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The Assessment of Motor and Process Skills (AMPS) is a standardized occupation-based measure; however, barriers often limit use in practice. The Knowledge to Action Framework (KTA) is one of the most widely used implementation approaches to induce practice change. The objective of the study is to examine the feasibility and acceptability of a KTA-informed intervention to increase the use of the AMPS. AMPS-trained occupational therapists were recruited through convenience sampling. Interventions included workshops, action planning, goal setting, peer support, and organizational resources. Recruitment and retention were tracked. Pre- and post-survey results of interventions’ helpfulness, AMPS behaviors, and motivational changes informed acceptability. Participants ( n = 5) rated 7/7 (100%) intervention strategies as helpful, reported decreased barriers and increased frequency of AMPS administration, increased resources for AMPS implementation, and improved compatibility with practice. Implementation of a KTA-informed intervention to increase AMPS practice was feasible and supported by environmental changes and peer support in a physical rehabilitation setting.

The role of Everyday Technology (ET) use is presented as subsidiary or neutral in policy for age- and dementia-friendly communities; and yet, research suggests that older people, especially those with dementia, experience increased challenges using ET in their everyday lives. Through the lens of micro-citizenship, the study aims to deepen the knowledge about how use of ET outside the home, including portable ETs, relates to participation in places visited within public space among people with dementia over time. Using a longitudinal study design, 35 people with dementia were recruited at baseline and followed over three years. Data were collected through semi-structured interviews using standardised questionnaires: the Participation in ACTivities and Places OUTside Home Questionnaire (ACT-OUT) and the Everyday Technology Use Questionnaire (ETUQ). Random intercept modelling and descriptive statistics were used to analyse the data. Throughout the three-year study, decreasing use of ET outside the home, including portable ETs, was associated with decreasing participation in places visited within public space, in a statistically significant way when controlling for age (F = 7.59, p = 0.01). The findings indicate that facilitating access and use of ET outside the home, among people with dementia, should be integral to promoting and maintaining participation in age- and dementia-friendly communities.

Background. Persons living with dementia face a reduction of their life space outside home and disengagement from participation, linked to places visited. Purpose. This study explored stability and change in perceived participation in places visited outside home and its relationship with occupational gaps among older adults. Method. Older adults living with ( n = 35) or without ( n = 35) dementia were interviewed using the Participation in ACTivities and Places OUTside Home (ACT-OUT) questionnaire and the Occupational Gaps Questionnaire (OGQ). Data analysis used descriptive and inferential statistics. Findings. The group of people living with dementia reported significantly fewer places ( p < .001) visited than the comparison group and having abandoned more places visited ( p < .001) than the comparison group. The number of occupational gaps was significantly different between groups ( p < .001). Implications. Participation outside home is not influenced in a uniform and straightforward way for persons living with dementia; the shrinking world effect appears differently in relation to types of places.

Introduction Older persons with cognitive impairment have often been disregarded in providing information on their own perceptions. This study explored the number of relevant everyday technologies and the ability to use everyday technologies as perceived by persons with cognitive impairment in comparison with their proxies’ estimates using the Short Everyday Technology Use Questionnaire. Method In this cross-sectional study, persons with cognitive impairment ( n = 21) and their proxies ( n = 21) were interviewed on separate occasions with the Short Everyday Technology Use Questionnaire, which measures the number of relevant everyday technologies and the ability to use everyday technologies. The data were analysed with t-tests, z-comparisons, and Fisher’s exact test. The level of significance was set at p Results At the group level, no significant differences were found between persons with cognitive impairments’ perceptions and their proxies’ estimates regarding the number of relevant everyday technologies or the ability to use everyday technologies. On the individual level, significant differences were found in the ability measures within four out of the 21 dyads. Conclusion The persons with cognitive impairment and their proxies verified each other’s responses, providing evidence that persons with cognitive impairment should be the primary source for information about their own everyday technology use.

RATIONAL Life satisfaction is strongly associated with participation in everyday life activities. Yet, older adults with cognitive impairments have been found to experience difficulties in accessing and engaging in more complex everyday activities, especially, if these involve everyday technology. Considering the rapidly advancing technological landscape, this may substantially affect individuals' life satisfaction and their participation in meaningful community-based and home-based activities. OBJECTIVES This study aimed to explore the associations between life satisfaction, ability to use everyday technology and number of relevant everyday technologies used in older adults (n = 117) with and without mild cognitive impairment (MCI) and Alzheimer's disease (AD). It also aimed to understand the role of depression, activity involvement and diagnosis regarding life satisfaction in this sample. METHOD Descriptive statistics, Mann-Whitney U tests and t-tests were applied to compare those satisfied and those dissatisfied with life regarding ability to use everyday technology and number of relevant everyday technologies used. FINDINGS The number of relevant community-based everyday technologies currently not used was significantly associated with being dissatisfied with life (p

Background: Older adults manage increasing numbers of everyday technologies to participate in home and community activities. Purpose: We investigated how assessing use of everyday technologies enhanced predictions of overall needed assistance among urban older adults. Method: We used a cross-sectional design to analyze responses from 114 participants completing the Everyday Technology Use Questionnaire, the Montreal Cognitive Assessment, and a sociodemographic questionnaire. We estimated overall needed assistance based on definitions in the Assessment of Motor and Process Skills. We created logistic regression models and receiver operator characteristic curves to analyze variables predicting overall needed assistance. Findings: With high specificity and sensitivity, the Everyday Technology Use Questionnaire and the Montreal Cognitive Assessment were the strongest predictors of overall needed assistance. Implications: Assessing everyday technology use enhanced predictions of overall needed assistance among urban older adults.

