We will search the evidence to assist your research reports Keeping you up-to-date with what’s new OCCUPATIONAL THERAPY UPDATE 3: SPRING 2015 Electronic resources Contact us for training Welcome to the third edition of Occupational Therapy Update. The aims of this publication are: To bring together a range of recently-published research reports, articles and electronic resources to help OT’s keep up-to-date with developments. To remind readers of OT Update of the services available from the Staff Library Service – we can supply you with 1:1 or small group training in literature searching skills; obtain full-text articles for you; or provide services in literature searching to help you with your research tasks. To respond to your information needs – if you have any suggestions on the type of information sources you would find helpful in future editions of OT Update, then please let us know – contact details are on page 10. Athens The Athens portal allows you to download the full text of articles, where the Trust has a subscription to the appropriate publisher. These are noted at the end of an abstract. You will need an Athens username and password to use the system, to register please log on to: https://register.athensams.net/nhs/nhseng/ If you are new to Athens and would like help in registering and starting to use Athens, please contact Steve Collman (Community Outreach Librarian) who can come to your workplace and help you get started. Please email steve.collman@nhs.net, or phone ext. 1547 to make an appointment – a 30 minute slot will get you up and running! Research Papers The following abstracts are taken from a selection of recently published papers. If you would like to order a copy of the full paper please contact the Staff Library Service – our contact details are on page 10. If the article is available electronically, this is noted at the end of the Abstract. Press CTRLclick to open the link. You will need to be registered for Athens (see above) to be able to access the full text. If you have any problems in downloading full text articles, please contact the Library. Wiley full text articles Articles published by Wiley will only download if you use a web browser newer than IE8, or Google Chrome. It is permissible to download Google Chrome to East Cheshire Trust computers. Contact the Library if you have problems downloading Wiley articles. Link to download Google Chrome: https://www.google.co.uk/chrome/browser/desktop/index.html?hl=en&brand=CHNG&utm_source=e n-hpp&utm_medium=hpp&utm_campaign=en 1 Paper 1 Title: Culturally responsive care in occupational therapy: an entry-level educational model embedded in service-learning Author(s): Talero, Pamela, Kern, Stephen B., Tup, Debra A. Citation: Scandinavian Journal of Occupational Therapy, 01 March 2015, vol./is. 22/2; (95102) Abstract: This study focuses on the design of an entry-level educational model of culturally responsive care in occupational therapy embedded in service-learning (CRCOT-SL) that is perceived as clear, relevant, evidence-based, and useful by occupational therapy educators. The purpose of the model is to guide OT educators in teaching students to enable occupational participation and social inclusion in cross-cultural encounters. Method. The design consisted in defining the areas of the model and the components of each area, and articulating the learning process embedded in service-learning. A formative evaluation of CRCOT-SL was then performed using survey methods to collect feedback from 30 OT educators regarding the clarity, relevance, evidence-based constructs, and usefulness of CRCOT-SL. Results: CRCOT-SL was perceived to be clear, relevant, evidence-based, and useful to 81.5% of the OT educators who participated in the study. Minor modifications to the model were completed based on the educator's feedback. Conclusions: CRCOT-SL is intended to respond not only to the dynamic, multicultural, and diverse environments in which practitioners currently practice but to the future needs of a global community facing social, political, economic, and environmental issues that will continue to affect dramatically people's living conditions and occupational needs. Source: CINAHL Link to full text: http://informahealthcare.com/doi/pdf/10.3109/11038128.2014.997287 Paper 2 Title: Occupational therapy inpatient rehabilitation interventions with deconditioned older adults following an acute hospital admission: A Delphi study Author(s) Timmer AJ, Unsworth CA, Taylor NF Citation: Australian Occupational Therapy Journal, February 2015, vol./is. 62/1; (41-9) Abstract: Older adults admitted to an acute hospital setting with an illness often experience deconditioning. Although occupational therapists frequently work with deconditioned older adults in inpatient rehabilitation programmes, limited information exists regarding the type of interventions used and how these interventions are provided. This study aimed to determine the level of consensus among Australian occupational therapists about occupational therapy service delivery and interventions commonly used during inpatient rehabilitation with older adults who have become deconditioned during acute hospital admission for a medical illness. METHODS: The Delphi technique was used to reach consensus among expert occupational therapists regarding