Community-Based Occupational Therapy Practice Among Older Adults: A Delphi Study

This capstone project explores the socio-political environment of current and potential community-based occupational therapy (OT) services among community-dwelling older adults, including the current state of community-based OT practice and the current awareness of OT’s potential impact on health and wellness among community-dwelling older adults. The goal is to identify how to increase the presence of OT in community settings to decrease the occupational injustice among the older adult population. The research method used is the Delphi Method, an anonymous structured communication between experts in the field of community-based OT practice and the older adult population. Experts, provided real-world knowledge and guidance to: 1. identify indicators that inhibit the presence of OT in community-based practice for the older adult, 2. identify if OT is a potential service within the community to improve health, wellness, and quality of life (QOL) for the prevention of disease among older adults, and 3. forecast how an increased presence of OT in community settings can decrease occupational injustice among the older adult population. Community-based OT practice was identified as a valuable service among older adults. Recommendations were established on how to increase community-based OT practice among older adults. Limitations were identified as to why OT is rare in community practice. A body of evidence, including this research, supports the need to address the OT profession’s theoretical, philosophical and practical perspective on community-based OT practice among older adults

Occupational Therapy in Youth Violence: An Occupation-Based Program for At-Risk Youth

Throughout the years, youth participating in violence has become an increased concern around the nation as there is an increase in media outlets displaying tragedies, such as mass school shootings caused by students. The at-risk youth population is a specific population disadvantaged in engaging in safe and health-promoting activities due to limited resources or opportunities. As a result, at-risk youth make decisions based on their disadvantaged environment (Farajzadegan et al., 2018; Gallagher et al., 2015a). Factors including socioeconomic status, social support from family or friends, and mental health impact an individual’s opinions, attitudes, and interests as well as their occupational choices. When one or more of these factors are lacking, it may hinder both social participation and self-regulation skills. Poor social participation and self-regulation skills impair initiating and maintaining positive relationships and the ability to cope and adapt to the social environment. When constantly faced with traumatic or significant life challenges, at-risk youth are more likely to have lower self-efficacy or beliefs in their capabilities (Burger & Samuel, 2017). Occupational therapists can further develop social participation and self-regulation skills. However, they are underutilized on intervention teams for the at-risk youth population despite their trained background in mental health. Therefore, the purpose of this capstone project was to implement an occupation-based program to improve social participation and self-regulation skills in at-risk youth to prevent youth violence and decrease maladaptive behaviors.https://soar.usa.edu/otdcapstonesspring2021/1014/thumbnail.jp

Implementing Trauma-Informed Care Across All Occupational Therapy Settings

A quantitative research design was utilized to analyze the effectiveness of an educational seminar on trauma- informed disseminated to occupational therapy practitioners, determining their previous knowledge on trauma-informed care. The research conducted has provided a more comprehensive understanding of this population and where services are needed. There is still much work to be done with this topic and the cultural shift towards providing trauma sensitive resources to occupational therapy practitioners. The future of trauma-informed care being incorporated into occupational therapy practice settings is up to the motivation and heart of future occupational therapists in hopes to strengthen the resources offered to those battling psychological trauma everyday. Our hope now and forever is to leave individuals better than we found them, with the promise to continue research and application.https://soar.usa.edu/otdcapstonesfall2023/1006/thumbnail.jp

Analysis of Role Changes for Women with Breast Cancer Related Lymphedema to Return to Work

Breast Cancer survivors diagnosed with secondary lymphedema have decreased quality of life and experience greater challenges when attempting to return to work compared to survivors who do not have secondary lymphedema. Limited research is available in understanding the impact breast cancer-related lymphedema has on survivors transitioning from traditional medical care to return to work. Occupational therapists specializing in Lymphedema therapy have the unique training skills and knowledge to address the challenges this population faces, as well as the tools needed to educate patients and their family members on how to manage returning to work, and make any adaptations to their work environment in order to achieve overall satisfaction and quality of life. A quantitative study was done to identify the impact BCRL has had on the role changes survivors with secondary lymphedema experience, as well as satisfaction with work. Results collected from the study were indicative of decreased overall satisfaction with return to work secondary to diagnosis, significant role changes with decreased independence and difficulties from employers, as well as little to no therapeutic services addressing return to work during this survivorship phase. Future recommendations include developing a program addressing return to work and successful techniques manage lymphedema symptoms of the affected limb within the work environment.https://soar.usa.edu/otdcapstones-spring2022/1042/thumbnail.jp

Occupational Therapist Perception and Utilization of Occupation-Based Evaluation and Assessment with Children and Youth with ASD.

