Search

Introduction: Allotment gardening is a popular pastime which anecdotally contributes to health and wellbeing, although the extent of supportive research evidence is unclear. This systematic review investigates the question: Does allotment gardening contribute to health and wellbeing? Method: A systematic search was conducted, including the terms 'allotment', 'garden', 'health' and 'wellbeing'. Abstracts of identified papers were compared with inclusion criteria, and 10 papers were finally selected. Critical appraisal and data extraction were conducted simultaneously. Qualitative research papers predominated and were analysed thematically. Resultant themes were compared and integrated with the findings of quantitative research papers. Findings: Thematic analysis of the qualitative and quantitative papers' findings revealed five distinct health and wellbeing themes. Allotment gardening provides a stress-relieving refuge, contributes to a healthier lifestyle, creates social opportunities, provides valued contact with nature, and enables self-development. Conclusion: This review suggests that allotment gardening does indeed impact health and wellbeing. It is therefore recommended as occupational therapy for people with health problems, and as a health promoting occupation for the general population. Research particularly focused on the impact of group and therapeutic allotment gardening, so further investigations are recommended to explore the health promoting influences of everyday allotment gardening for individuals. [ABSTRACT FROM AUTHOR]

Introduction: This paper draws on a study and its findings that set out to explore why some students appear to thrive, turning placement experiences into positive empowering opportunities despite the challenges, where others may not. Findings established a broader application beyond placements to inform curriculum design and delivery that nurtures professionalism, competence and identity from pre-admission to transition into practice as a journey of growth and development. Method: A mixed-methods approach was adopted. Questionnaires and interviews gathered data from two cohorts in traditional (n = 25) or role-emerging placements (n = 13). An interpretive approach was employed for the qualitative data. The quantitative data underwent statistical analysis. Findings: Students in role-emerging placements scored higher in resilience prior to and developed greater resilience as a consequence. These students scored higher in traits of openness, conscientiousness, extraversion and agreeableness and were more emotionally stable compared with students in traditional placements. Agreeableness was positively correlated with greater resilience in these students. Conclusion: Curricula design and delivery should embed opportunities throughout programmes of study enabling students to nurture an openness to new experiences, with positive risk taking, building an ability to thrive. Understanding individual differences in students informs the development of competence and identity pivotal for transition into practice. [ABSTRACT FROM AUTHOR]

This paper describes the review of the impact of the College of Occupational Therapists' publication, Occupational therapy defined as a complex intervention (Creek 2003). The background to the publication is outlined briefly. The method of data collection and the descriptive-explanatory method of data analysis are described. The three main findings are presented: occupational therapists have continued to access the definition throughout the 5 years since it was published; the definition has been read and used both in the United Kingdom and in other countries; and the definition is understood and used in a variety of different ways and for different purposes. The paper concludes that the definition of occupational therapy as a complex intervention captured a major shift in how occupational therapists understand the world, but that this way of thinking needs to be embedded more fully into all pre-registration and post-registration education programmes. [ABSTRACT FROM AUTHOR]

There is an expectation that all occupational therapists will be evidence-based practitioners. This paper reports on an education intervention that has helped therapists working in clinical practice to respond to the challenges posed by evidence-based practice. The intervention was developed for a group of clinicians who had already undertaken an evidence-based practice course. The aim was to enable them to apply evidence-based practice skills to their practice settings. The intervention, which used the problem of evidence-tinged practice as a focus, is described and the ten commandments generated by the clinicians involved are presented for others as a potentially useful tool. [ABSTRACT FROM AUTHOR]

Introduction: Telecare is increasingly part of the United Kingdom (UK)'s health and social care arrangements, and therefore occupational therapists' practice. Understanding factors which influence telecare's acceptance and usage is important to ensure optimal outcomes, both for service users and health and social care systems. Method: This paper uses data collected by a qualitative, multi-method, longitudinal research study (n = 60) to explore whether an American model of 'obtrusiveness' is applicable to the UK context by examining what factors influence older adults' acceptance and use of telecare. Findings: The obtrusiveness model is broadly applicable to the UK context, but there are also two further issues which affected the acceptance and use of telecare: the degree of control a service user feels they have and the information and support they receive in using their devices. Conclusion: The obtrusiveness model, plus the two additions (control and information), highlight important issues which could assist professionals working with telecare, including occupational therapists, in ensuring telecare is both accepted and well used. [ABSTRACT FROM AUTHOR]

Introduction: In response to growing demands on health and social care services there is an emphasis on communities addressing the needs of local populations to improve lives and reduce inequalities. Occupational therapists are responding to these demands by expanding their scope of practice into innovative settings, such as working with refugees, the homeless and residents of nursing homes, and within sport and leisure environments. The benefits of sport are widely acknowledged, and this paper argues that occupational therapists could play a pivotal role in enabling people to participate. Method: This qualitative study drew on a phenomenological approach and used interviews and thematic analysis to explore five occupational therapists' experiences of enabling people to participate in sport. Findings: Findings revealed that participants demonstrated the uniqueness of occupational therapy when enabling people to participate in sport and practised according to their professional philosophy. There were opportunities to reach wider communities and promote the value of occupational therapy by collaborating with organisations, but there were also challenges when working outside of traditional settings. Conclusion: The study emphasises the unique skills occupational therapists can bring to this setting. It highlights opportunities to expand their practice, to forge new partnerships in sports and leisure environments, and to address the national inactivity crisis. [ABSTRACT FROM AUTHOR]

The article offers information about the occupational therapy, along with mentions that improve visibility for occupational therapy evidence to support practice. It mentions that standardization of tools for critically appraising qualitative research papers, attempts to provide a method of gauging the level of evidence represented by qualitative research.

