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1.
BMC Musculoskelet Disord ; 22(1): 923, 2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34727896

RESUMO

BACKGROUND: Musculoskeletal disorders (MSDs) can create a temporary or permanent disability that reduce a person's ability to work. Physiotherapists (PTs), occupational therapists (OTs) and exercise therapists (ETs) are often involved in the early management of MSDs. There is a need for additional insights into therapists' experiences, barriers and needs to work-focused care. Moreover, there is no evidence on how OTs and ETs address work participation. Therefore, the aim of this qualitative study was 1) to investigate how generalist PTs, OTs and ETs provide work-focused healthcare and 2) to obtain insight into their perceived barriers and needs that affect their ability to address occupational factors. METHODS: An exploratory qualitative study using three focus groups. Generalist PTs, OTs and ETs were eligible to participate if they treated working patients with MSDs. A semi-structured interview guide with open-ended questions was developed. Two moderators facilitated each focus group using the interview guide, and all the groups were audio recorded. Data were analysed using inductive thematic analysis. RESULTS: Sixteen therapists (mean age 44 years, range 25-59) participated in this study. Participants were aware of the importance of taking occupational factors into account. Whether they address occupational factors is largely dependent on the patient's request for help. However, ETs and OTs consider it normal to ask about occupational factors during the diagnostic process, while PTs often address this in later consultations. Almost all participants were unaware of the existence of PTs, OTs or ETs who are specialised in occupational health. Moreover, almost all participants struggled with when to refer a patient to other (occupational) healthcare professionals. This study identified several needs of therapists. These included knowledge about laws and legislation and skills for identifying and addressing work-related or work-relevant complaints. CONCLUSIONS: Participants in this qualitative study were aware of the importance of taking occupational factors into account. However, how PTs, OTs and ETs address work participation and the extent to which they do so can be improved. There was a lack of knowledge about and cooperation with occupational health professionals, including PTs, OTs or ETs specialised in occupational health.


Assuntos
Terapia Ocupacional , Fisioterapeutas , Adulto , Pessoal Técnico de Saúde , Grupos Focais , Humanos , Pessoa de Meia-Idade , Terapeutas Ocupacionais , Pesquisa Qualitativa
2.
Occup Ther Int ; 2021: 9921710, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34729057

RESUMO

Purpose: Often people with spinal cord injury (SCI) require help from their caregivers to carry out activities of daily living. Such assistance may affect caregiver quality of life (QoL). This study investigates the QoL and its associated risk factors among caregivers of people with SCI to find possible ways to increase their QoL. Material and Method. A convenience sample of 135 Iranian caregivers of people with SCI participated in a cross-sectional study from the Brain and Spinal Injury Repair Research Center of Tehran (BASIR), Iran, from June 2018 to October 2019. The World Health Organization's Quality of Life Questionnaire (WHOQoL-BREF), the Beck Depression Inventory-II (BDI-II), the Caregiver Burden Scale (CBS), and a demographic questionnaire were administered. Hierarchical multiple linear regression analysis was then applied to identify risk factors associated with caregiver QoL. Results: Moderate to highly significant negative correlations were observed between all domains of the WHOQoL scale and subscales of the CBS and the BDI-II. After controlling for demographic and clinical variables, depression, burden, and level of injury were found to predict caregiver QoL significantly. Furthermore, QoL was lower in caregivers of people with quadriplegia than paraplegia (p < 0.05). Conclusions: The level of injury, self-perceived caregiver burden, and depression are associated with QoL for the caregivers of people with SCI. A holistic approach incorporating caregiver training, psychological interventions, and adequate support may enable better QoL for these caregivers.


