Australian Occupational Therapy Journal最新文献

{"title":"Fidelity, acceptability, and feasibility of the revised functional autonomy measurement system for hospitalised people: An implementation study","authors":"Aruska N. D'Souza, Casey L. Peiris, Susan Darzins, Tamara Tse, James Seymour, Ethan Hunt, Riley Hodgson, Celia Marston","doi":"10.1111/1440-1630.13006","DOIUrl":"10.1111/1440-1630.13006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The revised functional autonomy measurement system (SMAF-R) is an outcome measure of activity performance and resource needs. This study aimed to measure the implementability of the SMAF-R as a routine outcome measure in acute and subacute inpatients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a mixed-methods implementation study. Occupational therapists were asked to complete the SMAF-R in hospitalised people with an anticipated length of stay greater than 48 hours over a 12-month period (<i>n</i> = 13,348). A baseline audit of SMAF-R completion rates was conducted, and behaviour change interventions were delivered over 12 months. The Implementability of Healthcare Interventions conceptual framework was used to evaluate fidelity (completion rates), acceptability (staff survey with quantitative and qualitative responses), and feasibility (change in SMAF-R scores from admission to discharge). Quantitative and qualitative (analysed thematically) data were integrated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Consumer involvement</h3>\u0000 \u0000 <p>Occupational therapists and other staff working to improve outcome measure completion within the electronic medical record and other allied health teams were consulted when developing and delivering behaviour change interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Peak completion of the SMAF-R did not meet an 80% fidelity success rate (admission: 32% in acute and 66% in subacute; discharge: 12% in acute and 48% in subacute). Two thirds of occupational therapists reported the SMAF-R was an acceptable measure to use, but only 38% liked using it. Thematic analysis revealed three themes: (1) A greater understanding of the relevance of the SMAF-R influenced acceptability; (2) using the SMAF-R within an electronic medical record may facilitate completion; and (3) it takes more time to complete SMAF. Patients made clinically significant improvements in SMAF-R scores during their hospital stay (median difference 16.5 [6.5–27.0], <i>p</i> < 0.001, <i>n</i> = 764).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although most occupational therapists reported the SMAF-R was acceptable, there were mixed opinions regarding the relevance of the SMAF-R in this setting, which may have impacted fidelity. Additional prompting and training (especially regarding understanding SMAF-R relevance to practice) may assist with improving SMAF-R completion. Further research is required to assess the psychometric properties of the SMAF-R in the hospital environment.</p>\u0000 </section","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"72 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549085","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":"Investigating patient satisfaction with a hand therapy telehealth service during COVID-19","authors":"Elise M. Graham, Elspeth Ahern","doi":"10.1111/1440-1630.13003","DOIUrl":"10.1111/1440-1630.13003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Throughout the COVID-19 pandemic, outpatient hand therapy services were restricted. The use of telehealth was adopted to continue to provide care to patients with hand injuries.</p>\u0000 \u0000 <p>This survey aims to investigate patient satisfaction with hand therapy delivered via telehealth in a NSW public tertiary referral metropolitan setting and explore whether this differs for specific hand injury/conditions and treatments offered.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients using hand therapy services via telehealth between 28 June 2021 and 27 May 2022 responded to a bespoke electronic survey. Participants were grouped depending on their particular injury/condition and treatment received. Analysis was conducted using MS Excel, and correlations were determined by using Fisher's exact test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Community and consumer involvement</h3>\u0000 \u0000 <p>No consumers were involved in the study design or analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-eight of 262 patients responded to the survey (26% response rate). Overall results showed high patient satisfaction (<i>n</i> = 55, 81%) with hand therapy delivered via telehealth with most patients agreeing that telehealth should be offered going forward (<i>n</i> = 59, 87%). Benefits reported by patients included convenience, reduced travel time and parking issues, and time saving. Patients receiving therapy for ‘finger thumb bony injury with K wires’ demonstrated a statistically significant association of lower satisfaction with telehealth (<i>n</i> = 3, 43%, <i>P</i> = 0.02). Patients receiving wound care over telehealth were just as satisfied with their experience (<i>n</i> = 15, 82%) as overall results (<i>n</i> = 55, 81%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The survey suggests that patients are satisfied with their experience of telehealth for hand therapy. Patients with finger thumb bony injuries with k wires may be less suitable for telehealth. Wound care appears to be well received over telehealth in a hand therapy population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> PLAIN LANGUAGE SUMMARY</h3>\u0000 \u0000 <p>There is little evidence to guide hand therapists in which conditions or injuries patients find can be managed well with telehealth. Patients who answered a survey about their experience with telehealth for their hand therapy management overall reported satisfaction with the experience. Some patients had undergone surgery for bro","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"72 