Occupational therapy in residential aged care facilities (RACFs) can enhance residents' occupational engagement and wellbeing. However, industry reports suggest that occupational therapists in ...Australian RACFs have mostly provided physical therapies such as pain management via massage and not addressed residents' occupations. There is limited literature on what constitutes occupational therapists' practice in RACFs to inform policy and practice. The aim of this cross-sectional survey was to explore practice patterns of occupational therapists working in Australian RACFs and influences on their practice.
Occupational therapists working in Australian RACFs were invited from July 2019 to March 2020 to complete a self-report online questionnaire via email and advertisements on industry websites, newsletters, and social media. The questionnaire asked therapists about their caseload, referrals, assessments, and interventions. Data were analysed descriptively and presented as frequencies and percentages.
A total of 214 occupational therapists completed the survey. Occupational therapists' daily practice largely focussed on pain management; other areas of practice included falls prevention, pressure care, and mobility. The Aged Care Funding Instrument in place at the time of the survey was identified as the leading factor influencing therapists' choice of assessments and interventions. Organisational policies and procedures were also perceived as key factors influencing occupational therapy practice.
This paper highlights the influence of government funding and organisational policies in limiting occupational therapists' scope of practice and their ability to fully address the occupational needs of residents. Occupational therapists and the profession in general should be aware of factors in aged care funding models, and their application, that restrict occupational therapy practice and inhibit residents' function and advocate for change where needed. With the introduction of the Australian National Aged Care Classification funding model replacing Aged Care Funding Instrument, future research should explore potential changes to therapists practice following the implementation of the new funding model.
Background/aim
The home environment is a multidimensional and personally meaningful place, and the complexity of this environment often impacts on the home modification process and outcomes. Home ...modifications can appear as a straightforward solution to safety and occupational performance concerns; nevertheless, clients sometimes reject modifications or are unsatisfied with the completed works. To understand this phenomenon, this study aimed to determine what aspects of the home environment impact home modification decision making.
Method
In this qualitative descriptive study, 42 in‐depth interviews using a semi‐structured questionnaire were undertaken and analysed using a template analysis. The interviews explored the experience of the home modification process, including concerns and the decisions made about the modifications.
Findings
Four dimensions of the home environment were commonly found to affect decision making namely, the personal, societal, physical and temporal dimensions of home as well as social and occupational dimensions.
Conclusions
An understanding of the dimensions of home that impact decision making provides occupational therapists with a greater appreciation of the experience of home and allows them to enhance the effectiveness and acceptance of home modifications.
Abstract Objective This scoping review aimed to explore topics on which the views of residents of Australian residential aged care facilities (RACFs) have been sought. Methods Scoping review ...methodology as outlined by Arksey and O'Malley was used to identify, explore and report on the range of literature regarding views of RACF residents. Seven electronic databases were searched using broad search terms relevant to the RACF context. Descriptive numerical analysis was completed for publication year, journal name and target profession, research methods and participant types. Thematic analysis then focussed on the aims of the included studies. Results Four thousand two hundred and ninety studies were screened, and 104 publications met the inclusion criteria. A broad range of topics were explored by researchers, with the largest number of papers focused on residents' views of systems within RACFs ( n = 24) and new programs and interventions ( n = 21). Smaller topic areas included health conditions and health‐care services ( n = 13), socialisation ( n = 13), physical activity ( n = 3), self‐care ( n = 4), leisure ( n = 4), general everyday life ( n = 20) and aspects of the residential aged care environment ( n = 15). There was limited exploration of meaningful activity ( n = 13). The inclusion of residents with cognitive impairment was inconsistent, and the voices of other stakeholders were often privileged. Conclusion Voices of residents must be heard in order to prioritise the health and well‐being of this population. More research which focuses on what is important to residents is needed and must include residents with cognitive impairment more effectively. Identification of optimal research methods with this population would make an important contribution in this area.
Background/aim
Education on human rights will place occupational therapists in a strong position to address societal inequities that limit occupational engagement for many client groups. The imminent ...changes to the Minimum Standard for the Education of Occupational Therapists engender efforts towards social change and will require university‐level human rights education. This education might enhance the profession's influence on disadvantaging social structures in order to effect social change. To contribute to the evidence base for social change education in occupational therapy, this research aims to understand the knowledge, skills, confidence and learning experiences of occupational therapy students who completed a human rights course.
Methods
Final year occupational therapy students responded to questionnaires which included listing human rights, a human rights scale measuring knowledge and confidence for working towards human rights, and open questions. Numbers of rights listed, knowledge scores and confidence scores were calculated. Responses to the open questions were thematically analysed.
Results
After completing a human rights course, students had good knowledge and moderate confidence to work with human rights. Three themes were identified including ‘learning about human rights’, ‘learning about structural, societal and global perspectives on occupational engagement’ and ‘learning how occupational therapists can work with groups, communities and populations: becoming articulate and empowered’.
Conclusions
Human rights education fosters the development of occupational therapists who are skilled, knowledgeable, confident and empowered to address occupational injustices, according to these research findings. To develop a more occupationally just global society, education that considers iniquitous social structures and human rights is necessary.
Purpose
To identify factors impeding or facilitating Return to Work (RTW) after minor to serious musculoskeletal Road Traffic Injuries (RTI).
