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Introduction: Occupational therapists recommending home modifications in Australia are often required by funding bodies to consider 'value' and 'value for money' (VFM); however, clear guidance on how to define and apply these concepts is not always provided. This paper reports on a qualitative study examining how the concepts of value and VFM are currently understood and operationalised by occupational therapists in Australian home modification practice, with the aim of positively contributing to both policy and practice in this area. Methods: The study utilised constructivist grounded theory to collect and analyse qualitative data from 20 occupational therapists who were currently working across Australia and had professional experience in home modifications. Findings: The grounded theory that was derived from the analysis highlights the unique position that occupational therapists occupy in home modification work as they strive to align the values of different stakeholders to create solutions that all consider to be valuable. In the absence of consistent frameworks or methods for determining value and VFM, evidence also emerged of occupational therapists using a range of individual approaches such as using formal and informal care as metrics, cheapest option approaches, and comparative costing. Conclusion: In addition to a clear need for consistent and transparent approaches to understanding and operationalising VFM in home modifications, there is also a need for further investigation into the value systems that underpin this work. A conceptualisation of occupational therapists as street‐level policy agents has proven useful here as it highlights the position occupational therapists occupy, enacting, making, and, at times, challenging policy in day‐to‐day practice as they work to align the values of the various stakeholders. [ABSTRACT FROM AUTHOR]

Introduction: People living with advanced cancer want to continue participating in their valued occupations amid cancer progression. However, increasing dependence and bodily deterioration challenge a person's ability to do so, thus requiring adaptation to how they engage in their occupations. Theoretical frameworks on the process of occupational adaptation often do not address the implications of progressive functional decline. Methods: A longitudinal phenomenological design was used to understand the lived experience of occupational engagement for working‐aged adults living with advanced cancer. A semi‐structured interview series explored participants' experience of occupational engagement and how this changed over time. Data were analysed thematically and mapped against the Model of Human Occupation (MOHO). Findings: Eight adults (40–64 years old) participated in 33 interviews over 19 months. Three themes were constructed from the data: ongoing adaptation through doing, the significance of volition in adaptation, and everyday life is contingent on my environment. Study findings demonstrate that the process of adaptation occurs through occupational engagement, is motivated by volition, and is affected by the environment. Volition and the environment play a more central role in occupational adaptation than occupational competency for the advanced cancer cohort. Conclusion: Study findings further MOHO's theoretical conceptualisation of occupational adaptation by identifying the centrality of volition and the environment in the process of adaptation. For people living with advanced cancer, disease progression results in unremitting functional decline, thus rendering competency an unstable and untenable construct. Rather, this paper argues that occupational adaptation is facilitated by volition (i.e., the motivation behind the doing) and the environment, thus fostering a sense of identity and meaning at the end of life. Occupational therapists' awareness of the significance of volition and the environment can thus foster continued occupational engagement and meaning at the end of life for people living with advanced cancer. [ABSTRACT FROM AUTHOR]

Introduction: Employment of occupational therapists in generic roles in public mental health services (PMHSs) constrains capacity to undertake discipline‐specific activity meaning consumers may be unable to access valuable occupational therapy assessments and interventions that could promote recovery. Establishing a dedicated occupational therapy clinic has been identified as one way of improving care provided and outcomes for organisations, therapists, and consumers. To inform such developments, this paper reports evaluation of feasibility, acceptability, and sustainability of a pilot clinic established within a PMHS. Methods: An observational evaluation was used combining quantitative and qualitative data collected from service documents, clinic records, and in semi‐structured interviews with 42 stakeholders. Quantitative data were used to describe referrals and flow through the clinic. Framework analysis of qualitative data examined the process and outcomes of referrals and enabled understanding of acceptability, perceived impact and areas for improvement. Results: Substantial ground work, particularly stakeholder engagement, and redistribution of resources enabled establishment and successful operation of an assessment clinic for 12 months. Assessments were completed for 68% of the 100 accepted referrals, with the remainder in process or unable to be completed. Stakeholders agreed that the clinic enabled clinicians' timely access to specialist assessment, improving care for consumers. Occupational therapists valued the opportunity to deploy and develop discipline‐specific skills and when there was some impact on work flow of occupational therapists' 'home teams', team managers judged the investment worthwhile. Strong leadership by the discipline lead and support from team managers who enabled allocation of occupational therapists to the clinic were critical to success. Conclusion: An occupational therapy assessment clinic can be established and operate successfully within a public mental health setting. Redistribution of resources supported increased efficiency and consumer access to specialist interventions that support their recovery. [ABSTRACT FROM AUTHOR]

Aims: Up to 50% of children with attention deficit hyperactivity disorder (ADHD) also present with difficulties with motor proficiency. Several assessments of motor proficiency are available for occupational therapists, though the validity of these measures in an ADHD population requires further exploration. The aim of this paper was to evaluate the consistency of scores obtained using the long‐form and short‐form of the Bruininks–Oseretsky Test of Motor Proficiency—Second Edition (BOT‐2) in a school‐age ADHD sample. Method: The BOT‐2 long‐form was administered to 84 school‐age children (78 males) with ADHD; short‐form scores were extracted from the relevant long‐form items. Results: Long‐form and short‐form total scores were highly correlated (r =.87), though the average short‐form score was significantly higher. As a categorical measure, 52 children were classified as "at‐risk" for movement difficulties by the long‐form; but only 36 by the short‐form, yielding a false‐negative rate of 30.77%. The sensitivity of short‐form could be improved by raising the cut‐off thresholds of short‐form scores as identified by receiver operating characteristic curve analysis but did not yield practical utility. Interpretation: As a continuous indicator (i.e. total scores), the short‐form is comparable to the long‐form. However, the short‐form overestimates the child's motor proficiency relative to the long‐form and yields an unacceptably high rate of false negatives as a categorical measure. The current revision of the short‐form is therefore not recommended as a screening nor diagnostic instrument in an ADHD population. In the absence of ADHD‐specific norms, use of the long‐form provides greater opportunity for occupational therapists to identify those at‐risk for movement difficulties. However, any assessment of motor proficiency should be accompanied by a broader comprehensive assessment to best understand a child's motor functioning. [ABSTRACT FROM AUTHOR]

