The aim of the present study was to investigate how Swedish occupational therapists describe their work with persons suffering from cognitive impairment following acquired brain injury. A qualitative descriptive approach was used and interviews were conducted with 12 occupational therapists working in community and county council care. Qualitative content analysis was used and revealed three main themes: (1) "To make the invisible visible", (2) "To collaborate-a prerequisite for success", and (3) "Dilemmas to handle". The findings showed a complex scenario where the occupational therapists worked to make the cognitive impairments visible to themselves, the clients, and persons close to the client. Collaboration was perceived as a key factor. The dilemmas concerned different aspects in the rehabilitation process, which affected the occupational therapists' work with the clients. Identified areas in need of improvement are prioritizations and additional education regarding both intervention methods and theory. A reluctance to use standardized assessments was expressed and research that identifies and overcomes those hindrances in clinical practice is needed. Therapeutic use of self was described as important. To understand and illuminate the occupational therapists' comprehension of the concept further research is required.
Swedish occupational therapy practice for clients with cognitive impairments following acquired brain injury focuses highly on occupational performance. Therapies targeting executive functioning seem particularly important in practice and a collaborative approach involving clients, relatives and other staff is a prominent feature in practice.
Importance: There is a need for evidence-based occupational therapy interventions to enhance time management in people with time management difficulties. Objective: To pilot test the first part of the Let’s Get Organized (LGO) occupational therapy intervention in a Swedish context by exploring enhancements of time management skills, aspects of executive functioning, and satisfaction with daily occupations in people with time management difficulties because of neurodevelopmental or mental disorders. Design: One-group pretest–posttest design with 3-mo follow-up. Setting: Outpatient psychiatric and habilitation settings. Participants: Fifty-five people with confirmed or suspected mental or neurodevelopmental disorder and self-reported difficulties with time management in daily life. Intervention: Swedish version of Let’s Get Organized (LGO–S) Part 1, with structured training in the use of cognitive assistive techniques and strategies using trial-and-error learning strategies in 10 weekly group sessions of 1.5 hr. Outcomes and Measures: Time management, organization and planning, and emotional regulation were measured with the Swedish version of the Assessment of Time Management Skills (ATMS–S). Executive functioning was measured with the Swedish version of the Weekly Calendar Planning Activity, and satisfaction with daily occupations was assessed with the Satisfaction With Daily Occupations measure. Results: Participants displayed significantly improved time management, organization and planning skills, and emotional regulation, as well as satisfaction with daily occupations. Aspects of executive functioning were partly improved. ATMS–S results were sustained at 3-mo follow-up. Conclusion and Relevance: LGO–S Part 1 is a promising intervention for improving time management skills and satisfaction with daily occupations and should be investigated further. What This Article Adds: This study shows that LGO–S Part 1 is feasible for use in psychiatric and habilitation outpatient services. The results are promising for improved time management skills, organization and planning skills, and satisfaction with daily occupations and need to be confirmed in further studies.
Objective: To evaluate the effect of multi-grip myoelectric prosthetic hands on performance of daily activities, pain-related disability and prosthesis use, in comparison with single-grip myoelectric prosthetic hands. Design: Single-case AB design. Patients: Nine adults with upper-limb loss participated in the study. All had previous experience of single-grip myoelectric prostheses and were prescribed a prosthesis with multi-grip functions. Methods: To assess the changes in daily activities, pain-related disability and prosthesis use between single-grip and multi-grip myoelectric prosthetic hands, the Canadian Occupational Performance Measure, Pain Disability Index, and prosthesis wearing time were measured at multiple time-points. Visual assessment of graphs and multi-level linear regression were used to assess changes in the outcome measures. Results: At 6 months’ follow-up self-perceived performance and satisfaction scores had increased, prosthesis wearing time had increased, and pain-related disability had reduced in participants with musculoskeletal pain at baseline. On average, 8 of the 11 available grip types were used. Most useful were the power grip, tripod pinch and lateral pinch. Conclusion: The multi-grip myoelectric prosthetic hand has favourable effects on performance of, and satisfaction with, individually chosen activities, prostheses use and pain-related disability. A durable single-grip myoelectric prosthetic hand may still be needed for heavier physical activities. With structured training, a standard 2-site electrode control system can be used to operate a multi-grip myoelectric prosthetic hand.
The empirical descriptions generated from this study may help occupational therapists working with clients with cognitive impairments following acquired brain injury to describe how and with what intention they use themselves therapeutically in the rehabilitation process. In occupational therapy education, the results may be used to highlight how the concept may be understood in practice and to discuss it in relation to different client groups.
Three subscales were detected: the time management subscale with 11 items, the organization & planning subscale with 11 items, and the subscale of regulation of emotions with 5 items, with excellent to acceptable psychometric properties. The conclusions were that: ATMS-S is a valid instrument for self-rating of time management, organization & planning and for the regulation of emotions. ATMS-S can be useful for persons with mental disorders including mild neurodevelopmental disorders.
Aim The aim of this study was to describe how nurses and occupational therapists in municipal care of older people define and implement patient participation in their daily work. Design This study had a cross‐sectional design. Data were collected using an online questionnaire. Methods The questionnaire had both closed and open‐ended questions. One‐hundred and fourteen nurses and occupational therapists responded. Data were analysed with descriptive statistics and thematic analysis. Results Two main themes were identified as follows: “The professionals’ perspective at the centre – Patient participation to enhance compliance” and “The patients’ perspective at the centre – Patient participation as an ongoing process.” The themes covered a continuum. On one extreme, patient participation was equated with making the patient comply with what the professionals wanted to do. On the other extreme, all power was transferred to the patient. The first theme was restricted to the decision‐making process. The second theme covered the entire care or, rehabilitation, process.
Introduction: Different factors in the environment influence the use of powered wheelchairs or powered scooters, i.e. powered mobility devices (PMDs), but there is limited knowledge about how these factors interact and if any factor has a greater impact. According to the ICF the environment consists of five areas. Aim: To describe users' experiences of how environmental factors from all ICF areas influence the use of PMDs. Methods: Descriptive qualitative design including 14 interviews with PMD users, analyzed using inductive qualitative content analysis. Findings: Use of PMDs means a conditional freedom depending on the interaction of several environmental factors. Regardless of environmental factor the societal attitudes were always present, directly or indirectly, and influenced the participants' feeling of being included and involved in society. The environmental factors and how they influence PMD use are described in four categories, comprising the following subjects: societal attitudes, the service delivery process, accessibility to the physical environment and financial resources. Conclusion:The findings show that societal attitudes influence all other factors, directly by others people's attitudes, or indirectly by how legislation and guidelines are formulated, interpreted and applied. Therefore, a change of societal attitudes seems necessary to increase accessibility and participation for PMD users.
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