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Kessler D, Franz M, Malakouti N, Rajachandrakumar R, Baharnoori M, Finlayson M. Randomized Controlled Trial of Occupational Performance Coaching for Adults With Multiple Sclerosis. Arch Phys Med Rehabil 2024:S0003-9993(24)01042-6. [PMID: 38851554 DOI: 10.1016/j.apmr.2024.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVE To determine if the receipt of occupational performance coaching (OPC) by adults living with multiple sclerosis (MS) improves participants' satisfaction with performance in daily activities (primary outcome); improves perceived performance in daily activities, resilience, autonomy, and participation; and reduces illness intrusiveness and effect of MS (secondary outcomes). DESIGN Two-group randomized clinical trial with a waitlist control. SETTING Community. PARTICIPANTS Convenience sample of adults with MS were recruited through a research registry. Eighty-three individuals were approached; 35 were assessed for eligibility and 31 were enrolled and 30 completed baseline assessment (Final sample size, N=30). Participants were English-speaking, were without serious cognitive impairment or severe depression, and were not receiving other coaching interventions. INTERVENTIONS Six telephone sessions of OPC were delivered by a trained facilitator over 10 weeks. Initial sessions focused on goal setting, prioritization, and action planning. Subsequent sessions involved goal and action plan review, discussion of facilitators and barriers, and goal and plan refinement. MAIN OUTCOME MEASURES Primary outcome was participants' satisfaction with performance in daily activities, as measured by the Canadian Occupational Performance Measure (COPM). Secondary outcome measures included the COPM performance rating, Connor-Davidson Resilience Scale, Impact on Participation and Autonomy Questionnaire, Adapted Illness Intrusiveness Rating Scale, and MS Impact Scale. Measures were administered by a blinded assessor at baseline, 10 weeks, and 2 months. RESULTS Participants in the intervention and waitlist control groups were equivalent on demographic and outcome measures at baseline. At 10 weeks, the intervention group had significantly higher COPM ratings for both satisfaction (P<.001) and performance (P=.002). No other outcomes were significantly different. For the intervention group, the benefits of OPC were maintained at 2 months. CONCLUSIONS OPC led to improved satisfaction with performance and performance in daily activities. Future research with a larger sample is needed to determine other effects and who benefits most from OPC.
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Affiliation(s)
- Dorothy Kessler
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.
| | - Martina Franz
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Niloufar Malakouti
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | | | - Moogeh Baharnoori
- Department of Medicine, Division of Neurology, Queen's University, Kingston, Ontario, Canada
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
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Graham F, Williman J, Desha L, Snell D, Jones B, Ingham T, Latu ATF, Ranta A, Walker E, Makasini S, Ziviani J. Realist process evaluation of occupational performance coaching: protocol. BMJ Open 2024; 14:e075727. [PMID: 38844396 PMCID: PMC11163826 DOI: 10.1136/bmjopen-2023-075727] [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: 05/17/2023] [Accepted: 01/26/2024] [Indexed: 06/12/2024] Open
Abstract
INTRODUCTION A cluster randomised controlled trial, the Meaning, Agency and Nurturing Autonomy (MANA) study, is underway comparing the effects of occupational performance coaching (OPC) and usual care on the social participation, health and well-being of children with neurodisability and their caregivers. This protocol presents the realist process evaluation which is occurring in parallel with the trial to allow testing and further refinement of OPC programme theory, as represented in its logic model. The aim of this realist evaluation is to examine what works, for whom, in the implementation of OPC with caregivers of children with neurodisability (in particular, Māori and Pasifika) in current service delivery contexts. METHODS AND ANALYSIS Guided by OPC programme theory and realist evaluation processes, mixed-methods data collected from the MANA study OPC group will be analysed to elucidate when OPC works (outcomes), for whom, how (mechanisms) and under what circumstances (contexts). This will culminate in the synthesis of Intervention-Actor Context-Mechanism-Outcome configurations. Descriptive analyses will be reported for quantitative measures of treatment fidelity (OPC-Fidelity Measure), caregiver emotional response to OPC (Session Rating Scale) preintervention emotional state (Depression Stress and Anxiety Scale) and client outcomes (Canadian Occupational Performance Measure). Reflexive thematic analysis will be undertaken to analyse realist interviews with therapists who implemented OPC above and below fidelity thresholds and culturally focused interviews with clients of Māori or Pasifika ethnicity, informing understanding of the contexts influencing therapists' implementation of OPC with fidelity, and the mechanisms triggered within therapists or caregivers to elicit a response to the intervention. The MANA study trial outcomes will be reported separately. ETHICS AND DISSEMINATION Ethical approval for this study was granted by the New Zealand Health and Disability Ethics Committee (20/STH/93). In all participating jurisdictions local area approval was obtained, involving a process of local Māori consultation. Results will be disseminated to all participants, and more broadly to clinicians and policy-makers through conference presentations and peer-reviewed journal publications, which will inform decision-making about resourcing and supporting effective delivery of OPC to optimise outcomes for children and caregivers. TRIAL REGISTRATION NUMBER ACTRN12621000519853.
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Affiliation(s)
- Fiona Graham
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Jonathan Williman
- Public Health and General Practice, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand
| | - Laura Desha
- Department of Medicine, University of Otago, Wellington, New Zealand
| | | | - Bernadette Jones
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Tristram Ingham
- Department of Medicine, University of Otago, Wellington, New Zealand
| | | | - Annemarei Ranta
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Emma Walker
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Salote Makasini
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Jenny Ziviani
- The University of Queensland - Saint Lucia Campus, Saint Lucia, Queensland, Australia
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Miller V, Sampson MA, Howell D, Kitzman P. Coaching to Support Children With Disabilities in Occupational Therapy: A Literature Review. Occup Ther Health Care 2024:1-31. [PMID: 38690772 DOI: 10.1080/07380577.2024.2346913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 04/20/2024] [Indexed: 05/03/2024]
Abstract
IMPORTANCE Coaching is an effective intervention strategy in occupational therapy but there lacks consensus in the literature about terms, definitions, and approaches used which can be barriers to the clinical use of this method. OBJECTIVE The purpose of this review is to understand how coaching adults is used as an intervention to support children with disabilities. METHODS Guidelines from foundational scoping review articles and PRISMA-ScR were followed. Studies using adult coaching as an intervention to support children with disabilities were reviewed. A total of 20 articles met inclusion criteria and were included in the review. FINDINGS The use of coaching terms and definitions vary. There are commonalities with coaching structures, "key ingredients," and use of outcome measures among studies which can provide a starting framework for occupational therapists wanting to use coaching as an intervention in their practice. CONCLUSIONS AND RELEVANCE Coaching adults to support children with disabilities is already known to be an effective occupational therapy intervention strategy. Developing structured protocols with clearer and more unified terminology may improve the fidelity of this intervention approach. WHAT THIS ARTICLE ADDS This article presents current practices in adult coaching to support children with disabilities in Occupational Therapy. The authors discuss commonalities across coaching practices for therapists who wish to use coaching protocols in their clinical practice.
