American Journal of Occupational Therapy最新文献

{"title":"Rater Reliability and Responsiveness of GOT-Cog™, a Novel Occupational Therapy Cognitive Screen.","authors":"Emily Meise, John Corbett, Amanda Meyer, Pete Grevelding, Henry C Hrdlicka","doi":"10.5014/ajot.2026.051275","DOIUrl":"10.5014/ajot.2026.051275","url":null,"abstract":"<p><strong>Importance: </strong>The Gaylord Occupational Therapy Cognitive screen (GOT-Cog™) is a novel cognitive screening tool developed to support inpatient occupational therapy treatment planning. It has demonstrated excellent content, construct, and criterion validity, as well as good internal consistency.</p><p><strong>Objective: </strong>To assess GOT-Cog rater reliability and responsiveness.</p><p><strong>Design: </strong>Repeated-measures design. GOT-Cog was administered to participants twice at admission and once at discharge. When different investigators collected the first two assessments, interrater reliability was tested; when collected by the same investigator, intrarater reliability was tested. The first and final GOT-Cog scores were used to assess responsiveness.</p><p><strong>Setting: </strong>Single long-term acute care hospital (LTACH).</p><p><strong>Participants: </strong>192 participants, recruited from inpatients admitted with an order for occupational therapy services.</p><p><strong>Outcomes and measures: </strong>GOT-Cog total score was the primary outcome measure. Rater reliability was evaluated using interclass correlation coefficients (ICCs); responsiveness was calculated using effect size and score change.</p><p><strong>Results: </strong>Scale-level interrater reliability of GOT-Cog was moderate to good, ICC(2, 1) = .80 (95% confidence interval [CI] [.71, .87], r = .81, n = 87); intrarater reliability was good to excellent, ICC(2, 1) = .84 (95% CI [.76, .90], r = .86, n = 89). Domain-level rater reliability ranged from poor to excellent. A small effect size was demonstrated from admission to discharge (d = .37, n = 149) over a mean length of stay of 24.06 d (95% CI [20.70, 27.41]; n = 192).</p><p><strong>Conclusions and relevance: </strong>Previous findings are supported, which indicates that GOT-Cog has the validity and reliability needed to support its use in the LTACH setting with a mixed medically complex inpatient population. Plain-Language Summary: Conducted in the long-term care setting, this study explains how consistent the Gaylord Occupational Therapy Cognitive screen (GOT-Cog™) is when given to the same person, multiple times, and by the same or different people, as well as how sensitive it is to change over time. To test this, GOT-Cog was given to participants twice at inpatient admission and once at discharge. GOT-Cog was found to have moderate to good consistency when delivered by different people and good to excellent consistency when used by the same person. Over an average of 24 days, GOT-Cog showed a small level of change in participants who were tested admission and again at discharge.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Stakeholder Voices to Improve Occupational Therapy Research for Minoritized Autistic Hispanic and Latino Communities.","authors":"Lady Rios-Vega, Kristin Rising, Brian Freedman, Matthew Fields, Lisa Ross DeCamp, Erin Martinsen, Julian Ramos, John Arroyo, Roseann C Schaaf","doi":"10.5014/ajot.2026.051447","DOIUrl":"10.5014/ajot.2026.051447","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Stakeholder voices advance client-centered, culturally responsive occupational therapy research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To describe how engagement of culturally diverse, multilingual, and multidisciplinary stakeholders shaped a project aimed at culturally adapting an evidence-based autism intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A mixed-methods design was used to evaluate stakeholder engagement. Quantitative data were used to measure engagement frequency and quality, and qualitative data captured stakeholders' experiences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Engagement activities conducted online and in person at a local community setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Twenty-five stakeholders-7 parents or caregivers of autistic children, 3 autistic adults, 4 occupational therapy practitioners, 2 psychologists, 3 medical doctors, 3 cultural experts, and 3 teachers-were recruited through snowball sampling.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;Stakeholders engaged in activities designed to support a project that evaluates two methods of engagement and completes the cultural adaptation of an evidence-based intervention. Activities were guided by the foundational expectations for partnerships as outlined by the Patient-Centered Outcomes Research Institute.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes and measures: &lt;/strong&gt;The Stakeholder-Centric Engagement Evaluation measured engagement on a Likert scale ranging from 1 (never/poor) to 5 (always/excellent) for how often and how well engagement occurred. Qualitative data were collected using open questions in the survey.