INTRODUCTION:Disabled occupational therapy students face systemic barriers in clinical education. Although legal mandates require reasonable accommodations, implementation is often inconsistent, and few standardized guidelines exist for fieldwork education. This study is aimed at establishing best practices for supporting occupational therapy and occupational therapy assistant students with disabilities during fieldwork. MATERIALS AND METHODS:A three-round Delphi study was conducted with a panel of 30 experts, including disabled occupational therapy students, disabled occupational therapy practitioners, academic fieldwork coordinators (AFWCs), fieldwork educators (FWEs), disability services staff, and researchers. In Round 1, participants answered open-ended questions about challenges, accommodations, and environmental supports. Responses were analyzed using conventional content analysis. In Rounds 2 and 3, participants rated the importance and feasibility of proposed practices using a 7-point Likert scale. Practices with a median importance score of ≥ 6 and an interquartile range (IQR) < 2 were considered to have reached consensus. RESULTS:Forty-one best practices and 12 suggested available accommodations reached consensus for importance. The best practices were organized into six thematic categories: (1) facilitating communication, collaboration, and transparency; (2) advance planning; (3) normalizing and affirming accommodations; (4) education of key stakeholders; (5) individualized and flexible approaches; and (6) addressing structural barriers and institutional ableism. DISCUSSION:Findings highlight the need for structured, inclusive approaches to disability accommodations in occupational therapy clinical education. Key recommendations include proactive communication, early planning, stakeholder education, and flexible implementation of supports. Many best practices emphasize cultural shifts towards disability affirmation, universal design for learning, and structural change-rather than relying solely on individualized accommodations.
BACKGROUND:Community participation and environmental accessibility are core to inclusive practices for children with disabilities and their families. OBJECTIVE:The aim was to examine the Turkish validity and reliability of My Family's Accessibility and Community Engagement (MyFACE) Scale. It was conducted with the parents and caregivers of 105 children with disabilities who continue to receive education in special education and rehabilitation centers. METHODS:Data was obtained using the Participation Scale (PS), Child and Adolescent Participation Scale (CAPS), and the MyFACE. RESULTS:Cronbach's alpha internal consistency coefficient for total scale was found to be 0.859. Through MRFA performed to determine the number of subdimensions of the MyFACE scale, a unidimensional structure consisting of nine items was obtained. The factor loadings of the items forming the single dimension ranged from 0.584 to 0.865. It was found that the factor loadings of the scale can be classified as ranging from good to excellent. According to the results of the analysis, the χ2 statistic (χ2 = 36.857, p = 0.077), χ2/sd value (0 < 1.418 ≤ 2) and fit indices TLI (0.959), CFI (0.971), GFI (0.921), and RMSEA (0.063) evaluated according to cutoff points in literature showed good fit between the model and the data set. The Cronbach alpha values for these tests were 0.894 and 0.887, respectively. When the scale was readministered to 48 participants after a certain period, the intraclass correlation coefficient (ICC) was found to be 0.980 (ICC = 0.980, p < 0.001). CONCLUSIONS:The Turkish version of the MyFACE tool can be used in clinical settings or research alongside any intervention aimed at enhancing children's participation and can help support families' participation in the community.
