Showing papers in "Otjr-occupation Participation and Health in 2021"

Negotiating Time and Space When Working From Home: Experiences During COVID-19.

Abstract: Stay-at-home mandates following the COVID-19 pandemic increased work from home (WFH). While WFH offers many benefits, navigating work in nontraditional contexts can be a challenge. The objective of this study was to explore the benefits and challenges of WFH during COVID-19 to identify supports and resources necessary. Comments from two free-response questions on a survey regarding experiences of WFH (N = 648, N = 366) were analyzed using inductive qualitative content analysis. Four themes emerged: time use, considerations of working in the home space, intersections between work-life and home-life, and temporality of WFH as situated within a pandemic. Across all themes were concerns related to participation in both work and home roles, work performance, and well-being. Findings highlight the importance of support during times of disruption of occupational patterns, roles, and routines. Despite challenges, many individuals hoped to continue WFH. Organizations should consider the complex intersections of work-life and home-life to develop supportive policies and resources.

Stimulating Research to Advance Evidence-Based Applications of Telehealth in Occupational Therapy

Abstract: Occupational therapy focuses on therapeutic means to address participation in meaningful everyday tasks across the lifespan. No single setting is more conducive to this pursuit than individuals' authentic contexts. Occupational therapists are therefore uniquely suited to lead the charge toward stimulating research and advancing evidence-based application of telehealth. To this end, the American Occupational Therapy Foundation digitally convened their 2020 Planning Grant Collective to focus on the topic of Telehealth. Participants of the interdisciplinary collective collaboratively identified four themes: (1) Using technology to assess and intervene in the everyday context, (2) Partnerships with caregivers, (3) Telehealth delivery, and (4) Uniform data collection. Subgroups explored potential research and funding opportunities in their specialty area while also addressing the centralizing concepts of equity and diversity of telehealth delivery and COVID-19. Here, we provide a summary of the key concepts and recommendations from the 3 days of collaboration.

An Investigation Into the Relationship Between Playfulness and Well-being in Australian Adults: An Exploratory Study.

Abstract: Playfulness is well researched in children; however, much less is known about its impact on the well-being of adults. To investigate the relationship between playfulness and well-being in Australian adults. Participants (N = 175) completed the Other-directed, Lighthearted, Intellectual, and Whimsical (OLIW) scale for playfulness and the Positive Emotion, Engagement, Relationship, Meaning, and Accomplishment (PERMA-Profiler) scale for well-being through an online survey. Multiple regression analyses with bootstrapping were completed to investigate whether playfulness predicted well-being. Six of the eight regression models analyzed contained significant predictors of well-being in adults. Adult playfulness exhibited the most robust positive relations with positive emotion, engagement while with others and during activities, relationships, finding meaning in one's life, and overall well-being. Playfulness was significantly related to several different indicators of well-being in adults. Therefore, incorporating elements of playfulness during occupational engagement could potentially nurture an individual's well-being.

Navigating Intersecting Forms of Oppression in the Search for Employment.

Abstract: Opportunities for refugees to engage in occupations within host countries can be constrained by factors such as governmental policies or language barriers (Smith). Female refugees with physical disabilities may experience compounding barriers to participation related to their identity markers. The main aim of this study is to understand the experiences of female refugees with physical disabilities in seeking, preparing for, and obtaining employment. This study used an instrumental case study using semistructured interviews with five primary participants and four caregivers. Thematic analysis (Clarke & Braun) identified five key barriers to securing employment: (a) stigma and discrimination, (b) restrictive traditional labor market, (c) inaccessible and inadequate housing, (d) lack of cohesion and information across services, and (e) English language predominance. Findings highlight complex challenges experienced by the women who faced intersecting systems of oppression and can enable occupational therapists to address barriers associated with occupational injustice by improving services to better meet their needs.

Engagement in Household Chores in Youth With Chronic Conditions: Health care Transition Implications:

Abstract: This study examined associations between chores engagement, self-management, and transition readiness in youth with chronic conditions Youths with various chronic conditions attending a therapeuti

Becoming Anti-Racist Occupational Therapy Practitioners: A Scoping Study:

Abstract: The ongoing racism pandemic in the United States negatively impacts the health, safety, and occupations of Black, Indigenous, and/or People of Color. Although occupational therapy (OT) practitioners have a pressing obligation to actively address racism's causes and consequences, they lack guidance on what to do. This scoping study sought to identify and synthesize existing knowledge on ways OT practitioners and the profession can engage in anti-racist actions. Six databases were searched for content related to OT and anti-racism. The 31 included articles indicated that OT practitioners should: engage in reflexivity on ways their power and privilege impact therapeutic relationships, use inclusive models, consider how racism can impact client occupations and health care access, and address structural racism through advocacy and occupations as means. Although being anti-racist is a lifelong process, strategies within this study can support OT practitioners and the profession to initiate concrete anti-racist actions.