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513416","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":"Daily living skill support for autistic people through a neurodiversity-affirming practice lens","authors":"Chelsea Morrison, Andrew Cashin, Kitty-Rose Foley","doi":"10.1111/1440-1630.13002","DOIUrl":"10.1111/1440-1630.13002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Supporting daily living skill (DLS) development for autistic people is a component of occupational therapy practice. DLSs are essential for an increased quality of life (QoL), independent living, and community participation. Autistic young people experience poorer outcomes in terms of QoL and independent living than non-autistic peers. Finding a balance between targeted DLS support to maximise independent living and improve QoL, while avoiding attempts to ‘normalise’ or ‘change’ autistic people, presents as a dilemma for therapists striving to align with neurodiversity-affirming practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This theoretical paper explored literature pertaining to DLS and the neurodiversity movement in the context of occupational therapy values and the Canadian Model of Occupational Participation. Consideration of whether targeted DLS support is neurodiversity-affirming or whether occupational therapists are compelling autistic people to mimic behavioural norms perceived by society was discussed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>DLSs are an important factor for maximising QoL, regardless of neurotype. Occupational therapy values align with the core tenets of the neurodiversity movement, and occupational therapists are equipped with the values and skills to support the development of DLSs utilising affirming practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Occupational therapists should critically reflect on their practice to ensure alignment with the professions core values and recent occupational therapy models, to ensure affirming practice. Further research investigating DLS and neurodiversity-affirming practice would benefit occupational therapists striving to align with neurodiversity-affirming practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Consumer and Community Involvement</h3>\u0000 \u0000 <p>No consumer or community involvement. Consumers have been considered throughout the development of this paper through their representation in the literature. This involved a process of reviewing the literature and considering it in the scope of the questions and how occupational therapy sits within the neurodiversity movement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> PLAIN LANGUAGE SUMMARY</h3>\u0000 \u0000 <p>It is important to help autistic people to learn to do everyday things. Everyday things include ac","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"72 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.13002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481587","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":"Environmentally sustainable person–centred care: Occupational therapy students' attitudes, perceptions and self-perceived preparedness for practice","authors":"Felicity Murray, Ka Yan Hess, Tanya Rihtman","doi":"10.1111/1440-1630.12998","DOIUrl":"10.1111/1440-1630.12998","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Climate change threatens the environments in which person-centred occupational therapy occurs. Environmental sustainability is directly linked with the health and wellbeing of current and future generations, presenting occupational therapists with a unique advocacy and activist role. As practitioners of the future, there is an urgent need to understand students' attitudes, perceptions of, and self-perceived preparedness for, dealing with environmental determinants of health and intergenerational occupational and climate justice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional exploratory descriptive survey collected United Kingdom (UK) based allied health professional students' attitudes, perceptions, and self-perceived preparedness for advocating for environmental sustainability in the context of person-centred care. The survey was distributed to 48 gatekeepers in UK institutions with approved allied health professional training programmes (44 offered occupational therapy); 62 occupational therapy students responded. Descriptive and non-parametric inferential statistics were used to analyse quantitative data. Text and short answers were analysed qualitatively via inductive content analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Consumer and Community Involvement</h3>\u0000 \u0000 <p>The study was co-designed and implemented with MSc (pre-registration) occupational therapy students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants (94%) expressed concerns for climate change, with 84% feeling responsible for addressing environmental sustainability in health care. While 64.5% identified climate justice as a top priority, a perceived challenge emerged between person-centred care and sustainability, with only 18% of participants feeling prepared for environmental sustainability in occupational therapy practice. Participants requested education on personal and professional sustainability practices, as well as collective action. Sharing personal climate change experiences, advocating with family and friends, and facilitating connections for collective action were highlighted as potentially transformative educational tools in this area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Occupational therapy curricula should address environmental sustainability through pragmatic, critical, and ethical lenses to enhance students' preparedness for this advocacy and activist role. Reflection and continuous professi","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"72 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12998","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481588","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":"Relationships