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Introduction: New contexts of practice demand that professionals engage in critical reflection to handle new situations and to create new knowledge that is responsive to professional practices situated in unique historical and social contexts. Community of Practice offers a framework for professions to reflect together on practice dilemmas and to generate practical solutions. Methods: This paper presents a participatory action research project that traces the trajectory of a Community of Practice made up of seven occupational therapists working in primary health care and a researcher team, in Brazil. This study mapped the Community of Practice's trajectory between 2013 and 2017 through a group timeline analysis, which occurred gradually, in a collaborative mode. Results: Three distinct phases in the trajectory of the development of the Community of Practice were identified: narrative perspectives were utilised as a means to identify dilemmas and difficulties in practice; the investigation of clients' needs and identification of issues was an ongoing process; and the generation of practice‐based knowledge through the development of instruments to sustain clinical reasoning was a creative solution to practical dilemmas. Conclusion: Three main aspects were highlighted: the partnership between researchers and practitioners as a potential avenue for the production of knowledge relevant to professional practice; the negotiation of the dilemma of "putting practice into words" in the context of constantly changing local and global perspectives; and the investigation of situated practice as an important element that can strengthen, strain, resist or even modify hegemonic perspectives of knowledge production in our field. [ABSTRACT FROM AUTHOR]

Background/aim Engagement in desired occupations can promote health and wellbeing in older adults. Assessments of engagement often measure frequency, amount or importance of specific activities. This study aimed to develop a scale to measure older adults' evaluation of the extent to which their everyday activities are contributing to their health and wellness. Methods Eighteen items, each scored with a seven-point rating scale, were initially developed by content experts, covering perceptions of how daily activities contribute to physical and mental health, as well as satisfaction and activity participation in the last six months. Rasch analysis methods were used to refine the scale using the pencil and paper responses of 460 community-living older adults. Results Initial Rasch analysis indicated three unlabelled rating scale categories were seldom used, reducing measurement precision. Five items were conceptually different by misfit statistics and principal component analysis. Subsequently, those items were removed and the number of rating scale steps reduced to 4. The remaining 13-item, 4-step scale, termed the Activity Significance Personal Evaluation ( ASPEn), formed a unidimensional hierarchy with good fit statistics and targeting. Person separation reliability (2.7) and internal consistency (.91) indicated the tool is appropriate for individual person measurement. Relative validity indicated equivalence between Rasch measures and total raw scores. Conclusions ASPEn is a brief, easily administered assessment of older adults' perception of the contribution of everyday activities to personal health and wellness. ASPEn may facilitate occupational therapy practice by enabling clinicians to assess change in meaning of an older adult's activity over time. [ABSTRACT FROM AUTHOR]

Introduction: Currently in the Australian higher education sector, the productivity benefits of occupational therapy clinical education placements are a contested issue. This article will report results of a study that developed a methodology for documenting time use during placements and investigated the productivity changes associated with occupational therapy clinical education placements in Queensland, Australia. Supervisors' and students' time use during placements and how this changed for supervisors compared to pre- and post-placement is also presented. Methods: Using a cohort survey design, participants were students from two Queensland universities, and their supervisors employed by Queensland Health. Time use was recorded in 30 minute blocks according to particular categories. Results: There was a significant increase in supervisors' time spent in patient care activities (F = 94.0112,12.37 df, P < 0.001) between pre- and during placement (P < 0.001) and decrease between during and post-placement (P < 0.001). Supervisors' time spent in all non-patient care activities was also significant (F = 4.580 2,16 df, P = 0.027) increasing between pre- and during placement (P = 0.028). There was a significant decrease in supervisors' time spent in placement activities (F = 5.133 2,19.18 df, P = 0.016) from during to post-placement. Students spent more time than supervisors in patient care activities while on placement. Discussion: A novel method for reporting productivity and time-use changes during clinical education programs for occupational therapy has been applied. Supervisors spent considerable time in assessing and managing students and their clinical education role should be seen as core business in standard occupational therapy practice. This paper will contribute to future assessments of the economic impact of student placements for allied health disciplines. [ABSTRACT FROM AUTHOR]

