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Introduction: Implementing occupation‐based practice in low‐resourced settings can be challenging especially when working with children with HIV/Aids whose daily occupation of play is often affected by their health condition and other contextual factors such as poverty or stigma. Aim: The aim of this paper is to obtain consensus from experts on the content and application of a play‐based intervention for children with HIV/Aids living in a low‐resourced setting. Methods: A Delphi study involving two rounds using an online survey format was conducted with experts from the field of child development, play and/or HIV/Aids. Consensus agreement was reached when at least 70% of Delphi experts rated each item at 3 or higher on a 5‐point Likert scale. Consumer and Community Involvement: This paper is part of a multi‐stage study that involved input and feedback from families of children who were born HIV/Aids, occupational therapists working with families of children with HIV/Aids, and input from local and international experts working with people with HIV/Aids. Results: Thirty‐seven experts completed the first round, and 35 completed the second round of the study. Consensus was achieved on the application of the Cooper's Model of Children's Play, techniques to be used and the structure of the intervention. Experts also agreed on the inclusion of a pre‐intervention workshop as part of the play‐based intervention. Discussion and conclusion: The consensus on the content and application of a play‐based intervention framework through a process of gaining expert perspectives provides confidence that the intervention planned to promote play for children with HIV/Aids living in low‐resourced settings is likely to be effective. Key Points for Occupational Therapy: Occupation‐based practice is challenging when working with children with HIV/Aids in low‐resourced settings.Consensus was achieved on the play‐based intervention's theoretical model, techniques to be used, and the structure.Consensus from experts provides confidence that the intervention planned is likely to be effective. [ABSTRACT FROM AUTHOR]

Background: Strong evidence supports the provision of modified constraint‐induced movement therapy (mCIMT) to improve upper limb function after stroke. A service audit identified that very few patients received mCIMT in a large subacute, early‐supported discharge rehabilitation service. A behaviour change intervention was developed to increase the provision of mCIMT following an unsuccessful 'education only' attempt. This paper aims to systematically document the steps undertaken and to provide practical guidance to clinicians and rehabilitation services to implement this complex, yet effective, rehabilitation intervention. Methods: This clinician behaviour change intervention was developed over five stages and led by a working group of neurological experts (n = 3). Data collection methods included informal discussions with clinicians and an online survey (n = 35). The staged process included reflection on why the first attempt did not improve the provision of mCIMT (stage 1), mapping barriers and enablers to the Theoretical Domains Framework (TDF) and behaviour change wheel (BCW) to guide the behaviour change techniques (stages 2 and 3), developing a suitable mCIMT protocol (stage 4), and delivering the behaviour change intervention (stage 5). Results: Reflection among the working group identified the need for upskilling in mCIMT delivery and the use of a behaviour change framework to guide the implementation program. Key determinants of behaviour change operated within the TDF domains of knowledge, skills, environmental context and resources, social role and identity, and social influences. Following the development of a context‐specific mCIMT protocol, the BCW guided the behaviour change intervention, which included education, training, persuasion, environmental restructuring, and modelling. Conclusion: This paper provides an example of using the TDF and BCW to support the implementation of mCIMT in a large early‐supported discharge service. It outlines the suite of behaviour change techniques used to influence clinician behaviour. The success of this behaviour change intervention will be explored in future research. [ABSTRACT FROM AUTHOR]

Introduction: Daily living skills (DLS) are essential for an increased quality of life and autonomous living. DLS are a focus of occupational therapy practice; however, there has been no identified review of DLS acquisition in autistic adolescents or adults. A scoping review was undertaken of which the objective was to evaluate and synthesise the extent, range, and nature of research activity, and to identify research gaps in the existing literature as they relate to DLS acquisition and autistic adolescents and adults. Methods: A structured search of the literature was conducted. Studies published in English between 2011 and 2021 that included a focus on the acquisition of DLS in autistic adolescents and young adults were included. The titles and abstracts of 103 records were screened, and the full text of 53 records was reviewed. These reference lists were hand searched. Following this process, 25 papers were found to meet the inclusion criteria. Results: Findings indicate inconsistencies throughout the literature, with a lack of consensus on best practice methods, mediums, and/or tools to support optimal outcomes in terms of DLS acquisition for the autistic population. Themes related to (1) Generalisation of Skills Across Contexts, (2) Skill Maintenance, (3) Technology as a Teaching Method, (4) Participant and Family Perspectives, and (5) The Balance of Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) focus in research were extracted from the reviewed literature. There is a strong consensus in the findings of the identified papers that autistic adolescents and young adults experience poorer outcomes in terms of DLS acquisition than non‐autistic peers, and peers with other developmental or intellectual disabilities. Conclusion: Future research is needed to fill these identified gaps and provide a clearer understanding on interventions to support optimal outcomes for autistic individuals. [ABSTRACT FROM AUTHOR]

Introduction: The Student Practice Evaluation Form – Revised Edition (SPEF‐R) was used across Australian universities from 2008 to 2020 to assess occupational therapy student performance on practice placement. Evolution of practice contexts, placement models and professional competency standards prompted updating of the tool. This paper describes the second and final action research cycle in the development of the SPEF‐R2. Methods: Cycle 2 included three phases: (a) piloting of the SPEF‐R2 and post‐pilot survey to determine utility and applicability; (b) post‐pilot focus groups/interviews; and (c) final amendments for publication and launch. Quantitative data were summarised descriptively, and qualitative data were analysed using qualitative content analysis and reported using illustrative quotes. Results: In Phase 1, 23 participants piloted the SPEF‐R2 and completed a post‐pilot survey. Results indicated participants found the SPEF‐R2 relevant to a range of traditional and contemporary settings, easy to understand and an improvement over the previous version of the tool. Most participants found it more concise and less repetitive than the SPEF‐R. Participants particularly valued additions regarding culturally responsive practice, student health and well‐being and reflective practice. In Phase 2, five post‐pilot focus groups/interviews were held, gathering a deeper understanding of its utility. Discussion highlighted desire for an additional core item within the self‐management domain (Domain Two). Increased confidence in rating and provision of feedback on student performance were also evident. Reflection on findings led to final amendments and publication of the SPEF‐R2. Conclusion: Extensive consultation with the occupational therapy community informed the development of the SPEF‐R2, reflecting contemporary practice and meeting the expectations of Australian occupational therapists. Action research was an effective approach to the development of the SPEF‐R2. Use of the manual and training website and support from universities are paramount if practice educators are to use the tool effectively. [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: The assessment of executive functions is an integral component in determining fitness to drive. A structured review was conducted to identify assessment tools used to measure executive function in relation to driving and to describe these tools according to: (i) specific executive function components assessed; (ii) the tool's validity in predicting safe driving; and (iii) clinical utility. Methods: Sixty-nine articles were reviewed, identifying 53 executive function tools/assessments used in driving research. Each tool was critically appraised and the findings were compiled in a Driving Executive Function Tool Guide. Results: Among the 53 tools, there were 27 general assessments of cognition, 19 driving-specific and seven activities of daily living/instrumental activities of daily living assessments. No single tool measured all executive function components: working memory was the most common ( n = 20/53). Several tools demonstrated strong predictive validity and clinical utility. For example, tools, such as the Trail Making Test and the Maze Task, have the shortest administration time (i.e. often less than 10 minutes) and the most easily accessible method of administration (i.e. pen and paper or verbal). Driving-specific tools range from short questionnaires, such as the 10-minute Manchester Driving Behaviour Questionnaire, to more complex tools requiring about 45 minutes to administer. Conclusions and significance of the study: The appropriateness of a tool depends on the individual being assessed and on practical constraints of the clinical context. The Driving Executive Function Tool Guide provides useful information that should facilitate decision-making and selection of appropriate executive function tools in relation to driving. [ABSTRACT FROM AUTHOR]

