Occupational Therapy International

Introduction: Motor imagery training (MIT) has gained attention as an occupational therapy tool for children with developmental coordination disorder (DCD). Although MIT has shown some effectiveness in children with DCD, intervention methods for DCD can still be improved. Further, occupational therapists should update their knowledge of motor imagery (MI) and MIT for children with DCD and understand their application. Objective: The objective of this study is to survey the existing evidence on MI and MIT in children with DCD and comprehensively identify what is known and the problems that have been identified. Methods: We used the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Review and American Occupational Therapy Association guidelines for data collection and quality assessment. We searched for articles that included the words “developmental coordination disorder” and “motor imagery, motor imagery training (mental practice).” We searched the PubMed, Scopus, Medline, and the Cochrane Library databases; the search end date was March 12, 2024. Findings: In total, 30 articles, including seven clinical studies and 23 fundamental studies, were eligible for this review. We surveyed (1) methods for assessing MI ability or clarity in children with DCD, (2) what is known about MI in children with DCD, and (3) the methodology of MIT for children with DCD. Conclusion: Children with DCD have reduced MI ability compared to that had by typically developing children. Thus, MIT is recommended as a means of reducing the behavioral consequences of internal modeling deficits in children with DCD. On the other hand, information on the methodology used in MIT for children with DCD is inadequate, and no clear intervention measures have been proposed. In the future, it is important to clarify the amount of load when performing MIT and clarify the combination with other programs through more advanced research methods.

Introduction: Despite the global focus on occupation-based practice (OBP), limited research exists on its implementation in Iran. There is a lack of evidence on how OBP is practiced and the factors affecting its use among Iranian occupational therapists, which is essential for addressing barriers and promoting a more occupation-centered approach in clinical settings. Objectives: This study is aimed at determining the knowledge, attitudes, interests, usage rates, and environmental factors affecting OBP among Iranian occupational therapists and examining the relationship between sociodemographic factors and OBP. Study Type: This work is a cross-sectional analytical study. Data Collection Location: The data collection location of this study is the private and government clinics across Iran. Methods: A total of 202 participants completed demographic and OBP questionnaires. Key aspects such as total performance, usage rate, attitudes, knowledge, interest, and environmental factors were evaluated. Data analysis was conducted using SPSS software, employing statistical tests including ANOVA, Pearson’s correlation, and T-test. Results: The total OBP performance among Iranian occupational therapists is 64%, and 60.7% of them use OBP approaches. They have a positive attitude (83.6%) and high interest (78.3%) towards these approaches. However, environmental factors (44.7%) and an average level of knowledge (65.6%) have hindered the full utilization of these approaches. The average OBP score among occupational therapists in government settings was significantly higher than in private centers (p value < 0.001). Additionally, occupational therapists with a PhD scored higher than those with a bachelor’s or master’s degree (p value < 0.001). The level of work experience has a significant correlation with the total OBP score (p value < 0.05). Conclusion: This study examines the factors affecting OBP adoption in Iran, showing that while therapists have positive attitudes and interest, environmental barriers and limited knowledge hinder full implementation. Government-employed therapists and those with PhDs engage more, and work experience is crucial. The findings stress the need for targeted education and systemic changes, contributing to global insights on OBP integration.

Background and Purpose: A growing body of evidence demonstrates that physical exercise training is beneficial in the treatment of attention-deficit/hyperactivity disorder (ADHD). This study is aimed at examining the effects of a 12-week inline skating intervention on ADHD symptoms, executive functions (EFs), and motor proficiency in children with ADHD. Methods: This study employed an asymmetric crossover randomized controlled trial (RCT) design. A total of 24 children with ADHD (aged 6–12 years) were recruited from nongovernmental organizations, elementary schools, and parent networks. Participants were paired based on age, medication status, and ADHD presentation and then randomly assigned to either an intervention group (IG) (n = 12) or a wait-list control group (CG) (n = 12). The IG participated in a 12-week inline skating program (80-min sessions, twice weekly), while the CG maintained their regular daily routines and did not participate in any structured physical activity (PA) or skating training during this period. After 12 weeks, the CG underwent the same intervention. ADHD symptoms (parent reported), EFs (inhibition and spatial working memory), and motor proficiency (fine motor control, body coordination, manual coordination, strength, and agility) were assessed at three time points: baseline (T1), posttest (T2), and follow-up (T3). Data were analyzed using mixed-design ANOVA to evaluate the effects of the intervention. Results: Children with ADHD in the current study demonstrated improved symptoms, EFs, and motor proficiency (all p<0.05) after 12-week inline skating intervention. Moreover, the effects appeared to be sustained for at least 12 weeks. Conclusion: This RCT provides preliminary evidence that inline skating may be a feasible and beneficial PA intervention for children with ADHD. However, larger studies are needed to further evaluate its long-term efficacy. Trial Registration: Australian New Zealand Registry of Clinical Trials: ACTRN12624000593538