between sensory reactivity and occupational performance in children with paediatric acute-onset neuropsychiatric syndrome (PANS)","authors":"Michelle J. Newby, Shelly J. Lane, Kirsti Haracz, Janice Tona, Kerrin Palazzi, David Lambkin","doi":"10.1111/1440-1630.12999","DOIUrl":"10.1111/1440-1630.12999","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Paediatric acute-onset neuropsychiatric syndrome (PANS) is a neurodevelopmental disorder affecting children's performance in a fluctuating manner. This study investigates the relationship between sensory reactivity and occupational performance in children with PANS during exacerbation phases. Understanding these relationships is crucial for developing tailored interventions and managing the condition effectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study is part of a larger project in which a two-period bidirectional case-crossover design was employed to assess sensory reactivity and occupational performance in children with PANS. The current study used data from exacerbation phases only. Parents of children aged 4.6 to 13.1 years with PANS were recruited globally, and data were collected via online surveys. The Vineland Adaptive Behaviour Scale (VABS) evaluated occupational performance, and the Sensory Processing Measure (SPM) assessed sensory reactivity. Analysis utilised Pearson correlation to determine the relationships between sensory reactivity and occupational performance domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 60 participants who completed the SPM and 21 who completed the VABS showed moderate to strong negative correlations between the SPM total and several domain scores (vision, hearing, body awareness, balance, and motion) and the VABS Communication and Daily Living Skills scores, indicating that increased sensory reactivity is associated with decreased occupational performance during exacerbations. No significant correlation was found between sensory reactivity and socialisation skills.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings highlight the significant relationship between sensory reactivity and occupational performance during PANS exacerbations, particularly in communication and daily living skills domains. Further research is needed to examine factors influencing socialisation skills and to assess the effectiveness of sensory interventions in improving occupational performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Consumer and community involvement statement</h3>\u0000 \u0000 <p>Although there was no direct consumer and community involvement, two researchers on our team have family members with PANS. Their personal experiences provided vital insights into the challenges faced by children with PANS, deeply influencing our study's design, focus, and interpreta","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"72 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12999","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481589","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":"Participation in health promoting occupations among mothers of children aged 3–8 years with and without difficulties in sensory processing","authors":"Maya Baruch Doskalovich, Aviva Yochman, Jennifer R. Budman","doi":"10.1111/1440-1630.12996","DOIUrl":"10.1111/1440-1630.12996","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Participation in personally significant occupations often contributes to quality of life. Parenting a child with difficulties in sensory processing may present challenges that can affect subjective and objective components of parental participation, thus possibly decreasing their quality of life. This study aimed to compare these components between mothers of children with and without difficulties in sensory processing and explore their relationship with maternal quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy mothers of children aged 3–8 years with (50%) and without difficulties in sensory processing completed questionnaires measuring subjective occupational experience, objective frequency of participation in health promoting activities, and quality of life. No consumer or community involvement occurred.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Satisfaction with participation competence as well as objective frequency of participation in health promoting activities among mothers from the study group was found to be significantly lower than the control group. Additionally, a significant moderately strong correlation was found between these variables and the quality of life of all mothers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Subjective and objective participation in health promoting activities is lower in mothers of children with difficulties in sensory processing. Additionally, the quality of life in all mothers was linked to their perceived capability and frequency of engagement in health-promoting activities. Raising awareness to the experience of mothers of children with challenges in sensory processing may help bring to attention the importance of enhancing mothers' engagement in health-promoting activities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> PLAIN LANGUAGE SUMMARY</h3>\u0000 \u0000 <p>Mothering a child with difficulties in sensory processing can influence parents' emotional states and sense of competence, affecting how mothers take part in activities that support their health and quality of life. In this study, 70 mothers of children aged 3–8, with and without difficulties in sensory processing, were asked about how often they participate in activities that promote their health, their experiences, and about their quality of life. The mothers of children with difficulties in sensory processing felt less confident in their abilities and did fewer activities that support their healt","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"72 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12996","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395520","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 