Hong Kong journal of occupational therapy : HKJOT最新文献

Objective: To examine the effect of different management methods on the effectiveness of care preventive programmes for community-dwelling older adults.

Methods: This study comprised two facilitator-led (FL) and one participant-led (PL) preventive care classes in Japan. All participants received the intervention for approximately 12 weeks. Functional assessments, occupational dysfunctions, and subjective health were measured before and after the interventions. A two-way mixed design analysis of covariance (ANCOVA) was adopted to examine the effect of the interventions, adjusted for previous experiences with preventive care services. The level of significance was set at P < 0.05.

Results: Fourteen participants in the PL group (76.64 ± 6.48 years, 92.9% women) and 29 participants in the FL group (76.55 ± 5.75 years, 75.9% women) were included in the statistical analysis. ANCOVA showed significant group × time interaction effects in the Five Times Sit-to-Stand Test (FTSST), the Timed Up & Go (TUG), occupational deprivation of the Classification and Assessment of Occupational Dysfunction Scale, and self-rated health. Simple main effect tests showed that the TUG decreased significantly in the PL group, while occupational deprivation and self-rated health scores improved significantly. In contrast, FTSST scores significantly improved in the FL group.

Conclusion: PL-type management may be more appropriate for preventing social isolation and withdrawal, while FL-type management may be more appropriate for preventing physical frailty. Selecting not only adequate programmes but also an appropriate management type that matches the service purpose can help provide more effective care preventive services.

Introduction: Dry needling has been identified as a potential intervention for a variety of diagnoses. Limited evidence exists to support the use of dry needling following surgical intervention of a distal radius fracture. This case report demonstrates the impact of dry needling in the thumb following a distal radius fracture.

Methods: The patient was a 31-year-old healthy female who sustained a distal radius fracture and required surgical intervention. The patient required a volar plate removal and extensor tenolysis. The patient attended traditional occupational therapy with one session of dry needling to assist in improving range of motion and decreasing pain.

Results: The patient benefited from the use of dry needling. The patient had no pain with functional grasping and pinching following dry needling and improved on the Kapandji score from eight to nine out of ten. The patient also reported a decrease in overall pain, from seven to two on the Numeric Pain Rating Scale.

Discussion: The patient benefited from dry needling in the thumb to improve both range of motion and pain symptoms. While the evidence is limited, dry needling may be an appropriate intervention to assist in recovery and reduce thumb pain following distal radius fractures.

Background: Work personality was found to relate to successful work adjustment, job readiness, work motivation and job maintenance. The revised developmental work personality scale (RDWPS) is a self-reported assessment to evaluate the work personality of the examinee which further psychometric study is required and needs to be applied to different culture. The aim of this study was to examine the theoretical structure, validity, and reliability of the traditional Chinese version of the RDWPS.

Methods: The subjects were 113 university students with no known physical or mental illness who aged between 19 and 22. Cluster analysis was used to examine the theoretical structure. Rasch analysis was applied to examine the psychometric properties.

Results: We dropped the unfit three items and found the 11 items of traditional Chinese version of the RDWPS was adequate to fit the theoretical construct. The results of the Rasch analysis showed that the 11 items with a three-point rating scale of the traditional Chinese version of the RDWPS had acceptable internal consistency (α = 0.76), moderate reliability, and met the criteria of unidimensionality.

Conclusions: The results of this study provided initial evidence that the traditional Chinese version of the RDWPS can be readily applied to research related to work behavior for those whose primary language is traditional Chinese, with adequate reliability and validity.

Background/objectives: Several studies have indicated that stress is associated with common mental disorders, and work stress trebles the risk of developing them. However, a validated assessment tool for measuring and establishing psychological stress correlates in this group of clients remains unavailable. The objectives of the present study were to examine the psychometric properties of the Chinese version of the Perceived Stress Scale-10 (CPSS-10) on people with common mental disorders with different employment statuses and explore its correlates.

Methods: Two hundred and fifty-two participants with common mental disorders were recruited. The data were analysed through exploratory factor and confirmatory analyses to investigate construct validity. The convergent and discriminant validities were examined based on their correlation with other measures, while the internal consistency was estimated using Cronbach's α coefficient. A t-test was used to detect differences between groups. The CPSS-10 correlates were explored using multiple linear regression analysis.

