Hong Kong journal of occupational therapy : HKJOT最新文献

Objective/background: The rapidly increasing incidence of patients with dementia in Japan is creating an urgent demand for evidence-based occupational therapy (EBOT), which has been reported to improve clinical efficacy. This study aimed to examine the current practice of EBOT for patients with dementia in Japan and clarify factors influencing its application.

Methods: We conducted an anonymous, self-administered questionnaire survey by mail. The participants were 432 occupational therapists treating patients with dementia at 432 designated medical institutions nationwide. Descriptive statistics were calculated, and multiple regression analysis was performed to clarify the factors influencing the present application of EBOT.

Results: The response rate was 31.3%. Among the participants, 46.3% responded 'somewhat frequently' or more (5, 6, and 7 on a 7-grade scale) to a question on the frequency of practice of EBOT. Using multiple regression analysis with the stepwise method, we selected the model with the highest degree of fit. This model extracted three factors, namely, ability to understand scientific papers, sufficiency of means of getting information, and availability of advice, which had standardized partial regression coefficients (β) of 0.419, 0.214, and 0.158, respectively.

Conclusions: The three factors extracted using the multiple regression analysis indicate that in order to encourage EBOT for patients with dementia, occupational therapists need to acquire reading comprehension skills, so that they can assess the quality of scientific papers. Furthermore, it is important to create environments where they have access to publications and can discuss research with superiors and colleagues.

Background: Given the growing role of family caregivers in meeting the increasing demand for ageing-related care in Japan, the occupational adaptation of family caregivers needs to be evaluated.

Methods: This study developed the Occupational Adaptation Questionnaire for Family Caregivers (OAQC) and evaluated its reliability, validity, and effectiveness. To develop the OAQC item pool, the construct 'Occupation of nursing care engaged in by family caregivers' was evaluated. Using the Delphi method, 8 experts evaluated 64 items and confirmed that 41 items adequately represented the domain. The scale was then completed by 216 family caregivers of users of outpatient service establishments affiliated with hospitals in the Chubu region. The validity of the scale items was tested, and statistical analysis was performed. The construct validity and internal consistency of the OAQC were examined using exploratory factor analysis and the ω coefficient, respectively.

Results: The discrimination ability and difficulty level were calculated using the item response theory. The findings showed that the scale's reliability and validity were satisfactory. Construct validity was acceptable for 16 items with 5 factors. The OAQC also had high internal consistency, reliability, and effectiveness. The item slope parameters and difficulty parameters revealed good item response, indicating that the scale could effectively measure family caregivers' occupational adaptation.

Conclusion: The scale was compatible with the data obtained from family caregivers. Given its overall effectiveness, data obtained using the OAQC can contribute towards implementing personal care support programs for caregivers and enriching their lives by offering support from an occupational adaptation perspective.

Background: Academic integrity is viewed as honest and responsible scholarship and the moral code of academia. Reported incidences of academic dishonesty among health professional students are widespread and may be an indicator of future unprofessional behaviour in the workplace. Aim: This study investigated the potential predictors of academic integrity in undergraduate and graduate-entry masters occupational therapy students. Method: Occupational therapy students from five universities (n = 701 participants; 609 undergraduates; 92 graduate-entry masters) were recruited. Data were collected via a two-part self-report questionnaire that included six standardised scales: Academic Dishonesty Scale; Academic Dishonesty in the Classroom Setting Scale; Academic Dishonesty in the Clinical/Practice Education Setting Scale; Moral Development Scale for Professionals; Academic Dishonesty Tendency Scale; and Perceived Academic Sources of Stress. Data analysis involved multi-linear regression analyses with bootstrapping. Result: Significant predictors of academic integrity in occupational therapy students included age, gender, grade point average, public meaning, moral practice, general tendency towards cheating, tendency towards dishonesty in the conduct and reporting of research findings, tendency towards not providing appropriate references and acknowledgements and pressures to perform well academically. Conclusion: These findings will assist educators in identifying vulnerable students potentially prone to academic integrity infringements and implementing proactive strategies with them. Further studies are recommended to explore further predictors of students' academic integrity.

