The latest medical research on Occupational Therapist

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Effectiveness of Hospital-Based Interventions by Occupational Therapy Practitioners on Reducing Readmissions: A Systematic Review With Meta-Analyses.

Am J Occ Therapy

To systematically examine the published literature to determine the effects of occupational therapy interventions for adult hospitalized patients on readmission rates.

Systematic search of five electronic databases was performed from database inception until May 2020, supplemented by citation and reference list searches. Study Selection and Data Collection: This review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered prospectively; methodological quality of the included studies was assessed using the Downs and Black checklist. Meta-analyses were conducted with clinically homogeneous data; the overall body of evidence was graded for quality.

Meta-analysis of 7 studies with 16,718 participants provided low-quality evidence that 1-mo readmission rates were reduced when adult patients hospitalized for general medical and surgical care received additional occupational therapy interventions compared with standard care. Subgroup analysis of 4 studies provided moderate-quality evidence that interventions focusing on the transition from hospital to the community were effective in reducing 1-mo readmissions to hospitals compared with standard care.

Occupational therapy interventions can be effective in reducing readmissions among some adult hospitalized patient populations, including those admitted for surgery or management of acute medical conditions, with stronger evidence to support transitional care interventions. What This Article Adds: Occupational therapy interventions can be effective in reducing readmissions among adult hospitalized patients. There is a continued need for occupational therapy practitioners to understand their value and contribution to reducing avoidable readmissions to hospitals.

'Doing' dating: A cross-sectional survey of young adults (18-35 years) in Australia and Hong Kong.

Australian Occupational Therapy Journal

Dating is an occupation through which people form intimate relationships with others. Despite the importance of intimate relationships for wellbeing, there is limited information available in occupational therapy literature about the activities involved in dating and little guidance for practitioners who wish to support clients from diverse backgrounds who experience difficulties with dating. To address this gap, this study sought to explore dating among young adults (18-35 years) and compare dating activities between two contexts: Australia and Hong Kong.

Data were collected using an e-survey designed for this study and refined using cognitive interviewing (n = 12). It included questions about dating initiation and activities. Study design and reporting was guided by the Checklist for Reporting Results of Internet E-Surveys. Data were analysed using descriptive statistics and between group comparisons. Reponses to open ended questions were subjected to interpretative content analysis and quantified.

In total, 2208 young adults aged 18-35 who had at least one dating experience and resided in either Australia or Hong Kong completed the survey. Participants met their dates most commonly through school, friends, dating apps, and work. The most frequent ways to ask a person on a date were by suggesting 'hanging out' or going out for food, drink or to the movies. Most participants reported that organising a date required extended negotiation between the parties. Differences were found between participants from Hong Kong and Australia.

This is the first study of contemporary dating from an occupational perspective and provides an understanding of dating activities in two different cultural contexts.

Changing occupational roles for the young adult with cancer: A longitudinal case study.

Australian Occupational Therapy Journal

Young adulthood is a period of rapid occupational role development. While the impact of a cancer diagnosis at this time is likely to be substantial, little research has addressed this topic. The aims of this study were to gain insights into the impact of cancer on occupational roles throughout the cancer disease trajectory, from diagnosis to the palliative stage, for one young person.

A longitudinal case study design was used. Five semi-structured interviews, layered with photo elicitation, were conducted over 3 years. Qualitative data were analysed thematically.

Three themes emerged: the adjusted plan, establishing rules, and damage control and self-preservation. Challenges impacting participation in, and meaning of, and the occupational roles themselves shifted over time.

Findings provide knowledge of occupational adaptation, and the reconstruction of occupational role identity and participation, of the young adult living with cancer along the disease trajectory.

Occupational Therapy Interventions to Address Depressive and Anxiety Symptoms in the Physical Disability Inpatient Rehabilitation Setting: A Systematic Review.

Am J Occ Therapy

To determine what interventions within the occupational therapy scope of practice have been used to address depressive and anxiety symptoms in IPR and to determine intervention efficacy.

Nine databases for all publication years were searched (PubMed, Scopus, Embase, Web of Science, PsycINFO, Cochrane Library, AgeLine, OTseeker, and CINAHL). Study Selection and Data Collection: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for abstracting data and assessing quality. Included articles were peer reviewed, based in the United States, in English, controlled clinical trials or randomized controlled trials, in the IPR setting, and within the occupational therapy scope of practice. Two reviewers independently screened articles, with disagreements resolved by consensus.

Five of 8,082 articles met inclusion criteria. Diagnoses included stroke (n = 1), traumatic brain injury (n = 1), spinal cord injury (n = 1), and musculoskeletal conditions (n = 2). Results are discussed among four categories: study design and outcome variables, intervention type, intervention intensity, and intervention efficacy.

Limited, moderate-quality evidence exists within the occupational therapy scope of practice for addressing depressive and anxiety symptoms in the physical disability IPR setting. Interventions primarily included cognitive and behavioral strategies. Further research among diverse patient populations is needed to support occupational therapy practitioners in facilitating client participation and functioning. What This Article Adds: This systematic review provides an evaluation of the evidence within the occupational therapy scope of practice to address depressive and anxiety symptoms within the physical disability IPR setting. This research can support occupational therapy practitioners to comprehensively address physical and mental health for participation in IPR.

Health Services Research and Occupational Therapy: Ensuring Quality and Cost-Effectiveness.

Am J Occ Therapy

Health services research focuses on access, quality, and cost-effectiveness of care. As a result of increasing emphasis on value-based reimbursemen...