Methods
Six electronic databases were searched for ...studies published 1997–2020. Quantitative and qualitative studies were included if they investigated barriers or facilitators associated with RTW in people with minor to serious musculoskeletal RTI aged over 16 years. Methodological quality was assessed using McMaster Critical Review Form for Quantitative studies and McMaster Critical Review Form for Qualitative Studies. Results are presented narratively as meta-analysis was not possible.
Results
Eleven studies (10 quantitative and 1 qualitative) were included. There was strong evidence that individuals with higher overall scores on the (short-form or long-form) Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) at baseline were less likely to RTW, and individuals with higher RTW expectancies at baseline were more likely to RTW after musculoskeletal RTI. There was weak evidence for higher disability levels and psychiatric history impeding RTW after musculoskeletal RTI.
Conclusions
Post-injury scores on the ÖMPQ and RTW expectancies are the most influential factors for RTW after minor to serious musculoskeletal RTI. There is a need to identify consistent measures of RTW to facilitate comparisons between studies.
This review was conducted to critically appraise the literature regarding the patient's lived experience of, and adherence to, wearing compression garments post burn injury. Scholarly articles were ...identified from searches of the following databases: Pubmed, Cochrane Central, CINAHL, PsycINFO, and OT Seeker. Combinations of key words including compression therapy/garment, pressure therapy/garment, burn(s), adherence, and patient experience were utilized. Retrieved studies were included in the review if they were written in English, reported on adult burn populations, and the patient's lived experience of wearing compression garments. Included studies were critically appraised and content analysis was completed on the results sections of the two qualitative studies. Nine studies investigating patient's lived experiences were retained: one systematic review, one randomized controlled trial, five cross-sectional surveys, and two qualitative studies. An adherence framework provided a conceptual basis to categorize reported patient's lived experiences. Results identified a strong focus on patient and treatment-related experiences with limited investigation of condition, patient-provider and health care system experiences. Minimal investigation has been completed regarding the impact of these patient's lived experiences on the adherence to wearing compression garments. Additional research using qualitative methods is required to gain a deep understanding of patient's experiences and perspectives of wearing compression garments and how these experiences influence on their adherence to wearing them. Identification of key experiences that lead to patients removing their compression garments may lead to modification of treatment and system approaches to better align with patients' needs and development of potential interventions that promote adherence.
Introduction
Home is a meaningful and important place and the transition to home from hospital is considered a significant point in recovery for people after stroke. Six dimensions of the home ...environment have previously been described as important for well-being and contributing to one's experience of home: the physical, social, personal, temporal, occupational and societal dimensions. The aim of this study was to understand the experience of home for people with stroke after discharge to home from hospital rehabilitation.
Method
A secondary template analysis applied the dimensions of home to semi-structured interviews that explored the transition to home experience for seven participants with stroke at 4–6 weeks post discharge.
Results
All six dimensions were present in the descriptions of returning to home from stroke rehabilitation. The social, personal and occupational dimensions appeared to be the most prominent and often centred on loss or change.
Conclusion
People returning home after a stroke enter a different home environment than the one they experienced prior to stroke, with changes experienced in all dimensions of home. Closer attention to the dimensions during discharge preparation may enhance the transition experience.
Background/aim
Home modifications aim to enhance safety and occupational performance in the home. However, given the complexity and unique meaning of the home, they can impact aspects other than ...function. This qualitative descriptive study aimed to explore the impact of home modifications on clients and their family's experience of home.
Methods
Home modification clients and their family and carers participated in 42 in‐depth interviews which were analysed using a template analysis.
Findings
Home modifications impacted positively and negatively on five dimensions of the home environment, the personal, occupational, physical, temporal and social dimension. The outcomes of the modifications and the home modification process were influenced by three themes, workmanship, consultation or involvement in decision‐making, and the societal dimension of the home environment.
Conclusions
The negative outcomes and poor consultation experiences suggest the need for occupational therapists to understand their client's personal experience of home and to comprehensively follow‐up and evaluate these following home modifications.
Purpose: To explore the acceptability and value of three wearable GPS devices for older persons and individuals with a disability and safety concerns when accessing the community.
Methods: This pilot ...study explored six wearers' and their support persons' experience of using three different wearable GPS devices (a pendant, watch, and mini GPS phone), each for a two-week period.
Results: Participants identified safety as the main value of using a wearable GPS device. The acceptability and value of these devices was strongly influenced by device features, ease of use, cost, appearance, the reliability of the GPS coordinates, the wearer's health condition and the users familiarity with technology. Overall, participants indicated that they preferred the pendant.
Conclusions: Wearable GPS devices are potentially useful in providing individuals who have safety concerns with reassurance and access to assistance as required. To ensure successful utilization, future device design and device selection should consider the user's familiarity with technology and their health condition. This study also revealed that not all wearable GPS devices provide continuous location tracking. It is therefore critical to ensure that the device's location tracking functions address the wearer's requirements and reason for using the device.
Implications for Rehabilitation
The acceptability and usability of wearable GPS devices is strongly influenced by the device features, ease of use, cost, appearance, the reliability of the device to provide accurate and timely GPS coordinates, as well as the health condition of the wearer and their familiarity with technology.
Wearable GPS devices need to be simple to use and support and training is essential to ensure they are successfully utilized.
Not all wearable GPS devices provide continuous location tracking and accuracy of location is impacted by line of sight to satellites. Therefore, care needs to be taken when choosing a suitable device, to ensure that the device's location tracking features are based on the wearer's requirements and value behind using the device.
