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Müllenmeister C, Stoelting A, Schröder D, Schmachtenberg T, Ritter S, El-Sayed I, Steffens S, Klawonn F, Klawitter S, Homann S, Mikuteit M, Berg C, Behrens G, Hummers E, Cook A, Müller F, Dopfer-Jablonka A, Happle C. Evaluating the Feasibility, Acceptance, and Beneficial Effects of Online Occupational Therapy for Post-COVID-19 Condition: Protocol for a Randomized Controlled Trial (ErgoLoCo Study). JMIR Res Protoc 2024; 13:e50230. [PMID: 38739435 PMCID: PMC11130769 DOI: 10.2196/50230] [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: 06/26/2023] [Revised: 02/07/2024] [Accepted: 02/21/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Post-COVID-19 syndrome (PCS; also known as "long COVID") is a relatively novel disease comprising physical, psychological, and cognitive complaints persisting several weeks to months after acute infection with SARS-CoV-2. Approximately 10% of patients with COVID-19 are affected by long-term symptoms. However, effective treatment strategies are lacking. The ErgoLoCo (Occupational Therapy [Ergotherapie] for Long COVID) study was designed to develop and evaluate a novel occupational therapy (OT) concept of online delivery of therapy for long COVID. OBJECTIVE The primary study objective is to assess the feasibility of the online OT intervention in PCS. Secondary aims include the evaluation of online OT concerning cognitive problems, occupational performance, and social participation. METHODS This randomized controlled interventional pilot study involves parallel mixed methods process analyses and a realist evaluation approach. A total of 80 clients with PCS aged at least 16 years will be recruited into two interventional groups. The control cohort (watch and wait) comprises 80 clients with long COVID. Treatment is provided through teletherapy (n=40) or delivery of prerecorded videos (n=40) using the same standardized OT concept twice weekly over 12 weeks. Analyses of quantitative questionnaires and qualitative interviews based on the theoretical framework of acceptability will be performed to assess feasibility. Focus group meetings will be used to assess how acceptable and helpful the intervention was to the participating occupational therapists. Standardized tests will be used to assess the initial efficacy of the intervention on neurocognitive performance; limitations in mobility, self-care, and everyday activities; pain; disabilities; quality of life (QoL); social participation; and anxiety and depression in PCS, and the possible effects of online OT on these complaints. RESULTS The German Ministry of Education and Research provided funding for this research in March 2022. Data collection took place from October 2022 to August 31, 2023. Data analysis will be completed by the end of April 2024. We anticipate publishing the results in the fall of 2024. CONCLUSIONS Despite the enormous clinical need, effective and scalable treatment options for OT clients who have PCS remain scarce. The ErgoLoCo study will assess whether online-delivered OT is a feasible treatment approach in PCS. Furthermore, this study will assess the effect of the intervention on cognitive symptoms, QoL, and occupational performance and participation in everyday life. Particular emphasis will be placed on the experiences of clients and occupational therapists with digitally delivered OT. This study will pave the way for novel and effective treatment strategies in PCS. TRIAL REGISTRATION German Clinical Trial Registry DRKS00029990; https://drks.de/search/de/trial/DRKS00029990. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/50230.
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Affiliation(s)
| | - Andrea Stoelting
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Dominik Schröder
- Department of General Practice, University Medical Center Goettingen, Goettingen, Germany
| | - Tim Schmachtenberg
- Department of General Practice, University Medical Center Goettingen, Goettingen, Germany
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Simon Ritter
- Department of Pediatric Pulmology, Allergology and Neoantology, Hannover Medical School, Hannover, Germany
- RESIST Cluster of Excellence, Hannover, Germany
| | - Iman El-Sayed
- Department of General Practice, University Medical Center Goettingen, Goettingen, Germany
| | - Sandra Steffens
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Frank Klawonn
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbuettel, Germany
- Biostatistics Research Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Sandra Klawitter
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbuettel, Germany
| | - Stefanie Homann
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Marie Mikuteit
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- Department of Dermatology, Hannover Medical School, Hannover, Germany
| | - Christoph Berg
- FOM University of Applied Sciences for Economics and Management, Hannover, Germany
| | - Georg Behrens
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research, partner site Hannover-Brunswick, Hannover, Germany
| | - Eva Hummers
- Department of General Practice, University Medical Center Goettingen, Goettingen, Germany
| | - Aisha Cook
- Timmcook Occupational Therapy Center, Hannover, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center Goettingen, Goettingen, Germany
- Department of Family Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Alexandra Dopfer-Jablonka
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- RESIST Cluster of Excellence, Hannover, Germany
| | - Christine Happle
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- RESIST Cluster of Excellence, Hannover, Germany
- Biomedical Research in End-stage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
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Davies SJ, Gullo HL, Doig E. The Priority Goals and Underlying Impairments Contributing to Goal-Related Problems of People with Parkinson's Disease Receiving a Community-Based Rehabilitation Program. PARKINSON'S DISEASE 2024; 2024:9465326. [PMID: 38716035 PMCID: PMC11074914 DOI: 10.1155/2024/9465326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 05/12/2024]
Abstract
Background Goal setting is a core rehabilitation practice in Parkinson's disease (PD). Targeting therapy towards specific goals leads to greater improvements in performance and psychosocial outcomes. Goal setting in PD is feasible, and although the nature of goals has been described in previous studies, the underlying impairments related to goals have not been described. Understanding the nature of goals ensures that interventions for people with PD are aligned with their needs and priorities. Understanding the underlying impairments highlights which symptoms have the biggest impact on daily life and is necessary for planning appropriate interventions to target them. Aim To describe the nature of the goals of people with PD; the underlying impairments related to goals; and to compare differences between high and low priority goals. Method Deductive content analysis was used to map goal statements to the international classification of function (ICF) activity and participation category and to map therapist field notes detailing the primary underlying impairment to the ICF Body Functions category. These results were then compared across goal priority rankings. Results 88 goals of 22 people with PD were analysed. We found that people with PD set diverse goals across all chapters of the ICF Activity and Participation category, with "self-care" goals making up the highest proportion of goals. The primary underlying impairment related to the goals was predominantly related to impairments in "mental functions" under the Body Functions category. Regardless of goal priority, most goal-related underlying impairments were found to be in the "mental functions" category. Conclusion The goals of this sample of community-dwelling people with PD highlight their diverse needs and priorities. These findings indicate that nonmotor symptoms, namely, executive dysfunction and amotivation most commonly impact the performance of and participation in activities of greatest importance to people with PD. This trial is registered with ACTRN12621001483842.
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Affiliation(s)
- Sarah J. Davies
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
- School of Health, University of the Sunshine Coast, Sunshine Coast, Queensland 4556, Australia
| | - Hannah L. Gullo
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
- Allied Health Research Collaborative, The Prince Charles Hospital, Chermside, QLD 4032, Australia
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Brisbane, Australia
| | - Emmah Doig
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Brisbane, Australia
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Okita Y, Kawaguchi Y, Inoue Y, Ohno K, Sawada T, Levack W, Tomori K. Characteristics of goal-setting tools in adult rehabilitation: A scoping review. Clin Rehabil 2024; 38:234-250. [PMID: 37644842 PMCID: PMC10725121 DOI: 10.1177/02692155231197383] [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] [Received: 08/22/2022] [Accepted: 08/09/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVES This scoping review aims to map the literature on goal-setting tools in adult rehabilitation, exploring their characteristics, target users and supporting evidence to inform practice and future research in this area. METHODS We completed a comprehensive search of four databases to identify relevant articles on tools for goal setting in rehabilitation. We followed Arkey and O'Malley's scoping review process to guide article selection, data extraction and data analysis. RESULTS We identified a total of 165 studies that reported on 55 different goal-setting tools, including tools for goal selection and goal documentation (n = 31), goal setting and intervention planning (n = 15), and for measuring the quality of the goal-setting process (n = 9). Over half of the tools were primarily designed for use in rehabilitation of physical disabilities (n = 32). Some tools fell under multiple sub-categories based on their characteristics as follows: 22 framework tools, 12 interview tools, 9 outcome measurement tools for goal achievement, 6 outcome measurement tools for goal quality and 25 documentation tools. The majority of goal-setting instruments targeted goals at the level of activity and participation (n = 51) and aimed to facilitate a client-centred or shared decision-making approach to rehabilitation planning (n = 46). CONCLUSIONS This study provides a comprehensive overview of existing goal-setting tools, highlighting their characteristics, target users and identified needs. These findings can enhance practitioners' awareness of the range of goal-setting tools available and can enable more effective utilization of these tools in clinical practice. Further research should investigate how clinicians can combine multiple tools to deliver goal setting.