Objective: While musculoskeletal disorders (MSD) and physical strength have been extensively studied in health care professionals, little attention has been paid to health care support staff, such as patient care assistants and operation patient assistants, whose jobs are physically demanding. The purpose of this paper was to examine the musculoskeletal symptoms and physical strength of newly recruited health care support staff.

Method: Convenience sampling was conducted on 111 newly employed health care support staff in a public hospital. A custom-made pre-placement examination was performed. Data were analysed using descriptive, correlation, and regression analyses.

Results: Nearly one-third (32%) of the newly recruited health care support staff had experienced musculoskeletal symptoms in at least one body part during the preceding 12 months. Two-thirds (68%) of subjects were physically inactive, and sixty percent was overweight or obese. Handgrip strength was weaker than the local norm. The subjects' dominant handgrip strength, bilateral lifting, pushing, and pulling force were significantly correlated. Only bilateral lifting was significantly associated with MSD among the newly recruited health care workers.

Conclusions: This study reports the baseline prevalence of MSD symptoms in the newly recruited health care support staff. Their sedentary lifestyle and suboptimal physical strength may render them susceptible to occupational injuries and disease. An effective occupational health programme that provides periodic health surveillance should be considered for high-risk health care workers to allow proper interventions in a timely manner.

Background: Occupational balance, a fundamental concept in occupational therapy, is the arrangement of right amount and variety of occupations contributes to a person's health and well-being. This study was aimed to investigate the reliability and validity of the Chinese version of the Occupational Balance Questionnaire (OB-Quest) for people with insomnia.

Methods: The OB-Quest was translated into traditional Chinese and reviewed by an expert panel for content validity, cultural relevance and translation accuracy. Internal consistency, factor analysis and convergent validity, as well as test-retest reliability, were explored.

Results: The participants (n = 205), 115 adults with insomnia and 90 adults without insomnia, completed a survey of demographic background, the Chinese version of OB-Quest and the Chinese Insomnia Severity Index (C-ISI). The Chinese version of OB-Quest demonstrated excellent test-retest reliability (ICC= 0.98) and good internal consistency (Cronbach's α  =  0.80). Factor analysis indicated that a single-factor solution explained 42% of the variance, and 9 out of 10 items had a factor loading of 0.4 or above. The Chinese version of OB-Quest had significant correlations with C-ISI (r = -0.88; p < 0.001). A significant difference was found in occupational balance between groups with different levels of insomnia severity and without insomnia (F = 169.72; p < 0.001). As in a previous study, age, living environment and life role had no significant relationship with occupational balance.

Conclusion: The Chinese version of OB-Quest is a short, easy to understand and culturally relevant assessment for Chinese. It demonstrates satisfactory psychometric properties and had significant correlations with insomnia.

Objective: Upper limb paralysis, which is a sequela of stroke, limits patients' activities of daily living and lowers quality of life. The objective of this study was to examine the effects of peripheral nerve stimulation on hemiparetic upper limb functional recovery in chronic stroke patients undergoing low-frequency repetitive transcranial magnetic stimulation and occupational therapy.

Methods: The subjects were chronic stroke patients who participated in a two-week inpatient programme including repetitive transcranial magnetic stimulation and occupational therapy. There were two groups of patients: the peripheral nerve stimulation group (11 patients who underwent peripheral nerve stimulation) and the control group (11 patients who previously participated in the same inpatient programme but without peripheral nerve stimulation, selected via propensity score matching). The peripheral nerve stimulation group had 1 h of peripheral nerve stimulation on the median and ulnar nerves during occupational therapy. The outcome measures were the Wolf Motor Function Test, Fugl-Meyer Assessment, and Motor Activity Log.

Results: Wolf Motor Function Test, Fugl-Meyer Assessment, and Motor Activity Log showed significant improvement after the intervention in the peripheral nerve stimulation group. Particularly, the Fugl-Meyer Assessment hand score significantly improved in the peripheral nerve stimulation group compared to that in the control group (median change: 2 versus 0; p = 0.021, r = 0.49).

