Measurement of Self-regulation in Preschool and Elementary Children: A Scoping Review

AIMS

This scoping review sought to identify and characterize measurement of self-regulation in preschool and elementary aged children.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review (ScR) guidelines were applied. Databases from the fields of allied health, education, medicine, and social sciences were searched including: CINAHL, Education Database (ProQuest), Education Research Complete, EMBASE, ERIC, iNFORMIT Combined, Medline, PsychINFO, Social Sciences (ProQuest), Teacher Reference Center, and Web of Science. Articles published between 2015 and 2020 were included. Dual review was utilized at all stages and a third reviewer resolved any conflicts.

RESULTS

Sixty-seven studies were included in this review. A range of observational, self-report, teacher report, caregiver report, and observational measures of self-regulation were identified. Included studies were primarily published in education and psychology disciplines, with no studies by occupational therapists identified.

CONCLUSIONS

Although a range of measures were identified in this scoping review, the results highlight the lack of consensus regarding self-regulation measurement that occupational therapists use to design and implement therapy programs to address child emotional and behavioral needs.

Is occupational therapy an ableist health profession? A critical reflection on ableism and occupational therapy

Abstract Introduction There is a need to engage in critical reflection and reflexivity to deconstruct ableist conceptualisations and practices in occupational therapy. Objectives: 1) to discuss ableism as a social construction within a practice system, 2) to deconstruct ableist mechanisms employed within occupational therapy practice, and 3) to propose inclusive and justice-oriented practices that can improve patterns of practices within the occupational therapy profession. Method Online discussions and reflective writing, producing critical reflections, were done to curate our experiences and insights based on our personal and professional experiences, thoughts, and observations as Filipino occupational therapy practitioners. Critical reflexivity was seen both as process and output to address the research objectives. Findings Despite the efforts of scholars, educators, and practitioners in employing inclusive and justice-oriented occupational therapy practices, ableism continues to proliferate through overt and covert mechanisms within professional practices. Conclusion As the occupational therapy profession continues to evolve, practitioners are expected to be critically reflective and reflexive to mitigate discriminatory practices and promote inclusive and participatory practices today and beyond. This article hopes to serve as an eye-opener for occupational therapy practitioners and reconsider their doings, knowings, and sayings in their present and future practice.

Psychosocial influences in the development of cumulative trauma disorders

STUDY DESIGN

This study is a single-phase, qualitative study using grounded theory methodology.

INTRODUCTION

Cumulative trauma disorders (CTDs) are musculoskeletal disorders that impact health and productivity. CTD risk factors are present in the workplace, home, and community. Occupational and physical therapists specializing in hand and upper extremity rehabilitation (hand therapists) are widely involved with this population. Hand therapists often employ a medical model in the assessment and treatment of these conditions; however, the medical model has not proven to be consistently effective in relieving symptoms or producing a durable return to daily living activities.

PURPOSE OF THE STUDY

The purpose of this study was to explore the lived experiences of individuals diagnosed with CTD, and investigate the psychosocial phenomena influencing CTD development as an impediment to occupational performance.

METHODS

The principal investigator recruited 11 participants who met specific inclusion criteria, then used semi-structured interviews aimed at exploring the lived experiences of the participants while investigating the psychosocial phenomenon influencing CTD development. Interviews were transcribed and analyzed using a process of constant comparison, up until saturation occurred. Trustworthiness techniques were used in the data analysis phase and included peer reviews and member checking.

FINDINGS

The findings suggest that many psychosocial factors contribute to the development and impact of CTDs, at both onset of symptoms and throughout the duration of the condition. A significant number of contextual factors influence participants' function, behavior, relationships, and the course of medical care. Themes derived from the participants' expressions, included the following: 1) an initial strategy of "work through the pain," can be detrimental to symptom resolution and leads to progressive failure to meet role expectations, 2) a pervasive notion of CTDs as "an invisible disability," leaving participants feeling isolated and frustrated when significant others fail to offer support or reject them, 3) participants often delayed reporting symptom development to employers, family members, and medical personnel, risking permanent injury and disability, 4) a "stigma" is attached to CTDs that encourages isolation; however, the social support of even one significant other in a person's life can facilitate adaptation.

DISCUSSION AND CONCLUSION

All participants experienced hardship because of their conditions; however, two of the eleven participants capably navigated the process, using past experience and support from family and employer to successfully adapt. These findings offer support that CTDs are adaptive disorders. The study's conclusion suggests a new model to describe CTD dysfunction and presents new ways of thinking for clinicians who treat the CTD population.