Rina Juel Kaptain,1,2 Tina Helle,1,2 Ann-Helen Patomella,2 Ulla Møller Weinreich,3,4 Anders Kottorp2,5 1Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark; 2Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden; 3Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark; 4The Clinical Institute, Aalborg University, Aalborg, Denmark; 5Faculty of Health and Society, Malmö University, Malmö, SwedenCorrespondence: Rina Juel Kaptain Selma Lagerloefs Vej 2, Aalborg 9220, DenmarkTel +4572690928Email rio@ucn.dkPurpose: There have been calls for more knowledge of activities of daily living (ADL) performance in order to address interventions in pulmonary rehabilitation effectively. Everyday technology (ET) has become an integrated dimension of ADL, impacting the ways in which ADL is performed. To improve everyday functioning and quality of life, the use of ADL and ET use needs to be evaluated and addressed effectively in interventions. Therefore, the aim of this study was twofold: 1) to explore the quality of ADL performance, and 2) to investigate the relationship between observation and self-reported ADL performance and ability to use everyday technologies in people living with COPD.Methods: This cross-sectional study involved 84 participants aged 46– 87 years. Participants were recruited through healthcare centres in the Northern Region of Denmark using a convenience sampling procedure. Data were collected using standardized assessments that investigated different ADL perspectives: self-reported ADL tasks and ET use, observed motor and process ability, and need for assistance. Data were analysed and presented using descriptive statistics and Pearson’s correlation coefficient.Results: The most affected ADL tasks were mobility within or outside the home, lower dressing, bathing, pedicuring, cooking, shopping, cleaning and washing clothes. New insights into the quality of ADL performance in people living with COPD were presented in terms of detailed ADL motor skills and ADL process skills, as well as the predicted need for support to function in the community. Moreover, new insights into the relationship between observation and self-reported ADL performance (r=0.546, p< 0.01; r=0.297, p< 0.01) and between ADL performance and self-perceived ability to use ET (r=0.524, p< 0.01; r=0.273, p< 0.05; r=0.044, p=0.692) were presented.Conclusion: Overall, the knowledge from the present study is valuable for focusing interventions that address challenging ADL performance and ET use through relevant and realistic activities. The ability to use ET is important to evaluate and target pulmonary rehabilitation.Keywords: ADL skills, AMPS, everyday technology, occupational therapy, pulmonary rehabilitation

PURPOSE: Evidence regarding everyday life activities in people living with COPD is limited. Such evidence can improve our understanding when designing interventions for pulmonary rehabilitation that aim at increasing or maintaining participation in these activities. The aim of this study was to describe how people living with COPD experience and manage everyday life activities. MATERIALS AND METHODS: The sample comprised four males and four females with an age ranging from 65-87 years. Participants were interviewed in their own homes regarding experiences of performing and managing everyday life activities. Data were transcribed verbatim and analysed using content analysis. RESULTS: Findings from this study comprised the theme "Juggling to manage everyday life activities with COPD" and three categories representing the elements of this theme: (1) consequences of COPD symptoms, (2) adjustment of activities, and (3) contextual aspects. CONCLUSION: This study found the participants with COPD juggling the management of everyday life activities. The juggle generated a manageable daily life, which came at the expense of making deliberate choices and prioritizing everyday life activities that were necessary for participation in valued and engaging activities in order to maintain health and well-being. Implications for Rehabilitation People living with COPD experience a complex juggling between the consequences of COPD symptoms and contextual aspects when managing everyday life activities. The participants had largely accepted their disease and adjusted to their situation. The disease was still described as frustrating and generated less focus on making deliberate choices and prioritizing everyday life activities that are necessary for participation in valued and engaging activities. Health professionals need to support people living with COPD in making deliberate choices in order to continue participating in valued and engaging everyday life activities as they affect health and well-being. Pulmonary rehabilitation should focus more on supporting participation in social relations and on using everyday technologies.

Importance: Occupational therapy can play a role in primary care management of chronic diseases among older adults. Objective: To assess the feasibility of delivering a primary care occupation-focused intervention (Integrated PRimary care and Occupational therapy for Aging and Chronic disease Treatment to preserve Independence and Functioning, or i-PROACTIF) for older adults with chronic disease. Design: Feasibility study comparing i-PROACTIF with complex care management using a two-group randomized controlled trial design with data gathered at baseline and during and after the 8-wk intervention. Setting: Family medicine clinic serving an urban, low-income, working-class community. Outcomes and Measures: Feasibility indicators were recruitment, retention, utility of clinical assessments, and acceptability of interventions assessed through feedback surveys completed by patients and primary care providers (PCPs). Patient outcomes, including perspectives on chronic illness care, occupational performance, and overall well-being, were collected using standardized, validated measures and analyzed descriptively. Participants: Eighteen adult volunteers, ages ≥50 yr, with heart disease, arthritis, and uncontrolled diabetes completed the study. Ten PCPs completed feedback surveys. Intervention: i-PROACTIF focuses on preserving functional independence, is based on the Person–Environment–Occupation framework, and consists of two assessment sessions and six weekly treatment sessions. Results: Recruitment goals were achieved, with an 86% retention rate. Clinical measures unearthed deficits in areas that were unreported or underreported by patients. Participants reported being extremely satisfied with the intervention. Physicians and nurses also supported the intervention. Both groups showed improved scores on most outcomes. Conclusion and Relevance: Delivering and evaluating i-PROACTIF was feasible and acceptable. Future efficacy trials are needed before it can be used in clinical settings. What This Article Adds: The results of this study can inform future occupational therapy interventions and clinical trials in primary care for older adults with chronic conditions.