Background: Prior to implementing new programmes or practices, it is essential to understand the context, barriers and enablers to support successful use. The tailored activity programme (TAP) is an evidence‐based intervention provided by occupational therapists to support community‐dwelling people living with dementia and their carers. The programme was developed in the United States, and although it is not currently available for routine use in Australia, its implementation would address the needs of many Australians with dementia and their carers. Aim: The aim of the study is to understand the perspectives of occupational therapists and their managers regarding barriers and enablers to the delivery and implementation of the TAP in Queensland, Australia. Methods: A qualitative descriptive methodology was employed. Semistructured interviews were undertaken with occupational therapists (n = 18) who work with community‐dwelling people with dementia and their carers, and their managers (n = 10). Participants were recruited from a range of organisations across Queensland, and they were asked about potential barriers and enablers to implementing TAP. Interviews were recorded and transcribed verbatim. Data were mapped using framework analysis whilst remaining open to other themes. Findings: Themes were identified, and facilitating factors included the close alignment of TAP with occupational therapists' scope of practice; their acceptance of, and optimism about the programme and its perceived benefits including improved client outcomes; and an opportunity for occupational therapists to further develop their skills. Managerial support and carers' readiness and willingness to participate were also identified as important factors for success, whereas barriers were cost to clients and the capacity of the occupational therapy workforce to provide TAP. Conclusion: Occupational therapists and their managers expressed enthusiasm for TAP and awareness of its likely benefits, while also identifying barriers that will need to be addressed if implementation of the programme is to be successful in Australia. [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]

Introduction: Within Australia, the introduction of the National Disability Insurance Scheme has led to a growth in paediatric occupational therapists working in community settings. This growth has increased the demand for support from more senior paediatric occupational therapists to novice clinicians. Mentoring has long been valued by occupational therapists as a means to provide this support. Despite its apparent benefit, there is limited research on the contribution of mentoring as distinct from supervision, and its impact on mentees' skills and confidence in providing care. This study examined the contribution of mentorship to the development of professional capability in paediatric occupational therapy practice from the perspective of mentors and mentees. Methods: Interpretive description methodology was used. In‐depth interviews were conducted with nine mentors and eight mentees from three Australian states. Data were analysed inductively and thematically. Findings: All participants reflected on the challenges presented by the complexity of practice, requiring a knowledge base that mentees perceived they did not possess. The essential nature of non‐judgemental, emotional support allowed mentees to feel safe to discuss their concerns when they were often overwhelmed by practice. Mentorship was viewed as capacity building, building competence by scaffolding clinical reasoning and supporting theory to practice translation while developing resilience to cope with complexity. Conclusion: Study participants reported that successful mentorship assisted novice practitioners to integrate knowledge and skills required for complex clinical and professional reasoning. The emotional support provided through the relationship supported novice therapists to build their confidence and resilience while promoting professional identity and socialisation into the profession. The study raised questions related to how the profession best supports novice paediatric therapists in the current employment contexts, and the need to review how bodies of knowledge relevant to paediatrics are brought together to be used by both novice clinicians and senior therapists, who support them, for translation to effective practice. [ABSTRACT FROM AUTHOR]

Introduction: Collaborating with consumers in designing, delivering, and evaluating curricula is an ongoing initiative within occupational therapy tertiary courses in Australia. Within the Australian educational context, consumers are involved in on‐campus educational activities. Student occupational therapists must complete 1000 hours of practice placements as part of their education. To date, no research has explored how consumers could contribute to student occupational therapists' learning during practice placements. This study aimed to explore Australian occupational therapists' perceptions of consumers providing feedback to students during practice placements. Methods: A qualitative descriptive approach was adopted to engage with the diversity of practice contexts and gain a rich dataset from the occupational therapy profession. A qualitative questionnaire was developed and distributed using snowballing techniques. The questionnaire asked recipients to reflect on the risks, challenges, and benefits of consumers providing feedback to student occupational therapists from all stakeholders' perspectives. Demographic data were collated, and reflexive thematic analysis was used to construct themes. Findings: Responses were received from 81 participants. Most respondents identified as experienced occupational therapists from metropolitan locations across Australia. Reflective thematic analysis was used to construct three themes: Personal capability of consumers and students will enable, inhibit, and be developed by engaging in a feedback process; an educator‐controlled process to ensure safety for all stakeholders is required for time‐poor practice contexts; and us versus them: Shifting control to consumers can disempower practice educators. Conclusion: Engaging with consumers throughout all aspects of student occupational therapists' educational programme is required, including practice placements. New educational initiatives need to consider all stakeholders' concerns to ensure that authentic contribution from consumers is made within the various practice contexts. A co‐design approach that involves all stakeholders to develop a feedback process may result in high‐quality learning experiences that assist students to become safer, consumer‐centred health professionals. [ABSTRACT FROM AUTHOR]

Introduction: Experts by Experience involvement in the education of health professionals has gained momentum as an important strategy in ensuring quality, person‐centred education. Despite being a requirement for occupational therapy programs in Australia and internationally, involvement is variable and limited. Barriers to the implementation of academic roles have been identified, including negative attitudes of colleagues, systemic barriers, and insufficient evidence of their value. Mental health academics who do not identify as having lived experience (referred to as allies) have provided crucial support for Experts by Experience. Understanding their perspectives on implementation barriers and how they can be addressed is crucial to facilitating a broader level of meaningful involvement. Methods: A qualitative exploratory research project was conducted, involving in‐depth interviews with mental health academic allies (n = 16) from Australia, Ireland, and New Zealand. Participants were from the disciplines of nursing, occupational therapy, social work, and psychiatry. Data were analysed thematically. Findings: Two main themes were identified from the data analysis process: convincing colleagues and dealing with university barriers. Participants described varying attitudes from colleagues towards Experts by Experience, with many not understanding or appreciating their contribution to education and student outcomes. At the university level, reluctance to embrace innovation and funding and other resource shortages presented impediments to the implementation of Expert by Experience roles. Participants described using creative measures to overcome institutional barriers and encourage greater acceptance of such roles by colleagues. Conclusion: This research describes how allies experienced and overcame barriers they faced when supporting the implementation of academic positions for Experts by Experience. Allies have an important role to play in overcoming systemic barriers, and the approaches they have taken to achieve this may be an important source of learning for others with similar aspirations. [ABSTRACT FROM AUTHOR]