Background/aim: Activity pacing is one of the most widely endorsed interventions used by occupational therapists to assist clients to manage chronic pain conditions. It targets two behaviours that are thought to be maladaptive: activity avoidance and overactivity (activity engagement that severely aggravates pain). However, in more recent years, the potential for activity pacing to negatively impact activity participation has been recognised which deters habitually overactive individuals from adopting the self‐management strategy. The main aim of this study was to evaluate if variances in activity participation can be explained by how individuals approach activity engagement when in pain. Methods: Sixty‐eight adults with chronic pain completed a demographic questionnaire, the Pain and Activity Relations Questionnaire (PARQ), and recorded their participation in activities for five days using a paper diary. Two of the authors independently coded the recorded activities into one of three time‐use categories: rest, productivity or leisure/social. A MANCOVA model was produced to examine differences in time use across four 'approach to activity engagement' categories which were determined by scores on the PARQ. Results: A significant multivariate effect was found. Univariate comparisons revealed that 'overactives' (high overactivity, low avoidance) and 'pacers' (low overactivity, low avoidance) spent a similar amount of time resting over the five‐day period. 'Overactives' spent the most amount of time on productive tasks and the least amount of time on social/leisure activities out of the four subgroups. Conclusion: Results suggest that activity pacing does not negatively impact on activity participation in chronic pain populations. 'Pacers' spent a similar amount of time resting, and had a slightly better balance between productive tasks and leisure/social activities, when compared to 'overactives'. The results of this study can be incorporated into patient education and highlight potential treatment avenues for individuals with chronic pain who are habitually overactive. [ABSTRACT FROM AUTHOR]

Background/aim Therapy groups are commonly used in brain injury rehabilitation yet patient perceptions of participation in groups are largely uninvestigated. This paper describes the occupational therapy groups programme at an inpatient brain injury rehabilitation unit and presents an evaluation from the patient's perspective. Methods Participants were in patients with traumatic brain injury who participated in the groups programme and completed a customised self-report questionnaire measuring perceptions about and satisfaction with four occupational therapy groups. Data were analysed descriptively and comparisons made between groups with a functional focus (meal preparation and community access) and an impairment focus (cognitive and upper limb) using Z scores. Results Thirty-five participants (30 males, five females) completed a total of 83 questionnaires. Over 90% of responses agreed or strongly agreed that working with others was enjoyable, that the groups provided feedback and individualised treatment, and were useful for them. There were no significant differences in perceptions about the functional and impairment-focussed groups. An illustrative case example of participation in the groups programme is presented. Conclusions Overall, consumer feedback on different aspects of the occupational therapy groups programme in brain injury rehabilitation was positive. Further in-depth investigation of patient perceptions of groups including processes that facilitate or challenge participation is warranted. [ABSTRACT FROM AUTHOR]

Background/aim: Cognitive impairment is a common and often debilitating consequence of stroke. The current practice patterns of Australian occupational therapists who work in this area are not clearly known. The aim of this study was to investigate the theoretical approaches, assessments, interventions and research evidence used by Australian occupational therapists who work with patients who have cognitive impairment poststroke. Methods: A self-administered, purpose-designed online survey was used. Results: Survey responses were received from 102 occupational therapists. The client-centred approach was the most commonly used theoretical approach, with 81.3% and 72% using it often or all of the time with inpatients and outpatients, respectively. Assessments that were most frequently used were the Mini Mental State Examination (63.7% of participants), the Lowenstein Occupational Therapy Cognitive Assessment (45.1%), the Functional Independence Measure (57.8%, and the Assessment of Living Skills and Resources (10.0%). Interventions involving functional activities were used more frequently than compensatory techniques, such as diaries, alarms, or other electronic devices, and paper and pencil remedial exercises. Few (16%) participants used computer programs specifically designed for cognitive rehabilitation. Although 60.8% of the participants reported using research literature when making decisions about interventions, a higher percentage reported relying on their past experience (88.3%) and colleagues’ opinions (77.4%). Conclusion: This study provides an insight into the current practices of Australian occupational therapists who work with people who have cognitive impairment after stroke. Client-centredness is emphasised in current practice; however, the use of research evidence to inform practice appears to be limited. [ABSTRACT FROM AUTHOR]

Background The active involvement of parents and children in goal setting and intervention is integral to contemporary occupational therapy process models. However, parental perspectives on collaborative handwriting intervention are limited. This paper presents parental perspectives on a three-way collaboration involving teachers, parents and an occupational therapist in the application of Handwriting Without Tears® ( HWT®) with children with Down syndrome. Methods Within a larger mixed methods study, 44 parents completed purpose-designed questionnaires and six parents participated in a focus group, post 8 months of programme implementation. Both methods gathered parent's perspectives on the usefulness and limitations of applying HWT®. The focus group explored collaboration in depth. Analysis involved triangulation of data from descriptive analysis of numerical data with content analysis of open-ended questions and focus group data. Findings Enablers of parent-child engagement in HWT® were identified as; the parent-child-friendly aspects of HWT®, the teacher involvement ensuring continuity which eased demands on parents, the ongoing support/guidance of the occupational therapist and the child's involvement in HWT® group intervention. The occupational therapists' involvement was reported as essential to encouraging teacher/parent involvement. Barriers to child-parent engagement included fluctuations in child health, mood, attention span and time limitations including the child's involvement in other therapy programmes. Conclusions Parents perceived the HWT® and the three-way collaborative approach as enabling active parent-child engagement in handwriting intervention. This approach warrants further investigation. Findings have the potential to inform practice guidelines and pre- and post-graduation education related to collaborative handwriting intervention with children with Down syndrome and their families. [ABSTRACT FROM AUTHOR]

Background/aim The successful development and maintenance of professional identity is associated with professional development and retention in the health workforce. This paper explores students' perspectives on the ways pre-entry experiences and curricula content shape professional identity. Methods An online cross-sectional survey was sent to students enrolled in the final year of entry-level programmes in five countries. Descriptive statistical analyses of data were completed. Results The results reflect the perceptions of 319 respondents from five countries. Respondents identified professional education (98%) and professional socialisation during placement (92%) as curricula components with the greatest influence on professional identity formation. Discipline-specific knowledge such as, occupation-focussed models and occupational science were ranked lower than these aspects of practice. The students' length of programme and level of entry-level programme did not impact on these results. Conclusion When designing curricula educators need to be mindful that students perceive practice education and professional socialisation have the greatest affect on professional identity formation. The findings reinforce the need for curricula to provide students with a range of practice experiences, which allow the observation and application of occupation-based practices. It highlights a need for educators to provide university-based curricula activities, which better prepare students for a potential dissonance between explicit occupation-based curricula and observed practice education experiences. The study indicates the need for further research into the role curricula content, and in particular practice education, plays in the multidimensional formation of professional development within entry-level programmes. [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]

Introduction: Occupational therapists working in community aged care play a key role in service provision because of their expertise in considering the person, their occupations, and environmental context. To further understand occupational therapy practice in community aged care, this study aimed to explore the approaches, models, frames of reference, assessments, interventions, and outcome evaluation methods being used by Australian occupational therapists in aged care. Methods: An online questionnaire was developed, piloted, and delivered to occupational therapists working in community aged care in Australia. Responses to closed‐ended questions were analysed using descriptive statistics, and a summative approach to content analysis was applied to open‐ended questions. Results: Seventy‐one occupational therapists employed in community aged care across Australia participated in the questionnaire. Almost half of the respondents were employed in private practice. All respondents used a compensatory approach to practice, whereas just over three‐quarters used a restorative approach. The Person‐Environment‐Occupation (PEO) model was the most frequently used occupation‐focused model (n = 45). The biomechanical and rehabilitative frames of reference were each used by over two thirds of respondents. Cognitive assessments were most common, followed by functional and environmental assessments. The interventions of equipment and home modifications were very common followed by remedial therapy. Conclusion: Community aged care occupational therapists show coherence in theory‐to‐practice application, but there is wide diversity in practice decisions and possibly gaps in practice. Occupational therapists remain firmly client centred but apply compensatory approaches more than reablement approaches. This trend may be due to the influence of aged care funding models and limits on time. In addition to reacting to crisis, there is scope for occupational therapists to have a greater focus on early intervention to support dementia care and prevent falls. [ABSTRACT FROM AUTHOR]

