American Journal of Occupational Therapy最新文献

{"title":"Critical Care and Occupational Therapy Practice Across the Lifespan.","authors":"","doi":"10.5014/ajot.2023.77S3003","DOIUrl":"10.5014/ajot.2023.77S3003","url":null,"abstract":"<p><p>This AOTA Position Statement defines the distinct role and value of occupational therapy practitioners in critical care settings across the lifespan. Occupational therapy practitioners are essential interprofessional team members who address the needs of critically ill individuals by implementing evidence-based critical care guidelines that aim to improve the quality of survivorship.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139080977","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":"Promoting Participation-Focused Practices in Inclusive Educational Settings: Stakeholders' Perspectives Following a Knowledge Translation Initiative.","authors":"Michal Waisman-Nitzan,&nbsp;Yonat Ivzori,&nbsp;Dana Anaby","doi":"10.5014/ajot.2023.050262","DOIUrl":"https://doi.org/10.5014/ajot.2023.050262","url":null,"abstract":"<p><strong>Importance: </strong>Available participation-focused interventions (e.g., the Pathways and Resources for Engagement and Participation intervention [PREP]), are not well integrated into practice, indicating a knowledge-to-practice gap.</p><p><strong>Objective: </strong>To explore the perspectives of school-based (SB) occupational therapists and occupational therapy managers following knowledge translation (KT) programs for facilitating participation-based practices in inclusive education.</p><p><strong>Design: </strong>This was an implementation qualitative study. After taking part in KT programs for implementing PREP, which were tailored to the needs and contexts of each stakeholder group, occupational therapists participated in focus groups, and occupational therapy managers responded to open-ended survey questions. A content analysis was done separately for each group, then integrated and organized according to the Participation-focused KT (P-KT) framework.</p><p><strong>Setting: </strong>Inclusive educational setting.</p><p><strong>Participants: </strong>Seven occupational therapists working in inclusive schools and 39 occupational therapy managers.</p><p><strong>Results: </strong>We identified 10 themes addressing the micro, meso, and macro levels of the P-KT framework across the two groups. Five themes, common to all participants, addressed micro (e.g., setting participation-focused goals) and meso (e.g., school-PREP fit) levels. Macro-level themes were addressed by managers only (e.g., anchoring PREP to existing policy of the Israeli Ministry of Education).</p><p><strong>Conclusions and relevance: </strong>Targeting different stakeholders at the micro and meso levels of the educational system can initiate a shift in practice toward a focus on participation. KT intersectoral initiatives at the macro level (e.g., targeting community services and local policies), and engaging other stakeholders (e.g., students, families, and educators), are required to ensure the sustainability of participation-based practices. What This Article Adds: The authors present two knowledge translation programs that target both occupational therapists and managers in the educational system. The programs promote a shift in school-based occupational therapy services toward a focus on participation and environment.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487586","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":"A Call to Shift to Competency-Based Education.","authors":"Razan Hamed, Tyra M Banks, Danielle Mahoney, Phyllis Simon, Jean Fitzpatrick Timmerberg, Dawn M Nilsen","doi":"10.5014/ajot.2023.050402","DOIUrl":"10.5014/ajot.2023.050402","url":null,"abstract":"<p><p>This column explores the concept of competency-based education (CBE). A shift to CBE is a key trend for the future of health care education. Health care professions that have adopted, or started to adopt, a CBE framework include physical therapy, speech-language pathology, social work, medicine, nursing, pharmacology, and dentistry. Internationally, many occupational therapy programs are in the process of shifting to, or have shifted to, a CBE model. This column discusses how although select occupational therapy programs in the United States may individually be considering shifting to, or have shifted to, a CBE framework, there is no national movement to explore adopting the model for occupational therapy or a consensus on defined outcomes for the profession.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523008","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":"Habit Formation Intervention to Improve Type 2 Diabetes Self-Management Behaviors: A Feasibility Study.","authors":"Diana R Feldhacker, Moses N Ikiugu, Heather Fritz, William E Schweinle, Hongmei Wang","doi":"10.5014/ajot.2023.050351","DOIUrl":"10.5014/ajot.2023.050351","url":null,"abstract":"<p><strong>Importance: </strong>Self-management of lifestyle behaviors is the recommended focus for interventions to address Type 2 diabetes. Habit formation is an effective approach to changing personal behaviors, but evidence of success for Type 2 diabetes is limited.</p><p><strong>Objective: </strong>To examine the feasibility and preliminary effectiveness of occupation-based habit formation interventions for improving diabetes self-management behaviors.