Facilitating and barrier factors to the implementation of a transitional care program: a qualitative study of hospital coordinators in South Korea.

BACKGROUND: Transitional care is an integrated service to ensure coordination and continuity of patients' healthcare. Many models are being developed and implemented for this care. This study aims to identify the facilitators and obstacles of project performance through the experiences of the coordinator in charge of the Community Linkage Program for Discharge Patients (CLDP), a representative transitional care program in Korea. METHOD: Forty-one coordinators (nurses and social workers) from 21 hospitals were interviewed using a semi-structured questionnaire, and thematic analysis was performed. RESULT: Three themes were found as factors that facilitate or hinder CLDP: Formation and maintenance of cooperative relationships; Communication and information sharing system for patient care; and interaction among program, regional, and individual capabilities. These themes were similar regardless of the size of the hospitals. CONCLUSION: A well-implemented transitional care model requires a program to prevent duplication and form a cooperative relationship, common computing platform to share patient information between institutions, and institutional assistance to set long-term directions focused on patient needs and support coordinators' capabilities.

Development of Items for Transitional Care Service and Outcome Indicators of Discharged Patients for Improvement in Quality of Care.

BACKGROUND: In this study, with the aim of improving the quality of transitional care service for discharged patients, the Health Care Quality and Outcomes Indicators of the Organization for Economic Co-operation and Development and National Health Service Outcomes Framework of the UK were applied to derive service items for provision and develop evaluation indicators under categories of effectiveness, safety, and patient-centeredness. METHOD: A scoping review was conducted to derive core concepts and evidence materials/data for transitional care service. For the derived items of transitional care service and evaluation indicators, a three-round Delphi study was conducted with experts in the fields of healthcare/medicine/nursing/social welfare. RESULTS: First, as a result of the scoping review, components of transitional care service (assessment of need by period of transitional care service, multi-professional team, connection to community resources, etc.) and themes for outcome indicators (effectiveness, patient safety, patient-centeredness) were derived. Second, by classifying the items for assessment according to the hospitalization and transition period and conducting a Delphi study to derive service items for transitional care service, during the hospitalization period, presence/absence of a caregiver and need for a caregiver, activities of daily living, and necessity for home-based care services were identified as items of high priority. Regarding patient safety, risk of falls and fractures during hospitalization, and necessity for medication reconciliation were identified as the items of high importance. For the transition period, provision of education regarding adequate responses and handling of emergencies, provision of information and guidance on application of services for basic livelihood security program beneficiaries, and education for patient skills in self-management of health were derived as items of high priority. Third, for the derivation of outcome indicators for transitional care service, in the "effectiveness" category, the experts rated a reduction in the 30-day readmission rate as an item of high importance along with a decrease in emergency department visits, reduction in preventable admissions as indicators of high relevance. In terms of "patient safety," a decrease in drug adverse reactions, and reduction in the incidence of falls and pressure ulcers were identified as indicators of high priority. Finally, for the category of "patient-centeredness," patient experience assessment, level of service satisfaction reported by patients and their caregivers, and reducing burden on caregivers were identified as indicators of high priority. CONCLUSION: This study suggest practical implications for the service with high relevance and necessity for transitional period. It also presented outcome indicators of transitional care service to contribute toward an improvement in the quality of care.

Effects of Client-Centered Occupational Therapy on Behavioral Psychological Symptoms, Social Interaction, Occupational Performance, Quality of Life, and Caregiver Burden among the Individuals with Dementia.

This study aimed to verify the effects of client-centered occupational therapy on individuals with dementia. Twenty participants were randomly assigned to an experimental group (client-centered occupational therapy) and a control group (general occupational therapy). A pretest, post-test, and follow-up tests were used to compare the effects of the intervention. The experimental group had significant changes in all variables, and the control group showed significant differences in verbal social interaction, quality of life, and burden of caregivers (p < 0.05). As a result of repeated measurement variance analysis, it was found that there was a significant effect within the group except for the NPI-Q distress items (p < 0.05), but the effect was not verified in all areas between the groups. Client-centered customized occupational therapy can be more effective than general occupational therapy in problem behavior, social interaction, quality of life, caregiver burden, and occupational performance of individuals with dementia.

