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1.
Soins Gerontol ; 25(145): 22-25, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32988483

RESUMO

The hand, a vector of knowledge and understanding of the surrounding world, promotes relationships. For all medico-social professionals, taking care of the hand involves touch, benevolent accompaniment to encourage movement and involvement in the activities of daily life. Touch in the relationship with the elderly person places the occupational therapist in the dynamics of rehabilitation in an interprofessional team. Three facets of touch are described.


Assuntos
Terapia Ocupacional/métodos , Tato , Idoso , Mãos , Humanos
2.
Lancet Psychiatry ; 7(10): 893-910, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32949521

RESUMO

Mental illness and substance use disorders in the workplace have been increasingly recognised as a problem in most countries; however, evidence is scarce on which solutions provide the highest return on investment. We searched academic and grey literature databases and additional sources for studies that included a workplace intervention for mental health or substance abuse, or both, and that did an economic analysis. We analysed the papers we found to identify the highest yielding and most cost-effective interventions by disorder. On the basis of 56 studies, we found moderate strength of evidence that cognitive behavioural therapy is cost-saving (and in some cases cost-effective) to address depression. We observed strong evidence that regular and active involvement of occupational health professionals is cost-saving and cost-effective in reducing sick leave related to mental health and in encouraging return to work. We identified moderate evidence that coverage for pharmacotherapy and brief counselling for smoking cessation are both cost-saving and cost-effective. Addressing mental health and substance misuse in the workplace improves workers' wellbeing and productivity, and benefits employers' bottom line (ie, profit). Future economic analyses would benefit from the consideration of subgroup analyses, examination of longer follow-ups, inclusion of statistical and sensitivity analyses and discussion around uncertainty, and consideration of potential for bias.


Assuntos
Serviços de Saúde do Trabalhador/economia , Serviços de Saúde do Trabalhador/métodos , Terapia Ocupacional/economia , Terapia Ocupacional/métodos , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Terapia Cognitivo-Comportamental/economia , Terapia Cognitivo-Comportamental/métodos , Análise Custo-Benefício , Economia Médica , Humanos , Saúde Mental , Ensaios Clínicos Controlados Aleatórios como Assunto , Licença Médica/estatística & dados numéricos , Local de Trabalho
3.
Univ. salud ; 22(2): 186-197, mayo-ago. 2020. tab, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1115968

RESUMO

Resumen Introducción: El ejercicio de la práctica profesional relacionado con el reintegro laboral de personas con discapacidad, debe soportar su actuar en la evidencia científica. Con el avance de las tecnologías de información y comunicación se tiene acceso a un gran acervo de resultados de investigaciones, a las cuales se pueden acceder a través del uso de estrategias de búsqueda. Objetivo: Evidenciar la pertinencia de una estrategia de búsqueda para recuperar publicaciones científicas relacionadas con el reintegro laboral de personas con discapacidad. Materiales y métodos: Se presenta de forma sistemática la estrategia de búsqueda a partir de definición de la pregunta, identificación de términos de búsqueda en lenguaje común y controlado, ecuación de búsqueda, búsqueda-recuperación de artículos, criterios inclusión-exclusión, selección de artículos, lectura crítica y respuesta a pregunta de investigación. Lo anterior puede ser reproducido ajustando descriptores según el interés profesional. Resultados: Se recuperaron 15 artículos que responden a la pregunta ejemplo, evidenciando la pertinencia de la estrategia de búsqueda. Conclusiones: La estrategia de búsqueda de información académica propuesta, permite recuperar artículos que son pertinentes para el investigador y profesionales en su práctica diaria.


Abstract Introduction: The professionals to exercise their practice in an updated and effective way in the matter of return to work of persons with disabilities must support their actions in the scientific evidence. With technology you have access to a lot of information. To be effective and retrieve the data that is required the use of search strategies. Objective: To demonstrate the relevance of a search strategy to recover scientific publications, in this case, labor reimbursement of persons with disabilities. Materials and methods: The search strategy is systematically presented based on the definition of the question, identification of search terms in common and controlled language, search equation, search-retrieval of articles, inclusion-exclusion criteria, selection of articles, critical reading and answer to research question. The above can be reproduced by adjusting descriptors according to professional interest. Results: 15 articles were retrieved that answer the example question evidencing the relevance of the search strategy. Conclusions: An academic information search strategy allows retrieving articles that are relevant for the researcher and professionals in their daily practice.