Introduction: Driver‐trained occupational therapists are advanced practitioners who work with people to help maintain their independence and autonomy through driving. There is a lack of investigation of professional reasoning processes for why interventions are recommended by driver‐trained occupational therapists. This research project sought to explore the reasoning of driver‐trained occupational therapists when they plan, implement, and reflect on driver rehabilitation interventions. Methods: In‐depth semistructured interviews (n = 7) and one focus group (n = 5) were conducted with 12 experienced driver‐trained occupational therapists, comprising a wide range of experience, client populations, and licensing jurisdictions. Data were analysed using a modified template analysis approach. Results: Seven higher order modes that reflect professional reasoning theory and hierarchical models were evident in the work of the driver‐trained occupational therapists, with no new modes of reasoning emerging. Ethical reasoning regarding the balance of safety versus client independence was an overarching shared framework, with therapists mostly using interactive and conditional reasoning in practice. Twenty‐three second‐level themes were identified that exemplify how the reasoning modes operate in practice. Therapists described assessment activity even when solely asked about intervention, indicating the importance of assessment to intervention design. The full hierarchy of reasoning was evident during the rehabilitation phase. Conclusion: These findings elucidate the application of professional reasoning in advanced occupational therapy practices and could support driver‐trained occupational therapists in making driving rehabilitation recommendations if used in reflective practices. [ABSTRACT FROM AUTHOR]

Introduction: Retirement, being a major life event and a focus of healthy ageing in society, creates the opportunity for occupational therapists to support people transitioning from work to retirement. Little is known about the scope of practice of occupational therapy in the work‐to‐retirement transition. The aim of this study was to, in Australia, (1) explore the potential scope of practice and factors influencing the potential scope of practice of occupational therapy in the work‐to‐retirement transition and (2) map findings to occupational therapy theoretical frameworks to assist in articulating scope of practice. Methods: A qualitative study (thematic analysis as an independent approach within a qualitative descriptive methodology) was undertaken using semi‐structured interviews with Australian occupational therapists. Findings Australian occupational therapists (n = 14) were interviewed. Four themes were identified which related to the potential scope of occupational therapy practice in the work‐to‐retirement transition: finding meaningful occupation; modifying lifestyles and homes for better living; work engagement; and application of occupational therapy skills. Six themes were identified which related to contextual factors influencing the potential scope of occupational therapy practice in the work‐to‐retirement transition: right time; valuing our expertise; promoting occupation(al therapy); finding the money; life, work and retirement longevity; and social responsibility. Conclusion: The work‐to‐retirement transition can be incorporated into other practice areas or can be a unique practice area allowing for a more targeted service. The frameworks of who, what, when, and where and enablement skills assist in articulating occupational therapy scope of practice in the work‐to‐retirement transition. A number of contextual factors can be barriers and/or facilitators to occupational therapy practice. More clearly articulating occupational therapy practice in the work‐to‐retirement transition will enable the profession to promote their scope of practice assisting in obtaining professional and public recognition and overcoming barriers such as funding to enable provision of services within this area. [ABSTRACT FROM AUTHOR]

Introduction: Research capacity building enhances the abilities of individuals and is critical within health systems for quality patient care and promotes a culture of excellence within the occupational therapy profession. A research capacity building toolkit was proposed identifying strategies to support allied health professionals to undertake research. This study evaluated participant‐reported outcomes of research capacity building toolkit implementation in an occupational therapy department. Methods: An observational pre–post‐cohort study at a tertiary hospital with volunteer occupational therapists using the standardised Research Capacity in Context Tool (RCCT) and an author‐designed quality improvement (QI) survey was employed. The RCCT measures research capacity and culture at organisation, team and individual levels. Semi‐structured interviews were used to elicit reflections regarding participant experience. Results: All levels of the toolkit were implemented successfully. The response rate was 59% (n = 36) at baseline and 49.1% (n = 26) at follow‐up. Eighty‐five percent of participants held direct clinical roles. Nine clinicians participated in the interviews. There were significant improvements in the estimate mean for the organisation (6.51 [2019] compared with 8.13 [2020], p = <0.001) and the team (5.52 [2019] compared with 7.15 [2020], p = 0.001). The individual level did not significantly change with an estimate mean of 4.20 in 2019 increasing slightly to 4.84 in 2020 (p = 0.128). This was supported by the QI survey where improvements were noted in the department but not at an individual level. The qualitative findings verified the components of the toolkit including 'supporting clinicians in research', 'working together', 'valuing research for excellence' and reflected the importance of 'individual attributes'. Conclusion: The toolkit supported the implementation of specific strategies to enhance research capacity and culture. Improvements within the organisation and team were evident; however, these were not seen at an individual level. Further research about the contribution of individual‐related factors and processes to the building of research capacity is required. [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]

Introduction: The rapid shift to digital platforms during the COVID‐19 pandemic enabled occupational therapy practice education to continue while creating unique learning opportunities for students in an environment of high demand for practice education providers. How occupational therapy practice educators experienced fieldwork supervision during this rapid redesign of service delivery is not widely understood. This study aimed to explore the experiences of practice educators who supervised occupational therapy students during the COVID‐19 pandemic in Australia. Methods: Fifteen occupational therapy practice educators participated in focus groups and individual semi‐structured interviews. Reflexive thematic analysis was used to understand the experiences of the participants and explore the barriers and facilitators to providing practice education in this context. Findings The experiences of the occupational therapy practice educators were interpreted into three themes: (1) Opportunities lost and then created (as two subthemes); (2) The relationship between the student and practice educator (comprising subthemes of practicing self‐care and connection and support); and (3) Signing‐off of students' competencies. While digital platforms were initially viewed as limiting, they also were used to create new opportunities for student learning. Participants spoke of being mindful of their and students' wellbeing and finding ways to provide connection and support. Participants were challenged by the need to adapt how they evaluated students in the context of a pandemic. Conclusion: The findings of this study highlight the complexities of occupational therapy practice education in the rapidly shifting context of the COVID‐19 pandemic in Australia. The outcomes highlight the importance of creating new ways of using digital platforms during practice education while focussing on the relationships with students. [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: Driving is a valued occupation given the independence and freedom it provides. Safe driving performance can be impacted by medical conditions, change in functional status and ageing processes. Occupational therapy driver assessors (OTDAs) provide invaluable driving recommendations; however, this requires specialist training for the therapist and is costly for clients. The number of OTDAs is not expected to meet the growing demand for expert services in this area, and little is known about the practices that non‐ OTDAs use to assist clients with returning to driving. The aims of this study were to investigate the practices of non‐OTDAs in a community‐based rehabilitation setting in Australia with respect to knowledge, confidence and skills in assessments, recommendations and outcomes for clients as part of the return to driving process. Methods: A descriptive study including medical record audits between April and September 2019 and staff surveys were completed at a large metropolitan community‐based rehabilitation facility. Descriptive statistics and thematic analysis were used to summarise data. Results: A total of 102 client medical records were audited, and 13 clinician surveys were completed. Medical record audits identified that return to driving was not consistently addressed by occupational therapists. Clinician surveys outlined a lack of knowledge and confidence of return to driving processes and available assessment tools to guide this process. Conclusion: All occupational therapists have an ethical obligation to address driving as an activity of daily living; however, non‐OTDAs report that they are not equipped for this role. This may negatively impact on driver safety, independence and overall health and well‐being of clients in community‐based rehabilitation. Further research is indicated to develop evidence‐based driving resources to support best practice of non‐OTDAs. [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]

