American Journal of Occupational Therapy最新文献

{"title":"Staying Afloat: A Scoping Review of the Literature on Adapted Swim Instruction.","authors":"Katherine L Long, Kristina Kobza, Tania Santiago Perez, Erika Kemp, Tana B Carson","doi":"10.1177/19437676261464064","DOIUrl":"10.1177/19437676261464064","url":null,"abstract":"<p><p>ImportanceIndividuals with disabilities may require adaptations and modifications during swimming instruction.ObjectiveThe purpose of this scoping review is to summarize the literature on adapted swim instruction including the following: (1) identifying adapted swim strategies; (2) determining which populations have received adapted swim instruction; and (3) identifying gaps in the research.Data SourcesSix databases were searched for records published on or before September 29, 2025, including: PubMed, Excerpta Medica Database (EMBASE), Cumulative Index of Nursing and Allied Health Literature (CINAHL), SportDiscus, Web of Science, and Education Resources Information Center (ERIC).Study Selection and Data CollectionStudies were included in this review if they were peer-reviewed, written in English, focused on beginner swimming skill instruction, included participants with disabilities and/or instructors/caregivers of individuals with disabilities, and consisted of original research studies. Studies were excluded if they were not peer-reviewed, not written in English, or not focused on beginning swim instruction.FindingsFifty-five studies met inclusion criteria and described interventions for individuals with disabilities. Studies discussed 26 adaptive strategies utilized for swimming instruction. Two studies were Oxford Level 2 studies, indicating randomized-controlled trials and definitive observational studies.Conclusions and RelevanceThere is a lack of robust, high-quality studies on adapted swim instruction, indicating a need for future studies to strengthen the evidence base.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 5","pages":"930-954"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Rehabilitation Interventions on Improving Leisure Participation Following Stroke: A Systematic Review.","authors":"Serena Alves-Stein, Natasha A Lannin, Sharon Kramer, Kylie Wales, Laura Jolliffe","doi":"10.1177/19437676261464109","DOIUrl":"10.1177/19437676261464109","url":null,"abstract":"<p><p>ObjectiveTo investigate the effectiveness of rehabilitation interventions on increasing leisure participation in adult survivors of stroke.Data SourcesDatabases (Medline, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials) were searched from inception to September 2025.Study Selection and Data CollectionIncluded studies were randomized and nonrandomized controlled trials investigating leisure rehabilitation for community-living adults with stroke, which include a measure of leisure participation. Data extraction was performed using a predetermined data extraction form. The PEDro Scale was used to assess the risk of bias.FindingsA total of 6,813 records were retrieved, 46 were assessed at full-text review, and 8 studies were included. The meta-analysis included four studies, and another four studies were synthesized narratively. Leisure participation was higher in the intervention groups at the end of the intervention compared with the control (standardized mean difference = 0.80, 95% confidence interval 0.03 to 1.56). There was low certainty for this evidence due to the small number of studies and high heterogeneity. Subgroup analysis indicated possible benefits when intervention is provided earlier poststroke, and that leisure rehabilitation increases the number of leisure activities, but not the regularity of participation. It remains unclear whether any one intervention approach is more effective.Conclusions and RelevanceLeisure rehabilitation may improve leisure participation; however, the quality of evidence is low. Further well-designed trials are needed to address leisure participation following stroke, investigating the optimal timing of leisure rehabilitation and identifying the effective elements of the intervention.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 5","pages":"882-897"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extrinsic Environmental Factors Influencing the Achievement of Independent Oral Feeding in Preterm Infants.","authors":"Avery Cushing, Karlee Donovan, Jasmine Lewis, Katja Lucyshyn, Rebecca Robinson, Sandra Fucile","doi":"10.1177/19437676261464062","DOIUrl":"10.1177/19437676261464062","url":null,"abstract":"<p><p>ImportancePreterm infants frequently experience difficulty with the transition from full tube to independent oral feeding. The influence of extrinsic environmental factors, defined as causes external to the infant, that may affect this transition remains poorly understood.ObjectiveTo examine the association between extrinsic environmental factors and attainment of independent oral feeding in preterm infants.DesignA retrospective cohort study was conducted.SettingData were collected from a tertiary care, level II/III neonatal intensive care unit. Guided by the Oral Feeding in Preterm Infants Conceptual Model, extrinsic