Implementation of an advanced occupational therapy assistant-led groups programme in aged care rehabilitation

Background/aim: The use of support workers such as occupational therapy assistants is emerging as a strategy to enhance the health workforce, but there has been little evaluation of the feasibility of expanding support worker roles and responsibilities. This study aimed to implement an advanced occupational therapy assistant-led groups programme in a subacute aged care rehabilitation setting and to evaluate the impact on the clinical outcomes of group participants. Method: A prospective quasi-experimental cohort study was conducted comparing outcomes of 30 patients receiving a groups programme led by an advanced occupational therapy assistant with a historical control group of 40 patients receiving the groups programme led by an occupational therapist. The groups programme comprised up to six groups per week and included meal preparation groups and domestic training groups. Outcomes were Functional Independence Measure scores, Australian Therapy Outcome Measures, discharge destination, length of stay and patient satisfaction. Results: Discharge outcomes of patients participating in the assistant-led groups programme were not significantly different to patients who participated in the therapist-led groups programme. Patient satisfaction levels were not significantly different between groups. Conclusion: The introduction of an advanced occupational therapy assistant to replace an occupational therapist in facilitating a groups programme in aged care rehabilitation did not result in a decline in patient outcomes. However, the results should be interpreted tentatively given the study limitations and the advanced skills of the assistant involved. Further more rigorous longer term research with a larger sample is required

sj-docx-1-cjo-10.1177_00084174221142184 - Supplemental material for The Multiple Errands Test: A Guide for Site-Specific Version Development

Supplemental material, sj-docx-1-cjo-10.1177_00084174221142184 for The Multiple Errands Test: A Guide for Site-Specific Version Development by Shannon M. Scarff, Emily J. Nalder, Hannah L. Gullo and Jennifer Fleming in Canadian Journal of Occupational Therapy</p

sj-docx-2-cjo-10.1177_00084174221142184 - Supplemental material for The Multiple Errands Test: A Guide for Site-Specific Version Development

Supplemental material, sj-docx-2-cjo-10.1177_00084174221142184 for The Multiple Errands Test: A Guide for Site-Specific Version Development by Shannon M. Scarff, Emily J. Nalder, Hannah L. Gullo and Jennifer Fleming in Canadian Journal of Occupational Therapy</p

A scoping review of resilience among transition-age youth with serious mental illness: tensions, knowledge gaps, and future directions

Abstract Introduction The study of resilience among transition-age youth (aged 16–29 years) living with serious mental illness (SMI) has provided a promising new direction for research with the capacity to explore individuals’ strengths and resources. However, variability in how resilience is defined and measured has led to a lack of conceptual clarity. A comprehensive synthesis is needed to understand current trends and gaps in resilience research among this population. The purpose of the current study was to map how resilience has been conceptualized and operationalized among transition-age youth with SMI, explore resilience factors and outcomes that have been studied, and recommend areas for future research. Methods A six-stage scoping review methodology was used to systematically identify relevant empirical literature across multiple databases (MEDLINE, EMBASE, PsycINFO, AMED, CINAHL, Scopus), addressing transition-age youth diagnosed with SMI and resilience. Topic consultation and reaction meetings were conducted to gather feedback from transition-age youth with SMI, researchers, and clinicians during the review process to enhance the applicability of the review findings. A meta-narrative approach was used to organize included studies into research traditions (i.e., paradigms of inquiry with similar storylines, theoretical and methodological orientations). Resilience factors and outcomes, and the consultative meetings, were analyzed using content analysis. Results Twenty-four studies met inclusion criteria (14 quantitative, 9 qualitative, 1 mixed-method). Four research traditions were identified, each contributing a unique storyline which conceptualized and operationalized resilience in slightly different ways: Stress Adaptation, Person-Environment Interactions, Recovery-Focused, and Critical and Cultural Perspectives. Resilience factors and outcomes were most commonly evaluated at the individual-level or within the immediate environment (e.g., personal characteristics, social support networks). Limited research has explored the influence of macro-level systems and health inequalities on resilience processes. Results from the consultative meetings further demonstrated the importance of health services and sociocultural factors in shaping processes of resilience among youth. Conclusion The present results may be used to inform future work, as well as the development of age-appropriate, strengths-based, and resilience-oriented approaches to service delivery. Interdisciplinary and intersectional research that prioritizes community and youth engagement is needed to advance current understandings of resilience among transition-age youth with SMI

