Showing papers on "Occupational therapy published in 2022"

‘Learning in and out of lockdown’: A comparison of two groups of undergraduate occupational therapy students' engagement in online‐only and blended education approaches during the COVID‐19 pandemic

Abstract: Abstract Introduction In many countries, the COVID‐19 pandemic resulted in sudden changes to the delivery of health professions education in response to local and national lockdowns. Within occupational therapy, university education programs traditionally delivered in face‐to‐face classroom, and clinical settings, the transition to online learning presented unique issues and challenges for faculty and students. This study compared the experiences and perceptions of learning in two groups of occupational therapy students during the pandemic: one group converted to online learning only and the other had a blended approach that combined face‐to‐face on‐campus learning with some online lecture content delivery. Methods Two hundred and eight (n = 208) undergraduate occupational therapy students from three Australian universities completed an online self‐report demographic questionnaire and two standardised instruments: the Student Engagement in the e‐Learning Environment Scale and the Distance Education Learning Environment Scale. An independent‐samples t test with bootstrapping was completed to examine differences in students' scores. Results Statistically significant differences were observed between the online and blended learning groups across a range of the SELES and DELES subscales. The strongest findings related to psychological motivation (p = 0.001), personal relevance (p = 0.001), interactions with instructors (p = 0.002), instructor support (p = 0.001), student interaction & collaboration (p = 0.001), and cognitive problem solving (p = 0.001). Conclusion Occupational therapy students who transitioned to online‐only learning experienced higher levels of motivation, interactions with instructors and peers, and self‐directed learning than students who experienced a blended education delivery approach of face‐to‐face and online learning. The findings extend educators' understanding of the matrix of factors that have impacted students' education during COVID‐19 and support the development of contemporary and pedagogically sound online and traditional modes of occupational therapy instruction. The results provide evidence of the importance of well‐structured programs that facilitate active and flexible learning, provide meaningful and positive experiences, and promote initiatives safeguarding social and personal well‐being. Further research in this area is recommended.

Examining the effectiveness of virtual, augmented, and mixed reality (VAMR) therapy for upper limb recovery and activities of daily living in stroke patients: a systematic review and meta-analysis

Abstract: Abstract Introduction Virtual reality (VR), augmented reality (AR), and mixed reality (MR) are emerging technologies in the field of stroke rehabilitation that have the potential to overcome the limitations of conventional treatment. Enhancing upper limb (UL) function is critical in stroke impairments because the upper limb is involved in the majority of activities of daily living (ADL). Methods This study reviewed the use of virtual, augmented and mixed reality (VAMR) methods for improving UL recovery and ADL, and compared the effectiveness of VAMR treatment to conventional rehabilitation therapy. The databases ScienceDirect, PubMed, IEEE Xplore, and Web of Science were examined, and 50 randomized control trials comparing VAMR treatment to standard therapy were determined. The random effect model and fixed effect model are applied based on heterogeneity. Results The most often used outcomes of UL recovery and ADL in stroke rehabilitation were the Fugl-Meyer Assessment for Upper Extremities (FMA-UE), followed by the Box and Block Test (BBT), the Wolf Motor Function Test (WMFT), and the Functional Independence Measure (FIM). According to the meta-analysis, VR, AR, and MR all have a significant positive effect on improving FMA-UE for UL impairment (36 studies, MD = 3.91, 95 percent CI = 1.70–6.12, P = 0.0005) and FIM for ADL (10 studies, MD = 4.25, 95 percent CI = 1.47–7.03, P = 0.003), but not on BBT and WMFT for the UL function tests (16 studies, MD = 2.07, 95 percent CI = − 0.58–4.72, P = 0.13), Conclusions VAMR therapy was superior to conventional treatment in UL impairment and daily function outcomes, but not UL function measures. Future studies might include further high-quality trials examining the effect of VR, AR, and MR on UL function measures, with an emphasis on subgroup meta-analysis by stroke type and recovery stage.

Skills for Practice in Occupational Therapy

Abstract: List of contributors. Foreword. Preface. Acknowledgements. Chapter 1 - Introduction. Section 1: Thinking, judgement and decision skills for practice. Chapter 2 - Using theory in practice. Chapter 3 - Judgement and decision making in practice. Chapter 4 - Involvement and shared decision making in practice. Chapter 5 - Reflective practice: doing, being and becoming a reflective practitioner. Section 2: Professional skills for practice. Chapter 6 - Assessment skills for practice. Chapter 7 - Activity analysis. Chapter 8 - Goal setting in occupational therapy: a client-centered perspective. Chapter 9 - Therapeutic use of self: a model of the international relationship. Chapter 10 - Problem solving. Chapter 11 - Educational skills for practice. Chapter 12 - Group skills for practice in occupational therapy. Chapter 13 - Record and report writing. Section 3: Evidence-based and research skills for practice. Chapter 14 - Finding and appraising the evidence. Chapter 15 - Knowledge exchange. Chapter 16 - Clinical effectiveness skills in practice. Chapter 17 - Developing research in practice. Chapter 18 - Presentation and publication skills. Section 4: Leadership, supervision and management skills for practice. Chapter 19 - Management of self. Chapter 20 - Leadership skills. Chapter 21 - Practice education: skills for students and educators. Chapter 22 - Clinical supervision skills. Index.

