Use of harm reduction strategies in an occupational therapy life skills intervention

Thesis (M.S.)--Boston UniversityObjectives of Study: Harm reduction intervention strategies have the potential to support positive health outcomes. However, no studies have explored how these strategies can be implemented in an occupational therapy intervention. This study addresses this knowledge gap by examining harm reduction strategies that were discussed during group and individual sessions of an occupational therapist-led life skills intervention for people who have a mental illness and are or were homeless. Methods: This study is a secondary analysis of a larger study that used a longitudinal repeated measures design to implement a life skills intervention. This secondary analysis uses a mixed methods design. Qualitative methods were used for data collection and initial analysis. Quantitative methods were then used to analyze differences between settings. Results: Three major themes emerged from the data: Financial, Physical, and Psychosocial Hann Reduction. The most prevalent theme was Financial Harm Reduction. All three themes were present throughout all of the different life skills intervention modules. There was no significant difference in the themes used between settings. Limitations and Recommendations for Further Research: This study was limited to what was documented in the therapy notes. Although the notes may not include every discussion that occurred, these results suggest that harm-reduction strategies can be utilized in an occupational therapy intervention. Additional research is needed to investigate how harm reduction can be implemented in other areas of occupational therapy practice

Inpatients’ perspectives of occupational therapy in acute mental health

Background Research into service users’ views of occupational therapy in acute mental health is extremely limited. This collaborative study between South West London and St George’s Mental Health NHS Trust and Brunel University (UK) obtained inpatients’ perspectives of occupational therapy. Methods Service users and occupational therapists were involved in designing a self-report questionnaire and, following training, in recruiting participants and collecting data. Results Sixty-four (28.6%) inpatients responded and most had met an occupational therapist who had explained the purpose of their intervention. The most frequent group interventions were arts and crafts, relaxation, community meetings, cookery, sports and gym, with the latter two rated as most beneficial. There was much less choice about individual goals and interventions. A highly significant and positive correlation was found between occupational therapy meeting the needs of individuals and it improving their daily functioning and quality of their admission. Conclusions Occupational therapists need to provide more individual interventions and more fully involve inpatients in deciding on individual goals. Group interventions, which are meaningful, relevant and with an occupational focus, are most beneficial. Further research examining the effectiveness of cookery and sport and gym and establishing the benefits of engaging in group and individual intervention on acute wards is warranted

Individual patient data meta-analysis of randomized controlled trials of community occupational therapy for stroke patients

<p><b>Background and Purpose:</b> Trials of occupational therapy for stroke patients living in the community have varied in their findings. It is unclear why these discrepancies have occurred.</p> <p><b>Methods:</b> Trials were identified from searches of the Cochrane Library and other sources. The primary outcome measure was the Nottingham Extended Activities of Daily Living (NEADL) score at the end of intervention. Secondary outcome measures included the Barthel Index or the Rivermead ADL (Personal ADL), General Health Questionnaire (GHQ), Nottingham Leisure Questionnaire (NLQ), and death. Data were analyzed using linear or logistic regression with a random effect for trial and adjustment for age, gender, baseline dependency, and method of follow-up. Subgroup analyses compared any occupational therapy intervention with control.</p> <p><b>Results:</b> We included 8 single-blind randomized controlled trials incorporating 1143 patients. Occupational therapy was associated with higher NEADL scores at the end of intervention (weighted mean difference [WMD], 1.30 points, 95% confidence intervals [CI], 0.47 to 2.13) and higher leisure scores at the end of intervention (WMD, 1.51 points; 95% CI, 0.24 to 2.79). Occupational therapy emphasizing activities of daily living (ADL) was associated with improved end of intervention NEADL (WMD, 1.61 points; 95% CI, 0.72 to 2.49) and personal activities of daily living (odds ratio [OR], 0.65; 95% CI, 0.46 to 0.91), but not NLQ. Leisure-based occupational therapy improved end of intervention NLQ (WMD, 1.96 points; 95% CI, 0.27 to 3.66) but not NEADL or PADL.</p> <p><b>Conclusions:</b> Community occupational therapy significantly improved personal and extended activities of daily living and leisure activity in patients with stroke. Better outcomes were found with targeted interventions.</p&gt

Peer observation in professional development : occupational therapists perceptions

Aims: peer observation of practice is used to promote reflection and facilitate personal and professional development. However, there appears to be no published research on the use of peer observation by occupational therapists working in higher education. This action research project explored the perceptions of occupational therapy staff within a higher education setting towards the use of a peer observation of practice scheme. Methods: all colleagues within a directorate of occupational therapy were invited to complete a questionnaire. Additionally, five staff were invited to take part in semi-structured interviews and core themes were identified following thematic analysis, typified by grounded theory. Findings: staff used a range of methods to support professional development, including peer observation. Key themes identified were the concept that peer observation has both positive and negative connotations, that feedback must be carefully managed, that the relationship between observed and observer is important and that staff want clear ground rules for peer observation schemes. Conclusions: findings indicated the need for further research into peer observation and how such a scheme could be formally implemented

Identifying Instructional Methods for Development of Clinical Reasoning in Entry-Level Occupational Therapy Education: A Mixed Methods Design

