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Bass JD, Marchant JK, de Sam Lazaro SL, Baum CM. Application of the Person-Environment-Occupation-Performance Model: A Scoping Review. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024; 44:521-540. [PMID: 38519867 PMCID: PMC11180417 DOI: 10.1177/15394492241238951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
The Person-Environment-Occupation-Performance (PEOP) Model is one of several occupation-based models in occupational therapy. The model describes the transactional nature of person, environment, and occupation factors that support performance (doing), participation (engagement), and well-being (health and quality of life). The purpose of this study was to explore the extent and nature of evidence on the PEOP Model. We used a scoping review to identify and analyze journal articles that used the PEOP Model as a framework for study. The PRISMA extension for scoping reviews (PRISMA-ScR) criteria were used to develop the research methods. We found 109 articles that adopted the PEOP Model as an organizing framework. The studies reviewed represent the breadth of occupational therapy practice and the transactional nature of person, environment, occupation, and performance in the PEOP Model. The PEOP Model is a useful international framework for research and practice across populations, conditions, life circumstances, settings, and areas of practice.
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Petrofsky LA, Heffernan CM, Gregg BT, Smith-Forbes EV, Sturdivant RX. Sleep and Military Leaders: Examining the Values, Beliefs, and Quality of Sleep and the Impact on Occupational Performance. Mil Med 2024; 189:1023-1031. [PMID: 36919969 DOI: 10.1093/milmed/usad040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/06/2022] [Accepted: 02/03/2023] [Indexed: 03/16/2023] Open
Abstract
INTRODUCTION Sleep deprivation is rampant within the military population, and insufficient sleep can lead to physical and mental health problems impacting soldier's readiness and deployability. Past research has shown the importance of leadership's role in subordinates' sleep health. Understanding the values, beliefs, and quality of military leader sleep is essential to the development of effective interventions to optimize occupational performance and overall sleep health. Therefore, the purpose of this study was to examine the military leaders' values, beliefs, and sleep quality and the impact on occupational performance. The authors aimed to (1) identify military leaders' sleep quality and beliefs; (2) explore the relationship between military leaders' sleep quality, beliefs and attitudes about sleep, and impact on occupational performance; and (3) examine the value leaders place on sleep for themselves and subordinates in relation to occupational performance. MATERIALS AND METHODS This observational, mixed-methods study design recruited a convenience sample of 109 Army active duty medical service members currently serving in a leadership role. Participants completed an electronic survey to include general demographic information and three self-report measures: the Pittsburgh Quality of Sleep Index, the Dysfunctional Beliefs about Sleep, and the Functional Outcomes of Sleep Questionnaire. Eleven participants completed the semi-structured qualitative interview focusing on sleep values and the impacts on performance. Univariate and multivariate regressions were performed for statistical analysis of the quantitative survey data, whereas thematic analysis was used to analyze the qualitative interview data. This study was approved by the U.S. Army Medical Center of Excellence Institutional Review Board. RESULTS Multivariate regression analysis demonstrated small-to-medium effect sizes (R2 = 0.355-0.559) for relationships between sleep quality, sleep beliefs, functional performance, and demographic variables. More specifically, military grade, position, use of alcohol, time in service, and gender were all found to contribute significantly to scores on the Pittsburgh Sleep Quality Index, the Dysfunctional Beliefs About Sleep Scale-16, and the Functional Outcomes of Sleep Questionnaire-10 (P < .05). Qualitative data resulted in three primary themes: (1) Poor sleep degrades performance, (2) sleep is a top priority, and (3) leaders have a responsibility for subordinates' sleep health. CONCLUSIONS This sample of military leaders was found to perceive themselves as poor-quality sleepers despite demonstrating more functional attitudes and beliefs about sleep and reporting normal-to-mild impairments in daily functioning as a result of daytime sleepiness. Furthermore, findings suggest that leaders' sleep quality and beliefs stand to be further improved, whereas their sleep values need to be consistently demonstrated to subordinates. With a clearer understanding of military leaders' values, beliefs, and sleep quality, future research could focus on implementing and developing holistically based and individualized sleep interventions intended to optimize performance and sleep health.
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Affiliation(s)
- Lyddia A Petrofsky
- U.S. Army Medical Center of Excellence, San Antonio, TX 78234, USA
- U.S. Army-Baylor University, San Antonio, TX 78234, USA
| | - Corinne M Heffernan
- U.S. Army Medical Center of Excellence, San Antonio, TX 78234, USA
- U.S. Army-Baylor University, San Antonio, TX 78234, USA
| | - Brian T Gregg
- U.S. Army-Baylor University, San Antonio, TX 78234, USA
| | - Enrique V Smith-Forbes
- U.S. Army Medical Center of Excellence, San Antonio, TX 78234, USA
- U.S. Army-Baylor University, San Antonio, TX 78234, USA
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Mirza M, Trimboli C, Hartman J, Gamble A, Rfat M, Bentley J, Gross M, Alheresh R, Hussein Q, Markos T. Examining Barriers to Rehabilitation and Addressing Rehabilitation Needs Among Persons With Forced Migration Experiences: Interdisciplinary Perspectives. Arch Phys Med Rehabil 2024:S0003-9993(24)00990-0. [PMID: 38763346 DOI: 10.1016/j.apmr.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 04/01/2024] [Accepted: 05/02/2024] [Indexed: 05/21/2024]
Abstract
Globally, human displacement is at a record high. According to the United Nations High Commissioner for Refugees, 110 million people have been forcibly displaced worldwide owing to persecution, mass conflict, or human rights violations. Conflicts continue to rage in different parts of the world such as Ukraine, Palestine, Sudan, and Tigray. Large-scale political upheaval is also on the rise in many countries such as Haiti, Venezuela, and Iran. Natural disasters fueled by climate change will further contribute to large-scale forced migration. Persons with forced migration experiences (PFMEs) tend to have significant rehabilitation needs because of high risk of physical injuries, mental trauma, and exacerbation of pre-existing health problems during displacement. Rehabilitation practitioners in host countries must be well equipped to address the complex needs of this population. However, there is currently limited literature to guide best practice. In this article, a group of interdisciplinary professionals examine rehabilitation needs among PFMEs, provide examples of established and emerging rehabilitation interventions with PFMEs in the context of asylum and resettlement, identify barriers to accessing rehabilitation services in host countries, and propose avenues for professional advocacy in this area.