INTRODUCTION:Interprofessional collaboration (IPC) between optometrists and occupational therapists is key to optimising care for people with visual and functional difficulties. This study examines the experiences and perceptions of IPC among both disciplines in Spain, identifies factors shaping collaboration and compares actual collaborative practice with perceived IPC priorities. METHODS:A cross-sectional study was conducted using an online survey. Participants, 138 optometrists and 148 occupational therapists, were categorised into two groups: those with prior collaborative experience (G1 = 92) and those without (G2 = 194). The survey included sociodemographic data, practice fields and perceptions of IPC. Drawing on D'Amour's model, the dimensions of shared goals and vision, internalisation, formalisation and governance-and their related indicators-were analysed. Quantitative data were examined using descriptive statistics, chi-square tests, Fisher's exact tests, Mann-Whitney U tests and Kruskal-Wallis tests. Open-ended responses were analysed descriptively. RESULTS:Only 32.2% of participants reported prior IPC experience, and collaboration was more frequent in paediatric and private settings. Many G2 professionals indicated serving clients with low vision or acquired brain injury without collaborating, highlighting missed opportunities. G1 participants reported a positive impact on practice and professional learning and scored highly in internalisation, indicating trust and mutual understanding. Nevertheless, gaps persisted in shared goals, formalisation and governance. Occupational therapists reported a more client-centred approach than optometrists and perceived some role-boundary barriers. Limited role awareness and uncertainty about referral pathways were expressed by G2. Both groups noted a need for targeted training to support IPC. CONCLUSIONS:IPC between optometrists and occupational therapists in Spain is currently limited and mainly informal. Prior collaborative experience was associated with greater trust and clearer role understanding. Interprofessional education, clear referral pathways and organisational support are essential to strengthen IPC and ensure client-centred, comprehensive care for individuals with visual impairment.
This study investigates the engagement of young persons with disabilities (YPWDs) in agribusiness in Ghana, where participation remains limited despite commitments to inclusive development. Using a mixed-methods design, the research incorporates quantitative survey data from 169 respondents (97 females and 72 males) and qualitative insights from in-depth interviews and focus group discussions. The findings revealed that 52.8% of currently employed YPWDs were engaged in agribusiness. These were primarily older female youth with limited formal education. Participants identified seven barriers: physical inaccessibility, stigma and discrimination, lack of land, lack of financial support, limited training opportunities, inadequate knowledge, and general disinterest in the sector. Guided by inclusive capability theory (ICT), the analysis shows how social norms, institutional gaps, and environmental factors restrict YPWDs' ability to transform interest into meaningful agricultural participation. While the findings align with global evidence on youth disengagement from agriculture, this study emphasizes the intersection of disability and age-related marginalization. It argues that addressing exclusion in agribusiness requires capability-enhancing approaches, including inclusive infrastructure, disability-responsive financing, adapted extension services, and sustained public awareness. Such measures are vital for promoting social equity and strengthening national agricultural productivity while advancing sustainable development goals.
This scoping review is aimed at identifying and mapping occupational therapy-related assessments and interventions reported in prospective interventional studies and case reports on distal radius fractures, including studies addressing complications. Additionally, the review sought to summarize the current evidence in this field and identify areas requiring further research. Five studies met the inclusion criteria. Most studies primarily emphasized impairment-level outcomes, such as range of motion and grip strength, whereas activity, participation, occupational performance, and psychosocial aspects were addressed less frequently. Only a limited number of studies reported complications, and the included studies generally employed relatively narrow eligibility criteria. These findings suggest that existing evidence may have limited applicability to the broader population of patients with distal radius fractures, particularly those with complications. Future research should include broader patient populations and incorporate occupation-focused approaches to better address activity, participation, and occupational performance in distal radius fracture rehabilitation.
Learning is the primary occupation of adolescents in high schools, although they engage in a much wider range of occupations at school. Recent systematic and scoping reviews from high-income countries (HICs), classified by the World Bank, with the United States as the most prominent, provide evidence to support the role of occupational therapy in school participation for adolescents with developmental, health, and environmental barriers. However, participation for high school learners in the African context differs from that of learners from an HIC context, due to the unique challenges faced by learners in Africa. These challenges include poverty, educational challenges (e.g., early school dropout and teacher shortfall), infrastructure and resource shortages, cultural expectations and inequalities (e.g., family and gender norms), conflict, and instability. A scoping review was conducted to map interventions that promote participation in schools internationally and to evaluate their suitability for the African context. The Preferred Reporting Items for Scoping Reviews and Meta-Analyses (PRISMA) extension guidelines were used to guide this review. Sources about the nature of school-based interventions for adolescents (12-18 years) that indicated a clear link between the intervention and participation in schools, published in English (with no restriction on years) and peer-reviewed, were included. A total of 2689 studies (excluding duplicates) were identified, and 15 were included. Framework analysis was used to evaluate the suitability of interventions, including the characteristics of the evidence, community-based practice, practice approaches, sustainability, cultural norms, and spirituality. Four interventions were identified as suitable for the African context: a recovery program for adolescents with substance use disorders, a social cognitive intervention to promote social skills in adolescents with autism, a transition readiness service to promote work participation, and coping strategies to promote adolescents' mental health in schools. Recommendations were made to include spirituality when delivering interventions for adolescents in African schools.