Occupation's Role in Producing Inclusive Spaces: Immigrants' Experiences in Linguistic Minority Communities.

Abstract: While the "situatedness" of occupation in the context of migration has been explored using various approaches, there remains a need for a holistic and dynamic understanding of the concept of space and the spatiality of occupation. Adopting Lefebvre's theory of the production of space and taking a transactional approach to occupation, we examined the role of immigrants' occupational engagement in the production of Francophone minority community spaces in Metro Vancouver, Canada. We completed a critical ethnography and focus on findings from participant observations and in-depth and go-along interviews with French-speaking immigrants. Findings shed light on the influence of immigrants' occupational engagement on the production of minority spaces. To study the spatiality of occupation comprehensively, we need to move beyond an examination of the immediate environment to address other components of the production of space as well as the interrelation of spaces through occupation.

Pelvic Floor Dysfunction After Childbirth: Occupational Impact and Awareness of Available Treatment.

Abstract: Postpartum pelvic floor dysfunction (PFD) has been identified as a significant public health issue. The study aimed to (a) identify the impact of PFD on parous women's occupations, (b) explore how PFD impacts daily life, and (c) determine the level of awareness regarding availability of PFD treatment. The preliminary study utilized a mixed-methods descriptive design. In total, 255 participants completed the Mothers and Children (MAC) survey, distributed electronically throughout the United States. Results indicated that PFD symptoms limit parous women's occupational performance, specifically sexual activity and exercise. Despite results indicating PFD significantly detracted from participants' daily life, 66.8% of participants reported having no awareness of pelvic floor rehabilitation to address PFD. Findings suggest that further research and increased advocacy within the field of occupational therapy are necessary to increase the awareness of PFD rehabilitation and mitigate the impact on women's lives after childbirth.

Using Subthreshold Vibratory Stimulation During Poststroke Rehabilitation Therapy: A Case Series

Abstract: Subthreshold vibratory stimulation to the paretic wrist has been shown to prime the sensorimotor cortex and improve 2-week upper extremity (UE) therapy outcomes. The objective of this work was to determine feasibility, safety, and preliminary efficacy of the stimulation over a typical 6-week therapy duration. Four chronic stroke survivors received stimulation during 6-week therapy. Feasibility/safety/efficacy were assessed at baseline, posttherapy, and 1-month follow-up. For feasibility, all participants wore the device throughout therapy and perceived the stimulation comfortable/safe. Regarding safety, no serious/moderate intervention-related adverse events occurred. For efficacy, all participants improved in Wolf Motor Function Test and UE use in daily living based on accelerometry and stroke impact scale. Mean improvements at posttherapy/follow-up were greater than the minimal detectable change/clinically important difference and other trials with similar therapy without stimulation. In conclusion, the stimulation was feasible/safe for 6-week use. Preliminary efficacy encourages a larger trial to further evaluate the stimulation as a therapy adjunct.

Commercial Exergaming in Home-Based Pediatric Constraint-Induced Therapy: A Randomized Trial.

Abstract: Constraint-induced therapy (CIT) is highly effective yet not accessible to many families. Integrating commercial exergaming in home-based CIT may support the availability and attainability of the intervention. The study compared the effects of supplementary use of Nintendo Wii in home-based CIT with dose-equivalent conventional CIT. Eighteen children with cerebral palsy were randomly assigned to 8 weeks of CIT (CIT) or 4 weeks of CIT, followed by 4 weeks of Wii-augmented CIT (CIT-Wii). Outcome measures included the Bruininks-Oseretsky Test of Motor Proficiency (Manual Dexterity), the ABILHAND-Kids, the WeeFIM (Self-Care), the Test of Playfulness, the Engagement Questionnaire, and the Parenting Stress Index-Short Form. Both groups significantly improved motor outcomes and playfulness. The CIT group demonstrated greater improvement in self-care skills, whereas parental stress decreased only in the CIT-Wii group. CIT-Wii yields no significant difference in treatment effects from conventional CIT and may provide psychosocial benefits.

Metacognitive Strategy Training Is Feasible for People With Aphasia.

Abstract: Metacognitive strategy training shows promise for reducing disability following stroke, but previous trials have excluded people with aphasia. Considering the high incidence of poststroke aphasia, ...

