Occupational Therapists’ Perspectives on Caregiver Education of Stroke Survivors

Introduction: The objective of this research study was to gather a greater understanding of how occupational therapists provide education to caregivers of stroke survivors and how they address the needs of caregivers throughout the rehabilitation process. Methods: The researchers used a convergent mixed methods design. RedCap electronic surveys containing both open-ended and closed-ended questions were completed by 90 participants from multiple states. A focus group (n = 8) and a one-on-one interview (n = 1) were conducted to gather qualitative information regarding occupational therapists’ perspectives related to their experiences on educating caregivers in the acute rehabilitation setting. Descriptive statistics were used to analyze quantitative survey data. The focus group and the one-on-one interview were recorded and transcribed verbatim. Qualitative data were thematically analyzed. Interviews were coded individually and re-coded until consensus was reached. The results across data were compared to identify themes. Rigor was enhanced through the use of multiple coders, member checking, expert review, and triangulation of the results. Results: The survey results (n = 90) revealed the occupational therapists’ top five topics for caregiver education for stroke survivors: toileting (94.4%); dressing (94.4%); bathing (94.4%); functional mobility (91.1%); and hygiene/grooming (75.6%). Yet, 22% of the occupational therapists surveyed indicated they provided education only during the week of discharge, and 37.8% specified they only spent 15 min of education during an intervention. Five themes emerged from the qualitative data: (a) caregivers and stroke survivors have different needs, (b) occupational therapists must hurdle a variety of barriers when providing education, (c) access to various supports at the workplace is beneficial when providing caregiver education, (d) occupational therapists use a variety of methods to administer caregiver education, and (e) occupational therapists tend to prioritize ADL tasks during education. Conclusion: Clients and caregivers have a plethora of educational needs related to enhancing safety and independence with daily occupations prior to discharge from inpatient rehabilitation. Occupational therapists play a vital role in educating the caregiver as a means to enhance an individual’s quality of life and in easing the transition into the home environment after inpatient rehabilitation. The findings from this study highlight the common methods used for education by occupational therapists, as well as the challenges faced when providing caregiver education

Caregivers of Stroke Survivors: Exploring the Role of Spousal Caregivers through an Occupational Therapy Lens

The purpose of this qualitative study was to explore the occupational needs of caregivers of stroke survivors and to identify potential implications for occupational therapy’s role with this population. Methods: Focus groups and a semi-structured interview were used to gather an in-depth perspective on caregivers’ needs and level of participation in valued activities. Interactions were recorded and transcribed verbatim. Data analysis included open coding, formulation of categorical patterns, and thematic analysis. Rigor was enhanced through peer review, multiple coders, member checking, and triangulation. Results: Four primary themes emerged: (1) the essential need for additional services and support; (2) the amount of time spent on addressing spouses’ needs resulted in occupational loss; (3) finding new ways to participate in daily life activities; and, (4) an association between the survivor’s level of impairment and the caregiver’s quality of life. Conclusion: Demands of caregiving can lead to changes in roles, responsibilities, and routines. OT practitioners are uniquely qualified to reinstate valued occupations into daily life, formulate balanced routines, and provide client specific supports and resources. OT services could provide strategies to enhance caregivers’ ability to partake in meaningful occupations and resume a balanced lifestyle. More research is needed to determine the occupational needs of caregivers and the effectiveness of caregiver interventions

OT Practitioners’ and OT Students’ Perceptions of Entry-Level Competency for Occupational Therapy Practice

This study examined occupational therapy (OT) practitioners’ and OT students’ perceptions of the importance of 12 specific OT-related entry-level competency skills and the number of weeks required to consistently demonstrate skills for entry-level competency. The results indicated that, on average, practitioners (n = 39) and students (n = 38) agreed that all of the items were important. However, the students had significantly higher ratings regarding the importance of communication, occupation and client-centered goals, time management, interventions, and use of theory and evidence. They also rated a higher number of minimum weeks required to consistently demonstrate entry-level competency. The students who rated use of theory and evidence higher also rated a greater number of weeks to consistently demonstrate entry-level competency (Pearson r = .38; p= .02). The practitioners who rated psychosocial factors higher also rated a greater number of weeks to consistently demonstrate entry-level competency (Pearson r = .33, p = .04). These findings support the need for further research on defining entry-level competence and highlight the importance of communication between OT practitioners, students, and academic fieldwork coordinators to clarify which competencies are perceived as most important and the expectations regarding how long it takes for students to demonstrate them consistently