Objective: There is an increased risk of occupational imbalance and poor quality of life (QoL) if one has schizophrenia. Although evidence suggests a relationship between psychopathology and QoL, the association of occupational balance (OB) with QoL in schizophrenia is unclear. This study aimed to investigate the associations among psychopathology, occupational balance, and QoL in schizophrenia. Methods: This was a cross‐sectional study carried out in a Community Mental Health Center (CMHC). Ninety‐five individuals aged 18 years or older with the diagnosis of schizophrenia participated in the study. All participants completed a sociodemographic form, Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale in Schizophrenia (CDSS), Occupational Balance Questionnaire‐11 Turkish Version (OBQ11‐T), and the World Health Organisation Quality of Life Assessment Instrument (WHOQOL‐100‐TR). Relationships among clinical and depressive symptoms, OB, and QoL variables were examined through correlation analysis, and then multiple linear regression analysis was performed to determine the variables that have influences on QOL. Results: The study participants had low OB scores and the lowest mean in the WHOQOL‐social relationships subscale. WHOQOL‐overall QoL score demonstrated a moderate negative correlation with the PANSS‐total score and PANSS‐general psychopathology subscale score (r = −0.422, r = −0.463, P < 0.001) and a mild negative correlation with the CDSS‐total score (r = −0.390, P < 0.001). OBQ11‐T total score showed a moderate positive correlation with the WHOQOL‐overall score (r = 0.549; P < 0.001). Findings from the multiple linear regression analysis revealed that OBQ11‐T (β = −0.467, P = 0.000) and PANSS‐general psychopathology (β = −0.221, P = 0.045) were significant predictors of the overall QoL, explaining 48% of the variance in the overall QoL (adjusted R2 =.43, P < 0.001). Conclusion: Our study findings showed that OB and general psychopathology are determinants that should be considered in improving the QoL in individuals with schizophrenia. Thereby, addressing the symptoms of general psychopathology and occupational factors to improve the QoL may be achieved with the incorporation of occupation‐based programmes to routine treatment. However, further research is required. [ABSTRACT FROM AUTHOR]

Introduction: Many children in Aotearoa (New Zealand) and Australia experience complex trauma and its developmental impacts. Internationally, occupational therapists work with complex trauma and use sensory‐based, integrative, and functional approaches. The practices of occupational therapists in Aotearoa and Australia with children experiencing complex trauma have not previously been described. Methods: This article reports the quantitative results of a mixed‐methods study which profiled occupational therapists' practice in Aotearoa and Australia with children aged 0 to 12 years old who experienced complex trauma. Twenty‐five participants completed the survey. The average age of participants was 43 years (SD = 10.65), all were female (n = 25), and most identified as New Zealand European (n = 11) or Australian European (n = 9). A survey was distributed via Occupational Therapy New Zealand – Whakaora Ngangahau Aotearoa and Occupational Therapy Australia. Results: The majority of participants had a bachelor's degree (64%) and worked in community settings (76%). Fourteen participants (56%) used sensory approaches. The most common assessments used were those of sensory processing (n = 12, 48%) and observation (n = 12, 48%). The Sensory Profile was the most popular standardised assessment (n = 8, 32%). The most common interventions used with children experiencing complex trauma were sensory (n = 13, 52%) and play based (n = 13, 52%). Most participants reported not adapting their practices for Māori or Aboriginal children. Most participants felt somewhat prepared (n = 15) for working with complex trauma, with most reporting a lack of experience in this area (n = 10). Supervision was suggested by 92% (n = 23) of the participants. Conclusion: Sensory‐based practices were most common among occupational therapists in Aotearoa and Australia who worked with children experiencing complex trauma. The participants suggested supervision, social support, and practical training when working with complex trauma. Advocacy and research are required within this subspecialty, and further professional engagement in the application of culturally safe practice. [ABSTRACT FROM AUTHOR]

Background and objectives: Global migration and an increased life expectancy led to a growing number of people with dementia from Culturally and Linguistically Diverse (CaLD) backgrounds living in long‐term residential care settings. These minority groups' wellbeing may be negatively impacted due to poor culturally appropriate care that fails to honour valued cultural traditions. This study considered culturally appropriate dementia care for older adults with an Indian heritage living in Sydney‐based residential aged care facilities. Research design and methods: The Nominal Group Technique was employed to collect data from three groups of stakeholders of Indian heritage over a period of 6 months: care staff (n = 8), family of residential care recipients (n = 8), and community‐dwelling older adults (n = 7). Results: Perspectives highlighted six concepts for consideration: (1) embracing a person‐centred approach to promote culturally appropriate dementia care; (2) training staff in culturally appropriate forms of respect; (3) the impact of staff ratios on care; (4) the importance of familiarity to meaningful engagement; (5) the importance of food; and (6) the necessity of engaging family and the wider Indian community in residential care activities. Conclusions: Culturally appropriate dementia care for older adults with an Indian heritage is an area in need of further development. To ensure that residents with an Indian heritage are respected as an ethnic minority, it remains crucial that research is generated to inform policy development on each CaLD group as a separate entity. [ABSTRACT FROM AUTHOR]

Introduction: Learning from individuals with lived experience is considered an important element of developing recovery‐oriented practice capabilities in mental health contexts. Additionally, service user involvement in the education of occupational therapy students is a requirement in accreditation standards. Despite this, many barriers to meaningful inclusion of Lived Experience Educators have previously been identified. Method: This study evaluated the outcomes achieved by students who were involved in a unit of study that incorporated four recovery‐oriented practice workshops that were co‐designed and co‐delivered by Lived Experience Educators and an occupational therapy academic. Change over time was measured using the Recovery Knowledge Inventory (RKI) and the Capabilities for Recovery Oriented Practice Questionnaire (CROP‐Q). Change over time was evaluated using paired t‐tests. Students also provided qualitative feedback at the conclusion of the workshops. These comments were analysed using interpretive content analysis. Results: Students' scores on the RKI and CROP‐Q both demonstrated statistically significant improvements from the beginning of the semester to the end of semester (RKI: 53.6–57.7, t = 6.3, P < 0.001; CROP‐Q: 75.6–77.0, t = 2.4, P = 0.019). The most common categories included in the qualitative comments were: "Learning from real experiences"; "Learning about how to be a better clinician"; "See the strength and resilience of the educators, reduce stigma"; "Learning about the negative aspects of the mental health system"; and "More effective than other types of learning". Conclusion: This study has demonstrated that students who engaged with the co‐designed and co‐delivered workshops improved their recovery knowledge and recovery‐oriented capabilities over the course of the semester. Qualitative feedback also suggests that students' attitudes and skills for future practice were also influenced in positive ways by engaging with Lived Experience Educators. [ABSTRACT FROM AUTHOR]

Introduction: The occupational therapy profession has an essential role to play in healthy ageing that includes enabling participation, a construct that according to The International Classification of Functioning, Disability and Health (ICF), incorporates an environmental context. Environmental barriers and enablers of participation in community‐situated activities for people over the age of 65 have been identified. To support practice, occupational therapists require assessments with demonstrated content validity including comprehensive coverage of the construct. The purpose of this scoping review study was to investigate what instruments are available to assess community participation for people over the age of 65 that included environmental factors. Methods: A scoping review of the literature was conducted, utilising the Joanna Briggs Institute (JBI) scoping review methodology. The evidence source was review articles and inclusion criteria were that they reviewed instruments to assess participation that could be used for people over the age of 65. Items extracted from included instruments were evaluated against a preset list of community‐participation and environment categories that had been developed from the ICF. Results: Twenty‐three review studies met inclusion criteria and from these 240 instruments were extracted. Twenty instruments were retained after exclusions and from these, 540 instrument items were extracted. Of these, 280 (47%) were coded as community‐participation, and only 20 (3.4%) as environment items. Fourteen of the instruments included no environment items. Conclusions: No instrument was identified that comprehensively assessed community participation including the related environmental factors. Such an instrument is required to enable occupational therapy practitioners to support healthy ageing. The development of such an instrument will strengthen the profession's capacity to develop new ways of delivering services to older adults in line with emerging ways that aged care will be delivered and to advance its essential role in healthy ageing. [ABSTRACT FROM AUTHOR]

