Karen Atler

Occupational science: A data‐based American perspective

The purpose of this research was to provide a data‐based picture of the discipline of occupational science by identifying patterns of research in the first 5 years of presentations at the Society for the Study of Occupation: USA (SSO:USA). A grounded theory approach was used to examine 184 peer‐reviewed presentation abstracts, from 2002 to 2006. Among the 108 data‐based presentations, adults were the most studied group, with 46% of the data‐based abstracts focused on participants with a disability or clear disadvantage. Presenters’ research foci related to 4 themes: the personal experience of occupation, the context surrounding or impacting occupation, changes associated with occupation, and a descriptive perspective of occupation. Implications for occupational science are discussed.

Effectiveness of occupational therapy with frail community living older adults

This study examined the effectiveness of short-term, home-based occupational therapy guided by the Occupational Therapy Intervention Process Model for improving activities of daily living [ADL] with eight frail, older adults living in assistive living. A multi-method research approach was utilized to collect both quantitative and descriptive, qualitative data in the form of a retrospective examination of the participants’ clinical records. The quantitative component was a within-subjects, repeated-measures analysis of participants’ Assessment of Motor and Process Skills [AMPS] ADL motor and ADL process ability measures that revealed statistically significant improvement in ADL motor, but not ADL process abilities. The qualitative component was a content analysis of the clinical records. ADL baselines, goals, interventions and outcomes documented were analyzed. Improvement was noted in 77% of the written ADL goals. Results are discussed and recommendations were given for future research and documentation to improve the professions ability to support evidence-based practice.

An Argument for a Dynamic Interrelated View of Occupational Experience

This paper provides an argument for a more dynamic, interrelated understanding of occupational experience through the simultaneous examination of Pierces three dimensions: pleasure, productivity and restoration. Limited attention has been given to Pierces notion in part due to a lack of continued exploration of the interrelation of the three dimensions. However a body of new evidence strongly supports the theoretical assumptions of the importance of examining the relationship among pleasure, productivity and restoration to help understand occupational experience. This paper reviews several current theoretical ideas of occupational experience and subsequently argues for the advantage of using a dynamic interrelated view of occupational experience that allows for a deeper understanding of its complexity and idiosyncratic nature within and across people. The implications and limitations of this view of occupational experience, along with future directions for exploration, are presented for occupational science.

User-perceived utility of the Daily Experiences of Pleasure, Productivity, and Restoration Profile.

Background. Awareness of the relationship between everyday occupations and subjective experience could help clients make changes that promote health. Purpose. This study evaluated user-perceived utility of the Daily Experiences of Pleasure, Productivity, and Restoration Profile (PPR Profile), a time-use survey designed to uncover users’ experiences of pleasure, productivity, and restoration and to promote awareness of how these experiences are related to daily occupations. Method. Eighteen participants completed the PPR Profile on 2 days within 1 week and were subsequently interviewed. Content analysis was used to uncover themes. Findings. Analysis revealed that completion of the PPR Profile requires time and energy, completion more than once is useful, and the PPR Profile contributes to awareness. Four subthemes of awareness were identified: awareness of the here and now, insights into one’s occupations, context matters, and what is and what might be. Implications. Results support the utility of the PPR Profile to promote users’ awareness of their occupations and related subjective experiences. This awareness may encourage positive change. Further research is recommended to continue to evaluate the PPR Profile’s clinical utility.

Fueling the Engines: A Role for Occupational Therapy in Promoting Healthy Life Transitions

This article explores the potential role of occupational therapy in promoting healthy life transitions among people without illness or disease, The story of Roxana, a woman who moved with her family from Mexico to the United States, is described. The many transitions Roxana experienced are examined using the Person-Environment-Occupation Model. Implications for practice focus on assessment and intervention strategies that can help practitioners and individuals experiencing transitions use occupation to prevent illness and promote health.

Enhancing construct validity evidence of the Daily Experiences of Pleasure, Productivity and Restoration Profile

ABSTRACT The purpose of this study was to further assess the psychometric properties of the PPR Profile, a newly developed tool which assesses peoples experiences of pleasure, productivity, and restoration in the occupational context of their time use. The relationships between mean pleasure, productivity and restoration scores, a global indicator of occupational experience and measures of meaning in life, positive and negative affect, and life satisfaction were examined using data from students (n=266) from a western university in the United States. Relationships were examined using multiple regression models. Validity evidence of the PPR Profile based on relationship to other variables was found. Daily mean pleasure and daily mean productivity were statistically significant predictors of a global assessment of occupational experience, meaning in life, positive affect, and life satisfaction. When controlling for global occupational experience, pleasure helped explain positive and negative affect and satisfaction with life, whereas productivity contributed to explaining meaning in life and positive affect. Daily mean restoration was not a significant predictor of global occupational experience or any of the well-being variables. The findings support the validity of the PPR Profile and the importance of examining various ways of assessing occupational experience. Implications for future research are presented.

