Occupational therapy, cancer, and occupation-centred practice: impact of training in the model of human occupation.

INTRODUCTION: This study examined the influence of training in an occupation-centred model on the practice of occupational therapists working in a cancer hospital. There is an increased need for occupation-based rehabilitation services for individuals with and surviving cancer. Incorporating an occupation-centred model into practice has unique challenges for occupational therapists working in oncology settings. Utilizing an occupation-centred model of practice may influence the therapeutic reasoning of occupational therapists. METHODS: A generic qualitative inquiry (Patton, 2015) was used to examine therapeutic reasoning as related to post-professional training in a specific occupation-centred model, the Model of Human Occupation (MOHO). Initially, ten occupational therapists with various levels of experience, working across populations in a large cancer centre completed a training session about the MOHO. This was followed by participation in monthly focus groups with an emphasis on the use of MOHO in daily practice (Taylor, 2017). Focus group sessions were video recorded and transcribed. The transcripts were then analysed using open coding and theme generation (Patton, 2015). RESULTS: Three major themes were extracted from the data during the thematic analysis: understanding and using MOHO language; challenges in incorporating a conceptual model of occupation-centred practice in an oncology setting; and therapeutic reasoning implications. Patterns in the themes indicated a progression from learning the model, to applying the model, to reflection on practice. CONCLUSION: Post-professional training in an occupation-based model influenced the therapeutic reasoning and practice of occupational therapists in an oncology setting.

Roles Caregivers Take on in Pediatric Rehabilitation Telehealth Services: A Scoping Review.

BACKGROUND: Caregivers and children continue to use pediatric rehabilitation telehealth services (PRTS) post-pandemic. Understanding how caregivers support children during PRTS can help us fully integrate caregivers for positive outcomes. This scoping review describes the roles caregivers take on during PRTS. METHODS: We searched MEDLINE, CINAHL, PsycINFO, and ERIC for research published January 2005 to July 2023. We included English articles on the effect of PRTS. We excluded qualitative and non-peer-reviewed literature. RESULTS: Thirty-four articles met inclusion criteria. Caregivers were gatekeepers, technicians, implementers, trainees, collaborators, telehealth consumers, and supervisors in PRTS. Caregivers took on roles throughout PRTS, and roles varied by type of PRTS delivered. CONCLUSIONS: Caregivers take on multiple roles to support children during PRTS. Our results can inform clinical decisions about how to integrate and support caregivers in PRTS. Future research should explore strategies that support caregiver role taking to maximize caregiver involvement and outcomes in PRTS.

The Roles Caregivers Play to Support Their Children During Pediatric Telehealth ServicesCaregivers and children continue to use telehealth services because they are convenient for busy family schedules and result in positive child outcomes. Since caregivers impact how children participate in therapy and the goals they achieve, we need to understand what caregivers do to support their children during telehealth interventions. Therefore, we reviewed published articles on telehealth services for children to describe the roles caregivers play during telehealth interventions. We searched medical, health, psychology, and education databases for articles published between January 2005 and July 2023. We included articles written in English that reported the results of telehealth services for children. We excluded articles that reported caregiver perceptions of telehealth services for children because those articles described how caregivers participated in interviews or focus groups, not the telehealth intervention. Thirty-four articles were included in this review. Caregivers shared information with providers and made decisions for the family (gatekeepers), managed telehealth technologies (technicians), participated in formal training to learn interventions (trainees), carried out the interventions (implementers), worked with providers to identify challenges and solutions (collaborators), accessed and engaged with telehealth technology to complete the intervention (telehealth consumers), and watched over child during sessions for safety (supervisors). Caregivers took on roles before, during, and after the telehealth intervention. The roles they played varied by the type of telehealth intervention provided. Our results can help occupational therapy practitioners (OTPs) make decisions about the best ways to involve caregivers in telehealth services for children. Future research should explore factors and strategies that support caregivers as they take on roles during telehealth services for children.

Measuring Caregiver Outcomes in Pediatric Rehabilitation Telehealth Services: A Scoping Review.

Pediatric occupational therapy practitioners use telehealth to facilitate performance and participation in natural contexts. Optimal therapy outcomes occur when caregivers are integrated into telehealth sessions. This scoping review describes how caregiver outcomes are measured in the pediatric rehabilitation telehealth literature. We searched SCOPUS, MEDLINE, CINAHL, PsycINFO, and ERIC for articles on pediatric telehealth interventions published from January 2005 to June 2022. We excluded non-empirical articles and articles that measured children's underlying deficits only. Thirty-one articles met inclusion criteria. Studies measured caregiver outcomes with study-specific questionnaires, standardized measures, electronic tracking, and interviews. Caregiver outcomes improved after treatment, and caregivers reported high acceptability and satisfaction with telehealth. Ample evidence supports measurement of caregiver outcomes in pediatric rehabilitation telehealth services (PRTS). Future PRTS work should incorporate existing sound measures that comprehensively evaluate caregiver outcomes, including caregiver engagement and its components, to demonstrate the effect of occupational therapy telehealth services.