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Affiliation(s)
- Mansha Mirza
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, IL, United States.
| | - Concettina Trimboli
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Jeff Hartman
- University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - April Gamble
- Wchan Organization for Victims of Human Rights Violations, Kurdistan, Iraq
| | - Mustafa Rfat
- Brown School of Social Work, Washington University in St. Louis, MO, United States
| | - Jacob Bentley
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | | | - Rawan Alheresh
- Department of Occupational Therapy, University of Jordan, Amman, Jordan
| | - Qusay Hussein
- Steve Hicks School of Social Work, The University of Texas at Austin, TX, United States
| | - Tedros Markos
- Northeastern Illinois University, Chicago, IL, United States
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Hartman AG, Caspero K, Bodison SC, Soehner A, Akcakaya M, DeAlmeida D, Bendixen R. Pediatric Occupational Therapists' Perspectives on Sleep: A Qualitative Descriptive Study. Am J Occup Ther 2024; 78:7803205010. [PMID: 38512128 DOI: 10.5014/ajot.2024.050352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
IMPORTANCE Insufficient sleep is common among children seeking occupational therapy services but is rarely a focus of therapy despite sleep's critical impact on health. OBJECTIVE To examine pediatric occupational therapists' experiences, views, and confidence in addressing sleep concerns in their practice as well as barriers to and supports for doing so. DESIGN A qualitative descriptive study with thematic analysis of data from 1-hr virtual interviews. Rapport building, multiple-coder analysis, and member checking were used to ensure reliability and validity. SETTING Interviews were conducted remotely at each participant's preferred time and location. PARTICIPANTS Pediatric occupational therapists (N = 20) practicing across multiple settings in the United States were recruited through emails directed to their place of work and social media posts. A goal of 20 participants was set a priori with the goal of thematic saturation. OUTCOMES AND MEASURES A semistructured interview guide. RESULTS Participants were predominately cisgender (95%), female (85%), and White, non-Hispanic (90%). Overall, they voiced the importance of sleep but reported almost never writing sleep-related goals. Reported barriers that affected the participants' ability to fully address sleep in practice included therapists' lack of confidence and knowledge and low caregiver buy-in. CONCLUSIONS AND RELEVANCE The findings identify themes on the basis of which actionable steps toward promoting occupational therapists as sleep champions can be developed. Future implications include increasing sleep education opportunities, enhancing awareness of sleep health's impact on goal areas, and facilitating discussions about occupational therapy's role within the medical system and family system in supporting sleep. Plain-Language Summary: This qualitative study identifies what helps and hinders occupational therapists in addressing the sleep health concerns of their clients. We give occupational therapy clinicians and educators key supports to seek out or barriers to address.
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Affiliation(s)
- Amy G Hartman
- Amy G. Hartman, PhD, OTR/L, is Postdoctoral Fellow, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA;
| | - Kaitlyn Caspero
- Kaitlyn Caspero, MS, OTR/L, is Occupational Therapist and Founder, OT Graphically, Frederick, MD
| | - Stefanie C Bodison
- Stefanie C. Bodison, OTD, OTR/L, FAOTA, is Assistant Professor, Department of Occupational Therapy, University of Florida, Gainesville
| | - Adriane Soehner
- Adriane Soehner, PhD, is Assistant Professor, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Murat Akcakaya
- Murat Akcakaya, PhD, is Associate Professor, Department of Engineering, University of Pittsburgh, Pittsburgh, PA
| | - Dilhari DeAlmeida
- Dilhari DeAlmeida, PhD, is Associate Professor and Program Director, Department of Health Information Management, University of Pittsburgh, Pittsburgh, PA
| | - Roxanna Bendixen
- Roxanna Bendixen, PhD, OTR/L, FAOTA, is Associate Professor and Division Director, Department of Occupational Therapy, Medical University of South Carolina, Charleston
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Shelgikar AV. Sleep Education: A Narrative Review on Barriers and Opportunities to Grow a Diverse Sleep Team. Chest 2024; 165:1239-1246. [PMID: 38331383 DOI: 10.1016/j.chest.2024.01.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 11/15/2023] [Accepted: 01/27/2024] [Indexed: 02/10/2024] Open
Abstract
The increased recognition of sleep-wake disorders and their effects, along with the anticipated shortage of sleep medicine specialists, heralds a concomitant need to have more health care providers with dedicated training in the evaluation and management of sleep disorders across the life span. A narrative review of published literature on sleep education was conducted and identified factors related to diversity within the sleep team, barriers to implementation of sleep education, and strides in sleep education. Implementation of novel sleep education strategies will require creative navigation of barriers such as allocation of curricular time, availability of teaching faculty, and funding to train more members of the sleep team. Deliberate coordination within and across health professions programs, with efforts to share resources and leverage technology, will be instrumental to guide the next phase of growth in sleep education.