Understanding the dynamics and aspects of how activity choices impact health and well-being in people living with chronic obstructive pulmonary disease (COPD) is important to inform rehabilitation.To describe, firstly, how much time people living with COPD spend on work, daily living tasks, recreation and rest; secondly, how this population perceived competence, importance and enjoyment related to these activities; thirdly, if differences in such perceptions and time use were associated with the living situation and COPD severity.This cross-sectional study involved 76 participants (+45 years, COPD, living in ordinary homes), who completed the Occupational Questionnaire (OQ). Descriptive statistics and group comparisons were performed.Most of the participants' time were spent on daily living activities and recreational activities. Participants spent approx. 80% of their recorded time in OQ on activities they valued, enjoyed and in which they felt competent. Participants living alone scored significantly lower on enjoyment in restful activities than those living in couples (Findings underscore the importance of targeting overall daily activity repertoires including compositions of activity types, time use and perceived competence, importance and enjoyment.

Background: As the use of everyday technology is increasingly important for participation in daily activities, more in-depth knowledge of everyday technology use in relation to diagnosis and gender is needed. The purpose of this study was to investigate the stability of the perceived challenge of a variety of everyday technologies across different samples of varying diagnoses including both males and females. Methods: This cross-sectional study used 643 data records from clinical and research samples, including persons with dementia or related disorders, acquired brain injury, intellectual disability, various mental or medical disorders, and adults without known diagnoses. The Everyday Technology Use Questionnaire, comprising 93 everyday technology artifacts and services (items) measuring the level of everyday technology challenge and relevance of and perceived ability to use these was used for data gathering. A two-faceted Rasch model in combination with differential item functioning (DIF) analyses were used for comparing item hierarchies across samples. Results: Only three items (3.2%) demonstrated a clinically relevant DIF by gender, and nine items (9.7%) by diagnosis. Discussion: The findings support a stable hierarchy of everyday technology challenge in home and community that can facilitate planning of an accessible and inclusive society from a technological departure point. Implications for Rehabilitation The ability to manage everyday technology is increasingly important for participation in everyday activities at home and in the community for people with and without disabilities. This study demonstrates that differences in perceived challenges in using various everyday technologies across gender and diagnosis are minimal. The findings provide evidence of no or minor systematic bias in testing when using the Everyday Technology Use Questionnaire in clinical practice and research. Empirical knowledge about the perceived challenge of specific everyday technologies of people with variations in gender or diagnosis is still sparse, hence this study can inspire practice and future research.

Background: Everyday technologies are naturally integrated in people’s daily life. For older adults and adults living with a chronic disease like chronic obstructive pulmonary disease (COPD), the ability to use technologies for health management has become increasingly important. The aim of this study was to investigate inter-rater and test-retest reliability of the Danish version of the Everyday Technology Use Questionnaire (ETUQ) in a sample of older adults with (n = 23) and without (n = 24) COPD. Material and method: The ETUQ was initially translated in accordance with the dual panel approach and then administered to a sample of 47 participants. Svensson’s method for paired ordinal data was utilized to calculate and analyze reliability. Results: Overall, inter-rater and test-retest reliability of the Danish version of the ETUQ demonstrated excellent percentage agreement (PA) (>75%), although for test-retest reliability, nine items demonstrated fair (53%) to good (73%) agreement. Conclusion: This study supports the use of the Danish version of the ETUQ in a sample of older adults with or without COPD. Application to practice: The Danish version of the ETUQ is an evidence-based evaluation that can reliably contribute to clinical occupational therapy and research in Denmark focusing on everyday technology use.

As context may impact everyday technology (ET) use it is relevant to study this within different contexts.To examine the usefulness of the Everyday Technology Use Questionnaire (ETUQ) in different contexts by investigating and comparing (1) the level of challenge of ETs in the ETUQ and (2) the relevance of and perceived ability to use ET in samples of Swedish and Japanese older adults.The Swedish and the Japanese samples (n = 86/86) were interviewed using the ETUQ about relevance of and perceived ability to use ET. Data were analyzed using Rasch analysis, chi square and a general linear model. Moreover, Differential Item Functioning (DIF) was investigated.The hierarchy of ETs' level of challenge was generally stable in the two contexts. On group-level, the relevance was somewhat higher and the perceived ability to use ET significantly higher in the Swedish sample than in the Japanese.The similarities and differences between the technological landscapes of Sweden and Japan could be detected by ETUQ, demonstrating its usefulness in both countries. The potential causes to the differences in relevance of and perceived ability to use ET between older adults in Sweden and Japan need further exploration.

Rina Juel Kaptain,1,2 Tina Helle,1,2 Ann-Helen Patomella,2 Ulla Møller Weinreich,3,4 Anders Kottorp2,5 1Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark; 2Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden; 3Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark; 4The Clinical Institute, Aalborg University, Aalborg, Denmark; 5Faculty of Health and Society, Malmö University, Malmö, SwedenCorrespondence: Rina Juel Kaptain Selma Lagerloefs Vej 2, Aalborg 9220, DenmarkTel +4572690928Email rio@ucn.dkPurpose: A decline in the ability to perform activities of daily living (ADL) and ability to use everyday technology can pose threats to independent living, healthcare management and quality of life (QOL) of patients suffering from chronic obstructive pulmonary disease (COPD). Evidence of the relationship between these variables remains limited. The dual aim of this study was, first, to investigate if health-related QOL (HRQOL) was associated with quality in ADL performance and everyday technology use; second, to examine whether lung function, years with COPD diagnosis, living status or educational level affected physical and mental domains of HRQOL.Methods: This cross-sectional study included (N=80) participants aged 46–87 years recruited at healthcare centres in the Northern Region of Denmark using a convenience sampling procedure. Data were gathered through standardized assessments and analysed using multiple regression analysis.Results: The regression model explained 50.6% (R2=0.506) of the variation in HRQOL–physical. The following four variables were statistically significantly associated with HRQOL – physical: years since COPD diagnosis (p=0.023), ability to use everyday technology (p=0.006), amount of relevant everyday technologies (p=0.015) and ADL motor ability (p