Introduction: Persons with dementia experience time‐related problems, but there is a lack of instruments evaluating their time processing ability and daily time management. This study aimed to evaluate the psychometric properties of the instruments KaTid®‐Senior measuring time processing ability, and Time‐S© Senior and Time‐Proxy© measuring daily time management for persons with dementia. Methods: Persons with dementia (n = 53) and their significant others (n = 49) participated in the study. Rasch analyses were used to evaluate the instruments' rating scale functioning; internal scale validity; person‐response validity; unidimensionality; person‐separation reliability; and internal consistency. Versions excluding items with poor fit to the Rasch model were also evaluated. Results: Overall, the Rasch analyses showed acceptable psychometric properties. All instruments met the criteria for unidimensionality and the reliability was good. More challenging items should be added in KaTid‐Senior for better targeting of persons with mild dementia. Person‐response validity issues in Time‐S Senior need to be addressed. Conclusion: The instruments can validly and reliably be used to assess time processing ability and daily time management in persons with dementia in clinical research and healthcare settings. In turn, this can contribute to the development of methods to compensate for impaired time processing ability and daily time management. The assessments can also increase the possibility of early detection of impaired time processing ability and daily time management, thereby facilitating adequate timing of interventions and enhanced occupational performance. [ABSTRACT FROM AUTHOR]

Introduction: Despite play being widely used in occupational therapy practice as a means and ends in intervention, no research has explored how the play of children with HIV/AIDS is affected. Therefore, the specific processes through which play can be used in therapy with children with HIV/AIDS remains underexplored, especially in low resourced settings. This study aims to compare the level of playfulness of children with HIV/AIDS to that of age and gender matched typically developing children living in the same low resourced community. Methods: The Test of Playfulness (ToP) was used to examine the differences and similarities of play between children aged 4–7 years who are typically developing children (n = 52) and children with HIV/AIDS who receive antiretroviral treatment (n = 44). Each child was video recorded playing with a familiar playmate both indoors and outdoors. The videos were scored by two independent raters who were blinded to all aspects of the study. Scores were subjected to Rasch analysis to calculate interval level measure scores. Independent t‐tests were used to compare differences between the means of the groups. Results: Typically developing children scored significantly higher when playing outdoors, as compared to children with HIV [t (94) = 3.57, p =.001]. There was no significant difference between mean measure scores for indoor play when comparing typically developing children and children with HIV. Children who are HIV positive scored significantly lower than typically developing children on items related to the ability to suspend reality and framing in both indoor and outdoor environments. Conclusions: Children with HIV/AIDS exhibited lower levels of playfulness when compared to typically developing children. This study provides insight on the play profiles of children with HIV/AIDS, highlighting play deficits and differences between indoor and outdoor play. Occupational therapy can play a significant role in promoting playfulness in children with HIV/AIDS. [ABSTRACT FROM AUTHOR]

Introduction: Practice education is a fundamental component of health professional students' education and many personal, social and professional factors impact on students' performance. This study investigated the relationship between measures of resilience and practice education performance in occupational therapy students. Methods: A quantitative cross‐sectional study was used to collect the data. In all, 149 occupational therapy students completed a self‐report questionnaire comprised of demographic questions and two standardised scales: Resilience at University (RAU) and Resilience Scale for Adults (RSA). Students' practice education performance was measured by the Student Practice Evaluation Form–Revised (SPEF–R). Multi‐linear regression analyses with bootstrapping were completed to identify resilience factors that were predictive of occupational therapy students' practice performance. Results: Overall, occupational therapy students reported high levels of resilience based on the RAU and RSA subscale scores. "Managing Stress," "Find Your Calling" and "Living Authentically" were strong predictors of a range of key fieldwork performance SPEF–R factors, including "Professional Behaviours," "Self‐management Skills," "Co‐worker Communication" and "Communication Skills." Conclusion: The resilience factors identified as being significant predictors of practice education performance outcomes in occupational therapy students represent notable findings. They suggest that students' capabilities in managing their stress levels, finding meaning in their chosen profession, and engaging self‐care daily activities outside of the work environment that are meaningful, authentic and fit with one's personal values and beliefs can act as buffers against the challenges experienced by students who are completing practice education placements. The findings will assist academic and practice educators in identifying and targeting vulnerable students and strengthening resilience strategies through proactive pre‐practice placement initiatives. Qualitative studies are recommended to further explore the relationship between resilience and practice education performance in occupational therapy students. [ABSTRACT FROM AUTHOR]