performance patterns in children with paediatric acute-onset neuropsychiatric syndrome","authors":"Michelle J. Newby, Shelly J. Lane, Kirsti Haracz, Janice Tona, Kerrin Palazzi, David Lambkin","doi":"10.1111/1440-1630.12995","DOIUrl":"10.1111/1440-1630.12995","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Paediatric acute-onset neuropsychiatric syndrome (PANS) is a neuroimmune condition characterised by episodic exacerbations and remissions. This study investigates the impact of PANS on children's occupational performance during these phases, using the Vineland Adaptive Behaviour Scale (VABS). Understanding these variations is crucial for developing tailored interventions and managing the condition effectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A two-period bidirectional case-crossover design was employed to assess occupational performance in children with PANS at exacerbation (T-E) and remission (T-R) phases. Parents of children aged 4.6–13.1 years with PANS were recruited globally, with data collected via online surveys and monthly updates. The VABS evaluated occupational performance, with analysis using linear mixed models and Least Squares Means (LSMeans) for accurate representation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 27 participants showed significantly lower scores in the Adaptive Behaviour Composite and socialisation domain of the VABS at T-E compared with T-R, indicating a decline in occupational performance and social skills during exacerbations. During remission, participants demonstrated typical performance across all domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study highlights a marked decline in occupational performance and socialisation during PANS exacerbations, with improvements to typical levels during remission. These findings emphasise the need for targeted interventions to address occupational and social challenges in children with PANS during exacerbations, underscoring the episodic nature of the condition and the risk of misinterpreting behaviours if assessed during exacerbations. Multidisciplinary allied health support may benefit children with PANS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Consumer and community involvement</h3>\u0000 \u0000 <p>Although there was no direct consumer and community involvement, two researchers on our team have family members with PANS. Their personal experiences provided vital insights into the challenges faced by children with PANS, deeply influencing our study's design, focus, and interpretation, ensuring it reflects the realities of those affected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> PLAIN LANGUAGE SUMMARY</h3>\u0000 \u0000 <p>Our study looked","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"72 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12995","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395519","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":"Translating acceptability to sustained delivery: Clinician and manager perspectives on implementing modified constraint-induced movement therapy in an early-supported discharge rehabilitation service","authors":"Ashan Weerakkody, Erin Godecke, Barby Singer","doi":"10.1111/1440-1630.12993","DOIUrl":"10.1111/1440-1630.12993","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Modified constraint-induced movement therapy (mCIMT) improves upper limb (UL) function after stroke. Despite up to one-third of stroke survivors being eligible, clinical uptake remains poor. To address this, a multi-modal behaviour change intervention was implemented across a large seven-site early-supported discharge (ESD) rehabilitation service. This study investigated the acceptability of mCIMT implementation within this ESD service and identified adaptations required for sustained delivery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This qualitative study was nested within a mixed-methods process evaluation of mCIMT implementation. Four focus groups (<i>n</i> = 24) comprising therapists (two groups), therapy assistants (one group), and allied health managers (one group) were conducted. Data were analysed using reflexive thematic analysis and mapped to the Theoretical Domains Framework (TDF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Consumer and Community Involvement</h3>\u0000 \u0000 <p>Consumers were not directly involved in this study; however, lived experience research partners have helped shape the larger mixed-methods implementation study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Four themes were generated and mapped to the TDF. Factors related to acceptability included interdisciplinary practice in sharing workloads (belief about capabilities), practice opportunities across a range of UL presentations (skills), clinician attitudes influencing patient engagement (optimism), time constraints (belief about consequences), and cognitive overload from multiple systems and processes (memory, attention, and decision-making processes). Factors facilitating sustained delivery included improving stroke survivor education (knowledge), sharing success stories across teams (reinforcement), manager facilitation (social/professional role and identity), and the perception that the ESD setting was optimal for mCIMT delivery (social influences).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>mCIMT was acceptable in the ESD service, with clinicians feeling a responsibility to provide it. Key adaptations for sustained delivery included ongoing training, resource adaptation, and enhanced patient and carer engagement. Successful implementation and sustained delivery of mCIMT in the ESD service could enhance UL function and reduce the burden of care for potentially hundreds of stroke survivors and their carers.