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Affiliation(s)
- Valerie Miller
- Rehabilitation, Exercise, and Nutrition Sciences, University of Cincinnati, Cincinnati, OH, USA
- College of Health Sciences, University of KY, Lexington, KY, USA
| | - Mara A Sampson
- Department of Occupational Science and Occupational Therapy, Eastern Kentucky University, Richmond, KY, USA
| | - Dana Howell
- College of Health Sciences, University of KY, Lexington, KY, USA
- Department of Occupational Science and Occupational Therapy, Eastern Kentucky University, Richmond, KY, USA
| | - Patrick Kitzman
- College of Health Sciences, University of KY, Lexington, KY, USA
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Egan M, Kessler D, Gurgel-Juarez N, Chopra A, Linkewich E, Sikora L, Montgomery P, Duong P. Stroke rehabilitation adaptive approaches: A theory-focused scoping review. Scand J Occup Ther 2024; 31:1-13. [PMID: 37976402 DOI: 10.1080/11038128.2023.2257228] [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: 09/22/2022] [Accepted: 09/06/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Stroke rehabilitation consists of restorative and adaptive approaches. Multiple adaptive approaches exist. AIMS/OBJECTIVES The objective of this study was to develop a framework for categorising adaptive stroke rehabilitation interventions, based on underlying theory. MATERIAL AND METHODS We searched multiple databases to April 2020 to identify studies of interventions designed to improve participation in valued activities. We extracted the name of the intervention, underlying explicit or implicit theory, intervention elements, and anticipated outcomes. Using this information, we proposed distinct groups of interventions based on theoretical drivers. RESULTS Twenty-nine adaptive interventions were examined in at least one of 77 studies. Underlying theories included Cognitive Learning Theory, Self-determination Theory, Social Cognitive Theory, adult learning theories, and Psychological Stress and Coping Theory. Three overarching theoretical drivers were identified: learning, motivation, and coping. CONCLUSIONS At least 29 adaptive approaches exist, but each appear to be based on one of three underlying theoretical drivers. Consideration of effectiveness of these approaches by theoretical driver could help indicate underlying mechanisms and essential elements of effective adaptive approaches. SIGNIFICANCE Our framework is an important advance in understanding and evaluating adaptive approaches to stroke rehabilitation.
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Affiliation(s)
- Mary Egan
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Dorothy Kessler
- School of Rehabilitation Therapy, Queens University, Kingston, ON, Canada
| | | | - Anchal Chopra
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | | | - Lindsey Sikora
- Health Sciences Library, University of Ottawa, Ottawa, ON, Canada
| | | | - Patrick Duong
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
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Salsi S, Ariano E, Casey J, Loewen M, Engel L. Financial Capability Interventions Used for Specific Diagnoses Related to Functional Impairment: A Scoping Review. Am J Occup Ther 2024; 78:7801205060. [PMID: 38305720 DOI: 10.5014/ajot.2024.050254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
IMPORTANCE Occupational therapists often address financial occupations of clients with acquired functional impairments who experience challenges with financial capability (FC). OBJECTIVE To explore the intervention literature aimed at improving FC in five diagnostic adult populations. DATA SOURCES MEDLINE, CINAHL, PsycInfo, EconLit, and EMBASE; researchers also completed backward and forward citation searching and contacted expert authors. STUDY SELECTION AND DATA COLLECTION Two independent reviewers completed article screening, selection, and extraction using a scoping review approach; a priori inclusion criteria were peer-reviewed articles, written in English, involving adults with one of five diagnostic conditions, describing any intervention to improve FC. FINDINGS Twenty-four articles met the inclusion criteria. Most articles were aimed at substance use or mental health populations (n = 20); fewer focused on brain injury (n = 2), multiple sclerosis (n = 1), or mixed-diagnosis (n = 1) populations. Only 4 were randomized controlled trials (RCTs). Interventions were heterogeneous and complex, including components of skills training (n = 21), individualized budgeting (n = 18), representative payeeship (n = 11), education (n = 10), structured goal setting (n = 7), savings building (n = 5), metacognitive strategies (n = 2), and assistive technology (n = 1). CONCLUSIONS AND RELEVANCE Despite growth in the area, the literature regarding FC intervention is limited, with few RCTs and many populations unrepresented. The literature for a systematic review of FC intervention efficacy for these populations is insufficient, particularly because included studies used varied components, limiting comparison. Further research is imperative to guide evidence-based practice. Plain-Language Summary: This study is an overview of literature about interventions to address the financial occupations of clients with acquired functional impairments. The findings give occupational therapy researchers and clinicians the information they need to begin analyzing, using, and building the evidence to support the use of interventions to improve clients' financial capability and well-being.
