Healthy ageing through participation in community situated activities: A scoping review of assessment instruments to support occupational therapy practice.

INTRODUCTION: The occupational therapy profession has an essential role to play in healthy ageing that includes enabling participation, a construct that according to The International Classification of Functioning, Disability and Health (ICF), incorporates an environmental context. Environmental barriers and enablers of participation in community-situated activities for people over the age of 65 have been identified. To support practice, occupational therapists require assessments with demonstrated content validity including comprehensive coverage of the construct. The purpose of this scoping review study was to investigate what instruments are available to assess community participation for people over the age of 65 that included environmental factors. METHODS: A scoping review of the literature was conducted, utilising the Joanna Briggs Institute (JBI) scoping review methodology. The evidence source was review articles and inclusion criteria were that they reviewed instruments to assess participation that could be used for people over the age of 65. Items extracted from included instruments were evaluated against a preset list of community-participation and environment categories that had been developed from the ICF. RESULTS: Twenty-three review studies met inclusion criteria and from these 240 instruments were extracted. Twenty instruments were retained after exclusions and from these, 540 instrument items were extracted. Of these, 280 (47%) were coded as community-participation, and only 20 (3.4%) as environment items. Fourteen of the instruments included no environment items. CONCLUSIONS: No instrument was identified that comprehensively assessed community participation including the related environmental factors. Such an instrument is required to enable occupational therapy practitioners to support healthy ageing. The development of such an instrument will strengthen the profession's capacity to develop new ways of delivering services to older adults in line with emerging ways that aged care will be delivered and to advance its essential role in healthy ageing.

Reflection-in-practice: A survey of Australian occupational therapists.

INTRODUCTION: The ability to reflect on practice and context is an essential professional behaviour required by occupational therapists and included within practice guidelines and standards. Research has demonstrated the benefits of reflection within specialist areas of practice. However, there is a lack of research into reflection within, and across, work place practice. The aim of this study was to understand how occupational therapists define, conceptualise and engage in reflection in practice. METHODS: Occupational therapists (N = 112) participated in a cross sectional study, which utilised a self-administered, purpose designed survey distributed via the Occupational Therapy Australia (OTA), e-bulletin. Data were summarised using frequency and percentage distributions, mean and standard deviation, and Pearson's r correlation coefficients was used to measure relationships between variables. RESULTS: There was a high level of interest and engagement in self-reflection, and a positive relationship between 'years since graduation' and 'level of engagement in self-reflection'. Respondents strongly agreed that the purpose of reflection was to learn from experiences and that it was key to being a self-directed learner. They disagreed that its purpose was 'to describe and record my new learning' and that 'reflective practice is no different to clinical reasoning'. The highest ranked barrier was workplace demands, and participant knowledge of reflection theories was low. CONCLUSIONS: These participants were interested in and valued reflection-in-practice; however, workplace demands on time may explain low engagement in reflective journaling. Participants indicated low knowledge of reflection theories, and they identified this as a barrier. Their purposes for engaging in reflection were generally consistent with the professional standards pertaining to reflection. In the preferred definition, reflection was associated with contextual and systemic factors, concepts central to an occupational justice perspective. The findings of this study will contribute to developing an expansive understanding of reflection applicable to occupational therapy professional practice.