BackgroundSince the release of the Truth and Reconciliation Commission of Canada's Calls to Action in 2015, many post-secondary programs, including occupational therapy, have increased the integration of Indigenous content in curricula. However, limited research has examined how this influences learners' beliefs and attitudes, making it difficult to assess progress toward reconciliation.PurposeTo better understand the effects of Indigenous curricular content on learners' beliefs and attitudes.MethodA pre-post survey was administered to first-year occupational therapy learners as part of an ongoing program evaluation. This evaluation followed the introduction of 17 h of Indigenous content delivered across five courses.FindingsPost content integration, some learners demonstrated decreased perceived professional responsibility as future health professionals and reduced support for social action and related policies, alongside a small increase in blaming attitudes toward Indigenous Peoples. No statistically significant changes were observed in causal beliefs. Learners with higher blaming attitudes were less likely to endorse support for social action or feel responsibility to enact change.ImplicationsBy sharing this evaluation, we aim to foster dialogue among programs regarding successes, challenges, and resource needs, identify strengths and areas for improvement, and underscore the importance of ongoing critical evaluation given the potential for unintended backfire effects.
BackgroundIndividuals with long COVID experience persisting symptoms that affect daily life, particularly functional performance. Occupational therapists are well positioned to support this population given their expertise across broader health domains.PurposeThis rapid review describes the existing literature on the role of occupational therapy for adults and older adults with long COVID across the healthcare continuum.MethodsA search was conducted across MEDLINE (Ovid), EMBASE, and CINAHL (Ebsco) databases from January 1, 2020, to December 4, 2024.FindingsTwenty-one articles were included for data extraction. The occupational therapy role involved addressing key long COVID symptoms (e.g., fatigue, weakness, and cognitive impairments) that influenced daily occupational performance. Occupational therapy interventions were primarily delivered in rehabilitation settings and included retraining in activities of daily living, cognitive rehabilitation, physical and breathing exercises, patient education, return-to-work planning, and psychosocial support.ConclusionThe occupational therapy role involved addressing long COVID symptoms to regain functional independence to enable occupational engagement, primarily through patient education. Studies focused more on interprofessional, team-based interventions, versus occupational therapy-specific interventions in isolation. This highlights the need for further research on the unique role of occupational therapy within interprofessional teams and along the care continuum for more generalizable findings.
BACKGROUND:Artificial intelligence (AI) use is rapidly emerging in health care and health professions education; there is limited literature to guide its use in occupational therapy (OT) education. Understanding OT students' current knowledge and usage of AI in their education programs may offer insights for curriculum development. PURPOSE:To explore how OT students in Canada are using AI to support their learning. METHODS:An exploratory qualitative descriptive design was used. OT students (N = 12) from Master's level programs in Canada participated in semi-structured interviews. Data was analyzed using conventional content analysis. FINDINGS:Two main themes emerged: (1) "I use [AI] to get the ball rolling," which describes how students used AI for course content navigation and administrative tasks to improve efficiency, organization and reduce cognitive load; (2) "It's not good or bad, it's hard to say," which reflects the tension that students experience recognizing AI's potential, but also hesitancy with concerns about its accuracy, wariness due to their self-perceived knowledge limitations, and potential for academic misconduct. CONCLUSION:OT students are integrating AI into their academic routines with hesitancy and caution, suggesting the need for AI literacy and guidance within OT their professional education.
Background. Recovery after traumatic brachial plexus injury (BPI) involves complex interactions between injury, physical, psychosocial, and environmental factors that affect occupational performance and participation in life roles. This study examined the interrelationships between these outcomes. Method. This cross-sectional, mixed-methods study included 41 adults one-year postsurgical BPI repair. Quantitative measures included the Disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) (upper-extremity disability), the Canadian Occupational Performance Measure (COPM: performance, satisfaction), and the Participation Behaviour Questionnaire (PBQ). Qualitative data from semistructured COPM interviews were thematically analyzed (interpretive description) and linked to International Classification of Functioning Disability and Health categories using standard linking rules. Results. Self-care (88%) and productivity (68%) were the most frequently reported challenges. The mean QuickDASH score was 38.40/100 (SD = 22.70); COPM performance and satisfaction scores averaged 4.6/10 (SD = 1.61) and 4.0/10 (SD = 1.80); COPM performance showed a moderate, nonsignificant negative correlation with QuickDASH scores (r = -.32, P = 0.093) and a strong positive correlation with satisfaction (r = .90, P < 0.001). The QuickDASH scores were strongly correlated with PBQ participation restriction (r = .84, P < 0.001). Qualitative findings revealed a capacity-performance gap and psychosocial impacts, emotional regulation difficulties, altered identity, and existential concerns, that were not captured by quantitative measures. Implications. One year after BPI, participants showed partial functional recovery but continued to face personal and environmental barriers to real-world participation. Qualitative interviews identified areas of concern not sufficiently revealed by quantitative outcomes. Rehabilitation should incorporate physical restoration, environmental adaptation, and psychosocial support to rebuild occupational competence, identity, and participation.