Relationships Between Household Income and Functional Independent Behavior for Children With Autism

Abstract: Children in lower income households are less likely to be diagnosed with autism spectrum disorder (ASD) and diagnosis is often delayed. Lack of or delayed identification of ASD minimizes a child's ability to receive effective early intervention services that support development of functional independence skills. Research has yet to identify relationships between functional independence and household income for children with ASD. A cross-sectional national survey with 231 caregivers of children with autism aged 2-12 years was conducted. Caregivers completed a 90-min survey examining family demographics, intervention services, autism symptom severity, and children's functional behavioral outcomes. Significant differences in functional independence behavior scores were identified for children from the highest and lowest income categories when controlling for autism symptom severity, age of diagnosis, and receipt of intervention services. This study provides preliminary evidence to support the association between income and functional independent behavior for children with ASD.

Pilot Study of French-Canadian Lifestyle Redesign® for Chronic Pain Management.

Abstract: As chronic pain (CP) interferes with an individual's lifestyle by limiting meaningful activities and health-related quality of life (HRQoL), occupational therapy (OT) plays an important role in CP management interventions. This pilot study aimed to explore the influence of a 13-week French-Canadian Lifestyle Redesign® for CP. A mixed-methods research design including a preexperimental quantitative component pre-/posttest was used with 15 participants with fibromyalgia. Although pain remained unchanged after the intervention, improvements were observed in participants' engagement in meaningful activities (p < .01), life balance (p < .01), mental components of HRQoL (p < .01), depressive symptoms (p = .047), and pain self-efficacy (p < .01). After the intervention, phone interviews (n = 6) highlighted the participants' appreciation of the focus being placed on their daily routines and the development of a sense of belonging throughout the intervention. This study suggests the potential feasibility and benefits of an occupation-based approach in CP management.

Adapting Interventions for Occupational Therapy Practice: Application of the FRAME Coding Structure.

Abstract: Occupational therapy practitioners often adapt evidence-based interventions for implementation into practice, yet these adaptations are seldom captured systematically. The purpose of this study was to apply the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) to describe adaptations to one intervention modified for teletherapy in the wake of COVID-19. An embedded multiple case study design was used to track adaptations made to a vestibular and bilateral integration (VBI) protocol-traditionally delivered in-person-that was implemented via teletherapy in a pediatric outpatient clinic. The "Modification and Adaptation Checklist" was used to track protocol adaptations. Data were examined through descriptive analyses; 63 adaptations were made to the VBI protocol. The most frequently noted adaptation was "Repeating protocol activities," whereas the "Integrating another treatment approach with the VBI protocol" was the least common adaptation. The FRAME may be useful for tracking adaptations and evaluating how adaptations influence intervention effectiveness.

Canadian Occupational Therapists' Use of Technology With Older Adults: A Nationwide Survey.

Abstract: As rehabilitation specialists, occupational therapy practitioners play a gateway role regarding recommendation of various technologies for homecare. However, no study has investigated current occupational therapy practices concerning information and communication technology (ICT) for older adults in Canada. The objective of this study was to identify Canadian occupational therapists' (OTs) knowledge and practices of ICT with older adults as well as factors associated with its recommendation. A Canada-wide, cross-sectional, online survey was conducted. Of 387 OTs, only 12.4% reported recommending ICT in practice. ICTs supporting communication and cognition were the main types recommended. The reported barriers to use in practice differed between ICT familiar users and nonusers. Multivariate logistic regression analyses showed that clinicians with more years of clinical experience were more likely to recommend ICT. Clinicians' services, work environments, and client diagnosis were also factors associated with ICT recommendation. Additional research is needed to understand how to overcome barriers to ICT recommendation in OT practice.

The Effectiveness of Client-Centered Intervention With Telerehabilitation Method After Total Knee Arthroplasty.

Abstract: There is known to be a decrease in quality of life and perceived occupational performance and satisfaction following total knee arthroplasty (TKA). This study was planned to examine the effectiveness of a client-centered (CC) intervention with the telerehabilitation (TR) method on the quality of life, perceived occupational performance, and satisfaction after TKA. A total of 38 patients who had undergone TKA were randomly assigned to the CC and control groups. A 12-day intervention program was applied to the CC group. The Nottingham Health Profile (NHP) and Canadian Occupational Performance Measure (COPM) were applied before and after intervention. The 12-day intervention showed a strong effect on all parameters in the CC group (p<.001). In the postintervention comparisons, a significant difference was found in favor of the CC group (p < .001). CC interventions with the TR method can be used in post-TKA interventions.

