Recording of Falls in Elderly Fallers in Northern Greece and Evaluation of Aging Health-Related Factors and Environmental Safety Associated with Falls: A Cross-Sectional Study

Background. Elderly falls constitute a global problem with huge social and economic aspects. Fall risk factors are both intrinsic (physical and psychological) and extrinsic (related with environmental safety). Aim. To record both intrinsic and extrinsic risk factors and their correlation in elderly fallers in order to suggest specific guidelines for their medical care and environmental modification inside and outside the home. Method. The study involved 150 elderly fallers (median age 70 (67-74)), who completed a record containing information on known risk factors related to their health status, as well as information on the conditions and causes that led to the fall. Each fall was considered an independent event, while measurements were performed regarding balance, strength, their functional ability, and the fear of a possible fall. Descriptive analysis and frequency analysis were used to record the health and activity status of the participants as well as the fall-related environmental factors. Severity of each fall event across a variety of locations was examined using the Kruskal-Wallis one-way analysis of variance. Multiple linear regression was applied to examine the effect of the mean values of functional tests and medical records on the number of fall events. Results. In the span of 12 months, a total of 304 fall events were recorded. Regarding location, 77.6% occurred indoors; more frequent were the bedroom (28.6%) and the bathroom (28%). The interior stairs (10.5%), the kitchen (4.9%), and the living room (3.3%) were the less frequent locations. Concerning danger, falling on the interior stairs caused the longest hospitalization, followed by the kitchen and the bathroom. Extrinsic factors that led to both indoor and outdoor falls were the administration of psychotropic medication, poor space ergonomics, lack of basic safety standards, and poor lighting conditions. Vision problems and dizziness resulted in more falls than other intrinsic factors. Furthermore, reduced performance in the FICSIT-4 test and the 30-Second Chair Stand Test, as well as high scores in the CONFbal–GREEK questionnaire and the Short FES-I, shows a linear relationship with an increased number of falls. Conclusions. Ergonomic interventions can help prevent indoor elderly falls. Poor construction and lack of adequate lighting mainly cause outdoor falls. Regular eye examinations, management of vertigo, improvement of the balance and strength of the lower limbs, and reduction of fear of impending falls are the intrinsic factors that help prevent falls the most.

Preparing Advanced Clinicians and Practitioners: A Model for Mentorship in Occupational Therapy Practice

Mentoring is essential at all stages of a professional career. However, little has been written about the effectiveness of programs for practicing clinicians. This study was designed to address the need for evidence about the effectiveness of formal mentorship programs by describing the impact of the STAR mentorship program on a group of clinicians specializing in sensory integration and processing challenges. This study utilized an exploratory, retrospective, survey research design. Course evaluations were examined from 240 subjects following participation in a one-week, small group mentorship training program. Qualitative methods were adapted for use in this study. Sixteen codes, with operational definitions, were developed to analyze the surveys. Ninety-six percent indicated that the program met or exceeded their expectations; only 12.5% had a negative comment. Impact on psychosocial function was reflected by 22% of the participants. Comments related to impact on career function were indicated by 45% of the participants. Ninety-four percent provided positive comments about the program structure, and 74% responded with positive comments regarding content of the program. Positive outcomes were associated with this one mentorship program, suggesting a need for more in-person, structured mentored learning experiences. Mentorship is recommended as a method to address the growing need within the profession to support career development, build knowledge, skill and attitudes, and aspirations/commitment as well as enhance professionalism/professional development.

The Effect of Whole-Body Vibration on Proprioception and Motor Function for Individuals with Moderate Parkinson Disease: A Single-Blind Randomized Controlled Trial

Introduction. Previous studies have shown that whole-body vibration (WBV) may have a potential impact on gait and balance in individuals with Parkinson’s disease (PD). However, this body of work has proven inconclusive due to the diverse disease progression and broad age range associated with PD. The effects of WBV on proprioception, a sense frequently affected by PD, has rarely been studied. Objective. To investigate the short-term effect of WBV on proprioception and motor function for individual with moderate PD. Design. A single-blind randomized controlled trial. Setting. A hospital and a laboratory. Participants. 32 participants with moderate PD were recruited and randomly assigned into either the WBV or conventional therapy groups. Interventions. For the WBV group, each treatment session included five, one-minute bouts of whole-body vibration paired with one-minute rest (frequency: 6 Hz; amplitude: 3 mm). Each conventional therapy participant received balance and mobility training for 10 minutes. Main Outcome Measures. Outcome measures included proprioceptive sensitivity of the upper limb, position sense of the knee joint, Unified Parkinson’s disease rating scale : motor section (UPDRS-motor), functional reach test (FRT), and the timed up and go test (TUG). Results. No statistically significant difference was found between groups. However, both groups showed a significant improvement in motor function after treatment, including UPDRS-motor ( P = 0.04 ), less affected side of FRT ( P = 0.019 ), and TUG ( P = 0.006 ). Conclusions. Although the effect of WBV was not superior to the conventional therapy, it provided a passive and safe clinical intervention as an alternative treatment, especially for individuals with motor impairment or poor balance function.