</p><p><strong>Design: </strong>Single-subject design with multiple participants providing 4 wk of baseline data followed by 10 wk of intervention data.</p><p><strong>Setting: </strong>Individual telehealth sessions.</p><p><strong>Participants: </strong>Eight adults (ages 29-75 yr) with Type 2 diabetes, who had access to a telephone and who were not involved in other diabetes-related education or interventions voluntarily, enrolled into the study.</p><p><strong>Intervention: </strong>Participants engaged in 10 wk of habit formation intervention focused on four diabetes self-management domains: nutrition, blood glucose monitoring, medication management, and physical activity.</p><p><strong>Outcomes and measures: </strong>Data gathered included findings on measures of diabetes self-care behaviors and habit formation.</p><p><strong>Results: </strong>There was a significant change in self-care behaviors for 6 of the 8 participants (p < .05 for 1 participant, and p < .01 for 5 participants). Group changes were statistically significant (p < .001). Habit strength significantly improved for all areas of diabetes self-management (p < .001 for nutrition, blood glucose monitoring, and medication management and p = .001 for physical activity).</p><p><strong>Conclusions and relevance: </strong>Findings suggest that the occupation-based intervention was feasible and showed promise for developing self-management behaviors. What This Article Adds: Habits are considered foundational to occupations, yet application of the science of habit formation is often not well understood by occupational therapists. This study considered the theoretical components of habit formation that have been neglected by prior studies and demonstrates the feasibility and preliminary effect estimates of a habit formation intervention when used with people with Type 2 diabetes.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296194","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":"Complementary Health Approaches and Integrative Health in Occupational Therapy.","authors":"","doi":"10.5014/ajot.2023.77S3001","DOIUrl":"10.5014/ajot.2023.77S3001","url":null,"abstract":"<p><p>This AOTA Position Statement describes the use of complementary and integrative health approaches in occupational therapy practice and presents ethical and pragmatic matters, including diversity, equity, inclusion, cultural humility, continuing competence, standards of practice, and supporting evidence.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058921","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":"Visual Dysfunction and Occupational Performance in Persons With Parkinson's Disease.","authors":"Nicole J Tester, Chiung-Ju Liu, Yun Chan Shin, Aparna Wagle Shukla","doi":"10.5014/ajot.2023.050235","DOIUrl":"10.5014/ajot.2023.050235","url":null,"abstract":"<p><strong>Importance: </strong>Visual function is critical to support occupational performance for persons with Parkinson's disease (PwP), yet it can be adversely affected by the disease.</p><p><strong>Objective: </strong>To evaluate the prevalence and general awareness of visual dysfunction and identify the association between visual dysfunction and occupational performance in PwP.</p><p><strong>Design: </strong>Self-reported cross-sectional electronic survey.</p><p><strong>Participants: </strong>PwP, identified from a registered database at a neurological institute, were invited to complete the survey through emails and newsletters.</p><p><strong>Outcomes and measures: </strong>The survey contained items of self-reported visual difficulties, diagnosed eye conditions, and about general awareness about disease-related visual dysfunction. Ophthalmological symptoms and occupational performance were measured with the Visual Impairment Parkinson's disease Questionnaire and the Revised Self-Reported Functional Visual Performance Scale, respectively.</p><p><strong>Results: </strong>Data from PwP (n = 92; Mage = 69 yr) were analyzed. Nearly half were unaware that their disease could affect vision. Awareness was not associated with disease duration. Individuals reporting awareness tended to report difficulties with vision. Functional activities requiring vision were mildly impaired, and the frequency of ophthalmologic symptoms (commonly related to ocular surface disorder) was low. Nevertheless, a higher frequency of ophthalmologic symptoms was positively associated with a higher degree of disability in activities of daily living (Spearman's ρ = .49, p < .01).</p><p><strong>Conclusions and relevance: </strong>Visual dysfunction related to Parkinson's disease may affect occupational performance. Screening for changes in vision in these individuals may aid occupational therapists in addressing functional independence and activity engagement. What This Article Adds: People with Parkinson's disease may not have a general awareness that the disease can adversely affect visual function. Those individuals with awareness tend to notice changes in vision, and this disease-related visual dysfunction may limit engagement and participation in everyday activities. Active evaluation of visual function in people with Parkinson's disease is recommended. Occupational therapists could play a key role by screening for visual dysfunction and providing patient education in the clinic.