Potential occupational therapy scope of practice in the work-to-retirement transition in Australia.

INTRODUCTION: Retirement, being a major life event and a focus of healthy ageing in society, creates the opportunity for occupational therapists to support people transitioning from work to retirement. Little is known about the scope of practice of occupational therapy in the work-to-retirement transition. The aim of this study was to, in Australia, (1) explore the potential scope of practice and factors influencing the potential scope of practice of occupational therapy in the work-to-retirement transition and (2) map findings to occupational therapy theoretical frameworks to assist in articulating scope of practice. METHODS: A qualitative study (thematic analysis as an independent approach within a qualitative descriptive methodology) was undertaken using semi-structured interviews with Australian occupational therapists. FINDINGS: Australian occupational therapists (n = 14) were interviewed. Four themes were identified which related to the potential scope of occupational therapy practice in the work-to-retirement transition: finding meaningful occupation; modifying lifestyles and homes for better living; work engagement; and application of occupational therapy skills. Six themes were identified which related to contextual factors influencing the potential scope of occupational therapy practice in the work-to-retirement transition: right time; valuing our expertise; promoting occupation(al therapy); finding the money; life, work and retirement longevity; and social responsibility. CONCLUSION: The work-to-retirement transition can be incorporated into other practice areas or can be a unique practice area allowing for a more targeted service. The frameworks of who, what, when, and where and enablement skills assist in articulating occupational therapy scope of practice in the work-to-retirement transition. A number of contextual factors can be barriers and/or facilitators to occupational therapy practice. More clearly articulating occupational therapy practice in the work-to-retirement transition will enable the profession to promote their scope of practice assisting in obtaining professional and public recognition and overcoming barriers such as funding to enable provision of services within this area.

Benchmarking the research track record and level of appointment of Australian medical laboratory science academics.

BACKGROUND: Benchmarking across and within universities is a common tool to evaluate performance of a program and maintain accreditation requirements. While teaching remains a primary responsibility of many academics, academic research performance is a major contributor towards career advancement and standards in the medical laboratory science profession. While anecdotal evidence suggests academics are active contributors to the evidence base of the profession, there is a high variability in research output in relation to institution and level of appointment. The aim of the study was to benchmark the research track record of Australian medical laboratory science academics and provide insight into how research productivity informs the level of appointment of academics across their career pathway. METHODS: A bibliographic analysis of Australian medical laboratory science faculty websites and corresponding Scopus citation database profiles was conducted. A description of current research track record and relationships with holding a doctorate, academic appointment level, research and teaching interests, and institutional characteristics were explored. Quantitative data and frequencies were analysed using IBM SPSS version 26 to benchmark research track records by academic appointment level. RESULTS: There were 124 academics identified from 13 universities who had a teaching and research position in an undergraduate medical laboratory science program in Australia. Academics at the level of lecturer or higher typically held a doctorate (89%). Holding a doctorate strongly influenced the number of publications. The top 20% of researchers authored around half of the overall publications. The majority of academics did not have alignment of their major research and teaching areas however, alignment had no influence on number of publications. There was, however, an inconsistent relationship between metropolitan or regional university location and the number of publications. CONCLUSION: Data from this study provides academics with benchmarks for the research track record required at each level of appointment. When drawing conclusions on academic progression, promotion and tenure through research track record it would be mindful to assess each on a case by case basis. Institution (metropolitan versus regional) and research interest appears to influence publication number, h-index and citation scores.

Pre-retirement job and the work-to-retirement occupational transition process in Australia: A review.

BACKGROUND: The transition from work to retirement is a complex process and unique experience with a relationship existing between work and retirement with implications for health in later life. This review explored the relationship between pre-retirement job and participation in the work-to-retirement transition process in Australia by exploring: (i) factors influencing retirement in relation to pre-retirement job; (ii) how jobs are classified; (iii) the effect of pre-retirement job (based on categories) on this occupational transition; and (iv) the potential role for occupational therapy in this occupational transition. METHOD: An integrative literature review was completed. PRISMA guidelines were used. Study designs were analysed for methodological quality using the National Health and Medical Research Council levels of evidence. Thematic analysis determined retirement factors which were used to compare differences between jobs. RESULTS: This review included 15 papers. There were two Level III-2, one Level III-3 and 13 Level IV studies. Factors influencing retirement related to the stages of work, preparation, transition and retired. White collar and blue collar was the most common job classification system. Although white collar and blue collar worker definitions utilised were inconsistent, differences between the two groups were still determined in all stages. CONCLUSION: Differences in the work-to-retirement transition process, based on pre-retirement job, are evident. Understanding differences by job groupings may assist occupational therapists to understand individualised needs during this occupational transition and subsequent tailoring of interventions (both individual and group based) to enable engagement in meaningful occupation in the work-to-retirement occupational transition to effect active healthy ageing.

