟萃分析所包含的旨在改善心理健康、压力和幸福感的在线干预措施是有效的。支持家庭的职业治疗师在指导有额外需求儿童的家长采取循证干预措施以支持他们解决自身心理健康和幸福需求方面发挥着重要作用。
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引用次数: 0
Fidelity, acceptability, and feasibility of the revised functional autonomy measurement system for hospitalised people: An implementation study 住院病人功能自主性测量系统修订版的保真度、可接受性和可行性：实施研究。
IF 1.6 4区 医学 Q2 REHABILITATION
Australian Occupational Therapy Journal
Pub Date : 2024-10-30 DOI: 10.1111/1440-1630.13006
Aruska N. D'Souza, Casey L. Peiris, Susan Darzins, Tamara Tse, James Seymour, Ethan Hunt, Riley Hodgson, Celia Marston

Introduction

The revised functional autonomy measurement system (SMAF-R) is an outcome measure of activity performance and resource needs. This study aimed to measure the implementability of the SMAF-R as a routine outcome measure in acute and subacute inpatients.

Methods

This was a mixed-methods implementation study. Occupational therapists were asked to complete the SMAF-R in hospitalised people with an anticipated length of stay greater than 48 hours over a 12-month period (n = 13,348). A baseline audit of SMAF-R completion rates was conducted, and behaviour change interventions were delivered over 12 months. The Implementability of Healthcare Interventions conceptual framework was used to evaluate fidelity (completion rates), acceptability (staff survey with quantitative and qualitative responses), and feasibility (change in SMAF-R scores from admission to discharge). Quantitative and qualitative (analysed thematically) data were integrated.

Consumer involvement

Occupational therapists and other staff working to improve outcome measure completion within the electronic medical record and other allied health teams were consulted when developing and delivering behaviour change interventions.

Findings

Peak completion of the SMAF-R did not meet an 80% fidelity success rate (admission: 32% in acute and 66% in subacute; discharge: 12% in acute and 48% in subacute). Two thirds of occupational therapists reported the SMAF-R was an acceptable measure to use, but only 38% liked using it. Thematic analysis revealed three themes: (1) A greater understanding of the relevance of the SMAF-R influenced acceptability; (2) using the SMAF-R within an electronic medical record may facilitate completion; and (3) it takes more time to complete SMAF. Patients made clinically significant improvements in SMAF-R scores during their hospital stay (median difference 16.5 [6.5–27.0], p < 0.001, n = 764).

Conclusion

Although most occupational therapists reported the SMAF-R was acceptable, there were mixed opinions regarding the relevance of the SMAF-R in this setting, which may have impacted fidelity. Additional prompting and training (especially regarding understanding SMAF-R relevance to practice) may assist with improving SMAF-R completion. Further research is required to assess the psychometric properties of the SMAF-R in the hospital environment.