Understanding quality of life within occupational therapy intervention research: A scoping review

INTRODUCTION

There is little consensus regarding the meaning of quality of life (QOL) within occupational therapy literature. Measurement of QOL has varied in both research and practice. This scoping review explored the definitions and measures used within occupational therapy quantitative intervention research to evaluate QOL as an outcome.

METHODS

The review was completed by searching six databases using occupational therapy-related and QOL-related terms. Data were extracted from each article and authors performed descriptive statistics to establish trends for both definitions and measures.

RESULTS

Eighteen publications met the inclusion criteria. Seven articles included a definition of QOL. Most authors defined QOL as a multidimensional construct, comprised of varying domains. Fourteen different standardised measures and two non-standardised measures were utilised.

CONCLUSIONS

A clear conceptualisation of QOL that incorporates occupational therapy values such as client-centredness and holism is needed to advocate for the profession's role in health care and to encourage the development of suitable outcome measures.

A pilot programme evaluation of social farming horticultural and occupational activities for older people in Italy

The aim of this study was to evaluate a 1-year social farming programme conducted between 2014 and 2015, including horticultural and occupational activities on six agricultural farms for older people in good general health. Social farming is a practice that uses agricultural resources to provide health, social or educational services to vulnerable groups of people. Activity participation, social relationships, physical activity, and the quality of life of the participants were assessed using a pretest, posttest design. A total of 112 subjects were interviewed at baseline, though only 73 participants were retained through the end of the follow-up, resulting in a dropout rate of 34%. Data analysis revealed significant improvements in both social relationships and overall occupational engagement at the end of the programme, with significant increases in the frequency of contact with friends or relatives as well as the number of activities performed by the participants. This work adds to the literature on the effects of social farming and indicates that farming may provide opportunities for older people to engage in activities that stimulate social behaviours.

Quality of Life for People with Motor Neurone Disease: A Consideration for Occupational Therapists

Motor neurone disease (MND) is a rapidly progressive neurological disease of unknown cause, which results in relentless loss of function and, conversely, high levels of disability. There has been a significant increase in quality of life (QoL) literature in recent years and the philosophy of the occupational therapy process may be considered consistent with the QoL construct. However, little is documented in occupational therapy literature that promotes consideration of the QoL construct in practice. This may be explained by the profession's adherence to the medical model of health care intervention.

Expectations and desires continually shift for people with MND and individual-perceived QoL is determined by a continuous process of adjustment to increasing disability. In order to promote wellbeing, occupational therapists must identify what people with MND consider important in their lives.

Determining the Effectiveness of a Falls Prevention Programme to Enhance Quality of Life: An Occupational Therapy Perspective

Falls are common in older people and become more frequent with advancing age. Falling in older people is associated with mortality, decreased mobility, premature nursing home admissions and a reduced ability to perform activities of daily living. In an attempt to reduce the incidence of falls, the National Service Framework for Older People has emphasised the need to develop falls services that provide support for older people who have fallen and use health promotion initiatives. While there is evidence to suggest that home modifications can reduce falls in older people, there has been little research to evaluate the effectiveness of occupational therapy falls prevention programmes.

This paper reports the findings of an evaluation of a multifaceted falls prevention programme, which aimed to determine whether occupational therapy could enhance quality of life by educating people aged 65 years and over about the risk of falls. A pre-intervention and post-intervention non-standardised self-administered questionnaire was completed at week 1 and at week 14. Of the 172 older people attending the falls prevention programme, 78 (45%) completed both questionnaires.

The findings from this study suggest that an occupational therapy falls prevention programme can reduce the impact of falls on older people by enhancing confidence to perform activities, which in turn can increase quality of life. However, further research is needed to determine the effectiveness of anxiety management techniques.

Quality of Life for Individuals with Schizophrenia: Validating an Assessment That Addresses Client Concerns and Occupational Issues

This article describes the initial validation study of the Quality of Life Measure for Persons With Schizophrenia (QOLM-S). This new assessment is grounded in a holistic conceptual framework, addresses occupational issues, and was developed on the basis of qualitative data collected from individuals with schizophrenia. Data were collected from 91 individuals with schizophrenia to examine aspects of reliability and validity. Results support both the internal consistency of the QOLM-S, with a Cronbach's alpha reliability coefficient of 0.97 for the overall scale, and concurrent validity. Correlations between the domain and total scores of the QOLM-S provide initial support for construct validity. This study supports the use of the QOLM-S as a descriptive tool. Future research to enhance the clinical utility and further examine the psychometric properties of the QOLM-S are suggested.