Assuntos
Humanos , Pessoas com Deficiência , Retorno ao Trabalho , Trabalho , Terapia Ocupacional , Estratégias
4.
Medicine (Baltimore) ; 99(34): e21846, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846833

RESUMO

INTRODUCTION: Stroke often causes residual hemiparesis, and upper extremity motor impairment is usually more disabling than lower extremity in those who are suffering from post-stroke hemiparesis. Cell therapy is one of the promising therapies to reduce post-stroke disability. PATIENT CONCERNS: Three male participants were included in the study to investigate the feasibility and tolerability of autologous adipose tissue derived stromal vascular fraction. DIAGNOSIS: All participants had hemiparesis after 1st-ever stroke longer than 6 months previously. INTERVENTIONS: Under general anesthesia, liposuction of abdominal subcutaneous fat was performed. Stromal vascular fraction freshly isolated from the adipose tissue extract was injected into the muscles of paretic upper extremity. All participants received inpatient stroke rehabilitation consisted of physical and occupational therapy more than 3 hours a day for 2 months or more. OUTCOMES: The whole procedure did not produce any significant adverse event in all participants. Adipose tissue extracts yielded sufficient stromal cells. One participant showed clinically important change in upper extremity Fugl-Meyer assessment after the injection and it lasted up to 6 months. Functional magnetic resonance imaging showed concomitant increase in ipsilesional cortical activity. The other 2 participants did not show remarkable changes. LESSONS: Intramuscular injection of autologous adipose tissue derived stromal vascular fraction seems to be a safe and tolerable procedure in subjects with chronic stroke, and its utility in rehabilitation needs further investigation.


Assuntos
Tecido Adiposo/irrigação sanguínea , Tecido Adiposo/transplante , Transplante de Células-Tronco Mesenquimais/métodos , Reabilitação do Acidente Vascular Cerebral/métodos , Células Estromais/transplante , Tecido Adiposo/citologia , Adulto , Hemorragia Cerebral/complicações , Humanos , Injeções Intramusculares , Lipectomia/métodos , Imagem por Ressonância Magnética/métodos , Masculino , Células-Tronco Mesenquimais , Terapia Ocupacional/métodos , Paresia/fisiopatologia , Paresia/reabilitação , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico por imagem , Células Estromais/citologia , Extremidade Superior/fisiopatologia
5.
Orthopedics ; 43(5): 292-294, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32745217

RESUMO

The COVID-19 pandemic has had a strong impact on the care of orthopedic patients. This impact has been particularly difficult in New York State, which experienced the largest number of COVID-19 cases and led to a state- mandated pause on all elective surgeries. As a result, physical and occupational therapists became the principal providers of care and had to adjust their workflow to ensure quality care. Understanding the perspectives and needs of therapists relative to the circumstances created by COVID-19 is critical to safe and effective care. The goal of this study was to define the perspectives of therapists in New York State regarding the impact of COVID-19 on their work. An email-based 20-question survey was distributed to 250 therapists from all 10 regions of New York State who treated outpatient orthopedic patients during the peak of the pandemic in early April 2020. The survey collected demographic and practice information as well as responses regarding several clinical practice issues. The results provide insight into the concerns of therapists regarding the delivery of care, and responses clarify indications for therapy and for the use of telemedicine to achieve goals during the pandemic. The COVID-19 pandemic is profoundly impacting the work of therapists worldwide. Therapists responded to this survey expressing concerns about the safe delivery of care, access to personal protective equipment, use of telemedicine, and their role within health care during the pandemic. The results of this study can be used to establish guidelines for safe, effective, and efficient therapy during the pandemic. [Orthopedics. 2020;43(5):292-294.].


