A Survey of Occupational Therapy Practice in Beijing, China

Nurse-Led Motor Function Rehabilitation Program for Acute Ischemic Stroke: A Randomized Pilot Study

BACKGROUND

Rehabilitation care for patients with stroke in the acute stage must be strengthened. However, the evidence on how to strengthen this care is insufficient.

PURPOSE

This article was designed to evaluate the feasibility and effectiveness of implementing a nurse-led motor function rehabilitation program on patients with acute ischemic stroke.

METHODS

From January to October 2018, patients with initial acute ischemic stroke were assigned to one of two groups using a pilot randomized controlled trial design, with one group receiving a nurse-led motor function intervention program developed based on Orem's theory (7 consecutive days, twice daily for 30 minutes, experimental group) and the other receiving usual care (control group). The effectiveness measures included changes in the Motor Assessment Scale, the modified Barthel Index, and the National Institutes of Health Stroke Scale. The feasibility measures included patient retention rate, incidence of adverse events, and acceptance of nurses and patients.

RESULTS

We assigned 104 patients (male: 55.7%; age: 62.8 ± 13.2 years) to receive either a nurse-led motor function rehabilitation program or usual care. Eighty-eight patients were evaluated after 7 days (87% retention rate), including 43 (83% retention rate) in the experimental group. Patients accepted the intervention well, and no severe adverse events were reported. Nurses had good fidelity and showed high acceptance. The experimental group showed significantly higher postintervention Motor Assessment Scale and modified Barthel Index scores than the control group (p < .001), whereas postintervention National Institutes of Health Stroke Scale scores did not differ significantly between the two groups.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The nurse-led rehabilitation program used in this study was shown to be feasible and effective in improving motor function in patients with acute ischemic stroke. Further study is recommended to determine related clinical recommendations.

Job satisfaction among occupational therapists working in Riyadh, Saudi Arabia

BACKGROUND: Job satisfaction is a critical factor that must be considered in every profession. It is important for both the employees and the institutions they work for. OBJECTIVES: The aim of this study was to identify the level of job satisfaction of occupational therapists working in Riyadh, Saudi Arabia. METHODS: This is a cross sectional descriptive study. A validated job satisfaction questionnaire composed of 44 items was distributed and collected from licensed occupational therapists working in 4 hospitals in Saudi Arabia, with at least one year of experience in direct patient care. The sampling was a non-probability purposive sampling. RESULTS: A total of 48 occupational therapists responded to the questionnaire, most of which reported high overall satisfaction level. Occupational therapists showed satisfaction with coworkers, care provided to clients, and autonomy. On the other hand, occupational therapists showed dissatisfaction with salary compared to the work efforts, lack of reimbursement for continuing education, and lack of opportunities for career advancement. CONCLUSION: The overall level of satisfaction of the occupational therapists was high. Efforts must be directed towards maintaining this level of satisfaction. Human resources are encouraged to support areas of satisfaction and find solutions to areas of dissatisfaction.

Changing Perspectives of Local Therapists Eight Years after the Implementation of an Occupational Therapy Service in a Unique Himalayan Cross-Cultural Setting

Background. Whether concepts and principles of Occupational Therapy (OT) can successfully be applied to non-Western and cross-cultural settings is being intensively discussed. Aims/Objectives. We explored the changing perspectives of local occupational therapists (OTs) eight years after the implementation of an OT service in a Himalayan cross-cultural setting in terms of (1) treatment applied, (2) professional identity, and (3) cross-cultural interactions. Material and Methods. A qualitative study design was chosen, and semistructured interviews were conducted in all employed practitioners (a) during implementation and (b) eight years later (n = 7). Questions were carefully formulated in order to narrow down the intended issues but respecting crosscultural differences. The framework method was implemented for data analysis. Findings. Long-term empowering local OTs resulted in the successful development of a sustainable OT department in a unique Himalayan cross-cultural setting. Practitioners became aware of their therapeutic potentials, a clear sense of professional identity was developed, and it was recognised that sensitive cross-cultural practice is only achieved by an ongoing and intentional cultural learning process. Conclusions and Significance. Our findings suggest that OT can be applied to non-Western cross-cultural settings.

Job Satisfaction among Occupational Therapy Practitioners: A Systematic Review of Quantitative Studies

A comprehensive description of the factors associated with job satisfaction among occupational therapy practitioners is needed to promote their work well-being. This systematic review aimed to describe occupational therapy practitioners' job satisfaction and the related intra-, inter-, and extra-personal factors. Original peer-reviewed studies published between 2010 and 2019 were retrieved from four databases with the review including fourteen studies. The review was conducted according to the Joanna Briggs Institute guideline. The data were analyzed by narrative synthesis. Occupational therapy practitioners experienced high job satisfaction. Job satisfaction was found to be associated with significantly lower rates of turnover intention and higher rates of rewards. The relationships between job satisfaction, professional identity, exhaustion, and social environment showed conflicting results.