Effects on the survival rates, hematological parameters, and neurotransmitters in olive flounders, Paralichthys olivaceus, reared in bio-floc and seawater by Streptococcus iniae challenge.

Bacterial infections cause huge losses to aquaculture globally, and increased antibiotic resistance means that alternative methods of reducing mortality from bacterial diseases are required. We compared the resistance of Juvenile olive flounders, Paralichthys olivaceus, to Streptococcus iniae between those reared in biofloc and seawater conditions for ten months. Experimental fish were challenged with S. iniae at concentrations of 0, 3.36 × 106, 3.36 × 107, 3.36 × 108, and 3.36 × 109 colony forming units (CFU)/g fish for 96 h to evaluate the difference in S. iniae susceptibility of flounders reared in biofloc and seawater. The 96 h lethal concentration 50% (LC50) of fish injected with S. iniae was 2.41 × 109 CFU/g fish in biofloc and 1.51 × 108 CFU/g fish in seawater. Hematological parameters such as hemoglobin and hematocrit significantly decreased when fish were challenged by S. iniae. Plasma components such as calcium, glucose, cholesterol, total protein, GOT, GPT, and ALP were significantly altered by S. iniae infection and acetylcholinesterase activity was significantly inhibited. These results indicate that S. iniae infection affects the survival rates, hematological parameters, and neurotransmitter levels of flounders reared in biofloc and seawater, and that S. iniae susceptibility was higher in flounders reared in seawater than those reared in biofloc.

Effects on hematological parameters, antioxidant and immune responses, AChE, and stress indicators of olive flounders, Paralichthys olivaceus, raised in bio-floc and seawater challenged by Edwardsiella tarda.

Studies on the resistance of fish raised in bio-floc systems against bacterial infection are limited. We aimed to evaluate the changes in hematological parameters, antioxidant and immune responses, stress indicators, and acetylcholinesterase (AChE) in olive flounder, Paralichthys olivaceus, raised in bio-floc and seawater for 10 months and, then, infected with Edwardsiella tarda at concentrations of 0 (control), 6.61 × 104, 6.61 × 105, 6.61 × 106, and 6.61 × 107 CFU/g fish for 7 days. The lethal concentration 50% was 4.32 × 107 in bio-floc and 3.11 × 106 in seawater. Hematological parameters were significantly decreased by E. tarda challenge, and plasma components were significantly changed. The superoxide dismutase, catalase, and glutathione-S-transferase activities, as antioxidant responses, were significantly increased after infection, whereas the reduced glutathione level was significantly decreased. The lysozyme activity was significantly increased and the AChE level was significantly decreased after infection. Cortisol and HSP 70, as stress indicators, were also significantly increased. The results indicate that E. tarda infection affected various physiological factors in P. olivaceus. Additionally, P. olivaceus raised in seawater were more susceptible to E. tarda infection than those raised in bio-floc.

Toxic effects of waterborne nitrite exposure on antioxidant responses, acetylcholinesterase inhibition, and immune responses in olive flounders, Paralichthys olivaceus, reared in bio-floc and seawater.

Paralichthys olivaceus (mean weight, 280.1 ± 10.5 g; mean length, 28.37 ± 2.3 cm) was reared in bio-floc and seawater for 6 months to determine the toxic effects of waterborne nitrite exposure (0, 25, 50, 100, and 200 mg/L) for 1 week, compared to those observed with bio-floc and seawater only. The effects on antioxidant activity, immune responses, and acetylcholinesterase activity were measured. Following nitrite exposure, superoxide dismutase activity in the liver and gills was significantly elevated and catalase activity was significantly increased, except for in the gills of P. olivaceus reared in bio-floc. Further, glutathione S-transferase activity was significantly elevated in the liver and gills, and glutathione was significantly lower. Meanwhile, acetylcholinesterase activity in the liver and gills was significantly inhibited and plasma lysozyme activity and immunoglobulin M were considerably elevated.

