A randomized controlled trial for evaluating an occupational therapy self management intervention in adults with type 2 diabetes.

This study evaluated the efficacy of the Occupational Therapy Diabetes Self-Management intervention (OTDSM) to enhance glycemic stability and self-management skills in people with diabetes type-2. Based on this single-blind randomized trial, 30 subjects with diabetes type-2 were assigned to two groups of intervention and control. The intervention group received a 10-week program, consisting of four group visits and six individualized sessions. The control group received an individual session and three weekly phone calls. The primary study outcome, blood hemoglobin A1C, was measured before and three months after the study. The secondary outcome was assessed in terms of the participants' self-management behaviors, self-efficacy, diabetes distress, depressive symptoms, and performance and satisfaction with daily activities. These outcomes were evaluated three times: before, one month into, and three months after the study. The study findings demonstrated significant differences between the two groups in the hemoglobin A1C levels, self-management behaviors, self-efficacy, and performance and satisfaction with daily routines after the intervention (P < 0.05). No significant differences existed between the groups for the extent of diabetes distress and depressive symptoms. Inclusion of occupational therapy protocol into the plan of care for people with diabetes can improve health outcomes by promoting their routine participation in self-management activities.

Barriers to Occupational Therapy Fieldwork Education in Iran: The Perspectives of Fieldwork Educators and Students.

BACKGROUND: Clinical education is a vital factor in the process of learning in medical sciences universities. The aim of the present study was to explore the perspectives of fieldwork educators and students concerning barriers to occupational therapy fieldwork education in Iran. MATERIALS AND METHODS: A qualitative research was conducted from May 2019 to April 2020 to address the study objectives. The data analysis was performed using conventional content analysis based on Graneheim and Lundman's approach. Purposive sampling was used to enroll 12 educators and 14 students of various backgrounds (physical disabilities-adult, physical disabilities-pediatrics, psychosocial-adult, and psychosocial-pediatrics) in the study. RESULTS: The findings indicated that the main themes were related to fieldwork educators, fieldwork settings, educational planning, students, and educational regulation. CONCLUSIONS: It can be concluded that the perspectives of students and occupational therapy educators regarding the field of clinical education are not only important but also useful for the attainment of effective clinical education and the development of knowledge related to rehabilitation nursing education. Therefore, educational planners should develop effective programs based on these themes.

Development and psychometric evaluation of performance-based upper extremity motor control test (PB-UE-MCT) for people with cerebral palsy / Desenvolvimento e avaliação psicométrica do Teste de Controle Motor das Extremidades Superiores com Base no Desempenho (PB-UE-MCT) para pessoas com paralisia cerebral

Abstract Introduction Upper extremity disorders limits the performance in the activities of daily living, especially, in bilateral (two-handed) activities. Objective This study was designed to develop a performance-based upper extremity motor control test (PB-UE-MCT) and to measure its psychometric properties (including, convergent validity, intrarater reliability, and interrater reliability) for people with cerebral palsy (CP). Method The PB-UE-MCT was developed in three phases, including planning, construction, and psychometric evaluation. The participants included 50 people with CP with an age range of 6 to 18 years. To measure internal consistency, Cronbach's alpha was run (n=50). Intrarater and interrater reliability was measured for 25 participants. To assess convergent validity, the correlations of the PB-UE-MCT with the Manual Ability Classification System (MACS) and with the Selective Control Upper Extremity Scale (SCUES) were calculated. Results The values obtained for Cronbach's alpha (.90 to .96) indicated the excellent internal consistency of the PB-UE-MCT. The ICC values for intrarater reliability and interrater reliability were between .84 and .99 and between .89 and .99, respectively. The correlation coefficients obtained for the items of the PB-UE-MCT and those of the MACS were between .51 and .73. The correlation coefficients of the items of the PB-UE-MCT with those of the SCUES were in the range of .67 to .98, which proves the PB-UE-MCT's good to excellent levels of convergent validity. Conclusion The results confirm that the PB-UE-MCT is a valid and reliable tool for evaluating the upper extremity performance of people with CP through task analysis.

