Revisiting the Do-Live-Well Health Promotion Framework: A Citation Content Analysis.

Background. The Do-Live-Well (DLW) framework was first published in 2015 and aimed to fill a theoretical gap in the health promotion literature related to the links between occupational patterns and health. However, the extent of uptake and use of the framework since publication is unknown. Purpose. To explore and reflect on the adoption and application of DLW in the literature. Method. Citation content analysis of two seminal DLW publications was conducted from 2015 to November 2022 across six databases. Findings. Seventeen citations directly applied DLW to inform research (n = 10), practice (n = 5) and knowledge translation (n = 2). Implications. The findings highlight uptake of the framework in a range of settings, and how it can inform an occupation-based understanding of health and well-being. Ongoing knowledge dissemination, development of practice tools, and research to update evidence and examine relevance are needed to further advance the utility and application of the framework.

Undertaking Rehabilitation Research During the COVID-19 Pandemic: Emergent Strategies From a Trainee-Faculty Workshop.

Background: The COVID-19 pandemic has disrupted everyday rehabilitation research. Many academic institutions have halted in-person human research including rehabilitation sciences. Researchers are faced with several barriers to continuing their research programs. The purpose of this perspective article is to report the results of an interdisciplinary workshop aimed at understanding the challenges and corresponding strategies for conducting rehabilitation research during the COVID-19 pandemic. Methods: Twenty-five rehabilitation researchers (17 trainees and eight faculty) attended a 2-h facilitated online workshop in to discuss challenges and strategies they had experienced and employed to conduct rehabilitation research during the COVID-19 pandemic. Results: Rehabilitation researchers reported challenges with (1) pandemic protocol adjustments, (2) participant accessibility, and (3) knowledge dissemination, along with corresponding strategies to these challenges. Researchers experienced disruptions in study outcomes and intervention protocols to adhere to public health guidelines and have suggested implementing novel virtual approaches and study toolkits to facilitate offsite assessment. Participant accessibility could be improved by engaging community stakeholders in protocol revisions to ensure equity, safety, and feasibility. Researchers also experienced barriers to virtual conferences and publication, suggested opportunities for smaller networking events, and revisiting timeframes for knowledge dissemination. Conclusion: This perspective article served as a catalyst for discussion among rehabilitation researchers to identify novel and creative approaches that address the complexities of conducting rehabilitation research during the COVID-19 pandemic and beyond.

Exploring patient perspectives of barriers and facilitators to participating in hospital-based stroke rehabilitation.

BACKGROUND: Patient participation is recognized as an important element of rehabilitation. However, few studies have used a qualitative lens to specifically examine factors influencing patient participation in stroke rehabilitation. AIM: The purpose of this study was to investigate patient perspectives of barriers and facilitators to participating in hospital-based stroke rehabilitation. METHODS: Semi-structured interviews were conducted with 11 patients, with confirmed diagnoses of stroke, recruited from three separate rehabilitation settings. Analysis of the interviews was guided by a process of interpretive description to identify key barriers and facilitators to participation in stroke rehabilitation. RESULTS: Four main themes and corresponding sub-themes were constructed concerning participation in rehabilitation: (i) Environmental Factors, (ii) Components of Therapy, (iii) Physical and Emotional Well-Being, and (iv) Personal Motivators. An exploratory model of personalized rehabilitation emerged, integrating the themes emerging from the data. DISCUSSION: Personalized rehabilitation can be considered in comparison to person-centred care principles. The barriers and enablers experienced by patients in this study contribute to the existing knowledge of the patient experience of stroke rehabilitation and may be used to inform clinical practices and future research.Implications for RehabilitationThe surrounding environments can facilitate participation in rehabilitation using strategies to reduce noise and disruption and also by encouraging social interactions among patients.Increasing the frequency and consistency of communication with patients about rehabilitation goals and progress could enhance participation.Designing interventions to include activities that are meaningful and focused on the resumption of valued life roles is key to participation.Therapy intensity, time spent sedentary, and the emotional impact of stroke are aspects of rehabilitation patient's feel are neglected.

What you do every day matters: A new direction for health promotion.