Hematological parameters and antioxidant responses in olive flounder Paralichthys olivaceus in biofloc depend on water temperature.

The purpose of this study was to ascertain the optimum water temperature for breeding juvenile Paralichthys olivaceus in biofloc. Hemoglobin and hematocrit were significantly decreased when the temperature was higher than 28 °C. Plasma calcium, glucose, cholesterol, glutamic-oxaloacetic transaminase, and glutamic pyruvic transaminase were significantly elevated at high temperatures, whereas total protein was substantially lower. Superoxide dismutase and glutathione-S-transferase activities in the liver and gills were significantly elevated at high temperatures, whereas glutathione was significantly lower. This indicates that temperatures greater than 26 °C induced hematological changes and oxidative stress in the juvenile P. olivaceus in biofloc. We ascribe these changes to thermal stress.

A Hybrid FPGA-Based System for EEG- and EMG-Based Online Movement Prediction.

A current trend in the development of assistive devices for rehabilitation, for example exoskeletons or active orthoses, is to utilize physiological data to enhance their functionality and usability, for example by predicting the patient's upcoming movements using electroencephalography (EEG) or electromyography (EMG). However, these modalities have different temporal properties and classification accuracies, which results in specific advantages and disadvantages. To use physiological data analysis in rehabilitation devices, the processing should be performed in real-time, guarantee close to natural movement onset support, provide high mobility, and should be performed by miniaturized systems that can be embedded into the rehabilitation device. We present a novel Field Programmable Gate Array (FPGA) -based system for real-time movement prediction using physiological data. Its parallel processing capabilities allows the combination of movement predictions based on EEG and EMG and additionally a P300 detection, which is likely evoked by instructions of the therapist. The system is evaluated in an offline and an online study with twelve healthy subjects in total. We show that it provides a high computational performance and significantly lower power consumption in comparison to a standard PC. Furthermore, despite the usage of fixed-point computations, the proposed system achieves a classification accuracy similar to systems with double precision floating-point precision.

The planar cell polarity effector protein Wdpcp (Fritz) controls epithelial cell cortex dynamics via septins and actomyosin.

Planar cell polarity (PCP) signaling controls polarized behaviors in diverse tissues, including the collective cell movements of gastrulation and the planar polarized beating of motile cilia. A major question in PCP signaling concerns the mechanisms linking this signaling cascade with more general cytoskeletal elements to drive polarized behavior. Previously, we reported that the PCP effector protein Wdpcp (formerly known as Fritz) interacts with septins and is critical for collective cell migration and cilia formation. Here, we report that Wdpcp is broadly involved in maintaining cortical tension in epithelial cells. In vivo 3D time-lapse imaging revealed that Wdpcp is necessary for basolateral plasma membrane stability in epithelial tissues, and we further show that Wdpcp controls cortical septin localization to maintain cortical rigidity in mucociliary epithelial cells. Finally, we show that Wdpcp acts via actomyosin to maintain balanced cortical tension in the epithelium. These data suggest that, in addition to its role in controlling plasma membrane dynamics in collective mesenchymal cell movements, Wdpcp is also essential for normal cell cortex stability during epithelial homeostasis.

Comparison of immune response of Pacific white shrimp, Litopenaeus vannamei, after multiple and single infections with WSSV and Vibrio anguillarum.