Introduction: Professional identity is a multifaceted conceptual term combining behaviours, knowledge, skills, values, beliefs, contextual and socio-cultural factors with personal and group identity. The historical underpinning of occupational therapy is partly attributed to the difficulties occupational therapists face articulating their unique identity and the profession being misunderstood by others. Little is known about how occupational therapists working in community physical health settings experience their professional identity. Method: Interpretative phenomenological analysis was used to understand how five occupational therapists interpreted and made sense of their experiences of professional identity working in community UK physical health settings. Interviews were carried out following social media recruitment and analysed using interpretative phenomenological analysis guidance. Findings: Participants identified that their professional identity was forged through experiences over time developing skills, confidence and their inner understanding of who they were as an occupational therapists. Maintaining a secure professional identity was attributed to building their community of practice and creating a sense of belonging. Conclusion: Professional identity was forged through time and experience of 'doing', 'being' and 'becoming' occupational therapists. Building a community of practice and creating a sense of 'belonging' were key components of how these occupational therapists working in community physical health roles sustained their professional identity. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapists require research and evaluation skills to deliver evidence-based care, making research education integral to their training. We aimed to develop a student and staff-informed strategy to further embed research into the occupational therapy programmes and enhance the research culture at a United Kingdom Higher Education Institution. Method: We used group concept mapping to gather ideas from students and staff on how to embed research and improve research culture within the occupational therapy programmes at a United Kingdom Higher Education Institution. Participants generated, sorted and rated ideas for importance and success. We analysed the data to create a concept map and identified rating values for the themed clusters and their ideas. Results: The concept map contained four themed clusters of ideas: Wider research community, Integration of research into the core programme, Advanced research support and capacity building and Research awareness. Successes and improvement targets were identified within each cluster. Conclusion: Group concept mapping provided a structured and comprehensive method to develop a strategy for embedding research and fostering a research culture in occupational therapy programmes at a higher education institution. The four-themed concept map and identified priority targets serve as a foundation for implementing the strategy and improving research integration in occupational therapy education. [ABSTRACT FROM AUTHOR]

Introduction: Parent/carers of disabled children want timely and personalized support. Research suggests that technology may address some limitations associated with traditional methods of communication with therapists (e.g. letter, telephone). This exploratory study examined United Kingdom (UK) parents and carers views on the use of digital technology (i.e. computers/phones) in supporting their child and the potential for its greater use in the care of children with complex needs. Methods: An online survey was distributed via special schools and support forums/networks. Questions explored use of and attitudes to digital technology in the care of children with complex needs. Descriptive statistical analyses and content analyses were undertaken on the data. Results: Respondents were 43 parents/carers whose children used rehabilitation services prior to the COVID-19 pandemic. The majority used digital technology frequently to support their child and saw the potential for greater use in rehabilitation services – provided this was not at the expense of in-person therapist contact. Conclusion: Parents and carers held positive views of digital technology as a tool to support their child and enhance rehabilitation services. Recommendations include regular service consultation on parental/child attitudes to digital service delivery and longitudinal studies to assess related health outcomes. [ABSTRACT FROM AUTHOR]

Health policy requires occupational therapy to demonstrate evidence-based clinical outcomes and efficiency in order to survive. This has significant implications for occupational therapy researchers and managers and suggests a re-evaluation of the profession's priorities for research. This opinion piece aims to stimulate debate regarding the impact of occupational science on occupational therapy and the need for research that evaluates the effectiveness of occupational therapy interventions. This is achieved by reflecting on a personal experience of evaluating research evidence for clinical guidelines and by exploring current and future challenges. [ABSTRACT FROM AUTHOR]

Following the introduction of preceptorship as a requirement for most newly qualified practitioners in the National Health Service in the United Kingdom, a preceptorship programme for occupational therapists was designed. This was the first of its kind within occupational therapy and was endorsed by the College of Occupational Therapists. Participation in preceptorship was intended to ease the transition of newly qualified occupational therapists.This paper offers a definition of preceptorship for the profession in the United Kingdom and reports on a small qualitative study that evaluated the extent to which the interventions of the preceptorship programme ameliorated the challenges of transition. The evaluation was conducted within a realist framework. Data were collected by semi-structured interviews from four pairs of newly qualified occupational therapists and preceptors during the pilot year. The findings suggest that the preceptorship programme was successful in supporting the development of new practitioners and that implementation was optimised through strong leadership, a learning culture and positive supervision.This paper contributes to the body of knowledge relating to the transitional experience of occupational therapists and recommends changes to the programme to optimise its effectiveness for practice. [ABSTRACT FROM AUTHOR]

It is accepted that practice placements are instrumental in providing an invaluable education on professional concepts, attitudes and behaviours. However, despite suggestions that practice placement education needs to be modernised to meet the demands of the current climate, there is only evidence of a limited number of role-emerging placements within the United Kingdom despite their relative popularity and history abroad. This paper describes and briefly evaluates a 'model' of practice placement education within role-emerging settings for a full cohort of pre-registration occupational therapy students, which meets national and international standards and guidance for such programmes. [ABSTRACT FROM AUTHOR]