Results: Principal component analysis with varimax rotation yielded two factors, which accounted for 63.82% of the total variance, while confirmatory factor analysis confirmed its factor structure. The CPSS-10 had a positively moderate to strong correlation with other measures, thereby indicating its acceptable convergent and discriminant validities. The internal consistency ranged from acceptable to good for the two subscales and ten overall items, while the item-total correlation was adequate except for the seventh item. There were no group differences in gender nor employment status. Finally, the CPSS-10 predictors were studied.

Conclusion: The CPSS-10 is a reliable and valid instrument for people with common mental disorders with different employment statuses.

Objective/background: Agitation is a common behaviour of Alzheimer's Disease (AD). Although healing robots have previously been used for alleviating agitation for people with dementia in hospitals and other healthcare facilities, its effects remain unclear whether an information-support robot capable of disseminating information with user needs may have similar effects when it is applied in community dwellings. This study was to investigate the effects of information-support robots for reducing agitation in older people with AD residing alone in community-dwellings.

Methods: One participant with AD who lived alone in a community-dwelling was recruited. Participant's frequencies, durations, and time courses of four patterns of agitation at home at baseline and during intervention were analysed. In this study, agitation was defined as: (a) restlessness going to the corridor (RLtoC), (b) restlessness going to the toilet (RLtoT), (c) restlessness going to the entrance (RLtoE), and (d) restlessness going to multiple places (RLtoMP). In the intervention phase, the information-support robot disseminated daily schedule or date information to the participant.

Results: RLtoC and RLtoMP were significantly reduced in frequency during the intervention. The durations of each episode of RLtoT and RLtoMP in the intervention were slightly reduced than those at the baseline. There were no differences in time courses of episodes of RLtoC and RLtoMP after the intervention.

Conclusion: This case study showed that information-support robot was useful to alleviate agitation of an older adult with AD living alone in a community-dwelling. Further study is warranted.

Introduction: Authors created an Occupational Identity Questionnaire Provisional version (OIQ-P) to assess occupational identity for elderly individuals. The purpose of this study was to examine the psychometric properties of the OIQ-P.

Methods: Participants included 135 (42 males) elderly who lived locally and required care or support. OIQ-P was evaluated in terms of structural validity, criterion validity and internal consistency.

Results: Based on the results of an exploratory factor analysis and confirmatory factor analysis, an OIQ with a factor structure of 3 factors and 14 items was created. Rasch rating scale model revealed that 14 participants and 1 item did not fit the goodness of fit, nevertheless, the overall result was good. Spearman's rank correlation coefficient indicates that there was a law correlation between OIQ and the occupational identity scale of the Occupational Performance History Interview Version 2. In terms of internal consistency, the person separation index and person separation reliability coefficient were 2.30 and 0.84, respectively.

Conclusion: This study confirmed the structural validity, criterion validity and internal consistency for the OIQ. To enhance the clinical utility of the OIQ, it is necessary to examine the interpretability and conduct an intervention study using the OIQ.

Objective: To identify predicting factors of treatment outcomes of a two stage group-based and then individual-based intervention programme for patients with carpal tunnel syndrome (CTS).

Methods: A prospective cohort study where patients diagnosed with CTS were recruited from an out-patient occupational therapy clinic to join the two-stage CTS programme. The Stage-One programme consisted of splinting and educational talks in a group format, while the Stage-Two programme consisted of four weekly individual sessions providing psychosocial support, reinforcing correct ergonomics and mobilization. Baseline assessment on six potential predicting factors and four outcome measures was done for all patients. Patients were re-assessed at the end of the Stage-One and the Stage-Two programme. Analysis was done by binary logistic regression adjusted for baseline covariates.

Results: One hundred and sixty-six patients completed the Stage-One programme and 46 patients also completed the Stage-Two programme. Results showed that the Chinese Symptom Severity Scale (SSS) baseline score was the only significant predictor for the Stage-One programme outcomes (AUC for ROC was 0.708) with an optimum cut-off score of 23.5. On the other hand, the Chinese QuickDASH baseline score was the only significant predictor for the Stage-Two programme outcomes (AUC for ROC was 0.801) with an optimum cut-off score of 27.4.

