Catálogo de publicaciones - revistas

<jats:sec><jats:title>Background/aim</jats:title><jats:p>Ongoing changes to health‐care funding Australia wide continue to influence how occupational therapists practise in acute hospitals. This study describes the practice challenges experienced by Western Australian acute care occupational therapists. Then, it explores if and how acute care occupational therapists are modifying their practice in response to these practice changes.</jats:p></jats:sec><jats:sec><jats:title>Methodology</jats:title><jats:p>This study used a qualitative grounded theory approach. Semi‐structured interviews were completed with 13 purposively selected acute care occupational therapists from four Western Australian metropolitan hospitals. Data were analysed using a constant comparative method to provide detailed descriptions of acute care occupational therapy practice and to generate theory.</jats:p></jats:sec><jats:sec><jats:title>Findings</jats:title><jats:p>Five conceptual categories were developed. The first two addressed practice challenges: pragmatic organisational influences on client care and establishing a professional identity within the multidisciplinary team. Three categories related to therapist responses are as follows: becoming the client advocate, being the facilitator and applying clinical reasoning. Finally, modified practice was identified as the core category which explains the process whereby acute care occupational therapists are ensuring they remain relevant and authentic in the acute care context.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Western Australian acute care occupational therapists are practising in a highly complex health context that presents many challenges. They are responding by using a modified form of practice that ensures occupational therapy skills remain relevant within the narrow confines of this health setting.</jats:p></jats:sec>

<jats:sec><jats:title>Background/aim</jats:title><jats:p>Occupational therapists working in palliative care aim to enable clients living with a life‐limiting illness to continue participating in meaningful activities for as long as possible. However, little is published about the occupations people living with a life‐limiting illness wish to engage in, and how occupational therapists can best enable occupational engagement. Therefore, this study aimed to gain an in‐depth understanding of occupational therapists’ perceptions on clients’ occupational engagement post‐diagnosis of a life‐limiting condition.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Occupational therapists working in Australia with people with a life‐limiting illness were recruited to participate in a national online survey over the period of a month. Recruitment used a purposive, snowball sampling technique, resulting in 144 survey responses. Data were analysed using modified grounded theory methods.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Findings revealed two interrelated categories and four subcategories. The first category, <jats:italic>focusing on life</jats:italic> is concerned with therapists’ perceptions of how clients continue to focus on living post diagnosis and encompasses two subcategories: (i) <jats:italic>prioritised engagement</jats:italic> and (ii) <jats:italic>altered engagement</jats:italic>. The second category, <jats:italic>preparing for death</jats:italic>, centres on therapists’ perceptions of what clients do to practically prepare for death and find closure as their illness progresses, and is comprised of the two subcategories: (i) <jats:italic>practical preparation for death</jats:italic> and (ii) “facilitating closure”.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Therapists perceived that meaningful occupational engagement changes over time as occupational performance levels decrease and clients prepare for death.</jats:p></jats:sec>

<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>Research capacity building enhances the abilities of individuals and is critical within health systems for quality patient care and promotes a culture of excellence within the occupational therapy profession. A research capacity building toolkit was proposed identifying strategies to support allied health professionals to undertake research. This study evaluated participant‐reported outcomes of research capacity building toolkit implementation in an occupational therapy department.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>An observational pre–post‐cohort study at a tertiary hospital with volunteer occupational therapists using the standardised Research Capacity in Context Tool (RCCT) and an author‐designed quality improvement (QI) survey was employed. The RCCT measures research capacity and culture at organisation, team and individual levels. Semi‐structured interviews were used to elicit reflections regarding participant experience.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>All levels of the toolkit were implemented successfully. The response rate was 59% (<jats:italic>n</jats:italic> = 36) at baseline and 49.1% (<jats:italic>n</jats:italic> = 26) at follow‐up. Eighty‐five percent of participants held direct clinical roles. Nine clinicians participated in the interviews. There were significant improvements in the estimate mean for the organisation (6.51 [2019] compared with 8.13 [2020], <jats:italic>p</jats:italic> = &lt;0.001) and the team (5.52 [2019] compared with 7.15 [2020], <jats:italic>p</jats:italic> = 0.001). The individual level did not significantly change with an estimate mean of 4.20 in 2019 increasing slightly to 4.84 in 2020 (<jats:italic>p</jats:italic> = 0.128). This was supported by the QI survey where improvements were noted in the department but not at an individual level. The qualitative findings verified the components of the toolkit including ‘supporting clinicians in research’, ‘working together’, ‘valuing research for excellence’ and reflected the importance of ‘individual attributes’.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The toolkit supported the implementation of specific strategies to enhance research capacity and culture. Improvements within the organisation and team were evident; however, these were not seen at an individual level. Further research about the contribution of individual‐related factors and processes to the building of research capacity is required.</jats:p></jats:sec>

<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>People with end‐of‐life care needs are seen in an increasingly diverse range of health and community settings. Opportunity for continued occupational participation is highly valued by people at the end of life. This scoping review sought to identify the priorities and preferences for participation at the end of life and to map findings using the model of human occupation.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A search strategy informed by the research question was developed in collaboration with a research librarian. Data sources used were Ovid Medline(R), CINAHL, Ovid Emcare, Scopus, Web of Science and PsychInfo. Studies that focused on clinician perspectives, clinical care, grief and loss, did not clearly identify end‐stage diseases, &lt;18 years and written in languages other than English were excluded.</jats:p></jats:sec><jats:sec><jats:title>Findings</jats:title><jats:p>Forty‐four studies were included with a total of 1,070 study participants. Inductively developed themes were mapped against the model of human occupation constructs of volition (<jats:italic>personal causation</jats:italic>, <jats:italic>values</jats:italic>, <jats:italic>interests</jats:italic>), habituation (<jats:italic>habits of occupational performance and routine</jats:italic>), performance capacity and the lived body within the physical, social and occupational environment. The majority of findings sat within the construct of volition, particularly around sense of personal capacity, self‐efficacy and values. At the end of life, people prioritise ongoing engagement in valued occupations even if participation is effortful. As disease progresses, opportunity to exert influence and control over this participation and engagement increases in importance. Personal causation plays an important role in the experience of occupational participation at this time.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>This review provides important insights into the occupational priorities of people at the end of life and the importance of supporting agency and volition at this time. The model of human occupation and its client‐centred focus offer a framework for a more robust examination of ways to enhance volitional capacity and enable occupational participation for people at the end of life.</jats:p></jats:sec>