Hong Kong journal of occupational therapy : HKJOT最新文献

Background/objective: Physical, cognitive and psychological factors such as self-efficacy and motivation affect participation in populations with acquired disabilities. Volition is defined as a person's motivation for participating in occupation. The concept of 'volition' expands similar concepts and theories, which focus mostly on cognitive processes that influence motivation. Although volition seems to affect participation, the association between these two concepts has not been examined in populations with acquired disabilities. This scoping review explored this association.

Methods: The literature review used a structured five-stage framework, according to predefined inclusion and exclusion criteria. Seven electronic databases (CINAHL, PsycINFO, PubMed, Web of Science, SCOPUS, The Cochrane Library-Wiley, OTseeker) and Google Scholar were searched for relevant articles, published in English from January 2001 to May 2018.

Results: A total of 18 articles, relating to populations with various diagnoses were included. Two directly examined volition and participation and showed a positive association between them. Other articles discussed the effect of participants' chronic condition on their volition and participation, the effect of volition on participation, or the effect on participation of an intervention addressing volition.

Conclusions: An acquired disability affects both volition and participation, and volition seems to affect participation among people with acquired disabilities. Few articles showed positive effects of interventions that addressed clients' volition, on participation. Further research should include additional health conditions and types of literature, to better understand the association between these concepts. This understanding will contribute to the development of occupational therapy interventions that emphasise volition, in order to improve participation outcomes.

Background: Deep brain stimulation is a surgical treatment for Parkinson's disease. Its impacts on motor symptoms are widely reported; however, little is known about the broader impact of deep brain stimulation on the community lives of people with Parkinson's disease. Lifespace is a measure of lived community mobility, providing an indication of community access and participation.

Aims: This pilot study explored the feasibility of remotely monitoring the qualitative and quantitative community outcomes related to deep brain stimulation.

Methods: A longitudinal mixed methods study with a convergent design was undertaken exploring the lifespace, quality of life, life satisfaction and lived experiences of people with Parkinson's disease before and after deep brain stimulation. Data were collected through questionnaires, semi-structured interviews and a smartphone-based application which collected geolocation data.

Results: Quantitative and qualitative data from eight participants living with Parkinson's disease were analysed and integrated. At baseline, participants had a median age of 68 years and a median Hoehn and Yahr score of 2. Measuring a range of community-based outcomes indicated different change trajectories for individuals across outcomes. Key content areas were developed from the qualitative data: participation in occupations and travel and home. This study indicates the potential value of including geolocation data-based lifespace collection in metropolitan and regional areas.

Conclusions: Monitoring lifespace in conjunction with subjective measures provides insights into the complex and individually varied experiences. Further research could explore the impacts of deep brain stimulation on occupations and community participation to gain a deeper understanding of the related needs and support clinical approaches.

Objective: This study aimed to assess the construct validity of the Child Occupational Self-Assessment, translated to Persian that could provide occupational therapists with a tool to evaluate occupational competence and values of children in Iran.

Methods: A total of 250 children (87 girls and 163 boys) with attention deficit hyperactivity disorder aged 7.5-11 years referred from two specialised children's hospitals were included. The researchers read the questions to the children and they identified their own answers. The data were analysed based on the Rasch Rating Scale Model.

Results: Four of the items showed misfit and as a result of deleting these items the Persian version of the questionnaire has 21 items with an appropriate validity.

Conclusion: The Persian version of Child Occupational Self-Assessment can be used with new items format. It could be also useful to replace the missing question to develop the tool further.

Mental illness often leads to functional deficits that likely affect one's driving performance and may even pose threat to other road users. However, having a mental illness does not automatically preclude one from driving which is essential to mobility and productivity. Indeed, evaluating their fitness-to-drive would be of necessary. Despite that, there is still a lack of a local driving evaluation service that specifically addresses the impact of mental illness on driving capacity. This paper discusses the needs to evaluate the fitness-to-drive of people with mental illness. It advocates the development of such specific driver assessment service with a local example as illustration. Lastly, some of the challenges related to the drivers' responsibility to declare personal health status and large variety of assessment approaches are also discussed.

Background: Numerous touch-screen applications designed to support visual perceptual skills and fine motor development for young children are available.