Introduction: Engaging in employment enhances mental health recovery and is therefore of central focus for many occupational therapists working in mental health. Individual placement and support (IPS) is an evidence‐based, supported employment model specifically designed for individuals with severe mental illness who have the desire to work. Despite strong support for IPS in Australia, implementation challenges have been encountered. This study evaluates outcomes achieved by participants engaged with WorkWell, an IPS programme delivered by a large Australian non‐government organisation. In addition to following IPS principles, WorkWell was informed by principles of the collaborative recovery model (CRM). Method: De‐identified outcomes data for each participant were analysed by an independent research team. The proportion of individuals engaged with the programme who achieved a competitive employment placement was calculated. Average employment duration and weekly wages were calculated for individuals who achieved a competitive employment placement. Finally, the proportion of individuals who achieved some form of vocationally relevant outcome was calculated. Results: Ninety‐seven participants were engaged with the programme. Forty‐eight participants (49.5%) gained a competitive employment position. Average employment duration was 151 days (21.6 weeks) and average weekly wage was $478. Overall, 62 participants (63.9%) were supported to achieve some kind of vocationally relevant outcome (e.g. competitive employment, education, work trial or voluntary work) as a result of their engagement with the programme. Conclusion: While the addition of CRM principles appears to have supported positive outcomes for participants, especially in terms of employment duration, results for employment placement rates were lower than expected. While the employment placement rate compares favourably to results from the international literature and numerous programmes in Australia, more development is required to increase the proportion of individuals who are supported into competitive employment positions. Future research should focus on the specific elements of CRM that most contribute to enhancing IPS processes. [ABSTRACT FROM AUTHOR]

Background/aim: Children with ASD are known to have lower play skills than their typically developing peers. However, the play skills of children with ASD are rarely investigated using observational measures in the context of their everyday peer‐to‐peer play interactions. To explore the play skills of children with ASD and their aged matched classmates during a peer‐to‐peer play interaction. Methods: Using convenience sampling, four children with ASD (5–11 years) attending mainstream schools were recruited for this multiple case design study. Each child with ASD was paired with one of their aged matched typically developing classmates. Children's play skills were measured using the Test of Playfulness (ToP). Additional case data were collected through teacher‐reported social skills and behaviours. Rasch analysis was utilised to convert raw ToP scores into an interval level overall score for each child. Children's individual ToP item scores, social skills and behaviours are presented by case. Results: The two children with ASD who had the highest ToP scores, also had the highest teacher‐reported social skills. All children with ASD had greatest difficulty on ToP items reflecting suspension of reality and framing. Two children with ASD had higher ToP scores than their classmate. In these two cases, the classmates had similar play skills of children with ASD. Conclusion: The play skills of children with ASD varied by case. Across the cases, teacher‐reported social skills, classmate age and existence of friendship between children were all factors observed to influence play. These findings require replication and investigation in larger scale studies. [ABSTRACT FROM AUTHOR]

Background/aim: Knowledge translation (KT) aims to reduce research‐practice gaps. Few studies have investigated methods to build clinicians' capacity for KT. To: (i) evaluate the impact of a multifaceted KT capacity‐building intervention; (ii) understand barriers and enablers to clinicians' use of KT; and (iii) identify useful strategies. Methods: A pre‐post study to develop KT capacity amongst occupational therapy clinicians (n = 46) in a large metropolitan hospital. A customised questionaire (baseline and 18 months) identified KT‐related behaviours and barriers and enablers guided by the Theoretical Domains Framework (TDF). McNemar's tests and Wilcoxon signed rank tests were completed on matched data (n = 20). At follow‐up additional items explored perceptions of change and usefulness of strategies. Results: At follow‐up, participants had read more clinical guidelines (10 vs. 17) and more participants reported using strategies to increase the use of recommended clinical practices (P = 0.006). The main barriers at baseline were from the TDF domains of 'attention, memory and decision processes', 'knowledge' and 'environmental context and resources', while main enablers were from 'social/professional role and identity', 'reinforcement', 'social influence' and 'beliefs about consequences' domains. At follow‐up, significant improvements were seen in 'knowledge' (p < 0.001), 'environmental context & resources' (P < 0.001), 'skills' (P = 0.008) 'beliefs about consequences' (P = 0.011), 'beliefs about capabilities' (P = 0.018), and 'memory, attention & decision processes' (P = 0.048) and participants agreed that KT had become part of the departments' culture. Strategies perceived most useful included working as a team, having a dedicated staff member, mentoring meetings, department leader support, learning about KT over time, and training sessions. Conclusions: The KT capacity‐building intervention changed one clinician‐reported behaviour and perceived impact of barriers across six domains. Clinicians reported perceived improvement in understanding of – and confidence in – KT, and changes in the culture to one of engaging with KT as part of clinical practice. Further research into KT capacity building is needed. [ABSTRACT FROM AUTHOR]