Introduction: The top 10 priorities for occupational therapy research in the United Kingdom were identified via a priority setting partnership and published in 2020. This study aimed to evaluate utilisation of the top 10 priorities since 2020 and identify recommendations to re-focus research efforts. Method: A mixed methods approach involving evidence checking and stakeholder consultation was undertaken. Direct and selective methods were used to recruit stakeholders, including previous steering group members, who were invited to take part in 30-minute semi-structured interviews. Results: Eighty-one evidence sources were included and addressed the research priorities 127 times. Stakeholders (N = 7) discussed the top 10 priorities in relation to five key themes: (1) what has been done; (2) the most addressed priorities; (3) the least addressed priorities; (4) barriers to using the priorities (three barriers emerged); and (5) what should be done next (six strategies emerged). Conclusion: There was strong agreement that research priority 1 (how does occupational therapy have an impact and make a difference on everyday lives?) was the most addressed; however, all research priorities require more attention. Recommendations to refocus research efforts included continuing to support priority-driven research and greater promotion of the priorities. [ABSTRACT FROM AUTHOR]

Introduction: This study explored treatment of executive functioning impairment in adults after acquired brain injury (ABI), clinician's confidence and support received, in a sample of occupational therapists in the United Kingdom. Methods: A 24-item online questionnaire was sent to 750 members of the Royal College of Occupational Therapists Specialist-Section in Neurological Practice. Data was collected at a nominal and ordinal level and included yes/no Likert-type scale and free field comments. Descriptive statistical analysis was completed. Results: Seventy-six occupational therapists working in a range of neurological settings completed the survey. Frequently used interventions included education (n = 57, 75%), task modification (n = 56, 73%), instrumental activities of daily living (ADL) (n = 54, 71%), personal ADL (n = 53, 70%) and goal setting (n = 53, 70%). Seventy-one percent used metacognitive strategies. Occupation-based metacognitive approaches were rarely used. Thirty-one (41%) participants reported being fairly confident and 28 (37%) were very confident. Support for clinical practice was accessed most frequently through joint clinical sessions (n = 30, 39%). Findings: Participants used various clinical interventions to treat service users with executive dysfunction after ABI. Meta-cognitive strategies were employed; however, occupation-based metacognitive approaches were infrequently utilised, suggesting uncertainty in adopting these in practice. The need for further training on evidence-based interventions and knowledge translation support was highlighted. [ABSTRACT FROM AUTHOR]

Introduction People with co-occurring mental health and substance misuse problems are among the most excluded in society. A need to feel connected to others has been articulated in the occupational science literature although the concept of belonging itself has not been extensively explored within this paradigm. This paper reports findings from research that explored the meaning and experience of belonging for four people living with dual diagnosis in the United Kingdom. Method Researchers employed an interpretative phenomenological approach to the study. Four semistructured interviews were carried out. The interviews were guided by questions around the meaning of belonging, barriers to belonging and how belonging and not belonging impacted on participants’ lives. Data analysis facilitated the identification of themes across individual accounts and enabled comparisons. Findings Data analysis identified four themes – belonging in family, belonging in place, embodied understandings of belonging and barriers to belonging. Conclusion The findings add further insights into the mutable nature of belonging. A link between sense of belonging and attachment theory has been proposed, along with a way to understand the changeable and dependent nature of belonging through ‘dimensions of belonging’. [ABSTRACT FROM AUTHOR]

The article presents a research paper which focuses on the validity of the Evaluation of Daily Activity Questionnaire measurement in patients with musculoskeletal disorders. Studied musculoskeletal conditions include osteoarthritis, systemic lupus erythematosus and systemic sclerosis. Explored is the content validity and acceptability of such conditions.

The article presents a research paper on the use of adaptive equipment after a total knee replacement. Studied population include total knee replacement patients from a general hospital through the assessment from occupational therapy staff. Also evaluated are optimal functional outcomes after surgery.

This practice analysis considers the extent to which mental health occupational therapists utilize standardized assessments and other tools within local electronic clinical records. There is further analysis of a clinical dataset from a single service that highlights limitations in its use to inform cost effectiveness evaluation. The paper highlights the opportunity for the profession to promote greater consistency across clinical datasets at a time when many electronic record systems are being updated. This will require a collaborative approach to allow cross-organizational benchmarking and to adopt a set of variables and other outcome measures in order to successfully undertake economic evaluation. [ABSTRACT FROM AUTHOR]

This study is part of a larger research project investigating the assessment practices of paediatric occupational therapists in independent practice in the United Kingdom. The focus of this paper is the identification of the assessment methods used and the factors influencing respondents' satisfaction with them. The research design was a cross-sectional descriptive survey, using a postal questionnaire as the data collection tool. Out of 89 questionnaires sent, 66 (74%) were returned and 48 (54%) were deemed usable. The findings demonstrated that the respondents used a combination of assessment methods, with interviewing being used by all of them. The majority of the respondents were satisfied with the methods that they used. The most frequently mentioned factors influencing the respondents' satisfaction level were issues concerning standardised tests and the quality and quantity of the information gathered about the client. The implications for clinical practitioners include the benefits of using a combination of assessment methods and their selection after extensive clinical reasoning. Moreover, the use of interviewing is stressed and its multiple purposes are pointed out. [ABSTRACT FROM AUTHOR]

This paper reports on one section of a larger project, which examined employment issues from the perspectives of people with multiple sclerosis (MS) and the professionals who may support them in retaining or regaining employment. The aims of the study were, first, to explore the knowledge and experience of MS specialists, occupational therapists and disability employment advisers of employment and MS and, second, to identify the current practice of professionals supporting people with MS in work. A postal questionnaire was used to elicit a wide range of responses. The results showed that the impact of MS on employment was well understood, but that there was less awareness of the wider social influences on the ability to retain employment. There was evidence of a range of support being offered by some participants, but there appeared to be a gap between the problems reported and interventions offered overall. There is a need for further research to develop effective interventions targeted at supporting people with MS in work, which will underpin the implementation of Quality Requirement 6 of the National Service Framework for Long-Term Conditions. [ABSTRACT FROM AUTHOR]

