Inter-Rater and Test-Retest Reliability of the Sensory Integration Clinical Observations.

AIMS: The purpose of this study was to examine the inter-rater and test-retest reliability of the Sensory Integration Clinical Observations. METHODS: Clinical observations were administered by trained occupational therapists (recent graduates to 40 years of experience, median = 3 years) to 20 children aged 4 - 12 years. Testing was completed again on 16 children after an average of 2.5 weeks. Inter-rater therapists scored the measure from video recordings. Total score and section scores (i.e. Postural-Ocular, Motor Planning - Fine Motor, Vestibular Processing, and Praxis and Coordination) were obtained. RESULTS: Intraclass correlations found test-retest reliability of total score to be excellent (ICC=.95) and section scores to be acceptable (ICC = .79-.94). Inter-rater reliability was also excellent for total score (ICC-.94) and section scores (ICC=.84-.96). CONCLUSIONS: The Sensory Integration Clinical Observations can be administered reliably by multiple raters of varying levels of experience and results are stable over an average two-week interval. Good inter-rater reliability serves as a first step toward demonstration of consistency of administration and scoring of the Sensory Integration Clinical Observations. These findings may begin to establish a foundation for use of clinical observations to measure change in sensory-motor performance over time, although further research is needed.

Clinical utility of the Danish version of the Canadian Occupational Performance Measure.

BACKGROUND: The Canadian Occupational Performance Measure (COPM) is intended to help clients identify and evaluate their occupational performance issues. As it enhances client-centred practice (CCP), more frequent use of the COPM might fulfill the political agenda of patient involvement in Denmark. However, in a study translating the COPM into Danish, challenges were found highlighting the need to study its clinical utility. AIM: To examine the clinical utility of the Danish version of the COPM (COPM-DK) and help determine whether to recommend a more routinely use. METHODS: Data gathered during qualitative interviews with 16 occupational therapists (OTs) from various settings were subjected to a qualitative content analysis. RESULTS: The COPM-DK appeared to have clinical utility, especially regarding the meaning and relevance of the information obtained, and seemed to facilitate an occupational lens and CCP. The OTs' difficulties and concerns when using the COPM and their personal and environmental commitment to the COPM seemed associated with how they performed the COPM. Thus, training was recommended to facilitate a valid and reliable use. CONCLUSION: Given the benefits and the perceived utility of the COPM-DK, a more routinely use, to place OTs and CCP in the center of Danish healthcare system, is recommended.Key MessagesThe utility of the Danish version of the Canadian Occupational Performance Measure is supported, according to Danish occupational therapists in various rehabilitation settings and hospitals.Using the Canadian Occupational Performance Measure seems to enhance a client-centred practice with collaborative goals and helps to establish partnership, being of value to the interdisciplinary team, too.The utility and acceptability of the Canadian Occupational Performance Measure seemed to be linked to the occupational therapists' experience and understanding of the Canadian Occupational Performance Measure's content and form, thus an introduction course is recommended to avoid a use that affects the assessment's validity and reliability.

Occupational therapists' competencies utilised in Danish job centres.

BACKGROUND: Twenty-nine out of 94 Danish job centres employ occupational therapists (OTs) and numbers are increasing. Occupational therapy (OT) vocational rehabilitations are diverse, and a more specific description of OT practice within this field is lacking. AIMS: To explore how OTs employed at Danish job centres describe their own competencies and what they perceive that their colleagues from other professions request from them. MATERIAL AND METHODS: Firstly, working diaries were obtained from 16 OTs working in job centres and analysed using content analysis. Secondly, semi-structured interviews were performed and analysed using systematic text condensation. RESULTS: The 16 OTs described four areas of competencies to their profession's practice within job centres; client-centeredness; a holistic approach; work ability assessments and ergonomics and adaptation. The OTs perceived that their colleagues requested their work ability assessment skills and their competencies as health professionals. CONCLUSION: The OTs had a client-centered and holistic focus on the citizens' whole life situation and used their health professional education and knowledge of ergonomics and adaptation to strengthen their work ability assessments. SIGNIFICANCE: The OTs perceived that they had competencies that supplemented the competencies of the interdisciplinary team. The results therefore support the inclusion of OTs within job centres.