Introduction: To assist with the increasing orthopaedic workload, an allied health led hand therapy clinic was established to manage people having routine hand surgeries. The aim of this study was to evaluate patient and doctor satisfaction and safety of this alternative service delivery model. Methods: Prospective multimethod design evaluation was undertaken by occupational therapists and physiotherapists working in the field of hand therapy. Satisfaction surveys were completed by orthopaedic doctors and patients. Patient outcomes were assessed at 6 weeks post operatively using the Quick Disability of Arm, Shoulder and Hand questionnaire, total active range of motion, Crawford Classification, sensation using light touch and pain with activity utilising Wong Baker FACES® Pain Rating Scale. Quantitative satisfaction survey data were analysed and presented as frequencies and percentages with open question responses analysed using a qualitative description approach. All complications and readmissions within a 3‐month period were identified and recorded to assess safety of this model of care. Results: For the 6‐week post‐operative review, 81 patients were seen by an allied health professional rather than a doctor. Patient satisfaction was high with 90% of patients satisfied with post‐operative care provided by allied health; 2% of patients preferred to be seen by a doctor. Doctor satisfaction was also high with 95% of doctors being satisfied and confident with the quality of care provided. A high proportion of patients reported pain 2/10 or less with activity (82.72%), had full sensation (69.14%), excellent range of motion (82.72%), and Quick Disability Arm, Shoulder and Hand scores on average were below 25% indicating minimal functional deficits. Only five patients required doctor involvement post‐operatively. Conclusion: The allied heath led service delivery model was demonstrated to be safe and have high patient and doctor satisfaction, indicating an acceptable alternate pathway for management of people following routine hand surgery. [ABSTRACT FROM AUTHOR]

Introduction: Evidence indicates that assistance dogs placed in the home are effective in supporting individuals with Autism Spectrum Disorder (ASD) by increasing social and community participation and promoting quality of life. This study aimed to examine the outcomes of assistance dog placement on quality of life, independence, and participation of families including individuals with ASD placed with an assistance dog compared to families on the waiting list for an autism assistance dog and to evaluate the feasibility of the design for future studies. Methods: A cross‐sectional comparative study was conducted. The Adaptive Behaviour Analysis System, Social Responsiveness Scale, Autism Treatment Evaluation Checklist, Canadian Occupational Performance Measure, and Autism Family Experience Questionnaire were used to evaluate adaptive skills, behaviour, social difficulties, daily functioning, and family quality of life. Results: Six families who had an autism assistance dog placed with them, and 12 families who were on the waiting list were recruited using purposeful sampling. The pilot data found no significant differences between the two groups. However, trends were observed which suggested that assistance dogs can increase desired social behaviours, decrease ASD severity, and improve family wellbeing. For families with an assistance dog, more positive outcomes were observed for families who were partnered with an assistance dog for longer. Parents (and sometimes individuals with ASD) were able to complete and return the outcome measures via mail to collect the outcome data for the study. Conclusion: These study findings add to the developing evidence about the use of assistance dogs with this population. A larger sample size may have allowed for significant associations to be detected. The methods used were feasible to be applied in a larger study. These results may assist health professionals advocate for funding for assistance dog placement to individuals with ASD and their families. [ABSTRACT FROM AUTHOR]

The organisational, physical and social environment within residential aged care settings greatly influence its residents' sense of autonomy, choice and control and their ability to engage in meaningful occupations. Identifying to what extent these environmental contexts are supportive and well‐coordinated could assist with promoting meaningful engagement of residents. The Residential Environment Impact Scale (REIS) was developed to measure the impact of the physical and social environment on residents. This study examined the benefits and barriers to implementing the REIS in four Australian Residential Aged Care Facilities (RACFs) and factors to consider during implementation. Method: A multisite sequential mixed‐methods study was conducted. Research participants included occupational therapists conducting the REIS and leadership staff examining the REIS reports in four facilities. Data consisted of formal observations of the REIS assessment process, an online survey of all participants and two research consensus groups. Qualitative findings were generated from field notes, open‐ended survey questions and group discussions. Close‐ended survey questions provided quantitative data. Findings The REIS was considered a useful audit tool, generating a holistic overview of the RACF. It highlighted the quality of person‐centred care and the potential role of occupational therapists to promote opportunities for meaningful occupational engagement. Barriers included administration time, personal characteristics of residents and limited resources to action recommendations. Conclusion: The REIS has potential to be an audit tool for a whole‐environment approach to facility assessment of residents' sense of autonomy, occupational choice and meaningful engagement. As such, it provides occupational therapists with scope to support RACFs meeting national quality standards. [ABSTRACT FROM AUTHOR]

Introduction: The manual wheelchair skills training programme is used to structure teaching manual wheelchair use for people following injury or disability. This pilot study aimed to explore the outcomes of introducing a group wheelchair skills training programme on skill performance, confidence and frequency of wheelchair use for people with lower limb amputation in a rehabilitation setting from the perspective of participants and group facilitators. Method: This pilot study used a two‐phase mixed methods nested design. Eleven people with lower limb amputations received a minimum of two 45‐min wheelchair skills sessions, using the Wheelchair Skills Training Program, delivered in a mix of group and one‐to‐one sessions. In phase one, wheelchair skill performance, confidence and frequency were measured using the Wheelchair Skills Test Questionnaire‐Version 5.0, goal achievement was measured through the Functional Independence Measure and Goal Attainment Scale. These measures were repeated in phase two. Nested within phase two was qualitative data collection. Interviews were conducted with eight participants and a focus group held with three programme facilitators, to gather their perceptions of the training process. Descriptive statistics were used to analyse and report quantitative data and thematic analysis was used to combine qualitative data from the two participant groups. Results: Post intervention, the mean Wheelchair Skills Test Questionnaire score increased in performance (42.3 ± 13.4), confidence (33.9 ± 20.7) and frequency (33.9 ± 27.3). Goal Attainment was achieved or exceeded by 91% of all participants. Four themes were developed from qualitative data including, "motivators driving learning," "delivery methods, structure and profile of the Wheelchair Skills Training Program," "managing risk and safety" and "confidence in wheelchair use." Conclusions: The pilot study found that The Wheelchair Skills Training Program can improve wheelchair performance, confidence and frequency to support enhanced safety, independence and quality of life for people with lower limb amputations. [ABSTRACT FROM AUTHOR]

Background/aim This article aims to (1) identify instruments available to measure activity and participation in children with disabilities; (2) describe the reliability and validity of these instruments; and (3) consider whether the available instruments capture the extent of involvement, as well as the difficulty and satisfaction/enjoyment associated with performance in all life areas. Method A literature review was completed by undertaking an electronic search to identify instruments that measure activity and participation in children with disabilities. A further electronic search was conducted to obtain an adequate description of the instruments, including psychometric properties. Results The search identified 20 instruments purporting to measure activity and participation, however, no single instrument measured extent of involvement, difficulty and satisfaction/enjoyment in all life areas. There were instances in which each of these aspects was captured, but not within the one instrument. Instruments assessed combinations of frequency, difficulty, assistance, environment and satisfaction across varying contexts, for example, school, domestic life, recreational tasks, leisure tasks or all life areas. Conclusions Although a large number of instruments exist to measure varying aspects of activity and participation, there is currently no single instrument available to measure the extent of involvement, difficulty and satisfaction/enjoyment in all life areas. This finding indicates that there is the opportunity to develop a single instrument to measure activity and participation across all life areas. [ABSTRACT FROM AUTHOR]

Introduction: Being culturally secure, respectful and responsive can mean occupational therapists can contribute to improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples. New culturally responsive accreditation and competency standards provide an opportunity to decolonise the profession to enhance the cultural capabilities of graduates. The purpose of this study was to explore how well‐prepared Australian occupational therapy courses are to implement the new standards. Methods: The principles of participatory action research were applied. An initial survey with occupational therapy academic staff was used to inform questions for semi‐structured interviews. Semi‐structured interviews were conducted with 10 occupational therapy academics and occupational therapy accreditors. Interview data were thematically analysed. Findings: The four themes identified from the interviews were: occupational therapy profession drivers, effective leadership, community and Elder involvement, and course design and delivery. Conclusion: The new accreditation and competency standards are a promising step forward for the profession. However, the profession needs to be better prepared to decolonise Australian occupational therapy. A positive and culturally secure way forward is to engage Elders and other community members in learning experiences to build student, academic and practicing occupational therapist's cultural capability. Non‐Aboriginal and Torres Strait Islander leadership at all levels of the profession and within universities is crucial to establishing trusting, reciprocal relationships to support deep knowledge exchange. These relationships lay the foundation to build cultural capabilities and decolonise processes in the profession. [ABSTRACT FROM AUTHOR]