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Engagement frequency (M = 4.45, SD = 0.24) and quality (M = 4.29, SD = 0.23) were highly rated. Open-ended responses indicated that stakeholders were satisfied with their engagement and interested in additional capacity-building; their feedback shaped the main project in areas including recruitment, retention, data monitoring, and dissemination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;Stakeholders rated their research experiences highly. Engagement is vital to integrating lived experiences and cultural context into occupational therapy, advancing health equity through culturally responsive, client-centered care. Plain-Language Summary: The main project aimed to culturally adapt an evidence-based occupational therapy intervention for Hispanic and Latino autistic children and compare two methods of engagement. Hispanic and Latino families often face barriers accessing culturally and linguistically appropriate services and being included in research. This work was needed to ensure interventions are relevant, equitable, and supportive of their needs. The voices of those impacted by this work were included to guide the research process. We engaged 25 people-including parents, autistic adults, occupational therapy practitioners, psychologists, teachers, and cultural experts-to work closely with the research team. They supported","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057659","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":"Piloting a Tier 1 Strength-Based Parent Education Play Program: Promoting Play Within the Family Context.","authors":"Bella Chilczuk, Amiya Waldman-Levi, Zoe Hill, Gabby Tavory, Sarah Fabrizi","doi":"10.5014/ajot.2026.051384","DOIUrl":"10.5014/ajot.2026.051384","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Strength-based interventions can be an effective tool in promoting parental well-being in acting as change agents in their child's early development. Play is central to early childhood and skill development. However, research rarely examines play-based interventions specifically addressing parent and child play.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To assess the effectiveness of a Tier 1 strength-based play program on parents' ability to support their child's play and build parental sense of competence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A pilot, mixed-methods group, pre-post study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Virtual.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Forty-six parents were recruited through convenience sampling methods, and 12 were assigned to either an intervention group delivered online or a control waitlist group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;Tier 1 Promoting Family Resilience program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes and measures: &lt;/strong&gt;Parents completed a demographic questionnaire, the Parent/Caregiver's View of Supporting Children's Play and Playfulness, and the Parenting Sense of Competence Revised Scale. Open-ended pre- and postprogram questions were used to examine parents' expectations and gains.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For parents' sense of competence, no significant differences were found between the two groups. However, a trend for significance was found for parents' perception of their ability to support the child's play, U = 6.00, p = .05. Parents in the experimental group reported a decrease in self-efficacy, Z = .00, p &lt; .05. Parents' expectations aligned with the postprogram responses emphasizing capacity building.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;Among the Tier 1 program benefits are capacity building and increased support for play. Limitations include a small sample size and difficulty retaining participants. Results highlight the potential of Tier 1 strength-based programs to support parents in promoting their children's development through play education. Plain-Language Summary: Play is central to early childhood and skill development. Strength-based interventions can be an effective tool in promoting parental well-being and their child's early development, especially if they focus on play. This pilot study assessed the effectiveness of a strength-based play program on parents' ability to support their child's play and build parental sense of competence. Twelve eligible parents agreed to participate in this study and were assigned to either an intervention group delivered online or a control waitlist group. We did not find differences between study groups in the parents' sense of competence, but parents who attended the strength-based program reported an increase in their ability to support their child's play. Parents also felt that the program met their expectations and supported capacity building. Parents benefited from the provision of educational tools to suppor","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peer Mentoring Benefits in Rehabilitation for Individuals With Spinal Cord Injury: A Systematic Review.","authors":"Shannon Schoellig, Nicole Fudrini, Yvonne Monti, Emily Daley, Ana Gabriela De Oliveira, Jasmine Geis","doi":"10.5014/ajot.2026.051494","DOIUrl":"10.5014/ajot.2026.051494","url":null,"abstract":"<p><strong>Importance: </strong>The lived experiences of peer mentors with spinal cord injury (SCI) provide distinct value in the rehabilitation process and contribute to improved outcomes. When combined with traditional therapy, peer mentorship programs can enhance life satisfaction among individuals living with SCI.</p><p><strong>Objective: </strong>To explore the impact that peer-led mentorship programs and interventions have on the rehabilitation outcomes for individuals with a spinal cord injury (SCI).</p><p><strong>Data sources: </strong>PubMed, MEDLINE, PsycINFO, CINAHL, ERIC, Cochrane Database of Systematic Reviews, MedNar, and OpenGrey were searched between 2014 and 2024. The Cochrane Risk of Bias 2 tool was adapted and used to assess risk of bias in the included studies.</p><p><strong>Study selection and data collection: </strong>Inclusion criteria included individuals with SCI who participated in peer mentorship and reported outcomes on quality of life, well-being, independence, or activities of daily living (ADLs) or instrumental ADLs. Exclusion criteria included interventions conducted via telehealth or reported outcomes of social participation.