Internalizing Client-Centredness in Occupational Therapy Students

Background: Pre-licensure interprofessional education prepares students for collaborative client-centred practice. However, most interprofessional educational efforts are aimed at developing the collaborative component of practice. The purpose of this article is to share the findings of a study that explored occupational therapy students’ client-centred development, in order to inform other pre-licensure educators about integrating client-centredness into uni- and interprofessional education contexts.Methods and Findings: Twenty-nine participants were recruited from each of three stages assumed to be representative of occupational therapy client-centred development in each of the two years of the educational program and during the first year of practice. Semi-structured focus groups were used to capture the participants’ experiences. The core emergent theme, internalizing client-centredness, included three main processes: identifying occupational therapy as a client-centred profession, engaging in the push and pull of client-centredness, and defining self as a client-centred practitioner.Conclusions: Educators of pre-licensure health care students should deliberately focus on client-centredness in their uni- and interprofessional education curricula; the authors offer examples of curricular opportunities focused on internalizing client-centredness. Enabling health care students to internalize client-centredness may be an important aspect of developing practitioners who are prepared to enact interprofessional collaboration for client-centred practice

The experience of the self in Canadian youth living with anxiety: A qualitative study

This work is licensed under a Creative Commons Attribution 4.0 International License.Background Anxiety can create serious disruption in the life and mind of youth who are affected. Youth living with anxiety suffer a wealth of physical and psychological challenges, yet little is known about how anxiety influences the sense of the self. The purpose of this research was to explore the experience of the self in a sample of Canadian youth living with anxiety. Materials and methods The qualitative research approach of hermeneutic phenomenology was used. The sample consisted of 58 Canadian youth with anxiety, 44 females and 14 males between the ages of 10 and 22. Youth took part in open-ended interviewing, ecomaps, and photovoice. Data analysis followed a staged process, informed by Max van Manen. All sources of data were included in the analysis to form thematic statements. Results Entering into the lifeworld of youth revealed that they suffered deeply. A fractured sense of self underlined their experience, setting up for a great deal of self-scrutiny and a lack of self-compassion. They experienced a profound sense of responsibility for others at the loss of being-there-for-oneself. Navigating their social sphere presented an additional challenge. However, youth were genuinely interested in self-discovery through awareness and reflection. Conclusions The phenomenological accounts by youth on living with anxiety reinforce the challenges they experienced within themselves that give rise to a great deal of inner turmoil. Care and support to youth with anxiety requires an understanding of the ways in which the self may be fractured by their experiences with anxiety. Providing young people with an opportunity to share with others who had similar lived experiences can serve to contribute to a sense of healing for youth, while also providing a safe space in which young people can let down their guard and openly acknowledge or share their experiences without fear of stigmatization

Differences in Pre-licensure Interprofessional Learning: Classroom Versus Practice Settings

AbstractBackground: Health Canada and Cochrane reviews indicate a need for rigorous outcome testing following interprofessional learning, particularly in practice settings. This led to research questioning whether knowledge, attitudes, perceptions, values, and skills regarding collaborative patient care improve after interprofessional learning in classroom and practice settings based on the degree of exposure to interprofessional learning compared to a control group.Methods and Findings: Pre-licensure students from seven health-profession programs were assigned to three groups: Control (no intervention), Education (classroom-based interprofessional learning), and Full-Participant (classroom-based and practice-based interprofessional learning). They were later surveyed to assess outcomes. Immersion at an interprofessional practice setting had a greater impact on scores than classroom-based interprofessional education. Both interventions significantly improved attitudes, perceptions, knowledge, and skills related to interprofessional collaboration. Only immersion improved the perceived importance of sharing leadership. Changes after the education intervention persisted at five-month follow-up.Conclusions: Interprofessional learning in classroom and practice settings positively impacted participants' knowledge, attitudes, perceptions and values, and skills regarding interprofessional teamwork. Use of a longitudinal study with a control group provided evidence that pre-licensure interprofessional learning would increase awareness of the need to collaborate. Findings encourage longerterm study of how interprofessional learning in various settings could improve how future practitioners approach patient care

Effect of a low fat versus a low carbohydrate weight loss dietary intervention on biomarkers of long term survival in breast cancer patients ('CHOICE'): study protocol

<p>Abstract</p> <p>Background</p> <p>Weight loss in overweight or obese breast cancer patients is associated with an improved prognosis for long term survival. However, it is not clear whether the macronutrient composition of the chosen weight loss dietary plan imparts further prognostic benefit. A study protocol is presented for a dietary intervention to investigate the effects of weight loss dietary patterns that vary markedly in fat and carbohydrate contents on biomarkers of exposure to metabolic processes that may promote tumorigenesis and that are predictive of long term survival. The study will also determine how much weight must be lost for biomarkers to change in a favorable direction.</p> <p>Methods/Design</p> <p>Approximately 370 overweight or obese postmenopausal breast cancer survivors (body mass index: 25.0 to 34.9 kg/m²) will be accrued and assigned to one of two weight loss intervention programs or a non-intervention control group. The dietary intervention is implemented in a free living population to test the two extremes of popular weight loss dietary patterns: a high carbohydrate, low fat diet versus a low carbohydrate, high fat diet. The effects of these dietary patterns on biomarkers for glucose homeostasis, chronic inflammation, cellular oxidation, and steroid sex hormone metabolism will be measured. Participants will attend 3 screening and dietary education visits, and 7 monthly one-on-one dietary counseling and clinical data measurement visits in addition to 5 group visits in the intervention arms. Participants in the control arm will attend two clinical data measurement visits at baseline and 6 months. The primary outcome is high sensitivity C-reactive protein. Secondary outcomes include interleukin-6, tumor necrosis factor-α, insulin-like growth factor-1 (IGF), IGF binding protein-3, 8-isoprostane-F2-alpha, estrone, estradiol, progesterone, sex hormone binding globulin, adiponectin, and leptin.</p> <p>Discussion</p> <p>While clinical data indicate that excess weight for height is associated with poor prognosis for long term survival, little attention is paid to weight control in the clinical management of breast cancer. This study will provide information that can be used to answer important patient questions about the effects of dietary pattern and magnitude of weight loss on long term survival following breast cancer treatment.</p> <p>Clinical Trial Registration</p> <p>CA125243</p