Goal Setting Among Experienced and Novice Occupational Therapists in a Rehabilitation Center.

BACKGROUND.: Collaborative goal setting is an important part of client-centered occupational therapy. However, not all therapists have comparable skills when it comes to setting goals. PURPOSE.: The aim of our study was to explore the experiences of novice and expert occupational therapists who use the Canadian Occupational Performance Measure in the process of goal setting. METHOD.: This study followed a focused ethnography approach. Four beginners and four experienced occupational therapists were interviewed about their experiences with goal setting. We also observed them during a goal setting session. Data were analyzed using thematic analysis. FINDINGS.: The four main themes that emerged from the analysis showed both similarities and differences between novice and experienced therapists, especially in the areas of communication, guidance, and flexibility, as well as dilemmas they were facing. IMPLICATIONS.: Our findings challenge the client-centeredness of the participants and the relevance of work experience when it comes to collaborative goal setting.

Developing occupational therapists' capabilities for decision-making capacity assessments: how does a support role facilitate workplace learning?

INTRODUCTION: Healthcare practitioners are required to develop capabilities in an effective and efficient manner. Yet, developing capabilities in healthcare settings can be challenging due to the unpredictable nature of practice and increasing workloads. Unsurprisingly, healthcare practitioner development is often situated outside of practice, for example in formal teaching sessions. Supporting practitioners to develop capabilities through engagement with day-to-day practice, whilst advantageous in terms of authenticity and being highly valued, remains a key challenge for healthcare educators. This qualitative interview study aimed to explain, from the learner's perspective, how a dedicated support role develops occupational therapists' capability to contribute to decision-making capacity assessments. METHODS: Individual semi-structured interviews were conducted with a purposive sample of 12 occupational therapists. Informed by workplace learning theory, interview transcripts were analyzed using thematic analysis process. RESULTS: Participants provided rich descriptions of how they developed in their capability to engage in decision-making capacity assessments. Participants reported that their learning was facilitated by the dedicated support role in three key ways: 1) structuring a journey of learning, 2) providing tailored guidance, and 3) fostering a supportive learning environment. DISCUSSION: Participants valued the authentic workplace learning opportunities afforded by the dedicated support role. Findings suggest that capabilities, such as decision-making capacity assessment, can be developed through practice when enriched by a dedicated support role. However, further research examining the sustainability and transferability of this model and its application to other capabilities are warranted.

Fine Motor Activities in Elementary School Children: A Replication Study.

IMPORTANCE: The educational landscape is continually changing in response to legislation and the adoption of new standards, such as the Common Core. Currently, little is known about how these changes have influenced the school day. OBJECTIVE: To examine the motor and technology requirements of kindergarten, second-, and fourth-grade general education classrooms. DESIGN: For 6 full school days, we made unobtrusive observations of and took notes that described classroom activities throughout the day. Data were coded by a committee, allocating each minute of the day into 1 of 10 activity categories. SETTING: Kindergarten, second-, and fourth-grade classrooms. PARTICIPANTS: Three general education classrooms with approximately 20 students in each class. RESULTS: Students spent between 37.1% and 60.2% of the school day performing fine motor activities, with handwriting accounting for 3.4%-18.0% of the day. Time spent using technology was relatively sparse in kindergarten (4.8%) and second grade (3.1%) compared with fourth grade (14.3%). Transitions between activities (18.9%-23.4% of time spent) exceeded time spent handwriting. CONCLUSION AND RELEVANCE: This article provides an updated estimate of motor demands throughout the school day. Estimates of fine motor activities were consistent with previous research, but the focus on handwriting appears to have substantially diminished. WHAT THIS ARTICLE ADDS: Within the context of their own school, occupational therapists may find transitions to be a good opportunity for providing services within the classroom. In addition, handwriting practice outside of school may be more necessary in the current educational climate than in previous years.