Examining the effectiveness of virtual, augmented, and mixed reality (VAMR) therapy for upper limb recovery and activities of daily living in stroke patients: a systematic review and meta-analysis

Abstract: Abstract Introduction Virtual reality (VR), augmented reality (AR), and mixed reality (MR) are emerging technologies in the field of stroke rehabilitation that have the potential to overcome the limitations of conventional treatment. Enhancing upper limb (UL) function is critical in stroke impairments because the upper limb is involved in the majority of activities of daily living (ADL). Methods This study reviewed the use of virtual, augmented and mixed reality (VAMR) methods for improving UL recovery and ADL, and compared the effectiveness of VAMR treatment to conventional rehabilitation therapy. The databases ScienceDirect, PubMed, IEEE Xplore, and Web of Science were examined, and 50 randomized control trials comparing VAMR treatment to standard therapy were determined. The random effect model and fixed effect model are applied based on heterogeneity. Results The most often used outcomes of UL recovery and ADL in stroke rehabilitation were the Fugl-Meyer Assessment for Upper Extremities (FMA-UE), followed by the Box and Block Test (BBT), the Wolf Motor Function Test (WMFT), and the Functional Independence Measure (FIM). According to the meta-analysis, VR, AR, and MR all have a significant positive effect on improving FMA-UE for UL impairment (36 studies, MD = 3.91, 95 percent CI = 1.70–6.12, P = 0.0005) and FIM for ADL (10 studies, MD = 4.25, 95 percent CI = 1.47–7.03, P = 0.003), but not on BBT and WMFT for the UL function tests (16 studies, MD = 2.07, 95 percent CI = − 0.58–4.72, P = 0.13), Conclusions VAMR therapy was superior to conventional treatment in UL impairment and daily function outcomes, but not UL function measures. Future studies might include further high-quality trials examining the effect of VR, AR, and MR on UL function measures, with an emphasis on subgroup meta-analysis by stroke type and recovery stage.

New technologies promoting active upper limb rehabilitation after stroke: an overview and network meta-analysis

Abstract: The primary aim of this work was to summarize and compare the effects of active rehabilitation assisted by new technologies (virtual reality [VR], robot-assisted therapy [RAT] and telerehabilitation [TR)) on upper limb motor function and everyday living activity during the subacute and chronic phases of stroke. The secondary aims were to compare the effects of these technologies according to the intervention design (in addition to or in substitution of conventional therapy), the duration of active rehabilitation and the severity of patients' motor impairments.Several databases, namely PubMed, Scopus, Embase and Cochrane Library, were searched. Studies were included if they were meta-analyses with a moderate to high level of confidence (assessed with AMSTAR-2) that compared the effects of a new technology promoting active rehabilitation to that of a conventional therapy program among patients with stroke. Network meta-analyses were conducted to compare the effects of the new technologies.Eighteen different meta-analyses were selected and fifteen included in the quantitative analysis. In total these 15 meta-analyses were based on 189 different randomized controlled trials. VR (SMD≥0.25; P<0.05), RAT (SMD≥0.29; P≤0.29) and TR (SMD≥-0.08; P≤0.64) were found to be at least as effective as conventional therapy. During the subacute phase, RAT's greatest effect was observed for patients with severe-moderate impairments whereas VR and TR's greatest effects were observed for patients with mild impairments. During the chronic phase, the highest effects were observed for patients with mild impairments, for all studies technologies. Network meta-analyses showed that VR and RAT were both significantly superior to TR in improving motor function during the chronic phase but revealed no significant difference between VR, RAT and TR effectiveness on both motor function (during the subacute phase) and activity (during both chronic and subacute phase).This overview provides low-to-moderate evidence that rehabilitation assisted with technologies are at least as effective as conventional therapy for patients with stroke. While VR and RAT seem to be more efficient during the subacute phase, all technologies seem to be as efficient as one another in the chronic phase.

Prevalence and Predictors of Burnout Among Occupational Therapy Practitioners in the United States.

Abstract: IMPORTANCE Identifying the extent and predictors of burnout among occupational therapy practitioners is important so strategies can be developed to reduce burnout and mitigate associated consequences within the profession. OBJECTIVE To investigate the prevalence and determinants of burnout reported by U.S. occupational therapy practitioners. DESIGN Cross-sectional survey. PARTICIPANTS Occupational therapy practitioners working in a wide range of clinical settings who spent at least 50% of their time in direct patient care and who had been employed continuously for more than 6 mo. OUTCOMES AND MEASURES The outcome of interest was burnout, which was measured using the Emotional Exhaustion, Depersonalization, and Personal Accomplishment subscales of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Predictor variables included sociodemographic and workplace characteristics. The relationship between MBI-HSS subscale scores and predictor variables was jointly estimated using a multivariate multivariable linear regression analysis. RESULTS One hundred seventy-eight occupational therapy practitioners completed the survey. Higher perceived level of supervisor support, satisfaction with income, and educational attainment were associated with lower MBI-HSS subscale scores (ps = .001, .002, and .005, respectively). CONCLUSIONS AND RELEVANCE Burnout among occupational therapy practitioners can be conceptualized as an issue of workplace health and safety. Various stakeholder groups can consider potential systematic interventions involving measures to promote positive supervisor support in the workplace and salary negotiation skills for early-stage clinicians. Future research should explore broad interventions to reduce burnout among clinicians. What This Article Adds: We estimated the extent and predictors of burnout among U.S. occupational therapy practitioners. Future research, advocacy, and policy should address structural-level interventions to promote workplace cultures and conditions that can protect the occupational therapy workforce from burnout.