Our previous study demonstrated that Pacific white shrimp (Litopenaeus vannamei) infected by multiple pathogens showed higher mortality and death occurred more quickly than those infected by a single pathogen (Jang et al., 2014). For better understanding the defense mechanism against white spot syndrome virus (WSSV) and Vibrio anguillarum, immune responses of shrimp were evaluated in this study. The mRNA expression levels of five immune-related genes were analyzed by quantitative reverse real-time PCR, which included proPO-activating enzyme 1 (PPAE1), PPAE2, proPO activating factor (PPAF), masquerade-like serine proteinase (Mas) and ras-related nuclear gene (Ran). Results demonstrated that the transcription was suppressed more intensively in the multiple infection group than those in single infection groups. The transcriptional suppression was directly related to the higher mortality. The hypoimmunity could benefit pathogen invasion, replication and release of toxin in vivo. Results in this study will help to understand immune defense mechanism after shrimp were infected by multiple pathogens in aquaculture.

Distinct regulation patterns of the two prophenoloxidase activating enzymes corresponding to bacteria challenge and their compensatory over expression feature in white shrimp (Litopenaeus vannamei).

Prophenoloxidase activating enzyme 2 (PPAE2), which belongs to the second PPAE family of prawns, was isolated from white shrimp Litopenaeus vannamei. The currently identified lvPPAE2 and lvPPAE1 from our former report were taken as model candidates to analyze the relationship of the two shrimp PPAE families as well as the regulation mechanism of shrimp PPAEs. The tissue expression of lvPPAE2 was more ubiquitous than lvPPAE1. The mRNA abundance of lvPPAE2 was about 10 percent of lvPPAE1 in co-existed tissues. When challenged with Vibrio harveyi. LvPPAE2 showed a distinct transcriptional regulation pattern compared to lvPPAE1. Silence of lvPPAE2 significantly increased shrimp's susceptibility to V. harveyi, suggesting the lvPPAE2 plays essential role in shrimp host defense. A novel PPAE specific compensatory over expression feature was found in the two lvPPAEs. Single gene specific silence of lvPPAE1 and lvPPAE2 resulted in a significant difference in reduction of hemolymph PO activity. Double silence of the two lvPPAEs failed to cause a further reduction on PO activity or shrimp mortality to bacteria, despite that double silence sufficiently suppressed both of the two lvPPAEs. Our findings suggest both lvPPAEs contribute to shrimp melanization cascade and host defense against bacteria. Distinct regulation pattern corresponding to the same pathogen invasion suggests the two lvPPAEs are actually under different regulation ways. A novel PPAE specific compensatory over expression mechanism found in our study offered us a clue in understanding the robustness of shrimp innate immunity and network of crustacean proPO activating system.

Avoidance of specific calibration sessions in motor intention recognition for exoskeleton-supported rehabilitation through transfer learning on EEG data.

Exoskeleton-based support for patients requires the learning of individual machine-learning models to recognize movement intentions of patients based on the electroencephalogram (EEG). A major issue in EEG-based movement intention recognition is the long calibration time required to train a model. In this paper, we propose a transfer learning approach that eliminates the need for a calibration session. This approach is validated on healthy subjects in this study. We will use the proposed approach in our future rehabilitation application, where the movement intention of the affected arm of a patient can be inferred from the EEG data recorded during bilateral arm movements enabled by the exoskeleton mirroring arm movements from the unaffected to the affected arm. For the initial evaluation, we compared two trained models for predicting unilateral and bilateral movement intentions without applying a classifier transfer. For the main evaluation, we predicted unilateral movement intentions without a calibration session by transferring the classifier trained on data from bilateral movement intentions. Our results showed that the classification performance for the transfer case was comparable to that in the non-transfer case, even with only 4 or 8 EEG channels. Our results contribute to robotic rehabilitation by eliminating the need for a calibration session, since EEG data for training is recorded during the rehabilitation session, and only a small number of EEG channels are required for model training.

Effect of Hospital-to-Home Transitional Care for COPD on Patient-Centered Outcomes.