Initial development of a measure of evidence-informed professional thinking.

BACKGROUND AND AIMS: A number of theories have been proposed on clinical expertise and its development in occupational therapy and allied health professions. Clinical reasoning, outcome measurement and evidence-based practice are names for leading conceptualisations. The aim of this research was to develop an operational measure of habits of mind and practice that constitute these desirable professional activities amongst professional therapists. METHODS: Items were developed on the basis of literature review and feedback from an expert panel. An online self-report survey was completed by 107 occupational therapists and other allied health clinicians. Rasch analysis was used to identify and calibrate items that fit the criteria for equal-interval measurement. Residuals from identified equal-interval dimensions were examined using principal components analysis to identify multidimensionality. RESULTS: A two-dimension solution employing 32 items was identified. The first dimension comprised items on Critical Clinical Reasoning and had an item separation of 8.49 (0.99 reliability) and a person separation of 2.93 (0.90 reliability). The second dimension comprised items on Evidence-Informed Practice behaviours and had an item separation of 6.19 (0.97 reliability) and a person separation of 2.97 (0.90 reliability). These dimensions were positively correlated (r = .778, p < .001). We named the overall scale 'Evidence-Informed Professional Thinking', or EIPT. The EIPT measures correlated significantly with 12 of 13 relevant external criterion items. CONCLUSION: Evidence-informed professional thinking can be measured in terms of two correlated probabilistically equal-interval dimensions: Critical Clinical Reasoning and Evidence-Informed Practice behaviours. The EIPT measure should be useful in research on development and application of clinical expertise, quality and outcomes of care and implementation of improved practices among practicing therapists in clinical treatment settings. Further research is recommended to understand the generalisability, strengths, limitations and correlates of EIPT.

Making Functional Cognition a Professional Priority.

Functional cognition is a critical domain of concern for occupational therapy practice. As the health care system moves to assessing value through achievement of quality outcomes, the field of occupational therapy must address the inclusion of functional cognition in evaluation and treatment. Evidence indicates that impaired cognition contributes to risk of hospital readmission and poor overall health outcomes across diagnostic groups. Moreover, expenditure on occupational therapy services that address functional cognition has been shown to lower hospital readmission rates. To improve client outcomes, occupational therapists must consistently screen for and, when appropriate, evaluate and treat functional cognition impairments and consider functional cognition in the discharge planning process. Occupational therapy professionals must make a proactive, coordinated effort to establish the profession's role in evaluating and treating clients' limitations in functional cognition as a means to achieving improved quality care and client outcomes.

2019 EULAR recommendations for the generic core competences of health professionals in rheumatology.

BACKGROUND/OBJECTIVES: To maintain and optimise the quality of care provided by health professionals in rheumatology (HPRs), adequate educational offerings are needed. This task force (TF) aimed to develop evidence-based recommendations for the generic core competences of HPRs, with specific reference to nurses, physical therapists (PTs) and occupational therapists (OTs) to serve as a basis for their postgraduate education. METHODS: The EULAR standardised operating procedures for the development of recommendations were followed. A TF including rheumatologists, nurses, PTs, OTs, patient-representatives, an educationalist, methodologists and researchers from 12 countries met twice. In the first TF meeting, 13 research questions were defined to support a systematic literature review (SLR). In the second meeting, the SLR evidence was discussed and recommendations formulated. Subsequently, level of evidence and strength of recommendation were assigned and level of agreement (LoA) determined (0-10 rating scale). RESULTS: Three overarching principles were identified and 10 recommendations were developed for the generic core competences of HPRs. The SLR included 79 full-text papers, 20 of which addressed the competences, knowledge, skills, attitudes and/or educational needs of HPRs from multiple professions. The average LoA for each recommendation ranged from 9.42 to 9.79. Consensus was reached both on a research and educational agenda. CONCLUSION: Evidence and expert opinion informed a set of recommendations providing guidance on the generic core competences of HPRs. Implementation of these recommendations in the postgraduate education of HPRs at the international and national level is advised, considering variation in healthcare systems and professional roles.