Background: Everyday technologies (ET) such as smart phones, and internet banking are increasingly incorporated into daily activities. Therefore, valid assessments are needed to identify ability in ET use and to design and evaluate interventions. Aims: To evaluate and compare the stability over time (test-retest reliability) of measures generated with the short version of the Everyday Technology Use Questionnaire (S-ETUQ) in older adults with cognitive impairment or mild dementia. Materials and Methods: Data was collected with S-ETUQ at two occasions (m = 20.9 days in between) in a sample of (n = 73) older adults with cognitive impairment of different origin (n = 38) or mild dementia (n = 35). Stability of each participant’s S-ETUQ measure was examined using standardised difference z-comparisons. The test-retest reliability coefficient of the S-ETUQ measures was determined by Intraclass Correlation Coefficients. Comparisons were performed using Mann-Whitney u-tests. Results: The S-ETUQ measures were statistically stable between the two occasions. Hence, the group of persons with cognitive impairment demonstrated slightly higher stability and fewer differences compared to the group with mild dementia. The ICCs (0.82–0.90) indicated good to excellent agreement. Conclusions: S- ETUQ can be used with older people with cognitive impairments of varying degree to gather reliable and precise information regarding their use of ET.

Background: The Pediatric Evaluation of Disability Inventory (PEDI) is an assessment to evaluate children's performance in activities of daily living. Aims: The study investigated if the normative standard scores of the PEDI are applicable to the German version of the PEDI (PEDI-G) in Germany, Austria and Switzerland, and whether there are differences in the applicability of the PEDI-G between the three countries. Materials and methods: 75 children with normal development (35 girls, 40 boys) from Germany (n = 17), Austria (n = 16), and Switzerland (n = 42) aged between 0.9 month and 7.3 years (SD = 2.03) participated in the study. Descriptive statistics, independent samples t-tests, univariate analyses of variance (ANOVA) and post hoc Tukey tests were applied. Results: No significant differences were identified. However, the German-speaking sample showed higher scores for the domain social function in both scales and in the Caregiver Assistance Scale self-care. Lower scores were identified in the Functional Skills Scale mobility. Conclusions and significance: The results support that the normative standard scores of the PEDI are applicable to the PEDI-G and for Austria, Germany and Switzerland, as no significant differences between the countries were identified. However, the generalizability of the results is limited due to sample size and recruitment procedures.

Background: The changing technological environment is reflected in regular updates made to the everyday technology (ET) use questionnaire (ETUQ). Newly added ETs may not present comparable challenges across countries and diagnoses. Aims: To identify whether country context, or dementia diagnosis, impact ETs’ challenge level. Material and methods: 315 older adults from three countries were included; Sweden (n = 73), United States (n = 114), England (n = 128), and had a confirmed diagnosis of mild dementia (n = 99) or no known cognitive impairment (n = 216). Differential Items Functioning (DIF) analysis was performed on 88 ETs included in the ETUQ by country and diagnosis. The impact of DIF was evaluated in a Differential Test Functioning (DTF) analysis. Results: Nine items (10.2%) in the ETUQ showed statistically significant DIF between countries; five of which were public space ETs and none of which were information and communication technologies (ICTs). Three ICT items, and no others, showed significant DIF by diagnosis. The items’ DIF was shown to have no impact upon person measures of ability to use ET in the DTF. Conclusions and significance: The utility of the ETUQ in occupational therapy practice and research internationally is highlighted through the stability of the challenge hierarchy and lack of impact on person measures.

Background: Activities of daily living (ADL) are crucial for children because they enable them to participate in everyday life. For the evaluation of children`s ADL performance, health professionals such as occupational therapists use standardized ADL assessments. To implement assessments into practice it is important that the score generated from an assessment can be viewed as a unidimensional measure. Aim: To investigate the factor structure of the German Pediatric Evaluation of Disability Inventory (PEDI-G) in a sample of typically developing children and children with an impairment. Material and Methods: An exploratory factor analysis (EFA) with factor rotation was performed to assess the factor structure for the PEDI-G domains (self-care, mobility and social function) of the Functional Skills Scale and the Caregiver Assistance Scale. Results: 262 children (118 (45%) girls and 144 (55%) boys) participated in this study. Their mean age (SD) was 4 years (SD 1.91). Results suggest that the PEDI domains of the Functional Skills Scale and the Caregivers Assistance Scale can be used as unidimensional measures to evaluate child`s ability to perform activities of daily living. Conclusion: The results of this study support the use of the PEDI-G for research and practice in Austria, Germany and Switzerland.

Occupational therapists support everyday technology use; however, it is necessary to consider the challenges that people with dementia encounter with everyday technologies when participating in various places within public space.The purpose of the study was to explore stability and change in participation in places visited within public space in relation to the relevance of everyday technologies used within public space.People with dementia (Both samples participated in places within public space; however, participation and relevance of everyday technologies were significantly lower for the dementia group.To enable participation, occupational therapists need to be aware of challenges that technologies and places within public space present to people with dementia.

OBJECTIVE. We describe the development of a questionnaire, Participation in Activities and Places Outside Home (ACT–OUT), for older adults with cognitive impairment and align it to people with mild- to moderate-stage dementia. METHOD. ACT–OUT was developed in a cross-cultural collaboration in combination with three rounds of cognitive interviews in Switzerland with 26 older adults without cognitive impairment and five older adults with dementia. Qualitative data from the interviews were analyzed using a constant comparison approach. RESULTS. The final ACT–OUT Version 1.0 consists of three parts: (1) questions targeting places older adults visit; (2) questions on aspects influencing participation, such as transportation, familiarity, and risk perception; and (3) questions on perception of self. CONCLUSION. The development of an instrument such as ACT–OUT is more a cyclical than a linear process. This study is a first step toward a more systematic evaluation of out-of-home participation among older adults with and without dementia.