Une perspective socio-écologique sur l’anxiété chez les étudiants universitaires canadiens

Little is known about how factors related to the post-secondary academic setting impact Canadian students’ self-reported anxiety. Using a socio-ecological framework, we examined lifetime prevalence and correlates of self-reported student anxiety. Data were collected from 593 university students (422 of whom were undergraduates) from a university in central Canada through an online survey. Descriptive statistics and a series of regression models were used to examine the study’s objectives. Most students reported having experienced anxiety that had impacted their lives. Findings provide support for a socio-ecological explanation of anxiety: socio-demographic, relationship, and academic factors predicted self-reported student anxiety. The results highlight the need to ensure that campus services and supports are well equipped to address the mental health problems of students. Theoretical, practice, and research implications are noted.On sait peu de choses sur la façon dont les facteurs liés au milieu de l’éducation postsecondaire influencent le degré d’anxiété rapporté par les étudiants canadiens. Grâce à un cadre socio-écologique, nous avons examiné leur prévalence au cours de la vie et leurs corrélations avec l’anxiété rapportée par les étudiants. Les données furent recueillies par un sondage en ligne auprès de 593 étudiantes et étudiants universitaires (dont 422 de premier cycle) fréquentant une université du centre du Canada. Pour examiner les objectifs de l’étude, on a eu recours à des statistiques descriptives et à une série de modèles de régression. La plupart des étudiantes et étudiants ont rapporté avoir vécu une anxiété qui a eu des répercussions sur leur vie. Les résultats vont dans le sens d’une explication socio-écologique de l’anxiété&nbsp;: des facteurs relatifs à la sociodémographie, aux relations et aux études semblaient en lien direct avec les degrés d’anxiété rapportés par les étudiantes et les étudiants. Les résultats mettent en lumière la nécessité de s’assurer que les services aux étudiants et les services d’aide sur les campus sont en mesure de prendre en charge les problèmes de santé mentale. On y souligne des implications sur le plan de la théorie, de la pratique et de la recherche

Telerehabilitation Delivery in Canada and the Netherlands: Results of a Survey Study

Background: Following the onset of the COVID-19 pandemic, telerehabilitation (TR) has been expanding to address the challenges and risks of in-person delivery. It is likely that a level of TR delivery will continue after the pandemic because of its advantages, such as reducing geographical barriers to service. Many pandemic-related TR initiatives were put in place quickly. Therefore, we have little understanding of current TR delivery, barriers and facilitators, and how therapists anticipate integrating TR into current practice. Knowing this information will allow the incorporation of competencies specifically related to the use and provision of TR into professional profiles and entry-to-practice education, thereby promoting high-quality TR care. Objective: This study aimed to obtain a descriptive overview of current TR practice among rehabilitation therapists in Canada and the Netherlands and identify perceived barriers to and facilitators of practice. Methods: A web-based cross-sectional survey was conducted with occupational, physical, and respiratory therapists and dietitians in Canada (in French and English) and the Netherlands (in Dutch and English) between November 2021 and March 2022. Recruitment was conducted through advertisements on social media platforms and email invitations facilitated by regulatory and professional bodies. The survey included demographic and practice setting information; whether respondents delivered TR, and if so, components of delivery; confidence and satisfaction ratings with delivery; and barriers to and facilitators of use. TR satisfaction and uptake were measured using the Telehealth Usability Questionnaire and modified Technology Acceptance Model. Data were first summarized descriptively, and then, comparisons were conducted between professions. Results: Overall, 723 survey responses were received, mostly from Canada (n=666, 92.1%) and occupational therapists (n=434, 60%). Only 28.1% (203/723) reported receiving specific training in TR, with 1.2% (9/723) indicating that it was part of their professional education. Approximately 19.5% (139/712) reported not using TR at all, whereas most participants (366/712, 51.4%) had been using this approach for 1 to 2 years. Services delivered were primarily teleconsultation and teletreatment with individuals. Respondents offering TR were moderately satisfied with their service delivery and found it to be effective; 90.1% (498/553) indicated that they were likely to continue offering TR after the pandemic. Technology access, confidence, and setup were rated the highest as facilitators, whereas technology issues and the clinical need for physical contact were the most common barriers. Conclusions: Professional practice and experience with TR were similar in both countries, suggesting the potential for common strategic approaches. The high prevalence of current practice and strong indicators of TR uptake suggest that therapists are likely to continue TR delivery after the pandemic; however, most therapists (461/712, 64.7%) felt ill prepared for practice, and the need to target TR competencies during professional and postprofessional education is critical. Future studies should explore best practice for preparatory and continuing education