“Merging Yoga and Occupational Therapy (MY-OT): A feasibility and pilot study”

OBJECTIVE To examine the feasibility and benefits of the Merging Yoga and Occupational Therapy (MY-OT) intervention. DESIGN This is the primary analysis of a non-controlled pretest-posttest pilot study to understand the feasibility and impact of MY-OT on balance, balance self-efficacy, and fall risk factor management in people with chronic stroke. SETTING University research laboratory. PARTICIPANTS People with chronic stroke were included in the study if they: had sustained a fall or had fear of falling, were able to stand, and hand impaired balance and were at risk for falls (≤46 on the Berg Balance Scale (BBS)). INTERVENTIONS Individuals completed an 8 week intervention that included 16 sessions of both yoga and group occupational therapy (OT). Yoga included physical postures, breathing exercises, and meditation. OT focused on post-stroke fall risk factor management. MAIN OUTCOME MEASURES The BBS was used to assess balance, the Activities-specific Balance Confidence Scale (ABC) was used to measure balance self-efficacy. Five fall risk factor management scales were used. RESULTS Overall, the intervention was considered feasible, as individuals were able to safely complete the intervention with little attrition and high attendance. Balance improved by 30% (p=0.002). Balance self-efficacy improved by 15% (p=0.034). Each of the five fall risk factor management scales improved, but only two significantly improved (Fall Prevention and Management Questionnaire, 29%, p=0.004 and Fall Prevention Strategy Survey, 42%, p=0.032). CONCLUSION The results demonstrate that MY-OT is a potential intervention to improve multiple fall related outcomes for people with stroke. Therapists may consider these interventions for people with stroke, but additional research is warranted.

Strengths and limitations of the occupational therapy model curriculum guide as illustrated in a comprehensive curriculum revision process.

ABSTRACT The Model Curriculum was developed to guide curriculum design initiatives in occupational therapy. No data exist describing the Model Curriculum guide in an actual curriculum design process. This paper offers initial descriptive data on the strengths and limitations of the Model Curriculum guide as illustrated in a comprehensive curriculum revision process. The strengths of the Model Curriculum guide included: (1) it represented curriculum as a holistic academic plan and curriculum design as a series of decision points around interrelated elements, (2) it provided an orientation to the vocabulary and process of inductive curriculum design, (3) it provided a general process for undertaking curriculum revision work that was data-driven, and (4) the guide helped raise fundamental questions about the nature of curriculum and learning. Yet, each of these functions was also limited. Limitations are described and recommended revisions to the Model Curriculum guide are offered.

Impact of yoga on balance, balance confidence and occupational performance for adults with diabetic peripheral neuropathy: A pilot study:

Introduction The purpose of this study was to examine the preliminary efficacy of yoga on balance, balance confidence, occupational performance, and satisfaction with performance in adults with diabetic peripheral neuropathy. Method Fifteen adults with diabetic peripheral neuropathy attended eight weeks of yoga, including positive affirmations, breathing, postures and relaxation. Balance was measured using the Berg balance scale; balance confidence, using the activities-specific balance confidence scale; and occupational performance and satisfaction, using the Canadian occupational performance measure. We used a non-controlled pretest–posttest design. Findings Significant improvements were found for all measures. Improvements remained significant after the Bonferroni correction (α = 0.05/4–0.0125) and effect sizes were large for occupational performance and satisfaction (dCohen = 1.13, 1.07, respectively). Conclusion Yoga may significantly improve balance, balance confidence, occupational performance, and satisfaction for adults with diabetic peripheral neuropathy. Further research utilizing a control group, a larger sample size, and randomization is required.

Self-Management and Yoga for Older Adults with Chronic Stroke: A Mixed-Methods Study of Physical Fitness and Physical Activity

ABSTRACT Objective: This study investigated changes in physical fitness and physical activity among older patients with chronic stroke (stroke ≥ 6 months previous) after participation in a yoga infused self-management intervention. Methods: A mixed-methods secondary data analysis examined quantitative measures of endurance, strength, and gait speed and qualitative perspectives of intervention participants. Results: Based on Wilcoxon analysis, physical fitness outcome measures including endurance and lower and upper body strength significantly (p < .02) improved. Based on qualitative results of 2 focus groups and 14 individual interviews, participants expressed positive changes in endurance, strength, gait speed, flexibility, and balance. They also reported improvements in walking ability and duration, and expressed a desire to continue yoga and increase levels of exercise. Conclusions: With the objective of improving physical fitness and exercise for older adults with chronic stroke, it is important for self-management interventions to provide specific safe and feasible physical activity components, such as yoga. Clinical Implications: Health professionals may improve offered chronic stroke self-management interventions by incorporating yoga.