Meta-Analysis of Factors Associated with Occupational Therapist Burnout

Burnout, a reaction to chronic emotional stress, affects health and reduces the quality of service. Reportedly, healthcare professionals are especially vulnerable to burnout. This meta-analysis is aimed at examining the factors associated with occupational therapists’ burnout. The results of 2,430 occupational therapists, across 17 peer-reviewed English articles, the most recent published in 2020, were analysed. Results revealed significant associations between related variables and burnout. Marital status, work field, and work hours, job challenges, patient age, position, turnover intention, working type, and work addiction showed significant positive correlation effect sizes in relation to burnout, whereas age, education, engagement, job satisfaction, personal identity, professional identity, rewards, and feeling valued showed significant negative correlation effect sizes. The results of this meta-analysis suggest that strategies to reduce occupational therapists’ burnout need to consider organizational as well as psychological aspects.

Spiritual Care in Advanced Dementia from the Perspective of Health Providers: A Qualitative Systematic Review

Background. Worldwide, 47 million people suffer from dementia. Despite recognizing the importance of spirituality within dementia care, it is still unclear how this should be integrated into dementia services. Aim. To explore the perspective of health professionals regarding the spiritual care of people with advanced dementia. Methods. A qualitative systematic review was performed following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines for the study design. The inclusion criteria included original articles published from January 2008 to March 2019, using either qualitative or mixed methods. The quality of the articles included was evaluated using the consolidated criteria for reporting qualitative research, Standards for Reporting Qualitative Research, and the Critical Appraisal Skills Programme. Synthesis of findings was performed using thematic analysis. Results. Twelve studies were included in the review. Seventeen categories were identified, grouped into four themes: (1) the perception of spirituality, including the failure to address the same, (2) the spiritual needs of people with advanced dementia, (3) spiritual needs from health care providers, and (4) addressing spirituality, with the following categories: music, significant activities, among others. Conclusions. Spirituality is not formally addressed in this population, and professionals do not feel confident enough to be able to integrate spirituality in their care. It is necessary to identify and record the spiritual needs of people with advanced dementia, as well as to design specific care programs.

Role Perception of Occupational Therapists in Education Systems: Self-Efficacy and Employability Skills

Although the main framework for occupational therapy includes delivery of services in educational institutions with students with disabilities, little is known about how the occupational therapists perceive their role in this specific system. This research examines an integrated conceptual model wherein self-efficacy explains the occupational therapists’ role perception with employability skills as a mediator. Participants, 147 occupational therapists working in educational systems, completed an online demographic questionnaire, the Perception Questionnaire for Occupational Therapists in the Education System, General Self-Efficacy Questionnaire, and Employability Key Questionnaire. The proposed model was analyzed by the structural equation model (SEM) using AMOS software. The SEM provided excellent goodness of fit indices, χ 2 24 = 40.49 ; p = .019 ; NFI = .93 ; CFI = .97 ; RMSEA = .07 ; SRMR = .05 , and explained 40% of the variance in role perception. These findings highlight employability skills as the primary contributor that affects occupational therapists’ role perception. Self-efficacy and employment skills influence how occupational therapists working in education systems perceive their roles; thus, employment skills should be included in professional training and development courses. This study has implications for occupational therapists working on the education system to understand the meaningful effects of employability skills as critical to developing and improving their role perception.

Investigating the Effectiveness of Using a Situated Simulation-Based Program to Improve Occupational Therapy Students’ Interactions and Observation Skills with Children

Purpose. Interaction and observation are critical skills for occupational therapists who work with pediatric clients. The objective of this study was to investigate whether using standardized child patients within a situated simulation-based (SSB) program increases students’ knowledge and clinical skills when working with children in occupational therapy. Materials and Methods. This controlled trial with multiple measures recruited students from the pediatric occupational therapy curriculum enrolled in an SSB program in consecutive academic years ( n = 62 ). Experimental group students participated in a simulation experience with video training sessions, followed by an SSB exam with standardized child patients; the control group performed the video training simultaneously. Quantitative outcomes included quizzes to measure clinical knowledge, video training scores, and a situated simulation exam to assess clinical skills. Results. The experimental group had a significantly higher postwritten quiz scores than the control group; the video training scores were not significantly different between groups. Linear regression analysis showed a significant association between the SSB exam and postwritten quiz scores ( β = 0.487 , p = 0.017 ). The experimental group had a total pass rate of 65.6% for the SSB exam. The communication and interaction pass rate was 53.1%; the basic evaluation rate was 68.8%, implying that communication/interaction skills are hard to simulate from video training alone; therefore, the authentic fidelity of the SSB program needs to improve further to enhance learning. Conclusions. The SSB program with standardized child patients improved students’ clinical knowledge and skills more than lectures and practice alone. Using standardized child patients in programs or exams appears to positively influence students’ performance. Situated simulation-based learning that allows the realistic practice of observation and communication skills may enhance students’ clinical competency. Future research should develop standard training methods and evaluation processes in high-fidelity simulations for generalized use in other occupational therapy programs.