Objectives: This study aimed to investigate whether or not there were differences between children using tablets and non-tablets in visual perception and fine motor skills and to examine the association between visual perception and fine motor skills in two groups.

Methods: This study had tablet and non-tablet groups, each with 36 typically developing preschool children.

Results: Children in the non-tablet group yielded significantly higher scores in the subtests of visual discrimination, visual memory, spatial relationships, form constancy, visual figure ground, fine motor precision, fine motor integration, and manual dexterity than those in the tablet group. The association between visual perception and fine motor skills demonstrated different patterns in the two groups.

Conclusion: There are differences in visual perception and fine motor skills between children using tablets and non-using tablets. Different patterns of association relationship support the need for occupational therapists to consider the underlying mechanism.

Background and objective: Pulmonary rehabilitation programme (PRP) is an important component in the management of chronic obstructive pulmonary disease (COPD). However, to date so far there has been limited literature on the survival outcomes of patients with COPD after a PRP in Hong Kong. This study aimed to investigate the outcomes of a pulmonary rehabilitation programme on the survival rates of a retrospective cohort of patients with COPD.

Methods: This was a retrospective study that included subjects who participated in the PRP in a rehabilitation hospital from the year 2003 to 2015. A total of 431 patients with chronic obstructive pulmonary disease were identified from the electronic record system of the hospital. The dataset were split into two age groups for reporting and analysis using the mean age of 72 as the cut-off. Their median survival times were calculated using Kaplan-Meier analysis. Cox-proportional regression model was used to explore factors that predicted better survival. The most significant predictors were used as strata, and their respective effects on survival functions were analysed with Kaplan-Meier analysis again.

Results: The overall median survival of the cohort was 4.3 years. The median survival times of the younger patient group (aged <72) and the older patient group (aged ≥72) were 5.3 and 3.6 years, respectively. For the patients, aged <72 years old, Moser's Activities of Daily Living class and the pulmonary rehabilitation programme completion rate were the most significant survival predictors. For the patients aged ≥72 years old, Monitored Functional Task Evaluation score was the most significant survival predictor.

Conclusion: Moser's Activities of Daily Living class ≥2 and non-completion of PRP for younger group, low exercise capacity with Monitored Functional Task Evaluation score <17 for older group were identified as significant predictors of poor survival. The findings of this study helped identifying those patients with COPD who have the needs to be more intensively treated and closely monitored.

Objective/background: This study aimed to review the current evidence on the application of telerehabilitation in occupational therapy practice and its clinical outcomes over the last 10 years.

Methods: A systematic review was performed on studies published in English in the decade 2008 to 2017, retrieved from seven electronic databases (MEDLINE, Cochrane Library, CINAHL, Web of Science, SAGE, Science Direct and EMBASE). Only articles evaluating the use of telerehabilitation to provide occupational therapy services from a distance were included, with no restrictions on pathology, impairment, age, or the nature of occupational therapy intervention.

Results: Fifteen articles (three randomised controlled trials, eight quasi-experimental studies, one trial with single-group post-intervention and three case studies) were reviewed. Despite various study designs and outcome measures, most studies indicated positive therapeutic effects of using telerehabilitation in occupational therapy practice. There is insufficient evidence, however, to confirm that telerehabilitation is more effective than the face-to-face model. Little evidence was shown on the long-term effect and cost efficacy. Only two studies used smartphones in their applications.

Conclusion: Telerehabilitation offers an alternative service delivery model for occupational therapy, not only bridging distance but also offering user-friendly treatment for patients at home. Further research, particularly on the use of the most cutting-edge mobile technology, is needed to determine effectiveness in occupational therapy practice treating various diseases, conditions and impairments and the characteristics of patients, interventions and therapists that lead to the best fit with this alternative and emerging form of service delivery.

Introduction: Cognitive difficulties have been reported to have the greatest effect on function and quality of life in people with multiple sclerosis, affecting 50-60% of people. To date, few interventions have been developed to treat cognitive issues in multiple sclerosis. Here we report on a Cognitive Occupation-Based programme (COB-MS) for people with Multiple Sclerosis an evidence-based intervention to address everyday problems encountered due to cognitive difficulties. The aim of this research was to explore the views of people with multiple sclerosis and occupational therapists on the programme and its potential implementation in practice.