A Qualitative Study Investigating Stroke Survivors’ Perceptions of their Psychosocial Needs Being Met During Rehabilitation

Background: Depression and anxiety can negatively impact one’s recovery, outcomes, and quality of life. Even though therapists consider the mental health needs of their clients to be a priority, they are dissatisfied with their ability to completely address these needs. The purpose of this study was to examine the client’s perspective regarding the extent to which health care professionals addressed their psychosocial needs after a stroke. Method: A phenomenological research design was used to collect data from six participants. Interviews and focus group were audiotaped, transcribed verbatim, and thematically analyzed. Member checks, peer-review, multiple coders, triangulation, and expert examination were used to increase trustworthiness of findings. Results: Five themes emerged. People with strokes: (a) experience an array of emotions, (b) are not likely to initiate disclosure of their state of mental health, (c) feel their psychosocial needs are not being addressed by health care professionals, (d) grieve the loss of prior roles post stroke and work hard to establish a new normal routine and purpose in life, and (e) have suggestions for improved care. Conclusion: These findings reinforce the importance of addressing the mental health needs of individuals post stroke and the importance of identifying methods to enhance the ability to effectively address the psychosocial needs of clients post stroke

Evaluating Communication and Collaboration Among Healthcare Students

The purpose of this pilot study was to determine if the Interprofessional Collaborator Assessment Rubric (ICAR): Communication and Collaboration Dimensions would demonstrate good inter-rater reliability and be a useful and efficient tool to evaluate professional communication and collaboration between occupational therapy (OT) and physician assistant (PA) students. An additional aim of this study was to assess students’ thoughts, perceptions, and perceived value regarding these types of interprofessional opportunities. A sequential explanatory mixed methods design was used. An interclass correlation coefficient (ICC) examined the inter-rater reliability of the instrument for both faculty raters (n = 7) and standardized patient (SP) raters (n =5). Qualitative data was gathered from focus groups to assess the utility of the ICAR: Communication and Collaboration. Quantitative and qualitative data were also gathered from a convenience sample of student participants (n =19) to investigate the perceived value of this interprofessional experience. Quantitative data revealed that there was moderate inter-rater reliability for four out of five of the subscales. Three themes emerged from the rater and student focus groups. Students found the interprofessional education (IPE) opportunity to be valuable. They also felt that it enhanced their understanding of the OT/PA profession, as well as their comfort and ability to collaborate and communicate with other professionals. The results of this study suggest that the ICAR: Communication and Collaboration Dimensions has the potential to maintain inter-rater reliability among healthcare students. The results of this study also indicate that healthcare students view IPE events as being highly valuable and beneficial

Effectiveness of an Interprofessional Education Event for Graduate Health Professional Students

ABSTRACT Purpose: The purpose of this study was to investigate the impact of a single, optional, half-day, interprofessional education (IPE) event for a myriad of graduate-level health professional students (n=44) at a university in Illinois, USA. Methods: The researchers in this study examined students’ performance on two out of six of the domains on the Interprofessiomnal Collaborator Assessment Rubric (ICAR): Roles and Responsibilities and Communication Strategies. This study also investigated quantitative and qualitative findings related to student perceptions regarding this IPE opportunity. Results: Results indicated that students met or exceeded the minimum competency for the ranking of “developing” for all 6 of the behaviors evaluated. Results also revealed that this half-day extracurricuricular IPE event was viewed favorably by health-professional students and created a venue whereby students belonging to different health professional programs can enter into discussions and learn about each others’ respective roles and responsibilities in patient care. Conclusion: The creation and implementation of short term extracurricular IPE events may be a valuable alternative for healthcare programs that are unable to implement IPE activities due to some of the common barriers impacting the development, implementation, or continuation of IPE opportunities

The Impact of an Interprofessional Geriatric Training Experience: Attitudes of Future Healthcare Providers