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10846416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138483238","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":"Test-Retest Reliability of the Electronic Instrumental activities of daily living Satisfaction Assessment (EISA): A Cohort Study.","authors":"Abbas H Quamar, Mark R Schmeler, Michael McCue, Rory A Cooper, Mary R Goldberg, Carmen DiGiovine, Diane M Collins, Richard M Schein","doi":"10.5014/ajot.2023.050285","DOIUrl":"10.5014/ajot.2023.050285","url":null,"abstract":"<p><strong>Importance: </strong>Currently, no self-report instruments exist for assessing satisfaction with performing instrumental activities of daily living and occupations for people with disabilities using internet-connected assistive devices like accessible smartphones, tablets, laptops, and apps.</p><p><strong>Objective: </strong>To assess the test-retest reliability and internal consistency of the Electronic Instrumental activities of daily living Satisfaction Assessment (EISA) self-report outcome tool.</p><p><strong>Design: </strong>Repeated-measures cohort study with a time frame of 7 to 21 days.</p><p><strong>Setting: </strong>Multicity online recruitment at assistive technology clinics, nongovernmental organizations, advocacy and peer support groups for people with disabilities, and higher education institutions.</p><p><strong>Participants: </strong>Eighty-four participants with disabilities, age 18 yr or older, with a mean age of 43.3 yr (range = 19-75 yr), and 57% female.</p><p><strong>Intervention: </strong>Not applicable.</p><p><strong>Outcomes and measures: </strong>The a priori study hypotheses were that the EISA test-retest reliability scores would be above the minimum acceptable level (Rs > .80) and that internal consistency would be good (Cronbach's α = .70-.90).</p><p><strong>Results: </strong>On the basis of the study data, the EISA, Version 1.0, demonstrated good test-retest reliability (Rs = .81) and excellent internal consistency (Cronbach's α = .88).</p><p><strong>Conclusions and relevance: </strong>The results of the test-retest reliability and internal consistency analyses provide good support for the EISA to be used in clinical settings. What This Article Adds: This article documents the reliability and internal consistency of, to our knowledge, the first-ever self-report instrument for assessing satisfaction with performance of everyday occupations for people with disabilities using internet-connected assistive devices such as smartphones, tablets, laptops, and apps.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10846415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138488784","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":"Leadership Development of Women of Color in Occupational Therapy: A Qualitative Intersectional Analysis.","authors":"Ushentha Nirmul, Pamela Talero Cabrejo, Cristina Reyes Smith","doi":"10.5014/ajot.2023.050331","DOIUrl":"10.5014/ajot.2023.050331","url":null,"abstract":"<p><strong>Importance: </strong>Women of color hold social positions and group member identification in occupational therapy that differ from those of White majority women. Their experience with leadership acquisition warrants exploration of the complex social processes that shape their professional trajectory.</p><p><strong>Objective: </strong>To understand which intersecting patterns of social identity categories have shaped the leadership development of women of color leaders in occupational therapy in the United States and how they do so.</p><p><strong>Design: </strong>This study followed a qualitative multilevel intersectional approach.</p><p><strong>Setting: </strong>Multiregional interviews were conducted by means of virtual technology.</p><p><strong>Participants: </strong>Eight English-speaking women, self-identified as a leader and a woman of color living in the United States, were recruited by means of purposive, snowball sampling of women of color in leadership positions in occupational therapy.</p><p><strong>Outcomes and measures: </strong>An eight-step multilevel intersectional data analysis of participants' narratives was used to identify emergent intersecting patterns of social identity categories in their leadership development.</p><p><strong>Results: </strong>Participants' predominant intersecting patterns converged into four themes: (1) early leadership development does not happen without access to opportunities, (2) sponsorship and mentorship have implications beyond one's leadership development, (3) being seen is essential for leadership development, and (4) persevering is a constant state of struggle.</p><p><strong>Conclusions and relevance: </strong>Leadership development for women of color in occupational therapy thrives at the intersection of scholarship, mentorship, and authentic inclusion. What This Article Adds: The study expands leadership inquiry in occupational therapy to include the perspectives of women of color and to better understand the patterns of social identity categories in leadership achievement. Positionality Statement: The term women of color is a political designation coined in the 1970s by women in the minority to define solidarity with other oppressed women (Zavella, 2022). The term women of color is used to achieve a unified political voice to seek gender equality for women who feel unsupported by White feminist ideology (Zavella, 2022). Moreover, it describes multicultural and multiethnic solidarity among women who sit outside the structures of power and privilege and experience life at the intersection of gender and race. Thus, women of color include Black, Latinx, Asian, Pacific Islander, mixed-race women, and Native American women, including American Indian, Alaskan Native, and Native Hawaiian women (McKinsey & Company, 2022).