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Zhou L, Suwa S. Association among cognitive function, daytime activities, and nighttime sleep in older adults in a long-term care facility. Jpn J Nurs Sci 2024; 21:e12571. [PMID: 37937410 DOI: 10.1111/jjns.12571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 09/27/2023] [Accepted: 10/07/2023] [Indexed: 11/09/2023]
Abstract
AIM To determine how the nighttime sleep patterns of older adults in a long-term care facility vary according to cognitive function and participation in daytime activities. METHODS This observational study was conducted with older adults aged ≥65 years who are residents of a long-term care facility. Nighttime sleep was monitored using a non-wearable sleep monitor for 8 weeks. Based on the Mini-Mental State Examination scores for assessment of cognitive function, participants were classified into non-dementia, mild-to-moderate dementia, and severe dementia groups. The Mann-Whitney U test and Kruskal-Wallis test were used to analyze the data. RESULTS Twenty three older adults were included in this study. Sleep onset latency was significantly longer in the severe dementia group than in the non-dementia (p = .027) and mild-to-moderate dementia (p = .041) groups. Sleep efficiency was significantly lower in the severe dementia group than in the mild-to-moderate dementia group (p = .003), whereas wakefulness after sleep onset was significantly longer in the severe dementia group than in the mild-to-moderate dementia group (p = .011). The number of days spent engaging in recreational activities was <50%, whereas those spent taking a nap was >60% in all older adults. Older adults with mild-to-moderate dementia had better sleep and participated in more daytime activities than those with severe or no dementia. Moreover, bathing in a bathtub improved sleep onset latency. CONCLUSIONS This study demonstrates that participation in daytime activities and bathing in a bathtub affect nighttime sleep in older adults.
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Affiliation(s)
- Lu Zhou
- Doctoral Program, Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Sayuri Suwa
- Department of Community Health Nursing, Division of Innovative Nursing for Life Course, Graduate School of Nursing, Chiba University, Chiba, Japan
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Bailliard AL, Carroll A, D'Agostino EM. Predictors of Population Mental Health in Montana: An Occupational Justice Perspective. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024:15394492241230906. [PMID: 38369726 DOI: 10.1177/15394492241230906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Population-level analyses can demonstrate occupational injustices and their impact on population health. The objective of this article is to examine whether population-level occupational factors are related to the mental health of Montanans. We used linear regression models of the 2021 Montana County Health Rankings to examine the association between occupational justice and mental health, adjusting for covariates. Predictor variables were access to exercise, insufficient sleep, healthy food access, food insecurity, proximal jobs, and social support. Outcome variables were frequent mental health distress and poor mental health days. Adjusted models showed significant associations between both insufficient sleep (β = 0.25, 95% confidence interval [CI] = [0.0.11, 0.40]; Table 2) and food insecurity (β = 0.32, 95% CI = [0.22, 0.43]) and poor mental health days z scores. Adjusted models also showed significant associations between insufficient sleep (β = 0.18, 95% CI = [0.10, 0.26]) and food insecurity (β = 0.19, 95% CI = [0.12, 0.25]) and frequent mental health distress. Future research should study whether targeting sleep and food security can enhance Montanans's mental health.
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Hwang HS, Kim H. Factors Affecting the Quality of Sleep and Social Participation of Stroke Patients. Brain Sci 2023; 13:1068. [PMID: 37509000 PMCID: PMC10377525 DOI: 10.3390/brainsci13071068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Stroke patients are exposed to various psychosocial factors, such as depression, anxiety, and stress, which can cause problems with respect to their quality of sleep and social participation. (2) Objectives: We analyzed the causal relationships between the factors affecting sleep quality and social participation in hospitalized and community-based stroke patients using a path analysis model. (3) Methods: A questionnaire survey was administered to stroke patients from June to November 2020 using the Pittsburgh Sleep Quality Index to assess sleep quality; the Beck Depression Inventory to assess depression; the Beck Anxiety Inventory to assess anxiety; the Stress Scale to assess stress; and the Reintegration to Normal Living Index to assess participation. The data thus obtained were subjected to descriptive statistics, frequency analysis, and Pearson correlation analysis. In addition, anxiety, stress, and spasticity were set as exogenous variables to perform path analysis of their causal effects on depression (parameter), sleep quality, and social participation (final endogenous variables). (4) Results: In total, 145 people participated in this study, and the data of 129 people, excluding 16 insincere respondents, were analyzed. The general characteristics of the subjects comprised 84 males (65.1%) and 45 females (34.9%). Poor sleep quality comprised 54.3%, and good sleep quality comprised 45.7%, where the average age was 58.29 ± 15.46 years and the duration from onset was 39.73 ± 51.49 months. This study confirmed correlations between social participation and sleep quality, spasticity, depression, anxiety, and stress. Path analysis also revealed that anxiety and stress led to depression and that depression is a risk factor for sleep quality and social participation. (5) Conclusions: Sleep quality and social participation in stroke patients play an important role in rehabilitation. By carrying out this study, direct and indirect factors that affect sleep quality and social participation were analyzed, and the quality level in rehabilitation treatment should be improved from a structural point of view when approaching psychosocial factors.