Telehealth Clinical Practice Guide for Occupational Therapy, Physical Therapy, and Speech and Language Pathology: A Saudi and Middle Eastern Guide

Abstract: Telehealth refers to the application of telecommunications technology to deliver clinical services at a distance by linking clinician to patient, caregiver, or any person(s) involved in client care for assessment, intervention, consultation, and supervision. Telehealth for occupational therapy (OT), physical therapy (PT), and speech and language pathology (SLP) have produced service delivery venues that are of great benefit during the coronavirus disease 2019 pandemic. The concept of telehealth for rehabilitation services is relatively new in the Middle East, and no specialty-specific clinical practice standards or guidelines are published to guide the rehabilitation practitioners. Therefore, a specialty-specific telehealth practice guide for rehabilitation practitioners has been developed by an expert panel in the field of rehabilitation. This guide is documented in this article. Such a guide will be beneficial when providing tele-evaluation, teleintervention/telerehabilitation, teleconsultation, and telemonitoring through communication technologies. The purpose of this guide is to enable understanding of core telehealth clinical principles and aid the provision of OT, PT, and SLP telehealth services in Saudi Arabia. Also, the guide can potentially be implemented in other Middle Eastern countries. The guide is based on key telehealth guidelines involving the American Occupational Therapy Association telehealth resources, American Physical Therapy Association, American Speech and Hearing Association, telemedicine policies in Saudi Arabia by the national health information center at the Saudi Health Council, and a blueprint for telerehabilitation guidelines that are based on the American Telemedicine Association's Core Standards for Telemedicine Operations.

Use of health services and unmet needs among adults with cerebral palsy in Ireland

Abstract: To describe use of health services, unmet needs relating to health services, and identify factors associated with service use among adults with cerebral palsy (CP) in Ireland.

Occupational Therapy Using Ayres Sensory Integration®: A Randomized Controlled Trial in Brazil.

Abstract: IMPORTANCE Research conducted in the United States has found that occupational therapy using Ayres Sensory Integration® is an effective evidence-based intervention for children with autism spectrum disorder (ASD). Replication of this research in other cultures is needed. OBJECTIVE To evaluate the outcomes of occupational therapy using Ayres Sensory Integration in a sample of Brazilian children with ASD. DESIGN Prospective randomized controlled trial. SETTING Occupational therapy clinic. PARTICIPANTS Seventeen children with ASD ages 5-8 yr (n = 9 in the intervention group, n = 8 in the usual-care control group) recruited from a local hospital via flyers and word-of-mouth. Completed pretreatment characterization and baseline measurement. INTERVENTIONS The intervention group received occupational therapy using Ayres Sensory Integration, and the control group received usual therapeutic and educational services only. OUTCOMES AND MEASURES We conducted a pre-post assessment of self-care and socialization using the Pediatric Evaluation of Disability Inventory and individualized goal ratings. RESULTS Participants in the intervention group scored significantly higher on outcome measures of self-care (p = .046, rb = .57), social function (p = .036, rb = .61), and parent-identified goal attainment (p < .001, rb = .94) compared with the control group. CONCLUSIONS AND RELEVANCE Occupational therapy using Ayres Sensory Integration was effective in enhancing self-care, socialization, and goal attainment for children with ASD in a Brazilian cohort. What This Article Adds: This study contributes further support from outside the United States that occupational therapy using Ayres Sensory Integration is an effective evidence-based intervention to improve self-care, socialization, and parent-identified goal attainment in children with ASD.

Type of Findings Generated by the Occupational Therapy Workforce Research Worldwide: Scoping Review and Content Analysis

Abstract: Occupational therapists are needed to meet the health and occupational needs of the global population, but we know little about the type of findings generated by occupational therapy workforce research conducted worldwide. We aim to synthesize these findings and their range of content to inform future investigations. A scoping review with content analysis was used. Six scientific databases, websites of official institutions, snowballing, and key informants were used for searches. Two independent reviewers took selection decisions against the eligibility criteria published a priori in the review protocol. Of the 1246 unique references detected, 57 papers were included for the last 25 years. A total of 18 papers addressed issues of attractiveness and retention, often in Australia, and 14 addressed the issues of supply, demand, and distribution, often in the US. Only these two categories generated subtopics. Many workforce issues were rarely addressed as a main topic (e.g., race/ethnic representation). Cross-national, cross-regional, or cross-professional studies generated more actionable findings. Overall, we found few discernable trends, minimal evidence of research programs, and various gaps in content coverage or in the use of contemporary research approaches. There is a need for a coordinated strengthening of the occupational therapy workforce research worldwide.