Benchmarking the research track record and level of appointment of Australian occupational therapy academics.

BACKGROUND: Academic faculty are active contributors to the evidence base of the profession. Little is known about the research productivity of Australian occupational therapy academics. METHODS: A bibliographic analysis of Australian occupational therapy faculty websites and corresponding Scopus citation database profiles was conducted. A description of current research productivity benchmarks and relationships with holding a doctorate, academic appointment level and institutional characteristics were explored. RESULTS: The median H-index of Clinical and Associate Lecturers was 0, 1 for Lecturers, 4 for Senior Lecturers, 7.5 for Associate Professors and 13 for Professors. The number of publications and number of citing documents follows a Pareto tendency, where 20% of researchers are responsible for around 80% of the research track record of Australian occupational therapy academics. CONCLUSION: The findings provide a benchmark for Australian occupational therapy faculty research track records and associations with appointment levels. This benchmark differs across countries and disciplines. The results raise considerations for enhancing the overall research track record of occupational therapy academics.

A review of occupational therapy's contribution to and involvement in the work-to-retirement transition process: An Australian perspective.

BACKGROUND: Retirement from paid work is an occupational transition, which can have a profound impact on a person's life. This review explored occupational therapy's contribution to and involvement in the work-to-retirement transition process in Australia. METHODS: An integrative literature review was undertaken using seven article repository databases. PRISMA guidelines informed searches. Articles were included if participants were Australian; researchers' discussed retirement from an occupational perspective or the scope of practice of occupational therapists; and publication was from 1994 to June 2015 in a peer-reviewed journal. Articles were critically appraised and thematic analysis explored: (i) occupational perspective, (ii) occupational therapy scope of practice, (iii) theory and (iv) retirement definitions. RESULTS: Eight articles met the review criteria. Three occupational perspective themes were identified: retirement intention influences, retirement preparation and retirement roles and activities. No articles on the current scope of practice of occupational therapy were found. Three articles discussed potential occupational therapy approaches. Three themes on what retirement is were identified: complete cessation, gradual transition and intermittent worker. Four theory themes were identified: occupational therapy, ageing, identity and work. CONCLUSION: Occupational therapy has the potential to be involved in improving health and well-being for people in the work-to-retirement transition process. It is suggested that future research explore not only people's experiences but also the approaches of occupational therapy in assisting people through this occupational transition. The use of theory to guide Australian occupational therapy practice on retirement should also be explored. The use of consistent retirement definitions will assist in understanding research.

Investigation of the Consumer Perspective on Leisure in Mental Health Inpatient Units.

This study aimed to explore the barriers to engagement in activity and consumer satisfaction in inpatient settings. Participants were current inpatient consumers and completed an online anonymous survey. This included the Mental Health Satisfaction Improvement Program (MHSIP), Leisure Boredom Scale (LBS), and the Checklist of Leisure Interests and Participation (CLIP). A total of 57 participants partially completed the survey with 41 completed responses. Participants reported several barriers to engagement, including lack of staff, limited social engagement, limited range of activity, and a lack of resources. Most participants reported to be either "very satisfied" (24.24%) or "somewhat satisfied" (36.36%) with the level of activity offered. Participants reported to be bored due to a limited occupational range offered in the mental health inpatient unit. Participants identified the need for assistance in the facilitation of activity.

Assistive technology in palliative medicine: equipment needs.

OBJECTIVES: Most people prefer to die at home. Timely and appropriate provision of assistive technology can support people to remain at home in the palliative phase. A state-wide palliative care equipment programme (PCEP) was established in Queensland, Australia, to support coordinated assistive technology provision. The objective of this study was to identify population-wide palliative care equipment needs and their relationship to primary diagnostic categories. METHOD: A retrospective, cross-sectional analysis of equipment provided over a 19-month period was conducted. This included types of equipment provided and characteristics of the participants such as rurality, age and diagnostic category. RESULTS: There were 13 764 approved equipment requests, with a median time between equipment application and death being around 35 days. There were significant differences in the types of equipment typically required across diagnostic categories. CONCLUSION: The findings from the study can provide a benchmark for the development of population-wide PCEPs. For practitioners who are new to palliative care, typical trajectories of equipment needs by diagnostic group can help guide equipment planning.

