Exploring the association between volition and participation in daily life activities with older adults living in the community.

OBJECTIVE: To explore the association between volition and participation in daily activities with older adults living in the community. DESIGN: Cross-sectional study. SETTING: Community-dwelling, residing in Victoria (Australia). PARTICIPANTS: A total of 244 adults, of 70 years and older, drawn from a convenience sample, living in their own homes. MAIN MEASURES: Individuals' participation in daily activities was obtained via phone interviews, from the completion of the Phone-FITT survey. Levels of volition (identified under three items; personal causation, values and interests) were collected using the Volition Scale. Analyses were completed through linear regression. RESULTS: The participants' mean age was 77.5 years (SD 5.7) with 60% being female. Higher levels of participation were associated with higher levels of volition in light housework (n = 225, p = 0.008), shopping (n = 239, p = 0.018), lifting weights to strengthen legs (n = 23, p = 0.031), walking for exercise (n = 163, p < 0.001) and gardening (n = 183, p = 0.001). CONCLUSIONS: Increased volition is associated with increased participation in physical activities with community-dwelling older adults.

The measurement properties and factor structure of the Test of Visual-Perceptual Skills-Revised: implications for occupational therapy assessment and practice.

OBJECTIVES: The aim of this study was to examine the measurement properties of the Test of Visual-Perceptual Skills-Revised (TVPS-R). METHODS: A group of 356 typically developing children 5-11 years of age completed the TVPS-R along with three criterion measures. RESULTS: Several of the TVPS-R items had item-total subscale correlation coefficients were lower than the 0.20 correlation criteria. Cronbach's alpha coefficients varied between 0.74 and 0.84 for the seven subscales. The perceptual quotient (PQ) reliability coefficient for the age levels ranged between 0.79 and 0.91. The PQ total group reliability coefficient was 0.96. Results from the principal component analysis indicated that the majority of the TVPS-R items loaded on a dominant first factor. Confirmatory factor analytic models were assessed using four different goodness-of-fit indices. Two of the fit indices supported the unidimensional assumption (RMR and CFI ), while two of the fit indices did not support the TVPS-R one-factor model (chi-square and RMSEA). A unitary motor-free visual-perceptual factor was not found. CONCLUSION: The TVPS-R PQ should not be used as an overall performance summary score. Of the seven TVPS-R subscales, five can be used with confidence (visual discrimination, visual-spatial relationships, visual-sequential memory, visual figure ground, and visual-closure) whereas the visual memory and visual form constancy [corrected] subscales are not recommended.

A comparison of Canadian and Australian paediatric occupational therapists.

Paediatric occupational therapists were surveyed regarding their practices in Canada and Australia. Two hundred and eighty-nine Canadian occupational therapists and 330 Australian occupational therapists participated representing response rates of 28.9% and 55% respectively. The majority of respondents were female (98%), between 30 and 49 years of age (69%), had a bachelor's degree, worked on average 10.5 years in paediatrics and spent well over 50% of their work time in direct client care. The largest client diagnostic groups in both countries were those with developmental delays, learning disabilities and neurological disorders. Diagnostic groups were used as an organizing framework to portray theory, assessment and intervention use. Overall, the theoretical models cited most frequently in both countries were: Sensory Integration, Sensory Processing/Sensory Diet, Client-Centred Practice, and Occupational Performance Model. Australian therapists employed the Occupational Performance Model (Australia) for all groups, while it was rarely utilized in Canada. Common assessment tools in both Australia and Canada were the Peabody Developmental Motor Scales, Developmental Test of Visual Motor Integration, and the Bruininks-Oseretsky Test of Motor Proficiency. Intervention methods focused on: parental/care-giver education; activities of daily living/self-care skills training; client education; environmental modification; assistive devices; sensory integration techniques; sensory stimulation and sensory diet treatment methods; and neurodevelopmental techniques.

Integrated health human resource options: the impact on occupational therapy professional practice.

Healthcare systems in many countries have gone through numerous changes over the last two decades. Funding bodies and employers have tried to find cost-effective, innovative ways to deliver quality healthcare including methods to reduce labour expenses. Three approaches to cost-savings have been proposed for healthcare professionals: multiskilling, cross-training, and personnel substitution. The advantages and disadvantages associated with each approach are outlined. Issues related to professional practice roles are then reviewed and discussed. Implications for occupational therapy practice are presented and recommendations for the future are made.