environmental factors were selected for analysis.ParticipantsA total of 282 preterm infants (31.2 ± 2.4 weeks gestation) were included.MethodologyFactors including maternal medical history, type of medical condition, maternal substance use, non-nutritive sucking, skin-to-skin contact, feeding therapy, and days of hospitalization prior to initiating oral feeding were extracted from electronic medical records. Simple linear regressions identified potential external variables, which were entered into a multiple linear regression model.ResultsIn the final multiple linear regression model, maternal medical history, non-nutritive sucking, and skin-to-skin contact were significant predictors of time to independent oral feeding. Maternal age, substance use, feeding therapy, and days in hospital prior to starting oral feeds were not significant.Conclusion and RelevanceMaternal health and engagement, reflected in maternal medical history, opportunities for non-nutritive sucking, and skin-to-skin contact, are key extrinsic environmental factors influencing the transition to independent oral feeding. Integrating these maternal factors into occupational therapy management may enhance the attainment of independent oral feeding in preterm infants.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 5","pages":"845-852"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harm Reduction-Oriented Occupational Therapy for Substance Use Disorders: A Retrospective Cohort Study.","authors":"Yuichi Murata, Toshihiko Matsumoto, Naomichi Yamamoto, Toyohiro Hamaguchi, Toshiyuki Ishioka","doi":"10.1177/19437676261464094","DOIUrl":"10.1177/19437676261464094","url":null,"abstract":"<p><p>ImportanceIdentifying factors associated with sustained engagement in harm reduction-oriented occupational therapy may help inform more accessible interventions for individuals with substance use disorders (SUDs).ObjectiveTo examine participant characteristics associated with sustained engagement in the Real-Life Program (RLP), a harm reduction-oriented outpatient occupational therapy program for individuals with SUDs, and to explore changes in occupational and psychosocial outcomes among participants who continued the program.DesignRetrospective cohort study.SettingSingle-site outpatient occupational therapy program.ParticipantsFifty-five individuals with SUDs enrolled in the RLP. Participants were classified into continued (≥47% attendance) and noncontinued (<47%) groups based on the median participation rate.Outcomes and MeasuresCanadian Occupational Performance Measure (COPM), Rosenberg Self-Esteem Scale-Japanese version, Shitsu-Taikan-Sho Scale, and visual analog scales for craving intensity and perceived connectedness to others.ResultsPrior self-help group experience was significantly associated with continued participation. Older age showed a nonsignificant association. No other demographic or clinical characteristics differed significantly between groups. Among participants who continued the program, COPM Satisfaction improved significantly, whereas COPM Performance, self-esteem, alexisomia, craving intensity, and perceived connectedness did not.Conclusions and RelevancePrior self-help group experience was associated with sustained engagement in the RLP. Among participants who continued the program, satisfaction with daily occupations improved, although the clinical significance of this change remains uncertain. The RLP may provide a feasible harm reduction-oriented occupational therapy option for individuals with SUDs who have difficulty engaging in abstinence-based treatment programs.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 5","pages":"785-794"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Utility of an Occupational Therapist-Led Smart Home Modification Program: A Mixed-Methods Evaluation.","authors":"Kwangtae Mun, Junghun Aj Kim","doi":"10.1177/19437676261464098","DOIUrl":"10.1177/19437676261464098","url":null,"abstract":"<p><p>ImportanceFor smart home modification (SHM) to translate into routine practice, clinicians need evidence that occupational therapist (OT)-led workflows are clinically useful, feasible, and scalable in community settings.ObjectiveTo evaluate the clinical utility of an OT-led SHM program and to identify implementation barriers and strategies that support adoption and sustainment in community practice.DesignSequential explanatory mixed-methods study.SettingCommunity-based practice settings.ParticipantsTen licensed OTs who implemented the SHM program in community services. Therapists' implementation experience included delivering the program to 40 community-dwelling adults with physical disabilities (effectiveness outcomes reported separately).Outcomes and MeasuresOTs rated the clinical utility of 31 program recommendations using a structured evaluation form across appropriateness, applicability, and effectiveness (9-point scale) and documented whether each recommendation was applied. Semistructured interviews were conducted to explain rating patterns and to explore implementation barriers and improvement needs. Interview data were analyzed using thematic analysis by two coders with