Introduction Children with cerebral palsy (CP) face lifelong motor, functional, and participation challenges, requiring continuous support for daily activities. Although caregiving can enhance family bonds, it often negatively affects caregivers′ physical and social well‐being, family dynamics, independence, and financial stability. The aim of the present study was to investigate the associations between occupational balance, caregiver burden, and related factors among parents of Iranian children with CP. Methods This cross‐sectional study recruited 112 informal caregivers of children aged 2–18 years with CP from March to October 2023. Children′s functional status was assessed using classification systems for gross motor function (GMFCS), manual ability (MACS), communication function (CFCS), and cognitive status (SPARCLE). Caregivers′ burden, quality of life, and occupational balance were evaluated with the Caregiver Difficulties Scale (CDS), WHOQOL‐BREF, and OBQ‐11, respectively. Moreover, caregivers′ psychological well‐being was measured through the Perceived Stress Scale (PSS‐14) and Hospital Anxiety and Depression Scale (HADS). Data were analyzed using correlation analyses, independent t ‐tests, one‐way ANOVAs, and hierarchical multiple linear regression model. Results Caregivers′ occupational balance was significantly associated with key demographic and child‐related factors, including employment status, type of CP, and GMFCS level V. Psychological variables—anxiety/depression, perceived stress, caregiver burden, and quality of life—were also significant independent predictors. The final model explained 36.5% of the variance in occupational balance. Conclusion Caregivers′ occupational balance is influenced by caregiver characteristics, psychological well‐being, and the severity of the child′s functional limitations. Therefore, comprehensive and multidisciplinary interventions targeting both parents and children—including rehabilitation, psychological support, and social services—are essential and urgently needed.
Background Driving cessation can have adverse effects on an individual′s autonomy, health and well‐being. Consequently, it is essential to accurately assess the driving fitness of people with cognitive impairments. The performance analysis of driving ability (P‐Drive) has been identified as adapted for the Swiss context but is currently only available in English, Swedish, French and Norwegian. This study is aimed at translating P‐Drive into German and culturally adapt it for use in Switzerland. Method The study comprised a two‐phase approach, namely, translation and preliminary feasibility assessment, adapted from Beaton et al. (2000), including a focus group ( n = 6) who either work or have experience working with people with cognitive impairments and are experts on fitness‐to‐drive. Results Adaptation of the tool included words and terminology, the inclusion of Swiss roads legal concepts, manual clarifications, scoring clarification and speed‐limit interpretation. The 25 items for assessing driving ability were retained, with a substantial modification to the scoring threshold of Item 15 that may affect its equivalence with the original item. Conclusion A preliminary German Swiss version of P‐Drive was translated and tentatively culturally adapted to the conditions in Switzerland.
Effective referral pathways to occupational therapy are essential for continuity of care and recovery following upper limb injury or condition. Although challenges within South Africa's public healthcare referral systems are recognised, patients' experiences remain underexplored. This study explored patients' experiences of occupational therapy referral pathways within the Tygerberg substructure and identified factors influencing access to care. A qualitative descriptive design was used, with semistructured interviews conducted with seven purposively sampled participants. Data were analysed thematically using Braun and Clarke's framework. Three themes emerged: challenges in healthcare accessibility and referral processes; environmental, administrative and communication barriers affecting access to occupational therapy; and factors facilitating access and positive rehabilitation experiences. Findings highlighted the influence of health literacy, communication, transport, distance, community safety and referral delays on access to services. Despite these barriers, participants reported positive perceptions of occupational therapy and its outcomes. The findings emphasise the need for patient-centred referral pathways, improved patient education and enhanced communication within public healthcare rehabilitation services.
IntroductionOccupational therapists play a key role in assessing and treating somatosensory impairments post stroke including proprioception (limb position sense), touch, and temperature discrimination. Although research evidence and clinical guidelines offer strategies for assessing and treating this condition, there is limited information on how well these strategies are being implemented in routine practice. We aimed to describe the current practice of occupational therapists in somatosensory assessment and treatment of the upper limb of stroke survivors and to understand barriers and enablers to evidence-based care.MethodsThis observational study encompassed (1) a cross-sectional survey measuring self-reported use of somatosensory assessment and treatment strategies and perceived barriers to implementation and (2) a medical file audit to report on the use of somatosensory assessment and treatment with stroke patients. Data were analyzed descriptively, with enablers and barriers to evidence use classified using the three domains of the Capability, Opportunity, Motivation-Behavior (COM-B) change model.ResultsOf 50 files audited, 26 patients had documented upper limb impairment. Of these, 54% had sensation assessed. Treatment strategies were documented for 7 out of 12 patients with identified impairment. These findings aligned with therapist self-report, indicating that most clinicians used sensory assessment and treatment strategies less than once per month. Therapists reported capability (lack of skills and skill confidence) and opportunity (lack of time and opportunity to practice skills) as barriers to evidence-based practice. Occupational therapists expressed motivation to change and improve their skills in evidence-based sensory assessment and treatment.ConclusionOur findings highlight ongoing gaps between evidence and practice. Therapists report being motivated to provide evidence-based care but require support to overcome barriers, such as training and access to resources. Medical record audits aligned with survey findings; however, there were differences between reported and documented use and scope of sensory assessment and treatment in practice.
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.