</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300334","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":"Participation and Its Association With Health Among Community-Dwelling Adults With Chronic Stroke.","authors":"Jessica Kersey, Elizabeth Skidmore, Joy Hammel, Carolyn Baum","doi":"10.5014/ajot.2023.050255","DOIUrl":"10.5014/ajot.2023.050255","url":null,"abstract":"<p><strong>Importance: </strong>Little is known about the severity of participation restrictions among people living in the community with chronic stroke. Even less is known about the association between participation and health in this population.</p><p><strong>Objective: </strong>To describe participation among people with chronic stroke and examine the association between participation and physical and mental health.</p><p><strong>Design: </strong>Secondary analysis of baseline data from an intervention study.</p><p><strong>Setting: </strong>The parent multisite intervention study was conducted in the community, and assessments were administered in participants' homes.</p><p><strong>Participants: </strong>Thirty-one community-dwelling adults with chronic stroke.</p><p><strong>Outcomes and measures: </strong>Participation was measured with the Activity Card Sort (percentage of prestroke activities retained) and the Enfranchisement Scale of the Community Participation Indicators. Health was measured with the PROMIS®-29 Physical Health and Mental Health subscales. We calculated descriptive statistics for participation measures and Spearman's ρ correlations between participation and health outcomes.</p><p><strong>Results: </strong>Participation scores were poor on all measures of participation. Most striking, 94.9% of participants retained less than 80% of their prestroke activities. All measures of participation were modestly correlated with physical health (ρ = .28-.46) and were moderately correlated with mental health (ρ = .42-.63).</p><p><strong>Conclusions and relevance: </strong>Participation restrictions are prevalent among adults with chronic stroke, with potential implications for mental health. Stronger community-based rehabilitation and support services to enhance participation of this high-risk population are warranted. What This Article Adds: This report highlights the severity of participation restrictions among people with chronic stroke. Moreover, this report shows that people with stroke feel a lack of inclusion in the community and that participation is associated with mental and physical health.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10846419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50163279","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":"An Examination of Positive and Negative Outcomes During the COVID-19 Pandemic Among Persons With Multiple Sclerosis.","authors":"Helen M Genova, Michelle H Chen, Amanda Botticello, Gerald Voelbel, Grace Kim, Heba E Elsayed, Zuzanna Myszko, John DeLuca, Robert E McGrath, Peter Arnett, Yael Goverover","doi":"10.5014/ajot.2023.050287","DOIUrl":"10.5014/ajot.2023.050287","url":null,"abstract":"<p><strong>Importance: </strong>This study provides information to clinicians about how persons with MS coped in both positive and negative ways during a potentially traumatic experience (the coronavirus disease 2019 [COVID-19] pandemic), which will help clinicians to provide better services to this population in the face of stressful events.</p><p><strong>Objective: </strong>To describe both positive and negative outcomes among persons with multiple sclerosis (MS) and to examine whether resilience and social support were related to positive and negative outcomes during the peak of the pandemic.</p><p><strong>Design: </strong>An online survey administered during the COVID-19 pandemic.</p><p><strong>Participants: </strong>Participants were 74 individuals with MS and 104 healthy controls (HCs) recruited through social media and community support groups.</p><p><strong>Outcomes and measures: </strong>The survey included questionnaires that assessed both positive and negative responses to the pandemic, including benefit finding, loneliness, and distress. Resilience and social support were also assessed.</p><p><strong>Results: </strong>Differences were noted between persons with MS and HCs on negative but not positive outcomes. Better social support and resilience were related to positive outcomes.</p><p><strong>Conclusions and relevance: </strong>Both persons with MS and HCs were similar in benefit finding and stress management. However, negative outcomes were worse in the MS group. Our findings shed light on the importance of individuals with MS adopting a positive outlook to help during times of adversity. What This Article Adds: Among persons with disabilities such as multiple sclerosis, finding benefits during stressful times can be a potential coping mechanism. Furthermore, resilience and social support should be taken into account to moderate the effects of adverse events.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138446657","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}