Assuntos
Atitude do Pessoal de Saúde , Infecções por Coronavirus/epidemiologia , Procedimentos Ortopédicos/reabilitação , Ortopedia/tendências , Pacientes Ambulatoriais , Fisioterapia/tendências , Pneumonia Viral/epidemiologia , Telerreabilitação/tendências , Betacoronavirus , Procedimentos Cirúrgicos Eletivos/reabilitação , Correio Eletrônico , Humanos , New York/epidemiologia , Exposição Ocupacional , Terapia Ocupacional , Pandemias , Equipamento de Proteção Individual , Inquéritos e Questionários , Telerreabilitação/estatística & dados numéricos
6.
Mult Scler ; 26(10): 1163-1171, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32772807

RESUMO

BACKGROUND: People with multiple sclerosis (MS) may be at higher risk for complications from the 2019 coronavirus (COVID-19) pandemic due to use of immunomodulatory disease modifying therapies (DMTs) and greater need for medical services. OBJECTIVES: To evaluate risk factors for COVID-19 susceptibility and describe the pandemic's impact on healthcare delivery. METHODS: Surveys sent to MS patients at Cleveland Clinic, Johns Hopkins, and Vall d'Hebron-Centre d'Esclerosi Múltiple de Catalunya in April and May 2020 collected information about comorbidities, DMTs, exposures, COVID-19 testing/outcomes, health behaviors, and disruptions to MS care. RESULTS: There were 3028/10,816 responders. Suspected or confirmed COVID-19 cases were more likely to have a known COVID-19 contact (odds ratio (OR): 4.38; 95% confidence interval (CI): 1.04, 18.54). In multivariable-adjusted models, people who were younger, had to work on site, had a lower education level, and resided in socioeconomically disadvantaged areas were less likely to follow social distancing guidelines. 4.4% reported changes to therapy plans, primarily delays in infusions, and 15.5% a disruption to rehabilitative services. CONCLUSION: Younger people with lower socioeconomic status required to work on site may be at higher exposure risk and are potential targets for educational intervention and work restrictions to limit exposure. Providers should be mindful of potential infusion delays and MS care disruption.


Assuntos
Infecções por Coronavirus/epidemiologia , Emprego , Fatores Imunológicos/uso terapêutico , Esclerose Múltipla/terapia , Terapia Ocupacional , Modalidades de Fisioterapia , Pneumonia Viral/epidemiologia , Classe Social , Adulto , Fatores Etários , Betacoronavirus , Comorbidade , Infecções por Coronavirus/prevenção & controle , Assistência à Saúde , Gerenciamento Clínico , Suscetibilidade a Doenças , Escolaridade , Feminino , Comportamentos Relacionados com a Saúde , Acesso aos Serviços de Saúde , Terapia por Infusões no Domicílio , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Obesidade/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Fatores de Risco , Espanha/epidemiologia , Estados Unidos/epidemiologia
7.
Am J Occup Ther ; 74(5): 7405090010p1-7405090010p6, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804618

RESUMO

The U.S. population is aging at an unprecedented rate, creating both opportunities and challenges for the overall health of the nation. Occupational therapy practitioners can inform important health policies by developing an understanding of the basis for relevant laws and programs and how occupational therapy principles relate to policy goals. This column discusses the Older Americans Act of 1965 (reauthorized as the Supporting Older Americans Act of 2020) and describes ways in which the objectives of this legislation align with the principles and practice of occupational therapy. Recommendations are provided for how the field of occupational therapy can enhance current policy development and debate, thus leading to expanded opportunities for the profession.


Assuntos
Terapia Ocupacional , Idoso , Política de Saúde , Humanos , Estados Unidos
8.
Am J Occup Ther ; 74(5): 7405205020p1-7405205020p11, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804620

