Resumo Este ensaio aborda, a partir de uma perspectiva crítica do Sul, o que tem sido chamado de fundamentos da terapia ocupacional. Argumenta-se que os chamados fundamentos dispõem de certas ...categorias constitutivas que estão na base da construção de conceitos, teorias, estruturas de trabalho, com as quais a disciplina atua, sendo uma das principais a noção de natureza ocupacional, o conceito de indivíduo, entre outras. Essas categorias que sustentam o que foi chamado de fundamentos de nosso trabalho derivam principalmente do sistema-mundo no qual as disciplinas científicas foram produzidas, incluindo a terapia ocupacional, e que correspondem à racionalidade do projeto moderno, ocidental, norte-eurocêntrico. O objetivo deste ensaio é analisar criticamente e refletir sobre as categorias fundamentais da terapia ocupacional a partir de uma posição crítica do Sul, a qual possibilitará produzir uma terapia ocupacional radicalmente diferente daquelas do sistema do mundo ocidental moderno. Vamos chamá-la de terapia ocupacional Outra, que se baseia em uma ruptura radical das categorias centrais da profissão, para a qual propomos, como introdução, outras categorias que promovam uma compreensão histórica, situada, descolonizada da disciplina, orientada para o reconhecimento e uma práxis Sul-Sul que promova diálogos interculturais que rompam com o universalismo, o monotopismo e o monoculturalismo da terapia ocupacional.
Resumen El ensayo aborda, desde una perspectiva crítica Sur, lo que se ha llamado «los fundamentos» de la terapia ocupacional. Se plantea que estos disponen de ciertas categorías constitutivas que están en la base de la construcción de conceptos, teorías y marcos de trabajo en los que actúa la disciplina. Algunos de estos fundamentos primordiales son el de la naturaleza ocupacional, el concepto de individuo, entre otros. Estas categorías que sostienen nuestro quehacer devienen, primariamente, del sistema mundo en el cual se han producido las disciplinas científicas—entre ellas la terapia ocupacional—y que corresponden a la racionalidad del proyecto moderno occidental nor-eurocéntrico. El objetivo de este ensayo es analizar y reflexionar críticamente las categorías fundamentales de la terapia ocupacional desde una posición crítica Sur, la que permitirá abrir la posibilidad de producir una terapia ocupacional radicalmente diferente a las del sistema mundo moderno occidental. A esta la llamaremos una terapia ocupacional Otra, que se fundamenta en una ruptura radical de las categorías centrales de la profesión, para lo cual proponemos, a modo introductorio, otras categorías que promuevan una comprensión histórica, situada, de orientación descolonial de la disciplina, orientada al reconocimiento y a una praxis Sur-Sur que promueva diálogos interculturales que rompan con el universalismo, el monotopismo y monoculturalismo de la terapia ocupacional.
Abstract This essay addresses, from a critical perspective of the Global South, what has been called the foundations of occupational therapy. It argues that these so-called foundations rely on certain constitutive categories that form the basis of the construction of concepts, theories, and frameworks with which the discipline operates, including mainly the notion of occupational nature, the concept of the individual, among others. These categories that support what has been referred to as the foundations of our work primarily derive from the world-system in which scientific disciplines have been produced, including occupational therapy, and correspond to the rationality of the modern Western, North Eurocentric project. The purpose of this essay is to critically analyze and reflect upon the fundamental categories of occupational therapy from a critical position of the Global South, which will open up the possibility of producing an occupational therapy radically different from those of the modern Western world-system. We will refer to it as “alternative occupational therapy,” which is based on a radical rupture from the central categories of the profession. As an introduction, we propose other categories that promote a historically situated, decolonized understanding of the discipline oriented towards recognition and a South-South praxis that fosters intercultural dialogues breaking away from the universalism, monotopism, and monoculturalism of occupational therapy.