Introduction: Sex has been recognised as an activity of daily living, and sexuality as an important part of our identity, with implications for our self‐esteem and quality of life. Although this brings sex and sexuality within the scope of occupational therapy practice, empirical and anecdotal information suggests that neither are routinely included in therapy. The aim of this study was to investigate the experiences of therapists who are comfortable addressing sex and sexuality in practice, with a view to influencing future research and practice. The research question posed was as follows: "What can we learn from occupational therapists who successfully address the area of sexuality in everyday practice?" Methods: Interpretative Phenomenological Analysis (IPA) was used to explore the research question. Semi‐structured interviews were conducted with 11 Australian occupational therapists who were purposively recruited. Interviews were audio‐recorded, transcribed verbatim, and analysed following the guidelines for IPA data analysis. Results: Four master themes and five sub‐themes emerged from the analysis and are discussed under the following headings: sexuality matters; know your boundaries; just do it; and seek support and mentoring. The themes provide insight into how occupational therapists successfully integrate sexuality into everyday practice. Conclusion: According to the participants in this study, addressing sex and sexuality during therapy is part of providing holistic client‐centred care. With clear personal and professional boundaries, occupational therapists can address sexuality within routine practice utilising core occupational therapy skills, such as communication, collaborative problem solving, pacing, positioning, and adaptive equipment. Furthermore, participants demonstrated that this can be done within a range of settings. It starts with a commitment and the motivation to find a way. [ABSTRACT FROM AUTHOR]

Introduction: Competency standards outline the knowledge, skills, and attributes that are required for competent practice. This study describes the process followed to revise and validate the competency standards for occupational therapy driver assessors in order to guide clinical practice in this area of advanced occupational therapy practice. Methods: A mixed methods research approach was used in this study. In phase 1, three focus groups with driver assessors reviewed and suggested revisions to the competency standards for occupational therapy driver assessors. Phase 2 involved content validation with key stakeholders through a focus group with consumers, written feedback from Australian state, and territory driver licensing authorities, and a two‐round Delphi process with Australian occupational therapy driver assessors. Results: Forty‐nine occupational therapy driver assessors participated in the phase 1 focus groups. Deductive content analysis of the transcripts provided data to revise the competency standards. Inductive analysis provided an in‐depth understanding of the participants' views and was interpreted through six categories and their underlying subcategories: purposes and benefits; jurisdictional variations and practice diversity; language use; defining competent practice; challenging systems and processes; and competency standards content. Forty‐eight occupational therapy driver assessors participated in the Delphi process. In Round 1, only 1 of the 164 competency standards and practice behaviours rated did not achieve the pre‐determined 70% consensus rate. In Round 2, all statements achieved consensus, with the overall average consensus level obtained across the Round 2 statements at 96.8%. Conclusion: The revised Australian Competency Standards for Occupational Therapy Driver Assessors have been endorsed by Occupational Therapy Australia and released for clinical use. The methods described in this research provide a framework suitable for revision or development of competency standards in both other areas of occupational therapy practice and other health‐care professions. [ABSTRACT FROM AUTHOR]

Introduction: This prospective study examines the test–retest reliability of touchscreen DriveSafe DriveAware (DSDA). In a future study, the authors intend assessing the usefulness of DSDA to measure progress of patients undergoing treatment for neurological conditions. Evidence of test–retest reliability is required first. Methods: Australian adults with current driver's licences (N = 39) aged 20 to 91 years (Mage = 58) recruited from a convenience sample were assessed with DSDA. The assessment was repeated 6 weeks, 6 months, and 12 months later to match planned assessments of patients undergoing neurosurgical treatment in future research. DSDA classification, DriveSafe subtest score, and DriveAware subtest scores were analysed as a whole sample, and in three age groups. Results: DSDA classification and DriveAware scores were consistent over repeated tests. DriveSafe scores increased between test 1 and 2 (p =.006), and thereafter no significant change from test 2 to 4. DriveSafe scores of older participants (70+ years) increased between test 1 and 2 more notably than younger participants' scores. No DriveSafe scores decreased over time. Conclusion: DSDA classification and DriveAware scores demonstrated test–retest reliability for all age groups. DriveSafe scores did not demonstrate test–retest reliability between test 1 and 2 for participants 70+ years. However, DriveSafe scores demonstrated test–retest reliability after test 2, possibly indicating an initial learning effect for the DriveSafe score only. The authors posit that this result may have been influenced by older adults' reduced familiarity with iPad technology at first assessment. Further longitudinal research is required to confirm whether these results are consistent in a sample population with diagnosed cognitive impairment. Future research will assess whether repeated assessment of DSDA may be useful for monitoring and screening cognitive fitness to drive in patients who have undergone neurosurgical treatment and whether declining scores may indicate cognitive changes in ability to drive. [ABSTRACT FROM AUTHOR]

Introduction: The inclusion of a therapy dog has been suggested as a means of facilitating therapy engagement for children on the autism spectrum within occupational therapy sessions. The aim of this study was to seek an understanding of possible benefits and challenges of this practice from the perspectives of occupational therapists, trained in canine‐assisted therapy. Method: This study adopted an interpretive descriptive design. Six therapists participated in a semi‐structured, telephone interview to describe their experience of working as canine‐assisted occupational therapists with children on the autism spectrum. An inductive thematic analysis was used to analyse the data. Results: Two overarching themes emerged. The first captured how therapists incorporated their therapy dog into sessions to accelerate children's initial motivation to engage within the therapy process. Specifically, therapists discussed how involving their therapy dog facilitated the development of a secure relationship, supported autonomous task involvement and increased children's sense of confidence. Second, they identified challenges inherent in their practice, such as the therapist's ability to maintain a goal‐directed focus when including a therapy dog. Beyond the challenges within their own practice sessions, therapists reflected on issues thought to impact the occupational therapy profession since starting practice as a canine‐assisted occupational therapist. Conclusion: Findings from this study contribute to the current understanding of how occupational therapists incorporate therapy dogs into their practice with children on the autism spectrum. The specific challenges noted by the therapists highlighted the importance of canine‐assisted occupational therapy being viewed as an advanced scope of practice within Australia and, therefore, the need for training and practice guidelines to be established. [ABSTRACT FROM AUTHOR]

