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Background/aim: Australian guidelines and policies recommend the use of sensory approaches in mental health care. Nevertheless, many Australian psychiatric units report difficulty sustaining these approaches. To inform efforts to close the gap between recommendations and practice, the aim of this study was to understand the patterns of use of sensory approaches and what demographic and clinical factors influence their use, across one health region in Queensland, Australia. Methods: Using a cross‐sectional survey design, a custom‐designed questionnaire was distributed via email and in paper form to health professionals and peer support workers working in acute, secure, and community care psychiatric units across one health region. Information on demographics and the use of various sensory interventions was gathered utilising both open‐ended and Likert scale questions. Results: Useable questionnaires were collected from 183 participants from various disciplines (77% nursing). The majority reported using sensory approaches with a limited number of consumers, and almost 9% never used the approach. Activity‐based sensory interventions and sensory equipment were most often used, whereas sensory assessments, sensory plans, and sensory groups were least used. Sensory interventions were mainly used to reduce consumer anxiety and agitation and to assist with emotional regulation. Factors positively correlated with frequency of use for all interventions were discipline (occupational therapy); working in an acute inpatient unit; and training in sensory approaches. Age was negatively correlated with frequency of use only for weighted modalities. Conclusions: This study revealed that sensory approaches were used by most staff though with a limited proportion of consumers in psychiatric units in one large metropolitan health service. It provides insights into the factors influencing frequency of use, highlighting the importance of training in sensory approaches and access to occupational therapists. With this knowledge, we can work towards closing the gap between recommendations and the practice of sensory approaches. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapy often involves handwriting acquisition practices that include the non‐dominant hand when improvements in the dominant hand function are not possible because of trauma or stroke. This study explored whether character tracing and using a pegboard can effectively improve the handwriting of the non‐dominant hand. Methods: A randomised controlled trial involving 60 healthy university students aged ≥18 years was conducted. Participants were randomly assigned to the writing group, peg group or control group. The character recognition rate was evaluated by computer software. Furthermore, character quality and writing speed were evaluated by humans using global legibility scales. Evaluations were performed before the intervention (baseline) and on days 5 and 10 of the intervention. Using the non‐dominant hand, the writing group traced characters on paper with a ballpoint pen, and the peg group used a pegboard for 15 min/day for 10 days. Results: Compared with the peg and control groups, the writing group showed significant improvements in the character recognition rate and global legibility scale score. However, the global legibility scale score did not improve to the same level as that achieved with the dominant hand. None of the evaluation scores of the peg group showed significant improvements compared with those of the control group. There were no significant differences in improvements in the writing speed of the writing and peg groups compared with the control group. Conclusion: Tracing characters can improve the handwriting ability of the non‐dominant hand, but using a pegboard may be less effective. Future research is needed to examine how much practice is necessary to improve the handwriting ability of the non‐dominant hand sufficiently. [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]

Background/aim Evidence-based practice and research are beginning and endpoints on a research continuum. Progression along the continuum builds research capacity. Occupational Therapy has a low evidence base, thus, clinicians are not implementing evidence-based practice or publishing research. Barriers to implementing evidence-based practice and engaging in research include a lack of confidence. This research gauged Occupational Therapists' research experience, support needs and barriers, and compared levels of research anxiety between allied health disciplines. Methods A cross-sectional survey was sent to Health Practitioners in northern Queensland in May- June 2011. Responses about experience, support needs and barriers, between Occupational Therapists, were analysed using Chi-square 'goodness of fit' tests. Multivariate analysis compared responses between disciplines about research anxiety. This paper reports results for the subset of Occupational Therapists. Results The whole population, consisting of 152 Occupational Therapists, was sent a questionnaire, from which 86 responded. More Occupational Therapists than not had experience of evidence-based practice and less support was required, but they had little experience of producing research and required more support. The amount of support required for activities along the research continuum was inversely related to the level of experience in these tasks. Barriers included lack of staff and time. Occupational Therapists were more anxious about research (53 of 79, 67%) than all other Health Practitioner disciplines combined (170 of 438, 39%, P < 0.0001). Conclusion A cohesive strategy should focus on consolidating Occupational Therapists' evidence-based practice skills and building confidence. Clinicians wishing to engage in research need access to academic support. Academics and clinicians should work closely to produce clinically relevant research. [ABSTRACT FROM AUTHOR]