Addressing Phantom Pain Through Occupational Participation: A Qualitative Study of Support Group Participants:

Abstract: The purpose of this qualitative phenomenological study was to explore the adaptation process of support group participants who are survivors of lower limb amputation (LLA) experiencing phantom limb...

The Feasibility and Efficacy of an Israeli Lifestyle Redesign®–Based Program for Well Older Adults: A Pilot Study:

Abstract: The Israeli Lifestyle Program (ILP) was adapted from the original Lifestyle Redesign® intervention, aiming to enhance health, functioning, and quality of life (QoL) of older adults The purpose of this study was to examine the feasibility and effectiveness of the ILP The design of the study entailed a non-randomized trial with a 3-month follow-up including 18 women aged 65 to 81 recruited from a community center The research group (n = 9) participated in 15 weekly group meetings and three individual sessions The control group (n = 9) received an information booklet based on the ILP content Between-group comparisons revealed significant differences in change scores in favor of the research group for occupational performance (U = 190, p = 03), environmental (U = 215, p = 04), and social (U = 205, p = 03) QoL factors Findings also revealed reduction in depressive symptoms (U = 240, p = 07) These findings suggest community group programs for improving occupational performance and QoL

Reliability and Validity of Turkish Myasthenia Gravis-Activities of Daily Living Scale:

Abstract: Linguistic, reliable, and valid secondary efficacy measures are important in clinical settings and studies. The aim of the study is to report test–retest reliability and construct validity of Turki...

Parental Feeding Concerns for Children With Autism Spectrum Disorder: A Family-Centered Analysis:

Abstract: This study identifies and describes feeding concerns of parents of children with autism spectrum disorder (ASD) and examines the extent to which parents relate those concerns as having been addressed by therapists. Survey data were collected from 113 parents of children with ASD. Of the parents surveyed, 68% described a past or present concern with feeding; 60% of those parents with concerns said a therapist had not addressed those concerns. Feeding concerns were more likely addressed when therapists shared parent's concerns. Specific types of concerns, such as those around food selectivity and food refusal, were more likely addressed than difficulties around mealtime. A gap is identified between parental report of feeding difficulties and parental report of professional services addressing feeding needs. This analysis presents an opportunity for occupational therapists in the area of feeding, particularly around identifying and addressing parental concerns.

Out-of-Home Activities and Health in Older Adults: A Scoping Review:

Abstract: Participating in out-of-home (OOH) activities has been shown to benefit health in older adults. This scoping review aimed to describe the nature of the literature on OOH activities and health in community dwelling older adults, and the operationalization of OOH activity and health-related variables. We followed the Joanna Briggs Institute guidelines. Four databases were searched; studies were selected through title/abstract and full-text screening; and data on study characteristics, sample, and OOH activity and health-related variables were extracted, and summarized descriptively. Sixty articles were identified. There was a considerable focus on leisure and social activities (78% and 75%, respectively) but no predominant health-related outcome was identified. Few studies analyzed sex/gender and/or racial differences (25% and 2%, respectively). Future studies may include systematic reviews focused on health outcomes associated with social and leisure OOH activities; as well as gender-based and/or race-based differences in OOH and health relationships.

Smartphone Application for Measuring Community Participation in Veterans With Traumatic Brain Injury.

Abstract: The goal in the rehabilitation of veterans with mild traumatic brain injury (mTBI) is to improve community participation A tool that can objectively measure community participation is lacking The aims of this study are to evaluate the feasibility of a smartphone application (app) called MOVES to objectively measure community participation; and compare MOVES with a self-report questionnaire, and differences between veterans with mTBI and civilians without TBI It is a 6-week parallel observational study, which included seven veterans with blast-related mTBI and five civilians without TBI The measures include MOVES, Participation Assessment with Recombined Tools-Objective (self-report participation measure), Satisfaction Questionnaire, and Perceived Accuracy Daily Logs Participants were mostly satisfied using the MOVES app with 75% retention rate Perceived accuracy of the MOVES app was 90%, while the two groups showed similar discrepancies between the PART-O and the MOVES (52% vs 53%) The MOVES app is a feasible option to objectively measure community participation Self-report was discrepant from the MOVES app for both groups

Everyday Life Participation Using Powered Wheelchair Standing Devices by Boys With DMD.

Abstract: Powered wheelchair standing devices (PWSDs) allow supported standing for activity; however, little is known about their use. To understand factors affecting use of supported standing for participat...

Psychometric Properties of the Infant Toddler Activity Card Sort.