Assuntos
Terapia Ocupacional , Traumatismos da Medula Espinal , Atividades Cotidianas , Cuidadores , Estudos Transversais , Humanos , Irã (Geográfico) , Qualidade de Vida
3.
Occup Ther Int ; 2021: 9970566, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34729058

RESUMO

In Trinidad and Tobago, occupational therapy is an emerging profession with limitations in the number of practitioners and the scope of practice. With the development of a new Master of Science Occupational Therapy programme in the country, the profession is continuously growing. There has been an increased demand for culturally relevant research to build the occupational therapy evidence base locally. However, the narrow range of occupational therapy literature in the country makes it difficult to highlight research gaps and decipher what research areas should be prioritised to best impact occupational therapy practice at present. This group concept mapping study is aimed at identifying priority areas for occupational therapy research in Trinidad and Tobago from the perspectives of occupational therapy students and practitioners. Participants brainstormed and contributed specific research ideas they would like to see developed in the country. Individually, participants sorted these ideas into themes and rated each idea based on perceived importance and feasibility. Using the GroupWisdom™ software, multidimensional scaling and hierarchical cluster analyses were applied to the sort data to create idea clusters within a concept map. Rating values were analysed to determine priority research themes within the concept map. The resulting concept map illustrated seven research priorities: Contextualising Practitioner Development, The Realities of Emerging OT Practice, Localising Mental Health OT, Occupation and Participation of Children and Youth, School-based OT in the Local Context, OT with Special Populations, and OT Contributions to the Public Health Sector. These findings represent the research needs of the occupational therapy profession in Trinidad and Tobago and will help to focus future researchers' efforts to expand the local evidence base.


Assuntos
Terapia Ocupacional , Adolescente , Criança , Análise por Conglomerados , Humanos , Ocupações , Pesquisa , Trinidad e Tobago
4.
Am J Occup Ther ; 75(4)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780604

RESUMO

Throughout the course of their careers, occupational therapy practitioners will encounter many ethical dilemmas as a part of service provision to disabled people. This article illustrates how disability ethics can strengthen the application of the Occupational Therapy Code of Ethics in practice. To maintain the integrity of the occupational therapy profession, it is critical that practitioners integrate concepts of disability ethics into the profession so their practice will promote environments in which disabled people will flourish.


Assuntos
Pessoas com Deficiência , Terapia Ocupacional , Humanos
5.
Am J Occup Ther ; 75(4)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780606

RESUMO

IMPORTANCE: To date, little is known about the extent to which occupational therapy practitioners have adopted the core insights of disability studies. OBJECTIVE: To examine the degree to which occupational therapy practitioners endorse the medical model of disability versus the social model of disability in theory and in practice. DESIGN: Cross-sectional study. SETTING: Physical rehabilitation facilities, ranging from hospital to community settings. PARTICIPANTS: One hundred two Israeli occupational therapy practitioners. Outcomes and Measures: The Orientation toward Disability Scale, constructed for this study, has two dimensions that distinguish between the medical and social models of disability: locus of intervention (the person or environment) and client involvement (extent to which the practitioner fosters the client's autonomy in the rehabilitation process). Each dimension addresses both theoretical and practical endorsements. RESULTS: Greater support for the social model of disability was mostly evident in the client involvement dimension, whereas support for the medical model of disability was mostly evident in the locus of intervention dimension. Over both dimensions, the medical model of disability was significantly more endorsed in practice than in theory. Work setting and prior exposure to the social model of disability were found to affect practitioners' disability orientation. CONCLUSIONS AND RELEVANCE: Occupational therapy practitioners working in physical rehabilitation are still relatively far from fully adopting the critical insights of the social model of disability. This finding is especially relevant when their actual practice, rather than their theoretical views, is considered and when rehabilitation takes place in out-of-home settings. What This Article Adds: This study offers unique insight into the disability orientation of occupational therapy practitioners, showing a need for more training programs to expose students to the social model of disability. These programs should use critical discussions of the challenges that this model presents to the profession and barriers to implementing it in practice.