Background. A growing body of occupational therapy knowledge and practice focuses not on health but on social transformation, and couples occupational therapy with community development. A tension in ...both these fields is the disconnect between what practitioners espouse and what they do, limiting the potential of practice. To address this, practitioners are encouraged to engage in praxis—the critical synthesis of theory and practice. Purpose. To explore whether and how Australian occupational therapy-community development practitioners engage in critical praxis. Method. A critical dialogical method was employed to complete multiple in-depth interviews with four occupational therapy-community development practitioners. Interviews were transcribed and analyzed using thematic analysis. Findings. Practitioners appeared capable of praxis but were not consistently employing it. Findings were grouped into themes: disjointed praxis, authentic praxis, supporting praxis, and praxis challenges and solutions. Implications. Occupational therapists need to be supported to develop, use, and maintain skills in critical praxis.
Occupational therapy practitioners need updated information about which interventions may improve motor skills for young children.
To identify the effectiveness of occupational therapy interventions ...to promote motor development and prevent delay for children ages 0-5 yr.
Six databases (CINAHL, MEDLINE, PsycINFO, ERIC, Cochrane, and OTseeker) were searched for articles published from January 2010 to March 2017.
The search yielded 4,488 articles that were reviewed for inclusion. Fifty-six studies were entered into both evidence and risk-of-bias tables. Included studies used Level I-III designs, were within occupational therapy's scope of practice, included participants with a mean age younger than 6 yr, and addressed motor skills.
Three intervention themes emerged: early intervention for children younger than age 3 yr, interventions for preschool children ages 3-5 yr, and interventions for children with or at risk for cerebral palsy.
Occupational therapy practitioners should consider use of interventions with moderate or strong evidence as described in this review. Limitations include high risk of bias and limited evidence for several interventions.
This article provides occupational therapy practitioners with updated information on evidence-based practices for children age 5 and younger who have motor delays.
Introduction Chronic insomnia is a prevalent condition negatively impacting the health and daily functioning of many Veterans. Occupational therapy is focused on helping individuals maximize ...performance and participation in their daily activities. Sleep is our largest occupation consuming around 1/3rd of our lives and sleep challenges create barriers to daily goals. Therefore, sleep is something occupational therapy should be concerned with and address to improve sleep itself and possibly other functional outcomes as well. Methods We recruited a convenience sample of 45 student Veterans to participate in occupational therapist-led Cognitive Behavioral Therapy for Insomnia (CBTI). We collected pre- and post-intervention data on sleep quality and daily functioning using the PROMIS Sleep scales and the Canadian Occupational Performance Measure (COPM), respectively. The COPM assesses one’s perceived performance and satisfaction across five pre-selected domains of daily functioning. We examined un-adjusted pre-post changes for both constructs using paired t-tests and we examined the association between sleep quality and daily functioning over time using multivariable linear mixed models to account for the correlation of repeated measures within participants. The results represent a preliminary analysis of the first 16 participants. Results The preliminary sample included 14 males and 2 females who were fully matriculated students at Colorado State University. Mean (standard deviation) age was 32.1 (6.6) years. Un-adjusted analyses demonstrated significant (p < .05) improvements in sleep quality, perceived performance in daily functioning, and satisfaction with daily functioning. Similarly, the multivariable regression analyses yielded significant associations between changes in sleep quality and both performance and satisfaction with daily functioning over time. Conclusion Perceived performance and satisfaction with daily functioning can be enhanced through effective interventions targeting improvements in sleep quality in student Veterans. Additional research is needed to evaluate the variability in the improvements in daily functioning and to determine whether these effects are maintained longer-term. Support (If Any) The Restoring Effective Sleep Tranquility "REST" project is supported by the New Start for Student Veterans Program at Colorado State University.
The continuous development of mobile apps has led to many health care professionals using them in clinical settings; however, little research is available to guide occupational therapists (OTs) in ...choosing quality apps for use in their respective clinical settings.
The purpose of this study was to use the user version of the Mobile Application Rating Scale (uMARS) to evaluate the quality of the most frequently noted mobile health (mHealth) apps used by OTs and to demonstrate the utility of the uMARS to assess the quality of mHealth apps.