Occupational therapy and decision-making capacity assessment: A survey of practice in Ireland.

INTRODUCTION: The aim of the study was to explore occupational therapy practices regarding decision-making capacity assessment and to examine factors that impact on engagement in this area. METHODS: Occupational therapists in Ireland were invited to participate in a cross-sectional online questionnaire. RESULTS: One hundred and seventy-two occupational therapists responded. 65.77% (n = 98) reported that occupational therapy plays an important role in capacity assessment in their workplace. Occupational therapists most frequently contributed to decision-making capacity assessment for independent living (79.19%, n = 118), driving (45.89%, n = 67) and financial management (44.44%, n = 64). Many participants reported that this is more difficult than other aspects of practice and that they are not satisfied with decision-making capacity assessment procedures in their workplace. A large majority (91.86%, n = 113) reported occupational therapists would benefit from additional training and practice guidelines in the area of decision-making capacity assessment. CONCLUSION: The study confirms that occupational therapists have a role to play in the multi-disciplinary assessment of decision-making capacity. The results of the survey suggest that decision-making capacity assessment is complex and challenging. Factors such as confidence, education and training impact on engagement with this area of practice. There is a need to develop education resources and guidelines for occupational therapists.

Measuring fidelity of delivery of the Community Occupational Therapy in Dementia-UK intervention.

BACKGROUND: Interpreting data about intervention effectiveness requires an understanding of which intervention components were delivered and whether they were delivered as planned (fidelity of delivery). These studies aimed to develop a reliable measure for assessing fidelity of delivery of the Community Occupational Therapy in Dementia-UK intervention (COTiD-UK) (Study 1) and measure fidelity of delivery of COTiD-UK across sessions, sites and occupational therapists (Study 2). METHODS: The studies used a longitudinal observational design nested within a multi-site randomised controlled trial. Where practicable, all intervention sessions were audio-recorded. Fidelity checklists and coding guidelines were developed, piloted and refined until good agreement was achieved between two coders. Ten percent of sessions were purposively sampled from 12 sites and 31 occupational therapists. Transcripts were coded using checklists developed in Study 1; 10% of sets of intervention session transcripts were double coded to ensure that agreement was maintained. Percentages of components that were delivered were calculated for each session, site and occupational therapist. RESULTS: A reliable measure of fidelity of delivery for COTiD-UK was developed after several rounds of piloting and amendments. COTiD-UK was delivered with moderate fidelity across all six sessions (range: 52.4-75.5%). The mean range of fidelity varied across sites (26.7-91.2%) and occupational therapists (26.7-94.1%). CONCLUSIONS: A reliable, systematic method for measuring fidelity of delivery of COTiD-UK was developed and applied, and can be adapted for use in similar interventions. As COTiD-UK was delivered with moderate fidelity, there is a reasonable degree of confidence that intervention effects were attributable to COTiD-UK.

Increasing the uptake of stroke upper limb guideline recommendations with occupational therapists and physiotherapists. A qualitative study using the Theoretical Domains Framework.

INTRODUCTION: Despite the availability of stroke clinical practice guidelines and acceptance by therapists that guidelines contain 'best practice' recommendations, compliance remains low. While previous studies have explored barriers associated with implementing rehabilitation guidelines in general, it remains unknown if these barriers are applicable to upper limb rehabilitation specifically. To plan effective implementation activities, key motivators and barriers to use should be identified. METHOD: To investigate occupational and physiotherapists' perceptions of motivators and barriers to using upper limb clinical practice guideline recommendations in stroke rehabilitation, a mixed-method study was conducted. Using an online survey and semi-structured focus groups, physiotherapists and occupational therapists working in one of six stroke rehabilitation teams in Melbourne, Australia were invited to participate. Survey data were analysed using descriptive statistics, and thematic coding of free-text responses. Focus groups were transcribed, thematically coded and mapped against the Theoretical Domains Framework. RESULTS: Forty-six participants completed the survey and 29 participated in the focus groups. Key motivators to use guideline recommendations included past experience with specific interventions, availability of required resources and an enabling workplace culture. Barriers included: limited training/skills in specific interventions, the complexity of intervention protocols, and beliefs about intervention effectiveness. Lack of accountability was highlighted and therapists perceived they are rarely checked for quality assurance purposes regarding guideline adherence. CONCLUSION: Therapists identified that both motivators and barriers to implementing best-practice upper limb rehabilitation occur largely at the levels of the individual and the environment. As such, intervention efforts should focus at both these levels to facilitate change.

