Rosanne DiZazzo-Miller

Addressing Everyday Challenges: Feasibility of a Family Caregiver Training Program for People With Dementia

OBJECTIVE. The purpose of this study was to examine the feasibility and efficacy of the Family Caregiver Training Program for assisting with the basic activities of daily living of people with dementia. METHOD. A one-group pretest-posttest research design with a 3-mo follow-up was used to examine the efficacy of a manualized education program for caregivers. The 6-hr training was delivered to 72 family caregivers over 3 consecutive weeks (2 hr/wk) by trained clinicians. RESULTS. Caregivers showed a significant gain in knowledge of how to effectively assist with communication and nutrition, t(52) = 7.05, p < .000; transfers and toileting, t(45) = 3.10, p < .003; and bathing and dressing, t(44) = 2.71, p < .01, of their care recipients. CONCLUSION. Our findings demonstrate that this manualized intervention protocol is a promising method of equipping family members with the skills needed to face their everyday challenges in caring for people with dementia.

Reducing cognitive load while teaching complex instruction to occupational therapy students

Cognitive load theory is a field of research used to improve the learning of complex cognitive tasks by matching instruction to the learners cognitive architecture. We used an experimental posttest control-group design to test the effectiveness of instruction designed to reduce cognitive load (CL) and improve instructional effectiveness in teaching complex instruction to 24 first-year masters students under authentic classroom conditions. We modified historically taught instruction using an isolated-to-interacting-elements sequencing approach intended to reduce high CL levels. We compared control and modified instructional formats using written assessment scores, subjective ratings of CL, and task completion times. Analysis of variance revealed significant differences for postinstruction, posttest CL ratings, and delayed written posttest scores (p < .05). No significant differences were identified for posttest completion times. Findings suggest that this approach can be used to improve instructional efficiency in teaching human locomotion to occupational therapy students.

Diabetes self-management among Arab Americans: patient and provider perspectives.

BackgroundArab Americans have a high burden of diabetes and poor outcomes compared to the general U.S. population. Diabetes self-management (DSM) requires a partnership between patients and providers that fosters mutual understanding and shared decision-making. Cultural factors influence this process; however, little is known regarding the cultural impact on DSM or if perceptions differ between patients and providers.MethodsQualitative content analysis was used to analyze five focus groups–two groups with Arab American providers (nu2009=u20098) and three groups with adult Arab Americans with diabetes (nu2009=u200923). Focus groups examined patient and provider perspectives on the meaning of DSM and cultural barriers and facilitators among Arab American patients.ResultsFour distinct themes included limited resources for DSM education and support, stigma as a barrier to ongoing support, family support as an opportunity and challenge, and Arab American patient-provider relationships.ConclusionsFindings indicate several domains should be considered for clinical practice including a need to develop linguistically and culturally reliant educational materials and relevant supports for use in the Arab American population. Findings highlight differing views among providers and patients on the familial role in supporting DSM efforts and why some patients feel dissatisfied with clinical encounters.

The Impact of Arab American Culture on Diabetes Self-management Education

Purpose The purpose of this study was to better understand barriers and facilitators of diabetes self-management education (DSME) among Arab American patients with diabetes. Little is known about the impact of Arab culture on DSME. Methods Arab American adults (N = 23) with medically managed diabetes participated in 1 of 3 focus groups. An Arabic-speaking, trained moderator conducted video-recorded sessions. Verbatim Arabic transcripts were translated into English. Transcripts underwent a qualitative content analysis approach. Results Arab American cultural traditions such as food sharing, religious beliefs, and gender roles both facilitated and at times impeded DSME. Patients also held conflicting views about their interactions with their providers; some participants praised the authoritative patient-physician relationship style while others perceived the gaps in communication to be a product of Arab culture. Participants expressed that lack of available educational and supportive resources are key barriers to DSME. Conclusion Arab American culture affects DSM activities, and culturally sensitive educational resources are lacking. Development of DSME programs tailored to address relevant aspects of Arab culture might improve DSME outcomes in Arab American population.

Concurrent Validity of the International Family Quality of Life Survey

ABSTRACT The measurement of the social construct of Family Quality of Life (FQOL) is a parsimonious alternative to the current approach of measuring familial outcomes using a battery of tools related to individual-level outcomes. The purpose of this study was to examine the internal consistency and concurrent validity of the International FQOL Survey (FQOLS-2006), using cross-sectional data collected from 65 family caregivers of children with developmental disabilities. It shows a moderate correlation between the total FQOL scores of the FQOLS-2006 and the Beach Centers FQOL scale. The validity of five FQOLS-2006 domains was supported by the correlations between conceptually related domains.