Assuntos
Pessoas com Deficiência , Terapia Ocupacional , Estudos Transversais , Estudos sobre Deficiências , Humanos , Local de Trabalho
6.
Am J Occup Ther ; 75(4)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780607

RESUMO

IMPORTANCE: Discrimination based on disability-ableism-is pervasive and affects the opportunities of people with disabilities to fully engage in society. OBJECTIVE: The aim of this study was to explore the impact of occupational therapy graduate education on students' explicit and implicit disability attitudes throughout their graduate education. DESIGN: Longitudinal observational study, measuring occupational therapy students' attitudes on an annual basis. SETTING: Three Midwestern graduate occupational therapy programs. PARTICIPANTS: Occupational therapy students (N = 67). Outcomes and Measures: Participants completed the Symbolic Ableism Scale (to measure their explicit disability attitudes) and the Disability Attitude Implicit Association Test (to measure their implicit disability attitudes) on an annual basis, from when they entered their occupational therapy program to when they graduated. RESULTS: The students' explicit attitudes decreased (i.e., became more favorable) throughout their education; however, their implicit attitudes did not change. In fact, most students (68%) were implicitly ableist at graduation. CONCLUSIONS AND RELEVANCE: Occupational therapy education programs have an important role to play in terms of intervening with students' beliefs and preconceived assumptions about disability. Our finding suggests that occupational therapy programs may fail to intervene with students' ableist attitudes. What This Article Adds: Little longitudinal research has examined how students' implicit disability bias may be affected by their academic experience. Our findings about ableism among occupational therapy students should open the door for further dialogue on the existence of ableism in program content, its potential impact on future client interactions, and the development of approaches to address it.


Assuntos
Pessoas com Deficiência , Terapia Ocupacional , Atitude , Atitude do Pessoal de Saúde , Humanos , Estudos Longitudinais , Estudantes , Inquéritos e Questionários
7.
Am J Occup Ther ; 75(4)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780610

RESUMO

IMPORTANCE: In 2005, the American Journal of Occupational Therapy published a special issue focused on disability studies. Contributing authors challenged readers to reflect on their practices and recommended ways to change the field, yet literature on the current state of the integration of disability studies into occupational therapy is scarce. OBJECTIVE: To engage the original authors of the 2005 special issue in an examination of perspectives on how disability studies perspectives have contributed to changes within occupational therapy and what work remains. DESIGN: The research team conducted semistructured interviews with 11 authors who published an article in the special issue. Interview transcripts were analyzed using thematic analysis. Triangulation of coders, multiple phases of data analysis, and member checking were used to establish trustworthiness. RESULTS: Five themes emerged from the data: (1) exposure to disability and disability studies, (2) impact of the special issue on occupational therapy, (3) changes observed in occupational therapy beyond the special issue, (4) challenges integrating disability studies into occupational therapy, and (5) disability studies-informed recommendations for occupational therapy. CONCLUSIONS AND RELEVANCE: Although the original contributing authors acknowledged the transformative impact of disability studies on their own practice and scholarship, the results suggest that disability studies remains outside mainstream occupational therapy scholarship. Exploring the connections and divergence between disability studies and fields such as occupational science could improve understanding of how disability studies concepts are defined and used in theory and practice. What This Article Adds: Since the publication of the original special issue in 2005, the field of disability studies has continued to influence occupational therapy, although more often in individual than in systemic ways. Work is needed to embrace a disability studies-informed critical and intersectional foundation for the profession and explore the ways in which occupational therapy can better partner with populations through a disability studies lens.


Assuntos
Pessoas com Deficiência , Terapia Ocupacional , Estudos sobre Deficiências , Humanos , Projetos de Pesquisa
8.
Am J Occup Ther ; 75(4)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780612

RESUMO

Disability studies (DS) is an interdisciplinary field grounded in a minority studies philosophy that approaches disability as a socially constructed phenomenon. The first special issue of the American Journal of Occupational Therapy on DS was published in 2005. The present issue serves as a follow-up to highlight opportunities for and examples of DS integration into occupational therapy education, research, and practice. Studies in this special issue reflect a DS approach to research that prioritizes lived experiences, critical approaches, and participatory methodologies. Reported interventions focus on changing societal barriers rather than remediating individual impairments and acknowledge instrumental activities of daily living often neglected by traditional research. Studies on educational practices in occupational therapy have found persistent issues around negative attitudes toward disability and many opportunities to better infuse disabilities studies into curricula. Revisiting DS as it applies to occupational therapy has shown that many of the issues and considerations raised in 2005 remain in the field today. Recommendations across articles in this special issue highlight that advocacy and working for broader social change are essential for occupational therapy practitioners, given ongoing occupational injustices for people with disabilities. Infusing DS ideas into occupational therapy can promote greater alignment with priorities of disability communities and spur professional change to dismantle oppressive structures and ideologies.