Association between nurses' education about research and their research use.

Knowledge about research methods, skills for critical appraisal of research reports, and a positive attitude towards research have been identified as means to potentially overcome barriers to individual nurses' research utilization, and ultimately improve nursing practice. The objective of this study was to examine independent relationships between nurses' education about research and research use and their attitudes towards research, knowledge about research and research utilization. Research utilization and attitude towards research were measured using the Edmonton Research Orientation Scale. One hundred and seventy-five nurses working in a pediatric hospital responded to the survey. Higher levels of education were associated with both (1) positive attitudes towards research and (2) higher levels of self-reported research utilization. Whether or not nurses had university education, completing a course about research design or a course about how to read and use research was associated with positive attitudes towards research. Having completed a course about how to read and use research was not associated with self-reported research utilization. The association between having completed a course about research design and self-reported research utilization was not independent of the association between level of education and research utilization. The findings indicate that education about research may be one way to overcome negative attitudes towards research as a barrier to research utilization.

Translation of the Leisure Satisfaction Scale into French: a validation study.

Few standardized instruments are available for clients who speak languages other than English. The purpose of the study was to present and describe the process of translating an English standardized assessment into another language. Using the translation/validation methodologies described by Haccoun (1987) and Vallerand (1989), the Leisure Satisfaction Scale (LSS) was translated into French and then statistically validated. All correlations between both language versions of the LSS were found to be significant at the 0.01 level. Confirmatory factor analysis results were positive. Study findings indicate that the Haccoun (1987) and Vallerand (1989) methodologies provide clinicians with another option for ensuring culturally sensitive and relevant evaluations. Further research is needed to globally assess the measurement properties of the French version of this instrument.

Reliability and validity of the Leisure Satisfaction Scale (LSS--short form) and the Adolescent Leisure Interest Profile (ALIP).

This study aimed to evaluate the reliability and validity of the Leisure Satisfaction Scale (LSS short form) and the Adolescent Leisure Interest Profile (ALIP). The LSS and the ALIP are instruments that occupational therapists can use to evaluate the leisure activities that clients enjoy. Evaluation of leisure interest and participation will assist in creating goals for therapy to maximize a client's ability to participate in leisure activities. This study examined the test retest reliability and concurrent validity of the LSS and the ALIP using a sample of 37 adolescents between the ages of 13 and 17 with no known impairments. The assessments were administered individually or in small groups 7 to 17 days apart. Cronbach's alpha was used to determine the internal consistency. Pearson product moment correlations were calculated to examine the test retest reliability of the 60 subscales and the six question totals of the ALIP, as well as for the 6 subscales and total score of the LSS. Concurrent validity was evaluated between the 'How often?' question of the ALIP and the LSS (short form). Based on the study results, the ALIP and the LSS seem to have good test retest reliability levels when used with adolescents with no known physical or mental impairments. The concurrent validity between the two instruments was not supported, with many of the scores indicating only weak or no association to each of the subscales, suggesting that the assessments differ in some fundamental way. However, the evidence of some relationships between subscales may indicate some areas where the ALIP and the LSS are similar.

Use of the Edmonton Research Orientation Scale with nurses.

Improved understanding of the determinants of research utilization is fundamental to developing and testing strategies to increase research utilization. Inconsistent findings in this field of research about research utilization may be attributable, in part, to lack of development of measures. This research tested the internal consistency and construct validity of the Edmonton Research Orientation Scale (EROS) and its four subscales (Valuing Research, Research Involvement, Being on the Leading Edge, and Evidence-Based Practice), which are promising measures of research utilization and attitudes towards research. One hundred eighty-five registered nurses in a pediatric teaching hospital completed the EROS. Nurses who reported higher levels of education, better understanding of research topics or participation in quality management or research projects also reported higher levels on the EROS and EROS subscales. The Valuing Research and Evidence-Based Practice subscales were associated with having taken courses in research design and statistics. The findings suggest that the EROS and the Valuing Research and Evidence-Based Practice subscales may be used to measure nurses' attitudes towards research and research utilization.