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Affiliation(s)
- Yuho Okita
- School of Health Science, Swinburne University of Technology, Melbourne, Australia
| | - Yuko Kawaguchi
- Department of Rehabilitation, Kaikoukai Rehabilitation Hospital, Aichi, Japan
| | - Yuki Inoue
- Central Rehabilitation Department, Yokohama Rousai Hospital, Kanagawa, Japan
| | - Kanta Ohno
- Major of Occupational Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| | - Tatsunori Sawada
- Major of Occupational Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| | - William Levack
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Kounosuke Tomori
- Major of Occupational Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
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Liu S, Zhang K, Li X, Li C, Peng M. Effects of the different intensities of task-oriented training on the upper extremity motor function and self-care ability of stroke survivors: study protocol for a multiarm parallel-group randomised controlled trial in a tertiary hospital in China. BMJ Open 2023; 13:e074106. [PMID: 38070930 PMCID: PMC10729097 DOI: 10.1136/bmjopen-2023-074106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/19/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Although task-oriented training (TOT) may provide added therapeutic value to stroke survivors, current TOT guidance offers insufficient advice on standardisation, particularly choices of intensity, for clinical practice. Therefore, this study aims to explore the effects of different intensities of TOT on motor function and self-care ability of stroke survivors. METHODS AND ANALYSIS This randomised controlled clinical trial will recruit 72 participants from a tertiary hospital, diagnosed with decreased self-care ability and upper limb motor dysfunction post-stroke. All participants will be randomly assigned to one of three experimental groups or the control group to undergo intervention for 8 weeks. The participants in the control group (n=18) will receive traditional occupational therapy, while those in the experimental groups will receive different intensities of TOT (50%, 75% and 100% intensity for groups A, B and C, respectively). This protocol designed a more innovative and optimised TOT programme to explore the optimal intensity of TOT on stroke survivors. The primary outcome is Canadian Occupational Performance Measure, and the secondary outcomes include Modified Barthel Index, Wolf Motor Function Test and Motor Activity Log. ETHICS AND DISSEMINATION The Second Affiliated Hospital of Hainan Medical University Ethics Committee approved the medical and ethical protocol for this study (LW2022015). All participants will sign an informed consent form. The results will be presented in scientific conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER ChiCTR2200056390.
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Affiliation(s)
- Shengfeng Liu
- Department of Rehabilitation Therapy, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Kai Zhang
- Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Xuecha Li
- Department of Rehabilitation Therapy, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Chunxiang Li
- Department of Rehabilitation Therapy, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Mengsi Peng
- Department of Rehabilitation Therapy, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
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Davies SJ, Gullo HL, Doig E. Efficacy and Feasibility of the CO-OP Approach in Parkinson's Disease: RCT Study Protocol. Can J Occup Ther 2023; 90:363-373. [PMID: 36785891 PMCID: PMC10647899 DOI: 10.1177/00084174231156287] [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: 02/15/2023]
Abstract
Background. Parkinson's disease (PD) leads to cognitive dysfunction which limits participation and occupational performance. Cognitive Orientation to Daily Occupational Performance (CO-OP) approach is effective in other adult neurological populations and warrants investigation in PD. Purpose. To describe a study protocol evaluating the preliminary efficacy and feasibility of CO-OP approach in PD. Method. A randomised controlled trial (RCT) with adults with PD was assigned to either: CO-OP training-intensive (CO-OP-I, 20 sessions) or waitlist control (WLC) followed by CO-OP-standard (CO-OP-S, 10 sessions). Outcomes. Occupational performance and satisfaction of adults with PD in chosen goals. Measures will be obtained at baseline, post-intervention, and 3-month follow-up. Implications. As the first RCT focused on CO-OP in PD, this trial will provide evidence for the potential of this approach in PD and lay the groundwork for future large-scale trials. Trial Registration. Australian New Zealand Clinical Trials registry, ACTRN12621001483842. Registered November 1, 2021; retrospectively registered 3 months after commencement.
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Affiliation(s)
- Sarah J. Davies
- Sarah J. Davies, School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland 4072, Australia.
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Rothuizen-Lindenschot M, Graff MJL, de Boer L, de Groot IJM, Nijhuis-van der Sanden MWG, Steultjens EMJ, Koene S. Using PRPP-Assessment for measuring change in everyday activities by home-based videos: An exploratory case series study in children with multiple disabilities. Aust Occup Ther J 2023; 70:644-660. [PMID: 37365675 DOI: 10.1111/1440-1630.12893] [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] [Received: 11/06/2022] [Revised: 05/23/2023] [Accepted: 06/01/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Currently, paediatric health care aims to use a child-centred tailor-made approach. In order to design tailored occupational therapy, the implementation of personalised occupation-based measurements that guide and evaluate goal setting and are responsive to change is necessary. PURPOSE Primarily, this study explored the potential of the Perceive, Recall, Plan, and Perform (PRPP) assessment to measure the change in the performance of children with multiple disabilities. As a secondary evaluation, the feasibility of the PRPP-Intervention in a home-based program to enable activities was described. The overall aim is to show the potential of the PRPP-Assessment as an outcome measure to use as a base for designing tailor-made person-centred care. METHODS An exploratory longitudinal multiple case series mixed-methods design was used. The PRPP-Assessment, scored by multiple raters, was conducted based on parent-provided videos. The assessed activities were chosen by the child and/or parents. Responsiveness was evaluated by hypotheses formulated a priori and by comparing measured change with change on concurrent measures: Goal Attainment Scaling (GAS) and Canadian Occupational Performance Measure (COPM). Over a 6-week period, children and their parents (or caregivers) participated in an online home-based video coaching program where parents were coached in the implementation of the training, based on the PRPP-Intervention, by paediatric occupational therapists on a weekly basis. The feasibility of the intervention was explored using semi-structured interviews with children, parents, and the treating occupational therapists and was analysed by directed content analysis. RESULTS Three out of 17 eligible children agreed to participate and completed post-intervention measurement, of which two completed the intervention. Quantitative results showed that eight out of nine activities improved on the PRPP-Assessment and the COPM, and nine improved on the GAS. In total, 13 out of 15 hypotheses for responsiveness were accepted. Participants experienced the intervention as successful and acceptable. Facilitators and concerns over demand, implementation, practicality, integration, and adaptation were shared. CONCLUSION The PRPP-Assessment showed the potential to measure change in a heterogeneous group of children. The results indicated a positive tendency for the intervention and also provide directions for further development.
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Affiliation(s)
- Marieke Rothuizen-Lindenschot
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Nijmegen, Netherlands
- Department of Occupational Therapy, HAN University of Applied Sciences, Nijmegen, Netherlands
- Research Group Neurorehabilitation, HAN University of Applied Sciences, Nijmegen, Netherlands
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Maud J L Graff
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Nijmegen, Netherlands
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Lonneke de Boer
- Department of Paediatrics, Radboud Center for Mitochondrial Medicine, Nijmegen, Netherlands
| | - Imelda J M de Groot
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Maria W G Nijhuis-van der Sanden
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Nijmegen, Netherlands
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Esther M J Steultjens
- Department of Occupational Therapy, HAN University of Applied Sciences, Nijmegen, Netherlands
- Research Group Neurorehabilitation, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Saskia Koene
- Department of Paediatrics, Radboud Center for Mitochondrial Medicine, Nijmegen, Netherlands
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, Netherlands
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Gould KR, Feeney TJ, Hicks AJ, Ponsford JL. Individualized goal attainment scaling during a trial of positive behaviour support in adults with acquired brain injury. Neuropsychol Rehabil 2022; 32:2392-2410. [PMID: 34253157 DOI: 10.1080/09602011.2021.1947325] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Challenging behaviours after acquired brain injury (ABI) cause distress and reduce community participation. Evidence-based and effective interventions are needed. Positive Behaviour Support (PBS) interventions, such as PBS + PLUS, are person-driven and context-sensitive approaches which aim to improve quality of life and enhance behavioural self-regulation. This study aimed to expand the empirical outcomes of a recent waitlist-controlled trial of PBS + PLUS by examining individualized goal attainment. METHOD Participants were 44 adults with severe ABI sustained on average nine years previously (Range = 0.6-26) from the combined trial cohort who completed the intervention. Using Goal Attainment Scaling, trial therapists developed and reviewed goals collaboratively with the person with ABI and their natural supports. RESULTS The 182 goals in the sample focussed on psychological wellbeing, interpersonal relationships, routines and self-care. By the end of 12-month intervention, 84.6% of goals were achieved and 53.3% exceeded their expected outcome. CONCLUSIONS These findings indicate high levels of personally meaningful outcomes in a broad range of life-domains can be obtained for participants with severe ABI using PBS + PLUS. Whilst these results should be considered in combination with the findings of the waitlist-controlled trial, they contribute to the growing literature regarding benefits of PBS in enhancing quality of life post-ABI. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry identifier: ACTRN12616001704482.
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Affiliation(s)
- Kate Rachel Gould
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Australia
| | - Tim J Feeney
- Belvedere Health Services and the Mill School, Winooski, USA
| | - Amelia J Hicks
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Australia
| | - Jennie Louise Ponsford
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Australia
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Teasdale RM. Representing the values of program participants: Endogenous evaluative criteria. EVALUATION AND PROGRAM PLANNING 2022; 94:102123. [PMID: 35810659 DOI: 10.1016/j.evalprogplan.2022.102123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/08/2022] [Accepted: 06/25/2022] [Indexed: 06/15/2023]
Abstract
Evaluative conclusions are grounded in implicit and explicit criteria that describe a successful or high-quality intervention. Most often, evaluative criteria are drawn from program objectives that reflect the values and priorities of program designers and funders. Yet, an exclusive focus on program goals risks overlooking the values of program participants, the extent to which their actual needs and priorities are addressed, and, in certain types of programs, the choices participants make and agency they exercise. This article presents concepts and methods to guide evaluators in drawing some of the criteria used in an evaluation from program participants. The article outlines a typology of evaluative criteria and seven methods for drawing outcomes-focused criteria from program participants. The article concludes with a discussion of implications and future directions for research and practice.