RESUMO

IMPORTANCE: There is a critical gap in the literature regarding the efficacy of occupational therapy interventions for pediatric hematopoietic cell transplantation (HCT) patients. OBJECTIVE: To demonstrate that occupational therapy 4-5×/wk during inpatient hospitalization positively affects strength, coordination, and independence in activities of daily living (ADLs) of pediatric patients during HCT. DESIGN: Retrospective study. SETTING: Inpatient bone marrow transplant unit at a children's hospital. PARTICIPANTS: Thirty-two pediatric patients admitted for HCT. OUTCOMES AND MEASURES: Patients were seen by an occupational therapist as part of an interdisciplinary program. Interventions included play and leisure engagement, upper extremity therapeutic exercises, fine motor activities, and ADL training. Strength, coordination, and daily living skills data were documented prospectively and analyzed retrospectively to compare differences between patients seen by occupational therapy at high versus low frequency. RESULTS: For grip strength (dynamometer), fine motor dexterity (the 9-Hole Peg Test), and independence in ADLs (an ADL functional measure and the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test Daily Activities), the high-frequency group had a significantly smaller decrease in performance from time of admission at pretransplant (baseline) to peak decline after transplant. Grip strength and ADL scores for the high-frequency group returned to baseline at time of discharge more readily than for the low-frequency group. CONCLUSIONS AND RELEVANCE: Participation in occupational therapy 4-5×/wk had positive effects on strength, coordination, and independence in ADLs for patients undergoing HCT. WHAT THIS ARTICLE ADDS: This article provides evidence that occupational therapists are an important part of the interdisciplinary team treating pediatric bone marrow transplant patients. It also demonstrates that occupational therapy interventions delivered at a high frequency can have a positive impact on upper extremity strength and independence in ADLs.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Terapia Ocupacional , Atividades Cotidianas , Criança , Terapia por Exercício , Humanos , Estudos Retrospectivos
9.
Am J Occup Ther ; 74(5): 7405205030p1-7405205030p13, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804621

RESUMO

IMPORTANCE: Occupational therapy can play a role in primary care management of chronic diseases among older adults. OBJECTIVE: To assess the feasibility of delivering a primary care occupation-focused intervention (Integrated PRimary care and Occupational therapy for Aging and Chronic disease Treatment to preserve Independence and Functioning, or i-PROACTIF) for older adults with chronic disease. DESIGN: Feasibility study comparing i-PROACTIF with complex care management using a two-group randomized controlled trial design with data gathered at baseline and during and after the 8-wk intervention. SETTING: Family medicine clinic serving an urban, low-income, working-class community. OUTCOMES AND MEASURES: Feasibility indicators were recruitment, retention, utility of clinical assessments, and acceptability of interventions assessed through feedback surveys completed by patients and primary care providers (PCPs). Patient outcomes, including perspectives on chronic illness care, occupational performance, and overall well-being, were collected using standardized, validated measures and analyzed descriptively. PARTICIPANTS: Eighteen adult volunteers, ages ≥50 yr, with heart disease, arthritis, and uncontrolled diabetes completed the study. Ten PCPs completed feedback surveys. INTERVENTION: i-PROACTIF focuses on preserving functional independence, is based on the Person-Environment-Occupation framework, and consists of two assessment sessions and six weekly treatment sessions. RESULTS: Recruitment goals were achieved, with an 86% retention rate. Clinical measures unearthed deficits in areas that were unreported or underreported by patients. Participants reported being extremely satisfied with the intervention. Physicians and nurses also supported the intervention. Both groups showed improved scores on most outcomes. CONCLUSION AND RELEVANCE: Delivering and evaluating i-PROACTIF was feasible and acceptable. Future efficacy trials are needed before it can be used in clinical settings. WHAT THIS ARTICLE ADDS: The results of this study can inform future occupational therapy interventions and clinical trials in primary care for older adults with chronic conditions.


Assuntos
Terapia Ocupacional , Idoso , Doença Crônica , Estudos de Viabilidade , Humanos , Atenção Primária à Saúde , Inquéritos e Questionários
10.
Am J Occup Ther ; 74(5): 7405205050p1-7405205050p15, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804623