The development of crisis resolution/home treatment (CRHT) teams was outlined as a requirement in the National Health Service Plan (Department of Health 2000) and reiterated in the recent guidelines to have an impact on the provision of mental health care (Care Services Improvement Partnership [CSIP] 2006). The Home Option Service in Central Manchester, one of the first CRHT teams in the United Kingdom, provides support and a range of interventions, 24 hours a day, 7 days a week, for those service users experiencing a crisis in their mental health, as an alternative to hospital admission. The need for team working is explicit in the guidance statement to ensure fidelity and best practice for crisis services and it urges teams to provide clarity regarding their roles and responsibilities within the team approach (CSIP 2006). This paper illustrates a model for occupational therapists working within a crisis team in order to ensure that service users have access to occupational therapy when admitted to crisis care. Specific standards, in accordance with those outlined in the research and development strategic vision for occupational therapists in mental health (Association of Occupational Therapists in Mental Health 2006), have been identified to instigate a clear pathway for the stakeholders of crisis teams. A description of the development, implementation and evaluation of an integrated care pathway is provided, alongside a subsequent audit to measure the effectiveness of this model. [ABSTRACT FROM AUTHOR]

This study undertook a replication of the work conducted by Sumsion in 2004 in the United Kingdom regarding the application of a definition of client-centred practice. Twelve occupational therapists employed by a local mental health facility and working with adult outpatients participated in semi-structured interviews. Template analysis and open coding were used to analyse the data. The resulting concept map indicated that collaboration and meaningful goals were at the centre of client-centred practice and formed the two main categories of data. The therapist and the client were the protagonists in these categories, but the family, team and system also played major roles. A table within this paper outlines all the categories and themes that arose from the data. However, space limitations required a focus on only the category of collaboration and the therapist and client facilitators and challenges within this category. The therapists used both attitudes and actions to facilitate the client-centred process and the clients brought strengths to this relationship. Nevertheless, both groups faced many challenges that had to be overcome to enable the successful implementation of client-centred practice. [ABSTRACT FROM AUTHOR]

Attention deficit hyperactivity disorder (ADHD) is commonly comorbid with movement difficulties, including developmental coordination disorder (DCD). Compartmentalised service provision may result in children with ADHD not being screened, and assessed if necessary, for DCD and vice versa. In this study, 69 children attending an ADHD clinic were screened for movement problems, using the parent-completed Movement Assessment Battery for Children Checklist (Henderson and Sugden 1992). The results showed that 19% of the children with ADHD were defined as having a 'movement problem', with a further 16% defined as 'at risk'. This paper discusses the results of the study and the implications for paediatric occupational therapy. [ABSTRACT FROM AUTHOR]

Nonlinear dynamics systems theory, also referred to as chaos theory, is infiltrating the biomedical and social sciences, including the practice of occupational therapy. Consequently, the Neuro-occupation model has emerged for the treatment of different illnesses, in which a therapist strives to apply the benefits of this theory. This model provides occupational therapists with a method of anticipating the natural flux between underlying or hidden order and chaos in occupations, which allows individuals to function at their highest level. These occupations typically involve the interaction of numerous variables over time. By considering a nonlinear dynamics approach in illnesses such as alcoholism, occupational therapists may understand how meaningful occupations serve as a catalyst to facilitate change, which may assist in better understanding the effect of the therapeutic relationship with the clients they serve. This paper explains the nonlinear dynamics of the interventions in a single case study on alcoholism using the Neuro-occupation model. [ABSTRACT FROM AUTHOR]

This action research study used three focus groups and one interview to explore the experiences of five recently qualified occupational therapists, four supervisors and five occupational therapy managers. The participants were asked to identify the perceived development needs of new practitioners and the mechanisms that supported or hindered these being met. The findings showed that the recently qualified occupational therapists experienced satisfaction at making a difference in their first posts. However, for some, their first post had fallen short of their expectations because they faced challenges when moving from student to practitioner, sometimes with limited support. The participants identified development needs that they felt were common to other new practitioners and also the factors that constrained or enabled the meeting of these needs. These findings informed the second phase of the action research study to design a preceptorship programme that was compliant with the revised National Health Service employment contract (Department of Health 2005) and would improve the transitional experience of occupational therapists. This paper presents the focus group results and the rationale for the preceptorship programme, which was launched as a pilot evaluation study with occupational therapy staff from over 20 organisations in Autumn 2005. [ABSTRACT FROM AUTHOR]

Parents who are wheelchair users face the practical problem of manoeuvring a wheelchair at the same time as pushing a pushchair. The Bath Institute of Medical Engineering (BIME) has designed a pushchair to attach to a manual wheelchair. This paper describes the rationale behind the project and how disabled parents have been integral to the design process. The process and findings of the evaluation programme are reported. Evaluation is important to designers to understand the outcomes of their work. 'It's as simple as needing to know whether assistive technology works' (Smith 1998, p20). This process also provides insights to occupational therapists to guide them in their professional judgements about whether an equipment solution can meet user requirements. [ABSTRACT FROM AUTHOR]