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Affiliation(s)
- Ho-Sung Hwang
- Department of Occupational Therapy, Konyang University of Occupational Therapy, 158 Gwanjeodong-ro, Seo-gu, Daejeon 35365, Republic of Korea
| | - Hee Kim
- Department of Occupational Therapy, Konyang University of Occupational Therapy, 158 Gwanjeodong-ro, Seo-gu, Daejeon 35365, Republic of Korea
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Wheeler S, Acord-Vira A. Occupational Therapy Practice Guidelines for Adults With Traumatic Brain Injury. Am J Occup Ther 2023; 77:7704397010. [PMID: 37624997 DOI: 10.5014/ajot.2023.077401] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023] Open
Abstract
IMPORTANCE Occupational therapy practitioners are uniquely qualified to address the occupational needs of people with traumatic brain injury (TBI) and their caregivers to maximize participation, health, and well-being. OBJECTIVE These Practice Guidelines are informed by systematic reviews of the effectiveness of interventions that address impairments and skills to improve the occupational performance of people with TBI, as well as interventions for caregivers of people with TBI. The purpose of these guidelines is to summarize the current evidence available to assist clinicians' clinical decision-making in providing interventions for people with TBI and their caregivers. METHOD We reviewed six systematic reviews and synthesized the results into clinical recommendations to be used in occupational therapy clinical practice. RESULTS Sixty-two articles served as the basis for the clinical recommendations. CONCLUSIONS AND RECOMMENDATIONS Strong to moderate evidence supports multimodal sensory stimulation, unimodal auditory stimulation, physical activity, virtual reality, cognitive interventions, vision therapy, goal-focused interventions, individual and group training and education, and caregiver supports. Occupational therapy practitioners should incorporate these interventions into individual and group sessions to maximize recovery and promote occupational participation. Additional interventions are also available, based on emerging evidence and expert opinion, including prevention approaches, complexity of injury, and the use of occupation-based performance assessments. What This Article Adds: These Practice Guidelines provide a summary of evidence in clinical recommendations tables supporting occupational therapy interventions that address impairments resulting from and skills to improve occupational performance after TBI. The guidelines also include case study examples and evidence graphics for practitioners to use to support clinical reasoning when selecting interventions that address the goals of the person with TBI and their caregiver's needs.
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Affiliation(s)
- Steven Wheeler
- Steven Wheeler, PhD, OTR/L, FAOTA, CBIS, is Professor and Chair of Occupational Therapy, Division of Occupational Therapy, West Virginia University, Morgantown;
| | - Amanda Acord-Vira
- Amanda Acord-Vira, EdD, OTR/L, FAOTA, CBIS, is Associate Professor of Occupational Therapy, Division of Occupational Therapy, West Virginia University, Morgantown
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Experiences of Using Weighted Blankets among Children with ADHD and Sleeping Difficulties. Occup Ther Int 2023; 2023:1945290. [PMID: 36824380 PMCID: PMC9943603 DOI: 10.1155/2023/1945290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/14/2022] [Accepted: 02/01/2023] [Indexed: 02/16/2023] Open
Abstract
Introduction Sleeping difficulties are common in children with attention deficit hyperactivity disorder (ADHD). A sleep intervention with weighted blankets was designed to increase current understanding of using weighted blankets to target children's individual needs in connection with sleep and daytime functioning. Aim To explore how children with ADHD and sleeping difficulties experience the use of weighted blankets. Methods An explorative qualitative design in which 26 children with ADHD and sleeping difficulties, 6-15 years old, were interviewed about a sleep intervention with weighted blankets. Four categories emerged from qualitative content analysis. Results Children's experiences revealed that the use of weighted blankets 1) requires a commitment, by adjusting according to needs and preferences and adapting to the environment; 2) improves emotional regulation by feeling calm and feeling safe; 3) changes sleeping patterns by creating new routines for sleep and improving sleep quality; and 4) promotes everyday participation by promoting daily function and balancing activity and sleep. Conclusions Using weighted blankets promoted children's management of daily life with ADHD and sleeping difficulties. Occupational therapists can improve the assessment and delivery of weighted blankets tailored to individual needs based on increased knowledge from the children themselves.
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Odéus E, Pauli E, Steingrímsson S, Cederlund M, Franzén S, Helgesson C, Nyström K, Sondell J, Opheim A. Weighted blankets for sleep problems - prescription, use and cost analysis. Scand J Occup Ther 2023; 30:211-221. [PMID: 35500251 DOI: 10.1080/11038128.2022.2066017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Weighted blankets (WBs) have been suggested as a treatment option for insomnia and are commonly prescribed despite lack of evidence of efficacy. AIM To investigate prescription pattern, return rate and cost of WBs. MATERIAL AND METHODS This observational cohort register-based study in western Sweden included every individual who, in a 2.5-year period, was prescribed and received at least one WB (n = 4092). A cost evaluation was made by mapping prescription processes for WBs and sleep medication. RESULTS Individuals diagnosed with dementia, anxiety, autism or intellectual disability (ID) retained the WB longer than others. Individuals younger than six and older than 65 years had shorter use time. The cost evaluation showed that the prescription process for WBs was longer and resulted in a higher cost than for sleep medication. CONCLUSIONS Some individuals had longer use time, indicating a possible benefit from using a WB. Due to low risk of harm but high economic cost, a revision of the WBs prescription process could be recommended to identify those who might benefit from WB. SIGNIFICANCE Our result points towards a need for revision of the prescription process, to implement standardized sleep assessments, and create a more efficient prescription process to lower the cost.