RESUMO

IMPORTANCE: Spasticity is one of the most common and disabling motor impairments after stroke. OBJECTIVE: To examine the evidence for the effectiveness of stretching interventions, including splinting, on reducing upper extremity spasticity, increasing hand function, and improving functional tasks for adults with poststroke spasticity. DATA SOURCES: Databases searched were MEDLINE, CINAHL, OTseeker, AgeLine, and the Cochrane Library; results were limited to studies published from 2004 to January 2017. STUDY SELECTION AND DATA COLLECTION: Following PRISMA guidelines, we included articles describing Level I-III studies with participants who were adults with upper extremity spasticity and received a stretching intervention. FINDINGS: Eleven articles describing 6 Level I and 5 Level III studies met inclusion criteria. CONCLUSION AND RELEVANCE: For reducing upper extremity spasticity, low strength of evidence was found to support the use of static splinting, strong strength of evidence was found for the use of stretching devices, and low strength of evidence was found to support the use of dynamic splinting; no evidence was found for manual stretching to address spasticity. For increasing hand function, moderate strength of evidence was found to support the use of static splinting, dynamic splinting, and manual stretching, and low strength of evidence was found for the use of stretching devices. For improving functional tasks, moderate strength of evidence was found to support the use of static splinting, dynamic splinting, and manual stretching, and low strength of evidence was found for the use of stretching devices. WHAT THIS ARTICLE ADDS: This updated synthesis summarizes the current literature regarding the effectiveness of stretching interventions to improve poststroke spasticity, hand function, and functional tasks.


Assuntos
Terapia Ocupacional , Acidente Vascular Cerebral/complicações , Adulto , Humanos , Espasticidade Muscular , Contenções
11.
Am J Occup Ther ; 74(5): 7405205110p1-7405205110p7, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804629

RESUMO

IMPORTANCE: A reliable observational measure is necessary to measure clients' behaviors as they participate in activities. The Comprehensive Occupational Therapy Evaluation Scale (COTES) is designed to measure strengths and difficulties in various behaviors that support occupational performance. OBJECTIVE: To examine the test-retest reliability of the COTES (overall score and scores on the General Behavior, Social Behavior, and Work Behavior subscales) and calculate the minimal detectable change (MDC) for people with schizophrenia. DESIGN: Prospective, observational study. SETTING: A psychiatric center. PARTICIPANTS: COTES data for 118 people with schizophrenia were collected from occupational therapy records. Data from the initial and second COTES measurements were chosen for analysis. OUTCOMES AND MEASURES: Test-retest reliability of the overall scale and three subscales was evaluated using the intraclass correlation coefficient (ICC). The MDC was calculated on the basis of the standard error of measurement. RESULTS: ICCs for the overall scale and three subscales ranged from .91 to .97. The MDC values (MDC%) were 6.5 (10.5%) for the overall scale, 3.4 (13.5%) for the General Behavior subscale, 2.3 (15.2%) for the Social Behavior subscale, and 2.4 (11.0%) for the Work Behavior subscale. CONCLUSION AND RELEVANCE: The COTES has good test-retest reliability. Clinicians and researchers can use the MDC values provided in this study to explain the implications of change scores for behaviors that affect occupational performance for people with schizophrenia. WHAT THIS ARTICLE ADDS: The COTES has sound reliability and support for its use in determining whether people with schizophrenia make real improvements in behavior that affects occupational performance over time.


Assuntos
Terapia Ocupacional , Esquizofrenia , Humanos , Estudos Prospectivos , Reprodutibilidade dos Testes
12.
Am J Occup Ther ; 74(5): 7405205120p1-7405205120p9, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804630

RESUMO

IMPORTANCE: Designing, implementing, and measuring the effectiveness of sustainable Internationalization at Home programs will support the development of cultural competence among occupational therapy students. OBJECTIVE: To explore potential sustainable, effective methods for enhancing cultural competence in occupational therapy students through cross-cultural online collaborations. DESIGN: Pretest-posttest, parallel mixed-methods design. SETTING: An online collaboration using video conferencing technology and classrooms at the European University Cyprus and the University of St. Augustine for Health Sciences. PARTICIPANTS: Bachelor of science and master of occupational therapy students at the European University Cyprus and the University of St. Augustine for Health Sciences, respectively. INTERVENTION: Online video conferencing collaboration between occupational therapy students in which students discussed their perspectives and experiences regarding social injustice and occupational therapy's role in working with vulnerable populations. OUTCOMES AND MEASURES: Each campus participated in focus groups, and students completed individual reflections. Themes were derived from the qualitative information gathered. Quantitative data were collected using the Cultural Awareness Scale for Occupational Therapy Students (CASOTS). RESULTS: CASOTS did not reflect changes in cultural awareness. The qualitative measures identified students' desire to participate in more frequent and culturally diverse experiences. Challenges included length of preparation and actual communication time. Inclusion of prior asynchronous sessions and methods to overcome the language barrier was suggested for future implementation. CONCLUSION: Synchronous cross-cultural collaborations may enhance occupational therapy student's cultural awareness and may be more attractive than traditional in-class teaching. Further development is necessary to overcome challenges. WHAT THIS ARTICLE ADDS: Documenting the benefits and barriers of implementing Internationalization at Home experiences will allow academic institutions to create sustainable methods for enhancing occupational therapy students' cultural competence. Recommendations to further enhance Internationalization at Home experiences provide opportunities for increased cultural collaboration.