简介经修订的功能自主性测量系统（SMAF-R）是一种衡量活动表现和资源需求的结果测量方法。本研究旨在测量 SMAF-R 作为急性和亚急性住院患者常规结果测量方法的可实施性：这是一项混合方法实施研究。要求职业治疗师在 12 个月内完成预计住院时间超过 48 小时的住院患者（n = 13,348 人）的 SMAF-R。对 SMAF-R 的完成率进行基线审核，并在 12 个月内实施行为改变干预。医疗保健干预措施的可实施性概念框架用于评估忠实性（完成率）、可接受性（员工定量和定性调查）和可行性（从入院到出院期间 SMAF-R 分数的变化）。对定量和定性（专题分析）数据进行了整合：消费者参与：在制定和实施行为改变干预措施时，咨询了职业治疗师和其他致力于改善电子病历中结果测量完成情况的工作人员以及其他专职医疗团队：结果：SMAF-R 的峰值完成率未达到 80% 的成功率（入院：急性期为 32%，亚急性期为 66%；出院：急性期为 12%，亚急性期为 48%）：入院：急性期为 32%，亚急性期为 66%；出院：急性期为 12%，亚急性期为 48%）。三分之二的职业治疗师表示，SMAF-R 是一种可以接受的测量方法，但只有 38% 的职业治疗师喜欢使用它。主题分析揭示了三个主题：（1）更好地理解 SMAF-R 的相关性会影响其可接受性；（2）在电子病历中使用 SMAF-R 可能有助于完成；以及（3）完成 SMAF 需要更多时间。在住院期间，患者的 SMAF-R 评分有了明显的临床改善（中位数差异为 16.5 [6.5-27.0]，P 结论：SMAF-R 评分的临床改善对患者的康复具有重要意义：尽管大多数职业治疗师都认为 SMAF-R 是可以接受的，但对于 SMAF-R 在这种情况下的相关性却意见不一，这可能会影响其忠实性。额外的提示和培训（尤其是在理解 SMAF-R 与实践的相关性方面）可能有助于提高 SMAF-R 的完成度。白话摘要：修订版功能自主性测量系统（SMAF-R）是一种评估工具，用于测量日常活动（如淋浴）的表现以及完成这些任务所需的资源（如淋浴椅或他人的帮助）。职业治疗师可以在患者入院之初使用该工具，并在不同的医院环境下在入院结束时再次使用该工具，以评估患者的需求并了解他们是否有所改善。本研究旨在测量：（1）职业治疗师对住院患者使用 SMAF-R 的频率；（2）职业治疗师对 SMAF-R 的接受程度；（3）SMAF-R 是否显示出患者住院期间能力的变化。研究之前，对 SMAF-R 的通常完成情况进行了测量，结果发现只有不到 1%的患者完成了 SMAF-R。研究人员在 12 个月内采取了提高 SMAF-R 完成率的策略。此后，在不同的医院环境中，SMAF-R 的完成率提高到了 9% 到 38%。SMAF-R 评分的变化表明，患者在住院期间病情有所好转。大多数职业治疗师表示，SMAF-R 是一种可以接受的测量方法，但只有不到一半的人喜欢使用它。低完成率表明，SMAF-R 不适合在这种环境中使用，或者需要更多的支持来提高完成率。
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引用次数: 0
Investigating patient satisfaction with a hand therapy telehealth service during COVID-19 在 COVID-19 期间调查患者对手部治疗远程保健服务的满意度。
IF 1.6 4区 医学 Q2 REHABILITATION
Australian Occupational Therapy Journal
Pub Date : 2024-10-22 DOI: 10.1111/1440-1630.13003
Elise M. Graham, Elspeth Ahern

Introduction

Throughout the COVID-19 pandemic, outpatient hand therapy services were restricted. The use of telehealth was adopted to continue to provide care to patients with hand injuries.

This survey aims to investigate patient satisfaction with hand therapy delivered via telehealth in a NSW public tertiary referral metropolitan setting and explore whether this differs for specific hand injury/conditions and treatments offered.

Methods

Patients using hand therapy services via telehealth between 28 June 2021 and 27 May 2022 responded to a bespoke electronic survey. Participants were grouped depending on their particular injury/condition and treatment received. Analysis was conducted using MS Excel, and correlations were determined by using Fisher's exact test.

Community and consumer involvement

No consumers were involved in the study design or analysis.

Results

Sixty-eight of 262 patients responded to the survey (26% response rate). Overall results showed high patient satisfaction (n = 55, 81%) with hand therapy delivered via telehealth with most patients agreeing that telehealth should be offered going forward (n = 59, 87%). Benefits reported by patients included convenience, reduced travel time and parking issues, and time saving. Patients receiving therapy for ‘finger thumb bony injury with K wires’ demonstrated a statistically significant association of lower satisfaction with telehealth (n = 3, 43%, P = 0.02). Patients receiving wound care over telehealth were just as satisfied with their experience (n = 15, 82%) as overall results (n = 55, 81%).

Conclusion

The survey suggests that patients are satisfied with their experience of telehealth for hand therapy. Patients with finger thumb bony injuries with k wires may be less suitable for telehealth. Wound care appears to be well received over telehealth in a hand therapy population.