Background: Humans, as occupational beings, are inherently driven to achieve mastery and adaptation. This drive is evident in international graduate students who face unique academic and sociocultural challenges when adapting to unfamiliar environments, such as South Korea. These challenges can hinder their occupational participation, yet there is a notable gap in the literature addressing the specific occupational issues faced by international students in this context. Aim: This study is aimed at exploring the unique occupational challenges encountered by international graduate students in Korea and their general adaptive responses, analyzed through the lens of the occupational adaptation (OA) model. Additionally, this study proposed interventions for educational institutions and occupational therapy practitioners to support students in achieving OA. Method: A scoping review was conducted following the PRISMA guidelines. Systematic searches across global (Web of Science, Scopus, and PubMed) and Korean (RISS and KISS) databases identified qualitative studies published in English or Korean over the past 10 years. ChatGPT-4 assisted with data extraction, which was reviewed for accuracy. Study characteristics were summarized using descriptive statistics, and thematic analysis identified key themes related to occupational challenges. Results: The review identified 3 articles and 6 dissertations exploring the occupational challenges of 59 international graduate students in Korea. Most participants were master’s students, primarily from China, Uzbekistan, and Laos. Two main themes emerged: (1) the hierarchical nature of Korean culture, which impeded academic and social engagement, and (2) the fast-paced lifestyle, which disrupted occupational balance. These challenges led to stress, isolation, and reduced participation, affecting role competence and quality of life. While students attempted adaptive strategies, they were often insufficient, highlighting the need for targeted interventions. Conclusions: International graduate students in Korea faced significant pressure to achieve mastery in a demanding environment. Culturally sensitive interventions, combined with strategies like cognitive behavioral therapy (CBT) and lifestyle redesign, can improve stress management, self-advocacy, and occupational balance, leading to greater academic success.

Background: Few studies have examined the activity of the accessory inspiratory muscles as well as respiratory function simultaneously in individuals with chronic obstructive pulmonary disease (COPD) while performing activities of daily living (ADLs). This cross-sectional study is aimed at understanding the differences in the demands for respiratory expenditure and activity of the upper limbs and accessory inspiratory muscles during functional performance in individuals with and without COPD. Methods: Thirteen patients with mild to moderate COPD and 10 healthy adults were enrolled. All participants were asked to complete the requested ADL tasks involving upper limb elevation while recording activities of muscles of the accessory inspiratory muscles, as well as respiratory expenditure via the Delsys Trigno electromyography and Ultima CardiO2 system, respectively. Results: Muscle activity of the pectoralis major (PM) in the COPD group was significantly higher than that in the non-COPD group during washing both sides of the head (p<0.05) and storing 2- and 4-kg objects on a shoulder-height shelf (p<0.05). Ventilatory inefficiency and metabolic expenditure were significantly higher during the storage of objects at head height in the COPD group. A positive correlation was observed between sternocleidomastoid muscle activity and metabolic/ventilatory expenditure in the non-COPD group. However, muscle activity of the upper trapezius was significantly correlated with metabolic/ventilatory expenditure in the COPD group. Higher PM muscle activity and ventilatory inefficiency in the COPD group were found during performing ADLs involving upper limb elevation. Conclusions: Individuals with COPD demonstrated increased accessory inspiratory muscle activity, reduced ventilatory efficiency, and higher metabolic expenditure during ADLs involving upper limb elevation compared to healthy controls. The PM in the COPD group was the major accessory inspiratory muscle for performing ADLs involving upper limb elevation. These findings could inform recommendations for individuals with COPD to adjust their strategies for upper limb elevation while performing ADLs. Training of the larger accessory inspiratory muscles in rehabilitation programs has also been considered to enhance ADL performance in individuals with COPD. Trial Registration: ClinicalTrials.gov identifier: NCT04146948

