There is growing interest in an occupational perspective when working with people experiencing chronic pain. The Activity Card Sort Australia (18-64) is a client-centered and occupation-centered tool ...that has not been explored with this population. The aim of this study was to explore the process and experience of completing the ACS-Aus (18-64) with people experiencing chronic pain. This observational multiple-case study included video and audio-recordings of three participants (one male, one female, one nonbinary) completing the ACS-Aus (18-64) and semi-structured interviews at 1-week follow-up. Findings The findings for the process included two themes: the interaction (understanding engagement, therapeutic relationship and rapport, motivational interviewing) and the card sort (storytelling and reminiscing, identifying gaps and possibilities, categorizing and grouping cards). Occupational narratives of participants were developed from the experience. The ACS-Aus (18-64) supported participants to re-engage with their occupational selves and imagine future occupational engagement. Longitudinal studies are required to explore outcomes.
ABSTRACT
This study examined the convergent validity of three assessments: The Canadian Occupational Performance Measure (COPM), the Occupational Self Assessment (OSA), and the Melville-Nelson ...Self-Identified Goals Assessment (SIGA). All three assessments are designed to elicit client self-assessments of occupational performance, but each assessment involves a unique protocol. To provide partial information on clinical utility, duration of administration was also measured. Eighteen women and 12 men with varying diagnoses receiving rehabilitation in a Midwest transitional care center were administered these assessments in a counterbalanced order. Mean participant age was 74.0 years (SD = 9.9). Statistically significant positive Pearson correlations were found among the three primary variables: r =.51, p = 0.004 for COPM (performance) and OSA (competence); r =.58, p < 0.001 for COPM (performance) and SIGA (overall); and r =.41, p = 0.025 for OSA (performance) and SIGA (overall). The COPM was used as a model for the development of the SIGA, so the relatively robust correlation between these two assessments was anticipated. Durations of administration were positively skewed, so medians are reported: 17.5 min for the COPM, 12.5 min for the OSA, and 5.0 min for the SIGA. All three assessments gather data useful for a client-centered approach to occupational therapy but vary in format and duration of administration.
ABSTRACTClient-centered practice and outcomes research are missions of occupational therapy. Although strategies for client goal-setting have advanced the field, the process has limitations. This ...study tested a self-report strategy using brief, easy to score measures. The Goals for Occupational Therapy List was completed at mostly independent intake and paired with a follow-up measure of Goal Satisfaction Rating by 40 clients in an outpatient rehabilitation center. The strategy of pairing self-report measures of goal-setting and attainment was useful for clinicians and yielded important research findings. Application to occupational therapy and future research are suggested.
Self-assessment is an appropriate way to support client-centered practice and promote personal development in young occupational therapy clients. This study, the second study in a series of two, ...sought to refine the psychometric properties based on previous analysis of the Child Occupational Self-Assessment (COSA), a self-report tool based on the Model of Human Occupation. The COSA comprises 24 statements, which the child rates in terms of personal competence and importance. The Rasch Rating Scale Model was used to evaluate the measurement properties of the Competence and Values scales that result from these self-ratings. The original three-point rating scale was expanded to four response categories in this study, which resulted in improved reliability and sensitivity. In this second study, the items once again coalesced to form measures of competence and values, and the order of items from less to more competence and value was similar to that in the first study, supporting the internal validity of the COSA scales. The results provide evidence that the COSA can be used as meaningful and reliable client-directed assessment tool as well as an outcome measure.
Adults who experienced childhood sexual abuse frequently find dental treatment difficult to tolerate. Increased understanding of common long-term effects of this trauma may help dental professionals ...to respond more sensitively to patients who have experienced it.
The authors recruited 58 men and 19 women with self-reported histories of childhood sexual abuse from social agencies serving this population and interviewed the participants about their experiences with health care professionals, including dentists. The authors analyzed interview transcripts using the constant comparative method to identify main themes and patterns.