Item does not contain fulltext BACKGROUND: The Perceive, Recall, Plan & Perform (PRPP) system of task analysis might be feasible to evaluate occupational performance and information processing strategies for persons with Parkinson's disease (PD). AIM: To evaluate: (1) the random error between raters (inter-rater study), (2) the random error within raters (intra-rater study), and (3) the internal consistency of the PRPP. MATERIALS AND METHODS: (1) video-recorded performance of meaningful activities of 13 Dutch persons with PD, scored independently by 38 Dutch PRPP trained occupational therapists were included in the analysis. The random error between raters was analyzed with two-way random Intraclass Correlation Coefficients (ICC). (2) Four videos were scored twice by 30 raters (6 week time interval). The random error within raters was analyzed using one-way random ICC's. (3) Internal consistency study: data of 190 persons with PD were analyzed using Cronbach's alpha (alpha). RESULTS: Inter-rater reliability ranged from slight to moderate (ICC= 0.06-0.43). The mean intra-rater reliability ranged from moderate to almost perfect (ICC= 0.60-0.83). Internal consistency is good (alpha = 0.60-0.86). CONCLUSION: The limited inter-rater reliability but adequate intra-rater reliability and internal consistency show the feasibility of the PRPP when used for persons with PD. Implications for reliable clinical use are discussed.

AIM:The aim of this study was to evaluate the cross-cultural validity of the German version of the Pediatric Evaluation of Disability Inventory (PEDI-G) when used in Austria, Germany and Switzerlan ...

Introduction The number of older adults living with mild cognitive impairment (MCI) or mild-stage Alzheimer's disease (AD) is increasing and they are often expected to live in their own homes without support, despite limited ability to perform daily life activities. The Everyday Technology Use Questionnaire (ETUQ) has proven to be able to separate these groups and might also have potential to predict overall functional level (need of assistance in daily life activities) among them. Aim To investigate whether the ETUQ can predict overall functional level among older adults with MCI or mild-stage AD. Method Participants were older adults with a mean age of 76 years with MCI (n = 28) or mild-stage AD (n = 39). A three-step scale indicating (i) independence, (ii) need for minimal assistance or (iii) need for moderate to maximal assistance in daily life was dichotomised in two ways and used as outcome variables in two logistic regression models. Predictors in both models were perceived ability to use everyday technology (ET) and amount of relevant everyday technologies measured by the ETUQ. Ethical approval was obtained from the regional Ethical Committee. Result Perceived ability to use ET discriminated individuals who were independent or in need of minimal support from those in need of moderate to maximal assistance (OR = 1.82, p < 0.01, confidence interval = 95%; 1.76–2.82). The amount of relevant everyday technologies discriminated individuals who were independent from those in need of assistance at any level (OR = 1.39; p < 0.01; confidence interval = 95%; 1.11–1.75). Conclusion Both perceived ability to use ET and amount of relevant everyday technologies had potential to predict overall function but at different levels. The findings support the predictive validity of the ETUQ and suggest further research for the development of clinical cut-off criteria.

Background: There is a need for in-depth understanding of how elderly persons resume their occupations while recovering from physical disabilities in their home and community. The aim of this study was to explore and understand how engaging in occupations unfolded over time for some older persons with physical disabilities in Japan. Materials and methods: In this narrative-in-action study four elderly participants were recruited following a mixed purposive and convenience sampling method. Data was gathered at two to three weeks’ intervals over six months, with a follow-up visit at nine months. Qualitative interviews and participant-observations were analyzed using narrative analysis. Results: This study identified the central meaning of resuming occupations as re-establishing former and establishing new familiarity. Familiarity was expressed in three features, namely as repertoires of occupations fulfilling needs and meanings, as performing occupations according to expectation, and as a resource for dealing with problems of engaging in occupation. What was experienced as familiar could be adjusted to accommodate ones changing needs or situation. Conclusion and significance: (Re-)establishing familiarity is a new concept representing transitions from an occupational perspective. Facilitating familiarity can assist older persons to experience health and well-being, even while transitioning after an illness or injury.

Background/Objective The Everyday Technology Use Questionnaire (ETUQ), which evaluates the perceived relevance of and the perceived ability in everyday technology (ET) use, has demonstrated acceptable psychometric properties in Swedish studies of older adults. The aim of this study was to examine the reliability and validity of the ETUQ in a Japanese context in older Japanese adults. Methods A sample of older Japanese adults (n = 164) including persons with (n = 32) and without (n = 132) cognitive impairment was interviewed with the ETUQ, including original items (ETs) and added Japanese context-specific items. Data were analyzed using a Rasch measurement model. Results The analysis demonstrated acceptable functioning of the rating scale, internal scale validity, person response validity, and person-separation reliability of the Japanese ETUQ according to the Rasch model. However, evidence supporting unidimensionality in the Japanese ETUQ was not consistent in this sample. The added Japanese items did not significantly change the estimated individual person measures of perceived ability to use ET. Conclusion The Japanese ETUQ seems to be a sensitive tool to evaluate perceived ability in ET use among elderly people in Japan with and without cognitive impairment. Therefore, it could be used in research and clinical practice.

With an increasing number of ageing people who identify themselves as lesbian, gay, bisexual, transgender, or queer (LGBTQ), there is a risk that traditional housing for older people fails to meet the needs of these people. The aim of this study was to describe LGBTQ people's needs, preferences, and concerns according to ageing and housing.Based on a survey (n = 487), and six focus-group discussions (n = 30), with LGBTQ persons, quantitative and qualitative approaches were used to analyse the findings.When comparing the ranking of preferences (in terms of activity options, environmental features, and staff competence) in a senior housing setting between the LGBTQ people (n = 200) and heterosexual matched controls (n = 198), only minor differences were detected. The findings from the focus groups included: (1) a dilemma between segregation and openness, (2) the importance of safety associated with ageing together with persons with similar experiences, and (3) networks of persons at different ages connected through close friendship supported participation in activities in LGBTQ-profiled senior housing.The findings provide knowledge to improve awareness of sexual orientation when it comes to needs and preferences in relation to ageing and housing in a Swedish context.