Objective: This study is aimed at testing the immediate and retained treatment efficacies of digital mirror therapy (DMT) and digital action observation therapy (DAOT) on clinical outcomes in chronic stroke patients, in comparison with dose-matched, active control rehabilitation (CR). Methods: Nineteen patients were randomly assigned to the DMT, DAOT, or CR for 3 weeks. Outcome measures, including the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Chedoke Arm and Hand Activity Inventory (CAHAI), Revised Nottingham Sensory Assessment, Motor Activity Log (MAL), and visual analogue scale of the EQ-5D-5L, were conducted at preintervention (T0), postintervention (T1), and 1-month follow-up (T2). Results: There were no significant differences among the three groups on the outcomes at different time points. However, in the DMT group, scores were significantly higher on the FMA-UE and the CAHAI at T2 than at T0; in the DAOT group, those on the FMA-UE and the quality of movement subscale of the MAL were significantly higher at T2 than at T0. In the CR group, scores on the FMA-UE and the CAHAI were significantly higher at T1 than at T0. Conclusions: Both DMT and DAOT had retained treatment effects on motor function. DMT and DAOT might be feasible as alternative intervention strategies for chronic stroke patients. Trial Registration: ClinicalTrials.gov identifier: NCT04441190

Despite the critical role of occupational therapists in healthcare, there has been limited focus on understanding their job satisfaction compared to other health-related disciplines. This gap is significant as job satisfaction among occupational therapists profoundly influences employee morale, client care, and organizational dynamics. This study explored factors influencing occupational therapists’ job satisfaction through an ecological lens to enhance their work environments, promoting both personal and professional growth. A scoping review of qualitative evidence was conducted from 1921 to 2024 via CINAHL, Medline, Scopus, and AMED, including 10 qualitative articles. Thematic analysis was used to identify key themes. Four key themes were identified impacting job satisfaction including humanistic values driving professional fulfillment, professional identity and recognition, workplace structural barriers, and advocacy and strengthening approaches. Although occupational therapists find their job rewarding and fulfilling because of its client-centered care, they confront challenges particularly with professional recognition, career identity, and limited support. To enhance their job satisfaction, a more system-level ecological approach is required to enhance the leadership approaches, mentorship, communication channels, and collaboration opportunities.

Occupational therapy (OT) is an emerging healthcare profession in Vietnam, with limited awareness and understanding among local healthcare professionals (HCPs). This study is aimed at assessing the impact of an educational intervention designed to improve HCPs’ knowledge and attitudes toward OT in Vietnamese healthcare settings. Utilizing a mixed-methods approach, the study involved 13 participants from Da Nang Orthopedics and Rehabilitation Hospital and Da Nang Psychiatric Hospital, representing various healthcare disciplines. The intervention included a series of journal club sessions focused on the principles, scope, and culturally relevant applications of OT. Quantitative data from pre- and postintervention assessments revealed significant improvements in HCPs’ general knowledge of OT, its practice areas, and goals, with statistical significance observed in multiple domains. Qualitative data collected through field notes and reflective journals provided additional insights into HCPs’ evolving perceptions of OT’s role in holistic and mental healthcare. Notably, the study highlighted cultural factors, such as family involvement in patient care, which align with OT’s client-centered approach but may also pose challenges in the integration of OT services. Barriers to OT adoption, including resource limitations and institutional support, were identified, underscoring the need for ongoing advocacy and resource allocation to sustain the progress achieved through the intervention. The findings suggest that culturally tailored educational programs are essential for the effective integration of OT in Vietnam and similar contexts. This research contributes to the global understanding of OT’s role in diverse healthcare environments, providing a framework for expanding OT services in emerging regions.

Background: Research indicates that play can facilitate communication and emotional connection for children with autism and their parents. Currently, there is no research exploring the perceptions that parents of twins and triplets with autism have regarding their children’s play, despite these parents’ unique opportunity to observe and interpret the play behaviours of multiple same-age, same-diagnosis children raised in the same home environment. The purpose of this descriptive phenomenological study was to describe the value that parents of twins and triplets with autism place on active play. Method: The researchers used purposive sampling to recruit abroad sample of mothers (N=9) of twins and triplets with autism aged 4–11 years old. Participants took part in one semistructured online interview with the researcher which was then thematically analyzed. Results: One central theme emerged from our analysis. This theme is entitled active play as a “window into a child’s world” and contains five subthemes: (1) parent perceiving child’s strengths and weaknesses in active play, (2) parent facilitating active play experiences, (3) parent perceiving child’s intrinsic motivations for active play, (4) parent interpreting child’s active play behaviours, and (5) active play experiences as a medium for parent/child communication. Conclusions: These findings suggest that parents value active play because it affords them opportunity to observe their children’s characteristics through their active play behaviours (e.g., strengths and weaknesses) and use what they have learned to facilitate new active play experiences that encourage overall development. Through active play, parents also practice communicating verbally and nonverbally with their child.