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Affiliation(s)
- Sofia Salsi
- Sofia Salsi, MScA OT, OT Reg (MB), is PhD Graduate Student, Applied Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Emily Ariano
- Emily Ariano, MOT, OT Reg (MB), is Occupational Therapist, Victoria General Hospital, Winnipeg, Manitoba, Canada. At the time of this review, Ariano was Master of Occupational Therapy Student, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jennifer Casey
- Jennifer Casey, MOT, OT Reg (Ont.), is Occupational Therapist, Children's Therapy Collective and Children's First Initiative, Winnipeg, Manitoba, and Fort Frances, Ontario, Canada. At the time of this review, Casey was Master of Occupational Therapy Student, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Morgan Loewen
- Morgan Loewen, MOT, OT Reg (MB), is Occupational Therapist, Deer Lodge Centre, Winnipeg, Manitoba, Canada. At the time of this review, Loewen was Master of Occupational Therapy Student, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lisa Engel
- Lisa Engel, MSc (OT), PhD, OT Reg (MB), is Assistant Professor, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada, and Institute for Work and Health, Toronto, Ontario, Canada;
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Zhou X, Du M, Dai X, Zhu S, Zhou L, Li X. Intervention patterns and preliminary effectiveness on Social Participation following stroke: a scoping review. BMC Neurol 2023; 23:275. [PMID: 37464300 DOI: 10.1186/s12883-023-03250-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/17/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Stroke survivors suffer an overall loss of social participation. However, the interventions aiming at improving social participation have not yet been well-established. There is a need to synthesize existing knowledge on clinical interventions aiming at improving social participation among people with stroke. OBJECTIVE To describe the patterns of intervention that have been applied to stroke survivors to improve social participation and to determine the preliminary effects of these patterns. METHODS Eight online databases, including Cochrane Library, PubMed, Web of Science, Embase, Medline, CINAHL plus, PsycINFO, and Scoups were searched with predefined search terms from inception to September 22, 2022. References of included articles and previous reviews were also checked to identify additional studies. Two reviewers independently selected eligible studies and extracted data from the included articles. RESULTS A total of 98 studies were included, of which only 25 studies considered social participation as primary outcome of clinical interventions. The patterns of intervention were various, consisting of exercise-based intervention, occupational therapy, self-management program, and complex intervention. Of the 25 studies, eight studies found a positive effect of relative clinical intervention on social participation for stroke survivors. Of note, the same modality of intervention such as exercise-based intervention and self-management program produced paradoxical conclusion on social participation. CONCLUSION Exercised-based intervention, occupational therapy, self-management program, and complex intervention were important intervention modalities for the improvement of social participation among stroke survivors. Even though the preliminary effectiveness on social participation seems to be potentially positive, further high-quality researches are still required to reach a consensus to achieve optimal social participation among stroke survivors.
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Affiliation(s)
- Xuan Zhou
- Department of nursing, Naval Medical University, Shanghai, 200433, China
| | - Minxia Du
- Department of nursing, Xinxiang Medical University, Henan, 453000, China
| | - Xiaojie Dai
- Department of Orthopaedics, Changzheng Hospital, Shanghai, 200003, China
| | - Shenghui Zhu
- Department of nursing, Community Health Service Centre, Nanjing East Road, Huangpu District, Shanghai, 200002, China
| | - Lanshu Zhou
- Department of nursing, Naval Medical University, Shanghai, 200433, China.
- Nursing Department, Naval Medical University, 800 Xiangyin Road, Yangpu District, Shanghai, 200433, China.
| | - Xuemei Li
- Department of nursing, Naval Medical University, Shanghai, 200433, China.
- Nursing Department, Naval Medical University, 800 Xiangyin Road, Yangpu District, Shanghai, 200433, China.
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Ahmadizadeh Z, Shanbehzadeh S, Kessler D, Taghavi S, Khaleghparast S, Akbarfahimi M. Occupational Performance Coaching for Adults with Heart Failure: Randomized Controlled Trial Protocol. Can J Occup Ther 2023; 90:15-24. [PMID: 36266930 DOI: 10.1177/00084174221130167] [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] [Indexed: 11/05/2022]
Abstract
Background: Patients with heart failure (HF) usually experience functional disabilities and face participation challenges. Self-care behavior is an essential component of long-term management of HF. Purpose: This study aims to investigate the effect of occupational performance coaching (OPC) on self-care behaviors and participation in people with HF. Method: This study is a parallel group, single-blind, randomized controlled trial of 44 adults with HF, to evaluate the efficacy of OPC. Patients will be randomly allocated (1:1) into two groups. Both groups will receive usual self-care education and the intervention group will receive eight weekly sessions of OPC as well. We will measure the primary and secondary outcomes at baseline, 8, and 12 weeks after the intervention initiation. Implications: If OPC is superior to usual self-care education on improving self-care behavior and participation, the finding will support the integration of OPC into practice to improve participation and self-care behaviors of HF patients.
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Zhang L, Yan YN, Sun ZX, Yan DR, Chen YW, Lin KC, Ge XJ, Qin XL. Effects of Coaching-Based Teleoccupational Guidance for Home-Based Stroke Survivors and Their Family Caregivers: A Pilot Randomised Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192316355. [PMID: 36498427 PMCID: PMC9739622 DOI: 10.3390/ijerph192316355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/29/2022] [Accepted: 12/06/2022] [Indexed: 06/12/2023]
Abstract
The aim of this pilot study was to investigate the feasibility and effectiveness of a 3-month coaching-based teleoccupational guidance (CTG) programme for home-based stroke survivors and their family caregivers. An assessor-blind pilot randomised controlled study was conducted. Twenty-five participant dyads (each dyad consisted of one home-based stroke patient and their caregivers) were randomised to a control group (RTG, n = 12) or an experimental group (CTG, n = 13). Participant dyads in the RTG group received routine teleoccupational guidance. Participant dyads in the CTG group received a six-step procedure: coaching-based teleoccupational guidance over 3 months via WeChat. Participant dyad compliance, the difficulty and suitability of outcome measures, and adverse effects were used to assess feasibility. The Reintegration to Normal Living Index, the Lawton Instructive Activities of Daily Life (Lawton IADL) scale, the Intrinsic Motivation Inventory, the Fugl-Meyer Assessment-Upper Extremity scale, the 6 min walking test, and the Stroke-Specific Quality of Life Scale were used to assess effectiveness outcomes of home-based stroke survivors; the Caregiver Benefit Finding Scale and the Zarit Caregiver Burden Interview were used to assess the effectiveness outcomes of family caregivers. Feasibility measures were assessed at the end of the pilot trial, and effectiveness measures were evaluated pre-intervention and post-intervention (after 3 months). The CTG programme significantly improved home-based stroke survivors' participation in daily life, IADL score, and intrinsic motivation, and increased caregivers' perceived benefit, and tended (not significantly) to reduce care burden. CTG has the potential to promote better integration of home-based stroke patients into their families and society, improve their quality of life and family well-being, and provide a reference for home rehabilitation of other clinical chronic diseases. CTG is a safe, effective, and promising intervention for home-based stroke populations and their caregivers and warrants further investigation in a larger randomised controlled trial.