Health-related quality of life in boys with Duchenne muscular dystrophy: agreement between parents and their sons

This study investigated agreement between boys and their parents when reporting on health-related quality of life and the effects of steroid use, age, and physical functioning on self-reported health-related quality of life in boys with Duchenne muscular dystrophy. The Pediatric Quality of Life Inventory™ and brief functional measures were administered to 35 parent-son dyads. We found that agreement between parents and their sons was moderate (intraclass correlation coefficient [ICC](2,1) = 0.66; 95% confidence interval [CI], 0.40-0.80) to poor (ICC(2,1) = 0.64; 95% CI, 0.43-0.64). The boys' self-reports revealed a relationship between disease progression and physical functioning (r = -.75; P = .01); however, disease stage was not related to psychosocial functioning (r = -.27; NS). Parents and boys affected by Duchenne muscular dystrophy have a moderate to poor agreement on health-related quality of life measures, with parents reporting lower overall health-related quality of life when compared with their sons.

Feasibility of a computerized method to measure quality of "everyday" life in children with neuromuscular disorders

Measurement of quality of life is becoming increasingly important in health care. Self-reported quality of life is the preferred method of gathering this information, but children are often excluded from this process, their input being replaced by parent-proxy report. This feasibility study tested assessment of "daily" quality-of-life by a self-reported computerized method in boys with neuromuscular disorders. To establish feasibility, the method was required to be engaging, consistent, and convenient. Ten boys, aged 9-16 years, were given a personal digital assistant (PDA) and prompted randomly, eight times/day for 1 week, to answer 19 questions about their daily experiences (including happiness, mood, self-esteem, location, and activity). Subjects completed sampling with an acceptable response rate (79%). Split-week reliability analysis for participant variability (r = 0.45-0.88) indicated acceptable consistency. Participants reported that the method was easy and convenient, and analysis of standardized mean scores supported internal validity. The computerized method to assess "daily" quality of life, from the child's perspective, was feasible and may be useful to understand the impact of disease progression and interventions on day-to-day function.

Occupational Therapy in Chronic Liver Disease: A Gap in Service Delivery

Chronic liver disease (CLD) is increasing worldwide (World Health Organisation 2004). The symptoms that affect people with CLD are nonspecific and include joint pain, fatigue, anxiety, depression and cognitive difficulties. In many chronic diseases, such as chronic fatigue syndrome/myalgic encephalomyelitis and cancer, evidence is available to inform the management of these nonspecific symptoms and the role of the occupational therapist. No literature is available, however, on the role of the occupational therapist in clients with CLD. This opinion piece discusses occupational therapy in other chronic conditions and its applicability in the investigation and management of the symptom burden in people with CLD. It concludes that there is a need for occupational therapists to be at the forefront of research in this clinical area, appreciating the symptoms affecting clients with CLD and working towards developing services and interventions appropriate to this client group.

How can occupational therapists measure outcomes in palliative care?

The objective of this paper is to identify an outcome measure for occupational therapy interventions with palliative clients, in particular Home Assessments. Several possibilities beyond traditional functional measures are considered, and the notion of quality of life (QoL) as a potential measure and routine part of assessment is discussed.A systematic literature search resulted in 45 QoL tools that might be suitable for palliative care. The validation or development papers for these tools were closely examined. Twenty-four instruments met the inclusion criteria for further consideration for use by occupational therapists. The research found that it may be feasible for occupational therapists to use a QoL tool as a routine part of assessing each palliative patient, with the objective of focusing interventions to priority areas identified by the patient. Further work in this area will identify a range of established and validated methods of assessing QoL, suitable for different stages within the palliative phase of illness for purposes including assessment, support and targeted interventions.

Measuring quality of life in prosthetic practice: benefits and challenges

There is an increasing awareness that the inclusion of quality of life as an outcome measure is important in ensuring a client-centred and holistic assessment. This review outlines the benefits of quality of life as an outcome measurement in the field of prosthetics. It introduces the key concepts and challenges in the definition and assessment of quality of life post-amputation, including the relative advantages and disadvantages of adopting generic, disease/condition specific, dimension specific and individualized measures of quality of life. In conclusion, the review delineates and recommends issues and guidelines for consideration when undertaking quality of life research and assessment. A co-ordinated approach by practitioners in the field of prosthetics is necessary to ensure the inclusion of quality of life as an outcome measure and to ensure its measurement in a standardized and rigorous manner.