Vanessa Jewell

An Exploration into Occupation-Centered Practice in Skilled Nursing Facilities

ABSTRACT Aims: The aims of this pilot study were to identify occupational therapy interventions provided to short-term rehabilitation clients at skilled nursing facilities and to determine if therapists engaged clients in interventions with an occupation-centered approach. Methods: This study utilized a prospective mixed methods design with in-depth observations of two occupational therapists and three clients. Field notes, schematic drawings, and the Occupation-Centered Intervention Assessment documented and captured 57 interventions. Results: Provision of interventions occurred primarily in the clinic (36/57), with exercise and rote practice as the most common intervention approach (26/57), and interventions that utilized occupation were rated higher on the OCIA indicating a more occupation-centered approach. Conclusions: More than half of the interventions did not involve the use or focus on occupation, indicating a gap between theoretical frameworks and interventions taught in professional school and what actually occurs in practice.

Journey Interrupted: A Phenomenological Exploration of Miscarriage

Background: Miscarriage is a significant life event that impacts occupational performance, identity, and competence and that influences perceptions of motherhood. Because of the lack of social rituals often attributed to the death of a loved one, miscarriages may result in disenfranchised grief, which impedes coping. Methods: This phenomenological study explored the impact of miscarriage on relationships, perceptions of motherhood, and the meaning of occupation in the context of grief. Data was collected through semistructured interviews (N = 4) and completion of a brief demographic questionnaire. The interviews were digitally recorded, transcribed verbatim, and reviewed to ensure accuracy. Using inductive thematic analysis, the first author identified initial codes, collated the codes into preliminary themes, and then reviewed, further analyzed, and refined the themes. Results: Three overarching themes were identified: (a) the journey: ambiguity, vulnerability, and the trauma of a miscarriage; (b) seeking acknowledgement and validation of loss: impact on relationships; and (c) occupational engagement: evolving roles and perspectives. Conclusion: The findings of this study illustrated the complexity of the lived experience of miscarriage and highlighted the significant impact of miscarriage on self-identify, relationships, and the complex role of occupation in the context of bereavement. Comments Disclosure Statement: The authors report no conflict of interest. The authors presented the findings from this study at the 2017 American Occupational Therapy Association Annual Conference in Philadelphia, PA. The authors alone are responsible for the content and writing of this manuscript.

A systematic review of sound-based intervention programs to improve participation in education for children with sensory processing and integration challenges

ABSTRACT This systematic review evaluates current evidence for using sound-based interventions (SBIs) to improve educational participation for children with challenges in sensory processing and integration. Databases searched included CINAHL, MEDLINE Complete, PsychINFO, ERIC, Web of Science, and Cochrane. No studies explicitly measured participation-level outcomes in education. Ten studies provided limited evidence supporting the use of SBIs based on preliminary positive effects on occupations, client factors, and performance skills related to participation in education. Stronger experimental designs are needed measuring educational participation. Therapists should use caution using SBIs for this population and outcome until further research clearly substantiates or refutes this intervention.

Impact on Quality of Life Following the Implantable Miniature Telescope Procedure

ABSTRACT The purpose is to examine the impact of the Implantable Miniature Telescope procedure on the level of treatment satisfaction and quality of life of individuals with end-stage age-related macular degeneration. Six individuals who had undergone the Implantable Miniature Telescope procedure were recruited. The participants completed two survey instruments about their overall quality of life and level of treatment satisfaction post intervention. In-depth interviews were also conducted to gain a perspective of the participant’s lived experience. A moderately high quality-of-life and treatment satisfaction rating was reported by participants post intervention. Qualitative themes included loss of independence, realistic perspective about the procedure, importance of rehabilitation following the procedure, and high treatment satisfaction despite lack of improvement in visual functioning. Moderately high quality-of-life ratings and treatment satisfaction were reported despite reports of limited improvements in participants’ visual function and ability to utilize the Implantable Miniature Telescope. However, qualitative responses revealed a negative impact on quality of life in relation to their diagnosis of end-stage age-related macular degeneration, but not in direct relation to the Implantable Miniature Telescope procedure.

Psychometric Evaluation of the Occupation-Centered Intervention Assessment:

A challenge of intervention research is the lack of a means to identify and measure clinical practice from an occupation-centered approach. The objective of this study is to establish basic psychometric properties of the Occupation-Centered Intervention Assessment (OCIA). The study is approached by establishing content validity and utility through expert panel and two focus groups. Interrater reliability (IRR) was determined through standardized video analysis and Krippendorff’s alpha. Results from the expert panel and focus groups indicated an overall agreement that the OCIA was able to capture the full range of elements of rehabilitation-focused interventions for older adults (occupational, contextual, and personal relevance) and a good fit with the occupational therapy intervention process model. IRR found adequate level of agreement (α = .76). The OCIA has demonstrated initial basic psychometrics for observation of rehabilitation-focused interventions with older adults.