Introduction: Knowledge is lacking of how technological development has affected occupational engagement and performance. Changes in the environment, for example, new technology, are likely to create changes in the dynamics of occupations and exploring this among older adults is especially important. This study aimed to explore what can drive and hinder the incorporation of everyday technology into occupations and how new technology affects occupational engagement and performance among older adults. Method: A constructivist grounded theory methodology was applied. Data were collected by individual interviews with six women and five men between the ages of 67 and 92 years old. Participants also varied as regards their cognitive function and living conditions. Results: The findings concerned the match between technology and the participants' perceptions of occupational purposes, needs of control and safety, and the kind of technology user they strived to be. A good match was a driving force for technology usage and satisfaction with the altered occupations and vice versa. Conclusion: Occupational engagement and performance in relation to technology use can be facilitated, which is useful knowledge for stakeholders developing and implementing new technology, as well as those who encounter older adults with the needs or desire to use technology in their daily occupations.

Background: The trend towards telemedicine increasingly requires clients to manage everyday technology (ET) to access and use health services. The Management of Everday Technology Assessment (META) is an observation-based instrument developed to evaluate the ability to manage ET. Aim: To examine test-retest (TRR) and inter-rater reliability (IRR) of the Danish translation of the META for older adults with and without COPD. Method and Materials: 47 older adults with COPD (n = 23) and without (n = 24) were recruited. IRR was examined by four raters paired across 30 participants. TRR was examined for 21 participants by the same rater administering the META twice within four weeks. A rank-based method for paired ordinal data was used to calculate percentage agreement (PA) and measures of systematic disagreement and individual variability. Mann Whitney U tests were used to compare PA to health status (presence/absence of COPD). Results: Inter-rater PA was acceptable across 10 of 11 items and test-retest PA across 8 of 11 items. Systematic disagreement was present for one item in TRR. No significant differences in PA were found regarding health status. Conclusion: The Danish META generates reliable scores for this sample. However, conclusive statements cannot be made for all items.

Background: Children with acquired brain injury (ABI) often present with functional deficits that influence their societal participation and well-being. Successful reintegration into school calls for individual support to meet each child’s adjustment needs. The adjustment needs of children with ABI in school settings have not previously been explored. Aim: The objectives of the present study were (a) to describe adjustment needs in school settings for children with ABI and (b) to explore differences and similarities between reports from the children and their teachers. Methods: In this cross-sectional study, 20 children with ABI (mean age 12.8 ± 3.4 years; class grade 1-10) and their teachers were interviewed individually, using the School Setting Interview (SSI). Data were analyzed with descriptive and with non-parametric statistics. Results: (a) In the overall group, children rated that 55.6% of the 16 activities in the SSI needed no adjustment. The corresponding percentage for teachers was 48.4%. (b) In the child-teacher pairs, there was a positive relationship between teachers’ and children’s responses only in 3 out of 16 school activities and agreement varied strongly according to the activity in question. Conclusions and significance: It is important for occupational therapists and other professionals to specifically consider adjustment needs relating to school activities from various perspectives when aiming to provide individualized interventions.

Background: Technology use is relevant for engaging in everyday occupations and aging in place and difficulties might limit participation. Aim: The aim of the present study was two-fold: to investigate the internal scale validity of the Everyday Technology Use Questionnaire (ETUQ) in a matched Portuguese and a Swedish sample of older adults without known cognitive impairments and to compare everyday technology use (i.e., the relevance of Everyday Technology (ET) and perceived difficulty of using ET). Methods: The Rasch rating scale model was used to investigate the psychometric properties of the data from the two countries. Analyses were then used to compare the samples. Results: There is evidence of internal scale and person response validity in the Swedish and Portuguese ETUQ datasets. The Swedish sample demonstrated almost 25% more ETs to be relevant, as compared to the Portuguese sample (p

Background: In order to develop supporting interventions for people demonstrating problems ET use, a detailed level of description of strengths and deficits is needed. Aims: To explore clusters of specific performance skill required when using ET, and to evaluate if and in what way such clusters are associated with age, gender, diagnosis, and types of ETs managed. Materials and methods: A secondary analysis of 661 data records from 203 heterogeneous samples of participants using the Management of Everyday Technology Assessment (META) was used. Ward’s method and a hierarchical tree cluster analysis were used to determine and define the skill clusters. Results: Four distinct clusters of performance skill item profiles were found, across the 661 data records. These were then, based on each individuals’ cluster profiles in managing ET, categorized into two groups. The two groups were associated with, diagnosis and type of ETs managed. Conclusions and significance: The findings support a more dyadic person-ET approach in evaluation of ET management. The information from the skill clusters can be used to develop targeted intervention guides for occupational therapy and healthcare.

To evaluate the test-retest reliability of the Management of Everyday Technology Assessment (META) in a sample of people with acquired brain injury (ABI).The META was administered twice within a two-week period to 25 people with ABI. A Rasch measurement model was used to convert the META ordinal raw scores into equal-interval linear measures of each participant's ability to manage everyday technology (ET). Test-retest reliability of the stability of the person ability measures in the META was examined by a standardized difference Z-test and an intra-class correlations analysis (ICC 1).The results showed that the paired person ability measures generated from the META were stable over the test-retest period for 22 of the 25 subjects. The ICC 1 correlation was 0.63, which indicates good overall reliability.The META demonstrated acceptable test-retest reliability in a sample of people with ABI. The results illustrate the importance of using sufficiently challenging ETs (relative to a person's abilities) to generate stable META measurements over time. Implications for Rehabilitation The findings add evidence regarding the test-retest reliability of the person ability measures generated from the observation assessment META in a sample of people with ABI. The META might support professionals in the evaluation of interventions that are designed to improve clients' performance of activities including the ability to manage ET.

