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This Eleanor Clarke Slagle lecture describes the author's work with marginalized populations, including homeless adults with mental illness, premature aging conditions, and poor literacy; women who became homeless as a result of domestic violence; children in impoverished, urban school systems reading below grade level; and adults with severe and chronic mental illness that impeded their ability to secure employment, housing, and independent community living. The author illustrates how and why occupational therapy practitioners should become part of the primary care team that evaluates the impact of multiple disorders on marginalized populations' daily life activities, provides services to optimize community participation, and provides environmental modifications to enhance safety and function.
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Violência Doméstica , Pessoas Mal Alojadas , Transtornos Mentais , Terapia Ocupacional , Adulto , Criança , Feminino , Habitação , HumanosRESUMO
The purpose of this paper was to perform a scoping review examining the occupational therapy peer-reviewed literature regarding the LGBTQIA+ community to (a) determine what types of scholarship have been generated and (b) whether the association between LGBTQIA+ self-identification and homelessness has been identified and addressed in occupational therapy practice. A database search of seven peer-reviewed, health care publication indexes, with 19 key search terms was performed. The database search targeted articles published prior to January 2020. Fifty-three articles were identified within the occupational therapy literature and addressing the LGBTQIA+ community. The majority of this literature (n = 40) was exploratory studies through which researchers sought to better understand the unique needs of subgroups within the LGBTQIA+ community. Only three articles addressed the link between LGBTQIA+ self-identification and homelessness with no articles that addressed evaluation and intervention of the factors predisposing this population to homelessness. As occupational therapists have a unique skill set that could be used to help LGBTQIA+ community members transition from and remain free from homelessness, occupational therapy researchers must develop and assess interventions that target these factors. Occupational therapy educators should develop and assess curricular programming to heighten student comfort and preparedness in service delivery to this community.
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Pessoas Mal Alojadas , Terapia Ocupacional , Papel Profissional , Minorias Sexuais e de Gênero , HumanosRESUMO
IMPORTANCE: Women with attention deficit hyperactivity disorder (ADHD) and ADHD symptoms may experience difficulty carrying out desired life roles and activities. OBJECTIVE: To determine whether a 7-wk tailored occupation-based intervention can reduce perceived stress and ADHD symptoms and enhance perceived performance of and satisfaction with daily roles and activities among women with ADHD. DESIGN: Randomization to intervention (n = 11) and control (n = 12) groups. SETTING: Home and community. PARTICIPANTS: Twenty-three participants ages 20-55 yr, English speaking, and with a self-reported diagnosis of ADHD. INTERVENTION: The intervention was administered for 7 wk in individual 1-hr sessions and addressed routine establishment, organization, time management, stress management, and sensory regulation in the home and community. OUTCOMES AND MEASURES: Adult Attention Deficit Hyperactivity Disorder Self-Report Scale, Perceived Stress Scale, and Canadian Occupational Performance Measure. RESULTS: At 1-wk postintervention, statistically significant differences were found between intervention and control groups in perceived stress (Z = -3.838, p < .000, d = -2.66), ADHD symptoms (Z = -3.605, p < .000, d = -2.17), and COPM Performance (Z = -4.074, p < .000, d = 3.04) and Satisfaction change scores (Z = -3.759, p < .000, d = 2.82). CONCLUSION AND RELEVANCE: A 7-wk tailored intervention reduced perceived stress and ADHD symptoms and enhanced perceived performance of and satisfaction with desired occupational roles and activities in a sample of women with ADHD. Further research is warranted to determine whether the intervention can be useful to women with ADHD beyond the present sample. WHAT THIS ARTICLE ADDS: This intervention may offer an effective nonpharmacological option for women with ADHD symptoms.
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Transtorno do Deficit de Atenção com Hiperatividade , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Canadá , Feminino , Humanos , Pessoa de Meia-Idade , Projetos de Pesquisa , Autorrelato/estatística & dados numéricos , Adulto JovemRESUMO
A bibliometric analysis of high impact and highly cited peer-reviewed literature published between 1992 and 2016 by Canadian occupational therapy authors that were included in the Science Citation Index-Expanded (SCI-E) or Social Sciences Citation Index (SSCI) was completed. To complete the analysis, journal article titles, abstracts, author details, and keywords were searched. A second-filter identified articles where the first or corresponding author had a Canadian affiliation and occupational therapy qualification. The total number of times an article was cited since its initial publication and during 2016 in Web of Science Core Collection was recorded. A total of 919 retrieved articles met the inclusion criteria with 18 articles having 5 or more citations during 2016 alone and another 34 articles having 50 or more citations since their initial publication date. The top three journals where high impact and highly-cited articles were published were Archives of Physical Medicine and Rehabilitation, Disability and Rehabilitation, and American Journal of Occupational Therapy. The three institutions that generated the largest number of high impact and highly cited articles were McGill University, University of Toronto, and University of British Columbia. Therefore, as of 2016, Canadian occupational therapy authors published 18 high impact and 34 highly cited articles.