</p>\u0000 </sec","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"72 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12993","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395521","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":"Developing an initial explanatory theory for Partnering for Change using realist evaluation","authors":"Sandra VanderKaay, Cheryl Missiuna, Sheila Bennett, Sandra Sahagian Whalen, Leah Dix, Chantal Camden, Jennifer Kennedy, Wenonah Campbell","doi":"10.1111/1440-1630.12994","DOIUrl":"10.1111/1440-1630.12994","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Partnering for Change (P4C) is an innovative practice model for school-based occupational therapy developed in Canada and informed by a program of research spanning nearly two decades. National and international interest in P4C necessitated development of an explanatory theory to guide implementation in varied contexts. The purpose of this study is to document the process of theory development and to provide an overview of the initial P4C explanatory theory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Realist evaluation was used to construct an initial explanatory theory of P4C drawing on P4C developers' conceptualisations of the model, document analysis, and analysis of transcripts from interviews and focus groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Consumer and community involvement</h3>\u0000 \u0000 <p>No consumers were involved in the study design or analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Four sets of premises expressed as context-mechanism-outcome configurations (CMOCs) comprise the initial explanatory theory of P4C. An abstracted summary of these four sets along with contexts, mechanisms, and outcomes central to the P4C initial explanatory theory is presented. An exemplar CMOC is shared to illustrate how theoretical premises are developed and expressed using realist evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study advances knowledge regarding the hypothesised core elements of P4C and provides an example of using realist evaluation to advance knowledge in occupational therapy. Preliminary implications for clinical practice are discussed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> PLAIN LANGUAGE SUMMARY</h3>\u0000 \u0000 <p>Partnering for Change (P4C) is a way of providing occupational therapy services in schools that helps all children to learn and participate successfully. P4C was created in Ontario, Canada, and has been researched for almost 20 years. People in different parts of Canada and other countries are interested in trying P4C. As the researchers who created P4C, we think there is a need to explain how it works so it can be used in different places. This study explains how we created a theory to describe P4C. To develop this theory, we used a method called realist evaluation that would help us explain how, why, and in what situations P4C works best. To do this, we analysed documents and trans","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"72 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12994","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360682","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":"Manual wheelchair training approaches and intended training outcomes for adults who are new to wheelchair use: A scoping review","authors":"Kimberly Charlton, Carolyn Murray, Natasha Layton, Emilee Ong, Lucy Farrar, Trish Serocki, Stacie Attrill","doi":"10.1111/1440-1630.12992","DOIUrl":"10.1111/1440-1630.12992","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Wheelchair training is pivotal for safety, independence, and occupational engagement in the community, yet adults coming into wheelchair use often receive insufficient or untailored training. This research aimed to understand the range and type of manual wheelchair training approaches that exist for adults commencing wheelchair use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A systematic scoping review involved searching eight electronic databases and grey literature up to September 2023. Papers relating to manual wheelchair training for adults and their caregivers were included for data extraction. Eighty-seven articles were included in this review. The International Classification of Functioning (ICF) was used to organise and analyse data related to intended training outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Consumer and Community Involvement</h3>\u0000 \u0000 <p>Consumer consultation was not included in this review; however, the outcomes suggest that involving consumers in future wheelchair training research is critical to assure community participation outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data were extracted from 87 papers. Manual wheelchair training was delivered across diverse contexts encompassing varied support structures, trainer backgrounds, and technology and was commonly directed towards wheelchair users with spinal cord injury. Intended training outcomes most frequently mapped to the activity and participation component of the ICF (<i>n</i> = 39), followed by personal factors (<i>n</i> = 27), body structures and functions (<i>n</i> = 18), and environmental factors (<i>n</i> = 3), with limited focus on longer term occupational engagement outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Most existing manual wheelchair training focussed on the acquisition of individual wheelchair skill and may not facilitate generalised and long-term occupational participation outcomes. Further exploration into the contexts that support occupational engagement, particularly for older adults with progressive conditions, is required to support service provision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> PLAIN LANGUAGE SUMMARY</h3>\u0000 \u0000 <p>We looked at what manual wheelchair training approaches exist for adults who need to use a manual wheelchair and what training helps people to do/achieve. We did a scoping review th","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"72 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12992","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332875","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}