The occupational therapy practitioner's role in health promotion, injury prevention, and role participation for the older worker.

As the population of individuals aged sixty-five and older continues to grow, the number of older individuals participating in the workforce rises alongside, with projections estimating as many as 72 million older workers by 2030. Due to this rapid increase in the number of older workers, new challenges to worker health and to health-related productivity will arise in the coming years. Occupational therapy practitioners are uniquely suited to address many of these challenges given their background in activity analysis, assessment and modification of job demands, health promotion and successful aging. However, there is need for continued research in this area to expand the role of the occupational therapy practitioner in prevention and return-to-work interventions focused on the older worker, and to advocate for the value occupational therapy practitioners can contribute to this field.

The process of determining driving safety in people with dementia: A review of the literature and guidelines from 5 English speaking countries.

OBJECTIVES: To review literature and guidelines related to the process of determining driving safety in people with dementia. METHOD: Four electronic databases were searched in December 2016/January 2017. We limited our search to literature and guidelines published in the UK, USA, Canada, New Zealand and Australia. RESULTS: General practitioners are primarily responsible for driver licensing; however, they often feel ill-equipped and it can compromise the therapeutic relationship. Occupational therapist driving assessment is considered as the 'gold-standard' but is costly and often not available. Medical advisory boards assist the assessment process by providing independent licencing decisions. CONCLUSIONS: General practitioner training, funding for occupational therapist driving assessment and the establishment of a medical advisory board could be considered to improve the current practice of driving assessment in dementia.

[Values related to the occupational therapy profession: Identifying them to better define them]. / Valeurs liées à la profession d'ergothérapeute : les répertorier pour les définir.

BACKGROUND.: Inaccuracies and conceptual confusion characterize the literature on the values associated with occupational therapy. PURPOSE.: The purpose of this study was to identify values related to occupational therapy, propose definitions for those values, and validate the content of the definitions. METHOD.: A review of the literature ( n = 52) and consultation of occupational therapists ( n = 26) were used to document and define a series of values. The resulting list of values was tested for functionality by occupational therapists ( n = 5) and presented to occupational therapists with ethics expertise ( n = 6) to assess content validity of the value definitions. FINDINGS.: The proposed list presents 33 values with their definitions that the experts considered to be clear and representative of the realities they describe. The results show that the list is considered exhaustive. IMPLICATIONS.: This study identified values that are ideals that can guide occupational therapy practice and support the claims and cultural and ethical competencies of occupational therapists.

DESCRIPTION.: Des imprécisions et des confusions conceptuelles caractérisent les écrits sur les valeurs liées à l'ergothérapie. BUT.: Répertorier des valeurs liées à l'ergothérapie, proposer des énoncés qui les définissent et procéder à leur validation de contenu. MÉTHODOLOGIE.: Une recension des écrits ( n = 52) et la consultation d'ergothérapeutes ( n = 26) ont permis de documenter et de définir une série de valeurs. Le répertoire issu de ces démarches a été soumis à un test de fonctionnalité auprès d'ergothérapeutes ( n = 5), puis présenté à des ergothérapeutes détenant une expertise en éthique ( n = 6) pour en évaluer la validité de contenu des définitions des valeurs. RÉSULTATS.: Le répertoire proposé comprend 33 valeurs suivies de leur définition que les experts ont jugées claires et représentatives des réalités qu'elles désignent. Les résultats montrent que le répertoire est considéré comme exhaustif. CONSÉQUENCES.: Cette étude a permis de répertorier et de définir des valeurs qui constituent des idéaux susceptibles de guider la pratique ergothérapique et de soutenir les revendications ainsi que les compétences culturelles et éthiques des ergothérapeutes.