BackgroundOccupational therapy students and novice occupational therapists often face considerable challenges when entering acute mental health settings, particularly within South Africa ' s culturally diverse and resource-constrained contexts. This study explored the preparedness of University of KwaZulu-Natal (UKZN) occupational therapy students and novice practitioners for acute mental health practice within KwaZulu-Natal ' s complex healthcare landscape.MethodsA qualitative, exploratory design was used with purposive sampling to recruit 15 participants. Ten fourth-year students and five novice occupational therapists participated in focus group discussions and individual interviews. Data were analysed thematically to identify key patterns related to preparedness, challenges and experiential learning.FindingsThree overarching themes emerged: (1) educational preparation gaps, (2) practice readiness challenges and (3) systemic and transition constraints. Participants demonstrated strong theoretical knowledge but reported limited practical readiness, particularly regarding culturally responsive care, emotional regulation and evidence-based intervention in acute settings.ConclusionsThe findings emphasise the need to strengthen occupational therapy education through earlier and more intensive acute mental health exposure, enhanced clinical supervision and greater emphasis on cultural competence and acute care interventions. Grounded in experiential learning theory (ELT), improved experiential learning opportunities may better prepare graduates for effective, contextually relevant practice in South Africa ' s acute mental health environments.
INTRODUCTION:Group interventions are one mode of delivery that supports individuals experiencing challenges related to time management and occupational imbalance in their recovery. However, research on available group interventions, their key components, and how to evaluate their potential effects on time use and occupational balance is scarce. AIMS/OBJECTIVE:This study is aimed at contributing to the development of evidence-based occupational therapy interventions by describing research that evaluates group interventions for adults within the scope of time use and occupational balance. MATERIALS AND METHODS:A scoping review was conducted using four databases. Records published between 2014 and 2024 were identified, and data from the identified group interventions were extracted and summarized. The outcomes and instruments in the different articles were categorized according to Wilson and Cleary's conceptual model of patient outcomes. RESULTS:Thirty-one articles describing 13 different group interventions were included. The most commonly addressed measures within the time use and occupational balance domain were value or satisfaction measures (for occupations), performance measures (including aspects such as activity level, performance, and competence), and occupational balance measures. CONCLUSIONS:The lack of consensus regarding outcome measures for occupational therapy group interventions highlights the need to clarify and relate key concepts within the domain of time use and occupational balance.
INTRODUCTION:Occupational formulation offers a way to synthesise assessment information to understand a person's occupational participation and needs. Although increasingly recognised in professional guidelines, there has been limited exploration of its development and application in occupational therapy. METHODS:A scoping review was conducted following Arksey and O'Malley's framework and PRISMA-ScR guidelines. Comprehensive searches were undertaken across five databases (AMED, CINAHL, Emcare, PsycInfo and Google Scholar), a global theses repository, and multiple grey literature sources. Inclusion criteria focused on English sources describing the use by occupational therapists of formulation or conceptualisation related to occupational concepts. One hundred and two eligible sources were identified, from which data were extracted, tabulated and synthesised narratively. RESULTS:The reviewed sources spanned 2002-2025, mainly originating from the United Kingdom and United States, and mental health settings. Sources included some evaluations and practice reflections but limited empirical research. Four strands of occupational formulation development were identified: formulation associated with the Model of Human Occupation, descriptions of the occupational therapy practice process, psychological formulation approaches and bespoke occupational approaches. Identified key features of occupational formulation were as follows: its grounding in occupational theory, inclusion within the practice process between assessment and goal development/therapy planning, collaborative emphasis, narrative approach, provision of a structure and being an ongoing process. Reported purposes included synthesising assessment findings, supporting reasoning, supporting shared understanding and therapy planning, enhancing communication and promoting an occupational focus. Benefits for the person, therapeutic relationship, occupational therapist and team were reported. DISCUSSION:Occupational formulation is both a process and a written product that can strengthen occupational therapy practice by linking theory to practice, enhancing reasoning and supporting collaborative care. Definitions are proposed to support consistent use in research and practice. CONCLUSION:Occupational formulation shows promise for enhancing occupational therapy practice. Further research should evaluate its effectiveness across diverse practice settings and populations.