Background: Circus use by occupational therapists is an emerging practice area with limited evidence. Purpose: The study is aimed at exploring occupational therapists’ current use of circus and identifying the potential for broader applications addressing both individual and community needs. Method: Purposive sampling was adopted to recruit eight circus-using occupational therapists to participate in this collective case study. Semistructured interviews yielded qualitative data, which were coded and thematically analyzed. Findings: Circus is being used primarily to address performance capacity limitations but with an awareness of its potential to address broader community and sociopolitical needs. Analysis yielded two distinct “cases.” The first, individual-focused circus, exemplifies how circus is used to address performance capacity, while the second, community-focused circus, describes current and envisaged future circus use as community development. Conclusion: There is potential to move toward a more occupation-focused and community-driven use of circus in sociopolitical contexts. Further exploration is needed into the therapeutic benefits of circus use by occupational therapists. The inclusion of educational content that builds students’ capacity to adopt community development approaches in practice, alongside enhanced understanding of collaboration benefits between occupational therapists and “activist” disciplines, is paramount, if we are to address occupational injustices and promote occupational rights.

Introduction: With little evidence to guide practice, the decision to conduct a predischarge home visit poses challenges for occupational therapists. This study is aimed at evaluating the impact of a newly developed support tool for home visit decision‐making on therapists’ confidence, ease, and accuracy in decision‐making and stakeholders’ satisfaction in the communication of the decision and examining its clinical utility and reliability. Method: The predischarge home visit decision‐making support tool was trialed by occupational therapists from five facilities across an Australian metropolitan health service. Using a pre–post study design, therapists completed a purposefully developed questionnaire on decision‐making practice including ease and confidence in decision‐making. Accuracy of decision‐making was also evaluated using case studies. Clinical utility and reliability data was also gathered. Results: While therapists’ confidence and ease in decision‐making did not change with use of the tool, accuracy in decision‐making improved regardless of therapist’s experience in home visiting. The interrater reliability of the tool was moderate, with a Fleiss’ kappa value of 0.51. Good internal consistency was demonstrated with the removal of one item ( α = 0.83). Clinical utility was supported with therapists rating the tool as timely and easy to use. Conclusion: The developed tool offers therapists a reliable tool to support clinical practice, by providing guidance in clinically reasoning the decision to conduct a home visit.

Introduction: Mental health occupational therapy is an expanding workforce due to the increasing demand for services in many countries, including Australia. Due to the nature of the role, therapists can experience unique challenges that impact retention and wellbeing, consequently affecting career progression. It is, therefore, important to understand career planning and development for mental health occupational therapists to ensure their professional needs are addressed, which would also benefit service sustainability. This study is aimed at understanding the perspectives of mental health occupational therapists within the Nepean Blue Mountains Local Health District on career planning, development, and progression. This health district spans urban and regional areas and has recently introduced a new career framework underpinned by Benner’s career planning model. The practical implications of this study are significant, as the insights gained will inform the development of strategies and policies that support the career progression and wellbeing of mental health occupational therapists, ultimately enhancing the quality and sustainability of service provision in this field. Method: In this qualitative descriptive study, seven occupational therapists shared their perspectives through semistructured interviews. The data were transcribed verbatim, and an inductive qualitative content analysis was employed. Results: Three categories and seven subcategories were identified. The health district career framework was found to be beneficial to support career planning and development, with a few adjustments suggested by participants. Conclusion: Having a career framework offers a structured approach to support career planning, development, and progression for mental health occupational therapists.