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Bibliometria , Terapia Ocupacional , Revisão da Pesquisa por Pares , Publicações Periódicas como Assunto , CanadáRESUMO
The objective of this study was to determine the internal validity and separation reliability of the Inventory of Reading Occupations - Adult (IRO-Adult), an assessment of functional literacy participation for adults. Participants included 69 adults with typical reading abilities and difficulties with reading. The fit of the IRO-Adult items was analyzed with the Rasch model of unidimensionality using goodness-of-fit analysis and analysis of standardized residuals. Also analyzed was the tool's ability to reliably separate distinct levels of reading participation and the optimal functioning of its rating scales. The IRO-Adult items fit the Rasch model of unidimensionality. Three test items can be further refined to strengthen internal validity. Items are able to reliably detect multiple levels of reading participation and change in functional literacy participation over time. Several categories in the tool's rating scale can be combined for better clarity and to optimize rating scale functioning. The study provides preliminary evidence of validity and reliability of the IRO-Adult as a useful tool to assess functional literacy participation of adults. Further studies on other psychometric properties and clinical utility are warranted.
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Alfabetização , Terapia Ocupacional , Leitura , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: Homelessness prematurely ages people. A large subgroup of formerly homeless adults between ages 40 and 64 yr have health conditions similar to or worse than people categorized as elderly. Little is known about the impact of this group's chronic health conditions on their ability to safely function in supportive housing. METHOD: Home safety visits were carried out with 25 formerly homeless adults, ages 40-64 yr, now residing in supportive housing. RESULTS: Participants had physical, cognitive, and mental health problems that significantly interfered with their ability to perform daily life skills, safely function in an apartment, and manage chronic health conditions. Home safety hazards included cluttered walking paths, the presence of steps, and the lack of grab bars and nonskid flooring. CONCLUSION: The homeless population would benefit from aging specialists, such as occupational therapists, who could help people to maintain and function more safely in their homes. Without such services, this population may be at risk for home safety events leading to hospitalization and mortality.
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Acidentes por Quedas/prevenção & controle , Envelhecimento/fisiologia , Pessoas Mal Alojadas/psicologia , Transtornos Mentais/reabilitação , Adulto , Envelhecimento/psicologia , Habitação , Humanos , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Bibliometrics refers to the collection and measurement of publishing and citation data configurations with the goal of quantifying the influence of scholarly activities. Advantages of bibliometrics include the generation of quantitative indicators of impact, productivity, quality and collaboration. Those parties who benefit from the results of bibliometric analysis include researchers, educators, journal publishers, employers and research funding bodies. METHODS: A bibliometric analysis was completed of peer-reviewed literature from 1991 to 2015, written by Australian occupational therapists (who were able to be identified as such), and indexed in the Science Citation Index-Expanded (SCI-Expanded) or the Social Sciences Citation Index (SSCI) databases. "Occupational therapy" and "occupational therapist(s)" were used as keywords to search journal articles' publication title, abstract, author details, keywords and KeyWord Plus. RESULTS: Between 1991 and 2015, 752 peer-reviewed journal articles were published by Australian occupational therapy authors. On average, those articles had 3.7 authors, 35 references, and were nine pages in length. The top four journals in which Australian occupational therapists published were Australian Occupational Therapy Journal, British Journal of Occupational Therapy, American Journal of Occupational Therapy, and Physical and Occupational Therapy in Paediatrics. The four Australian institutions that generated the largest number of occupational therapy articles were the University of Queensland, University of Sydney, La Trobe University, and Monash University. The top four countries with whom Australian authors collaborated in manuscript writing were the United Kingdom, United States, Canada and Sweden. CONCLUSION: The volume of occupational therapy peer-reviewed literature has grown over the last two decades. Australian authors have and continue to make significant contributions to the occupational therapy body of knowledge nationally and internationally.