BACKGROUND: Appropriate hospital-to-home transitional care has been recognized for its positive impact on health care usage and health outcomes in patients with COPD. However, there is limited research assessing its effects on patient-centered outcomes, focusing on patient symptoms and experiences. METHODS: This single-blind randomized controlled trial included subjects diagnosed with COPD at one of 2 university hospitals in South Korea. The study included 179 subjects (transitional care group [transitional care], 87; usual care group [usual care], 92). The transitional care received transitional care comprising post-discharge care planning, personalized education, breathing exercises, telephone counseling, home visits, and referral to social services. We analyzed the effects of these interventions by comparing breathing symptoms and various patient-centered outcomes between the 2 groups. RESULTS: The Modified Medical Research Council scores (mean [SD], transitional care 1.3 [1.06], usual care 1.82 [1.1], P = .002) and COPD Assessment Test scores (transitional care 6.32 [5.5], usual care 9.43 [7.16], P = .001) in the intervention group demonstrated more significant improvement than did those in the usual care. Following intervention, the subjects exhibited enhanced awareness of their disease, an increased frequency of inhaler use (transitional care 49.69 [1.67], usual care 46.86 [7.92], P = .002), and lower depression and anxiety scores. Additionally, the transitional care outperformed the usual care in the domain of subject experience during hospitalization (transitional care 39.34 [6.14], usual care 37.5 [5.61], P = .036), preparedness before discharge (transitional care 34.54 [4.96], usual care 32.3 [5.09], P = .003), and post-discharge management (transitional care 34.72 [4.36], usual care 30.29 [4.26], P = .003). CONCLUSIONS: Evidence-based transitional care services can exert positive effects on patient-centered indices. Our findings can be used as evidence of the need to establish patient-centered transitional care as a form of universal care for patients with COPD.

Morphometric changes in the cultured starry flounder, Platichthys stellatus, in open marine ranching areas.

Hatchery seeds released into open coasts for wildstock enhancement are often a biological pollutant and affect the recipient ecosystem integrity. We studied morphological changes in two hatchery populations of the starry flounder Platichthys stellatus; one released into the open coast from the hatchery (released population) and the other kept in the hatchery (captive population). The released population differed significantly from the captive population 3-36 months after release from the hatchery. Two-way ANOVA comparison revealed that 11 of 15 starry flounders differed significantly in morphological measurements, 10 of 15 differed in pigmentation, and 5 of 15 differed in morphometric ratios between the two populations. Pigmentation on the blind side (a representative sign of captive flounders) also differed between the two populations with an occurrence rate of 22.7% for the former and 39.5% for the latter groups. The released population was more similar to wild populations than to captive populations in terms of morphology; namely, longer and broader heads, a narrower body shape, longer fins, and a shorter and narrower peduncle.

Detection of tactile-based error-related potentials (ErrPs) in human-robot interaction.

Robot learning based on implicitly extracted error detections (e.g., EEG-based error detections) has been well-investigated in human-robot interaction (HRI). In particular, the use of error-related potential (ErrP) evoked when recognizing errors is advantageous for robot learning when evaluation criteria cannot be explicitly defined, e.g., due to the complex behavior of robots. In most studies, erroneous behavior of robots were recognized visually. In some studies, visuo-tactile stimuli were used to evoke ErrPs or a tactile cue was used to indicate upcoming errors. To our knowledge, there are no studies in which ErrPs are evoked when recognizing errors only via the tactile channel. Hence, we investigated ErrPs evoked by tactile recognition of errors during HRI. In our scenario, subjects recognized errors caused by incorrect behavior of an orthosis during the execution of arm movements tactilely. EEG data from eight subjects was recorded. Subjects were asked to give a motor response to ensure error detection. Latency between the occurrence of errors and the response to errors was expected to be short. We assumed that the motor related brain activity is timely correlated with the ErrP and might be used from the classifier. To better interpret and test our results, we therefore tested ErrP detections in two additional scenarios, i.e., without motor response and with delayed motor response. In addition, we transferred three scenarios (motor response, no motor response, delayed motor response). Response times to error was short. However, high ErrP-classification performance was found for all subjects in case of motor response and no motor response condition. Further, ErrP classification performance was reduced for the transfer between motor response and delayed motor response, but not for the transfer between motor response and no motor response. We have shown that tactilely induced errors can be detected with high accuracy from brain activity. Our preliminary results suggest that also in tactile ErrPs the brain response is clear enough such that motor response is not relevant for classification. However, in future work, we will more systematically investigate tactile-based ErrP classification.