PLAIN LANGUAGE SUMMARY

There is little evidence to guide hand therapists in which conditions or injuries patients find can be managed well with telehealth. Patients who answered a survey about their experience with telehealth for their hand therapy management overall reported satisfaction with the experience. Some patients had undergone surgery for bro

介绍：在 COVID-19 大流行期间，门诊手部治疗服务受到限制。为了继续为手部受伤的患者提供治疗，我们采用了远程医疗技术。本调查旨在调查患者对新南威尔士州公立三级转诊大都市通过远程医疗提供的手部治疗服务的满意度，并探讨患者对特定手部损伤/病症和所提供治疗的满意度是否有所不同：方法： 在 2021 年 6 月 28 日至 2022 年 5 月 27 日期间通过远程保健使用手部治疗服务的患者对定制的电子调查做出了回复。根据参与者的特定损伤/病症和接受的治疗进行分组。使用 MS Excel 进行分析，并通过费雪精确检验确定相关性：社区和消费者参与：没有消费者参与研究设计或分析：262 名患者中有 68 人对调查做出了回复（回复率为 26%）。总体结果显示，患者对通过远程医疗提供手部治疗的满意度很高（n = 55，81%），大多数患者同意继续提供远程医疗（n = 59，87%）。患者反映的好处包括方便、减少了旅行时间和停车问题，以及节省了时间。接受 "带 K 线的手指拇指骨损伤 "治疗的患者对远程医疗的满意度较低，这与远程医疗有显著的统计学关联（n = 3，43%，P = 0.02）。通过远程医疗接受伤口护理的患者对其体验的满意度（n = 15，82%）与总体结果（n = 55，81%）相当：调查表明，患者对远程医疗手部治疗的体验感到满意。带 k 线的手指和拇指骨伤患者可能不太适合远程医疗。在手部治疗人群中，通过远程医疗进行伤口护理似乎很受欢迎。白话总结：目前几乎没有证据可以指导手部治疗师，让他们知道患者认为哪些疾病或损伤可以通过远程医疗得到很好的治疗。在一项关于远程医疗手部治疗经验的调查中，回答问题的患者总体上对远程医疗的经验表示满意。一些患者曾因手指和拇指骨折接受过手术，在愈合过程中使用钢丝将骨头固定在一起。这些患者不太可能对远程医疗的手部治疗护理感到满意。大多数需要通过远程医疗进行伤口护理的患者对此表示满意。
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引用次数: 0
Daily living skill support for autistic people through a neurodiversity-affirming practice lens 从肯定神经多样性的实践角度为自闭症患者提供日常生活技能支持。
IF 1.6 4区 医学 Q2 REHABILITATION
Australian Occupational Therapy Journal
Pub Date : 2024-10-15 DOI: 10.1111/1440-1630.13002
Chelsea Morrison, Andrew Cashin, Kitty-Rose Foley

Introduction

Supporting daily living skill (DLS) development for autistic people is a component of occupational therapy practice. DLSs are essential for an increased quality of life (QoL), independent living, and community participation. Autistic young people experience poorer outcomes in terms of QoL and independent living than non-autistic peers. Finding a balance between targeted DLS support to maximise independent living and improve QoL, while avoiding attempts to ‘normalise’ or ‘change’ autistic people, presents as a dilemma for therapists striving to align with neurodiversity-affirming practice.

Methods

This theoretical paper explored literature pertaining to DLS and the neurodiversity movement in the context of occupational therapy values and the Canadian Model of Occupational Participation. Consideration of whether targeted DLS support is neurodiversity-affirming or whether occupational therapists are compelling autistic people to mimic behavioural norms perceived by society was discussed.

Results

DLSs are an important factor for maximising QoL, regardless of neurotype. Occupational therapy values align with the core tenets of the neurodiversity movement, and occupational therapists are equipped with the values and skills to support the development of DLSs utilising affirming practice.

Conclusion

Occupational therapists should critically reflect on their practice to ensure alignment with the professions core values and recent occupational therapy models, to ensure affirming practice. Further research investigating DLS and neurodiversity-affirming practice would benefit occupational therapists striving to align with neurodiversity-affirming practice.