service delivery and interventions commonly used in an ideal clinical setting. Data were analysed from three rounds of surveys and the percentage of agreement between clinicians were calculated. RESULTS: Twenty-six participants completed round one survey, with 24 completing subsequent surveys (92% response rate). Fifteen commonly used interventions were identified, including showering/dressing, light meal preparation and home assessment. Consensus was reached on commonly used aspects of service delivery, including intervention provision, programme length, team members and follow up after discharge. CONCLUSION: Results generated may assist in guiding occupational therapists in the attributes of service delivery and the type of interventions currently considered best practice when working with deconditioned older adults in a rehabilitation setting. The information provides preliminary data for effectiveness studies. Source: Medline 2 *This article is available to download – please access it using your Athens login when prompted. Available in fulltext from Australian Occupational Therapy Journal at Wiley [See page 1 concerning downloading articles published by Wiley] Paper 3 Title: Impact of an evidence-based practice course on occupational therapist's confidence levels and goals. Author(s) Brangan J, Quinn S, Spirtos M Citation: Occupational Therapy in Health Care, January 2015, vol./is. 29/1; (27-38) Abstract: Confidence levels of 136 Irish occupational therapists were measured before and after an evidence based practice training course. Ranked scores on the evidence based practice confidence scale showed statistically significant improvement in all areas between pre and post course. Goals set by therapists to integrate EBP into their practice following the course were analysed and grouped into categories which included: 1) getting ready to use evidence based practice, 2) examining current and best practices, and 3) promoting a culture of evidence based practice in the workplace. Course feedback using Likert scales identified satisfaction with course content and delivery method. Source: Medline Paper 4 Title: Effectiveness of occupation-based interventions to improve areas of occupation and social participation after stroke: an evidence-based review Author(s) Wolf TJ, Chuh A, Floyd T, McInnis K, Williams E Citation: American Journal of Occupational Therapy, January 2015, vol./is. 69/1 Abstract: This evidence-based review examined the evidence supporting the use of occupation-based interventions to improve areas of occupation and social participation poststroke. A total of 39 studies met the inclusion criteria and were critically evaluated. Most of the literature targeted activity of daily living (ADL)-based interventions and collectively provided strong evidence for the use of occupation-based interventions to improve ADL performance. The evidence related to instrumental ADLs was much more disparate, with limited evidence to support the use of virtual reality interventions and emerging evidence to support driver education programs to improve occupational performance poststroke. Only 6 studies addressed leisure, social participation, or rest and sleep, with sufficient evidence to support only leisure-based interventions. The implications of this review for research, education, and practice in occupational therapy are also discussed. Source: Medline Link to full text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4281705/ Paper 5 Title: Does occupational therapy play a role for communication in children with autism spectrum disorders? Author(s): Hébert, Michèle L. J., Kehayia, Eva, Prelock, Patricia, Wood-Dauphinee, Sharon, Snider, Laurie Citation: International Journal of Speech-Language Pathology, 01 December 2014, vol./is. 16/6; (594-602) Abstract: This study investigates occupational therapy for early communication in children with autism spectrum disorders (ASD). The research explored the role of occupational therapists in supporting children with ASD to become better communicators by considering their inter-professional collaboration with speech-language pathologists. Convenience samples of 21 clinical occupational therapists and speech-language pathologists were recruited to participate in semi-structured audio-recorded focus groups, using a qualitative 3 design. Distinct views included a child-centred focus from speech-language pathologists, whereas occupational therapists spoke of the child through societal viewpoints, which later pointed to occupational therapists' proficiency in enabling skill generalization in ASD. An equal partnership was consistently reported between these clinicians, who identified the same objectives, shared strategies, joint treatments, and ongoing collaboration as the four main facilitators to inter-professional collaboration when treating children with ASD. Three unique roles of occupational therapy comprised developing non-verbal and verbal communication pre-requisites, adapting the setting, educating-partnering-advocating for the child, and providing occupation-based intervention. These three themes meshed with the discipline-specific occupational therapy domains represented in the Person-EnvironmentOccupation framework. When working in inter-professional collaboration, speech-language pathologists and occupational