Hong Kong journal of occupational therapy : HKJOT最新文献

Background: Mindfulness-based interventions (MBIs) applied in the field of occupational therapy (OT) have shown promising results, particularly in enhancing emotional well-being, stress regulation, and pain management. However, to the best of our knowledge, a systematic review of the existing research on MBIs in the context of OT is lacking. This review aims to: (1) outline the types and components of MBIs applied in OT; and (2) summarize the current empirical evidence on their effectiveness in OT practice, focusing on health-related and OT-related outcomes.

Methods: Seven databases were searched with key terms related to mindfulness and OT, including PubMed, Web of Science, Embase, Cochrane Library, CINAHL, PsychInfo and Medline. The review included randomized controlled trials (RCTs) and quasi-experimental studies published in English covered the period from the inception of the databases to October 2024. Exclusion criteria included articles that were not peer-reviewed, lacked outcome data, or were not applied in OT. The Joanna Briggs Institute methodology was employed for the systematic review, which included critical appraisal and narrative synthesis.

Results: A total of 10 studies were included in this review. The critical appraisal scores ranged from 50 to 91.67 (mean = 74.31), with RCTs scoring between 50 and 91.67 (mean = 73.33), and quasi-experimental studies between 62.5 to 88.89 (mean = 75.28). The interventions categorized were creative and art-based mindfulness activities (n = 2), structured MBIs (n = 3), and multi-modal MBIs (n = 5). MBIs demonstrated significant effectiveness in improving mental health, particularly overall mental health levels, and may offer potential benefits in promoting activity and participation. However, no significant additional benefits were observed for physical health, cognitive function, or health-related quality of life.

Conclusion: MBIs are evidence-based interventions that can effectively improve mental health, particularly in overall health levels, and may promote activity and participation. Occupational therapists can incorporate approaches, such as creative and art-based mindfulness activities, structured MBIs, and multi-modal MBIs, in their daily practice. Further exploration and integration of these interventions into OT education and practice should be encouraged.

Background: Spatial neglect, a disorder of lateralized spatial attention, is often considered to be a hidden condition because symptoms do not appear unless comprehensive assessment is completed. The Kessler Foundation Neglect Assessment Process (KF-NAP®) is a standardized method using the Catherine Bergego Scale (CBS) to detect and measure spatial neglect during daily activities. It is a frequently used tool because it assesses spatial neglect during functional activities, meaning it is comprehensive and applied. Since it was introduced in 2012, the KF-NAP has been adopted in numerous inpatient and outpatient settings and gone through several revisions. The latest and most used version is the 2015 edition.

Methods: Users have been providing the developers of the assessment informal feedback and suggestions during training sessions, lectures, and professional conferences. In addition, as part of a multisite implementation project, the developers asked KF-NAP users to provide their comments about the tool.

Results: Using this qualitative information, the developers made changes to the KF-NAP Manual by adding detail to the observation and scoring procedures, a "questions to consider" section to each item-specific instruction, and highlighted instructions based on practice setting. For example, clarification about how to assess the personal belongings category in an outpatient setting is provided, which includes more details on what items to ask and directions about setup.

Conclusions: This article aims to inform health professionals working with the neurological population about the KF-NAP 2023 Manual. The goal is to help users improve their experience and consequently improve practice.

Objective: The Contextual Memory Test-2 (CMT-2) is an updated version of the CMT, which is a standardized occupational therapy assessment to evaluate an individual's memory, awareness and strategy use to guide occupational therapy interventions. This study aimed to examine, amongst younger adults (<40 years old) and middle-to-older adults (>40 years old) in Singapore, (1) the relationship between strategy use and memory performance (2) the relationship between online awareness and memory performance, and (3) explore the relationship of memory performance and online awareness with age. The secondary objective was establishing preliminary normative data on CMT-2 for the Singapore adult population.