Investigating the effectiveness of Socially Assistive Robot on Depression and Cognitive Functions of Community Dwelling Older Adults with Cognitive Impairments.

We evaluated a socially assistive robot (SAR) named Hyodol during a six-week intervention. This study enrolled 69 older adults with cognitive decline. To screen the eligibility, we have used the following three criteria, namely Korean-Mini-Mental Status Exam score ≤ 26). Clinical Dementia Rating 0.5-2), and Diagnostics and Statistical Manual V. Participants were divided into three groups based on their cognitive function (i.e. very mild cognitive impairment (vMCI), mild cognitive impairment (MCI), and moderate cognitive impairment (MOCI). The groups were instructed to use Hyodol at home for a six-week period. Baseline and post-intervention surveys were performed after six weeks to examine the changes in perceived health, depression, and cognitive function. The vMCI group showed a reduction in the depression score after the intervention (t = -2.447, p = 0.040), in comparison to their peers in the control group. Further, the MCI group showed an improvement in the cognitive function score after the intervention (t = 2.690, p = 0.021). No significant improvement was found among MOCI participants who used the SARs. The significance of this study was to examine whether participants with different levels of cognitive functioning would diverge after a period of intervention using the Hyodol SARs. Moreover, it presented preliminary data for services and policies for home care treatment targeted to cognitive decline in older adults.

Study Protocol for a Hospital-to-Home Transitional Care for Older Adults Hospitalized with Chronic Obstructive Pulmonary Disease in South Korea: A Randomized Controlled Trial.

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition characterized by persistent inflammation in the airways, resulting in narrowing and obstruction of the air passages. The development of COPD is primarily attributed to long-term exposure to irritants, such as cigarette smoke and environmental pollutants. Among individuals hospitalized for exacerbations of COPD, approximately one in five is readmitted within 30 days of discharge or encounters immediate post-discharge complications, highlighting a lack of adequate preparedness for self-management. To address this inadequate preparedness, transitional care services (TCS) have emerged as a promising approach. Therefore, this study primarily aims to present a detailed protocol for a multi-site, single-blind, randomized, controlled trial (RCT) aimed at enhancing self-management competency and overall quality of life for patients with COPD through the provision of TCS, facilitated by a proficient Clinical Research Coordinator. The RCT intervention commenced in September 2022 and is set to conclude in December 2024, with a total of 362 COPD patients anticipated to be enrolled in the study. The intervention program encompasses various components, including an initial assessment during hospitalization, comprehensive self-management education, facilitation of social welfare connections, post-discharge home visits, and regular telephone monitoring. Furthermore, follow-up evaluations are conducted at both one month and three months after discharge to assess the effectiveness of the intervention in terms of preventing re-hospitalization, reducing acute exacerbations, and enhancing disease awareness among participants. The results of this study are expected to provide a basis for the development of TCS fee payment policies for future health insurance.

Exploring bacterioplankton communities and their temporal dynamics in the rearing water of a biofloc-based shrimp (Litopenaeus vannamei) aquaculture system.

