Hong Kong journal of occupational therapy : HKJOT最新文献

Background: Despite the clearly identified roles and need for occupational therapy in primary care, guidance on a consistent global response is lacking.

Purpose: This study aimed to gain insight into the global state of occupational therapy primary care services.

Method: Data from an online survey of the 100 WFOT member organisations was grouped by country income levels; weighted global means and ANOVA were calculated.

Results: Fifty-nine member organisations from five world regions responded, 33 (55.9%) representing high-income countries. Activities of daily living was the most addressed area; other health facilities (e.g., mental health services, rehabilitation services) were reported as a common setting. People with developmental disabilities, those with chronic illness/needs, and older adults were most likely to receive occupational therapy primary care services, with a higher likelihood of being financed by government (public) in one-on-one settings. Workforce supply, funding and training were consistently reported as key limiting factors for the profession in primary care.

Implications: While recognizing regional histories and needs, it behooves the profession to work collectively to advance its capacity to provide primary care services. Key enablers to advance this area include workforce initiatives and funding access in line with a global workforce strategy for occupational therapy.

Introduction: Adolescents with executive function deficits have difficulties performing complex daily tasks. Process-oriented dynamic testing with graded prompts training offers valuable insights to improve adolescents' thinking and performance abilities in occupational therapy interventions. This study explores the effectiveness of graded prompts training in improving performance during the Rey-Osterrieth Complex Figure (ROCF) task.

Method: This secondary analysis included data from 41 adolescents with executive function deficit profiles who had participated in the therapeutic occupational therapy intervention program 'Functional Individualized Therapy for Teenagers'. Dynamic pre- and post-test phases, focused on copying and immediate recall, were assessed using accuracy, placement, and organization strategy scores.

Results: Results indicate significant improvements following graded prompts training in copying and memory accuracy (67% and 180%), placement (49% and 237%), and organization strategy (66% and 99%). Positive correlations were observed between improved copying accuracy and organization, memory accuracy and organization, and copying and memory organization (p < .001).

Conclusion: Graded prompts training may improve the performance of adolescents with executive function deficits during complex tasks (e.g., ROCF). Future research should explore the training's long-term effects and applications in diverse clinical settings to validate further and expand these promising results. This training could become integral to therapeutic interventions for enhancing this population's daily functioning and overall well-being.

Background: Educational technology's rapid evolution has resulted in an increase in the adoption of virtual reality (VR)-based educational modules in medical and nursing education.

Purpose: To develop and integrate a 360-degree video depiction of medical facilities into occupational therapy educational curriculum, and assess its impact on students' learning through a questionnaire survey and text-mining.

Method: Participants included 62 first-year occupational therapy majors from the 2022 and 2023 cohorts. The participants viewed a 360-degree video of three facilities (one psychiatric hospital and two general hospitals) in a class on their smartphones. They responded to self-administered questionnaires on the VR experience, including a free comment question that was subjected to text mining.

Findings: Early clinical exposure facilitated by VR benefited students. The ease of viewing images, enhanced understanding of the rehabilitation facilities' environment, and a significant boost in learning motivation after class were evident. The data revealed students' growing excitement for future 360-degree video-based classes and their high satisfaction with facility tours.

Conclusion: This study demonstrated that early experiential learning using VR effectively motivates occupational therapy students and deepens their understanding of clinical environments.

Introduction: Occupational therapy utilizes altruistically motivated activities, potentially influencing both frontal alpha asymmetry (FAA) associated with approach motivation and autonomic responses. This study examines the effects of altruistically motivated craft activities on FAA and autonomic activity.

Methods: Fifteen rehabilitation students (21.0 ± 0.4 years) performed a netcraft task under altruistic and selfish conditions. EEG and ECG were measured during the craft task, and FAA and autonomic indices were analyzed.

Results: FAA score was significantly higher in the altruistic condition (p = .040, d = 0.59), indicating increased approach motivation. Sympathetic activity was significantly lower in the altruistic condition (p = .018, r = -0.68), indicating reduced sympathetic activity.