Methods: One hundred and thirty-two healthy participants aged 18-71 were recruited via convenience sampling and underwent virtual or face-to-face assessment. CMT-2 was administered to assess their immediate recall (IR), delayed recall (DR), total recall (TR), strategy use, and online awareness of performance through prediction and estimation discrepancies.

Results: Higher recall scores were found for efficient strategies as compared to inefficient (IR: p = .012; DR: p = .003; TR: p = .003). For different strategy types, 'context' yielded higher recall scores than 'limited association' (IR: p < .001, DR: p = .016). During IR, 'association' also obtained a higher recall score than 'limited association' (p = .007). Significant strong negative correlation of IR prediction discrepancy with recall score was found (r_s (130) = -.611, p < .001).

Conclusion: The preliminary normative data of CMT-2 among healthy adults in Singapore highlighted the role of effective memory strategies and online awareness in memory recall performance, suggesting the prioritization of these areas during interventions.

Objectives: Legible handwriting is crucial for academic success, especially among elementary school students. However, there is limited research on handwriting interventions for logographic languages. The purpose of this study was to develop a Geometric-Based Handwriting Intervention (GBHI) Program for improving Chinese handwriting and to investigate its feasibility and preliminary outcomes.

Methods: The intervention program was created using psycho-geometric, developmental, and motor learning theories, along with cognitive principles specific to Chinese character writing. Comprising 4 course modules, it was designed to systematically incorporate the geometric structure of Chinese characters into activities targeting fundamental handwriting skills. A two-phase feasibility study was conducted. In Phase 1, eight typically developing elementary students participated in a single 3-h course module to assess their satisfaction with the program. In Phase 2, four elementary students completed all four course modules to evaluate the feasibility and explore potential benefits, as measured by the Chinese Handwriting Evaluation Form (CHEF), the Chinese Handwriting Legibility Assessment for Children (CHLAC), and assessments of handwriting-related fundamental skills.

Results: In Phase 1, participants reported high satisfaction with the problem, with an average rating of 4.40 on the 5-point Likert-type satisfaction questionnaire. In Phase 2, participants demonstrated improvements in handwriting performance following completion of the GBHI program.

Conclusion: This study contributes to the growing body of research on handwriting interventions, particularly within the context of logographic language education. The program introduces a novel approach to teaching Chinese character writing, and the successful delivery of the 4-module intervention supports its feasibility for implementation.

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.

Objective: The aim of this study was to investigate the effect of Health Qigong (HQ) exercise on the subjective and objective sleep quality and the quality of life in male patients with drug abuse who received treatment at a mandatory drug rehabilitation residential institution.

Methods: Ninety male patients (mean age, 36.85 ± 8.72 y) were included and randomly divided into the Health Qigong (HQ) group, aerobic exercise (AE) group, or control group. The participants in the HQ and AE groups exercised four times a week for 1 hour per session for 12 weeks, while the control group maintained their original lifestyle. The following parameters were recorded before and after exercise: Pittsburgh Sleep Quality Index (PSQI); SF-36; and total sleep time, sleep efficiency, sleep latency, deep sleep time, deep sleep rate, light sleep time, and light sleep rate using actigraphy.

Results: Health Qigong improved the subjective sleep quality, objective sleep quality, and quality of life after a 12-week intervention. Considering the subjective sleep quality, Health Qigong helped improve several aspects of the PSQI, including the overall sleep quality (p < 0.01), sleep latency (p < 0.01), sleep duration (p < 0.01), sleep latency (p < 0.01), sleep disturbance (p < 0.01), and day dysfunction (p < 0.01). In relation to the objective sleep quality, Health Qigong improved the total sleep time (p < 0.01), sleep efficiency (p < 0.01), sleep latency (p < 0.01), deep and light sleep rate (p < 0.01). Considering the quality of life, Health Qigong helped improve the role-physical (p < 0.01), general health (p < 0.01), bodily pain (p < 0.01), and mental health (p < 0.01) aspects of SF-36.

Conclusion: Health Qigong may be an effective approach to improve the subjective and objective quality of sleep and life quality of patients with drug abuse.