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Affiliation(s)
- Rebecca M Teasdale
- Educational Psychology, University of Illinois at Chicago, 1040 W. Harrison St, Chicago, IL 60607, USA.
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Spalding K, Gustafsson L, Di Tommaso A. Exploring Patient Outcomes After Participation in an Inpatient Occupation-Based Group: A Longitudinal Observational Cohort Study. Am J Occup Ther 2022; 76:23880. [PMID: 35943844 DOI: 10.5014/ajot.2022.049241] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Occupation-based interventions are used during inpatient rehabilitation, and group models may enhance intervention delivery. However, little is known about the impact of occupation-based groups on patient outcomes. OBJECTIVE To examine the effect of an occupation-based group on patient outcome measures of instrumental activities of daily living (IADL) skills over time and explore demographic differences among patients. DESIGN Longitudinal observational cohort study with four time points: preintervention, postintervention, 30-day follow-up, and 90-day follow-up. SETTING Tertiary hospital general rehabilitation ward. PARTICIPANTS Inpatient adults age 18 or older recruited using consecutive sampling from those referred to the group. INTERVENTION The LifeSkills group, which focused on repetitive practice of meaningful occupation-based activities. OUTCOMES AND MEASURES Demographic data were obtained, and the Canadian Occupational Performance Measure (COPM), Goal Attainment Scaling, Lawton IADL scale, and a self-efficacy scale were administered at each data point. RESULTS Thirty people (21 women, 9 men; ages 35-91 yr) participated, with 5 lost to follow-up. A statistically significant increase in scores postintervention occurred on all measures and was also seen at 90-day follow-up for COPM occupational performance, satisfaction, and self-efficacy scores. Lawton IADL scale scores at follow-up were lower than those at preintervention and statistically significant. No significant differences were found for age and diagnosis. CONCLUSIONS AND RELEVANCE Positive patient outcomes of goal achievement, occupational performance, satisfaction, and self-efficacy were seen at discharge, with evidence of sustainability over time. This could be a resource alternative for addressing skill retraining because people with different diagnoses and in different age groups benefited equally. What This Article Adds: Occupation-based group programs have encouraging application in general inpatient rehabilitation for addressing patient outcomes.
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Affiliation(s)
- Kaitlyn Spalding
- Kaitlyn Spalding, MPhil, BOccThy, is Graduate Master of Philosophy Student, Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia, and Advanced Occupational Therapist, Occupational Therapy Department, Surgical Treatment and Rehabilitation Service, Brisbane, Queensland, Australia;
| | - Louise Gustafsson
- Louise Gustafsson, PhD, BOccThy(Hons), FOTARA, is Professor, Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Amelia Di Tommaso
- Amelia Di Tommaso, PhD, BHlthSc(OT)(Hons), is Lecturer, Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
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Brown J, Ackley K, Knollman-Porter K. Collaborative Goal Setting: A Clinical Approach for Adults With Mild Traumatic Brain Injury. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2394-2413. [PMID: 34529919 DOI: 10.1044/2021_ajslp-21-00078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose Speech-language pathologists (SLPs) have many available procedural options when setting treatment goals. Extant literature supports goal setting protocols that include and value the perspectives of the client; however, in practice, rehabilitation professionals may lean toward expert models of care when planning treatment. Our purpose is to describe a newly developed approach for SLPs and individuals with mild traumatic brain injury (mTBI) to work together to build meaningful, relevant goals. Method We utilized a multiple case study format to exemplify goal setting procedures. Specifically, we describe procedures and outcomes for a 29-year-old female 28 days postinjury and a 70-year-old male 9 months postinjury. Results Clients who engaged in this protocol worked collaboratively with a clinician to identify strengths and challenges postinjury, select and prioritize goal areas, and discuss and develop meaningful, personalized treatment activities. For both participants, use of the proposed protocol resulted in meaningful goals that addressed their self-reported deficits as well as their respective cognitive-linguistic deficits noted on objective, standardized measures. Conclusions Clinician and client collaboration during treatment goal development can facilitate increased client motivation and functional outcomes. The described approach is feasible from a clinical resource standpoint and promotes a systematic approach to placing the client at the forefront of clinical decision making to enhance therapeutic gains. Such client-centered approaches may be particularly valuable for individuals with mTBI who experience substantial cognitive and communicative challenges but may maintain high levels of self-awareness postinjury.
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Affiliation(s)
- Jessica Brown
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, AZ
| | - Kristen Ackley
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, AZ
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Kronberg J, Tierney E, Wallisch A, Little LM. Early Intervention Service Delivery via Telehealth During COVID-19: A Research-Practice Partnership. Int J Telerehabil 2021; 13:e6363. [PMID: 34345340 PMCID: PMC8287712 DOI: 10.5195/ijt.2021.6363] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Coaching has been identified as a best practice for early intervention (EI) services provided through the Individuals with Disabilities Education Act (IDEA) Part C. The current study describes the establishment and progress of a research-relationship partnership to deliver coaching via telehealth during the COVID-19 pandemic. Community-based EI providers implemented 9-weeks of telehealth coaching and evaluated the extent to which child and caregiver outcomes differed between families that had previously received in-person services versus telehealth only. Four EI providers completed the intervention with n=17 families of children aged 6-34 months during the pandemic (April-August 2020). We used the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) to collect outcomes on caregiver identified goals; we used Wilcoxon Signed Rank Tests to examine pre- to post-intervention data. Results showed significant improvements in parent satisfaction, child performance, and goal attainment (all p<.01). Findings suggest that telehealth coaching procedures implemented by community-based EI providers resulted in improvements in caregiver identified goals for young children.
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Affiliation(s)
| | | | - Anna Wallisch
- Juniper Gardens Children's Project, University of Kansas, Kansas City, Kansas, USA
| | - Lauren M Little
- Department of Occupational Therapy, Rush University Medical Center, Chicago, Illinois, USA
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Hoepner JK, Sievert A, Guenther K. Joint Video Self-Modeling for Persons With Traumatic Brain Injury and Their Partners: A Case Series. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:863-882. [PMID: 33784468 DOI: 10.1044/2021_ajslp-20-00074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose Individuals with traumatic brain injury (TBI) experience impairments to self-regulation and social communication that strain relationships. Video self-modeling (VSM) provides visible and audible, tangible evidence of what they do well and what could improve. Conducting such training in the context of authentic exchanges with their everyday partners may support positive change in social communication. The present investigation sought to evaluate indices of improved social communication. Method A mixed-methods design was employed for this case series investigation. Quantitative measures include pre- and postoutcomes on goal attainment scales (GASs) and measures of conversational effectiveness. Qualitative measures include responsiveness to video-supported prompts, conversational behaviors, and metacognitive statements. Results Participants perceived gains on GAS of 3-4 SDs, as well as perceived improvements on the La Trobe Communication Questionnaire. Those gains were validated by gains on the adapted Measure of Participation in Conversation and Measure of Skill in Supported Conversation. Individuals with TBI and their partners reached consensus on most goals and postintervention La Trobe Communication Questionnaire ratings. Participants made accurate judgments about their behaviors at a high rate, given video review. Conversational behaviors and use of metacognitive statements varied across participants and conversational contexts. Field notes and session transcripts provide evidence that both dyads increased internalization of VSM goals and purpose. Conclusions Joint VSM shows promise as a method for eliciting accurate self-assessments among individuals with TBI and their close partners. Both dyads perceived positive gains in interactions within and outside their dyads. Furthermore, joint VSM and GAS appear to improve self-awareness and internalization of VSM goals and purpose.
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Affiliation(s)
- Jerry K Hoepner
- Department of Communication Sciences and Disorders, University of Wisconsin-Eau Claire
| | - Alexis Sievert
- Department of Communication Sciences and Disorders, University of Wisconsin-Eau Claire
| | - Kaitlin Guenther
- Department of Communication Sciences and Disorders, University of Wisconsin-Eau Claire
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Cadematori C, Alpajora B, Sivori T, Betz S, Gerhardt N, Dunn W, Mulcahey MJ. Preliminary examination of Coaching in Context with clients with spinal cord injury. Spinal Cord Ser Cases 2021; 7:27. [PMID: 33850100 PMCID: PMC8042629 DOI: 10.1038/s41394-021-00391-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 01/18/2021] [Accepted: 02/18/2021] [Indexed: 11/09/2022] Open
Abstract
STUDY DESIGN Repeated measures pilot study. OBJECTIVES This study examined Coaching in Context when introduced to community-dwelling adults with spinal cord injury (SCI). SETTING Urban community. METHODS Three volunteers participated in up to ten, 45-60-min Coaching in Context sessions. Number of coaching sessions was recorded. Usefulness of Coaching in Context was examined by the Canadian Occupational Performance Measure (COPM), Goal Attainment Scaling (GAS), and the Moorong Self-efficacy Scale (MSES). Data were examined descriptively. RESULTS Preliminary examination of Coaching in Context revealed successful implementation with adults with SCI living in the community. Mean COPM performance and satisfaction scores increased by 2.55 (SD = 2.25) and 4.27 (SD = 2.41), respectively. With the exception of one, each goal achieved or exceeded GAS expected level. Changed MSES scores ranged from +7 to +16. CONCLUSIONS The ability to implement and evaluate Coaching in Context with three adults with SCI was demonstrated. Improvement in goals established for coaching was also documented.
