Professional Perspectives on Children's Health Assets: A Delphi Study.

This study aims to describe a local community expert's perspective on the identification of and access to children's health assets and to gather proposals to promote children's health and well-being within their community. The health asset approach is essential for health promotion, and there is evidence of its benefits to individuals' or communities' health when this approach is observed. Children's health assets are gaining increasing interest, but the literature that captures the perception of professionals working with children is scarce. Qualitative research designed with Delphi methodology was carried out with the participation of 25 professionals working in a neighbourhood with children and families. The participants stated that this neighbourhood was a good environment for the healthy and happy growth of children but pointed out that there were inequities. They emphasised the importance of economic and physical security and feeling loved. The absolute best aspects of the neighbourhood according to these experts were its support networks, mutual help, educational and health services, and green spaces, and the most deficient aspects were the possibility of a hopeful future and emotional support within the family unit. Poverty and/or the scarcity of economic resources were identified as the main barriers to accessing health assets. Special difficulties in access to health for migrant and Roma children were also identified. The panel of experts made concrete action proposals. It was recommended to support resources and services that already exist in their community. The experts prioritised work with families, education, working in conjunction with vulnerable groups, community participation, and networking.

Is the Combination of Robot-Assisted Therapy and Transcranial Direct Current Stimulation Useful for Upper Limb Motor Recovery? A Systematic Review with Meta-Analysis.

Stroke is the third leading cause of disability in the world, and effective rehabilitation is needed to improve lost functionality post-stroke. In this regard, robot-assisted therapy (RAT) and transcranial direct current stimulation (tDCS) are promising rehabilitative approaches that have been shown to be effective in motor recovery. In the past decade, they have been combined to study whether their combination produces adjuvant and greater effects on stroke recovery. The aim of this study was to estimate the effectiveness of the combined use of RATs and tDCS in the motor recovery of the upper extremities after stroke. After reviewing 227 studies, we included nine randomised clinical trials (RCTs) in this study. We analysed the methodological quality of all nine RCTs in the meta-analysis. The analysed outcomes were deficit severity, hand dexterity, spasticity, and activity. The addition of tDCS to RAT produced a negligible additional benefit on the effects of upper limb function (SMD -0.09, 95% CI -0.31 to 0.12), hand dexterity (SMD 0.12, 95% CI -0.22 to 0.46), spasticity (SMD 0.04, 95% CI -0.24 to 0.32), and activity (SMD 0.66, 95% CI -1.82 to 3.14). There is no evidence of an additional effect when adding tDCS to RAT for upper limb recovery after stroke. Combining tDCS with RAT does not improve upper limb motor function, spasticity, and/or hand dexterity. Future research should focus on the use of RAT protocols in which the patient is given an active role, focusing on the intensity and dosage, and determining how certain variables influence the success of RAT.

Gender Composition in Occupational Therapy Journals' Editorial Boards.

This paper analyses the Editorial Board (EB) distribution of Occupational Therapy journals from a gender perspective. The "Occupational Therapy" field in the Scimago Journal and Country Rank (SJR) and the "Occupational Therapy" term in the title search of the Journal Citation Report (JCR) were used to find the Occupational Therapy-specific journals. The following indicators were calculated: Editorial Board Member (EBM) gender distribution by journal, publisher, subject speciality, country, and journal quartile. Thirty-seven journals were located, including 667 individuals, 206 males (31%) and 461 females (69%). Referring to the EB positions, most members (557) were EB members, 70 were listed as Associate Editors, and 20 as Editorial Leaders. The results show that the proportion of women in the EB's of Occupational Therapy journals represents a majority. Regarding the distribution by gender of the EBMs, six journals had a female proportion below the cut-off point revealed in this study (69%). Four did not reach parity, with female representation below 50%. Additionally, the balance among the EBMs is significantly underrepresented compared to the percentage of female Occupational Therapy practitioners.

Lessons Learned: Occupational Therapy in Nursing Homes during the First Wave of COVID-19 in Spain.