Introduction: The British Journal of Occupational Therapy (BJOT) recently introduced a requirement for authors to report Patient and Public Involvement (PPI). The public and people using health and social care services have knowledge which holds value in research beyond use as data. Involvement in research process can help shape the generation of critical evidence informing policies and practices; however, little is known about prior PPI reporting. Method: A scoping review was conducted identifying public involvement in research published in BJOT between 2015 and 2021. An electronic search was conducted using key terms. Data were extracted in duplicate or triplicate using GRIPP2 short form checklist. Results: Twenty-five studies were identified which reported public involvement, this was 6% of research published in BJOT. Patients and public were mainly involved in study steering or advisory groups and their primary activity was developing or piloting study materials. There were low levels of reporting the aim, outcome and critical reflections on involvement activities. Main approaches to involvement were consultation (37%) and collaboration (30%). There was inconsistent use of language and terms. Recommendations: Consistent PPI reporting using Guidance for Reporting Involvement of Patients and the Public (GRIPP 2), critical reflection of impact of PPI, acknowledgement of public contributors, future scoping review investigating impact of BJOT PPI authorship guidelines. [ABSTRACT FROM AUTHOR]

Introduction: Community development approaches are increasingly used by occupational therapists in response to occupational justice theory, which posits that both individuals and community groups may be denied access to meaningful occupations through societal powers outside their control. Previous research has found that occupational therapists feel insufficiently prepared for a role in community development and tend to use their general skill set, sometimes in combination with generic community development approaches. This study explored whether the reflective framework for community development in occupational therapy is applicable and useful for occupational therapists in the United Kingdom. Methods: A mixed methods approach was used, combining an online questionnaire and focus groups with occupational therapists who already work in community development. Findings were compared with the framework. Findings: The participants recognised most aspects of the Framework in their own practice, but some key aspects such as collaboration with the community at every stage were less prominent. They found the framework applicable to the UK context, particularly for occupational therapists inexperienced in community development practice. Conclusion: This study has highlighted community development practice by occupational therapists in the United Kingdom and concluded that the framework would support them in fulfilling this role more effectively. [ABSTRACT FROM AUTHOR]

Introduction: While most children have developed effective handwriting by secondary school age, some have handwriting difficulties that hamper academic progress. Occupational therapists play a role in assessment and planning support, which may include introducing typing as an alternative. However, there is limited understanding regarding how decisions are made about recommending typing. This study explored the support provided to adolescents with handwriting difficulties by occupational therapists, and the contextual factors that influence their decision-making. Method: Semi-structured interviews were conducted with 13 occupational therapists and analysed using thematic analysis. Findings: Although there was shared practice underpinned by occupational therapy philosophy, there was also divergent practice due to different approaches. Roles and responsibilities, resources, and evidence and experience influenced occupational therapists' practice. Understanding the adolescent's motivation, the effect of handwriting difficulties on well-being and the need for a functional method to record schoolwork, was central to occupational therapists' decision-making to recommend typing. Conclusion: Strategies are needed to address the knowledge-practice gap, including evidence-based guidelines. Closer collaboration between occupational therapists and school staff could increase understanding of roles and highlight the unique occupational therapy contribution. Further research examining whether, when and how to introduce typing as an alternative to handwriting would support best practice. [ABSTRACT FROM AUTHOR]

Background: A health inequalities gap exists between wealthy and deprived areas. Community-level occupation-focused interventions may support citizens and address inequities within their environments. Since the global financial crash of 2008 and fiscal policy changes within the United Kingdom, there has been a rise in food insecurity. Community volunteer initiatives have responded by providing for their residents. The aim of this study was to explore how occupational therapists may be agents for social change through exploring perspectives of members and volunteers from a community food cooperative in an area of social deprivation. Methods: Eight semi-structured interviews were conducted with cooperative members and volunteers within a food cooperative established to address food insecurity in a local community. Data were analysed using thematic analysis. Results: We found three main themes: It's Not a Foodbank, Shared Hardship and a cross-cutting theme of Community. The results suggest occupation-focused responses can support the development of community and collective occupations thereby contributing solutions to shared problems. Conclusion: A community-centred, rights-based approach has supported local community need where socio-economic disadvantage and health inequalities were identified. Scope exists for occupational therapists to work genuinely with (not for) communities to address occupational injustice through collective occupation. [ABSTRACT FROM AUTHOR]

Introduction: Post-stroke fatigue (PSF) is common and debilitating. However, while its effective management is a priority for clinicians and stroke survivors, there remains little evidence to provide guidance or underpin practice. Our aim, therefore, was to gain insights into the experiences of clinicians who routinely manage patients with fatigue. Method: Qualitative interview study. The target was to recruit a purposeful sample of approximately 20 participants with expertise in managing PSF and fatigue arising from other conditions. Maximum variation sampling was used to ensure a balance of participants across different settings. Data were analysed using a framework approach, iteratively developed and refined by including emergent themes. Results: We recruited 20 participants: nine occupational therapists (OTs), five physiotherapists, three nurses and three psychologists, which included three 'fatigue experts' from Europe and Australia. Analysis generated core themes around management and strategies used; these were similar regardless of professional background, clinical or geographical setting or condition treated. OTs felt a particular responsibility for fatigue management, although multidisciplinary teamwork was stressed by all. Conclusion: There are clear similarities in clinicians' experiences of managing PSF and fatigue across different conditions and also across professional groups. Clinicians rely predominantly on their own clinical knowledge for guidance. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapists have an integral role in the treatment of people with functional neurological disorder, yet there is evidence of variable implementation of occupational therapy in community settings. This study explored the barriers and enablers to delivering community-based occupational therapy to people with functional neurological disorder in the United Kingdom. Methods: Community-based neurological occupational therapists (n = 10) with experience in functional neurological disorder were invited to complete semi-structured qualitative interviews. The interview schedule and analysis were based on the Theoretical Domains Framework, a behavioural science tool for investigating barriers and enablers to clinical practice. Data were analysed using a combined content and framework analysis approach. Findings: Important barriers to treatment included limited published information to guide practice, lack of professional role clarity and restricted multidisciplinary team working. Enablers included occupational therapists' dual training in physical and mental health and focus on activity engagement. Service provision, quality and access varied across geographical locations. Conclusion: Occupational therapists are uniquely placed to help people with functional neurological disorder; however, findings suggest that existing community service structures in many regions in the United Kingdom are inadequate and limit the quality of treatment that can be provided. Additional resources are required to support occupational therapy service provision in community settings. [ABSTRACT FROM AUTHOR]