Nintendo® Wii Therapy Improves Upper Extremity Motor Function in Children with Cerebral Palsy: A Systematic Review with Meta-Analysis

Abstract: Background: Nintendo® Wii-based therapy (NWT) is a non-immersive virtual reality therapy used to recover upper extremity (UE) motor function in children with cerebral palsy (CP). We aimed primarily to elucidate the effectiveness of NWT in improving UE motor and functional impaired abilities in children with CP, compared to conventional therapy or no intervention. The secondary aim was to assess if NWT is more effective when used alone or combined with conventional therapy. Methods: A systematic review with meta-analysis was conducted from a bibliographic search in PubMed, Scopus, PEDro, Web of Science, and CINHAL, ending in October 2021, in accordance with PRISMA guidelines. We included randomized controlled trials that compared NWT vs. conventional therapy or no intervention in terms of their impact on different UE impaired abilities (grip strength, tip grip strength, UE dissociated movements, functional capacity in daily living activities, gross and fine motor dexterity, and grasping ability) in children with CP. Effect size was calculated with standardized mean difference (SMD) and its 95% confidence interval (95% CI). Results: Nine studies (276 participants) were included. NWT is more effective than conventional therapy at improving grip strength (SMD = 0.5, 95% CI 0.08, 0.91), tip grip strength (SMD = 0.95, 95% CI 0.3, 1.61), and grasping ability (SMD = 0.72, 95%CI 0.14, 1.3). NWT is more effective than conventional therapy at improving functional capacity in daily living activities (SMD = 0.83, 95% CI 0.07, 1.56). For fine manual dexterity, NWT was better than no intervention (SMD = 3.12, 95% CI 1.5, 4.7). Conclusions: Our results indicate that NWT is effective at improving various UE impaired motor skills in children with CP.

Effects of Occupational Therapy via Telerehabilitation on Occupational Balance, Well-Being, Intrinsic Motivation and Quality of Life in Syrian Refugee Children in COVID-19 Lockdown: A Randomized Controlled Trial

Abstract: We aimed to evaluate the effects of an occupational training program via telerehabilitation on well-being (WB), occupational balance (OB), intrinsic motivation (IM), and quality of life (QoL) in Syrian refugee children resettled in Turkey during the COVID-19 pandemic. This was a single-center, prospective, randomized, non-blinded trial in which children aged 13–15 years and attending a secondary school were recruited. OB, WB, IM, and QoL were evaluated via the OB Questionnaire (OBQ11), the Well-Star Scale (WSS), the IM Scale (IMS), and the Pediatric Quality of Life Inventory (PedsQL). The intervention group attended online occupational therapy classes. Online classes were carried out as five sessions per week, each session lasting 1 h, for 3 weeks. Questionnaires were performed at the outset of the study and following the training program. Overall, 52 refugee children were randomized into the intervention and control groups, each including 26 children. The mean OBQ11, WSS, IMS, and PedsQL scores significantly improved more in the intervention group than in the control group. This was the first study investigating the effects of a customized online training course on OB, WB, IM, and QoL in Syrian refugee children, also affected unfavorably by the COVID-19 lockdown. Our results showed significant improvements in all the study scales that we used to quantify the alterations in the aforementioned traits.

Using activity-based therapy for individuals with spinal cord injury or disease: Interviews with physical and occupational therapists in rehabilitation hospitals

Abstract: Objective: To understand if and how physical therapists (PTs) and occupational therapists (OTs) use activity-based therapy (ABT) and its associated technologies for the rehabilitation of individuals living with spinal cord injury or disease (SCI/D) in Canadian rehabilitation hospital settings. Design: Qualitative study. Setting: Through rehabilitation hospitals participating in the Rick Hansen Spinal Cord Injury Registry, we recruited licensed OTs and PTs to participate in focus groups. Participants: Twelve PTs and ten OTs from nine sites across eight provinces participated. Outcome Measures: To inform the development of a semi-structured interview guide, we used the Theoretical Domains Framework. To analyze the data, we used interpretive description. Results: We identified three themes that influenced therapists’ use of ABT and associated technologies for SCI/D rehabilitation. (1) Therapists’ decision-making approach to ABT and technology. Therapist roles, site-specific dynamics and goal setting influenced decision-making. Assuming roles such as mentor, liaison and advocate led to more ABT use. Site-specific dynamics concerned levels of ABT knowledge, teamwork, and staffing. In hospital rehabilitation, there was competition between discharge and neurorecovery goals. (2) Therapist perceived individual factors. Patient factors either increased (i.e. patients’ motivation, self-advocacy) or prevented (i.e. mourning period, tolerance) the likelihood that ABT was introduced by therapists. (3) ABT and equipment access. Technology was used for ABT in a variety of ways. Access was affected by visible (e.g. equipment cost) and invisible barriers (e.g. departmental relations). Conclusions: The use of ABT and its associated technologies in Canadian rehabilitation hospitals is variable. Ongoing education could be offered, and site-specific implementation strategies could be developed, to promote ABT use.