Introduction: Over the last 20 years, the number of individuals affected by obesity in Australia has increased by 56%. The impact of excessive weight gain results in a wide range of physical, psychological and social difficulties, with resultant changes to occupational performance and engagement. For some people within this population, a further consequence of this increasing weight gain contributes to additional difficulties, with the individual being considered to be "bariatric". For these people, resultant changes include decreased capacity to engage in self‐care activities, leisure occupations and productive roles, creating significant difficulties in undertaking important life roles. This phenomenological study aimed to understand the occupational engagement of individuals with bariatric needs, and to identify potential opportunities to support the engagement and participation of these individuals from the perspectives of Australian occupational therapists. Methods: Qualitative data were collected from 11 semi‐structured interviews with occupational therapists from a variety of practice settings. Results: Thematic analysis identified four central themes (a) Occupational engagement was significantly impacted by a lack of suitable resources and availability of daily living equipment; (b) Health and well‐being were impacted by a disruption in meaningful occupational engagement; (c) Occupational roles were limited due to poor occupational identity and perceptions of not belonging within the community; (d) Occupational therapists do have a varied role when working with individuals with bariatric needs. Conclusion: Occupational therapists engaged in this study indicated that people with bariatric needs were significantly impacted by many complex issues as a result of their health condition, often contributing to poor health and decreased well‐being. Occupational therapists are well‐placed to engage with individuals with bariatric needs across many care contexts and must take up potential opportunities to provide services targeted towards the increased engagement and participation of these individuals, with resultant improvements to health and well‐being. [ABSTRACT FROM AUTHOR]

Introduction: Conceptualisation of occupation requires understanding of subjective wellbeing and experiences of occupation. Opportunities for participation in productivity activities, such as employment, may be limited for people with intellectual disability (ID). An occupational wellbeing framework was recently re‐imagined to focus on the subjective meaning of a person's occupational life rather than occupational performance. This study analysed experiences and possible benefits to occupational wellbeing of young adult men with ID in an intergenerational mentoring program based on Australian Men's Sheds using this revised occupational wellbeing framework. Methods: A qualitative approach was used to gather individual semi‐structured interviews at the end of an intergenerational mentoring program to explore occupational wellbeing experiences. Eight individual mentees and five parents of mentees (n = 13) from the different Men's Sheds sites agreed to participate in an individual interview about their experiences of the program. All mentees were male aged between 17 and 24 years. Family members included four female mothers and one male father. Data were highlighted, selected and deductively coded using content analysis according to the five occupational wellbeing domains of the framework. Results: Mentees reflected upon their experience with their mentor, the program, activities and environment of the Men's Shed. Findings were organised in relation to each of the five domains of occupational wellbeing, including contentment, competence, belonging, identity and autonomy. Experiences of mentees and their family members reflected the positive impact of participation on each domain and occupational wellbeing, including opportunities for socialisation outside of the program, mastery of skills and knowledge and validation of belief in self. Conclusion: Mentees involved in an intergenerational mentoring program in Australian Men's Sheds report benefits of participation in activities that foster and increase occupational wellbeing experiences. The experience of such domains should be considered when attempting to understand the quality of life and function for people with disabilities. [ABSTRACT FROM AUTHOR]

Introduction: With the introduction of the National Disability Insurance Scheme (NDIS) in Australia, occupational therapy graduates need to be adequately prepared to support service users in this new policy context. There is, however, limited research informed by service users themselves to inform contemporary occupational therapy curriculum redesign. The aims of this study were: (a) to explore the experience of occupational therapy service provision from the perspective of service users with lived experience of disability; (b) to gain an understanding of the perceptions of people with lived experience of disability regarding the NDIS and whether it will change how they work with occupational therapists; (c) to gain an understanding of the perspectives of people with lived experience of disability regarding the NDIS, and how this influences curriculum content for occupational therapy education. Methods: A pragmatic qualitative design, underpinned by the constructivist paradigm was utilised. Demographic surveys and semi‐structured interviews were completed with 10 participants who were purposively recruited. Peer debriefing and use of an audit trail were undertaken to enhance the rigour of the analysis. Results: Three themes were identified: (a) Occupational therapists as gatekeepers for equipment provision; (b) experience of the NDIS (Knowledge and understanding of the NDIS; Uncertainty regarding the NDIS; Choice and control in the NDIS); (c) curriculum content for occupational therapy. Conclusion: The insights provided by the people with lived experience in this study inform key areas of focus for occupational therapy curriculum to adequately prepare graduates to work in the evolving NDIS environment. Involving service users in an authentic manner in curriculum design, content delivery and student assessment is crucial for "real‐world" applicability of student education. [ABSTRACT FROM AUTHOR]

