Jonathan Jarry

Vision and hearing impairment and occupational therapy education: Needs and current practice

Introduction It is unclear what sensory impairment screening content should be included in the core-educational process for occupational therapists. The purpose of this study was to identify what content is currently being taught with regard to screening for vision and hearing loss, and to gather recommendations from specialists in this field of practice in order to formulate recommendations to improve professional entry-level occupational therapy curriculum content. Method Using a mixed-methods design, the two-phase study investigated the perceptions of five curriculum chairs, as well as 10 occupational therapists specializing in sensory rehabilitation. Results Curriculum chairs reported minimal course content with regard to training in the sensory domain, a dearth that was corroborated by specialists working with individuals affected by sensory loss. While vision-related topics were well covered, hearing-related information was sparser, and dual sensory impairment was mostly absent. Conclusion Occupational therapists are well positioned to play an essential role with the population living with sensory loss. However, most clinicians are not adequately prepared to practice with this clientele, and most expertise is gained after graduation. There is a need for stakeholders to discuss the minimal acceptable curriculum content needed to ensure that graduates are prepared to work in this growing area

Screening for sensory impairment in older adults: Training and practice of occupational therapists in Quebec.

Background. The goal of occupational therapy education is to train generalists who can refine their knowledge after graduation according to the requirements of the professional environment. However, it is currently unclear to what extent sensory screening should be included in the educational curricula. Purpose. The purpose of this study was to examine the sensory screening education for and practice by occupational therapists working with older adults. Method. A cross-sectional survey was used to collect data from members of the Quebec Order of Occupational Therapists. Descriptive statistics were used in the analysis. Findings. Data from 102 respondents indicated that training on sensory impairment–related topics was minimal and in stark contrast to the proportion who reported serving clients with a visual (92%), hearing (84%), or combined impairment (53%). Implications. Occupational therapy considers numerous aspects of physical, cognitive, and emotional well-being. The question remains as to what extent vision and hearing health should take their place among these priorities.

Recommendations for successful sensory screening in older adults with dementia in long-term care: a qualitative environmental scan of Canadian specialists

Objectives This study aimed to identify screening tools, technologies and strategies that vision and hearing care specialists recommend to front-line healthcare professionals for the screening of older adults in long-term care homes who have dementia. Setting An environmental scan of healthcare professionals took place via telephone interviews between December 2015 and March 2016. All interviews were audio recorded, transcribed, proofed for accuracy, and their contents thematically analysed by two members of the research team. Participants A convenience sample of 11 professionals from across Canada specialising in the fields of vision and hearing healthcare and technology for older adults with cognitive impairment were included in the study. Outcome measures As part of a larger mixed-methods project, this qualitative study used semistructured interviews and their subsequent content analysis. Results Following a two-step content analysis of interview data, coded citations were grouped into three main categories: (1) barriers, (2) facilitators and (3) tools and strategies that do or do not work for sensory screening of older adults with dementia. We report on the information offered by participants within each of these themes, along with a summary of tools and strategies that work for screening older adults with dementia. Conclusions Recommendations from sensory specialists to nurses working in long-term care included the need for improved interprofessional communication and collaboration, as well as flexibility, additional time and strategic use of clinical intuition and ingenuity. These suggestions at times contradicted the realities of service provision or the need for standardised and validated measures.

AB097. Barriers and facilitators related to the use of optical low vision aids, a scoping review

Background: In recent decades, several studies have been performed in the field of (non-)use of assistive technology devices (ATs) and have found that many variables are likely to be involved in the decision-making process of whether a person with a disability uses or abandons their aids. In low vision rehabilitation, high variability rates and a variety of reasons for non-use of low vision aids has been reported. Determinants of non-use of ATs have previously been categorized into personal factors, ATs factors, environmental factors of the user, and intervention factors. It is probable that some of these factors are also associated with the use of optical low vision aids (OLVAs). Thus, using a framework about adherence with medical interventions, the aim of this scoping review was to explore barriers and facilitators related to OLVAs (non-)use. Methods: Existing guidelines of the scoping review Methods were used to examine and summarize the extent, range, and nature of findings regarding factor categories associated to OLVAs usage. Searches were conducted using the following online databases: Embase, MedLine, and ERIC without limitation on publication dates. A combination of key words and MeSH terms was used based upon the identified core concepts of the research question: (I) low vision; (II) assistive technology; and (III) adherence. A charting form, a flow chart of the study selection process, and a combination of a descriptive numerical analysis and a thematic analysis of 24 studies were performed. Results: The results of this review indicate high variability rates (range: 13–50%, M =24%, SD =10%) of people possessing OLVAs but not using them. Most authors do not use a precise definition of “non-use”, and when a definition is provided, the terminology is inconsistent. As expected, the four categories of variables identified are likely to be involved in OLVAs’ (non-)use: (I) the largest number of concerns were personal factors. Several aspects regarding personal characteristics were identified, such as demographic, physical, psychological, social-emotional, and occupational factors. Some variables, such as age, diagnosis and visual acuity were reported as contradictorily influencing the OLVAs’ usage; (II) ATs factors were associated with quality, appearance, practical aspects of use and the very type of OLVAs; (III) environmental factors referred to social support, physical barriers, expectations of the social environment, presence of a helper, and stigmatization; (IV) finally, intervention factors consisted of taking into account user’s opinions, positive health care experiences, instruction and training, provision processes, delivery periods, and follow-up services. Conclusions: This scoping review provides the preliminary evidence that factors related to OLVAs non-use could be classified into the same four typical categories described in the theory of non-adherence. These results suggest that strategies intended to enhance adherence might be for OLVAs should focus on these four aspects of device use.

SENSORY SCREENING IN DEMENTIA AND ALZHEIMER'S DISEASE: A SCOPING REVIEW

views. Per protocol, open-ended questions explored symptoms, medical and caregiving information, expectations and preferences for information sources. Interview notes were reviewed to detect common themes. Results: 27 CG (19F/8M; mean 59 years; 8 spouses, 17 adult children, 2 relatives, 2 friends) cared for 29 care-recipients. Emergent themes: 1)Behavioral symptoms often troubling but not recognized as CI symptoms , or CG lacked vocabulary to describe; 2)CG did not distinguish medical from caregiving information, though initially wanted medical information; 3)Symptoms accumulated gradually; rare that a threshold moment led to information-seeking; 4)The primary care provider (PCP) was the first information source; CG requested information rather than the PCP offering, and even when asked the PCP provided little; 5)Barriers: denial or stigma of dementia, unaware of available caregiving information, CG overwhelmed, PCP busy, Internet frustration; 6)CG trust and value the PCP, and expect PCP to provide information or recommend other sources; 7)CG are open to many sources, but desire PCP to specifically endorse. Conclusions:Public education could reduce stigma, and enable CG to recognize and describe early symptoms. Case-finding by screening for cognitive and behavioral symptoms could identify CI earlier, so information is received sooner. The PCP is the crucial port of entry to health information, providing it directly or guiding the CG to recommended sources; therefore, our aim is to develop mechanisms that facilitate busy PCP’s ability to address information needs.