This research aims to explore the perception that occupational therapists working in elderly care facilities have about the measures implemented against the COVID-19 pandemic in their resources, and the impact that these measures have had on occupational therapy in these facilities. An interpretive paradigm was selected, using a qualitative approach and a phenomenological design. Sixteen occupational therapists working in elderly care facilities in two Spanish regions were included. Data were collected through semi-structured interviews. A discourse analysis of the narrative information was carried out using open, axial, and selective coding processes and the constant comparison method. Four themes were extracted from the analysis results: The initial chaos in senior centers; The blurring of occupational therapists' roles; The emergence of technology; and organizational and therapeutic proposals for future pandemics. The pandemic had a significant impact on the care and therapeutic processes in elderly care facilities. Occupational therapists had to stop performing their functions to dedicate themselves to other support, auxiliary or communication tasks between the center and the families. Similarly, it is worth noting the emergence of low-cost technology to facilitate communication and to carry out some therapeutic interventions.

Analysis of Fear Post COVID in First-Year Students after the Incorporation to the Classroom: Descriptive Study in University Students of Health Sciences.

BACKGROUND: After the onset of the COVID-19 pandemic, social restriction measures were implemented, among them, the adaptation of university teaching to online modality until the end of the 2019-2020 school year in order to stop the spread of the SARS-CoV-2 virus. At the beginning of the 2020-2021 school year, the Spanish universities opted for face-to-face teaching. To that end, different special measures and adaptations were implemented in higher education facilities, aimed at minimizing the risk of infection and ensuring safe face-to-face learning. The objective was to explore and describe the level of fear of first-year students after the start of in-person classes in the context of the COVID-19 pandemic. METHODS: The sample was 185 first-year students who were evaluated on the first day of class. For that purpose, an ad-hoc questionnaire was administered to collect demographic information and to find the level of fear and concern. The Fear of COVID-19 Scale was used to assess the severity of the participants' fear of the pandemic situation. RESULTS: The results indicate that participating university population does not report fear of the virus, but they describe various psychosomatic characteristics, such as increased pulse rate and heart palpitations (p = 0.008) and insomnia (p = 0.05) when they think about infection with coronavirus. Nevertheless, when data are disaggregated by gender, we observe differences specifically in women (83.2%), such as fear (p = 0.006) and sweaty hands when they think of the virus (p = 0.023). CONCLUSIONS: Incoming university freshmen do not express concern or fear of potential infection with COVID-19, but they are concerned about family transmission after beginning face-to-face classes.

Analysis of Occupational Balance and Its Relation to Problematic Internet Use in University Occupational Therapy Students.

(1) Objective: to explore and describe the relationship between the occupational balance of university students taking a Degree in Occupational Therapy and the problematic use of the Internet and how these, in turn, favour or not the appearance of phubbing behaviour which involves "a behaviour that happens when an individual looks at his mobile phone during a conversation with other individuals, escaping from interpersonal communication". (2) Methods: this is a quantitative descriptive study of an observational and cross-sectional nature, not experimental. The Spanish version of the Occupational Balance Questionnaire (OBQ-E), the Internet Addiction Test and the Phubbing Scale were used for data collection. 192 university students taking the Degree in Occupational Therapy of the University of Castilla-La Mancha participated (168 women and 24 men). (3) Results: the average score obtained in the OBQ-E was 38.7, indicating a moderate occupational balance; and (4) Conclusions: occupational therapy students from the Faculty of Health Sciences of the University of Castilla-La Mancha have a moderate occupational balance. Furthermore, this is negatively related to both problematic Internet use and phubbing, so a higher occupational balance indicates less Internet addiction and less phubbing.

Fathers in the Care of Children with Disabilities: An Exploratory Qualitative Study.

OBJECTIVE: to explore the perception and experience of fathers of children with disabilities in caring for their children; to know their role and how these tasks impact their daily life, health and physical, mental and/or emotional well-being. METHODOLOGY: qualitative approach study with phenomenological design. The sample consisted of seven young fathers of underage children with various diagnoses. The data were collected through semi-structured interviews; the discourse analysis was carried out through open and axial coding processes. Three themes emerged from the results of the analysis: (1) shared responsibilities, (2) somewhat difficult to fit in, and (3) either you join or you split. RESULTS: Fathers must readjust their work schedule, reduce their working hours, or give up their job altogether to take care of their children, as well as give up their social life. They lack time to enjoy their leisure time, to spend time with their partner, to take care of themselves. This involvement in caregiving generates an important occupational imbalance that has repercussions above all on their mental health. CONCLUSIONS: The sharing of caregiving tasks also impacts significantly on parents' lives, it also takes away time and opportunities, and sometimes health and quality of life.