Occupational therapy education must teach using contemporary and evidence-based practices that yield graduates with clinical reasoning skills to successfully practice in dynamic and challenging environments. Researchers used a mixed-methods research design to identify the most frequently used and valued instructional methods for developing clinical reasoning with entry-level occupational therapy students. Researchers recruited full-time educators teaching in entry-level occupational therapy programs throughout the United States. Ninety-two occupational therapy educators completed the survey for the quantitative portion of the study. Subsequently, six occupational therapy educators participated in an interview for the qualitative portion of the study. Participants most frequently used laboratory experiences and least frequently used rotating chair discussion for developing clinical reasoning. Participants perceived experiential learning as the most valuable and rotating chair discussion as the least valuable instructional method for developing clinical reasoning. The three themes of the educator, the student, and the environment emerged from the qualitative data. Outcomes suggest occupational therapy educators must embrace the role of facilitator and continue to explore a variety of effective instructional methods. In order to achieve this role, occupational therapy educators need to engage in personal and professional development. Researchers provide additional strategies for developing the clinical reasoning skills required for successful occupational therapy practice

Qualitative research is consonant with the espoused values of occupational therapy: A Review of Qualitative Research in Occupational Therapy

In her 2001 edited text, Qualitative Research in Occupational Therapy: Strategies and Experiences, Joanne Valiant Cook presents an approachable and informative introduction to qualitative research for occupational therapists. As the discipline of occupational therapy continues to develop its own base of knowledge, the need for research methods which capture the complexity of occupation has become evident. Through considering the similarity between the founding principles of occupational therapy and the world-view of qualitative research, Cook presents a theoretically-oriented research guide specific to the domain of concern of occupational therapy. Examples of qualitative studies and reflections of occupational therapy researchers will be helpful to occupational therapy practitioners and researchers embarking upon the journey of qualitative inquiry to contribute to the discipline’s body of knowledge

Program to Increase Occupational Therapy Inclusion in Community Mental Health Practice

Occupational therapists are qualified mental health providers, however, inadequate numbers of practitioners work in the community to treat individuals with mental health conditions. A program to advocate for the profession of occupational therapy in community-based mental health was created to increase capacity for occupational therapy practitioners in this setting. A two-hour virtual workshop was implemented to educate participants on occupational therapy\u27s role, the barriers that limit occupational therapy inclusion, and methods to increase occupational therapy inclusion. Results indicate the virtual workshop was effective at increasing an individuals knowledge on the roles, limitations, and opportunities for occupational therapy practitioners in community mental health settings. Future recommendations include providing additional workshops to improve advocacy efforts through increased attendance.https://soar.usa.edu/otdcapstones-spring2022/1024/thumbnail.jp

A Preliminary Historical Report on Embracing Online Education in Occupational Therapy

The relevance and popularity of online occupational therapy education have been increasingly recognized. This paper describes the historical development of online occupational therapy education. Findings revealed three shifts in occupational therapy education, namely shifts in perception, in mode of instruction, and in the roles of teachers and students. The inception of online education in occupational therapy was a product of technological advancement and the demand for improved access to occupational therapy online education. The early phase of occupational therapy online education was confronted with challenges related to hesitance in the development and implementation of online programs and to negative perceptions about online education. The development and implementation of online occupational therapy programs were greatly shaped by factors such as technological tools, methods of teaching delivery, and the dynamics of teaching and learning processes. The potential of online occupational therapy education remains vast, but experts caution that quality should not be compromised

Assessing Unmet Needs of Caregivers after Stroke: Occupational Therapist Practices and Perspectives

Background: Family caregivers of stroke survivors often feel unprepared and overwhelmed post discharge with numerous unmet needs. Occupational therapists can play an integral role in addressing family caregivers’ needs. Limited research exists on assessment practices of occupational therapists in identifying caregivers’ needs poststroke. This study explores the practices and perspectives of occupational therapists in assessing unmet caregivers’ needs. Method: A cross-sectional, mixed methods research design was used to electronically survey 15 occupational therapists. Part 1 of the survey explored participant methods for identifying caregivers’ needs and their views on using formal caregiver assessment tools. Part 2 gathered participant perspectives on three selected caregiver assessments. Descriptive statistics and thematic analysis were used to interpret the data. Results: The participants perceive formal assessments as beneficial. However, they use informal strategies to assess the unmet needs of caregivers rather than formal assessment. Reimbursement challenges, productivity pressure, and questionable necessity are barriers to conducting formal assessments. Advantages and disadvantages of each assessment are discussed. Conclusion: Occupational therapists face barriers to conducting formal assessment across settings. Implementation of recent policies is needed to further support occupational therapy’s role in addressing caregivers’ needs. This study can inform future development of assessment tools tailored to occupational therapy

Occupational Therapy\u27s Role in Mealtime Participation in Schools

A mixed-methods research design was utilized to explore the role of occupational therapy in mealtime participation in school-based settings. Interviews and surveys were completed to understand occupational therapy practicers\u27 perceptions, attitudes, and experiences with providing services related to mealtime. The themes that emerged from the study including (a) occupational therapy practitioners experience inhibiting and supporting contextual factors that affect their involvement in mealtime, (b) admin and occupational therapy culture and the interpretation of educational relevance can differ between each school, and (c) occupational therapy practitioners go through a decision-making process when deciding to address mealtime.https://soar.usa.edu/otdcapstonesspring2023/1007/thumbnail.jp