Background/aim: Cocaine consumption may result in irreversible structural changes in the brain. The long‐term effects of cocaine are related to a wide range of deteriorated cognitive functions. This study aimed to examine the fine motor control and hand‐function in cocaine users compared to healthy controls. Methods: An observational study was conducted. Sociodemographic variables, substance consumption, the Purdue Pegboard and the Jebsen–Taylor Hand‐function Test were evaluated bilaterally in 35 participants who were cocaine users and in 35 healthy participants. Differences between sides (dominant and non‐dominant hands) and groups were analysed with analysis of variance (ANOVA). Results: The ANOVA revealed significant differences between groups (P < 0.001) and between sides (dominant and non‐dominant hands) (P = 0.005) for the one‐hand pin placement subtest of the Purdue Pegboard Test. Also, ANOVA tests showed significant differences between sides, but not groups, for the simulated feeding (P < 0.001) and stacking checkers (P < 0.001) Jebsen–Taylor subtests. Cocaine user participants exhibited significantly lower scores in bilateral pin placement and required more time for the Jebsen–Taylor subtests compared to healthy participants. Conclusions: Cocaine user participants display deficits of fine motor control and some aspects of manual dexterity when compared to healthy controls. These findings show the convenience of incorporating functional rehabilitation by occupational therapists as a key component within the treatment of cocaine users. This study therefore opens a new field of practice for occupational therapy based on the assessment and treatment of motor deficits in the hand and the upper limb of people who consume cocaine. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to examine the differences in developmental skills between children with and without handwriting difficulties in their last year of kindergarten education. Methods: Standardised tests on handwriting performance and developmental skills were administered to 20 typically developing children, 21 children with handwriting difficulties in Chinese and 23 children with handwriting difficulties in both Chinese and English. We used one‐way MANOVA, univariate ANOVA and post hoc comparisons, to compare the developmental skills between children with and without handwriting difficulties. Multiple regression analysis was used to identify the significant predictors of developmental skills for Chinese and English handwriting performance. Results: Higher proportion of children faced handwriting difficulties in Chinese than in English. Their major problem in Chinese handwriting was on stroke formation, while the results did not indicate the key factor leading to English handwriting difficulties. The results also showed that children with handwriting difficulties had significantly poorer visual motor integration, some aspects of visual perception and fine motor skills than typically developing children. Reading skills were not a key factor contributing to handwriting performance. In addition, visual and fine motor integration and spatial relationship were the significant predictors of Chinese and English handwriting performance, which accounted for 39.7 and 43.6% of the variance respectively. Conclusion: First, the results suggested that more resources should be devoted to coaching children to learn Chinese than English handwriting. Second, besides direct repetitive practice on handwriting, there is a need to incorporate learning activities to facilitate the development of visual motor skills, visual perception, and fine motor skills as a preparation for learning to write or in improving handwriting performance among kindergarten children. [ABSTRACT FROM AUTHOR]

Background/aim: Limited research has been available to support the use of the Kettle Test in a subacute rehabilitation setting with patients diagnosed with a variety of medical conditions. The Kettle Test is an occupation based performance measure designed to detect cognitive processes and function. The aim of this research was to measure the correlation between three cognitive tests, the Mini‐Mental State Examination (MMSE), Cognitive Functional Independence Measure (Cognitive FIM) and the Kettle Test. Secondly, to assess the efficacy of these tests in predicting functional outcomes via the motor subscale of the Functional Independence Measure (mFIM). Methods: A prospective single‐centre cohort study in a subacute rehabilitation setting of 97 patients. Results: Correlation coefficients between the tests were statistically significant and moderately strong, with values ranging from 0.593 to −0.589. Significant positive correlations were seen between admission MMSE, Cognitive FIM and the mFIM and significant negative correlations between Kettle Test scores and the mFIM. The Kettle Test score had a stronger relationship with mFIM (r = −0.40; P < 0.01) compared to the Cognitive FIM (r = 0.33; P < 0.01) and MMSE (r = 0.26; P < 0.05). The Kettle Test variance is significantly associated with the MMSE and Cognitive FIM at admission and discharge measures. Modelling identified that age and gender significantly contribute to this relationship. When adjusted for age and gender the MMSE and Cognitive FIM both explained the 47% of the variance at discharge. Conclusion: There were statistically significant inter‐test correlations between the MMSE, Cognitive FIM and Kettle Test. The Kettle Test had the strongest relationship to patient functional outcomes. [ABSTRACT FROM AUTHOR]