Description. In recent years, some occupational therapists have joined family medicine groups (FMGs). Despite certain integration obstacles identified in the literature, this practice remains poorly documented. Objective. To explore the practice of occupational therapists in FMGs and identify the factors influencing it. Methodology. This descriptive qualitative study includes six semi-structured interviews conducted with occupational therapists in FMGs. The interviews were analyzed using mixed thematic analysis. Results. Four professional occupational therapy activities emerged: 1) deploying service offer; 2) conducting assessment; 3) carrying out intervention; and 4) supporting team skills. Practice is influenced by various factors, mainly related to how the FMG is organized (internal rules, part-time employment, availability of equipment, size and layout of premises) and the individuals involved (previous experience, colocation within the FMG, mentorship opportunities, and collaborations outside the FMG). Conclusion. Occupational therapy practice within FMGs is promising, but it requires short-term development and dissemination activities to ensure the implementation of the full scope of occupational therapists' role within FMGs.
IntroductionThe perception of occupational therapists is essential to the improvement of universal accessibility projects. However, there is little evidence on the involvement of occupational therapists in this field.AimTo explore occupational therapists' perceptions of their professional experience and training in universal accessibility, and its integration into their practice.MethodologyThis study adopts a interpretative descriptive qualitative methodology. Semi-structured individual interviews were conducted with nine participants in Quebec, Canada. Thematic analysis was done.ResultsInterviews revealed three main themes: 1) knowledge of universal accessibility, 2) the accessibility project process, and 3) the occupational therapist's contribution to universal accessibility. Each theme also includes sub-themes: The main findings related to a lack of training in universal accessibility, the engagement and roles of occupational therapists in accessibility projects, and the added value of this professional's contribution to projects.ConclusionThese results can help occupational therapists and other professionals in the field of universal accessibility better understand the role of occupational therapists in this field and can guide occupational therapy programs in improving academic training in this area. This could help define the occupational therapist's role in this field and optimize their contribution.
BackgroundPrevious research has explored experiences of choral music-making and its benefits for health and well-being.PurposeThe purpose of this study is to explore what makes engaging in choral music-making meaningful for choral musicians in Canada as illuminated by their experience of the first 18-22 months of the COVID-19 pandemic.MethodsSemi-structured interviews were conducted with 18 participants who are involved with choral music-making across Canada. Interpretive description was used to analyze the interview data.FindingsThree themes were identified: (1) music-making contributing to a sense of community, (2) transcendent properties of music-making, and (3) music-making contributing to a sense of self.ImplicationsThis study provides insight into aspects of music participation which contribute to its meaningfulness, the utility of considering choral music-making as a co-occupation, and the relationship between choral music-making and participants' self-concept. The findings provide insight on how occupational therapists can support people who engage in this meaningful occupation.
Background. Numerous risk factors for stroke are modifiable and are associated with lifestyle and daily habits. An occupational perspective in prevention, which emphasizes habits and routines, can facilitate sustainable and healthy lifestyle changes. Additionally, lifestyle changes generally take place within a social context, making family involvement indispensable. Purpose. This study aims to explore family support from the perspective of persons with risk for stroke (PWRS) who participated in an occupation-based stroke prevention program, and their family members. Method. Explorative qualitative design using interviews was conducted with 10 PWRS who participated in the Make My Day intervention and 10 family members of intervention participants, including both married and nonmarried partners and adult children. Data were analyzed using an inductive semantic approach and reflexive thematic analysis. Findings. Family support depends on the nature of relationships, the family's willingness to accept support, and expectations. Three themes were generated through the analysis: (a) shared perspectives on lifestyle influence support, (b) balancing support and individual responsibility, and (c) generating tensions from different views on health and lifestyle habits. Conclusion. Family support encourages lifestyle changes by sharing activities, offering encouragement, and providing positive reinforcement. Nonetheless, difficulties can occur in maintaining a balance between supporting family members and respecting their personal responsibility, particularly when family members have varying levels of understanding regarding health.