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Affiliation(s)
- Li Zhang
- Graduate School, Hebei Medical University, Shijiazhuang 050051, China
| | - Yan-Ning Yan
- Department of Rehabilitation Medicine, Hebei General Hospital, Shijiazhuang 050051, China
| | - Zeng-Xin Sun
- Department of Rehabilitation Medicine, Hebei General Hospital, Shijiazhuang 050051, China
| | - Dong-Rui Yan
- Department of Rehabilitation Medicine, Hebei General Hospital, Shijiazhuang 050051, China
| | - Yuan-Wu Chen
- Department of Rehabilitation Medicine, Hebei General Hospital, Shijiazhuang 050051, China
| | - Keh-Chung Lin
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei 10617, Taiwan
- Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei 10055, Taiwan
| | - Xin-Jing Ge
- Department of Rehabilitation Medicine, Hebei General Hospital, Shijiazhuang 050051, China
| | - Xiao-Lu Qin
- Department of Rehabilitation Medicine, Hebei General Hospital, Shijiazhuang 050051, China
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“I Could Really Use This”: Occupational Therapy Students’ Perceptions of Learning to Coach. Occup Ther Int 2022; 2022:2266326. [DOI: 10.1155/2022/2266326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/10/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022] Open
Abstract
Coaching, an evidence-based approach in other fields, is relatively novel within occupational therapy (OT) and is not yet widely taught in OT programs. In recent studies, experienced occupational therapists have reported that coaching added value to their practice, but OT students’ perspectives are missing from the literature. This phenomenological study explored OT students’ (
) perceptions of the value of learning to coach while in fieldwork. Three themes emerged from the inductive qualitative analysis: Coaching Requires a Mindset Shift, Change is a Journey, and Impact on Clients. Occupational therapy students perceived that coaching required a different way of thinking and reimagining their role, saw the value of learning to coach in the clients’ outcomes, and recognized the potential for their future practice regardless of settings. The study findings suggest that incorporating coaching skills into OT education could be beneficial to students when they enter the profession.
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Coaching While Waiting for Autism Spectrum Disorder Assessment: A Pilot Feasibility Study for a Randomized Controlled Trial on Occupational Performance Coaching and Service Navigation. J Autism Dev Disord 2022:10.1007/s10803-022-05558-3. [PMID: 35488977 PMCID: PMC9055011 DOI: 10.1007/s10803-022-05558-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 11/18/2022]
Abstract
Aim To determine whether short-phase Occupational Performance Coaching combined with service navigation support is feasible for families waiting for autism assessment. Method A pilot feasibility study was conducted using a blinded randomization procedure that allocated participants to one of three trial arms: (1) face-to-face coaching, (2) videoconference coaching, and (3) usual care. Outcomes included a retention aim of 70–80%, goal attainment and secondary standardised measures of adaptive behaviour, social skills, parenting stress, service access and family quality of life. Results Caregivers and children (n = 16, child mean age of 3 years 7 months) were recruited following referral for an autism assessment. Retention was 75%, with change scores in performance and satisfaction of selected goals higher in the intervention groups than the usual care group. Interpretation Findings support progression to a future randomized controlled trial assessing intervention efficacy.
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Kersey J, Hammel J, Baum C, Huebert K, Malagari E, Terhorst L, McCue M, Skidmore ER. Effect of interventions on activity and participation outcomes for adults with brain injury: a scoping review. Brain Inj 2022; 36:21-31. [DOI: 10.1080/02699052.2022.2034043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Jessica Kersey
- Department of Occupational Therapy, University of Pittsburgh, School of Health and Rehabilitation Science, Pittsburgh, Pennsylvania, USA
| | - Joy Hammel
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Carolyn Baum
- Program in Occupational Therapy, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Kelly Huebert
- Department of Occupational Therapy, University of Pittsburgh, School of Health and Rehabilitation Science, Pittsburgh, Pennsylvania, USA
| | - Emily Malagari
- Department of Occupational Therapy, University of Pittsburgh, School of Health and Rehabilitation Science, Pittsburgh, Pennsylvania, USA
| | - Lauren Terhorst
- Department of Occupational Therapy, University of Pittsburgh, School of Health and Rehabilitation Science, Pittsburgh, Pennsylvania, USA
| | - Michael McCue
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elizabeth R. Skidmore
- Department of Occupational Therapy, University of Pittsburgh, School of Health and Rehabilitation Science, Pittsburgh, Pennsylvania, USA
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Jamali AR, Alizadeh Zarei M, Sanjari MA, AkbarFahimi M, Saneii SH. Randomized controlled trial of occupation performance coaching for families of children with autism spectrum disorder by means of telerehabilitation. Br J Occup Ther 2021. [DOI: 10.1177/03080226211061492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction This study examined the effectiveness of occupational performance coaching, which was delivered through telerehabilitation, in improving children with autism spectrum disorders (ASD) occupational performance, behavior problems, and prosocial behavior in addition to parental self-efficacy and quality of life. Method Forty-three children were matched and randomized to occupational performance coaching or waitlist groups. Occupational performance, parental self-efficacy, behavioral problems, and prosocial behaviors were assessed using the Canadian Occupational Performance Measure, Child adjustment and parent efficacy scale-developmental disability (CAPES-DD), the Short-Form Health Survey, and goal attainment scale. Results The intervention group showed greater improvement on occupational performance, specified goals, and behavioral problems. No progress was seen on the CAPES-DD prosocial behavior subscale. In addition, parental quality of life improvement was not maintained after the follow-up phase. Conclusion Occupation performance coaching, which was delivered through telerehabilitation, was effective on children with ASD occupational performance and parental self-efficacy, but it was not effective on the prosocial behaviors of these children.