A previous study surveying OTs' use of apps in therapy compiled a list of apps frequently noted. A total of 25 of these apps were evaluated individually by 2 trained researchers using the uMARS, a simple, multidimensional analysis tool that can be reliably used to evaluate the quality of mHealth apps.
The top 10 apps had a total quality score of 4.3, or higher, out of 5 based on the mean scores of engagement, functionality, and aesthetics. Apps scored highest in functionality and lowest in engagement. Apps noted most frequently were not always high-quality apps; apps noted least frequently were not always low-quality apps.
Determining the effectiveness of using apps in clinical settings must be built upon a foundation of the implementation of high-quality apps. Mobile apps should not be incorporated into clinical settings solely based on frequency of use. The uMARS should be considered as a useful tool for OTs, and other professionals, to determine app quality.
Cochrane reviews of physiotherapy (PT) and occupational therapy (OT) for Parkinson's disease found insufficient evidence of effectiveness, but previous trials were methodologically flawed with small ...sample size and short-term follow-up.
To evaluate the clinical effectiveness and cost-effectiveness of individualised PT and OT in Parkinson's disease.
Large pragmatic randomised controlled trial.
Thirty-eight neurology and geriatric medicine outpatient clinics in the UK.
Seven hundred and sixty-two patients with mild to moderate Parkinson's disease reporting limitations in activities of daily living (ADL).
Patients were randomised online to either both PT and OT NHS services (n = 381) or no therapy (n = 381). Therapy incorporated a patient-centred approach with individual assessment and goal setting.
The primary outcome was instrumental ADL measured by the patient-completed Nottingham Extended Activities of Daily Living (NEADL) scale at 3 months after randomisation. Secondary outcomes were health-related quality of life Parkinson's Disease Questionnaire-39 (PDQ-39); European Quality of Life-5 Dimensions (EQ-5D), adverse events, resource use and carer quality of life (Short Form questionnaire-12 items). Outcomes were assessed before randomisation and at 3, 9 and 15 months after randomisation.
Data from 92% of the participants in each group were available at the primary time point of 3 months, but there was no difference in NEADL total score difference 0.5 points, 95% confidence interval (CI) -0.7 to 1.7; p = 0.4 or PDQ-39 summary index (0.007 points, 95% CI -1.5 to 1.5; p = 1.0) between groups. The EQ-5D quotient was of borderline significance in favour of therapy (-0.03, 95% CI -0.07 to -0.002; p = 0.04). Contact time with therapists was for a median of four visits of 58 minutes each over 8 weeks (mean dose 232 minutes). Repeated measures analysis including all time points showed no difference in NEADL total score, but PDQ-39 summary index (curves diverging at 1.6 points per annum, 95% CI 0.47 to 2.62; p = 0.005) and EQ-5D quotient (0.02, 95% CI 0.00007 to 0.03; p = 0.04) showed significant but small differences in favour of the therapy arm. Cost-effective analysis showed that therapy was associated with a slight but not significant gain in quality-adjusted life-years (0.027, 95% CI -0.010 to 0.065) at a small incremental cost (£164, 95% CI -£141 to £468), resulting in an incremental cost-effectiveness ratio of under £4000 (£3493, 95% -£169,371 to £176,358). There was no difference in adverse events or serious adverse events.
NHS PT and OT did not produce immediate or long-term clinically meaningful improvements in ADL or quality of life in patients with mild to moderate Parkinson's disease. This evidence does not support the use of low-dose, patient-centred, goal-directed PT and OT in patients in the early stages of Parkinson's disease. Future research should include the development and testing of more structured and intensive PT and OT programmes in patients with all stages of Parkinson's disease.
Current Controlled Trials ISRCTN17452402.
This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 63. See the NIHR Journals Library website for further project information. The Birmingham Clinical Trials Unit, University of Birmingham, received support from the UK Department of Health up to March 2012. Catherine Sackley was supported by a NIHR senior investigator award, Collaboration for Leadership in Applied Health Research and Care East of England and West Midlands Strategic Health Authority Clinical Academic Training award.