BackgroundThrough the teaching of the Canadian Model of Occupational Performance and Engagement (CMOP-E), a number of repeated challenges were witnessed. The purpose was to critically reflect, through dialogue, on potential additions to align with societal evolution.ProcessThe application of the CMOP-E was discussed with occupational therapy students for over more than 20 years of teaching at both the undergraduate level and the professional master ' s level in occupational therapy. Three key issues repeatedly emerged and triggered an in-depth reflection. The content of this reflection was discussed with a variety of senior academics holding expertise in the CMOP-E.Key IssuesArguments supporting the idea that it would be of value to make explicit the concept of "identity" within the spirituality dimension are proposed. The environment should be considered at three levels: micro, meso, and macro levels, and a reflection is presented on the space that should be allowed for "virtual" as another category of environment. Lastly, "relationships" should be explicitly considered as a domain of occupation and not as an affective state or the social environment.ImplicationsMaking these three "additions" to the description of the model will help to clarify how the CMOP-E can be used in contemporary practice.
ObjectiveOccupational therapy plays a crucial role in the rehabilitation and recovery of individuals facing acute psychiatric challenges. However, the practice within acute psychiatric inpatient settings is often fraught with unique challenges that can hinder effective intervention. This qualitative study is aimed at exploring the multifaceted obstacles and challenges that occupational therapists encounter in these environments.MethodThis study utilized a qualitative approach with conventional content analysis. A total of 14 participants were involved, comprising active and experienced therapists, individuals currently hospitalized in acute settings, and psychiatrists. After obtaining ethical approval and informed consent, in-depth, unstructured interviews were conducted in accordance with the research objectives. Purposeful sampling and maximum diversity strategies were employed to select and invite participants, who subsequently underwent in-depth, semistructured interviews. The interviews were meticulously recorded and subsequently transcribed. The transcribed texts were subjected to analysis through the inductive qualitative content analysis.ResultsThe challenges associated with implementing occupational therapy interventions in acute psychiatric inpatient settings were categorized into five main areas: patient engagement, therapist safety concerns, burnout and high work pressure, lack of standard facilities and space, and unawareness of the need for such interventions.DiscussionConsidering the various challenges faced by occupational therapists in acute psychiatric inpatient settings, a comprehensive and coordinated approach is essential. Issues such as patient engagement, therapist safety concerns, burnout and high work pressure, lack of standard facilities, and unawareness of the need for such interventions all impact the effectiveness of therapy. Ongoing training and education, coupled with supervision and mentorship, can empower therapists and promote self-care practices to mitigate burnout. Fostering interdisciplinary collaboration, conducting regular meetings to discuss patient progress, and ensuring role clarity among team members are essential to facilitate comprehensive care. Providing adequate facilities and resources, ensuring safe working conditions, and raising awareness about the importance of occupational therapy are crucial.