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Affiliation(s)
- Caitlin Cadematori
- Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Bernadette Alpajora
- Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Taylor Sivori
- Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Samantha Betz
- Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Nicole Gerhardt
- Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - M J Mulcahey
- Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA.
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Pike S, Cusick A, Wales K, Cameron L, Turner-Stokes L, Ashford S, Lannin NA. Psychometric properties of measures of upper limb activity performance in adults with and without spasticity undergoing neurorehabilitation-A systematic review. PLoS One 2021; 16:e0246288. [PMID: 33571238 PMCID: PMC7877653 DOI: 10.1371/journal.pone.0246288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 01/15/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION This systematic review appraises the measurement quality of tools which assess activity and/or participation in adults with upper limb spasticity arising from neurological impairment, including methodological quality of the psychometric studies. Differences in the measurement quality of the tools for adults with a neurological impairment, but without upper limb spasticity, is also presented. METHODS 29 measurement tools identified in a published review were appraised in this systematic review. For each identified tool, we searched 3 databases (Medline, Embase, CINAHL) to identify psychometric studies completed with neurorehabilitation samples. Methodological quality of instrument evaluations was assessed with use of the Consensus-based Standards for the Selection of Health Status Measurement Instruments (COSMIN) checklist. Synthesis of ratings allowed an overall rating of the psychometric evidence for each measurement tool to be calculated. RESULTS 149 articles describing the development or evaluation of psychometric properties of 22 activity and/or participation measurement tools were included. Evidence specific to tool use for adults with spasticity was identified within only 15 of the 149 articles and provided evidence for 9 measurement tools only. Overall, COSMIN appraisal highlighted a lack of evidence of measurement quality. Synthesis of ratings demonstrated all measures had psychometric weaknesses or gaps in evidence (particularly for use of tools with adults with spasticity). CONCLUSIONS The systematic search, appraisal and synthesis revealed that currently there is insufficient measurement quality evidence to recommend one tool over another. Notwithstanding this conclusion, newer tools specifically designed for use with people with neurological conditions who have upper limb spasticity, have emergent measurement properties that warrant further research. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42014013190.
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Affiliation(s)
- Shannon Pike
- School of Allied Health, Human Services and Sport (Occupational Therapy), La Trobe University, Melbourne, Victoria, Australia
- Wagga Wagga Ambulatory Rehabilitation Service, Murrumbidgee Local Health District, Wagga Wagga, New South Wales, Australia
| | - Anne Cusick
- Discipline of Occupational Therapy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kylie Wales
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Newcastle, New South Wales, Australia
| | | | - Lynne Turner-Stokes
- Regional Hyper-acute Rehabilitation Unit, London North West University Healthcare NHS Trust, Northwick Park Hospital, London, United Kingdom
- King’s College London, Department of Palliative Care, Policy and Rehabilitation, London, United Kingdom
| | - Stephen Ashford
- Regional Hyper-acute Rehabilitation Unit, London North West University Healthcare NHS Trust, Northwick Park Hospital, London, United Kingdom
- King’s College London, Department of Palliative Care, Policy and Rehabilitation, London, United Kingdom
- Centre for Nursing, Midwifery and Allied health led Research, University College London Hospitals, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Natasha A. Lannin
- School of Allied Health, Human Services and Sport (Occupational Therapy), La Trobe University, Melbourne, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
- Department of Neurosciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia
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15
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Evensen J, Soberg HL, Sveen U, Hestad KA, Bronken BA. The Applicability of the Patient-Specific Functional Scale (PSFS) in Rehabilitation for Patients with Acquired Brain Injury (ABI) - A Cohort Study. J Multidiscip Healthc 2020; 13:1121-1132. [PMID: 33116558 PMCID: PMC7553661 DOI: 10.2147/jmdh.s259151] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/24/2020] [Indexed: 12/05/2022] Open
Abstract
Aim The primary aim of this study was to investigate the applicability of the Patient-Specific Functional Scale (PSFS) in patients with acquired brain injury (ABI) admitted to a specialized rehabilitation unit in a regional hospital. A secondary aim was to identify patient characteristics and functioning that predicted changes in the PSFS. Patients and Methods In a cohort study, 59 patients with ABI were assessed for the ability to complete the PSFS. A trained multidisciplinary team applied the PSFS as part of a collaborative development of rehabilitation goals. The modified Rankin Scale (mRS), the Functional Ambulation Categories (FAC), the Rivermead Behavioural Memory Test (RBMT), the Norwegian Basic Aphasia Assessment (NBAA) and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) were used to identify characteristics of the sample. Multivariate regression analyses were performed to investigate associations between changes in the PSFS score from admission to discharge and a selected set of participant baseline characteristics and functioning. Results Fifty-four patients (92%) of the patients with ABI were able to complete the PSFS. The five (8%) who were unable to complete the PSFS had severe cognitive or language impairment. The PSFS score improved by a mean of 2.6 (SD 2.0) points from admission to discharge. The LOTCA score made the strongest unique contribution to explain the change in the PSFS score (beta = 0.477, p= 0.020). Conclusion In the present study, most patients with ABI (92%) were able to complete the PSFS. Cognitive function on admission was a predictor of improved functioning on the PSFS.
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Affiliation(s)
- Janne Evensen
- Department of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, Gjøvik, Norway
| | - Helene Lundgaard Soberg
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Unni Sveen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Knut A Hestad
- Department of Health and Nursing Sciences, Faculty of Health- and Social Sciences, The Inland Norway University of Applied Sciences, Elverum, Norway.,Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
| | - Berit Arnesveen Bronken
- Department of Health and Nursing Sciences, Faculty of Health- and Social Sciences, The Inland Norway University of Applied Sciences, Elverum, Norway
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A Survey of Pediatric Competencies in Entry-Level Physical Therapy Programs in Australia. Pediatr Phys Ther 2020; 32:356-365. [PMID: 32925813 DOI: 10.1097/pep.0000000000000730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe perspectives of pediatric physical therapy clinical facilitators on contemporary curricula for Australian entry-level physical therapy programs. METHODS Physical therapy clinical facilitators completed an online survey based on the Academy of Pediatric Physical Therapy of the APTA essential competencies. RESULTS Conditions including cerebral palsy, cystic fibrosis, and prematurity were highly rated by most participants to include in an entry-level program. Exercise prescription, goal-directed training, and group-based physical therapy were the highest rated interventions. Outcome measures considered important to include were the Alberta Infant Motor Scale and Goal Attainment Scale. Students should demonstrate knowledge and skills using relevant frameworks and have practical opportunities to interact with children. CONCLUSION Pediatric clinical facilitators perceived that theoretical knowledge on frameworks, human development, movement skills, pediatric conditions, exercise prescription, and outcome measurement as well as face-to-face experiences with children are important to include in Australian entry-level physical therapy programs.
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Mathews SB, Mozolic-Staunton B, Jefford E, Salehi N. Canadian Occupational Performance Measure and Early Intervention: A Scoping Review. JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 2020. [DOI: 10.1080/19411243.2020.1744210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Skye B. Mathews
- School of Health and Human Sciences, Southern Cross University, Coolangatta, Queensland, Australia
| | - Beth Mozolic-Staunton
- School of Health and Human Sciences, Southern Cross University, Coolangatta, Queensland, Australia
| | - Elaine Jefford
- School of Health and Human Sciences, Southern Cross University (Midwifery) New South Wales, Lismore, Australia
| | - Nasim Salehi
- School of Health and Human Sciences, Southern Cross University, Coolangatta, Queensland, Australia
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18
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Hill AE, Nelson A, Copley JA, Quinlan T, McLaren CF, White R, Castan C, Brodrick J. Real gains: development of a tool to measure outcomes for urban First Australian children accessing culturally responsive interprofessional therapy. J Interprof Care 2020:1-8. [PMID: 32838601 DOI: 10.1080/13561820.2020.1801611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 05/18/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022]
Abstract
Healthcare services are accountable to their clients, communities, governments and funding sources to clearly demonstrate the effectiveness of interventions. A First Australian children's therapy service delivering culturally responsive, interprofessional collaborative practice aimed to evaluate their service. However, this process was constrained by available outcome measures which lacked the flexibility necessary for meaningful use within the dynamic and relational nature of their service delivery. This paper outlines an action research process in three cycles which was used to develop the Australian Therapies Outcome Measure for Indigenous Clients (ATOMIC) with the aim of evaluating therapy outcomes for urban First Australian children engaged in culturally responsive interprofessional therapy. Interrater reliability values of 0.995 and 0.982 were established for ATOMIC pre- and post-therapy measures, respectively, during a pilot phase involving 16 participants. Participants in the main study were 80 First Australian children aged two to 16 years who attended between two and nine interprofessional therapy sessions with occupational therapists and speech pathologists. Pre- and post-therapy ATOMIC scores confirmed progress on pre-determined functional goals across a range of skill domains. Outcomes of this study demonstrated that real gains are being made in urban First Australian children's lives following interprofessional collaborative service provision.