Situación ocupacional y recursos sociales de las mujeres mayores en situación de dependencia atendidas por un servicio de ayuda a domicilio en el ámbito rural / Situação ocupacional e recursos sociais das mulheres idosas em situação de dependência assistidas por um serviço de apoio domiciliar nas zonas rurais / Occupational situation and social resources of older women in a situation of dependency assisted by a home help service in rural areas

Resumen Introducción La situación ocupacional de las mujeres mayores puede generar la necesidad de cuidados específicos. Objetivo El objetivo de este trabajo es analizar la situación ocupacional y los recursos sociales de las mujeres mayores dependientes atendidas por un Servicio de Ayuda a Domicilio en el ámbito rural. Metodología Se utilizó un diseño cualitativo transversal y exploratorio. Se realizó un muestreo por propósito. A través de entrevistas en profundidad se obtuvieron las narrativas de 10 mujeres mayores en situación de dependencia. Las entrevistas fueron grabadas para su posterior transcripción y análisis. Se realizó un análisis del discurso de la información narrativa mediante los procesos de codificación abierta, axial y selectiva y el método de comparación constante. Se utilizó el software de análisis cualitativo Atlas.ti. Resultados A partir de las narrativas de las participantes emergieron cuatro temas: 1) las limitaciones para la realización de las actividades instrumentales de la vida diaria y los apoyos informales; 2) las restricciones en la participación social, ocio y tiempo libre; 3) las dificultades derivadas de los problemas de salud y, 4) el peso de los valores y creencias en su vida cotidiana. Conclusion Las mujeres mayores en el ámbito rural tienen limitaciones a la hora de realizar algunas actividades instrumentales de la vida diaria, especialmente aquellas que guardan una más estrecha relación con la movilidad, y las actividades de participación social y de ocio. Se pone de manifiesto la necesidad de poner en marcha políticas públicas de atención a las personas en sus domicilios y espacios comunitarios.

Resumo Introdução A situação ocupacional das mulheres idosas pode gerar a necessidade de cuidados específicos. Objetivo O objetivo deste trabalho é analisar a situação ocupacional e os recursos sociais das mulheres idosas dependentes atendidas por um serviço de apoio domiciliar nas zonas rurais. Metodologia Foi utilizado um desenho qualitativo transversal e exploratório. Uma amostragem de conveniência foi realizada. Foram utilizadas entrevistas em profundidade para obter as narrativas de 10 mulheres idosas dependentes. As entrevistas foram gravadas para posterior transcrição e análise. A análise discursiva das informações narrativas foi realizada por meio de processos de codificação aberta, axial e seletiva e pelo método de comparação constante. Foi utilizado o software de análise qualitativa Atlas.ti. Resultados Quatro temas emergiram das narrativas dos participantes: 1) limitações para a realização de atividades instrumentais da vida diária e apoios informais; 2) restrições à participação social, lazer e tempo livre; 3) dificuldades decorrentes de problemas de saúde e 4) o peso dos valores e crenças no seu cotidiano. Conclusão As mulheres idosas nas zonas rurais têm limitações quando se trata de realizar algumas atividades instrumentais da vida cotidiana, especialmente as que estão mais estreitamente relacionadas com a mobilidade, a participação social e as atividades de lazer. Destaca-se a necessidade de implementar políticas públicas para cuidar das pessoas em suas casas e espaços comunitários.