therapists agree that occupational therapy is indispensable to early intervention in enabling communication in ASD. Source: CINAHL Paper 6 Title: Sexual orientation and occupation: some issues to consider when working with older gay people to meet their occupational needs Author(s): Twinley, Rebecca Citation: British Journal of Occupational Therapy, Dec 2014, vol. 77, no. 12, p. 623-625 Abstract: The surge of people now entering their older adult lives in many societies, including the United Kingdom, makes understanding and meeting the occupational needs of this population paramount. For many older gay people, growing up presented a unique set of challenges, some of which may still be experienced as barriers to realizing and/or overcoming their occupational needs. Sexual orientation is understood as one of many factors that can impact upon the individual experience of occupation and justice, and this opinion piece highlights four of the potential threats to occupational justice for some older gay people. It proposes that such challenges have triggered associated occupational needs for some older gay people - needs that remain largely obscure and unrecognized in occupational therapy literature. Source: BNI Link to full text: http://bjo.sagepub.com/content/77/12/623.full.pdf+html Paper 7 Title: Parent perspectives on occupational therapy assessment reports Author(s): Makepeace, Elizabeth, Zwicker, Jill G. Citation: British Journal of Occupational Therapy, 15 November 2014, vol./is. 77/11; (538545) Abstract: Occupational therapy assessment reports in paediatric practice are written for multiple audiences, such as health professionals, school personnel, and parents. As such, reports may not meet the needs of all recipients. In an effort to better target parents in clinical report writing, the purpose of this study was to determine what parents view as important, relevant, and understandable in occupational therapy assessment reports, and to explore evidence for best clinical report-writing practices in paediatrics. Method: This qualitative study used in-depth interviews to gather parent perspectives on reports written for their children. All interviews were audio-recorded and transcribed. Interpretive description with a thematic, inductive approach was used to recognize patterns and themes by coding recurrent data and summarizing results. Findings: Ten parents completed one-onone interviews. Five key themes were identified: generating an accurate record of assessment; answering referral queries; understanding terminology; using the report for information sharing and partnership building; and being prompted to take action. Conclusion: Results encourage therapists to include parents as the primary audience of 4 reports, to clearly answer referral questions, and to use language and terms that are understandable. Reports must be easily shared with other stakeholders and include simple, age-appropriate recommendations that parents can implement during everyday activities. Source: CINAHL Link to full text: http://bjo.sagepub.com/content/77/11/538.full.pdf+html Paper 8 Title: Musculoskeletal hand symptoms and functional limitation in communitydwelling adults aged 50 years and over: results from a cross-sectional study Author(s): Myers, Helen, Thomas, Elaine, Dziedzic, Krysia Citation: British Journal of Occupational Therapy, 15 November 2014, vol./is. 77/11; (546555) Abstract: Hand pain and problems are common in community-dwelling adults aged 50 years and over. As the population ages, the absolute number of people with these issues is likely to increase. Debilitating hand problems affect at least 12% of the older population in the United Kingdom, but fewer than 1 in 30 people with this degree of disability consult an occupational therapist. Method: This paper describes a new analysis of a population study using data from surveys and a nested clinical cohort. Demographic characteristics, and the nature, severity, and frequency of symptoms and functional limitation in 1,811 adults aged 50 years and over with disabling hand problems are described, and the potential need for healthcare estimated. Findings: Moderate or severe functional limitation within the previous week was commonly reported. Irrespective of age and gender, weakness was the most frequently reported severe symptom (n = 470, 27%). Most problems occurred in activities requiring strength (such as opening a jar: n = 945, 52%). More females reported difficulty with tasks requiring strength (such as opening a jar: f: 59%; m: 38%), and more males reported difficulty with dexterous activities (such as picking up coins: m: 24%; f: 17%). Conclusion: The results from this study have implications for current and future management of hand problems in the community, highlighting a potential role for occupational therapy. Source: CINAHL Link to full text: http://bjo.sagepub.com/content/77/11/546.full.pdf+html Paper 9 Title: Occupational therapy for people living with a life-limiting illness: a thematic review Author(s): Hammill, Kathrine, Bye, Rosalind, Cook, Catherine Citation: British Journal of Occupational Therapy, 15 November 2014, vol./is. 77/11; (582589) Abstract: Little is known about occupational therapy practice for people with a life-limiting illness. This paper aims to review the available occupational