Abstract: The Infant Toddler Activity Card Sort (ITACS) is a new measure that engages caregivers in goal development by measuring participation in early childhood. Initial evaluation of the ITACS is required to assess its psychometric properties. To evaluate test-retest reliability, concurrent validity, and between-group differences of the ITACS. Caregivers (N = 208) of children 0-3 years, who were typically developing (TD) or had a developmental delay (DD), completed the ITACS and Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) with repeat assessment after 2 weeks later (n = 117). The ITACS demonstrated moderate concurrent validity with the PEDI-CAT. Children with DD had significantly more activity concerns on the ITACS than TD. Adequate test-retest reliability was not achieved. The ITACS is a useful tool for identifying caregiver concerns in activity engagement; interventions can be tailored to address concerns and increase participation in childhood routines.

Effect of Standing on a Standardized Measure of Upper Extremity Function

Abstract: Although many daily activities that require the upper extremity are performed in standing, arm motor function is generally measured in sitting The purpose of this study was to examine the effect of standing on a measure of upper extremity function, the Jebsen Hand Function Test (JHFT) Twelve nondisabled adults (263 ± 31 years) completed the JHFT with the right and left arms under two conditions: sitting and standing Total time to complete the JHFT increased when performed in standing compared with sitting in both arms (p = 005); mean increase was 44% and 56% for the right and left arms, respectively Checker stacking was the only subtest that showed a significant increase in completion time in standing for both arms (p = 001); card turning showed an increase for the left arm only (p = 002) Measurement of upper extremity function in standing may provide insight into arm motor capacity within the context of standing postural control demands

Imbuing Occupations with Spiritual Significance Fosters Experiences of Hope.

Abstract: In theories of occupational therapy, occupation serves as a conduit for creating meaning and well-being. A crucial component of occupational therapy is developing and maintaining hope of clients during periods of major difficulty. Understanding the relationship between hope and occupation can prove helpful in stressful situations, such as caring for children with chronic illnesses. The aim of the present study was to identify occupations that foster experiences of hope among mothers of adult children with mental illness. A qualitative approach, informed by a constructivist framework and thematic analysis, was used to interpret and explicate relevant occupation-related themes that fostered hope in four mothers. The mother-participants reported engaging in various occupations, yet only occupations that were imbued with spiritual significance fostered experiences of hope. This study brings to the forefront of occupational therapy discourse the issue of spiritual connectedness as a potential link between occupations and hope.

Sensory-Based Priming for Upper Extremity Hemiparesis After Stroke: A Scoping Review.

Abstract: Sensory priming is a technique to facilitate neuroplasticity and improve motor skills after injury. Common sensory priming modalities include peripheral nerve stimulation/somatosensory electrical stimulation (PNS/SES), transient functional deafferentation (TFD), and vibration. The aim of this study was to determine whether sensory priming with a motor intervention results in improved upper limb motor impairment or function after stroke. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and EMBASE were the databases used to search the literature in July 2020. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and recommendations for the Cochrane collaboration. In total, 30 studies were included in the analysis: three studies examined TFD, 16 examined PNS/SES, 10 studied vibration, and one combined the three stimulation techniques. Most studies reported significant improvements for participants receiving sensory priming. Given the low risk, it may be advantageous to use sensory-based priming prior to or concurrent with upper limb training after stroke.

Determinants of Time to Care for Children and Adolescents With Disabilities.

Abstract: Time use studies uncover the organization of daily routine of families of children with disabilities. The objective of this study is to identify determinants of time spent caring for children/adolescents with cerebral palsy (CP), autism spectrum disorder (ASD), and typical development (TD). Participants were caregivers of children/adolescents with/without disability. Structural equation modeling tested a proposed model of time spent in child care. The variables in the model were as follows: questionnaire (families' socioeconomic status [SES]), children's functioning (The Pediatric Evaluation of Disability Inventory-Computer Adaptive Test [PEDI-CAT]); hours of care (daily diaries), number of adaptations used, and help with child care (parents' report). Distinct variable combinations explained 78% of the variation in the time to care (TD model), followed by 42% (ASD) and 29% (CP). Adaptations indirectly affected time to care through its effect on functioning (CP); family's SES affected functioning through its effect on adaptation use (ASD). In conclusion, knowledge of factors affecting caregivers' time spent on children's care help occupational therapists implement family-centered strategies.

Fostering Change Through Occupation-Based Intervention: An International Joint Group Concept Mapping Study.

Abstract: Further consolidation and clarity regarding occupation as a means to foster change in interventions are needed. The study aimed to utilize the knowledge of occupational scholars to systematically d...

Childhood Health Assets in a Spanish Neighborhood: Children and Families' Perception.

Abstract: The health assets (HA; factors or resources that maintain or improves health) approach has hardly been incorporated in occupational therapy, and even less so in research focused on children’s perce...