Assuntos
Terapia Ocupacional , Comunicação , Competência Cultural , Chipre , Humanos , Comportamento Social , Estados Unidos
13.
Am J Occup Ther ; 74(5): 7405205140p1-7405205140p17, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804632

RESUMO

IMPORTANCE: Autistic adults face decreased community participation for employment, education, and social activities plus barriers to driving and transportation. However, little is known about their experiences of moving around community environments. OBJECTIVE: To explore contextual issues and experiences of independent community mobility and driving for autistic adults and to determine the modes of community mobility, regions studied, and methodologies used. DATA SOURCES: Seven databases were searched from 2000 to 2019. All empirical research relating to autism, community mobility, and driving for people older than age 5 yr was mapped. Studies examining experiences of community mobility and driving were selected for scoping review. STUDY SELECTION AND DATA COLLECTION: Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews methodology was used. Thirteen studies reporting specifically on autistic adults' experiences with public transportation, driving, and pedestrian navigation of community environments were included. These studies were analyzed using concepts from the Person-Environment-Occupation-Performance Model. FINDINGS: Nine studies examined experiences of autistic adults. Seven studies explored proxy perspectives. Those studies examining driving primarily focused on learner driver experiences. Although most studies reported on personal and environmental factors, some studies reported on broader social communication and personal narrative factors. None used inclusive methodology involving autistic adults. CONCLUSIONS AND RELEVANCE: A broader focus on the contextual experiences of community mobility and driving is needed to support participation of autistic adults in their communities. Linking community mobility experiences with participation outcomes and expanding research to include experienced drivers and nonurban populations is an important component of this work. WHAT THIS ARTICLE ADDS: Occupational therapy interventions should address community mobility and driving skills before school transition. Autistic adults' skill development may be affected by person factors such as motivation, anxiety, social skills, communication, and occupational performance desires. Environmental factors such as parental concerns, community safety, pedestrian environments, traffic volume, and public transportation design are important. Further research partnering with autistic adults could better inform future occupational therapy interventions for community mobility and driving.


Assuntos
Transtorno Autístico , Condução de Veículo , Terapia Ocupacional , Adulto , Humanos , Meio Social , Transportes
14.
Am J Occup Ther ; 74(5): 7405347010p1-7405347010p5, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804634

RESUMO

Occupational therapy practitioners provide interventions to promote activity engagement to multiple clinical populations. They help clients develop restorative, adaptive, and compensatory skills to improve their performance in daily activities. The issue addressed in this article is that current clinical frameworks lack translation of learned skills to consistent everyday performance. There is a gap between what clients can do and what clients actually do in everyday life. Behavioral activation provides an explicit, structured, and practical approach that can translate capacity into long-term engagement. This article presents behavioral activation as a transdiagnostic approach that targets populations experiencing chronic illness to bridge the gap between what the client can do in therapy and what the client could do in everyday life. WHAT THIS ARTICLE ADDS: People with chronic illness have difficulty translating the skills learned in traditional practice settings to everyday life. Behavioral activation offers occupational therapy practitioners a practical structure to promote the translation of learned skills.