Abstract Introduction The occupational situation of older women may generate the need for specific care. Objective The aim of this work is to analyse the occupational situation and social resources of dependent elderly women assisted by a Home Help Service in rural areas. Methodology A cross-sectional and exploratory qualitative design was used. A purposive sampling was carried out. In-depth interviews were used to obtain the narratives of 10 dependent older women. The interviews were recorded for later transcription and analysis. A discourse analysis of the narrative information was carried out using open, axial and selective coding processes and the constant comparison method. The qualitative analysis software Atlas.ti was used. Results Four themes emerged from the narratives of the participants: 1) limitations for the performance of instrumental activities of daily life and informal supports; 2) restrictions on social participation, leisure and free time; 3) difficulties arising from health problems and 4) the weight of values and beliefs in their daily lives. Conclusion Older women in rural areas have limitations when carrying out some instrumental activities of daily life, especially those more closely related to mobility, and social participation and leisure activities. The need to implement public policies to care for people in their homes and community spaces is highlighted.

Burnout Syndrome in Occupational Therapists in Spain: Prevalence and Risk Factors.

The objective of this study was to assess the potential levels of burnout syndrome in occupational therapists in Spain, as well as the risk factors involved in its prevalence. The data were obtained through an online survey. The tool utilised for this purpose was the Maslach Burnout Inventory General Survey (MBI-GS) that takes into consideration the following dimensions: emotional fatigue, depersonalisation and reduction of personal satisfaction. A sociodemographic questionnaire was also utilised. The sample of the study included 758 occupational therapists, 90.8% of whom were women and 9.2% of whom were men. For identifying the variables associated to the presence of burnout, the prevalence was compared through the chi-squared test, and the odds ratios by age were calculated through the binary logistic regression model. We found that 69.4% of the occupational therapists presented burnout syndrome and especially emotional fatigue (63.5%). Likewise, relevant and significant differences in the prevalence of burnout syndrome were observed depending on the age, marital status, number of children, work field and type of workday. We can conclude that burnout syndrome poses a clear risk for the health of occupational therapists that could have direct consequences on the work environment, affecting the way the interventions are performed with patients. This study could help to raise awareness on this reality and the factors implied. We suggest the implementation of measures (individual, labour and political) both for the prevention of burnout in occupational therapists as well as for reducing the levels of those who suffer from it.

Mothers Who Take Care of Children with Disabilities in Rural Areas of a Spanish Region.

The purpose of this research is to describe how the mothers of children with disabilities in rural areas of Extremadura perceive care tasks and the subjective impact that these tasks have on their daily life and health, as well as the subjective assessment that these mothers make of the benefits and services of the Spanish welfare policy. An interpretative paradigm was selected, using a qualitative approach and a phenomenological design. Twelve mothers were included. Data were collected through semi-structured interviews. A discourse analysis of the narrative information was performed using open, axial, and selective coding processes and the constant comparative method. Three topics have been extracted from the findings of the analysis: (1) extensive care responsibilities, (2) impacts upon well-being and daily life, and (3) resources that "barely" help. The care tasks performed by mothers of children with disabilities in rural areas have an enormous impact on their daily life and health. This involvement in caregiving generates a significant occupational imbalance which has an impact on their mental health, and which causes economic and social problems.

Dependency and Care: Perspectives from the Point of View of Professionals Assessing Situations of Dependency in Spain.

OBJECTIVE: To describe how the assessors of dependency have perceived the process of implementation of the Dependency Act in Spain. METHODS: A qualitative method was used to analyse interview data (discourse analysis). Purposive sampling was applied. Sixteen occupational therapists were included, who served as dependency assessors in Extremadura, a region of southern Spain. Data were collected through semi-structured interviews between February and March 2019, focused on the characteristic of the Dependency Act. A discourse analysis of the narrative information was performed using processes of open, axial, and selective coding, as well as the constant comparative method. RESULTS: Three topics were identified: (1) Benefits of implementation, connected with the consideration as subjects of rights and the increase in resources. (2) Difficulties linked to the bureaucratization of the process, the lack of sensitivity of the scale of assessment, and the unequal access to benefits and services. (3) The impact of the 2012 budget cuts on financing and on dependent people and their families. CONCLUSIONS: The Dependency Act has established itself as a political tool that has generated important social and economic benefits. However, significant difficulties have emerged, which should be addressed to ensure better care for dependent persons.