Background: With the introduction of consumer‐directed care in the Australian community aged care sector, there are more opportunities for occupational therapists to provide evidence‐based services that meet consumer needs. There is also an increasing requirement for health professionals to promote their interventions to consumers. Particularly for the implementation of new programs within organisations. However, occupational therapists have historically neglected widely promoting the role of occupational therapy services for older people. This study examines the perceptions of occupational therapists and their managers in promoting their service; the Care of People in their Environment (COPE) Program. Methods: This study utilised a qualitative interpretative description; including 28 in‐depth interviews. Purposeful sampling ensured a variety of occupational therapists from different health contexts. Thematic analysis captured key emergent themes related to promoting occupational therapy interventions and implementation. Results: Many occupational therapists were apprehensive about promoting or selling their services and interventions. Greater levels of confidence in promoting the program were present when the program aligned with traditional models of service delivery and organisational processes. Occupational therapists described having limited opportunity to directly promote the program to consumers as community case managers were mostly the main contact at the organisation. There was limited consideration of promotion strategies and therefore limited enactment of strategies by organisations. Not‐for‐profit and non‐government organisations recognise that the changed community aged care market provided new business opportunities. Conclusion: With changes in the Australian aged care system, occupational therapy has great opportunity to provide diverse, evidence‐based interventions driven by the needs of consumers. Reframing the notion of 'selling', to empowering consumers to be more informed about their options, will allow occupational therapists to build confidence in their promotional skills. Promoting evidence‐based programs will have positive outcomes for the visibility, professional identity and recognition of occupational therapy. [ABSTRACT FROM AUTHOR]

Introduction: This pilot study examined the effect of collaborative consultation with teachers in school‐based occupational therapy (SBOT) using iPad application for goal‐setting—Aid for Decision‐Making in Occupation Choice for School (ADOC‐S). Method: A single arm pre‐post intervention design was conducted at four preschools in Japan. The participants were 10 preschool teachers (10.5 ± 0.4 years of teaching), and 10 children (3.8 ± 0.4 years old; five boys). The teachers received three collaborative consultations (1 hr for each) from one occupational therapist. Firstly, the occupational therapist conducted an observational assessment of the child's school life, then the teacher and occupational therapist identified occupation‐based goals for each child using the ADOC‐S. Secondly, the teacher and the occupational therapist developed the graded goals using the Goal Attainment Scale (GAS) and discussed the daily intervention plan for the teachers to conduct. Thirdly, the occupational therapist followed up on the intervention process using GAS. The subjective outcome was measured at 10 point‐satisfaction and performance score in each goal using Canadian Occupational Performance Measure (COPM). The observed outcome was measured using GAS and Strengths and Difficulties Questionnaire (SDQ). Results: All the participants including teachers and children successfully underwent the intervention process. Significant improvement was found pre‐post and effect size (ES) was large on the COPM (ES; r =.85–.94), GAS (ES; r =.98–.99) and SDQ (ES; r =.64). All goals (30/30) exceeded expectations of GAS from zero to +2. Conclusion: Although there are some limitations and considerations which need to be resolved for future studies, our results suggest that ADOC‐S would help build a rapport with a teacher in SBOT settings, and this collaborative consultation would facilitate a positive outcome. [ABSTRACT FROM AUTHOR]

Introduction: Life review writing can be used to improve depressive symptoms in well older adults, but it is unclear whether the reminiscing, writing, or socialising is associated with the improvements. This study assessed the feasibility of a controlled trial comparing life review writing with two active control groups designed to isolate the acts of (a) engaging in a meaningful leisure activity and (b) socialising. Methods: Twenty‐four participants from a 100‐bed assisted living facility were enrolled in the study. Participants ranged in age from 70 to 98 years (M = 83.9, SD = 7.6). Eight 1‐hour weekly sessions were held, with participants assigned to one of three groups: (a) life review writing, (b) painting, or (c) coffee from around the world. At baseline, participants completed a demographic and health questionnaire, the Mini‐Cog, and the Geriatric Depression Scale Short Form (GDS‐15). The GDS‐15 was administered again at weeks 4 and 8, along with the health questionnaire at post‐test. Results: Nearly 25% (N = 24) of the facility's residents attended at least one session, with an average attendance rate of 66.4%, or 5.3 sessions. However, to achieve this participation rate, our original plan to employ random assignment had to be abandoned. The groups were a partial success insofar as we successfully isolated engaging in a meaningful activity in the painting group, but the writing group engaged in less reminiscing than hoped. At post‐test, seven participants reported health, mood, and social life benefits. GDS‐15 scores fluctuated over time, with no significant improvement from pre‐ to post‐test. Conclusion: The residents' low willingness to be randomised creates a serious selection bias, but randomising volunteers into different activities runs counter to client‐centred therapy. To scrutinise the mechanisms of change of life review writing, we recommend comparing two writing groups: one that reminisces and one that does not. [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: Limited research has been conducted from a longitudinal and qualitative perspective on the experience of life after mild stroke. This restricts the knowledge held in this area. This study aimed to answer the question: How do people with mild stroke understand their experiences in the first 6 months after hospital discharge? Methods: Interpretative Phenomenological Analysis, involving five Australians with mild stroke, interviewed at 1‐, 3‐ and 6 months post‐hospital discharge. Results: Two themes emerged about the transitional journeys post‐mild stroke: (i) Understanding and representation of stroke and (ii) Underlying relationship dynamics revealed. The first theme had two subthemes: (i) Society defines the stroke experience, and (ii) The past determines the present. The first of these reflected the impact that societal perceptions of 'stroke' had on participants' views of their mild stroke, including feelings of being 'lucky' even when experiencing hidden difficulties that were viewed as liveable repercussions. The second explores how previous health conditions acted as a mediator for participants' experiences of the mild stroke and how personal attributes assisted adaption to post‐mild stroke changes. The final theme highlights how participants' relationships were either strengthened or weakened after the mild stroke, dependent on previous relationship dynamics. Conclusion: Current societal perceptions of stroke are centred on 'observable' symptoms; however, more subtle symptoms common in the mild stroke population remain widely unknown by the general public impacting post‐mild stroke experiences. Previous health conditions and personal attributes have an impact on how people react to their mild stroke and help to explain the individualist nature of mild stroke outcomes. Relationship dynamics prior to mild stroke can impact on post‐mild stroke family functioning, and should be screened for, and supported by health professionals. All of these factors emphasise the need for a patient‐centred and multidisciplinary approach when determining interventions. [ABSTRACT FROM AUTHOR]

Introduction: The core tenet of occupational therapy is that engaging in meaningful occupations promotes health and wellbeing. Despite this, surprisingly little research has explored the meaningfulness of occupational therapists' own work. Occupational therapists in mental health have been identified as at risk of poor work‐related wellbeing, therefore, it is important to explore potential 'protective factors' that may support wellbeing. Meaningfulness of work may be one such factor. This study was established to explore the relationships between job satisfaction, burnout, professional identity and meaningfulness of work activities for occupational therapists working in mental health. Method: Participants (N = 118) completed a time use diary and measures of job satisfaction, burnout and professional identity. 'Meaningfulness of work activities' was constructed from respondents' ratings of each work activity according to client‐relatedness, occupational therapy specificity and value of the activity to the individual, clients and families and colleagues. Relationships between meaningfulness of work activities, job satisfaction, burnout and professional identity were explored using bivariate correlations and stepwise regression. Analyses were also conducted to examine differences between individuals in working in 'generic' roles and those in 'occupational therapy specific' roles. Results: Higher levels of meaningfulness of work activities were associated with higher job satisfaction, lower burnout and stronger sense of professional identity. The element of meaningfulness of work activities of 'value to self' was the most influential in terms of associations with each of the measures. There were no statistically significant differences in ratings of job satisfaction, burnout or professional identity between respondents in 'generic' and 'occupational therapy specific' positions. Conclusion: Efforts to increase the meaningfulness of work activities for occupational therapists in mental health may enhance work‐related wellbeing. Supporting staff to engage in work duties they find valuable through individualised work allocations across teams may be an innovative approach to improve staff satisfaction and wellbeing. [ABSTRACT FROM AUTHOR]