Resumo Introdução Distúrbios dos membros superiores limitam o desempenho nas atividades da vida diária, especialmente em atividades bilaterais (com as duas mãos). Objetivo Desenvolver um teste de controle motor de membros superiores baseado em desempenho (PB-UE-MCT) para avaliar pessoas com paralisia cerebral espástica. Método O PB-UE-MCT inclui planejamento, construção e avaliação psicométrica. Os participantes incluíram 50 pessoas com paralisia cerebral entre 6 e 18 anos. Para medir a consistência interna, o alfa de Cronbach foi executado (n = 50). A confiabilidade intra-examinador foi medida para 25 participantes que realizaram o teste duas vezes com um intervalo de duas semanas. Para confiabilidade entre avaliadores, dois examinadores administraram separadamente o teste a 25 participantes. Para avaliar a validade convergente, foram calculadas as correlações do PB-UE-MCT com o Manual Ability Classification System (MACS) e com a Selective Control Upper Extremity Scale (SCUES). Resultados Os valores obtidos para o alfa de Cronbach (0,90 a 0,96) indicaram a excelente consistência interna do PB-UE-MCT. Os valores de ICC para confiabilidade intraexaminador e confiabilidade interexaminador estavam entre 0,84 e 0,99 e entre 0,89 e 0,99, respectivamente. Os coeficientes de correlação obtidos para os itens do PB-UE-MCT e do MACS ficaram entre 0,51 e 0,73. Os coeficientes de correlação dos itens do PB-UE-MCT com os das SCUES situaram-se na faixa de 0,67 a 0,98, o que comprova os níveis de validade convergente bons a excelentes do PB-UE-MCT. Conclusão O PB-UE-MCT é uma ferramenta válida e confiável para avaliar o desempenho dos membros superiores de pessoas com paralisia cerebral durante a realização de tarefas.

Fatigue in Children with Cancer: Reliability and Validity of the Persian Version of Child, Parent, and Staff Fatigue Scale.

CONTEXT: The fatigue is reported as the most common and annoying symptom in patients with cancer, timely diagnosis, and treatment can significantly influence the treatment and rehabilitation. It is crucial to have an appropriate tool to accurately assess fatigue status. OBJECTIVES: Our purpose was to assess psychometric properties of the Persian versions of fatigue scale by Original Scales from the viewpoint of children with cancer (Child Fatigue Scale [CFS]-24 h), their parents (Parent Fatigue Scale [PFS]-24 h), and staff (Staff Fatigue Scale FSF-24 h). METHODS: Convenience sampling of the participants was conducted 100, including children with cancer within the age range of 7-12 years, their parents, and caregivers in medical staff. Test-retest reliability and internal consistency were evaluated using intraclass correlation (ICC) and Cronbach's alpha coefficient. Dimensionality was determined by factor analysis. The patients' fatigue was also assessed through visual analog scale-fatigue (VAS-F). RESULTS: Test-retest (ICCCFS = 0.71, ICCPSF = 0.82, and ICCSFS = 0.78) was acceptable with a high level of internal consistency (αCFS = 0.80, αPFS = 0.83, and αSFS = 0.84). Factor analysis identified three, five, and two components for the CFS, PFS, and Staff Fatigue Scale (SFS), respectively. There was moderate correlation between CFS and VAS-F. CONCLUSIONS: Results of the current study indicated that CFS in children with cancer, PFS in their parents, and SFS in medical staff were valid and reliable instruments to assess fatigue from the viewpoint of children with cancer along with their parents and medical staff.

Assessment priorities in cerebral palsy using ICF core set by Iranian occupational therapists.

BACKGROUND.: International Classification of Functioning, Disability and Health (ICF) core set for cerebral palsy allows for the description of the levels of functioning in cerebral palsy. It is not exactly clear which of these levels is more important for evaluation from the perspective of occupational therapists in Iran. By identifying these priorities, we can establish a better plan for intervention. PURPOSE.: This study defines assessment priorities in children with cerebral palsy (<6 years). METHOD.: Sixty-two Iranian occupational therapists studied the priorities of assessment based on the Iranian ICF core set. The therapists were asked to rate the code categories from 1 to 3. The results are presented as mean values. FINDINGS.: Occupational therapists first focus on body functions assessment, then activities/participation, and ultimately, environmental factors. IMPLICATIONS.: Occupational therapists in Iran have a bottom-up approach toward clients with cerebral palsy. It may be necessary to revise the educational curriculum, prepare a training course, and provide more supervision for practising occupational therapists.

Participation in Peer-Play Activities Among Children With Specific Learning Disability: A Randomized Controlled Trial.