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Affiliation(s)
- Anne E Hill
- School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Australia
| | - Alison Nelson
- Organisational Development, The Institute for Urban Indigenous Health, Windsor, Australia
- The Poche Centre for Indigenous Health, The University of Queensland, St Lucia, Australia
| | - Jodie A Copley
- School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Australia
| | - Teresa Quinlan
- School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Australia
| | - Chrisdell F McLaren
- Clinic Lead Paediatric Occupational Therapy, The Institute for Urban Indigenous Health, Windsor, Australia
| | - Rebekah White
- Paediatric Occupational Therapy, The Institute for Urban Indigenous Health, Windsor, Australia
| | - Catherine Castan
- Clinic Lead Speech Pathology, The Institute for Urban Indigenous Health, Windsor, Australia
| | - Julie Brodrick
- Locum Dietitian, Royal Women's Hospital, Herston, Australia
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Doig EJ, Fleming J, Ownsworth T. Evaluation of an occupation-based metacognitive intervention targeting awareness, executive function and goal-related outcomes after traumatic brain injury using single-case experimental design methodology. Neuropsychol Rehabil 2020; 31:1527-1556. [PMID: 32669043 DOI: 10.1080/09602011.2020.1786410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Self-awareness is commonly impaired after traumatic brain injury and impacts on rehabilitation engagement and community re-integration outcomes. Interventions which incorporate metacognitive strategy instruction have the potential to improve rehabilitation engagement and outcomes. This study aimed to determine whether an occupation-based intervention incorporating metacognitive strategy instruction resulted in goal achievement and improved online awareness and executive function performance during goal-related tasks. A single-case experimental design using a multiple-baseline design across behaviours was used with two participants with severe traumatic brain injury to evaluate the effectiveness of the 6-week intervention. Repeated measures of goal-related performance, percentage of self-corrected errors and executive function were made via independent analysis of video footage and documentation logs. Data analysis involved 2SD bandwidth analysis and overlap data, reliable change index and evaluation of goal achievement across phases. There were improvements in self-corrected errors for one participant, which were maintained. Significant reductions in anxiety (RCI = ±5.98) were evident for both participants, with a significant reduction in stress (RCI = ±7.05) for one participant following the intervention. The occupation-based intervention incorporating metacognitive strategy instruction led to improvements compared to baseline performance in some targeted goals, online awareness and executive function performance during goal-related tasks and reduced stress and anxiety.
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Affiliation(s)
- Emmah J Doig
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Tamara Ownsworth
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
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Jung Y, Sim J, Park J, Kim J, Kim M. Usefulness of Goal Attainment Scaling in Intensive Stroke Rehabilitation During the Subacute Stage. Ann Rehabil Med 2020; 44:181-194. [PMID: 32475098 PMCID: PMC7349038 DOI: 10.5535/arm.19087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 10/01/2019] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the usefulness of goal attainment scaling (GAS) in intensive stroke rehabilitation during the subacute stage. METHODS Medical records of subacute post-stroke patients who had undergone intensive rehabilitation under hospitalization, before and after the application of GAS, were collected. GAS was conducted at the initial evaluation of each patient. Specific goals were suggested by physical and occupational therapists and were determined by the responsible physiatrist. A 5-point scale was used for the GAS score after 4 weeks of rehabilitation according to the preset criteria of each goal. To evaluate the influence of GAS in rehabilitation practice, functional improvements were compared between two patient groups before (n=121) and after (n=141) GAS. To assess progress in GAS practice, the standard GAS score was calculated, and the changes were observed over a 3-year period. The standard GAS score converged to 50 points when the goal was achieved. The therapists who used GAS also completed a survey regarding its usefulness. RESULTS There were no statistical differences in the motor and cognitive outcomes of the patient groups before and after applying GAS scoring. Successive yearly changes in the standard GAS scores showed progressive convergence to 50 points, signaling that the patient's goal-setting abilities improved. According to the survey, most therapists felt that GAS enhanced the quality of therapies (84.6%). CONCLUSION GAS improved goal-setting for the rehabilitation of subacute post-stroke patients and might have a positive effect on rehabilitation.
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Affiliation(s)
- Youngsu Jung
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, Korea
| | - Jaehoon Sim
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, Korea
| | - Joonhyun Park
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, Korea
| | - Jongmoon Kim
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, Korea
| | - MinYoung Kim
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, Korea
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Salminen AL, Heiskanen T, Suomela-Markkanen T. A Multiform, Group-Based Rehabilitation Program for Visually Impaired Young People to Promote Activity and Participation. A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3682. [PMID: 31574986 PMCID: PMC6801900 DOI: 10.3390/ijerph16193682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/19/2019] [Accepted: 09/26/2019] [Indexed: 11/16/2022]
Abstract
Young people with visual impairment (YPWVI) face several challenges in their everyday lives. However, little is known about interventions that focus on promoting their participation that contributes to health and well-being and is considered the most relevant outcome in rehabilitation. OBJECTIVES This study investigated the clinical outcomes and acceptability of a new one-year, multiform, group-based rehabilitation program for YPWVI. The aim of the pilot program was to support them becoming more independent and to promote their participation. Rehabilitation consisted of group-meetings in an institutional setting, online group meetings, individually tailored one-on-one guidance, individual online discussions and parents' group meetings. Fifteen young persons with visual impairment were recruited and 14 completed the intervention, six of whom were blind or had severe visual impairment and eight had mild visual loss. METHODOLOGY The study utilized a mixed methods triangulation design. Clinical outcome measures were goal attainment scaling (GAS) and occupational performance (COPM) completed with qualitative interview data. Focus group interviews with participants and parents were used to evaluate the acceptability of the program. RESULTS GAS-rated personal goals were widely achieved and the scores of both performance and satisfaction scales of COPM improved. Overall, the rehabilitation program proved to be acceptable. Group-based rehabilitation was deemed very important and it enabled peer support. However, two-day periods of inpatient rehabilitation, proved to be too short, whereas five-day periods were considered to disturb schoolwork. CONCLUSIONS Group-based multi-form rehabilitation for YPWVI can have a positive impact on activity and participation of the participants. The program can support independence and the achievement of rehabilitation goals. The group format was applauded for providing social support and company. The program required some structural modifications.
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Affiliation(s)
- Anna-Liisa Salminen
- Research department, The Social Insurance Institution of Finland, FI-00250 Helsinki, Finland.
| | - Tuija Heiskanen
- Research department, The Social Insurance Institution of Finland, FI-00250 Helsinki, Finland.
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Goal statements in brain injury rehabilitation: A cohort study of client-centredness and relationship with goal outcome. BRAIN IMPAIR 2019. [DOI: 10.1017/brimp.2019.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractBackground:Currently, there is increasing recognition of the need to use a client-centred approach to goal setting in rehabilitation. However, there is limited research to guide practice with community-dwelling clients with acquired brain injury. An understanding of the characteristics of client-centred goals and the extent to which client-centeredness influences goal outcomes is required.Objective:To examine the relationships between the client-centredness of goals and their characteristics, content, recall and outcomes of client-centred goals in brain injury rehabilitation.Methods:A prospective cohort design study was employed. Participants were 45 clients with brain injury receiving outpatient rehabilitation, who completed measures of client-centredness after goal setting. Each goal was classified according to whether it was specific, measurable, non-jargonistic, and participation-focussed, included a timeframe and was recalled by participants.Results:Participants set 223 goals with 20 clinicians from multiple disciplines. Levels of client-centredness did not differ according to the characteristics, content and recall of goals, with the exception of goal specificity (p< 0.01). Client-centredness was significantly and positively correlated with goal outcomes (p< 0.05).Conclusions:The use of client-centred goals is recommended for improved rehabilitation outcomes. Applying goal documentation criteria does not necessarily mean that goals will be client-centred, and highly specific goal statements may not reflect what is important and meaningful to clients.
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Roe D, Brown T, Thyer L. Validity, responsiveness, and perceptions of clinical utility of the Canadian Occupational Performance Measure when used in a sub-acute setting. Disabil Rehabil 2019; 42:2772-2789. [PMID: 30829096 DOI: 10.1080/09638288.2019.1573934] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: The validity, responsiveness, and clinical utility of the Canadian Occupational Performance Measure was investigated when used in a sub-acute setting.Materials and Methods: Fifty older adults (mean age 78.2 years, Standard Deviation = 7.2; 64% female) completed the Canadian Occupational Performance Measure, Functional Independence Measure and the Short-Form 36 Health Questionnaire. The Canadian Occupational Performance Measure was correlated with the Functional Independence Measure and Short-Form 36 Health Questionnaire and the admission and discharge Canadian Occupational Performance Measure Performance and Satisfaction scores were compared for significant differences. Qualitative interviews with were completed with six older adults and six occupational therapists to explore the utility of the Canadian Occupational Performance Measure.Results: The Canadian Occupational Performance Measure Satisfaction scale was significantly associated with the Functional Independence Measure and Short-Form 36 Health Questionnaire. Significant differences were found between the admission and discharge Canadian Occupational Performance Measure Performance and Satisfaction scale scores. From both the clients' and therapists' perspectives, four key qualitative themes emerged: (1) "Likes" about the Canadian Occupational Performance Measure; (2) Effects on practice; (3) Utility; and (4) Future use.Conclusions: This study provides evidence of the Canadian Occupational Performance Measure's validity, responsiveness and clinical utility when used in a sub-acute setting.Implications for rehabilitationThe Canadian Occupational Performance Measure appears able to effectively evaluate the outcomes of occupational therapy interventions, including in sub-acute rehabilitation settings. It is an individualized outcome measure where clients are responsible for measuring their own progress and meaningful outcomes from therapy.Evidence of the Canadian Occupational Performance Measure's convergent validity, predictive validity and responsiveness to change was found which contributes to the body of knowledge of its psychometric properties.From a qualitative perspective, the Canadian Occupational Performance Measure was found to improve clinical decision making, facilitating client engagement, formulating clear treatment goals and making therapy more meaningful for clients.