Working with children with cortical visual impairment who use augmentative and alternative communication: implications for improving current practice

Abstract: Abstract The aim of this study was to describe how professionals from multiple disciplines (e.g., speech-language pathologists, teachers, occupational therapists) in the United States reported challenges they face in delivering services to children with cortical visual impairment (CVI) who use augmentative and alternative communication (AAC). Three surveys were utilized to identify barriers to and priorities for improving educational and clinical services and in-service and preservice education from the perspectives of professionals in school, community, and university settings. Results suggest that current service delivery models may not be meeting the needs of either children with CVI who use AAC or the professionals whose job it is to provide them with services. Professionals in community-based settings appeared to encounter more barriers. Findings help to support a discussion about approaching AAC interventions for children with CVI who use AAC by adopting interprofessional collaborative practice (IPCP) and interprofessional education (IPE) models, which reflect long-standing best practice guidelines for AAC service delivery and are encouraged by multiple professional organizations.

Pilot Study of the Cognitive-Functional Intervention for Adults (Cog-Fun A): A Metacognitive-Functional Tool for Adults With Attention Deficit Hyperactivity Disorder.

Abstract: IMPORTANCE Adults with attention deficit hyperactivity disorder (ADHD) often experience chronic challenges in their life roles. There is a need for evidence-based occupational therapy interventions to help enhance their functioning. OBJECTIVE To determine the preliminary effectiveness of the Cognitive-Functional Intervention for Adults (Cog-Fun A), a metacognitive-functional occupational therapy tool for the improvement of occupational performance (OP) and quality of life (QoL) in adults with ADHD. DESIGN One-group pretest-posttest design with a 3-mo follow-up. SETTING Community setting in Jerusalem, Israel. PARTICIPANTS Fourteen adults, ages 18-60 yr, with a valid diagnosis of ADHD and an indication of executive function (EF) impairment. INTERVENTION Participants received 15 1-hr weekly sessions that addressed self-awareness of strengths and challenges through education and guided discovery as well as strategy acquisition and implementation within a context of occupational goal attainment. OUTCOMES AND MEASURES The Behavioral Rating Inventory of Executive Function-Adult version, an adult ADHD QoL measure, the Canadian Occupational Performance Measure, and the Self-Regulation Skills Interview were administered. RESULTS Twelve participants completed the intervention. Posttreatment scores revealed statistically significant improvements in EF, awareness, OP, and QoL. Gains in QoL showed a modest reduction at the 3-mo follow-up. CONCLUSIONS AND RELEVANCE The Cog-Fun A is a promising intervention for improving OP and QoL among adults with ADHD and should be investigated further. What This Article Adds: The Cog-Fun A offers an effective nonpharmacological, metacognitive-functional, occupation-centered treatment option for adults with ADHD.

Stroke Rehabilitation: Recent Progress and Future Promise

Abstract: Significant advancements in acute stroke medical management have changed stroke rehabilitation. In addition, an ever-changing health care ecosystem and heightened awareness of continued and new challenges requires that the occupational therapy profession consider new, innovative, and pragmatic approaches to measurement, intervention, and health services research, and clinical practice. The profession must elevate the focus and rigor of research examining occupation and participation after stroke, and their associations with health. Intervention research must progress beyond early phase pilot studies to a robust collection of meaningful large multisite studies that demonstrate the effectiveness of our interventions and the effectiveness of wide-scale implementation to ensure quality and consistent delivery of evidence-based practices in occupational therapy. These studies must address the accessibility of these practices for all people who have sustained stroke, and particularly those people who are most vulnerable to inaccessible stroke rehabilitation service delivery systems.

The Dignity Project Framework: An extreme citizen science framework in occupational therapy and rehabilitation research

Abstract: Abstract Introduction Engaging citizens and patients as research partners is receiving increasing emphasis across disciplines, because citizens are untapped resources for solving complex problems. Occupational therapists are engaging in inclusive research, but not always in equitable partnership. Moving beyond inclusive research to a dignified framework for research prioritises lived experience and human rights in health research. Methods Using nominal group technique over a series of three working group meetings, eight experts, including three with lived experience of disability and research, prioritised principles and steps for conducting dignified rehabilitation research in partnership with citizens with disability. Findings Embedding transparency, accessibility and inclusion, dignified language, and authenticity throughout research were integral to maintaining dignity and safety for citizens with disability engaged in research. The Dignity Project Framework encompasses five phases, namely, (1) vision, (2) uncover, (3) discuss, (4) critical reflection, and (5) change, which address the prominent criticisms of the disability community about research and embed the principles of importance into research practice. Conclusion The framework builds on inclusive research frameworks to a human rights‐based, dignified framework for extreme citizen science. Grounding disability in contemporary conceptualisations and providing a method for democratising knowledge production provide occupational therapists with a method for dignified partnership with citizens with disability.

Occupational Therapy Practice Guidelines for Adults With Chronic Conditions.