BACKGROUND:Attention deficit hyperactivity disorder (ADHD) in adolescence is associated with executive function difficulties, which compromise academic performance, daily functioning, and adaptive behaviors. Occupational therapy is aimed at improving EF and occupation and participation impairments. This study presents preliminary findings on the effectiveness of a multicomponent intervention protocol designed to enhance cognitive abilities in adolescents with ADHD. METHODS:A quasi-experimental design with one-group, pretest-posttest, was used to evaluate the impact of the MOTI, which included computer-based cognitive training, academic skills training, and complementary but not mandatory a parents' psychoeducation group. Fifty-four adolescents aged 13-18 participated. Preintervention and postintervention assessments measured cognitive abilities and mental health indicators. RESULTS:Significant improvements were observed in working memory (digit span, CAB), mental flexibility (Trail Making B), and processing speed (Trail Making A). Omissions on the continuous attention test decreased (p = 0.046), and students self-reported better planning and organizing skills (p = 0.034). CONCLUSIONS:Evidence supports the effectiveness of the multicomponent intervention protocol (MOTI) in improving executive functions in adolescents aged 12-18 with ADHD. Initial analyses of the cognitive and academic skills training component reveal positive outcomes in targeted executive functions, reinforcing this multicomponent intervention as a valuable occupational therapy approach for this population.
AIM:The aim of this study was to investigate the effects of sensory integration therapy on balance, functional independence, functional mobility, sensory processing, and cognitive function in children with cerebral palsy. METHODS:Twenty-two children with cerebral palsy attending a rehabilitation center participated in the study. Participants were randomly assigned to the study group (two females, nine males; 7.3 ± 1.7 years) and the control group (four females, seven males; 8.3 ± 1.4 years). Sociodemographic data were collected using a structured questionnaire. Balance was assessed with the Pediatric Berg Balance Scale, functional mobility with the Timed Up and Go Test, functional independence with WeeFIM, sensory processing with the Sensory Profile, and cognitive function with Dynamic Occupational Therapy Cognitive Assessment for Children (DOTCA-Ch). Both groups received balance and coordination exercises (1 session/week, 45 minutes), while the study group additionally received individualized sensory integration therapy (1 session/week, 45 min) for 12 weeks. RESULTS:Both groups showed improvement in all measured variables after the intervention. Although both groups demonstrated improvements in Berg Balance Scale and Timed Up and Go Test scores following the intervention, no statistically significant between-group differences were observed (p > 0.05). Significant differences (p < 0.05) were found between groups in WeeFIM, DOTCA-Ch, and specific subscales of the Sensory Profile (sensory seeking, emotional response, inattention, sensory sensitivity, and perceptual fine motor domains). CONCLUSION:Consistent with the hypothesis, sensory integration therapy combined with balance and coordination exercises was associated with improvements in balance, functional mobility, independence, sensory processing, and cognitive function in children with cerebral palsy. However, these findings should be interpreted cautiously because formal group × time interaction analyses were not performed.
OBJECTIVES:This review aimed to comprehensively synthesise evidence on the therapeutic efficacy of driving rehabilitation for patients with acquired brain injury (ABI) and identify and analyse key predictors of successful return-to-driving. METHODS:A comprehensive literature search was conducted using four databases: PubMed, Embase, Web of Science and ProQuest. Eleven studies (four randomised controlled trials and seven cross-sectional studies) were included in the final analysis. Reporting completeness and methodological quality were assessed using PRISMA checklists. A random-effects model was used to calculate the standardised mean differences (SMDs) and odds ratios (ORs). MAIN FINDINGS:A qualitative analysis of cross-sectional studies identified cognitive processing speed, reaction time and functional independence as frequently reported predictors of returning to driving, with a pooled meta-analysis further highlighting lower initial injury severity (higher GCS scores) as a significant predictor of returning to driving. The meta-analysis revealed that simulator- and VR-based training significantly reduced driving errors (SMD = -1.19, 95% confidence interval [CI]: -1.75 to -0.64; p < 0.0001). The intervention significantly increased the likelihood of passing the on-road driving test by approximately 3.37 times (OR = 3.37, 95% CI: 1.36-8.35). CONCLUSION:The results of this review suggest that simulator-based interventions may positively impact driving performance and current cognitive and functional activities, as well as psychological self-efficacy, and facilitat a successful return to driving in patients with ABI. These findings provide a baseline for developing clinical guidelines for the safe resumption of driving.