therapy literature in order to develop a greater understanding of the role and practice trends of occupational therapists working in this area. Methods: A systematic search of literature published from 1975–2013 was conducted. Three hundred and fifty-five pieces of literature were located and screened for inclusion using a three-stage process. All literature that met the inclusion criteria was then analysed thematically. Findings: An in-depth review of 52 articles, three position statements, two key occupational texts, and one clinical guideline identified three themes in the literature. These themes comprised: (i) reframing practice: defining a palliative approach in occupational therapy; (ii) continuing occupational engagement despite loss; and (iii) preparing for practice when your client is dying: educational requirements of occupational therapists. Conclusion: Occupational therapy has an important role to play in the care of people with a life-limiting illness. However, knowledge gaps remain concerning the scope of 5 the role and how best to engage clients in meaningful occupations at the end of life. Further education is required at the undergraduate level and for clinicians working in this area. Source: CINAHL Link to full text: http://bjo.sagepub.com/content/77/11/582.full.pdf+html Paper 10 Title: Parents' experiences with physical and occupational therapy for their young child with cerebral palsy: a mixed studies review Author(s): Kruijsen-Terpstra, A. J. A., Ketelaar, M., Boeije, H., Jongmans, M. J., Gorter, J. W., Verheijden, J., Lindeman, E., Verschuren, O. Citation: Child: Care, Health & Development, 01 November 2014, vol./is. 40/6; (787-796) Abstract: Understanding the experiences of parents with their child's intervention might help meet the needs of parents and, subsequently get them engaged in their child's intervention. As parents' early beliefs regarding their child's intervention has consequences for treatment participation, it is important to understand these parental perspectives. The aim of this mixed studies review was to give an overview of the experiences and related factors of parents of young children (0-5 years of age) with cerebral palsy in relation to the physical and/or occupational therapy of their child in a rehabilitation setting. The literature was searched systematically for qualitative and quantitative studies published between January 1990 and July 2011. Inclusion criteria were (1) the study population consisted of parents of children with cerebral palsy, with at least 25% of children under the age of five; (2) children had received physical and/or occupational therapy in a rehabilitation setting; and (3) the experiences of the parents with their child's therapy were addressed. Data were synthesized with the framework synthesis method resulting in a conceptual framework describing the factors that are related to the parents' experiences with their child's interventions. A total of 13 studies (eight qualitative and five quantitative) were included and evaluated. Parents expressed various aspects in context, process and outcomes when asked about their experiences with their child's intervention. They had different needs over time and needed time to build a collaborative relationship with their child's therapists. The proposed framework acknowledges the various aspects in context, process and outcomes that parents reported when asked about their experiences. Knowing this, the importance of the broader context of the child in a family should be acknowledged; realizing the impact that the demands of daily life, supports and resources provided to parents, attitudes in the community and culture have on parental experiences. Source: CINAHL *This article is available to download – please access it using your Athens login when prompted. Available in fulltext from Child: Care, Health and Development at Wiley [See page 1 concerning downloading articles published by Wiley] Paper 11 Title: Preparing for motherhood: a role for occupational therapy Author(s): Acharya, Vinita Citation: WFOT Bulletin, 01 November 2014, vol./is. 70/; (16-17) Abstract: Parenting as an occupation is significant as it can influence the overall development of a child. Clients with mental illness may find it challenging to cope with the demands of parenting. Occupational therapy can assist women with mental illness in performing their role as a mother. Preparing for motherhood can ensure that the mother gets the opportunity to nurture her natural maternal instinct and the child can receive good emotional and physical environment which would lay the foundation for its future emotional health. Clients with mental illness and children of parents with mental illness can both benefit through occupational therapy in preparing for motherhood. Occupational therapy with its unique holistic approach can make it possible for women with mental illness to have 6 a good self-concept of themselves as mothers through competency building and skills training. Source: CINAHL Paper 12 Title: Utilizing participation in meaningful occupation as an intervention approach to support the acute model of inpatient palliative care Author(s): Ashworth, Erin Citation: Palliative & Supportive Care, Oct 2014, vol. 12, no. 5, p. 409-412 Abstract: Palliative care is a model of care that aims