Background: Handwriting is a crucial skill for elementary school students that involves complex subskills, including visual coordination, motor planning, cognitive abilities, and self-regulation. To inform intervention plans and support occupational performance and participation, occupational therapists use occupational profiles and performance analysis to assess children’s strengths, weaknesses, handwriting performance, and school and personal contexts. Objective: This study is aimed at identifying and assessing the characteristics, as perceived by parents and teachers, that both facilitate and impede the improvement of children’s handwriting. Methods: We employed a qualitative approach with inductive content analysis and collected data via semistructured individual interviews following purposive sampling of parents and teachers (N = 8) in Indonesia. The initial and subsequent interviews lasted 30–60 min and 20–40 min, respectively. Results: We analyzed the results based on two themes: (1) client factors that enhance handwriting abilities and (2) environmental factors that contribute to improving handwriting abilities. Psychological well-being, cognitive abilities, and motor performance significantly influenced handwriting skills. Children with poor emotional control, boredom, lack of age readiness, and memory difficulties often struggled with writing. Additionally, underdeveloped fine motor skills contributed to impaired handwriting abilities. Conclusions: Our findings have significant implications for occupational therapists. It highlights the impact of motor-related and external factors on handwriting abilities in children. The study suggests that occupational therapists can tailor interventions to children’s needs by understanding parents’ and teachers’ perspectives. Additionally, it underscores the importance of collaboration between parents, therapists, and teachers in improving handwriting skills and emphasizes the critical role of siblings and peers in enhancing children’s handwriting performance.

Introduction: In this study, we aim to apply BIG to patients with schizophrenia to confirm changes in mental symptoms, task performance, and occupational balance through motor and cognitive enhancement. Method: This study used a single-subject A-B-A design. It consisted of a total of 22 sessions, with 4 sessions in the baseline period, 16 sessions in the intervention period (Lee Silverman Voice Treatment-BIG), and 2 sessions in the follow-up period. The subjects were three male patients diagnosed with chronic schizophrenia, all severe cases. During the 22 sessions, the timed up and go test (TUG) and functional reach test (FRT) and the Montreal Cognitive Assessment (MoCA) were used to determine changes in motor function and cognition, and the subjective cognitive and mental score (SS), Canadian Occupational Performance Measure (COPM), and Occupational Balance Questionnaire-Korean (OBQ-K) were used to determine changes in psychiatric symptoms, work performance, and work balance satisfaction before and after the intervention. Statistically significant changes were determined using the two standard deviation (2SD) band method. Results: The TUG, FRT, and MoCA showed significant results in the intervention period compared to the baseline period. The SS, COPM, and OBQ-K also showed positive changes in scores from pre- to postintervention. Conclusion: In this study, BIG was found to promote improvement in motor and cognitive function in chronic schizophrenia patients, with positive effects on psychiatric symptoms, task performance, and occupational balance satisfaction.

Introduction: Weighted blankets are an intervention used in healthcare settings for alleviating anxiety and sleep problems. Selection of appropriate outcome measures that capture relevant effects is important in clinical practice and research. However, outcomes used are diverse and not standardised. Therefore, this scoping review is aimed at identifying, synthesising, and describing available research and used outcome measures in research studies evaluating weighted blankets. Methods: A scoping review was conducted, with a search of four databases. The search included studies published until February 2024. Results were categorized according to target population (adult or child) and primary outcome (sleep or anxiety). A conceptual map was developed to describe outcome measures used in the field. Results: A total of 38 studies were identified, including 12 randomised controlled trials, 13 pre–post-studies, 6 case studies, 3 register studies, and 3 qualitative studies. The State–Trait Anxiety Inventory and the Anxiety Visual Analogue Scale were commonly used outcome measurements in evaluation of weighted blanket effects on anxiety and most commonly conducted in an adult population. There was considerable heterogeneity in the outcomes used, particularly within the domain of sleep. In studies evaluating weighted blankets as a sleep intervention for children, objective measurement methods such as actigraphy were common, as was the use of a sleep diary. Conclusion: Even though there is extensive research available evaluating weighted blanket use and effects, there is a lack of standardised outcome measures and instruments are not adapted to use within occupational therapy practice. More research is necessary, informing clinical practice about which measures to use and when. Furthermore, there is a need to develop an instrument specifically tailored for use within occupational therapy practice to evaluate sleep interventions.