What are the attributes of excellence in an acute practice occupational therapist?

BACKGROUND/AIM: There is anecdotal recognition within the profession that novice occupational therapists who perform well at interview do not necessarily make the best practising clinicians. Further anecdotal evidence suggests that it is difficult to tell (at interview) which occupational therapists will follow which path and whether further training can achieve excellence in existing staff. What is it that makes the difference? What attributes do those truly 'excellent' clinicians have that makes them better than others? METHOD: A two-round Delphi survey was utilised and 18 expert occupational therapists were purposively recruited from Perth's three adult tertiary hospitals. Panellists rated and ranked sixteen possible attributes that could comprise excellence in an acute practice occupational therapist. RESULTS: The final order of importance (from most to least) of the 16 possible attributes of excellence was determined. Communication, Self-management and Critical Thinking were found to be the three most important attributes, whereas Humility was considered the least important attribute. All attribute rankings achieved at least a low level of consensus. CONCLUSION: We now have a much clearer picture of what excellence looks like in the acute practice setting, giving managers a new understanding. There is now the possibility of integrating this information into both the recruitment of new staff and the professional development of existing staff. In this way we can move forward to a future that includes the active development of occupational therapy excellence in ways that were not possible before these results were available.

Internationally educated occupational therapists transitioning to practice in Canada: A qualitative study.

BACKGROUND/AIM: While internationally educated occupational therapists (IEOTs) may assist Western countries in addressing workforce shortages, their transition to practice can be difficult. Provincial and national levels of government in Canada have funded initiatives to address the barriers experienced by IEOTs. The purpose of this study is to identify the key forces shaping the experiences of IEOTs transitioning to practice in Canada. METHODS: An interpretive description approach was taken to interview 11 IEOTs who graduated from the Occupational Therapy Examination and Practice Preparation (OTepp) program. Data analysis was guided by the theoretical scaffolding of the occupational therapy profession. Two team members, who are also occupational therapists, developed codes and categories independently and then through discussion reached a higher level of interpretation. RESULTS: The experiences of IEOTs in Canada were shaped by two key forces: Realising that more than exam preparation is required and the impact of previous person, environment and occupation transactions. Participants underestimated their learning needs related to their transition to Canadian practice. As they engaged in the OTepp program, they realised that their learning extended beyond that required for the national certification exam. Also, the extent to which the participant (person), previous context (environment) and previous practice (occupation) were similar to Canadian therapists, influenced IEOTs' performance in OTepp and their overall transition to practice. The Person-Environment-Occupation (PEO) model provided a framework to contextualise this theme. CONCLUSION: IEOTs will benefit from individualised learning needs assessments and education plans to address their specific needs. At an international level, the occupational therapy profession must engage in dialogue about the differences between education programs and the resulting implications for the profession. More research is also needed to understand the experiences of IEOTs who withdraw from or do not engage in formal supports.

What occupational and physical therapists know about farmers' health.

Farmers are at high risk for losing their occupation because of their susceptibility for developing chronic conditions and incurring injuries. Although, occupational and physical therapists have basic education in return-to-work methods, specialty training is needed to help farmers with disabilities. The North Carolina AgrAbility Partnership, part of the U.S. Department of Agriculture's supported AgrAbility Program, implemented an exploratory survey of North Carolina occupational and physical therapists before developing training curricula for working with farmers. State occupational and physical therapy association members were surveyed on what types of conditions they could treat, how comfortable they were in treating these conditions and making recommendations for environmental modifications, and what resources are available for farmers related to work site accommodations. Findings showed that less than one third of therapists had farm exposure or had ever treated farmers. Significant differences in identifying farmers' typical conditions were found between therapists who had treated and those who had not treated farmers. Physical therapists were more comfortable than occupational therapists in treating farmers for repetitive stress syndromes, work-related trauma, and musculoskeletal disorders while occupational therapists were more comfortable in treating farmers for social isolation and low vision. More physical therapists also rated themselves as competent in farm environmental assessment and adaptation. On the other hand, occupational therapists were aware of more agencies that aid farmers. Finally, few therapists had education on working with farmers or had heard of AgrAbility. To create farmer-centered intervention, therapists should take continuing education courses and investigate resources for helping farmers with chronic conditions and disabilities return to their chosen occupation.