Background and PurposeThis study investigated fundamental motor skills in children with specific learning disorder (SLD) compared with their typically developing (TD) peers, focusing on individual skill mastery and performance patterns across diagnostic subtypes.MethodsA total of 90 children (45 SLD and 45 TD) aged 8-11 years participated. Fundamental motor skills were assessed using the process-oriented Test of Gross Motor Development-2 (TGMD-2).ResultsResults demonstrated that children with SLD exhibited significantly lower motor skills proficiency than TD peers, with significantly lower scores found across most locomotor (running, galloping, hopping, jumping, and sliding) and object control (batting, catching, throwing, and rolling) skills. The SLD group was significantly less likely to demonstrate mature movement patterns in 9 out of 12 skills, and the majority of children with SLD were categorized in the "Poor" or "Below average" performance ranges, underscoring a critical qualitative deficit in motor execution. However, no significant differences in gross motor performance were observed among the SLD subtypes (dyslexia, dyscalculia, dysorthographia, and mixed).ConclusionThese findings highlight a pervasive fundamental motor skills deficit that warrants routine motor assessment for children with SLD to inform targeted, process-oriented interventions aimed at mitigating long-term developmental risks.
OBJECTIVE:Developmental coordination disorder (DCD) is a neurodevelopmental condition marked by impaired motor coordination despite the absence of an underlying neurological condition affecting movement (e.g., cerebral palsy, muscular dystrophy, and degenerative disorder). Motor imagery training (MIT) has recently gained attention as a rehabilitation approach for children with DCD. Effective implementation of MIT requires accurate assessment of motor imagery (MI) abilities; however, no comprehensive evaluation tool for children exists in Japan. This study is aimed at developing a Japanese version of the Movement Imagery Questionnaire for Children (MIQ-C) and examining its reliability and responsiveness. METHODS:Thirty-three children (18 males and 15 females; mean age 10 ± 0.9 years) participated. Internal consistency was assessed using Cronbach's alpha. Test-retest and interrater reliability were examined using intraclass correlation coefficients. Responsiveness was evaluated by examining changes in MIQ-C scores before and after training tasks. RESULTS:The Japanese version of the MIQ-C demonstrated strong internal consistency (Cronbach's α = 0.82). Test-retest and interrater reliability showed moderate to strong agreement. No significant changes were observed in response to specific tasks, supporting appropriate responsiveness. CONCLUSIONS:The Japanese version of the MIQ-C is a reliable and valid instrument for assessing MI abilities in Japanese children, providing a useful tool to support the implementation of MIT in clinical and educational settings.
Cancer-related fatigue (CRF) is a debilitating symptom experienced by many people undergoing radiation therapy, significantly impacting daily functioning and quality of life. Occupational therapists play a vital role in managing CRF, yet the lack of standardised outcome measures tailored to occupational therapy practice hinders effective assessment and intervention. This scoping review is aimed at identifying and mapping validated fatigue outcome measures suitable for outpatient radiotherapy settings and discussing their relevance to occupational therapy. Following the Arksey and O’Malley framework, a comprehensive search was conducted across MEDLINE, CINAHL, Embase, and PubMed, identifying 445 records. After screening, 12 studies published between 2010 and 2022 from seven countries were included. Breast, head and neck and prostate cancers were commonly studied, most often using prospective cohort designs. Most studies used multidimensional, self-reported outcome measures, administered at multiple times throughout radiotherapy and at follow-up. While these measures assessed physical, emotional and cognitive fatigue, few addressed activity or participation in daily life. The findings highlight a gap in outcome measures that comprehensively evaluate activity and participation. This gap limits their utility in tailoring interventions or demonstrating the impact of occupational therapy. This review underscores the need for developing or adapting CRF outcome measures that better align with occupational therapy goals to enhance clinical decision-making and research in outpatient radiotherapy settings.