A scoping review to characterize bridging tasks in the literature on aging with disability

Abstract Background Bridging involves improving knowledge sharing and collaboration across different fields, such as aging and disability. The objectives of this review were to describe: 1) the contexts where bridging has occurred in relation to delivery of health services for adults aging with neurological or developmental conditions; and 2) characterize and map bridging tasks, stakeholders involved, and outcomes discussed in peer-reviewed literature. Methods Seven databases were searched around the core concepts of “bridging,” “aging,” and “disability.” In total, 10,819 articles were screened with 49 meeting the inclusion criteria of discussing aging with developmental or neurological disability, explicitly describing bridging tasks, published in English and a peer-reviewed publication. Bibliographic information, sample characteristics, and data on bridging was extracted and included in the qualitative synthesis. Results Intellectual and/or Developmental disabilities were the most studied population (76% of articles), and most articles were published in the United States (57%). Twenty-two bridging tasks were identified, and categorized into three domains: health and social service delivery (e.g., care coordination tasks), policy (e.g., policy change), and research and training (e.g., mentoring). Stakeholders involved ranged from health care professionals to policy makers and organizations in aging and disability services. Conclusions The resulting matrix will assist in the specification of bridging in research and practice. Future work should evaluate specific models of bridging and their effects on health service delivery

Reflections on life: Experiences of individuals with brain injury during the transition from hospital to home

Background: The transition from hospital to home has been described as a distinct rehabilitation phase for individuals with brain injury. As most research to date has quantitatively measured outcomes or used a sample with mixed brain injury diagnoses, less is known about the experience of transition following traumatic brain injury (TBI). Aims: This study aimed to examine the lived experiences of individuals with TBI during the first 6 months following discharge from hospital. Design: A qualitative investigation was conducted with 16 individuals with TBI using semi-structured interviews. Data analysis: Data were analysed thematically using a Framework approach. Results: Transition experiences were characterized by a desire to return to normality and a changed perspective on life, by accepting change or altering priorities. The process of transition was dynamic as individuals experienced the dominant themes in cyclical patterns. Conclusions: Research has highlighted the significant adjustment for individuals with TBI, particularly in relation to identity change, appraisal and coping. The themes of wanting normality and changing life perspective which were dominant in the current study highlight the significance of the transition phase in the process of adjustment and that transition is characterized by adapting to a new normality

Listening in combat - surveillance technologies beyond the visual in the First World War

The arts of combat have long motivated humans to extend the range of, and refine the capacities of, their senses. For centuries, innovations from both military and civilian origins have extended and enhanced those capacities in ever-escalating strategic efforts to secure crucial intelligence both to win battles and win new markets. Much is known about the visual technologies that co-evolved between civilian and military usage: the telescope in the seventeenth century, the observation balloon in the eighteenth century, and the submarine periscope in nineteenth century, extended to trench usage in the First World War. We focus here on the sense of hearing, its technological enhancements, and its interplay with other senses, thereby to explore the sensory interplay of vision and sound in extreme human combat situations. We argue that, both for those at the battle front and those remote from it, the significance of this increased significant of hearing in the early twentieth century cannot be understood without reference to the combat experiences and technological initiatives of the First World War. Our core claim is that the rise of listening cultures of various forms during and after the First World War owed much to the changing technologies, strategies and behaviors, cultivated in the context of military endeavors