Background/aim: Designing psychosocial interventions that parents perceive as appropriate is essential to enhancing their engagement with the intervention and their long‐term use of the intervention strategies. The aim of this study was to explore the long‐term appropriateness of a play‐based psychosocial intervention for children with Attention Deficit Hyperactivity Disorder (ADHD) from the perspectives of parents. Methods: Semi‐structured phone interviews were conducted with 14 parents of children with ADHD who participated in a randomised controlled trial of the play‐based intervention 1 year earlier. Results: Thematic analysis led to the development of three core‐themes: (i) Everybody needs a parenting handbook, (ii) No one thing you are dealing with, and (iii) A different approach: Reframing. Discussion: The core‐themes related back to a definition of intervention appropriateness that acknowledges the intervention as important/relevant, beneficial, socially and ecologically valid and promotes sustainable change, indicating parents perceived the intervention as appropriate. The core‐themes also resembled aspects of the process of family adaptation. Findings highlight the importance of designing interventions that are appropriate from parents’ perspectives to enhance their long‐term engagement and use of the intervention strategies as well as outcomes for their child in the long term. [ABSTRACT FROM AUTHOR]

Background/aim Numerous tools have been developed to evaluate handwriting performances by analysing written products. However, few studies have directly investigated kinetic performances of digits when holding a pen. This study thus attempts to investigate pen-grip kinetics during writing tasks of school-age children and explore the relationship between the kinetic factors and fine motor skills. Methods This study recruited 181 children aged from 5 to 12 years old and investigated the effects of age on handwriting kinetics and the relationship between these and fine motor skills. The forces applied from the digits and pen-tip were measured during writing tasks via a force acquisition pen, and the children's fine motor performances were also evaluated. Results The results indicate that peak force and average force might not be direct indicators of handwriting performance for normally developing children at this age. Younger children showed larger force variation and lower adjustment frequency during writing, which might indicate they had poorer force control than the older children. Force control when handling a pen is significantly correlated with fine motor performance, especially in relation to the manual dexterity. Conclusions/significance of the study A novel system is proposed for analysing school-age children's force control while handwriting. We observed the development of force control in relation to pen grip among the children with different ages in this study. The findings suggested that manipulation skill may be crucial when children are establishing their handwriting capabilities. [ABSTRACT FROM AUTHOR]

Background/aim The use of simulators as an assessment and intervention tool for driving is an emerging field in occupational therapy. We investigated the potential usefulness of a driving simulator to improve on-road skills and cognitive functions in drivers with Parkinson's disease ( PD). Method Fifteen participants with PD, and Hoehn and Yahr stages between 2 and 3 participated in this pre-post comparison study. Twelve of the 15 individuals (median age (Q1-Q3), 68 (63.5-72.5); 10 men) completed 10 hours of training in a high-fidelity driving simulator. A practical road test as well as off-road cognitive and simulator tests were administered at pre-training and post-training. Results Nine participants, who passed the road test before training, passed at post-training. Furthermore, all three participants who initially failed the on-road test passed after training. Participants' performance improved significantly from pre- to post-training on two cognitive tests: (i) the Montreal Cognitive Assessment and (ii) Dot Cancellation test. Conclusion This pilot study demonstrates the potential usefulness of a simulator to improve on-road driving and driving-related cognitive skills in PD. Adequately powered randomized controlled trials are needed to further expand this field of study. [ABSTRACT FROM AUTHOR]