Date Presented 04/06/19 The AMPS is a valid and reliable measure of occupational performance. However, use of this measure can be met with barriers. In this study, therapists with AMPS certification participated in a multimodal knowledge translation curriculum. Participants completed a pre- and postsurvey. Study results support use of a multimodal curriculum to assist with overcoming barriers and increasing utilization of the AMPS. This framework could be applied to other assessments for increased clinical use. Primary Author and Speaker: Bridget Hahn Additional Authors and Speakers: Piper Hansen Contributing Authors: Anders Kottorp, Heidi Fischer

Date Presented 04/05/19 Primary Author and Speaker: Ryan Walsh Additional Authors and Speakers: Jenica Lee, Caniece Leggett, Ruxandra Drasga Contributing Authors: Holly Shapnick, Anders Kottorp

Objective: The aim of this study was to evaluate complex intervention using time aids for children with intellectual and developmental disabilities who exhibit limitations in daily time management. Methods: Participating children (n = 47) (F17/M30) were aged 6–11 with ADHD, autism spectrum disorders, mild or moderate intellectual disability, spina bifida, and cerebral palsy. This study used a Randomized Block and Waiting List control group design, with 25 children allocated to control and 22 to intervention group. In total 10 children (21.3%), five from each group, dropped out, leaving 37 children in the data analysis. Results: Children in both groups gained significantly in time-processing ability between the first and second data collection, but the children in the intervention group improved time-processing ability significantly more than controls. The control group also displayed significant changes after receiving intervention between the second and third data collection. The intervention had a large effect (ES Cohen's d = 0.81) on time-processing ability and a medium effect (ES Cohen's d = 0.68) on managing one's time. Conclusions: This study provides preliminary evidence that time-processing ability and managing one's time can be improved by intervention using time aids in children with intellectual and developmental disabilities, supporting the need to consider time aids in intervention in these children.

International partnerships are a mechanism for supporting the academic development of occupational therapy and promoting cultural competence. This case study describes the factors that have helped to sustain a post-qualifying programme implemented by five higher education institutions in Denmark, the Netherlands, Sweden, Switzerland and the UK since 1999. Data collection methods were documentary analysis and the reflections of a purposive sample of six key informants. Cohort and outcome data, from 193 students from 31 countries who enrolled between 1999 and 2011, are reported. Each cohort comprises students from an average of eight countries to optimize inter-cultural dialogue. Four factors support sustainability. These are 1) supportive professional European networks; 2) timeliness and alignment with European higher education policy; 3) partnership structures and processes that emphasize joint decision making and accountability; and 4) the stimulus and satisfaction associated with internationalization. The main limitations are considering the OT-EuroMaster as an intrinsic case study and using opportunistic data collection that undermines the rigor and transferability of the findings. Future opportunities include doctoral networks, transnational research and sharing our curricula design with other Regions to spread the collaborative, capacity building endeavours more widely.

OBJECTIVE. We investigated how everyday technology use related to activity involvement over 5 yr in people with mild cognitive impairment. METHOD. Thirty-seven older adults with mild cognitive impairment were evaluated regarding everyday technology use and involvement in activities over time. Information on diagnostic changes was collected from medical files. Linear mixed-effects models were used in data analysis. RESULTS. Ability to use everyday technology showed a significant effect on activity involvement (p = .007) beyond the effects of time, diagnostic change, and age. Decreases in number of everyday technologies used (p < .001) and share of accessible and relevant everyday technologies used (p = .04) were associated with decreasing activity involvement. However, these two aspects did not reinforce each other. CONCLUSION. When monitoring activity involvement in clients with cognitive decline, health care professionals should take into account clients’ ability to use everyday technologies and the amount of everyday technologies they use.

Background. Occupational therapists sometimes find it challenging to integrate client-centered and occupational therapy specific assessments in practice. The aim of this study was to explore the use of occupational therapy specific assessments such as the Assessment of Motor and Process Skills (AMPS) among occupational therapists in Sweden and Japan. Methods. Interviews and qualitative thematic analyses were utilized. Findings. Four themes are reported: (1) use it or lose it, (2) simply no space until after hours, (3) biggest barriers can be colleagues, and (4) being more specific: communication. Conclusion. In keeping with previous studies, occupational therapists often find it challenging to implement client-centered and occupation-based assessment tools into practice. However, more work is needed to understand how best practices can be incorporated into a changing occupational therapy daily practice.

Objective: To examine the relationship among (a) quality of activities of daily living (ADL) task performance, (b) quality of social interaction, and (c) the extent of discrepancy between the person’s and the occupational therapist’s perspectives; and explore patterns of strengths and challenges among people with developmental disabilities (DD). Methods: Fifty-eight adults with different types of DD, living in northern Sweden, were evaluated using the Assessment of Motor and Process Skills (AMPS), the Evaluation of Social Interaction (ESI) and the Assessment of Compared Qualities – Occupational Performance (ACQ-OP) and Assessment of Compared Qualities – Social Interaction (ACQ-SI). The relationships among assessments were analysed using Pearson correlation analyses. Cluster analysis was used to group participants based on their evaluation results. Results: The quality of ADL task performance and the quality of social interaction demonstrated weak to moderate positive relationships while the ACQ-OP and ACQ-SI demonstrated a strong positive relationship. The cluster analysis resulted in identifying three distinct groups that differed significantly from one another. Conclusion: The findings support the clinical use of multiple assessment tools, including observation and self-report, to evaluate different aspects of occupational performance. Comprehensive and relevant evaluation supports collaborative goal setting and intervention planning.