As the older adult population increases, it is vital to educate and train healthcare providers as members of interprofessional healthcare teams who can work effectively with these individuals. Ageism is a potential obstacle to achieving this goal. The purpose of this pre/post-test design pilot study was to determine the impact of an interprofessional geriatric training experience on the attitudes of future healthcare providers towards interprofessionalism and working with older adults. Sixteen graduate level students from occupational therapy and clinical psychology programs completed four interprofessional sessions with older adults residing in a long-term care facility. Quantitative data were gathered from pre/post-test scores on three instruments: (1) Self-Perceptions and Older Adults Questionnaire; (2) A Refined Version of Aging Semantic Differential; and (3) Readiness for Interprofessional Learning Scale. Results of paired sample t tests indicated that participants described older adults significantly more positively and their perceptions about working with older adults became significantly more positive following the interprofessional geriatric training experience. Additional data were gathered regarding participants’ perceptions of the interprofessional training experiences at the conclusion of the study. This feedback regarding students’ perceptions of the interprofessional geriatric training experiences indicated that the majority of the participants found the experiences with the older adults to be valuable and that the interprofessional learning activities helped them better understand the older adults. The results of this pilot study suggest that even short-term interprofessional experiences may have the ability to positively influence the attitudes of future healthcare providers regarding older adults

Life Review Study: An Opportunity to Increase Quality of Life and Personal Meaning for Older Community-Dwelling Adults

The purpose of this study was to examine the effects of a life review intervention on older adults’ self-perceived ratings of quality of life, depression, and mastery. A sequential explanatory mixed-methods design was used. Quantitative data was gathered via a pre-posttest design. Qualitative data was gathered regarding participants’ perceived value of the life review program. A Wilcoxon signed rank sum test indicated that one item on the WHO-QOL BREF (modified) had a significant change, indicating fewer negative feelings after the life review intervention. Six themes emerged from the qualitative data: (1) Nostalgia; (2) Reflection; (3) Appreciation; (4) Proliferation of additional memories; (5) Sharing in similar experiences with others; and (6) Gratefulness. Results indicated that participation in a five-week, home-based, life-review intervention program has the potential to improve self-perceived quality of life and sense of personal mastery for older adults sheltering at home during the COVID-19 pandemic.</p

A Pilot Interdisciplinary Falls Screening and Educational Event: Perceptions of Community-Dwelling Older Adults

Introduction: Falls are the leading cause of death and disability among people 65 years of age and older. Likewise, falls have psychological consequences which often lead to avoidance of activities, fear of falling, and further disabilities. Even though the impact of falls on one’s daily life and independence are substantial, evidence suggests that falls can be prevented by multi-factorial assessments and client-specific interventions. Objective: The purpose of this study was to determine (a) perceived knowledge of falls, (b) reported confidence in fall prevention, (c) perceived likelihood of implementing falls screening recommendations, (d) reported fear of falling, and (e) perceived value and satisfaction among community-dwelling older adults who attended an interdisciplinary falls screening and education event. Methods: An interdisciplinary group of professionals from behavioral sciences, family medicine, occupational therapy, optometry, pharmacy, and physical therapy screened 33 community dwelling older adult participants (66-84 years of age) using multi-factorial assessments and discipline-specific screening tools. Individualized recommendations were provided to each participant in verbal and written formats. Participants then completed a questionnaire at the conclusion of the event regarding their perceptions of knowledge gained about falls, confidence in preventing falls, perceived likelihood of implementing fall screening recommendations, fear of falling, and overall feedback regarding the event. Results: The majority of the participants indicated increased perceived knowledge of falls, confidence in preventing falls, and perceived high likelihood of implementing recommendations, along with decreased fear of falling. The majority of the participants also found the event to be valuable (85%), enjoyable (94%), and easy to understand (100%). Conclusion: The results of this study suggest that participants found this falls screening event to be valuable and improved their knowledge regarding falls, as well as their confidence in being able to prevent falls. This study highlights the potential value of an interdisciplinary team approach to increase knowledge, enhance prevention, and decrease fear of falling in community dwelling older adults

Preparing Occupational Therapy Students for the Complexities of Clinical Practice

This paper examined the effect of a unique amalgam of adult learning methodologies near the end of the occupational therapy (OT) students’ didactic education as a means to enhance readiness for clinical practice. Results of quantitative and qualitative data analysis indicated that the use of standardized patients, in combination with a sequential, semistructured, and progressively challenging series of client cases, in an OT adult practice (intervention) course, improved the students’ self-perception of their level of comfort and skill on various foundational, yet essential, OT-related competencies