Description. In recent years, some occupational therapists have joined family medicine groups (FMGs). Despite certain integration obstacles identified in the literature, this practice remains poorly documented. Objective. To explore the practice of occupational therapists in FMGs and identify the factors influencing it. Methodology. This descriptive qualitative study includes six semi-structured interviews conducted with occupational therapists in FMGs. The interviews were analyzed using mixed thematic analysis. Results. Four professional occupational therapy activities emerged: 1) deploying service offer; 2) conducting assessment; 3) carrying out intervention; and 4) supporting team skills. Practice is influenced by various factors, mainly related to how the FMG is organized (internal rules, part-time employment, availability of equipment, size and layout of premises) and the individuals involved (previous experience, colocation within the FMG, mentorship opportunities, and collaborations outside the FMG). Conclusion. Occupational therapy practice within FMGs is promising, but it requires short-term development and dissemination activities to ensure the implementation of the full scope of occupational therapists' role within FMGs.
Background: The 2021 competencies for occupational therapists in Canada require therapists to promote equity, work to reduce power inequities, and engage in anti-oppressive practice. This means not only examining how we may be reproducing oppression and privilege within workplaces and therapeutic spaces, but also working to transform harmful social conditions in the world around us. While advocacy is well-established in the profession, activism may be less familiar. Purpose: The authors reflect on experiences and relevant literature to examine how advocacy, activism, and agitating may be part of a spectrum of justice-oriented change-making efforts in occupational therapy. Key concepts: All require careful analysis and mobilization of power, identifying the roots of inequities and potential strategies for change. There are multiple ways to engage in this work, but it has often been construed as "unprofessional." The authors argue that it is in fact professional, demanding nuanced, ethical commitment, and moral courage. Implications: Arguably, confronting social inequities is an essential part of a professional duty to the public. Collective action is most effective for change-making, building solidarity with others around a clear analysis of power and processes for social transformation.
Background: Many postsecondary Canadian healthcare students report mental health challenges. Meaningful participation may reduce stress and enhance well-being. While participation encompasses both attendance and involvement, little is known about how involvement relates to emotional well-being (EWB) in occupational and physical therapy (OT/PT) students. Purpose: Using Experience Sampling Method, this study examined the association between momentary ratings of involvement in outside-of-school activities and EWB among OT/PT students, and whether this association differed by program. Method: Thirty-eight students (87% female) participated. Using the m-Path app, participants completed a set of five questions several times daily over a period of two weeks, reporting current activity, involvement level, and three emotional states. Pearson correlations and mixed-effect models were used. Findings: Of the 957 observations, non-academic activities were most common (80%). Involvement was most strongly associated with happiness and cheerfulness (0.4 > r > 0.9), seen in 53% of the participants. These associations were significant in both programs, with greater effects among OT students (0.52 >β > 0.59). Conclusion: Involvement in outside-of-school activities, captured in real-time, is important to students' well-being, particularly happiness and cheerfulness. Findings may interest OT/PT students and directors seeking to support well-being through occupation.
Background. Psychotherapy encompasses a range of evidence-based mental health interventions adopted by healthcare providers, including occupational therapists. Advocacy for public funding and regulation of psychotherapy requires critical reflections on occupation-based approaches within this changing landscape. Purpose. To explore the perspectives and practices of Canadian occupational therapists regarding psychotherapy. Method. An online survey of Canadian therapists providing mental health services (n = 487) was conducted, followed by 8 regional focus groups (n = 63) to explore perspectives in more depth. Analysis of the survey and focus group data identified key trends in practice patterns and beliefs. Findings. There was variation in the extent to which psychotherapy was adopted, but trends in the types of approaches and perceived competence in foundational skills. Tensions were noted in the extent to which psychotherapy was linked to occupational therapy (OT) practice. Most felt that occupational therapy offered a unique occupation-based approach, but practice was shaped by differences in the regulatory context, and recognition of their role. Implications. Lack of clarity regarding the definition of psychotherapy, provincial differences in regulation, and limited external awareness of our role speaks to the need for national conversations, research and guidelines regarding occupation-based psychotherapy.