Participants reported aspects of dental treatment that can be particularly difficult for them and offered ideas about how dental health professionals could make the experience more tolerable for them. The data analysis produced suggestions about how dentists might respond sensitively to patients who frequently cancel appointments, are distressed by certain body positions, need a sense of control and fear judgment. The authors also report participants' thoughts about questions from dental practitioners regarding a history of childhood sexual abuse.
Adults who report a history of childhood sexual abuse are more likely to experience dental treatment more positively when dental professionals have some understanding of the long-term effects of such abuse, including how it can affect dental treatment interactions. Such knowledge enables dental professioinals to respond to their needs in a sensitive manner.
Although power mobility has many potential benefits for users, power mobility incidents and accidents are a serious concern. To date, little research has explored power mobility safety, and no gold ...standard exists to determine whether the user is a safe driver. As a possible alternative to a facility unilaterally imposing regulations on power mobility users, we conducted a research project in which power mobility users and other stakeholders used the Delphi method to develop guidelines for power mobility use within a residential facility setting. This article presents the overarching principles for power mobility use and noteworthy items from the safety guidelines that participants developed. These findings highlight the safety issues that are encountered in residential care settings and suggest some strategies to deal with them.
Occupational engagement (OE) has been presented as a core construct in occupational therapy; however, its broad conceptualization and confounding definitions are problematic. Clarifying the construct ...of OE would help occupational therapists to explicate the nature of their practice. The purpose of this study was to explore occupational therapists’ perspectives of the construct of OE. Qualitative descriptive methodology was used to collect data using semistructured interviews with nine practicing occupational therapists in the Greater Toronto Area. Qualitative content analysis, using an inductive approach, was employed to uncover emerging categories. Participants spoke about transitioning from therapeutic engagement to OE with a client by following a client’s path of choice. The essential elements and influencers of OE were highlighted, and the relationship between OE and occupational performance was discussed. The findings provide an initial understanding of essential elements necessary to enable clients to initiate engagement in therapy and then, subsequently, in occupations of their choice.
The purpose of this study was to validate the Occupational Self Assessment (OSA). The Occupational Self Assessment is an evaluation tool and an outcome measure based on the Model of Human Occupation ...and concepts of client-centered practice. It is a two-part rating form that elicits client's perceptions and values concerning their own occupational competence, values, and the impact of the environment on their occupational behavior. Data were collected from 302 clients which included physically disabled, psychiatrically disabled and non-disabled adults. Rasch analysis was used to analyze the data. Results supported the preliminary validity and reliability of the OSA and recommendations are given for further improvement of the tool.
Following a stroke, depression and anxiety may negatively affect recovery and decrease quality of life. Occupational therapy (OT) practitioners are distinctly qualified to address both the physical ...and psychosocial sequelae of a stroke, including clients’ mental and emotional health. This study explored the ways in which OT practitioners address the mental health needs of clients post stroke. A sequential explanatory mixed-methods design was used to collect both survey and focus group data. In all, 754 OT practitioners across the United States completed an online survey, and 10 practitioners participated in focus groups. Practitioners considered their clients’ mental health needs to be a priority (68.17%); however, only 56.64% were satisfied with the care they provided related to mental and emotional health. They identified barriers that included limited time, increased productivity standards, expectations related to physical recovery, and poor educational preparation. Practitioners are motivated to improve their provision of mental health services to clients post stroke. To address the conflict between practice realities and professional values, education programs should better integrate curricular components that focus on physical and mental health.
The purpose of this study is to describe important features of occupational therapy practice for treatment of military service members with chronic symptoms and a history of mild traumatic brain ...injury (mTBI) in a military concussion care clinic from service members’ perspectives with support from occupational therapy practitioners. Two series of focus groups were conducted with service members with chronic mTBI-related symptoms (n = 6) and practitioners (n = 5). Data were analyzed concurrently with collection. We identified five main themes: therapeutic relationship, consistent inclusion of family members, combat versus noncombat injuries, loss of military identity, and assessment against population norms. The findings of this study suggest that service members’ evaluations of occupational therapy are based on the overall experience of the encounter, centered by the therapeutic relationship, rather than specific intervention strategies or technology.
PDF