to improve quality of life (QOL) for patients and their families/carers who are facing the challenges associated with a life limiting illness (WHO, 2012). Until recently, palliative care has been seen to be largely focused on the medical management of specific symptoms, with little or no consideration given to the patient's occupational identity and goals. Occupational therapy is a profession whose core philosophy is grounded in occupational participation. Occupational therapists have the skills and expertise to incorporate an individual's occupational performance goals into their treatment plan, thereby helping people to participate in personally meaningful occupations, within the limitations of their illness and physical capacity. The present article aims to illustrate (using case-study examples) how personally meaningful occupational participation can better support an acute model of palliative care practice, resulting in better patient outcomes and improved quality of life for both patients and their carers. Source: BNI Link to full text: http://journals.cambridge.org/action/displayFulltext?type=1&fid=9370558&jid=PAX&volumeId=12&is sueId=05&aid=9370554&bodyId=&membershipNumber=&societyETOCSession= Paper 13 Title: Communicating with Employers: Experiences of Occupational Therapists Treating People with Musculoskeletal Conditions Author(s) Coole, Carol, Birks, Emily, Watson, Paul, Drummond, Avril Citation: Journal of Occupational Rehabilitation, 01 September 2014, vol./is. 24/3; (585595) Abstract: Many employed people with musculoskeletal conditions rely on healthcare practitioners, including occupational therapists, for work-related advice and support. The purpose of this study was to explore the experiences of occupational therapists in communicating with patients' employers. Methods: Qualitative data were collected from the responses of occupational therapists to ten statements/open questions in a questionnaire survey of UK occupational therapists. Data were copied verbatim into word documents and analysed thematically. Results: A total of 649 comments were made by 143 respondents. Five themes were identified that were associated with communicating with employers: patient-dependent; employer-dependent; therapist-dependent; extrinsic factors; methods of communication. Conclusion: This study has identified that communication between occupational therapists and employers is influenced by a number of factors, including those which are outside the therapists' control. These need to be acknowledged and addressed by therapists, their professional organisation, employers, commissioners, therapy service managers, educators and employees in order to support return-to-work and work retention of people with musculoskeletal conditions. Source: CINAHL Link to full text: http://link.springer.com/article/10.1007%2Fs10926-013-9476-3 7 Paper 14 Title: Return to work after stroke: recording, measuring, and describing occupational therapy intervention. Author(s): Grant, Mary, Radford, Kathryn, Sinclair, Emma, Walker, Marion Citation: British Journal of Occupational Therapy, 15 September 2014, vol./is. 77/9; (457465) Abstract: Existing research on vocational rehabilitation following stroke has been criticised for not describing intervention in sufficient detail for replication or clinical implementation. The purpose of this study was to test the feasibility of recording and measuring the content of an early stroke-specific vocational rehabilitation intervention delivered to participants in a feasibility randomized controlled trial, using a proforma previously developed for a study of vocational rehabilitation following traumatic brain injury. Method: The proforma was adapted for use in stroke with input from an expert panel and was used to record intervention content, in 10-minute units, following each intervention session. Findings: Twenty-five people, working or in education at the time of stroke, participated in the study. Two thirds of the therapists’ time was spent in face-to-face contact (43%) and liaison with the patient and others (20%). Intervention mainly focused on work preparation (21%) and the return to work process (24%). The remaining time was consumed by administration (19%) and travel (18%). Conclusion: The proforma was quick and easy to use and captured the main focus of intervention. This study suggests that it can be used to record strokespecific vocational rehabilitation intervention content and has potential for wider use in research and clinical practice. Source: CINAHL Link to full text: http://bjo.sagepub.com/content/77/11/582.full.pdf+html Paper 15 Title: Occupational performance and strategies for managing daily life among the elderly with heart failure Author(s): Norberg, Eva-Britt, Boman, Kurt, Löfgren, Britta, Brännström, Margareta Citation: Scandinavian Journal of Occupational Therapy, 01 September 2014, vol./is. 21/5; (392-399) Abstract: The aim of this study was to describe experiences of limitations in occupational performance and strategies for managing daily activities among the elderly with chronic heart failure (CHF). Methods: Ten participants from primary healthcare with a confirmed diagnosis of CHF were interviewed. The interviews were analysed using qualitative content analysis. Results: The first theme, 'Redefining an active