Introduction: The dosage of occupational therapy and physiotherapy positively correlates with rehabilitation patient and health service outcomes. Nevertheless, increasing the dosage during inpatient rehabilitation without additional resources can be challenging. This study aimed to determine feasibility of increasing the dosage of inpatient occupational therapy and physiotherapy rehabilitation with independent tasks and exercises outside of supervised sessions, the 'My Therapy' programme. Methods: A two‐group, quasi‐experimental, pre–post‐design examined feasibility of delivering My Therapy in addition to usual care, compared to usual care alone, for hospitalised musculoskeletal and frail older rehabilitation patients. My Therapy was prescribed by the occupational therapist and physiotherapist. A booklet was provided with an individually tailored set of tasks and exercises that were a sub‐set of routine therapy, to be practised safely, effectively and independently outside of supervised sessions. The primary outcome was feasibility of My Therapy implementation to achieve at least 70% adherence. Secondary outcomes were self‐reported daily My Therapy participation (minutes), total daily rehabilitation participation (minutes), adverse events, length of stay, 10‐metre walk speed, FIM scores and discharge destination. Results: Participation in My Therapy was achieved by 72% (83/116) of the My Therapy group, who averaged 14 min (SD 14) of daily practice outside of supervised sessions. Total daily rehabilitation participation was 177 min (SD 47) for My Therapy participants (n = 116) and 148 min (SD 88) for usual care participants (n = 89); mean difference 30 min (p =.00). A minimal clinically important difference in FIM was achieved for a significantly higher portion of the My Therapy group (22%, n = 26) compared to usual care (10%, n = 9; p =.02). There were no adverse events, safety concerns or group differences for other secondary outcomes. Conclusion: My Therapy was a feasible and safe way to increase the dosage of inpatient occupational therapy and physiotherapy rehabilitation via independent practice. Clinical Trial Registry: ACTRN12616000691448. [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: Post traumatic stress disorder (PTSD) resulting from military service can seriously impact quality of life. There is support for the use of service dogs amongst people with PTSD in managing symptoms by reducing anxiety and depression. To date, few studies have investigated this phenomenon comprehensively, particularly in relation to enhancing participation in daily occupations. Methods: We explored the experience of a group of ex‐serving members of the Australian military with PTSD, who had partnered with a service dog. We sought to understand the influence of the service dog on PTSD symptom management and participation in meaningful daily occupations. Seven participants who had been paired with a service dog were recruited from a Veterans' support organisation. Two semi‐structured focus group sessions were conducted, audio‐recorded and transcribed verbatim. The transcripts from the focus group sessions and researcher field notes were analysed independently by two researchers using an inductive approach to generate codes and themes. Results: The themes that emerged from the data were: isolation, safety, lifeline, reconnection and challenges. Veterans in this study reported that partnering with a service dog helped them to feel safe, helped them to manage the symptoms and impact of PTSD, resulting in improved sleep quality, emotional regulation, reduced anxiety, enhanced anger management, and a reduction in the misuse of alcohol and prescription medication and suicidal ideation. These changes led to improved relationships and increased participation in meaningful daily occupations. Ongoing financial support for veterans who have partnered with a service dog needs to be more closely examined. Conclusion: These findings are important and highlight that a larger and more comprehensive, research project examining the impact of service dogs on the quality of life. [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: Occupation and an occupational perspective of health and wellbeing are required to be taught in accredited occupational therapy programmes internationally. Current research into occupational therapy education has commonly focused on curriculum design and the experience of students and their developing skills for practice. Little research has focused on the perspectives of educators and in particular their own reflections and beliefs on the use of occupation in occupational therapy education. The aim of this study was to uncover Australian educator perspectives of occupation in occupational therapy education. Method: This study utilised a qualitative research framework. Eight occupational therapy educators and practice education coordinators completed semi‐structured interviews. Educators ranged in experience from two to over 20 years in the university sector. The interview transcripts were transcribed verbatim, forming the data for analysis. Braun and Clarke's thematic analysis was used to analyse the dataset. Results: Three themes emerged from the data: occupation is our framework; the balance between practice education and occupation‐centred education; and educators changing the focus. Overall, educators believed that the 'occupation for health' philosophy and its application are important foundations for education. However, educators provided varied responses on how to teach these concepts to students. Conclusion: Gaining educators' opinions on the importance of occupation in education is beneficial for ensuring consistency throughout occupational therapy curricula. Theoretical models were endorsed by educators to foster occupation‐based practice. Educators must continue to innovate within the profession for occupation‐based approaches in practice and education to be strengthened in the future. [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/aim: Occupational therapists who work in palliative care are frequently exposed to the experience of death and dying. Previous occupational therapy research has offered insight into factors that influence feelings relating to death and dying and associated coping strategies. However, existing literature is dated and has not specifically examined the concept of grief. This study addresses this gap in knowledge by exploring the lived experience of professional grief among occupational therapists working in palliative care settings. Methods: Semi‐structured interviews were conducted with six Australian palliative care occupational therapists. The data were collected and analysed using an interpretive phenomenological approach. Results: Four interrelated themes were identified as core to the lived experience of professional grief among participants. These included; ‘knowledge of self’, ‘giving permission for connections and feelings’, ‘filtering experience’ and ‘being present at work and at home’. Conclusion: Considered in combination, these themes offer a guide for therapists to explore their own experience of and responses to professional grief and, in doing so, foster the development of personalised management strategies. [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 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]

Background/aim With increasing rates of cancer survival in Australia, more people are living with long-term side effects of cancer and its treatment, and cancer survivorship is now considered a distinct phase of cancer care. While occupational therapists play an integral role in multidisciplinary care for people with chronic conditions, there is little evidence documenting the occupational therapy role for people living with chronic cancer-related conditions. This study aimed to explore the views of Australian occupational therapists about current practice and what constitutes best practice for cancer survivors. Methods A cross-sectional online survey was developed and distributed via emailed invitations to the Occupational Therapy Australia membership to collect responses from occupational therapists in a range of locations and practice settings around Australia. Results A total of 204 completed surveys were returned (response rate of 4%). More than 70% ( n = 143) of respondents worked with people with cancer at least sometimes and most worked in acute (13.8%, n = 28) or community (11.2%, n = 23) settings. Participants rated equipment provision as the most common intervention (94%, n = 192), followed by energy conservation (91%, n = 185) and pressure care (78%, n = 160). Lack of funding for occupational therapy positions and a lack of recognition of the role of occupational therapy by health professionals and consumers were identified as key barriers to survivorship care. Conclusion Research is needed to provide evidence supporting the role and practice of occupational therapy with cancer survivors. Collaborative work with multidisciplinary teams is needed to develop long-term routine treatment pathways that include occupational therapy interventions. [ABSTRACT FROM AUTHOR]

Background/aim The Assistance to Participate Scale ( APS) measures the assistance parents provide to children with disability to participate in play and leisure. The primary aim of this study was to extend the psychometric development of the APS through application to a typically developing sample. Methods Parents ( N = 125) of typically developing Australian children aged three to eight years completed an online questionnaire comprising the APS, Pediatric Evaluation of Disability Inventory ( PEDI), Pediatric Quality of Life Scale (Peds QL) (caregiver scales) and demographic questions. Guided by the COnsensus-based Standards for the selection of health Measurement INstruments ( COSMIN), structural validity of the APS was investigated using principal components analysis; internal consistency reliability through calculation of Cronbach's α; construct validity through convergence with previously validated measures of paediatric occupational performance and quality of life ( PEDI, Peds QL) and investigation of five research hypotheses developed a priori. Results Structural validity of the APS was confirmed. Internal consistency (Cronbach's α = 0.76) was good for this unidimensional scale. Construct validity was substantiated by moderate correlations with the PEDI and Peds QL (physical), and data that supported all research hypotheses. Statistically significant differences were found in APS scores based on sex ( P = 0.018), age ( P < 0.001), school attendance ( P < 0.001) and elder sibling ( P = 0.006). Conclusions Results of this study indicate the APS is a valid and reliable measure of the parental role in a typically developing child's play. Validation upon a typically developing sample offers preliminary guidelines regarding the normative pattern of assistance provided to children during play. Further research in line with the COSMIN is required. [ABSTRACT FROM AUTHOR]