Objective: The purpose of this study was to determine the impact of client-centered occupational therapy intervention on the mental health, activities of daily living (ADL), and community participation of older adults with depression. Methods: This study was a single-blind, randomized controlled study conducted on older adults with depression, and those who met the selection and exclusion criteria were randomly divided into an experimental group of 15 people and a control group of 15 people. The experimental group performed client-centered occupational therapy intervention using the Canadian Occupational Performance Measure (COPM) and Barth Time Construction (BTC), and the control group performed case management and a strength-brain exercise program. Both groups underwent intervention twice a week for 60 min, for a total of 16 sessions. Before and after the intervention, depression, anxiety, stress, ADL, and community partitioning were measured using assessment tools with proven reliability and validity in both the experimental group and the control group. Results: The experimental group exhibited significant changes after the intervention in depression, anxiety, stress, social integration, and community integration scores (p<0.05 and p<0.01), while the control group showed significant changes only in depression scores (p < 0.05). As a result of comparing the amount of change between the experimental and control groups, significant differences were found in social integration among the areas of depression, stress, and community integration (p<0.05 and p<0.01). Conclusion: These results suggest that client-centered occupational therapy intervention could serve as an effective intervention for improving mental health, ADL, and community participation in older adults with depression. Trial Registration: Korea Clinical Research Information Service (CRIS): KCT0009358

Background: Individuals with intellectual disability (ID) exhibit various problems, such as attention, learning, and physical–motor difficulties. The study is aimed at investigating the effects of video game–based therapy programs on cognitive and physical functions in individuals with ID. Methods: The study, conducted through a three-arm randomized trial, involved 45 adults aged 18–30 with mild to moderate ID. Participants were divided into three groups: Group 1 received home-based video game–based therapy, supervised video game–based therapy, and occupational therapy–based activity training. Group 2 received video game–based therapy supervised by a therapist and an occupational therapy–based activity training program. Group 3 received occupational therapy–based activity training only. MOXO d-CPT was used to evaluate attention; sit-to-stand test, joint position sense, and nine-hole peg test were used to assess physical–motor functionality. Results: Results showed significant improvements in attention, functional performance, proprioception, and fine motor skills in all groups (p<0.05). Group 1 was superior to Group 3 in nondominant JPS-flexion, sit-to-stand test, and nondominant JPS-abduction parameters (p<0.017). When comparing Group 1 and Group 2, Group 1 was found to be more effective in the sit-to-stand test parameter compared to Group 2 (p<0.017), while the other parameters of the two groups were similar to each other (p>0.017). There were no significant differences between groups for different outcome measures (p>0.017). Conclusion: The study suggests that video-based game exercises combined with occupational therapy interventions can effectively enhance cognitive functions, functional performance, proprioception, and fine motor skills in adults with ID. Trial Registration: ClinicalTrials.gov identifier: NCT06097819

Introduction: The application of the person–environment–occupation–performance (PEOP) model in occupational therapy education offers valuable insights into the interaction between person, environment, and occupational factors and how these elements influenced the strategies used to adapt and navigate the transformation of health professions education during the COVID-19 pandemic. This study explored how individual characteristics, contextual demands, and the nature of educational occupations shaped the adaptation and performance of educators and students. Materials and Methods: The study used a qualitative, exploratory research design at a public higher education institution (HEI) in South Africa, focusing on the occupational therapy program. Purposive sampling was used to recruit key participants (n=44), including management, academic educators, clinical supervisors (academics), academic support educators, and occupational therapy students. Data collection occurred via the Zoom platform for 45–60-min semistructured interviews. Thematic analysis, guided by the PEOP model, was employed to analyze qualitative data, which was recorded, transcribed, and coded using NVivo (Version 12 Pro). The study ensured trustworthiness and adherence to ethical principles. Results: The PEOP model was used as a framework to formulate the themes, namely, (1) person, (2) environment, (3) occupation, (4) occupational performance, and (5) occupational performance and participation. In the context of occupational therapy education, particular emphasis was placed on the adaptations and responses of educators and students as they navigated the demands of their educational occupations during the pandemic. Discussion: The curriculum underwent rapid adjustments, requiring theoretical instruction and clinical practice modifications. These changes posed significant challenges and highlighted pre-existing gaps within HEIs, as experienced by educators and students. Conclusions: This study highlighted the importance of supporting optimal occupational performance among educators and students, emphasizing the necessity of providing adequate resources and support. This ensures the well-being of educators and students, enabling effective engagement and participation as they navigate the evolving educational landscape.