Assuntos
Terapia Ocupacional , Humanos
15.
Am J Occup Ther ; 74(5): 7405390010p1-7405390010p4, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804635

RESUMO

Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association's (AOTA's) Evidence-Based Practice Project. This article presents a case example of a young child with autism spectrum disorder who receives occupational therapy evaluation and intervention in natural environments (home and child care center). Systematic review findings supporting enhancement of key life occupations through interventions to develop cognitive, motor, social-emotional, and self-care skills for young children were published in AOTA's Occupational Therapy Practice Guidelines for Early Childhood: Birth-5 Years (Frolek Clark & Kingsley, 2020) and the March/April 2020 issue of the American Journal of Occupational Therapy (Gronski & Doherty, 2020; Kingsley et al., 2020; Tanner et al., 2020). Each article in the Evidence Connection series applies evidence from the published reviews on a topic to a related case. These articles are designed to promote application of the evidence to practice.


Assuntos
Transtorno do Espectro Autista , Terapia Ocupacional , Criança , Pré-Escolar , Emoções , Meio Ambiente , Prática Clínica Baseada em Evidências , Humanos
17.
Am J Occup Ther ; 74(4): 7404205010p1-7404205010p13, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32602440

RESUMO

IMPORTANCE: Patients with cancer frequently experience difficulties with everyday activities. This scoping review explores occupational therapy group interventions in oncology, an area relevant to occupational therapy practitioners, but one that has limited evidence. OBJECTIVE: This scoping review examines the association between occupational therapy-based oncology groups and improved functional activity of daily living outcomes for adults with cancer. It poses the following research question: Are occupational therapy groups associated with improved functional outcomes for adults with cancer? DATA SOURCES: Searches of MEDLINE, CINAHL, AMED, OTseeker, Health Source: Nursing/Academic Edition, and OTDBase were completed for peer-reviewed articles published from 1997 to 2018. STUDY SELECTION AND DATA COLLECTION: Inclusion criteria were articles published in English and occupational therapy-based groups for adults with cancer. FINDINGS: Eight articles matched the inclusion criteria. The articles reviewed were 2 randomized controlled trials, 1 case study, 1 descriptive exploratory research study, 1 mixed-methods study, 2 pretest-posttest studies, and 1 longitudinal prospective comparative study. CONCLUSIONS AND RELEVANCE: Occupational therapy groups led to a significant increase in occupational performance and satisfaction, an improvement in functioning, and a decrease in fatigue. Engagement in important roles and occupations and sharing the experience with others were also highly valued. This review provides support for the implementation of group-based occupational therapy interventions in oncology. Further research is required in this area, particularly in the inpatient setting with men included in the sample. WHAT THIS ARTICLE ADDS: This scoping review demonstrates the benefits of group-based occupational therapy interventions for adult patients with cancer.


Assuntos
Terapia Ocupacional , Psicoterapia de Grupo , Adulto , Humanos , Masculino , Ocupações , Estudos Prospectivos
18.
Am J Occup Ther ; 74(4): 7404205020p1-7404205020p15, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32602441

RESUMO

IMPORTANCE: Cannabinoids are at the center of much interest and controversy within health care and society. However, minimal research has investigated the impact of cannabinoids on quality of life (QoL) and occupation. OBJECTIVE: The literature suggests that cannabinoids may have therapeutic potential, although the available research is limited. A scoping review was conducted to address the gap in the literature regarding the impact of recreational and medicinal cannabinoids on QoL and occupational engagement. DATA SOURCES: Databases searched included Ovid and CINAHL; sources derived from a manual search of reference lists were also used. Of the 691 articles that were identified, 22 articles met the inclusion and exclusion criteria. STUDY SELECTION AND DATA COLLECTION: This scoping review was conducted in accordance with Arksey and O'Malley's five stages. Inclusion criteria included English language, clear focus or description on the impact of nonsynthetic cannabinoids on QoL and occupation, and published between January 2011 and May 2019. Exclusion criteria included minors, single case studies, animal studies, antineoplastic articles, and articles that only discussed or investigated effects of synthetic cannabinoids. FINDINGS: The findings were inconclusive, and the primary research that emerged from the literature investigated the effects of cannabinoids on pain management, sleep, appetite, and other physiological functions in both recreational and medicinal users. CONCLUSIONS AND RELEVANCE: The findings derived from the literature raised more questions, and further research is warranted. Occupational therapy practitioners have an opportunity to use their knowledge and skills to address the impact of cannabinoids on occupational engagement and QoL. WHAT THIS ARTICLE ADDS: Practitioners have the opportunity to provide education regarding cannabis use and monitor how it affects occupational engagement and QoL for both recreational and medicinal users.