Introduction: A major amendment to the Mental Health Act 2007 was to broaden the professional groups eligible to undertake specific roles under the Act. One such role was the approved mental health professional (AMHP), whose responsibility is to conduct assessments of people deemed mentally disordered to determine whether they meet the criteria for detention, known as 'sectioning'. Traditionally, this role was undertaken by social workers. Although occupational therapists are now eligible to undertake the role, uptake has been low. Method: A critical literature review was conducted to explore the AMHP role and occupational therapy in order to develop an understanding of the fit between the two. A wide-ranging search identified 282 articles, 30 of which were relevant to the review question. Findings: Coding identified four overarching interrelated themes: values, social (work) perspective, independence of the AMHP role and impact on therapeutic relationship. Coherence exists between social work values and occupational therapy values so it is more likely that structural issues, rather than incongruent values, are impeding occupational therapists' uptake of the AMHP role. Conclusion: A register of occupational therapists employed as AMHPs, and further research exploring reasons for low uptake, is recommended. [ABSTRACT FROM AUTHOR]

Introduction: As the scope and nature of practice evolves in an ever-changing health and social care landscape, it is imperative the profession continues to expand the evidence base underpinning interventions. The Royal College of Occupational Therapists partnered with the James Lind Alliance to bring together people with lived experience, occupational therapists and other people working in the health and care sector to identify contemporary research priorities for the profession in the United Kingdom. Method: The JLA's well-established methodology was adopted. An opening consultation survey gathered unanswered questions. Analysis of responses and evidence checking preceded an initial prioritisation survey. The final prioritisation workshop drew on nominal group technique. Findings: 927 respondents submitted 2193 questions. Those within the project's scope were captured in 66 overarching summary questions using thematic analysis. These were initially ranked by 1140 respondents. 18 questions comprising the 10 most highly ranked by people with lived experience and by those with professional experience were considered by 19 participants in the final workshop. Together, they reached consensus on the Top 10 priorities. Conclusion: These research priorities provide a contemporary framework influencing and guiding future research, ensuring it addresses the issues of greatest importance to people accessing and delivering services. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapy has long had a strong presence in military mental healthcare. Today's veterans have complex needs and can face challenges reintegrating into civilian life. This exploratory study investigated whether veterans receiving mental health treatment who participated in a bespoke occupational therapy and resilience workshop intervention improved their perceived participation in everyday life. Method: An interpretivist hermeneutic phenomenological approach was used to explore veterans' perspectives. Ten participants took part in two semistructured focus groups. Thematic analysis was used to identify and analyse patterns within the data. Findings: Most participants developed occupational goals and started to make lifestyle changes; participants developed an appreciation of the value of occupation; participants developed insight into their recovery journeys; and value was placed on the 'healing power' of the group. Conclusion: This exploratory study provides preliminary evidence to suggest occupational therapy was influential in helping participants understand the impact of occupation on health and start making lifestyle changes. Participants also reflected on their recovery journeys. The benefits of doing this within a group environment appear to have been particularly therapeutic. Original occupational therapy research in this specialism is sparse. This novel study provides insight that can further discussion and enhance understanding about what the profession can offer this client group. [ABSTRACT FROM AUTHOR]

Introduction: While the Model of Human Occupation Screening Tool has undergone psychometric development and testing and is widely used in mental health practice, only a few small-scale studies to date have examined its use in clinical practice. Method: A national survey was conducted with United Kingdom occupational therapists working in mental health settings to evaluate the use of the Model of Human Occupation Screening Tool. The survey included the modified version of the Usefulness, Satisfaction, and Ease of Use (USE) questionnaire and two open-ended questions. The latter were coded through inductive content analysis and all responses were analysed using Statistical Package for the Social Sciences software. Results: n =105 questionnaires were analysed. The Model of Human Occupation Screening Tool was found to be a useful tool, with most therapists scoring it favourably on the usefulness (74.7%), ease of use (76.1%), ease of learning (81.2%) and satisfaction (80.6%) subscales. It was praised as a valuable outcome measure, guiding interventions and providing a comprehensive overview of assessed individuals. Time consumption, inaccessible terminology and lack of sensitivity to change were indicated as possible downfalls. Conclusion: Therapists valued the Model of Human Occupation Screening Tool as an assessment tool, but more importance should be placed on training to overcome some of the limitations identified here. Also, its suitability to the setting in which it is used should be considered before implementation in practice. [ABSTRACT FROM AUTHOR]

Approximately 21,000 personnel are discharged from the U.K military each year (Centre for Social Justice 2014). A number of these veterans experience difficulty during the transition from military to civilian life (Bergman etal 2014). Objective: To determine the occupational performance challenges faced by U.K. military veterans, in order to develop occupational therapists' understanding of the difficulties that may occur when transitioning. Method: A quantitative design was utilised in the form of an online survey, based on the Occupational Self Assessment (Version 2.2) to assess the occupational performance challenges of thirty-one veterans (Baron et al 2006). Results: The five most frequent occupational performance challenges were managing finances, having a satisfying routine, relaxing and enjoying oneself, expressing oneself to others and having opportunities to participate in valued and liked activity. A high proportion of participants who rated the occupations as a challenge felt they were not important, specifically those relating to personal achievement and socialising with others. Conclusion: A veteran's transition from military to civilian life can have a significant negative impact on the individuals' occupational performance of daily life activities. This paper presents a U.K. perspective of the occupational challenges experienced by veterans. Ethical approval: This research project was approved by Teesside University School of Health and Social Care, Research Governance and Ethics Committee 15/10/2015. [ABSTRACT FROM AUTHOR]