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Affiliation(s)
- Ali Reza Jamali
- Occupational Therapy Department, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Alizadeh Zarei
- Occupational Therapy Department, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sanjari
- Biomechanics Lab., Rehabilitation Research Center, and Department of Basic Rehabilitation Sciences, Faculty of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Malahat AkbarFahimi
- Occupational Therapy Department, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Hassan Saneii
- Basic Sciences, Iran University of Medical SciencesIran University of Medical Sciences, Tehran, Iran
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Kessler D, Anderson ND, Dawson DR. Occupational performance coaching for stroke survivors delivered via telerehabilitation using a single-case experimental design. Br J Occup Ther 2021; 84:488-496. [PMID: 34381289 PMCID: PMC8326897 DOI: 10.1177/0308022620988471] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/23/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Sustaining a stroke has a devastating, long-term impact on participation in everyday life. Despite the recognition of participation as a key outcome of stroke rehabilitation, there are few effective interventions that address participation. Occupational performance coaching is a promising intervention designed to improve participation among stroke survivors. Delivery of occupational performance coaching using telerehabilitation could improve access. This study examined the feasibility, acceptability and potential efficacy of telerehabilitation occupational performance coaching. METHOD A single-case experimental design was used. Six community-dwelling stroke survivors received 10 sessions of telerehabilitation occupational performance coaching over 16 weeks. We examined the feasibility and acceptability of telerehabilitation occupational performance coaching, improvement in performance and satisfaction with identified goals. RESULTS Telerehabilitation occupational performance coaching was feasible and acceptable to deliver; participants who started the intervention completed it and reported high satisfaction and a strong therapeutic relationship. All participants experienced technological issues that required resolution. Goal-performance and/or satisfaction improved for five of six participants. Sixty-four percent of goals showed trends for improvement and 43% showed significant improvements. CONCLUSIONS Findings support the feasibility and acceptability of telerehabilitation occupational performance coaching, along with its efficacy for improving performance and satisfaction with performance of goals. Further research is needed to prove the effectiveness of telerehabilitation occupational performance coaching and to determine who may benefit most.
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Affiliation(s)
- Dorothy Kessler
- School of Rehabilitation Therapy, Queen’s University, Kingston, Canada
| | | | - Deirdre R Dawson
- Rotman Research Institute, Baycrest, Canada
- Department of Occupational Science & Occupational Therapy and Rehabilitation Sciences Institute, University of Toronto, Canada
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Fraser T, Karon L, Lund A, Sveen U, Kessler D. Examining components of community psychosocial stroke interventions using concept mapping. Scand J Occup Ther 2021; 29:325-336. [PMID: 34181505 DOI: 10.1080/11038128.2021.1933172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Stroke impacts psychosocial well-being and engagement in occupation. Psychosocial interventions reduce depression and anxiety but may not impact occupation. Knowledge of key processes and components of community psychosocial stroke interventions can inform future intervention development. AIM/OBJECTIVE(S) To determine the essential elements common to three psychosocial interventions for stroke survivors. MATERIAL(S) AND METHOD(S) Concept maps were created for three community psychosocial stroke interventions based on published literature and communication with researchers who tested the intervention with stroke survivors. The concept maps were then compared to identify common elements. Ongoing communication with researchers ensured accurate representation of each respective intervention. RESULTS Similarities in intervention processes and components included support for autonomy; individualized information exchange; coping, life skill development and adaptation support; competence development; and the incorporation of goals. Differences included intervention delivery (individual versus group), and the avenues in which psychosocial needs are addressed (occupation versus dialogue). CONCLUSIONS Concept mapping identified similarities among the three interventions that can be best understood using self-determination theory. Clinicians may utilize findings revealed in the process to inform evidence-based psychosocial stroke interventions. SIGNIFICANCE Knowledge of key 'active ingredients' for psychosocial community stroke interventions, can be used to guide clinical reasoning and inform development of interventions.
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Affiliation(s)
- Theresa Fraser
- School of Rehabilitation Therapy, Queens University, Kingston, Canada
| | - Leora Karon
- School of Rehabilitation Therapy, Queens University, Kingston, Canada
| | - Anne Lund
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Unni Sveen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Dorothy Kessler
- School of Rehabilitation Therapy, Queens University, Kingston, Canada
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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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Bernie C, Williams K, Graham F, May T. Coaching While Waiting for Autism Spectrum Disorder Assessment: Protocol of a Pilot Feasibility Study for a Randomized Controlled Trial on Occupational Performance Coaching and Service Navigation Support. JMIR Res Protoc 2021; 10:e20011. [PMID: 33410761 PMCID: PMC7819777 DOI: 10.2196/20011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 10/14/2020] [Accepted: 11/03/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND In Australia, the average time between a first concern of autism spectrum disorder (ASD) and diagnosis is over 2 years. After referral for assessment, families often wait 6-12 months before their appointment. This can be a time of uncertainty and stress for families. For some families, other forms of assistance are not accessible and thus timely intervention opportunities are missed. There is little evidence about how to provide the best support for children or caregivers while on assessment waiting lists. OBJECTIVE The aim of this study is to determine whether use of a coaching intervention called Occupational Performance Coaching (OPC) combined with service navigation support is feasible for families waiting for ASD assessment, as a crucial first step in planning a randomized controlled trial. METHODS A pilot and feasibility study will be conducted using recommended constructs and associated measures, which will be reported using CONSORT (Consolidated Standards or Reporting Trials) guidance. Participants will be child and caregiver dyads or triads, recruited within 4 months of their child (aged 1-7 years) being referred to one of two services for an ASD assessment in Victoria, Australia. A blinded randomization procedure will be used to allocate participants to one of three trial arms: (1) coaching and support intervention delivered face to face, (2) coaching and support intervention via videoconference, and (3) usual care. Descriptive statistics will be used to describe the sample characteristics of parents and children, inclusive of service access at baseline and follow up. Recruitment rates will be reported, and retention rates will be evaluated against a predicted rate of 70%-80% in each intervention arm. Goal attainment, using the Canadian Occupational Performance Measure, will indicate preliminary evidence for efficacy within the intervention arms, with an increase of 2 or more points on a 10-point performance and satisfaction scale considered clinically significant. RESULTS The study was approved by The Royal Children's Hospital Research Ethics and Governance Department in September 2018. As of October 2020, 16 families have been recruited to the study. Data analysis is ongoing and results are expected to be published in 2021. CONCLUSIONS Study findings will support planning for a future randomized controlled trial to assess the efficacy of OPC and service navigation support for caregivers of children awaiting ASD assessment. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12620000164998; www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378793&isReview=true. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/20011.