Introduction: Participation in community‐based recreation and leisure activities may afford valuable opportunities to young people with cognitive disabilities (CD) to develop important self‐determination skills needed for success in adulthood. To evaluate whether these programmes are achieving their intended impact, it is important to have a tool that captures the perspective of the participants using an accessible method. This article describes the content development and evaluation of accessibility and feasibility of the Participatory Experience Survey (PES). Method: Participant observation and focus group sessions were conducted in conjunction with a summer youth programme hosted by a special education advocacy organisation. Photos were used to guide identification of factors influencing both negative and positive experiences. Findings informed question content. Three groups of stakeholders, parents of youth with CD (Group 1), service providers (Group 2), and experts in cognitive disability and/or programme planning (Group 3) reviewed the PES to provide feedback on the relevance and accessibility of the measure. After stakeholder feedback was incorporated, cognitive interviewing was conducted with young people with CD to assess instrument accessibility and appropriateness for use in context. Results: Youth described their participation in three categories: personal, social and environmental. Stakeholder Groups 1 and 2 identified 15 questions as needing revisions. Seven additional questions were added based on suggestions from stakeholder Group 3. Cognitive interviewing led to revision of 13 questions and removal of 16 questions due to issues related to vocabulary, item meaning, response bias, repetitiveness and length. Conclusion: The PES has the potential to offer programmes a means to more fully include young people with disabilities in programme evaluations, leading to better‐structured, more supportive programmes. Additional validity and feasibility work is needed to confirm these initial findings. [ABSTRACT FROM AUTHOR]

Background/aim: The transition from student to occupational therapy practitioner is challenging. In South Africa, this transition is undertaken in rural and underserved areas, as graduate health professionals are deployed by the government for a year of compulsory Community Service. This study set out to establish the characteristics of these practice settings, the resources available for occupational therapy services, the availability and quality of supervision, and participants' perceived ability to communicate with their patients and negotiate cultural differences. Methods: A cross‐sectional survey design was utilised and a questionnaire was sent to all occupational therapists completing Community Service in 2013 (N = 240). Data were analysed using Stata 12 and IBM SPSS Statistics 21.0. Frequencies and percentages were calculated for categorical variables and associations tested with Odds Ratios and the Pearson's Chi square test. Responses to open‐ended questions were post‐coded. Results: A 44.3% (n = 103) response rate was achieved. Practice settings often provided few resources. Although most participants had supervisors (89.6%), many did not find supervision satisfactory (65.9%). Communication difficulties featured strongly (73.9%), but the majority of participants felt they possessed basic cultural competence. Conclusion: Participants worked within complex practice settings that were frequently resource‐restricted with less than satisfactory supervision. Practice required cultural competence and an ability to work across language barriers. Undergraduate curricula need to be tailored to equip new graduates to navigate these contextual realities. Furthermore, human resourcing strategies need to be evaluated and effective supervision and support structures need to be developed. [ABSTRACT FROM AUTHOR]

Introduction: Validity is a dynamic process and as part of a continual process of evaluation of tools, this study aimed to evaluate content validity of the WorkHab functional capacity evaluation, a tool used in occupational rehabilitation. Methods: A cross sectional survey of health professionals who conduct FCEs investigated their ratings of item relevance and item difficulty across different categories of work and injuries. The survey also explored the relationship of the WorkHab FCE items with the physical demand items of the Dictionary of Occupational Titles (DOT). Results: The majority of items of the WorkHab FCE were rated as relevant for manual work and vocational retraining with over 90% agreement between the 106 respondents. Therapists identified the WorkHab items of climbing, crawling and balance as less relevant for sedentary work. Lifting items were perceived as the most difficult for those with a lower back injury, or an upper limb injury. Sixteen of the 18 WorkHab FCE items had 100% agreement with the equivalent items on the DOT. The WorkHab FCE items that had poor agreement with the DOT were mainly sensory items such as see, feel, talk and hear. Conclusions: The findings of this study support the content validity for the WorkHab FCE specifically in relation to manual work and for vocational retraining purposes. [ABSTRACT FROM AUTHOR]

Background/aim: Client‐centred goal setting is fundamental to occupational therapy practice and has been increasingly embraced by all rehabilitation practioners. Goal setting in clinical practice is a highly individualised process and may be more challenging with people with acquired brain injury. However, research examining practice is limited. We developed the Client‐Centred Goal Setting Practice Framework to explain how client‐centred goals are developed in brain injury rehabilitation. This framework was based on interview data and may reflect practitioner's theoretical knowledge rather than goal setting processes used in routine practice. The aims of this study were to explore the application of the framework to every‐day practice, examine the extent to which goal setting was client‐centred and refine the framework. Methods: A mixed methods approach was employed. Participants were community dwelling clients with ABI and their practitioners, drawn from a hospital outpatient service and community private practices. The communication exchange between practitioners and clients during routine goal setting was audio‐recorded, transcribed verbatim and analysed using framework analysis. Quantitative measures evaluated the client‐centredness of goals. Results: A total of 65 goal setting sessions with 36 clients and 17 practitioners (n = 8 occupational therapists) were analysed. The three goal setting phases of the framework and associated processes and strategies were represented. The 'establishing trust' process was interwoven throughout all phases and an additional strategy, 'social connection' was identified. Conclusion: The framework provides preliminary evidence about the core processes and strategies which uses establishing trust to engage clients with ABI in goal setting, and may be a useful tool to guide client‐centred goal setting practice in similar services. [ABSTRACT FROM AUTHOR]

Background/aim: Increased age and cognitive decline have been linked to difficulties with activities of daily living (ADL) and instrumental activities of daily living (IADL). Cognitive decline can often be signalled by complaints about one's cognition, such as memory. With older Australians living longer, there is an increasing proportion of the population at risk of declined performance in daily tasks. The aim of this study was to identify if subjective memory complaints in later life among older women predict changes in independence in performing ADL and IADL. Methods: Data were from 3721 women born 1921–1926, who completed Surveys 4–6 of the Australian Longitudinal Study on Women's Health. Memory complaints and difficulties on ADL were measured at each survey, using the Memory Complaint Questionnaire and 16 questions regarding specific ADL. Latent growth modelling examined correlations between initial scores on each measure, changes in measures, and the association between memory complaints and changes in ADL and IADL. Results: There was a significant association between baseline scores for subjective memory difficulty and baseline ADL and IADL scores. Initial memory difficulty was also associated with increase in ADL and IADL difficulty. Conclusions: Subjective memory complaints may be a risk factor for decline in performance on ADL. Attention to these concerns may be important in identifying functional decline in older age. [ABSTRACT FROM AUTHOR]

Background/aim: Hands are commonly involved in burn trauma. Occupational therapy in the acute phase aims to reduce the risk of deformities and facilitate return to usual occupations. This study aimed to describe usual occupational therapy care at a major adult burns service, and measure recovery from hand burns in the first six months post‐acute hospital discharge. Method: To describe usual occupational therapy care, an audit of patient contact statistics over six months was undertaken, and occupational therapy staff were interviewed. To measure recovery, a prospective cohort study recruited adults hospitalised with hand/upper limb burns at the Victorian Adult Burns Service. Recruitment occurred over a four month period. Functional recovery was measured at three time points: discharge, three and six months post‐discharge. Instruments included the Quick Disabilities of the Arm, Shoulder and Hand and the Functional Assessment for Burns. Results: Usual care was calculated to be one 30 minute session of daily occupational therapy. Interventions were described using the Template for Intervention Description and Replication. Participants (N = 10) were aged 22–65 years and were treated for burns ranging from 2% to 40% total body surface area. Scores on the Functional Assessment for Burns suggested high functional independence at discharge. Quick Disabilities of the Arm, Shoulder and Hand scores improved significantly at each time point, with most substantial improvement occurring between discharge and three months. Involvement of the first web‐space was associated with poorer recovery in the first three months post‐discharge (P = 0.04). Six participants (60%) had returned to work at the three month follow‐up, and seven (70%) at six months. Conclusion: The Quick Disabilities of the Arm, Shoulder and Hand was responsive to recovery in the post‐discharge period. Further research into upper limb recovery following burns is needed, including exploration of the relationship between recovery and first web space hand burns. [ABSTRACT FROM AUTHOR]