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Affiliation(s)
- Ellen Odéus
- Region Västra Götaland, Sahlgrenska University Hospital, Queen Silvias Children's hospital, Department of Occupational and Physiotherapy, Gothenburg, Sweden.,Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Emelie Pauli
- Region Västra Götaland, Sahlgrenska University Hospital, Gothia Forum for Clinical Trials, Gothenburg, Sweden
| | - Steinn Steingrímsson
- Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Psychiatry, Gothenburg, Sweden
| | - Mats Cederlund
- Region Västra Götaland, Habilitation & Health, Gothenburg, Sweden
| | - Stefan Franzén
- Region Västra Götaland, The Swedish National Diabetes Register, Gothenburg, Sweden.,Sahlgrenska Academy, Health Metrics Unit, University of Gothenburg, Gothenburg, Sweden
| | - Carina Helgesson
- Region Västra Götaland, Regional Primary Health Care Unit, Health Care pharmacy and Medical aid, Gothenburg, Sweden
| | - Kristina Nyström
- Region Västra Götaland, Habilitation & Health, Gothenburg, Sweden
| | - John Sondell
- Region Västra Götaland, Head Office, Department of Data management and Analysis, Gothenburg, Sweden
| | - Arve Opheim
- Region Västra Götaland, Habilitation & Health, Gothenburg, Sweden.,Sahlgrenska Academy, Institute of Neuroscience and Physiology, Rehabilitation Medicine, University of Gothenburg, Gothenburg, Sweden
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Lee A, Boykin L. Manuscript: effects of bereavement on graduate students: a qualitative study. CADERNOS BRASILEIROS DE TERAPIA OCUPACIONAL 2023. [DOI: 10.1590/2526-8910.ctoao245532132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
Abstract Introduction Bereavement can be characterized by the loss, through death, of a significant person. Individuals who experience bereavement can experience changes in their roles, habits, and routines. In addition, individuals can experience changes in their occupations, such as social and leisure participation and in their activities of daily living. Objective This research aimed to identify graduate students' needs and problem areas following the loss of a loved one to better inform the role of occupational therapy in assisting students during the bereavement process. Method This study utilized a mixed-methods approach. The survey developed and distributed to participants contained qualitative and quantitative data to understand better the relationship between grief, occupational participation, and academic performance. Results This study reviewed the students' needs and problem areas after losing a loved one and determined the areas that impact students' daily living. Conclusion This study demonstrated that losing a loved one affects students' academic performance and ability to perform daily activities.
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Affiliation(s)
- Amanda Lee
- University of Saint Augustine, United States of America
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The telehealth program of occupational therapy among older people: an up-to-date scoping review. Aging Clin Exp Res 2023; 35:23-40. [PMID: 36344805 PMCID: PMC9640899 DOI: 10.1007/s40520-022-02291-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND The average life expectancy of older people is increasing, and most seniors desire to age at home and are capable of living independently. Occupational therapy (OT) is client-centered and uses patients' meaningful activities, or occupations, as treatment methods, thus playing an important role in later adulthood. Telemedicine removes the constraints of time and space, and the combination of OT and telemedicine can greatly improve medical efficiency and clinical effectiveness. AIMS The purpose of this scoping review was to examine the scope and effectiveness of telehealth OT for older people. METHODS This scoping review was conducted following the methodological framework proposed by Arksey and O'Malley. We searched the literature in five databases following the PICOS (Population, Intervention, Comparison, Outcome, Study design) guideline, from inception to April 2022. Two trained reviewers independently retrieved, screened, and extracted data, and used a descriptive synthesizing approach to summarize the results. RESULTS The initial search yielded 1249 studies from databases and manual searches, of which 20 were eligible and were included in the final review. A thematic analysis revealed five main themes related to telehealth OT: occupational assessment, occupational intervention, rehabilitation counseling, caregiver support, and activity monitoring. CONCLUSIONS Telehealth OT has been used widely for older people, focusing primarily on occupational assessment and intervention provided conveniently for occupational therapists and older clients. In addition, telehealth OT can monitor patients' activities and provide rehabilitation counseling and health education for the elderly and their caregivers, thus improving the security of their home life and the efficacy of OT. During the COVID-19 pandemic, telehealth will be an effective alternative to face-to-face modalities.
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Enam N, Grampurohit N, Farber RS. Sleep Management within Skilled Nursing Facilities: A Practice Survey. Occup Ther Health Care 2023; 37:1-17. [PMID: 33228469 DOI: 10.1080/07380577.2020.1846234] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A cross-sectional descriptive survey of 105 occupational therapy practitioners examined the practice patterns in sleep management within skilled nursing facilities. All participants viewed sleep as essential to address in their settings, since clients frequently reported inadequate sleep, daytime sleepiness, difficulty staying asleep, and situational interruption. Majority of the practitioners reported not screening, assessing, treating, or documenting sleep issues and lack the use of standardized assessments and evidence-based interventions for sleep. Results suggest that practitioners need more training, education, and advocacy skills to promote the role of occupational therapy in addressing sleep management in skilled nursing facilities.
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Affiliation(s)
- Nabila Enam
- Occupational Therapy, University of the Sciences, Philadelphia, PA, USA
| | - Namrata Grampurohit
- Occupational Therapy, Thomas Jefferson University - Center City Campus, Philadelphia, PA, USA
| | - Ruth S Farber
- Rehabilitation Sciences/Occupational Therapy, Temple University, Philadelphia, PA, USA
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Ludwig R, Eakman A, Bath-Scheel C, Siengsukon C. How Occupational Therapists Assess and Address the Occupational Domain of Sleep: A Survey Study. Am J Occup Ther 2022; 76:23962. [PMID: 36399390 PMCID: PMC9891903 DOI: 10.5014/ajot.2022.049379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
IMPORTANCE Sleep is a foundational occupation in the Occupational Therapy Practice Framework: Domain and Process (2nd ed.), yet little is known about how occupational therapists assess and address sleep in practice. OBJECTIVE To survey practicing occupational therapists' comfort with their level of knowledge about sleep, how they are assessing and addressing sleep in clinical practice, and the amount of sleep-related education they have received. DESIGN Cross-sectional survey study. SETTING Electronic survey. PARTICIPANTS Practicing occupational therapists were invited to participate in November 2020. Survey invitations were sent via email targeting occupational therapists serving as clinical instructors. OUTCOMES AND MEASURES The survey consisted of 41 items assessing comfort with sleep knowledge, occupation of sleep, and sleep education received. This survey was modified from a previous survey and tailored to the occupational therapy profession. RESULTS A total of 169 occupational therapists completed the survey. Most (87%) agreed that sleep was an occupation, but only 44% evaluated their clients' sleep, and 30% established treatment goals pertaining to sleep. In addition, 66% reported not receiving education about sleep in their entry-level occupational therapy program, and 78% reported receiving no continuing education about sleep in the past 2 yr. Most (92%) reported that occupational therapists should be better prepared to evaluate and treat sleep after graduation. CONCLUSIONS AND RELEVANCE Most occupational therapists identified sleep as an area of occupation but had limited knowledge of how to assess and address sleep in practice. Entry-level occupational therapy education programs must enhance sleep-related curricula, and continuing education programs tailored to sleep issues within occupational therapists' practice are needed. What This Article Adds: The results of this study indicate gaps in occupational therapists' knowledge regarding how best to assess and treat sleep problems. We offer next steps to improve the profession's capacity to address the occupation of sleep.