Assuntos
Pessoas com Deficiência , Terapia Ocupacional , Atividades Cotidianas , Estudos sobre Deficiências , Humanos , Ocupações
9.
Am J Occup Ther ; 75(4)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780613

RESUMO

IMPORTANCE: Evidence supports interventions for work and social participation for adults with multiple sclerosis (MS). OBJECTIVE: To systematically collect and evaluate the evidence for the effectiveness of interventions within the scope of occupational therapy practice to improve or maintain the performance of and participation in education, work, volunteering, leisure, and social participation among adults with MS. DATA SOURCES: MEDLINE, PsycINFO, CINAHL, OTseeker, and Cochrane Database of Systematic Reviews searches for articles published from January 2011 to December 2018. Study Selection and Data Collection: Two independent reviewers analyzed articles using Cochrane methodology. Articles were assessed in terms of inclusion and exclusion criteria, quality, and risk of bias. FINDINGS: Although the review was developed to address education, work, volunteering, leisure, and social participation, only work and social participation outcomes were found in the literature. Six hundred eighteen articles were reviewed, and 4 articles met the inclusion criteria. One Level 1b study and 1 Level 3b study provided moderate strength of evidence with moderate risk of bias for an online work intervention to improve self-esteem and better understand career goals. One Level 3b study provided low strength of evidence for interdisciplinary rehabilitation to address work. Finally, 1 Level 1b study with a yoga group intervention provided moderate strength of evidence with low risk of bias to improve social participation. CONCLUSIONS AND RELEVANCE: This review highlights the lack of evidence related to various types of participation for adults with MS. The evidence focused on work and social participation was limited. What This Article Adds: This review highlights the need for interventions within the scope of occupational therapy for increased participation for adults with MS.


Assuntos
Esclerose Múltipla , Terapia Ocupacional , Adulto , Humanos , Atividades de Lazer , Participação Social , Revisões Sistemáticas como Assunto
10.
Am J Occup Ther ; 75(4)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780614

RESUMO

IMPORTANCE: Disability studies-informed occupational therapy is predicated on full and equal partnerships among occupational therapy practitioners, researchers, and disability communities. Community-based participatory research (CBPR) is an approach to research that aligns with this vision yet is not without challenges. Understanding the tensions that arise from stakeholders' perspectives and priorities is critical for promoting collaboration between occupational therapy professionals and disability community partners. OBJECTIVE: To understand the group dynamics and relational processes of a CPBR team in the context of an intervention development study focused on health management for people with disabilities (PWD). DESIGN: This 9-mo ethnographic study included semistructured interviews and participant observation. Data were analyzed thematically. SETTING: Community-based multiagency collaborative. PARTICIPANTS: Nine participants (6 academic team members, 4 of whom were trained as occupational therapists; 2 disability partners; and 1 managed-care organization representative) took part. Three participants self-identified as PWD. FINDINGS: CBPR processes, although productive, were fraught with challenges. Team members navigated competing priorities, varying power dynamics, and multifaceted roles and identities. Flexibility was needed to address diverse priorities, respond to unexpected challenges, and facilitate the project's success. CONCLUSIONS AND RELEVANCE: Deep commitment to a shared goal of health care justice for PWD and team members' willingness to address tensions promoted successful collaboration. Intentional relationship building is needed for occupational therapy researchers to collaborate with members of disability communities as equal partners. What This Article Adds: Disability studies-informed occupational therapy research demands that team members intentionally nurture equitable relationships through shared governance, clear communication, and recognition of the fluid nature of power dynamics.