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Affiliation(s)
- Charmaine Bernie
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Department of Allied Health, The Royal Children's Hospital, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Katrina Williams
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
- Developmental Paediatrics, Monash Children's Hospital, Melbourne, Australia
- The Murdoch Children's Research Institute, Melbourne, Australia
| | - Fiona Graham
- Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand
| | - Tamara May
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
- The Murdoch Children's Research Institute, Melbourne, Australia
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Swanton R, Gustafsson L, Froude E, Hodson T, McInerney M, Cahill LS, Lannin NA. Cognitive strategy training for adults with neurological conditions: a systematic review and meta-analysis exploring effect on occupational performance. Br J Occup Ther 2020. [DOI: 10.1177/0308022620933095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction The objective of this systematic review was to synthesise the evidence for cognitive strategy training to determine its effectiveness to improve performance of activities of daily living in an adult neurological population. Method Medline, CINAHL, EMBASE, PSYCInfo, PsycBITE and Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews were searched until August 2019. Studies examining the effect of cognitive strategy training on functional performance were included. Population criteria included adults with non-progressive neurological conditions. External and internal validity of included studies was systematically evaluated using an appropriate methodological quality assessment for each study design. A content analysis was conducted of the methodologies used. Findings Forty-one studies met the inclusion criteria and were appraised for content, 16 randomised or quasi-randomised trials were meta-analysed. Trial quality was generally ‘good’, Physiotherapy Evidence Database scale scores ranged from 3 to 8 (out of 10). For activity performance outcomes post-intervention, there was a significant benefit of cognitive strategy training over usual care (standardised mean difference 0.79, 95% confidence interval 0.49–1.09; P < 0.00001). Conclusion More high-quality research is needed to strengthen the evidence base for cognitive strategy interventions to improve activity performance outcomes for adults with non-progressive neurological conditions. Systematic review registration PROSPERO CRD42016033728
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Affiliation(s)
- Ruth Swanton
- School of Health and Rehabilitation Sciences, University of Queensland, Australia
- School of Allied Health, Australian Catholic University, Sydney, Australia
| | - Louise Gustafsson
- School of Health and Rehabilitation Sciences, University of Queensland, Australia
- School of Allied Health Sciences – Occupational Therapy, Griffith University, Queensland, Australia
| | - Elspeth Froude
- School of Allied Health, Australian Catholic University, Sydney, Australia
| | - Tenelle Hodson
- School of Health and Rehabilitation Sciences, University of Queensland, Australia
- School of Allied Health Sciences – Occupational Therapy, Griffith University, Queensland, Australia
| | - Michelle McInerney
- School of Allied Health, Australian Catholic University, Sydney, Australia
| | - Liana S Cahill
- School of Allied Health, Australian Catholic University, Sydney, Australia
- Department of Community and Clinical Allied Health, La Trobe University, Australia
- Neurorehabilitation and Recovery, Stroke, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia
| | - Natasha A Lannin
- Department of Community and Clinical Allied Health, La Trobe University, Australia
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
- Alfred Health, Melbourne, Australia
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Lin YN, Wu CY, Yeh PC, Wu YH, Lin WC, Skidmore ER, Chang FH. Adapting Strategy Training for Adults With Acquired Brain Injury: A Feasibility Study in a Chinese Population. Am J Occup Ther 2020; 74:7403205130p1-7403205130p10. [PMID: 32365319 DOI: 10.5014/ajot.2020.035923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Before introducing strategy training into a cross-cultural (Chinese) context, it is necessary to evaluate its feasibility. OBJECTIVE To examine the feasibility of applying strategy training to improve participation outcomes of rehabilitation patients in Taiwan and evaluate the potential intervention effects. DESIGN A single-group, repeated-measures study. SETTING Rehabilitation outpatient settings. PARTICIPANTS A convenience sample of adults (N = 20) with a primary diagnosis of acquired brain injury (ABI) and with cognitive impairment received the intervention and were assessed before and after it. INTERVENTION The participation-focused strategy training intervention, a modified version of the strategy training intervention, was provided to participants in 1-2 sessions weekly for a total of 10-20 intervention sessions. OUTCOMES AND MEASURES Feasibility indicators, Participation Measure-3 Domains, 4 Dimensions (PM-3D4D), and Canadian Occupational Performance Measure (COPM). RESULTS Eighteen participants completed 100% of the scheduled intervention sessions. Participants had very good engagement in the intervention sessions with sufficient comprehension. Participants reported moderate to high satisfaction. Positive score changes were observed for the PM-3D4D (d = 0.46-1.25) and COPM scales (d = 1.82 and 2.12). CONCLUSIONS AND RELEVANCE This study demonstrated the feasibility of delivering participation-focused strategy training in Taiwan to people with cognitive impairment after ABI. The preliminary evidence also showed that participants who received the strategy training intervention had positive changes in participation outcomes and in performance of their self-identified goals. On the basis of this study's findings, a larger clinical trial is warranted to evaluate the efficacy of the strategy training intervention. WHAT THIS ARTICLE ADDS Participation-focused strategy training is feasible and acceptable for Taiwanese community-dwelling adults with cognitive impairment after ABI. However, because strategy training is quite different from traditional rehabilitation delivered in Taiwan, additional instructions and discussion among the therapist, client, and caregiver may be needed before the intervention is provided.
