Occupational Therapy Services in School-Based Practice: A Pediatric Occupational Therapy Perspective from IrelandRead the full article
Occupational Therapy International publishes research reflecting the practice of occupational therapy throughout the world. Topics include reliability and validity of clinical instruments, assistive technology, community rehabilitation etc.
Chief Editor, Dr Mackenzie worked in orthopaedics, general medicine and managed the Hunter Equipment Service and PADP services before being appointed as the first occupational therapist employed by community health services in Newcastle.
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United Nations Convention on the Rights of Person with Disabilities (UNCRPD) Implementation: Perspectives of Persons with Disabilities in Namibia
The Namibian government ratified the UNCRPD and its optional protocol in 2007 raising expectations that such a convention would fundamentally improve the lives of persons with disabilities. However, persons with disabilities continue to experience inequalities and violation of dignity. This study explores the impact of the UNCRPD as reflected on the lives of persons with disabilities in Namibia. An exploratory qualitative study with the use of photovoice and in-depth interviews was conducted in Omusati and Khomas regions, Namibia. Persons with disabilities () were recruited via purposive sampling, of which participants were engaged in three focus group discussions. Participants employed in the disability sector () were engaged in in-depth interviews. Data were thematically analysed. The study findings revealed the inadequacy of disability rights information dissemination and continued barriers to inclusivity of persons with disabilities. Stigma, discrimination, limited financial opportunities, weak political support, and limited accessibility to physical infrastructure caused barriers to inclusivity. However, opportunities to advance the UNCRPD were also identified. There is a need for the disability sector to build on identified institutional facilitators to advance disability rights through mobilisation of local resources, communities, and government to redress the challenges identified in Namibia.
Clinicians’ Views on the Need for Cultural Adaptation of Intervention for Children with ADHD from the Ultraorthodox Community
Culture is a core context within occupational therapy, with a recent literature emphasizing the importance of cultural competence, as well as culturally sensitive assessment and intervention. The recent literature has indicated the efficacy of the Cognitive-Functional intervention (Cog-Fun) for children with ADHD among the general Israeli population, yet no studies to date have examined the necessity of cultural adaptations for minority groups. The current study examines the necessity of adapting the intervention protocol and process to the Ultraorthodox (UO) population, as perceived by occupational therapists. The study included 28 occupational therapists certified to use the Cog-Fun intervention, who reported using this approach with UO children. Participants responded to an online questionnaire developed for this study, regarding characteristics of the UO population and necessary adaptions to the Cog-Fun intervention process and protocol. Findings were analyzed using descriptive statistics and qualitative content analysis. Results of the study point to the necessity of addressing various features of the UO community, including daily routines and habits, cultural values, knowledge regarding ADHD, and accessibility of information. Participants also reported a need to adapt the graphic content of the intervention materials. The qualitative data expanded on the perceptions of the participants through four main themes: (a) knowledge regarding ADHD diagnosis and intervention; (b) perceptions and attitudes regarding ADHD diagnosis and medication; (c) factors affecting communication between the OT, parents, and teachers; and (d) adapting the intervention protocol to habits, routines, and lifestyle of UO families. This study has direct implications for therapists utilizing the Cog-Fun with UO children and may also provide insights relevant to occupational therapists using other treatment approaches with children from this culture, as well as other minority or traditional groups. Furthermore, this study may serve as an important addition to the limited literature describing cultural adaptations of evidence-based interventions.
Protocols Used by Occupational Therapists on Shoulder Pain after Stroke: Systematic Review and Meta-Analysis
Introduction. Shoulder pain as a consequence after a stroke has multifactorial causes and can prevent the functional return of the upper limb. In addition, the effectiveness of clinical protocols applied by occupational therapists remains uncertain. Objective. To identify the main treatments currently used by occupational therapists for pain in the shoulder after a stroke. Method. Articles in English published between 2015 and 2019, of the randomized clinical trial type, with populations that stroke survivors a stroke and sequelae of shoulder pain were selected. The terms and combinations used were “shoulder pain and stroke and occupational therapy,” in the electronic databases, Directory of Open Access Journals (DOAJ), Occupational Therapy Systematic Evaluation of Evidence (OTseeker), and PubMed. Statistical Review Manager (version 5.3) established the significance level . Results. Thirty-nine articles were found, but only four met the inclusion criteria. Electrical stimulation, therapeutic bandaging, and dry needling were eventually employed. For the meta-analysis, pain was the primary outcome, and range of motion (ROM) and upper limb function were secondary. Pain, ROM (external rotation, abduction, and flexion), and manual function were compared, and the meta-analysis showed improvement in the treatment group in clinical trials: pain (MD -2.08; 95% CI -3.23, -0.93; ), ROM (MD 4.67; 95% CI 1.54, 7.79; ), and manual function (MD 1.84; 95% CI 0.52, 3.16; ). Conclusion. Dry needling, California tripull taping (CTPT), and functional electrical stimulation controlled by brain-machine interface (BCI-FES) are proved effective in shoulder pain and functionality.