Canadian health promotion campaigns directed towards healthy living have traditionally emphasized discrete behaviours that influence health and wellbeing, such as diet, physical activity and smoking. Although this traditional approach is important and supported by evidence, it does not account for broader determinants of health. The purpose of this commentary is to propose an innovative health promotion approach that expands the healthy living discourse through a focus on patterns of daily activity. We highlight four key public health messages derived from a synthesis of existing research evidence. The messages are based on the premise that what you do every day has an important impact on health and well-being. Rather than being prescriptive or outlining minimum requirements, this approach invites reflection on various experiences and activity patterns that shape the health and well-being of individuals and communities. This broader and more inclusive approach to healthy living reflects diverse needs and experiences, making it relevant and attainable for people of all ages and abilities. Future efforts directed at operationalizing the key messages for individuals and communities hold much promise for populations that may be at risk of activity patterns believed to contribute to poor health and well-being.

Occupational therapy in primary care: Results from a national survey: L'ergothérapie dans les soins primaires : Résultats d'un sondage national.

BACKGROUND.: To support integration of occupational therapy in primary care and research in this area, it is critical to document examples of occupational therapy in primary care. PURPOSE.: This study describes occupational therapy roles and models of practice used in primary care. METHOD.: An electronic survey was sent to occupational therapists across Canada. Participants were identified using purposive and snowball sampling strategies. Descriptive statistics were used to analyze the data. FINDINGS.: Respondents ( n = 52) were almost exclusively working on interprofessional teams. Intervention was provided most frequently to individual clients, and services were provided both within the home/community and in the clinic. Occupational therapists offered a range of health promotion and prevention services, predominantly to adults and older adults. A number of supports and barriers to the integration of occupational therapy were identified. IMPLICATIONS.: A growing number of occupational therapists are working in primary care providing a broad range of services across the life span.

The emerging role of occupational therapy in primary care.

BACKGROUND: Few studies have examined the role of occupational therapy working in a primary care setting. PURPOSE: The objective of the study was to describe the emerging role of occupational therapy in Family Health Teams, a model of interprofessional primary care. METHOD: A multiple case study design was used to provide in-depth description of the occupational therapy role. Data collection included interviews, document analyses, and questionnaires. Each case was first analyzed individually, followed by cross-case analyses to determine common themes. FINDINGS: The role of occupational therapy in Family Health Teams epitomizes that of a generalist, whose overarching focus is on function. Occupational therapists are working across the life span with a wide range of client populations. Older adults and individuals with complex chronic conditions are two prominent areas of occupational therapy focus. IMPLICATIONS: Understanding the impact of health conditions on daily function and enabling participation in activities are unique and important contributions of occupational therapy.

Renegotiating environments to achieve participation: A metasynthesis of qualitative chronic disease research.

BACKGROUND: Qualitative studies describe environmental influences on participation in adults with chronic disease, but translating these findings into practice can be difficult. PURPOSE: This study sought to synthesize qualitative research findings regarding the influence of environmental factors on participation among adults with chronic disease. METHODS: Searching revealed 31 I articles that describe the link between environment and participation for adults with osteoarthritis, rheumatoid arthritis, diabetes mellitus, heart disease, cancer, chronic obstructive pulmonary disease, and/or depression. Study findings were analyzed using metasynthesis methods to identify themes. FINDINGS: For adults with chronic disease, renegotiating their environments and occupations to achieve, maintain, or rework their participation involves understanding support processes, being ordinary and able, navigating systems, and navigating physical environments. IMPLICATIONS: Key areas that occupational therapy interventions can target are facilitating constructive collaboration between client and support person, fostering connections with others, recognizing cultural pressure to be ordinary and able, and advocating for supportive policy and practice.

Validity of predischarge measures for predicting time to harm in older adults.

BACKGROUND: Concern is often expressed about the ability of persons with cognitive impairment to manage safely after discharge home from hospital. Measures validated for predicting safety are required. PURPOSE: The purpose of this study was to determine whether two predischarge functional measures were valid for predicting time to incident of harm after discharge. METHOD: Participants (n = 47) were recruited from an inpatient rehabilitation unit. The Assessment of Motor and Process Skills (AMPS) and Cognitive Performance Test (CPT) were administered in hospital. Incident-of-harm outcome was measured by caregiver telephone questionnaire monthly for 6 months. FINDINGS: Compared with all independent variables, AMPS Process scale was the best single predictor of time to incident of harm (p = .01). CPT had a high specificity (91%) for identifying persons who did not have harm. IMPLICATIONS: Both AMPS and CPT demonstrated predictive validity for harm outcome over less predictive variables, such as comorbidities and activities-of-daily-living burden of care.

Administration of the Canadian Occupational Performance Measure: effect on practice.

