<p>The overall aim of the present thesis was three-fold. The overall aim of the present thesis was three-fold. The first was to study occupational performance in individuals with severe mental disorders and their experiences of occupational therapy, the second to study experienced burden of family caregivers and the third to test the validity and the homogeneity of assessment tools in this area. The samples consisted of individuals with severe mental disorders participating in organised occupations (n= 112), occupational therapy records (n=64), occupational therapists working in mental health care (n=7) and family caregivers of individuals with severe mental disorders (n=256). Data were collected by questionnaires, structured and narrative interviews, observations and occupational therapy records. Individuals with severe mental disorders reported problems related to leisure and work activities and the occupational therapists recorded problems concerning how to organise and structure occupational performance. Individuals functioning on a high cognitive level experienced problems related to work and productive activities. Participation in occupational therapy strengthened their confidence in their own ability. The "Experience of Occupational Performance Questionnaire" (EOPQ) was developed from data on the experiences of women participating in occupational therapy. A principal component analysis gave seven factors with acceptable homogeneity. There is a need for assessment tools to evaluate occupational therapy. The EOPQ represents an attempt to fulfil this need. Family caregivers experienced limitations of daily activities as a burden. The ability to perform daily activities was studied from three perspectives, the individuals’, the occupational therapists’, and the experienced burden of the family caregivers. These perspectives are complementary and thus necessary for planning and implementation of individually adapted occupational therapy as well as for the evaluation of outcomes.</p>

The overall aim of the present thesis was three-fold. The overall aim of the present thesis was three-fold. The first was to study occupational performance in individuals with severe mental disorders and their experiences of occupational therapy, the second to study experienced burden of family caregivers and the third to test the validity and the homogeneity of assessment tools in this area. The samples consisted of individuals with severe mental disorders participating in organised occupations (n= 112), occupational therapy records (n=64), occupational therapists working in mental health care (n=7) and family caregivers of individuals with severe mental disorders (n=256). Data were collected by questionnaires, structured and narrative interviews, observations and occupational therapy records. Individuals with severe mental disorders reported problems related to leisure and work activities and the occupational therapists recorded problems concerning how to organise and structure occupational performance. Individuals functioning on a high cognitive level experienced problems related to work and productive activities. Participation in occupational therapy strengthened their confidence in their own ability. The "Experience of Occupational Performance Questionnaire" (EOPQ) was developed from data on the experiences of women participating in occupational therapy. A principal component analysis gave seven factors with acceptable homogeneity. There is a need for assessment tools to evaluate occupational therapy. The EOPQ represents an attempt to fulfil this need. Family caregivers experienced limitations of daily activities as a burden. The ability to perform daily activities was studied from three perspectives, the individuals’, the occupational therapists’, and the experienced burden of the family caregivers. These perspectives are complementary and thus necessary for planning and implementation of individually adapted occupational therapy as well as for the evaluation of outcomes.

Sammanfattning Syftet: Att sammanställa vad som fanns beskrivet i vetenskaplig litteratur om bedömningsinstrument som kan användas av arbetsterapeuter för bedömning av behov av bostadsanpassning för vuxna med främst fysiskt funktionsnedsättning.   Metod: Systematisk litteraturstudie med sökning på fyra sökord i sju databaser. För att få ytterligare information om de funna bedömningsinstrumenten gjordes en manuell sökning via artiklarnas referenslistor för att kunna besvara frågeställningarna.   Resultat: Författarna fann sju bedömningsinstrument som bedömde olika aspekter av miljön i relation till person och/eller aktivitet. Inget av bedömningsinstrumenten var avsett att enbart bedöma behovet av bostadsanpassning. Resultatet styrker behovet av bedömningsinstrument som innehåller både observation och självskattningsmoment för att få en helhetsbild av miljöns tillgänglighet och användbarhet.   Konklusion:  Arbetsterapeuter som bedömer behovet av bostadsanpassning behöver bedömningsinstrument som mäter både subjektiva och objektiva aspekter av hemmiljö. Fem av bedömningsinstrumenten innehöll antingen självskattnings- eller observationsmoment och om de kombineras med varandra får arbetsterapeuten en helhetsbild. Två av bedömningsinstrumenten innehöll båda aspekterna. / Summary   Purpose:   To compile what was described in scientific literature on assessment instruments that can be used by occupational therapists to assess the need for home modifications for adults with primarily physical disabilities. Method: Systematic literature search with four keywords in seven databases. To obtain additional information about the assessment instruments a manual search of article reference lists was carried out in order to answer the specific study questions of the study. Results: The authors found seven assessment instruments which assessed various aspects of the environment in relation to person and / or activity. None of the assessment instruments were designed to only assess the need for home modifications. The results proved the need for assessment instruments that contain both observation and self-assessment elements to obtain a complete picture of environmental accessibility and usability. Conclusion: Occupational therapists who assess the need for housing modification needs assessment instrument that measures both subjective and objective aspects of the home environment. Five of the assessment instruments contained either self-estimation or observation moments and when combined, the occupational therapist gets an complete picture. Two of the assessment instruments included both aspects.