Background/aim: Professional practise placements in occupational therapy education are critical to ensuring graduate competence. Australian occupational therapy accreditation standards allow up to 200 of a mandated 1000 placement hours to include simulation‐based learning. There is, however, minimal evidence about the effectiveness of simulation‐based placements compared to traditional placements in occupational therapy. We evaluated whether occupational therapy students completing a 40 hour (one week block) Simulated Clinical Placement (SCP) attained non‐inferior learning outcomes to students attending a 40 hour Traditional Clinical Placement (TCP). Methods: A pragmatic, non‐inferiority, assessor‐blinded, multicentre, randomised controlled trial involving students from six Australian universities was conducted. Statistical power analysis estimated a required sample of 425. Concealed random allocation was undertaken with a 1:1 ratio within each university. Students were assigned to SCP or TCP in one of three settings: vocational rehabilitation, mental health or physical rehabilitation. SCP materials were developed, manualised and staff training provided. TCPs were in equivalent practice areas. Outcomes were assessed using a standardised examination, unit grades, the Student Practice Evaluation Form‐Revised and student confidence survey. A generalised estimating equation approach was used to assess non‐inferiority of the SCP to the TCP. Results: Of 570 randomised students (84% female), 275 attended the SCP and 265 the TCP (n = 540, 94.7% retention). There were no significant differences between the TCP and SCP on (i) examination results (marginal mean difference 1.85, 95% CI: 0.46–3.24; P = 0.087); (ii) unit score (mean (SD) SCP: 71.9 (8.8), TCP: 70.34 (9.1); P = 0.066); or (iii) placement fail rate, assessed using the Student Practice Evaluation Form‐Revised (100% passed both groups). Conclusion: Students can achieve equivalent learning outcomes in a 40 hour simulated placement to those achieved in a 40 hour traditional placement. These findings provide assurance to students, educators and professional accreditation bodies that simulation can be embedded in occupational therapy education with good effect. [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: The Assistive Technology Outcome Profile for Mobility (ATOP/M) was designed to isolate the impact of mobility assistive technology on perceived difficulty with activity and participation. The study objectives were to examine its measurement properties (test‐retest reliability and convergent validity) and applicability for middle‐aged and older power wheelchair (PWC) users. Methods: Four ATOP/M subscales were administered using computer adaptive testing (activity with mobility device, activity without mobility device, participation with mobility device, participation without mobility device). Test‐retest reliability (4‐wk interval), convergent validity (a priori hypothesis testing of correlations with participation (Late‐life Disability Instrument) and mobility (Life‐space Assessment)) and applicability (respondent burden, distributions) were examined with 116 PWC users between 50 and 85 years of age presenting with a variety of diagnoses. Results: When using powered mobility, perceived difficulty with activity and participation scores were similar to the general population of mobility devices users (T‐score range 46.3–53.7), while activity and participation were significantly lower without mobility devices (T‐score range 35.3–39.4). Test‐retest reliability intra‐class coefficients of the four subscales ranged between 0.82 and 0.91, and convergent validity was supported by moderate correlations (r = 0.35–0.47). Respondent burden was higher for the without devices subscales and none of the subscales had significant floor/ceiling effects. Conclusion: Our results provide support for reliability and convergent validity of the ATOP/M for PWC users. Specific strategies were recommended to optimise applicability with this population such as administration guidelines for reframing the without device scale and timing of data collection. [ABSTRACT FROM AUTHOR]

Background/aim: Parent proxy reports are well used in occupational therapy, yet historically parent report instruments of motor skill have not required parents to report on the same motor skills that their children are assessed on. The aim was to examine how well a parent report of children's fundamental movement skill (FMS) was associated with children's actual FMS. Method: A sample of 100 children aged 7–9 years from Melbourne, Australia, were recruited. Parents/guardians completed proxy report (parent version of the 'Pictorial Scale of Perceived Movement Skill Competence' (PMSC)) and children's actual motor skills were assessed ('Test of Gross Motor Development' 3rd edition (TGMD‐3)). Data were first analysed using Pearson's correlation coefficients and then hierarchical linear stepwise regression was conducted with actual skill as the outcome variable in each model. Results: The PMSC‐Parent (r = 0.36, P < 0.001) was moderately associated with children's actual skill. After age and sex adjustment, the PMSC‐Parent explained 11.4% of variance in total skills. Parent report of their children's object control scores (PMSC object control scale) was significantly associated with children's actual object control (B = 0.36, P < 0.001) and explained 11.3% of the variance. Parent report of children's locomotion scores (PMSC locomotion scale) was associated with children's actual locomotor skills (B = 0.27, P = 0.007) and explained 6.2% of the variance. Conclusion: Parents are able to report to some degree on their children's FMS competency, in particular, their object control competence. Parent proxy report of FMS may help inform occupational therapists to identify children with low FMS competency to develop interventions targeting FMS. [ABSTRACT FROM AUTHOR]

Background/aim: Occupational therapists offer a unique perspective regarding the contribution of the environment to occupational performance. Therefore, a scale that measures the unique characteristics of the primary school classroom environment where children complete their daily schoolwork occupations is needed. The aim of this study was to develop and psychometrically evaluate a new teacher‐report questionnaire that measures a number of environmental characteristics of primary school classrooms. Methods: Participants (N = 117) completed the Classroom Environment Questionnaire (CEQ), which utilises a 4‐point Likert scale where teachers rate 51 environmental characteristics of their classroom. Teachers also rate the extent to which they believe the physical, social, temporal, institutional and cultural classroom environmental domains contribute to students' schoolwork performance using a 10‐point scale. The structural validity of the CEQ was examined using principal component analysis (PCA). Inter‐item correlations were examined using Pearson r correlations, while the internal consistency of the CEQ was assessed using Cronbach's alpha. Results: PCA revealed the CEQ to be multidimensional, with 31 items loading onto nine viable factors, representing the unique nature of classroom environments. Based on the PCA results, 20 items were removed from the CEQ. Cronbach's alpha and correlation analysis indicated that most CEQ subsections had acceptable internal consistency (alpha range 0.70–0.82), with four subsections demonstrating a lower level of internal consistency (alpha range 0.55–0.69). Conclusion: Preliminary structural validity and internal consistency analysis findings confirm that the CEQ has potential to be a useful scale for professionals wishing to examine the unique characteristics of primary school classrooms that influence the occupational performance of students. Ongoing analyses will be undertaken to further explore the CEQ's validity and reliability. [ABSTRACT FROM AUTHOR]

Background: The aim of the current study was to assess the construct validity and internal consistency of a measure used by an occupation‐based, mental health program. The measure was formulated according to the 3B theory of being, belong and becoming and system impacts. Methods: The scale was administered to a sample of 122 current members of Northern Initiative for Social Action. Confirmatory factor analysis (CFA) was carried out to examine the model fit of the 3B Scale. Internal reliability was assessed using Cronbach's alpha measure of internal consistency. Results: The CFA confirmed the four hypothesised underlying constructs of the 3B theory. The results of the CFA reported adequate model fit. Each factor had good to excellent internal reliability with Cronbach's alpha ranging from 0.81 to 0.91. Conclusion: The 3B Scale is a valid and reliable tool for measuring Being, Belonging and Becoming needs in an occupation‐based mental health program. The 3B Scale is an example of an outcome measure created specifically to quantify program outcomes and demonstrates that instruments suited to unique programs can be individually configured and assist occupational therapists in their efforts to measure client perspectives. These are the essential first steps to client‐centred practice and the development of practice‐based evidence. The 3B Scale may be useful to similar peer‐led programs, as well as community‐based occupational programs that foster participation. Further research is needed to determine whether the 3B Scale can detect change over time. [ABSTRACT FROM AUTHOR]