Conclusions: Altruistically motivated craft activities increased relative left frontal cortical activity and decreased sympathetic activity, highlighting their potential benefit in occupational therapy. These findings are not only consistent with previous research, but also support the inclusion of altruistic activities in therapeutic interventions to improve mental health and well-being.

Objectives: The Assessment of Positive Occupation 15 (APO-15) is a scale initially developed to evaluate participation in well-being-promoting occupations among individuals with mental illness. This study examines the psychometric properties of the Japanese version of the APO-15 for individuals with physical illness, focusing on its validity, reliability, and interpretability.

Methods: We evaluated the psychometric properties of the APO-15 using a sample of 1,259 individuals with physical illness living at home, in hospitals, and in nursing homes. Validity was evaluated using confirmatory factor analysis (CFA) to confirm the factor structure, and concurrent validity was examined by correlating APO-15 scores with measures of happiness and psychological distress. Reliability was assessed by internal consistency analysis using Cronbach's alpha, and item difficulty was analyzed using the Rasch Rating Scale Model (RSM). Interpretability was established through a T-scale-based five-level criterion for client status.

Results: The APO-15 showed strong psychometric properties. CFA indicated a good fit for the factor structure (RMSEA= 0.100, CFI= 0.944, TLI= 0.930). Internal consistency was high, with a Cronbach's alpha of 0.914. Item difficulty analysis revealed a bias towards easier items, consistent with previous findings in mental illness populations. The T-scale-based five-level criterion effectively classified client status, though significance was noted between most levels except levels 1 and 2.

Conclusion: The Japanese version of the APO-15 is a reliable and valid tool for assessing occupational participation and promoting well-being among individuals with physical illness. It provides a robust framework for occupational therapists to support clients' well-being through targeted occupational engagement.

Background: Individuals with mobility disabilities are less likely to meet physical activity standards and are at greater risk of developing non-communicable chronic diseases at earlier ages. Public parks are an essential resource for participation in physical activity. However, environmental factors may limit the participation of wheelchair users. The objective of this study was to evaluate the feasibility of using the Path Environment Audit Tool (PEAT) and to explore the wheelchair accessibility of five public parks in Saudi Arabia through descriptive analysis.

Methods: A descriptive study design was implemented to evaluate wheelchair accessibility features of five public parks in Riyadh, Saudi Arabia, and process, resource, and management assessments were conducted. Phone GPS-App Strava was used to track the segments and measure their distances.

Results: Audits in multiple parks using PEAT were time-consuming despite being user-friendly. The descriptive analysis of paths and trails across the five parks showed some positive features, such as adequate bollard/gate clearance, but the path slope and condition of the path surfaces were more variable.

Conclusion: This study is the first to examine wheelchair accessibility in public parks in Saudi Arabia. Preliminary audits of paths/trials in five public parks revealed the strengths and weaknesses of accessibility and features that promote physical activity participation for wheelchair users. These findings can guide future use of PEAT in large-scale studies and inform environmental modifications.

Introduction: This study investigated the relationship between sensory processing, respiratory sinus arrhythmia, and social participation in people with psychiatric disorders.

Method: This study recruited 30 participants, primarily women, from a psychiatric university hospital with a mental health diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (mean age: 37.7 ± 16.0 years). Sensory processing, autonomic nervous function, and social participation were measured using the Adolescent/Adult Sensory Profile®, respiratory sinus arrhythmia, and World Health Organization Disability Assessment Schedule, respectively. Through mediation analysis, a model wherein sensory processing mediated the relationship between respiratory sinus arrhythmia and social participation was developed.

Results: Social participation was moderately to highly correlated with Adolescent/Adult Sensory Profile® quadrants (excluding sensory seeking) and respiratory sinus arrhythmia. Furthermore, the mediation analysis revealed that sensory avoiding mediated the relationship between respiratory sinus arrhythmia and social participation, consequently counteracting the direct relationship.

Conclusion: A mediation model was constructed, which indicated that individuals with psychiatric disorders and low parasympathetic nervous system activity expressed higher sensory processing quadrant of sensory avoiding. Ultimately, this was associated with reduced social participation.