consensus procedures and an audit trail. Mixed-methods integration mapped themes to recommendation-level ratings.ResultsOverall, OTs rated the recommendations as highly clinically useful across domains. Applicability was comparatively lower for budget planning and for developing/implementing automation scenarios. Interviews indicated that cost constraints and technical complexity reduced feasibility, whereas OT-led goal prioritization, partial automation, simplification of operational steps, context-based training, and caregiver-inclusive education supported adoption. Revisits were most commonly linked to predictable maintenance events (e.g., unplugged power, device resets, battery depletion), underscoring the need for platform-based self-management resources and a triage pathway separating clinical OT tasks from technical support.Conclusions and RelevanceOT-led SHM shows strong clinical utility in community practice when delivered through occupation-centered assessment, tailored training, and iterative refinement. Scalable implementation may be strengthened by feasible automation strategies, caregiver-inclusive education, and structured support pathways that reduce preventable follow-up.Article ContributionThis study provides clinically grounded evidence for the utility of a manualized, OT-led SHM workflow and offers implementation strategies (partial automation, caregiver-inclusive training, platform-based self-management with triage) to support sustainable community delivery.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 5","pages":"853-866"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor.","authors":"Ted Brown, Diane Smith, Diane Powers Dirette, Patricia Crist","doi":"10.1177/19437676261468685","DOIUrl":"10.1177/19437676261468685","url":null,"abstract":"","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 5","pages":"751-752"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational Therapy Interventions in Down Syndrome: A Scoping Review.","authors":"Katherine L Long, Mario Sergio Barrios Lago, Eliza L Nelson","doi":"10.1177/19437676261464084","DOIUrl":"10.1177/19437676261464084","url":null,"abstract":"<p><p>ImportanceIndividuals with Down syndrome experience multiple conditions requiring occupational therapy intervention, but no review papers have explored the research literature to support such intervention.ObjectiveTo map the literature on occupational therapy interventions for individuals with Down syndrome across the lifespan and identify gaps in the evidence base for future research and education that require attention.Data SourcesSix databases were searched: OTSeeker, PubMed, PsychINFO, PEDro, CINAHL, and Cochrane Library for studies published on or before June 19, 2025.Study Selection and Data CollectionThis review was conducted according to PRISMA-ScR and Joanna Briggs Institute methodology for scoping reviews. Included studies had participants with Down syndrome, were published in English, contained an OT intervention, and were peer-reviewed. Excluded studies lacked participants with Down syndrome, were not in English, did not have an OT intervention, or were not peer-reviewed.FindingsWe retrieved 421 records and included 21 articles in this review. While most studies utilized rigorous designs (n = 16), none were designated \"High Quality\" due to multiple methodological flaws, such as failure to assess treatment fidelity or lack of random assignment to condition.Conclusions and RelevanceThis review suggests a need for studies with more methodological rigor, that address adults with Down syndrome, and that detail a greater variety of interventions. Practitioners and scholars should emphasize data-driven decision making, implementation of practice guidelines for Down syndrome, and the promotion of continuing education opportunities on Down syndrome.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 5","pages":"898-907"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring About Care: The Paradox of Self-Care in Occupational Therapy.","authors":"Mario S Staller, Anne Kramer, Swen Koerner","doi":"10.1177/19437676261468684","DOIUrl":"10.1177/19437676261468684","url":null,"abstract":"<p><p>ImportanceSelf-care is increasingly promoted in occupational therapy as a response to practitioner stress, burnout, compassion fatigue, and professional exhaustion. Although self-care may support practitioner wellbeing, it may also individualize problems that are partly produced by organizational and systemic conditions.ObjectiveTo examine self-care in occupational therapy as a paradoxical extension of the care imperative and to develop a reflexive, paradox-oriented understanding of self-care practice.DesignConceptual analysis drawing on form theory and systems-theoretical observation. The analysis examines how self-care becomes observable through the distinction between self-care and non-self-care and how this distinction shapes professional expectations.FindingsThe paradox of self-care lies in its attempt to relieve the burden of care by extending the care imperative to practitioners themselves. Self-care supports recovery and professional sustainability, yet it may