Conclusion: The combined use of peripheral nerve stimulation with occupational therapy after repetitive transcranial magnetic stimulation may result in a better functional recovery of in hemiparetic upper limb. Peripheral nerve stimulation with stimulation above the sensory threshold and below the motor threshold is easy to combine with occupational therapy upper limb function training and is therefore clinically useful.

Background: Previous studies have reported a relationship between upper limb motor function and activities of daily living. However, their relationship after removing the influence of lower limb motor function has not been clarified.

Objective: This study aimed to investigate the relationship between Fugl-Meyer assessment upper limb and total Functional Independence Measure motor score and between Fugl-Meyer assessment upper limb and each item contained in Functional Independence Measure motor score after eliminating the influence of the motor function of the affected lower limb.

Methods: This retrospective cross-sectional study included 58 subacute stroke patients. To investigate the relationship between the Fugl-Meyer assessment upper limb and total Functional Independence Measure motor score before and after removing the influence of Fugl-Meyer assessment lower limb, Spearman's rank correlation coefficient and partial correlation analysis were used. Additionally, the relationship between Fugl-Meyer assessment upper limb and each item of Functional Independence Measure motor score after removing the influence was assessed.

Results: Before removing the influence of Fugl-Meyer assessment lower limb, Fugl-Meyer assessment upper limb was strongly correlated with total Functional Independence Measure motor score (r = 0.74, p < 0.001). However, it became weak after removing the influence (r = 0.27, p = 0.04). Regarding each item of Functional Independence Measure motor score, Fugl-Meyer assessment upper limb was correlated with grooming (r = 0.27, p = 0.04), bathing (r = 0.28, p = 0.03), dressing upper body (r = 0.33, p = 0.01), dressing lower body (r = 0.31, p = 0.02), and stair-climbing (r = 0.31, p = 0.02) after removing the influence.

Conclusion: These findings suggest that the relationship between the upper limb motor function and activities of daily living is strongly influenced by lower limb motor function.

Purpose/aim: Spatial neglect is caused by damage to neural networks critical for spatial attention. Spatial neglect without proper treatment impedes rehabilitation outcomes. Prism adaptation treatment, a visuomotor protocol, has been used with stroke survivors with spatial neglect to improve function. This case report explored the feasibility and potential effects of prism adaptation treatment in an individual with spatial neglect after glioblastoma removal.

Methods: Feasibility was designed and tested to include acceptability and implementation. Exploratory aim on the effectiveness of the intervention was determined using the Catherine Bergego Scale via the Kessler Foundation Neglect Assessment Process, star cancellation, line bisection and scene copying.

Results: The patient reported favouring the treatment. Eight sessions, one session a day, were completed over two weeks. The patient's spatial neglect symptoms reduced on all assessments.

Conclusion: Prism adaptation treatment was feasible and effective; however, further research is needed to understand the complete benefits of prism adaptation treatment in this population.

Introduction: Health professionals who work in mental healthcare settings need to use standardised, objective instruments; however, it is also extremely important that they maintain a client-focused perspective. The purpose of this study was to investigate the validity and reliability of the 'Traditional Chinese version of the Occupational Self-Assessment' (TC-OSA).

Methods: A total of 593 participants with mental illnesses participated in the study. The data were analysed using confirmatory factor analysis as well as the Rasch measurement model.

Results: The results of our analysis revealed that the TC-OSA encompasses four domains: self-performance (11 items), self-habituation (5 items), self-volition (5 items) and environment (8 items). Most of the items within each domain were found to have a good fit with the Rasch measurement model, whereas the CFA index was found to have a good fit for only three of the domains, the one exception being the environment domain.

Conclusions: We suggest applying the scale in clinical practice to identify the priority of intervention and as a measure for changes in outcomes. Further development and refinement of the environmental domain is guaranteed.