Changing times: trials and tribulations of the move to Master's entry-level education in Canada.

BACKGROUND: Most health care professions are reviewing issues related to the changing nature of professional education and practice. Social work, physical therapy, speech-language pathology, audiology, and recently occupational therapy, have raised the entry-level training requirements to the graduate level to enhance formal education programs. PURPOSE AND SCOPE: In the past few years, this trend has generated considerable debate and discussion within the occupational therapy profession both in Canada and internationally. In November, 2001 the Canadian Association of Occupational Therapists (CAOT) announced that Canadian universities must convert to entry-level Master's programs by 2008 to receive re-accreditation (CAOT, 2002a). This paper describes the historical evolution of Canadian occupational therapy education, outlines several issues within occupational therapy that are impacting the move, and discusses benefits and challenges to Master's level training. PRACTICE IMPLICATIONS: Recommendations are presented for the development of Master's entry-level occupational therapy training programs in Canada.

A profile of canadian pediatric occupational therapy practice.

PURPOSE: This study established a current profile of Canadian pediatric occupational therapy practice in terms of theories/practice models, assessments, and interventions. METHOD: Respondents were 272 members of the Canadian Association of Occupational Therapists who indicated that pediatrics was their primary area of clinical practice. A purpose-designed survey was mailed to participants. RESULTS: The response rate was adequate at 27.2% (n = 272/1,000). The primary client groups seen by pediatric therapists were developmental delay, learning disability, neurology, and those requiring rehabilitation. Sensory Integration and Client-Centred Practice were the most frequently utilized theories/practice models. The most commonly used assessments were the Developmental Test of Visual Motor Integration, Peabody Developmental Motor Scales, Bruininks-Oseretsky Test of Motor Proficiency, and the Sensory Profile. The most frequently used intervention techniques with pediatric clients were the instruction of parents/caregivers and children; assistive devices, adaptive equipment, and technology; activities of daily living/self-care skills; and environmental modification/access/structuring/adaptation. CONCLUSIONS: Pediatric occupational therapists mainly used theories/ practice models that focused on three areas: Client-Centred practice, practice-oriented theories, and several theories/practice models based on occupation. Interventions focused on teaching, activities unique to occupational therapy, and on the functional needs of the client.

A comparison of paediatrics occupational therapy university program curricula in New Zealand, Australia, and Canada.

Comparisons were made of the paediatric content of professional entry-level occupational therapy university program curricula in Australia, New Zealand, and Canada using an ex post facto survey methodology. The findings indicated that in Australia/New Zealand, paediatrics made up 20% of the total curriculum, but only 13% in Canada. Canadian reference materials were utilized less often in Canadian universities than in Australia/New Zealand. Theories taught most often in Australia/New Zealand were: Sensory Integration, Neurodevelopmental Therapy, Client-Centered Practice, Playfulness, and the Model of Human Occupation. In Canada, the most frequent theories were: Piaget's Stages of Cognitive/Intellectual Development, Neurodevelopmental Therapy, Erikson's Eight Stages of Psychosocial Development and Sensory Integration. The most frequently taught paediatric assessment tools in both regions were the Bruininks-Oseretsky Test of Motor Proficiency and Miller Assessment for Preschoolers. Paediatric intervention methods taught to students in all three countries focused on activities of daily living/self-care, motor skills, perceptual and visual motor integration, and infant and child development.

Characteristics of the occupational therapy journal of research: the first twenty years.

As evidence-based practitioners, occupational therapists are required to keep abreast of the relevant professional literature, be able to understand and critique research, and to incorporate improvements into daily practice for the benefit of clients (Barber, 1990). The current study proposes to assist readers in this responsibility through a retrospective analysis of the Occupational Therapy Journal of Research (OTJR) between 1981 and 2000. A total of 452 manuscripts were published on a broad range of topics in the OTJR during this period, 75.4% of which were feature articles with a strong research focus. Author characteristics and collaboration, subject and specialty themes, and reference list citations are examined and implications discussed. As a primary research journal together with publications that have a clinical or practice orientation, the OTJR is an important reference source for evidence-based practice. It will be interesting to monitor how OTJR evolves as the primary occupational therapy research journal since changing its focus in 2002.