Consumer and Community Involvement

No consumer or community involvement. Consumers have been considered throughout the development of this paper through their representation in the literature. This involved a process of reviewing the literature and considering it in the scope of the questions and how occupational therapy sits within the neurodiversity movement.

PLAIN LANGUAGE SUMMARY

It is important to help autistic people to learn to do everyday things. Everyday things include ac

简介支持自闭症患者发展日常生活技能（DLS）是职业治疗实践的一部分。日常生活技能对于提高生活质量（QoL）、独立生活和社区参与至关重要。与非自闭症青少年相比，自闭症青少年的生活质量和独立生活能力较差。如何在有针对性的 DLS 支持（最大限度地提高独立生活能力并改善 QoL）与避免试图 "正常化 "或 "改变 "自闭症患者之间找到平衡点，是治疗师努力与神经多样性肯定实践保持一致的一个难题：这篇理论性论文以职业治疗价值观和加拿大职业参与模式为背景，探讨了有关 DLS 和神经多样性运动的文献。讨论了有针对性的 DLS 支持是否是对神经多样性的肯定，或者职业治疗师是否在强迫自闭症患者模仿社会认知的行为规范：结果：无论神经类型如何，DLS 都是最大限度提高 QoL 的重要因素。职业治疗的价值观与神经多样性运动的核心理念相一致，职业治疗师具备利用肯定性实践支持DLS发展的价值观和技能：职业治疗师应批判性地反思自己的实践，确保与职业核心价值观和最新的职业治疗模式保持一致，以确保平权实践。对DLS和神经多样性肯定实践的进一步研究将有利于职业治疗师努力与神经多样性肯定实践保持一致：没有消费者或社区参与。在本文的编写过程中，我们通过文献中的表述对消费者进行了考虑。这涉及到对文献进行回顾的过程，并在问题的范围内对其进行考虑，以及职业疗法在神经多样性运动中的定位。通俗易懂的语言总结：帮助自闭症患者学会做日常事物非常重要。日常事务包括洗澡、清洁和烹饪等活动。这些事情很重要，这样自闭症患者才能独立生活。研究表明，自闭症青少年不太可能独立完成日常活动。重要的是，治疗师要帮助自闭症患者学习如何进行日常活动，但不要试图改变他们的性格。因为对所有人来说，完成日常活动都是 QoL 的重要组成部分。
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引用次数: 0
Environmentally sustainable person–centred care: Occupational therapy students' attitudes, perceptions and self-perceived preparedness for practice 以人为本的环境可持续护理：职业治疗专业学生对实践的态度、看法和自我认知准备。
IF 1.6 4区 医学 Q2 REHABILITATION
Australian Occupational Therapy Journal
Pub Date : 2024-10-15 DOI: 10.1111/1440-1630.12998
Felicity Murray, Ka Yan Hess, Tanya Rihtman

Introduction

Climate change threatens the environments in which person-centred occupational therapy occurs. Environmental sustainability is directly linked with the health and wellbeing of current and future generations, presenting occupational therapists with a unique advocacy and activist role. As practitioners of the future, there is an urgent need to understand students' attitudes, perceptions of, and self-perceived preparedness for, dealing with environmental determinants of health and intergenerational occupational and climate justice.

Methods

A cross-sectional exploratory descriptive survey collected United Kingdom (UK) based allied health professional students' attitudes, perceptions, and self-perceived preparedness for advocating for environmental sustainability in the context of person-centred care. The survey was distributed to 48 gatekeepers in UK institutions with approved allied health professional training programmes (44 offered occupational therapy); 62 occupational therapy students responded. Descriptive and non-parametric inferential statistics were used to analyse quantitative data. Text and short answers were analysed qualitatively via inductive content analysis.

Consumer and Community Involvement

The study was co-designed and implemented with MSc (pre-registration) occupational therapy students.