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Affiliation(s)
- Yen-Nung Lin
- Yen-Nung Lin, MS, MD, is Associate Professor, Graduate Institute of Injury Prevention and Control, College of Public Health; Associate Professor, Department of Physical Medicine and Rehabilitation, School of Medicine; and Chair, Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chao-Yi Wu
- Chao-Yi Wu, MS, OTR/L, is Doctoral Candidate, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Pei-Chun Yeh
- Pei-Chun Yeh, BS, OTR/L, is Occupational Therapist, Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hsuan Wu
- Yi-Hsuan Wu, MS, OTR/L, is Occupational Therapist, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Wan-Chi Lin
- Wan-Chi Lin, MS, OTR/L, is Occupational Therapist, Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Elizabeth R Skidmore
- Elizabeth R. Skidmore, PhD, OTR/L, is Chair and Professor, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, and Professor, Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Feng-Hang Chang
- Feng-Hang Chang, ScD, OTR/L, is Associate Professor, Graduate Institute of Injury Prevention and Control, College of Public Health, and Associate Professor, Department of Physical Medicine and Rehabilitation, School of Medicine, Taipei Medical University, Taipei, Taiwan;
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Lamarre J, Egan M, Kessler D, Sauvé-Schenk K. Occupational Performance Coaching in Assisted Living. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2019.1659466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Julie Lamarre
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Mary Egan
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Dorothy Kessler
- School of Rehabilitation Therapy, Queens University, Kingston, ON, Canada
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20
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Nott M, Wiseman L, Seymour T, Pike S, Cuming T, Wall G. Stroke self-management and the role of self-efficacy. Disabil Rehabil 2019; 43:1410-1419. [PMID: 31560230 DOI: 10.1080/09638288.2019.1666431] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE This study explored the impact of a 12-week stroke self-management program on occupational performance, the role of self-efficacy on improving occupational performance and the potential barriers and facilitators to self-efficacy as reported by clients and careers. MATERIALS AND METHODS Participants (n = 40) were recruited to participate in a self-management program after admission to hospital with diagnosis of stroke. A pre-post study was conducted and data were obtained from participants using: the Canadian Occupational Performance Measure, Stroke Self-efficacy Questionnaire, and semi-structured interviews with five participants and two careers. Data analysis was conducted using parametric statistics and thematic analysis. RESULTS Significant improvements were observed in occupational performance (t = 11.2; p = 0.001) and satisfaction (t = 9.7; p = 0.001). Self-efficacy was shown to be a significant mediator to improvements in occupational performance (F = 7.08; p < 0.01) and satisfaction (F = 6.52; p = 0.02). Three key barriers and facilitators emerged from the thematic analysis: "Support in making the transition home," "Getting back to normal," and "Reflecting on shared experiences." CONCLUSIONS Engagement in a stroke-specific self-management program can improve client-perceived occupational performance and satisfaction. Self-efficacy was shown to be a mediating variable to occupational performance improvements. Future research should explore further the facilitatory strategies of self-efficacy during stroke self-management programs to maximize rehabilitation outcomes.Implications for rehabilitationMulti-modal self-management programs are recommended as effective for improving client-perceived occupational performance of people who have experienced stroke.Returning to valued occupations, goal setting, shared experiences, and local support are recommended components of a self-management program for stroke survivors.Focusing on enhancing client confidence, competence, and self-efficacy is recommended to achieve occupational performance gains through self-management.Occupational therapy coaching is recommended to guide participants through the self-management processes of goal-setting, shared problem-solving, performance evaluation, and reflection.
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Affiliation(s)
- Melissa Nott
- School of Community Health, Charles Sturt University, Albury, Australia
| | - Leah Wiseman
- Department of Occupational Therapy, Albury-Wodonga Health, Wodonga, Australia
| | - Tanya Seymour
- Department of Occupational Therapy, Albury-Wodonga Health, Wodonga, Australia
| | - Shannon Pike
- Wagga Wagga Health Service, Ambulatory Rehabilitation Service, Wagga Wagga, Australia
| | - Tana Cuming
- School of Community Health, Charles Sturt University, Albury, Australia
| | - Gemma Wall
- School of Community Health, Charles Sturt University, Albury, Australia
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21
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Egan MY, Laliberté-Rudman D, Rutkowski N, Lanoix M, Meyer M, McEwen S, Collver M, Linkewich E, Montgomery P, Quant S, Donnelly B, Fearn J. The implications of the Canadian Stroke Best Practice Recommendations for design and allocation of rehabilitation after hospital discharge: a problematization. Disabil Rehabil 2019; 42:3403-3415. [PMID: 30973029 DOI: 10.1080/09638288.2019.1592244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Introduction: Implementation of the Canadian Stroke Best Practice Recommendations has improved inpatient rehabilitation. As attention is turned to the design and allocation of rehabilitation after hospitalization, examination of their implications for post-discharge rehabilitation could help optimize service planningMethods: Critical discourse analysis modeled on Alvesson and Sandberg's method of problematization was conducted to determine how the Canadian Stroke Best Practice Recommendations envision and shape post-discharge rehabilitation, and identify any tensions and potential ways to resolve them.Results: Within the Canadian Stroke Best Practice Recommendations post-discharge rehabilitation is implicitly viewed as a continuation of inpatient rehabilitation. Rehabilitation is largely envisioned as a set of biomedical procedures aimed at normalization through correction of impairment. There is potential tension between this implicit goal and the explicit goal of providing patient and family-centered care and promoting reengagement in valued activities and roles.Conclusion: An alternate vision of post-discharge rehabilitation could help resolve this tension. Post-discharge rehabilitation could be envisioned as a self-management intervention. Rather than primarily an expert-driven process of measuring impairment and applying procedures aimed at normalization, rehabilitation would be considered facilitation of self-management with the goal of reengaging in forms of participation that comprise a satisfying life.Implications for RehabilitationImplicit assumptions within best practice guidelines powerfully influence recommendations. These ideas are difficult to examine because they seem self-evident.Implicit assumptions in the Canadian Stroke Best Practice Guidelines envision post-discharge stroke rehabilitation as an expert-driven, impairment-focused biomedical procedure.This biomedical image makes it difficult to provide care that meets the guideline's explicit goals of client- and family-centeredness.Reimagining post-discharge stroke rehabilitation as a chronic self-care management intervention aimed at developing a satisfying life after stroke could improve patient care.