Conclusions: The significant predictor for the Stage One Programme was the Chinese SSS baseline score and that for the Stage Two Programme was the Chinese QuickDASH baseline score. The optimum cut-off scores identified may be applied clinically to guide client-centered treatment planning.

Introduction: Stroke is acknowledged globally and among Nigerian rehabilitation researchers as a public health problem that leaves half of its survivors with significant neurological deficits and inability to re-establish pre-existing roles. Consequent to the dearth of country specific data on return to work and its determinants for stroke survivors in Nigeria, this study investigated the predictors of return to work among stroke survivors in south-west Nigeria.

Method: Two hundred and ten stroke survivors from five tertiary health facilities in Osun state, Nigeria responded to a validated three-section questionnaire assessing return to work rates and its determinants after stroke in this study. Collected data were analysed using descriptive statistics and inferential statistic of chi-square, t-test and multiple logistic regression.

Result: The mean age of the respondents was 52.90 ± 7.92 years. Over 60% of the respondents returned to work with about half of them in full time employment (32.9%). Majority of the respondents noted that travel to and from work (43.8%) and access at work (43.3%) had an impact on their ability to work. The symptoms of stroke (odds ratio (OR) = 0.87), the environment (OR = 0.83), body function impairments (OR = 0.86) as well as activity and participation problems (OR = 0.80) were the significant predictors of return to work. Hemiplegia or paresis of the non-dominant side of the body was associated with a higher chance of return to work (OR = 7.64).

Conclusion: Body function impairments, activity and participation problems were independent predictors of return to work after stroke. Similarly, side of hemiplegia plays a prominent role in resumption of the worker role of stroke survivors in south-west Nigeria.

Aims: This study was to test the reliability and validity of the Assessment of Positive Occupational 15 (APO-15) for individuals experiencing mental illness.

Methods: A sample of 408 people experiencing mental illness living in communities or admitted to hospitalized was recruited. The sample has completed demographic information, the Assessment of Positive Occupation 15 (APO-15), the Japanese version of the Self-identified Stage of Recovery Part-B (SISR-B), the Japanese version of the Recovery Assessment Scale (RAS), the General Health Questionnaire 12 (GHQ-12). APO-15 is a measure of how engaged one is in occupations that promote well-being. The final version of the APO-15 was developed by assessing the validity and reliability by mainly using confirmatory factor analysis (CFA), item response theory (IRT).

Results: This study indicated satisfactory the validity and reliability of APO-15 in a group of individuals experiencing mental illness. CFA showed acceptable values for all indices of fit, namely comparative fit index (CFI), Tucker-Lewis index (TLI) (i.e., greater than .90), and the value of root mean square error of approximation (RMSEA) was .087, which was acceptable. The IRT showed satisfactory responses for the item slope parameter (α) and item difficulty parameter (β) in APO-15.

Discussion: APO-15 was demonstrated good psychometric properties in measuring involvement in the occupation to promote well-being in individuals experiencing mental illness. In conclusion, the APO-15 is an important tool to enable occupational therapists to assess clients who are not engaged in well-being promoting occupations and thus enable them to participate in such occupations.

Background: Psychological factors contribute to chronic pain and may lead to physical inactivity and poor functional outcomes.

Purpose: We conducted a non-randomized controlled study to evaluate the effectiveness of goal setting and achievement following occupational therapy (OT) intervention to improve pain, psychological factors, and physical activity among patients after high tibial osteotomy (HTO).

Method: We analyzed the data of 31 patients who underwent HTO, allocated into OT intervention and control groups. Goal achievement was encouraged through OT in the intervention groups; the control groups did not receive OT intervention. Outcome measures included the Canadian Occupational Performance Measure (COPM) score (before and after the OT intervention), walking pain, pain catastrophizing, anxiety, depression, pain self-efficacy, and physical activity level.

Results: OT significantly improved the COPM score, depression, and physical activity. At the final assessment, the depression score was lower while the step count and physical activity time were significantly higher in the intervention group than in the control group (p < 0.05).

Conclusion: Embedding goal setting and achievement as part of an OT intervention improved the outcomes after HTO.