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Affiliation(s)
- Rebecca Ludwig
- Rebecca Ludwig, OTR/L, is PhD candidate, Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City;
| | - Aaron Eakman
- Aaron Eakman, PhD, OTR/L, FAOTA, is Associate Professor, Department of Occupational Therapy, Colorado State University, Fort Collins
| | - Carrie Bath-Scheel
- Carrie Bath-Scheel, PhD, OT/L, is Professor Emeritus, Department of Occupational Therapy, Concordia University Wisconsin, Mequon, and Director of Ergonomics, OccuPro, Kenosha, WI
| | - Catherine Siengsukon
- Catherine Siengsukon, PhD, PT, is Associate Professor, Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City
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Ho ECM, Siu AMH. Evaluation of an occupation-based sleep program for people with Insomnia. Hong Kong J Occup Ther 2022; 35:168-179. [DOI: 10.1177/15691861221136261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Sleep problems are a health issue worldwide. Based on the Person-Environment-Occupation-Performance model, we developed an occupation-based sleep programme to promote awareness of sleep hygiene factors, promote an environment conductive to sleep, and restructure participation in daytime activities with a focus on occupational balance. Method This study uses a non-equivalent group design to evaluate the effectiveness of an occupation-based sleep intervention among community-dwelling adults with insomnia, when compared with a treatment-as-usual (TAU) group which focused on sleep hygiene, and relaxation. Results When compared with the TAU group ( n = 20), the intervention group ( n = 22) had significant improvement in sleep duration, occupational balance, and reduction in mood symptoms at both post treatment and 1-month follow up. Conclusion The results demonstrated that an occupation-based programme is an effective treatment for insomnia disorder and demonstrated the role which occupational therapy could play in primary health care service.
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Affiliation(s)
- Eris C. M. Ho
- Occupational Therapy Department, Tai Po Hospital, Hospital Authority, New Territories, Hong Kong
| | - Andrew M. H. Siu
- Department of Health Sciences, Brunel University London, London, UK
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McVeigh J, Crozier M, Macinnes V, Morris-McCall J, Stewart S, Hick S, Thompson C. Occupational therapists’ perspectives on current practice in chronic pain and sleep disturbances. Br J Occup Ther 2022. [DOI: 10.1177/03080226221083230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Chronic pain and sleep disturbances are often co-morbid. Sleep disturbances can negatively affect self-care occupations, cognition, mood, emotional functioning and physical wellbeing. Aim To explore occupational therapists’ experience working with clients with chronic pain and sleep difficulties. Method Semi-structured interviews were conducted with 11 occupational therapists with experience working with clients with sleep disturbances and chronic pain. Findings The relationship between sleep disturbances and chronic pain was described as being complex and multifaceted. Participants believed they were uniquely placed to work with clients experiencing these two conditions. They felt inadequately equipped to treat sleep disturbances and chronic pain. Participants indicated that best practice required multiple interventions and a team-based approach. Finally, the participants noted that sleep disturbances and chronic pain are a growing area of practice. Conclusion The findings suggest that occupational therapists tailor their intervention strategies to be early, multi-pronged and individualised. Institutional barriers need to be addressed to further develop occupational therapists’ skill set when working in the areas of sleep and chronic pain. Further research to support the interventions currently used in practice to treat these two conditions is needed.
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Affiliation(s)
- J McVeigh
- Curtin School of Allied Health, Curtin University, Perth, Australia
- Movement Physiology Laboratory, University of Witwatersrand, Johannesburg, South Africa
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Molly Crozier
- Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Venetia Macinnes
- Curtin School of Allied Health, Curtin University, Perth, Australia
| | | | - Sophie Stewart
- Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Shannon Hick
- Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Craig Thompson
- Curtin School of Allied Health, Curtin University, Perth, Australia
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
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Nielsen SS, Skou ST, Larsen AE, Søndergaard J, Christensen JR. Associations of health-related quality of life with sociodemographic characteristics, health, pain, and lifestyle factors, and motivation for changing lifestyle in adults living with chronic pain: a cross-sectional exploratory study. Scand J Pain 2022; 22:142-153. [PMID: 34449176 DOI: 10.1515/sjpain-2021-0062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 08/09/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES We investigated the associations between health-related quality of life (HRQoL) and health, pain and lifestyle factors, as well as motivation for lifestyle changes, in adults living with chronic pain referred to a Danish pain centre. METHODS A total of 144 outpatients completed a questionnaire on HRQoL (EQ-5D-5L), health, pain, lifestyle factors (Body Mass Index [BMI], physical activity, smoking, alcohol, physical fitness, eating, sleep and stress) and motivation for lifestyle changes. We used multiple linear regression analyses to assess associations between HRQoL and the independent variables. RESULTS The participants (age mean 50 years, 81% females) had ≥2 body pain sites (93%), BMI≥25 (64%), sedentary lifestyle (43%) and multiple (n≥2) elevated metabolic risk factors (58%). Most considered lifestyle important for HRQoL (72%) and expressed moderate to very high motivation for changing lifestyle (92%). Poorer HRQoL in the study population was significantly associated with higher pain intensity in the most painful body site (β=-0.316, p=0.001) and very poor sleep quality (β=-0.410, p=0.024). Serious-to-extreme problems in usual activities were associated with significantly poorer health (β=-0.328, p=0.030). CONCLUSIONS Adults living with chronic pain participating in this survey had significantly lower self-evaluated HRQoL than the general population. Lower HRQoL was significantly associated with greater pain intensity and poor sleep quality. Serious-to-extreme problems in usual activities, such as work, study, housework, family and leisure, were associated with poorer self-evaluated health. We observed high frequencies of overweight, obesity, sedentary lifestyle, pain in multiple body sites and multiple lifestyle-related risk factors in the study population. Most participants felt motivated for changing lifestyle. Further interventions addressing pain alleviation, sleep quality, prevention of problems in usual activities and promotion of healthy lifestyle, e.g. physical activity and healthy eating, are needed to estimate the effect of a lifestyle-oriented approach on health and quality of life in people living with chronic pain. The results of this study will inform the research project reg. SJ-703, the Danish the Research Ethics Committee for Region Zealand, Denmark.