Assuntos
Pessoas com Deficiência , Terapia Ocupacional , Antropologia Cultural , Pesquisa Participativa Baseada na Comunidade , Promoção da Saúde , Humanos
11.
Am J Occup Ther ; 75(4)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780616

RESUMO

IMPORTANCE: Sexuality is an important part of the human experience. However, little is known about the experience of sexuality from the perspective of adults with intellectual and developmental disabilities (IDD). OBJECTIVE: To review evidence about the lived experience of sexuality among adults with IDD to inform future research and practice. DATA SOURCES: We located articles using search terms summarized into three categories: intellectual disability, sexual activity, and feelings/opinions. Articles were indexed in the following electronic databases: CINAHL, Scopus, PubMed, and PsycINFO. Study Selection and Data Collection: Arksey and O'Malley's methodology was used to review scientific literature published between 2008 and 2018. The studies were in English, were located in peer-reviewed journals, and described the experience of sexuality from the perspective of people with IDD or observations of expressed sexuality. FINDINGS: Seventeen articles met inclusion criteria. Four main themes emerged: intimate relationships, oppressed sexual activity, knowledge, and identity. Findings indicate that sexuality is a part of the lives of many adults with IDD, regardless of their engagement in sexual activity. CONCLUSIONS AND RELEVANCE: Barriers to expression of sexuality exist for people with IDD. Some of these barriers are internal, although many are external. The results provide support for addressing sexuality among adults with IDD. What This Article Adds: This review provides evidence to support occupational therapy practitioners in including sexuality as a part of their holistic view of clients and as an area for advocacy.


Assuntos
Deficiência Intelectual , Terapia Ocupacional , Adulto , Criança , Deficiências do Desenvolvimento , Humanos , Comportamento Sexual , Sexualidade
12.
Am J Occup Ther ; 75(4)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780618

RESUMO

IMPORTANCE: Adults aging with intellectual and developmental disabilities (IDD) continue to face barriers to participation in meaningful occupation; moreover, the increased life expectancy of adults with IDD intensifies the need for age- and environment-specific support. OBJECTIVE: To map and categorize transdisciplinary literature on environmental modifications and supports for adults aging with IDD. DATA SOURCES: Studies published between January 1, 2000, and January 1, 2019, identified through PubMed and Scopus. Study Selection and Data Collection: Eleven articles met the inclusion criteria and contained information specific to occupational participation based on environmental modification (e.g., physical space, technology, universal design, type of living setting), social supports (e.g., family members, caretakers, peer groups, health care professionals, policies, organizational infrastructure), or both and adults age ≥35 yr with IDD. FINDINGS: Eleven studies met the criteria for this scoping review. Thematic coding was used to examine the articles within one or more themes: definition of need, environmental risk and assessment, environmental setting, intervention and program planning, use of technology, and bureaucracy. CONCLUSIONS AND RELEVANCE: This review highlights collective and individual outcomes in the areas of assessment, intervention, and advocacy. Further research is needed within the scope of occupational therapy and disability studies that examines environmental factors and participation outcomes in this population. What This Article Adds: The authors define the interconnectedness of adults aging with IDD and environmental factors, identify barriers to participation, and guide occupational therapy practitioners' logic on how to positively affect environmental change and supports through intervention.


Assuntos
Deficiência Intelectual , Terapia Ocupacional , Adulto , Envelhecimento , Criança , Deficiências do Desenvolvimento , Humanos , Apoio Social
13.
Am J Occup Ther ; 75(4)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780620

RESUMO

IMPORTANCE: Engaging in travel is linked to quality of life. People with disabilities travel less often than people without disabilities, likely because of the challenges they experience during hotel stays. OBJECTIVE: To explore how people with various physical and sensory disabilities experience hotel stays and to identify opportunities for occupational therapy intervention. DESIGN: Qualitative, phenomenological design with semistructured interviews. PARTICIPANTS: Eight adults with physical or sensory disabilities who had at least two hotel stays in the past year. Outcomes and Measures: We used a semistructured interview guide to ask participants about their experiences during hotel stays. RESULTS: We identified six themes: (1) customer service, (2) reservation process, (3) built environment challenges, (4) traits and skills, (5) use of technology, and (6) safety and emergency preparedness. CONCLUSION: The physical, virtual, and social environments of hotels create challenges for people with physical and sensory disabilities. People with such disabilities use skills to improve their hotel experience. Occupational therapy practitioners can affect the hotel experience of people with disabilities through advocacy, consultation with hotels, and direct intervention with clients. What This Article Adds: This article offers novel information about the impact of the hotel environment on people with physical and sensory disabilities, the ways in which people with such disabilities manage these challenges, and intervention opportunities for occupational therapy practitioners.