Methods: Data were elicited from a purposive sample of 12 people from two stakeholder groups, people with multiple sclerosis (n = 5) and occupational therapists (n = 7), through focus groups and interviews. The programme and related materials were presented, and contributions recorded, transcribed and thematically analysed.

Results: Two main themes were identified from analysis of the data: response to the intervention and challenges to implementing the programme. Occupational therapists agreed that the COB-MS is client-centred. People with multiple sclerosis thought that it was a validating intervention. The overall format was viewed to be useful and feasible.

Conclusion: The COB-MS for people with Multiple Sclerosis is the first known cognitive intervention using an occupation frame of reference to address difficulties faced among persons with multiple sclerosis and was found to be timely and relevant to the needs of the population.

Objective: This study aimed to translate, culturally adopt and validate a Chinese version of the Disabilities of the Arm, Shoulder and Hand (DASH) for use in patients with upper extremity musculoskeletal diseases in Hong Kong.

Methods: We followed a standard five-stage process: forward translation, synthesis, backward translation, expert panel review and field-testing to achieve linguistic and conceptual equivalence. The version was officially known as Chinese (Queen Mary Hospital, Hong Kong version) DASH. (Chinese QMH,HK version DASH) (http://www.dash.iwh.on.ca/sites/dash/public/translations/DASH_Chinese_HK_2013.pdf).

Results: Its internal consistency was then evaluated with 138 participants suffering from upper extremity musculoskeletal conditions. The results were high in DASH-Disability/Symptom module (DASH-DS) (Cronbach alpha 0.97), DASH-Work module (DASH-W) (Cronbach alpha 0.97) and DASH-Sports / Performing Arts module (DASH-SM) (Cronbach alpha 0.99). The test-retest reliability was evaluated with a subgroup of participants who had completed the Chinese (QMH,HK version) DASH on two occasions, with a median interval of 6.5 days. The results were excellent among DASH-DS Intraclass Correlation Coefficient (ICC) = 0.98 and DASH-W (ICC = 0.90). Good test-retest reliability was found in DASH-SM (ICC = 0.89). Construct validity of DASH-DS showed good correlation with the sub-domains of physical functioning (r = -.564) and social functioning (r = -.544) of the Short Form 36 Health Survey (SF-36). Similarly, construct validity of DASH-W also showed good correlation with the sub-domains of physical functioning (r = -.510) and bodily pain (r = -.503) of SF-36.

Conclusion: The Chinese (Queen Mary Hospital, Hong Kong version) Disabilities of the Arm, Shoulder and Hand is considered as a reliable and valid instrument that can provide a standardised measure of patient-centred outcomes for patients with upper extremity musculoskeletal disorders in Hong Kong.

Objective: Driving ability in older people is affected by declining motor, cognitive and visual functions. We compared perceptual and cognitive skills and driving behaviour in a Japanese population.

Methods: We used a driving simulator to measure the effects of spatial navigation skills and eye movements on driving ability. Participants were 34 older and 20 young adults who completed a simulated driving task involving a lane change and a right turn at an intersection. We used an eye tracker to measure gaze. We measured visual recognition (Benton Judgment of Line Orientation Test (BJLO)), spatial navigation (Card-Placing Test (CPT A & B)), visual perception (Raven's Colored Progressive Matrices (RCPM)) and driving ability (Stroke Drivers' Screening Assessment).

Results: Older participants scored significantly lower on the BJLO, CPT-A & B and RCPM, showed a significant correlation between gaze time and CPT-A & B scores (both p < .01) and had a longer gaze time. There were significant between-group differences in saccade switching (p < .01 right turn), distance per saccade (p < .05 for right turn and lane change) and saccade total distance (p < .05 right turn; p < .01 lane change). There was an association between age and rate of gaze at the right door mirror (p = 0.04).

Conclusion: The findings indicate that older drivers have poorer eye movement control and spatial navigation. This is likely to result in delayed responses and difficulties in predicting the on-coming driving environment. Driving simulation could help older drivers in their driving abilities.