Introduction: This qualitative research explores the experience of partner caregivers and how their partner's dementia impacts on their daily living and occupational lives, with the aim of informing the sustainability of homecare and decreasing the likelihood of formal care. Method: Ten participants were recruited through Alzheimer's Society groups. They were interviewed using the same semi-structured interview process and asked questions about their daily activities and caregiving role. The data was analysed using Braun and Clarke's thematic analysis process and themes generated using inductive coding and reasoning. Findings: Three main themes were identified: (1) losing occupational activities and roles; (2) adapting to a new occupational life and (3) adjusting to a new relationship in the trajectory of their partner's illness. Conclusion: This study highlights the complex occupational challenges experienced by partner caregivers of people with dementia. It suggests that there is a role for occupational therapists in sustaining homecare by working with partner caregivers as 'expert service users'. Involvement should be provided at critical points of the caregiving journey and include co-creating technology solutions for social inclusion, sustaining adaptive engagement in personal occupations, creating opportunities for restoration and supporting caregivers to preserve their partner's personhood. [ABSTRACT FROM AUTHOR]

Introduction: Stroke is a major cause of mortality and disability in childhood. There is a false belief that children will recover better than adults and recent research confirms that younger age at injury can have a negative impact on rehabilitation outcomes, resulting in lifelong disability. Self-care is a key rehabilitation outcome for children and young people. Methods: This service evaluation reviews routinely collected clinical self-care data from one specialised residential rehabilitation centre in the United Kingdom. Admission and discharge scores from the United Kingdom Functional Independence Measure +Functional Assessment Measure, Rehabilitation Complexity Scale – E and Northwick Park Nursing Dependency Scale were analysed. Results: Twenty-six children and young people age 8 years and over with severe stroke were included. Mean scores of independence increased and mean scores of complexity and dependency decreased. A proportion of the sample had ongoing self-care needs in relation to support needed in washing, dressing and bathing. A small number remained highly dependent, requiring assistance from two carers. Conclusion: Children and young people make significant gains in self-care independence during specialised rehabilitation. However, a proportion return to the community with high self-care needs. Occupational therapists and the wider care team should address ongoing self-care needs in this population. [ABSTRACT FROM AUTHOR]

Introduction: Evidence-based occupational therapy home programmes for children with unilateral cerebral palsy have demonstrated efficacy; however, uptake into routine practice is varied. The aim of this study was to gain a deeper understanding of the therapist-perceived supports and barriers to using occupational therapy home programmes for children with unilateral cerebral palsy, based on evidence of best practice in the United Kingdom. Method: Fourteen occupational therapists completed semi-structured telephone interviews. Using a qualitative framework analysis approach, support and barrier factors were indexed against the Theoretical Domains Framework, before being categorised more broadly using the Capability, Opportunity, Motivation and Behaviour Model. Findings: Common supports included: (a) strong leadership within the team to facilitate the translation of occupational therapy home programmes and evidence-based interventions into service-specific protocols; (b) knowledge exchange within professional networks and (c) mentorship. Common barriers included: (a) lack of resources; (b) restricted opportunities to review occupational therapy home programmes and (c) difficulties keeping up-to-date with the evidence in this area. Conclusion: To be effective, occupational therapy home programmes need to be based on evidence of best practice; analysis indicated an urgent need to capture outcomes, record parental practice, further integrate 'occupation' within goal-setting, and develop use of conceptual models of practice to both enhance family-centred care and articulate the profession's unique contribution. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to identify the barriers and facilitators to the implementation of a high fidelity individual placement and support service in a community forensic mental health setting. Method: In-depth interviews were conducted with clinical staff (n = 11), patients (n = 3), and employers (n = 5) to examine barriers and facilitators to implementation of a high fidelity individual placement and support service. Data was analysed using thematic analysis, and themes were mapped onto individual placement and support fidelity criteria. Results: Barriers cited included competing interests between employment support and psychological therapies, perceptions of patients' readiness for work, and concerns about the impact of returning to work on welfare benefits. Facilitators of implementation included clear communication of the benefits of individual placement and support, inter-disciplinary collaboration, and positive attitudes towards the support offered by the individual placement and support programme among stakeholders. Offences, rather than mental health history, were seen as a key issue from employers' perspectives. Employers regarded disclosure of offending or mental health history as important to developing trust and to gauging their own capacity to offer support. Conclusions: Implementation of individual placement and support in a community mental health forensic setting is complex and requires robust planning. Future studies should address the barriers identified, and adaptations to the individual placement and support model are needed to address difficulties encountered in forensic settings. [ABSTRACT FROM AUTHOR]

Introduction: The facilitation of meaningful leisure participation for children and young people requires an understanding of what leisure means to them. This study aimed to understand meaningful leisure from the perspective of children and young people with complex physical and communication disabilities. Method: A hermeneutic phenomenological research design was used. Data was gathered through multiple interviews with six young people supported by photo elicitation, Talking Mats and direct observation. Individual case studies were analysed, together with six autobiographies of people with similar disabilities. Data analysis was iterative and multi-directional, alternating between segments and the whole throughout interpretation. Results: Leisure experience meanings were uniquely constructed for each person, based on preferences, personality and circumstances. The tree of leisure emerged as a useful metaphor for three essential features (control, engrossing, enjoyment) and four key meanings (escape, exploration, exchange and expression) of leisure. Children and young people experienced five meaningful outcomes that lasted beyond the leisure activity (restoration, protection, construction, reflection and connection). Conclusion: For children and young people with disabilities, a balanced array of diverse leisure experiences provides a powerful and accessible route to wellbeing. Implications for practice include understanding the individual, focusing on the social environment, supporting self-advocacy and promoting opportunities for free movement. [ABSTRACT FROM AUTHOR]