Background Occupational therapists use standardized scales to assess how individuals process and respond to sensory information. Currently, there is limited evidence about the convergent validity between the Adult/Adolescent Sensory History (ASH) and the Sensory Processing Measure 2-Adult Form (SPM-2-Adult). Purpose. The study examined the convergent validity of the ASH and SPM-2-Adult when completed by young adults. Method. Fifty Australian adults aged 21-35 completed the ASH and SPM-2-Adult. Spearman's rho correlations were used to analyze the data. Results. Most ASH and SPM-2-Adult subscales were significantly associated with correlations ranging from rho = 0.301 to 0.858 (p < .033-.001). Statistically significant correlations were obtained between the SPM-2-Adult Vision subscale and every ASH subscale (rho = 0.322-0.841, p < .023-.001) while the SPM-2-Adult Taste and Smell subscale yielded the most non-significant correlations with the ASH. Most of the statistically significant correlations between the ASH and SPM-2-Adult were in the moderate range. Conclusion. Promising evidence of convergent validity between the ASH and SPM-2-Adult sensory subscales and total scales was demonstrated, whereas the convergent validity findings between the ASH Functional-Problems subscales and the SPM-2-Adult sensory subscales were less robust. This adds to the psychometric body of concurrent validity evidence between the two scales.
Background. Return to driving following acquired brain injury enhances participation in community-based occupations, yet may be difficult to achieve and not without risk. Evidence supports on-road driving remediation to achieve functional fitness to drive post-acquired brain injury. Purpose. To determine if skills acquired through on-road driving remediation are maintained. Method. Secondary analysis of randomized controlled trial findings compared functional fitness to drive status and driving performance as rated by on-road occupational therapy driver assessment post-intervention and six-month follow-up. Findings. Of 25 participants with acquired brain injury (26-65 years), 95% of the 19 deemed functionally fit and 50% of the six deemed not functionally fit to drive retained that status at follow-up. Four changed status, with most (n = 3) shifting from not fit to fit. No significant change in functional fitness to drive status or driving performance observed at follow-up (p = .625). Being fit to drive at follow-up was significantly associated with competent observation, awareness, speed control, planning, judgement, and self-navigation. Conclusions. Following on-road driving remediation devised by an occupational therapist with advanced training in driver assessment and delivered by a qualified driving instructor, skills were maintained six-month follow-up post-acquired brain injury.
BACKGROUND:The extension of work stoppages is linked to several common psychosocial factors associated with the diagnoses causing the work stoppages, highlighting the need for effective transdiagnostic interventions. REDO®, a group occupational therapy approach, has proven effective in Sweden in promoting return to work (RTW). PURPOSE:The objectives of this study were: (1) to translate the REDO® intervention manual into French; (2) to adapt it to the Quebec context; (3) to design REDO® in a hybrid format; and (4) to conduct a pilot test including an assessment of acceptability and feasibility. METHOD:REDO® was translated using professional software, followed by content validation by several experts. The adaptation took into account contextual factors in RTW in Quebec. For the pilot test, a mixed design with triangulation was used, including various questionnaires assessing acceptability and pre-post changes, and fieldnotes documenting feasibility. FINDINGS:Six individuals who had been on sick leave for 8-23 months and who had various mental or physical disorders completed the entire REDO® program. Four individuals were in the process of RTW at the post-group follow-up. Improvements were noted in life balance and feelings of efficacy in dealing with obstacles to RTW. The approach was highly acceptable to the participants. CONCLUSION:Thanks to its versatility, REDO® offers real potential for promoting RTW and improving the quality of life of people on long-term sick leave.
Background. Studying the implementation of occupation-based stroke prevention interventions in primary healthcare is necessary and will provide insights of interventions' feasibility in clinical practice. Purpose. To explore the implementation of the Make My Day (MMD) stroke prevention intervention in Swedish primary healthcare with health professionals (HPs) and among persons at risk for stroke. Method. The Medical Research Councils process evaluation framework domains, implementation, mechanisms of impact and context, guided investigation of the implementation. Data were collected through logbooks, fieldnotes, and interviews. Descriptive statistics were used to analyze process data while thematic analysis was applied to explore experiences of and interactions with the MMD intervention and contextual influences. Results. There was a high belief in using engaging occupations to facilitate lifestyle habit change among HP's and persons at risk for stroke. The HP's complementary competencies, sharing experiences within groups and digital self-monitoring was valued. Time constraints and age differences in groups impacted MMD delivery. Reaching a representative sample, and different Swedish primary healthcare settings was challenging. Conclusion. The occupation-based framework and intervention implementation was feasible yet sustainability in Swedish primary healthcare requires securing HP staff and time to deliver prevention like MMD, and reaching hard-to-reach groups in the study population.