Biofloc technology (BFT) has recently gained considerable attention as a sustainable method in shrimp aquaculture. In a successful BFT system, microbial communities are considered a crucial component in their ability to both improve water quality and control microbial pathogens. Yet, bacterioplankton diversity in rearing water and how bacterioplankton community composition changes with shrimp growth are rarely documented. In this study, the Pacific white shrimp, Litopenaeus vannamei was cultivated in a greenhouse-enclosed BFT system. Rearing water samples were collected on a weekly basis for 5 months (152 days) and water quality variables such as physicochemical parameters and inorganic nutrients were monitored. In parallel, 16S rRNA gene pyrosequencing was employed to investigate the temporal patterns of rearing-water microbiota. The productivity, survival rate, and feed conversion ratio were 3.2-4.4 kg/m3, 74%-89%, and 1.2-1.3, respectively, representing successful super-intensive cultures. The metataxonomic results indicated a highly dynamic bacterioplankton community, with two major shifts over the culture. Members of the phylum Planctomycetes dominated in rearing water during the early stages, while Actinobacteria dominated during the middle stages, and Chloroflexi and TM7 dominated during the late stages of culture. The bacterioplankton community fluctuated more in the beginning but stabilized as the culture progressed. Intriguingly, we observed that certain bacterioplankton groups dominated in a culture-stage-specific manner; these groups include Rhodobacteraceae, Flavobacteriaceae, Actinobacteria, and Chloroflexi, which either contribute to water quality regulation or possess probiotic potential. Altogether, our results indicate that an operationally successful BFT-based aquaculture system favors the growth and dynamics of specific microbial communities in rearing water. Our study expands the scientific understanding of the practical utilization of microbes in sustainable aquaculture. A thorough understanding of rearing-water microbiota and factors influencing their dynamics will help to establish effective management strategies.

Effects of assistive technology-based occupational therapy on community-dwelling people recovering from stroke.

PURPOSE: The purpose of this study was to investigate the effect of assistive technology-based occupational therapy on occupational performance, satisfaction, and psychosocial impacts of community-dwelling people recovering from stroke. METHODS: A total of eleven community-dwelling people recovering from stroke participated in an occupational therapy intervention based on the core concepts of the Human Activity Assistive Technology (HAAT) model. The intervention involved the adoption of assistive technology devices (ATDs) to perform individual goal activities in the daily lives of people recovering from stroke. The intervention was conducted weekly as a 30-min session for a total of 4 weeks, in the home where each participant actually resided. RESULTS: All participants in the intervention showed statistically significant improvements in occupational performance, satisfaction, and goal attainment level with regard to the individually meaningful activities, between pretest, posttest, and follow-up. User satisfaction with the ATDs and associated services was generally 'satisfactory,' and the mean score significantly increased from post-intervention to follow-up. The psychosocial impact of assistive technologies significantly improved from post-intervention to follow-up evaluation. CONCLUSION: Interventions involving concepts, processes, and strategies based on the HAAT model should be continuously performed to select and adopt appropriate interventions involving assistive technologies.

An exploratory study on the role of occupational therapists in home-based rehabilitation team in South Korea.

Introduction: Cooperation among rehabilitation team members is essential in the home-based rehabilitation setting. Q-methodology that can quantitatively analyze the subjectivity of members of the rehabilitation team was used to explore the role of occupational therapists (OTs) in home-based rehabilitation. Methods: The Q-methodology process was implemented in five steps: Step 1 - Representative statements about the role of OTs were collected through in-depth interviews, open questionnaires, and literature reviews (Q-sample); Step 2 - A total of 34 rehabilitation team members (physical therapists, OTs, social workers, nutritionists) were recruited (P-sample); Step 3 - The statements were classified according to their subjective perspective (Q-sort); Step 4 - Factor analysis was performed based on the correlation among the responses from the participants (Q-factor analysis); Step 5 - The awareness factor for roles was interpreted (Interpretation of awareness factors). Results: The roles of OTs perceived by members of the home-based rehabilitation team were formed into five factors (A) Adaptation within home environments; (B) Professional development; (C) Reliable service execution; (D) Client needs resolution; and (E) Focus on activity participation. In all factors, perspectives on the role of OTs in helping clients participate in their roles and activities at home were included. These factors included issues and directions addressed in prior literature on the development of occupational therapy. Conclusions: In home-based rehabilitation, OTs must play a professional role in ensuring clients live fully at home, and cooperate with team members for an effective rehabilitation approach.