Lived experience of using assistive technology for sandy beach based leisure for Australian people with mobility limitations.

PURPOSE: This study explores experiences of using beach assistive technology (AT), such as beach wheelchairs, powered wheelchairs, prosthetics and crutches, to participate in sandy beach-based leisure for people with mobility limitations. METHODS: Online semi-structured interviews were conducted with 14 people, with mobility limitations and experience of using Beach AT. A phenomenological interpretative hermeneutic approach guided reflexive thematic analysis of verbatim transcripts. FINDINGS: Three overarching themes were identified as: The meaning of using Beach AT, Practicalities of using Beach AT and Responses to using Beach AT. Each overarching theme was underpinned by subthemes. Meaning included: AT connects me, AT impacts my identity and AT attracts attention. Practicalities included: using AT requires other people, AT impacts spontaneity, AT limitations and AT use differs in water. Responses to using Beach AT included: I didn't think it was possible, adaptions to AT limitations and not everyone wants to own Beach AT. CONCLUSION: This study illustrates the use of Beach AT as a facilitator for beach leisure, enabling connections to social groups and contributing to one's identity as a beachgoer. Access to Beach AT is meaningful and may be made possible through personal Beach AT ownership or access to loaned AT. The unique nature of sand, water, and salt environments requires users to identify how they plan to use the devices, with realistic expectations that the Beach AT may not enable full independence. The study acknowledges the challenges related to size, storage, and propulsion, but emphasizes that these can be overcome through ingenuity.

People with mobility limitations require Beach assistive technology (AT) to facilitate beach leisure, social participation and to establish their identity as beachgoers.People with mobility limitations who plan to use Beach AT should be prepared to overcome pragmatic challenges related to size, storage, and propulsion, and should have realistic expectations about the level of independence that can be achieved.Successful use of Beach AT may involve ingenuity through adaptations such as selecting appropriate times for beach activities as well as making physical adjustments to AT devices.Access to Beach AT is an important consideration for improving participation in leisure activities for people with mobility limitations. This is possible through both personal ownership and/or loaning AT.

Quantifying graduation of layered below-the-knee compression garment combinations using a model-based assessment.

OBJECTIVE: Often people with lymphedema and vascular conditions will be prescribed layered compression garments to assist them in donning their garments and improve treatment compliance. However, little evidence of the interface pressures produced by these layered garments is available. In the present study, we explored the pressures produced by layering high and low class below-the-knee compression garment combinations and quantified the graduation of these combinations to understand the effect that layer order might have on the interface pressure. METHODS: The present study used a mechanical test design to measure the interface pressure at four sites (B, smallest ankle dimension; B1, circumference at Achilles tendon and gastrocnemius muscle junction; C, widest calf dimension; and D, below the knee) for 30 combinations of low and high class compression garments using a PicoPress (Microlab Elettronica, Ponte San Nicolò, Italy). RESULTS: The results demonstrated a pattern consistent with graduation for sites B1 to D for 100% of the garment combinations. However, the graduation was reversed for sites B to B1 for 100% of the garment combinations, possibly due to limitations regarding the shape of the model limb. The results indicated no significant differences in the interface pressure when the higher class garment was applied as the bottom layer vs the top layer. A strong correlation (R > 0.95; P < .001) was between the actual pressures produced by the combinations of the garments and the expected pressure determined by summing the pressures of the individual garments. CONCLUSIONS: Graduation was observed from site B1 to site D, indicating that double layering of these garment combinations maintained guideline adherence. Layering the garments produced pressures that were, in general, cumulative of the pressure from each garment alone, with some variance. Because of the uncertainty of the B site results in the present study, the clinical implications in relation to the primary aim are limited. The findings from the secondary aim suggest that clinically, garment wearers can don their layered garments in any order and achieve the same interface pressure results.

Assistive technology in palliative care: a statewide equipment programme.