Children with ASD participate less in ADLs & IADLs than typically developing children(Travers et al.,2022). The problem is a gap between the known occupation-based assessments and utilization of the assessments by occupational therapists treating children and youth with ASD (Manee et al., 2020; Luna, 2019). This gap results in decreased activity participation diversity for the child and decreased ability for the occupational therapists to evidence effectiveness of occupation-based services (Manee et al., 2020; Luna, 2019). The purpose of this quantitative type of capstone project is to analyze occupational therapists who treat children and youth with ASD to determine the utilization frequency of occupation-based assessments in home, school, and community contexts. The findings of this quantitative research study were that there was no relationship between the years of experience and the use of OB Assessment tools or performance skills assessment tools and OTs are experiencing barriers at a high frequency. Findings also include that there is a lack of knowledge and unawareness on OB assessment tools. The future implications are to further understand why the knowledge of occupation-based assessments so limited to occupational therapy practitioners and why aren’t rehab managers and occupational therapy leaders ensuring the availability of a wide range of suitable assessment tools in their settings.https://soar.usa.edu/otdcapstonesspring2023/1044/thumbnail.jp

Exploring The Role of Occupational Therapy in Long-Term Telerehabilitation for Stroke Survivors

Strokes are the second leading cause of death and leading cause of long-term disability worldwide and incidence is on the rise (Katan & Luft, 2018). In the past 25 years, the burden of disability from neurological disorders, including strokes, have increased exponentially due to the increase in the aging population and decrease in mortality rates (Raghavan, 2019). Out of the 795,000 new victims of stroke annually, 26% remain disabled during activities of daily living (ADLs) and 50% experience a reduction in mobility due to hemiparesis (Katan & Luft, 2018). Although stroke survivors do receive rehabilitation services after the onset of the stroke, few receive the full course of proper rehabilitation to regain prior level of function and enhance quality of life (Lynch, et al, 2017). This is a result of the inequality of access to rehabilitation after a stroke, which is not only a problem in the United States but internationally as well (Lynch, et al., 2017). Telerehabilitation is a form of technology that can be used to create a safe rehabilitation environment from the comfort of one’s home in addition to being cost-effective (Chen, et al., 2016). Telerehabilitation is a tool that occupational therapists can utilize to promote access to necessary rehabilitation services long-term. This emerging approach can enhance the continuity of care once patients are discharged from rehabilitation by ensuring that they continue to improve their recovery beyond what is available currently (Kairy, et al., 2016). The purpose of this quantitative research project is to analyze stroke survivor’s perception regarding participating occupational therapy services via telehealth to improve their long-term recovery. Through survey methods, this project aims to identify how long-term participation in telerehabilitation improves stroke survivor’s participation in meaningful activities.https://soar.usa.edu/otdcapstonesspring2021/1016/thumbnail.jp

Qualitative Exploration of the Perception and Satisfaction of Occupational Engagement and Level of Awareness of Treatment options for Parous Women with Pelvic Floor Dysfunction.

This poster looks to provide an overview of the results of the capstone project looking to fill a gap in the literature regarding the impact that pelvic floor dysfunction has on the occupational engagement of parous women, and their knowledge of occupational therapy treatment options for pelvic floor dysfunction (Burkhart et al, 2021). Data collection occurred over 2 weeks and the inclusion criteria for this study consisted of parous (having beard children) women, ages 18 to 65, and having at least 1 symptom of pelvic floor dysfunction (i.e., urinary problem, bowel problem, or pelvic organ prolapse). The research questions were, what are common problem areas in occupational performance for parous women diagnosed with pelvic floor dysfunction? How do parous women diagnosed with pelvic floor dysfunction rate their satisfaction related to problem areas in occupational performance? Lastly, what awareness do parous women with pelvic floor dysfunction have of treatment options available to them? Although all areas presented to be problems areas for the participants of this study, the most common problem areas were functional mobility, active recreation, and self-care. The average satisfaction of each occupation was less than a 5.5 out of 10. 84.6% of participants state that they were not at all aware that occupational therapists treat pelvic floor concerns. At least 61.5% of participants rated themselves as not having any knowledge of treatment options concerning their pelvic floor symptoms based on the 1-10-point Likert scale interview.https://soar.usa.edu/otdcapstones-spring2022/1028/thumbnail.jp