Background/aim Practice education is an integral component of the learning process for occupational therapy students. The dramatic increase in Australian occupational therapy programmes and students enrolled over the last decade is placing exponential demands on universities and practice education providers to meet accreditation and registration requirements. This study aimed to explore practice education from the perspectives of Australian occupational therapy university programmes. Methods A purpose-designed survey was emailed to the heads of all Australian occupational therapy programmes. The survey gathered qualitative and quantitative data on courses offered, number of students, practice education hours and models, practice education administration and funding, and challenges for stakeholders. All data were summarised and are presented descriptively. Results Responses were received from 21 (95.5%) Australian university occupational therapy programmes, with a total enrolment of 5569 undergraduate and 659 graduate-entry masters students. Practice education hours were predominantly in the later years of study and used an apprenticeship model for supervision. There was a trend for observation, simulation and service-learning experiences to be placed in the early years of programmes. Participants reported that the increasing student numbers presented difficulties within the changing clinical contexts. There was a call to re-examine the 1000-hour requirement for practice education. Conclusion Practice education is a critical issue for Australian occupational therapy. Increasing student numbers place mounting financial and resource demands on education programmes and practice education providers. There is a need for a national, collaborative approach to develop guidelines and processes to ensure sustainability relating to practice education. [ABSTRACT FROM AUTHOR]

Background/aim Clinical supervision is important for effective health service delivery, professional development and practice. Despite its importance there is a lack of evidence regarding the factors that improve its quality. This study aimed to investigate the factors that influence the quality of clinical supervision of occupational therapists employed in a large public sector health service covering mental health, paediatrics, adult physical and other practice areas. Methods A mixed method, sequential explanatory study design was used consisting of two phases. This article reports the quantitative phase (Phase One) which involved administration of the Manchester Clinical Supervision Scale ( MCSS-26) to 207 occupational therapists. Results Frequency of supervision sessions, choice of supervisor and the type of supervision were found to be the predictor variables with a positive and significant influence on the quality of clinical supervision. Factors such as age, length of supervision and the area of practice were found to be the predictor variables with a negative and significant influence on the quality of clinical supervision. Conclusion Factors that influence the perceived quality of clinical supervision among occupational therapists have been identified. High quality clinical supervision is an important component of clinical governance and has been shown to be beneficial to practitioners, patients and the organisation. Information on factors that make clinical supervision effective identified in this study can be added to existing supervision training and practices to improve the quality of clinical supervision. [ABSTRACT FROM AUTHOR]

Background/aim Fieldwork placements are central to occupational therapy programmes. A variety of placements assists occupational therapy students by increasing their exposure to a range of experiences. Placements in developing countries extend and offer alternative learning opportunities and can enable unique personal and professional competencies. However, it is unknown how placement experiences of occupational therapy students in developing countries have made an impact on their practice as graduates. This exploratory investigation aimed to identify the perceptions of occupational therapy graduates about the experiences and outcomes of fieldwork placements they had completed in developing countries. Methods Nine occupational therapy graduates who had completed a fieldwork placement in a developing country were recruited. Qualitative data were gathered using semi-structured interviews and were analysed to code and construct relationships and highlight key categories. Results Being immersed outside of personal comfort zones was a primary mechanism to produce lasting benefits after placement. The process of overcoming challenges was supported and fuelled by personal characteristics and environmental features of the placement. The experience resulted in gains of personal qualities, professional skills and insights, which translated to practice as graduates. Conclusions Unique outcomes were gleaned from placements in developing countries as students that contributed personally and professionally to current and future practice as graduates. A larger national or international study would provide further evidence to inform education providers and future students about the value of placements in developing countries for student learning and development, and graduate outcomes. [ABSTRACT FROM AUTHOR]

Background/aim Home modifications aim to enhance safety and occupational performance in the home. However, given the complexity and unique meaning of the home, they can impact aspects other than function. This qualitative descriptive study aimed to explore the impact of home modifications on clients and their family's experience of home. Methods Home modification clients and their family and carers participated in 42 in-depth interviews which were analysed using a template analysis. Findings Home modifications impacted positively and negatively on five dimensions of the home environment, the personal, occupational, physical, temporal and social dimension. The outcomes of the modifications and the home modification process were influenced by three themes, workmanship, consultation or involvement in decision-making, and the societal dimension of the home environment. Conclusions The negative outcomes and poor consultation experiences suggest the need for occupational therapists to understand their client's personal experience of home and to comprehensively follow-up and evaluate these following home modifications. [ABSTRACT FROM AUTHOR]

Background/aim The Activity Card Sort ( ACS) is an interview-based, client-centred tool that measures the activity engagement of older adults aged 65 years and above. The tool consists of photos which clients are asked to sort into categories to reflect their previous and current level of engagement. The activities that older adults engage in may differ to that of younger adults and there is a need to explore the development of an ACS Australia for adults aged 18-64 years. Methods The Delphi survey method as applied by previous ACS development was used in this study. Purposeful and snowball sampling were employed to recruit participants between the ages of 18 and 64 years who were Australian citizens or residents. Demographic information was obtained via a questionnaire. There were two stages in the study. The first Delphi survey generated, selected and finalised activities and the second Delphi survey generated, selected and finalised categories. Results Australian citizens and residents were involved in the development of the activities ( n = 61) and categories ( n = 65). The final tool includes 85 activities sorted into three broad categories representing personal care, daily life and home maintenance; rest and relaxation; and high and low impact activities. Conclusions This study has resulted in the development of a preliminary version of an ACS for adults aged 18-64 years. Further work is required to determine the psychometric properties of the tool. [ABSTRACT FROM AUTHOR]

Background/aim Growth in the number of occupational therapy programmes in Australia has resulted in a critical shortage of academics. When experienced clinicians are recruited into academia, they may find the transition process difficult. The study aimed to explore clinicians' perspectives of what happens when they transition into academia. Method A constructivist grounded theory approach was used in this qualitative research project. Recruitment was conducted using purposive and theoretical sampling from occupational therapy programmes in Australia. Interview transcripts were analysed using constant comparative method through a process of open, axial, selective and theoretical coding. Results Sixteen participants engaged in semi-structured in-depth interviews. The theory of transition into academia included a process of 'weighing up the commitment' to academia and the core category of 'a good fit for me'. The transition was characterised by the taxing nature of the work, the need to learn multiple aspects of a new role, the different values and beliefs in an academic environment and the amount of time it took to achieve success. Participants underwent a shift in identity to adjust to the academic environment and eventually reached a point where they were able to judge if academia suited them. Conclusion Australian universities have long-standing cultural practices which differ considerably from clinical settings. Transitioning from a clinical to an academic occupational therapy role requires complex adjustments to values, beliefs and identity. The process involved consideration by the new academics of their 'fit' for academia, and how committed they were to stay. [ABSTRACT FROM AUTHOR]