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Bibliometria , Terapia Ocupacional , Publicações Periódicas como Assunto/estatística & dados numéricos , Austrália , Pesquisa sobre Serviços de Saúde/estatística & dados numéricos , Humanos , Internacionalidade , Fator de Impacto de RevistasRESUMO
OBJECTIVE: A bibliometric analysis was completed of highly cited occupational therapy literature and authors published from 1991 to 2014 and accessible in the Science Citation Index Expanded (SCI-Expanded) and Social Sciences Citation Index (SSCI) databases. METHOD: Data were obtained from the SCI-Expanded and SSCI. Articles referenced >100 times were categorized as highly cited articles (HCA). RESULTS: Of 6,486 articles found, 31 were categorized as HCA. The American Journal of Occupational Therapy published the largest number of HCA (n = 8; 26%). The 31 HCA were distributed across seven countries: United States (20 articles), Canada (3), United Kingdom (3), Australia (2), the Netherlands (1), New Zealand (1), and Sweden (1). The three authors with the highest Y-index were S. J. Page, F. Clark, and W. Dunn. CONCLUSION: A latency period of 4 to 5 yr post-publication appears to be needed for a journal article to gain citations.
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A bibliometric analysis was completed of peer-reviewed literature from 1991-2015, written by American occupational therapists, to examine US high impact scholarship with "occupational therapy" and "occupational therapist(s)" used as keywords to search journal articles' publication title, abstract, author details, and keywords. Results included 1,889 journal articles from 1991-2015 published by American occupational therapists as first or corresponding author. Sixty-nine articles attained a TotalCitation2015 ≥ 50 and 151 attained a Citation2015 ≥ 5 indicating that they were the most highly cited literature produced in this period. Although the majority (58%) of this literature was published in occupational therapy-specific journals, 41% was published in interdisciplinary journals. Results illustrate that the volume of highly cited American occupational therapy peer-reviewed literature has grown over the last two decades. There is need for the profession to strategize methods to enhance the publication metrics of occupational therapy-specific journals to reduce the loss of high quality publications to external periodicals.
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Bibliometria , Terapia Ocupacional , Editoração , Autoria , Humanos , Fator de Impacto de Revistas , Terapeutas Ocupacionais , Publicações Periódicas como Assunto , Estados UnidosRESUMO
The purpose of this study was to determine if a housing transition program was feasible and acceptable to homeless clients with mental illness and substance use histories. Ten male residents of a homeless shelter participated in the 3-week housing intervention. The intervention used a DVD format with instructional videos, graphics, and opportunities for hands-on practice of functional skills in a simulated apartment environment. Outcome measures included goal attainment scale scores (GAS), satisfaction surveys, and case manager reports. Six of the 10 participants completed the program and achieved GAS scores at a greater level than expected at baseline (T > 50). Participants reported the intervention to be engaging and enhanced their knowledge of the housing transition process. The intervention appears to have assisted the participants in the attainment of housing skills and warrants further study.
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Comportamento do Consumidor , Educação não Profissionalizante/métodos , Lares para Grupos , Habitação , Pessoas Mal Alojadas/educação , Transtornos Mentais , Avaliação de Programas e Projetos de Saúde , Logro , Adulto , Estudos de Viabilidade , Objetivos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Transtornos Mentais/complicações , Pessoa de Meia-Idade , Projetos Piloto , Treinamento por Simulação , Transtornos Relacionados ao Uso de Substâncias/complicações , Gravação em VídeoRESUMO
Although occupational therapists were once integrally involved in mental health practice, the percentage of therapists presently working in this clinical area is low. In 2017, the American Occupational Therapy Foundation convened a planning grant collective (PGC) to generate research to support populations with serious mental health challenges. The PGC's primary mission was to identify key research areas in which occupational therapists and colleagues could work collaboratively to demonstrate evidence for occupational therapy services supporting mental health community participation. Participants included 21 members from six professions and three program officers from federal funding establishments. The PGC identified seven overarching research concepts, three broad areas of research inquiry, and eight possible studies addressing occupational therapy's contribution to research promoting community participation and health outcomes for people with mental illness. This article provides a summary of the PGC proceedings so that researchers can collaboratively implement identified research topics.