Abstract: IMPORTANCE Demand is increasing for occupational therapy practitioners to help the growing population of adults with chronic conditions manage their conditions. OBJECTIVE This Practice Guideline, which is informed by systematic reviews of the literature on the use of self-management interventions, is meant to guide occupational therapy practitioners' clinical decision making when working with community-dwelling adults with chronic conditions. The chronic conditions included heart disease, chronic lung conditions, diabetes, and kidney disease. The self-management interventions addressed ADLs and sleep and rest; IADLs; education, work, volunteering, leisure, and social participation; and the caregiver role. METHOD We reviewed, discussed, and integrated the clinical recommendations developed from four systematic reviews, supporting literature, and expert opinion to provide recommendations for practice. RESULTS A total of 102 articles were included in the systematic reviews, which served as the primary basis for the practice recommendations. CONCLUSIONS AND RECOMMENDATIONS Strong to moderate evidence supports clinical recommendations for the use of self-management interventions when working with clients with chronic conditions. We recommend the use of a multimodal approach that includes three components-education, goal setting, and problem solving-over an extended period to assist clients in establishing self-management habits and routines. On the basis of emerging evidence and expert opinion, we recommend that occupational therapy practitioners consider using a prevention approach, helping clients establish habits and routines, and emphasizing shared goal setting when addressing clients' self-management of chronic conditions. What This Article Adds: This Practice Guideline provides a summary of strong to moderate evidence that supports clinical recommendations for the use of self-management interventions with clients with chronic conditions. When guided by this evidence, occupational therapy practitioners are better able to help clients meet their occupational challenges.

Occupational Therapy-Based Energy Management Education in People with Post-COVID-19 Condition-Related Fatigue: Results from a Focus Group Discussion

Abstract: Persons with post-COVID-19 conditions have prolonged symptoms and longer-term consequences which can prevent them from returning to previous everyday functioning. Fatigue is the most frequent symptom reported in literature. Occupational therapists (OTs) are specialized in client-centered problem analysis, counseling, and education to recover occupational engagement and performance in everyday life. Since the beginning of the COVID-19 pandemic, OTs have been challenged to respond with services adequate to the needs of this patient group. Energy management education (EME) was initially developed for persons with multiple sclerosis-related fatigue and then made independent of diagnosis suitable to persons living with chronic disease-related fatigue. EME, a structured self-management education, is becoming a part of the new services. This study was aimed at exploring the initial experiences of OTs using the EME protocol and materials with persons with postacute COVID-19 and/or post-COVID-19 condition-related fatigue and gathering their recommendations for improvements and adaptions. One online focus group discussion took place in May 2021 with OTs experienced in using the EME protocol. The topics addressed were the institutional context of the OTs and their experiences during the treatment. A thematic analysis was performed. According to nine OTs working in different settings in Switzerland, the EME protocol is exploitable in both in- and outpatient settings and was judged appropriate by them, even if the EME materials can be improved. The main challenges for the OTs were the short period their patients had lived with fatigue; the discrepancy between self-concept, self-perception, and performance; and the insecurity, fear, and anxiety related to recovery. Further research is needed to include the perspective of EME participants and to measure quantitative outcomes such as fatigue impact, self-efficacy, occupational performance, and quality of life. Until the existing EME protocol is improved, it is applicable to persons with post-COVID-19 condition-related fatigue.

Occupational Engagement and Quality of Life in Occupational Therapy Students and Professionals during Coronavirus Pandemic

Abstract: This nationwide study addressed how occupational engagement and quality of life (QoL) were affected in occupational therapy (OT) students and professionals during the 2019 Novel Coronavirus (COVID-19) pandemic. Research questions addressed: 1) if daily occupations changed; 2) how QoL was affected; 3) in what manner OT background influenced coping; 4) recommendations to OT students, practitioners, and the profession. Although 198 students and 249 professionals responded initially to the survey, an average of 161 professionals and 95 students completed the critical questions described herein. Six students and eight professionals participated in interviews. Separate online surveys via SurveyMonkey gathered quantitative and qualitative data from the students and professionals, and interview guides facilitated qualitative data collection from both groups. The anonymous surveys included rating scales, multiple-choice, ranking, and open-ended questions. The interviews, using open-ended questions, occurred via telephone or Skype audio calls in the summer and early fall of 2020. Both professionals and students reported their occupational engagement drastically changed due to the Pandemic. Similarly, they indicated a decrease in their own QoL compared to before the Pandemic. Grounded Theory of Pandemic Occupational Adaptation and Engagement in OT Professionals and Students emanated from the findings. The COVID-19 Pandemic affected millions in various ways. OT professionals and students reported telehealth as beneficial for treating clients and providing education to OT students. Mental health should be a priority for everyone to maintain good QoL and cope with pandemic-related and future life challenges. Participant commitment to the occupational therapy profession continues to be strong. How to cite this paper: Fisher, G., Ahlberg, M., Cragle, C., Kudeh, D., Laytos, M., Lopes, K., Riesterer, C., Sedon, M., Scott, A., Sock, L., & Victor, J. (2022). Occupational Engagement and Quality of Life in Occupational Therapy Students and Professionals during Coronavirus Pandemic. Open Journal of Social Sciences, 10, 211-239. https://doi.org/10.4236/jss.2022.101019 Received: December 19, 2021 Accepted: January 21, 2022 Published: January 24, 2022 Copyright © 2022 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/

Implementing Pathways and Resources for Engagement and Participation (PREP) for Children with Disabilities in Inclusive Schools: A Knowledge Translation Strategy

