Search

Objective: To investigate the relationship between on-road driving remediation and achieving fitness to drive following acquired brain injury. Design: Randomized controlled trial. Setting: Tertiary hospital outpatient driver assessment and rehabilitation service, Australia. Participants: Thirty-five participants (54.3% male), aged 18–65 years, 41 days-20 years post-acquired brain injury (including stroke, aneurysm, traumatic brain injury) recommended for on-road driving remediation following occupational therapy driver assessment were randomly assigned to intervention (n = 18) and waitlist control (n = 17) groups. Intervention: Intervention group received on-road driving remediation delivered by a qualified driving instructor in a dual-control vehicle. The waitlist control group completed a 6 week period of no driving-related remediation. Main measure: Fitness to drive rated following the conduct of an on-road occupational therapy driver assessment with a qualified driving instructor where outcome assessors were blinded to group allocation. Results: The intervention group were significantly more likely to achieve a fit to drive recommendation than no driving specific intervention (p = 0.003). Conclusion: Following comprehensive assessment, individualized on-road driving remediation programs devised by an occupational therapist with advanced training in driver assessment and rehabilitation and delivered by a qualified driving instructor are significantly associated with achieving fitness to drive after acquired brain injury. [ABSTRACT FROM AUTHOR]

Objective: This scoping review aimed to explore topics on which the views of residents of Australian residential aged care facilities (RACFs) have been sought. Methods: Scoping review methodology as outlined by Arksey and O'Malley was used to identify, explore and report on the range of literature regarding views of RACF residents. Seven electronic databases were searched using broad search terms relevant to the RACF context. Descriptive numerical analysis was completed for publication year, journal name and target profession, research methods and participant types. Thematic analysis then focussed on the aims of the included studies. Results: Four thousand two hundred and ninety studies were screened, and 104 publications met the inclusion criteria. A broad range of topics were explored by researchers, with the largest number of papers focused on residents' views of systems within RACFs (n = 24) and new programs and interventions (n = 21). Smaller topic areas included health conditions and health‐care services (n = 13), socialisation (n = 13), physical activity (n = 3), self‐care (n = 4), leisure (n = 4), general everyday life (n = 20) and aspects of the residential aged care environment (n = 15). There was limited exploration of meaningful activity (n = 13). The inclusion of residents with cognitive impairment was inconsistent, and the voices of other stakeholders were often privileged. Conclusions: Voices of residents must be heard in order to prioritise the health and well‐being of this population. More research which focuses on what is important to residents is needed and must include residents with cognitive impairment more effectively. Identification of optimal research methods with this population would make an important contribution in this area. [ABSTRACT FROM AUTHOR]

Despite the popularity of the flipped classroom, its effectiveness in achieving greater engagement and learning outcomes is currently lacking substantial empirical evidence. This study surveyed 563 undergraduate and postgraduate students (61% female) participating in flipped teaching environments and ten convenors of the flipped courses in which the student sample was enrolled. Results suggest that higher education students can be differentiated based on their preferences for elements of a flipped classroom, resulting in two clusters of students: those who embrace most aspects of a flipped classroom environment as well as prefer it (labelled "Flip endorsers") and those who are close to neutral on some elements of a flipped classroom environment but who especially do not endorse the pre-learning aspects (labelled "Flip resisters"). Flip endorsers were found to have more positive attitudes towards the course activities (both pre-class and in-class) and to have felt more involved and engaged in the content. These findings shed some light on the types of students who might prefer flipped classrooms, but more importantly identify those who are likely to resist a change to a flipped classroom environment. The findings also suggest that although students may find the flipped classroom more difficult, student outcomes and active participation in class activities do improve when course convenors (a) use a theoretical perspective to inform their flipped teaching strategy, (b) integrate assessment into the design of their flipped classroom, and (c) flip the entire course.

Background: Mothers of children with autism experience poorer health and wellbeing compared to mothers of children with other disabilities or typically-developing children. This qualitative phenomenological study aimed to explore the daily life experiences of mothers of children with autism, and the strategies they use to manage their roles, their emotions, and their child's behaviours. Method: In-depth interviews were conducted with 7 mothers and the data were analysed using interpretative phenomenological analysis. Results: Findings revealed that the mothers were challenged by the demands of their multiple roles while dealing with the paradox of accepting their child for who they were, and at the same time also desiring their typical growth and development. However, the mothers reported various strategies they used to manage their roles, their emotions, and their child's behaviours. Conclusions: The findings indicate that health professionals working with these families must support mothers in managing various aspects of their lives, including those not directly related to their child with autism. (Contains 2 tables.)