Applying modern measurement approaches to constructs relevant to evidence-based practice among Canadian physical and occupational therapists.

BACKGROUND: Evidence-based practice (EBP) is a complex process. To quantify it, one has to also consider individual and contextual factors using multiple measures. Modern measurement approaches are available to optimize the measurement of complex constructs. This study aimed to develop a robust measurement approach for constructs around EBP including practice, individual (e.g. knowledge, attitudes, confidence, behaviours), and contextual factors (e.g. resources). METHODS: One hundred eighty-one items arising from 5 validated EBP measures were subjected to an item analysis. Nominal group technique was used to arrive at a consensus about the content relevance of each item. Baseline questionnaire responses from a longitudinal study of the evolution of EBP in 128 new graduates of Canadian physical and occupational therapy programmes were analysed. Principles of Rasch Measurement Theory were applied to identify challenges with threshold ordering, item and person fit to the Rasch model, unidimensionality, local independence, and differential item functioning (DIF). RESULTS: The nominal group technique identified 70/181 items, and modified Delphi approach identified 68 items that fit a formative model (2 related EBP domains: self-use of EBP (9 items) and EBP activities (7 items)) or a reflective model (4 related EBP domains: attitudes towards EBP (17 items), self-efficacy (9 items), knowledge (11 items) and resources (15 items)). Rasch analysis provided a single score for reflective construct. Among attitudes items, 65% (11/17) fit the Rasch model, item difficulties ranged from - 7.51 to logits (least difficult) to + 5.04 logits (most difficult), and person separation index (PSI) = 0.63. Among self-efficacy items, 89% (8/9) fit the Rasch model, item difficulties ranged from - 3.70 to + 4.91, and PSI = 0.80. Among knowledge items, 82% (9/11) fit the Rasch model, item difficulties ranged from - 7.85 to 4.50, and PSI = 0.81. Among resources items, 87% (13/15) fit the Rasch model, item difficulties ranged from - 3.38 to 2.86, and PSI = 0.86. DIF occurred in 2 constructs: attitudes (1 by profession and 2 by language) and knowledge (1 by language and 2 by profession) arising from poor wording in the original version leading to poor translation. CONCLUSIONS: Rasch Measurement Theory was applied to develop a valid and reliable measure of EBP. Further modifications to the items can be done for subsequent waves of the survey.

Occupational Therapy for Adults with Overweight and Obesity: Mapping Interventions Involving Occupational Therapists.

BACKGROUND: Worldwide obesity rates are increasing. The effectiveness of occupational therapy in overweight and obese adults has not yet been clarified. OBJECTIVES: The scoping review aimed at examining the evidence on interventions involving occupational therapists in the treatment of adults with overweight and obesity. METHODS: Data on interventions involving occupational therapists and reporting on lifestyle-related outcomes in overweight and obese adults was extracted from the databases Cochrane, PubMed, CINAHL, and Embase, including hand and reference search. The scoping review methodology of Arksey and O'Malley was used. Conclusions were based on numerical and narrative analysis. RESULTS: Thirteen articles reporting on eleven studies met the inclusion criteria. Several studies showed significant weight loss. However, the studies possessed high heterogeneity and showed insufficient explication of the role and contribution of occupational therapy to the outcomes. CONCLUSIONS: The interventions with involvement of occupational therapists were suggested to help short-term weight loss. Occupational therapists contributed to the outcomes with a holistic approach, educating on the role of activity, providing technological support, and promoting enjoyment of being active. There is a need for further documentation of the effectiveness, role, and contributions of occupational therapy in the treatment of overweight and obese adults in all settings.