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Affiliation(s)
- Debbie Roe
- Occupational Therapist, Casey Hospital, Monash Health, Berwick, Victoria, Australia
| | - Ted Brown
- Department of Occupational Therapy, Faculty of Medicine, Nursing & Health Sciences, Monash University - Peninsula Campus, Frankston, Victoria, Australia
| | - Laura Thyer
- Department of Occupational Therapy, Faculty of Medicine, Nursing & Health Sciences, Monash University - Peninsula Campus, Frankston, Victoria, Australia
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Rodakowski J, Becker AM, Golias KW. Activity-Based Goals Generated by Older Adults With Mild Cognitive Impairment. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2018; 38:84-88. [PMID: 29343175 PMCID: PMC5837952 DOI: 10.1177/1539449217751357] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Client-centered care is one promising rehabilitation model that may support the unique needs of older adults with mild cognitive impairment (MCI). This secondary analysis examined (a) whether older adults with MCI generated activity-based goals using a client-centered model and (b) the types of goals generated. Thirteen older adults with MCI addressed 55 goals. Using client-centered care, the participants generated goals despite subtle limitations in activities and participation. Participants generated the greatest number of goals related to instrumental activities of daily living. This study demonstrated that older adults with MCI generated goals through a client-centered model. This is important because older adults with MCI are at risk for disability, and they may benefit from early rehabilitation care models that minimize activity limitations and participation restrictions despite underlying cognitive impairments.
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Affiliation(s)
- Juleen Rodakowski
- Department of Occupational Therapy, University of Pittsburgh
- Clinical and Translational Science Institute, University of Pittsburgh
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Trevena-Peters J, McKay A, Ponsford J. Activities of daily living retraining and goal attainment during posttraumatic amnesia. Neuropsychol Rehabil 2018. [DOI: 10.1080/09602011.2018.1441033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Jessica Trevena-Peters
- Monash Institute of Cognitive & Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, Australia
- Monash Epworth Rehabilitation Research Centre, Richmond, Australia
| | - Adam McKay
- Monash Institute of Cognitive & Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, Australia
- Monash Epworth Rehabilitation Research Centre, Richmond, Australia
- Epworth Healthcare, Richmond, Australia
| | - Jennie Ponsford
- Monash Institute of Cognitive & Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, Australia
- Monash Epworth Rehabilitation Research Centre, Richmond, Australia
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Atler KE, Barney L, Moravec A, Sample PL, Fruhauf CA. The Daily Experiences of Pleasure, Productivity, and Restoration Profile: A case study: Étude de cas sur l'utilité du Daily Experiences of Pleasure, Productivity, and Restoration Profile. The Canadian Journal of Occupational Therapy 2018; 84:262-272. [PMID: 29364712 DOI: 10.1177/0008417417723119] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Occupational therapy enables clients to self-manage their health through the use of occupation; however, additional occupation-focused assessments are needed to capture people's subjective experiences associated with everyday activities as awareness of one's experiences can help promote change. PURPOSE This qualitative case study explored the utility of one such assessment, the Daily Experiences of Pleasure, Productivity, and Restoration Profile (PPR Profile). METHOD Five spousal caregivers completed and discussed the PPR Profile with an occupational therapist. Interviews with the caregivers and therapist occurred during and following use. Content analysis revealed several themes. FINDINGS Both caregivers and the occupational therapist reported that use of the PPR Profile provided benefits but not without challenges. IMPLICATIONS The findings support preliminary utility of the PPR Profile; however, additional research is needed and occupational therapists need to be aware of the challenges when deciding to use the tool.
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Alaniz ML, Rosenberg SS, Beard NR, Rosario ER. The Effectiveness of Aquatic Group Therapy for Improving Water Safety and Social Interactions in Children with Autism Spectrum Disorder: A Pilot Program. J Autism Dev Disord 2017; 47:4006-4017. [PMID: 28864911 DOI: 10.1007/s10803-017-3264-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Drowning is the number one cause of accidental death in children with Autism Spectrum Disorder (ASD). Few studies have examined the effectiveness of swim instruction for improving water safety skills in children with moderate to severe ASD. This study examines the feasibility and effectiveness of an aquatic therapy program on water safety and social skills in children with mild to severe ASD (n = 7). Water safety skills were evaluated using the Aquatics Skills Checklist and social skills were measured using the Social Skills Improvement Scale. We provide preliminary evidence that children with ASD can improve water safety skills (p = 0.0002), which are important for drowning prevention after only 8 h of intervention. However, social skills did not respond to intervention (p = 0.6409).
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Affiliation(s)
- Michele L Alaniz
- Children's Services Center, Casa Colina Hospital and Centers for Healthcare, 255 E. Bonita Ave., P.O. Box 6001, Pomona, CA, 91769, USA.
| | - Sheila S Rosenberg
- Children's Services Center, Casa Colina Hospital and Centers for Healthcare, 255 E. Bonita Ave., P.O. Box 6001, Pomona, CA, 91769, USA.,Casa Colina's Research Institute, Pomona, CA, USA
| | - Nicole R Beard
- Children's Services Center, Casa Colina Hospital and Centers for Healthcare, 255 E. Bonita Ave., P.O. Box 6001, Pomona, CA, 91769, USA.,Curative New Berlin Therapies, New Berlin, WI, USA.,Children's Services Center, University of Southern California, Los Angeles, CA, USA
| | - Emily R Rosario
- Children's Services Center, Casa Colina Hospital and Centers for Healthcare, 255 E. Bonita Ave., P.O. Box 6001, Pomona, CA, 91769, USA.,Casa Colina's Research Institute, Pomona, CA, USA
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Finch E, Cornwell P, Copley A, Doig E, Fleming J. Remediation of social communication impairments following traumatic brain injury using metacognitive strategy intervention: a pilot study. Brain Inj 2017; 31:1830-1839. [DOI: 10.1080/02699052.2017.1346284] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Emma Finch
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Speech Pathology Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Centre for Functioning and Health Research, Metro South Hospital and Health Service, Brisbane, Queensland, Australia
| | - Petrea Cornwell
- Allied Health Research Collaborative, The Prince Charles Hospital, Metro North Hospital and Health Service, Chermside, Queensland, Australia
- Behavioural Basis of Health, Menzies Health Institute Queensland, Griffith University, Mt Gravatt, Queensland, Australia
- Collaborative for Allied Health Research and Learning, Metro North Hospital and Health Service, Chermside, Queensland, Australia
| | - Anna Copley
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Emmah Doig
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Centre for Functioning and Health Research, Metro South Hospital and Health Service, Brisbane, Queensland, Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Centre for Functioning and Health Research, Metro South Hospital and Health Service, Brisbane, Queensland, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
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Patterson F, Fleming J, Doig E, Griffin J. Participant evaluation of an inpatient occupational therapy groups programme in brain injury rehabilitation. Aust Occup Ther J 2017; 64:408-418. [DOI: 10.1111/1440-1630.12392] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2017] [Indexed: 01/15/2023]
Affiliation(s)
- Freyr Patterson
- Occupational Therapy Department; The Princess Alexandra Hospital; Brisbane Queensland Australia
- The School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Queensland Australia
| | - Jennifer Fleming
- Occupational Therapy Department; The Princess Alexandra Hospital; Brisbane Queensland Australia
- The School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Queensland Australia
- Centre for Functioning and Health Research; Queensland Health; Buranda Queensland Australia
| | - Emmah Doig
- The School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Queensland Australia
- Centre for Functioning and Health Research; Queensland Health; Buranda Queensland Australia
| | - Janelle Griffin
- Occupational Therapy Department; The Princess Alexandra Hospital; Brisbane Queensland Australia
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Kahjoogh MA, Kessler D, Rassafiani M, Hosseini SA, Khankeh H, Akbarfahimi N. Occupational performance coaching for mothers of children with cerebral palsy: A case report. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2017. [DOI: 10.12968/ijtr.2017.24.5.218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mina Ahmadi Kahjoogh
- PhD candidate of occupational therapy. Department of Occupational Therapy, School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Mehdi Rassafiani
- Associate professor, Pediatric Neurorehabilitation Research Centre, Department of Occupational Therapy, School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Ali Hosseini
- Professor, Social Determinants of Health Research Centre, Department of Occupational Therapy, School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences. Tehran, Iran
| | - Hamidreza Khankeh
- Post-Doc professor, Department of Health in Emergency and Disaster, and Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Nazila Akbarfahimi
- Assistant professor, Department of Occupational Therapy, School of Rehabilitation, University of Social Welfare and Rehabilitation Science, Tehran, Iran
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Švajger A, Piškur B. The clinical utility of the Canadian Occupational Performance Measure in vocational rehabilitation: A qualitative study among occupational therapists in Slovenia. Work 2017; 54:223-33. [PMID: 27061695 DOI: 10.3233/wor-162287] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Few studies exist on the clinical utility of the Canadian Occupational Performance Measure (COPM) in vocational rehabilitation. OBJECTIVE The aim of this study was to explore how Slovenian occupational therapists working in vocational rehabilitation, perceived the usefulness of the COPM in their everyday practice. METHODS A qualitative study using two focus group discussions was conducted. The meaning condensation method was applied to analyze the data. RESULTS Analysis revealed the following key themes: (1) the COPM facilitates collaboration with the client; (2) the COPM is a source of evidence and empowerment for occupational therapists; (3) the challenges that arise when using the COPM; (4) the use of COPM requires training; and (5) using the COPM results and understanding their meaning. CONCLUSIONS The study reveals new insights into using the COPM results in occupational therapy, especially into the contextual factors that influence the meaning and importance of work for clients in vocational rehabilitation.