Purpose: This study explored the administration of goal attainment scaling (GAS) by entry-level occupational therapy (OT) students, examining their competency following minimal training. While GAS is valuable for measuring progress toward individualized client goals, its implementation requires specific skills and training that may challenge entry-level practitioners. Method: Using retrospective data from a study of sensory garments’ effects on children with autism spectrum disorder (ASD), we analyzed GAS administration by five entry-level OT students. Students received both indirect training through their curriculum and 3 h of direct research-specific preparation. Using a modified version of the GAS checklist, we evaluated students’ competency through video recordings of GAS administration sessions and written GAS. Results: Analysis revealed variable competency levels among students. While overall performance met 82.4% of checklist criteria, individual student competency varied considerably (54.5%–95.4%). Three of five students achieved the established 75% competency threshold. Students consistently met criteria for conceptual goal construction and timeframe specification but struggled with maintaining single dimensions of change and specifying observable behaviors. Conclusions: Entry-level OT students demonstrated varying levels of competency in GAS administration following minimal training. Our findings suggest the need for more comprehensive training in specific aspects of GAS, particularly in scale construction and behavioral specification. These results have important implications for how OT programs prepare students to implement GAS in clinical practice.

Basic Activities of Daily Living-Preschool Period Tool (BADL-P) is a fast and quick test that does not require a special environment, where activities of daily living (ADLs) in preschool children are questioned. The aim of the study was to conduct a Turkish reliability and cultural adaptation of the BADL-P. The study was conducted among 211 parents of preschool children. Validity was determined using exploratory factor analysis. To determine convergent validity, the Functional Independence Measure for Kids (WeeFIM) scale was used. Cronbach’s alpha, intraclass correlation coefficient (ICC), and item–total correlation (ITC) values were calculated to assess the reliability of the BADL-P. Totally, 99 girls and 112 boys, aged 3–6 years, with the children’s mean age of 4.50±0.75 years (3 years=11%, 4 years=32.1%, 5 years=52.2%, and 6 years=4.8%), were included. Exploratory factor analysis revealed that the BADL-P had sufficient fit. The BADL-P was weakly to highly correlated with the WeeFIM (p<0.05 and p<0.001). Cronbach’s alpha and ICC values of the BADL-P were acceptable (0.912 and 0.837, respectively). The ITC values of each item of the BADL-P were also acceptable (ranged from 0.232 to 0.683). Children in the 5–6 age group demonstrated higher scores and exhibited more advanced development in the ADL areas compared to children in the 3–4 age group (p<0.05). The Turkish version of the BADL-P is valid, reliable, and sensitive to assessing and monitoring the performance of Turkish preschool children in ADL.

Background: Individuals diagnosed with tuberculosis (TB) and multidrug-resistant (MDR) TB may struggle to return to work after they have completed a rehabilitation program. Multidrug-resistant tuberculosis (MDRTB) has been seen as a condition that is resistant to treatment, hence causing individuals to be economically in-active for considerable periods of time. Objective: The aim of the current study was to explore the views of individuals living with MDRTB, individuals with TB, and health professionals treating individuals with TB and MDRTB about the development of a vocational rehabilitation program. Method: The researchers used an exploratory descriptive research design, and semistructured interviews were conducted with five key informants and four participants who were diagnosed with pulmonary tuberculosis (PTB) and MDRTB. Thematic analysis was used in order to analyse the study findings. The current study is the second of two articles. The first article focused on barriers and facilitators linked to returning to work for individuals living with TB and MDRTB. The current article focuses on the development of a vocational rehabilitation program. Results: The findings of the original study revealed five themes; however, for the purpose of this article, only two themes will be presented, namely, Theme 1: promoting a holistic model and Theme 2: the use of resources for activity engagement. The latter theme contributed to the participant’s view of the development of a vocational rehabilitation program. Conclusion: The study provided a description of the components of a vocational rehabilitation program that has been adapted from the Model of Occupational Self-Efficacy (MOOSE). The above program has been designed for individuals diagnosed with PTB/MDRTB and has the potential to assist them in returning to work. It is suggested that vocational rehabilitation programs be incorporated into general medical programs that focus on improving the functioning of individuals diagnosed with PTB/MDRTB.

This study is aimed at investigating the impact of internal and external attention focus on learning a throwing skill in children with autism, as well as the relationship between working memory and learning rate. Twenty-four children aged 6–8 years with autism were assigned to internal and external attention groups. Participants performed a throwing task while their working memory was assessed using Cornoldi’s working memory test. The data was analyzed using ANOVA with repeated measures involving two attention instructions and five blocks during the acquisition stage. An independent t-test was conducted during the retention phase. Furthermore, a Pearson correlation test was utilized to explore any potential relationship between working memory and performance in both the acquisition and retention stages. Data analysis revealed no significant difference between the internal and external attention groups during the acquisition phase (p>0.05), but a significant difference was found in the retention phase (p<0.05). There was no correlation between working memory and learning outcomes (p>0.05). The results suggest that internal attention may enhance motor learning in children with autism, and reducing working memory load does not necessarily favor external attention.