Analysis of Firefighters’ Psychological Trauma and Interrupted Domains

Firefighters are at a high risk of experiencing posttraumatic stress, anxiety, depression (Teoh et al., 2019), suicidality, substance abuse (Bing-Canar et al., 2019), and burnout (Teoh et al., 2019). Firefighters are regularly exposed to traumatic events on calls which results in their decreased mental health; and associated decreased participation in meaningful occupations, routines, and roles (Edgelow & Cramm, 2020; Edgelow et al., 2021; Wittwer et al., 2021). This project contains both research and a program. The purpose of this research was to understand how firefighter demographics interact with interrupted occupations, routines, and roles and at what frequency when faced with work-related psychological trauma and stress (Edgelow et al., 2021; Gulliver et al., 2021; Pennington et al., 2022). There were relationships between the years of firefighter experience as well as marital status with participation in occupations, routine changes, and role identification. The next step for research is to further study demographic interactions with stress and functional impairment and with more nuance in a qualitative, mixed methods, and longitudinal study. The purpose of this program was to educate firefighters on ways to re-engage in interrupted occupations, routines, and roles to reduce the negative effects of work-related psychological trauma (Edgelow & Cramm, 2020; Torchalla et al., 2019). Participants found the workshop interesting, useful, and informative, especially the mental health statistics for firefighters. Future implications for this program are to implement it at every level of the career, deliver education to loved ones, and advocate to administration, unions, and local council members.https://soar.usa.edu/otdcapstonesspring2023/1040/thumbnail.jp

Analysis of Firefighters’ Psychological Trauma and Interrupted Domains

Firefighters are at a high risk of experiencing posttraumatic stress, anxiety, depression (Teoh et al., 2019), suicidality, substance abuse (Bing-Canar et al., 2019), and burnout (Teoh et al., 2019). Firefighters are regularly exposed to traumatic events on calls which results in their decreased mental health; and associated decreased participation in meaningful occupations, routines, and roles (Edgelow & Cramm, 2020; Edgelow et al., 2021; Wittwer et al., 2021). This project contains both research and a program. The purpose of this research was to understand how firefighter demographics interact with interrupted occupations, routines, and roles and at what frequency when faced with work-related psychological trauma and stress (Edgelow et al., 2021; Gulliver et al., 2021; Pennington et al., 2022). There were relationships between the years of firefighter experience as well as marital status with participation in occupations, routine changes, and role identification. The next step for research is to further study demographic interactions with stress and functional impairment and with more nuance in a qualitative, mixed methods, and longitudinal study. The purpose of this program was to educate firefighters on ways to re-engage in interrupted occupations, routines, and roles to reduce the negative effects of work-related psychological trauma (Edgelow & Cramm, 2020; Torchalla et al., 2019). Participants found the workshop interesting, useful, and informative, especially the mental health statistics for firefighters. Future implications for this program are to implement it at every level of the career, deliver education to loved ones, and advocate to administration, unions, and local council members

Culture Change for Occupational Therapists on Safe Patient Handling and Mobility (SPHM): Advocacy for SPHM Policies for a National Organization.

Safe patient handling and mobility is an ergonomic approach consisting of policies, programs, and equipment to reduce WMSD and facilitate a culture of safety among patients and healthcare practitioners. Due to occupational therapy’s established role in ergonomics, practitioners are skilled to utilize SPHM to provide evaluative, consultative, preventative, and therapeutic services to patients while preventing WMSDs to healthcare practitioners. Despite OT’s contributions to SPHM, occupational therapy practitioners are not recognized as leaders in SPHM. To address this problem, in the Spring 2021 meeting, the AOTA Representative Assembly was presented a request for action by a taskforce that also recognized this problem. They moved that a position statement a be written and made available for members and external audiences. A position statement was created to present the current position of a national organization, AOTA, on occupation therapy’s role in SPHM. In this statement SPHM is defined, and the components of SPHM are presented. SPHM on an individual, group, and organizational level will be applied to occupational therapy. The current state and national legislation of SPHM was discussed. As well as a look into inclusion of SPHM into the curriculum, and implications for occupational therapy.https://soar.usa.edu/otdcapstonesfall2021/1028/thumbnail.jp