Abstract: Abstract Aims: To examine the effectiveness of PREP (Pathways and Resources for Engagement and Participation) knowledge translation (KT)-program on (a) change in practice behaviors and improved knowledge of school-based occupational therapists, and (b) participation of children with disabilities in inclusive education. Methods: A mixed-methods design was employed. Therapists (n = 39) completed a 30-hour program. Each therapist applied PREP intervention to one child (n = 39) aged 4-15 (Mean = 9.31, SD = 2.4). Therapists’ outcomes included: (a) knowledge of PREP evaluated using a clinical vignette, analyzed descriptively, (b) change in practice behavior measured by the Professional Evaluation and Reflection on Change Tool (PERFECT), analyzed thematically. Change in children’ participation pre- and post-KT-program and during follow-up was measured by the Canadian Occupational Performance Measure (COPM), analyzed using ANOVA. Results: Therapists acquired knowledge of PREP (vignette mean score 17.7/20). PERFECT revealed therapists’ self-perceived changes in practice: incorporating an environmental perspective, expanding partnerships, and redirecting focus on participation. Completing the KT-program was a primary enabler and reason for change. Children’s participation significantly improved post KT-program and during follow-up in both performance (p < 0.001) and satisfaction (p < 0.001). Conclusions. KT strategies, as illustrated in this study, accelerated the uptake of evidence-based interventions, minimizing existing ’know-do' gaps and promoting children’s health through participation.

Interventions for Instrumental Activities of Daily Living Among Adults With Multiple Sclerosis: A Systematic Review.

Abstract: IMPORTANCE Occupational therapy practitioners need updated information about interventions that may improve or maintain functional changes in instrumental activity of daily living (IADL) engagement caused by multiple sclerosis (MS). OBJECTIVE To conduct a narrative synthesis of updated evidence on interventions within the scope of occupational therapy to improve or maintain performance of and participation in IADLs among adults with MS. DATA SOURCES CINAHL, MEDLINE in PubMed, Cochrane, OTseeker, and PsycINFO. Study Selection and Data Collection: This systematic review followed the Cochrane Collaboration methodology and is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for conducting a systematic review. Inclusion criteria were Level 1 or 2 evidence, published in English, published from January 2011 to December 2018, intervention within the occupational therapy scope of practice, and at least one IADL outcome measure. FINDINGS Nineteen randomized controlled trials (including pilot and feasibility trials) and 1 preintervention-postintervention study met inclusion criteria. Results of this review show strong strength of evidence for coaching interventions in addressing physical activity (PA) routines and moderate support in addressing medication routines. Moderate strength of evidence was found with mixed results for interventions involving coaching plus prescribed PA in improving PA participation. CONCLUSIONS AND RELEVANCE This systematic review supports occupational therapy practitioners addressing PA and medication health management and maintenance IADLs through the use of coaching interventions when treating people with MS. Other IADLs were addressed by the articles in this review but require more evidence to make clinical recommendations. What This Article Adds: Occupational therapy practitioners' skills in promoting habits and routines paired with utilization of evidence-supported coaching interventions can support independence with health management and reduce the negative impact of MS on daily activity participation.

Wheelchair service provision education in Canadian occupational therapy programs

Abstract: Occupational therapists in Canada play a central role in wheelchair service provision. Inadequate entry-to-practice professional education has been identified as a major concern in the delivery of wheelchair related services. The goal of this study was to describe the current education provided in Canadian occupational therapy programs and to map this content against the recommended WHO 8-step wheelchair service provision process. The study used a descriptive cross-sectional online survey design. Educators were recruited from accredited occupational therapy programs in Canada. Participants completed a short sociodemographic questionnaire and a survey with 97 closed- and open-ended questions regarding the wheelchair service provision education provided in their curriculum. Survey data was then mapped according to the WHO 8-step wheelchair service provision process. Twenty-nine educators from all Canadian occupational therapy programs (n = 14) were enrolled. Most participants (55.2%) were full-time faculty members that had been teaching in occupational therapy programs for an average time of 10.9 years. All programs covered at least 4 of the WHO recommended steps, but only 5 programs covered all steps. Assessment and Prescription steps were covered in every program while the Referral & Appointment, Funding & Ordering, Fitting and User Training steps were covered in most programs. The pedagogic approach, the amount of time dedicated to wheelchair-related content, and the type of evaluation used varied greatly between programs. This study is the first to provide a detailed description of wheelchair service provision education across all Canadian occupational therapy programs according to the WHO 8 steps and provides a foundation for collaborative efforts to promote best practice in entry-to-practice professional education.