Šio darbo tikslas – įvertinti pacientų, persirgusių galvos smegenų insultu, prisitaikymą namuose pirmąją savaitę po reabilitacijos. Tyrimo uždaviniai: įvertinti pacientų, persirgusių galvos smegenų insultu, kasdienes veiklos sutrikimus išvykstant iš reabilitacijos; įvertinti veiklos sutrikimus namų aplinkoje pirmą savaitę po reabilitacijos; įvertinti veiklos sutrikimus namų aplinkoje, priklausomai nuo lyties, amžiaus, susirgimo pobūdžio ir gyvenamosios aplinkos. Tyrimas buvo atliktas VšĮ Šiaulių Apskrities Ligoninės, Fizinės medicinos ir reabilitacijos II-ame skyriuje ir pacientų namuose 2009-09 – 2010-02 mėn. Tyrime dalyvavo 55 pacientai, persirgę galvos smegenų insultu. Iš jų 36 (65,5%) moterys ir 19(34,5%) vyrai, amžiaus vidurkis 63,3±10,6 metų. 31 (65,9%) moteris persirgo smegenų infarktu ir 5 (62,5%) hemoragija. 16 (34,5%) vyrų persirgo smegenų infarktų ir 3(37,5) hemoragija. Pacientai buvo apklausti reabilitacijos pabaigoje ir pirmą savaitę po reabilitacijos namuose naudojant Kanadietišką Veiklos Vertinimo Testą (KVVT). Reabilitacijos pabaigoje buvo apklausti 55 pacientai, namuose atklausti 37 pacientai, su 18 pacientų nepavyko susisiekti. Vertinant veiklos sutrikimus KVVT, reabilitacijos pabaigoje, pacientai dažniausiai įvardino apsitarnavimo 62%, produktyviosios veiklos 22% ir laisvalaikio 16% veiklos sutrikimus. Reabilitacijos pabaigoje veiklos atlikimas ir pasitenkinimas atliekama veikla buvo sutrikę. Moterys veiklos atlikimą vidutiniškai įvertino 4,9±1,2 balais... [toliau žr. visą tekstą] / The aim of the research is: to evaluate adjustment at home firs weak after rehabilitation of the persons who suffer from stroke. The objectives of the research are: to evaluate the functional state and disorders of activity of patients who suffer from stroke at the end of rehabilitation; to evaluate the functional state and disorders of activity of patients who suffer from stroke at home; to evaluate the adjustment at home according to the sex, age, the nature of the disease and living environment. The research took place at a Šiauliai Comunity Hospital, Physical medicine and rehabilitation II-nd inpations departments in 2009-09 – 2010-02. 55 patients were examined. 19(34,5%) men and 36(65,6%) women took part in the research. average of age 63,3±10,6 year. 3(5,45%) men had a hemoragia and 16(29,1%) men had an ishemic stroke. 31(56,4%) women had an ishemic stroke and 5(9,1%) women had a hemoragia. Patiens was evaluate at the end of rehabilitation ant first weak after rehanilitation at home using Cannadian Occupational Performance Measure (COPM). 55 patient was evaluate at the end of rehabilitation, 37 petiens was evaluate at home ant with 18 patient could not be contacted. Evaluated activities disorder with COPM, patient usualy named self care 62%, productive activity 22% and leasure 16% activities disorder. Women performance average evaluate 4,9±1,2 point out of 10 possible points according to the COPM at the end of rehabilitation... [to full text]