Background/aim: Australian accreditation standards for occupational therapy courses require consumer participation in the design, delivery and evaluation of programs. This study investigated whether a mental health consumer – as one of two assessors for an oral assessment in a mental health unit – impacted engagement, anxiety states and academic performance of undergraduate occupational therapy students. Methods: Students (n = 131 eligible) self‐selected into two groups but were blinded to the group differences (assessor panel composition) until shortly prior to the oral assessment. Control group assessors were two occupational therapy educators, while consumer group assessors included an occupational therapy educator and a mental health consumer. Results: Pre‐ and post‐assessment data were successfully matched for 79 students (overall response rate = 73.1%). No evidence was found of significant differences between the two groups for engagement, anxiety or academic performance (all P values >0.05). Conclusion: Including mental health consumers as assessors did not negatively impact student engagement and academic performance, nor increase student anxiety beyond that typically observed in oral assessment tasks. The findings provide support for expanding the role of mental health consumers in the education and assessment of occupational therapy students. Development of methods to determine the efficacy of consumer involvement remains an area for future research. [ABSTRACT FROM AUTHOR]

Background: Peer‐mentoring is often described as effective means to promote professional and leadership skills, yet evidence on practical models of such programs for occupational therapy students are sparse. The purpose of this study was to evaluate the outcomes of a peer‐mentoring program designed for graduate occupational therapy students. Methods: Forty‐seven second‐year student volunteers were randomly assigned to individually mentor first‐year students in a year‐long program. Students met biweekly virtually or in person to provide mentorship on everyday student issues, according to mentees’ needs. Faculty‐led group activities prior and during the peer‐mentoring program took place to facilitate the mentorship relationships. Program effectiveness was measured using the Multi‐factor Leadership Questionnaire (Avolio & Bass, MLQ: Multifactor Leadership Questionnaire, 2004) and an open‐ended feedback survey. Results: Results of multi‐variate MANOVA for repeated measures indicating significant enhancement in several leadership skills (F(12,46) = 4.0, P = 0.001, η2 = 0.579). Qualitative data from feedback surveys indicated that an opportunity to help; forming relationships; and structure as enabler were perceived as important participation outcomes. Students expressed high satisfaction and perceived value from their peer‐mentoring experience. Conclusion: As we seek ways to promote our profession and the leadership of its members, it is recommended to consider student peer‐mentoring to empower them to practice and advance essential career skills from the initial stages of professional development. Evidence found in this study demonstrates that peer‐mentoring programs can promote leadership development and establishment of networks in an occupational therapy emerging professional community, at a low cost. The peer‐mentoring blueprint and lessons learned are presented with hopes to inspire others to implement peer‐mentoring programs in their settings. [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]

Objective We examined whether the three subtests of the Beery Buktenica developmental test of visuomotor integration predicted quality of handwriting across and within groups of boys and girls classified as proficient, at risk or non-proficient writers according to the Concise Assessment Scale for Children's Handwriting. Method The Beery Buktenica developmental test of visuomotor integration and the Concise Assessment Scale for Children's Handwriting tests were administered to 240 grade 2 children. Results Proficient writers scored better on the visuomotor integration subtest than non-proficient writers, while proficient and at risk writers scored better than non-proficient writers on the motor coordination subtest. No differences were found on the visual perception subtest. Girls were more often classified as proficient writers than boys, and they scored better on the motor coordination subtest. Across groups, regression indicated that gender and both the visuomotor integration subtest and the motor coordination subtest were significant predictors for the quality of handwriting (i.e., accounted for 17% of the variance). Conclusions After one year of writing tuition, the visuomotor integration subtest (and to a lesser extent the motor coordination subtest) but not the visual perception subtest significant relates to quality of children's handwriting as measured with the Concise Assessment Scale for Children's Handwriting. However, the relatively little variance explained also points to other abilities and/or task constraints that underlie quality of handwriting. [ABSTRACT FROM AUTHOR]