OBJECTIVES: This paper examines the impact of the Medical Aids Subsidy Scheme (MASS) Palliative Care Equipment Programme (PCEP), a new initiative across Queensland, Australia, and explores the translational potential of this large scale, comprehensive, government funded programme to other jurisdictions. METHODS: The five dimensions of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework were retrospectively applied to MASS PCEP, with primary programme data compared with data from secondary sources. RESULTS: Extensive Reach and Adoption of the programme was demonstrated, with 3695 unique clients accessing the programme from the 17 Queensland hospital and health services. Seventy-four per cent of clients had a cancer diagnosis. Operationalising Effectiveness, Implementation and Maintenance dimensions revealed many positive programme aspects at individual and organisational levels, as well as ongoing challenges including transporting equipment to rural and remote regions and the impact on the workforce to respond to referrals and prescribe assistive products. Programme participants had a shorter public hospital stay (4.5 days), compared with the Queensland palliative care average (7.1 days). CONCLUSIONS: The programme has high translational potential to other jurisdictions. Assistive equipment at the end stages of life may enhance well-being by extending time spent at home, increasing independence and reducing carer burden.

Current occupational therapy scope of practice in the work-to-retirement transition process: An Australian study.

BACKGROUND: Occupational therapists have skills to work with people considering or experiencing the transition from paid work to retirement. AIM: The aims were to explore: (1) occupational therapists' experiences and perceptions in working with people transitioning to retirement; (2) current scope of practice of occupational therapy in the work-to-retirement transition; and (3) factors influencing current scope of practice of occupational therapy in the work-to-retirement transition. METHODS: Qualitative semi-structured interviews with Australian occupational therapists were thematically analysed. RESULTS: Fourteen Australian occupational therapists were interviewed. Three overarching themes (12 sub themes) emerged: (1) occupational therapists' application of a contemporary occupational paradigm; (2) current approaches adopted by occupational therapists are add on, stylistic and talk based; and (3) contextual challenges and opportunities encountered by occupational therapists. CONCLUSION/SIGNIFICANCE: Occupational therapists use enablement skills (e.g. coach; collaborate) and consider various professional reasons (e.g. engagement in meaningful occupation; health responsibility) when addressing the transition from work to retirement. Overcoming barriers to service provision (e.g. funding; lack of role clarity) will facilitate a more comprehensive service provision to enable health and well-being of older adults.

Identifying age-friendly behaviours for bus driver age-awareness training.

BACKGROUND: Occupational therapists may be involved in advocating for age-friendly bus systems and training bus drivers in age-awareness. In order to develop evidence-based bus driver age-awareness training programs, the specific required bus driver behaviours should be explicated. PURPOSE: This study aims to define, clarify, and illustrate behaviours associated with bus driver friendliness and helpfulness. METHODS: Forty older people (aged 60 and over) in Queensland, Australia, completed a round trip bus journey and subsequent interview. Qualitative content analysis of participant observations with stimulated recall interviews was used to identify categories and themes around friendly and helpful bus drivers. FINDINGS: General professional behaviours included making older people feel safe, courtesy, friendliness, helpfulness and being aware of invisible disabilities and specific professional behaviours included giving time, pulling in close to the curb, communication, and information. IMPLICATIONS: The findings are incorporated into suggestions for a bus driver age-awareness training program.

Social Circus for People with Disabilities: A Video Analysis through the Lens of the MOHO.

BACKGROUND: Social circus is a branch of circus that primarily focuses on personal and community development, rather than an elite level of professional artistry required of traditional circus. Social circus engages participants in circus activities such as juggling and acrobatics with therapeutic aims such as building confidence or developing life skills. While there is a growing body of literature around social circus, there is currently limited literature exploring the interface between social circus and occupational therapy theory. OBJECTIVE: This study is aimed at examining existing examples of social circus for people with disability (via YouTube videos) through the lens of the Model of Human Occupation (MOHO) to consider the link between social circus and contemporary occupational therapy practice. METHODS: The study utilised video analysis as the guiding methodology. A two-part qualitative thematic analysis was conducted on transcripts of YouTube video audio and on-screen text, as well as visual analysis of the corresponding imagery. RESULTS: Social circus provides people with disabilities opportunities to actively participate and experience dignity of risk, independence, and autonomy, in a safe and inclusive environment amongst others. As a highly flexible activity (in structure, timing, tasks, outcomes, and environments), social circus accommodated differences in capacities and provided opportunity for the development of skills, both circus-specific and generalisable to everyday life. Social circus allowed people with disability to shape new identities as performers, friends, and members of a community. CONCLUSION: Social circus offers a unique means for successfully attaining and achieving a wide range of occupational outcomes for people with and without disability across a diverse range of settings. Utilising an occupational therapy lens led to insights around the social circus environments, development of identity and transference of circus skills to everyday tasks and occupations, that were not previously acknowledged in the social circus literature. Our findings support social circus implementation and collaboration within contemporary occupational therapy practice.