Assuntos
Antineoplásicos , Canabinoides/efeitos adversos , Terapia Ocupacional , Humanos , Ocupações , Qualidade de Vida
19.
Am J Occup Ther ; 74(4): 7404205030p1-7404205030p11, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32602442

RESUMO

IMPORTANCE: A key objective of the Americans With Disabilities Act of 1990 (ADA) is community integration; yet, nearly 30 yr later, little is known about the participation of people with disabilities who transition from institutions to the community. OBJECTIVE: To understand how people with disabilities describe full participation after transitioning from an institution to the community and to identify environmental barriers and facilitators to participation during and after this transition. DESIGN: The ADA-Participatory Action Research Consortium (ADA-PARC), a collaboration among researchers, people with disabilities, and community organizations, is implementing a multimethod, participatory action research study of participation among people with disabilities posttransition. This article presents qualitative findings from semistructured interviews collected as part of the larger ADA-PARC project. SETTING: ADA-PARC community partners across the United States. PARTICIPANTS: One hundred fifty-three adults with disabilities. OUTCOMES AND MEASURES: We used a semistructured interview guide to ask participants about their experiences during and after transition to the community. RESULTS: We identified four themes: (1) the process of transition as ongoing rather than a single event, (2) access to everyday occupations as full participation and what fully represents "living a life," (3) environmental barriers to participation, and (4) social identity as participation as the transformative process of moving from the disempowering isolation of the institution to being integrated into the community. CONCLUSIONS AND RELEVANCE: As people with disabilities transition into community settings, they require ongoing supports to facilitate their full, long-term participation. WHAT THIS ARTICLE ADDS: People with disabilities reported that transitioning from institutions to the community was itself not enough to support their full community participation; rather, they viewed transition as an ongoing process, and they needed services and supports to fully participate. Occupational therapy practitioners working in institutional and community settings can partner with local disability advocacy communities to support their clients' sense of identity and self-confidence during and after transition to the community.


Assuntos
Pessoas com Deficiência , Terapia Ocupacional , Adulto , Participação da Comunidade , Humanos , Institucionalização , Organizações , Estados Unidos
20.
Am J Occup Ther ; 74(4): 7404205070p1-7404205070p8, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32602446

RESUMO

IMPORTANCE: Student teaching clinics (STCs) are an increasingly popular means of providing clinical learning opportunities to health profession students. Although research exists on the learning outcomes of students participating in STCs, little research exists on the outcomes of clients participating in STCs. OBJECTIVE: To examine client-perceived outcomes at a university-based occupational therapy STC in the Pacific Northwest. DESIGN: Retrospective chart review. PARTICIPANTS: Participants included all clients (pediatric and adult) attending the STC during spring 2016. Seventy client charts were reviewed, and 56 charts (80%) met the study inclusion criteria. INTERVENTION: Intervention included 12 wk of student-led occupational therapy that was client centered and occupation based. OUTCOMES AND MEASURES: Client perceptions of performance and satisfaction in self-identified valued occupations were measured using the Canadian Occupational Performance Measure (COPM) before and after intervention. RESULTS: Clients demonstrated statistically significant increases in both COPM Performance and Satisfaction scores as well as clinically significant improvement in Satisfaction scores. CONCLUSIONS AND RELEVANCE: Clients reported improvements in performance and satisfaction in valued occupations after attending an STC. The COPM has potential to be used as a client-reported outcome measure for occupational therapy services in STCs, across diagnoses and ages. Areas for future research and clinical implications are discussed. WHAT THIS ARTICLE ADDS: This study demonstrates that STCs have the potential to provide positive outcomes for clients as well as student therapists. It provides preliminary support for using the COPM to assess client outcomes in STCs.


Assuntos
Terapia Ocupacional , Adulto , Canadá , Criança , Humanos , Noroeste dos Estados Unidos , Estudos Retrospectivos , Estudantes
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