Background/aim Research into the paid employment of people with spinal cord injury or traumatic brain injury is prevalent; however, little research has examined the factors that may support employment for adults with a concomitant spinal cord injury and traumatic brain injury (dual diagnosis). This study aimed to determine the level of paid employment reported by people with dual diagnosis and to explore contextual factors that supported paid employment. Methods This cross-sectional cohort study recruited 30 participants with dual diagnosis from a specialist spinal rehabilitation unit. Interviews were conducted during the first five years post-rehabilitation discharge to determine level of paid employment and contextual factors that supported employment. Results At interview, 47% of participants were in paid employment. Employment type at interview indicated a shift away from more physically intensive jobs. Employed and unemployed participants reported a high level of social support and reported experiencing few physical or attitudinal barriers in their day to day lives. These environmental factors did not differentiate between employed and unemployed participants (z range = −0.98 to −0.17; P value range = 0.33-0.86). The most common facilitator of employment identified by participants was the personal factor - motivation (93% of employed participants). Conclusion When considering the impact of contextual factors on paid employment for people with a dual diagnosis of spinal cord injury/traumatic brain injury, personal factors may be of greater influence than environmental factors. Study participants experienced few physical or attitudinal barriers and reported highly supportive interpersonal relationships. [ABSTRACT FROM AUTHOR]

Aim The Canadian Occupational Performance Measure ( COPM) is an outcome measure of clients' self perceptions of performance and satisfaction with occupational performance and is widely used in paediatric research. The aim of this study was to explore how a new outcome measure, the Belief in Goal Self-Competence Scale (Bi GSS), was perceived by paediatric occupational therapists to compliment the COPM as a way of documenting client confidence in goal pursuit. Methods Two hundred and forty-one occupational therapists participated in an online survey through paediatric listserv groups and professional networks. Therapists' views about goal setting and the utility of the Bi GSS were analysed descriptively and open ended questions were analysed thematically. Results Overall, goal setting was viewed as a highly important aspect of therapy ( n = 221, 90.7%) although only 22% ( n = 52) of respondents indicated using formal goal setting tools. For the subset of respondents who frequently used the COPM ( n = 101, 42%) almost all (97.87%) indicated that they would find the Bi GSS to be moderately or highly useful to their current practice. Suggestions for improvement of the measure involved wording and formatting. Conclusion This study supports existing evidence that goal setting is highly valued by occupational therapists, however, formal tools are not always used. There was preliminary support for a measure such as the Bi GSS as a means of documenting children's and families confidence in goal pursuit. [ABSTRACT FROM AUTHOR]

Background/aim Changes to functioning and cognition are commonly reported following chemotherapy. These changes are highly individual, and may not be fully recognised or understood. Breast cancer is the most common cancer diagnosed in women worldwide, yet little is known about the impact of cognitive changes for these women following treatment and many do not benefit from occupational therapy services. The aim was to describe changes in cognitive function experienced by women who had undergone chemotherapy, and the strategies used to overcome the associated challenges. Method This was a qualitative phenomenological study conducted with nine women, aged between 39 and 67 years, from New South Wales. Participants were breast cancer survivors who had received chemotherapy treatment, and self-reported chemobrain symptoms. Data were collected through semi-structured in-depth telephone and face-to-face interviews. Data were transcribed, coded and thematically analysed. Results Six themes described the chemobrain experience for these women. They were: uncertainty about the origin of the chemobrain experience; persistent but inconsistent impacts on function; simple function turned complex; losing functional independence in family life; strategies to maintain function; and the need for recognition of the subjective experience of cancer treatment. Conclusion The experiences of cognitive and functional changes following chemotherapy for those reporting chemobrain symptoms are highly individual, and include the need for adaptive strategies. Some similarities in the types of impairments were experienced. As breast cancer survivorship rates continue to rise, there is a need for occupational therapy services to assist women in returning to daily occupations during or following their cancer treatment. [ABSTRACT FROM AUTHOR]

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

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

Evidence-based practice (EBP) and research utilisation (RU) are promoted as ways for clients to receive the best level of care. However, limited research has evaluated the use of these approaches by occupational therapists. This study investigated the knowledge, attitudes, practices of and barriers to EBP and RU of a group of paediatric occupational therapists from Australia. Questionnaires were received from 138 participants (response rate 46%) who completed the Research Knowledge, Attitudes and Practices of Research Survey, the Edmonton Research Orientation Survey and the Barriers to Research Utilisation Scale. The participants held positive attitudes towards research, and were willing to access new information to guide practice approaches. However, participants were less confident in their research knowledge and practices and implemented research findings into clinical practice. Multiple barriers to RU were perceived, particularly associated with the presentation and accessibility of research. Participants reported limited engagement in conducting research studies, although the majority of the participants reported implementing the findings of research into their clinical practice to some extent. Additional research education and support within organisations would be beneficial to ensure that children and families are receiving occupational therapy services that are based on sound, high-quality research evidence. The findings of this study provide insight into the perceived research knowledge, attitudes, practices of and barriers to Australian paediatric occupational therapists, enabling specific strategies to be implemented to increase the use of EBP and RU within the profession. [ABSTRACT FROM AUTHOR]

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

In 2008, the Council of Australian Governments announced its goals to improve Indigenous life expectancy, health, education and employment: 'Closing the Gap' (). Internationally, occupational therapists seek to promote social justice and human rights through occupation. Despite this effort, Australian occupational therapists have largely remained silent in response to the national agenda of closing the gap in Indigenous health. This article identifies the challenges of research and practice at the 'cultural interface', the juncture where Western knowledge meets the Indigenous knowledge of our clients. The article draws on the first author's research experience with Indigenous peoples. Through a process of reflection on the challenges highlighted by research at the cultural interface, this article identifies a range of professional processes used to negotiate differing and conflicting perspectives. By comparing the research context with occupational therapy practice, the author identifies some of the actions and supports that can be used by occupational therapists to provide culturally appropriate and negotiated interventions with Indigenous people. Although a number of individual occupational therapists work with Indigenous communities and individuals to improve the services offered, it is suggested that the occupational therapy profession needs to work together towards closing the gap. The development of special interest groups, professional networks and a National Position Statement on Indigenous Health would provide the background to developing guidelines for practice with Indigenous clients. [ABSTRACT FROM AUTHOR]