</p><p><strong>Findings: </strong>Five articles were analyzed for synthesis, which included individuals 18 yr and older with an SCI. Findings support peer mentorship as an important component of rehabilitation. Findings may have limited generalizability across different settings and populations because of the small number of available studies and variability in study designs, interventions, and outcome measures. None of the articles reviewed included occupational therapists.</p><p><strong>Conclusions and relevance: </strong>This review highlighted the benefits of peer mentorship in enhanced life satisfaction. Findings support peer mentorship as an important component of rehabilitation. Future research should examine the benefits of incorporating peer-led intervention programs across the continuum of care, including occupational therapy, in enhancing best practices in SCI rehabilitation. Plain-Language Summary: Peer mentorship programs can help people with spinal cord injuries adjust to daily life by providing guidance, support, and encouragement that professionals without lived experience may not offer. This review found that peer mentoring can improve psychological well-being and health management and reduce unplanned hospital visits. Evidence is limited because of the small number of studies and variations in study design; however, the results suggest that meaningful benefits may be present. Further research is needed to determine the most effective way to implement peer mentorship across rehabilitation settings.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidimensional Sleep Health of Toddlers With Down Syndrome: A Descriptive Study Guided by the Pediatric Sleep Health Framework.","authors":"Waad Aljurayyad, Angela R Caldwell, Amy G Hartman","doi":"10.5014/ajot.2026.051493","DOIUrl":"10.5014/ajot.2026.051493","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Sleep health supports child development and family well-being. Toddlers with Down syndrome experience elevated sleep difficulties, yet few studies have examined their sleep within a multidimensional framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To apply the Pediatric Sleep Health framework (Peds B-SATED) to characterize multidimensional sleep health and sleep-related practices of toddlers with Down syndrome (12-36 mo).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Secondary analysis of cross-sectional descriptive data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Clinics and organizations serving families of children with Down syndrome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Twenty-four mothers of children with Down syndrome were recruited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes and measures: &lt;/strong&gt;Parent-reported Brief Infant Sleep Questionnaire items mapped onto the Peds B-SATED domains (Behavior, Satisfaction, Alertness, Timing, Efficiency, Duration). Descriptive statistics summarized sleep profiles and parental practices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Fifty percent of the sample demonstrated multidomain sleep difficulties; 33% had difficulties in a single domain, and 17% had none. Behavior was the most problematic domain (63%), followed by satisfaction and efficiency (29% each), timing (25%), and duration (13%). Most children had structured sleep behaviors (consistent bedtimes/routines ≥80%; falling asleep independently, 70%; limited prebedtime screen exposure, 67%) and high parental satisfaction. Most children woke up happy and took one daytime nap (&gt;90%). Sleep timing and efficiency were characterized by early bedtimes (median lights-out 8 p.m.; median wake 7 a.m.), no night awakenings (71%), and mean sleep latency of 13.5 min. Mean 24-hr sleep duration was 12.5 hr.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;A multidimensional approach to characterizing sleep health reveals heterogeneous sleep profiles across domains and offers clinicians and researchers an in-depth view of intervention targets for toddlers with Down syndrome. Plain-Language Summary: This study examined the sleep health of toddlers with Down syndrome ages 12-36 months by using the Pediatric Sleep Health framework, which looks at multiple aspects of sleep, including routines, quality, timing, and duration. Parents of 24 children completed a questionnaire about their child's sleep, and then we mapped their responses to this sleep health framework. We found that most children went to bed and woke up early, slept about 12.5 hr per day, and were described as good sleepers. However, many children had at least one area of difficulty, most often related to bedtime behaviors (63%). In general, about 17% had no sleep-related concerns, whereas the remainder experienced challenges in one or more areas. These findings show that even when overall sleep appears good, specific sleep behaviors may still benefit from attention. Using a multidimensional sleep health framework can help identify t","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13173275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856623","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":"Efficacy of a Modular Lifestyle Intervention Through Occupation for Individuals With Rheumatoid Arthritis: A Randomized Controlled Trial With 6-Month Follow-Up.","authors":"Sultan Baştürk, Gamze Ekici, Timur Pırıldar, Fatoş Kırteke","doi":"10.5014/ajot.2026.051512","DOIUrl":"10.5014/ajot.2026.051512","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Rheumatoid arthritis (RA) causes persistent symptoms that limit individuals' ability to engage in meaningful daily occupations. Occupational therapy plays a key role in integrating lifestyle and behavioral strategies into comprehensive RA management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine the efficacy of a client-centered, modular lifestyle intervention (LI) on occupational performance and health outcomes of individuals with RA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A randomized controlled trial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Rheumatology outpatient clinic of a university hospital.