Introduction: While occupational therapy home assessments are effective to identify environmental falls risk factors, patients may not receive these services due to workforce distribution and geographical distances. Technology may offer a new way for occupational therapists to conduct home assessments to identify environmental fall risks.

Objectives: To (i) explore the feasability of identifying environmental risk factors using smartphone technology, (ii) develop and pilot a suite of procedures for taking smartphone images and (iii) examine the inter-rater reliability and content validity between occupational therapists when assessing smartphone images using a standardised assessment tool.

Method: Following ethical approval a procedure was developed and participants recruited to submit smartphone images of their bedroom, bathroom and toilet. Two independent occupational therapists then assessed these images using a home safety checklist. Findings were analysed using inferential and descriptive statistics.

Results: Of 100 volunteers screened, 20 individuals participated. A guideline for instructing patients to take home images was developed and tested. Participants averaged 9.00 minutes (SD 4.401) to complete the task, whilst occupational therapists took approximately 8 minutes to review the images. The inter-rater reliability between the two therapists was 0.740 (95% CI: 0.452-0.888).

Conclusion: The study found that use of smartphones was to a large extent feasible and conclude that the use of smartphone technologies is a potential complimentary service to traditional home visits. The effective prescription of equipment in this trial was identified as a challenge. The impact on costs and potential falls incidents remains uncertain and more research is warranted in representative populations.

Background/objective: We have been practising the Neuropsychological and Educational Approach to Remediation (NEAR) as cognitive remediation (CR) in a psychiatric hospital and have implemented it in combination with regular interviews based on Motivational Interviewing (MI) approximately 2 years after launching NEAR. In this study, we investigated whether combining MI with CR affected completion of the programme, cognitive functions, global functioning, and personal recovery of patients with schizophrenia by analysing medical records.

Methods: In this retrospective observational study, 14 participants were assigned to the NEAR group and 12 participants were assigned to the NEAR + MI group. Fifteen participants in the NEAR group (n = 6) and NEAR + MI group (n = 9) completed the programme. First, the difference in the completion rate between the groups was examined using the chi-squared test. Second, measures of cognitive functions, global functioning, and personal recovery pre-and post-intervention were examined using the Wilcoxon signed-rank tests for those in each group who completed the programme. Third, therapeutic responses for each group were compared using the Mann-Whitney U tests.

Results: There were no statistically significant differences in completion rates between the groups. In the NEAR group, verbal memory and overall cognition improved after the intervention. On the other hand, not only cognitive functions but also global functioning and personal recovery improved in the NEAR + MI group. Moreover, changes in global functioning and personal recovery were significantly higher in the NEAR + MI group.

Conclusion: Study findings indicated that combining MI with CR improves cognitive functions, global functioning, and personal recovery in patients with schizophrenia.

Background: To investigate the physical and psychological effects of five-element music therapy combined with Baduanjin qigong treatment on inpatients with mild coronavirus disease 2019 (COVID-19) in Wuhan.

Methods: A mixed-methods study was used. In the quantitative study, a randomized controlled trial was performed on 40 study participants divided into a control group (n = 20) and an intervention group (n = 20). The Self-rating Anxiety Scale, Self-rating Depression Scale and Pittsburgh Sleep Quality Index were compared. For qualitative analysis, it adopted purposive sampling method, 13 patients of different ages from 18 to 60 years old and different exercise behavior were selected as the participants from the intervention group. A semi-structured interview method was used to collect data, and the content analysis method was used for data analysis. An interview outline was developed to assess the psychological condition and personal functional-exercise behavior of patients.

Results: In the quantitative study, the anxiety self-scores and depression self-scores of patients in intervention group were significantly lower compared with control group after treatment (p < .05). The sleep quality of intervention group was significantly improved compared with control group (p < .001). Participants in the qualitative study responded to questions posed through semi-structured interviews. The effect of intervention was good, which has been supported and recognized by patients.

Conclusion: The treatment of five-element music therapy combined with Baduanjin qigong on patients with mild COVID-19 alleviated anxiety and depression, and improved sleep quality, which was beneficial to the patients' physical and psychological recovery.