Background: Academic integrity is the moral code of academia. Students who demonstrate trustworthiness in an academic setting are more likely to be dependable in a clinical setting. It is, therefore, important for occupational therapy academic and fieldwork educators to know the academic integrity profile of their students and to address any areas of academic dishonesty in curriculum design and delivery. To date, there has been no baseline description of the academic honesty profile of Australian occupational therapy students. Aim: To establish a baseline of academic integrity and academic dishonesty among occupational therapy undergraduate and graduate‐entry masters students in a cohort of Australian students. Methods: Seven hundred and one students from five Australian universities completed a self‐report questionnaire comprising demographic questions and six standardised scales measuring academic integrity. Results: Overall, occupational therapy students reported high levels of academic and fieldwork integrity; however, some areas of concerns exist. Students report copying material without citations at least once during their studies (55%), obtaining test questions at least once during their studies (42.6%) or padding out a bibliography (39.5%). Conclusion: Occupational therapy education needs to continue to emphasise the importance of academic and fieldwork integrity. Students need to be explicitly taught what academic honesty and dishonesty is and be provided with the resources and time to complete academic work to reduce the risk of academic dishonesty. [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: Allied health professionals frequently use surveys to collect data for clinical practice and service improvement projects. Careful development and piloting of purpose‐designed surveys is important to ensure intended measuring (that respondents correctly interpret survey items when responding). Cognitive interviewing is a specific technique that can improve the design of self‐administered surveys. The aim of this study was to describe the use of the cognitive interviewing process to improve survey design, which involved a purpose‐designed, online survey evaluating staff use of functional electrical stimulation. Methods: A qualitative study involving one round of cognitive interviewing with three occupational therapists and three physiotherapists. Results: The cognitive interviewing process identified 11 issues with the draft survey, which could potentially influence the validity and quality of responses. The raised issues included difficulties with: processing the question to be able to respond, determining a response to the question, retrieving relevant information from memory and comprehending the written question. Twelve survey amendments were made following the cognitive interviewing process, comprising four additions, seven revisions and one correction. Conclusions: The cognitive interviewing process applied during the development of a purpose‐designed survey enabled the identification of potential problems and informed revisions to the survey prior to its use. [ABSTRACT FROM AUTHOR]

Background/aim: Somatosensation is the ability to detect and recognise body sensations such as touch, vibration, pressure, pain, temperature and proprioception. Cerebral palsy is a neurological disorder that is often accompanied by impairments in somatosensation. Current somatosensory assessments have limited psychometrics established for use with these children. The aim of this study was to identify therapists’ current practice and perspectives related to the assessment of somatosensation in children with neurological disorders. Methods: A cross‐sectional questionnaire was used to identify the somatosensory assessments currently used in clinical practice, time allocated to assessment, and therapists’ satisfaction and confidence using the available assessments of somatosensation. The questionnaire was adapted from a previously utilised questionnaire that identified therapists’ use of somatosensory assessments with adults post‐stroke. Results: A total of 135 therapists responded to the questionnaire. Seventy‐nine (92%) occupational therapists and 44 (89.7%) physiotherapists indicated that they currently assessed or treated children with somatosensory deficits. Sixty‐four (82.1%) occupational therapists and 38 (86.3%) physiotherapists regarded assessment of somatosensation in children with neurological disorders as important to very important. However, only seven (8.8%) occupational therapists and seven (15.9%) physiotherapists reported confidence in their ability to do so. The methods with which therapists detect and measure somatosensory impairment in children with neurological disorders are variable, with non‐standardised and/or informal assessments most frequently used. Conclusion: Despite there being recommendations of best practice for the assessment of specific domains of somatosensation in children with cerebral palsy, current practice does not yet mirror these recommendations. Additionally, therapists have low satisfaction and confidence with what they are currently using, highlighting the need for a comprehensive and standardised assessment of somatosensation for use in children with neurological disorders. [ABSTRACT FROM AUTHOR]

Background: Deep brain stimulation (DBS), a surgically based treatment for people living with Parkinson's disease (PD), can result in a significant improvement of motor symptoms. However, the broader impact of DBS and the changes it creates are not well understood. Greater understanding of the experiences and needs related to DBS would enable development of relevant outcome measures and supports. Objectives: To explore the lived experiences of people undergoing DBS for Parkinson's disease. Methods: A descriptive phenomenological study was undertaken exploring experiences, perspectives and outcomes with key stakeholders. Semi‐structured, audiotaped interviews were undertaken with people with PD who have had DBS, their family members and health professionals across four states and territories in Australia. Results: Perspectives and experiences of 14 people with PD undergoing DBS, 10 family members and 11 health professionals were analysed. Occupations emerged as a key aspect throughout the DBS experience. Two major themes captured the role of occupation in relation to DBS: Occupations as a barometer, where occupational experiences and performances shaped people's understanding of their condition, the impact of treatments and their overall adjustment; and Shifting occupational identity where the life transition of DBS altered the occupational experiences of relationships, volition, roles and responsibilities of people with PD and their family members. Conclusion: Occupational experiences and changes served as an important way for people with PD and their families to understand and communicate their experiences of PD and related treatments. There is an identified need for outcome measures and clinical education and interventions to reflect this. [ABSTRACT FROM AUTHOR]

Background/aim: Enteral feedings are part of the daily mealtime experience for many caregivers of children with cerebral palsy. The scope of occupational therapy practice incorporates multiple aspects of the enteral feeding process. Yet, the research in this area is very limited. The purpose of this study was to provide practitioners with better understanding of the impact enteral feedings of children with cerebral palsy have on family mealtime routines. Methods: Using a complimentary mixed method approach, data were obtained through an online survey containing the Satisfaction Questionnaire with Gastrostomy Feeding (SAGA‐8) and supplementary questions, and qualitative semi‐structured phone interviews. Participants were caregivers of children with cerebral palsy who receive their primary nutrition through a gastrostomy tube. Results: This study's cohort consisted of n = 36, SAGA‐8, and n = 6 in‐depth interviews. The mean age of children of was 9.4 (6.94 SD) with a mean age of 3.4 (5.35 SD) when enteral feeding was introduced. While families' overall situations positively changed after the gastronomy tube placement, environmental barriers and length of feeding time continued to present a challenge to mealtime routines. The mixed methods data analysis revealed that successful adjustment to having a child with a gastronomy tube and problem solving are closely linked and a consistent part of mealtime experience. Conclusion: Findings highlighted the necessity of comprehensive support from health professionals in achieving positive mealtime experience. Themes in this study indicated that caregivers would benefit from a professional with knowledge in the development and integration of rituals and routines to support positive outcomes. [ABSTRACT FROM AUTHOR]

Background Within the context of growing concerns about a potential oversupply of occupational therapist, this research examines when, where and how long new graduates take to gain employment and identifies influences upon the health and university systems. Method A mixed method research design, using an online survey was adopted to investigate the topic. Two consecutive cohorts of graduates from a single university program were invited to participate. Results Seventy-five (58%) responses were received, with 63 (84%) currently employed in an occupational therapy role. Of the 12 (16%) not employed, only 3 (4%) described themselves as actively seeking employment in an occupational therapy role. A wide spread of employment settings and scope of practice areas was reported. Conclusion Findings suggest that occupational therapy graduates are gaining employment in a range of settings and practice areas, relatively quickly. This research adds evidence to the conversation around graduate employment within a region of Australia. The Australian population, health system and university changes are possible factors influencing employment. The research reveals the difficulties in understanding the current situation with limitations in data collected, varied terminology and an ever changing job seeking environment. The research provides a starting point for the occupational therapy profession to further understand the directions the profession is taking. University programs may also benefit by using the research to tailor course content to assist graduates in gaining employment or to present students with the prospects of new employment opportunities. [ABSTRACT FROM AUTHOR]