Assuntos
Pessoas com Deficiência , Terapia Ocupacional , Adulto , Humanos , Pesquisa Qualitativa , Qualidade de Vida
14.
Am J Occup Ther ; 75(5)2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780629

RESUMO

IMPORTANCE: An analysis by the Substance Abuse and Mental Health Services Administration (SAMHSA; 2015a) found that an additional 10,000 mental health care providers will be needed by 2025 to meet the expected growth in demand for treatment of people with mental illness, substance use disorder, or both. Despite being the largest payer of mental health services in the United States, the Medicaid program has extremely low numbers of mental health providers (Frank et al., 2003). OBJECTIVE: This Health Policy Perspectives column is a collaboration among academics, clinicians, and students in the fields of occupational therapy and law in an effort to advance state occupational therapy associations' efforts to gain formal recognition of occupational therapy practitioners as Qualified Mental Health Providers (QMHPs) and/or Qualified Behavioral Health Providers (QBHPs). CONCLUSION: Coordination among states to identify barriers and opportunities in this important advocacy effort are needed for continued successful inclusion of occupational therapy practitioners as QMHPs, QBHPs, or both. What This Article Adds: This column will assist other states in their efforts by providing legislation, strategic advocacy examples, and a course of action.


Assuntos
Serviços de Saúde Mental , Terapia Ocupacional , Transtornos Relacionados ao Uso de Substâncias , Humanos , Medicaid , Estados Unidos
15.
Am J Occup Ther ; 75(5)2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780631

RESUMO

IMPORTANCE: The recovery model in mental health involves person-driven care and informed decision making to enhance engagement in meaningful activities and inclusion in society. To facilitate the recovery process, occupational therapy practitioners must support their clients in understanding how their participation in meaningful occupation is intimately related to their health and well-being. OBJECTIVE: To explore whether engaging in an occupational reflection intervention on an inpatient psychiatric unit can support the recovery of adults living with serious mental illness (SMI). DESIGN: Using a phenomenological design, we conducted semistructured interviews to assess whether participation in an occupational reflection intervention supported recovery. SETTING: An inpatient psychiatric unit at a university medical center. PARTICIPANTS: We recruited 10 adults living with SMI using purposive sampling. INTERVENTION: Participants engaged in a structured occupational reflection intervention using the Occupational Experience Profile (OEP). The OEP is a time-use diary that captures respondents' subjective experiences of pleasure, productivity, restoration, and connection in relation to their participation in occupations over 24 hr. Study participants engaged in collaborative analyses regarding their OEP results to explore their subjective experiences in relation to their occupational participation. Outcomes and Measures: Participant self-report during interviews. RESULTS: Engaging in structured reflection affected participants' experiences of recovery by promoting insight into and awareness of how occupations affect mental health, encouraging positive reframing of occupational experience, and facilitating identification of strategies to support recovery and meaningful participation after discharge. Conclusions and Relevance: Occupational reflection can promote the recovery of adults living with SMI. What This Article Adds: A structured occupational reflection intervention can help adults living with SMI in inpatient psychiatric units to understand the close relationship between their participation in occupations and their health. This process provides valuable insight to clients regarding how to support their recovery through engagement in meaningful occupation.


Assuntos
Terapia Ocupacional , Psiquiatria , Adulto , Humanos , Pacientes Internados , Saúde Mental , Ocupações
16.
Am J Occup Ther ; 75(5)2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780633

RESUMO

Unpaid caregivers are often expected to help family members or friends overcome activity limitations and participation restrictions to successfully age in place. Caregivers assume multiple responsibilities, such as managing their own physical and psychosocial needs and navigating a complex health care system, and many feel ill equipped to fulfill the necessary health care responsibilities for their care recipients. Underprepared caregivers may cause poor outcomes for care recipients. Federal and state policy proposals call attention to the need to better support caregivers, especially as their numbers increase. Occupational therapy practitioners are well positioned to effectively engage caregivers as they navigate the health care system. The occupational therapy process looks broadly at the functional abilities, environmental contexts, and occupational demands that play a pivotal role in successful aging in place for clients and better outcomes for their caregivers. Now is the time to define occupational therapy's distinct value to this area.