Dementia in the context of disability

ABSTRACT Patients and caregivers often associate dementia with devastation and a loss of productive contribution to society. People with dementia are often depicted as confused individuals struggling through embarrassing episodes, followed by a loss of independence. The burden and devastation of the diagnosis on the families of people with dementia is exacerbated by their assumption of the role of caregiver with inadequate preparation or training. Disability scholars, in contrast, offer physical and occupational therapists a nontragic view of disability that recognizes the importance of countering the stigma and discrimination that too often accompany dementia. This case example of a woman diagnosed with dementia provides insight into the negative impact of these tragic, dependent views of dementia throughout and following the diagnosis process. Viewing her experiences through the lens of disability scholarship can increase awareness and improve the quality of care on the part of both therapists and family caregivers.

Erratum to: Diabetes self-management among Arab Americans: patient and provider perspectives

Unfortunately, the original version of this article [1] contained an error. The acknowledgements section was included incorrectly and should have acknowledged The Martha Schnebly Endowed Research Fund.

Spinal Cord Injury Induced by Gun Shot Wounds: Implications for Occupational Therapy

People with spinal cord injuries secondary to gunshot wounds present with many unique occupational challenges in terms of their overall health and well-being, and often live in violent cultures that limit occupational performance. Further awareness and understanding of this subgroup can enable occupational therapists to develop appropriate strategies needed to address the many challenges faced by this population. An in-depth understanding of cultural competence is necessary in the identification, planning, and delivery of appropriate and effective treatment. Further, a case example demonstrates the significant influence occupational therapy can achieve in this area of practice.

Contribution of Head Position, Standing Surface, and Vision to Postural Control in Community-Dwelling Older Adults

Postural control requires the integration of sensorimotor information to maintain balance and to properly position and orient the body in response to external stimuli. Age-related declines in peripheral and central sensory and motor function contribute to postural instability and falls. This study investigated the contribution of head position, standing surface, and vision on postural sway in 26 community-dwelling older adults. Participants were asked to maintain a stable posture under conditions that varied standing surface, head position, and the availability of visual information. Significant main and interaction effects were found for all three factors. Findings from this study suggest that postural sway responses require the integration of available sources of sensory information. These results have important implications for fall risks in older adults and suggest that when standing with the head extended and eyes closed, older adults may place themselves at risk for postural disequilibrium and loss of balance.

Occupational Therapy Essentials for Clinical Competence, by K. Sladyk, K. Jacobs, and N. MacRae: Thorofare, NJ: SLACK Inc., 2010, 672 pages, hardcover,

substantive essence. At a chapter’s end are brief concluding remarks. The text is supported by a strong foundation of research references. Citations for referenced research materials are placed following a chapter’s concluding section. Some instructive tables and figures are sewed seamlessly into the textual fabric. Within the context of later-life mental-health care, a multitude of subjects fall within the expansive ken of the assorted contributors. In the book’s first part, the region of inclusivity, user involvement, and practitioners is scrutinized in Chapter 1; social care is explored gingerly in Chapter 2; and the area of mental-health promotion attracts attention in Chapter 3. In the book’s second part, the view of contributors ranges expansively to disparate clinical contexts, encompassing anxiety, depression, psychosis, alcohol misuse, and dementia. In concluding Chapter 12, comprising the book’s third part, some of the major strands forming the cloth of the text are joined together. Critics may caution that the real-life bridge, connecting earnest discussion about complex issues and daunting challenges affecting later-life mental-health care and worthy change, may be quite difficult to traverse. But the expertly informed and thoughtfully opinionated discourse pervading the book may certainly help bridge the divide. The efforts of the contributors to this very fine and academically intense book, Mental Health and Later Life, may be of quite edifying value to multitudinous professionals, extending to gerontologists, psychologists, psychiatrists, psychoanalysts, psychotherapists, psychiatric nurses, dementia care specialists, neurologists, family therapists, family medicine physicians, cognitive therapists, occupational therapists, social workers, social scientists, public health professionals, neuroscientists, health care lawyers, and health policy makers.