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Affiliation(s)
- Andreja Švajger
- University Rehabilitation Institute, Republic of Slovenia, Ljubljana, Slovenia
| | - Barbara Piškur
- Faculty of Health and Care, Centre of Research Autonomy and Participation for Persons with a Chronic Illness & Department of Occupational Therapy, Zuyd University, Heerlen, the Netherlands
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Yang SY, Lin CY, Lee YC, Chang JH. The Canadian occupational performance measure for patients with stroke: a systematic review. J Phys Ther Sci 2017; 29:548-555. [PMID: 28356652 PMCID: PMC5361031 DOI: 10.1589/jpts.29.548] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 12/01/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study investigated whether the Canadian Occupational Performance Measure is a suitable outcome measure for assessing patients with stroke in research and clinical settings. [Subjects and Methods] The study included into two parts: (1) an investigation of the reliability and validity of the Canadian Occupational Performance Measure for patients with stroke and (2) an exploration of Canadian Occupational Performance Measure results in randomized controlled trials of patients with stroke. For this review, the study searched the MEDLINE, PubMed, and CINAHL Plus with Full Text databases for articles published before September 2015. [Results] Finally, three eligible articles were collected in part 1, and ten randomized controlled trials studies were collected in part 2. The findings of part 1 revealed that the Canadian Occupational Performance Measure had efficient test-retest reliability, however, the Canadian Occupational Performance Measure revealed weak associations with other assessment tools such as Barthel Index used for patients with stroke. Six of the randomized controlled trials studies used the Canadian Occupational Performance Measure as a primary outcome and two as a secondary outcome, while the other two as a goal-setting instrument. [Conclusion] This review indicates that the Canadian Occupational Performance Measure is appropriate for clinicians, including physiotherapists, in assessing outcome for patients with stroke. The Canadian Occupational Performance Measure can assist patients in identifying their outcome performance and provide therapists with directions on interventions.
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Affiliation(s)
- Shang-Yu Yang
- Department of Occupational Therapy, Shu Zen Junior College
of Medicine and Management, Taiwan
- Institute of Allied Health Science, College of Medicine,
National Cheng Kung University: No.1 University Road, Tainan City 701, Taiwan
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health
and Social Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Ya-Chen Lee
- Department of Occupational Therapy, College of Medical and
Health Science, Asia University, Taiwan
| | - Jer-Hao Chang
- Institute of Allied Health Science, College of Medicine,
National Cheng Kung University: No.1 University Road, Tainan City 701, Taiwan
- Department of Occupational Therapy, College of Medicine,
National Cheng Kung University, Taiwan
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Doig E, Fleming J, Ownsworth T, Fletcher S. An occupation-based, metacognitive approach to assessing error performance and online awareness. Aust Occup Ther J 2016; 64:137-148. [DOI: 10.1111/1440-1630.12322] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Emmah Doig
- School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Queensland Australia
| | - Jenny Fleming
- School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Queensland Australia
- Occupational Therapy Department; Princess Alexandra Hospital; Brisbane Queensland Australia
- Centre for Functioning and Health Research; Metro South Health District; Queensland Health; Brisbane Queensland Australia
| | - Tamara Ownsworth
- Griffith School of Applied Psychology and Behavioural Basis of Health Program; Griffith Health Institute; Griffith University; Brisbane Queensland Australia
| | - Stephanie Fletcher
- School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Queensland Australia
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Hui C, Snider L, Couture M. Self-regulation workshop and Occupational Performance Coaching with teachers: A pilot study. The Canadian Journal of Occupational Therapy 2016; 83:115-25. [PMID: 27026722 DOI: 10.1177/0008417415627665] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Teachers' occupational role and performance can be undermined when working with students with disruptive classroom behaviours. PURPOSE This pilot study aimed to explore the impact of school-based occupational therapy intervention on teachers' classroom management self-efficacy and perceived performance/satisfaction in their management of students with disruptive behaviours. METHOD This pilot study used a multiple-case replication study design. A cohort of regular classroom elementary school teachers (n = 11) participated in a 1-day workshop on sensorimotor strategies for supporting student self-regulation followed by eight individual sessions of Occupational Performance Coaching (OPC). Measurement tools were the Canadian Occupational Performance Measure, Goal Attainment Scaling (GAS), and Teachers' Self-Efficacy Scale-Classroom Management. FINDINGS Improvement in teachers' perception of performance, satisfaction, and classroom management was seen. GAS showed clinically significant improvement. Improvements were sustained at 7 weeks follow-up. IMPLICATIONS Preliminary results support the use of sensorimotor education combined with OPC to enable teachers' occupational performance.
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Koski J, Richards LG. Reliability and Sensitivity to Change of Goal Attainment Scaling in Occupational Therapy Nonclassroom Educational Experiences. Am J Occup Ther 2015; 69 Suppl 2:6912350030p1-5. [PMID: 26539684 DOI: 10.5014/ajot.2015.016535] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Occupational therapy programs are charged with measuring student progress in nonclassroom experiential components (American Occupational Therapy Association, 2012). Currently, the major nonclassroom educational experience is Level II fieldwork. Level II performance is assessed using the Fieldwork Performance Evaluation, which is inappropriate for measuring doctoral-level experiential component achievement. This study's purpose was to determine test-retest reliability and sensitivity of Goal Attainment Scaling (GAS) for assessing skill development in nonclassroom occupational therapy experiences. GAS demonstrated high test-retest reliability for each of the five goals, and we found a significant amount of change on the GAS, with higher scores at the 12-wk than at the 6-wk assessment. Results indicate that the GAS is reliable and sensitive to changes in student performance on Level II fieldwork and may therefore warrant investigation as a valid tool to measure student performance in the entry-level doctoral experiential component.
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Affiliation(s)
- Jeanette Koski
- Jeanette Koski, OTD, OTR/L, is Assistant Professor and Academic Fieldwork Coordinator, Division of Occupational Therapy, College of Health, University of Utah, Salt Lake City;
| | - Lorie Gage Richards
- Lorie Gage Richards, PhD, OTR/L, FAHA, is Chair and Associate Professor, Division of Occupational Therapy, College of Health, University of Utah, Salt Lake City
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Prescott S, Fleming J, Doig E. Goal setting approaches and principles used in rehabilitation for people with acquired brain injury: A systematic scoping review. Brain Inj 2015; 29:1515-29. [DOI: 10.3109/02699052.2015.1075152] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Chapleau A, Harrison J. Fieldwork I Program Evaluation of Student Learning Using Goal Attainment Scaling. Am J Occup Ther 2015; 69 Suppl 2:6912185060p1-8. [PMID: 26539679 DOI: 10.5014/ajot.2015.018325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This article describes a program evaluation of student learning during the Level I fieldwork experience of a master of science in occupational therapy program. We sought to determine the utility of Goal Attainment Scaling (GAS) as a measure of student learning. Over four semesters, from fall 2013 through fall 2014, 240 students completed goal attainment scales for an individualized learning goal for the semester. Using a quantitative pretest-posttest design, we found significant increases in levels of student learning goal attainment during Level I fieldwork. Qualitative data from exit surveys revealed high levels of satisfaction with the program, particularly related to the opportunity to learn a new way of envisioning and writing individualized goals. These findings support the use of GAS as an outcome measure of student learning during fieldwork.