Background/aim Employee wellbeing is an important issue for mental health services. Poor employee wellbeing (i.e., high levels of burnout or low job satisfaction) is associated with poorer consumer outcomes and higher staff turnover. This study set out to examine factors related to job satisfaction, turnover intention and burnout in a group of occupational therapists in mental health. Method Thirty-four occupational therapists (response rate approximately 60%) in a metropolitan public mental health service participated in a whole-of-service workforce survey. The survey included measures of job satisfaction, turnover intention, burnout, job hindrances, job challenges and job resources and questions about positive and negative aspects of positions and factors that attracted employees to their current position. Results Burnout was associated with lower job satisfaction and higher turnover intention. Higher job satisfaction was associated with rewards (remuneration and recognition) as well as cognitively challenging work. The variables most significantly associated with poorer wellbeing (higher turnover intention and burnout) were recipient contact demands (perception that contact with service users or families was demanding), and feelings of stress or fatigue. Conclusion This study provides a detailed analysis of factors associated with job satisfaction, turnover intention and burnout in a group of occupational therapists working in mental health. To promote workforce wellbeing and enhanced retention, interventions to minimise burnout should be implemented and evaluated. These strategies should focus on enhancing job resources such as supervisor support, feedback and participation in decision making as well as building the personal resilience of occupational therapists working in mental health. [ABSTRACT FROM AUTHOR]

Background/aim The Better Access to Mental Health program has enabled eligible occupational therapists to provide services to people with a mental health condition. No studies have yet reported the influence of occupational therapy under this scheme. The aim of this study was to investigate whether attending an occupational therapist under this initiative influences change in psychological distress of clients as measured by the Kessler Psychological Distress Scale (K10). Method A quasi-experimental pretest-posttest design, using pre-existing data collected in the process of regular treatment was used. Data from a total of 31 clients (mean = 17.13 years, SD = 3.603) were accessed for this study. Pre- and post-intervention scores on the K10 were used to determine if psychological distress had changed over the course of intervention. Results Highly significant improvements ( P < 0.001) were found between the K10 pre-intervention score (mean = 25.68, SD = 9.944) and the K10 post-intervention score (mean = 21.00, SD = 9.212). Male K10 post-intervention scores (mean = 17.64, SD = 5.3) significantly improved ( P = 0.05), whereas results for females were not statistically significant. Medication use, diagnosis, age, number of sessions and prior contact with health services did not influence the results. Results from specific evidence-based interventions were not able to be considered in this study. Conclusion The results of this study demonstrate effectiveness of occupational therapy services for adolescents and provide support for the ongoing participation of occupational therapists in this scheme. [ABSTRACT FROM AUTHOR]

Background/aim: Driving cessation has been recognised as affecting the health and wellbeing of older people. Further exploration of the impact of driving status on time use, role participation and life satisfaction was required. Methods: A cross-sectional survey of 234 older people (current drivers, retired drivers and people who have never driven) was employed. Time use in the previous week, role participation and life satisfaction were measured and compared between the groups, while controlling for sociodemographic variables (health status, activities of daily living and instrumental activities of daily living status, gender, age and living situation). Results: When compared to current drivers, retired drivers had significantly lower life satisfaction (P = 0.01), fewer present roles (P < 0.0001) and were less likely to participate in volunteer (P = 0.005) and family member roles (P = 0.009). Retired drivers spent less time on social leisure (P = 0.002) and away from home (P = 0.0001), and more time in solitary leisure (P = 0.0001). Comparing the participation of retired drivers with those who had never driven indicated that retired drivers spent significantly less time in volunteer work ( P = 0.009). Conclusions: The findings indicate that older non-drivers may require support for participation and wellbeing. [ABSTRACT FROM AUTHOR]

Introduction More than 50% of people do not resume driving post-stroke. Potential disincentives include limited knowledge about assessment, access to services, cost and fear of failure. Factors contributing to a successful return to driving have been the focus of limited research. Aim To determine the proportion of people with stroke who successfully pass their first on-road occupational therapy driving assessment, and factors associated with a successful assessment outcome. Methods A retrospective cohort study design was used. The primary data collection method was a review of 441 consecutive occupational therapy driving assessment reports from one Australian metropolitan centre. Participants had a diagnosis of stroke, a driving licence pre-stroke and completed a driving assessment between 1999 and 2010. Results Of the 441 records analysed, the mean age of drivers was 65.4 years ( SD: 15.4). The majority (53.7%) passed their first assessment (pass/conditional pass); only 8.8% failed. A weak relationship was found between initial driving assessment outcome and time post-stroke (rs = 0.19), but a fair relationship with younger age (rs = 0.31) and higher scores on three off-road assessments (rs = −0.26 to −0.28). The strongest predictors of initial driving assessment outcome were off-road assessment scores, age, gender and time post-stroke (R2 = 19.7%, P < 0.01). Conclusions Data on stroke severity are required to confirm these preliminary predictors of driving assessment outcome. Stroke severity should be routinely documented by driving assessment services for use in future research. [ABSTRACT FROM AUTHOR]