Nonpharmacological Treatment for Supporting Social Participation of Adults with Depression
Background. Social withdrawal is predominantly seen among adults with depression. However, a dearth of reviews exists that explore nonpharmacological treatments, especially occupational therapy (OT) interventions and their effect in promoting social participation. The aim of this research was to review what intervention programs are conducted to support the social participation of adults with depression and their effectiveness. Method. A systematic review was performed wherein relevant articles were searched in PubMed, CINAHL, Wiley Online Library, PsycINFO, and OTseeker databases and AJOT, BJOT, SJOT, and OTMH journals. Only English articles published from January 2010 to December 2018, which tackled intervention for adults aged 20–60 years with depression, were considered. Ten out of 918 studies met the screening criteria. Result. Among the ten studies, the effective intervention programs were categorized as either occupation-based intervention (OBI) or cognitive behavioral therapy-based intervention (CBT-BI). These programs sought the following outcomes: behavioral change in social participation (), reduction of depression or depressive symptoms (), life satisfaction (), and quality of life (QoL) (). Studies showed moderate () to strong () level of certainty, whereas they also revealed high to unclear () and low () risk of bias. Conclusion. Both OBI such as animal-assisted therapy and CBT-BI such as behavioral change program and health education have a strong level of certainty and low risk of bias in promoting social participation by supporting positive behavioral change and reducing depressive symptoms. Furthermore, the sport and exercise program of OBI was popular in encouraging participation and engagement with other people. Other programs were suggested for combined interventions to support social participation, life satisfaction, and QoL.
Rasch Analysis of the Norwegian Version of the Occupational Balance Questionnaire in a Sample of Occupational Therapy Students
Background. Recently, the Occupational Balance Questionnaire developed in Sweden was translated into Norwegian. No studies to date have examined the measurement properties of the Norwegian version of this questionnaire. Aim. The study is aimed at examining the psychometric properties of the Norwegian version of the Occupational Balance Questionnaire, the OBQ11-N. Methods. Along with sociodemographic data, 180 occupational therapy students enrolled at two Norwegian universities completed the OBQ11-N as well as one question each related to health and quality of life and some sociodemographic variables. Rasch analysis was employed for examining rating scale functioning, item and person validity, dimensionality, and differential item functioning. Results. Item categories were ordered, but there were potential gaps in the measurement of the construct. Person reliability was fair, whereas item reliability was low. Point biserial correlations were positive, indicating that all items contributed to the construct. Factor loadings were low for two items, and there were indices of a second underlying dimension and item redundancy. Many people were not aligned with the items, and some items functioned differently across various demographic variables. Conclusion and Significance. The OBQ11-N did not function as an adequate measure of occupational balance in a sample of students. Potentially, the detected measurement problems may be solved by adding more relevant items to a larger item pool, from which the best fitting items should be selected.
Leisure and Productivity in Older Adults with Cancer: A Systematic Review
Introduction. Self-care, leisure, and productivity are important occupational domains for older adults’ quality of life, which might be affected by cancer and its treatment. A great number of publications about older adults focus on function or self-care, so we aimed to analyse how cancer and its treatments affect leisure and productivity. Secondary objectives were to identify whether particular clinical and/or sociodemographic factors were associated with occupational disruptions and to assess the impact of rehabilitation approaches on leisure and productivity in this population. Methods. A systematic review of the 2009-2019 literature performed on Medline, Embase, and the Cochrane Central Register of Controlled Trials. Results. 1471 publications were retrieved: 48 full texts were assessed; seven of these (four cross-sectional studies, two cohort studies, and a case report) were reviewed, including data on 16668 people (12649 healthy controls, 3918 cancer survivors, and 101 ill patients). Older adults with comorbidities and a low level of activity before cancer diagnosis may be more at risk of occupational disruptions. However, studies focused more on physical activity than leisure and productivity. Two studies mentioned occupational therapy. Discussion. As cancer can become a chronic disease, it appears important to also offer occupation-centred assessments and follow-up. Conclusion. An occupation-centred approach could be developed; its effectiveness must be assessed.