Results

Participants (94%) expressed concerns for climate change, with 84% feeling responsible for addressing environmental sustainability in health care. While 64.5% identified climate justice as a top priority, a perceived challenge emerged between person-centred care and sustainability, with only 18% of participants feeling prepared for environmental sustainability in occupational therapy practice. Participants requested education on personal and professional sustainability practices, as well as collective action. Sharing personal climate change experiences, advocating with family and friends, and facilitating connections for collective action were highlighted as potentially transformative educational tools in this area.

Conclusion

Occupational therapy curricula should address environmental sustainability through pragmatic, critical, and ethical lenses to enhance students' preparedness for this advocacy and activist role. Reflection and continuous professi

导言：气候变化威胁着以人为本的职业疗法所处的环境。环境的可持续发展直接关系到当代人和子孙后代的健康和福祉，为职业治疗师提供了一个独特的宣传和活动角色。作为未来的从业人员，我们迫切需要了解学生对处理健康环境决定因素以及代际职业和气候正义的态度、看法和自我认知准备情况：一项横断面探索性描述性调查收集了英国（UK）专职医疗专业学生在以人为本的护理背景下倡导环境可持续发展方面的态度、认知和自我认知准备情况。该调查问卷分发给了英国拥有经批准的联合健康专业培训课程（44 个提供职业疗法）的院校中的 48 名把关人；62 名职业疗法专业的学生作了回复。对定量数据采用了描述性和非参数推断统计法进行分析。通过归纳内容分析对文本和简答进行了定性分析：消费者和社区参与：这项研究是与职业治疗硕士（注册前）学生共同设计和实施的：结果：94%的参与者对气候变化表示担忧，84%的参与者认为有责任在医疗保健中解决环境可持续性问题。64.5%的参与者认为气候公正是当务之急，但在以人为本的护理和可持续发展之间出现了明显的挑战，只有18%的参与者认为自己已经为职业治疗实践中的环境可持续发展做好了准备。参与者要求开展有关个人和专业可持续发展实践以及集体行动的教育。他们强调，分享个人气候变化经验、与家人和朋友一起倡导以及促进集体行动的联系，是这一领域具有潜在变革性的教育工具：职业治疗课程应通过务实、批判和伦理的视角来解决环境可持续性问题，以提高学生为扮演这一倡导者和积极分子角色所做的准备。建议对环境可持续实践进行反思和持续的专业发展。通俗易懂的语言总结：职业治疗师认为，支持人们参与对他们重要的职业是非常重要的。然而，一些人选择参与的活动可能会对环境和地球造成负面影响。重要的是，要确保职业治疗师在支持人们选择活动时，不会导致现在或将来在获得他人健康和有意义的职业方面出现不平等。这是因为职业治疗师也有责任防止职业不公正。职业治疗专业的学生是未来的专业人员，因此必须让他们参与有关这一主题的研究。他们需要掌握一些技能，以便同时确保提供以人为本的护理，既不损害环境，也不会导致职业不公正。既要确保职业治疗师提供以人为本的护理，又要控制职业不公正的风险，这可能被视为职业特有的两难选择。在这项研究中，英国的职业治疗专业学生完成了一项调查，内容涉及他们的感受、观点以及应对这一困境的准备情况。结果显示，大多数受访者关注气候变化，但认为他们所接受的职业疗法教育没有为他们以环境可持续的方式从业做好充分准备。他们被要求提出解决这一问题的想法，文章讨论了如何根据这一想法改变职业疗法课程。
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引用次数: 0
Relationships between sensory reactivity and occupational performance in children with paediatric acute-onset neuropsychiatric syndrome (PANS) 儿科急性神经精神综合征（PANS）患儿的感觉反应性与职业表现之间的关系。
IF 1.6 4区 医学 Q2 REHABILITATION
Australian Occupational Therapy Journal
Pub Date : 2024-10-13 DOI: 10.1111/1440-1630.12999
Michelle J. Newby, Shelly J. Lane, Kirsti Haracz, Janice Tona, Kerrin Palazzi, David Lambkin
<div> <section> <h3> Introduction</h3> <p>Paediatric acute-onset neuropsychiatric syndrome (PANS) is a neurodevelopmental disorder affecting children's performance in a fluctuating manner. This study investigates the relationship between sensory reactivity and occupational performance in children with PANS during exacerbation phases. Understanding these relationships is crucial for developing tailored interventions and managing the condition effectively.