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Forty-five individuals diagnosed with RA were randomly assigned to an LI group (n = 23) or a control group (n = 22).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;The LI group received an eight-session, occupation-based LI; the control group received twice-weekly well-being check phone calls over 4 wk.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes and measures: &lt;/strong&gt;The primary outcome was the Canadian Occupational Performance Measure (COPM) Performance score. Secondary outcomes included COPM Satisfaction, Disease Activity Score-28, visual analog scale for pain, Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire, and Rheumatoid Arthritis Quality of Life Scale scores. Assessments were conducted at baseline, postintervention, and 6-mo follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with the control group, the LI group demonstrated significantly greater improvements in the primary outcome (COPM Performance) as well as in secondary outcomes including COPM Satisfaction, pain, fatigue, and quality of life. A delayed reduction in disease activity was observed at the 6-mo follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;The LI produced durable improvements in occupational performance and patient-reported outcomes, supporting its integration as a sustainable adjunct to pharmacological care for individuals with RA. Plain-Language Summary: People with rheumatoid arthritis often have difficulty completing daily activities because of pain, fatigue, and limitations in movement. This study explored whether a structured lifestyle program based on occupational therapy principles could help improve these challenges. All participants continued their usual medical treatment throughout the study. In addition, one group received an eight-session lifestyle intervention focused on meaningful daily activities, healthy habits, energy conservation, and participation in social and leisure activities. The control group received their usual medical treatment along with brief well-being check phone calls. Participants who received the lifestyle program showed greater improvements in performing and enjoying daily activities and reported lower fatigue levels than those in the control group. These findings suggest that adding an occupation-based lifestyle program to standard medical care may provide meaningful benefits for peop","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discordance Between Self-Report and Performance-Based Measures Among At-Risk Older Adults: A Secondary Data Analysis.","authors":"Chiung-Ju Liu, Wen-Pin Chang, Inga Wang","doi":"10.5014/ajot.2026.051408","DOIUrl":"10.5014/ajot.2026.051408","url":null,"abstract":"<p><strong>Importance: </strong>Subtle, age-related declines in occupational performance among at-risk older adults may go undetected when assessed solely with self-report measures, potentially leading to missed intervention opportunities. Understanding discrepancies between self-reported and performance-based occupational performance outcomes can inform assessment selection and interpretation.</p><p><strong>Objective: </strong>To examine the discrepancies between the two types of measure among community-dwelling older adults at risk for losing independence.</p><p><strong>Design: </strong>Cross-sectional study using secondary data analysis.</p><p><strong>Participants: </strong>Seventy-one community-dwelling older adults (M age = 74 yr, SD = 9) who showed muscle weakness and reported difficulty with activities of daily living.</p><p><strong>Outcomes and measures: </strong>Canadian Occupational Performance Measure (COPM) Performance score and Assessment of Motor and Process Skills (AMPS) Motor Skills score were used as outcome measures. Participants were categorized as overestimators if they reported a higher COPM Performance score but had a relatively lower AMPS Motor Skills score and as underestimators if the reverse was true.</p><p><strong>Results: </strong>Participants who overestimated their occupational performance (n = 12, M age = 79 yr, SD = 10 yr) were generally older (Z = 2.91, p = .004) and had poorer physical functioning (Zs = -2.54 to 2.42, all ps < .05) but reported higher satisfaction with their performance (Z = 4.72, p < .001) compared with those who underestimated their performance (n = 20, M age = 69 yr, SD = 7 yr).</p><p><strong>Conclusions and relevance: </strong>Use of both self-report and performance-based assessments may be warranted to identify late-life disability, particularly among older adults of advanced age or with declined physical functioning. Plain-Language Summary: Older adults of advanced age or with poor physical functioning may rate their occupational performance differently from how they actually perform everyday activities. This study found that some older adults tend to overestimate their performance, even when their actual performance suggests otherwise. These mismatches between how older people think they are performing and how they actually perform could lead to missed chances for support or intervention if only a self-report measure is used. Using self-report followed by performance-based measures is recommended to identify late-life disability among these older adults.