Assuntos
Vida Independente , Terapia Ocupacional , Atividades Cotidianas , Idoso , Cuidadores , Família , Humanos , Estados Unidos
17.
Am J Occup Ther ; 75(5)2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780638

RESUMO

IMPORTANCE: Evidence of the effectiveness of cognitive activity and preparatory tasks in improving the cognitive skills and functional performance of people with cognitive decline is limited. OBJECTIVE: To examine the efficacy of a high-ecological cognitive intervention. DESIGN: Quasi-experimental, pretest-posttest design with nonequivalent control. SETTING: Community. PARTICIPANTS: Older adults with mild cognitive impairment from two senior centers. INTERVENTION: Twelve 90-min weekly group sessions of a high-ecological cognitive intervention using simulated everyday cognitive tasks (experimental group) and of nutrition education (active control group). Outcomes and Measures: Cognitive skills were measured with the Color Trails Test (CTT), the Contextual Memory Test (CMT; Immediate Recall [CMT-Im] and Delayed Recall [CMT-De] tasks), and the Wechsler Adult Intelligence Scale-Fourth Edition Digit Span subtest (Digits Forward and Digits Backward). Cognitive-functional performance was measured with the Rivermead Behavioural Memory Test-Third Edition (RBMT-3; Immediate Recall [RBMT-3-Im] and Delayed Recall [RBMT-3-De] tasks) and the Cognitive Failures Questionnaire (CFQ). RESULTS: Thirty-seven participants (M age = 70.84 yr; 70.3% women) met the inclusion criteria for analysis (20 participants in the intervention group, 17 participants in the control group). Multivariate linear regression showed that the intervention group improved significantly more than the control group on the CTT, CMT-Im, and RBMT-3-Im but not on the CMT-De, RBMT-3-De, and CFQ. CONCLUSIONS AND RELEVANCE: Twelve 90-min weekly group sessions of a high-ecological cognitive intervention improved attention, executive function, immediate memory, and objective cognitive-functional performance with immediate-memory task demands. What This Article Adds: Carefully designed and structured simulated everyday cognitive tasks can be used as a cognitive training agent to improve both cognitive skills and objective cognitive-functional performance. The effectiveness of group-based cognitive interventions depends on the skills of occupational therapy practitioners in activity analysis and grading.


Assuntos
Disfunção Cognitiva , Terapia Ocupacional , Idoso , Cognição , Função Executiva , Feminino , Humanos , Masculino , Desempenho Físico Funcional
18.
Am J Occup Ther ; 75(5)2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780640

RESUMO

IMPORTANCE: Time management is crucial for managing daily activities but is difficult for many people with neurodevelopmental or mental disorders. Few sustainable interventions have addressed time management in daily life. OBJECTIVE: To describe the experiences and meaning of attending the Swedish version of the Let's Get Organized (LGO-S) group intervention. DESIGN: Qualitative design with interviews 1 to 4 mo after the completed intervention. SETTING: Outpatient psychiatric and adult habilitation clinics. PARTICIPANTS: Twelve adults with neurodevelopmental or mental disorders. INTERVENTION: LGO-S, a manual-based group intervention that focuses on time-management skills. Outcomes and Measures: Semistructured interviews analyzed with qualitative content analysis. All authors took an active part in the analysis process; consensus was reached. RESULTS: The overarching theme, "a roller-coaster process toward control over time in daily life," describes the participants' process during and after intervention. Four main categories describe the meaning of understanding why time management is difficult and how to use tools for improvement, a process of change that was facilitated by the learning environment. Participants described the process as a struggle to take control over time, but they noted that the positive changes in daily life made it worthwhile. CONCLUSIONS AND RELEVANCE: Participation had a positive impact on daily life. The opportunity for skills training with support over an extended period, a changed view on failure, and the group format appear to be important success factors. What This Article Adds: The LGO-S, with its structured training of time-management skills, contributes to occupational therapy practice with an intervention that clients experience as bringing meaningful and positive changes to daily life functioning.