The article offers developments in the publication's, "British Journal of Occupational Therapy," activities in Great Britain. In 2008, it used electronic submission for submitting papers to the journal, resulting in the rise of its international articles forwarded by its contributors. To increase its quality, impact and relevance, it also revised its guidelines for authors and updated the appearance of the periodical to keep it updated with modern publishing practice. Aside from these moves, it also launches its International Advisory Board aimed at increasing its international standing by promoting the journal through wider practice and research networks.

Introduction: Placements are considered vital in promoting theory-to-practice learning. With role-emerging placements increasingly being offered, the learning processes experienced by students warrants further investigation. This research explored the learning experiences of students, from both supervisor and student perspectives, over the duration of a role-emerging placement in schools, to contribute to our understanding of this important student learning process. Method: Action research was used across four cycles with 14 students and 11 supervisors. Data were collected through reflective field notes, placement documentation and semi-structured interviews. Findings were analysed using template analysis. Findings: Limited established occupational therapy procedures and role models meant that the students created and used knowledge differently from role-established placements. The procedural knowledge upon which students most heavily relied in previous placements was largely inaccessible to students. Students relied on occupational therapy conceptual and dispositional knowledge, with the support of their peer and supervisor to guide practice. Tensions were seen between providing a service for the school and taking the necessary time to understand and implement the occupational therapy process systematically. Conclusion: Role-emerging placements are valuable for transformational student learning. These placements do, however, present challenges that require careful negotiation and structured guidance. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapy home programmes for children with cerebral palsy have a robust evidence-base, but their content and usage in United Kingdom practice is unknown. Method: A national online survey questionnaire was conducted with occupational therapists to explore their current occupational therapy home programme practices, and attitudes toward using home programmes with children with cerebral palsy. Recruitment was through members of two sections of the Royal College of Occupational Therapists, a University's Fieldwork-Supervisor's Database and self-selection following promotion on occupational therapy networks, social media and newsletters. Results: Of all survey respondents (n = 123), the majority of respondents (n = 74; 60%) used occupational therapy home programmes. The uptake and use of evidence-based home programme content varied, revealing evidence-practice gaps. Respondents clearly articulated their professional reasoning and acknowledged benefits of using home programmes. However, they reported barriers to implementing them within a family-centred framework, citing time constraints, lack of knowledge, skills and training, and insufficient support. Conclusion: Occupational therapists report challenges to implementing evidence-based interventions and the routine, systematic application of a range of standardised measurement tools pre/post occupational therapy home programmes. Such tools would enhance quality outcomes for children with cerebral palsy and their families. However, occupational therapists indicated the need for greater organisational support, further education and skill development in these areas. [ABSTRACT FROM AUTHOR]

Introduction Health policy promotes living well with dementia. Occupational therapists deliver interventions to support people with dementia and family carers to live well. This study aimed at identifying influences on uptake of a community occupational therapy intervention by people with dementia and carers, as little evidence about this topic exists. Method Seventeen semi-structured, paired interviews with people with dementia and carers were conducted as part of the 'Valuing Active Life in Dementia' research programme. A secondary, qualitative analysis of these interviews explored influences on uptake of the intervention. Findings Four main themes were identified: 'Grabbing at straws and keen to take part'; 'We're trying to put a routine in'; 'We didn't know what to expect', and 'Give it a go'. Factors identified as potentially influencing uptake included whether the intervention was perceived as potentially meeting needs for support and activity, and whether participants were struggling to adjust or cope. Conclusion Despite limited expectations or apprehension, uptake of this intervention was demonstrated. Understanding why people with dementia and carers accept intervention offers can inform what occupational therapists provide and how it is offered. Further research is required to determine the occupational therapy interventions people with dementia and carers might find supportive at different stages of the disease trajectory. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including HIV on personal activities of daily living outcomes in an African stroke cohort, an audit of dressing practice in acute stroke care in England, and protocol for a post-stroke fatigue intervention.

Introduction Occupational therapy pre-registration programmes are increasing their academic entry criteria globally to positively impact on professional practice. However, there is a lack of evidence of how a range of variables influence student outcomes. Method An observational, retrospective cohort design measured previous degree, age, ethnicity and gender, on final academic and practice placement outcomes of previous MSc Occupational Therapy (pre-registration) students (n = 153). Pearson’s product-moment correlation and one-way ANOVA tests were performed on the data to assess any significant relationships between variables. Results There was a significant positive correlation between final academic percentage and practice placement outcome, r = .245, n = 121, p = .007. Previous degree significantly correlated with final academic outcome, r = .333, n = 153, p = .000, but not with higher practice placement performance. Gender, ethnicity and age did not correlate with student outcomes. Students with previous degrees in the arts performed slightly better than those with social sciences. Conclusion Prior academic ability significantly predicts academic but not necessarily practice placement outcomes on an MSc Occupational Therapy programme. Although more academically able students appear to develop skills for practice to a higher standard, other student values-based attributes should be measured prior to admission. Research exploring the best combination of academic and interpersonal skills for recruitment is required. [ABSTRACT FROM AUTHOR]