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057638","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":"Clinician Scientists in Occupational Therapy: Bridging the Knowledge-to-Practice Gap.","authors":"Jessica Edelstein, Karen Harpster, Laura Lee Robins, Kelly Tanner, Miranda Yelvington, Stacey Reynolds","doi":"10.5014/ajot.2026.051442","DOIUrl":"10.5014/ajot.2026.051442","url":null,"abstract":"<p><p>Occupational therapy research continues to expand in breadth and rigor, yet significant gaps persist between what is known and what is done in practice. Across health care, only about 14% of research is ever adopted into practice, and on average, it takes 17 yr for scientific discoveries to be implemented (Hanney et al., 2015; Kowalski et al., 2022; Morris et al., 2011; Munro & Savel, 2016). Therefore, the ability of scientific discoveries to improve patient outcomes will remain limited unless health care professions and researchers can overcome this knowledge-to-practice gap (Bennett et al., 2018). Addressing this gap will require new models that more intentionally integrate research expertise within clinical practice.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational Therapy in Crisis.","authors":"Stacy Smallfield, Wanda J Mahoney","doi":"10.5014/ajot.2026.051454","DOIUrl":"10.5014/ajot.2026.051454","url":null,"abstract":"<p><p>The occupational therapy profession in the United States is in crisis. This is not a new phenomenon in occupational therapy's history; we have previously experienced two crises, in the 1940s and 1970s. Crises arise when the current professional paradigm insufficiently addresses occupational therapy practice challenges. Similar to the past, there are issues in society, health care, and the profession prompting this identity crisis. Occupational therapy practitioners no longer have a consensus about the field's theoretical base, view of humans, and scope of practice. By calling attention to this crisis, we hope to awaken occupational therapy practitioners to actively decide the future of our profession.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of Individualized Occupational Therapy for Inpatients With Schizophrenia: Two-Year Follow-Up of a Multicenter Randomized Controlled Trial.","authors":"Hirofumi Nagayama, Takeshi Shimada, Takafumi Morimoto, Kohei Ikeda, Masayoshi Kobayashi","doi":"10.5014/ajot.2026.051323","DOIUrl":"10.5014/ajot.2026.051323","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Schizophrenia typically requires long-term treatment, making cost-effective interventions essential, yet the cost-effectiveness of individualized occupational therapy (IOT) remains unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare the cost-effectiveness of IOT plus group occupational therapy (GOT) with GOT alone for inpatients with schizophrenia over 2 yr.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Secondary analysis of data from a multicenter, two-arm, parallel randomized controlled trial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Fourteen clinical facilities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Sixty-two inpatients with schizophrenia who completed 2-yr follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;GOT alone or IOT+GOT during 3 mo of hospitalization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes and measures: &lt;/strong&gt;Quality-adjusted life-years (QALYs) and total medical costs from a health care payer perspective over 2 yr.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with GOT alone (n = 30), IOT+GOT (n = 32) produced greater cumulative QALYs (M difference = 0.156) and lower total medical costs (M difference = -¥290,784). The incremental cost-effectiveness ratio was -¥3,304,420 per QALY gained. Incremental net benefit was positive at willingness-to-pay thresholds of ¥5,000,000 and ¥6,000,000 per QALY. The cost-effectiveness acceptability curves showed a 94.2% probability of cost-effectiveness at a threshold of ¥6,000,000. Cost data were complete for approximately 40% of participants; missingness was addressed using multiple imputation, with complete-case sensitivity analysis yielding directionally consistent findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;IOT+GOT was more cost-effective than GOT alone over 2 yr, supporting its wider adoption as an economically sound rehabilitation strategy for clients with schizophrenia. Given the extent of missing cost data, the results should be interpreted with appropriate caution. These findings offer long-term economic evidence to inform mental health policies and resource allocation in psychiatric care. Plain-Language Summary: Schizophrenia often requires long-term treatment, resulting in substantial health care costs. This study examined whether adding individualized occupational therapy to standard group occupational therapy offers a more cost-effective approach for inpatients with schizophrenia. Sixty-two patients were followed for 2 years after receiving either group occupational therapy alone or a combination of individualized occupational therapy and group occupational therapy during hospitalization. The results indicated that patients who received individualized occupational therapy and group occupational therapy experienced greater improvements in quality of life and slightly lower total medical costs. Furthermore, the cost-effectiveness analysis showed a 94.2% probability that the intervention would be cost-effective under Japan's commonly accepted willingness-to-pay threshold. These findings su","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}