ABSTRACT: THE EFFECT OF A COMPREHENSIVE OCCUPATIONAL THERAPY INTERVENTION PROGRAMME ON THE OCCUPATIONAL PERFORMANCE OF PEOPLE WITH RHEUMATOID ARTHRITIS, LIVING IN SOWETO. C Dreijer du Plessis Post-graduate student, University of the Witwatersrand, Johannesburg, South Africa Introduction: Rheumatoid Arthritis (RA) is a chronic disabling joint disease. Empowering patients with RA to self manage the disease can lead to changes in behaviour, pain or physical health and psychosocial health status. Limited evidence exists for the efficacy of comprehensive Occupational Therapy (OT) intervention for patients with RA in improving functional ability. Objective: The primary objective of the study was to evaluate the impact of comprehensive OT intervention on patients with RA in producing a sustained improvement in patients' functional ability. Methods: A prospective randomized control study over 4 months in which patients with moderately disabling RA, following a week of in-patient rehabilitation care, received either home visits and focus group care (group 1) or standard care (group 2). Primary outcome measures included the modified Health Assessment Questionnaire Disability Index (HAQ-DI), Disease activity score (DAS28) and SF- 36 scores. Results: There were 29 and 22 patients in each group, respectively. The HAQ-DI improved significantly in both groups following the 1 week in-patient care (p<0.05) and there was a clinically significant difference between the groups at the 4 months follow-up visit. The SF-36 scores did not change significantly for group 1 while group 2 showed significant improvements in 5 of the 8 domains at four months. However, group 2, had significantly worse SF-36 scores at baseline compared to group 1. There was a significant improvement in disease activity with the experimental group having 25% fewer tender joints. During the focus groups,the two main themes of "behavior and self management" and "problems that interfere with occupational performance" emerged. Conclusion: A comprehensive in-patient occupational therapy programme does lead to sustained significant improvement in functional ability and Health related quality of life (HR-QOL). Focus groups and home based intervention appears to have a clinically significant impact on disease activity. Key words: Rheumatoid Arthritis, Comprehensive Occupational Therapy intervention, Home based intervention, Occupational Performance.

Abstract: Introduction: Cerebral palsy (CP) in children can severely affect balance, movement and posture (Vitrikas et al., 2020). Children with CP seem to participate less in personal care and hygiene, home and school tasks. Participating in everyday life activities is fundamental for every person and seem to be important for independence (Parkes et al., 2010). Occupational therapy aims to provide engagement in activities of daily living and meaningful occupations (Soderback, 2009). Aim: The aim of this review is to identify intervention methods that facilitate activities of daily living for children with cerebral palsy. Method: For this scoping review three databases were used for data extraction: Cinahl, Pubmed and Psycinfo. All steps by the Johanna Briggs Institute (JBI) manual, were followed. Results: Seven interventions were proposed. Those were either activity focused or function focused. The methods were active vestibular intervention, goal-oriented program, group-task oriented program, constrained-Induced movement therapy, virtual reality intervention, “regular” occupational therapy program and Hand Arm Intensive Therapy (HABIT). Conclusions: Different interventions seemed appropriate for facilitation of daily activities for children with CP. In each intervention different assessment scales were used to measure outcomes and this may give an unclear view of which might be the most effective for this population.

When people are healthy, they are able to accomplish with relative ease what they set out to do, such as going to work, traveling, meeting with friends, and taking care of their personal necessities. However, once chronic illness becomes a factor in a person’s life, he or she is faced with limitations in the ability to perform daily activities, take care of health needs and participate in life activities. More effort is required for everyday activities, leading to abandonment of previously enjoyed routines and further declines in health and quality of life (Erlandsson, 2013a). In response to the complex, dynamic, and often unpredictable care requirements of individuals with one or more chronic conditions, newer primary care delivery models were developed to improve health management and reduce costs (Sevick et al., 2007). The expectation is that these interprofessional team–based models are the best way to address the needs of persons with multiple chronic conditions (Piette et al., 2011). However those charged with providing primary care based on these models have been unable to expand beyond disease-based episodic approaches and healthcare delivery is thus perceived as inadequate in fully serving this growing population (Fortin et al., 2013). The author developed and implemented occupation-based occupational therapy (OT) services and the VA Everyday Matters workshop to demonstrate that OT should be included as a vital component of a primary care effort aimed at meeting the complex needs of Veterans with chronic conditions. Health behavior theory and occupational therapy models informed the role of OT in primary care and the development of the workshop. The use of an occupation-based approach represents an innovative change in how health promotion is conceptualized and delivered in the traditional primary care setting. The immediate and long-term outcomes of this project will have important implications for occupational therapy practice and will contribute to a growing body of knowledge about the health promoting effects of occupation. Findings from the program evaluation will be disseminated throughout the VA and will inform the continued development of innovative ways occupational therapy and primary care can partner to optimize function and quality of life for at-risk Veteran populations.