also add another layer of responsibility by requiring practitioners to care for their own capacity to care. In doing so, it can individualize exhaustion and background the organizational and systemic conditions that make self-care necessary. Self-care can therefore function both as a necessary resource and as a problem-generating solution that stabilizes stress as an expected feature of occupational therapy work.Conclusions and RelevanceA paradox-oriented understanding does not reject self-care but keeps its ambivalence visible. Occupational therapy practitioners, educators, and organizations should approach self-care not only as an individual competency but also as information about the conditions under which care work is performed. Reflexive self-care includes caring for oneself, questioning when care has become too expansive, and setting limits to the care imperative itself.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 5","pages":"963-968"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating Legal Services: A Proposed Lens for Occupational Therapy Practitioners Supporting Asylum Seekers.","authors":"Sally Wasmuth, Annie DeRolf, Hannah Romero De Gante, Leah Brenner","doi":"10.1177/19437676261464058","DOIUrl":"10.1177/19437676261464058","url":null,"abstract":"<p><p>This article provides a lens through which occupational therapy practitioners (OTPs) can support immigrants seeking asylum in the United States. We argue that navigating legal services is a critical entry point where OTPs can collaborate with asylum seekers and legal aid organizations. While existing literature addresses occupational therapy assessments and interventions for this population, few studies emphasize how OTPs can assist asylum seekers in navigating the legal system to secure rights that enable safe participation in essential occupations such as work, education, social engagement, and leisure. To address this gap, we propose three strategies: (1) building partnerships with legal aid organizations, (2) conducting ongoing needs assessments with legal organizations and asylum seekers, and (3) collaborating to provide occupation-based resources and care. Partnerships among OTPs, asylum seekers, and legal professionals foster knowledge exchange and holistic, client-centered, evidence-based support. Legal experts offer insight into structural barriers; asylum seekers contribute lived experience and personal strengths; OTPs bring expertise in promoting participation and wellbeing through meaningful activity. Recognizing that asylum seekers often face systemic obstacles to daily engagement, we position legal navigation as a critical focus for OTPs. By outlining actionable strategies, this article equips OTPs to deliver responsive, justice-oriented care tailored to asylum seekers' lived realities.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 5","pages":"955-962"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational Therapists' Perspective on Driver Assessment and Rehabilitation Practice in Saudi Arabia: A Descriptive Qualitative Study.","authors":"Doha Hassan Alhashmi, Aislinn Lalor, Jennie Oxley, Ellie Fossey","doi":"10.1177/19437676261464067","DOIUrl":"10.1177/19437676261464067","url":null,"abstract":"<p><p>ImportanceDriving facilitates independence and community engagement, especially in Saudi Arabia, where most people rely on cars. Medical conditions can impair driving ability, and occupational therapists play a key role in evaluation and rehabilitation. However, guidance and services to support safe return to driving in Saudi Arabia remain limited.ObjectiveTo explore current practices and challenges in driver assessment and rehabilitation as perceived by occupational therapists in Saudi Arabia.DesignThis descriptive qualitative research involved semi-structured individual interviews with participants. Data were analysed using reflexive thematic analysis, guided by the Behaviour Change Wheel (BCW) framework.SettingInterviews were conducted either in-person or virtually at each participant's preferred time and location.ParticipantsThirteen licensed occupational therapists with at least one year of experience in a rehabilitation setting in Saudi Arabia.ResultsSix themes were identified: (1) insufficient knowledge and practical skills, (2) lack of training and supporting infrastructure, (3) motivation [but it is hard], (4) recommended interventions, (5) recommended changes in policies and (6) collaboration.Conclusions and RelevanceAddressing the identified gaps in knowledge, skills and infrastructure through the suggested interventions and policy changes could enable occupational therapists in Saudi Arabia to contribute effectively to driver assessment and rehabilitation services for at-risk drivers, as well as promote road safety for all within Saudi Arabia. Collaborative efforts of occupational therapists and other stakeholders are essential to further leverage study findings in co-creating solutions to address safe return to driving and improving road safety in general.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 5","pages":"771-784"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}