Exploring the Risk Factors for Depressive Symptoms Among Chinese Rural Older Adults

The purpose of the current study was to examine risk factors for depressive symptoms among older adults in rural China. Data were derived from the National Health Services Survey in China. A total of 2,586 rural adults age ≥60 were included in the study. Sociodemographic factors, health risk factors, and behavioral factors were measured, along with self-rated depressive symptoms. Older age (>70 years), lower education level, and living without a partner were associated with depressive symptoms. After adjusting for socioeconomic status and social support, individuals who had at least one chronic disease, experienced pain, and were unable to take care of themselves or perform household chores were more likely to report depressive symptoms (all p < 0.001). Community health care and nursing services should focus on pain control, improvement of daily physical function, and social support for older adults in rural China. [Journal of Psychosocial Nursing and Mental Health Services, 58(2), 41-47.].

An individualised, non-pharmacological treatment strategy associated with an improvement in neuropsychiatric symptoms in a man with dementia living at home

More than 90% of people with dementia experience neuropsychiatric symptoms which are often distressing and can result in early institutionalisation, diminished quality of life, increased frequency of emergency department visits along with stress and ill-health in caregivers. Non-pharmacological interventions are recommended as first-line treatment for neuropsychiatric symptoms, instead of medications such as atypical antipsychotics which have significant side effects. Most systematic reviews of non-pharmacological interventions for neuropsychiatric symptoms of dementia focus on patients in long-term care facilities and there are a limited number of research studies assessing the use of non-pharmacological interventions for patient's living at home. In this case report, we discuss an elderly man with dementia whose cognitive symptoms were accompanied by significant neuropsychiatric symptoms of suspicion, delusions, agitation and aggression. We describe how a programme of individualised, non-pharmacological interventions was associated with an improvement in neuropsychiatric symptoms within 3 months.

Overview of reviews of standardised occupation-based instruments for use in occupational therapy practice

INTRODUCTION

Using standardised instruments is one approach to support evidence-based practice. Referring to systematic reviews is an option to identify suitable instruments. However, with an abundance of systematic reviews available, therapists are challenged to identify an appropriate instrument to use. Therefore, this overview of reviews aimed to summarise relevant systematic review findings about standardised occupation-based instruments relevant for occupational therapy practice.

METHODS

An overview of reviews was conducted. A systematic search was performed on four databases up to March 2018. Included systematic reviews were analysed for quality using A MeaSurement Tool to Assess systematic Reviews (AMSTAR).

RESULTS

A total of 2187 articles were identified after removing duplicates. Ultimately, 58 systematic reviews were identified that yielded 641 instruments. From those, 45 instruments were selected for appraisal as they met the inclusion criteria of being developed mainly by occupational therapists and were recommended in the summarised findings from the systematic reviews. The instruments were classified according to the following occupation domains: (i) multidimensional, (ii) activities of daily living, (iii) productivity, (iv) social, (v) sleep/rest, (vi) sexuality and (vii) spirituality. No systematic review was identified that specifically focussed on occupations related to school/education, leisure and play.

DISCUSSION

Certain occupation domains such as activities of daily living, social and sleep/rest received high attention amongst researchers. There is a need for systematic reviews of instruments to measure education/school, play and leisure. Limited numbers of instruments were developed by occupational therapists outside the occupation domain of activities of daily living, and in areas of practice other than children and older people. Nevertheless, this overview can give some guidance for occupational therapists in selecting a suitable occupational therapy instrument for practice.

Views of people with schizophrenia and their caregivers towards the needs for psychiatric rehabilitation in urban and rural areas of mainland China

This qualitative study explores and compares the views of the individuals with schizophrenia and their caregivers in the urban and rural areas of Wuxi towards the needs for psychiatric rehabilitation. The results may more precisely guide the government and policy makers to tailor the corresponding strategies and services. With interview guides, individual face-to-face semi-structured interviews were conducted among a total of 16 participants (four people with schizophrenia and their caregivers in the urban areas and in the rural areas, respectively). All interviews were audio-recorded, transcribed, and analyzed using an inductive approach. The findings revealed commonalities and discrepancies on their views about the needs of rehabilitation interventions and community care, the healthcare resources for medication, the major factors of employment, and the support to caregivers for facilitating recovery. Some policy and service implications to promote psychiatric rehabilitation of the people with schizophrenia and their caregivers in Wuxi are discussed. With careful consideration of the possible socio-cultural differences, the findings may also serve as references for the related researchers and clinicians in other regions in China.