Aim: The aim of diploma thesis was clinical utility of the Czech version of Canadian Occupational Performance Measure (COPM) in both parts. Utility in performance of activities of daily living and utility in satisfaction with performance of activities of daily living for physically disabled adults persons. Methods: The pre-research consisted of 40 persons with physical disability after stroke. For data collection was used Canadian Occupational Performance Measure, Barthel index and Subjective QUAlity of Life Analysis (SQUALA). Hypotheses were vitrificated by correlation analysis using Spearman's Rank Correlation Coefficient. Results: P-value (p = 0,00001) from the test of dependence of measured values by COPM in performance of activities of daily living and BI was lower than level of significance α = 0,05; 0,00001 < 0,05. P-value from the test of dependence of measured values by COPM in satisfaction with performance of activities of daily living and SQUALA questionnaire was lower than level of significant α = 0,05; 0,041 < 0,05. Conclusion: The results of the statistical analysis did not confirm the independence of the measured values by the Czech version COPM, BI and the SQUALA questionnaire. It was supported the using COPM in both parts, in performance of activities of daily living and in satisfaction...

Introdução: A dor crônica pélvica É uma das doenças mais frequentes entre mulheres na idade reprodutiva, e como a maioria delas, tem impacto direto na vida conjugal, social e profissional da mulher. O impacto da dor no desempenho ocupacional das mulheres afeta diretamente a atividade econômica domiciliar, visto que, atualmente, a mulher representa uma parte considerável da renda familiar. A terapia ocupacional pelo Modelo Canadense de Desempenho Ocupacional as dimensões holísticas do individuo nas 3 áreas de desempenho ocupacional: autocuidado, produtividade e lazer; e do ponto de vista do estudo da dor, os procedimentos da terapia ocupacional incluem a avaliação da multiplicidade de fatores físicos, psicossociais e ambientais agravados pela dor, nos diversos contextos de desempenho do indivíduo. Objetivo: Caracterizar o desempenho ocupacional de mulheres portadoras de DPC atendidas em um serviço terciário e verificar a associação entre as limitações ocupacionais com a presença de dor pélvica crônica, o grau de cinesiofobia e os sintomas psicológicos. Casuística e Métodos: Estudo transversal qualitativo descritivo. Foram coletadas 150 mulheres, sendo 75 mulheres com DPC (grupo: dor) e 75 mulheres saudáveis (grupo: saudáveis), todas as participantes receberam o termo de consentimento livre e esclarecido. O cálculo do tamanho da amostra foi realizado sobre proporções com margem de erro relativo em populações infinitas através da seguinte expressão: n=(z2 · q)/(2 p). As avaliações e escalas utilizadas foram: Visual analogue scale VAS (Escala visual analógica),Escala de faces, Questionários de saúde do paciente: PHQ-4 (Patient Health Questionnaire), SRQ (Self-reportQuestionnaire), Escala Tampa de Cinesiofobia, Medida Canadense de Desempenho Ocupacional (COPM). Os dados obtidos foram registrados em formulário próprio. Foi avaliada a distribuição normal das variáveis através do teste de DAgostino e Pearson. Para verificar a associação entre grupos e variáveis qualitativas nós utilizamos o teste exato de Fisher, ou o Qui-quadrado quando mais pertinente. Resultado: Mulheres com DPC estão inseridas em menor número no mercado de trabalho em relação a mulheres saudáveis, e apresentam mais alterações no sono e histórico de cirurgia abdominal, além de terem pontuações acima da média nos testes PHQ-4, SRQ e Tampa, o tempo de dor (M) foi de 108 meses e o VAS (M) 74. As mulheres com DPC se preocupam menos com o autocuidado, nas 3 subcategorias de autocuidado as mulheres com DPC ressaltam menos importância. Na categoria produtividade o nível de 8 importância é homogêneo, mas apesar de mulheres com DPC estarem em menor número no mercado de trabalho, na subcategoria trabalho ambos os grupos apresentam preocupações em suas atividades de trabalho, em relação à tarefas domésticas mulheres com DPC se preocupam mais do que mulheres com saudáveis, e o inverso ocorre em deveres. Na ultima categoria analisada ambos os grupos revelam o lazer e suas 3 subcategorias importantes de forma homogenia. O desempenho e satisfação de mulheres com DPC é menos do que a média do grupo de mulheres Saudáveis. Conclusão: O desempenho e a satisfação de mulheres com DPC são prejudicados devido, principalmente, a DPC. Alterações no sono e cirurgia abdominais anteriores, podem estar relacionadas diretamente com DPC. Essas mulheres apresentam um comportamento como a perda de identidade, isolamento social, coping e dor social. O questionário TAMPA sugere que mulheres com DPC apresentam medo ao realizar suas atividades. Nosso trabalho tenta preencher uma lacuna na literatura sobre o desempenho ocupacional em mulheres portadoras de dor pélvica crônica, pois pouco se sabe sobre a doença e o quanto interfere no desempenho ocupacional dessas mulheres. / Introduction: Pelvic chronic pain is one of the most common disease among women of reproductive age, and like most of them, have a direct impact on marital life, social and professional woman. The impact of pain on work performance of women directly affects household economic activity, since, currently, the woman is a substantial part of household income. Occupational therapy by the Canadian Model of Occupational Performance holistic dimensions of the individual in the three areas of occupational performance: self-care, productivity and leisure; and from the viewpoint of the pain study, occupational therapy procedures include the evaluation of the multitude of physical, environmental and psychosocial factors aggravated by pain in many contexts individual\'s performance. Objective: To characterize the occupational performance of women with DPC met in a tertiary center and the association between occupational limitations with the presence of chronic pelvic pain, the degree of kinesiophobia and psychological symptoms. Methods: Qualitative descriptive cross-sectional study. 150 women were collected, of which 75 women with CPP (group: pain) and 75 healthy women (group: healthy), all participants were given free and informed consent form. The calculation of sample size was performed on proportions with margin of error relative in infinite populations by the following expression: n = (z 2 q) / (2 · p). Reviews and scales used were: Visual analogue scale VAS (visual analogue scale), Face Scale, Health Questionnaires patient: PHQ-4 (Patient Health Questionnaire), SRQ (Self-report Questionnaire), Scale Tampa kinesiophobia, Measurement Canada Occupational Performance (COPM). Data were recorded on a specific form. The normal distribution was evaluated variables by D\'Agostino and Pearson test. To investigate the association between groups and qualitative variables we used Fisher\'s exact test or chi-square when more relevant. Result: Women with DPC are inserted into fewer in the labor market compared to healthy women, and have more sleep disturbances and history of abdominal surgery, and have above average scores on the PHQ-4 tests, SRQ and Tampa, time of pain (M) was 108 months and the VAS (M) 74. Women with DPC care less about the \"self-care\" in the three subcategories of \"self-care\" women with DPC emphasize less important. In the category \"productivity\" the level of importance is homogeneous, but despite women with CPP are outnumbered in the labor market, in the subcategory \"work\" both groups have concerns about their work activities, regarding the \"housekeeping\" women with CPP are more concerned than women with healthy and the opposite occurs in \"duties\". In the last category analyzed both groups reveal the \"leisure\" and its 10 three major subcategories of homogeneous manner. The performance and satisfaction of women with CPP is less than the average of the group Healthy women. Conclusion: The performance and satisfaction of women with CPP are harmed due mainly to DPC. Changes in previous abdominal surgery and sleep, can be directly related to DPC. These women exhibit behavior such as loss of identity, social isolation, coping and social pain. The CAP survey suggests that women with CPP have fear when performing their activities. Our work tries to fill a gap in the literature on occupational performance in women with chronic pelvic pain, because little is known about the disease and how much interferes with the work performance of those women.