An analysis of data from an international survey was undertaken to determine the impact of the COVID-19 pandemic on telehealth practice in occupational therapy worldwide, in addition to facilitators ...and barriers in utilising this form of service delivery.
The global online survey was circulated in the occupational therapy community by the World Federation of Occupational Therapists (WFOT) between April and July 2020, collecting responses to closed-ended questions, in addition to free-text comments. Descriptive statistics and bivariate analyses were used to assess relationships between respondent characteristics and the utilisation of telehealth. Thematic statement analysis provided further insight regarding factors impacting telehealth use.
Findings revealed a significant increase in the use of telehealth strategies with the onset of the pandemic among survey respondents, with many reported benefits. Bivariate analyses indicated telehealth users were more likely to score higher feelings of safety and positive work morale, as well as perceive employer expectations to be reasonable. Restricted access to technology, limitations of remote practice, funding issues and slow pace of change were identified as barriers for some respondents to utilising telehealth. Facilitators included availability of supportive policy, guidelines and strategies, in addition to education and training.
This study advances the understanding of the current scope of occupational therapy telehealth practice in the context of the ongoing COVID-19 pandemic. Although results suggest long-term potential for telehealth use as an adjunct to traditional service provision, important considerations were identified regarding factors influencing integration of such strategies.
Background/aim
Knowledge and understanding of deficits in executive functions has expanded in recent years and its relevance to occupational therapy has been established. The purpose of this review ...was to identify, analyse, synthesise and describe the updated occupational therapy scientific literature that addresses the subject of executive functions, specifically focusing on children and adolescents.
Method
Scoping review methodology was implemented to map the occupational therapy literature on executive functions in children and adolescents over the past decade. Articles were retrieved from five electronic databases.
Results
Fifty publications met the inclusion criteria. The research included a wide age range, different diagnoses, use of diverse executive functions definitions and assortment of assessments and interventions.
Conclusion
A unique definition of executive functions among children and adolescents was proposed. This definition can assist both clinicians and researchers in the field. Continued research to establish the profession in a key position is recommended to understand the underlying mechanisms of daily performance.
Research studies supporting occupational therapy interventions to address feeding, toileting, and sleep can be applied to practice in early intervention and preschool settings to improve the outcomes ...of young children and their families.
To examine the effectiveness of interventions within the scope of occupational therapy practice to improve activities of daily living, rest, and sleep for children ages 0-5 yr and their families.
Five databases (MEDLINE, PsycINFO, CINAHL, OTseeker, ERIC) and Evidence-Based Medicine Reviews, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, and Database of Abstracts of Reviews of Effectiveness were searched for studies published between January 2000 and March 2017.
Inclusion criteria were Levels I-III evidence, being within occupational therapy's scope of practice, including participants with a mean age younger than 6 yr, and addressing self-care, activities of daily living, and rest and sleep.
Forty articles were appraised, and three themes emerged: interventions to address feeding and eating, interventions to address toileting, and interventions to address rest and sleep. Additional subthemes of behavioral approaches, parent and caregiver education, and contextual intervention were revealed.
Occupational therapy practitioners should consider the use of interventions with moderate or strong evidence as described in this review. Limitations include risk of bias and limited evidence for several interventions.
This article provides a broader perspective on evidence-based practice by examining studies within the scope of occupational therapy practice published outside of current occupational therapy publications. The review includes studies from nutrition, nursing, and psychology, which address interdisciplinary care, family coaching and education, and behavioral approaches within the professional scope of occupational therapy to improve the functional performance, routines, and quality of life for young children and their caregivers.
The purpose of this study was to identify the incidence of incivility experienced by a purposive sample of novice occupational therapists who graduated from a master’s level program that focused on ...developing servant leaders as part of its mission. Data from this group was then compared to outcomes from a previous national survey of novice occupational therapists. Incivility in both studies was measured using the Negative Acts Questionnaire-Revised (NAQ-R). An independent samples t-test showed that NAQ-R total scores and person-related incivility subscores were significantly (p
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