Factors Associated with Quality of Life among Caregivers of People with Spinal Cord Injury

Purpose. Often people with spinal cord injury (SCI) require help from their caregivers to carry out activities of daily living. Such assistance may affect caregiver quality of life (QoL). This study investigates the QoL and its associated risk factors among caregivers of people with SCI to find possible ways to increase their QoL. Material and Method. A convenience sample of 135 Iranian caregivers of people with SCI participated in a cross-sectional study from the Brain and Spinal Injury Repair Research Center of Tehran (BASIR), Iran, from June 2018 to October 2019. The World Health Organization’s Quality of Life Questionnaire (WHOQoL-BREF), the Beck Depression Inventory-II (BDI-II), the Caregiver Burden Scale (CBS), and a demographic questionnaire were administered. Hierarchical multiple linear regression analysis was then applied to identify risk factors associated with caregiver QoL. Results. Moderate to highly significant negative correlations were observed between all domains of the WHOQoL scale and subscales of the CBS and the BDI-II. After controlling for demographic and clinical variables, depression, burden, and level of injury were found to predict caregiver QoL significantly. Furthermore, QoL was lower in caregivers of people with quadriplegia than paraplegia ( p < 0.05 ). Conclusions. The level of injury, self-perceived caregiver burden, and depression are associated with QoL for the caregivers of people with SCI. A holistic approach incorporating caregiver training, psychological interventions, and adequate support may enable better QoL for these caregivers.

Identifying Occupational Therapy Research Priorities in Trinidad and Tobago: A Group Concept Mapping Study

In Trinidad and Tobago, occupational therapy is an emerging profession with limitations in the number of practitioners and the scope of practice. With the development of a new Master of Science Occupational Therapy programme in the country, the profession is continuously growing. There has been an increased demand for culturally relevant research to build the occupational therapy evidence base locally. However, the narrow range of occupational therapy literature in the country makes it difficult to highlight research gaps and decipher what research areas should be prioritised to best impact occupational therapy practice at present. This group concept mapping study is aimed at identifying priority areas for occupational therapy research in Trinidad and Tobago from the perspectives of occupational therapy students and practitioners. Participants brainstormed and contributed specific research ideas they would like to see developed in the country. Individually, participants sorted these ideas into themes and rated each idea based on perceived importance and feasibility. Using the GroupWisdom™ software, multidimensional scaling and hierarchical cluster analyses were applied to the sort data to create idea clusters within a concept map. Rating values were analysed to determine priority research themes within the concept map. The resulting concept map illustrated seven research priorities: Contextualising Practitioner Development, The Realities of Emerging OT Practice, Localising Mental Health OT, Occupation and Participation of Children and Youth, School-based OT in the Local Context, OT with Special Populations, and OT Contributions to the Public Health Sector. These findings represent the research needs of the occupational therapy profession in Trinidad and Tobago and will help to focus future researchers’ efforts to expand the local evidence base.

Assessment of Participation within the International Classification of Functioning, Disability, and Health (ICF): The Turkish Validity and Reliability of the Participation Scale

Objective. The aim of the study was to investigate the reliability and validity of the Turkish version of the Participation Scale (P-Scale). Methods. A total of 152 students, with a mean age of 20.27 ± 2.19 , participated in the study. Sociodemographic information (age, gender, and family income) was recorded; all participants completed the P-Scale twice with a 15-day interval. Translation and cross-cultural adaptation were performed to analyze the validity and reliability of the P-Scale. Cronbach’s alpha and McDonald’s alpha were used for scale reliability statistics and explanatory (EFA) and confirmatory (CFA) factor analysis; Mardia’s multivariate normality and assumption tests were used for the validity of the scale. The factor extraction methods were minimum rank factor analysis in EFA and weighted least squares mean and variance adjusted estimator polychoric correlation matrix in CFA. Results. Internal consistency of the scale was found good with Cronbach’s alpha (0.852) and excellent with McDonald’s alpha (0.924). The EFA and CFA resulted in two-factored structure, with the explained variance found to be higher than 30%. Conclusions. Analysis demonstrated that the P-Scale had a satisfactory level of reliability and validity in Turkish university students.