Assuntos
Transtornos Mentais , Terapia Ocupacional , Adulto , Humanos , Suécia , Gerenciamento do Tempo
19.
Am J Occup Ther ; 75(5)2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780641

RESUMO

IMPORTANCE: Spanish-speaking populations represent a significant percentage of occupational therapy clientele globally. Culturally appropriate Spanish translations of assessments are therefore imperative. This study describes the process of a culturally adapted translation of a set of tests for use with Spanish-speaking pediatric populations. OBJECTIVE: To produce a culturally adapted Spanish translation of the Evaluation in Ayres Sensory Integration® (EASI) for international use. METHOD: We used cultural adaptation methodology that included direct and back translations of the EASI by bilingual translators and interviews with pediatric occupational therapists and children ages 3-6 yr from Spain. Linguistic experts helped revise the translations, and pediatric occupational therapy leaders in five Spanish-speaking North and South American countries reviewed the translations for comprehensibility and cultural appropriateness. RESULTS: Back translations demonstrated equivalence with the original EASI tests except for a few test instructions and scoring criteria. Interviews with occupational therapists and children in Spain revealed some comprehension difficulties for several tests, which were revised in consultation with a linguistic expert. Additional adaptations were made on the basis of recommendations to address cultural differences by occupational therapy leaders from five North and South American countries. Most changes in wording were made in one EASI test (Praxis: Following Directions) that is heavily dependent on language comprehension. CONCLUSIONS AND RELEVANCE: We used currently recommended methodologies to develop and adapt a Spanish translation of the EASI for use across diverse cultures. What This Article Adds: A Spanish translation of the EASI has been developed for use in culturally diverse Spanish-speaking countries around the world.


Assuntos
Terapia Ocupacional , Criança , Pré-Escolar , Comparação Transcultural , Humanos , Idioma , Inquéritos e Questionários , Traduções
20.
Am J Occup Ther ; 75(5)2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780643

RESUMO

IMPORTANCE: Occupational therapy practitioners can play a pivotal role in supporting breastfeeding mothers as they transition to and form new routines for this occupation. OBJECTIVE: To explore whether occupational therapy programming can assist breastfeeding mothers in reaching their personal occupation-based wellness goals. DESIGN: Mixed-methods design that involved development of an occupational profile and a goal attainment scale (GAS). After the intervention, participants rescored their GAS goals and completed a semistructured exit interview. SETTING: Nonprofit lactation center located in the suburbs of a large mid-Atlantic U.S. city. PARTICIPANTS: Women recruited through convenience sampling who had been breastfeeding an infant for <6 mo, who were not currently weaning, and who had met with a lactation consultant at least once since giving birth were eligible (N = 17). INTERVENTION: Group occupational therapy that consisted of 10 weekly 1-hr sessions. Topics were based on occupational profiles, GAS scores, and lactation consultant input. Outcomes and Measures: Each participant created and scored three goals using the GAS before and after the intervention. RESULTS: Data from 14 of the 17 participants were analyzed. The average postintervention GAS score was 56.50 (M = 50), indicating that most personal wellness goals were reached. Thematic analysis revealed that occupational therapy programming helped mothers persevere with breastfeeding, feel more confident as new parents, and value both themselves and their baby. CONCLUSIONS AND RELEVANCE: There is an increasing role for occupational therapy practitioners in helping new mothers reach their personal wellness goals in ways that support their ability to continue breastfeeding. What This Article Adds: Maternal wellness and breastfeeding represent an emerging area of practice in which occupational therapy practitioners can provide new mothers with physical, social, and psychological supports that help them maintain self-efficacy related to breastfeeding and other meaningful occupations. This study provides foundational evidence in support of this collaboration.


Assuntos
Aleitamento Materno , Terapia Ocupacional , Feminino , Humanos , Lactente , Mães , Pais , Gravidez , Autoeficácia
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