<scp>Short‐Term</scp> Effects of Occupational Therapy on Hand Function and Pain in Patients With Carpometacarpal Osteoarthritis: Secondary Analyses From a Randomized Controlled Trial

Abstract: To assess the short-term effects of multimodal occupational therapy on pain and hand function in patients referred for surgical consultation due to first carpometacarpal (CMC1) joint osteoarthritis (OA).In this randomized controlled trial, patients with CMC1 joint OA referred for surgical consultation at 3 rheumatology departments were randomized to 3 months multimodal occupational therapy (including patient education, hand exercises, orthoses, and assistive devices) or usual treatment (OA information). Pain was measured on a numeric rating scale from 0 to 10 (0 = no pain). Function included grip and pinch strength (Newtons), range-of-motion (palmar and CMC1 joint abduction [°]; flexion deficit in digits 2-5 [mm]), and self-reported Measure of Activity Performance of the Hand (MAP-Hand; range 1-4, 1 = no activity limitation) and short version of the Disability of the Arm, Shoulder, and Hand (QuickDASH; range 0-100, 0 = no disability). Between-group difference was assessed with follow-up values as dependent variables and group as an independent variable, adjusted for baseline values and time to follow-up.Among 180 patients (mean ± SD age 63 ± 8 years; 81% women), 170 completed the short-term follow-up assessment (3-4 months after baseline). Compared to usual treatment, occupational therapy yielded significantly improved pain at rest (-1.4 [95% confidence interval (95% CI) -0.7, -2.0]; P < 0.001), pain following grip strength (-1.1 [-0.5, -1.7]; P = 0.001), grip strength (23.4 [95% CI 7.5, 39.3]; P = 0.004), MAP-Hand score (-0.18 [95% CI -0.09, -0.28]; P = 0.001), and QuickDASH score (-8.1 [95% CI -4.6, -11.5]; P < 0.001).The multimodal occupational therapy intervention had significant short-term effects on pain, grip strength, and hand function in patients with CMC1 joint OA.

Occupational therapy lifestyle intervention added to multidisciplinary treatment for adults living with chronic pain: a feasibility study

Abstract: Objectives To evaluate the feasibility and outcomes of an occupational therapy lifestyle intervention for adults living with chronic pain. Design This one-group pre-post interventional study investigated the feasibility and outcomes of the Redesign Your Everyday Activities and Lifestyle with Occupational Therapy (REVEAL(OT)) intervention targeting meaningful activities and lifestyle. Settings The occupational therapist-led intervention was added to standard multidisciplinary chronic pain treatment at a Danish pain centre. Participants Of the 40 adult participants aged 18–64 (mean 46.6±10.9 years old, 85% females, chronic pain duration ≥3 months), there were 31 completers. Intervention Three feasibility rounds were carried out in 2019–2021. The intervention focused on meaningful activities, healthy eating habits and daily physical activity. Methods of didactical presentations, group discussions, personal reflection and experiential learning were used in the intervention composed both of individual and group sessions. Outcomes Primary outcomes were predefined research progression criteria evaluated by the red-amber-green method. Secondary outcomes measured pre-post changes in health-related quality of life and occupational performance and satisfaction. Results The study demonstrated satisfactory programme adherence (77.5%), patients’ self-perceived relevance (97%), timing and mode of delivery (97%) and assessment procedure acceptance (95%). No adverse events causing discontinuation occurred. Recruitment rate (n=5.7 monthly), retention (77.5%) and the fidelity of delivery (83.3%) needed improvement. We observed no improvement in health-related quality of life (mean=0.04, 95% CI −0.03 to 0.12) but positive change in occupational performance (mean=1.80, 95% CI 1.25 to 2.35) and satisfaction (mean=1.95, 95% CI 1.06 to 2.84). The participants reached the minimal clinically important difference for occupational performance (≥3.0 points in 13.8%) and satisfaction (≥3.2 points in 24.0%). Conclusions The REVEAL(OT) intervention was feasible to deliver and beneficial for the participants’ occupational performance and satisfaction. The interventions’ recruitment, retention and delivery strategies need optimisation in a future definitive trial. Trial registration number NCT03903900

Profile of occupational therapy services in non‐urban settings: A global scoping review

Abstract: Abstract Introduction Regional, rural, and remote people represent nearly half the world's population yet experience disproportionally higher disease, mortality, and disability rates, coupled with limited healthcare access. Occupational therapy has committed to occupational justice, yet no descriptive framework of services provided by occupational therapists in non‐urban locations exists. Understanding current non‐urban service practices will provide a basis for non‐urban service development and research to reduce this inequity. Methods Four databases were systematically searched for publications describing non‐urban occupational therapy services, from any country, written in English, French, Portuguese, or Spanish, from 2010 to 2020. Publications were screened against criteria for inclusion, and data were identified using an extraction tool and presented in a frequency table, on a map, and in a searchable supporting information Table S1. Results Only 117 publications were included discussing services provided to populations across 19 countries. They were mostly published in English (98%) and about populations from English‐speaking countries (70%). Included publications discussed individualist services (65%), for defined age groups (74%), and for people with specific medical diagnoses (58%). Services were commonly provided in the client's community (56%), originating from urban locations (45%) where the provider travelled (26%) or contacted clients using telehealth (19%). Individual 1:1 enabling strategies were most described (59%), including remediation (34%), compensation (9%), or education (7%). Community enablement strategies were infrequently described (14%), focused primarily on transformation to improve existing service delivery (9%), with some redistributive justice (3%), and one community development strategy (1%). Exploratory research services accounted for the remaining studies (27%). Differences were noted between Global North and South approaches. Conclusion Globally, occupational therapy has limited focus on non‐urban services and favours individualist rehabilitative strategies provided by therapists remote from the client's context. Further research is required on the effectiveness and appropriateness of occupational therapy strategies to improve rural/urban inequity and health outcomes.