Unravelling the Complexities of Workplace Disclosure Among Persons with Non-Visible Disabilities and Illnesses: A Qualitative Meta-Ethnography.

Journal of Occupational Health Psychology

Deciding whether and how to disclose a disability at work for persons with non-visible disabilities and illnesses involve complex processes. Research has focused on antecedents and outcomes of disclosure. More research is needed to understand the lived experiences related to disclosure decision-making and actual navigation of disclosure and concealment at work.

To understand the experiences of persons with non-visible disabilities and illnesses regarding workplace disclosure decision-making, navigating disclosure and/or concealment, and experiential differences across disability and illness types, ages, geographic locations, and genders.

We conducted a qualitative meta-synthesis using Noblit and Hare's seven steps of meta-ethnography. Searches were conducted via six databases. Studies were analyzed to develop conceptual categories, third-order constructs (themes), and a line-of-argument with comparisons drawn from the disclosure decision making model, disclosure process model, and consideration of disability and illness types, genders, ages, and geographic locations.

Twenty-four studies were included involving 489 participants, aged 16 to 81, from nine countries, focusing on one non-visible disability or illness, or multiple. We developed four themes for the disclosure decision-making process (self- and other-focused, experiential, and environmental/workplace factors) and two themes for the disclosure/concealment event (disclosure/concealment logistics and timing) and noted emerging trends across ages, genders, disability and illness types, and geographic locations.

Knowledge obtained could be used among professionals who support persons with non-visible disabilities and illnesses to help them navigate disclosure at work, and to consider the role of age, genders, disability and illness types, and geographic locations on disclosure.

Framing the Care of Injured Workers: An Empirical Four-Jurisdictional Comparison of Workers' Compensation Boards' Healthcare Policies.

Journal of Occupational Health Psychology

The objective of this study was to explore how workers' compensation policies related to healthcare provision for workers with musculoskeletal injuries can affect the delivery and trajectories of care for injured workers. The principal research question was: What are the different ways in which workers' compensation (WC) policies inform and transform the practices of healthcare providers (HCPs) caring for injured workers?

We conducted a cross-jurisdictional policy analysis. We conducted qualitative interviews with 42 key informants from a variety of perspectives in the provinces of Ontario and Quebec in Canada, the state of Victoria in Australia and the state of Washington in the United States. The main methodological approach was Framework Analysis.

We identified two main themes: (1) Shaping HCPs' clinical practices and behaviors with injured workers. In this theme, we illustrate how clinical practice guidelines and non-economic and economic incentives were used by WCs to drive HCP's behaviours with workers; (2) Controlling workers' trajectories of care. This theme presents how WC policies achieve control of the workers' trajectory of care via different policy mechanisms, namely the standardization of care pathways and the power and autonomy vested in HCPs.

This policy analysis shed light on the different ways in which WC policies shape HCP's day-to-day practices and workers' trajectories. A better understanding and a nuanced portrait of these policies' impacts can help support reflections on future policy changes and inform policy development in other jurisdictions.

The Role of Altered Sensory Processing and Its Association with Participation in Daily Activities and Quality of Life among Older Adults in the Community.

Occupational Therapy in Health Care

To identify variables that contribute to fall risk in older adults, this study examined the relationship between fall risk, sensory processing, par...

Occupational Therapy Service Delivery Among Medicaid-Enrolled Children and Adults on the Autism Spectrum and With Other Intellectual Disabilities.

Am J Occ Therapy

To describe occupational therapy services delivered to Medicaid-eligible persons younger than age 65 yr identified as having ASD, ID, or both and to evaluate demographic factors associated with occupational therapy service utilization in this population.

Beneficiaries identified as having ASD only, ASD+ID, or ID only who were younger than age 18 yr (N = 664,214) and ages 18-64 yr (N = 702,338). Outcomes and Measures: We analyzed Current Procedural Terminology® and Healthcare Common Procedure Coding System procedure codes, Medicaid Statistical Information System type of service codes, and Center for Medicare & Medicaid Services provider specialty codes.

Only 3.7% to 6.3% of eligible adult beneficiaries received occupational therapy; in contrast, 20.5% to 24.2% of children received occupational therapy. Significant predictors of service use varied by group; however, differences by race-ethnicity, eligibility on the basis of poverty, and geographic location were observed. Among children, the most frequent billing code was for "therapeutic activities" (43%-60%); among adults, it was "community/work reintegration training" (29%-39%).

Billed procedure code patterns do not consistently reflect the unique occupational focus that occupational therapy providers deliver to people with developmental disabilities. Disparities in occupational therapy receipt warrant further attention to understand the social and structural factors affecting service delivery. What This Article Adds: Occupational therapy services paid for by Medicaid are used more frequently by children with ASD and ID than by adults with these diagnoses. Greater understanding of the intersectional factors that drive service delivery and disparities is needed.

Physical Activity Self-Efficacy in Older Adults with Vision Loss: A Grounded Theory Study.

Occupational Therapy in Health Care

The purpose of this study was to develop a model describing the process of how older adults with age-related macular degeneration develop physical ...

The Development and Preliminary Psychometric Properties of the TeleWrite: A Telehealth-Based Handwriting Assessment for School-Aged Children.

Occupational Therapy in Health Care

This article describes the development and preliminary psychometric properties of the TeleWrite, a handwriting assessment tool designed to measure ...

Measuring Value: Cost-Effectiveness Analysis for Occupational Therapy.

Am J Occ Therapy

Stroke rehabilitation is expensive, and recent changes to Medicare reimbursement demand more efficient interventions. The use of cost-effectiveness...