Participation patterns and determinants of participation of young children with cerebral palsy.

INTRODUCTION: Understanding participation patterns of young children with cerebral palsy (CP) will enable occupational therapists to tailor family- and child-centred services. This study compares participation patterns and participation barriers of young children with CP with those of typically developing (TD) children. In addition, effect of age and gender on participation were examined as well as child-related determinants of participation for young children with CP. METHODS: Participants were a convenience sample of 110 young children with CP and 150 TD children, aged 36-72 months. Children with CP represented different levels of the Gross Motor Function Classification System-Expanded and Revised (GMFCS-E&R), the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS). The Arabic Preschool Activity Card Sort was used to measure participation level as well as barriers of participation. T-tests, ANOVA, and exploratory regressions were employed. Significance was set at p < .05. RESULTS: Young children with CP showed significant decreased overall and domain-specific participation compared to TD children (p < .001). Perceived barriers of participation were mostly related to child-factors for young children with CP compared to greater variability in barriers in TD children. Gender had no significant effect on participation regardless of diagnosis; however, pattern of the effect of age was different among the two groups. MACS was found to be the only significant predictor of participation for children with CP (p = .001). CONCLUSION: Occupational therapists should focus on enhancing participation for young children with CP and consider participation barriers when designing their interventions. Several factors need to be considered when aiming to enhance participation of children with CP. The use of the MACS could contribute to better intervention planning.

Factors influencing job satisfaction among Jordanian occupational therapists: a qualitative study.

PURPOSE: The main purpose of this study was to explore factors influencing job satisfaction and dissatisfaction among Jordanian occupational therapists. METHODS: Ours was an explorative qualitative study involving the use of structured open-ended written questions. Participants were asked to answer in narrative their perception about the factors behind their job satisfaction and dissatisfaction. In addition, they were asked to express their suggestions, ideas, or solutions for increasing job satisfaction. RESULTS: Ninety-three occupational therapists responded to the survey. For job satisfaction questions, four themes emerged: a humanistic profession; professional issues; work benefits; and work environment. Participant's comments at the end of the survey revealed one general theme for improving job satisfaction, 'a call for improvement'. DISCUSSION: This qualitative study revealed that the humanistic nature of occupational therapist was counterbalanced by several dissatisfying factors for occupational therapy practitioners in Jordan. The need for better supported working conditions in terms of financial rewards, recognition, awareness and resources as well as public and professional recognition of occupational therapists are needed to enhance the occupational therapy profile in Jordan. A comprehensive collaboration is highly needed between the individual practitioners, representatives of the profession, government and hospital administrators.

Efficacy of a Work Disability Prevention Program for People with Rheumatic and Musculoskeletal Conditions: A Single-Blind Parallel-Arm Randomized Controlled Trial.

OBJECTIVE: Work disability rates are high among people with rheumatic and musculoskeletal conditions. Effective disability preventive programs are needed. We examined the efficacy of a modified vocational rehabilitation approach delivered by trained occupational therapists and physical therapists on work limitation and work loss over 2 years among people with rheumatic and musculoskeletal conditions. METHODS: Eligibility criteria for this single-blind, parallel-arm randomized trial included ages 21-65 years, 15 or more hours/week employment, a self-reported doctor-diagnosed rheumatic or musculoskeletal condition, and concern about staying employed. The intervention consisted of a 1.5-hour meeting, an action plan, written materials on employment supports, and telephone calls at 3 weeks and 3 months. Control group participants received the written materials. The primary outcome was the Work Limitations Questionnaire (WLQ) output job demand subscale. The secondary outcome was work loss. Intent-to-treat analyses were performed. RESULTS: Between October 2011 and January 2014, 652 individuals were assessed for eligibility. A total of 287 participants were randomized: 143 intervention and 144 control participants. In total, 264 participants (92%) completed 2-year data collection. There was no difference in the mean ± SD WLQ change scores from baseline to 2-year followup (-8.6 ± 1.9 intervention versus -8.3 ± 2.2 control; P = 0.93). Of the 36 participants who experienced permanent work loss at 2 years, 11 (8%) were intervention participants and 25 (18%) control participants (P = 0.03). CONCLUSION: The intervention did not have an effect on work limitations but reduced work loss. The intervention can be delivered by trained rehabilitation therapists.

The Work Activity and Participation Outcomes Framework: a new look at work disability outcomes through the lens of the ICF.

Work disability is common among people with chronic conditions. The terminology in the field is variable and often used interchangeably and there is a lack of comprehensive frameworks to describe work as an outcome. Varied operationalization of work disability makes it difficult to establish precise estimates of the impact of chronic musculoskeletal conditions on work. A new conceptual framework was developed using the International Classification of Functioning, Disability and Health and was named 'Work Activity and Participation Outcome (Work APO) Framework' which clarified definitions in the field. Applying the framework to people at risk of work disability and evaluating their outcomes could advance the literature.

Working conditions of occupational therapists in Jordan.

The purpose of this study was to investigate the working conditions and factors related to job satisfaction among Jordanian occupational therapists. A self-administered survey consisting of several questions about the participants' jobs was developed for this study. The inclusion criteria included occupational therapists who worked in the field of occupational therapy (OT) in Jordan and who had at least six months of experience. The survey was distributed to 120 occupational therapists in different OT settings. One hundred and one occupational therapists from different hospitals, centres, schools and universities responded to the survey. Salaries of the participants were low in comparison with the salaries of the rest of healthcare practitioners in Jordan. Chi-square analysis revealed significant relationship between participants' perceived job satisfaction and the administration of the setting, and between the choice of studying OT and the salary that the participant makes. Most occupational therapists in Jordan are young, have modest experience and work in general OT services in government-owned facilities or paediatric centres. A sense of dissatisfaction was obvious among the participants. Further studies are needed to explore reasons of work satisfaction and dissatisfaction among occupational therapists in Jordan.