Clinical responsiveness of self-report functional assessment measures for children with juvenile idiopathic arthritis undergoing intraarticular corticosteroid injections.

OBJECTIVE: The Childhood Health Assessment Questionnaire (CHAQ), Juvenile Arthritis Functional Assessment Report (JAFAR), and Juvenile Arthritis Functional Status Index (JASI) are widely used functional measures for juvenile idiopathic arthritis (JIA) that differ in content, format, and completion time. We compared the responsiveness and child-parent agreement of the JAFAR, CHAQ, and JASI in a prospective, multicenter study. METHODS: Children and adolescents from 5 rheumatology centers were enrolled. Subjects were about to undergo therapy (intraarticular corticosteroid injections [IAS] and methotrexate or hip surgery (MTX/hip]) expected to produce a functional improvement. All subjects were studied before the intervention and at 6 weeks and 6 months posttreatment. At each study visit, the 3 measures were administered in randomized, balanced order to both parents and children. RESULTS: A total of 92 subjects (mean age 12.8 years) were enrolled in the study, 74 of which were in the IAS group. The responsiveness of all 3 measures was moderate to strong. The standardized response mean at 6 weeks for the IAS group on the JAFAR, CHAQ, and JASI was 0.41 (95% confidence interval [95% CI] 0.18, 0.64), 0.70 (95% CI 0.47, 0.93), and 0.36 (95% CI 0.13, 0.59), respectively. The CHAQ was somewhat more responsive to change at 6 weeks (IAS group: relative efficiency 0.34 [JAFAR], 0.27 [JASI]), but less responsive at 6 months (MTX/hip group: relative efficiency 5.1 [JAFAR], 3.9 [JASI]). All 3 questionnaires showed acceptable parent-child agreement, and overall, there were few differences between the 3 questionnaires. CONCLUSION: The functional outcome measures currently used for JIA are all adequately responsive for use in trials or in the clinic setting. The choice of which measure to use should therefore be based on the time available for completion, the intended clinical/research use, and the depth of content required.

Research utilization among pediatric health professionals.

The present study investigated research use and attitudes toward research among pediatric health professionals. All nurses and allied health professionals in a pediatric teaching hospital were surveyed using previously tested and published measures. Over half of the participants had some formal education in research but, for some participants, that education was many years ago. Most participants reported poor or very poor understanding of research design. Two variables were independently associated with a positive attitude towards research: (i) better understanding of how to conduct a literature search; and (ii) higher level of education. Five variables were independently associated with research use: better understanding of research design; having presented at a conference in the past two years; sense of calling to the profession; better understanding of how to conduct a literature search; and attending rounds. A small proportion of variance in both research use and a positive attitude towards research was explained by the independent predicator variables. Further research is required to identify characteristics of the workplace environment that support research use.

Barriers to paediatric nurses' research utilization.

BACKGROUND: A number of studies have investigated barriers to research utilization among nurses in various countries, and standardized scales have been validated to study this. Reported barriers have been categorized as individual, organizational and environmental, with organizational characteristics generally accounting for more variance. However, information about research utilization among paediatric nurses is lacking. AIM: The objective of the research reported here was to investigate barriers to research utilization and relationships between those barriers and participation in research, self-reported research utilization and education among paediatric nurses. DESIGN: A survey of all nurses in a paediatric teaching hospital; 176 nurses (33.3%) responded. Two standardized measures were used, the Barriers Scale and the Edmonton Research Orientation Scale. RESULTS: Lack of time to read research was the most frequently cited barrier to using research and administrators not allowing implementation was the least frequently cited. Characteristics of the communication and of the setting were more likely to be cited as barriers to research use than were characteristics of the nurse. Nurses who reported higher levels of actual research use were slightly less likely to see characteristics within themselves as barriers. Those who had taken a course about reading or using research were more likely to see the organization as a barrier. Barriers to research use were not associated with self-reported understanding of research. CONCLUSIONS: These results are congruent with previous findings that implementing research in practice is a complex process. They indicate that individual nurses' knowledge about research may not be as important as the process by which organizations implement research. However, the Barriers Scale measures general perceptions about barriers to research utilization and not nurses' specific experiences with barriers to implementing particular research.