Introduction: Occupational therapists working in psychiatry are routinely required to undertake vocational assessments and to support clients into work. To make such efforts successful, the use of evidence-based practice and outcome measures is becoming increasingly important. Objectives: The objectives were to examine the psychometric properties of the Worker Role Interview (WRI, version 10.0) with a psychiatric population in the United Kingdom, particularly its construct validity as a baseline assessment and an outcome measure. Method: Data were collected from 34 psychiatric clients rated by seven occupational therapists. Rasch analysis was used to examine scale validity, validity of therapists' rating patterns of clients, rater consistency, precision of client measurement and the scale's aptitude in detecting different ability levels. Results: All items except one demonstrated acceptable goodness-of-fit to the Rasch model. Over 90% of clients fitted the model. The scale detected five ability levels, but client measures were slightly imprecise. Raters used the scale consistently and implications of rater leniency are discussed. Conclusion: The study provides evidence of construct validity, supporting the use of the WRI as a standardised baseline assessment in a mental health population. Further development of the WRI might be indicated and its usefulness as an outcome measure should be tested with larger samples.

Background As people with intellectual disabilities (ID) today live integrated in society and use different technological artefacts and services in their everyday life, more in-depth evaluation methods are crucial to detect strengths and limitations of their everyday technology use. The Everyday Technology Use Questionnaire (ETUQ) was originally designed to investigate the extent to which older adults with cognitive limitations can use the everyday technology that is of relevance to them. The purpose of this study was to explore and evaluate evidence of the validity of ETUQ among adult persons with ID. Methods The original 93-item ETUQ was used to interview 120 adult participants with ID, recruited from a region in northern Sweden. A Rasch model was used to analyse the psychometric properties of the rating scale, scale validity, person response validity and person separation. Results The ETUQ rating scale displayed sound psychometric properties when used with this sample. The goodness-of-fit statistics showed that 15 (16%) of the 93 items demonstrated higher values than expected. A step-by-step removal process of items not demonstrating fit to the model resulted in an ETUQ version with 46 items (49%) that met all the criteria for scale validity. Fifteen participants (12%), primarily with mild ID, still demonstrated a higher number of unexpected responses included in ETUQ. Conclusions The results of this study indicate that the ETUQ generates a valid measure of perceived difficulty in using everyday technology including adult persons with ID.

Date Presented 4/19/2018 We validated unidimensional, long and short forms of a tool measuring self-efficacy in interprofessional competence based on a sample of 1,350 students, including entry-level occupational therapy students and students from 10 other health professions programs. Primary Author and Speaker: Anders Kottorp Additional Authors and Speakers: Elizabeth Peterson Contributing Authors: Mary T. Keehn, Valerie Gruss, Memoona Hasnain

Date Presented 4/21/2018 This study compared self-efficacy in interprofessional competence among students representing various health professions programs, including occupational therapy (entry level). Primary Author and Speaker: Anders Kottorp Additional Authors and Speakers: Elizabeth Peterson Contributing Authors: Mary T. Keehn, Valerie Gruss, Memoona Hasnain

Date Presented 4/19/2018 This study of older people with and without functional limitations in an urban environment targeted everyday technology access and use, activity engagement, cognition, and perceived health. Primary Author and Speaker: Anders Kottorp Additional Authors and Speakers: Jenica Lee, Ryan J. Walsh Contributing Authors: Ruxandra Drasga, Caniece Leggett, Holly Schapnik

Objective: The aim of this study was to evaluate the psychometric properties of the Assessment of Awareness of Disability (AAD), applied to a sample of clients with a variety of diagnoses, using two different Rasch models. Methods: The sample consisted of 245 clients admitted to occupational therapy services in Sweden. The psychometric properties of the AAD measures were analysed and compared using both Rasch partial credit (PCM) and rating scale (RSM) models. Results: In relation to rating scale properties and person response validity, the RSM yielded better results. However, the PCM demonstrated better item goodness-of-fit statistics than the RSM, supporting the internal scale validity of the AAD. Some systematic indications of sample-dependent misfit were also found in the data. Conclusion: The results support the validity of the AAD in a sample of clients with various diagnoses, although some limitations of the tool are addressed. The outcomes also demonstrate the importance of making cautious choices when selecting a Rasch model for investigating psychometric properties, as the choice has a substantial impact on the interpretation of the findings.

Background. Limited self-awareness of disabilities can compromise individuals' occupational performance. Purpose. The Assessment of Awareness of Disability (AAD) provides occupational therapists with a standardized methodology for measuring clients' self-awareness when performing activities of daily living (ADL). This is the first study that formally examines the stability of the AAD measures. Methods. The AAD was administered twice to 15 participants with acquired brain injury (ABI) within one or two days. One participant's data were excluded because significant changes in his ADL process abilities were detected. Two criteria were used to examine the stability of the remaining 14 participants' AAD measures: standardized diference Z-scores and a difference of 0.65 logits. Findings. All 14 participants' AAD measures were stable on the basis of their Z-scores; 13 participants' measures were stable based on the 0.65 logit difference. Implications. Occupational therapists can have confidence that the AAD generates stable measures when administered to adults with ABI.

Technology increasingly influences the everyday lives of most people, and the ability to manage technology can be seen as a prerequisite for participation in everyday occupations. However, knowledge of the ability and skills required for management of technology is sparse. This study aimed to validate a new observation-based assessment, the Management of Everyday Technology Assessment (META). The META has been developed to assess the ability to manage technology in everyday life. A sample of 116 older adults with and without cognitive impairment were observed and interviewed by the use of the META when managing their everyday technology at home. The results indicate that the META demonstrates acceptable person response validity and technology goodness-of-fit. Additionally, the META can separate individuals with higher ability from individuals with lower ability to manage everyday technology. The META can be seen as a complement to existing ADL assessment techniques and is planned to be used in both research and practice.