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Affiliation(s)
- Svetlana Solgaard Nielsen
- Research Unit of User Perspectives and Community-Based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Naestved, Slagelse & Ringsted Hospitals, Slagelse, Denmark
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Søren T Skou
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Naestved, Slagelse & Ringsted Hospitals, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Anette Enemark Larsen
- Department of Occupational Therapy, Institute of Therapy and Midwifery Studies, Faculty of Health Sciences, University College Copenhagen, Copenhagen, Denmark
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jeanette Reffstrup Christensen
- Research Unit of User Perspectives and Community-Based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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BİLSEL BA, AYDÖNER S. Çevre Faktörü ve Ergoterapi: Teori ve Model Yaklaşımları. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2021. [DOI: 10.38079/igusabder.995196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Levine D, Work B, McDonald S, Harty N, Mabe C, Powell A, Sanford G. Occupational Therapy Interventions for Clients with Ehlers-Danlos Syndrome (EDS) in the Presence of Postural Orthostatic Tachycardia Syndrome (POTS). Occup Ther Health Care 2021; 36:253-270. [PMID: 34520307 DOI: 10.1080/07380577.2021.1975200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Postural orthostatic tachycardia syndrome (POTS) is often seen in clients with Ehlers-Danlos syndrome (EDS), primarily hypermobile EDS. Research has shown clients with EDS and POTS may experience limitations affecting not only their physical function, but also their social, emotional, and mental well-being. Using a client-centered approach, occupational therapy practitioners assess health, well-being, symptomatology (fatigue, muscle pain, dizziness, etc.), participation and engagement in occupation, and provide interventions to improve quality of life. This paper will address occupational therapy interventions to treat common symptomatology for clients with EDS in the presence of POTS, including environmental modifications, use of adaptive equipment and orthoses, exercise and fall prevention, energy conservation and pacing, sleep hygiene, and routine and habit development to promote optimal engagement in meaningful occupations.
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Affiliation(s)
- David Levine
- Department of Physical Therapy, The University of Tennessee at Chattanooga, Chattanooga, TN, USA
| | - Brittany Work
- Department of Occupational Therapy, The University of Tennessee at Chattanooga, Chattanooga, TN, USA
| | - Susan McDonald
- Department of Occupational Therapy, The University of Tennessee at Chattanooga, Chattanooga, TN, USA
| | - Nicole Harty
- Department of Occupational Therapy, The University of Tennessee at Chattanooga, Chattanooga, TN, USA
| | - Carolee Mabe
- Department of Occupational Therapy, The University of Tennessee at Chattanooga, Chattanooga, TN, USA
| | - Alison Powell
- Department of Occupational Therapy, The University of Tennessee at Chattanooga, Chattanooga, TN, USA
| | - Graceline Sanford
- Department of Occupational Therapy, The University of Tennessee at Chattanooga, Chattanooga, TN, USA
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Ho ECM, Dür M, Stamm T, Siu AMH. Measuring the occupational balance of people with insomnia in a Chinese population: Preliminary psychometric evidence on the Chinese version of the Occupational Balance Questionnaire. Hong Kong J Occup Ther 2020; 33:33-41. [PMID: 33815022 PMCID: PMC8008376 DOI: 10.1177/1569186120944534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 05/31/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Occupational balance, a fundamental concept in occupational therapy, is the arrangement of right amount and variety of occupations contributes to a person's health and well-being. This study was aimed to investigate the reliability and validity of the Chinese version of the Occupational Balance Questionnaire (OB-Quest) for people with insomnia. METHODS The OB-Quest was translated into traditional Chinese and reviewed by an expert panel for content validity, cultural relevance and translation accuracy. Internal consistency, factor analysis and convergent validity, as well as test-retest reliability, were explored. RESULTS The participants (n = 205), 115 adults with insomnia and 90 adults without insomnia, completed a survey of demographic background, the Chinese version of OB-Quest and the Chinese Insomnia Severity Index (C-ISI). The Chinese version of OB-Quest demonstrated excellent test-retest reliability (ICC= 0.98) and good internal consistency (Cronbach's α = 0.80). Factor analysis indicated that a single-factor solution explained 42% of the variance, and 9 out of 10 items had a factor loading of 0.4 or above. The Chinese version of OB-Quest had significant correlations with C-ISI (r = -0.88; p < 0.001). A significant difference was found in occupational balance between groups with different levels of insomnia severity and without insomnia (F = 169.72; p < 0.001). As in a previous study, age, living environment and life role had no significant relationship with occupational balance. CONCLUSION The Chinese version of OB-Quest is a short, easy to understand and culturally relevant assessment for Chinese. It demonstrates satisfactory psychometric properties and had significant correlations with insomnia.
