Theory Is Essential in Promoting the Distinct Value of Occupational Therapy in Rehabilitation of Adults With Low Vision: A Systematic Review.

IMPORTANCE: Evidence for occupational therapy interventions should be grounded in theory to support practitioners' role in the rehabilitation of adults with low vision. OBJECTIVE: To analyze the content of publications on interventions for adults with low vision to determine theories proposed or used to guide interventions and to categorize their level of evidence. DATA SOURCES: CINAHL, Scopus, PubMed, and Embase. METHOD: A quantitative summative content analysis of articles published from 1984 through 2021. RESULTS: Fourteen articles provided a theoretical rationale for occupational therapy interventions for adults with low vision. Nine provided evidence for interventions supported by theory, and 3 suggested theories to support interventions. Eleven were found in peer-reviewed publications; 10 were in occupational therapy publications. Of the 14, 50% were categorized at the lowest level of evidence. CONCLUSIONS AND RELEVANCE: Few high-level studies on occupational therapy interventions for adults with low vision exist that provide a rationale for treatment based on theory. Application of theories provides clinical reasoning that distinguishes occupational therapy interventions from those of other professions serving adults with low vision. If interventions are not grounded in theory, the occupational therapy profession risks losing its distinction from other similar professions in low vision rehabilitation. Plain-Language Summary: This is the first content analysis of theories recommended and used to guide occupational therapy interventions for adults with low vision. This systematic review highlights occupational therapy's distinct value over other professions but also points to a dangerous gap in the literature that threatens practitioners' role in the rehabilitation of adults with low vision.

A Missing Piece of Occupational Therapy Education: Attitudes About Sex.

Following a lecture on sexual health and function, occupational therapy students were surveyed regarding their past sex education and their comfort level with the topic of sex. Students indicated a lack of sexual education received from parents/guardians and a prevalence of fear-based education from formal or informal sources. Results reflected a significant increase in students' perceived comfort level with the topic following the lecture from a provider trained and certified in sexual health. As sexuality falls within the domain of occupational therapy, these results suggest a need for comprehensive sex education taught to students by qualified instructors.

Occupational Therapy Assessments of Cortical or Cerebral Visual Impairment: A Systematic Review.

IMPORTANCE: Cortical or cerebral visual impairment (CVI), a leading cause of visual dysfunction in children across the globe, can result in delayed development of fine and gross motor skills, functional mobility, and socialization, which affects all areas of occupation. No assessments are recommended for occupational therapy practitioners working with children with CVI. OBJECTIVE: To appraise the measurement properties and clinical utility of CVI assessments appropriate for use by occupational therapy practitioners. DATA SOURCES: MEDLINE via PubMed, Scopus, and Web of Science. STUDY SELECTION AND DATA COLLECTION: We followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines for systematic reviews of patient-reported outcome measures for relevant studies. FINDINGS: A total of 590 records yielded 15 studies of the measurement properties of 12 assessment tools, 8 patient-reported outcome measures and 4 clinician-reported or performance-based outcome measures. We report on the quality of measurement properties of 10 of the 12 outcome measures. None had high-quality evidence of content validity, structural validity, or test-retest reliability. Most had indeterminate internal consistency as a result of a lack of confirmatory factor analysis. Three instruments demonstrated high quality and sufficient construct validity. CONCLUSIONS AND RELEVANCE: On the basis of the COSMIN guidelines, all 12 outcome measures have the potential to be recommended but require further study before definitive recommendations can be made. What This Article Adds: This is the first systematic review of assessments of CVI feasible for use by occupational therapy practitioners. High-quality studies of measurement properties are lacking. Further examination of the measurement properties of outcome measures is required.

Addressing Current Issues in Vision Rehabilitation as a Specialty Practice of Occupational Therapy.

The purpose of this paper was to examine the low number of occupational therapy practitioners in the United States that possessed specialty or advanced certification in low vision. The discussion explores possible reasons for this finding, including insufficient educational accreditation standards to prepare occupational therapy students to work with people with visual conditions, lack of clarity on the definition of low vision leading to misalignment with the profession's scope of practice, inconsistent requirements for advanced certification, scarcity of post-professional preparation programs, and other issues. We propose several solutions to prepare occupational therapy practitioners to meet the challenges and needs of people of all ages with visual impairments.