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Affiliation(s)
- Mary Y Egan
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada.,Bruyere Research Institute, Ottawa, ON, Canada
| | | | | | - Monique Lanoix
- Faculty of Philosophy, Saint Paul University, Ottawa, ON, Canada
| | - Matthew Meyer
- London Health Sciences Centre, Matthew Meyer, London, ON, Canada
| | - Sara McEwen
- Sunnybrook Research Institute, Toronto, ON, Canada
| | - Margo Collver
- London Health Sciences Centre, Southwestern Ontario Stroke Network, London, ON, Canada
| | - Elizabeth Linkewich
- North and East GTA Stroke Network, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | - Sylvia Quant
- North and East GTA Stroke Network, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Beth Donnelly
- Champlain Stroke Network, The Ottawa Hospital, Ottawa, ON, Canada
| | - Jennifer Fearn
- Health Sciences North, Northeastern Ontario Stroke Network, Sudbury, ON, Canada
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Ahmadi Kahjoogh M, Kessler D, Hosseini SA, Rassafiani M, Akbarfahimi N, Khankeh HR, Biglarian A. Randomized controlled trial of occupational performance coaching for mothers of children with cerebral palsy. Br J Occup Ther 2018. [DOI: 10.1177/0308022618799944] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction The purpose of this study was to assess the efficacy of occupational performance coaching in mothers of children with cerebral palsy. Method A randomized controlled trial was used. Thirty mothers of children with cerebral palsy were randomly assigned to an occupational performance coaching group or control group. The Canadian Occupational Performance Measure and Sherer General Self-efficacy Scale were measured before and after the study. Results Occupational performance coaching had significant effects on participants’ occupational performance and self-efficacy. In child-related goals, there was also a statistically significant difference between two groups ( p = 0.05). Conclusion The results indicated that occupational performance coaching could be an effective intervention to increase the self-efficacy of mothers and improve the occupational performance of children and mothers of children with cerebral palsy. This trial is registered at NCT02915926 at clinicaltrials.gov
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Affiliation(s)
- Mina Ahmadi Kahjoogh
- Assistant Professor, Occupational Therapy Department, School of Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Dorothy Kessler
- Assistant Professor, School of Rehabilitation Therapy, Queen’s University, Kingston, Canada
| | - Seyed Ali Hosseini
- Professor, Social Determinants of Health Research Center, Occupational Therapy Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mehdi Rassafiani
- Associate Professor, Occupational Therapy Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait
- Pediatric Neurorehabilitation Research Center, The University of Social Welfare and Rehabilitation Sciences, Kuwait, Iran
| | - Nazila Akbarfahimi
- Assistant Professor, Occupational Therapy Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hamid Reza Khankeh
- Post-Doc Associate Professor, Department of Health in Emergency and Disaster, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Akbar Biglarian
- Associate Professor of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Kessler D, Walker I, Sauvé-Schenk K, Egan M. Goal setting dynamics that facilitate or impede a client-centered approach. Scand J Occup Ther 2018; 26:315-324. [PMID: 29671662 DOI: 10.1080/11038128.2018.1465119] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Client-centred goal setting is central to the process of enabling occupation. Yet, there are multiple barriers to incorporating client-centred goal setting in practice. We sought to determine what might facilitate or impede the formation of client-centred goals in a context highly supportive of client-centred goal setting Methods: We used conversational analysis to examine goal-setting conversations that took place during a pilot trial of Occupational Performance Coaching for stroke survivors. Twelve goal-setting sessions were purposively selected, transcribed, and analyzed according to conventions for conversation analysis. RESULTS Two main types of interactions were observed: introductory actions and goal selection actions. Introductory actions set the context for goal setting and involved sharing information and seeking clarification related to goal requirements and clients' occupational performance competencies. Goal selection actions were a series of interactions whereby the goals were explored, endorsed or dropped. CONCLUSION Client-centred occupational performance goals may be facilitated through placing goal-setting in the context of life changes and lifelong development of goals, and through listening to clients' stories. Therapists may improve consistency in adoption of client-suggested goals through clarifying meaning attached to goals and being attuned to power dynamics and underlying values and beliefs around risk and goal attainability.
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Affiliation(s)
- Dorothy Kessler
- a School of Rehabilitation Therapy , Queen's University , Kingston , Canada.,b Rotman Research Institute , Toronto , Canada.,c Bruyère Research Institute , Ottawa , Canada
| | - Ian Walker
- d University of Ottawa , Ottawa , Canada
| | | | - Mary Egan
- e School of Rehabilitation Sciences , University of Ottawa , Ottawa , Canada
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Kessler D, Egan MY, Dubouloz CJ, McEwen S, Graham FP. Occupational performance coaching for stroke survivors (OPC-Stroke): Understanding of mechanisms of actions. Br J Occup Ther 2018. [DOI: 10.1177/0308022618756001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Occupational performance coaching modified for stroke survivors is a promising new intervention to improve occupational performance post stroke. In the intervention, following client-centred occupational goal-setting, clients are led through strengths-based problem-solving and experimentation. Emotional support, individualized education and goal-focused problem-solving are hypothesized as key elements. Examination of clients’ experiences is necessary to better understand how occupational performance coaching modified for stroke survivors works, and improve its potential effectiveness. Method A descriptive qualitative study was embedded in a pilot randomized controlled trial. Semi-structured interviews were completed with seven participants in the treatment arm who received occupational performance coaching modified for stroke survivors. Qualitative content analysis was used for analysis. Findings Three categories were identified related to participants’ experiences of occupational performance coaching modified for stroke survivors: (a) the coaching was helpful; (b) the coaching provided opportunity for insightful reflection and (c) a different approach was preferred. Findings also lend support to the critical role of hypothesized key components and theorized mechanisms of action, and demonstrate the overarching role of the therapeutic relationship and the contribution of personal characteristics. Conclusion The revised theoretical understanding of occupational performance coaching modified for stroke survivors provides a valuable framework for communicating the actions that occupational therapists take in enabling occupation and emphasizes the role of the therapeutic relationship in client-centred approaches to improving occupational performance post stroke.
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Affiliation(s)
- Dorothy Kessler
- Assistant Professor, School of Rehabilitation Therapy, Queen’s University, Canada
- Scientist, Bruyère Research Institute, Canada
| | - Mary Y Egan
- Professor, School of Rehabilitation Sciences, University of Ottawa, Canada
| | | | - Sara McEwen
- Scientist, Sunnybrook Research Institute, Toronto, Canada
| | - Fiona P Graham
- Senior Lecturer, Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, New Zealand
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25
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Graham F, Ziviani J, Kennedy-Behr A, Kessler D, Hui C. Fidelity of Occupational Performance Coaching: Importance of Accuracy in Intervention Identification. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2017; 38:67-69. [PMID: 29171339 DOI: 10.1177/1539449217738926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Establishing fidelity processes and measures is an important step in the development of interventions. Accurate referencing, naming of interventions and robust discussion of deviations from the theories, methods or terminology underpinning interventions support the fidelity of future applications of interventions in research and clinical settings. This commentary clarifies the establishment of fidelity for Occupational Performance Coaching (OPC) in relation to a recent article on this topic by Dunn and colleagues. Fundamental flaws in the referencing, labelling, theoretical underpinnings and methods inaccurately described as OPC are outlined. Guidance in establishing fidelity for future applications of OPC is provided.
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Affiliation(s)
- Fiona Graham
- 1 University of Otago, Christchurch, New Zealand
| | | | - Ann Kennedy-Behr
- 3 University of the Sunshine Coast, Maroochydore, Queensland, Australia
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