Describing how occupation is used in practice can be challenging for occupational therapists. Occupation-centred, occupation-based, and occupation-focussed terminology are frequently used interchangeably and ambiguously to describe practice. However, ambiguous language creates confusion and inadequately demonstrates the value of occupation. This scoping review aimed to identify how occupation-centred, occupation-based, and occupation-focussed terminology are defined and represented in occupational therapy literature. A five-step scoping review included papers published between 2014 and 2019 from four databases. Extracted data were summarised to outline how the terms were being used within the literature. Initial searching yielded 819 articles and 35 papers met inclusion/exclusion criteria. Within current literature, occupation-focussed and occupation-based terminology were inconsistently described. A limited number of articles used occupation-centred and occupation-focussed terminology to describe practice, whilst occupation-based was more prominent. Occupation-based terminology was represented in numerous ways to describe assessments, practice tools, interventions, research, and theory. Discrepancies between the description and implementation of occupation-based practice were most prominent within interventions. Findings demonstrated that occupation-based and occupation-focussed terminology were used interchangeably and inconsistently in literature. It is timely to consider how this is problematic for our professional identity and perceptions of occupation in practice. [ABSTRACT FROM AUTHOR]

A strong professional identity helps occupational therapists maintain professional values and thrive when facing work-related challenges and opportunities including generic, blurred or emerging roles, funding pressures and a push for outcome evidence. A scoping review will build understanding of professional identity and how to maintain it in such circumstances. To scope what is currently understood of professional identity in occupational therapy and factors which influence ability to maintain this and adapt in challenging work environments. Using Arksey and O'Malley's scoping review framework three databases were searched using the terms 'occupational therap*' and 'professional identity'. Data extraction and thematic analysis highlighted the extent and nature of current literature and mapped key concepts. 89 papers were included. Professional identity was revealed as a multidimensional construction. Four themes emerged: developing a shared ontology, embracing the culture, enacting occupational therapy, and believing in occupational therapy. Factors which influenced development and maintenance of professional identity included occupation-centred practice, ontological reflexivity, linking theory to practice and professional socialization. The enhanced understanding of professional identity and factors which preserve or enhance it can help the profession identify how to position itself to remain resilient and adaptive in an ever-changing environment. [ABSTRACT FROM AUTHOR]

Introduction: Occupation‐centred practice is key to aligning with the contemporary paradigm. Benefits of this approach for clients and the profession are well documented, yet how to identify occupation‐centred practice is not yet understood. Therefore, this study aimed to uncover the characteristics of occupation‐centred practice and how they can be identified in practice. Methods: A three round Delphi survey was conducted to gain consensus on the defining characteristics of occupation‐centred practice. Purposive, convenience, and snowball sampling were used to distribute three survey rounds to occupational therapists internationally. Content analysis was used to create characteristics, descriptions, and examples of occupation‐centred practice. Percentage agreement between occupational therapists were calculated to determine consensus. Results: Responses were received from 100 participants in round one, 89 in round two, and 70 in round three. Round one generated 12 characteristics that were refined and finalised into four defining characteristics, one of which had three subcharacteristics. The four characteristics are as follows: guided by theory and philosophy grounded in occupation, language and documentation promotes occupation among stakeholders, understanding and incorporating the person's context, and occupation as core to practice, which includes occupation in goal setting, assessment, and intervention. Descriptions and examples were generated for each characteristic. Conclusion: This study presents valuable information for occupational therapists wanting to practise in an occupation‐centred manner. The characteristics, descriptions, and examples provide a foundation upon which occupational therapists can understand and identify occupation‐centred practice. Examples provided were highly influenced by factors including practice settings and preferred terminology. Future research will explore the creation of a tool for occupational therapists to evaluate their own practice against the characteristics to demonstrate areas of strength and for development. [ABSTRACT FROM AUTHOR]

Background Internationally, patient and public involvement (PPI) is core policy for health service quality improvement (QI). However, authentic QI partnerships are not commonplace. A lack of patient and staff capability to deliver successful partnerships may be a barrier to meaningful QI collaboration. Objectives The research questions for this scoping review were: What is known regarding the capabilities required for healthcare staff and patients to effectively partner in QI at the service level?; and What is known regarding the best practice learning and development strategies required to build and support those capabilities? Methods A six-stage scoping review was completed. Five electronic databases were searched for publications from January 2010 to February 2020. The database searches incorporated relevant terms for the following concepts: capabilities for PPI in healthcare QI; and best practice learning and development strategies to support those capabilities. Data were analysed using descriptive statistics and qualitative content analysis. Results Forty-nine papers were included. Very little peer-reviewed literature focused explicitly on capabilities for QI partnerships and thus implicit paper content was analysed. A Capability framework for successful partnerships in healthcare quality improvement was developed. It includes knowledge, skills and attitudes across three capability domains: Personal Attributes; Relationships and Communication; and Philosophies, Models and Practices, and incorporates 10 capabilities. Sharing power and leadership was discussed in many papers as fundamental and was positioned across all of the domains. Most papers discussed staff and patients' co-learning (n=28, 57.14%). Workshops or shorter structured training sessions (n=36, 73.47%), and face-to-face learning (n=34, 69.38%) were frequently reported. Conclusion The framework developed here could guide individualised development or learning plans for patient partners and staff, or could assist organisations to review learning topics and approaches such as training content, mentoring guidelines or community of practice agendas. Future directions include refining and evaluating the framework. Development approaches such as self-reflection, communities of practice, and remote learning need to be expanded and evaluated. [ABSTRACT FROM AUTHOR]