Occupational therapy graduates in South Africa are increasingly required to practice in acute mental health settings, yet the extent to which current curricula prepare them adequately remains underexplored. This study examined the competencies required for acute mental health occupational therapy practice through a comparative document analysis of four national and international frameworks: the WFOT Minimum Standards (2016), HPCSA Minimum Standards (2024), WHO Recommendations for Occupational Therapy Practice in Mental Health (2024), and WHO mhGAP Intervention Guide (2016), mapped against the University of KwaZulu-Natal (UKZN) exit-level outcomes (2024). Seven core competency domains were identified across the frameworks. The UKZN outcomes demonstrated strong alignment in cultural competence and interdisciplinary collaboration, partial alignment in recovery-oriented practice, assessment skills, therapeutic use of self, and professional resilience, and confirmed gaps in condition-specific knowledge, risk assessment, trauma-informed care, crisis intervention, and transition planning. These findings demonstrate that acute mental health competency preparation cannot be achieved through alignment with any single regulatory document, including the HPCSA framework. This therefore calls for both urgent curriculum reform and strengthening of accreditation standards across all South African occupational therapy programs.
BackgroundIn light of the global unemployment crisis, there is a need for research on nonconventional work, including self-employment, an alternative placement option for persons with disabilities.ObjectiveThe objective of the study is to establish consensus on the components of an evidence-based framework to facilitate self-employment for persons with disabilities.MethodsEnd users, service providers and policy actors participated in this Delphi study. Relevant data was collected online and analysed thematically, descriptively and using frequencies.ResultsThe response rates were n = 19/21 (91%) in Round 1, n = 16/19 (84%) in Round 2 and n = 15/16 (94%) in Round 3. The main findings of Round 1, through an open-ended question, were (i) an ideal tool, considerations and interventions related to entrepreneurial skills for persons with disabilities and (ii) expected roles and capacities of persons with disabilities. Through the 5-point Likert scale evaluations in Round 2, the participants identified critical components of the framework, including (i) key features, (ii) legislation that informs disability rights, (iii) involved key role players, (iv) characteristics, roles and duties of persons with disabilities and (v) the ideal tool's facilitation steps. In the final round, the participants agreed on the content of the framework's user's guide document to include the following: (i) purpose of the tool, (ii) background of the tool, (iii) how to use the tool and (iv) tool supporting resources.ConclusionConsensus on the components of a framework was achieved; experts regarded the framework as being nonprescriptive, prioritising practicality, accessibility and sustainability within and beyond the South African context. Participants proposed measures like a user's guide to support framework operationalisation.
INTRODUCTION:Spinal cord injury (SCI) is associated with inequality-related participation restrictions. Participation education has been proposed as an intervention to promote participation in daily occupations. This pilot randomized clinical trial (RCT) evaluates the feasibility and minimal effect of the SADL-eM, a participation educational intervention, on the participation of people with spinal cord injury (PW-SCI) in daily occupations. METHODS:A two-arm pilot RCT included 32 PW-SCI from three inpatient rehabilitation settings in the Gaza Strip aged 18-65 years. Eligible cases were randomized equally into two groups. Both groups received standard care. The intervention group also used the SADL-eM during occupational therapy sessions. Participation and adherence were assessed at baseline and after 6 weeks. The Arabic version of the Spinal Cord Independence Measure-Self Reported (SCIM-SR-Ar) was the primary outcome measure. RESULTS:Demographic and injury characteristics were homogenous at baseline (p > 0.05). There was no difference between groups at baseline (p < 0.05). Comparing intervention to standard care, the SADL-eM was insignificant after 6 weeks of intervention (p > 0.05) while the inpatient rehabilitation improved participation in daily occupations (16.06%-17.00%) in the total sample (p ≤ 0.001). CONCLUSION:There was an improvement in all outcome measures used; however, the SADL-eM did not reach significance. The intended RCT has major barriers, for example, a low recruitment rate. Community settings can be unique for such an RCT. TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT04735887.