Background/aim There is a well-documented need for interventions to successfully address the social difficulties of children with attention deficit hyperactivity disorder. This study aimed to further the development of a previously conducted pilot of a play-based intervention. To achieve this, children's social play outcomes pre-post and 18-month following the intervention were examined by raters unaware of the study's purpose. Additionally, parents' experiences of the intervention were explored. Methods Participants included five children with attention deficit hyperactivity disorder who had participated in a play-based intervention and their typically developing playmates; parents of children with attention deficit hyperactivity disorder also participated. Children and their playmates attended an 18-month follow-up play session and parents participated in semi-structured interviews. The Test of Playfulness was used to measure children's play outcomes in the context of social play with a peer, pre-post and 18-months following the intervention. Wilcoxon signed-ranks ( Z) and Cohen's- d were used to measure effect. Thematic analysis was used to analyse reoccurring themes from parents' interviews. Results Children's social play outcomes improved pre-post intervention ( Z = 2.02; P = 0.04; d = 1.6) and were maintained 18-month post intervention ( Z = 0.14; P = 0.89; d = −0.4). Core themes included: the intervention as an enjoyable experience, a common language for talking about play/social interactions, an observable change in children's skills, transference of skills and the need for support to refresh learnt lessons over time. Conclusions The intervention demonstrated preliminary and long-term efficacy in developing the social play skills of children with attention deficit hyperactivity disorder. Further research is required to optimise intervention feasibility and parent involvement prior to conducting a large-scale research. [ABSTRACT FROM AUTHOR]

Background/aim Older people admitted to acute hospitals are at risk of functional decline. There is limited research into strategies that reduce such risks. The aim of this study was to investigate whether individualised activities of daily living retraining programmes improve functional outcomes, influence the choice of discharge destinations and reduce length of stay for older people in acute care. Methods A pilot non-randomised controlled study (pre-test/post-test) with block allocation to control and intervention groups was undertaken in an acute geriatric unit at a large teaching hospital. The study was conducted over a six-month period in two consecutive blocks. The intervention group received activities of daily living retraining three times per week for up to one hour per session. The control group received standard, mainly assessment-based occupational therapy services. The Modified Barthel Index was used to measure functional status on admission and discharge. Results At discharge, there was no statistical difference in the change of total Modified Barthel Index score between control and intervention groups. Of the 10 items scored on the Modified Barthel Index, ambulation and chair/bed transfers approached significance ( P = 0.0603 and P = 0.0547 respectively). No evidence was found for a difference in length of stay between intervention and control groups (mean length of stay 15.2 vs. 11.7 days respectively, P = 0.19). Raw data suggested that retraining programmes may reduce the level of care patients required on discharge. Conclusions Trends from this study indicate that functional retraining programmes could be effective in preventing functional decline. Further research is needed to reach more definite conclusions. [ABSTRACT FROM AUTHOR]

Background/aim: Reduced walking ability and loss of confidence are common after stroke. Many people cannot drive or use public transport, which can restrict participation. This qualitative study aimed to explore the experiences and attitudes of people following stroke to travelling outdoors early after hospital discharge. Methods: Two semi-structured interviews were conducted with 19 people post-stroke, all of whom were receiving rehabilitation to increase outdoor travel. Mean age was 68.6 years (SD 11.7 years). Eight significant others also participated. Interviews were conducted at home (median 21 days post-discharge), with a second interview three months later. Questions focussed on common destinations, modes of travel including driving when relevant and factors that influenced outdoor travel. Qualitative data were analysed using constant comparative (grounded theory) methods, resulting in themes and categories. Results: People with stroke were categorised as either a hesitant or confident explorer, in relation to walking, catching public transport and driving. Factors influencing outdoor travel included their emotional disposition, having meaningful destinations, expectations of recovery and the sphere of influence, including family and therapists. These factors could have an enabling or restricting effect. A pre-stroke walking habit also positively contributed to outdoor travel. Gate-keeping by therapists, general practitioners and family members seemed to adversely affect travel. Conclusions: This emerging theory offers insights into the experiences and attitudes to outdoor travel of people who were ambulant and participating in community rehabilitation following a stroke. Future research could explore the experiences of people with more severe mobility, cognitive and communication problems. [ABSTRACT FROM AUTHOR]

There is a need for culturally appropriate assessments for Australian Indigenous children. This article reports the selection of culturally appropriate and gender-neutral play materials, and changes in administration identified to develop further the Indigenous Child-Initiated Pretend Play Assessment (I-ChIPPA). Twenty-three typically developing children aged four to six years from the Pilbara region in Western Australia participated in the study. Children were presented with four sets of play materials and frequency counts were recorded for each time the child used one of the play materials in a pretend play action. Twelve of the 23 children came to play in pairs. Both boys and girls used the Pilbara toy set including the dark coloured dolls and Pilbara region animals, more frequently than the standardised play materials from the Child-Initiated Pretend Play Assessment (ChIPPA). This study reports the first steps in the development of the I-ChIPPA. Future development will include the refinement of the administration and scoring with pairs of children, and then validity testing the assessment. [ABSTRACT FROM AUTHOR]