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Transtornos Mentais , Terapia Ocupacional , Planejamento em Saúde , Humanos , Saúde Mental , Terapeutas OcupacionaisRESUMO
BACKGROUND: Although systematic and scoping reviews have identified a range of interventions for persons experiencing homelessness, no known reviews have captured the range and quality of intervention studies aimed at supporting a transition from homelessness. OBJECTIVES: To capture the range and quality of occupational therapy intervention studies aimed at supporting a transition to housing following homelessness. METHOD: Using Joanna Briggs Institute (JBI) guidelines, we conducted a systematic review including a critical appraisal and narrative synthesis of experimental studies. RESULTS: Eleven studies were included. Critical appraisal scores ranged from 33.3 to 88.9 of a possible score of 100 (Mdn = 62.5; IQR = 33.4). The majority of studies evaluated interventions for the development of life skills (n = 9; 81.8%), and all were conducted in the USA. Several of the included studies were exploratory evaluation and feasibility studies, and all were quasi-experimental in design. Only three studies (27.2%) incorporated a control group. Intervention strategies included (1) integrated group and individual life skills interventions (n = 6); (2) group-based life skills interventions (n = 3); and (3) psychosocial and consultative interventions (n = 2). CONCLUSIONS: Research evaluating occupational therapy interventions aimed at supporting homeless individuals as they transition to housing is in an early stage of development. SIGNIFICANCE: Implications for research and practice are discussed.
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Integração Comunitária/psicologia , Integração Comunitária/estatística & dados numéricos , Habitação/estatística & dados numéricos , Pessoas Mal Alojadas/psicologia , Pessoas Mal Alojadas/estatística & dados numéricos , Terapia Ocupacional/métodos , Terapia Ocupacional/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados UnidosRESUMO
BACKGROUND: Asthma affects approximately 6 million children in the United States and can greatly impact quality of life and occupational engagement. Although occupational therapists are well-equipped to address participation limitations, insufficient evidence exists to support the role of occupational therapists in asthma treatment. METHOD: The purpose of this study was to further understand the occupational limitations experienced by children with asthma. We also explored a dual diagnosis of asthma and obesity. The participants included children with (n = 84) and without (n = 63) asthma living in New York City. The Child Behavior Checklist, Youth Self Report, Brief Respiratory Questionnaire, and accelerometer data were used to examine occupational participation. RESULTS: Although accelerometry data demonstrated that children with asthma were equally as active as their non-asthmatic peers, the participants with asthma perceived themselves as participating more in sedentary occupations and were less likely to be members of sports teams. They also had more missed school days and nights of troubled sleep. The children with both asthma and obesity reported the highest level of activity limitations. CONCLUSION: This study illustrates specific limitations experienced by children with asthma and supports the need for occupational therapy intervention. Future studies are needed to design and assess interventions that will support the addition of occupational therapists to multidisciplinary asthma treatment teams.
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This study aims to determine whether a functional literacy program using principles from the Cognitive Orientation to daily Occupational Performance approach and Occupational Adaptation theory, and embedded in community-based daily activities, could enhance occupational participation in a sample of sheltered homeless adults. This study used a two-group, controlled design with pre- and post-intervention measures. Intervention was carried out in a group setting in 1.5 hr, twice-weekly sessions over 8 weeks. Intervention addressed literacy skills needed to complete participant identified, desired daily activities. Statistically significant differences were found between intervention and control groups' perceived functional literacy skills with regard to occupational performance (Z = -4.075, p < .0001, d = 1.02) and satisfaction (Z = -4.113, p < .0001, d = 1.40); reading frequency (Z = -3.594, p < .0001, d = 0.48), reading effectiveness (Z = -10.673, p < .0001, d = 0.68), level of support (Z = -10.410, p < .0001, d = 1.81), and reading efficiency (Z = -10.297, p < .0001, d = 1.83). The intervention enhanced perceived reading and occupational participation in the study's sample. Further research is needed to replicate and translate results in daily practice.
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Educação/métodos , Pessoas Mal Alojadas/psicologia , Alfabetização/psicologia , Terapia Ocupacional/métodos , Orientação , Idoso , Emprego/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , LeituraRESUMO
Factors accounting for the profession's dearth of effectiveness studies to date may include (1) confusion about the differences between basic and applied research, (2) biases in the academic system that promote and reward basic research activities, (3) greater public and private funding for basic research than for clinical (applied) research, (4) difficulties inherent in conducting effectiveness studies, and (5) competing responsibilities for faculty and clinician time commitments. Although these factors may impede occupational therapy researchers from participating in effectiveness studies, strategies can be developed to promote the profession's increased participation in evidence-based research. Part II of this editorial, which follows in the next AJOT issue, will examine possible solutions to overcome impediments and increase the profession's participation in research providing support for occupational therapy intervention.