Background. While it is a well-recognized and cost-effective preventive occupational therapy (OT) intervention, the impact of the Lifestyle Redesign® training, including its French version, is unknown. Purpose. This study aimed to explore experience of French-Canadian OTs and students about the Lifestyle Redesign® training and its influence on their knowledge and behavioural intention. Method. A cross-cultural validation and action research were used including a pre-experimental component (OTs questioned before and after the training). Semi-directed focus groups were digitally audiotaped and transcribed, which then underwent thematic content analysis. Findings. Aged between 22 and 60, 24 women (20 OTs and four OT students) completed the French version of the Lifestyle Redesign® training. Participants welcomed access to a French version of the approach and reported that the themes covered were adapted to the Quebec context, but a more "turnkey" and socio-constructivist course should be considered. The French Lifestyle Redesign training was found to increase participants' knowledge (p < .01) but not their intention to offer the approach to their older clientele over the next year. Conclusion. Lifestyle Redesign® is a culturally promising training and its French-Canadian version can be further optimized to best support OT needs, foster adoption into practice, and address emerging realities.
Background: In primary care (PC) clinical, healthcare utilization, and financial outcomes associated with Lifestyle Redesign® Occupational Therapy (LR-OT), a framework that incorporates healthy habits into daily routines, are not well documented in the United States. Purpose: (a) Compare clinical outcomes, healthcare utilization, and associated cost differences between patients who received LR-OT and a control group. (b) Assess the investment required integrate LR-OT into PC. Method: LR-OT was integrated into a safety-net PC clinic. In a hybrid effectiveness-implementation clinical trial (#NCT03293914), clinical (glycated hemoglobin A1c [HbA1c], blood pressure, cholesterol, and body mass index) and utilization (outpatient, emergency department [ED], hospital visits) data were extracted from medical records of provider-referred adults with diabetes (HbA1c ≥ 9.0%) who were willing to make lifestyle changes. Results: Of 155 referred patients, 142 were randomized to LR-OT (n = 73) or a control group (n = 69), and 42 completed eight LR-OT sessions within 6 months. Underpowered clinical outcomes indicated no significant change, with aggregated trends suggesting LR-OT supports sustained cardiometabolic improvement. Savings of $250,518.96 is attributed to LR-OT, driven by significant decreases in ED visits (p = .03) and hospital days (p = .03), despite nonsignificant increases in outpatient utilization. The projected cost-benefit of integrating a full-time LR-OT in PC is $352,326.72 with a 236% return on investment. Conclusion: Clinical trends and significant reductions in acute care services drove healthcare-wide cost savings, demonstrating clinical and financial value of integrating LR-OT into PC.
Background. Occupational therapists have identified a critical need for resources to support addressing driving after stroke. A previous feasibility study found that the Practice Resource to Address Driving After Stroke (PReDAS) was a useful practice resource. However, more robust research is needed to examine how use of the PReDAS-2 may support professional development. Purpose. To evaluate the relationship between use of the PReDAS-2 and self-reported clinical reasoning and self-efficacy of occupational therapists for addressing driving in acute care settings. Method. A concurrent, multiple baseline design was employed. Visual and Tau-U analyses were conducted. Findings. Occupational therapists' self-reported clinical reasoning and self-efficacy to address driving after stroke improved with use of the PReDAS-2. Visual and Tau-U analyses indicated a large treatment effect of the PReDAS-2 for self-reported clinical reasoning (Tau-U = 0.7) and self-efficacy (Tau-U = 0.9). Conclusion. The present study provides preliminary evidence that the PReDAS-2 increases self-reported clinical reasoning and self-efficacy for addressing driving. Making the PReDAS-2 available to occupational therapists seeking to supplement their clinical practice may be warranted. Further research is necessary to determine if the PReDAS-2 should be recommended for use in acute care settings.