Background/aim: Networking, together with knowledge acquisition and resource sharing, are key components of occupational therapists' professional development. To enhance the connectedness and clinical support available to occupational therapists, OT AUSTRALIA Queensland developed an online community of practice (CoP). No research regarding the use of online CoPs by occupational therapists has been conducted. This study aimed to explore occupational therapists' perceptions of the benefits of, barriers to, and reasons for using or not using the online CoP. Methods: Two focus groups were conducted, one with therapists who had used the CoP (n = 5) and the other with therapists who had not used it (n = 9). Participant responses to focus group questions informed the development of a survey asking therapists about their use of the CoP, its benefits and reasons for using/not using it, which was sent via email to all OT AUSTRALIA Queensland members. Results: Motivation to use the CoP, technology, workload management impacts, potential benefits and time considerations emerged as themes from the focus groups. Of the 55 survey respondents, 58.2% were aware of the CoP but only 32.7% had accessed it. Potential benefits of the CoP identified by participants included time efficiency, structural flexibility, networking capabilities and mentoring opportunities. Reasons for not accessing and/or participating in the CoP included access difficulties, usability difficulties, personal communication preferences and perceived irrelevance of available information. Conclusion: The findings of this study suggest that the CoP is still in the early stages of development; however, it has the potential to be further embraced by therapists if further promotion, training and minor usability modifications are undertaken. [ABSTRACT FROM AUTHOR]

Background: Handwriting is an important activity that is commonly affected by neurological and orthopaedic conditions. Handwriting research has predominantly involved children. Little is known about handwriting behaviour in healthy older adults. Aim: This study aims to describe the handwriting practices of 30 unimpaired adults aged 65 years and over. Methods: In this cross-sectional observational study, data were collected from 30 older adults using a self-report questionnaire, digital pen recordings over three days and a handwriting log. Data were analysed using descriptive statistics. Results: The mean age of participants was 75.1 years (standard deviation = 6.9). Variations in handwriting were evident in letter size, slant and spacing. Participants wrote very little - a median of 18 words per occasion (interquartile range = 10.5-26.9 words). Most handwriting involved self-generated text (85%), not copied or transcribed text. Participants stood while writing for 17% of handwriting occasions. The most common reasons for handwriting were note taking (23%) and puzzles (22%). Conclusions: Legibility may not depend exclusively on the handwriting script that a beginning writer is taught, but may be a result of other factors as the person ages. A comprehensive adult handwriting assessment and retraining programme should be relevant to older adults, including common handwriting activities, involving selfgenerated text and few words. [ABSTRACT FROM AUTHOR]

Occupational therapists need to be able to work competently with all clients, including First Australians. Currently, there are no national standards for occupational therapists working with First Australian clients. This article presents current issues in practice and education with First Australians and makes recommendations for the future. A survey of 41 occupational therapists working with, or interested in First Australian health issues was conducted at a workshop held at the Australian National Occupational Therapy Conference in 2008. Results of the workshop group discussions were also collated. Several themes emerged from both survey data and discussions. A substantial proportion of participants rated their confidence and competence to work with First Australians as low to moderate. Higher levels of perceived confidence and competence were associated with current experience in the field. Discussions centred around six major themes: building relationships, service provision and design, education and training of occupational therapists, increasing First Australian representation within occupational therapy, professional issues and political issues. These themes were further collapsed into areas of action, which could be taken by individuals, managers, researchers and professional bodies to improve practice with First Australians. Occupational therapists will benefit from coordinated efforts, on individual and systemic levels, to work more effectively, and in partnership with, First Australians. Such developments should include guidelines for practice, education and research; professional development and networking opportunities; and improved collaboration, especially with First Australian partners, on a national level. [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]