Introduction: Poor fit between the work environment and work expectations is associated with high levels of workplace-related stress. Work stress in occupational therapy has been attributed to the nature of the profession and various other workplace-related factors. Workplace-related stress leading to burnout has been found to be higher in early career occupational therapists with less than 5 years of experience. This study explored workplace factors that result in poor person–work environment fit in six work–life areas in South African early career occupational therapists. Methods: A descriptive electronic survey design was used to access a sample of South African 261 occupational therapists with 2–5 years of work experience. The Area of Work–Life Survey (AWS) considers six work–life areas: control, workload, community, rewards, values, and fairness, which were used to collect data. Data were analysed to determine low, moderate, and high work environment fit for workplace factors including employment setting, field of practice, years’ experience, time with current organization, and hours worked. Results: Of the six work–life areas, only the scores for workload fell below the norm for the respondents. All six work–life areas were impacted by employment settings, with respondents in public health hospitals and clinics indicating significantly low person–environment fit in most areas. Respondents in physical rehabilitation had a significantly low fit for workload, as did years of experience, length of time with organization, and hours worked. Fairness had a low fit for physical rehabilitation and medicolegal fields of practice. Conclusion: Workload impacted workplace-related stress in respondents with scores below the norm on the AWS for this work–life area. Although some work-related factors affected workplace-related stress, the overall scores for the other work–life areas were above the norm, with only respondents in public service settings and in the field of physical rehabilitation reporting low work environment fit.

Background and Purpose: The present study is aimed at evaluating the effects of the COVID-19 pandemic on Iranian adolescents’ participation in various domains of life. The electronic version of the Iranian Adolescent Participation Assessment Tool-COVID-19 (IAPAT-C) was developed and validated for this purpose. Methods: This study was conducted in two phases. In the first phase, the electronic version of the IAPAT-C was developed and validated through a methodological study involving five stages: content validity review, cognitive interviews, item analysis, structural validity assessment using confirmatory factor analysis, and reliability analysis. The tool was adapted from the previously validated IAPAT and revalidated for this study. In the second phase, the effects of COVID-19 on adolescents’ participation were evaluated using a longitudinal one group before and after comparative design. The study involved 654 adolescents aged 13–18, and the data were analyzed using SPSS19 and G∗Power 3 software. Results: The IAPAT-C evaluates the participation of Iranian adolescents in 54 daily life activities before and after the COVID-19 pandemic. It utilizes a 5-point Likert scale and was validated through an expert panel review for content validity. Additionally, cognitive interviews with six adolescents confirmed its comprehensibility, relevance, and comprehensiveness. Item analysis, based on data from 38 participants, demonstrated strong interitem correlations (0.6–0.94) and excellent internal consistency (Cronbach’s alpha>0.7). The tool’s structural validity was supported by confirmatory factor analysis, which showed that the measurement model was a good fit. Convergent and discriminant validity of model constructs were also confirmed. Notably, COVID-19 significantly impacted all aspects of adolescents’ lives, except for work. Conclusion: The electronic version of the IAPAT-C was valid and reliable. COVID-19 significantly affected various aspects of Iranian adolescents’ daily lives. Accordingly, it is necessary to provide appropriate interventions and policies for this sensitive class.

This study investigated the treatment methods used by physical and occupational therapists for poststroke paretic upper limbs and the factors influencing their decision-making processes. For the treatment methods of poststroke paretic upper limbs, the respondents were asked to select the most clinically used treatment according to the severity of the patient’s condition. For the factors influencing their decision-making processes, the respondents were asked to indicate each determinant using a 5-point Likert scale (1 = no influence at all to 5 = very strong influence). Six hundred thirty-eight therapists participated in this study. Exploratory factor analysis was used to assess the validity of the questionnaire. The findings indicated task-specific training (N=333, 52%) as the most popular for mild cases, followed by repetitive facilitative exercise (n=143, 22.3%) for moderate cases and electrical stimulation (n=246, 38.4%) for severe cases. This study revealed that evidence about treatment (very strong: n=171 (27.0%), and strong: n=287 (45.0%)) and patient preferences (very strong: n=203 (31.8%), and strong: n=251 (39.3%)) affected decision-making significantly regarding treatment methods for the poststroke paretic upper limb.