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Affiliation(s)
- Ann Chapleau
- Ann Chapleau, DHS, OTRL, is Associate Professor, Department of Occupational Therapy, College of Health and Human Services, Western Michigan University, Kalamazoo;
| | - Jennifer Harrison
- Jennifer Harrison, PhDc, LMSW, CAADC, is Faculty Specialist and Field Coordinator, School of Social Work, College of Health and Human Services, Western Michigan University, Kalamazoo
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Imms C, Mathews S, Nicola Richmond K, Law M, Ullenhag A. Optimising leisure participation: a pilot intervention study for adolescents with physical impairments. Disabil Rehabil 2015. [DOI: 10.3109/09638288.2015.1068876] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Toto PE, Skidmore ER, Terhorst L, Rosen J, Weiner DK. Goal Attainment Scaling (GAS) in geriatric primary care: a feasibility study. Arch Gerontol Geriatr 2014; 60:16-21. [PMID: 25465505 DOI: 10.1016/j.archger.2014.10.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Revised: 10/28/2014] [Accepted: 10/30/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Evaluate the feasibility of generating patient-centered goals using GAS with older adults who have multiple chronic conditions, recruited through primary care. METHOD Adults age 65+ (N=27) were recruited from a geriatric primary care center. Participants were asked to identify 2-4 activity-based goals and set attainment levels using GAS. At 8 weeks, participants were asked to rate current level of their goal performance. Physician surveys were used to evaluate if goals were realistic and feasible, and patient surveys were implemented to evaluate satisfaction. GAS T-scores were used to quantify change in goal achievement. RESULTS Ninety-three percent (n=25) of participants were able to establish a minimum of two goals using GAS. 100% of participants were able to rate goal performance at follow-up. Physician survey results identified 100% of goals realistic and 93% achievable and 100% of participants were either neutral or satisfied with the process. Significant improvement was reported in GAS change scores (t(24)=6.54, p<0.001). CONCLUSION Findings support the feasibility of GAS for older adults with multiple chronic conditions in geriatric primary care as a strategy to facilitate patient-centered care and suggest that the process of personalized goal-setting itself may facilitate goal attainment.
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Affiliation(s)
- Pamela E Toto
- Department of Occupational Therapy, University of Pittsburgh, 5012 Forbes Tower, Pittsburgh, PA 15260, USA.
| | - Elizabeth R Skidmore
- Department of Occupational Therapy, University of Pittsburgh, 5012 Forbes Tower, Pittsburgh, PA 15260, USA
| | - Lauren Terhorst
- Department of Occupational Therapy, University of Pittsburgh, 5012 Forbes Tower, Pittsburgh, PA 15260, USA
| | - Jules Rosen
- School of Medicine, University of Pittsburgh M240 Scaife Hall 3550 Terrace Street Pittsburgh, PA 15261, USA
| | - Debra K Weiner
- Geriatric Research, Education and Clinical Center - VA Pittsburgh Healthcare System, 3950 Allequippa Street, Pittsburgh, PA 15261, USA; School of Medicine and Clinical & Translational Science Institute, University of Pittsburgh, USA
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Doig E, Kuipers P, Prescott S, Cornwell P, Fleming J. Development of Self-Awareness After Severe Traumatic Brain Injury Through Participation in Occupation-Based Rehabilitation: Mixed-Methods Analysis of a Case Series. Am J Occup Ther 2014; 68:578-88. [DOI: 10.5014/ajot.2014.010785] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. We examined participation in goal planning and development of self-awareness for people with impaired self-awareness after traumatic brain injury.
METHOD. We performed a mixed-methods study of 8 participants recently discharged from inpatient rehabilitation. Self-awareness was measured using discrepancy between self and significant other ratings on the Mayo–Portland Adaptability Index (MPAI–4) at four time points. We calculated effect size to evaluate the change in MPAI–4 discrepancy over time.
RESULTS. Seven participants identified their own goals. We found a large reduction in mean MPAI–4 discrepancy (M = 8.57, SD = 6.59, N = 7, d = 1.08) in the first 6 wk and a further small reduction (M = 5.33, SD = 9.09, N = 6, d = 0.45) in the second 6 wk of intervention. Case data indicated that 7 participants demonstrated some growth in self-awareness.
CONCLUSION. Engagement in occupation-based, goal-directed rehabilitation appeared to foster awareness of injury-related changes to varying extents.
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Affiliation(s)
- Emmah Doig
- Emmah Doig, PhD, BOccThy Hons, is NHMRC Post Doctoral Research Fellow, School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia Campus, Brisbane, Queensland, Australia 4067;
| | - Pim Kuipers
- Pim Kuipers, PhD, BA Hons, MA, Grad Dip Rehab, is Associate Professor, Centre for Functioning and Health Research, Metro South Health District, Queensland Health, Brisbane, Australia, and Population and Social Health Research Program, Griffith Health Institute, Griffith University, Brisbane, Australia
| | - Sarah Prescott
- Sarah Prescott, B Int Bus, BOccThy Hons, is PhD Student, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Petrea Cornwell
- Petrea Cornwell, PhD, B SpPath Hons, is Principal Research Fellow, Metro North Hospital and Health Service, Queensland Health, Chermside, Brisbane, Australia, and School of Applied Psychology and Behavioural Basis of Health, Griffith Health Institute, Griffith University, Mount Gravatt, Brisbane, Australia
| | - Jennifer Fleming
- Jennifer Fleming, PhD, BOccThy Hons, is Associate Professor, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia, and Centre for Functioning and Health Research, Metro South Health District, Queensland Health, Brisbane, Australia
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Ciro CA, Hershey LA, Garrison D. Enhanced task-oriented training in a person with dementia with Lewy bodies. Am J Occup Ther 2014; 67:556-63. [PMID: 23968794 DOI: 10.5014/ajot.2013.008227] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite the inevitable loss of function seen in people with progressive dementias, interventions for reversing or minimizing functional loss are understudied. Research supports task-oriented training, but practical gaps in how to best evaluate clients for this training and how to implement it in clinical settings may be thwarting translation to occupational therapy practice. We structured an intervention model called STOMP (Skill-building through Task-Oriented Motor Practice) using a unique blend of task-oriented training and motor-learning principles. In this article, we describe through a case study the process and outcome of using STOMP to improve functional skills in a woman with moderate dementia with Lewy bodies. Our findings suggest that STOMP has the potential to serve as a structure for the evaluation and treatment of occupational performance deficits in people with dementia and that this model warrants further investigation.
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Affiliation(s)
- Carrie A Ciro
- Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, 1200 Stonewall Avenue, Oklahoma City, OK 73117-1215, USA
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Grant M, Ponsford J. Goal Attainment Scaling in brain injury rehabilitation: Strengths, limitations and recommendations for future applications. Neuropsychol Rehabil 2014; 24:661-77. [DOI: 10.1080/09602011.2014.901228] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Client-centred occupational therapy approaches aim to increase client motivation and confidence in working towards self-identified occupational performance goals. In this opinion piece we explore whether measurement of confidence in goal pursuit could complement existing tools, such as the Canadian Occupational Performance Measure (Law et al 1998), in documenting clinical outcomes. Cognitive theories of motivation and behaviour change support links between confidence in problem solving around self-identified goals, effort, and motivation to persist and engage in therapy. We propose that evaluating goal-related confidence is an important but neglected area of practice. Providing feedback about confidence in relation to goal pursuit may increase the likelihood of occupational performance goals being attained.
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Affiliation(s)
- Anne A Poulsen
- Senior Research Fellow, University of Queensland — Division of Occupational Therapy, School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, St Lucia, Queensland, Australia
| | - Jenny Ziviani
- Professor, Children's Allied Health Research, Queensland Health; University of Queensland — School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, St Lucia, Queensland, Australia
| | - Katja Kotaniemi
- Occupational Therapy Graduate, University of Queensland — Division of Occupational Therapy, School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, St Lucia, Queensland, Australia
| | - Mary Law
- Professor, McMaster University — School of Rehabilitation Science, IAHS Bldg, 1400 Main St W, Hamilton, Ontario, Canada and Adjunct Professor, LaTrobe University, Melbourne, Australia
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Custer MG, Huebner RA, Freudenberger L, Nichols LR. Client-chosen goals in occupational therapy: strategy and instrument pilot. Occup Ther Health Care 2013; 27:58-70. [PMID: 23855538 DOI: 10.3109/07380577.2012.747120] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACT Client-centered practice and outcomes research are missions of occupational therapy. Although strategies for client goal-setting have advanced the field, the process has limitations. This study tested a self-report strategy using brief, easy to score measures. The Goals for Occupational Therapy List was completed at mostly independent intake and paired with a follow-up measure of Goal Satisfaction Rating by 40 clients in an outpatient rehabilitation center. The strategy of pairing self-report measures of goal-setting and attainment was useful for clinicians and yielded important research findings. Application to occupational therapy and future research are suggested.
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Affiliation(s)
- Melba G Custer
- Department of Occupational Therapy, Eastern Kentucky University, Richmond, KY 40475-3100, USA.
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Rao AK. Occupational therapy in neurological disorders: looking ahead to the American Occupational Therapy Association's centennial vision. Am J Occup Ther 2012; 66:e119-30. [PMID: 23106997 PMCID: PMC3665413 DOI: 10.5014/ajot.2012.005280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The Centennial Vision articulated by the American Occupational Therapy Association includes moving the profession to being science driven and evidence based. The American Journal of Occupational Therapy contributes to this vision by publishing high-quality research. I reviewed research in the practice area of neurological rehabilitation published between May 2010 and October 2011. In particular, I reviewed effectiveness and efficacy studies, instrument development and testing, and basic research studies. Concerns emerging from the review were (1) few studies in neurological rehabilitation; (2) many disorders not represented; (3) exclusive use of impairment-level outcomes in some studies; and (4) high preponderance of case series designs in effectiveness studies. To achieve the Centennial Vision, the field needs to improve the volume and diversity of research in neurological rehabilitation. It is also important to modify academic and clinical practice to enable occupational therapists to spend more time in producing high-quality evidence to support the crucial role they play in neurological rehabilitation.
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Affiliation(s)
- Ashwini K Rao
- Department of Rehabilitation and Regenerative Medicine and G. H. Sergievsky Center, Columbia University, New York, NY, USA.
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