</p> </section> <section> <h3> Methods</h3> <p>This study is part of a larger project in which a two-period bidirectional case-crossover design was employed to assess sensory reactivity and occupational performance in children with PANS. The current study used data from exacerbation phases only. Parents of children aged 4.6 to 13.1 years with PANS were recruited globally, and data were collected via online surveys. The Vineland Adaptive Behaviour Scale (VABS) evaluated occupational performance, and the Sensory Processing Measure (SPM) assessed sensory reactivity. Analysis utilised Pearson correlation to determine the relationships between sensory reactivity and occupational performance domains.</p> </section> <section> <h3> Results</h3> <p>Data from 60 participants who completed the SPM and 21 who completed the VABS showed moderate to strong negative correlations between the SPM total and several domain scores (vision, hearing, body awareness, balance, and motion) and the VABS Communication and Daily Living Skills scores, indicating that increased sensory reactivity is associated with decreased occupational performance during exacerbations. No significant correlation was found between sensory reactivity and socialisation skills.</p> </section> <section> <h3> Conclusion</h3> <p>Findings highlight the significant relationship between sensory reactivity and occupational performance during PANS exacerbations, particularly in communication and daily living skills domains. Further research is needed to examine factors influencing socialisation skills and to assess the effectiveness of sensory interventions in improving occupational performance.</p> </section> <section> <h3> Consumer and community involvement statement</h3> <p>Although there was no direct consumer and community involvement, two researchers on our team have family members with PANS. Their personal experiences provided vital insights into the challenges faced by children with PANS, deeply influencing our study's design, focus, and interpreta
简介儿科急性发作神经精神综合征（PANS）是一种神经发育障碍，会对儿童的表现产生波动性影响。本研究调查了 PANS 患儿在病情加重阶段的感觉反应性与职业表现之间的关系。了解这些关系对于制定有针对性的干预措施和有效控制病情至关重要：本研究是一个大型项目的一部分，该项目采用了两期双向病例交叉设计来评估 PANS 患儿的感觉反应性和职业表现。本研究仅使用了病情加重阶段的数据。研究在全球范围内招募了 4.6 至 13.1 岁 PANS 患儿的家长，并通过在线调查收集数据。维尼兰适应行为量表（Vineland Adaptive Behaviour Scale，VABS）评估职业表现，感觉处理量表（Sensory Processing Measure，SPM）评估感觉反应性。利用皮尔逊相关分析法确定感觉反应性与职业表现领域之间的关系：来自 60 名完成 SPM 和 21 名完成 VABS 的参与者的数据显示，SPM 总分和几个领域得分（视觉、听觉、身体意识、平衡和运动）与 VABS 沟通和日常生活技能得分之间存在中度到高度的负相关，这表明感觉反应性的增加与病情恶化期间职业表现的下降有关。感觉反应性与社交技能之间没有发现明显的相关性：研究结果凸显了 PANS 病情加重期间感觉反应性与职业表现之间的重要关系，尤其是在沟通和日常生活技能领域。需要进一步开展研究，以检查影响社交技能的因素，并评估感官干预措施在改善职业表现方面的效果：虽然没有消费者和社区的直接参与，但我们团队中的两名研究人员都有患有泛发型心肌炎的家庭成员。他们的亲身经历为我们提供了有关 PANS 患儿所面临挑战的重要见解，对我们的研究设计、重点和解释产生了深刻影响，确保研究能够反映受影响者的实际情况。平实的语言摘要：我们研究了 PANS 症状发作时儿童日常活动与感官反应之间的关系。年龄在 4.6 岁至 13.1 岁之间的儿童的家长填写了调查问卷，测量感觉反应性及其子女完成日常任务的情况。我们的研究结果表明，在症状发作时，儿童在沟通和日常生活技能方面会遇到很大困难。这些困难与症状发作时感觉反应性的增强直接相关。这凸显了在这些时期提供有针对性的职业治疗以帮助儿童控制症状和改善日常功能的重要性。
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