People with neurocognitive disorders (NCD) condition called dementia are mainly taken care by family members. The number of people suffering from neurocognitive disorders is estimated to increase. Providing care for the person with NCD can be stressful and demanding which is why effective interventions to support caregivers are needed. Occupational therapy practitioners have unique knowledge of the person, environment and occupation and how those factors influence on individuals occupational performance. Occupational therapy ́s interventions to support caregivers with NCD have mainly concentrated on problems in the behaviour of person with NCD. The aim of this scoping review was to identify why some caregivers are managing better as a caregiver before any interventions have been done. What are those aspects of Person (P), Occupation (O) and Environment (E) that facilitate occupational performance (OP) when taking care for a person with NCD. PEO-model by Law et. al (Law et al., 1996) was utilized to formulate research question, in search words and in summarizing the results. The search from Ageline, Cinahl, Psycinfo and PubMed databases was done in January 2018 and went back 10 years. Results found 23 relevant articles for inclusion in the scoping review. Facilitating factors emphasized the supports of relationship seen as an overlap of caregivers and individuals with NCD on occupational performance. Facilitating personal factors of resilience, finding gains in caregiving, self -efficacy and religiosity were found to have an impact on care that the caregiver provides. Facilitative aspects of occupations highlighted importance of daily occupations as a source of well-being for both caregiver and person with NCD. In conclusion, facilitating aspects of relationships, personal factors and engagement in activities and hobbies supported occupational performance of both the caregiver and a person with NCD. Taking these factors into consideration could help target interventions more precisely to meet caregivers needs.