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Terapia Ocupacional , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Medicina Baseada em Evidências , Humanos , National Institutes of Health (U.S.) , Terapia Ocupacional/educação , Avaliação de Resultados em Cuidados de Saúde/tendências , Apoio à Pesquisa como Assunto/estatística & dados numéricos , Estados UnidosRESUMO
These factors are important to consider when appraising the strength of research evidence. Although all studies have limitations, applied designs that address many of the factors described here can provide stronger evidence of the effectiveness of occupational therapy intervention. This appraisal process is critical not only to build the profession's body of evidence but also to ensure that our evidence is considered scientifically sound and credible by insurers, fellow health care professionals, and consumers.
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Prática Clínica Baseada em Evidências , Terapia Ocupacional , Projetos de Pesquisa , Humanos , Projetos de Pesquisa/normasRESUMO
OBJECTIVE: This study assessed the effectiveness of a supported education program for adults with psychiatric disabilities. METHOD: Thirty-eight adults with psychiatric disabilities were randomly assigned to an experimental group (n = 21) that received supported education services or to a control group (n = 17) that received treatment as usual. RESULTS: We found a statistically significant difference between experimental and control group participant scores on the five instruments used to measure the program's effectiveness. Sixteen of the 21 experimental group participants (76%) completed the program. At 6-month follow-up, 10(63%) had enrolled in an educational program, had obtained employment, or were applying to a specific program. Only 1 of the control group participants was enrolled in an educational program. CONCLUSION: The results support the effectiveness of the supported education program. A significant number of participants were able to improve their basic academic skills, enhance professional behaviors and social skills, and return to the school or work environment.
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Educação Inclusiva/organização & administração , Transtornos Mentais/reabilitação , Terapia Ocupacional , Adulto , Capacitação de Usuário de Computador , Educação Inclusiva/normas , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Apoio SocialRESUMO
BACKGROUND.: The use of bibliometrics to evaluate the quality and impact of refereed journals has increased along with access to electronic databases and citation counts. PURPOSE.: This analysis compared and contrasted the range of publication metrics available for English-language occupational therapy journals. METHOD.: Bibliometric data were sourced for 23 English-language occupational therapy journals, including data from the Journal Citation Reports (JCR) 2- and 5-year impact factor, JCR Immediacy Index, Eigenfactor Score, Article Influence Score, Scopus Source Normalized Impact per Paper, SCImago Journal Rank (SJR) score, and ResearchGate journal impact score. H-indexes for journals were also sourced. FINDINGS.: The American Journal of Occupational Therapy had the highest publication metrics. SJR-based scores included a larger number of journals, whereas JCR-based metrics were more restrictive in the number of journals included. IMPLICATIONS.: Multiple metrics should be used to comprehensively understand occupational therapy journal performance.
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Bibliometria , Terapia Ocupacional/estatística & dados numéricos , Publicações Periódicas como Assunto , Humanos , IdiomaRESUMO
BACKGROUND: Journals are currently assessed and ranked using a number of different quantitative performance metrics. AIM: To compare and correlate the publication metrics of English-language occupational therapy journals published in 2015. METHOD: Bibliometric data was sourced for 14 English-language occupational therapy journals including the Journal Citations Report (JCR) 2-year impact factor (IF), Eigenfactor Score (EFS), Article Influence Score (AIS), Scopus Source Normalized Impact per Paper (SNIP), Scopus Citescore, and SCImago Journal Rank (SJR) score. The JCR, Scopus, and SJR 2015 bibliometric data were correlated. RESULTS: The top six English-language occupational therapy journals in relation to JCR IF, EFS, AIS, SNIP, Citescore, SJR score, and SJR IIF were AJOT, AOTJ, POPT, CJOT, SJOT, and BJOT. JCR IF, EFS, JCR AIS, SNIP, Citescore, SJR score and SJR IIF were all significantly correlated with coefficients ranging from 0.751 to 0.961 (p < 0.05; p < 0.01). The calculated SJR IIF was on average 0.335 larger than the JCR IFs reported. CONCLUSIONS: The findings indicate that the range of available bibliometric measures should be used collectively to yield a more comprehensive assessment of journal and article rankings rather than the singular use of IF scores that currently and frequently occurs in many jurisdictions.