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Affiliation(s)
| | - Mona Dür
- IMC University of Applied Sciences Krems, Austria
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Jones C, Moyle W. A feasibility study of Dreampad™ on sleep, wandering and agitated behaviors in people living with dementia. Geriatr Nurs 2020; 41:782-789. [PMID: 32522427 DOI: 10.1016/j.gerinurse.2020.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 04/19/2020] [Accepted: 04/22/2020] [Indexed: 11/17/2022]
Abstract
This feasibility study examined Dreampad™, a sleeping device, on sleep, wandering and agitated behaviors in people living with dementia. Four nursing home residents (2 males and 2 females; mean age = 89.8 years (SD = 7.2); mean MMSE scores = 9.3 (SD = 8.7)) used Dreampad™ daily over 4-weeks when they slept. Agitation was assessed pre- and post-intervention. Wandering and sleeping patterns were assessed using a wearable actigraphy device over 24 hours at baseline and every week during the intervention. Dreampad™ was deemed acceptable and feasible for use with people living with dementia by family and care staff. No support for Dreampad™ in improving sleep or behaviors of agitation and wandering was found. Challenges in using the wearable actigraphy device are reported. Attention is needed to ensure consistent use of Dreampad™ by people living with dementia and their wear adherence of the actigraphy device. Further rigorous research is warranted and can be guided by the study outcomes.
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Affiliation(s)
- Cindy Jones
- Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia; Menzies Health Institute Queensland, Australia.
| | - Wendy Moyle
- School of Nursing and Midwifery, Griffith University, Queensland, Australia; Menzies Health Institute Queensland, Australia.
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Magnusson L, Håkansson C, Brandt S, Öberg M, Orban K. Occupational balance and sleep among women. Scand J Occup Ther 2020; 28:643-651. [PMID: 32186421 DOI: 10.1080/11038128.2020.1721558] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND In occupational therapy, while several studies have focussed on occupational balance, few have investigated it in the context of sleep. AIMS The aim of this study was to investigate the associations between sleep and occupational balance among women. MATERIAL AND METHODS In total, 157 women responded to the Occupational Balance Questionnaire and Karolinska Sleep Questionnaire. Linear regression was used to analyse data. RESULTS The median score for occupational balance was 12 (interquartile range [IQR] 9), while that for sleep was 86 (IQR 16). Sleep and sleepiness fatigue were significantly associated (p < 0.1) with satisfaction with the number of occupations during a regular week. Difficulties awakening and snoring disorders were significantly associated (p < 0.1) with balance with physical, social, intellectual, and restful occupations. CONCLUSIONS The majority of participants slept well and had a good sleep quality. There is an association between occupational balance and sleep. In particular, aspects related to the number of occupations, adequate time to perform them and the time spent recovering and sleeping were associated with good sleep quality. Balance among physical, social, intellectual, and restful occupations was associated with difficulties awakening and snoring. SIGNIFICANCE Our results support the need for occupational therapists to focus on occupational balance, to improve women's sleep.
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Affiliation(s)
- Lina Magnusson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Carita Håkansson
- Division of Occupational and Environmental Medicine, Faculty of Medicine, Lund University, Lund, Sweden
| | - Sofie Brandt
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Malin Öberg
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Kristina Orban
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Akbarfahimi M, Nabavi SM, Kor B, Rezaie L, Paschall E. The Effectiveness of Occupational Therapy-Based Sleep Interventions on Quality of Life and Fatigue in Patients with Multiple Sclerosis: A Pilot Randomized Clinical Trial Study. Neuropsychiatr Dis Treat 2020; 16:1369-1379. [PMID: 32581540 PMCID: PMC7269630 DOI: 10.2147/ndt.s249277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Sleep difficulties are common in patients with multiple sclerosis (MS), which may increase feelings of fatigue, negatively interfere with daily activities, and consequently reduce their quality of life. Studies examining the effects of sleep-targeted interventions in MS are currently limited in the literature. Therefore, we aim to assess the effects of occupational therapy interventions on sleep quality, fatigue, and quality of life in patients with MS. PATIENTS AND METHODS In a single-blind, randomized, controlled trial, which occurred between April 2018 and March 2019 in Tehran, Iran, 20 eligible patients with MS were assessed using the Pittsburgh Sleep Quality Index (PSQI), Fatigue Impact Scale (FIS), Fatigue Severity Scale (FSS), and Short-Form Health Survey (SF-36). Patients were allocated randomly into the two following groups: patients receiving care-as-usual for MS (CAU) and patients receiving care-as-usual plus intervention (CAU + intervention). Both intervention groups underwent 2-3 sessions per week lasting 30-45 minutes for 8 weeks and received follow-up assessments. Data were analyzed using independent sample t-tests and Mann-Whitney U tests using SPSS (16 ver.) statistical software. RESULTS In the intervention group, sleep quality improved significantly across all items (p<0.001, effect size = 0.60) except for sleep efficiency and the use of sleep medications. FSS and FIS in the sleep intervention group were significantly reduced (p<0.001, effect size = 0.76 and p<0.001, effect size = 0.82, respectively). The quality of life in the intervention group improved significantly (p<0.004, effect size = 0.51-0.76) with the exception of the social functioning subgroup. CONCLUSION Although this is the result of a pilot study and more patients should be added, this intervention program demonstrates improvement in sleep quality and quality of life while decreasing fatigue in patients with MS. Adjunction of this program, if results are similar with more patients, to routine occupational therapy (OT) interventions can help improve the rehabilitation program of MS patients.
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Affiliation(s)
- Malahat Akbarfahimi
- Department of Occupational Therapy, School of Rehabilitation Sciences, Neuroscience Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Massood Nabavi
- Regenerative Biomedicine Department, Cell Research Center, Royan Institute for Stem Cell Biology and Technology, ACCR, Tehran, Iran
| | - Benyamin Kor
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Leeba Rezaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ethan Paschall
- Clinical Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
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