OBJECTIVE: Children with a specific learning disability (SLD) have deficits in social and academic competence and executive function (EF). In this study, we used the Model of Human Occupation to investigate the effect of peer-play activities on occupational values and competence as well as EF skills (i.e., behavior regulation and metacognition) in children with SLD. METHOD: Forty-nine children ages 7-11 yr with SLD were randomly assigned to the peer-play and control groups. Outcome measures were the Behavior Rating Inventory of Executive Function and the Child Occupational Self-Assessment (COSA). RESULTS: Data analysis showed that the effects of the intervention on EF skills were medium to large. The occupational values and competence did not change according to the COSA. CONCLUSION: Occupational therapy practitioners can use peer-play activities to enhance EF in children with SLD; however, perceived occupational values and competence may not show any changes with the peer-play intervention using a self-assessment instrument.

Effect of Play-based Occupational Therapy on Symptoms of Hospitalized Children with Cancer: A Single-subject Study.

OBJECTIVE: Cancer is one of the four leading causes of death in children. Its courses of diagnosis and treatment can cause physiologic symptoms and psychological distress that secondarily affect children's quality of life and participation in daily activities. The aim of this study was to investigate the effect of play-based occupational therapy on pain, anxiety, and fatigue in hospitalized children with cancer who were receiving chemotherapy. METHODS: Two hospitalized children with acute lymphoblastic leukemia at least 4 months after diagnoses who received two courses of chemotherapy participated in this pilot study. Takata Play History and Iranian Children Participation Assessment Scale were used to develop intervention protocol. Nine, 30-45 min play-based occupational therapy sessions took place for each child. Children filled out the Faces Pain Scale, Visual Fatigue Scale, and Faces Anxiety Scale before and after each intervention session. RESULTS: Pain, anxiety, and fatigue levels decreased in both participants. Furthermore, the results showed a relationship between pain, anxiety, and fatigue variables in these children. CONCLUSIONS: Play-based occupational therapy can be effective in improving pain, anxiety, and fatigue levels in hospitalized children with cancer receiving chemotherapy.

Undergraduate prosthetics and orthotics teaching methods: A baseline for international comparison.

BACKGROUND: Education of Prosthetics and Orthotics is a relatively recent professional program. While there has been some work on various teaching methods and strategies in international medical education, limited publication exists within prosthetics and orthotics. OBJECTIVES: To identify the teaching and learning methods that are used in Bachelor-level prosthetics and orthotics programs that are given highest priority by expert prosthetics and orthotics instructors from regions enjoying a range of economic development. STUDY DESIGN: Mixed method. METHODS: The study partly documented by this article utilized a mixed method approach (qualitative and quantitative methods) within which each phase provided data for other phases. It began with analysis of prosthetics and orthotics curricula documents, which was followed by a broad survey of instructors in this field and then a modified Delphi process. RESULTS: The expert instructors who participated in this study gave high priority to student-centered, small group methods that encourage critical thinking and may lead to lifelong learning. Instructors from more developed nations placed higher priority on student's independent acquisition of prosthetics and orthotics knowledge, particularly in clinical training. CONCLUSIONS: Application of student-centered approaches to prosthetics and orthotics programs may be preferred by many experts, but there appeared to be regional differences in the priority given to different teaching methods. CLINICAL RELEVANCE: The results of this study identify the methods of teaching that are preferred by expert prosthetics and orthotics instructors from a variety of regions. This treatment of current instructional techniques may inform instructor choice of teaching methods that impact the quality of education and improve the professional skills of students.

Factors affecting clinical reasoning of occupational therapists: a qualitative study.

BACKGROUND: Clinical reasoning is generally defined as the numerous modes of thinking that guide clinical practice but little is known about the factors affecting how occupational therapists manage the decision-making process. The aim of this qualitative study was to explore the factors influencing the clinical reasoning of occupational therapists. METHODS: Twelve occupational therapy practitioners working in mental and physical dysfunction fields participated in this study. The sampling method was purposeful and interviews were continued until data saturation. All the interviews were recorded and transcribed. The data were analyzed through a qualitative content analysis method. RESULTS: There were three main themes. The first theme: socio-cultural conditions included three subthemes: 1- client beliefs; 2- therapist values and beliefs; 3- social attitude to disability. The second theme: individual attributions included two subthemes 1- client attributions; 2- therapist attributions. The final theme was the workplace environment with the three subthemes: 1- knowledge of the managers of rehabilitation services, 2- working in an inter-professional team; 3- limited clinical facilities and resources. CONCLUSION: In this study, the influence of the attitudes and beliefs of client, therapist and society about illness, abilities and disabilities upon reasoning was different to previous studies. Understanding these factors, especially the socio-cultural beliefs basis can play a significant role in the quality of occupational therapy services. Accurate understanding of these influential factors requires more extensive qualitative and quantitative studies.