BACKGROUND: The Canadian Occupational Performance Measure (COPM) is recommended as a systematic approach to identify issues and determine client progress in occupational therapy, yet little empirical evidence is available that supports this practice. PURPOSE: To determine if COPM administration was associated with changes in eight dimensions of occupational therapy practice. METHODS: Twenty-four occupational therapists on eight geriatric rehabilitation sites completed a before-and-after study with a repeated baseline. The eight practice dimensions were assessed after three months of usual care (no COPM use) and after three months of intervention (COPM use) using chart stimulated recall (CSR) interviews and chart audit. FINDINGS: Mean practice scores for CSR interviews indicated a statistically significant practice improvement (p < .0001) across the eight dimensions, including knowledge of client perspective, clinical decision making, clinician ability to articulate outcomes, and documentation. Chart audit indicated that COPM use resulted in identifying more occupation-focused issues. IMPLICATIONS: COPM administration could improve occupational therapy practice.

Optimal positioning of occupational therapy.

BACKGROUND: Occupation is central to occupational therapy. Although occupation is a universal experience, occupational therapists need to consider the risks and opportunities of exploring new roles and maintaining existing services. PURPOSE: I propose three questions to guide the optimal positioning of occupational therapy services. First, how proximal is occupation in the role? Second, how strong is the evidence to support occupational therapy in the role? Third, is the timing right for change? These questions are applied to the role of occupational therapy in primary health care. KEY ISSUES: Occupation is proximal and the evidence is emerging to support an occupational therapy role in primary health care. Reforms make timing ideal. IMPLICATIONS: If we focus on the underlying principles of primary health care reform, the potential for an emerging role in primary health care is optimal. The same three questions can be used to transform and optimally position occupational therapy.

An agenda for occupational therapy's contribution to collaborative chronic disease research.

BACKGROUND: To meet the needs of adults with chronic diseases, Canadian health care is moving toward more interdisciplinary, collaborative practice. There is limited high-quality evidence to support practice in this area. Occupational therapists can play a significant role in this area of practice and research. PURPOSE: To develop an agenda of priority areas within collaborative chronic disease research to which occupational therapy can make a contribution. METHODS: The project involved literature and Internet review, a consensus meeting with a range of stakeholders, a survey of occupational therapists, and synthesis of findings to create a research agenda. FINDINGS: An interdisciplinary and intersectoral group of stakeholders identified seven main priority areas. One priority is specific to occupational therapy while the remaining six cross disciplines. IMPLICATIONS: The research agenda can support funding applications and encourage interdisciplinary research collaboration to ultimately produce research evidence that can benefit people with chronic diseases.

Assessment tools for evaluating fitness to drive: a critical appraisal of evidence.

BACKGROUND: Many office-based assessment tools are used by occupational therapists to predict fitness to drive. PURPOSE: To appraise psychometric properties of such tools, specifically predictive validity for on-road performance. METHODS: A literature search was conducted to identify assessment tools and studies involving on-road outcomes (behind-the-wheel evaluation, crashes, traffic violations). Using a standardized appraisal process, reviewers rated each tool's psychometric properties, including its predictive validity with on-road performance. FINDINGS: Seventeen measures met the inclusion criteria. Evidence suggests many tools do not have cutoff scores linked with on-road outcomes, although some had stronger evidence than others. Implications. When making a determination regarding driver fitness, clinicians should consider the psychometric properties of the tool as well as existing evidence concerning its utility in predicting on-road performance. Caution is warranted in using any one office-based tool to predict driving fitness; rather, a multifactorial-based assessment approach that includes physical, cognitive, and visual-perceptual components, is recommended.

A scoping review of the use of theory in studies of knowledge translation.

BACKGROUND: Advancing the science of knowledge translation (KT) in occupational therapy is critical. Explicit application of theory can advance this science; yet, how theory is applied and the degree to which it can guide research remain poorly defined. PURPOSE: To understand how theory is applied within KT research. METHODS: A scoping review was conducted to examine and summarize the extent, range, and nature of the application of three specific KT theories: Diffusion of Innovations, Promoting Action on Research Implementation in Health Services framework, and Theory of Planned Behaviour. FINDINGS: Theory use was seen most frequently in medicine and nursing. Only 3 of 90 articles were in rehabilitation. Five approaches to theory application were found, the most common being the use of to predict success of KT (57/90). IMPLICATIONS: In-depth study of the importance and methods of theory application in KT research is needed, in particular in occupational therapy.