Priorities for an age-friendly bus system.

This article presents the results of a study on the barriers and facilitators to bus use for people aged 60 or older. Two complementary methodologies, nominal group technique and focussed ethnography, were used to identify barriers and facilitators and rank their importance. Two sample sites from Queensland, Australia, were selected, with 227 people participating in the nominal group technique and 40 people participating in the focussed ethnography component. Seven priorities for age-friendly bus systems emerged from the data: vehicle entrance/exit; bus driver friendliness and helpfulness; timetables and scheduling of buses; bus stop locations; pedestrian infrastructure; information and training for older people; and bus routes and destinations. These findings will assist researchers, policy makers, and transport providers to set evidence-based strategic directions for creating age-friendly bus systems. Both methods provide complementary perspectives on bus usability, which could not be gained from either method alone.

Benchmarking the research track record and level of appointment of Australian dietetic academics.

AIMS: Research involvement is fundamental to the practice of dietetics. The present study aims to benchmark the research track record of Australian dietetic academics, and to provide insight into how research productivity informs the level of appointment of academics across the career pathway. METHODS: Australian dietetic faculty websites and corresponding Scopus database profiles were used to support a bibliographic analysis of Australian dietetic academics' research track record. Current research productivity in relation to academic attributes, level of appointment, and institutional characteristics were explored. RESULTS: In Australia, dietetic academic level of appointment is logarithmically related to number of publications and relatively consistent across regions and university networks. CONCLUSIONS: Benchmarking provides universities with guidance regarding the performance to expect from academics at each academic level as well as feedback regarding recruitment and promotion practices. The present study provides an important benchmark for Australian dietetic academics and offers implications for individual academics and university management.

Bus use and older people: a literature review applying the Person-Environment-Occupation model in macro practice.

The same reasons that prompt older people to give up driving can also result in difficulties with accessing public transport. Difficulties using public transport can limit older people's participation in society, thereby impacting negatively on their health. Focusing on public buses, this review explicates the link between bus usability and the health of older people and frames existing evidence on bus usability issues. The Person-Environment-Occupation (PEO) model offers a framework by which bus usability can be assessed. A combination of person-centred, environmental, and occupation-related factors, including bus design, service provision and performance, information, and the attitudes of staff and the community, impact on older people's ability to catch buses. More systematic research needs to take place in order to develop a comprehensive understanding of bus usability. Occupational therapy has a key role to play in conceptualizing, implementing, and evaluating improvements in bus usability for older people.

The experiences of work: Retirees' perspectives and the relationship to the role of occupational therapy in the work-to-retirement transition process.

BACKGROUND: Work experiences have the potential to influence retirement. Occupational therapists' understanding of the importance of engagement in occupation for active healthy ageing places them in a position to facilitate the work-to-retirement transition. OBJECTIVE: To describe the experience of work from retirees' perspectives to understand the influence of work on retirement and to discuss the role of occupational therapy in the work-to-retirement transition. METHODS: Semi-structured interviews with retirees were utilised. Thematic analysis identified themes and categories in relation to the experience of work. Categories were related to the Model of Human Occupation (MOHO). RESULTS: Eleven retirees were interviewed. Twelve categories relating to the experience of work were identified and were captured under three over-arching themes: Varied experiences and motivators; Intersection of work and life; and Impact of context. Categories collectively covered all MOHO concepts. Questions to guide therapeutic reasoning were developed to assist putting MOHO theory in to practice. CONCLUSIONS: Working experiences can be an influencing factor on retirement life. Occupational therapy could enable active healthy ageing through understanding the experience of work and how this can assist older workers to remain in the workforce, find a balance between work and other areas of life, and to choose retirement activities.

Age-friendly buses? A comparison of reported barriers and facilitators to bus use for younger and older adults.

AIM: To determine whether older people reported and prioritised different barriers and facilitators to bus use than younger people. METHOD: The Nominal Group Technique was used with 301 participants (231 older, 70 younger) to elicit reported barriers and facilitators to bus use. Categories were developed using qualitative content analysis and comparisons of categories and priorities were made. RESULTS: Driver friendliness, ease of entry/exit and information useability were prioritised barriers and facilitators for older people. In contrast, younger participants prioritised bus punctuality, signage clarity, information provision at bus stops, bus service availability and parking facilities at the bus stop. Some similarities between older and younger adults were noted relating to convenience and bus scheduling. CONCLUSIONS: Older and younger adults have specific requirements for public transport systems which should be addressed in order to promote useable transport for all.