life, aware of one's impaired body', was based on four sub-themes: realizing one's limited activity ability; striving to preserve an active life; focusing on meaningful activities; and changing vs. not changing habits and roles. The second theme, 'Planning activities and balancing the degree of effort', was based on three sub-themes: limiting, organizing, and rationalizing activities; adjusting activities to today's ability; and using technology and adapting the environment. Conclusions: Elderly people with CHF are struggling with an ongoing process of occupational adaptation due to periodical physical decline and fluctuating day-to-day ability. This highlights a need for information on strategies from a holistic perspective and client-centred occupational therapy interventions. Source: CINAHL Paper 16 Title: Women's experiences of cognitive changes or 'chemobrain' following treatment for breast cancer: A role for occupational therapy? Author(s): Player, Lucy, Mackenzie, Lynette, Willis, Karen, Loh, Siew Yim Citation: Australian Occupational Therapy Journal, 01 August 2014, vol./is. 61/4; (230-240) 8 Abstract: Changes to functioning and cognition are commonly reported following chemotherapy. These changes are highly individual, and may not be fully recognised or understood. Breast cancer is the most common cancer diagnosed in women worldwide, yet little is known about the impact of cognitive changes for these women following treatment and many do not benefit from occupational therapy services. The aim was to describe changes in cognitive function experienced by women who had undergone chemotherapy, and the strategies used to overcome the associated challenges. Method: This was a qualitative phenomenological study conducted with nine women, aged between 39 and 67 years, from New South Wales. Participants were breast cancer survivors who had received chemotherapy treatment, and self-reported chemobrain symptoms. Data were collected through semi-structured in-depth telephone and face-to-face interviews. Results: Six themes described the chemobrain experience for these women. They were: uncertainty about the origin of the chemobrain experience; persistent but inconsistent impacts on function; simple function turned complex; losing functional independence in family life; strategies to maintain function; and the need for recognition of the subjective experience of cancer treatment. Conclusion: The experiences of cognitive and functional changes following chemotherapy for those reporting chemobrain symptoms are highly individual, and include the need for adaptive strategies. Some similarities in the types of impairments were experienced. As breast cancer survivorship rates continue to rise, there is a need for occupational therapy services to assist women in returning to daily occupations during or following their cancer treatment. Source: CINAHL *This article is available to download – please access it using your Athens login when prompted. Available in fulltext from Australian Occupational Therapy Journal at Wiley [See page 1 concerning downloading articles published by Wiley] Paper 17 Title: Occupational therapy for Parkinson's disease: increasing awareness Author(s): Saint-Hilaire M Citation: Lancet Neurology, June 2014, vol./is. 13/6; (527-9) Abstract: The occupational therapy intervention might not have focused on aspects of Parkinson's disease that become problematic for both caregivers and their patients in more advanced disease, such as cognitive deficits, other non-motor symptoms, and social isolation. Findings have shown that social concerns are a primary focus for individuals with Parkinson's disease and their caregivers and that disease symptoms and social aspects of self-care are inter-related. Typically, physical therapy and occupational therapy in Parkinson's disease have been prescribed when patients become substantially disabled. Source: Medline *This article is available to download – please access it using your Athens login when prompted, then select ‘NHS England’ from the dropdown box. Available in fulltext from Lancet Neurology, The at ProQuest If you would like a hard copy of any of the above papers – not listed as being available to download - then please contact Carole Keeling who will obtain them for you. There is usually a charge of £1.00 per article. Contact details are below. 9 Books in the Staff Library The Staff Library Service has a collection of approximately 34 titles on Occupational Therapy, held at shelfmark 615.8515. If you’re not already a member, join for free today. Joining takes just a few minutes and we can also arrange out-of-hours access to the library and help you sign up for Athens. Examples of recent titles: Duncan, EAS. Foundations for practice in Occupational Therapy, 2012. Soderback, I. International handbook of Occupational Therapy interventions, 2010. Staff Library Service We are located on 2nd floor, New Alderley House. We are staffed from 8.30 am – 5.00 pm Monday-Thursday and 8.30 am – 4.30 pm on Friday. General library enquiries/renewals: ext. 1362 or 3923 or email: ecn-tr.stafflibrary@nhs.net Carole Keeling –Outreach Librarian: ext 3398 or email: c.keeling@nhs.net (providing training and evidence searches). Please send me your feedback on Occupational Therapy Update Library website: http://ectsl.weebly.com/ 10